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For several years we have been carrying on in our Iowa Speech Clinic laboratories research in the field of speech pathology. We have utilized largely physical equipment to record the particular reactions we were studying. We have found that the stutterer presents definite functional neuromuscular derangements during stuttering and differs from the normal speaker in certain neuromuscular functions not directly related to speech But we have not paid much attention to the so-called subjective or personal aspect of the stutterer's difficulty. He was not asked to tell us anything about his views of the organic disturbances which accompanied his speech efforts. The point is that we sought and secured strictly objective instrumental determinations of the various abnormalities.
It seems to us, however, that now we have gone far enough towards the solution of certain problems by the instrumental method to take account profitably of the subjective or personal side of the stutterer's speech disorder. Other workers have considered after a fashion this phase of the problem in securing introspective data from their subjects at the time of examination to serve as supplementary material. Our aim is somewhat different We wish to secure the stutterer's statement of his own reactions to his stuttering organism
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and to society from the earliest incident of recall to the present moment.
We are very fortunate in having an ideal combination in Mr. Wendell Johnson, who is a stutterer with training in psychology and in writing. In addition, he has served for three years as a subject in numerous objective studies of stuttering and has been one of a large group subjected to corrective treatment for stuttering. Over half of this group of stutterers have recovered completely or shown marked improvement. At the present time Mr. Johnson enjoys a large measure of speech freedom. His improvement and the complete relief of others are the result of a certain type of training, based upon the concept that stuttering is a definite neuromuscular derangement of the functional type in which there is a general reduction in cortical activity. This reduction in cortical activity is due to transient and mutually inhibitive activities of the associative areas of the right and the left cerebral hemispheres. In the stutterer, instead of nervous energy flowing into one center of greatest facility in transmission, it flows into two centers of equal facility in transmission, which function in reaction patterns of opposite orientation and configuration to produce in the peripheral speech organs simultaneous or alternate opposition in muscular movement. The symptoms of stuttering are mainly signs of the rivalry between the two sides of the brain. They are of two kinds: those, such as tonic blocks, which show evidences of the simultaneous activity of two centers of opposite sign; and those, such as prolonged inspiration, the interruption of expiration, and clonic blocks, which indicate
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the alternate activity at two centers of opposite sign.
The neurological basis of stuttering, which is a lack of a sufficiently dominant center of activity, is a functional variant. We may think of its existence in terms of a margin of dominance which exists in range from zero amount to a very large and safe amount in different individuals. If the margin is small, stimuli of slight emotional value and conditions which bring about small amounts of physical and mental fatigue will produce the stuttering. If there is zero amount of dominance, we have the stutterer who stutters under all conditions--in the quiet of his room as well as in a social situation. If the margin is large, we have the normal speaker under practically all physical and mental conditions.
The causes of a lack of dominance in one or the other of the two cerebral hemispheres--and consequently of stuttering--may be considered under two heads: heredity and environment. A certain number of children are born with no potentialities for the development of one center of hyper-excitability and hyper-irritability--the dominant center--or with only a very slight neuro-physiological bias in favor of a left-handed development which will be opposed by a right-handed environment. They generally stutter from the beginning. Others possess a natively dominant center which would warrant normal speech development were it not interfered with through birth injuries, physical diseases, emotional shocks, and educational practices which favor the shifting of left handed children to the use of the right hand. The dominant center is the most easily affected by such
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disturbing factors because it is the center of greatest susceptibility to all kinds of environmental stimuli.
In the corrective treatment of stuttering the sole aim is to build up or establish a single dominant center of activity in the one or the other of the two cerebral hemispheres. This is accomplished in the main by the development of a dominant motor lead through one side of the body. If careful laboratory examinations reveal that the motor facility as determined by training is out of harmony with the native physiologic leads, the attempt is made to reestablish the native physiologic leads through training designed for that purpose. In a great number of cases this corrective training consists in having the individual return to the use of the left hand in all major manual functions, especially writing. The details of this training are too involved to be adequately presented here.
Although Mr. Johnson came to us as a "right-handed" individual, we have attempted, on the basis of laboratory findings, to make of him a thoroughgoing left-handed person. It is in connection with the laboratory work and his remedial training that he has prepared his subjective and personal side of the story. In certain instances it supports the instrumental findings and completes the picture. In other instances it opens up new problems and suggests new lines of approach. One of the most obvious contributions involved in Mr. Johnson's study is its forceful opposition to many of the ridiculous theories held in certain quarters and its attack upon the neglect and misconception so characteristic of the popular attitude towards stutterers. Its chief value, probably, is to give
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parents and teachers an appreciation of the stutterer's real self--the feeling, sensing self which is so often ignored. Mr. Johnson's emphasis on the importance of this very point is not overdone. Our knowledge of the personal feelings of dozens of stutterers convinces us that he has expressed a common attitude among those of his type of disorder.
We wish to recommend heartily the value of the book as an original production for study by psychologists and psychiatrists; and we wish to emphasize its importance to parents and teachers who are concerned with the care of stuttering children. But, over and above the contribution of this little book to psychology and speech pathology, it stands as a memorable human document. In telling of the role that stuttering has played in his life, in the development of his personality, the author touches on a theme which is of keen interest to the public generally. To a subject which has been strangely neglected--the place of the stutterer in a glib society--he has given the weight of vital interest and significance.
Lee Edward Travis
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