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at and which, it is hoped, every child will reach, it is well known that there is a proportion
which will get only so far and for whom continued therapy seems useless. This is true
only if the criterion of success is perfection. If a lower standard is accepted the picture
becomes brighter, and the stimulus to aim higher in any particular case continuosuly
grows as each stepping stone is negotiated. That it is right to accept this lower standard
is open to question only if the situation in the field is unknown to the questioner.
Though speech is an accepted method of communication in human affairs, it is not an
inborn power, and the acquisition of speech is much harder for some children than
others. Too often it is forgotten that speech must be learned and the child needs teaching.
Teaching may be by organised lessons or, as occurs in most families, by giving an
example to be followed. The speech used by the parents, and incidentally the language,
is that which will be used by the infant in first starting to speak. Even before words are
used the intonation and tune of the words will be copied. The normal infant with all
normal faculties will be the best copyist, if there be any reduction in these faculties,
almost any one of them, it is likely that speech will be affected. Developmental defects
of the mouth such as a cleft palate, or defects, congenital or acquired, of hearing are
easily seen to be likely to affect the process of learning speech. Sometimes the importance
of vision as an aid to the acquisition of speech is forgotten ; blind children are often slow
in developing good speech.
When the adult of normal intelligence utters a word it is seen mentally in all its
aspects, spelling, meaning, sound and pictured if it be possible to do so ; when this
complex is disrupted the state is one of aphasia. This may arise as a result of brain
damage, for example after cerebral thrombosis, or cerebral tumour.
In the child a similar picture is seen where there is no real aphasia but one of the links
is missing. A child with undetected high tone deafness presents a frequent example and it
is only when the real handicap is revealed that progress is made in treatment. Mental
retardation is another misleading cause of speech difficulty, and it is with this group that
this note is specially concerned.
It is worth while to give speech therapy to the educationally sub-normal child with
defective speech. Though some make rapid progress, most of these children go very
slowly. What is learned today is lost tomorrow. Repetition over many months may
succeed in effecting great improvement, and speech becomes more developed and
comprehensible.
Even if, as may well be the case, perfect speech is beyond the capabilities of the child,
he will have achieved a very much better standard than had the situation been left as it
was. The child is more easily understood in conversation, and is therefore better able
to hold its own in the world, he becomes more acceptable to his fellows and altogether
more socially competent.
Slow progress is the rule and the measure of success can be only an individual one,
but there is a measure in nearly every case ; such progress is not evenly, regularly made
but proceeds at differing speeds and, as already said, seems sometimes for a time almost
to cease. Perseverance, patience and refusal to be discouraged are qualities necessary to
the therapist. When children treated in primary schools for the educationally sub-normal
move into secondary schools, their relative improvement in speech may regress, so that
it is necessary to keep them under observation and, if their old habit of slovenly speech
returns, to institute a short course of training. It is in these ways that the weekly attendance
of a speech therapist in each of the Council's schools for educationally sub-normal
children has been justified. The development of speech therapy for these handicapped
children has been a most satisfactory advance.
Home and
hospital
tuition
Some handicapped pupils receive tuition at home or hospital in accordance with the
provisions of Section 56 of the Education Act, 1944. The numbers vary from day to day,
as children are admitted to, or discharged from, hospital, but during 1956 approximately
250 children received such tuition, about 60 to 70 at home, 40 to 50 individually in
hospital and about 140 in permanent teaching groups in ten hospitals.
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