THE VALUE AND USE 0E MUSIC. ACTIVTTTES IN THE ’ ! TREATMENT OF SPEECH DELAYED CHILDREN Thesis for the Degree of M. M. MICHIGAN STATE UNIVERSITY CHARLES D. SEYBOLD 1970 .. ' u . . ———___——_—_——_—— . 1 \'~" —.‘-.M-~'->. ‘7’ ’ *- A - C—. -.—- -..— - - - _ .. . - ‘ -— - . - - O r .- o’ a--...--..--«~--.—¢-.~ww.-qwasw.mvlvgwofi “f... _ .‘ .-‘ ‘ . n - a . ‘.- ‘ . _ I - ‘3 O '; ~ - »: . LIBRARY Michigan Stab University f - ABSTRACT THE VALUE AND USE OF MUSIC ACTIVITIES IN THE TREATMENT OF SPEECH DELAYED CHILDREN BY Charles D. Seybold The purpose of this study was to assess the value and use of music activities in the treatment of speech delayed children. The question to be answered was: Can a music therapist devise a music activities program for speech de- layed children and stimulate these children to use spon- taneous speech that is commensurate with their age? Eight subjects (pre-school children) were randomly drawn from the available pOpulation of speech delayed children in therapy at the speech and Hearing Clinic, Michigan State University. The eight subjects were then randomly assigned to either the control group or the exper- imental group: four in each group. A regular program of speech therapy was established for the control group and directed by a speech therapist; a program of music activi- ties was devised for the experimental group and directed by a music therapist. Each child received individual therapy of fifty minutes, twice per week, for eight weeks. At the completion of the eight weeks of therapy, each subject Charles D. Seybold was administered the Houston Test for Language Develop- ment. Results of the study were not statistically signifi- cant at acceptable standards. However, statistical analy- sis showed significance at the .10 level. Although the results of this study were not statis- tically significant, it is thought that the study indicates a need for further research in the clinical uses of music activities in a speech therapy program. THE VALUE AND USE OF MUSIC ACTIVITIES IN THE TREATMENT OF SPEECH DELAYED CHILDREN BY Charles D. Seybold A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF MUSIC Department of Music 1970 ACKNOWLEDGMENTS ,The writer wishes to express sincere appreciation to Mr. Robert Unkefer and Dr. Robert G. Sidnell of the Depart- ment of Music for their wise counsel and many helpful sug- gestions throughout this study. Grateful appreciation is also expressed to Dr. Leo Deal and Mrs. Jean Waldo of the Department of Audiology and Speech Sciences for their encouragement, direction, and contributions to this investigation. A very special thanks is given to Miss Cindy McQueen, for her time and diligence given to this study as the speech clinician for the control group. ii TABLE OF CONTENTS Page ACKNOWLEDGMENTS. . . . . . . -. . . . . . ii LIST OF APPENDICES . . . . . . . . . . . iv- Chapter I I INTRODUCTION 0 O O O O O O O O O I 1 Purpose of the Study. . . . . . . . 4 Definition of Terms . . . . . . . . 5 overView O O O O O O O O O O O O 7 Speech Development . . . . . . . . 10 II. REVIEW OF RELATED LITERATURE . . . . . . 14 III. DESIGN OF THE STUDY . . . . . . . . . 24 Problem . . . . . . . . . . . . 24 Sample . . . . . . . . . . . . 24 Procedures and Techniques of Treatment. . 26 Experimental Group . . . . . . . 26 Control Group . . . . . . . . . 30 IV. ANALYSIS OF RESULTS . . . . . . . . . 33 Discussion . . . . . . . . . . . 35 Recommendations . . . . . . . . . 39 APPENDICES . C O O O O O O O O O C O O 4 o BIBLIMRAPHY C O O O O O O O O O O O . O 5 7 iii LIST OF APPENDICES Appendix Page A. Music and Lyrics . . . . . . . . . . 41 B. Story of Little Rabbit Foo Foo . . . . . 47 C. The Houston Test for Language Development. . 49 D. Analysis of Data--Mann-Whitney U Test . . . 54 iv CHAPTER I INTRODUCTION Through the centuries, peOple have used music and speech as media of entertainment and communication. Today it is known that both music and speech can be vehicles of much broader educational and emotional experience and are not limited to the stereotyped performances that so often were expected of children for the entertainment of their parents. Music activities and speech are areas in which child- ren can experience success, belonging, and a sense of satisfaction. It is a societal belief that both have much in common. Both involve imitation, empathy, and sound dis- orimination. In terms of application to music activities, it has been found that the functional goals for children are fourfold: 1. Physical; better muscular coordination and reaction. 2. Emotional; matching moods and identifying themselves with what they hear through various sound stimuli. 3. Social; active participation, singing and rhythmic activities, developing confidence, and stimulating interest. 4. Intellectual; correlating music with other subjects, places, and things. These same goals can apply to young children during the deve10pment of speech. 1. Physical; neuro-muscular control of the lips, jaw, tongue, and various other important speech producing mechanisms. 2. Emotional; play acting for peOple through various sound stimuli. 3. Social; interacting with peers, developing confidence, and stimulating interest. 4. Intellectual; relating language and speech with other subjects, places, and things.2 These similar goals suggest that it might be ad- vantageous to use music activities and speech techniques in combination to stimulate the young child to use in- telligible speech. The question can be raised as to whether or not such a combination could result in better treatment of speech delayed children. In working with children who show inadequate language development, one often finds (as stated above) that music therapy and speech therapy are working toward the same general goals: yet each discipline is, for the most part, unaware of what the other is doing. It would seem, there- fore, that coordination of these therapies would result in 1Louise Kifer Myers, Teaching Children Music in the Elementa School (Englew C 1 s, New Jersey: Prentice- HaII, Inc., I§325 , p. 9. 2Beatrice B. Groginski, "The Use of Music in a Speech Improvement Program in the Kindergarten Class" (unpublished Master's thesis, Texas WOmen's University, 1960), p. 17. more efficient total programming for the client. For this program to be effective, the two programs should be de- signed to allow each to serve and enhance the other. For example, a child is usually pleased with his ability to identify objects or actions by name. When the music thera- pist can teach the child to identify these objects or actions, the child should be able to experience greater success with the music therapist in therapy. Conversely, if music therapy can create a situation which requires the Child to use the words learned in speech therapy, the words may attain greater meaning and significance for the child. In essence, the problem is documenting more and better ways of helping the speech handicapped through the use of music activities. Vocal music and speech seem to be so closely related that not only are there common perceptual factors operating in both, such as auditory discrimination, aural perception, and muscular coordination, but also there seems to be many possibilities of using music activities in speech therapy. Before more practical work is done in the field of music and speech, it is essential to know more about the relation- ships between speech therapy and the use of music activi- ties in treating the speech handicapped. The present study is directed to the greater under- standing of this relationship. The idea of using music in a speech therapy setting is neither new nor original. Such use has been reported by Van Riper and Butler,3 Anderson,4 Bryngelson and Mikalson,5 and Hawk.6 It is with the belief that music activities can 'be integrated with and directly supportive to the speech therapy program that this study was undertaken. In this study music activities were used in an at- tempt to stimulate speech delayed children to use spon— taneous speech. Purpose of the Study The purpose of this study is twofold. First, an at- tempt was made to develop and present techniques for speech improvement with speech delayed children, which represented a synthesis of selected procedures of music therapy as well as some conventional methods found in a speech therapy pro- gram for speech delayed children. Second, the synthesized 3Charles Van Riper and Katherine G. Butler, S eech in the Elementary Classroom (New York: Harper & Bros., I555), p. 21. 4Virgil A. Anderson, Improving the Child's Speech 1P0 (New York: Oxford Press, 1 5Bryng Bryngelson and Elaine Mikalson, Speech CQET rection Through Listening (Chicago: Scott Foresman & Co., I359), p. 24. 6Sara Stinchfield Hawk, S eech Therapy for the Physicallygandicap ed (Stanfor , California: Stanford University Press,—l 50), p. 86. techniques were evaluated and contrasted to conventional methods of speech therapy. This study seeks to answer the following questions: 1. Will the use of music activities stimulate spon- taneous speech? 2. Can a music therapist devise a music activities program for delayed speech children and stimulate these children to use spontaneous speech? 3. Will the use of music aid in the teaching of basic language concepts? Definition of Terms The following definitions are used in the discussions presented in the study: Therapy is the science which deals with the treatment or application of remedies for the cure, alleviation, or prevention of disorders.7 Speech development is best described as a dynamic, continuing learning process.8 Auditory discrimination is the ability to distinguish sounds correctly.9 7Lee Edward Travis, Handbook of Speech Pathology (New York: D. Appleton-Century Co., 1957), p. 66. 8Mildred F. Berry and Jon Eisenson, S eech Dis- orders (New York: Appleton-Century-Crofts, Inc., I956), p. 158. 9Hallowell Davis, Hearing and Deafness (New York: Rinehart Books, Inc., 1955), p. 1531 Auditory training is the process of teaching the 10 child to take full advantage of sound clues. "Delayed speech is when a child appears to have an adequate receptive symbol system but the amount of verbal output is not commensurate with his age. When stimulated, the child may speak; and when he speaks, he may show typi- cal vocabulary, morphology, and syntax for his age. The problem seems to be that he is not often motivated to speak. He seems to be inhibited in his desire to communi- ll cate orally." Spontaneous speech is defined as any speech initiated by the child, as opposed to imitative speech. Music activities can best be described as various musical activities adapted or composed to reinforce and en- hance the teaching of specific concepts, language patterns, and for stimulating the child to use spontaneous speech. Music therapy is defined, for the purposes of this study, as those techniques used in therapy to achieve the established goals. These techniques involve the use of music to stimulate the speech response by always initiating this response by the use of various musical stimuli which follow a specified sequence of events. 10Charles Van Riper and John Irwin, Voice and Articu— lation (Englewood Cliffs, New Jersey: Prentice-Hall, Inc., I§§§), p. 153. 11Leo Deal, Ph.D., Personal Communication, Professor of Speech Pathology, Department of Audiology and Speech Science, Michigan State University, June, 1970. Speech therapy with speech delayed children is de- scribed in the following quotation: . . . create the necessary motivation, con— vince the child that it is possible and reward— ing to use intelligible speech. The child must come to know the characteristics of the in- dividual speech sounds and the ways in which they occur in words. One must provide simple speech models within the child's ability to du- plicate. Through self- talk and parallel talk, one must provide the language symbols needed for thinking, communication, social control, emotional expression, and the development of a self concept.12 Overview Delayed speech and language development occurs with greater frequency and, at times, with greater complexity 13 than any other known communication disorder. To some de- gree, both the frequency and the complexity of delayed speech seem to have increased during the last decade.14 This apparent increase is due, at least partially, to several factors. First, in this supersonic age in which we live, with its television, telephone, and telespatial communications, there is a tendency for adults to impose stricter demands on young children for earlier and more accurate speech 12Charles Van Riper, Speech Correction (4th ed.: Englewood Cliffs, New Jersey: Prent1ce Hall, Inc., 1963), p. 151. 13Nancy E. WOod, Delayed Speech_~ and Language Develop- ment (Englewood Cliffs, New Jersey: Prentice-Ha Foun a- t1ons of Speech Pathology Series, 1964), p. 1. l4 Ibid. development than ever before.15 Parents, siblings, tea- chers, relatives, and even neighbors seemingly join in a concerted effort to remind children of the need to speak effectively and clearly.16 During the last twenty or thirty years, our levels of aspiration for speech de- velopment have risen. Therefore, when contrasted with children of the 1940's and the 1950's, children today must learn to communicate very early and on a much more complex level--often because of an emphasis placed upon the need for effective speech as a social tool.17 Secondly, according to WOod, more parents have be- come aware of developmental schedules and the many factors that may interrupt normal development. Through such popu- lar writings as those of Spock, Gesell, Ilg, and Ames, parents are more aware of what a child should be doing at various stages of normal development. With this more cri- tical awareness, parents are seeking professional help earlier than they have in the past. They want to know whether their child is significantly delayed in speech development; and, if so, what can be done to alleviate or to solve the problem.18 15Ibid. 161bid. 171bid. 18Ibid., p. 2. Another factor, according to Wood, is that medical science has made significant advances in reducing the mor- tality rate at birth. Today, more children are living who previously would have expired at birth. At the same time, many of the children who have survived traumatic deliveries are found later in life to have subtle and sometimes con- fusing disorders. Frequently, one of these disorders is a reduced capacity to communicate verbally, for many of these children do not learn to talk at the expected time or with the expected accuracy and frequency.19 Finally, Wood stated, the development of new tests, the availability of new clinical services, the wealth of new information from research and the promise of more to come have all sharpened the abilities of specialists to de- tect the presence of speech and language problems at an earlier age.2.o For these and other reasons, more and more children are being referred to clinics, diagnostic centers, or specialists in private practice because they do not com— municate adequately. Speech is the primary medium through which we make ourselves understood in everyday life; the vehicle by which we orally express our needs and desires, our hopes and lgIbid. ZOIbid. 10 fears, our every thought. But speech means more than simply talking to make ourselves understood. Everyday speech is so badly cluttered with incorrect and indistinct diction, poor tone quality, slang phrases, and colloquial- isms, it often ceases to be the fine attribute of person- ality and character that it should be.21 Speech Development To understand the child's normal speech pattern and to teach the child, it is important also to understand the child's speech develOpment, as presented here. Speech deveIOpment is best described as a dynamic learning process, not as a still-life picture.22 we are not born with either the desire or the need to speak.23 we learn to speak only because those around us use this method of communication. Like all types of learned behavior, speech develop- ment depends upon the maturation of the individual. Maturation determines when behavior can be learned, for maturation establishes certain periods of life when the organism has established a "readiness."24 21George 0. Bowen and Kenneth C. Meek, Son and Speech (Boston: Ginn and Company, 1952), p. v1. 22Berry and Eisenson, op. cit., p. 128. 23Wood, 0p. cit., p. l. 2‘GIbid. , p. 9. 11 WOod has adequately abridged the speech development sequence into a short and most understandable form:25 Speech sounds develOp in a series of stages that proceed from the prelinguistic utterances through the linguistic use of symbols. The prelinguistic stage of development begins with non-meaningful reflexive sounds which are re- lated to the physiological changes in the in- fant during the first three months of life. From the third to the sixth month, the child gives evidence of responding to his own verbal play. It has been rather clearly proved that babies do not deve10p speech sounds during this period of non—purposeful vocalization by imi- tating adults, but rather by imitating their own babblings. Hence, babbling is not true speech; it has no symbolic value. Rather, it is an autostimulation process whereby the child produces sounds randomly and then responds to his own vocalizations. Developmentally, between the sixth and ninth months, a refinement period occurs; and toward the end of this stage, the child begins to pro- duce paired syllables (for example: bye-bye; mama: dada; bebe). These repetitive sounds are classified too often by anxious parents as speech. Actually, these repetitive sounds are not true speech, for they have no symbolic value. However, repetitions such as these form the basic groundwork for the development of speech. Up to this point, the average child's speech develOpment can be predicted with a fair de- gree of accuracy, without too much concern for differences in environment. It is at this stage (6 to 9 months), however, and in the months that follow, that some children are . found to proceed more rapidly in speech develop- ment than do others. There are many influences which seemingly play a part in this develOp- ment; environmental differences are of major importance, and it has been demonstrated that a verbally rich environment can accelerate the child's rate of speech development. From 18 months to two years, a child usually acquires between 10 and 20 words which he can 251bid., pp. 10-13. 12 use meaningfully. Most of these words are nouns, usually the names of peOple or things. This is the period of echoic speech. During this time, children may imitate words used by adults perfectly, even to intonation and inflection, without knowledge of what the words mean. This is also the period when a child may string various sounds together or develop words that may have meaning for him but for no one else. This type of controlled vocalization is commonly referred to as jargon. . Between the second and third years, a greater growth in vocabulary occurs, within a shorter period of time, than in any other period of life. Part of this growth in vocabulary is due to the fact that sometime during this period, children discover the use of "the question". As any adult who has spent time in the company of a three—yearéold can testify, questioning be- comes a major communication tool for youngsters of this age. From this point on, the child's speech and language development becomes a pro- cess of refinement and growth. Vocabulary in- creases, and sentence structure becomes more complex. As a social being, the child depends more and more upon words to express his thoughts, ideas, Opinions, and wishes. This study is concerned with those children who do not discover "the question." Many children are slow to say their first words, and some are still unable to speak in simple sentences. Some speech delayed children use only gestures or grunts; others speak copiously, but in a jar- 26 Some have dif- gon even their parents cannot understand. ficulty in receiving messages: they do not hear or compre- hend the spoken word. For a few, the problem seems to be emotional, they do not want or dare to talk. Speech therapists have come to diagnose these children as having 26Van Riper, op. cit., p. 102. l3 delayed speech problems. These children have failed to acquire normal speech as a usable tool. They have been slow in speech mastery. They cannot use speech as other children do to serve the various needs which speech can serve. 27 27Ibid., p. 103. CHAPTER II REVIEW OF RELATED LITERATURE There is a dearth of controlled reports in which music therapy and speech therapy techniques have been re- lated. However, considerable interest has been shown in such a combination: many articles and reports of tech- niques have included the combination in a loosely related manner. Today the use of music in speech instruction has led to increasing emphasis for practical research in this area. Hawk, in her speech work with physically handicapped children, has said, "Chant on four different notes, going up the scale, starting on middle C," and later in the same article, "Imagine yourself climbing a vocal ladder, going up one round at a time until you have reached at least one octave in range."1 In her work in speech therapy, she found many uses of music to reinforce her approach. Kuper used musical ear-training in speech therapy. As part of her speech therapy techniques in auditory discrimination, she used musical ear-training in pitch 1Hawk, op. cit., p. 86. 14 15 and rhythm perception to help pitch deficient children overcome articulation defects.2 McIntyre designed a study to evaluate the effects of a program of creative activities (music activities included) upon the consonant articulation skills of adolescents and pre-adolescent children with consonant articulation dis- orders.3 The analysis of the data demonstrated the follow- ing: 1. The experimental group (creative arts program) made a significant reduction in the number of consonant articulation errors from pre-to—post test scores. The control group (no creative arts program) exhibited no such change. 2. Greater percentages of children in the experi- mental group showed improvement in their articu- lation skills from pre-to-post test than did the control group. 3. The experimental group evidenced significantly greater progress along the error continuum from omission through substitution and distortion and finally to correctly articulated sounds than did the control group. 4. The girls in the experimental group made a significantly greater contribution to the total reduction of consonant articulation errors than did the boys in the same group. 2Eolin Kuper, "Speech Training for Pitch Deficient Children Having Articulatory Defects, by Instruction in Musical Ear-Training in Pitch and Rhythm.Perception" (un- published Master's thesis, John Hopkins University, 1951). 3Barbara McIntyre, "The Effect of a Program of Crea- tive Activities Upon the Consonant Articulation Skills of Adolescent and Pre-Adolescent Children with Speech Dis- orders" (unpublished Ph.D. dissertation, University of Pittsburgh, 1957). 16 5. A reduction in the number of distortions contri- buted most to the significant change exhibited by the experimental group from pre-to-post test. Murphy and Fitzsimmons, in a pilot study, concluded that music therapy had helped improve the subjects' speech.4 In this study, music was the tool used in treatment for speech problems. The authors concluded that all the sub; jects were talking more, and all showed considerable im— provement in the intelligibility, the inflection, and the spontaneity of their speech. The evaluation was subjective. Kaplan summarized that a music program had contri- buted to the established objectives and successes of a speech program for exceptional children.5 The author did not intend this to be a controlled study but a summary of a music program in operation for children with speech and hearing problems stemming from organic impairments. Stonely told of the accidental discovery of applying singing techniques in aiding stutterers to overcome their handicaps.6 It was discovered that stutterers could sing words without the usual hesitation and repetition common to them. 4Albert T. Murphy and Ruth Fitzsimmons, "Music Ther- apy for the Speech-Handicapped," The Elementary School Journal, Vol. 59 (May, 1959), 111. 5Max Kaplan, ”Music Therapy in the Speech Program," Exceptional Children, Vol. 22 (December, 1955), 113. 6Herbert Stonely, "Music as a Speech Corrective," Music and Letters, Vol. 36 (January, 1955), 40. l7 Nemoy and Davis used humming up and down the scale for voice building exercises and breathing in and out to music to assist in securing rhythmic breathing.7 Scheihing used music in a speech therapy clinic to (1) supplement speech activities with songs that stressed vowel and specific consonant sounds: (2) provide singing activities as a method of communication: (3) provide a socializing activity; (4) provide techniques for gross pitch discrimination; (5) provide opportunity for rhythmic develOpment, muSCle coordination, and gross movement to musical rhythms; and (6) provide a media for emotional expression.8 Michel described a music therapy program for the speech habilitation of cleft-palate children and related that not only were the children able to reap the bene- fits of musical participation in terms of ex- panded perception of sounds in general--pitch, range, vocal quality, etc.--through singing and other forms of music, but also, many of them were enabled to learn concepts of correct speech articulation through . . . music. 7Elizabeth McGinley Nemoy and Serena Foley Davis, The Correction of Defective Consonant Sounds (Magnolia, Mass.: Expression Co., 1954). 8Geneva Scheihing, a personal communication to Dorothy Brin Crocker, "Using Music in a Speech Therapy Program," Music Therapy, 1958, ed. by the National Association for Music Therapy (Lawrence, Kansas: The Allen PreSs, 1959), 105. - 9Donald E. Michel, "Music Therapy in Cleft Palate Dis- orders,” Music:gherapy, 1961, ed. by the National Associa- tion for Music Therapy (Lawrence, Kansas: The Allen Press, 1963), 115. 18 "Using Music in a Speech Therapy Program," by Crocker, acquainted music therapists with some of the current uses of music by speech therapists and mentioned some techniques used by several music therapists in working with children having speech problems.10 Gilliland reported that the music therapist can be useful in speech therapy as follows: 1. Providing music for the vocalization of vowel sounds. 2. Providing rhythmic activities for the identification of speech rhythms. 3. Providing a musical experience for aphasics who can often sing when they cannot speak. 4. Providing a music experience, such as hum- ming, which can help alleviate emotional release when speech is impossible. These conclusions reached by the author are based on the author's personal experience and beliefs and were not ob- jectively measured. Although empirical data were not collected, a pre- cedent was set by Arthur and Elaine in the composition of 12 special music for use in speech training. Their songs, 10Dorothy Brin Crocker, "Using Music in a Speech Ther- apy Program," Music Therapy, 1958, ed. by the National Asso- ciation for Music Therapy (Lawrence, Kansas: The Allen Press, 1962), 115. 11Esther Goetz Gilliland, "Coordination of Music Therapy with Other Adjunctive Therapies," American Archives of Rehabilitation Thergpy, 2 (March, 1954), 7-12. 12Sister Mary Arthur and Sister Mary Elaine, we Speak Through Music (Valhalla, N.Y.: Stanbow Productions, Inc., ' O l9 composed to emphasize particular consonant sounds, were de- signed for use by the speech correctionist with the child who has an articulation disorder. A A study concerning the effect of music on the articu- lation patterns of southern Negro children was conducted by Marsh. Results indicated that singing experiences could increase the duration of certain ending consonant sounds 13 The author com- when articulated in continuous speech. posed special music for the words of the "Pledge of Alle- giance to the Flag" with rhythmic and melodic emphasis on the ending consonants of the words: allegiance, stands, and justice. The subjects were divided into three groups: (1) no-contact control; (2) singing; and (3) chanting; and they were exposed to treatment for five minutes on five consecutive days. Speech patterns were analyzed: (a) on the voice spectograph and (b) in terms of articulated syllabic frequency. Results of the study were not statis— tically significant; however, trends did indicate that music could be effective in teaching certain types of articu- lation. Preus concluded from his study that musical memory was not affected by children with articulation disorders. When comparing normal speaking children and children with 13P. Jane Marsh, “The Effect of Music Singing on the Speech Articulation of Negro Disadvantaged Children," (un- published research paper, Florida State University, 1969), pp. 15-18. ' ’ 20 articulation disorders, Preus found no significant dif- ference in muSical memory of the two groups.14 A series of research studies has been made to deter- mine the relationship between 1ack of musical talent and speech deficiency. Travis and Davis concluded from their study that the sense of pitch, intensity, and tonal memory enter into the function of speech.15 Eisenson, Kastein, and Schneiderman found a statis- tically significant difference in pitch discrimination be- tween a group of voice defectives and a normal speaking group.16 Mange, in his study, found that pitch discrimi- nation appears to be related to normalcy of articulation.17 Clark, testing the ability of discrimination of sim— ple tunes (as one of 15 tests) in children between the ages l4Alf Edward Preus, "A Comparative Study of Musical Memory in Children with Articulation Disorders and Normal Speaking Children," (unpublished Master's thesis, Dept. of Music, western Michigan University, 1962), pp. 44-49. 15Lee Edward Travis and Mildred C. David, "The Re- lation Between Faulty Speech and Lack of Certain Musical Talents,” Psychological Monographs, XXXVI (1927), 71-81. 16Jon Eisenson, Shulemith Kastein, and Norma Schneiderman, "An Investigation into the Ability of Voice Defectives to Discriminate Among Differences in Pitch and Loudness," Journal of Speech and Hearing Disorders, XXIII (1958), 577-582. 17Charles V. Mange, "Relationships Between Selected Auditory Perceptual Factors and Articulation Ability," Journal of Speech and Hearing Research, III (1960), 67-74 0 21 of four and six, found a significant difference between her 18 In this study, fifteen experimental and control groups. testsoof sensory and motor ability and kinesthetic sensi- bility were administered to a group of children with func- tional articulatory defects and a group of normal-speaking children, matched on the basis of age, sex, intelligence quotients and socio-economic status. The results of the study indicated that the experimental group (articulatory defect group) showed a performance that was consistently and significantly inferior to that of the control group (normal speaking children). Gilkinson found a low order of relationship between musical talent and speech skill in students enrolled in” college speech courses.19 Mase found that there was no reliable difference in the tonal memory and rhythm of child- ren with functional articulation speech defects and com- parable children without any speech defects.20 In the thesis, "The Use of Music in a Speech Improve- ment Program in the Kindergarten Class“ by B. B. Groginski, 18Ruth M. Clark, "Maturation and Speech DeveloPment," in Psychological and Psychiatric Aspects of S eech and Hearin , ed.IBy Dom1nick A. Barbara (Springfield, III. Cha Ies C. Thomas, 1960), p. 238. 19Howard Gilkinson, “The Seashore Measures of Musical Talents and Speech Skills," Journal of Applied Psychology, XXVII (1943), 444. 20Darrel E. Mase, "Etiology of Articulatory Speech De- fects," in Columbia University Contributions to Education No. 921 (New York: CdIumbia Un1vers1ty Teaéfierf sColIege, W 22 the results indicated by the Wisconsin Phonetic Inventory and the Original Discrimination Test seemed to show little difference in improvement between the group receiving music and speech training as compared with the group receiving speech training alone.21 However, it was indicated by the author that because of the nature of her study, the data were inadequate to document the results of her study. This study was not specifically geared to any one speech handi- cap but of the nature of a general speech improvement pro- gram. Varied literature is presented here to point out the widely divergent findings and combination of uses of music with various aspects of speech and speech therapy. McIntyre, Murphy and Fitzsimmons, Michel, and Arthur and Elaine objectively reported various positive aspects of using music in connection with treating the speech handi- capped. Hawk, Kuper, Kaplan, Nemoy and Davis, and Scheihing indicated from personal experiences that music was an ef- fective tool for treating the speech handicapped in com- bination with speech therapy techniques. However, Clark, Gilkinson, and Groginski found that music used in speech therapy was statistically not an effective tool in treating the speech handicapped. With the exception of the Marsh study, the review of the literature failed to reveal specific studies in which 21Groginski, op. cit., p. 52. 23 music therapy and speech therapy techniques have been.com- bined to help solve speech problems identified in any particular diagnostic category. Many authors report the use of music to reinforce a speech program. The literature does seem to indicate a need for more effective research, particularly focused on specific diag- nostic categories of the speech handicapped. CHAPTER III DESIGN OF THE STUDY Problem The problem of this study was to assess the effect and use of music activities in a speech therapy program for speech delayed, pre-school children. The question to be answered was this: Could a music therapist devise a music activity program for delayed speech children and stimulate these children to use spontaneous speech? The primary objective of.the experiment can be stated in the form of the following testable hypothesis: There will be a significant difference in the amount of spontaneous speech exhibited by the experi- mental subjects (music activities group) as compared to the control subjects (speech therapy group) after eight weeks of therapy. Sample The sample consisted of eight pre-school children from the Lansing, Michigan, area. These eight children were randomly drawn from the available population of speech delayed children in therapy at the Speech and Hearing Clinic, Michigan State University. All the children were diagnosed “speech delayed" by differential diagnosis, and all had received previous group therapy. These eight 24 25 children were then randomly assigned to either the experi- mental treatment group or the control group, four in each group. All the subjects drawn were males, and all had functional impairments with no known organic problems. The mean age for the experimental group was five years, two months, whereas the mean age for the control group was five years, one month. The control group received a regular program of speech therapy for speech delayed children, conducted by a graduate student in speech pathology, completing her last term of study for a master's degree. The experimental group received a program of therapy centered around music activities, geared to speech delayed. children, conducted by a graduate student in music ther- apy, completing his last term of study at the master's de- gree level. Both the control and experimental groups were to follow the general treatment goals established by Van Riper for speech delayed children: In treating the child with delayed speech, . . . the child must come to know the characteristics of the individual speech sounds and the ways in which they occur in words. we must provide sim- ple speech models within his ability to duplicate. Through self-talk and paralleled talk, we must provide the language symbols needed for think- ing, communication, social control, emotional expression, and the development of a self— concept . . . 1 1Van Riper, op. cit., p. 151. 26 Each subject was scheduled for individual therapy, fifty minutes per session, twice per week for eight weeks. Each subject was administered a pre-test (the Houston Test for Language Development*). Specific comments regarding the Houston Test are included in the appendix. After eight weeks of therapy, each subject was again administered the Houston Test for expressive language, and the raw scores from this test were used to assess the strength of the null hypothesis by analysis of the Mann- Whitney U Test. Procedures and Techniqges of Treatment Experimental Group Although each child was seen individually, the pro— cedures and techniques employed apply to all the children in the experimental group. The following procedures are based on the assumption that best results will be achieved if the child regards speech training as an enjoyable ex- perience that is closely related to everyday living. The drills were presented in the form.of motivated games and *This study was originally designed as a pre-test, post-test control group design in which experimental sub- jects are assigned randomly from.a common population to the experimental and the control group. However, due to a theft of the pre-tests, it was impossible to keep the orig- inal design. Therefore, since the subjects were randomly drawn from the available population, the design of the study was changed to a single post-test design, using the Mann- Whitney U test for data analysis. This change was approved by the author's graduate committee. 27 devices. These motivating devices provided assistance in bridging the gap between formal repetition of speech ex- periences and the transfer to spontaneous speech.2 Most of the music activities used were based upon singing for the following reasons: Singing is thought to be a most pleasurable and effective means of teaching young children; spoken word patterns that might be dull and repetitious drill can be enjoyably practiced over and over as rhythmical phrases in a song.3 Although the language content of each song used in this study has been the pri- mary consideration in selecting songs, the criteria of being fun for children to sing and suitability to children's voices have been adapted or composed to reinforce the tea- ching of specific concepts and language patterns. The songs are simple, short, and change only a few key words from one verse to another. The songs in therapy were used as a referent and followed a specific sequence of events. All activities were devised to stimulate the speech response by starting each activity with music. After the musical response was elicited by the child, a related non-musical activity im- mediately followed. This procedure was based on the idea that music was used to stimulate these children to use spontaneous speech. 2Nemoy and Davis, op. cit., p. xi. 3Alfred Ellison, Music with Children (New York: McGraw-Hill Book Co., Inc., 1959), p. vii. 28 Each therapy session for the experimental group was patterned after the program described below: 1. The session began with the clinician and the client singing "Good Morning" to each other to the tune of ”Happy Birthday.” This technique was used to "set the. stage" for therapy and establish a musical mood for the therapy session. 2. The traditional "Alphabet Song," sung to the tune of "Twinkle, Twinkle Little Star," was sung and accompanied by such various instruments as the piano, autoharp, and xylophone. After the musical response, the procedure was connected to the speech experience by encouraging the child to talk about the alphabet while he played with alphabet blocks or while he copied certain letters of the alphabet on the chalkboard. 3. Sounds of animals to the tune of "Old MacDonald Had a Farm" were used to stimulate expressive speech. To stimulate the speech experience in this activity after singing the song, the client and the clinician played with toy animals or told stories about these animals or looked at pictures of animals or colored animal pictures in a coloring book. The song "The Farmer in the Dell" was also used to get the speech response. 4. The kazoo, an inexpensive toy musical instrument through which one hums or sings, was used in a game called "Bumblebee," which involved the naming of various parts of 29 the body. The child would be encouraged to buzz on the kazoo like a bee and then land on some part of the clini- cian's body at which time the child would be asked to name the part of the body on which he had landed. This proce- dure was reversed so that the clinician could play the part of the bee and land on some part of the child's body and then ask the child to name that particular body part. Also used was the song "If You're Happy and You Know It, Clap Your Hands," whereby various body parts were substituted in the verse, e.g., stomp your feet, blink your eyes, touch your toes, etc. 5. Basic language concept songs were used to teach such concepts as on and off, open and shut, high and low, up and down, round and round, in and out; and the primary colors were used in conjunction with the song, "The Wheels on the Bus Go Round and Round" (in Appendix A). After singing the song, the child would be encouraged to say and demonstrate the action words used in the song. 6. Story-telling time was used to foster spontaneous speech. Each child was taught and encouraged to partici- pate in the story of "Little Rabbit Foo Foo" (in Appendix B) sung to the tune of "Down by the Station." The clini- cian would improvise sound effects with the piano to support the story and encourage the child to play tone clusters and glissandos. This activity was introduced as a play ex- perience for fun to help ease the trauma usually associated 30 with speech handicapped children in therapy. Stories such as “Little Rabbit Foo Foo" were also used to encourage the use of the imagination, reinforce the teaching of singular and plural statements, and teach basic language concepts. 7. Number concepts were taught through song and story. "Little Rabbit Foo Foo" and similar type stories that involved counting, along with the song "Ten Little Indians," were used to teach number concepts. After the response was elicited in song, then a related activity was used to encourage the child to use speech, e.g., the game of cowboys and Indians. 8. Approximately five to ten minutes of every ses- sion was devoted to each child's individual preference with a musical activity. At this time, the child could choose the type of music activity he liked best, e.g., singing, playing the autoharp, marching and jumping to music, or playing the piano. 9. EaCh session ended with the clinician and the client singing "good-bye" to each other to the tune of "Frere Jacques" (in Appendix A). Control Group. In the control group, as in the experimental group, each child was seen individually. Although each session did not follow a specified sequence of events for every child as in the experimental group, the speech clinician 31 cited many common procedures and techniques employed in therapy for every case: and these are listed below: 1. To stimulate the child to use longer phrases and sentences, the clinician provided structured responses for each child to imitate. Each structured response was de- vised on the basis of each child's ability regarding syn- tactical ability, memory span of responses, vocabulary, and his understanding of grammar. Each child was encouraged to imitate such phrases as "I want the red head," "I want the yellow leg," (referring to the "Cootie"). The clinician would then ask the child what part of the "Cootie" he wanted. In order for the child to get that part of the “Cootie,” he would have to ask for it by using the struc- tured response. 2. Each child participated in activities requiring the taking of turns and some form of competition with the clinician, such as who could build a boat the fastest with the "Build-O-Fun" game. 3. Each child was asked to identify colors, articles of clothing, and body parts with activities such as the "Cootie" and "Popeye the weatherman" game. The "Popeye the weatherman" game contains color forms and articles of cloth- ing suited for the four different seasons. The purpose of the game is to dress "Popeye" according to a specified season . 32 4. The "Alphabet of Sound" pictures were used to stimulate the child visually. The "Alphabet of Sounds" consists of pictures illustrating an action relating to a particular phoneme in isolation. When the clinician pro— vided the oral clue, auditory stimulation was achieved, e.g., the client would be shown a pieture of a boy blowing bubbles through a straw which illustrates the /B/ (bah) sound in isolation. The clinician would then provide the oral clue (bah), and this isolated sound was then used in conjunction with a word and then the word was placed in a phrase or sentence. This technique might simply be called a form of sound discrimination. 5. To stimulate spontaneous speech, games such as 4 5 6 and the "Cootie," "Zoo-It-Yourself," "Build-O-Fun," "Popeye the Weatherman"7 were used. In general, these games involve the manipulation of objects, using the imagi- nation, identifying colors and body parts, and the teach- ing of basic language concepts. 4Cootie--Schoper Manufacturing Co., Inc., Minneapolis, Minn., 1949. 5Zoo-It-Yourself--Rexall Drug and Chemical Co., Tupperware DiviSion, Orlando, Florida, 1966. 6Build-O-Fun--Rexall Drug and Chemical Co., Tupper- ware DiviSion, Orlando, Florida, 1965. 7Popeye the weatherman--Colorforms, Inc., Norwood, New Jersey, 1959. CHAPTER IV ANALYSIS OF RESULTS The purpose of this study has been to determine whether the addition of music activities in speech therapy would provide the necessary stimulation for the speech de- layed child to use spontaneous speeCh. The results of treatment of speech delayed children in a control group were compared with those children in the experimental group. The control group received a regular program of speech therapy, whereas the experimental group received a program of therapy using music activities as a technique to stimu- late the children to use spontaneous speech. The Houston Test, described in Appendix C, was ad- ministered to the children at the completion of eight weeks of therapy in an attempt to measure the resultant differ- ences in spontaneous speech, if any. The Mann-Whitney U Test for ordinal measurement (see Appendix D) revealed that the experimental group was not significantly better than the control group at acceptable levels.1 1The Mann-Whitney U Test was chosen for use in this study because the sample size was very small, the study employed two independent samples, and only ordinal measure- ment was achieved. 33 34 Siegel suggests that in contemporary statistical de— cision theory, a common practice is for the researcher sim- ply to report the levels associated with his findings. Siegel also suggests that . . . the reader should not infer that the writer believes in a rigid or hard—and-fast approach to the setting of significance levels. Rather, it is for heuristic reasons that sig- nificance levels are emphasized; such an ex- position seems the best method of clarifying the role which the information contained in the sampling distribution plays in the decision- making procedure. The value of some research is lost because re- searchers fail to report their findings when these findings are not at common, acceptable significant levels. In this study the Mann-Whitney U test revealed U levels of four (4) for the experimental group and eight (8) for the control' group. The resultant level of U = 4 of the experimental group is significant at the .10 level. Although this level of significance is less than satisfactory to draw specific and concrete conclusions, it does suggest that the experi- mental group was experiencing more success in the area of spontaneous speech than the control group. This study sug- gests that the observed differences between the two groups may be due to chance alone one time out of ten when exposed to the treatment procedures employed for this study. 2Sidney Siegel, Non-Parametric Statistics for the Behavioral Sciences (New York: McGraw-Hill BoOk Co., 1956), p. 8. 35 Discussion The main purpose of this study was to determine whether the use of music activities could stimulate speech delayed children to use spontaneous speech more easily than regular speech therapy techniques, thus providing an ef- fective and more efficient means of speech therapy when music was used in conjunction with and supportive to a pro- gram of speech therapy. The results seem to imply that music activities could be an effective tool for use in speech therapy with speech delayed children. The theft of the pre-tests prevented statistical measurement from a gain scores technique and necessitated the use of the Mann-Whitney U Test. This study was con- ducted during the Spring term at Michigan State University. It was impossible to begin another study using a pre-test, post-test design because another group of children was not available for therapy until the Fall term. This re- searcher was permitted by his advisors to continue this study even though the original measuring tools had tobe changed. Several other aspects of the study seem to warrant discussion. All subjects involved in therapy were males. This fact may suggest inadequate randomization or the need to conduct another study involving only female subjects. This suggestion of another study with only female subjects, using the same therapists as the present study, might offer 36 some clues as to the influence the therapists have upon the subjects. The fact that the therapist for the control group was a female, whereas the therapist for the experimental group was a male, suggests a need to investigate further the possibility of switching these positions or conducting re— search that would involve both a male and a female therapist in each group. The influence of the therapists upon the subjects was impossible to determine, isolate, or measure. In the pre- sent study, it is speculated that the influence of the therapists was present in both groups and not isolated to one group or the other. In future studies of this nature, it is recommended that some measure be devised to help isolate this variable. The diagnostic category of delayed speech posed a problem. The differential diagnosis techniques used by speech therapists do not provide a diagnosis that is spe4 cific enough. Further investigation might well be extended to experimental work with children with more noticeable and more specific speech deviations. The three questions posed in Chapter I can now be answered: 11 Will the use of music activities aid in spon- taneous speech? Although the statistical analysis (see Appendix D) seems to suggest that the use of music activi- ties will aid spontaneous speech, the level of significance 37 is not positive enough to answer specifically this question in the affirmative. Based upon the author's observations and personal experiences in the area of using music activi- ties in connection with speech therapy, it is suggested that a most effective program of therapy for speech delayed children would be one in which music activities were used in conjunction with and supportive to a regular speech therapy program. 2. Can a music therapist devise a music activities program for delayed speech children and stimulate these children to use spontaneous speech? Yes, it seemed evident from the results of this study that a music therapist could devise a music activities program and use this program ef- fectively in therapy. Even though statistical analysis did not demonstrate positive differences between the two groups, it is thought that this question can still be answered in the affirmative. In this study, the experimental group did just as well, if not better, than the control group. 3. Will the use of music aid in the teaching of basic language concepts? There is no clear cut answer to this question. If we use the level of significance of .10 as being acceptable, the results would tend to indicate that music activities could be an effective tool for tea- ching basic language concepts. The Houston Test, used as the measuring devise for this study, specifically measures various aspects of language concepts. The better rankings 38 exhibited by the experimental group tend to support the claim that music would be an effective tool for teaching language concepts to speech delayed children. In general, this study has not demonstrated that music activity was the reason for the conclusions drawn from the data. However, the results do suggest that the music activities group, conducted by a music therapist fol- lowing a specified program of events, exhibited a greater amount of spontaneous speech than did the control group, as measured by the Houston Test. Specific techniques for using music activities to stimulate spontaneous speech have been described and ap- plied in this study. It is speculated that any positive aspects exhibited by the experimental group were due to several reasons: (1) a societal belief that music is pleasurable and experiences associated with music are fun, (2) music provided a more comfortable atmosphere with less pressure placed upon the specific speech experience, and (3) music provided an acceptable outlet for feelings of frustration, hostility, and aggression which are gen- erally associated with the speech handicapped. The author wishes to acknowledge the limitations of the study presented here and to point out that the infer- ences made to the population are limited in that they can only apply to pre-school children with delayed speech pro- blems. 39 Recommendations While the results of this single study do not con- clusively support the hypothesis, it does point out the need for further research. Further investigation in this area of a combined approach might well be extended to ex- perimental work with children with more noticeable speech deviations suCh as specific articulation disorders, be- cause of the need for a more specific diagnostic category. In view of the results implied here, as well as the find- ings of several other investigators, it might be found that the addition of music to a speech program for speech handi- Fapped children would have specific value and far-reaChing effects. The possibilities here are vast, not only from the standpoint of speech itself, but also in the areas of relaxation and muscular coordination which are so essential for better speech. Further research is needed to define limitations, un- cover more efficient methods of therapy techniques for the speech handicapped, and explore different designs for better research. APPENDICES 4O APPENDIX A MUSIC AND LYRICS 41 APPENDIX A The following four pages contain the music and ly— rics to songs used with the children in the experimental group. The language content of each song used in the experi- mental group has been the primary consideration in select- ing these materials. All songs were adapted from traditional songs. 42 43 GOOD MORNING SONG (Happy Birthday To You) morn-ing to you, Good morn-ing to you, morn-ing, Hi *Name of child 44 THE WHEELS ON THE BUS GO AROUND AND AROUND on the bus go and 1- round; L "p-fif- g_ 3-!F‘ :2E:i:....-.d:,- I p—r 1 L I I .. ”11.1-..” ....-- . ....... -11.... . r 1 I # .J...----f .1..- .. ..- E. ..._..-... - _...-.._..._--.. --.. 1.1-31-1. 4 \ round an} a-round,a- round and a-round: The wheels 01 thebus go :- + c..- ---o- w.--wv-o --.-§~.|.-\ 0‘. ‘—-n~- o-~n. h-‘ c...- o- ‘_I .- u..-u.‘u-.~o-“ L-—-— w." ~~s-v~n~ruw~ .U-v-v-.. o — _ - u- - IJALI II 1111: i i 'l I 3 i Y ’ I ) town. All through the 45 Lyrics to The Wheels on the Bus Go Around and Around l. Sing about the parts of a bus: The wheels on the bus go around and around. lights [go off and on. door goes open and shut. windows go up and down. (windshield) wipers go back and forth. horn on the bus goes beep, beep, beep. motor goes vroom, vroom, vroom. children go bounce, bounce, bounce. driver says "move on back." 2. Sing about the parts of a room: The window in the room goes up and down. door goes open and shut. door on the cabinet goes open and shut. hands on the clock go around and around. 3. Sing about other vehicles: The wheels on the firetruck go around and around. siren goes whoooeeeooo. ladder goes up high. firemen hang on tight. 4. Sing about colors of objects: The color of the bus is red, red, red. firetruck is red, red, red. taxi-cab is yellow, yellow, yellow. your bike is green, green, green. 46 GOOD-BYE SONG (Frere Jacques) Time to go home, Time to go home, Yes it is, Yes it is, 1.--. Cc. .- .1 It is time to go home, It is time to go home, Godd-bye * APPENDIX B STORY OF LITTLE RABBIT F00 F00 47 APPENDIX B The following story of "Little Rabbit Foo Foo" is sung to the traditional tune of "Down By the Station." Little Rabbit Foo Foo Little Rabbit Foo Foo HOpin' through the forest Picking up the field mice and foppin' em on the head. (Spoken in a very scary voice) Down came the fairy Godmother and she said Little Rabbit Foo Foo I don't want to see you Picking up the field mice and foppin' em on the head. (Spoken) "I'll give you three chances, (two, one, verses) and then I'll turn you into a goon." Little Rabbit Foo Foo was so scared he ran all the way home and jumped into bed. (Snore) The next morning he woke up, rubbed his eyes, stretched: he went to the window, opened the window, took a deep breath and said: "Oh what a beautiful morning. . . I think I'll go outside.“ Repeat above verses and dialogue until down I to one chance. (Last chance) (Also spoken) I gave you three chances, so now I will have to turn you into a goon, and she did. THE MORAL OF THE STORY IS: "HARE TODAY, GOON TOMORROW! I 1" 48 APPENDIX C THE HOUSTON TEST FOR LANGUAGE DEVELOPMENT 49 APPENDIX C The Houston Test for Language Development Author: Margaret Crabtree, Ed.D. Year: 1963 - Part II (for children 3 to 6 years) Publisher: The Houston Test Co. P.O. Box 35152 Houston, Texas 77035 A search of the literature revealed very few tests that could be used to assess the expressive language of a child. The Houston Test for Language Development was chosen for this purpose. The Houston Test specifically measures spontaneous speech. It measures and evaluates a child's responses to various stimuli, length of words, syntax, and number of words are the measures recorded for scoring. The results of the test are given in a raw score which can be converted to language ages. Language development, like all other growth pro- cesses in children is irregular. Therefore, it is inappro- priate to make too exacting an application of the scale to a specific age. If a child's total score is within a year of the norm set, his performance is considered adequate. The age levels for this test have been stated in broad rather than in specific terms. Language does not 50 51 develop in precise time increments such as a month but de- velops irregularly like all other areas of growth in child— ren. It does develop, however, in a certain time-order. A child should not be considered speech delayed if he scores within a year of the norms for his age. He does have a problem if he scores two or more years below those set for his chronological age. The reliability of the Houston Test is certainly questionable. The norms established for Part II of the Houston Test were based on a sample of 215 white children in the greater Houston area. These children were equated as to age and sex. The items were scored on a percentage basis and were arranged according to difficulty. A reli- ability coefficient was not given. The materials needed for administering the test are as follows: the manual of instructions, vocabulary cards (20 pictures of common objects, 9 colored pictures for naming action, 3 colored pictures for eliciting a descrip- tive word, and 6 cards for naming colors), miniature ob- jects, crayons and drawing paper, and a record form. Each child is administered the test individually. The test is untimed. The items need not be administered in order except those dealing with vocabulary and articu- lation. The test takes about 30 minutes to administer. Some examples from the Houston Test are listed below: II. III. IV. Other Self age. 52 Identity--the child is asked to tell his name and Body Parts—-the child is told to identify the follow- ing body parts: chin elbow knee ankl e Body Parts--the child is then asked to answer the fol- lowi l. 2. 3. 4. 5. Audi foll waH ng questions: Point to and tell me what you see with? (answer is eyes) Point to and tell me what you hear with? (answer is ears) ‘ Point to and tell me what you eat with? (answer is mouth) Point to and tell me what you smell with? (answer is nose) etc. tory Judgement--the child is asked to make the owing judgements: Which is bigger--mommy or baby? Which is faster--a truck or an airplane? Which is older--daddy or baby? etc. ‘ Gestures--the child is asked to demonstrate each of the 10 0‘01wa following: Clap your hands. Close your eyes. Show me your teeth. Pretend to comb your hair. Pretend you are eating an ice cream cone. etc. items on the test include the following: Syntactical Complexity Sentence Length Prepositions Seri a1 Counting Object Counting Repe tition of Speech Patterns 53 Repetition of Melodic Patterns Geometric Designs Verbalizations while Drawing Verbalizes (tells a story) about Drawings APPENDIX D ANALYSIS OF DATA-- MANN-WHITNEY U TEST 54 APPENDIX D Mann-Whitney U Test Experimental Group Control Group Raw Scores Rank Raw Scores Rank 26 6 31 5 35 4 36 2.5 47 - l 36 2.5 15 7 R1=10 R2=l8 _ y n2(n2+l) _ U—nln2 . 2 R2 U=(4)(3) +—i§§L -l8 U=(12+10)-18 U=4 U1=nln2-U Ul=8 This resultant level of U=4 is significant at the .10 level. 55 BIBLIOGRAPHY 56 BIBLIOGRAPHY Arthur, Sister Mary, and Elaine, Sister Mary. we Speak Through Music. Valhalla, N.Y.: Stanbow Pro- ductions, Inc., 1959. Anderson, Virgil A. Improving the Child's Speech. New York: Oxford Press, 1953. Berry, Mildred F., and Eisenson, Jon. Speech Disorders. 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