Dr. Mange: Let's do this with a recorder.

Ken: I have cleft palate.

Virginia: I have cerebral palsy.

Mary: I talk hard.

Narrator: By recognizing and understanding their handicaps, these children have completed an important step toward developing positive relationships in life. But even with this, the way will not be easy and they will need help.

[ Music ]

Speaker: The Exceptional Child, a child with differences. It is our hope that through these programs, we might better understand this child and help him.

Narrator: These children are taking part in an extremely helpful activity, that of recording their own voices and later listening to themselves and each other in an attempt to improve their speech. I'm Ed Jones, your host on these programs, and today we're going to meet some of the special problems that face the child with a speech handicap. A handicap which in one case may be slight, and, in another, may cause a child to be completely unintelligible.

Many of us take our ability to communicate through speech for granted, forgetting that it is the life blood of much of modern existence, in obtaining an education, in building personal relationships, and in holding a job. Effective speech is vital and its importance is felt very early in life.

The need to belong to a group of some kind and be accepted by others is a need felt by every child, and the child with a speech handicap finds it far more difficult to satisfy this need. He may be confronted with laughter and rejection by his classmates. He may even be excluded from classroom discussion.

Depending upon the severity of the handicap, there are countless other penalties that may serve to frustrate him greatly. There are more children with speech defects than there are children who are blind, deaf and crippled combined. And just as there are thousands upon thousands of variations in speech among children who are normal, there are equally as many variations and degrees of defect among children with speech handicaps.

With some, the defect may cause only minor difficulties, keeping the child only slightly behind children who are normal in developing wholesome relationships. With others, the defect may cause definite and frustrating limitations, preventing the child from ever making his relationships complete.

Today, we shall meet one broad classification of speech problems, and here to help us understand these problems as they affect the child with a speech handicap, we have Dr. Charles V. Mange, Assistant Professor of Audiology and Speech Pathology in the Division for the Education of Exceptional Children at Syracuse University.

Dr. Mange: Speech problems may result from a number of different causes. In some of these may have an organic basis which interferes with the ability to communicate and to produce speech.

Ken was born with a cleft palate. Many children with a cleft palate also have cleft lips but Ken was quite fortunate. He did not have a complete roof in his mouth as we do and, consequently, found it difficult to build up air pressure for the air would pass through the cleft into the nasal cavity and then out through the nose.

A number of speech sounds require expulsion of air under pressure, including such sounds as "p," as in pipe, and "b," as in boy, and several others. And other sounds also require the contact of the tongue with the palate, such as "k," in cat, and "g" in gun.

Ken, let's see if you can build up pressure now just a moment and do what I do. Puff up my cheeks and blow.

[ Blowing ]

Dr. Mange: Let's see if you can get a little more pressure here.

[ Blowing ]

Dr. Mange: All right. Not easy for you yet, is it?

Ken: No.

Dr. Mange: Virginia was born with cerebral palsy, a condition where damage to the centers of the brain which assist in directing and controlling muscle movements, where this center is impaired. And sometimes the impairment also involves those muscles which are required for speech.

Let's see now, Virginia, if you can do this as quickly as I do. La, la, la.

Virginia: La… La… La.

Dr. Mange: All right, let's try it again.

Virginia: La, La, La.

Dr. Mange: Good, that's better. But it's not easy for you yet, either, is it?

Virginia: No.

Dr. Mange: Mary has a type of organic problem which makes it difficult for her to learn both language and speech. Words and their meanings and sentence structure problems are especially difficult for her. Most of us develop a rather extensive vocabulary quite early in life, we're able to produce rather complex sentences without even developing this with conscious effort. But Mary must work hard to do this kind of thing.

You've learned quite a few new words, though, in the last few months, haven't you, Mary?

Mary: I -- yes, I am.

Dr. Mange: When speech is different from the normal, we notice this difference almost immediately. Sometimes our response indicates simply interest, sometimes our own embarrassment and sometimes even ridicule. Each time the speech-handicapped person opens his mouth to communicate, he displays his problem and he is subject to the frustrations and the reactions of others.

Another frustration results in trying to make one's self understood, for our world is a very highly verbal and social world. We have to talk, and we have to talk in school, we have to talk in our jobs, and we have to talk in many different social situations. Impairment in speech can result in significant maladjustment with the effects seen throughout life, and almost every child who has a speech handicap experiences some kind of adverse reactions by his listeners. Even though these occur but rarely, the effects may be great.

Child: But it took a long time to plant the seeds by hand.

Teacher: All right, fine, Vinny. Ken, would you --

Ken: We and all -- (words unintelligible)

Teacher: Let's try that again. Garden seeds…

Ken: Garden seeds were in the ground. Now, they'll place until the corn -- while his father is breaking up the hard earth. And then -- he was not thinking about corn, he was thinking about protein.

[ Children snickering ]

Teacher: Oh, that's enough of that. All right, Ken, go on.

Ken: I can't.

Teacher: Oh, sure you can. Go ahead, read on from there. That was all right.

No? All right. Tommy, would you go on from there? We'll come back to Ken.

Dr. Mange: If these experiences continue and sensitivity about speech develops, the effect is very often seen in reluctance to recite in the classroom situation. And even when requested to do so, many children will respond in such a way as Kenny just did, by saying "I don't know."

The effects in later life are often seen in a deliberate avoidance of social contacts and a reluctance to date, and in employment problems. An economic penalty is imposed on these people, also, since many jobs are closed to those who have difficulty in speech because of the necessity for public contact and responsibility.

However, many of these problems need not develop if treatment is provided early in the life of the child. This treatment must be directed not only toward the feelings and the reactions but also to work on the speech problem itself, and such treatment must begin with adequate diagnosis, which is usually the responsibility of a team of specialists.

Narrator: One member of the team of specialists helping Kenny to develop improved speech is the surgeon. Many different structures in the mouth and throat work together to produce speech and the surgeon is concerned with all of these. Sometimes his examination shows some of them are not operating properly. He may be able to suggest some procedure to establish normal functioning, and, thus, provide a firm, organic foundation for improved speech.

[ No audio ]

Narrator: Kenny has had a series of operations to correct his cleft palate, but a considerable time has elapsed since the surgery and Kenny continues to have speech difficulties. They may be due to additional organic problems, but it's also possible that Ken has preserved through habits the speech patterns which resulted from his cleft palate.

[ No audio ]

Narrator: Distinct normal speech is dependent to a great degree on the teeth. The orthodontist sees to it that they're in the proper position with relation to the tongue and the lips. If they're not, some speech sounds may become distorted, perhaps distracting, oftentimes embarrassing.

His examination involves a good deal of mouth opening and closing and stretching of Kenny's lips with a tongue depressor. Takes a good deal of sitting still and an awful lot of patience for a little boy. But Ken knows the team members are using all their skills to help him achieve more normal speech, and even though he has to submit to many tedious examinations like this one, he now does so quite willingly and with a good deal of interest.

The members of Ken's team get together periodically to match viewpoints about his difficulty and exchange ideas about possible treatment. There no longer seems to be any organic basis for Kenny's speech difficulty. It appears most likely his major problem is habit, the habit of continuing speech patterns learned early in life before his cleft palate was surgically corrected.

From now on, the major responsibility will lie with the speech therapist. She will be Kenny's closest and most frequent contact with the team, working with him to help break old speech habits and learn new speech production methods.

Through Kenny's mother, the team has gained a clearer insight into Kenny's personality and his reactions to his speech difficulties. Now, the team must help her to anticipate Kenny's reactions to the treatment, and she must be helped to handle him correctly in cooperation with the speech therapist.

Kenny has been through a lot. Examination, evaluation, surgery, reexamination and evaluation. Now the team members are starting him on another course, speech therapy. But with Kenny, there's a good chance of success, and the reward will be more normal speech and the opportunities that go with it.

Dr. Mange: Virginia, who has a different organic speech problem resulting from cerebral palsy, has also been seen periodically by a team of specialists. They have suggested a continuing program of therapy to meet her specific needs. In many cerebral palsy speech problems, the child must be trained in getting ready to speak so that the extraneous movements of arms and legs do not spread into the muscles of speech.

Speaker: Virginia, the first thing we're going to talk about this morning is something we've mentioned before but never talked, really, too much about it, and that's getting ready to speak. And I think you'll find that some things that will help you in preparing yourself is, one, just using this back of the chair and sitting back and relaxing, where you feel comfortable, and trying to get your hands anyplace you want to put them, on the top of the table if you're close enough to a table, or in your lap. Or sometimes you have arms on the chair, and if you can rest them on the arms of the chair, you'll find that will give you the feeling of being secure in the chair so that you can speak very well.

For a while, we'll just leave your hands right here in your lap. Looks like you're most comfortable that way. Do you feel pretty comfortable now and relaxed?

Virginia: Yeah, yeah.

Speaker: I'm going to ask you a few questions and while I do that, I'm going to put my -- start with my hand on your hands so that you'll be conscious of my holding you steady. And while you answer me, will you try and think about where your hands are resting and how you are -- try to keep as still as you can. And then I'm going to move my hand away and see if you can do it without even my having -- my being there. All right? What is one of your favorite hobbies?

Virginia: I like writing for --

(Words unintelligible)

Speaker: Well, wouldn't you know. What is one of your favorite records that have come out lately?

Virginia: Elvis Presley "Jailhouse Rock."

Speaker: Oh, the "Jailhouse Rock." Have you got that record in your collection?

Virginia: Not yet.

Speaker: Are you going to get it?

Virginia: Yeah.

Speaker: What is something else that -- what is your favorite rock and roll singer? Who is your favorite rock and roll singer?

Virginia: Elvis Presley.

Speaker: Elvis Presley, huh? I thought once before you told me it was Eddie Fisher. Is he just a favorite singer?

Virginia: I used to like him but…

Speaker: Okay. Do you notice now when I took my hand away, you began to use your fingers?

Virginia: Yes.

Speaker: Use your hands, and you did very well afterwards, though, you began to concentrate on holding it right here.

Dr. Mange: Although Ken's speech problem is not as severe as that of Virginia, he still has need of some special help. He has developed the ability to produce most sounds accurately but there are a few difficult ones remaining. It is just as important, however, that he not only be able to produce these sounds but to do them rapidly and blend one into another smoothly. These skills are required if he is to develop speech which is acceptable to his listeners.

Speaker: Raise your tongue as high as you can, way up in the back. That's it. Make the sound whenever you're ready. All right. That was a little bit better. Try it just once more in watching where your tongue is. Raise your tongue real high. No, let's get it ready, get yourself ready and get the tongue up again. Feel it, feel where I marked it with the tongue depressor. Way up.

[ Clicking sound ]

Speaker: Okay, that was pretty good, Kenny. Now, Ken, another sound we worked on was the "S" sound. Can you give me a good "S" sound for me now?

Ken: SSSS.

Speaker: You made a good correction on that one. Now the problem comes up where we try to put this sound together with other sounds, such as the word miss.

Ken: Miss.

Speaker: What about pass?

Ken: Pass.

Speaker: Okay. Can you say this word -- this sentence for me? Miss Johnson is my teacher.

Ken: Miss Johnson is my teacher.

Speaker: All right. Kenny, sometimes we -- when you made it, you make the "S" sound and then you stop and go on to the other sounds. Would you show me how you did that wrong before, and this is what we're learning now.

Ken: Pass.

Speaker: Passs.

Ken: Pass.

Speaker: Okay. Let's look in the mirror and see if we can do something about that. A handy little speech mirror, isn't it? Okay. Let's say the word passs, and hold on to the ah, P-A-A-A-S-S-S.

Ken: Pass.

Speaker: That was pretty good. How about misssss.

Ken: Miss.

Speaker: I think we almost had it. Let's stop it again -- start it again, rather. Miss.

Ken: Miss.

Speaker: No, you hold on to the "I" just a little more.

Ken: Misss.

Speaker: All right, Kenny, let's try it with this. You know all your vowels, don't you? I'm sure you do. Let's put our "S" word before all of our vowels but let's hold on to it so that we can bring the two of them together, all right? Do you want to start --

Ken: Siss.

Speaker: No, Ssssay. Hold right on to it.

Ken: Say.

Speaker: All right, that was pretty good.

Ken: See.

Speaker: Okay.

Ken: Sigh.

Speaker: Very good.

Ken: So.

Speaker: Good.

Ken: Sue.

Speaker: Let's do that one a little bit --

Ken: Sue.

Speaker: Okay, good. Now let's put it on the end. Where we say A-S, A-C-E.

Ken: A-C-E.

Speaker: Let's hold on to the "A" and get the "A" right with it.

Ken: Ace.

Speaker: Ace. Let's go through this.

Ken: E-S.

Speaker: You've got the idea now.

Ken: I-S. Osss, usss.

Speaker: Good. Now let's say, "Miss Johnson is my teacher," and hold on to "miss."

Ken: Miss Johnson is my teacher.

Dr. Mange: In addition to the specific training provided in the individual therapy session, Ken needs the opportunity to utilize his skills in a group situation. Here the presence of a few other classmates makes it more difficult to concentrate on speech and provides a more challenging opportunity for practice.

Narrator: Kenny is rather sensitive about speaking in front of a group, even in the familiar atmosphere of his own classroom. This is not Kenny's regular classroom, it's a speech therapy room and a situation deliberately staged by Kenny's speech therapist. Kenny's friends snicker purposely when he makes a speech error. By doing this, they help him experience the feelings and emotions he will in real class situations time after time. The snickering is embarrassing and he becomes tense, his reaction is to stop. This is a critical time and one when the proper kind of encouragement from the speech therapist is very important to him. Ken does continue after some urging. Some uncomfortable feelings remain. These show, as he protrudes his lips and twists the microphone cord and works very hard to produce proper speech, but he keeps going. Something which has been difficult for him before.

[ No audio ]

Narrator: Situational therapy such as this helps to prepare Kenny for real situations he faces every day in his normal class routine. Kenny's class has come to understand him and his speech problems very well. For the most part, they accept him as a contributing member of their group and this in itself is valuable for him.

[ No audio ]

Narrator: But even the most understanding group sometimes imposes penalties on the person with a speech problem. If it's not an outright snicker, it may be inattentiveness or the trace of a hidden smile. Ken has learned to be less sensitive to reactions such as this.

It's important for Ken to experience real situations like this one where he must communicate through speaking, but the things done for him in speech therapy can be evaluated, and when things go well, he experiences the pleasures and rewards that come through expression, and through good communication with his friends and classmates.

[ No audio ]

Dr. Mange: The parents' role in assisting the child to improve his speech and his relationships with others is especially important. The opportunity for an exchange of information and attitudes between parents of children with similar problems can greatly assist in providing the stimulation and the methods needed for improvement. Sometimes such meetings are conducted by the speech therapist, and, in other cases, by the psychologist, the teacher or other interested member of the team.

Speaker: Yes, that's right. Now, you mentioned that there was something that you wanted to bring up about Mary that you thought maybe the other mothers could have some suggestions for you.

Mother 1: Yes. Mary has a type of brain damage and she's reluctant to speak, either at school or around, you know, her playmates, and even sometimes at home. And I just don't know what to do about it and I thought maybe they could help me in some way.

Mother 2: Well, Kenny had a similar problem when he was younger and how we worked it out was through the speech therapist and the school teacher. I went right to school with the -- and had several sessions with the teacher, and she helps at school by correcting him alone, not among the other children, but tells him afterwards different things that he has done wrong and helps him, and he appreciates that. He comes home and tells me about it.

And then we work with him at home with our daughter, doing different of the therapy sessions, reading and things like that with him.

Speaker: Did you have any experience with Virginia on that kind of problem?

Mother 3: Yes, we did, too. When Virginia was a little bit younger, she was going to the clinic and she had quite a bit of trouble with her speech, and the therapist up there would teach her the different sounds. And then they decided that if we helped her at home, between the therapist at the clinic and having help at home, would help her out quite a bit.

So we got together and it's really helped her quite a bit. Now she talks pretty good. I mean, you can understand her, but, still, at times, she's shy and won't speak because she's afraid the people won't understand her. But by getting together like, that it has helped quite a bit.

Mother 1: It's really cooperation on everyone's part.

Mother 3: Yes.

Mother 1: Teacher and home.

Mother 3: Yes, it is, helps a lot.

Mother 1: Speech school. How do they react with other children?

Mother 2: Well, they -- with the other children, having grown up with them, they don't even realize the problem too much. They do realize that -- well, in Kenny's situation, that he is -- speaks different than they, but it doesn't bother them at all and they've never made fun of him or anything like that. He -- and at school, they've gone right through school with him, so there's no problem there.

Mother 1: Is it because he's a younger child? With my child, she's about 10, would she notice it more?

Mother 2: Well, Kenny is 10, also. He did when he was younger but now there's no problem there with him, and I think probably we've worked with him ever since he was around three years old here at the university, and it's really worked out very well. with the family, and with the -- him.

Speaker: The school and the therapist and the family, hum?

Mother 2: Everyone concerned.

Mother 3: It's really a family problem. You have to work it out together, the family.

Speaker: This sort of weaves into another item you wanted to mention.

Mother 3: Yes, about the shopping business with Virginia. We think it's about time that she should go shopping on her own because she can get on the bus by herself and everything. It's just the idea that she doesn't like to ask for things for herself because she imagines that maybe they won't understand what she wants.

Dr. Mange: These parents have children who have come a long way in the improvement of their attitudes and speech. A few years ago, Ken and Virginia were almost completely unintelligible, and Mary was using almost no speech whatsoever. They have improved and improved greatly and, yet, there is more to do. But the doing is becoming easier because each of them has developed a real interest in their own problems.

Their willingness and their eagerness, really, to participate in this program indicates a measure of self-confidence and poise which many of us might envy. They've all improved because they have the potential to improve. But just as importantly, because someone was concerned a number of years ago.

Ken was concerned. His embarrassment and tension are indications of that concern. Because of this, his parents were concerned and they were interested enough to sacrifice for the evaluation, the surgery and the treatment which he needed.

The therapist was also concerned. She has worked to assist Ken in many ways in addition to his speech. As a part of therapy, the parents have had to take an active part in understanding, in motivating and in providing rewards for his efforts to help himself.

Narrator: Every child has his own pattern of growth. When the child has a specific handicap, such as a speech defect, this pattern, of course, is more complicated. With special education, therapy, and understanding at home, in school and in the community, the child himself can come to understand his own problem and achieve with greater assuredness a happy and secure relationship in the world.

When the defect is more severe, this, of course, is far more complicated and more difficult. And the expectations for some children, unfortunately, will be greatly limited.

It is up to all of us to try to understand the exceptional child and to help him in every way possible to achieve the maximum. Next week, we shall try to understand the relationships of another group of children with another kind of speech defect, those with problems of stuttering.

Remembering that a child with a handicap is yet a child, an exceptional child with a life that may be somewhat restricted, sometimes even distorted, but one that can grow and continue to grow toward fulfillment. As we know more about the total development of children with handicaps, we shall be able to help the exceptional child more and more in his quest for full and positive relationships. With the hope that if he cannot completely eliminate his handicaps, he may effectively reduce the restrictions they cause.

A child is born, new life begun, a life which may be exceptional but need not be without beauty and achievement.

[ Music ]

Speaker: This is National Educational Television.