"*7?" . l LANGUAGE PERFORMANCE OF kNSI’I'EUTIONALIZED AND NON-EHSTITUTEGNAUZED TRAENABLE MENTAL RETAfiDATES The“: for fine Deqrru of M. A. MICHIGAN STATE UNIVERSITY Daie W. Kitchen 1965 THESIS [J LIRRARY Michlgan State UniverSIty ROOM USE ONLY rg—Ottl 33% "-1368... I, LU ABSTRACT LANGUAGE PERFORMANCE OF INSTITUTIONALIZED AND NON-INSTITUTIONALIZED TRAINABLE MENTAL RETARDATES by Dale W. Kitchen The purpose of the present study was to compare the performance of an institutionalized and non-institu- tionalized trainable mentally retarded population on the Parsons Language Sample. Forty-eight subjects and one examiner were used in the investigation. The subjects consisted of mentally retarded children, ages seven years 11 months through 10 years ll months, randomly selected according to chronolog- ical age and scores obtained on the WISC, Revised Stanford- Binet, Forms L and M, the Kuhlmann-Binet Intelligence Test, and the Cattell Infant Intelligence Scale. The examiner was a male graduate student enrolled in Speech and Hearing Science at Michigan State University. Each subject was tested individually and his or her responses were recorded verbatim by the examiner. The test environment consisted of a small room, limited in dis- tractions, and equipped with a table and two small chairs. The Parsons Language Sample was utilized for pur- poses of assessing language performance. This test consists Dale W. Kitchen of the following seven subtests: (l) Tact Subtest (2) Echoic Subtest (3) Echoic Gesture Subtest (4) Comprehension Subtest (S) Intraverbal Subtest (6) Intraverbal Gesture Subtest (7) Mand Subtest The test was administered strictly according to the proce— dures recommended with the Sample. Raw scores for each subject were recorded for all of the subtestso The scores were analyzed using a three dimensional analysis of variance. The Michigan State University CDC 3600 computer was utilized for purposes of analysis. The results indicated significance for Tact language perform- ance as a function of intelligence, Tact language perform- ance as a function of intelligence and chronological age, Comprehension language performance as a function of age, Intraverbal language performance as a function of age, and Mand language performance as a function of environment. Due to a violation of equal sample variances, no positive statement could be made concerning Tact language perform— ance as a function of intelligence and chronological age. On the basis of the analysis of the data, the fol- lowing conclusions were made: Tact language performance increases with intelligence. Comprehension language per- formance increases with chronological age. Intraverbal Dale W. Kitchen language performance increases with chronological age. Mand language performance varies as a function of environ- ment, with institutionalized mentally retarded children scoring significantly higher than non-institutionalized mentally retarded children. Implications for future research were suggested and discussed. LANGUAGE PERFORMANCE OF INSTITUTIONALIZED AND NON—INSTITUTIONALIZED TRAINABLE MENTAL RETARDATES By Dale W. Kitchen Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Speech 1965 ACKNOWLEDGMENTS I would like to express my thanks to the Chairman of my Committee, Dr. Elsie M. Edwards, Associate Professor of Speech, for her excellent cooperation; and to Dr. James W. Hillis, Assistant Professor of Speech, and Dr. Leo V. Deal, Assistant Professor of Speech, for serving as members of my Committee. I would also like to extend my thanks to the follow— ing for their c00peration and assistance in the conducting of this study: Dr. Al Baumeister, Research Director, Mount Pleasant State Home and Training School; Mr. Howard Holland, Mount Pleasant State Home and Training School; Dr. Maureen Bailey, Clinical Psychologist, Plymouth State Home and Train- ing School; Mr. Peter Zeibell, Clinical Psychologist, Lapeer State Home and Training School; Mr. Marvin Beekman, Director of Special Education, Lansing Public Schools; Mr. William Seiter, County Superintendent, Montcalm County; and Miss Margaret Knowles, Director, Lincoln School Foundation, Grand Rapids. ii TABLE OF CONTENTS Page LIST OF TABLES . . . . . . . . . . . . . . . . . . . . iv LIST OF ILLUSTRATIONS O O O O O O O O O O O O O O O O O V LIST OF APPENDICES . . . . . . . . . . . . . . . . . . vi Chapter I. STATEMENT OF THE PROBLEM . . . . . . . . . . . 1 Introduction Statement of Purpose of Study Hypothesis Importance of Study Definition of Terms Organization of Thesis II. REVIEW OF THE LITERATURE . . . . . . . . . . . 12 III. SUBJECTS, EQUIPMENT, AND PROCEDURES. . . . . . 32 Subjects Test Environment Materials Procedure IV. ANALYSIS AND DISCUSSION. . . . . . . . . . . . 42 Analysis Discussion V. SUMMARY AND CONCLUSIONS. . . . . . . . . . . . 56 Summary Conclusions Implications for Future Research APPENDICES O O O O O O O O O O 0 O O O O O O O O O O O 59 BIBLIOGRAPHY O O O O O O O O O O O O O O O O O O O O O 76 iii LIST OF TABLES Table Page 1. Chronological Age, Sample Size, Intelligence Score, and Measuring Instrument Each of the Six Institutional Groups . . . . . . . . . . . . 34 2. Chronological Age, Sample Size, Intelligence Score, and Measuring Instrument Each of the Six Non-Institutional Groups . . . . . . . . . . 34 3. F Statistic Summary Table. . . . . . . . . . . . 43 iv LIST OF ILLUSTRATIONS Page Mean Tact Score Plotted Against Intelligence Quotient Level. . . . . . . . . . . . . . . . . 51 Mean Tact Score Plotted Against Chronological Age Level with Intelligence Quotient Level as the Parameter . . . . . . . . . . . . . . . . . 52 Mean Comprehension Score Plotted Against Chronological Age Level . . . . . . . . . . . . 53 Mean Intraverbal Score Plotted Against Chronological Age Level . . . . . . . . . . . . 54 Mean Mand Score Plotted Against Environment Level 0 O O O 0 0 O O O O O O O O O O O O O O O 55 Appendix A. B. LIST OF APPENDICES THE PARSONS LANGUAGE SAMPLE. . RAW SCORES O O O O O O O O O 0 vi CHAPTER I STATEMENT OF THE PROBLEM Introduction The concept that institutionalization affects lan— guage performance has been discussed by various individuals with interest in this problem. Gesell and Amatruda are concerned with defects and deviations of development when they write, First and foremost the child in institution X,Y,Z lacks the normal tensions of language,--the tensions of intercommunication by facial expression, by ges— ture, by pantomimic action, by social laughter, by interjections, by words and sentences, and by other forms of expressional behavior, both on the give and take sides, which occur in the intimacy of home life. According to the authors, certain of the institutional mechanisms_are operating to create "syndromes of retarda- tion" one of which is retarded language development and limited verbal expression. They further state, "There can be no doubt that institutional children are retarded in language development." In summary, they conclude that, "The behavior [verbal] improves with improvement of 1Arnold Gesell and Catherine Amatruda, Develop- mental Diagnosis (2nd ed. rev. and enlarged; New York: Medical Book Department of Harper and Brothers, 1947), pp. 325-26. environment."1 It seems feasible that separation of the child from the influences of the home environment acts to place certain limitations on language development and verbal output. The mother-child interaction within the confines of the home environment is stressed by McCarthy.2 She indicates that the rate of language development shows a direct relation- ship to the amount of contact a child has with the mother. Those children spending the most time with their mothers tend to develOp language at a more rapid rate. More specifically related to the topic of this paper, Lyle has conducted several studies which deal with the re- lationship between language performance of retarded child- ren and institutionalization. For a number of reasons which require closer exam- ination, large institutions are often unsatisfactory environments for the verbal development of children. It seems likely that long residence in the insti— tution retards verbal intelligence much more than nonverbal intelligence. In addition, Lyle concludes that the verbal development of imbeciles could be less affected by institutionalization if greater emphasis were placed on social organization and lIbid. 2Dorothea McCarthy, "Home Influences: Factors that Influence Language Growth," National Council of Teachers of English (Chicago: 1953), pp. 8-16. 3J. G. Lyle, "The Effect of an Institutional Environ- ment Upon the Verbal Development of Imbecile Children: II. Speech and Language," Journal of Mental Deficiengy Research, 4 (1960), pp. 122-28. human relations at the institutional level. Schlanger appears to agree with the above findings when he writes, concerning mental retardation, The institutionalized child is deprived of certain motivational factors affecting speech verbal out— put through the severance of significant familial relationships, the lack of challenge offered in routinized living and the constant companionship of peers which minimizes his speech experiences and practice.1 Various studies dealing with speech and language deficiency indicate that institutionalized retarded popu- lations show higher incidence figures than non—institution- alized populations. Hudson2 points to a twelve percent incidence of speech defects with a general language retarda- tion among a group of non-institutionalized educable mental retardates. Donovan3 evaluated the speech performance of 2000 educable mentally retarded school children (I.Q. 50—74). The results of the study indicated eight percent of the group had severely defective speech. A study by Gens,4 utilizing 1252 institutionalized 1B. B. Schlanger, "Environmental Influences on the Verbal Output of Mentally Retarded Children," Journal of Speech and Hearing Disorders, 19 (1954), pp. 339—43. 2Margaret Hudson, ”Methods of Teaching Mentally Retarded Children" (Unpublished manuscript, George Peabody College, 1958), pp. 1—131. 3Helen Donovan, ”Organization and Development of a Speech Program for the Mentally Retarded Children in New York City Public Schools," American Journal of Mental De- ficiency, 62 (1957), pp. 455-59. 4G. W. Gens, "Speech Retardation in the Normal and Subnormal Child," Training School Bulletin, 47 (1950), pp. 32-36. subjects, showed significantly higher incidence figures. Seventy to seventy-five percent of the population studied indicated severe speech defects. Schlangerl found 79 per— cent of an institutionalized mentally retarded population to have articulatory defects (sound omissions, substitutions, and distortions). This variance of incidence figures between the in- stitutionalized and non-institutionalized groups may be attributed, in part, to differences in research methodology, differences in a definition of mental retardation, differ- ences in the intellectual ranges which were sampled, and the size of the populations selected for each study. The findings of Schlanger and Lyle, however, point to the strong possibility that institutionalization tends to retard lan- guage performance by virtue of the fact that the institu— tionalized retardate has been removed from the mainstream of social-verbal interchange. Bender lends support to this concept of deprivation when she writes, Our experiences at Bellevue have shown us that a child can stand many disturbing and distressing experiences provided they are not actually destruc- tive to the organism, and provided the child has the emotional and interpretive support from an adult as a parent or parent substitute. That is sufficient mothering care is necessary to permit the normal maturation of the individual or to 1B. B. Schlanger, "The Speech and Hearing Program at the Training School," Training School Bulletin, 53 (1957), PP. 267-72. compensate for deficiencies in either sensory and motor functioning.1 The mentally retarded child can be seen to express varying degrees of either sensory or motor dysfunction, or both. It seems doubtful that sufficient mothering care is given the institutionalized mentally retarded child. Accord- ing to Bender, this care should be provided to assist com- pensation of the organism to deficiencies of sensory or motor functioning. According to Kirk,2 language involves processes of encoding and decoding and can be thought to be both a sen- sory and speech-motor task. If the retarded child expresses limited usage of sensory-motor equipment, if the retarded child is placed within the confines of an institution and removed from significant adult relationships, then it seems safe to assume, in most instances, that the institutional- ized retarded child has neither proficient language usage nor the opportunity, based on Bender's concept, to compen- sate for this deficiency. Kirk indicates this to be true, when he writes, "Trainable mentally retarded children, for example, are delayed and retarded in all aspects of lLauretta Bender, Psychopathology of Children with Organic Brain Disorders (Springfield, Illinois: Charles C. Thomas Publisher, 1956), p. 121. 2Samuel A. Kirk, "A Behavioral Approach to Learning Disabilities," Conference on Children with Minimal Brain Impairment, Sponsored by the Easter Seal Research Founda- tion, National Society for Crippled Children and Adults, Inc. (Urbana, Illinois: January, 1963), p. 40. O I 1 communication." Statement of Problem and Purpose of Study Increased emphasis in speech and language pathology, as these relate to mental retardation, points the way to a need for original research devoted to both disciplines. "As long as speech correctionists deal with problems of language and speech retardation they will almost of neces- 'sity be confronted with problems of mental retardation."2 Increasing pressures are being placed on the profession of speech pathology to devote increasing amounts of time and effort to work with the mentally retarded. In our own clinical experience, mental retardation has been one of the most frequently encountered factors associated with language and speech retarda- tion. We feel there is a very important role for speech therapy in the field of mental retardation. This will require that speech pathologists not only increase their knowledge of the speech of the men— tally retarded but of the field of mental retarda- tion itself.3 A belief in the preceding statements, a background in speech pathology, and an interest in mental retardation leads to the following statement of purpose: It is the purpose of this study to compare the lan- guage performance, on the Parsons Language Sample, of two lIbid. 2Jack Matthews, "Speech of the Mentally Retarded," in Lee Edward Travis (ed.), Handbook of Speech Pathology (New York: Appleton-Century-Crofts, 19577, pp. 532-33. 3Ibid. trainable mentally retarded populations, institutionalized and non-institutionalized. It is thought that answers to the following questions might be obtained, in part: (1) Do institutionalized trainable mental retardates perform differently from non-institutionalized mental retardates on the Parsons Language Sample? (2) If so, in what subtest areas is there a significant difference? Hypothesis The preceding questions serve as a basis for the following null hypothesis: 1. There is no significant difference between the scores obtained by the institutionalized men— tal retardates and the non-institutionalized mental retardates on any of the subtests of the Parsons Language Sample. Importance of Study_ The Research Committee of the American Speech and Hearing Association was structured to explore research needs and possibilities of twelve problem areas related to speech pathology and audiology. One of the subcommittees was de- signed to survey speech and language problems associated with mental retardation and delayed speech and language development. Certain questions were set forth by this sub- committee, one of which is pertinent to the comprehensive and meaningful development of this paper. What are the interactions of cultural, social and other environmental factors with the speech and language behavior of the mentally retarded?1 The purpose of this paper as it is stated herein seems directly related to the subcommittee question. If a significant difference can be found to exist between the language performance of the institutionalized and non-in— stitutionalized retarded groups, then possibly this project can contribute to a degree of insight into the interactions of environmental factors and the mental retardate's language performance or behavior. Subtest analysis will point out the strengths and weaknesses of both groups in language performance. According to Schlanger,2 institutionalization con- tributes to language retardation due to complete associa- tion with peers and absence of a conventional home environ- ment. This study uses a new language assessment device and applies it to a population in which there is much cur- rent interest. Subtest analysis may provide insight into the mechanisms of both environments, mechanisms which tend to retard or enhance language performance. The statistical treatment of the results of this study may reinforce the information presented by Schlanger 1J. L. Bangs at 21., "VIII. Report of Subcommittee on Speech and Language Problems Associated with Mental Re- tardation and Delayed Speech and Language Development," Journal of Speech and Hearing_Disorders, Monograph Supple- ment V (September, 1959), pp. 50-52. 2B. B. Schlanger, "Speech Therapy with Mentally Retarded Children," Journal of Speech and Hearing Disorders, 23 (1958), pp. 298-301. (and others) or may offer contradictory conclusions regard- ing the language performance of institutionalized and non- institutionalized retardates. In either case, it is thought that knowledge can be gained regarding total language per- formance of retardates. Definition of Terms For purposes of this study, the terms used are de- fined in the following manner: Language Performance--The preceding terms are de- fined according to the tasks of the subtests of the Parsons Language Sample: 1. Tact. In this subtest the examiner presents an object or picture and asks, "What is it?" The controlling stimulus is vocal and the correct response is vocal. 2. Echoic. In this subtest the child is asked to repeat digits, words, and sentences. The controlling stimuli are vocal and the response is vocal and bears a point-to-point relation to the stimulus. 3. Intraverbal. The examiner asks the child questions such as, "What do you do when you are hungry?" The stimulus is vocal, the response is vocal, but unlike the re- sponse in the previous subtest, it does not bear a point-to-point relation to the vocal stimulus. 4. Comprehension. The examiner asks the child to execute a series of commands. The com- mands are given by speech, by gestures, and by speech and gestures combined. Thus, the controlling stimulus can be either vocal or non-vocal. The correct response is a motor act. 5. Echoic Gesture. The examiner demonstrates a series of motor acts which the child re- peats. The controlling stimuli are non- vocal; the response is non-vocal and bears a point-to—point relation to the stimulus. lO 6. Intraverbal Gesture. The examiner asks the child a series of questions which can be answered by gestures. The controlling stimulus is vocal; the response scored is non-vocal. 7. Mand. The examiner presents the child with a series of situations in which the appro- priate response would be to ask a question or make a request. For example, the exam- iner might ask the child to draw a picture but fail to make paper and pencil available. A correct response could be either a vocal or a non-vocal request. Parsons Language Sample--A test developed out of the efforts of members of the Parsons Project in Language and Communication of Mentally Retarded Children. Seven subtests (previously described) consisting of 123 items are used for purposes of identifying specific language abil- ities or disabilities in retarded children between seven years eleven months and fifteen years eight months. Trainable Mentally Retarded--For purposes of this study, the trainable mentally retarded individual may be defined in the following manner: 1. Chronological age range seven years eleven months to ten years eleven months; 2. Is developing at the rate of one-third to one- half of the normal child, or indicates an in- telligence quotient between 30 and 50 as deter- mined by qualified testers; 3. May be either institutionalized or non-insti- tutionalized; 4. Must be non-mongoloid; lJ. Spradlin, “Assessment of Speech and Language of Retarded Children: The Parsons Language Sample," Journal of Speech and Hearing Disorders, Monograph Supplement X TJanuary, 1963), pp. 29-30. ll 5. Is ineligible for classes for the educable men- tally retarded; 6. Is designated as "trainable mentally retarded" by a qualified examiner. Institutionalized--This term supposes a background of mental retardation and refers to placement in a state- supported facility for purposes of custodial care. These persons classified as "institutionalized" have been removed from the society in which they posed extreme problems of care. Non-Institutionalized--Refers to that group of train- able mentally retarded children enrolled in state-supported, special education, public school programs. This group lives at home with parents, guardians, or persons responsible for their care. CHAPTER II REVIEW OF THE LITERATURE Speech pathologists often refer to factors which do not lie within the organism but are external yet influ- ential in the development of speech and language. Environ- mental variables, as these affect speech and language de- velopment, can be thought of as external factors. These factors have been studied by numerous persons using normal and retarded subjects. The material set forth here serves as a review of the literature concerning the studies which have been com- pleted and are related to the development of this paper. One of the earliest investigations concerned with speech and language retardation and environment was con- ducted by Beckey, in 1942. A detailed clinical study was made of fifty children with retarded speech development and of a control group of fifty children with normal speech. Home conditions of both groups were evaluated from parent consultation, home calls, and observation of the child with the mother. Attempts were made to secure a control group which was equivalent to the delayed group. The following results were obtained when an attempt was made to determine the role of the environment as an etiological factor of 12 l3 delayed language development: 1. Children of the delayed group has too much iso- lation for the encouragement of speech. 2. Fathers of the children of the retarded speech group frequently belonged to the lower socio- economic groups. 3. Severe fright was found to be a factor among the children with delayed speech. 4. Anticipation of wants of the child occurred quite often among the parents of the delayed speech children. Beckey concluded that certain psychological factors within the home environment have a direct bearing on development or lack of development, of speech and language. Mason2 wrote of a girl who was speechless until six and a half years old. The child had been forced to dwell with a mute and uneducated mother for this period of time. There was no environmental stimulation for speech and language, resulting in complete lack of development of these skills. Mason pointed to the importance of environ- mental stimulation when she concluded that exposure to a speaking environment, with remedial instruction, resulted in the arduous acquisition of speech and language for the patient. lRuth E. Beckey, "A Study of Certain Factors Related to Retardation of Speech," Journal of Speech Disorders, 7 2Marie Mason, "Learning to Talk After Six-and-a- Half Years of Silence,” Journal of Speech Disorders, 7 l4 Goldfarb,l utilizing graphic Rorschach data, studied the effects of early institutional care on the personality of the adolescent. The responses of an institutional and non-institutional matched group were compared. It was con- cluded that institutional children tended to deviate from the normal pattern of response more than did foster home children. Institutional children showed greater trends toward "concreteness," apathy, passive surrender to environ- mental stimulation (or lack of it), and weak reorganization of experience. Goldfarb concluded that the institutional- ized child with normal intelligence indicated a generalized deficiency of personality structure as determined by pro- jective techniques. In another study, Goldfarb2 compared 40 institutional children with 40 non-institutionalized children. Children placed in foster homes after institutional babyhood rear- ing were found to exhibit less security, more isolation from other people, less ability to enter into meaningful relationships, more frequent speech and language retarda- tion, and greater school deficiency than children who ex- perienced infant rearing in foster homes. In another study, Goldfarb utilized an institutional lWilliam Goldfarb, "The Effects of Early Institu- tional Care on Adolescent Personality (Graphic Rorschach Data)," Child Development, 14 (1943), pp. 213-23. 2William Goldfarb, "Infant Rearing and Problem Be- havior,” American Journal of Orthopsychiatry, 13 (April, 15 group consisting of 8 boys and 7 girls with a mean age of 12 years 4 months. They had entered the institution in early infancy (mean age 4.5 months), had remained in the institution 3 years, and had then been transferred to fos- ter homes. These children were equated with 15 children who had always been with families. The two groups were matched in terms of chronological age and sex. The follow- ing methods of investigation were employed to evaluate speech and language performance of the two groups: A. General estimate rating B. Fluency rating C. Recording of diction errors The results of that portion of the study devoted to speech and language are summarized by Goldfarb in the following manner: The institution baby has come to the community with a minimum of language, vocabulary, and information. The infinite number and variety of experiences open to a child living in a typical home and community are absent in the institution. In addition, because of his isolation from adults, the institution child is severely retarded in language, has a much nar- rower vocabulary than his community brother, and tends to mispronounce the words he is familiar with. The limitation in a specific skill such as language tends to restrict the child's intellectual capacity. In still another study, Goldfarb compared 15 child- ren who had been admitted to an institution at 4.6 months and transferred to foster homes at 37 months, with a matched group of children who had spent most of their lives in foster lWilliam Goldfarb, "The Effects of Early Institution- al Care on Adolescent Personality," Journal of Experimental Education, 12 (1943-1944), pp. 106-29. 16 homes. Language was evaluated with the Williams, McFarland, and the Little Language Achievement Scale. Individual scores were obtained for speech sounds employed, speech intelli- gibility, and level of language organization. ‘The total language achievement score was the sum of these three scores. The results indicated that the foster home children were superior to the institution group in the three phases of language evaluated. The foster home children tended-to maintain superiority even after the institution children had been in foster families for seven months. The vocabulary of both groups was measured by the picture vocabulary test of the revised Stanford-Binet (Form L). The institution children were inferior in vocabulary in both the first and second tests. Goldfarb comments on this when he writes, Again, it is apparent that even after six months in the normal community, the average vocabulary of the institutional children was still inferior to the vocabulary performance of the foster home children during the first examination.l 2,3,4 Aldrich, Sung, and Knop investigated infant lWilliam Goldfarb, ”Effects of Psychological Dep- rivation in Infancy and Subsequent Stimulation," American Journal of Psychiatry, 102 (1945-1946), pp. 24-26. 2C. Aldrich, C. Sung, and C. Knop, "The Crying of Newly Born Babies: I. The Community Phase,” Journal of Pediatrics, 26 (1945), pp. 313-26. 3C. Aldrich, C. Sung, and C. Knop, "The Crying of Newly Born Babies: II. Individual Phase," Journal of Pediatrics, 27 (1945), pp. 89-96. 4C. Aldrich, C. Sung, and C. Knop, "The Crying of Newly Born Babies: III. The Early Period at Home," Jour— nal of Pediatrics, 27 (1945), pp. 428-35. l7 crying in a series of studies. The infants used in the study were observed for 24 hours a day during a 30 day period in a hospital nursery. The studies compared the amount of crying under home-care conditions with the amount of crying after increased individualized nursing care in the hospital nursery. The results of these studies indi- cated that hospital nursery babies cry 117 minutes per day with 11.9 prolonged crying spells of three minutes or more. In the home situation only four prolonged crying spells were noted. Increased nursing care in the hospital nursery resulted in 51.4 percent decrease in the amount of crying. The authors concluded that the environment has a bearing on the child's emotional development and subsequent acquisi- tion of speech and language. Carlton and Carlton1 used eight different picture sequences from two popular children's paint books (Blondie and the Lone Ranger) to evaluate the spontaneous use of clauses and the number of oral errors present in the speech of two groups of retarded children. Seventy-two mentally defective school children with an age range of 14 to 16 and a mental age range of 8-6 to 10-5 were selected randomly from 11 Minneapolis schools for defective children. Another group of mentally defective adolescents, 61 in number, the total population falling within the restrictions of the 1T. Carlton and L. Carlton, "Errors in the Oral Language of Mentally Defective Adolescents and Normal Ele- mentary School Children," Journal of Genetic Psychology, 66 (1945), pp. 183-219. 18 study, were examined at the Minnesota School and Colony at Fairbault, Minnesota. The results of the study indicate no significant differences in the types of grammatical er- rors in the speech of the retarded children whether they lived in an institution or home community. The institutional children did, however, consistently make a higher mean num- ber of errors. Levyl has studied the effects of institutional ver- sus boarding home care on infant behavior. She concludes that care provided in an institution results in reduced emotional security and decreased external stimulation which is essential if the child is to capitalize on his innate capacities. Institutional care seems to affect the child's personality in later years, as opposed to boarding home care which, according to Levy, has no marked detrimental effects on the personality. Brodbeck and Irwin2 studied the results of reduced speech stimulation with 90 babies under six months of age in an orphanage where a minimal speech environment existed. The curves for phoneme types and frequencies of the orphan- age babies were below the curves of the home babies. 1R. J. Levy, "Effects of Institutional vs. Board- ing Home Care on a Group of Infants," Journal of Personal- ity, 15 (1946-1947), pp. 233-41. 2A. Brodbeck and O. C. Irwin, "Speech Sounds of Infants without Families," Child Development, 17 (1946), pp. 145-56. 19 Moore,1 using the Smith-Williams Vocabulary Test, evaluated the oral language of a group of orphanage and non-orphanage children. An analysis of variance statis- tical treatment of the results showed a significant differ- erence attributable to influences of environment, with the orphanage group indicating markedly inferior vocabulary development. Schlanger compared verbal output of two groups of mentally retarded children. Twenty-one children from an institutional environment, at St. Coletta School for Excep- tional Children in Jefferson, Wisconsin, were compared with 21 children from special classes in the Madison, Wisconsin, School System. Subjects were matched according to chrono- logical age, mental age, intelligence quotient, and con- sonant articulation proficiency. Mean sentence length and number of words per minute scores were obtained and statis— tically analyzed. View-Master pictures were used to elicit spontaneous speech from each subject. Schlanger summarized the conclusions when he writes, The superiority of the city children in language development is evident as far as these measures evaluate this skill. The city children achieved a mean sentence length of 5.36 words compared to the institutionalized children's mean of 4.18 words. This difference of 1.18 is significant at the one percent level of confidence. 1J. K. Moore, "Speech Content of Selected Groups of Orphanage and Non-Orphanage Preschool Children," Journal of Experimental Education, 16 (1947), pp. 122-23. 28, B. Schlanger, op. cit., pp. 122-23. 20 In addition, the city children used 64.9 words per minute, or 15 more words per minute than the institutional children. The difference was significant at the three percent level of confidence. Schlanger concluded that severance of famil- ial ties, and the resulting emotional reactions results in a loss of security in interpersonal relationships which appear to be reflected in minimal verbalization. The re- sult is the use of overt actions for verbalization and a reduction in the practice needed to develop and maintain adequate speech patterns. Badt studied the effects of institutionalization on the ability of retarded children to define words and manipulate concepts. Sixty in-patients of a state school for mental defectives were drawn from those children who attended the institutional academic program. The subjects ranged in age from seven to fifteen, were diagnosed as idio- pathic or familial mentally deficient, and ranged in intel- ligence quotient from 50-75. The vocabulary list of the Stanford Binet Intelligence Scale (Form L) was used to as- sess the subject's ability to verbalize abstract definitions. Responses to the vocabulary items were scored plus or minus according to pre-determined Stanford Binet standards. All plus responses were weighted as follows: Word Level Example Score Orange Abstract "a fruit," "a color" 5 Orange Use "to eat" 3 Orange Descriptive "it's round and yellow" 1 An Abstraction Score was obtained for each subject by totalling the scores for each word. Relations were sought 21 between abstraction scores (subject's ability to define words abstractly) and chronological age, Stanford-Binet mental age, and duration of institutionalization. The results of the study indicate Pearson product moment correlations of .34 between chronological age and abstraction scores, .24 between abstraction score and men- tal age. In her discussion of the relationship between duration of institutionalization and abstract thinking, Badt concludes, This evidence seems to show that the length of time spent by the subjects in the institution strongly affects the level at which they define words and manipulate concepts. The longer the time of institutionalization, the lower is ab- stracting ability.l Haggerty investigated the effects of prolonged hos- pital care on a group of children. Data were accumulated on 100 children over a five-year period. All subjects had spent a considerable amount of time in child care and hos- pital settings. All subjects were in the seventh grade of grammar school; the mean age of the group was 12.7 years. The average age at which the children were separated from their homes was 3.7 years, with 3.5 years the average length of placement in a hospital setting. The hypothesis, as set forth by the author, was that "Early and prolonged hospitalization or institutionalization lMargit Badt, "Levels of Abstraction in Vocabulary Definitions of Mentally Retarded School Children," American Journal of Mental Deficiency, 63 (July, 1958 - May, 1959), pp. 241-46. 22 can affect a child's personality development through the disruption of verbal communication ability." A parts-of- speech analysis was used to study the language of the sub- jects. In an effort to obtain language samples, all oral responses were recorded, with a recorder, from a sentence completion test and from responses (stories) given to the Thematic Apperception Test. The oral vocabulary portion of the WISC was also included. Rorschach data were obtained for a personality inventory. The results of the study show that the subjects indicated lower than normal language content, with a pat- tern resembling that of schizophrenics who are considered to express regressed language facility. In addition, the institutional group were very similar to schiZOphrenics in their selection of functional and example types of defini- tions, as opposed to the higher conceptual abstractions of normals. Haggerty concludes in the following manner: It appears from the results of this study that early and prolonged hospital or other institu- tional experience can damage personality integra- tion and can lead to an inhibition of prOper com- municability.l In 1959 Psychologist J. G. Lyle designed a study to determine whether institutional imbecile children were retarded in verbal intelligence as compared with a similar group of imbeciles who attend day schools and live at home 1A. D. Haggerty, "The Effects of Long-Term Hospital- ization or Institutionalization Upon the Language Develop- ment of Children," Journal of Genetic Psychology, 94 (June, 1959), pp. 205-209. 23 with parents. The institutional sample consisted of 77 children selected from Fountain Hospital in London. One hundred seventeen children constituted the day-school sample, drawn from special training schools in the Middlesex area. The Minnesota Preschool Scale of Intelligence (Form A) was uti- lized to determine verbal intelligence. The following limitations were used in defining procedure: (1) I.Q.(s) were restricted to the 20-50 range, the range used to define imbecility. The non- verbal portion of the Minnesota Preschool Scale was used to provide an 1.0. measure. (2) The chronological age range suggested by the upper and lower limits of the test was restricted to six years six months to thirteen years six months. No child with a mental age below two years six months or above five years eleven months was included in the sample. (3) There were no deaf, blind, or severely spastic children included in either sample. In addition, the institutional sample consisted of 34 mon- gols and 43 non-mongols distributed more or less equally among the various age groups. The day school sample con— tained 76 mongols and 41 non-mongols, proportionately more mongols than the institutional sample. The Minnesota test is calibrated in C-scores described as equal units of equal 24 interval from which M.A. equivalents are derived by means for a conversion table. The results of the study were summarized by Lyle in the following manner: (1) There were no significant differences between any of the C-score means on the non-verbal sub- test of the Minnesota Preschool Scale, indicat- ing that in terms of non-verbal M.A., the four groups of imbeciles were comparable. Discrep- ancies in verbal intelligence cannot, therefore, be explained in terms of differential brightness. (2) There were highly significant differences be- tween the C-score means on the verbal subtest of the Minnesota Preschool Scale between the Day School and Institution groups both for mon- gols and non-mongols, in favor of the Day School group. The mean discrepancy was 12 months of verbal M.A. in the case of mongols and six months of verbal M.A. in the case of non-mongols. (3) There was a significant difference between mon— gols and non-mongols in the Institution of nine months of verbal M.A. The difference between mongols and non-mongols in Day Schools was not significant. (4) It seems likely that long residence in the in- stitution retards verbal intelligence much more than non-verbal intelligence. The reason for this appears to be simply that in the institu- tion children have learned only a very limited repertoire of speech.1 In another study, Lyle utilized the same subjects in an attempt to measure and compare different aspects of speech and language. A number of scales were designed, based on the Analytical Scale of Language Achievement de- scribed by Williams, McFarland, and Little, in order to 1J. G. Lyle, "The Effect of an Institution Environ- ment Upon the Verbal Development of Imbecile Children: I. Verbal Intelligence," Journal of Mental Deficiency Research, 3-4 (February, 1959), pp. 122-28. 25 assess various aspects of speech and language. The following ad hoc scales were utilized in the study: (1) (2) (3) (4) (5) (6) (7) (8) Word Naming. This test, according to Lyle, measures the ability to attach verbal symbols to familiar objects and actions. Comprehension of Words. The child is required to point to objects or execute commands named by the examiner. Definition of Words. This test involves the skill to make pertinent verbal associations to named objects. Speech Sounds. This scale was used to deter- mine the ability to discriminate and utter 80 speech sounds contained in simple words repeated by the child. Complexity of Language. A scale was used to measure the complexity of sentences used by the children in describing pictures. Clarity of Speech. Frequency of Speech. Two teachers' ratings were obtained independently for each of these variables. Verbal Intelligence. Statistical treatment of the results of the study indicates the following conclusions: (1) (2) (3) The various scales of speech and language were highly correlated, attributable to one factor, verbal ability. Non-mongols were superior to mongols in verbal ability whether in day school or in the insti- tution. Institutionalized imbecile children were lower in verbal ability expressed as a composite ver- bal score, than those at day school whether they were mongols or non-mongols. 26 (4) The interaction effect between Institution Day School and Mongol/Non-Mongol variables was not significant. (5) Sex did not have a significant effect upon the criterion for verbal ability. (6) Form A of the Minnesota Preschool Scale seems to be a functional intelligence test for imbe- cile children, containing a non-verbal subtest which correlates .80 with Stanford—Binet, and a subtest of verbal ability which correlates .70 with various ad hoc verbal tests.1 In conclusion, Lyle cites restricted learning oppor- tunities for speech, restricted motivation to utilize lan- guage as a communicative tool, and emotional disturbance concomitant with mental retardation as factors which oper- ate to retard verbal development within the confines of the institution. In a follow-up study, Lyle compared two matched groups of subjects to determine whether or not emphasis on personal relationships would enhance verbal performance of retardates. The two groups each consisted of 9 males and 7 females. In eleven cases, mongols were paired with mon- gols, or non-mongols with non-mongols, since it was thought possible that this broad classification could be relevant to verbal ability. Five of the sixteen pairs could not be matched for "clinical type." The subjects were matched according to verbal and non-verbal intelligence as deter- mined by the Minnesota Preschool Scale of Intelligence. 1J. G. Lyle, "The Effect of an Institution Environ- ment Upon the Verbal Development of Imbecile Children: II. Speech and Language," Journal of Mental Deficiency Research, 3-4 (January, 1960), pp. 1-13. 27 The following ad hoc verbal tests were administered to all of the 32 subjects: (1) Speech Sounds, (2) Comprehension of Words, (3) Word Naming, (4) Definition of Words, and (5) Complexity of Language. The experimental group of 16 subjects were placed in the Brooklands Unit, a large, detached house located a number of miles from the institution. The matched control group remained in the institution. Within the Brooklands Unit, emphasis was placed on the fostering of personal re— lationships and the provision of opportunities for the re- tarded children to talk with the adult staff, and to other children. The control group subjects continued to live within the institution with the same regimented approach. The subjects remained in these environments for a period of three years. The results of the first retesting indicated the following: (1) On verbal tests the non-mongols improved at a more rapid rate than the mongols; this tend- ency was not cancelled by placing mongols in a more favourable environment. (2) Significant differences were found in favour of the experimental Brooklands group on three of the verbal tests; on the remaining verbal tests and the non-verbal subtest of the Minne- sota, no significant differences were found. The verbal tests for which significant differ- ences were found were Comprehension, Complexity of Language, and Definition of Words. (3) The Brooklands group improved about 4 months 28 of verbal M.A. more than the control group.1 In an 18—month retest, the results obtained were siJnilar to those obtained at the first retesting. Over the 18-4nonth period, the following behavior changes were noted in. the experimental group: (1) Formation of personal relationships with staff adults, (2) More interaction with peer groups, and (3) Increased social—emotional security. Sievers and Essa utilized the Differential Language Fax:;ility Test to compare the language development of insti- ‘UJtLionalized and community mentally retarded children. In adkicition, all subjects were given a speech and language eXEaxnination according to procedures developed by Essa. TRUE procedures included all of the following: (1) a modified speech reception hearing test, (2) an abridged articulation test, (3) an oral response test, (4) a rating of speech intelligibility, and (5) taped recorded responses to pictures. Seventy-four subjects with M.A.'s between 3-0 and S‘ill were randomly selected from an Ohio Training school. TENS community group consisted of the same number of subjects, randomly selected and falling within the same mental age 1J. G. Lyle, "The Effect of an Institution Environ- meint Upon the Verbal Development of Imbecile Children: III. lie Brooklands Residential Family Unit," Journal of Mental Ekzfiiciency Research, 3-4 (January, 1960), pp. 14-23. 29 range as the institutional group. The Stanford-Binet Scale vnas administered to each subject as an estimate of M.A. Ifue chronological age range of the institutional group was frcxn 6—11 to 16-11 with an 11-9 mean; the chronological age: range of the community group was from 7-7 to 16-4 with a mean of 11-3. The results of the study indicate that the insti- 'U4t:ional group had a significantly lower mean on the total scx31:e of the DLFT. The community group performed at a sig- nicfticantly higher level on the following five subtests of the DLFT: (l) Labeling Objects, (2) Labeling Pictures, (3) Word Association, (4) Mutilated Pictures, and (5) Picture Series Description.1 The DLFT subtest performance changed with M.A. Wif:hin both groups. This would seem to indicate that the 'rellardate's language behavior tends to follow the same de- VEfiLopmental pattern as normal children. Contrary to previous findings (Schlanger, 1954), thfii institution group had a higher mean verbal output than trfie community group. This was the only significant differ- Eruze between the institutional and community groups in any 1D. J. Sievers and S. H. Essa, "Language Develop- "Wnut in Institutionalized and Community Mentally Retarded Cniildren," American Journal of Mental Deficiengy, 66 (May, 1962), pp. 413-20. 30 of the tests of the speech evaluation. The different re- sults of the Schlanger and Sievers-Essa studies were attrib— uted to differences in research methodology. In 1964, Mueller and Weaver compared the psycholin- guistic abilities of two groups of mental retardates. One of the hypotheses of the Mueller-Weaver study was stated as follows: (1) Trainable mental retardates in day school classes will score significantly higher on overall language ability on the Illinois Test of Psycholinguistic Abilities (ITPA) than will institutionalized trainable mental re- tardates of comparable intelligence quotient and chronological age. A matched pairs design was used in which subjects from the institution and day school were matched for sex and race, matched within six months of age, and within seven points in 1.0. Sixty-eight subjects were obtained for each group. Chronological age was limited from 8 to 19 and 1.0. was restricted to a 20-56 range. The results of the study indicate that the insti- tutionalized trainable mental retardates were significantly higher in overall language ability than the day school group of trainable mental retardates. This finding is contrary to most of the studies presented in this review of the lit— erature. The authors conclude that, lMax Mueller and S. Joseph Weaver, "Psycholinguistic Abilities of Institutionalized and Non-Institutionalized Trainable Mental Retardates," American Journal of Mental Deficiency, 68 (May, 1964), pp. 775-83. 31 The superiority of the institutional group's total language ability scores in the present study raises the possibility that the ITPA tests some aspect of language that tests used in previous studies did not.1 Ibid. CHAPTER III SUBJECTS, EQUIPMENT, AND PROCEDURES Subjects For purposes of this study, the institutionalized population consisted of resident patients from the Mount Pleasant State Home and Training School, the Lapeer State Home and Training School, and the Plymouth State Home and Training School. These facilities are tax maintained by the State of Michigan for the custodial care of mentally retarded patients. Upon the medical certification of two physicians, persons are committed to such facilities by court order. A diagnosis of mental retardation must pre- cede admission. The non-institutionalized population consisted of mentally retarded children living in Lansing, Montcalm Coun- ty, and the Grand Rapids area. All non-institutionalized subjects were living at home with parents, other relatives, or guardians responsible for their care. Subjects were in attendance at Forrest Road and Woodhaven Schools in Lansing, the Friendbrooke and Forest Grove Schools in Mont- calm County, and the Lincoln School Foundation in Grand Rapids. All of the aforementioned facilities are public training schools. 32 33 Subjects selected for the study had normal hearing and vision. Normal hearing was assumed if no diagnosis of hearing loss was indicated by the records of the public school or the institution. Vision was assumed to be normal if a subject could correctly identify the number of fingers held up by the examiner at the testing distance. This study was concerned with assessing the language performance, as measured by the Parsons Language Sample, of an institutionalized and non-institutionalized mentally retarded population. The institutionalized and non-insti- tutionalized groups ranged in chronological age from 7 years 11 months to 10 years 11 months, and were divided into two intelligence quotient categories, 30-39 and 40-49. This classification resulted in two populations defined by chron- ological age and full scale scores on the Wechsler Intelli- gence Scale for Children,1 the Revised Stanford-Binet, Forms L or M,2 the Kuhlmann-Binet Intelligence Test,3 and the Cattell Infant Intelligence Scale.4 The sampling procedure for each of the two popula- tions involved random selection of subjects from institutional lDavid Wechsler, Wechsler Intelligence Scale for Children (New York: Psychological Corporation, 1949). 2L. M. Terman and M. A. Merrill, Measuring Intelli- gence (Boston: Houghton-Mifflin Company, 1937). 3F. Kuhlmann, A Handbook of Mental Tests (Baltimore: Warwick and York, 1922). 4P. 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