(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Biodiversity Heritage Library | Children's Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "An experimental study of stuttering"

F5 



M 



UC-NRLF 



$B L57 ^7D 




G 



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 



I N^ I — < 



F5^ 






^^* 



AN EXPERIMENTAL STUDY OF STUTTERING* 



By John Madison Fletcher 



I. Introduction 301 

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 
/3. Changes in Heart-Rate 
;'. Galvanic Changes 

V. Interpretation 229 

VI. Psychological 230 

A. Emotions 

a. Historical; b. Results 
a. Objective 
fi. 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 Qark University. 



202 •'•• ' fllix:her 

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 valrie 



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.^ 

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 : 

7. 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 

^ W. Wundt, Ueber reine und angewandte Psychologic, Psychol. 
Stud., V. igog, 1-47. 



N^ 



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 (24;22).'^ The developmental stammer, 

J 2 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 tah, 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 ^ and 2. The organic type of this 
defect is due to the shortness of the lingual frenum, or 
" tongue-tie." * 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 
(66; 211) 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. iii ff. 



h 



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 (66; 202) 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.* 

There are no complete statistics on the number of male and 
female stutterers; but estimates (24; 362 ff.) show that male 
stutterers preponderate over females in ratios ranging from 

* 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 (^y), that such differences are not con- 
genital but are due to the habit of constriction.^ 

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, s 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 

^ 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. N. 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 (i8) 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 : 



Normal Speaking 



Stuttering 



fi. Av. 26.2 mm. 

[2.M.V. 3.79 ." 
fi. Av. 35.6 mm. 



L2.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 : 

1. Retardations 

2. Total misplacements 
J. Interruptions 

These are characteristic both of inhalation and of exhalation. 
/. 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, j. Interruption may occur in two 
ways ; o. 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 relation 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 


.... 


2 


13 
9 

21 
8 
9 
1 
6 
1 
1 
4 
8 

18 


4 

i 
io 

2 

i 

1 

8 

1 


"2 
5 
2 
6 

"s 

8 

1 

13 

25 


1 
3 

i 

45 

6 

4 

6 

36 

31 

12 


1 

"23" 
7 
2 
2 

"2 
2 
1 




2 




3 




4 




5 


9 


6 




7 




8 




9 




10 




11 




12 








Totals 


4 


2 


99 


28 


65 


145 


40 





TABLE L 

(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 

"6 
1 
1 

"2 
2 
3 

io' 


'2 
2 

12 
■3 


10 

8 

11 

1 
24 

■4" 
2 
1 

■5' 
9 


2 

i 

'2 

■4 

'2 
3 


1 
3 
2 
3 
2 
1 
3 
4 
1 
9 
1 
22 


1 
1 

6 
45 
5 
2 
6 
19 
34 
11 


.... 

"6 

17 

"2 

'"i" 

4 




2 




3 




4 




5 


5 


6 


3 


7 




8 




9 




10 




11 


1 


12 








Totals 


26 


19 


75 


14 


52 


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 ( 


Dpposite 


Speaking 


Rest 


Speaking 


Rest 


Speaking 


Rest Sp 


eaking 


Rest 


1 


.... 

"2 
"2 

.... 


i 
i 


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 


"2 
.... 

"2 

"8 

.... 

1 
2 
2 
2 

"4' 

"2 


ie 

ii 
2 

1 

■5 
2 
4 

i 
5 

i 


1 
3 

i" 

1 

i' 

'5' 
2 

1 




2 






3 




4 




5 




6 




7 




8 




9 




10 




11 




12 




13 




14 




15 




16 




17 




18 




19 




20 




21 








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 11. 

(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 
2 
1 
2 
7 

12 
6 
4 
4 
4 

10 
8 
7 

22 
8 
6 
8 
8 


'4 
1 

'i 
"i 
'2 
"i 
"i 


"8 

"5 

11 

7 

3 

.... 

"2 
.... 

"3' 

1 
4 
3 


12 

6 

14 

12 

is 
'i 


10 

3 

11 

"2 

"3 
2 

"4 
.... 

.... 


7 
10 

5 
10 
10 

2 

1 

'4 
3 
3 
3 

'i 

1 

"i 
3 






2 










3 




4 




5 




6 




7 




8 




9 




10 




11 




12 




13 




14 




15 




16 




17 




18 




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 sHghter 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 in. 

(Crest.) Subject E. B. 

Showing the same as Table I above ( page 213), with a different subject. 





Ahead 


Behind 


Synchronous 


Opposite 




Speaking 


Rest 


Speaking 


Rest 


Speaking 


Rest 


Speaking 


Rest 


1 


.... 


1 


17 
10 
17 
13 
13 
15 
22 


24 
10 
12 
11 
9 
18 
23 


"i' 

"6 
3 


9 

5 

1 


.... 




2 






3 




4 




5 




6 




7 








Totals 


1 


1 


107 


107 


13 


15 


1 





TABLE in. 

(Trough.) Subject E. B. 

Showing the same as Table III above, but using the trough instead of 
the crest of the thoracic curve as a point of comparison. 





Ahead 


Behind 


Synchronous 


Opposite 




Speaking 


Rest 


Speaking 


Rest 


Speaking 


Rest 


Speaking 


Rest 


1 


"6 

"5 
1 


8 

6 

18 

'4 


12 
7 
1 

13 

28 
1 

16 


9 

io 

22 


"3 

2 

.... 

8 
2 


6 
9 
3 
3 

14 

1 










2 




3 




4 




5 




6 




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.* 

B. Vocalization 

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 

' Gutzmann's classification of breathing abnormalities is as follows : 

1. Primary disturbances 

a. Too 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 h. 
Ten Gate (i8) 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 i, 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 i. 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.''' 

' 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 

d. 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, s^ 
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.* 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.^ 

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. 

^ 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.^" 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 vowel 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 occasior* 
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 (15 138) 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 lobt'B 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 
\jf 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 I. 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 the 
subject during the experiment in order to avoid variations 
in the depth of submergence of the hand. The jars we'-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 (ii6), 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, i. 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 
y^ 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." 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 shght 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. 

/3. 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.^^ 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 

18 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... 
H.A... 
H.A... 
A.N... 
A.N... 
A.N... 
A.N... 
R.T... 
A.N... 
D.D... 
H.A... 


25 
33 

■3 
15 

■58 

12 
1 


1 
1.5 

i" 

1 

4.5 

i" 
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 


■36 
34 

7 

'60 
13 

'53 


i;5 
2.1 
1.2 

0.8 


'29 
'64 

'80 

is 

31 

4 




2. 


1 5 


3 




4 


1.5 


5 




6 




7 


1.5 


8 




9 


4 


10 


3.2 


11 


0.7 







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.^* 

1* 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, 
v/hich 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 y 
A. Emotions 

a. Historical. Hornig (yy; i88) 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/^ 

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.^* 

b. Results, Our data have been secured by two methods. 
/. 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 

1* 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 Medizinski 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 situaticMis, 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 reUeve 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 ; loi ) , 
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; yj) 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 taH< 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 

ZoneflF 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. N.) 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 Aufgahe 

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 " Aufgahe consciousness." With the stutterer the realiza- 
tion of the Aufgahe 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 Aufgahe. 
This reHef from the complete responsibility imposed by the 
Aufgahe, together with the accompanying or consequent 
changes in emotion-states, already described as characteristic 
of these situations (pp. 23iff, above), seems to be an adequate 
indication of the principle involved. 

In certain tests, already described (p. 225f.), 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 Aufgahe 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; Nervbse 
Angstsustdnde 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."" 

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 ; h, 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. 

1'' 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. 207f.) 



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.^^ 

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.^* 

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 

i^Betz (11; 273 flf.) 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. 

^^ 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, i&)) ; and 
this view is accepted by writers less well known (i5;2i). 
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. N.) 
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 

taring 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. 

IX. Bibliography 

- I. Appelt, Alfred. Stammering and Its Permanent Cure. London, 
191 1, 234 pp. 

2. AuERBACH, S. Traumatische Neurose und Sprachstorungen. 

Monats. f. Psychiat. u. Neurol. XVIL, 1905, 84-92. 

3. Bair, J. H. The Practice Curve. A Study in the Formation of 

Habits. Psychol. Rev. Mon. Sup., No. 19, 1902, 70 p. 

4. Barber, L Sprachstorungen des Kindes. Arts als Erzieher, V., 

1909, 73-74. 

5. Barth, E. Neuere Ansichten iiber Stottern, Stammeln, Poltern, 

und Horstummheit, Wien. klin. Rundschau, XVIII., 1904, 
697-724. 

6. Bayerthal, J. Ueber Gehirn und Sprachstorungen bei Schulkin- 

dern. Zeits. f. Kinder f or schung, XVI., 1910, 1-8. 
«7. Behnke, Emil. On Stammering, Cleft Palate, and Lisping. 
London, 1907, 89 pp. 

8. Bell, Alexander Graham. Lectures upon the Mechanism of 

Speech. New York, 1906. 129 pp. 

9. Berger, Hans. Ueber die korperlichen AUsserungen psychischer 

Zustdnde. Jena, 1907, 216 pp. 
to. Berillon, M. Le traitement psychologique du begaiement mental 
et de la timidite. Rev. de I'hypnot. et psychol.-phys. XVIII., 
1903-4. 172-174. 

11. Betz, W. Vorstellung und Einstellung. Archiv f. d. ges 

Psychol, XVIL, 1910, 273-274. 

12. Bilungs, M. L. and Shepard, J. F. The Change of Heart Rate 

with Attention. Psychol. Rev. XVIL, 1910, 217-228. 

13. Binet, a. Qu'est-ce qu'une emotion? Annee psychol., XVIL, 

191 1. 1-47. 

14. Binet, A., and Henri, V. Les actions d'arret dans les phenom- 

enes de la parole. Rev. phil., XXXVIL, 1894, 608-620. 

15. Bonnet, Louis A. L. Etude critique sur la parents morbide du 

begaiement avec les tics et les crampes fonctionelles. Bor- 
deaux, 1906. 168 pp. 

16. Bramwell, B. Functional Speech Affection Cured by the Milk 

Isolation Plan of Treatment. Clin. Studies, IV, 1905-6, 77-79. 

17. Brill, A. A. The Anxiety Neuroses. lour. Abn. Psychol., V., 

1910, 57-68. 



250 FLETCHER 

i8. TEN Gate, M. J. Ueber die Untersuchung der Athmungsbewe- 
gung bei Sprachfehlern. Monats. f. Sprachheilkunde, XII., 
1902, 247-259; 321-341- 

19. Chervin, Arthur. Begaiement et autres maladies fonctionelles 

de la parole. Paris, 1901, 551 pp. 

20. CoEN, R. Pathologic und Therapie der Sprachanomalien. Wien, 

1886, 246 pp. 

21. Collins, J. The Faculty of Speech. New York, 1898', 432 pp. 

- 22. CoLMAN, U. S. Impediments of Speech. Allbutfs System of 
Medicine, VII., 448-456. 

23. CoLOMBAT, Marc. Traite de tons les vices de la parole et en 

particulier du begaiement. Paris, 1840, 558 pp. 

24. CoNRADi, Edward. Psychology and Pathology of Speech Devel- 

opment in the Child. Fed. Sem., XL, 1904, 327-380. 

25. Dattner, B. Eine psychoanalytische Studie an einem Stotterer. 

Centralbl. f. Fsychoanalyse, II., 191 1, No. i, 18-26. 

26. Denhardt, Rudolf. Das Stottern; eine Fsychose. Leipzig, 1890, 

298 pp. 

27. . Vom Stottern. Deutsche Med. Zeitung, XXIX., 1908, 

93 ff. 

28. DiEFFENBACH, J. F. Die Heilung des Stotterns durch eine neue 

chirurgische Operation. Berlin, 1841, 35 p. 

29. Dittrich, Ottmar. Grundziige der Sprachpsychologie. Halle, 

1904, 786 pp. 

30. . Bilderatlas sum ersten Bande der Grundziige der 

Sprachpsychologie. Halle, 1903, 95 pp. 

31. Dodge, Raymond. Die motorischen Wortvorstellungen. Halle, 

1896, 78 pp. 

32. Donaldson, Henry Herbert. The Growth of the Brain. Lon- 

don, 1895, 374 pp. 

33. Donley, John E. A Further Study of Association Neuroses. 

Jour. Abn. Fsychol., II., 1907-8, 45-57. 

34. DuNLAp, K. Galvanometric Deflection with Electrode Applied to 

the Animal Body. Fsychol. Bull. VIL, 1910, 174-177. 

35. DuPROT, G. L. Les troubles de la parole chez I'enfant. Man. 

gen. de I'instruction primaire, No. 18, 1900, 277-279. 

36. Ferrari, G. C. Le emozioni e la vita del subcosciente. Rivista 

di psicologia, VIIL, 1912, 97-118. 

37. FiTZ, G. W. A Study of Types of Respiratory Movements. 

Jour. Exper. Med., I., 1896, 677-6^12. 

38. Foster, Michael. A Text-Book of Fhysiology. Sixth Ed. 

New York, 1893 

39. Franz, Shepherd Ivory. On the Functions of the Cerebrum; 

the Frontal Lobes. Archives of Psychology, I., No. 2, 1907. 
64 pp. 

40. Geissler, L. R. Consciousness under Negative Instruction. 

Amer. Jour. Fsychol, XXIII. , 1912, 183-213. 

41. GiRARD, G. M. De I'anxiete. (These med.) Bordeaux, 1902, 

86 pp. 

42. Glorieux, M. Tic hysterique avec hypertrophic musculaire. 

Brux, 1906. 120 pp. 

43. Godtfring, Otto, tjnsere stotternden und stammelden Kinder. 

Kiel, 1906. 23 pp. 

44. Greene, E. The Preponderance of Male Stammerers over Fe- 

males. N. Y. Med. Jour. LXXIIL, 1901. 635-638. 

45. Gregoire, J. Les vices de la parole. Paris, 1908. 119 pp. 



AN EXPERIMENTAL STUDY OF STUTTERING 251 

46. Grossard, M. Begaiement et vegetations adenoides. Bull, de 

lar., otol. et rhin., VI., 1903. 261-266. 

47. Grunbaum, Ferdinand. Erkldrung des Stotterns, dessen Heilung 

und Verhiltung. Leipzig, 1897. 63 pp. 

48. GuTZMANN, Hermann. Das Verhaltnis der Affekte zu den 

Sprachstorungen. Zeits. f. klin. Med. LVIL, 1905. 385-400. 

49. . Ueber Sprachstorungen bei Neurasthenikern. Ver- 

handl. d. Kong. f. inner e Med. XXL, 1901. 518-522. 
50. . Ueber Untersuchung und Behandlung der durch 

Gaumen- oder Zahndefekte entstehenden Sprachstorungen 
Deutsche Zahnartzl. Wochenschr. VIII., 1905. 186-209. 
51. . Die Sprachstorungen als Gegenstand des klinischen 

Unterrichts. Leipzig, 1905. 39 pp. 
52. . Stimmbildung und StimmpAege. Wiesbaden, 1906 

161 pp. 
53. . Sprachstorungen und Sprachheilkunde. Berlin, 1908. 

189 pp. 
54. . Grundziige der Behandlung der nervosen Sprachstor- 
ungen. Deutsche Med. Wochenschr., XXXIL, 1906. 612-617. 
55. . Ueber psychogenen Sprachstorungen. Monats. f. 

Sprachheilkunde, XX., 1910. 93-94; 97-ii7- 
56. . Nochmals die psychogenen Sprachstorungen. Monats. 

f. Sprachheilkunde, XX., 1910. 204-210; 241-247. 

57. . Das Stottern. Frankfurt a. M., 1898. 460 pp. 

58. . Die soziale Bedeutung der Sprachstorungen. Klin. 

Jahrh. XII., 1904. 295-364. 
59. . Ueber die neueren Fortschritte in der Untersuchung 

und Behandlung der Sprachstorungen. Zeits. f. diact. u. phys. 

Therapie. VIIL, 1904-5. 531-604. 
60. . Sur le symptomatologie et le traitement de I'aphonie 

spasmodique et d'autres troubles phonateurs d'origine. Archiv 

internat. de laryng. XXL, 1906. 689-723. 
61. . Ueber die Bedeutung der Erblichkeit ftir die Entste- 

hung von Sprachstorungen. Zeits. f. aertzl. Fortbild. IV, 

1907. 481-489. 
62. . Des Kindes Sprache und Sprachfehler. Leipzig, 1894, 

264 pp. 
63. . Die Heilkurse fiir Stotterenden. Monats. f. Sprach- 
heilkunde. XVIL, 1907. 386-391. 
64. . Physiologic der Stimme und Sprache. Braunschweig, 

1909. 208 pp. 
65. . Stimmbildung und StimmpAege. Wiesbaden, 1906, 

161 pp. 
66. . Die Atembewegung in ihrer Beziehung zu den 

Sprachstorungen. Monats. f. Sprachheilkunde. XVIIL, 1908. 

179-201. 
67. . Ueber Stellung und Beviregung des Kehlkopfes bei 

normalen und pathologischen Sprachvorgangen. Beitr. z. Anat. 

Physiol. Path. u. Ther. des Ohres, usw. I., 1908. 89-133. 
68 . Ueber die spastischen Stimmstorungen und ihre Be- 
handlung. Med. Bl.. XXVIII. 1905- 543 ff. 
69. . Sprachstorungen und Rhino-Laryngologie. Zeits. f. 

Laryngologie, I., 1908. 97-99- 
70. . Ueber die Bedeutung des Vibrationsgefiihls fiir die 

Stimmbildung Taubstummer und Schwerhoriger. Monats. f. 

Sprachheilkunde, XVIL, 1907. 59 ff. 



252 FLETCHER 

71. . Zur Frage der gegenseitigen Beziehung zwischen 

Bauch- und Brustatmung. (Verhandl. d. XX. Congresses f. 

innere Med.) Monats. f. Sprachheilkunde, XVIII., 1908. 223 ff. 
7^. Hall, G. Stanley. Educational Problems. New York, 191 1, 

II. 714 pp. 
y:i. . A Study of Fears. Amer. Jour. Psychol., VIII., 

1897. 147-249. 

74. Halle, . Ueber Storungen der Atmung bei Stotterern. 

Monats. f. Sprachheilkunde, X., 1900. 225-236. 

75. HoEPFNER, T. Psychologisches iiber Stottern und Sprechen. 

Zeits. f. Psychotherapie u. med, Psychol. III., 191 1. 264-289. 

76. . Stottern als assoziative Aphasie. Zeits. f. Patho- 

psychol., I., 1912. 449-552. 
77. HoRNiG, Reinhold. Untersuchungen iiber das Wesen und Heilung 
des Stotterns. Monats. f. Sprachheilkunde, XIX., 1909. 157- 
160; 183-192. 

* 78. Hunt, James. Stammering and Stuttering. London, 1865. 
258 pp. 

- 79. Ibershoff a. E. On the Nature, Causes, and Treatment of Stut- 
tering, etc. Med. Brief. XXXVI., 1908. 202-208. 

80. Ives, M. J. Illustrated Phonetics. New York, 1909. 132 pp. 

81. Janet, Pierre M. F. The Major Symptoms of Hysteria. 

(Trans.) New York 1907. 345 pp. 

82. Jones, Ernest. Zwei interessante Falle von Versprechen. 

Zentralbl. f. Psychoanalyse, II., 191 1. 33-34. 

83. KiESOW, F. Versuche mit Mosso's Sphygmomanometer iiber die 

durch psychische Erregungen usw. Phil. Stud. XL, 1895. 
41-60. 

84. KoEHLER, W. Akustische Untersuchungen I. Zeits. f. Psychol., 

LI v., 1910. 241-289. 

85. Krause, F. Horen und Sprechen. Coethen, 1905. 198 pp. 

86. Kussmaul, Adolf. Die Storungen der Sprache. Vierte Aufl., 

von H. Gutzmann. Leipzig, 1910. 409 pp. 

87. Langfeld, Herbert Sidney. Suppression with Negative Instruc- 

tion. Psychol. Bull., VII. 1910. 200-208. 

88. Langwill H. G. Stammering and Its Treatment. The Practi- 

tioner, LXXXV., 1910. 568-582. 
89. . A Plea for the Scientific Treatment of Stammering. 

Rev. Neur. and Psychiatry, V., 1907. 259-280. 
90. Laubi, Otto. Ein Fall von Psychoanalyse bei einem erwach- 

senen Stotterer. Monats. f. Sprachheilkunde, XXL, 191 1. 

62-72; 111-118. 
91. . Psychische Einfliisse bei der Aetiologie und Behand- 

lung des Stotterns. Monats. f. Sprachheilkunde, XVII. , 1907. 

411-418. 
92. Legel, O. Die Sprache und ihre Storungen, usw. Potsdam, 

1905. 322 pp. 
93. . Des Kindes Sprachstorungen {Stottern, Stammeln, 

Lispeln, usw.) und ihre Heilung. Potsdam, 1908. 222 pp. 

94. Leroy, E. B. Le langage: essai sur la psychologie normale et 

pathologique de cette fonction. Paris, 1905. 293 pp. 

95. Liebmann, a. Vorlesungen iiber Sprachstorungen. Berlin, 1906. 

132 pp. 

96. Maas, Paul. Die Sprache des Kindes und ihre Storungen. 

Kinderfehler, XV., 1909-10. 32 ff. 



AN EXPERIMENTAL STUDY OF STUTTERING 253 

97. MacCready, E. B. The Relation of Stuttering to Amusia. 

Jour. Amcr. Med. Ass'n., LV., 1910. 208 ff. 

98. Makuen, G. Hudson. Nomenclature of Defects of Speech. 

Laryngoscope, XX., 1910. 1070-1073. 
99. . What the Laryngologist may do for the Correction 

of some of the more common Forms of Speech Defects. Tr. 

Amer. Laryng., RhinoL, and Otol. Soc, 1904-5. 81-88. 
100. . What Shall We Do with the Stammerer? Intemat. 

Med. Mag., XII., 1903. 728-730. 
101. . An Unusual Form of Stammering. St Bartholomew 

Hasp. Report, XLL, 1906. 534 ff. 
102. . The Physiology of Language and its Relation to the 

Treatment of Stammering. N. Y. Med. Jour., LXXXIV., 1906. 

1261-1263. 
103. . A Brief History of the Treatment of Stammering. 

Phil. Med. Jour., XIII, 1909-10. 191-197. 

104. Marbe, K. and Seddig, M. Untersuchungen schwingender Flam- 

men. Annalen d. Physik (IV. Folge), XXX., 1909. 579-592. 

105. MentZj Paul. Die Wirkung akustischer Sinnersreize auf Puis 

und Athmung. Phil. Stud., XL, 1895. 61-124; 371-393; 563- 
602. 

106. Meumann, E. Die Sprache des Kindes. Ziirich, 1903. 82 pp. 
107. . Vorlesungen sur Einfiihrung in die experimentelle 

Pddagogik, II. Aufl. Leipzig, 191 1, I., 726 pp. 

108. Mieleche, a. Ueber Stottern als padagogische Fehler usw. 

Monats. f. Sprachheilkunde, XVIL, 1907. 364-370. 

109. MoTT, F. W. The Brain and the Voice in Speech and Song. 

New York, 1910. 112 pp. 
no. Nagel, W. Handbuch der Physiologic des Menschen. Braun- 
schweig, 1909, IV. 992 pp. 

111. Neuhoff, J. Das Stottern und andere Sprachfehler. Leipzig, 

1908. 35 pp. 

112. Neumann, A. Ueber Sprachstorungen und Stottern betm Schrei- 

ben. Graz, 1893. 94 pp. _ 

113. Oltuszewski, W. Psychologic und Philosophic der Sprache. 

Berlin, 1901. 70 pp. 

114. Peterson, F. and Jung, C. G. Psychophysical Investigations 

with the Galvanometer and Pneumograph in Normal and In- 
sane Individuals. Brain, XXX. 1907. 153-218. 

115. Pillon, F. La memoire affective: son importance theoretique 

et pratique. Rev. phil, LI., 1901. 1 13-138. 

116. Radecki, W. Recherches experimentelles sur les phenomenes 

psycho-electriques. Arch, de psychol., XL, 191 1. 209-293. 

117. Reichhardt, M. Die seelischen Hemmungserscheinungen des 

Stotterns: Eine pddagogisch-psychologische Studie. Leipzig, 
1903. 27 pp. 

118. RiBOT, Th. The Psychology of the Emotions. (Trans.) New 

York, 1897. 455 PP- 

119. RiCKSHER, C, and Jung, C. G. Galvanic Phenomena and Respira- 

tion. Jour. Abn. Psychol., XL, 1907-8. 189-317. 

120. RouMA, G. Enquete scolaire sur les troubles de la parole chez 

les ecoliers beiges. Intemat. Archiv f. Schulhygiene, II., 1906. 
151-189. 

121. RoussELOT, P. J. Phonetique experimentale. Paris, 1908. 

1252 pp. 



254 FLETCHER 

122. Sarbo, Arthur von. Maladie des Tics und die damit in Ver- 
bindung stehenden Sprachstorungen. Monats. f. Sprachheil- 
kunde, XVII, 1907. 178-183; 205-210. 

123. . Die hysterischen Sprachstorungen. Monats. f. Sprach- 

heilkunde, XVII., 1907. 97-106; 140-149. 

124. ScHAEFER, E. A. Text-Book of Physiology. N. Y., 1898, II, 

1365 PP 

125. Scripture, E. W. The Treatment of Negligent Speech by the 

General Practitioner. Med. Rec, LXXIV., 1908. 257-260. 
126. . The Treatment of Stuttering. Med. Rec, LXXI., 

1907. 771 ff. 
127. . The Treatment of Hyperphonia (Stuttering and 

Stammering) by the General Practitioner. Med. Rec, 

LXXIIL, 1908. 480-481. 
128. . Penmanship Stuttering. Jour. Amer. Med. Ass'n., 

LIL, 1909. 1480-1481. 
129. . Stammering : Its Nature and Treatment. Synopsis of 

Lecture before Boston Soc. of Neurol, and Psychiatry. Bos- 
ton, May 10, 1912. 

130. Sherrington, C. S. The Integrative Action of the Nervous Sys- 

tem. New York, 1906. 411 pp. 

131. SiDis, B. The Galvanic Phenomena. Psychol. Bull. VII., 1910. 

321-322. 
132. . The Nature and Causation of the Galvanic Pheno- 
mena. Psychol. Rev., XVII., 1910. 19-36. 

133. SiDis, B., and Kalmus, H. T. The Study of Galvanometric De- 

flections. Psychol. Rev., XV., 1908. 391-396. 

134. Smith, Theodate L. On Muscular Memory. Amer. Jour. 

Psychol, VII., 1895-6. 453-490. 

135. Starch, D. Mental Processes and Concomitant Galvanometric 

Changes. Psychol. Rev., XVII., 1910. 19-36. 

136. Stekel, William. Nervose Angszustdnde und ihre Behandlung. 

II. Aufl. Berlin, 1912. 448 pp. 

137. Thumb, A. Die experimentelle Psychologie in Dienste der 

Sprachwissenschaft. Marburg, 1909. 13 pp. 

138. Titchener, E. B. a Text-Book of Psychology. New York, 

191 1. 565 pp. 

139. Tomor, Ernest. Die Rolle der Muskeln beim Denken. Archiv. 

f. d. ges Psychol., XVII., 1910. 362-366. 

140. VAN DER ToRREN, J. Das normale Verhoren, Versprechen, Ver- 

lesen, und Verschreiben, nebst ihren Beziehungen zur Path- 
ologic. Zeits. f. d. ges. Neurol, u. Psychiatric, IV., 1911-1912. 
657-678. 

141. Town, Clara Harrison. Congenital Aphasia. Psychol. Clin., 

v., 191 1. 167-179. 

142. Troemner, E. Zur Pathogenese und Therapie des Stotterns. 

Wien. klin. ther. IVoch. XII., 1905. 189-196; 219-223. 

143. . Ursachen und Handlung des Stotterns. Deutsche 

Med. Woch., XXX., 1904. 1336 ff. 

144. Varendonck, J. Phobies d'enfants. Rev. Psychol, III., 1910. 

5-45- 

145. Wells, F. L., and Forbes, A. On Certain Electrical Processes in 

the Human Body and Their Relation to Emotional Reactions. 
Archives of Psychol, II., No. 16, 1911. 1-39. 

146. Wundt, William. Volkerpsychologie: Die Sprache. Berlin, 

1911. 695 pp. 



AN EXPERIMENTAL STUDY OF STUTTERING 255 

147. Wyllie, John. The Disorders of Speech. Edinburgh, 1894. 

495 pp. 

148. Zahn, Th. Ueber die Ursachen des Stotterns. Monats. f. 

Sprachheilkunde. XXL, 191 1. 149-158. 

149. ZoNEFF, P., and Meumann, E. Ueber Begleiterscheinungen 

psychischer Vorgange in Athem und Puis. Phil. Stud., 
XVIIL, 1902. 1-113. 

150. ZuND-BuRGUET, A. fitude physiologique et pratique sur les 

troubles externes ou mechaniques de la parole. Arch. Internat. 
de Laryng., XIX. 1905. 486; 825; XX., 1906, 856 flf.; XXL, 
1907. 186 ff. 
(Since the completion of this study two books have appeared that 
should be added to the above list.) 

151. Bluemel, C. S. Stammering and Cognate Defects of Speech. 

New York, 1913. 2 v. 

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 showring 
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 vip 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. 

Pl.\te 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, /3 to ;'. 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. 



14 DAY USE 

RETURN TO DESK FROM WHICH BORROWED 

neiQcv umm 

This book is due on the last date stamped below, or 

on the date to which renewed. 

Renewed books are subject to immediate recall. 


MAR 14 1966 








7Mr'66SH 




AUG 25 1970 




AUG 2 6 1970 7 






































j 


LD21-40rr,.5.'6- ,, . Genial Library 
(Fi3n- ■ ■ ~ r University of Cahrornia 

Berkeley