_Dysphrasia of the Delirious_ (_Wahnsinnigen_).--Children that have begun to speak often make new words for themselves. They have already invented signs before this; they are also unintelligible often-times because they use the words they have learned in a different sense.

_Dysphrasia of the Insane_ (_Verruckten_).--The child is not yet prepared to speak. He possesses only non-co-ordinated sounds and isolated rudiments of words, primitive syllables, roots, as the primitive raw material of the future speech.

In many insane persons only the disconnected remains or ruins of their stock of words are left, so that their speech resembles that of the child at a certain stage.

_Dysphrasia of the Feeble-minded._--The child at first reacts only upon strong impressions, and that often indolently and clumsily and with outcry; later, upon impressions of ordinary strength, without understanding--laughing, crowing, uttering disconnected syllables.

So the patient reacts either upon strong impressions only, and that indolently, bluntly, with gestures that express little and with rude words, or he still reacts upon impressions of ordinary strength, but in flat, silly, disconnected utterances.

_Dysphrasia of Idiots._--Children have command at the beginning of no articulate sounds; then they learn these and syllables; after this also words of one syllable; then they speak short words of more than one syllable and sentences, but frequently babble forth words they have heard without understanding their meaning, like parrots.

Imbeciles also frequently command only short words and sentences or monosyllabic words and sounds, or, finally, they lack all articulate sound. Many microcephalous idiots babble words without understanding their meaning, like little children.

_Echo-speech or Echolalia_ (_Imitative Reflex Speech_).--Children not yet able to frame a sentence correctly like to repeat the last word of a sentence they have heard; and this, according to my observations and researches, is so general that I am forced to call this echolalia a physiological transition stage. Of long words said to them, the children usually repeat only the last two syllables or the last syllable only.

The feeble-minded also repeat monotonously the words and sentences said by a person in their neighborhood without showing an awakened attention, and in general without connecting any idea with what they say.

(Romberg.)

_Interjectional Speech._--Children sometimes have a fancy for speaking in interjections. They express vague ideas by single vowels (like _a_), syllables (e. g., _na_, _da_), and combinations of syllables, and frequently call out aloud through the house meaningless sounds and syllables. D and W are as yet undeveloped.

Often, too, children imitate the interjections used by members of the family--_hop!_ _patsch_, _bauz!_ an interjectional echolalia. Many deranged persons express their feelings in like manner, in sounds, especially vowels, syllables, or sound-combinations resembling words, which are void of meaning or are a.s.sociated merely with obscure ideas (Martini). Then D is connected with M only through L and S, and so through _i_ and _e_.

_Embolophrasia._--Many children, long after they have overcome acataphasia and agrammatism, delight in inserting between words sounds, syllables, and words that do not belong there; e. g., they double the last syllable of every word and put an _eff_ to it: _ich-ich-eff_, _bin in-eff_, etc., or they make a kind of bleat between the words (Kussmaul); and, in telling a story, put extra syllables into their utterance while they are thinking.

Many adults likewise have the disagreeable habit of introducing certain words or meaningless syllables into their speech, where these do not at all belong; or they tack on diminutive endings to their words. The syllables are often mere sounds, like _eh_, _uh_; in many cases they sound like _eng_, _ang_ (angophrasia--Kussmaul).

_Palimphrasia._--Insane persons often repeat single sounds, syllables, or sentences, over and over without meaning; e. g., "I am-am-am-am."

"The phenomenon in many cases reminds us of children, who say or sing some word or phrase, a rhyme or little verse, so long continuously, like automata, that the by-standers can endure it no longer. It is often the ring of the words, often the sense, often both, by which the children are impressed. The child repeats them because they seem to him strange or very sonorous." (Kussmaul.)

_Bradyphrasia._--The speech of people that are sad or sleepy, and of others whose mental processes are indolent, often drags along with tedious slowness; is also liable to be broken off abruptly. The speaker comes to a standstill. This is not to be confounded with bradyphasia or with bradyarthria or bradylalia (see above).

In children likewise the forming of the sentence takes a long time on account of the as yet slow rise and combination of ideas, and a simple narrative is only slowly completed or not finished at all, because the intellectual processes in the brain are too fatiguing.

_Paraphrasia._--Under the same circ.u.mstances as in the case of bradyphrasia the (slow) speech may be marred and may become unintelligible because the train of thought is confused--e. g., in persons "drunk" with sleep--so that words are uttered that do not correspond to the original ideas.

In the case of children who want to tell something, and who begin right, the story may be interrupted easily by a recollection, a fresh train of thought, and still they go on; e. g., they mix up two fairy tales, attaching to the beginning of one the end of another.

_Skoliophrasia._--Distracted and timid feeble-minded persons easily make mistakes in speaking, because they can not direct their attention to what they are saying and to the way in which they are saying it, but they wander, allowing themselves to be turned aside from the thing to be said by all sorts of ideas and external impressions; and, moreover, they do not notice afterward that they have been making mistakes (cf. p. 53).

Children frequently put a wrong word in place of a right one well known to them, without noticing it. They allow themselves to be turned aside very easily from the main point by external impressions and all sorts of fancies, and often, in fact, say the opposite of what they mean without noticing it.

III. DYSMIMIA.

Disturbances of Gesture-Language (Pantomime).

_Perceptive Asemia._--Patients have lost the ability to _understand_ looks and gestures (Steinthal).

Children can not yet understand the looks and gestures of persons about them.

_Amnesic Amimia._--Aphasic persons can sometimes imitate gestures, but can not execute them when bid, but only when the gestures are made for them to imitate. Children that do not yet speak can imitate gestures if these are made for them to see, but it is often a long time before they can make them at the word of command.

_Ataxic Dysmimia and Amimia_ (_Mimetic Asemia_).--Patients can _no longer_ execute significative looks and gestures, on account of defective co-ordination.

Children can not express their states of desire, etc., because they do _not yet_ control the requisite co-ordination for the corresponding looks and gestures.

_Paramimia_ (_Paramimetic Asemia_).--Many patients can make use of looks and gestures, but confound them.

Children have not yet firmly impressed upon them the significance of looks and gestures; this is shown in their interchanging of these; e. g., the head is shaken in the way of denial when they are affirming something.

_Emotive Language_ (_Affectsprache_) _in Aphrasia._--In Aphrasia it happens that smiling, laughing, and weeping are _no longer_ controlled, and that they break out on the least occasion with the greatest violence, like the spinal reflexes in decapitated animals.

(Hughlings-Jackson.)

Emotive language may continue when the language of ideas (Begriffssprache) is completely extinguished, and idiotic children without speech can even sing.

In children, far slighter occasions suffice normally to call forth smiles, laughter, and tears, than in adults. These emotional utterances are _not yet_ often voluntarily inhibited by the child that can not yet speak; on the contrary, they are unnecessarily repeated.

_Apraxia._--Many patients are _no longer_ in condition, on account of disturbed intellect, to make right use of ordinary objects, the use of which they knew well formerly; e. g., they can no longer find the way to the mouth; or they bite into the soap.

Children are _not yet_ in condition, on account of deficient practice, to use the common utensils rightly; e. g., they will eat soup with a fork, and will put the fork against the cheek instead of into the mouth.

4. Development of Speech in the Child.

We may now take up the main question as to the condition of the child that is learning to speak, in regard to the development and practicability of the nerve-paths and of the centers required for speech. For the comparison of the disturbances of speech in adults with the deficiencies of speech in the child, on the one hand, and the chronological observation of the child, on the other hand, disclose to us what parts of the apparatus of speech come by degrees into operation. First to be considered are the _impressive_ and _expressive_ paths in general.

All new-born human beings are deaf or hard of hearing, as has already been demonstrated. Since the hearing but slowly grows more acute during the first days, no utterances of sound at this period can be regarded as responses to any sound-impressions whatever. The first cry is purely reflexive, like the croaking of the decapitated frog when the skin of his back is stroked (Vol. I, p. 214). The cry is not heard by the newly-born himself and has not the least value as language. It is on a par with the squeaking of the pig just born, the bleating of the new-born lamb, and the peeping of the chick that is breaking its sh.e.l.l.

Upon this first, short season of physiological deaf-mutism follows the period during which crying expresses bodily conditions, feelings such as pain, hunger, cold. Here, again, there exists as yet no connection of the expressive phenomena with acoustic impressions, but there is already the employment of the voice with stronger expiration in case of strong and disagreeable excitations of other sensory nerves than those of general sensation and of the skin. For the child now cries at a dazzling light also, and at a bitter taste, as if the unpleasant feeling were diminished by the strong motor discharge. In any case the child cries because this loud, augmented expiration lessens for him the previously existing unpleasant feelings, without exactly inducing thereby a comfortable condition.

Not until later does a sudden sound-impression, which at first called forth only a start and then a quivering of the eyelids, cause also crying. But this loud sign of fright may be purely reflexive, just like the silent starting and throwing up of the arms at a sudden noise, and has at most the significance of an expression of discomfort, like screaming at a painful blow.

It is otherwise with the first loud response to an acoustic impression _recognized_ as new. The indefinable sounds of satisfaction made by the child that hears music for the first time are no longer reflexive, and are not symptoms of displeasure. I see in this reaction, which may be compared with the howling of the dog that for the first time in his life hears music--I see in this reaction of the apparatus of voice and of future speech, _the first sign of the connection now just established between impressive_ (acoustic) and _expressive_ (having the character of emotive language) _paths_. The impressive, separately, were long since open, as the children under observation after the first week allowed themselves to be quieted by the singing of cradle-songs, and the expressive, separately, must likewise have been open, since various conditions were announced by various sorts of crying.

Everything now depends on a well-established _intercentral communication_ between the two. This is next to be discussed.

The primitive connection is already an advance upon that of a reflex arc. The sound-excitations arriving from the ear at the central endings of the auditory nerve are not directly transformed into motor excitations for the laryngeal nerves, so that the glottis contracts to utter vocal sound. When the child (as early as the sixth to the eighth week) takes pleasure in music and laughs aloud, his voice can not in this case (as at birth) have been educed by reflex action, for without a cerebrum he would not laugh or utter joyous sounds, whereas even without that he cries.

From this, however, by no means follows the existence of a speech-center in the infant. The fact that he produces sounds easily articulated, although without choice, like _tahu_ and _amma_, proves merely the functional capacity of the peripheral apparatus of articulation (in the seventh week) at a period long before it is intentionally used for articulation. The unintentionally uttered syllables that make their appearance are, to be sure, simple, at least in the first half-year. It is vowels almost exclusively that appear in the first month, and these predominate for a long time yet. Of the consonants in the third month _m_ alone is generally to be noted as frequent. This letter comes at a later period also, from the raising and dropping of the lower jaw in expiration, an operation that is besides soon easy for the infant with less outlay of will than the letter _b_, which necessitates a firmer closing of the lips.

But in spite of the simplicity of all the vocal utterances and of the defectiveness of the articulatory apparatus, the child is able (often long before the seventh month) to respond to address, questions, chiding, either with inarticulate sounds or with vowels or by means of simple syllables, like _pa_, _ta_, _ma_, _na_, _da_, _ma_, _mo_, _go_, _ro_ [_a_ as in _father_; a as in _fate_; o like _i_ in _bird_.] Since these responses are entirely, or almost entirely, lacking in microcephali and in children born deaf, they are not purely reflexive, like sneezing, e. g.; therefore there must be in the case of these a cerebral operation also, simple indeed, but indubitably intellectual, interposed between sound-perception and vocal utterance, especially as the infant behaves differently according to what he hears, and he discriminates very well the stern command from the caress, forbidding from allowing, in the voice of the person speaking to him. Yet it is much more the _timbre_, the accent, the pitch, the intensity of the voice and the sounds, the variation of which excites attention, than it is the spoken word. In the first half-year the child hears the vowels much better than he does the consonants, and will imperfectly understand or divine the sense of a few sounds only--e. g., when his name is uttered in a threatening tone he will hear merely the accented vowel, for at the first performance taught him, purposely postponed to a very late period (in his thirteenth month), it made no difference to my child whether we asked without changing a feature, "Wie gross?" (how tall?) or "ooss?" or "oo?" In all three cases he answered with the same movement of the hand.

Now, although all infants in normal condition, before they can repeat anything after others or can understand any word whatever, _express_ their feelings by various sounds, even by syllables, and _distinguish_ vowels and many consonants in the words spoken to them, yet this does not raise them above the intelligent animal. The response to friendly address and loud chiding by appropriate sounds is scarcely to be distinguished as to its psychical value from the joyous barking and whining of the poodle.

The pointer-dog's understanding of the few spoken utterances that are impressed upon him in his training is also quite as certain at least as the babe's understanding of the jargon of the nurse. The correctly executed movements or arrests of movement following the sound-impressions "Setz dich! Pfui! Zuruck! Vorwarts! Allez! Fa.s.s!

Apporte! Such! Verloren! Pst! La.s.s! Hierher! Brav! Leid's nicht!

Ruhig! Wahr Dich! Hab Acht! Was ist das! Pfui Vogel! Pfui Hase! Halt!"

prove that the bird-dog understands the meaning of the sounds and syllables and words heard as far as he needs to understand them. The training in the English language accomplishes the same result with "Down! Down charge! Steady! Toho! Fetch! Hold up!" as the training in the French language, with yet other words--so that we can by no means a.s.sume any hereditary connection whatever between the quality of the sound heard and the movement or arrest of movement to be executed, such as may perhaps exist in the case of the chick just hatched which follows the clucking of the hen. Rather does the dog learn afresh in every case the meaning of the words required for hunting, just as the speechless child comprehends the meaning of the first words of its future language without being able to repeat them himself--e. g., "Give! Come! Hand! Sh! Quiet!" Long before the child's mechanism of articulation is so far developed that these expressions can be produced by him, the child manifests his understanding of them unequivocally by corresponding movements, by gestures and looks, by obedience.

No doubt this behavior varies in individual cases, inasmuch as in some few the imitative articulation may be to some extent earlier developed than the understanding. There are many children who even in their first year have a monkey-like knack at imitation and repeat all sorts of things like parrots without guessing the sense of them. Here, however, it is to be borne in mind that such an echo-speech appears only after the _first_ understanding of some spoken word can be demonstrated; in no case before the fourth month. Lindner relates that when he one day observed that his child of eighteen weeks was gazing at the swinging pendulum of the house-clock, he went with him to it, saying, "Tick-tack," in time with the pendulum; and when he afterward called out to the child, who was no longer looking at the clock, "Tick-tack!"