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An Experimental Study of
Stuttering
BY
JOHN MADISON FLETCHER
A DISSERTATION SUBMITTED TO THE FACULTY OF
CLARK UNIVERSITY, WORCESTER, MASS. IN PARTIAL
FULFILMENT OF THE REQUIREMENTS FOR THE
DEGREE OF DOCTOR OF PHILOSOPHY, AND ACCEPTED
ON THE RECOMMENDATION OF JOHN WALLACE BAIRD
Reprinted from the AMERICAN JOURNAL OF PSYCHOLOGY
April, 1914, Vol. XXV, pp. 201-255
F5 1
AN EXPERIMENTAL STUDY OF STUTTERING*
By JOHN MADISON FLETCHER
I. Introduction 201
II. Differentiation and Definition 203
III. Physiological 206
A. Breathing
a. Historical; b. Subjects; c. Method; d. Results
B. Vocalization
a. Method; b. Results
C. Articulation
a. Method; b. Results
D. Accessory Movements
a. Tics; b. Larynx Movements; c. Miscellaneous Move-
ments
IV. Psycho-physical 224
a. Method; b. Results
a. Volumetric 'Changes
ft. Changes in Heart-Rate
y. Galvanic Changes
V. Interpretation 229
VI. Psychological 230
A. Emotions
a. Historical; b. Results
a. Objective
ft. Subjective
B. Attitudes
C. Imagery
D. Attention
E. Responsibility for Aufgabe
F. Psychoanalysis
G. Association
VII. Heredity 247
VIII. Conclusions 247
IX. Bibliography 249
X. Illustrative Plates 255a
I. INTRODUCTION
The aim of the present thesis is to offer a psychological
study of stuttering. This phenomenon is a familiar one but
it has received scant notice. The only scientific attention that
has been paid to it has come from medical authorities. To
the medical fraternity it has been known at least since the
* From the Psychological Laboratory of Clark University.
.'. ' ' t ' ', '
202 '" FLETCHER
days of the Egyptian hieroglyphics (19) ; but from the medi-
cal point of view there is yet no concensus of opinion as to
its nature or its treatment.
In reference to the question of incidence no complete sta-
tistics are available. On the basis, however, of certain care-
ful estimates it_ is claimed (24; 38-39) that there are ap-
proximately a half million speech defectives in the United
States. This number is much in excess of the number of the
blind, the deaf and dumb, the insane, or the feeble-minded.
Defects of speech are considered to be of more scientific
and practical importance in Germany than in the United
States. In 1886, under Minister of Education von Gossler,
the government began activities on behalf of these defectives
which have not ceased (72; 112 ff.). Owing to the efforts of
the late Dr. A. Gutzmann and his son, Dr. H. Gutzmann,
the University of Berlin has been the source from which
teachers from the various cities of Europe have secured train-
ing for service in the schools. Japan, through the activities
of Isawa, has also taken an interest in the problem. In the
United States the subject has not received its due scientific
attention, while the practical handling of the problem has
been almost totally neglected. The victims are not even pro-
tected from the charlatans who prey upon them.
It is hoped that the present research will show materials
for laboratory use in the study of other problems of general
psychology. Advantage could, of course, not be taken of
all the ramifications of the problem; nevertheless the clinical
cases used in our investigation seemed constantly to afford
excellent materials for the study of such topics of general
psychological interest as the physiological expression of emo-
tions, the phenomena of inhibition and association, the Auf-
gabe consciousness, communication, motor co-ordination, vol-
untary control, attention, etc. Our cases presented a variety
of mental conditions that are capable of being repeated at
will, conditions which it would be impossible to produce with
normal subjects under the usual laboratory conditions. Yet,
unlike the insane or the feeble-minded, they possess an intel-
ligence that is normal; and hence they are able to carry out
detailed instructions and, if trained, to introspect.
This study, however, is not an attempt to fill a lacuna in
any psychological system ; it is a frank appropriation of the
ordinary methods of laboratory psychology for the study of
a problem that seems to be not only a legitimate one for
psychology, but also a problem that is of sufficient value to
justify the research. It is to be hoped that the practical val'.ie
AN EXPERIMENTAL STUDY OF STUTTERING 203
that the problem happens to possess will not rob it of its
scientific interest for those who hold to the Wundtian notion
of the province of pure psychology. 1
The study seems to have turned out to be neither exclu-
sively functional nor exclusively structural. It was found
necessary to view the phenomenon of stuttering from both
aspects, a fact which cannot, of course, be said to make of
it a peculiar problem. It also seems to lie somewhat between
the fields of normal and abnormal psychology. The subjects
are not to be distinguished physically from other people;
they are of normal intelligence ; their thought processes are
logical. In the linking of ideas with the motor processes of
speech, however, they are not normal. Arising out of this
inability there are to be found certain other associated ab-
normal conditions that are to be indicated in detail later.
It is desired that the present study will help toward the
narrowing of the problem to more convenient proportions.
At the present stage it is necessarily comprehensive. In order
to reduce it to as narrow a compass as possible the following
main problems have been set : /. to describe stuttering in
terms of its physiological manifestations ; 2. to enumerate and
describe the associated mental conditions ; and J. to ascertain,
if possible, the part played by these mental states in its
causation.
II. DIFFERENTIATION AND DEFINITION
In order to avoid confusing stuttering with other forms of
speech-defects it will be necessary to adopt a differentiation
of the several groups of defects, which for present use will
be as follows:
/. There is a class of speech-defects resulting from dis-
eases or lesions in those portions of the brain that have to
do with the function of speech. This type of defect is known
as aphasia. It may be sensory, motor, or associative, accord-
ing as the region of the brain affected is a receptive, emissive,
or associative center. There are many types of this defect,
such as aphemia, agraphia, alexia, apraxia, etc. It is an
organic disorder due to the degeneration or destruction of
brain tissue ; it is therefore a form of dementia and hence is
a problem for psychiatry rather than for psychology. It will
not be taken into account in the present study.
2. Secondly, we have a class of speech defects to be
1 W. Wundt, Ueber reine und angewandte Psychologic, Psychol.
Stud., V. 1909, 1-47.
204 FLETCHER
designated in this connection as " stammering." Schulthess
(24; 27) in 1830 recognized this as a distinct type of defect,
and differentiated it from stuttering by the adoption of the
two terms " Stottern " and " Stammeln," which are still in
use in Germany. In England and America the terms " stut-
tering " and " stammering " are used synonymously, with the
result that a confusion exists as to the two conditions desig-
nated by these terms. To avoid this confusion it has been
suggested that technical terms be adopted to designate the
two fundamentally different defects. Scripture (127) pro-
poses the terms " hypophonia " and " hyperphonia " to desig-
nate stammering and stuttering respectively. " Hypophonia,"
he says, is " subenergetic phonation," while " hyperphonia " is
" superenergetic phonation." This terminology is open to the
objection that a differentiation on the basis of the amount
of nervous energy employed in speaking does not harmonize
with the facts. Stuttering is not merely speaking with an
excess of nervous energy ; nor does stammering consist merely
in speaking with a less amount than normal.
Dr. Makuen has proposed terms that more nearly describe
actual conditions (98). For stuttering he proposes the term
" dyslalia," or difficult speech ; for stammering he proposes
the term " pseudolalia," or incorrect speech. However, be-
tween the difficulty of securing the general adoption of a new
terminology and that of differentiating the terms already in
use, the writer has chosen the latter alternative mainly be-
cause this does not necessitate a break with the terms in use
in the German literature of the subject, which is the most
extensive.
Stammering is mispronunciation (107; 567-568). The
stammerer, unlike the stutterer, can always speak; but his
speech is incorrect. This type of defect is found in two
forms, namely, (i) the anatomical, and (2) the developmen-
tal. The anatomical stammer is due to a malformation of one
or more organs of articulation, as the lips, tongue, teeth, hard
or soft palate, the nasal or pharyngeal cavities, etc. The de-
velopmental stammer has no such physical cause, but is due
to the incorrect functioning of the organs of articulation re-
sulting in certain cases from immaturity, as in the " baby
talk" of normal children, in whom the condition is not re-
garded as pathological unless it is prolonged beyond the age
of five or six years (24J22). 2 The developmental stammer,
J z Colman (22 ; 454) gives an extreme case of " baby talk," or infantile
stammer. This child in attempting to say the Lord's Prayer spoke as
follows : " Oue Tade na ah in edde, anno de Di na, I tidde tab, I du
AN EXPERIMENTAL STUDY OF STUTTERING 205
which is characteristic of all children at an early age, arises
from incomplete perception of vocal sounds and from lack of
co-ordination of the muscles of articulation. Lisping is a
common form of stammer and consists in the substitution of
th sounds for those of 5 and z. The organic type of this
defect is due to the shortness of the lingual frenum, or
" tongue-tie." 3 Stammering possesses no special psychologi-
cal interest and will not be considered in the present study.
5. Thirdly, there is a class of defects to be designated as
" stuttering." This group is distinguished from the foregoing
types mainly by its intermittent character. Stuttering may be
called a temporarily appearing inability to begin the pronun-
ciation of a word or syllable. (107; 567-568). The capacity
of the stutterer to speak seems to be related to certain mental
attitudes or states of mind. It is this characteristic that gives
the subject its psychological interest.
The evidence for the diagnosis of this defect as primarily
mental seems to be accumulating. It was formerly thought
to be due to permanent anatomical anomalies, which were
amenable to surgical treatment (28). Wedge-shaped portions
were cut from the back of the tongue ; the hypoglossal nerve,
the lingual frenum, and the various extrinsic and intrinsic
muscles of the tongue were severed. The tongue was pierced
with needles. Cauteries, blisters, and embrocations of petro-
leum, also inoculations of croton oil were administered. Tinc-
ture of rectified alcohol, peppermint oil and chloroform were
applied. Wooden wedges were placed between the teeth.j
Smoking was recommended as a sedative to the vocal cords.
The above and various other remedies were devised on
the assumption that the difficulty was organic and peri-
pheral (103). This theory gave place to the notion that,
though the defect is not caused by gross anomalies, yet a
permanent impairment of the nervous system is present.
Kussmaul holds consistently (86) to the view that stuttering
is a " spastic co-ordination neurosis." This view is adhered
to by many modern writers, especially by those who approach
the subject from the medical point of view. Gutzmann
(665211) holds that every stutterer is neuropathically af-
de di on eet a te e edde, te ut te da oue dade ded, e didde oue tetedde
a ne ahdin to te tetedde adase ut, ne no te tetate, ninne ut enu, to I
ah te nini, pone e dordy, to edde e edde, Ame."
3 Scripture, in his recent book, Stuttering and Lisping (New York,
1912, 251 pp.), written subsequently to the completion of this paper,
has attempted to change the meaning of the term " lisping " to include
defects that are usually classified as stammering. See pp. in ff.
206 FLETCHER
flicted. Scripture claims (125) that "stuttering is a distinct
form of nervous disease ... ; it can be properly and legally
treated only by a physician."
There is, however, a tendency among many medical authori-
ties to lay chief stress upon the mental aspects of the phe-
nomenon, so that the third stage in the progress of its diag-
nosis may be said to be the one in which mental rather than
physical conditions are regarded as primary. Makuen, for
example (103), says that "many persons stammer (stutter)
under certain conditions, largely because they think they will.
All their past experiences with speech have combined to con-
firm them in the thought and it soon becomes a sort of " fixed
idea." Langwill (88) believes that "stammering (stuttering)
is essentially a functional affection, a neurosis, the result of
the defective working of the complex co-ordinated mechanism
concerned in the production of speech, and not a defect of
structure. Pathological lesions, therefore, need not be looked
for." Gutzmann, in spite of his agreement with Kussmaul,
as indicated above (p. 205), says (59): "In the psychology
of stuttering we do not find the destruction of any separate
fibres or special centers ; also the connection between the sen-
sory center and the ideational centers, on the one hand, and
the motor center, on the other, are undisturbed. The stutterer
simply does not succeed in making the co-ordination from the
motor center to the organs well enough to produce the correct
mutual functioning."
III. PHYSIOLOGICAL
Physiologically the function of speech involves the co-ordi-
nated action of the three musculatures of (i) breathing, (2)
vocalization, and (3) articulation. The aberrations from the
normal, that are found in the stutterer's speech, in respect to
these three functions, will be taken up in order.
A. Breathing
a. Historical. Until the methods of observation and pal-
pation had given place to the use of instruments, such as those
devised by Marey, Bert, Zwaardemaker, Rousselot and others
(59), exact study of these functions was impossible. With
some exceptions the earlier studies of breathing were pri-
marily physiological ; and they largely disregarded the mental
influences which are taken into account by such studies as
those by Mentz (105) and Zoneff and Meumann (149).
Before abnormalities could be indicated it was necessary to
AN EXPERIMENTAL STUDY OF STUTTERING 207
establish the simpler facts of normal breathing, such as the
difference between rest-breathing and breathing during speak-
ing; the relations between thoracic and abdominal breathing,
and the like. Halle, who recognizes the influence of mental
states on breathing, but who does not attempt a definite cor-
relation, was one of the earliest investigators in this field (73).
He found in the stutterer:
1. Tonic or clonic spasms of the diaphragm in all cases;
2. Psychical alterations of the breathing curve both before
and after speaking;
3. Poor economy of breathing;
4. Attempts at speaking during inspiration ;
5. Withholding of the breath after speaking.
Gutzmann (66) originally accepted the findings of Halle
but has subsequently changed his opinion. His more recent
conclusion (665202) is that if one would avoid error one
should disregard the influence of mental states on breathing
changes altogether. This conclusion, however, seems in turn
to be modified by his admission that certain states of mind
can have an effect on breathing (64; 16). To admit that this
is an unsettled question would have an important bearing
upon the problem in hand, for, if mental states have no influ-
ence on the breathing, stuttering, in so far as it is a disturb-
ance of breathing, must be essentially physiological.
Ten Gate, who was the first to make simultaneous records
of thoracic and abdominal breathing-curves, found (18) that
the stutterer is not below the normal in chest expansion;
and that, though his expiration period is shorter than the
normal, his lung capacity is not below the average. How-
ever, he finds that the stutterer's strength of inspiration is
greater than that of expiration, which is the reverse of the
condition found with the normal speaker. 4
There are no complete statistics on the number of male and
female stutterers; but estimates (245362 ff.) show that male
stutterers preponderate over females in ratios ranging from
4 This last finding would seem to point to some permanent physio-
logical difference that is characteristic of the stutterer. As bearing
upon this point it is of interest to quote certain findings mentioned
by Greene (44). Greene reports that in cases of forced breathing the
strength of inspiration of women is 60 per cent, of that of men, and
that of expiration is 66.7 per cent. ; that in quiet breathing the strength
of the inspiration 66.7 per cent, of that of men, and that of expiration
is 63.25 per cent. In all cases, therefore, women are inferior to men
in strength of respiration. Yet there are several times as many male
stutterers as female. Strength of respiration, therefore, does not seem
to be a determining causal factor.
208 FLETCHER
2:1 to 10:1. The male preponderance is much greater in
childhood than it is in adulthood; psychological, physiological,
and sociological differences between .the sexes have been
pointed out as causes of this preponderance. Differences in
breathing-types have been most frequently suggested. That
there are sex differences in this regard seems to be granted ;
it is held, however (37), that such differences are not con-
genital but are due to the habit of constriction. 5
b. Subjects. L. R. is a boy fifteen and a half years old,
who dropped out of school while in the sixth grade because
of his inability to talk. He is in good health, is well grown
and well nourished. He is cheerful, energetic and of normal
mentality. He began to stutter at the age of two without
any known cause.
E. B. is a boy in the eighth grade of the public school, and
in spite of his difficulty is making normal progress in his
studies. He is healthy and of normal intelligence; his here-
dity, so far as could be ascertained, was negative for all that
could be considered to form a neuropathic basis for his defect.
F. Q. is a boy 17 years old, of good intelligence, and of
pleasing manner. He has had for some years a valvular dis-
order of the heart. His stuttering was said to have originated
in an experience of fright. While playing on the street at
the age of six he was accosted by a man who he now thinks
must have been insane, and who asked to be directed to a
certain place. ., When the boy attempted to show him the
man grasped him by the hand, dragged him into some tall
grass and left him. When the man went away the boy es-
caped and has stuttered since that experience.
P. A. is a boy 14 years old, normally intelligent, and in
good health. He is somewhat rough, indifferent, headstrong,
and unreliable. There are no significant facts of heredity,
nor is the history of the origin of his defect known.
A. N. is a young man 22 years of age, of good intelligence,
cheerful and friendly. He has good business qualities, and is
of good habits. His heredity is negative, and the history of
the origin of his defect is unknown. His stuttering is of
5 If permanent breathing-differences, due to constriction, are respon-
sible for the differences in the numbers of male and female stutterers
it would seem that where customs of tight-lacing do not exist there
should be no such marked differences. As bearing upon this point
the writer secured from Japan statistics concerning the prevalence of
stuttering among 135,852 boys and 20,637 girls. These statistical data
show approximately the same sex differences as are found in other
countries. In one prefecture (Yamaguchiken) 5.06 per cent, of the
boys are stutterers while only .16 per cent of the girls stutter.
AN EXPERIMENTAL STUDY OF STUTTERING 209
severe degree; he is often unable to think of what he is
trying to read when stuttering. His mind seems to become
befogged under those conditions, and only the memories of
feelings and strains are left behind. Even when not attempt-
ing to speak he reports that conditions of what appear to
be " blank abstraction " come over him.
W. 2V. is a boy 12 years of age, and is the son of a stut-
terer. The father reports that he himself acquired the defect
by imitating a school-mate who stuttered. The boy is re-
garded by his teacher as being one of the best students in
the school. He is in good health. In his stuttering he shows
a tonic closing of the lips, the bottom lip pressing against
the inner side of his upper teeth, while the chin is in a tremor.
In reading, his eyes run ahead to detect the difficult words.
H. A. is a young man 24 years of age who dropped out of
high school on account of his defect. His stuttering began in
the fourth grade, and is attributed to the act of imitating a
school-mate. He is intelligent, active, competent ; he is the son
of a physician, and he has excellent training as a machinist.
His health is good, and his heridity is negative. His stuttering
is worse in conversation than in reading aloud. Talking over
the telephone is easier for him than any other form of speech.
His stutter movements are strongly suppressed, being confined
to the opening and closing of the mouth while the tongue is
adhering to the roof of it. Certain consonants give him much
difficulty.
/. L. is a young lady of 18, who is in the third year of
the high school. On account of protracted illness, she lost
considerable time from school while in the grades. On re-
turning, she was nervously anxious to keep up with her class ;
and her stuttering began during this period. She reports
that when she realizes that she is going to be called upon by
her teacher to recite, her heart beats violently. In addition to
the stutterer's usual ability to sing she also possesses the
ability, not uncommon among stutterers, to speak in public
and to participate in amateur theatricals without fear of stut-
tering. Her stuttering is confined to certain consonants, of
which she is in dread. She too runs ahead in her reading
to see if difficult letters are ahead of her.
H. D. is a young man, aged 21, who began stuttering at
the age of 5 by imitating a cousin. He is in good health, and
is physically and mentally vigorous. He was one of the best
debaters in his high school, and was the orator of his class
on graduation. Under the stimulus of speaking in public,
he does not stutter, while in private conversation he is often
210 FLETCHER
unable to make himself understood. His stutter movements
consist of clinching the jaws and holding them in tonic condi-
tion until a violent explosion of the attempted sound takes
place. Often his mouth will open widely without effecting
the sound desired.
The greater part of the data for the present study was se-
cured from these nine subjects. Many other stutterers were
examined, from whom we obtained a limited number of rec-
ords bearing on certain points.
c. Method. The subjects were seated comfortably in a
chair by the side of the table upon which stood the register-
ing instruments ; the instruments were hidden from view by
a screen. Extraneous noises and other distractions were re-
duced to a minimum. Time-lines were recorded by means
of a Jacquet chronometer. The apparatus was so ar-
langed that the experimenter could manipulate it without
moving from his seat, or being seen by the subject. For tak-
ing the breathing curves two Sumner pneumographs were
used, one being placed about the thorax and the other about
the abdomen. The registrations were made by Marey tam-
bours on smoked paper attached to the drum of a kymograph.
Signal keys connected with the kymograph by means of tam-
bours were used to indicate when the subject was endeavoring
to speak. Cards on which were printed various selections of
prose and poetry were used as material for speech. When
these failed, as they sometimes did, to evoke stuttering, the
subject was asked to relate in his own language the substance
of something he had read or to give an account of something
with which he was known to be familiar. If this failed,
strangers were brought into the room and the effects noted.
Attention must be called to the fact that, while in these
experiments, methods of registration must remain constant,
the stimulus used to provoke stuttering, which is the phe-
nomenon to be studied, cannot remain constant for the ob-
vious reasons that the same stimulus will not produce stutter-
ing in all individuals, and that the same stimulus will not
produce constant effects in the same individual.
Strictly speaking the asynergies of vocal utterance would
include the disordered action of each musculature taken by
itself, and in its relation to the other two musculatures (See
p. 206.) In the study of breathing our chief emphasis will be
put on the first aspect; whereas in \ocalization and articula-
tion it has been necessary for reasons to be indicated later to
give chief emphasis to the second aspect.
AN EXPERIMENTAL STUDY OF STUTTERING 211
d. Results, In general it has been found that stutterers
present no permanent peculiarities of breathing unrelated to
the function of speaking. This is in accord with the findings
of ten Gate (18) and contrary to those of Gutzmann (66).
It must further be said that there are apparently as many
varieties of breathing peculiarities among stutterers as there
are varieties of stuttering.
Detailed measurements of the breathing-curves were made
by using a line drawn in the direction of the movement of
the drum to be used as a line of reference from which meas-
urements were made in millemeters to a point midway be-
tween the top of the expiration and the bottom of the inspi-
ration curves. These measurements show that the mean
variations and the averages are characteristically greater in the
breathing-curve during stuttering than during normal speech.
The total results of the cases measured are as follows :
fi. Av. 2,6.2 mm.
Normal Speaking \
[2.M.V. 3.79 ."
fi. Av. 35.6 mm.
Stuttering \
[2.M.V. 4.62
The arhythmic character of breathing is evident from these
data.
Many peculiarities of the curves, however, are minute; and
do not lend themselves to tabular statement. (See Plates.)
The characteristic aberrations may be grouped in three general
classes :
/. Retardations
2. Total misplacements
j. Interruptions
These are characteristic both of inhalation and of exhalation.
i. Retardation means the withholding of inhalation beyond
the average time, and the attempt to speak when the lungs
are comparatively empty. Exhalation may also be withheld;
but this is not so characteristic. Exhalation for the stutterer
is apparently more easily performed than inhalation; but it
does not always result in the production of sound. Many
cases show complete exhalation before the production of
sound. In one case exhalation lasted eight seconds yet
the attempt at sound was vain. Exhalation is aften inter-
rupted by short, spasmodic inhalations. 2. Total misplace-
ment means the complete breaking up of the natural rhythm
212 FLETCHER
to the extent that inhalation occurs where exhalation should
take place or vice versa. 3. Interruption may occur in two
ways; a. inhalation may be broken into by exhalation; or
b. exhalation may be broken into by inhalation. These
forms are frequently found; the speech accompanying such
breathing is characterized by broken, jerky blurts of speech,
appearing frequently in the form of repetition of the initial
syllable of a word.
A study of the ratio of the time of inspiration to that of
expiration was also attempted with the following results : On
computing the averages of the records of each individual, and
then the average of these individual averages, it was found
that the fraction representing the inspiration-time divided by
the expiration-time during normal speaking was .217 sec.,
whereas in stuttering it was .535 sec. ; or, otherwise stated,
the ratio of inspiration to expiration was found to be more
than twice as great in stuttering as in normal speech. Stated
in other terms it appears as follows:
Inspiration : expiration : : 217 : 1000 in normal speech;
: : : 535 : 1000 " stuttering.
Since the date of ten Gate's investigations (18), consider-
able emphasis has been placed upon the temporal relations
between the thoracic and the abdominal curves. These rela-
tions have been expressed by such general terms as " ahead,"
" behind," " synchronous," and " anachronous." These terms
are found to be inexact for tabulating results for the reason
that if. for instance, we take the top of the abdominal curve
it may be (i) ahead, (2) behind, (3) synchronous with, or
(4) in opposite phase with the top of the thoracic curve if
we use the latter as a curve of reference. Similarly, the bot-
tom of the abdominal curve may sustain four relations to the
bottom of the thoracic curve. Our tabulated results show
that many records are characterized throughout by the fact
that, during speaking, the crest of the abdominal curve is
behind, while the bottom is ahead ; whereas in rest there had
been complete synchronism.
The following were compiled from typical cases of breath-
ing curves of stutterers in an attempt to determine whether
any definite temporal relationship could be established be-
tween the thoracic and the abdominal curves. In each case
the thoracic curve is compared with the abdominal. Two
points of the thoracic curve are taken, namely, the crest and
the trough, and these two points are compared with the two
corresponding points on the abdominal curve. Each of these
AN EXPERIMENTAL STUDY OF STUTTERING
213
TABLE I.
(CREST.) SUBJECT L. R.
Showing the temporal relati9n which the thoracic curve may sustain
to the abdominal. The figures in the various columns of the table indicate
the number of times the temporal relationship, designated at the top of
the column, occurs in the record whose number appears in the extreme
left-hand column.
No. OF
RECORD
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
1..
13
9
21
8
9
1
6
1
1
4
8
18
4
'i
16
2
'i
1
'8
1
"2
5
2
6
"3"
8
1
13
'25'
1
'3
'i
45
6
4
6
36
31
12
1
'23'
7
2
2
"2
2
1
'2
2..
3
4
5..
3
6
7
8
9....
1
'2
10
11
12
Totals
4
2
99
28
65
145
40
TABLE I.
(TROUGH.) SUBJECT L. R.
Showing the same as Table I above, but using the trough instead of
the crest of the thoracic curve as a point of comparison.
No. OF
RECORD
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
1..
1
10
8
11
1
24
2
'i
'2
1
3
2
3
2
1
3
4
1
9
1
22
1
1
'6
45
5
2
6
19
34
11
"i"
"e"
17
"2
"i'
4
'S
3
'i
2
3
6
1
1
2
2
4
5
6..
7..
2
2
3
\2
4
2
1
"5"
9
'4
'2
3
8
9
10..
11...
12
10
3
Totals
26
19
75
14
62
130
31
9
214
FLETCHER
points on the thoracic curve can sustain four general tem-
poral relations to the corresponding points on the abdominal
curve. These relations are, I. ahead, 2. behind, 3. synchro-
nous, 4. opposite in phase. The numbers of the record ap-
pear in the left hand column. The figures in the other col-
umns of the table indicate the number of times the temporal
relation, designated at the top of the column, occurs in the
record whose number appears at the left.
TABLE II.
(CREST.) SUBJECT F. Q.
Showing the same as Table I above (page 213) with a different subject.
No. of Record
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
1..
19
9
11
9
25
9
8
8
4
6
8
6
8
5
5
2
24
13
11
12
12
15
23
15
5
7
14
'i
5
1
'3
"2
1
3
2
I
1
3
4
to to to (- !- oo- to' (-
16
ii
2
1
'5
2
4
'i
5
"i"
1
"i"
5
6
7
8..
9
10
11..
2
12..
13
1
14
2
15
16..
17
18
'2
4
"2
'i
5
2
1
19..
20
21
1
Totals
6
2
214
91
27
48
15
Tables I, II, and III show the following characteristics :
1. The temporal relations of the crest of the two curves
do not agree with the temporal relations of the bottom. (Cf.,
e. g., the crest and trough of Table II.)
2. The character of the breathing curve varies with the
individual. (Cf., e.g., the totals of Tables I, II, and III.)
AN EXPERIMENTAL STUDY OF STUTTERING
215
TABLE II.
(TROUGH.) SUBJECT F. Q.
Showing the same as Table II above, but using the trough instead of
the crest of the thoracic curve as a point of comparison.
No. of Record
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
1..
5
'4
1
'i
"8
"5
11
7
3
12
6
14
12
13
10
3
11
"2
"3
2
7
10
5
10
10
2
1
2
3
4..
4
2
1
2
7
12
6
4
4
4
10
8
7
22
8
6
8
8
5
6
7
8
9
10
1
'2
"i"
"2
'i
"4"
"i"
4
3
3
3
11
12
13
14
15
'i
1
1
1
16
17
18
'i
3
1
4
3
"i"
1
3
19
20..
21
Totals
128
11
49
58
37
64
3. The individual records of each subject present marked
peculiarities at certain times. (Cf., e. g., record 6, Table I,
trough.)
The abdominal curve usually shows slighter fluctuations
than the thoracic. The former frequently assumes a tonic
condition, which has often been described as " cramp " though
certain objections have been raised (74) to the use of this
term. In many cases the thoracic and abdominal curves
tended to approach each other, often to the point of touch-
ing ; and this would sometimes continue throughout the speak-
ing interval.
With certain subjects (one in particular, L. R.) there was
found on certain days a complete point-for-point opposition
of phase, such as Janet (81 ; 256) found to exist in hysterical
paralysis of the diaphragm. This phenomenon appeared dur-
ing the speaking interval only.
216
FLETCHER
TABLE III.
(CREST.) SUBJECT E. B.
Showing the same as Table I above ( page 213), with a different subject.
No. of Record
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
I
1
17
10
17
13
13
15
22
24
10
12
11
9
18
23
2
1
4
9
3
4 . . .
"6
3
5
1
....
5..
6
7
Totals
1
1
107
107
13
15
1
TABLE III.
(TROUGH.) SUBJECT E. B.
Showing the same as Table III aboye, but using the trough instead of
the crest of the thoracic curve as a point of comparison.
No. of Record
AHEAD
BEHIND
SYNCHRONOUS
OPPOSITE
Speaking
Rest
Speaking
Rest
Speaking
Rest
Speaking
Rest
1.
8
6
18
12
7
1
13
28
1
16
'9
16
22
"3"
2
"i"
8
2
6
9
3
3
14
1
2.
3
6
4
5
6..
5
1
4
7
Totals
12
36
78
41
16
36
The thoracic seems to be more sensitive to mental disturb-
ance than the abdominal curve. The latter sometimes remains
stationary while the thoracic curve shows a uniform upward
tendency or else considerable fluctuation.
In many cases breathing disturbances appear before the
speaking interval, and also subsequent to it. These after-
period disturbances have continued as long as eight seconds.
Breathing abnormalities seem to tend toward becoming
stereotyped in certain forms for certain individual stutterers.
AN EXPERIMENTAL STUDY OF STUTTERING 217
These individual peculiarities are numerous and varied in
character. They often appear as temporarily adopted expe-
dients to help out in the beginning of speech, just as the stut-
terer will often be found to start himself speaking by utter-
ing a vowel sound like " ah." Breathing peculiarities of this
kind are too numerous and varied to admit of classification. 8
B. Vocalisation
a. Method. The abnormalities of vocalization do not
admit of being studied in isolation from the other physiologi-
cal processes of speech as well as those of breathing. The
aberrations to be studied under this heading will be the asyner-
gies between vocalization and the other processes of speech,
particularly that of breathing. This seems to be one of the
most characteristic physiological manifestations of stuttering.
The writer is not aware of any other attempt to study the
relation between breathing and vocalization except by the use
of the signal key, which is an inaccurate method.
It was not thought necessary for the present study to secure
minute records of the pitch and quality of the voice. It was
deemed sufficient to employ an apparatus which would faith-
fully record when the voice was sounding, and which at the
same time would not be responsive to the breath. After the
6 Gutzmann's classification of breathing abnormalities is as follows :
1. Primary disturbances
a. Top frequent inspirations ; b. prior postponement ; c. clonic
and tonic spasms ; d. temporal opposition of costal and abdominal
breathing.
II. Secondary disturbances
a. Spasms of breathing dependent upon spasms of the organs
of articulation.
The writer has found examples of all of the above disturbances, and
in addition has found disturbances which may be classified as the
opposite of I, a. and b.
Ten Gate (18) finds:
/. That rest-breathing curves of the stutterer are like those of the
normal person.
2. Disturbances of speech-breathing are always present in speech
defects.
3. The normal anachronism of speaking-breathing is broken up in
case of the stutterer.
4. Inspiration curves are steeper in the stutterer than in the normal
individual.
The writer's findings corroborate points /, 2, and 4, but not 3. The
findings reported above have not agreed with the claim that anything
like a permanent synchronism between costal and abdominal breath-
ing is to be found in the speech of the stutterer.
218 FLETCHER
trial of several instruments the Rousselot microphone was
found to be best suited to our purpose. The breathing records
were made simultaneously with the voice, and on the same
kymograph. It was therefore necessary for the drum to turn
slowly ; hence the stylus connected with the microphone shows
only a rapid up-and-down movement during the period of
vocalization.
' b. Results. It is to be remembered that the characteristic
normal rest-breathing curve shows inspirations and expira-
tions of approximately the same length, and that the thoracic
and the abdominal curves are approximately synchronous in
phase. When normal speech begins, the expiration period is
greatly lengthened and the inspiration period is greatly short-
ened. Also normal speech shows vocalization at the initial
point of expiration. Radical departures from these conditions
occur in the stutterer's speaking interval. Parallel with the
misshapen breathing curves, already discussed, the micro-
phone enables one to locate and measure the periods of vocali-
zation. The aberrations so far noted are of two general
kinds : /. misplacement, and 2. faulty utilization of voice.
Under /. will appear frequent cases in which the subject is
found to be vocalizing when both his thoracic and abdominal
curves indicate inspiration, and still again when his thoracic
and abdominal curves are out of phase.
It may almost be said that faulty utilization is invariably
present. This lends itself to a sort of quantitative statement.
By the selection of a series of type cases from normal and
abnormal speaking, the following averages were secured : In
the abnormal type, the expiration interval averaged 24.6 sec-
onds. The vocalization interval occupied 9 seconds of this,
which means that 36.5 per cent, of the expiration interval
was utilized in vocalization. The rest of this interval was
taken up by aphonic disturbances such as are shown by the
pneumograph.
The normal records, on the other hand, showed that of
an average expiration interval of 26.8 seconds, 25.6 were util-
ized in vocalization. Or with normal speaking there appears an
efficiency of 90 per cent., as compared with an efficiency of
36.5 per cent, in the case of the abnormal. 7
7 It may be said that the voice of the stutterer often seems to the
auditor to be husky and suppressed, indicating a tension of the throat
muscles, and an improper functioning of the muscles in control of
the vocal cords. The husky sounds of the stutterer's voice often gives
one the impression of the voice of fear.
AN EXPERIMENTAL STUDY OF STUTTERING 219
C. Articulation
a. Method. By asynergies in articulation will be meant
here the disharmonies between the action of the muscles of
articulation and those of vocalization. This disharmony is
regarded as one of the most important manifestations of stut-
tering. Since instruments attached to the lips, teeth, etc., of
the subject will register the facial contortions which are char-
acteristic of many stutterers, and thus interfere with the
study of the actual processes of articulation, the writer has
felt the need of an apparatus sufficiently delicate to record
the sound of the vocalized consonants and at least to indicate
the location on the voice records of the mutes such as the
explosives, fricatives, etc., in addition to showing the pitch,
intensity and, if possible, the quality of the vocal sounds.
At Stanford University and subsequently at Clark Univer-
sity more than a year was devoted to experiments with the
Marbe smoke-ring apparatus in the hope that it could by some
improvements be made to serve our purposes. 8 The attempt
to use this apparatus was abandoned for the following rea-
sons: i. It can only register pitch, the amount of deposit
on the paper is not a reliable measure of intensity; 2. the
rapid motion of the kymograph was a source of distraction
to the subjects and made lengthy records difficult to procure;
j. consonantal sounds cannot be recorded by this means. The
flame is inclined to flare out from the drum especially when
explosive consonants are pronounced; an important point in
the study of the stutterer's voice is thereby lost. 9
8 This apparatus consists of an arrangement by which an acetylene
flame, set in motion by the vibrations of the air-waves against a cur-
rent of gas that passes by a rubber diaphragm in a manner similar
to that seen in the Koenig-flame apparatus plays upon the drum of
a kymograph which receives deposits of soot (smoke-rings) according
to the pitch of the sound.
9 An attempt was made to obviate some of these difficulties by the
use of various sorts _ of diaphragms. One attempt at improvement
consisted in the substitution of a telephone disc for the rubber diaph-
ragm. A brass cap was fitted over an ordinary telephone diaphragm
in such a way as to form a thin air chamber over it; and a small
gas burner was attached to the center of this cap. The gas was in-
troduced over the diaphragm at the side. It was then possible to
keep the vibrating body near to and at a constant distance from the
flame; and the subject could be kept at a distance from the distrac-
tions of the apparatus. Preliminary tests failed to show this to be
a satisfactory instrument for the study of the asynergies of articula-
tion. These difficulties are not insuperable, however, and it is planned
to renew our attempts to overcome them by the use of instruments
like Hensen's phonautograph or Hermann's phonophotograph (no;
790).
220 FLETCHER
b. Results. For reasons already cited the writer cannot
here offer results of graphic records similar to those given
in our discussion of breathing and vocalization. The findings
are therefore to be reported descriptively.
By articulation is meant the molding of vowel sounds into
words or syllables by the appropriate positions of the lips,
tongue, teeth, hard and soft palate, and the relative openings
of the nasal and pharyngeal cavities. Stutterers (without ex-
ception so far as the writer knows) can sing. Singing brings
vocalization into prominence and reduces articulation to minor
importance. This fact has led authorities to conclude that
the consonant and not the vowel is the source of the stutterer's
difficulties, although it has led another recent writer to draw
the very opposite conclusion. 10 Hunt holds that stutterers
have difficulties with vowels as well as with consonants, and
so does Mr. Isawa of the Board of Education of Japan, who
claims to have found at least one vowel stutterer. We there-
fore find three distinct theories with reference to this ques-
tion. One theory holds that consonants alone are the source of
the stutterer's difficulty; another that the vowe) alone is the
source of the difficulties, while a third theory holds that both
consonants and vowels are responsible for the defect.
The vowel stutterers are generally described as being unable
to leave off certain vowel sounds when once they have begun
to sound them. This characterization is, in the opinion of
the writer, wrong for two reasons: i. The essence of stutter-
ing consists in an inhibition of utterance, and not in an in-
ability to cease utterance (See p. 205) ; and 2, what seems to
be an inability to cease sounding a particular vowel is in
reality an inability to combine that vowel with the succeed-
ing consonantal sound to which the stutterer has been looking
forward. This claim is in harmony with the well-known law
mentioned by Bonnet (15; 52) that when a function demands
the united harmony of a number of acts, if one of these acts
cannot be executed (is inhibited), the others will continue to
reproduce themselves until the co-ordination of the move-
ments can finally be secured. This is a familiar occurrence
with the stutterer ; it is seen most frequently in the repetition
of the initial syllable or letter of a word.
10 Bluemel says (151; v. i; 184-185): "The stammerer (stutterer)
rarely has difficulty in singing. But song differs from speech chiefly
in the manner in which the vowels are produced; while there is mani-
festly no radical change in the consonants. The absence of the stam-
merer's impediment in song indicates, then, that the vowels occasion
the difficulty in speech."
AN EXPERIMENTAL STUDY OF STUTTERING 221
The writers who hold that the consonants are the sources
of difficulty for the stutterer have in many cases attempted
to make out lists of such consonants. A study of such lists
and several attempts to secure them from stutterers have led
the writer to conclude that they are not the same for all
stutterers, and that they do not remain constant for the indi-
vidual stutterer. Experiments have moreover shown that if
the consonants that are known to be difficult for a certain
stutterer are arranged so that they appear in the middle or
at the end of a word, instead of at the beginning, the same
difficulty is not experienced. Stutterers are also found to be
able to whisper without stuttering (the writer has found only
one exception to this). The writer has never seen a case of
stuttering in the pronunciation of a vowel that was wholly
isolated from consonants. He has tested several of his se-
verest cases in this regard by having them read sentences by
eliminating all the consonants and sounding only the vowels.
If one were compelled to indicate just what point constitutes
the difficulty for the stutterer it would doubtless be nearer
the facts to say that the asynergy in question consists in the
failure of vocalization to be co-ordinated with articulation.
This would point to the syllable rather than either the con-
sonant or the vowel. But even so it must be said that the
factors that determine the difficulty in all cases seem to be
not the nature of the sounds themselves but the mental ex-
periences undergone by the stutterer in his attempts at pro-
nouncing them. Furthermore, meaning can generally not be
attached to a single vowel or consonant but it can to a sylla-
ble. This, as will be shown later (pp. 24of.), has an impor-
tant bearing on the rise of stuttering.
**
D. Accessory Movements -
Under this heading are grouped the spasmodic radiations
of bodily movements which accompany stuttering but which
bear no necessary relation to the normal functioning of speech.
These radiations include both bodily and facial contortions,
which are not merely asynergic but are surplus, unrelated,
and illogical in their nature, and for that reason have been
called tics.
a. Tics. Stuttering has been defined as a convulsive tic.
Bonnet, however, has clearly shown the difference between
the two phenomena (15). He finds (15:38) that tics are
often superadded to stuttering, furthermore that stuttering
and tics are of common neuropathic stock, and that one may
222 FLETCHER
become transformed into the other. They possess some
marked differences, however. The number of persons, for
instance, who are subject to tics is the same for both sexes,
a condition which is not true in the case of stuttering. The
most frequent age for the appearance of stuttering is from
three to five, the next most frequent is from five to ten. Tics
appear later, rarely coming before the fifth year. They ap-
pear most frequently from six to ten ; and the next most fre-
quent time of onset is from eleven to fifteen. There are
tics of adolescence, and even of old age, whereas stuttering
is thought never to begin after twenty. Stuttering may result
from imitation ; tics do not. Tics need no provoking cause ;
they appear apropos of anything or of nothing. Stuttering
movements appear only during an attempt to speak. Bonnet
thinks (15; 52 ff.) that stutter movements were perhaps
primitively adapted to a function. Speech, it is remembered,
involves not only the articulatory muscles but mimic muscles
as well. In these mimic muscles we may expect compensa-
tory reactions which have the likeness of tics but which lack
their essence. The tic is a natural act, a gesture. Stuttering
is a progressive attempt to speak, which is thwarted by mus-
cular disorder, dyskinesia, and functional asynergy. In stut-
tering there is an attempt at motor co-ordination for the pur-
pose of emitting a word or syllable thought of, while the
tic is a useless, and involuntary movement which is complete
within itself though purposeless.
Bonnet gives (15; 82) the following stigmata of ticqueurs:
i. psychopathic predisposition, 2. mental infantalism, j. femi-
nism, 4. mental degeneration. He believes that stutterers pre-
sent neuropathic symptoms, but some of these are probably
the " result of the tribulations of the life of the stutterer."
Mental infantalism, if present at <all, is found only during
the school-age. After twelve the stutterer makes progress
rather above his age. Feminism is thought to appear in young
stutterers, and in certain cases also in later life, particularly
in those cases that seek solitude. Over against the weaker
qualities Bonnet cites cases of " illustrious stutterers " who
have been " the indefatigable champions of the cause of re-
ligion, art and politics." He therefore concludes that the
stigma of degeneration can not be assigned. By fixation of
attention a ticqueur may control or at least decrease the vio-
lence of his spasmodic movements. The fixation of attention
(See p. 238) by the stutterer decreases the power of control,
and increases the violence of the movements.
Von Sarbo (122) says that verbal tics, such as the use of
AN EXPERIMENTAL STUDY OF STUTTERING 223
" you know," " you see," " you understand," etc., are espe-
cially characteristic of cured stutterers. In the writer's opin-
ion these are not true tics but are expedients which have been
purposely adopted, and which are employed to release the
initial tension. The stutterer can utter them, apparently for
the reason that they mean nothing (See pp. 24of.). It is of
interest to know that, whereas all hysterical movements re-
spond to mental influence, tics do not, but are even refractory
to hypnosis (122; 206).
The term " spasm " is frequently applied to stutter move-
ments. Pitres (15; 47), however, calls attention to the fact
that spasms are slow, progressive, and rhythmic, contractions,
whereas stutter movements are quick, jerky, arhythmic, and
explosive.
b. Larynx Movetnents. Another class of movements, be-
lieved by certain investigators to be closely related to stutter-
ing, includes the larynx movements. The writer holds that
it is incorrect to assume that because the larynx is a speech
organ therefore all its movements, whether normal or abnor-
mal, are essentially related to the function of speech. What-
ever superfluous larynx movements are found to characterize
the stutterer's speech are, it is held, to be regarded as being
as foreign to speech as if they occurred in a remote peripheral
organ, as for example, in the foot, where thev do often occur,
and should be set down as accessory. Gutzmann has given an
account of studies made of larynx movements in abnormal
speech (67). The methods employed were observation and
palpation. The tip of the nose and the ear lobes were held in
line and the movements of the larynx were observed while the
subject talked or sang. Dermographic marks and Roentgen
rays were also employed in obtaining records. Laryngographs
were devised by Pilton and improved by Rousselot. Gutz-
mann himself used the Zwaardemaker apparatus with the
Krueger-Wirth Kehltonschreiber for indicating the point at
which the vocal sound began.
Gutzmann distinguishes the abnormal movements which
begin at the larynx from those which begin elsewhere and
extend to the larynx. He believes that if the cramp which
closes the glottis comes when the larynx is at its lowest point
there is a sudden rise from top to bottom of its position due
to the crowding of the expiration air against the closed glot-
tis. Accompanying this condition the abdominal muscles are
Densely contracted, and the neck veins are distended, though
the neck muscles do not seem to be contracted. In other
cases various larynx and neck muscles are involved. Although
224 FLETCHER
Sikorski (Ibid) claims that the cramped contraction of the
neck muscles seldom changes the position of the larynx in
any appreciable degree, yet he considers it important to deter-
mine which neck muscles participate in these cramps.
Gutzmann concludes his own investigations (67) by saying
that the symptomatology of stuttering is almost unlimited and
that general conclusions are therefore impossible. This con-
clusion is in harmony with the findings of the present study
on breathing (See p. 229).
c. Miscellaneous Movements. Besides the classified acces-
sory movements already enumerated there are certain ill-
defined and miscellaneous movements which usually occur in
the stutterer's attempt to speak. The writer has observed
acts of stamping the feet, of snapping the fingers, of twisting
the head, and of opening the mouth ; jerky contortions of the
face, whistling, pressing the tongue against the roof of the
mouth, pressing the lips against the teeth, and pressing the
lips together.
IV. PSYCHOPHYSICAL
Under this heading will be noted certain physiological
changes which are closely associated with, if not conditioned
by, changes of mental states (138; 484) ; although not essen-
tially related to the function of speech, these physiological
changes are found to accompany the stutterer's attempt to
talk. These are changes of heart-rate, volumetric changes of
the blood supply, and galvanic changes.
a. Method. In the study of heart-rate, and of distribution
of blood supply, the Lehmann plethysmograph was introduced,
in addition to the pneumograph and microphone, already re-
ported. The subject was seated as in the other investigations,
and with his right hand inserted in the plethysmograph. The
stylus of the plethysmograph tambour was adjusted to a posi-
tion in vertical line with the others, in order to secure simul-
taneously J. the thoracic breathing curve, 2. the abdominal
breathing curve, and the records j. of the heart-rate, 4. of
the volumetric changes and 5. of the voice.
The galvanic records were taken separately from all others.
The Deprey d'Arsonval galvanometer was employed. The
kind of electrode that proved most suited to our purposes
was a large glass jar filled with a solution of sodium chloride.
Large copper sheets were placed around the inside of the jar,
and to these were soldered the copper wires which led through
the batteries and the galvanometer. In the bottom of this jar
AN EXPERIMENTAL STUDY OF STUTTERING 225
was fixed a wooden handle which was firmly clasped by tbe
subject during the experiment in order to avoid variations
in the depth of submergence of the hand. The jars we r e
placed on either side of a comfortable armchair in which the
subject sat. An adjustable reading-rack was placed in front
of him so as to obviate the necessity of movement. The
method of registration was an adaptation of the one used
by Radecki (116), in which light from the galvanometer mir-
ror was thrown on a graduated scale, which was set at a
distance of one meter from the galvanometer. A pointer,
suspended from a cord, ran along the scale and could be made
to follow the light as it changed its position. The cord which
carried the pointer also carried a wire marker, which traced
lines horizontally on the smoked paper of a kymograph. If
now the deflections of light caused by the turning of the
galvanometer mirror were accurately followed, the marks on
the kymograph would indicate the exact amount of deflection.
b. Results, a. Volumetric changes. These results admit
of general description rather than tabulated statement. /. It
was observed that there was a marked attention drop where
the subject was told to speak or read. The drop was much
more decided when the subject was called upon to read, than
when he was called upon to speak. This drop occurred in
73 per cent, of the cases. 2. Immediately after the attention
drop there begins a rise which usually lasts until the end of
the period during which the subject is stuttering. This is
found in 90 per cent, of the records. In some cases the rise
is extreme, amounting in one case to 4.3 cm. in 43 seconds,
and in another to 5 cm. in 31 seconds, j. These rises are
usually not uniform; they are characterized by many fluctua-
tions, but they have a general upward tendency. In 62 per
cent, of the records the general rise is interrupted by irregu-
larities. 11 4. Tests were made in which the subjects were
asked to imagine themselves in situations in which they would
be likely to stutter, and to recall, as vividly as possible, occa-
sions on which they had stuttered. Some of the subjects were
11 The extreme disturbances of breathing, and the various bodily
movements which accompany the speech of the stutterer constitute a
source of error in the use of the plethysmograph which must con-
stantly and carefully be guarded against. The following phenomena
were observed : Sudden bodily movements, especially of the hand, were
found to distort the pulse curve and were thus recognized ; true
plethysmograms are found to be not in phase with the corresponding
breathing-curves ; the plethysmograms that are affected by breathing
disturbances do not show these effects until from 3 to 5 seconds after
the disturbance.
226 FLETCHER
proficient in this, as their introspective reports afterwards
showed ; but the curves showed no positive changes. In cer-
tain cases there was a slight decline. 5. The most important
result accruing from this part of the study is the fact that
both the amount of the general rise, and the distortions of the
plethysmograms are correlated with the degree of the severity
of the stuttering (approximately estimated). This fact has
been observed by several means, a. Records were made of
normal individuals while reading; b. records were made of
stutterers while speaking normally, as for instance, while some
one was reading in unison with them ; c. records were made of
cases who could speak better while reading than while talking
spontaneously ; d. finally cases of severe stuttering were com-
pared with less severe cases.
ft. Changes in heart-rate. In tabulating the results of our
study of the pulse-rate, three points of measurement were
chosen; first, a point in the period just prior to the speaking
interval; secondly, a point at the beginning of the speaking
interval ; thirdly, a point at the close of the speaking interval.
The measurements were made at ten-second intervals; and
the numbers thus obtained were multiplied by six to give the
pulse-rate per minute.
When these results are averaged it is found that the pulse-
rate for the first period is 90.2; for the second period, 99.8;
and for the third period, 98.6. The range of variation of the
first period is from 72 to 120; of the second period it is from
78 to 126; of the third period it is from 72 to 129. One of
the subjects, W . N., was only twelve years and seven months
old. Lest there might be an error due to his naturally higher
heart-rate, the results were again averaged with his figures
left out. These averages are as follows : for the first period,
88.9 ; for the second period, 99. i ; and for the third period,
97.2. These investigations continued through more than a
year, so that the excitement due to the novelty of laboratory
conditions cannot be assigned as an explanation of the find-
ings. Preliminary tests, moreover, were carefully excluded.
From the above results it appears, i. that the average pulse-
rate is above normal in the period anticipatory of speaking;
2. that the second period is still more above the normal ; 3.
that the third period shows a greater average than the first,
but less than the second; 4. that in general, under those con-
ditions that are calculated to produce stuttering, the speech
of the stutterer is attended by an abnormal acceleration of the
pulse-rate.
AN EXPERIMENTAL STUDY OF STUTTERING 227
7. Galvanic Changes. The experiments here reported were
continued through a period of only three months. While they
have not gone far beyond the preliminary stage, the results
seemed at least to merit mention.
During the progress of these experiments both observation
and introspective evidence indicated that a state of excite-
ment was present in the subject when he took his seat in the
chair in anticipation of the painful experience of speaking.
The galvanometer deflection confirmed this indication. It
was therefore found necessary to devise a means of reduc-
ing this state of tension until the galvanometer reached a
stable point which might be regarded as a zero point. We
attempted by various methods, such as the phonograph, free
and pleasant conversation, etc., to reduce the subject's tension.
During these preliminaries the experimenter was in a position
to observe the changes in the galvanometer deflection without
the knowledge of the subject. 13 During this preliminary
period of relaxation the deflection tended consistently in one
direction (See Plates; see also Table V. p. 228). When the
signal to read was given the deflection began to take the oppo-
site direction, in some caess immediately, in other cases after a
few seconds. Succeeding most of the speaking records there
is again a reversal in the direction of the deflection and a
return to the initial direction of the relaxation period. In
the midst of one reading period, the subject became suddenly
amused and laughed at his own efforts at speaking. This
caused a deflection of 15 millimeters in a direction corre-
sponding to that of the initial relaxation period. Some
records show continuous deflection in one direction, so that
the greatest deflection appears at the end of the record.
Other records tend to rise to the extreme position at the
central part of the record, and then gradually subside toward
the end. Others show deflections that are so sudden that it
was impossible to follow accurately with the tracer all the
changes that were indicated by the galvanometer mirror. It
may be said that the subject in whom this condition was found
to exist can read well under favorable conditions. He is a
declaimer in the high school. Only occasionally does he halt
at a word which he has seen ahead of him. It was at such
places of anticipated trouble that the galvanometer changes
13 Record 9, Table V (p. 228) shows the effect of failure to reduce
this state of excitement. The subject's introspections reported excite-
ment at the beginning; and the slight variation as compared with other
records is evident.
228
FLETCHER
were obtained. The tabulated statement of the extent of
these changes can be seen by reference to Table V, below.
TABLE V
The measurements given in this table are in millimeters ;
the time of actual changes is recorded in seconds. The meas-
urements are made in three periods as follows : Period I is
the preliminary relaxation period; Period II is the interval
during which the subject is speaking; while Period III is
the final relaxation period after the speaking has ceased.
The extent of the maximum variation is found at various
points in the speaking period. It is found by measuring the
lowest and the highest points in any single, continuous varia-
tion that seems extreme. The columns under a indicate the
extent of the variation during the periods indicated above
them ; those under b show the time during which the variation
took place.
No. of Record
Subject
Period I.
Period II.
Period III.
Maximum
a
b
a
b
a
b
a
b
1..
A.N...
25
33
1
1.5
47
28
23
11
58
23
65
53
11
21
3
7
3.5
2
5
3
3.2
4.6
3.6
5
4.8
2.5
2
H. A...
30
34
7
1.5
2.1
1.2
29
1.5
3.
H. A.
4
A.N..
3
15
1
1
64
1.5
5..
A.N...
6...
A.N...
7..
A.N..
58
4.5
'60
13
'53
3.8
0.8
3.6
80
1.5
8..
R.T...
9....
A.N...
12
1
1
1.5
18
31
4
4
3.2
0.7
10..
D. D...
11. . .
H. A.
The findings so far as the present study has gone seem to
show a. that the stutterer is subject to a period of galvanic
disturbance prior to the speaking interval; b. that this condi-
tion continues in varying degree throughout the interval of
stuttering; c. that, as with the volumetric changes (See p.
226), the degree of galvanic deflections varies approximately
with the severity of the stuttering. 14
14 Attention should be called to record eleven in Table V, in which
the stutterer is reading in unison with the experimenter without stut-
tering. The table shows much slighter variation in this record than
in others of the same subject. In record 4 the galvanometer took the
direction of relaxation while two stutterers are reading together;
AN EXPERIMENTAL STUDY OF STUTTERING 229
V. INTERPRETATION
It was thought best at the outset to approach the study
of stuttering from the physiological side. This was done not
without the expectation that these features would on exami-
nation warrant generalizations which would possess diagnos-
tic value. The findings from the purely physiological side
have, however, forced the conclusion that, taken alone, they
do not represent the essential features of the phenomenon.
The physiological manifestations of stuttering may be de-
scribed by such general terms as " incoordinations," " dis-
turbances," " asynergies," etc. ; but the description of the es-
sential, uniform or characteristic features has not been pos-
sible. The literature of the subject, and the writer's own
studies have failed to show precisely what are those physio-
logical manifestations of stuttering that may be called path-
ognomonic. The physiological accompaniments, as the fore-
going results have gone to show, have not been uniform ; and
they have been found to be sometimes present and sometimes
absent in the same individual. Nor has it been possible to
establish the existence of a neuropathic diathesis, since it is
impossible to know how many neuropathic symptoms are pri-
mary or causal, and how many are secondary or sequential.
On the other hand, however, it has been found that the
/presence of certain states of mind is a constant attendant if
not an antecedent of stuttering. The writer's opinion is
that these are antecedent and causal; and the indefinite char-
acter and almost unlimited variety of the physiological mani-
festations of stuttering go to show that the latter are symp-
tomatic of conditions which are central and not peripheral.
The possibilities of inhibitions, which may be regarded as
causing the initial break in the synergic functioning of speech,
are enhanced as the source of control approaches the cortical
regions on account of the multiplication of the synapses,
which Sherrington regards as the seat of inhibition (130;
192). The remaining portion of this paper will, therefore,
be devoted to an attempt to set forth as far as possible those
states of mind which are peculiar to the stutterer and which
are associated with the function of speech. Since our sub-
jects were not trained psychologists, it was naturally impos-
sible for them to couch their descriptions in technical termi-
nology. No attempt was made to suggest psychological terms
curiously enough, neither one stuttered here, nor had any fear of
stuttering. One of the subjects (A.N.) had just previously given
a record in which the deflection was 64 mm. in the opposite direction.
230 FLETCHER
to the subjects ; and for fear of doing violence to the facts
we prefer to present the reports of introspections in their
original form.
VI. PSYCHOLOGICAL v --
A. Emotions
a. Historical. Hornig (77; 188) holds that, although fear
and anxiety aggravate stuttering, they do not cause it, but
are merely secondary manifestations. He grants that emotions
can and do arise as effects of stuttering ; and these same emo-
tions, forming memory complexes which associate themselves
with the function of speaking, arise again when speaking is
necessary to hinder it by producing the inhibitions, asyner-
gies, etc., already described. So that certain emotions and
stuttering are seen to operate in a vicious circle. Wundt holds
(146; 65) that speech originated in the expression of emo-
tion, and that movements of expression, of which speech is
one, have continued to be closely allied with the emotions.
Gutzmann's position on this question seems difficult to
make consistent. He believes that speech belongs to the
movements of expression, and that it always exhibits a pleas-
ant or an unpleasant affective tone (48; 385 ff.). Particularly
does he think (Ibid; Cf. p. 207, above) that breathing and
voice, no less than the mimic muscles, are responsive to emo-
tional conditions. Emotions, he says, always change the
rhythm and the depth of breathing, the costal breathing being
more responsive than the abdominal. The fact that costal
breathing is more disturbed in stuttering than abdominal, in-
dicates that emotions play a part here. He holds that the
emotions affect the action of the vocal cords ; and that they
play a prominent part in the speech development of the child.
The extreme emotion felt by the deaf-mute child on first
learning to utter a word is cited in confirmation of this view.
(Ibid., p. 395.) He grants further that the cortical and in-
fracortical regions are more ready to discharge a function
when stimulated by emotions ; yet he holds that emotions
are of no fundamental significance in the causation of stutter-
ing. He believes that the child experiences no intensive de-
pression on account of his stuttering, but that this feeling of
depression comes only with maturer years and increase of
intelligence. Many stutterers, he says, have no experience
that could be called " anxiety before speaking," though in
reading, such an experience may appear in certain cases. He
claims that he had observed " visual indications " of emotions
in one subject just before coming to the letter k, which usu-
AN EXPERIMENTAL STUDY OF STUTTERING 231
ally caused difficulty ; but he asserts that the very contrary
conditions are also found. His position is (66; 203) that it
is possible to eliminate emotions from stuttering without al-
tering the defect. 15
Meumann (107; 578) holds that every child stammers at
some time during his first or second year. When stammer-
ing has occurred in the child, the ridicule and mocking of his
associates may produce shyness and depression, which are
fertile soil for the production of word-anxiety and lack of
confidence, both of which are symptoms which characterize
the stutterer. One seems to be justified in supposing that
stuttering never arises in a permanent form except through
the intervention of an emotional shock. Mispronunciation,
ataxia, lapsus linguae, and Versprechen may occur under
certain circumstances in normal individuals ; and these are
similar to the first stage of stuttering. They are not patho-
logical ; but in the young they may readily become so. An
American psychologist has given the writer a valuable illus-
tration of this in a personal experience, which is quoted
verbatim: " Between the ages of sixteen and eighteen I under-
went a dental operation for straightening the teeth. During
the time when I was wearing a plate with attachments, my
speech was seriously interfered with, and there were many
sounds that I was unable to articulate clearly. On an -occa-
sion when a number of young people of my own age were
present, I attempted to say something about preliminary col-
lege examinations ; the word " preliminary " caused me great
difficulty, and finally, after several attempts, I was obliged
to give it up and was greatly embarrassed by the incident.
After the removal of the plate I still found myself unable to
pronounce the word (preliminary) clearly and met with an-
other embarrassing experience in consequence. I have never
since felt safe in attempting to use the word in conversation,
for although there is absolutely no physical defect and al-
though I can always pronounce the word without difficulty
by pausing a little and making an effort, yet any attempt to
use it in conversation is likely to be followed by disaster. In
consequence of this I invariably avoid using the word and
substitute some other expression." The genesis of stuttering
through imitation may, in the writer's opinion, be accounted
15 It seems hardly necessary to remark that Gutzmann's "visual
indications " are as inadequate for the detection of physiological mani-
festations of emotions as were the old methods of observation and
palpation for the detection of abnormalities of breathing. The writer
takes issue with Gutzmann's position and presents data secured both
from physiological registrations, and from introspective reports.
232 FLETCHER
for on the same principle. Prior to the emotional experience
which changes its character and makes it pathological, the
imitative stuttering develops an increasingly habitual char-
acter. Bonnet reports (15 ; 55) that in the case of some stut-
terers the mouth is dry and bitter, and the tongue feels as
though it were covered with a plaster-like substance. He
finds that some stutterers have veritable trances during which
one may observe all the secretory and vaso-motor phenomena
that characterize emotions. He has noticed (15; 76) that
stutterers have less difficulty in speaking when partially in-
toxicated, because, as they report, they do not feel the same
dread under these conditions. He agrees with Merge and
Feindall that stuttering is more a matter of the emotions than
of the intellect or the will; and with Morel that stuttering
can, like obsession, be defined as being at bottom a morbid
state of the emotions which expresses itself by motor diffi-
culties, particularly in articulation, arhythmic breathing and
vaso-motor disturbances. Stutterers on going to purchase
a railroad ticket or an article in a store will often take along
a card on which is written the name of their destination or
the article wanted. Bonnet (15; 71) regards this as an un-
mistakable sign of word-fear, which he thinks arises from
the age of 8 to 9, and is particularly common between 15
and 25.
If Ribot is correct in holding (118; 171) that, in certain
individuals, emotional memories are possible, while in others
they are not, it would seem certain that stutterers belong to
the latter class. Titchener claims that two classes of indi-
viduals are not to be differentiated in respect to this capacity ;
but that emotional memories are possible in every individual
if the experiences have been sufficiently pronounced. " When
a boy is flogged at school," he says (138; 493 ff.), "he has,
besides the immediate pain of the flogging, all sorts of antici-
patory and subsequent stirs of organic sensation, flutterings,
sinkings, chokings, breath-catchings, nauseas. If, when he
recalls the flogging in later life, the cortical excitations that
underlie his memory-ideas revive the splanchnic and other
excitations that constitute the stimuli to organic sensations,
then the scene comes back to him with its affective coloring
upon it." The stutterer apparently undergoes most, if not
all, of the organic sensations enumerated by Titchener. And,
upon recall, his painful experiences with attempts at speak-
ing not only bring back memory-ideas with " affective color-
ing ", but they revive in varying degrees the original organic
experiences.
AN EXPERIMENTAL STUDY OF STUTTERING 233
Appelt (i; 15) thinks that stuttering "is purely a psychic
ailment at whose core stands the dread of speaking." This
acts as " an inhibiting agent " to obstruct the speech. 16
b. Results. Our data have been secured by two methods.
i. The method of expression (138; 240 ff) employs apparatus
for the registration of bodily changes during the act of speech
by the stutterer. Detailed reports have already been made
of the studies of breathing, vaso-motor, pulse, and galvanic
changes. They therefore need only to be counted in this con-
nection as objective data in the study. 2. The method of im-
pression has, in the present research, been a difficult one to
employ. The difficulty has been due not only to lack of psy-
chological training on the part of the subjects, but to the fact
that even on immediate retrospect the stutterer's memory
seems vague and hazy as to details. He is often wholly un-
able to recall what he has read only an instant before. Indis-
tinct memories of his environment and of the bodily sensa-
tions connected with his strained efforts at speaking, espe-
cially his remembrance of sensations in the throat, the chest,
and the abdomen constitute his memory content. In some
16 The part played by the emotions in stuttering has an important
analogy in certain hysterical phobias. To Stekel it is more than an
analogy, for he contends (136; 300) that stuttering is a form of hys-
teria. The analogy is shown in certain pathological cases, for whose
description the writer is indebted to Dr. Edward Cowles of Clark
University.
The first is a case of the fear of sweating reported from the McLean
Hospital, Waverley, Mass. This subject was frequently distressed
when at church or social gatherings by feeling very warm and by
excessive perspiration. The hospital report states that " the patient
might be playing cards when suddenly he would think that he was
going to get hot; he would not sweat for a time perhaps, but the idea
that he was going to sweat remained in his mind; he tried to get
rid of the thought of sweating; he would become worked up and
stirred up, feel a thumping about the heart, a disagreeable sensation
in the region of the stomach, and the perspiration would come out."
The second case is that of the fear of nose-bleeding, which is re-
ported in the Russki Medisinski Vestnik, December, 1901. A young
man became subject to nose-bleeding, which was generally preceded
by vaso-motor disturbances like blushing, blanching, chill and general
malaise. If he happened to leave his handkerchief at home, or if
he found himself in a place where it would be particularly distressing
for his nose to bleed, it would then be most likely to occur. If while
attending a lecture at the university the thought of nose-bleeding oc-
curred to him it would bleed. (One can ask, in this connection,
whether the fear or the bleeding constituted the obsession. And the
same question is also pertinent in the case of stuttering. The writer
believes that the weight of evidence, in the present study, shows that
the true obsession is mental in the case of stuttering.)
234 FLETCHER
cases a feeling of complete bodily relaxation quickly super-
venes to affect the recall. Two subjects reported that this
relaxation was so pronounced that they felt as if they would
like to lie down and sleep after a siege of stuttering. One
subject reported that while talking his attention was divided
between what he wanted to say and what were his chances of
saying it without stuttering.
All of our subjects reported that certain letters and col-
locations of sound looked ominous to them, if they ran their
eyes ahead while reading. Synonyms are constantly employed
as substitutes for the difficult words.
It was found that if some one read the selection aloud with
the stutterer, he was always able to read without stuttering.
An attempt was made to obtain data regarding the states of
mind under the two situations, in which the stutterer is read-
ing alone, and in which he is reading in unison with some one
else. (Graphic records have already been presented, showing
that there are differences in physiological processes in the two
cases, p. 228, footnote, etc.).
Many subjects, were sure that their feelings were different
in the two cases, but were unable to describe the differences.
One subject reported that he had " much less fear of failing
when reading with some one than when reading alone."
When reading with this subject (A. N.) the experimenter
frequently skipped words, and even whole sentences ; yet it
was found that the stutterer continued to read through these
intervals without stuttering. His introspective reports testi-
fied that he felt " secure " while reading alone in these inter-
vals because he knew that if he " got stuck " he would be
aided and prompted by the experimenter.
Other subjects reported " fear," " anxiety," " uneasiness,"
" distrust " of themselves, " lack of confidence," " dread," etc.
"A feeling of strain " was frequently reported. One subject
said that he often felt himself sweating; and many felt the
rapid beating of their hearts.
In describing his mental state during stuttering one subject
(H. A.) said: "When I am about to speak, I am usually
in a somewhat excited state, sometimes more so than at
others; when I get into that state I am unable to control
myself and I fear the outcome. I experience an internal
trembling and I frequently wonder if I show my excitement
to any great extent. I wonder sometimes as to the effects
of this on my physical condition. Often I wish that I would
somehow vanish when I am in this condition ; and at other
times I should like to show my ability in other lines, such as
AN EXPERIMENTAL STUDY OF STUTTERING 235
starting a fight or throwing some object through the window
or door; it seems as if that would relieve my state of ner-
vousness."
H. A. was found to be able to read fluently a card with
whose contents he was familiar, especially if he had read the
card before several times. On being asked to reproduce the
contents of the card he would stutter severely. When asked
to describe his feelings in these two cases he reported that
in reading the card he felt " confident " that he could read
it as he had done before ; that he felt " passive," or " indif-
ferent." When asked to reproduce the contents, he reported
that his feelings were changed, that he now felt a " lack of
assurance," that he felt himself " getting excited." He would
try to prevent this but the effort to do so made him worse.
(Cf. the case of phobia, p. 233, footnote). On being asked to
give the contents of the card he felt more self-conscious than
in reading a familiar selection; he reports that his attention
is " very poor " while talking, and that his muscles are very
tense, especially those about the throat. Several subjects re-
ported a " feeling of dread " before approaching a stranger
to whom they knew they must speak. One subject (A. N.)
said that if he entered a store to make a purchase and found
no one there whom he knew, a dread seemed to take hold of
him, and often he made his escape without purchasing.
The introspections also showed that after the speaking in-
terval there continues for some seconds a state of excitement
which gradually subsides to an indifference-point. This is
corroborative of the physiological findings already mentioned
(p. 228, and Table V.).
B. Attitudes
In addition to the more pronounced types of mental dis-
turbances which have been studied by the foregoing methods,
there is to be mentioned a group of mental states which it
seems best to designate as " attitudes." These states are not
so pronounced or intensive as affections or emotions. They
do not so fully emerge into consciousness, and hence they
do not so readily admit of study ; but they nevertheless exer-
cise an important influence on stuttering. Binet (13) holds
that in the attitudes, whether consciously perceived or not,
we have the physiological basis of the emotions. Ferrari
(36), in agreement with this position, suggests that the au-
tonomic nervous system is the anatomical substrate of the
emotional life in general as well as the attitudes mentioned
by Binet.
236 FLETCHER
The assumption of the existence of such attitudes, which
differ from emotions perhaps only in degree, seems necessary
to account for the extreme physiological effects which some-
times attend what appear to be slight environmental changes.
By means of this hypothesis it also seems easier to account
for the strength of the morbid associations which characterize
stutterers. These attitudes arising from apparently trifling
causes are again and again found to determine the stutterer's
ability to speak.
It is interesting to note that Geissler's study of conscious-
ness under negative instruction holds that suppression or in-
hibition of articulation may be either ideational or attitudinal
(40). Scripture (129) believes that stuttering is a psycho-
neurosis, whose essential pathology lies in the disturbance of
the stutterer's feeling toward others. This disturbance of
the feeling toward one's environment is the phenomenon
which is here to be discussed as an attitude. It appears in
all degrees from what may be regarded as a primarily intel-
lectual Einstellung to the stage at which it passes into an
emotion, such as fear.
In consequence of our lack of subjects trained in introspec-
tion, no attempt could be made to analyze these states of
mind; hence the data herein submitted are necessarily objec-
tive and sometimes merely inferential. Sufficient facts are at
hand, however, to make the point clear. The number of these
facts could have been extended indefinitely. Appelt ( I ; 101 ) ,
who was himself a stutterer for many years, says that travel-
ing in a strange country has a marked salutary effect on stut-
tering; pleasant company has the same effect. He finds
further, a fact often noted, that in the presence of those who
are in authority over or in any way superior to the stutterer,
his difficulty is more pronounced. This is particularly true
if his auditors watch him closely.
It is usually easy for stutterers to talk to children or to
animals. The thought that his observer is unacquainted with
his difficulty is also helpful to the stutterer (i ; 102). Nearly
all stutterers are able to speak or read without stuttering
when alone. Many stutter in conversation but do not stutter
in public speaking. The most helpless stutterer studied by the
writer had during one summer a position as " spieler " for a
side show at a summer resort. This position required him
to stand in front of the tent and announce to the passers-by
what was to be seen within. He filled this position with suc-
cess. He stuttered violently in conversation ; yet, whenever
he was called upon in the laboratory to give his side-show
AN EXPERIMENTAL STUDY OF STUTTERING 237
" spiel," he could do so without stuttering. Such expedients
as changing their style of speaking, as imitating some one's
peculiar form of speech, as getting away from their accus-
tomed personality and playing a role usually make it possible
for the severest stutterer to speak fluently and without diffi-
culty. Pitres (15; 102) tells of a clown who played his
role perfectly, but who stuttered so badly in private con-
versation that he could not even say " good morning." Many
stuttering actors show no stuttering when on the stage. Masks
are found in many "cases to relieve stuttering. One of our
subjects (A. N.) reports that if he can get into the spirit of
a poem as he reads it aloud, and can feel its meaning he can
read it without stuttering.
Bonnet (15; 77) gives an instance of the use of smoked
glasses in certain cases for the purpose of giving a feeling
of isolation, which was helpful to the subject. Two of the
writer's subjects reported that they had less difficulty when
speaking in the presence of distracting noises. One subject
had a position in an office near a railroad. He found that he
could answer the telephone when a train was passing, but
otherwise he could not. One subject reported that he could
talk better in a store if the counter over which he had to
speak was a narrow one than he could if it was a wide one.
Stutterers are delicately responsive to the moods, tempers
and attitudes of their associates. They seem to " feel the
presence " of others quickly and profoundly ; and their ability
to taVk is profoundly influenced by this factor.
C. Imagery
It is a well-known phenomenon in psychology that the
kinaesthetic images of a certain movement of the body affects
the power of voluntary control of that movement (3) ; and
this phenomenon is confirmed by the familiar facts of stutter-
ing, which seems to take place more readily in those organs
whose functioning is too complex to admit of direct represen-
tation in consciousness. The act of breathing, for instance,
can be imaged only partially and more or less abstractly,
because the working of the diaphragm can not be imaged
and can be controlled only through the lower arch of the
abdominal wall. The diaphragm is especially concerned in
the breathing abnormalities found in stuttering (66). To
co-ordinate vocalization with breathing introduces the func-
tion of another complication of muscles which does not admit
of direct imaginal representation. The action of the articu-
latory organs does admit of representation in consciousness,
238 FLETCHER
and although stuttering speech manifests itself to the eye
and to the ear as being primarily a disturbance of articula-
tion, the real asynergy has been shown (p. 218, above) to be
not merely in the articulatory system, but between this system
and others, especially that of vocalization. Whispering, which
involves only the musculatures of breathing and articulation,
is usually found to be possible for stutterers.
The organs of speech are neither completely under volun-
tary control, nor are they exclusively non-voluntary. The ab-
stract act of speech may be called voluntary; but the co-
ordinated action of the muscles which execute the details of
speech is non-voluntary. Speech movements, says Hoepfner
(76; 268), are the first to lose their motor (concrete?) char-
acter and to become what must be called abstract (begriffliche)
movements. The conscious antecedents of speech movements
seem to be general, vague, and except in the articulatory
movements, lacking in details. More and more as speech
matures is the attention shifted from the physiological process
to the content of the thought to be uttered. It is suggested
(32; 263) that the cortical centers send their impulses to
groups of muscles and not to individual muscles. Stuttering,
it is to be noted, is not confined to speech. Other groups of
muscles which are comparable to the speech muscles in the
degree of complexity and in the abstract character of the con-
scious antecedents of their functioning show this same phe-
nomenon. The writer has had one case of stuttering in
deglutition co-existing with stuttering in speech. Bonnet
(15 ; 328) reports a case of stuttering connected with defaeca-
tion and deglutition. Scripture (128) and Neumann (112)
report cases of stuttering in writing.
D. Attention
Zoneff and Meumann (149) have shown the effect of atten-
tion on the quality of the breathing-curve. They find that in
concentrated attention and in the emotions, the thoracic curve
is more affected than the abdominal. (Cf. the findings re-
ported on p. 215 of this paper.) It has long been recognized
that attention plays a part in stuttering. It does not seem,
however, to exert its influence only by direct action on the
breathing-curve, but rather in more indirect fashion by af-
fecting the morbid associations which themselves are the more
direct antecedents of stuttering.
The surgical operations practiced by Dieffenbach (28) are
now thought to have owed whatever ameliorative effect they
may be credited with to their influence on the attention of the
AN EXPERIMENTAL STUDY OF STUTTERING 239
subject, or to suggestion. Placing corks or wedges between
the teeth, shrugging the shoulders, tapping with the feet,
pinching with the fingers, whistling or counting before speak-
ing and numerous similar therapeutic expedients, all of which
have been known to be effective in certain cases, seem to owe
their efficacy to the fact that they distract the attention of
the stutterer from his difficulty, and that, in consequence,
they afford him a relief from the morbid inhibitions by which
his speech is hindered.
Stuttering has frequently been alleviated by the act of writ-
ing during speech. Many stutterers can speak perfectly while
sewing, embroidering, or playing the piano. Others resort
to blowing the nose, to scratching the head, or to stroking
the mustache before attempting to speak. One subject
(A. JV.) reported that in reading aloud alone, which he could
do without stuttering, he often stopped to wonder at his
success ; and whenever he did so, he at once began to stutter.
If alone, he could recover himself ; but when any one else was
present, he could not. One person of normal speech, a psy-
chologist, reported that there was one word which he had
difficulty in using in public speaking. If he used the word
without thinking about it, he had no trouble in pronouncing
it; but if his attention should fall on it before he got to it
he found it prudent to avoid the use of it. This, in intensi-
fied form, is the common experience of the stutterer. It has
already been noted (p. 221, above) that the so-called difficult
consonants are generally found at the beginning of words.
If the stutterer is able to begin a word he is in most cases
able to complete it. It is to be noted that in all reading, at-
tention is most keenly concentrated on the first parts of the
words. The introduction of rhythm into speech has often
had a marked effect on the stutterer's ability to speak.
Rhythm, expression, and distraction from fixed ideas consti-
tute the essential principles of treatment according to Scrip-
ture (125).
Kussmaul (85 ; 23) stated that stuttering did not exist
among the Chinese because of the rhythmic character of their
speech. (The 1910 edition of his book, edited by Gutzmann,
says that this defect should not exist among the Chinese.)
The writer has made sufficient investigation of this topic to
justify him in saying that stuttering does exist among the
Chinese. Besides numerous private inquiries among persons
who have lived in China and among those who have lived
near Chinese settlements in America, an attempt was made
to ascertain if the Chinese government had taken notice of-
240 FLETCHER
ficially of the existence of the defect. The government had
not taken official action on the question ; but Mr. Jung Kwai,
Secretary of the Imperial Legation at Washington, D. C, in
answer to an inquiry, says that stuttering is by no means
unknown in China, and that more than one member of the
Legation at Washington is subject to this defect.
Stuttering cannot, therefore, be said to be essentially related
to rhythm in speech. The beneficial results derived from in-
troducing rhythm into speech seem to ensue only so long as
the innovation is a novelty to the stutterer, and therefore
capable of affecting his attention ; its therapeutic value is lost
when it is a natural characteristic of speech as is the case in
the Chinese language.
It is to be noted in conclusion that the wide variety of thera-
peutic measures employed for the treatment of stuttering
could have ameliorative effects only through their influence on
some common factor such as attention.
E. Responsibility for Aufgabe
Associated with the emotions and attitudes already men-
tioned, the realization of his responsibility for speaking weighs
heavily on the stutterer. When a question is put to him, for
instance, he feels the necessity to speak. If he does not speak
he realizes that unpleasant consequences will follow ; the per-
sons with whom he has attempted to speak will become
amused, or embarrassed, if not angry. If he were dumb or
deaf the situation could be made intelligible to his auditors,
but this cannot be done in his case. If he begins to speak
and halts, unable to go further, the responsibility to proceed
and the heightened feeling of his inability to do so overwhelms
him. The realization of that demand, the idea that something
is expected of him by way of reaction or reply or communi-
cation in consecutive speech, that compulsion arising from a
question put directly to him, or a social or business situation
in which he may find himself, is the state of mind here meant.
If it were necessary to choose some single psychological term
in present use to designate this state, that term would be
the " Aufgabe consciousness." With the stutterer the realiza-
tion of the Aufgabe is keen, if not morbid; and, as will ap-
pear from the facts, it determines his ability to speak in many
instances, and is not confined merely to " coloring " his re-
actions. As typical of this feeling of the obligation or neces-
sity to speak Bonnet (15; 69) mentions a stutterer who said
that he possessed one good thing which he could use only
when he had need of it, namely, speech. One of the writer's
AN EXPERIMENTAL STUDY OF STUTTERING 241
subjects (A. N.) said that he never had any trouble talking
nonsense. Another subject (H. D.) reported that when called
to the telephone he would frequently take the instrument in
his hand and while raising it to his mouth would keep saying
" hello " without removing the receiver from its hook. The
instant he took the receiver off and got into connection with
the parties at the other end of the line, and realized a necessity
to speak, he became powerless to say anything. Another
stutterer reported that he could talk better to his mother than
to any one else because she seemed to have the ability to an-
ticipate what he meant to say and could relieve him, at various
points, of the necessity of continuing to speak. H. A. re-
ports that he is helped if his auditor seems indifferent to
what he is saying. H. D. states : " I stutter worse when a
specific answer is needed, and when a person is looking at
me to hear my answer; it is very hard for me to ask for a
transfer, upon any particular car-line, such as Lincoln Street,
Greendale, etc. Here a particular word must be spoken;
there is no opportunity to substitute a word which I could
pronounce more easily." Gutzmann has noted that the stut-
terer finds greater difficulty when a choice of words is im-
possible (48; 398). A. N. reports that he is less able to
speak if he realizes that some one is watching him ; the mere
feeling of the presence of another person often renders him
unable to speak.
All of our subjects demonstrated their ability to read with-
out stuttering when some one read in unison with them. The
writer feels justified in concluding that, under these condi-
tions, the stutterer is not so clearly conscious of the Aufgabe.
This relief from the complete responsibility imposed by the
Aufgabe, together with the accompanying or consequent
changes in emotion-states, already described as characteristic
of these situations (pp. 23 iff, above), seems to be an adequate
indication of the principle involved.
In certain tests, already described (p. 225$.), the stutterer
was asked to recall circumstances under which he had stut-
tered or would be very likely to stutter. The results were
wholly negative. The reason seems to be that in this case
the stutterer was entirely relieved of the task of speaking;
and all efforts to revive the physiological processes by mere
recall failed.
The assumption of the Aufgabe is only possible when speak-
ing has meaning. Breathing, vocalization and articulation,
taken separately or in co-ordination, are possible for the
stutterer provided they do not have to cooperate so as to pro-
242 FLETCHER
duce significant speech. That singing is possible to the stut-
terer seems to be due for the most part to the fact that sing-
ing consists chiefly in vocalization (p. 220, above), and to the
fact that singers do not so much feel the responsibility of
conveying some meaning to their auditors.
F. Psychoanalysis
An impetus to the discussion of psychoanalysis in its rela-
tion to stuttering was given by Gutzmann (55) in his review
of two books on the subject (Eine neue psychologische Be-
handlungsmethode des Stotterns by Netkatschew; Nervose
Angstzust'dnde und ihre Behandlung by Stekel). In his dis-
cussion, Gutzmann adheres (55; 68) to his original somato-
genic theory of stuttering. He claims that the emotions pres-
ent are secondary and not primary; and that stuttering is not
an anxiety neurosis but an incoordination neurosis due to
congenital weakness of the speech apparatus. Stekel (p. 233,
footnote) holds to the psychogenic theory of stuttering, and
classifies it as a form of hysteria with an anxiety mechanism
which originates in sexual traumata.
Laubi had taken the position (91) that stuttering is due to a
mental cause but is dependent upon peculiar diathesis in the
form of congenital or acquired structural changes in the nervous
system. The fact that it yields to such a variety of treatments
warrants him in calling it psychogenic. In a subsequent dis-
cussion (90) he cites a case which he claims to have improved
by psychoanalysis. Emotional memory-complexes he finds to
be the cause of stuttering. The emotional excitability may be
either inherited or acquired. In the latter case, if the emo-
tional experience is not originally related to speech it may
become so related by a process of transfer (Freudian). For
instance, if stuttering should arise in a child as a result of
its being bitten by a dog named Schnauz, the emotional com-
plex will be connected with the memory of that name ; and
the child thereafter will probably be found to stutter on all
sch sounds. Gutzmann replies (56) that hypnotic-psychoan-
alytic methods have not been successful in the treatment of
stuttering, that strong mental stimulations may cause stutter-
ing but only under two conditions, when the excitement is
strong, and when the individual is susceptible. Structural
modifications are produced in both cases ; and these he re-
gards as the essential causes of the defect.
Appelt (i) holds to the Freudian view of stuttering. He
attempts to show (i ; 109) how erotic impressions, which arise
AN EXPERIMENTAL STUDY OF STUTTERING 243
from fondling in childhood, come under the influence of edu-
cational restraints, and may for that reason give rise to in-
tensive inhibitions. The rise of stuttering depends upon the
extent of the repression (V ' erdrdngung} and the peculiar dia-
thesis of the individual. He holds that shock, fright or disease
never produce stuttering, but that these factors are often re-
garded as causes by parents and physicians, whereas the real
causes lie farther back. Imitation can only cause stuttering
where the imitator and the imitated have the same complexes.
Freudian identification must be present in the form of an
unconscious inference that if the stutterer observed can have
such paroxysm of speech, the observer himself may also have
them since he possesses the same complexes. Appelt classes
stuttering (i ; 133) with the phobias and the obsessions. The
physical and mental symptoms of stuttering are " merely the
projections of the conflicts which have accumulated in the
emotional complex. All paroxysms of stammering (stutter-
ing) are produced by energy which is supplied by suppressed
libido." 17
The writer is unable to accept the Freudian interpretation ""
of stuttering for the following reasons :
1. He agrees with Gutzmann that the employment of the
method of psychoanalysis has not been sufficiently successful
in the treatment of stuttering to warrant its adoption. Treat-
ments based upon other diagnoses have been much more suc-
cessful. Mere suggestion, wholly aside from the Freudian
hypothesis, seems sufficient to explain the results of the use
of the method.
2. Emotional memory-complexes in children may be ac-
counted for without reference to the sexual element from the
facts, a, that speech in general possesses a genetically emo-
tional character ; b, that speech in the child is usually attended
by stronger feelings and emotions than in the case of
the adult ; c, that morbid conditions easily arise with the child
from various causes, such as embarrassment resulting from
errors of speech, from criticism, from ridicule or from mock-
ery ; d, that the child at an early age is compelled to use the
complex musculatures of speech without the possibility of devel-
oping slowly by the use first of the more fundamental and then
the accessory, according to the law for the best development
of motor co-ordination ; e, that emotional memory-complexes
may arise from nervous shocks other than sexual.
17 Scripture (Stuttering and Lisping, New York, 1912) seems at the
present to accept the Freudian view of stuttering.
244 FLETCHER
j. There seems to be no adequate reason for supposing
that only those emotional complexes which have a sexual
origin can cause stuttering. Such a theory of stuttering,
when one attempts to apply it, is found to necessitate the
introduction of another theory, namely, that of transfer, to
explain how sexual traumata are switched into the function
of speech.
4. The hysterical conditions supposed to be caused by the
suppression of the sexual complexes seem to be more charac-
teristic of females than of males, while stuttering is many
times more common in males than in females. (See pp. 2O7f.)
G. Association
In a former section (p. 221) it was shown that the
difficulty encountered by the stutterer in the pronouncing of
certain letters is determined, not by the nature of the letters
themselves, but by the experiences associated in the stutterer's
mind with the use of those letters. One of the subjects,
W '. N., acquired a persistent tendency to stutter in pronounc-
ing a particular word in consequence of one unsuccessful
attempt to give a number while going through his regular
lest in counting from one to twenty. To instruct him to be
on his guard as he came to that number seemed each time to
furnish a positive suggestion to stutter.
Bonnet (15; 75) cites a similar case: A soldier had an-
swered " present " for three months without stuttering. One
day when the roll was called by a sergeant who had pun-
ished him the day before, he was unable to answer " present " ;
and he continued to stutter only when that particular officer
called the roll. Bonnet holds that any case of stuttering which
originates in reading will remain a case of reading-stuttering.
The same phenomenon appears in reciting, in telephoning,
etc. This may be called " associative stuttering." It is not,
however, to be construed as meaning a new variety of stut-
tering. If we extend the notion of association beyond the
range of conscious ideas and make it include a wider range
of physiological processes, all stuttering may be said to be
associative. As a descriptive term there appears no objec-
tion to regarding stuttering as an " associative neurosis " pro-
vided one agrees with Donley (33) that this does not repre-
sent a " disease entity," or a " disease form," but only a
" functional variation." The rise of vaso-motor, secreto-
AN EXPERIMENTAL STUDY OF STUTTERING 245
motor, and other physiological changes through association,
when there is no conscious recall, is not peculiar to stutterers
alone. 18
Langf eld's studies (87) show that in association experi-
ments, where the reagent is instructed not to respond with
the name of the presented picture, the negative Aufgabe may
produce a " locking of the muscles of the organs of speech,"
which sometimes occurs without " consciousness of the in-
struction or of a judgment." He finds that suppression may
be present in various forms, from a voluntary act to a purely
automatic reaction. In the case of the stutterer, the Aufgabe
consciousness involves no explicit negative instruction but
the complex of associations which is antagonistic to the posi-
tive instructions is effective in accomplishing the inhibition.
Hoepfner (76) holds that stuttering is an associative apha-
sia. This term is objectionable only in that it generally implies
an organic lesion or a structural malformation.
The mechanization of associations and the fixing of neural
paths is unquestionably present in stuttering; and, in so far,
stuttering falls within the category of habit, unless we choose
to limit the notion of habit to the modifications produced by
repeated performance. 19
Stuttering arising from shock, from disease, and from imi-
tation (which in some cases may be repeated very few times),
is obviously not due to repeated performance. Just how being
bitten by a dog (53; 92) can produce stuttering in the same
fashion in which habits are acquired is not easy to see ; but
it is possible that, in such a case, speech may be regarded as
the natural mode of defence through which the nervous shock
found expression, and in doing so fixed the line of nervous
discharge as effectively as repeated performance would. In
such a case the whole anxiety neurosis or association complex
must become switched off into the function of speech, so that
it no longer attaches itself to the particular experience of
being bitten by a dog, which was the original cause of the
18 Betz (n; 273 ff.) reports an incident which seems to have a
bearing here: One day, on a street-car, he saw a fellow passenger
light a cigar and settle back in his seat for a comfortable smoke. But
a sudden jolt of the car dislodged the cigar and threw it upon the
floor ; and the ludicrousness of the incident caused Betz to smile. A
few days later he saw a stranger whom he felt he had seen before.
In his prolonged effort to " place " the stranger he found himself smil-
ing ; and the reproduced smile proved to be the medium through which
the street-car incident and the smoker's face were finally recalled.
19 Cf. Baldwin and Stout's discussion of habit in Baldwin's Dic-
tionary.
246 FLETCHER
shock, but to the general function of speech. It would, then,
no longer be a general condition of anxiety but would be con-
nected only with the act of speaking.
The part played by the element of conation in stuttering
also seems to differentiate it from habit as commonly under-
stood. In the first place stuttering in all of its pathological
aspects can scarcely constitute the goal of voluntary effort.
The imitation of stutter movements, to be sure, may be volun-
tary and as such may obey the laws of the acquisition of
habit, but when this mere imitation of the stutter movements
gets to be actual stuttering a new condition arises in which
the individual becomes a victim not merely of the motor habit
acquired through a few repetitions but a victim rather of the
associated mental conditions. To illustrate, the writer has
the history of a case in which a child became a stutterer by
attempting to show his mother how a clown had stuttered in
a circus. If stuttering were a mere motor habit it is evident
that the clown would have been much more of a stutterer
than the child by reason of the constant repetition of stutter-
ing in his daily performances.
Again, just as " repeated performance " is not essential to
the rise of stuttering, and when carried out does not always
result in stuttering, so it is found that " cures " are not al-
ways effected in the same fashion in which one motor habit,
for instance, is supplanted by another. Many stutterers, for
instance, are cited (125, 126, 127) who ceased to stutter al-
most immediately when shown how to introduce some new
variation, such as rhythm, into their speech.
It is to be noted further that if stutter movements were
simply motor habits like peculiarities of hand-writing, for in-
stance, they would be expected to occur with equal if not
increased facility in the absence of attention. It has already
been shown (p. 239) that stuttering tends to disappear
when the stutterer's attention is distracted from his speech.
From the above considerations the writer has concluded
that the term " habit " does not wholly describe the true con-
ditions of stuttering, and that if the term is to be employed
it should be used to designate rather the mental states which,
it is held, constitute the essential pre-conditions of stuttering.
But it is to be borne in mind that these mental states do not
obey the law of habit by coming into being through volitional
conation, nor are they marked by a progressive decrease of
this volitional element until the habit has become fixed. In-
AN EXPERIMENTAL STUDY OF STUTTERING 247
stead they come involuntarily and there is no evidence against
the assumption that they continue to be opposed in equal
degree by the will of the stutterer.
VII. HEREDITY
The study of heredity in its relation to stuttering would
not come within the scope of an experimental attack upon
the problem, such as the writer has undertaken. It will,
therefore, be mentioned only in so far as it has a bearing on
the conclusions reached in the present study. The facts so
far known seem only to warrant opinions rather than defi-
nite conclusions regarding the inheritance of the defect; and
the opinions differ. Gutzmann believes that stuttering is due
to inherited peculiarities of structure (55, 61, 122, 180) ; and
this view is accepted by writers less well known (15521).
McReady (97) classifies stuttering with amusia, and states
that it is due to " biologic variations " in the brain centers.
This view illustrates the futility of undertaking to base stut-
tering on physical stigmata. A distinguishing characteristic
of stuttering is its intermittence (p. 205) ; if persons afflicted
with amusia were found to possess the power of tonal dis-
crimination when in certain states of mind and not when
in others there would be some grounds for classifying the
two defects together.
One cannot but admit the possibility and even probability
that a favorable neuropathic diathesis is present in the stut-
terer; but it is acknowledged that this does not explain why
many persons of neuropathic diathesis never stutter. The
causation of stuttering by imitation also seems out of accord
with the structural explanation of the defect. To establish
the hereditary character of stuttering one must find a stutterer
who is descended from stuttering ancestors, and who has
never observed stuttering in others, which is obviously a very
difficult thing to do. One of the writer's subjects (W . AT.)
was the son of a stutterer ; and the father reported that he
himself had acquired the defect by imitating a school-mate.
To assert that the son inherited the father's acquired character
would be to cut the knot of the whole inheritance problem at
once. Such errors as this, it is feared, have crept into statis-
tical reports on the problem of heredity in stuttering.
VIII. CONCLUSIONS
i. The motor manifestations of stuttering are found to
consist of asynergies in the functioning of the three muscula-
tures of speech, breathing, vocalization, and articulation.
248 FLETCHER
2. Accompanying these asynergies there are also to be
found tonic and clonic conditions of other muscles which are
not involved in normal speech. These accessory movements
tend to become stereotyped in each individual.
3. Stutterers are found to differ widely in type of asynergy,
and particularly in accessory movements. It is, therefore,
impossible to assert that any form of breathing, of articula-
tion, or of vocalization constitutes the essence of stuttering.
4. Besides the motor manifestations of stuttering there are
other accompanying conditions which consist in disturbances
of pulse-rate, and of blood distribution, and in psycho-galvanic
variations ; these changes appear before, during, and after the
speaking interval. The intensity of these manifestations is
found to vary approximately with the severity of the stut-
tering.
5. The essential condition of the rise of stuttering seems
to be a complex state of mind, which should be classified
generically as feeling, in the wider sense of that term (138;
227). It is to be noted, however, that the quality rather than
the intensity of these feeling states governs the rise of the
defect. Certain forms of excitement, such as that incident
to speaking in public, for example, caused stuttering to dis-
appear entirely in over fifty per cent, of our cases.
6. In general the feelings that tend toward inhibition or
depression, such as fear, anxiety, or dread, or shame or em-
barrassment, are the ones that are most likely to be the pre-
cursors of stuttering. Probably all of these attendant mental
states operate in a vicious circle in that they act as both
cause and effect. The writer is of the opinion that in general
the permanent condition of nervousness that is thought to be
characteristic of stutterers should be regarded as effect rather
than cause.
7. The states of feeling that have to do with the produc-
tion of stuttering vary in degree from strong emotions to mere
attitudes or moods. These latter are often so slight in degree
that it is difficult for the subject to report their presence, and
yet by the logical " method of difference " it seems necessary
to consider their presence as a causal factor.
8. In addition to states of feeling, stuttering seems to be
affected by the quality of mental imagery, by attention, and
by association. All movements that, like those of speech, are
incapable of clear and detailed imaginal representation in con-
sciousness are, in the same way as speech, liable to functional
disorders that are analogous to stuttering. When the stut-
terer's attention can be distracted from his speech his stut-
AN EXPERIMENTAL STUDY OF STUTTERING 249
tering generally ceases. The affective and emotional experi-
ences associated with the pronunciation of sounds, rather than
the nature of the sounds themselves, determine the rise of
stuttering.
9. Stuttering, therefore, seems to be essentially a mental
phenomenon in the sense that it is due to and dependent upon
certain variations in mental state. Hence the study of stut-
tering becomes a specifically psychological problem; and it
seems evident that a detailed analysis of all the various as-
pects of the phenomena of stuttering will furnish important
contributions to general psychology.
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AN EXPERIMENTAL STUDY OF STUTTERING 253
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AN EXPERIMENTAL STUDY OF STUTTERING 255
147. WYLLIE, JOHN. The Disorders of Speech. Edinburgh, 1894.
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(Since the completion of this study two books have appeared that
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151. BLUEMEL, C. S. Stammering and Cognate Defects of Speech.
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152. SCRIPTURE, E. W. Stuttering and Lisping. New York, 1912.
251 PP.
X. ILLUSTRATIVE PLATES
Typical records are here reproduced to illustrate certain
physiological phenomena that accompany stuttering, not all
of which are amenable to detailed description or tabulation.
The records read from left to right; the time is recorded in
seconds. In all the breathing records the amount of inhala-
tion is registered by the downward movement of the stylus,
that of exhalation is indicated by the upward movement ; the
duration of both inhalation and exhalation is measured by
the extent of the movement in the horizontal direction. By
comparing all points of each curve that lie on a line drawn
perpendicular to the line of movement of the drum the tem-
poral relations of the different phases of the processes re-
corded can be determined.
PLATE A gives two records taken at different intervals and showing
the thoracic curve above and the abdominal curve below in each case.
Below the abdominal curve of each record, the registration of the
microphone is shown by the up and down movements of the stylus.
The abnormality of this record is shown in the arhythmic character
of the breathing curve and also in the scantiness of the voice record.
PLATE B is reproduced for the purpose of comparing it with record
C following to illustrate the possibility of both normal and abnormal
speaking in the same subject. The perpendicular lines are drawn to
show the method of comparing the several registrations. In this
record the subject is stuttering, while in record C he is speaking
normally. Note the tendency to attempt to speak when the lungs
are empty, and even during the exhalation period.
PLATE C is to be compared with record B. The regular succession
of inhalation by exhalation, the short inhalation and the long ex-
halation period, also the complete utilization of the exhalation period
by vocalization, as shown by the microphone record, are the chief
points of difference between the two.
PLATE D gives a plethysmogram showing simultaneously the volu-
metric changes and the heart-rate, also the thoracic and the abdominal
breathing curves. Sudden breathing and vaso-motor changes are seen
to mark the period of the beginning of speech.
PLATE E gives the same as record D with the addition of a voice
record. In addition to the marked irregularities of the breathing
curve the steady rise of the plethysmographic curve is to be noted.
The full extent of this rise is greater than could be shown in the
length of the reproduction here given.
PLATE F shows the tracings that followed the deflections of the
galvanometer during the stuttering of two subjects H. A. (top), and
A. N. (bottom). A. N. is a much worse stutterer than H. A., and
there is also found in his case a much wider deflection. It is seen
that A. N.'s curve reaches a maximum and then moves gradually in
the direction of relaxation, or upward.
PLATE G shows the galvanometer deflections obtained from the same
subject when reading under different conditions. In the first regis-
tration, A. B., the subject, is reading alone and stuttering. In the
second registration he is reading with the experimenter, a to /?, with-
out stuttering, and also relaxing, /? to y. The introspective report of
this record showed the presence of " strain," and " lack of confidence "
in the first registration, and " less emotional excitement " in the second.
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