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This has been classed as a case of congenital word deafness, but differs from typical cases in the
extent to which commands are understood when heard, in spite of the influences impelling the child
to rely upon sight. Dr. Thomas, who examined her in November, 1908, reports on the striking difference
between heard speech which is merely repeated (echolalia) and seen speech (lip-reading) which
is immediately answered rationally; for instance :—
Query : What is the time ? (By ear only).
Answer: What is the time. (Mumbled without intelligence.)
Query : What is the time ? (Lip-read.)
Answer: (Immediately looking at the clock.) Three o'clock.
Query : What is your father doing ? (Lip-read.)
Answer : Gone to work.
Query: What is your mother doing? (By ear only.)
Answer : What is your mother doing ? (Echolalic.)
In this case the word deafness prevents the higher word centre being effective, and the child
can only repeat words heard without comprehending their meaning, but she lias now learned to understand
by lip-reading. But on further examination many interesting points come out:—
(By ear)—Q. What is the number of your house ?
A. What is the number of my house ? (But no attempt to reply to the question.)
(By ear)—Q. How many brothers and sisters have you ?
A. How many brothers and sisters have 1 ? (But no sign of answering the
question.)
(By eye)—Q. What is your sister's name ?
A. Bertha.
The alteration in the pronouns marks an advance on mere echolalia. This substitution of the
correct pronoun is especially taught in deaf schools. On further examination it was found that after
she had repeated (echolalia) a question, if interrogated by lip-reading without the question being put
again, she could answer it, thus—
(By ear)—Q. What is the number of your house ?
A. What is the number of my house.
(By eye)—-Q. Well! tell me. • *
A. Forty.
Again—
(By ear)—Q. How far away do you live ?
A. How far away do I live.
Teacher (by eye) —Q. Weil! tell him.
A. Not very far away.
The child was evidently using some subconscious action. The motor centre being roused by
echolalia, by directing attention to this the meaning of the phrase is perceived. Telling the child not
to repeat the question but to think of it, and answer—
(By ear)—Q. Wrhat is your brother's name ?
A. WThat is my brother's name ?—Willie.
(By ear)—Q. Wrhen is your birthday, Dorothy ?
A. Wrhen is my birthday, Dorothy ?—December thirtieth
(By ear)—Q. When do you say your birthday was ?
A. When do you say my birthday was?—December thirtieth,
(By ear)—Q. Do you like cake ?
A. Do I like cake?—Yes.
The child was now given to understand that she was on no account to repeat the question, but
to think carefully of what she heard. She found great difficulty in doing this, but after pondering some
time a correct answer was obtained without the echolalic motor response being evoked aloud. It was
evident that considerable restraint had to be exercised to prevent this, and every now and again, in spite
of instructions, the echolalia recurs to words heard but never to words seen. In January, 1909, she
answers ordinary speech correctly even with her back to the speaker, but if a whisper is used she
at once reverts to the echolalic answers, showing that the auditory centre is still not completely controlled.
In this girl's case no language was acquired until lip-reading was established, and the quickest
and most direct route to her consciousness is by this centre. Questions heard are repeated by echolalia,
but now she corrects her pronouns subconsciously. If special attention is directed to the motor response
to questions heard understanding can be attained and a correct answer given. With great effort,
heard phrases are understood without motor response being interposed, but not easily, often with error
and often forcing the motor response in spite of attempted inhibition. Evidently the auditory centre
is very weak, and it is difficult on any other hypothesis to explain this case.
IV.—M.B., No. 15,152, girl, aged 7, January, 1908; Deaf School. A.B. (below), her brother:—
Did not speak before admission to centre 13 months ago ; has made slight progress in lip-reading since.
Resembles brother in general condition. Hearing present but defective ; watch at 5 cm. No spontaneous
speech ; defective understanding and somewhat unintelligent; hardly any power of speech reproduction.
Examined by Dr. Thomas 10 months later, she had made great progress, but in spite of her intelligence,
it is still difficult to communicate owing to want of language. She has a strained puzzled
expression, but gives great attention. She hears conversational tones and repeats by echolalia without
comprehension. Will often name a thing shown, although she cannot recognise the word when spoken.
The incidence of defect is on the word hearing centre, and she is in exactly the same position as her
brother was at her age.