London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1906

[Report of the Medical Officer of Health for London County Council]

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Summary of M.D. children of all ages :—

Ages.Numbers.Discharging earsMouth breathersAdenoids:Enlarged glandsResiduar of disease in drumsFailed to pass 20ft testVery deaf, nothing at 2½ftWax
B. G.B. G.B. G.B. G.B. G.B. G.B. G.B. G.B. G.
7134 09 56 36 66 32 11 —8 8
8365 324 1119 919 916 72 31 112 8
945 277 326 1322 1014 1218 105 5- -22 14
1044 359 423 2019 1516 1117 104 53 122 19
1148 228 332 1616 79 620 64 31 223 11
1258 209 429 1018 617 527 65 52 120 13
1352 2811 934 1515 716 419 205 71 —28 13
1427 125 117 77 49 59 73 21 —14 6
1511 21 17 —3 —5 —4 11 —1 —4 1
162 3- 22 1- -1 1— 2- -1 1
Totals336 17859 30203 98125 61112 59136 7231 3111 5146 94
Percentages51414 1660 5537 3433 3340 409 173 2844 52

DEVELOPMENT OP ARTICULATORY CAPACITY FOR CONSONANTAL
SOUNDS.
The development of speech in children is the evolution of one of the latest acquired faculties
and one most liable to disturbance, and hence also most susceptible of education at the proper time.
Series of cases have already been described in a previous report where certain speech faculties are
rudimentary or wanting so that such children have been classed as imbecile; these are, however,
comparatively gross and rare exceptions. The study of the development of the speech faculty at
school ages should afford material of great value to the teacher as well as the physician. This study
has been undertaken by Dr. Ernest Jones. The immense field to be covered necessitated restriction
for the present to the development of the articulatory power for consonants.
Difficulties of pronunciation (dyslalias) may arise :—
i. From mechanical defects in the peripheral speech apparatus.
ii. From lack of adequate education and practice or exercise (blesitas).
Some 650 children were examined in the schools of the North Kensington district. They
were selected so as to represent average samples and to eliminate such matters as social grade
or great poverty as far as possible. Further, children are only dealt with who were selected by their
teachers as having normal speech capacity. They, however, frequently choose children of better
mental capacity, so that it is probable the children examined may have been generally somewhat
above the average in mental capacity. The cases finally examined and now analysed number 450.
There were 25 of each sex for each year of age during compulsory school attendance. The 200
with " defective speech " will be reported on later.
Frequency.—The absolute frequency of blesitas is very great, the mispronunciation of vowels
being most common. Only 2 of 3,000 children seen were noted as quite free from defect. As
blesitas may be avoided entirely by training. its occurrence has an important bearing upon elementary
education so far as it relates to the training of speech production. With regard to age
and sex distribution, the incidence is only determined for the commonest defect, consonantal blesitas.
Methods.—21 single, 75 double and 13 triple consonantal sounds were used. These sounds
were given in suitable test words, in the three positions they can occupy, namely, commencing,
ending, or in the middle of words. Marks from 0 to 3 were recorded for each sound ; 0 meant unintelligibility
or another sound substituted, 1 just recognisable, 2 obvious defect, and 3 the correct sound
given. The only criterion was intelligibility, and the full mark 3 might be recorded for a sound
which had a gross accent, or would have seemed horribly uncouth to a purist. As some of the sounds
do not occur in English in all the three positions, the total number used was not 3 x 109 = 327, but
actually 227 only. The full number of marks was 1,266, as double consonants were given 6, and
triple 9. For statistical purposes and in these records all marks are reduced to a total maximum
of 1,000. The spontaneous speech of a child who only got 930 marks or less was practically unintelligible
to a stranger. It is probable also that the standard adopted for the younger children was
lower than the others, an unconscious bias, difficult to contend against, giving some leniency in
marking the youngest. The method of obtaining the articulation was the most favourable possible,
the children being asked to repeat the word as spoken to them, and even to watch the speaker's
lips, and when necessary easier words were tried first, so that the utmost limit of articulatory
capacity was evoked. The total number of tests made was 105,000.
Sex Incidence.—The standard reached by the girls, 980.1 average marks, was higher
than that reached by the boys, 974.9, chiefly owing to the preponderant number of boys who got
very low marks.
Age Incidence.—Dr. Jones has gone into a very detailed examination of the age incidence
in the sexes, which can only be summarised here.
14958 D 2