Case Studies

The following is the case of a 9 year old child treated by Katherine Rudolph.                                   

A. Impulse for Speech

Alan has an enthusiastic appreciation of speech and movement.

B. Breathing – Flow of Speech

Hurried, muttered speech and shallow breathing need to be improved.

C. Balance of Vowels

The sense for the form created through pronunciation of the vowels and accuracy of their shaping should be more practiced.

He can carry a tune in time.

D. Balance of Consonants

Articulation Placement in Sound groups

Alan often substitutes F for Th and tends to speak W for R. This must be patiently corrected when it does not cause embarrassment in the social situation.

His problems with S, Sh, Z, Ch and J will very likely disappear with the coming ‘two front teeth’.

His voice has a clear musical sound. Although at the beginning of the first 7 week period he was shy and looking downward, shoulders a bit bent, with a small nervous voice; after two sessions he became quite natural and enthusiastic.

His family situation has been going through change with a possible marital crisis, and separation. He has a 5 year old sister. The siblings were observed to play harmoniously together.

Alan’s breathing is shallow, coming from the chest region instead of the diaphragm. This is in part the reason he has trouble with the ‘r’ sound. A feeling of security can be brought about by clear articulation.

At present the fluency problem is being corrected by encouraging breathing from the diaphragm.

E. Course of Therapy

Walking and speaking on the rhythm is not hard for Alan. The continuity of a session is especially important. So a beginning was made in story form. The verse beginning ‘Here on the earth I stand’ as well as the one ending ‘The earth is sure beneath my feet’ both reinforce the threefold being.

There is an adventure to be undergone, beginning with the participants speaking and moving. ‘Around the rough and rugged rock, the ragged rascals ran’, then the reverse ‘The ragged rascals…’. The running itself is encouraged to get the diaphragm working strongly. The repetition of the end phrase as the beginning of the following sentence strengthens the will. The effort will be made to correct the ‘splay footed’ tendency. This, as well as the slightly protruding ears manifests a personality that is perhaps ‘opened-out’ to the world and thus over-sensitive. His inner-world will need to be centered, so to eventually bring down his talents. This is often the case with the big-headed, cosmic child.

Thus ‘The path before me winds about’ into an inward spiral, which leads to a stream welling up and flowing in peace.

The ‘seed of courage’ will be found near the stream. First, exercises for strengthening the tongue are carried through: ‘Nimble Nixie Nock’ and “An elf leaned low’ are followed by ‘Hippy Happy Hoppy’ which is the first jumping the rhythm exercise.

In the next 7 week period this inner space by the stream will be used to unfold a movement exercise with verses I made to supplement the centering movement work given by Emily Pikler. When the right-left crossing has been culminated, then the ‘Hip Hip Hoorah’ exercise can be properly observed and the incarnation process will be spurred on; a speech improvement can be thereby experienced.

In the coming sessions this centering exercise will be the ‘seed of courage’ plant unfolding.

The path outward is always executed at the end of each session. The treasure of the inner space is that it has a secret nature.

‘Slowly Silently’, the trochee mood leads out of the inner bush land and on towards home again.

I look forward to carrying the aforesaid process through to benefit Alan’s speech and well.

A Description of Further Sessions with Alan

A. In the past eight sessions Alan has enjoyed developing the story-in-motion. His impulse and eagerness to carry through the process has continued.

B. By speaking of everyday events, whereby he takes one step for each word, his speech slows down enough to understand. However at other times he forgets and, again the blurry muttered descriptions take place. By continued efforts of ‘stepping and speaking’, one can hope that this habit of hurried speech will end. Breathing from the diaphragm has been encouraged and, this has helped, in part, to strengthen the consonants.

C. He needs to differentiate more in the shaping of vowels.

D. We have worked, in the process of verses and exercises on the r, the th, the sh, the ch and the j. Now that his two front teeth are coming in, it is clear that he doesn’t differentiate between s and sh. He can speak the sh with a special exercise in which he rediscovers the palate with his tongue. Juxtaposition of the T and Ch, D and J, and D and Sh have helped him to properly place Ch, J and Sh. However it will take much practice before he acquires the habit of pronouncing them properly.

E. Has Alan a fine hearing difficulty? Perhaps the effort should be made to have his perception of the sounds tested.

F. Course of Therapy

The story has been expanded. When he has followed ‘the path’ and reaches the stream that wells up, he plants the ‘seeds of courage’. (This is an exercise whereby the ‘crossing’ from right to left and back is reinforced. It was introduced by Emma Pikler and is in widespread use as a movement exercise.) I have added the spoken couplets which occur after the movements, as recommended in anthroposophical speech therapy:

Lying down:

Brave seed true head right

How do you do? head left

How do you grow? head right

How do you move? head left

Curled up:

Warm and round in the ground roll to right

Waiting for the day roll to left

Warm and round in the ground roll to right

Waiting for the day roll to left

On stomach:

I stretch, I reach head right, stretch left arm

To see the spring head left, stretch right arm

I stretch I reach head right, stretch left arm

To see the spring head left, stretch right arm

On stomach, bending:

I feel the light and I must rise right elbow, left knee

left knee, right elbow

I feel the light and I must rise right elbow, left knee

left knee, right elbow

To and fro, the rain now flows Crawling to the rhythm. ALWAYS right

My roots drink deep knee, left arm, left knee, right arm

Wake up

Standing:

Here I stand in the sun Gesture of arms stretched out above Leaf and flower free in air like a plant.

Now I’m grown

On my own

Hello there Wave with right towards left

Hello there Wave with left towards right

This exercise must be carried on precisely, with the right/left polarities each time. It is very easy for Alan to move both right arms and legs or elbows at the same time, which is not desired. The consistent practising will slowly correct the kind of unilateral movement and enhance the incarnation process. This gives focus and balances the limbs. Thus the speech organ awakens and also comes into focus. Less slouching and leaning are needed.

A few more speech exercises with right/left movement have been added to the story. Many ‘brave seeds’ have grown. The singing exercises “Inch by Inch, Row by Row’, ‘Take your Staff and Wander’ and ‘Soon A Caterpillar to Butterfly’ continue to aid the ‘walking and talking’. They must be carefully observed each time to ensure the right/left is really kept in polarity. So at the end, ‘Hip, Hip, Hoorah’ is carried out as if by second nature.

When Alan arrives at the sea-shore in ‘Take Your Staff and Wander’, he hears the ocean billows laughing ‘Ho, Ho, Ho; Ha, Ha, Ha, Hee, Hee, Hee’. This encourages diaphragm breathing and strengthens the breath; he sees ‘Suzy selling sea shells by the sea shore’. The Sh is felt also with movement of the foot (imaginary pushing the sand back and forth on the consonant Sh). It will also take Alan a while to incorporate the Sh into his regular speech. The more correction, the better; at the right time, of course, so he doesn’t get embarrassed in a group.

So the balance of consonants is now:

Lip Sounds M B P F V are good

Teeth Sounds L N D T are good

but Th is too often F

R is still sometimes W

Sh needs differentiation from S

Ch & J are far forward from where the mid-tongue should touch the palate.

Palatal Sounds G, K & H are good.

G. Alan enjoys the process of the story-in-motion. It is of great help that his mother takes an active interest and has come to a few sessions to learn the speech and movement, and thus help Alan at home. With perseverance, I believe that he will be able, in time, to conquer the speech difficulties.

A Description of the Story in Motion in Use during this Therapy

The story-in-motion has been continually built up and expanded including exercises designed to correct his speech disturbances and qualities of soul-moods to reinforce alertness, courage and perseverance. Each session begins by building up the adventure. As well as giving him a chance to demonstrate what he has already begun to master, this repetition brings the needed progression of soul qualities back into existence.

Alan cannot yet give account in complete sentences of the content of the story. It must constantly be brought back to his consciousness.

The first sequence of sessions was in the form of a spiral development in space. The posture exercise at the beginning, the ‘r’ exercises, and the will exercise built into the spiral path are still not always well executed. It is a question of his attentiveness at the moment. ‘R’ still becomes ‘w’ at times but overall he has made improvement and continues to do so. He enjoys the three fluency exercises when the spiral path has led to the spring that well up and flows in peace.

After having planted the brave-seeds and harvested the blossoms the path continues down to the ocean. ‘Take your staff and wander’ has the same attribute as a will exercise as ‘The path before me winds about,’ namely, the last words of each line are repeated as the first words of the next line. The will is thus reinforced. Along this out winding path the trochee ____ _ falling rhythm helps to evoke a sense of grounding. Along this wandering, different experiences ensue. A town where blacksmiths work brings on the first alliterative experiences which will also help penetrate Alan’s will and grounding in the limbs.

Then the real consonantal problems are tackled at the seashore, where ‘Theophilas Thistledown’ brings differentiation between the ‘f’ and the ‘th’, which Alan often still confuses. These will eventually be learned as he meets each word consciously. ‘Mofer’ has to become ‘Mother’. ‘Fafer’ will become ‘Father’, ‘fird’ shall become ‘third’, etc. The lower jaw is parallel to the limbs system in the structure of the face and we are striving to awaken this function in Alan’s individual development. Almost every problem we have confronted so far in his speech can be seen as an aspect of this problem.

The ‘s’ is confused with the ‘sh’ (which Alan is just beginning to master now). By working with a mirror and relaxing of the tongue, he has been able to pronounce the ‘sh’ for the first time. ‘She sells sea shells by the sea shore.’ However he will have to ‘wake up’ his jaw and lower lip in a conscious manner, exploring each new ‘sh’ sound. This will be methodically learned with specially made exercises. Such enlivening speech as in ‘Huge boats to row’ will also help the ‘waking up’ process. ‘Lazy speech’ needs to be corrected and the efforts and success which Alan experiences must be praised.

The centering effect, as in ‘Tick-tock’ and ‘Brave Seed True’ will be carried on. Right-left, up-down and centering movement will be practised with speech.

The use of a mirror has facilitated Alan’s perception of his organ of speech. Ten minutes of work at pronouncing the ‘r’, the ‘sh’, the ‘gr’, ‘tr’, ‘cr’, and ‘spr’ help him see his own chin and jaw and lower lip in movement, when he is pronouncing them correctly. This is a beginning for him of his own understanding of sound.  After further testing, he has been found to have no perceptible learning difficulties.

The use of spiral colour drawing with pastels and the water colour painting of ‘Brave-seed true’ are a special treat for Alan. Colour work, which he does well, can help him build self-confidence. His feeling soul is growing to be stronger and the colour work also allows him to express and communicate better

The Treatment of a Patient with Acquired Head Injuries

The following is the case of a private patient treated by Katherine Rudolph. For this case history we have called him Ben, (not his real name), to make it easier for you to follow as we update his progress. Ben is a 35 year old schizophrenic. An accident 14 years ago, involving a head injury, left him with brain damage to the right side.

He can walk unsteadily but doesn't fall. His dexterity at painting has increased in the last 5 months.

A Progress Report

Ben has shown engagement in his connection to the painting, the clay work and the pastels. The 10 sessions have been a beginning of a sequence which will be continuing.

Warm colours are stimulating to the brain. On the first day three paintings were made in quick succession. A desert mood of warm yellows and reds, and a blossom-like apparition in red, were a sign of Ben’s enthusiasm for colour. Realising the need for strong paper, I brought Fabriano-rough grade for the next session. Even when the colour is ‘smashed’ onto the paper, it holds its form. White was added to the yellow and dark reds which created a warm peach blossom, in sunset moods. Ben works better indoors because his attention disperses too much on the patio. However, his kitchen table is becoming more wobbly, due to his exuberant motions.

From the 3^rd to the 7^th lesson, clay modelling of the platonic solids was attempted.

As the painting can loosen cramping and call for the verbal response (however thus far he has not uttered any word), the clay modelling allows Ben’s forces to have a work-out, such as he gives the clay, centralises his forces, his natural tendency seems to be the opposite. Tearing the clay apart allows him to express aggression and disperses consciousness. As we carried on with the metamorphosis, I brought cardboard models of the tetrahedron, the square, the octahedron, the icosahedron and the pentagonal dodecahedron. This progression connected with the Greek experience of the elements: fire, earth, air and water, has the effect of spacial centring and balancing: forward-backwards, right-left, above-below. Ben was introduced to the Egyptian Pyramidal form as well. This brought back a memory of his early childhood (with the help of his mother, who was present). They had visited pyramids in Mexico. Ben seemed to be aware and remembering the form, and a larger model may be attempted in the weeks to come. Earth and fire unite!

At times, Ben is allowed ‘a free hand’ with the clay. He tends to roll it into a sausage form which he then twists until it breaks apart and continues to tear it apart. This process is enjoyed. At the mid-point, when the twisting begins, there is an element of beauty in the convex-concave indentation. To see beauty in art shall be one of the goals for him. I believe that Ben is generally sturdier on his feet after the modelling sessions.

The last three sessions were a mixture of pastel work and clay modelling. With the pastels, Ben can use his strength to cover the paper with warm colour. The kitchen table may go down! Fire seems to be flashing in his attempts, so I brought the rhythm from Goethe’s ‘Pandora’:

Kindle the fire flame

Fire’s the first of names

Highest achieved he

Who robbed the spark

He who has kindled it

Forges it, moulds it to

Crown for the head

Clapping this rhythm will be continued to see if he can make utterances related to this or join into the clapping. An ‘a’ experience was also spoken:

‘Strengthening weightiness straightens wavering daintiness

Wavering daintiness straightens strengthening weightiness’

I look forward to continuing the Art Therapy with Ben in the coming week.

A Description of Further Sessions with Ben

In the last nine weeks Ben has continued appreciating the painting therapy. He is quite concentrated and enjoys close observation of colour flowing into colour.

His tendency would be to let everything flow into one but he is learning when the painting can be said to be finished. He raises his thumb when he experiences the painting to be ready to dry. This does not always happen, but only at times when he is really in control. He also points, if asked what colour he wants to paint.

Recently Ben has begun to enjoy making violet. I place ultramarine blue in one corner and carmine red in the diagonal corner. All Ben’s attention is directed on making violet slowly come into being. Sometimes a red violet is surrounded by blue at the end, or at others a gradual appearance of violet occurs diagonally in the middle.

It is the therapist’s intention to cause Ben to be aware of a balance between up-and-down, right-and-left, and centre-and-periphery. The central experience is very important for his consciousness. Thus the sun-like or moon-like centering effect is often used. It lets Ben see the whole of the painting at once, instead of leaving him without a view of the finished painting.

At times during the week, his painting can be left out or hung up so he can recall what he has accomplished.

Even when he is tired, Ben does not stop painting. He is curious what will happen to the colours.

The colours are speaking and interacting together. Often the therapist intones vowels to go along with the colour dialogue. Sometimes musical tones are evoked: accord and dissonance. Or a story may be told of one colour visiting another. Indeed the colours have specific qualities (as J W Goethe has said: “The deeds and sufferings of light.”) Therefore if vermilion red visits blue directly a kind of dissonance can occur: ‘brown’. But eventually this dissonance can be harmonised through a balance of colour qualities. Ben likes this dissonance, which is a sign of his temperament. For him to see the boundaries of this – how there is a place for all the qualities – pure and mixed colours – to live and speak together, can be an entrance into social life for him. The chance that he might give utterance to this stimulus is always present; though only a few times he has voiced syllables.

To experience how it might feel as a human being to live in a world of colour, expressly one of one’s own painting brings forth qualities of soul and imagination. Thus, I often have asked him how he feels in that ‘world’. Let’s create a place which feels good to live into. Sometimes Ben is able of his own accord to find a boundary in the colours and consciously let it be. When he finds his own boundaries as well, he will be more and more able to communicate.

With the new easel, where his paper is stretched onto the board, this differentiating quality will be enhanced.

- Katherine Rudolph

Ben has shown engagement in his connection to the painting, the clay work and the pastels. The 10 sessions have been a beginning of a sequence which will be continuing.

Warm colours are stimulating to the brain. On the first day three paintings were made in quick succession. A desert mood of warm yellows and reds, and a blossom-like apparition in red, were a sign of Ben’s enthusiasm for colour. Realising the need for strong paper, I brought Fabriano-rough grade for the next session. Even when the colour is ‘smashed’ onto the paper, it holds its form. White was added to the yellow and dark reds which created a warm peach blossom, in sunset moods. Ben works better indoors because his attention disperses too much on the patio. However, his kitchen table is becoming more wobbly, due to his exuberant motions.

From the 3^rd to the 7^th lesson, clay modelling of the platonic solids was attempted.

As the painting can loosen cramping and call for the verbal response (however thus far he has not uttered any word), the clay modelling allows Ben’s forces to have a work-out, such as he gives the clay, centralises his forces, his natural tendency seems to be the opposite. Tearing the clay apart allows him to express aggression and disperses consciousness. As we carried on with the metamorphosis, I brought cardboard models of the tetrahedron, the square, the octahedron, the icosahedron and the pentagonal dodecahedron. This progression connected with the Greek experience of the elements: fire, earth, air and water, has the effect of spacial centering and balancing: forward-backwards, right-left, above-below. Ben was introduced to the Egyptian Pyramidal form as well. This brought back a memory of his early childhood (with the help of his mother, who was present). They had visited pyramids in Mexico. Ben seemed to be aware and remembering the form, and a larger model may be attempted in the weeks to come. Earth and fire unite!

At times, Ben is allowed ‘a free hand’ with the clay. He tends to roll it into a sausage form which he then twists until it breaks apart and continues to tear it apart. This process is enjoyed. At the mid-point, when the twisting begins, there is an element of beauty in the convex-concave indentation. To see beauty in art shall be one of the goals for him. I believe that Ben is generally sturdier on his feet after the modelling sessions.

The last three sessions were a mixture of pastel work and clay modelling. With the pastels, Ben can use his strength to cover the paper with warm colour. The kitchen table may go down! Fire seems to be flashing in his attempts, so I brought the rhythm from Goethe’s ‘Pandora’:

Kindle the fire flame

Fire’s the first of names

Highest achieved he

Who robbed the spark

He who has kindled it

Forges it, moulds it to

Crown for the head

Clapping this rhythm will be continued to see if he can make utterances related to this or join into the clapping. An ‘a’ experience was also spoken:

‘Strengthening weightiness straightens wavering daintiness

Wavering daintiness straightens strengthening weightiness’

Ben has shown significant improvement and will have continued treatments in the future

© Copyright 2005 Katherine Rudolph, Exploring The Word In Colour And Speech