1 1". I l« FIRST SETMES NO. 39 DECEMBER 15, 1920 UNIVERSITY OF IOWA STUDIES STUDIES IN CHILD WELFAEE VOLUME I NmiBER 3 A PRELIMINARY STUDY IX CORRf:CTI\ E SPEECH bv SARA ^\. STINCIIFIELD PUBLISHED BY THE UNIVERSITY, IOWA CITY Issued semi-monihly throughout the vear. Entered at the post office at Iowa City, Iowa, as seciiiid class matter. Acceptance for mailing at special rates of postage providcfl for in section IIO;'., Act of October 3, 1917, authorized on July 3, 1.918 LEASE HANDLE WITH CARE University of Connecticut Libraries GAYLORD RG t5h UmVEESITI OF IOWA STUDIES Hz^ IN CHILD WELFAEE hZ^ Professor Bird T. Baldwin, Ph. D,, Editor FROM THE IOWA CHILD WELFARE RESEARCH STATION VOLUME I NUMBER 3 A PRELIMINAEY STUDY IN COERECTIVE SPEECH by SARAM. HcKwV^;, . PUBLISHED BY THE UNIVEESITY, IOWA CITY STUDIES IN CHILD WELFARE Pages 1. The Physical Groivth of Children from Birth to Maturity, by Bird T. Baldwin (in press) 250 2. A Survey of Musical Talent in the Public Schools, by Carl E, Seashore 36 3. A Preliminary Study in Corrective Speech, by Sara M. Stinchfield 36 4. An Analytic Study of a Class of Five and Six Year Old Children, by Clara H. Town (in press) 100 5. Investigations in the Artificial Feeding of Children, (reprints) by Amy L. Daniels, Albert H. Bypield, and Rosemary Loughlin 24 6. Child Legislation in Iowa, by Frank C. Horack 40 UNIVERSITY EXTENSION BULLETINS BY MEMBERS OF RESEARCH STATION STAFF 57. Diet for the School Child, by Amy L. Daniels 59. The Physical Growth of the School Child, by Bird T. Baldwin 65. Feeding the Baby, by Amy L. Daniels and Albert H. Byfield School Lunches (in press), by Amy L. Daniels Diet Card (in press), by the Staff CONTENTS Editok's Foreword 5 Introduction 7 Observations on University Observational School Pupils . 8 A Tentative Classification and Analysis of Defective Speech Conditions and Causes op Speech Disorders . . 9 A Keport of Two Type Cases with Outlines of Remedial Treatment, Training and Results 18 Materials for Speech Examination 27 Materials for Phonographic Test Records 30 Sample Speech Drill Charts 32 Selected References 35 EDITOR'S FOREWORD This study presents in a practical manner a brief analysis of some common speech defects among young children, with remedial sug- gestions in the form of special exercises. A more detailed account of consecutive work with two stutterers shows the significance of nutrition, orthodontic treatment, environment, mental attitude, in- tellectual status and systematic training. No attempt has been made to give an anatomical description of the speech organs or an exhaustive treatment of the causes of speech defects. The selected references are limited to those bearing di- rectly on the practical problems of corrective speech. This mono- graph is a portion of a dissertation presented by the writer in partial fulfillment of requirements for the degree of Master of Arts in child welfare. Miss Stinchfield's work has been made possible through the cor operation of the divisions of the Research Station, the Department of Psychology, the Colleges of Medicine, Dentistry and Education, and the Department of Public Speaking. Bird T. Baldwin Office of the Director Iowa Child Welfare Eesearch Station University of Iowa, Iowa City September, 1920 A PEELIMINAEY STUDY IN COKRECTIVE SPEECH I. INTRODUCTION The greatest progress in the acquiring and perfecting of a technique of speech is made, as a rule, by a child from the sixth month to the end of the third year of age. The quality of the child 's environment and the training in these early years is of special sig- nificance to the investigator in speech development. Young animals make noises as an instinctive response to environ- mental or internal stimuli and babies indulge in vocalization in the same way in which they reach and grasp for objects or ceaselessly move their eyes from place to place. Certain of these chance sounds resulting from accidental positions of the baby's vocal organs tend to be reproduced because of pleasant results of either approval and admiration of its efforts or satisfaction of its wants. Gradually these sounds become associated with the objects or activities which they represent. The sounds which shall become attached to an object depend on the language environment of the child. One child may come to associate the sound "bow wow" with a dog, another will say "doggie", and a third may say "woof woof", depending largely on which name tends to become fixed as a result of parental approval. Children frequently develop a language of their own, intelligible only to themselves or to their playmates. "When this mode of speech has once become established, it takes careful train- ing to develop more desirable speech habits. Hand in hand with growth in control of the speech mechanism goes the development of normal speech so that between the fifth and sixth years, or by the time the child enters school, the early infantile habits of erroneous articulation should be outgrown. When "infantile speech" (baby talk), or indistinct, poorly articu- lated speech persists into the fifth year, there are underlying causes which may be organic and functional, of which the speech disturb- ance is only an indication. These causes may be classed as organic 8 IOWA STUDIES IN CHILD WELFARE if the disturbances of the speech mechanism are due to physical defects such as malformations of the palate or uvula, paralysis or atrophy of nerves and muscles ; or functional if there is apparently no defect of structure but an interference with the normal action of the speech mechanism due to such causes as insufficient imagery, neurotic disturbances, or similar conditions. The distinction is an arbitrary one and is made only for purposes of further analysis and classification. In order to obtain an empirical basis for corrective speech work, a preliminary study was made with one hundred thirteen children in the first six grades of the University Elementary School of the State University of Iowa, supplemented by observations on three hundred children in the public schools of Pittsburgh, Pennsylvania. The results make it possible to present at this time, a tentative classification of some of the common faulty speech conditions and causes of speech defects. As examples of the possibilities of the methods in remedial treatment, two type cases of stuttering from Iowa public schools are discussed in detail. A scale or method for speech examination is appended, together with a list of selected references. II. OBSERVATIONS ON UNIVERSITY ELEMENTARY SCHOOL PUPILS The procedure in the University Elementary School consisted in : (1) tests to discover individual speech disorders; (2) the immediate correction of minor defects through training; (3) educational, med- ical or orthodontic treatment, in cooperation with the teachers. University specialists, and the home. Among the children examined there were forty-five cases where organic conditions were responsible for the defect. In fifteen addi- tional cases the speech difficulty seemed to have a functional cause such as nervous instability. In ninety-three cases, this number in- cluding, of course, some of the cases of the first two classes, there was a functional disturbance evidenced by poor speech habits. Table I gives the distribution of the types of speech inaccuracies throughout the grades surveyed. PRELIMINARY STUDY IN CORRECTIVE SPEECH 9 TABLE I Distribution of Organic and Functional Speech Defects Among One Hundred Thirteen Elementary School Pupils I. Organic II. Functional No. of A, Nervous B. Incorrect Pupils Grade Instability Speech Habits in Grade I 5 2 10 12 II 6 2 13 15 III 7 1 15 19 rv 11 3 23 25 V 6 2 10 16 VI 10 5 22 26 45 15 93 113 The chief indications of inadequate speech development in the order of the frequency of their occurrence among these children were: tone monotony, poor enunciation and articulation, slurring (omission of sounds), marked mispronunciation, inaudibility, "sluggishness" (excessive slowness), nasality, lisping, faulty res- piration, ''cluttering" (excessive rapidity), stuttering (repetition of syllables), and "throaty" tones. A group of twenty-five children most in need of corrective work were selected for special class training in speech with good results in the elimination of the more common faults. III. A TENTATIVE CLASSIFICATION AND ANALYSIS OF DEFECTIVE SPEECH CONDITIONS AND CAUSES OF SPEECH DISORDERS CLASSIFICATION A. Defective Control of Breath Speech conditions Breathing on an inspiration instead of an expiration "Breathy" tones Spasmodic movements of diaphragm, glottis, and larynx Causes Adenoids Diseases of naso-pharynx, nasal septum, sinus infection Hypertrophied tonsils Poor posture General physical debility Nervous conditions affecting the breathing mechanism 10 IOWA STUDIES IN CHILD WELFARE B. Defective Articulation Condition: Mispronunciation Causes Malformations of oral cavity Thickened tongue Interdental spaces Inaccurate tongue position Paralysis of parts of peripheral speech mechanism Defects of peripheral sensory mechanism, especially visual and auditory Central defects in motor, sensory, perceptual or imaginal areas Functional nervous disturbances Wrong habits of speech Defective mentality Condition: Echolalia Causes Defective mentality Infantile speech habits Condition: ''Sluggishness" Causes Physical debility Malnutrition Adenoids Hypertrophied tonsils Defective mentality Nervous disorders Condition : ' ' Cluttering ' ' Causes Nervous disorders and psychical condition Incorrect speech habits Condition: Stuttering and stammering Causes General physical debility Shallow breathing Nervous disorders Psychotic condition C. Defective Vocalization Condition: Complete absence of speech or absence of special tones PRELIMINARY STUDY IN CORRECTIVE SPEECH 11 Causes Paralysis of parts of peripheral speech mechanism — lips, tongue, larynx, palate, or vocal cords. Lesions in central areas — motor, imaginal, association — or in projection fibres, or in lower nuclei Deafness Functional nervous disorders Psychotic condition Condition: Nasality Causes Cleft palate Hair lip Adenoids Deflected septum Laryngeal or palatal paralysis Persistence of wrong habits of speech Lack of use of nasal passages Condition: Monotony Causes Cleft palate Adenoids Deflected septum Infected tissues Peripheral or central defects in nervous mechanism Psychotic conditions Condition: Hoarseness, harshness Causes Defect of vocal cord Local inflammation Condition : ' ' Throatiness ' ' Causes Elongated uvula Thick tongue Hypertrophied tonsils "Wrong habits of speech Condition: Non-sihilant or high pitched voice Causes Shallow breathing Defect of vocal cord Thymus and thyroid disease Local inflammation 12 IOWA STUDIES IN CHILD WELFARE ANALYSIS OF DEFECTIVE SPEECH CONDITIONS AND CAUSES A. Defective Control of Breath One of the most important factors in defective speech is poor control of breath during speech. This lack of control is both a symptom of disturbed speech functioning and a cause of further speech disorders. Under normal conditions the motor response to the speech impulse is immediate and accurate. Through habit formation the child gradually gains control of the muscles of tongue, lips, uvula, and larynx until the process of phonation has become automatic and effortless. Speech disorders are almost always asso- ciated with disturbances in the normal smooth working of this process. A common cause of faulty respiration is the obstruction of the respiratory passages by adenoids, hypertrophied tonsils and thyroid glands or inflamed tissues. Other contributory causes are : poor posture, general physical debility, and functional nervous con- ditions affecting normal breathing. If automatic breathing is thus interrupted the child speaks in a jerky manner, attempts phonation on an inspiration instead of an expiration, or produces gasping or ' * breathy ' ' tones, in which the breathing sounds are distinctly audi- ble. In extreme cases these conditions are accompanied by spasms of the diaphragm, rapid pulse, throbbing arteries and great mental excitement, sometimes with fear. The development of breath con- trol is therefore regarded by most authorities in the field of speech and song as the first point of attack for the correction of voca) defects. B. Defective Articulation Mispronunciation Under the head of mispronunciation may be classed a variety of symptoms due to a number of causes. The common characteristic of these cases is the fact that the word as articulated does not cor- respond to the printed word or to the correct sound. Mere in- ability to read fluently can scarcely be classed as a speech difficulty. There are, nevertheless, cases of children who habitually speak with ease but hesitate and become confused when confronted with the printed page. Another more serious condition is lisping, which is defined by the majority of authorities in the field of speech as the substitution of other sounds for s, z, sh, and zh sounds as they PRELIMINARY STUDY IN CORRECTIVE SPEECH 13 occur in various combinations. Frequently the fullness and dis- tinctness of normal enunciation gives place to a blurred effect. The child may be able to produce the individual sounds of all con- sonants accurately, but slurs and alters them when they "occur in combinations. Under the term ''blurred enunciation" are classified the production of indistinct initial, middle or final letters, inaccu- rate prefixes, diphthongs and consonant combinations, and the drop- ping of syllables. Another class of mispronunciations includes cer- tain aphasie conditions in which there is distortion of words, trans- position of syllables or phrases, or utterance of meaningless combi- nations of words and sounds. The babbling and lalling of infants and of adult idiots are similar meaningless combinations of sounds, due, however, to different causes. The causes of mispronunciation are both organic and functional ; in fact, so closely are causes related in most cases that it is fruitl^s to attempt to assign to each its share in producing the defect. A common cause of mispronunciation is the poor shape and size of the oral cavity, resulting from malocclusion, high palate, inter-dental spaces, thickened tongue, or incorrect placing of tongue with dis- tortion of the space through which the air must pass for correct articulation. Lisping is especially apt to occur under these condi- tions. Mispronunciation will also occur if there is paralysis of the muscles and nerves governing the peripheral speech mechanism. For example, a paralysis of the facial nerve on one side will make it impossible for both sides of the mouth to act coordinately in shaping certain letters. Any deficiency in the peripheral sensory mechanism will also be reflected in faulty pronunciation, since accurate per- ception is the basis for a correct concept. A child who is myopic mispronounces letters he does not clearly see; a child who hears only certain tones mispronounces words he has only partially heard. In both cases a false concept is formed as a basis for future mis- pronunciation. Correction of these defects of the sense organs is possible. This is not true, however, with another class of causes in which there are central defects in the motor, sensory, perceptual or imaginal areas that render impossible the correct apprehension of a word and the execution of the vocal act. The same defect is pro- duced by functional nervous disturbances of these centers. Incor- rect speech habits, sometimes as a result of imitation, are another frequent source of mispronunciation, A combination of organic 14 IOWA STUDIES IN CHILD WELFARE disabilities and incapacity for rapid formation of correct habits would account in large measure for the mispronunciation and other types of speech defect commonly observed in mental deficiency. The speech of the mentally deficient child varies from an in- ability to pronounce numerous consonants, to unintelligible speech of a babbling or of a laUing type. There is frequently a misappli- cation of words, inability to recall the appropriate word, imperfect arrangement of sentences or slurred, hesitating and indistinct speech. Speech usually develops late in mental defectives. Idiots commonly have no speech at all. Imbeciles are able to understand and speak short sentences, but never acquire a large vocabulary or perfect articulation. Morons show fewer imperfections of articu- lation and a more extensive vocabulary, but are usually incapable of constructing or understanding a complicated sentence. It is recognized by authorities on feeble-mindedness that there is a dis- tinct relationship between the capacity for speech and the degree of mental defect. In fact, an early classification of mental defectives used the degree of speech development as a criterion for the amount of defect, those without speech being classed as idiots. This is un- wise, however, as the absence of speech may be due to some very different cause. In view of our modern knowledge of aphasia and similar disorders, it would be manifestly incorrect to class as idiots all children in whom speech is absent. Echolalia Echolalia is a peculiar form of verbal response seen in the lower grades of mental defect. In can be classed as a speech defect only because the subject does utter words. It has been explained as a symptom of an organic condition in which the lower nervous centers are abnormally permeable to the nervous discharge with the result that the incoming excitation is immediately transformed into an outgoing impulse without traversing the appropriate higher speech areas. Consequently, the child merely echoes words or phrases with no understanding of their meaning. Partial echolalia may appear and persist as an infantile speech habit in children who are not abnormal. *' Sluggishness" The normal speech of children is fairly energetic and smooth. PRELIMINARY STUDY IN CORRECTIVE SPEECH 15 Excessively slow and hesitant speech is usually associated with physical disabilities. The speech of many feeble-minded children, especially cretins, is frequently sluggish because of their general lack of energy and vitality, resulting in slow reactions. In normal children such sluggishness may be due to exhaustion after ilkiess, anaemia, or interference with proper respiration, because of the presence of adenoids and hypertrophied tonsils. Sluggish speech is also often manifest in nervous disorders or psychotic conditions such as dementia praecox, depressed states and the hysterias, ''Cluttering" In contrast to ''sluggishness" is the condition known as ''clut- tering," when there is excessive rapidity of utterance. The "clut- terer" is often a child of superior mentality whose thoughts run ahead of his ability to express them, with resulting faulty articula- tion because of the inability of the motor mechanism to keep pace with the speech impulse. In highly neurotic children who show this speech condition, the over-productiveness is associated with respira- tory difSculties, defects of vocalization such as shrillness, monotony, ■etc, and intense mental excitement. The treatment for these de- fects must be directed toward improving the general nervous condi- tion of the child and training him in good speech habits. stuttering Stuttering is difficult, unrhythmical speech characterized by spas- modic contractions of the entire oral mechanism and incoordination •of the respiratory, laryngeal, and oral muscles. The nerve centers are often so innervated that the individual is unable to phonate ■either momentarily or for a longer period. This condition may persist for several weeks. The accumulated energy which is not directed into the appropriate centers in the oral mechanism over- flows into centers controlling the muscles of eyes, face, chest and ^rms. Stuttering seems to be dependent on a congenital weakness of the speech organs ; some authorities believe that it may recur in several individuals in successive generations of the same family, A great many very young normal children show slight signs of stuttering, Iiowever, when they have not yet acquired sufficient control of the speech process to make it automatic. This is especially the case in ichildren of neurotic and emotionally unstable type. Indeed there 16 IOWA STUDIES IN CHILD WELFARE is an intimate connection between stuttering and strong emotion. Adults who have been cured of stuttering will suffer a relapse under great excitement and children will often manifest the first signs after a shock or fright. Any great physical strain, a severe illness, chorea, or pubescent changes will precipitate an attack in neurotic subjects who are predisposed to the disorder. In addition to being handicapped by nervous instability, or per- haps because of this defect, the stutterer generally suffers from a morbid mental state. He is typically introspective, hypersensitive, apprehensive, and seclusive. His speech disturbance makes him socially ill-adjusted and his unsocial tendencies serve to isolate him still further. Before speech and respiration exercises can be ex- pected to cause much improvement, the stutterer's whole mental attitude must be changed, his attention directed to external inter- ests, and his social personality developed. General physical up- building is of fundamental importance in the correction of stutter- ing, as of all speech defects of nervous origin, and usually brings an immediate improvement in the condition. C. Defective Vocalization Under the head of defects of vocalization are classed complete absence of speech and certain departures from the quality of the normal voice. Absence of power to speah results in some eases from lesions, dis- ease, or congenital defects producing paralysis of the parts of the peripheral speech mechanism — lips, tongue, larynx, and palate. A paralysis of a certain part produces a characteristic change in the vocal quality, due to the change in the aperture through which the air must pass, or to non-functioning of some of the vocal cords. Complete absence of speech results also from lesions in the central areas — ^motor, imaginal, associational — or in their projection fibres. The phenomena of aphasia resulting from such lesions have been too frequently described to bear repetition here. Absence of speech also occurs as a result of functional involvement of any part of these centers or of their pathways. Mutism is frequently consequent upon congenital or acquired deafness, since the child is not stimulated to imitate sounds which the hearing child experiences. For the deaf child special devices must be used in order that visual, tactual, and kinaesthatic imagery PRELIMINARY STUDY IN CORRECTIVE SPEECH 17 may serve as guides and awaken speech in a child bom deaf or pre- serve it from deterioration in one who has become deaf. Refusal to speak is a psychopathic manifestation frequently mis- taken for real inability to vocalize. A number of other changes in quality, not due primarily to paralysis, are discussed below. Nasality is frequently due to changes in the air passages result- ing from cleft palate or hair lip. Owing to the absence or shortness of the velum, the child is unable to shut off the opening into the" naso-pharynx during the emission of oral consonants, with a result- ing unpleasant quality in these tones. Nasality may also be due to deflection of the nasal septum which interferes with the reinforce- ment of tone by the resonance chambers of the head. So, also, adenoid growths blocking the naso-pharynx interfere with the nasal resonance. Nasality also results from certain forms of laryngeal and palatal paralysis. Frequently it is merely the result of habitual constric- tion of the throat and posterior nasal passages. Monotony. Absence of proper inflection and of pitch changes characteristic of the normal voice frequently occurs as a result of cleft palate, adenoids, deflected septum, or obstruction of the pas- sages by diseased tissue. Peripheral or central defects in the nervous mechanism are often responsible for the monotonous tones frequently observed in the speech of persons suffering from nervous and mental diseases. Hoarseness; harshness. Chronic pharyngitis, or "clergyman's sore throat", is one of the most common types of huskiness or hoarseness. The muscles of the pharynx become constricted in movement, inflamed and uncomfortable, modifying the vocal resonance. This may be due to extreme fatigue, long continued use of the voice under abnormal conditions, or to misuse of the voice. Other defects of the vocal cords may be responsible. Recurrent or persistent hoarseness is an indication of abnormal conditions neces- sitating medical examination. "Throatiness." A peculiar quality of the voice known as "throatiness" sometimes results from an elongated or hyper- trophied uvula, which interferes with the lingual sounds. Hyper- trophied tonsils or a thickened tongue will partly fill the resonance chamber, altering the timbre of the voice to produce this effect. A 18 IOWA STUDIES TN CHILD WELFARE habit of elevating the posterior portion of the tongue and pressing the soft palate against the posterior wall of the pharynx is another frequent cause of this unpleasant vocal quality. Non-sibilant voice. When no deformity or physical defect exists in the speech resonance chamberf!, a non-sibilant or high-pitched voice of unpleasing quality is frequently due to shallow breathing and respiratory disturbances. The attempt to speak with only residual air in the lungs, rather than upon a fresh inspiration, will produce such speech. It is also found that affections of the thymus and thyroid glands are associated with this type of speech. Atrophy, defect, or local inflammation of the vocal cords is capable of pro- ducing high pitched tones, lacking in richness and without the over- tones wTiich are found in the voice of lower pitch. It appears from this analysis that some speech defects are due to organic conditions such as paralysis, which are not subject to cor- rection. For children with other organic defects such as malforma- tion and obstruction in the air passages, the prognosis is favorable, provided these conditions are corrected. Children suffering- from functional conditions which may be classed as minor speech inaccu- racies due to incorrect habits, will respond to treatment and train- ing in a most satisfactory manner. A program for successful work in the correction of speech defects must include: (1) correction of physical defects and general physical upbuilding; (2) establishment of proper mental attitude: (3) speech training. As type studies of this mode of procedure there follow two cases. IV. A REPORT ON TWO TYPE CASES Type Case A In September, 1918, a ten year old boy who had been a stutterer since the age of three years, was brought to the Iowa Child Welfare Research Station for examination. As he was found to be in need of medical treatment, he was kept in his home in a small town in Towa for this purpose during four months, and then brought back to Iowa City for six months' observation and training. By means of numerous interviews, letters, and conversations with the boy himself, the staff of the Station gradually gained an insight into the child's background and personality. The boy had been physically feeble from infancy. While the PRELIMINARY STUDY IN CORRECTIVE SPEECH 19 family history showed no grave abnormalities, it did reveal a neuro- pathic strain. In a maternal uncle and in the boy's only sister, a girl nineteen months his senior, appeared the same tendency to stuttering that handicapped the boy. The boy 's mother, though an intelligent woman, who had taught school for a number of years before her marriage, was of a nervous and introspective type. John's habitual emotional tone was low; he did not care to play with other hoys of his age with whom he could not compete on ac- count of his lack of strength, and he was extremely sensitive to criticism and very much aware of his disabilities. Anthropometric measurements showed that John did not vary- greatly from the average for his age ; the height, weight and breath- ing capacity were slightly below the normal. The boy appeared malnourished and was very easily fatigued. Although the tonsils and adenoids had been removed (and cir- cumcision performed after the boy's preliminary examination at the Station), it appeared from the report of the University Hospital that his general condition was still poor. He showed the effects of rickets in infancy. At the time of examination, there was present a latent tetany and chronic indigestion, which seemed to be con- nected partly with his habits of eating large amounts of a poorly balanced diet, and partly with his poor mastication as a result of dental deformities. The University dental clinic found that he suffered from malocclusion and marked protrusion of the upper teeth, both upper and lower arches being narrower than is normally the ease. This dental condition contributed to his speech defect. Nasal obstruction had been removed, but the boy still had poor control of the breathing apparatus; there was marked spasmophilia of the respiratory and facial muscles during speech, with some involve- ment of the frontal muscles and protrusion of the eyeball. His specific stuttering difficulties were with the production of the vowels a, 0, u, in initial positions and with certain consonants at the begin- ning of words; stuttering took place upon practically every con- sonant when used as an initial letter. During protracted stuttering the hypertonicity of the speech mechanism communicated itself to the muscles of the arms, head, and trunk. The speech defect was associated with much forgetfulness and frequent mental confusion, resulting in a blocking of the speech 20 IOWA STUDIES IN CHILD WELFARE centers and peripheral speech mechanism under excitement. Under favorable circumstances, a mental rating was obtained which showed John to be of average intelligence with a Terman I, Q. of 103. Other psychological tests, undertaken because of their pos- sible bearing on the speech problem, revealed normal audition but an exceedingly poor functioning of imagery. It seemed evident that the first step in overcoming the speech difficulty was to improve the boy's general condition and provide a better environment. Arrangements were accordingly made to have him board in Iowa City in a family where there were two active boys whose companionship would prove beneficial. A schedule was made for each hour of the day in order that the boy might acquire better habits of living. Diet was carefully regulated, proper amount of rest insured, and healthful outdoor exercise encouraged. A rec- ord of weight was kept and the appended weight curve plotted. Orthodontic work was undertaken at the University Clinic to correct the malocclusion. John was not allowed to attend afternoon school but rested for a period after dinner and was then given special speech training. This included tongue and mouth gym- nastics, breathing exercises, harmonic gymnastics, drill on difficult sounds, together with general work to improve speech melody and inflection and to increase range and volume of tone. A special effort was made through dramatization, playing store and using the telephone, to establish self-confidence. Phonographic records were made of the boy's speech twice a month so that the gradual elimina- tion of stuttering could be studied. As part of John's difficulty in speech seemed to be connected with his introverted habit of mind, an attempt was made to overcome his morbid tendencies by having him come to the laboratory regularly to talk over his problems and acquire a more wholesome attitude toward life. It was understood from the beginning that the complete rehabili- tation of this boy would require a very long period of close super- vision in a controlled environment. Nevertheless, the corrective measures undertaken for even these few months, produced a meas- ureable result as is shown by the appended curves and photographs of his progress in overcoming speech difficulties, increasing his weight, and obtaining more normal occlusion. The accompanying weight curve shows in an interesting way the PRELIMINARY STUDY IN CORRECTIVE SPEECH 21 lbs. 61 30 7S 76 77 76 7S 74 73 72. 7/ ,, .. — .. Two sessions of behoof. — — (?/?« School ■Sassion , Forqoi to Drink Milk , £xi»nsivt Oarfal Treatment, —•'■— After refurn home , when taking Cod Liver Oil, / s f '"*^, / b^ , ,x> \ ^/ .^^ •"-c"' 1 \ / C 1 \ / - J \: P -0 cy' 10 M ZO to 10 SO 10 20 30 IQ HO 30 10 Jan. Feb. Inarch April M^ij Weight-eurve — John £0 30 10 June 20 30 /o go JO Jul If ■effect of the prevention of excessive fatigue, of special additions to diet, of dietary disturbances, and of irritability due to dental treat- ment — each such disturbance resulting in a loss of weight. As a result of improved assimilation of food consequent upon better liv- ing conditions and dental care, growth in weight was considerably stimulated. The record of phonographic speech errors shows similar fluctua- tions. In general, there was a reduction of stuttering errors from fifteen in the first record to none in the record taken at the end of four months. When the dental appliance was first placed in the mouth, the errors again increased, but they were practically elim- inated after six months' treatment. The great improvement in the shape of the dental arches is shown by the appended photographs of the casts made of John's teeth before and after treatment, including a period of ten months. In view of his generally improved condition, it was thought not inadvisable for him to return home provided occasional visits were made for further orthodontic work and re-examination at the Child Welfare Station. Up to the present time there appears to have 22 IOWA STUDIES IN CHILD WELFARE o 10 AHend/ng one Sess/ori o-f School , Frequenf Denial Treafn)enf leodinq to Fixture, of Appliance^, Child Taking- Cod Liver OH. (Sehf homa June. lOth.) K \ \j s \ \ \ \ 1 / \ \ \ ^ S r/ \ Si^ y^ ,:j -e J( /(. ■) 4 ,?. /< 7 £ -3 n ■> £ Ji > A > -e 3 O / ^ O J o / -? c -Jn Speech-errors — John been continued gain in weight, generally improved speech (though occasional relapses into bad speech habits have occurred), and a real improvement in social reactions. Weight op John Jan. 24, 1919 Feb. 8th Feb. 25th March 8th March 21st April 8th April 15th April 24th May 14th May 29th June 10th June 24th July 9th July 25th 7114 lbs. 72% 727/8 771/2 77 77% 771/2 78 75% 733^ 75% 77 761/2 77% PRELIMINARY STUDY IN CORRECTIVE SPEECH 23 Phonographic Speech Record of John January 10th to August 8th, 1919 errors January 10th 15 January 24th 12 February 7th 12 February 21st 7 March 7th 4 March 20th 3 April 15th April 26th 2 May 16th 7 May 30th 10 July 25th August 8th 2 The picture shown below in the accompanying cut represents the degree of malocclusion existing before John began orthodontic treatment at the Dental Infirmary in May, 1919. The picture at the right shows the improved occlusion ten months later (March, 1920), the following results being evident: first, the widening of the mouth space (% inch in the canine region and approximately % inch in the premolar region) ; second, the correction of the in- ward slant of the premolars to normal position ; third, the improved position of the incisors of both upper and lower arches ; fourth, the development of the premaxillary bone. Since these corrections have been made, good mastication of food has been secured, proper breathing habits are being established, and physical growth has been accelerated. 24 IOWA STUDIES IN CHILD WELFARE Type Case B In January, 1918, a member of the psychological department of the University on a trip to a nearby town examined a girl of twelve years, who was suffering from stuttering. He reported her to be of about average intelligence, but very nervous. In October, 1918, she was brought to the Research Station for further examination. The family history as reported by the parents revealed a tendency to "nervousness" in the mother's family and another case of stut- tering — the mother's brother. The girl herself had begun stutter- ing upon entering school and at the beginning of each school year had shown for a time a slight speech disturbance. During the fall of 1918, this recurring attack had become so severe as to impress the parents with the necessity of seeking help from the Research Station. The girl had had no very severe diseases and appeared to be well developed, though slightly underweight. The physical examination at the University Hospital revealed nothing of consequence except enlarged tonsils. Her posture was, however, poor, her chest was noticeably flat, and her behavior showed signs of excessive nervous- ness, being characterized by jerky, awkward movements. The child was obviously in the prepubescent period, though the parents did not seem to be aware of this fact. They had, however, consulted the family physician in regard to this nervousness and had been specially warned against over-stimulation. Alice's emotional condition was apparent in her facial expres- sion, which indicated sulkiness, stubbornness, and pouting. Further acquaintance showed her to be a highly strung, over-stimulated girl of nervous temperament, easily excited, lacking in control and decidedly willful. The mental examination at the Research Station confirmed the earlier diagnosis of average intelligence. With a chronological age of thirteen years, seven months, and a Terman mental age of four- teen years, eight months, her I. Q. was 108 No defects in imagery were discovered, although there apparently was a deficiency of this sort, since Alice was unable to reproduce short stories or to recount incidents from her daily life and showed, moreover, an intense dis- like for any exercise requiring reproduction from imagination. She had also all the inhibitions and dread of failure common to habitual stutterers. PEELIMINARY STUDY IN CORRECTIVE SPEECH 25 The speech examination indicated a functional disturbance with excessive rapidity and lack of rhythm. During speech there was interference with normal respiration, the hypertonicity being fre- quently communicated to the muscles of the eye, face, and dia- phragm. There were frequent interruptions in the middle of a word or phrase with attempts to speak while an inspiration was taking place. Certain consonants in initial position were pro- nounced with difficulty and then in an explosive manner, indicating incoordination of the respiratory and vocal muscles. All these difficulties became less noticeable when the child was required to speak slowly. From these examinations it was apparent that this interrelated group of disturbances could be overcome only by means of general physical upbuilding, combined with specific speech training. Ac- cordingly, Alice was brought to Iowa City and placed in the home of a woman with some training in the care of special cases. Her school program, rest, recreation, and diet were controlled by means of a schedule for every hour of the day. Regular speech training was undertaken for the purpose of establishing normal habits of breath control, of insuring proper formation of vowels and con- sonants, and of securing a transfer of attention from habitual faults to distinct utterance. lbs. aA C/?e S&ss/on o^ School Cmot/ona/ Disturbance, 97 J ) r \ \ J / 1 ' 3S A r- -J 1 \ J 03 ^ J V P^ ^ O/ y y ^ / AQ cr y^— to ZO JO 10 £0 30 /O eO so /O £0 30 'O £0 -^O /o ^O 30 Jan. Feb. March A on' I Maij June Weight-curve — AKce 26 IOWA STUDIES IN CHILD WELFARE The effect of five months in a controlled environment is shown in the accompanying weight chart. In general, there is an increase in weight, although there are three distinct drops in the curve, each corresponding to an occasion of marked emotion disturbance. 16 /Z ^ a V Shows Norma/ Proqress in •Speech Improvame-nt, Shows Disturbance^ in Spe&ch Due^ to rmof/ona/ Chancre, \ \ k v A \ \ \ \ ^ y^ N / r^- "-.. ''•^3 /O ZO JO /O ZO -50 /O ZO 30 /O 40 ^O /O £0 .30 Jan. Feb. March April Mat^ Speech-errors — Alice The result of speech training during these five months is shown in the appended curve of errors plotted from the phonographic test records made by the child at frequent intervals during the elimination of stuttering. This curve shows a gradual reduction of errors, but with lapses in speech control similar to the loss in weight and coincident with the same occasions of emotional disturbance. The distinct improvement under controlled conditions was so evident that the parents took steps to place this girl in a boarding school where she might continue her speech training and acquire emotional control under close supervision. PRELIMINARY STUDY IN CORRECTIVE SPEECH 27 Weight of Alice January 7th 891/2 lbs. February 14th 9214 March 15th 933/4 March 25th 96 April 4th 931/2 April 14th 957/8 April 25th 951/4 May 6th 97% May 13th 98 May 20th 99 May 27th 97 June 4th 97 June 11th 981/4 Phonographic Speech Record op Alice January 10th to May 30th, 1919 errors January 10th 14 January 24th 9 February 7th 10 February 22nd March 7th 2 March 21st April 15th April 24th 2 May 17th ' May 30th V. MATERIALS FOR SPEECH EXAMINATION In checking the speech errors of individual children, the examiner uses the accompanying word lists and test sentences containing the consonants in initial, middle and final position; sentences contain- ing the five vowels, long and short ; the most common of the difficult consonant combinations ; and the diphthongs uy, -oy, -ow, -ew. The particular sounds are arranged in test sentences which are given to the child to be read, while the examiner checks the cor- responding word list, underlining the character which gives diffi- culty or which is inaccurately articulated. The Roman numerals, I, II, III and IV on the examiner's page refer to error types, such 28 IOWA STUDIES IN CHILD WELFARE as initial, middle or final consonant, long or short vowel, difficult consonant combination, or diphthong. The Arabic numerals 1 to 46 correspond to the number of the sentence in which listed sound appears. The date of the first examination is noted, the words missed being underlined on that date. As the errors are progressively eliminated, the columns at the right are to be filled in to show date of first elimination, reappearance of difficulty, and approximate date of final elimination for each sound. INDrVIDUAL SPEECH EECOED Date X accurate ; o inaccurate Name Address I. Consonants in initial, middle and final position ELIM. EEAP. FINAL ELIM. 1. bear, nibble, stub 2. cook, baked, cake 3. Dan, conduct, good 4. flying, offer, off 5. goose, again, egg 6. hopes, harm, hounds 7. jockey, injured, hedge 8. key, broken, take 9. let, dollar, will 10. must, Emma, some 11. Nan, dinner, fountain 12. pack, apples, deep 13. queen, toque 14. read, rural, fruit, fire 15. sit, listen, us 16. trembled, tattered, blast 17. very, velvet, have 18. will, tower, now 19. exact, inexpert, fox 20. yellow, merry 21. zeal, prisoner, cause 22. children, peaches, lunch ' 23. shy, dashing, marsh 24. wheel, pleasure 25. that, father, with 26. thought, author, Smith PRELIMINARY STUDY IN CORRECTIVR SI»ERCH 29 II. Vowels (1), (long) 27. cat, cake, bite 28. «se, boat Vowels (2), (short) 29. kit, mend, bat 30. bond, ■up III. Difficult consonant combinations 31. Dwight, twirl, athwart 32. great, crowd, praise 33. fright, brave, track 34. drove, through, spruce 35. mild, melt 36. supple, able, kettle 37. spear, struck, split 38. squire, escape, sword 39. shrink, strike 40. dusk, smooth, snow 41. place, flooded, gloom 42. clouds, blend, sloping 43. gathering, strength, brinfc 44. stands, scrub IV. Diphthongs 45. Guy, toy 46. few, cows TEST SENTENCES FOE INDIVIDUAL SPEECH RECOED 1. The bear nibbled at the stub. 2. The cook baked a cake. 3. Dan's conduct was good, 4. He went flying off after the offer. 5. The goose again laid a golden egg. 6. He hopes not to harm the hounds. 7. The jockey was injured in taking the hedge. 8. Take the broken key. 9. Let me borrow a dollar and I will repay you. 10. He must give Emma some candy. 11. Nan ate her dinner by the fountain. 12. Pack the apples in a deep box. 13. The queen wore a brown toque. 14. I read that the fire in rural places spoiled much fruit. 15. Sit and listen with us. 16. He trembled in his tattered garments at the blast. 17. That is very like the velvet which I have. 30 IOWA STUDIES IN CHILD WELFARE 18. Will he mount the tower now? 19. To be exact, he is an inexpert fox hunter. 20. The yellow glow of the Yule log and merry laughter attracted them. 21. The zeal of the prisoner was used in a poor cause. 22. The children shared their peaches at lunch. 23. The shy creature went dashing through the marsh. 24. The wheel gave him pleasure. 25. I think that your father went with him. 26. I thought the author's name was Smith. 27. You may eat the cake if you will give me a bite. 28. Shall you use the boat? 29. Kit was unable to mend the bat. 30. The bond was locked up in the safe. 31. Dwight twirled the stick athwart the path. 32. The great crowd praised the speaker. 33. The frightened brave fled from the track. 34. They drove through forests of spruce. 35. This mild weather melts the snow. 36. With supple movements he was able to lift the iron kettle. 37. As the spear struck, the armour split in twain. 38. The squire escaped the sword. 39. They shrink from declaring a strike. 40. At dusk the fence was smoothly capped with snow. 41. The place was flooded with gloom. 42. The clouds blend with the sloping horizon. 43. Gathering strength, he drew himself to the brink. 44. There stands a scrub pine. 45. Guy has a new toy. 46. They keep a few cows. VI. MATERIALS FOR PHONOGRAPHIC TEST RECORDS Part of the materials used in testing John is here assembled as samples of the method of procedure in speech cases of his type. The tests were usually given at two weeks intervals. Every other test was generally a re-test on the material of the preceding test to note the effect of specific drill on sounds which the test had shown were inadequately produced. This drill was never on the test mate- rial itself. TEST SET 3 (1) Words showing range of tone. (2) Words showing volume of tone. (3) Sentences arranged so as to contain sounds of vowels, and consonants used in initial position, the numeral indicating the number of times each PEELIMINARY STUDY IN CORRECTIVE SPEECH 31 was used, as follows: a(2), b(5), d(3), e(l), f(2), g(l), h(3), i(l), j(l), k(5), 1(2), m(l), 11(1), p(7), qu(l), r(l), s(2), t(6), th(voiceles8, 1), th(voiced, 10), v(2), w(2)— (oo), wh(l), y(l). 1. Patty bought more white wafers. 2. A few fine villages. 3. The tall timbers cover two lots. 4. Come quickly, the cows are in the corn. 5. Verily, he has saved enough to prevent poverty. 6. I think that will do. 7. Does Zeus answer the people thus? 8. Peter paid the price gladly. 9. Eing the library bell. 10. George can bring the bugler's horn. 11. She tried to drill nine youths. 12. The ship bore treasure. (4) Short selection containing a, e, i, o, oo vowel sounds in initial position. As:— "Have you seen an apple orchard, in the spring, in the spring? An English apple orchard in the spring? When the spreading trees are hoary with their wealth of promised glory, and the mavis pipes his story, in the spring ! ' ' TEST SET 4 A short story, arranged so as to contain the following consonants and vowels used in initial position, the numbers referring to the number of times each was used: a(13), b(9), d(8), e(2), f(8), g(4), h(16), i(8), j(2), k(4), 1(3), m(4), n(2), p(ll), qu(l), o(4), o(l), oo(3), r(5), s(7), t(8), u(l), w(13), y(l), ph as f (1), wh(l), th(voiceless, 1), th(voiced, 21). STORY Peter, one day, wished to make some trench candles. So he took some wafers of white wax, heated them in a pan until they dissolved into a thin liquid ; then he found many of Phillip's thick newspapers. He then bought a quire of plain paper for the outside. He folded the papers over and back and did not forget the directions. Bringing from his room some strips for wicks, he placed them in the center of each, rolling the paper about it, and jamming it together, he fastened with mucilage the outer edge. He was going to call George, but remembered that he had gone to choir practice at the church, after the bell rang, and would soon go by on his way back to the shop. It would be more pleasure to show him the result of the work done by one's self, he thought. So he dipped the paper candles in paraffin, and after they dried, he lighted one. It gave forth a dim yellow light. r> / \ q: (^ 32 IOWA STUDIES IN CHILD WELFARE VII. SAMPLE SPEECH DRILL CHARTS Long: vowels; CHAN T,« SAY, -LAH-LAY-LEE-LAW-LOH-LOO- -HAH -HAY-HEE-HAW-HOH-HOO- - D AH -DAY-DEE -DAW-DO H-D 00- "MAH-MAY-MEE-MAW-MOH-MOO- Vowel strengrtheninor . -ah-AY- EE - -kah-kaY-KEE - AW- OH- 00 KAW-KQH-KOO Same With n.v.f.t.b.gr. Exercises for Vowel Drill CONSONANT ATTACK -AN -AN -AN-^AN-AN-AN-CAN -AT- AT -AT -AT -AT -AT -MAT -AIN-AIN-AIN-AIN - AIN -AIN- RAIN -IKE- IKE- IKE -IKE -IKE- IKE-LIKE -EW- EW- EW-EW - EW - EW -FEW ^JRCH-URCH-URCH^JRCH-4JRCH-URCB-CHURCH -AM - AM -AM -AM -AM- AM -JAM - AY - AY - AY - AY - AY - AY - DAY Same with g.n.b,w,y,t. Exercises for Consonant Attack; Used Chiefly with Stutterers PRELIMINARY STUDY IN CORRECTIVE SPEECH 33 s « Inflection. \ \ OEE -O-EE -WHO - BELLS - WINDOW -FALL - HOME - RINGING -MILL -KIT - QUICKLY -TEN - PEAL - SISTER -1.ArE you GOING HOME TO AY ? -2.1 SAW YOUR FATHER LAST NlGHIl Exercises for Developing Inflection <>neech Building. CXhe too .— 6.\Vhere is my ? ZThe ffirl ^ .-7. Who is ^? .The ice .-8. May I ffo ? TThe store — ^i have a— and a—. SThe top • -H).He bought a-— and a— Unking. I. John found ^ qgw t^ p. ZJohn found ^ ngy tp p and ^ P^ cil. iJohn found a n^w to p, a^ncil and ^ok. 4. John found ^Joo. ^^nciL ^_bof)k. and ^jri^P. Exercises for Speech Building; Used in stimulating Spontaneous Speech Exercises in Phrase Linking; Used in Work for Smooth, Rhythmical Speech 34 IOWA STUDIES IN CHILD WELFARE fchant; I Say; ■# O ^ lshout;_Q|^ij King Co.le" was a merry old soul. ~Great wide wonderful, beautiful Ui '" " \!tORLD« -With the wonderful w^tIr ~ round you curled: -And THE wonderful grass UPON YOUR BREAST. -World. Yojj are grandly and beautifully dressed. Exercises Used for Vowel Drill on the Eounded Vowel Sounds o, oo and the Diphthong eoo WORD DRILLS. Initial. Final. Middle. *- meat -name -aim 4ine -amaze -sense - make -nine -hum -moon -dreamer -any "- my -not -comb-can -summer -money -must -need ~foam_seen - tramp - sooner -move -number -hem -ton - hammer - dinner -The murmur of music makes him calm. -The murmuring: pines and the hemlocks. -To him, money seems most important. -Count out nine new coins. -John ate his dinner by the fountain. -The negro nurse crooned an ancient melody. Specimen Chart Using m, n, in Initial, Middle, and Final Position in Words and Sentences; Similar Charts Are Used for All the Consonants PRELIMINARY STUDY IN CORRECTIVE SPEECH 35 VIII. SELECTED REFERENCES* 1. Aiken, W. A. The Voice. New York: Longmans, Green & Co., 1910. Pp. 59 2. Appelt, a. Stammering and its Fermanent Cure. London: Methuen & Co., 1911. Pp. 234. 3. Barth. Neuere Ansichten ilber Stottern, Stammeln und Horstiimmheit 1904. 4. Bastian, H. A. Treatise on Aphasia and Other Speech Defects. London: Lewis, 1898. Pp. 366, 5. Blanton, M., and Blanton, S. Speech Training for Children. New York: Century Co., 1919. Pp. 261. 6. Bleummel, C. S. Stammering and Cognate Defects of Speech. New York: Stechert, 1913, I, IL Pp. 715. 7. Collins, J. The Genesis and Dissolution of the Faculty of Speech. A Clinical and Fsychological Study of Aphasia. New York: Macmillan, 1893. Pp. 439. 8. Fletcher, J. M, The Etiology of Stuttering. J. Amer. Med. Assn., Apr. 8, 1916 (64), 1079. 9. Proeschels, E. Lehrbuch der Sprachheilkunde. Leipzig u Wien: Deut- ieke, 1913. Pp. 397. 10. GuTZMANN, H. Des Kindes Sprache und Sprachfehler. Leipzig: Weber, 1894. Pp. 264. 11. GxJTZMANN, H. Sprachheilkunde. Berlin: Fischer, 1912. Pp. 648. 12. KussMAUL, A. Disturbances of Speech. Ziemssen's Cyclopaedia of the Fractice of Medicine. New York: Wood & Co., 1877 (14), 581-865. 13. Maas, p. Die Sprache des Kindes und ihre Storungen. Wiirzbnrg: Kabitzsch, 1909. Pp. 125. 14. Mackenzie, M. Hygiene of the Vocal Organs. New York: Werner, 1891. Pp. 285. 15. Makuen, G. H. a Study of 1,000 Cases of Stammering with Special Eef- erence to the Etiology and Treatment of the Affection. Therapeutic Gas., June, 1914. Eeprint, U. S. Bur. of Educ, Bull. 4, 1915, 95-98. 16. Merry, G. N. Outlines of the Frinciples of Speech. Monograph, State Univ. of Iowa, 1919, Chap 3 (Breathing). 17. Mills, W. Voice Production. Philadelphia : Lippincott Co., 1913, Pp. 294. 18. Nadoleczny, M. Disorders of Speech and Fhonation in Childhood. Shaw & Lafetra, The Diseases of Children. Philadelphia: Lippincott, 1914 (7), 359-480. 19. Potter, S. O. L., Speech and its Defects. Philadelphia: Blakiston Son & Co., 1882. Pp. 114. 20. EoBBiNS, S. A Flethysmo graphic Study of Shod- and Stammering. Amer. J. of Fhysiol., 1919, (18), 285-330. 21. EoiiMA, G. La Parole et les troubles de la parole. Paris: 1907. 22. Scharr, J. Die Behandlung Stotternder. Hanover: Soedel, 1919. *.Sug-gt-slioriS were received frim Dr. .7. E. Wallin in tlir propnration of this list. 36 IOWA STUDIES IN CHILD WELFARE 23. Scripture, E. W. The Elements of Experimental Plwnetics. New York: Scribner, 1902. Pp. 627. 24. ScRiPTUKE, E. W. Researches in Experimental Phonetics. Washington, D. C: Carnegie Institution, 1906. Pp. 204. 25. Scripture, E. W. Stuttering and Lisping. New York: Macmillan, 1914. Pp. 251. 26. Scripture, M. K., and Jackson, E. Manual for the Correction of Speech Disorders. Philadelphia: Davis, 1919. Pp. 236. 27. Still, G-. F. Disorders of Speech. Common Diseases and Disorders of Childhood. London: Prowde, 1915, 740-754. 28. Struempell, D. Die EntwicMung der Sprache und die aphatischen Sprachstorungen. Zsch. f. Pad. Psych., 1916, 6-21. 29. Swift, W. B. Speech Disorders in School Children and How to Treat Them. Boston and New York: Houghton Mifflin, 1918. Pp. 128. 30. Tredgold, a. F. Mental Deficiency. New York: Wood, 1916, 128-164. 31. Wallin, J. E. Report on Speech Defectives in the St. Louis Public Schools. St. Louis: Ann. Sep. of the Board of Educ, 1915-16. 32. Wallin, J. E. Theories of Stuttering. J. of Appl. Psychol., 1917, 349- 367. 33. Wyllie, J. The Disorders of Speech. Edinburgh: Oliver & Boyd, 1894. Pp. 495. 34. Wrescpiner. Die SpracJie des Kindes. Ziirieh: Art Institut. Orell Flissli, 1912. University of Connecticut Libraries