The Case History
In preceding chapters, we have emphasized the importance of a thorough study of each individual speech defective; in those which follow, we shall outline examination methods which provide for a systematic exploration of factors causing or contributing to the speech defect.
Uses and limitations of the case history. The first of these examinations is the case history. Although it is incomplete, unsatisfactory, and unreliable in many ways, no substitute for it has been found. Its function is to serve as an outline of questioning and prompting, as a system of signposts pointing out pathways that should be followed, as a land-marked map of unexplored territory. It tends to prevent superficiality and snap-judgment during diagnosis. It conserves time and energy. When used by a trained examiner who appreciates its weaknesses and limitations and who is alert to follow up any significant leads that appear, it gives us a picture of the individual which is of inestimable value. When used a poor examiner who merely asks the questions and records the answers, or who loses himself in a mass of irrelevant information, it is practically worthless.
Rapport. In administering the case history, it is first necessary to get sufficient rapport to insure an earnest desire to coöperate and a feeling of ease in communication. The achievement of such rapport is an art which can be learned and improved by intelligent endeavor. In general,