The Medical History of Speech Disorders

microphone-1716069_1920Dr Marjore Lorch from Birkbeck’s Department of Applied Linguistics and Communication talks to us about her recent investigation into the first recorded case of spasmodic dysphonia (SD) – a condition in which  involuntary spasms in the tiny muscles of the larynx cause the voice to break up, or sound strained, tight, strangled, breathy, or whispery. The below interview is adapted from an interview given to the National Spasmodic Dysphonia Association and published in their newsletter Our Voice, 2016, 26 (1) 14-15.

What did this piece of research entail?

Together with Dr Renata Whurr, I investigated the very first case of spasmodic dysphonia that is regularly cited in the current research literature. We found that the picture presented by this patient, translated from German in the 1870s, was not what it seemed. The clinical description was not consistent with our current view and it is likely that the patient didn’t actually have SD. Subsequently, we discovered that research by a British clinician, writing at the same time, contained observations very similar to our current characterization.

How did you get involved in historical research?

I was fortunate to have teachers throughout my training who stressed that the way to understand neurogenic disorders, observed clinically, was to go back and read earlier descriptions to understand how syndromes were characterized by the perspective of the observers which changed over time.

Can you explain how historical research impacts current and future research?

I believe that applied medical history can contribute important insights into current clinical issues. This method puts a spotlight on understanding the way assumptions, concerns and questions change over time and how that influences the types of answers that are pursued. This kind of approach may be particularly useful in making progress on points that have been debated over the years by analyzing the types of symptoms that have been considered central to different formulations in the past. For example, whether clinicians considered SD to be psychogenic or neurogenic has changed over time. To develop a more nuanced and detailed picture to drive forward future avenues of research, it is valuable to go back and review historical observations. It can be a source of inspiration to revisit previous hypotheses and characterizations. The benefit is that it may produce a reassessment of things that were held as unquestioned assumptions.

What drew you to spasmodic dysphonia research?

I began my involvement with spasmodic dysphonia research in the early 1990s through my work with Dr Renata Whurr who was head of Speech and Language Therapy at the National Hospital for Neurology and Neurosurgery at Queen Square London. Over the years we have collaborated on a variety of aspects regarding SD. Initially, this was focused on treatment. However, I later became interested in the linguistics aspects of the problem. We investigated how the vocal cord movement disorder interacted with the articulatory properties of different languages. One important finding drew attention to the fact that speakers with SD will have different vocal symptoms depending on what language they speak. For example, the diagnostic features of SD for English will not adequately describe the characteristics of French SD speakers. Put more simply, if you have SD, your symptoms will be slightly different depending on the language you speak.

What has surprised you the most about researching the history of spasmodic dysphonia?

When my colleague, Dr Whurr, and I went back to the original case of SD reported in the 1870s that is still cited today, we were amazed to find that the individual didn’t have a voice disorder that we would recognize as SD. This research revealed the common practice of perpetuating a reference to historical literature without necessarily going back to the source. The selection of emblematic cases is also influenced by the assumptions held by the researcher. Our work highlighted how a particular view of the past may be colored by present day biases. In this instance, a strong belief in Freudian psychology in the mid-20th century may have played a part in choosing a historical case that was formulated as “hysterical”. It also highlighted how more significant and worthwhile observations may not be promoted, because of social rather than scientific reasons. By reading the 19th century literature, we recovered important observations about SD that had been lost to posterity.

How do you think this research will help people with SD?

Our research has highlighted the contribution of the 19th-century clinician, Morell Mackenzie, who described the particular sound of a person’s voice, which will lead directly to the diagnosis of SD. This is of vital importance as there is often a long delay in diagnosing SD. It is important to recognize that changes in voice may be the only symptom of this neurogenic disorder.

Further information:

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What’s in an umlaut?

This post was contributed by Professor Penelope Gardner-Chloros, Department of Applied Linguistics and Communication

It sometimes seems as if the news is made up of either cataclysmically large or vanishingly small issues. There are quite enough of the former to worry about at the moment, you might think – and the latter – the ‘human interest’ stories – are just there to sell newspapers.

UmlautIn theory, they do not get much smaller than the argument, reported in this week’s papers, which is raging in a small town in Minnesota.

Lindström was founded by Swedish immigrants in the 19th century. The reason for the current battle is that the Minnesota Department of Transportation has decreed that the town name should consist only of ‘standard English characters’. Therefore the umlaut, i.e. the two dots above the o, has been omitted from the sign. The inhabitants are up in arms over this – apparently petty – issue.

It is interesting to look beyond the apparently trivial casus belli and consider the deeper issues at stake. Is it possible that someone in the Transportation Department is ‘anti-immigrant’, or at least very right wing (in European terms)?

They may be a supporter of the ‘English Only’ movement, which argues that immigrants should integrate linguistically. Rather than being encouraged to maintain their language of origin, which linguistic studies have shown time and time again to be beneficial to their OVERALL linguistic proficiency AND to their wellbeing, in some states they are instead obliged to take additional remedial English classes.

In this case, the immigrants in question have long ago been eaten by the worms; the umlaut-supporters are merely symbolically honouring their distant ancestors, and their own origins.

The kindest interpretation of the Department’s refusal to add the umlaut is that they just want an easy life and cannot be bothered with the idiosyncacies of the local population, which necessitate additional signwriting resources. But I suspect the issue is related to their convictions about what it means to be American.

Whichever it is, the importance of the umlaut for the population clearly goes well beyond its tiny presence on the town sign. Like so many linguistic issues, it can only be understood in terms of the link between language and identity. Crush my language, my accent, my alphabet, my name, and you deprive me of my individuality, my history, my sense of belonging to a particular group.

In Alsace under the German Occupation, Jean had to become Hans and François had to become Fritz – on pain of serious punishment. Europeans joining Islamic State change their names to Islamic ones. In this case, a Swedish name which indexes the heritage of the town is being bleached into an English name. Perhaps next year it could have an e added at the end, then why not remove the ‘str’ and replace it with an h? ‘Lindhome’ would sound as American as apple pie.

Of course none of this matters a single jot compared with the big issues in the news – until you start to realise that language is one of the main ways in which our identity is expressed. Languages, words, names – and people’s expressed wishes about them – should not, and cannot, be swept under the carpet – or painted out on signs.

Find out more about Professor Penelope Gardner-Chloros

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Why “younger” is not always “better” in foreign language learning

TProfessor Jean-Marc Dewaelehis post was contributed by Professor Jean-Marc Dewaele of Birkbeck’s Department of Applied Linguistics and Communications.

Politicians can be forgiven for not having much time to read the fine print when asking advisers to translate research findings into workable policies. Or does it work the other way round? Do politicians decide on policies first and subsequently ask advisers for appropriate research findings to back up the policy?  This seems the case when considering the wide consensus across the world about the benefits of early introduction of foreign languages (FLs) in pupils’ school curriculum. The expression “younger is better” in education sounds perfectly plausible, is simple and convincing, and must be a vote winner.

In the UK, FLs used to be introduced in secondary education. Estelle Morris, then Secretary of State for Education, changed this policy in 2002, scrapping compulsory modern FLs for 14- to 16-year-olds, and introducing them in primary schools. She claimed in 2006 that: “Starting at a much younger age is the best way of making sure we get more pupils taking exams and, more importantly, more of them enjoying and feeling confident about speaking a language other than their own”.

In other countries, FL teaching has even been introduced in nursery schools.  There seems to be a universal consensus among politicians that an early start in FLs will lead to a smoother, quasi-effortless learning process leading to high levels of proficiency in the FLs. Is this a myth?!

Spanish ClassCounter-intuitively, research suggests that adolescents and adults progress more quickly than children when learning FLs in a school context (so-called “instructed FL learning”). Many researchers have serious doubts about age of onset being the most important variable in successful FL learning. Indeed, research shows quite clearly that starting age is only one of many independent variables in very complex question.

A crucial distinction exists between so-called naturalistic and instructed FL learning.  Research on naturalistic learners, typically immigrants, shows that younger children are indeed more likely to become undistinguishable from native speakers of the FL compared to their parents and older siblings. However, the picture is not so clear in research on instructed FL learning, a crucial distinction that is commonly overlooked.

A large-scale project on Age of Onset of Acquisition (AoA) in formal foreign language teaching, the Barcelona Age Factor project has looked at effects of starting age and the comparisons were always of groups with same amount of instruction hours (200, 400, 700, and 800 hours of instruction). Earlier exposure (ages eight to nine) to English (as a third language) in a classroom did not result in better performance. Learners who started English at age 11 and those who had started at age 14 were found to progress more quickly than early learners but, after a similar number of hours of exposure, the differences between the groups were limited, with older starters still having a slight advantage. In another study with young adult learners who had 2500 hours of instruction, AoA was not found to have an effect but amount and type of exposure had a positive effect. In other words, input seems more important than AoA.

A Swiss study (Pfenninger, in press) found no advantages of an early start among Swiss learners of English even after five years of instruction. The writing skills of late starters caught up with those of the early starters within six months.  One possible explanation is that older learners have greater metalinguistic, metacognitive and strategic skills.

Munoz points out that from the observations that younger immigrants and immersion students in naturalistic settings seem to outperform older peers “an inferential leap is made in the assumption that learning age will have the same effect on students of a foreign language, when they are exposed to only one speaker of that language (the teacher, who is not usually a native speaker) in only one setting (the classroom) and only during very limited amounts of time”.

This does not mean that there are no age effects at all in learning and later use of the FLs.  Indeed, younger children seem to be more motivated in learning FLs. In my own research on language choice and self-perceived proficiency among more than 1500 adult bi- and multilinguals, I found that early starters in a FL felt more proficient in speaking, comprehending, reading and writing their FLs. They were also more likely to choose the FL for the expression of anger and feelings, for inner speech and mental calculation.  Interestingly, the effect of mode of instruction was even stronger than age of onset: participants who had acquired the FL naturalistically or in mixed mode (formal instruction combined with authentic use) outperformed participants who had learned the FL through classroom instruction only.

In their excellent overview of the literature on age and the teaching of FLs, Lambelet and Berthele point out that more research is needed on improving age-appropriate teaching techniques in order to boost motivation levels and metalinguistic awareness of FL learners of all ages. Moreover, extra thought needs to be given to the primary school teachers who are suddenly expected to teach a FL and who may lack in confidence and competence. In other words, those arguing for an early introduction of FLs at school need to take the nuanced research findings into account and avoid promising miracles.

At what age did you start learning a foreign language? How do you think this affected your fluency and confidence in the language? Please leave your comments below.

Further reading

  • Dewaele, J. M. (2009). Age effects on self-perceived communicative competence and language choice among adult multilinguals. Eurosla Yearbook, 9, 245–268.
  • Enever, J. (2011). ELLiE. Early Language Learning in Europe. London: British Council.
  • Lambelet, A. & Berthele, R. (2014). Âge et apprentissage des langues à l’école. Revue de literature. Fribourg: Research Centre on Multilingualism.
  • Pfenninger, S. (in press).The literacy factor in the optimal age debate: a 5-year longitudinal study. International Journal of Bilingual Education and Bilingualism.
  • Muñoz, C. (2011). Input and long-term effects of starting age in foreign language learning. International Review of Applied Linguistics in Language Teaching, 49, 113–133.

Other posts by Professor Dewaele:

Other blogs about linguistics:

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Exploring Intercultural Communication: Language in Action

This post was contributed by Professor Zhù Huá, of Birkbeck’s Department of Applied Linguistics and Communication. Professor Huá’s book, Exploring Intercultural Communication: Language in Action, is published by Routledge.

In a recent episode of Downton Abbey, Mr Carson, the butler of the house and a master of etiquette, met the black jazz singer Ross for the first time. Overcome by Ross’s skin colour, he struggled with words. All he could come up with was ‘Have you considered visiting Africa?’

Those days of social and cultural compartmentalization of different racial groups are long gone.  We meet, interact and build relationships with ‘others’ who may look different, speak different language(s) or are guided by different values from ‘us’, either by choice or by chance in various social spaces, due to a bundle of processes including globalisation and technological advances. Intercultural Communication Studies, pioneered by the American Anthropologist, Edward Hall, in the 1950s to research the cultures of the ’enemies’ of the US at that time, are primarily interested in understanding how people from different cultural and ethnic backgrounds interact with each other, and what impact such interactions have on group relations, as well as individuals’ identities, attitudes and behaviours.

Intercultural communication naturally entails the use of language and language is key to understanding culture. When you offer tea to a visitor and she says ‘no, thank you’, how do you know that she is not just being polite or ‘indirect’? After all, in some parts of the world such as East Asia, declining first before accepting someone’s offer is the preferred norm of behaviour. When a student remains ‘quiet’ and ‘passive’ in the classroom, how much can we attribute non-participation to the cultural factor and can we assume active participation means success?  We all seem to know students who are quiet in the classroom but produce excellent course work!

Going to the commercial side of things, does it surprise you that Häagen-Daz ice cream is not Danish, but made in Minneapolis, US? Why is ‘Frenchness’ commodified and displayed for sale through popular books  ‘French women do not get fat’, ‘French women do not sleep alone’ and ‘French parents do not give in’?  What led to the closure of Tesco branches in the Unites States and China? When you travel to a new place, how do you think of the general advice offered by some tourist websites and guidebooks on culturally specific etiquette, customs, practices and national character? Are they helpful or do they merely reinforce cultural stereotypes? I have come across a website offering advice on touring in China. It says ‘Chinese people are inherently shy and modest. They do not display emotion and feelings in public and find speaking bluntly unnerving.’  For a cultural insider, these comments seem very foreign.

Yet, sometimes culture is blamed when it should not be. Last December, a news story appeared in many English language newspapers.  It was alleged that the newly appointed Swedish ambassador to Iran, Peter Tejler, insulted the Iranian President Mahmoud Ahmadinejad by ‘exposing the soles of his shoes’ when he was sitting with his legs crossed during a formal meeting. The Atlantic Wire has gone one step further and invited an expert from the University of West Florida to explain that it was a taboo in the Muslim culture to show the sole of a shoe, because soles are ‘considered dirty, closest to the ground, closer to the devil and farther away from God’. However, a number of Iranian students and scholars I talked to following the incident found the news headline bewildering, to say the least. They attested that similar to many other cultures, it was nothing unusual to sit with legs crossed in their home culture and whether exposing soles or not was not a problem at all. With their help, I traced back to the Arabic newspaper, Asriran, where the news first appeared. It turned out that the Swedish diplomatic was frowned upon not because he exposed the sole of his shoe, but because he breached a diplomatic etiquette by sitting too comfortably and crossing legs in a formal diplomatic meeting.

Exploring Intercultural CommunicationIntercultural communication permeates our everyday life in many different and complex ways. In the book, Exploring Intercultural Communication: Language in Action (published by Routledge, 2014), I use a ‘back to front’ structure, starting with the practical concerns of intercultural communication in five sites – language classroom, workplace, business, family and studying/travelling abroad. I then focus on the question ‘how to communicate effectively and appropriately in intercultural interactions’. In the third part, I go behind the questions of what and how and examine key theories, models and methodological considerations in the study of intercultural communication.  The main message of the book, I believe, is that intercultural communication provides an analytical lens to differences we see and experience in our daily social interactions with other people who may look different from us, speak a different language, or speak the same language in a different way.

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