CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
TEMPORAL SEQUENCING OF
VERBAL AND MOTOR BEHAVIOR
IN SCHIZOPHRENIC CHILDREN
A thesis submitted in partial satisfaction of the
requirements for the degree of Master of Arts in
Education, Early Childhood/Special Education
by
Nancy Rebecca Elliot
August
1985
The Thesis of Nancy Rebecca Elliot is approved:
Rose M. Bromwich, Ed.D.
Claire
c.
Cavallaro, Ph.D.
California State University, Northridge
ii
Acknowledgements
I would like to express my deepest thanks to Elizabeth
Ringsmuth, whose guidance and support gave me the strength
and encouragement during all phases of this project.
Many
thanks to Rose Bromwich and Claire Cavallaro wnose ideas
and thoughtful suggestions were extremely helpful in the
writing of the text.
Finally, a very special tnanks to
John M. Watkins, who allowed me the opportunity and accessibility to use his invaluable collect1on ot data.
It was
from observing his original research work, and clinical
applications of intervention w1th tnese children tnat
inspired me to propose this present study.
iii
Table of Contents
Page
Acknowledgements
ii~
List of Tables
vi~
List of Figures
vi~i
Abstract
ix
INTRODUCTION AND REVEW OF LITERATURE
Variables Affecting Self-Regulating Speech
1
3
Age
3
IQ
6
Situational Factors
Task
7
Setting
8
Task Difficulty
9
Cognitive Style
11
Functional Implications
15
Methodological Problems in Categorizing
Private Speech
20
Rationale for Choice of Population
23
METHODS
Subjects
27
Selection
27
Chronological and Mental Age Matching
30
Equipment
30
Experimental Task
32
iv
0
Page
Coding Private Speech
33
Scoring of Block Design Performance
33
Recording of Motor and Verbal Behavior
34
Data Analysis
35
RESULTS
36
Characteristics of Private Speech
36
Self-stimulating Speech
36
Remarks to Nonhuman Others
36
Verbal Regulation
36
Emotional Interjection
38
Subvocalization
38
Social Speech
38
Total Private Speech
39
Verbal and Motor Behavior
40
Before Placement of Block
40
During Placement of Block
42
After Placement of Block
42
No Motor Behavior
4J
DISCUSSION
44
Private Random Speech vs Particular Pattern
44
Response to Failure or Success
45
Difference Between Schizophrenics and Normal
Control
46
Implications for Intervention
47
FOOTNOTES
50
v
'
Page
REFERENCES
51
APPENDICES
A:
Block Designs
63
B:
Manual of Instruction for Scoring Speech
64
C:
Unitization
66
D:
Categorizing Motor Behavior
67
E.
Data Summary Sheet for Scoring
Spontaneous Speech
68
Copyright Notice Page
72
vi
List of Tables
Page
Table 1:
Characteristics of Schizophrenic and
Normal Control Groups
31
Table 2:
Temporal Sequencing of Verbal and
Motor Behavior
41
_vii
List of Figures
Page
Figure 1:
Comparison of Private Speech
Between Schizophrenics and
Normal Controls.
viii
37
Abstract
Temporal Sequencing of
Verbal and Motor Behavior
in Schizophrenic
Chi~dren
by
Nancy Rebecca
Ell~ot
Master of Arts in Education
The production of spontaneous verbalizations which do
not address or adapt to a
l~stener,
may be observed in
young children. The functional nature of this speech can
provide insight into the cognitive functioning of the
individual.
The identification of mediational deficits
among a group of childhood-onset schizophrenics can enable
educators to begin to develop effective intervention for
the classroom.
The purpose of this study was to
exam~ne
schizophrenic
children's spontaneous speech in a naturalistic context.
Moreover, the study examined how the child's verbalizations related sequentially to a motoric behavior.
Ten schizophrenic and ten normal control
chi~dren
were
each observed and videotaped while solving five block
designs.
The
ch~ld's
motoric pertormance on the block
design as well as the spontaneous speech were unitized and
J
categorized.
Results indicated that the sch1zophrenics produced a
higher level of spontaneous speech which was not related
to motor behavior.
Furthermore, the actual result of
block placement, either positive or negative, increased
the probability of spontaneous speech emitted.
The most
striking results of this study involve the actual sequencing of verbal and motor behavior between the sch1zophrenic
and age matched normal children, with the schizophrenics
producing verbal and motor behavior simultaneously.
The
normal control group however, produced speech only before
or after a motor movement.
The data indicate that these two groups ditter signif1cantly in their distinct patterns in integrating their
spontaneous speech with motor1c acts.
It was noted that
the schizophrenics are demonstrating a more random use of
private speech, which not only is dysfunctional, but may
;
i./
elicit certain symptomatic behaviors of schizophrenia.
Furthermore, the data provide a basis for the development
of self-guidance training.
Finally, the study presents
ideas for further investigation.
These ideas include (1)
specific categories of speech as related to a particular
I
1
motor behavior (2) increasing cognitive pertormance by v
invoking task-oriented speech (3) generalization to various
other tasks using verbal mediation training.
X
TEMPORAL SEQUENCING OF
VERBAL AND MOTOR BEHAVIOR
IN SCHIZOPHRENIC CHILDREN
CHAPTER ONE:
INTRODUCTION AND REVIEW OF LITERATURE
A major theoretical question addressed by developmental psychologists, concerns the degree to which private
speech governs a specific motor act.
The production of
spontaneous verbalizations which do not address or adapt
to a listener, may be observed in young children.
For
example, when presented with a task requiring problem
solving, the child often talks while pertorming.
The
following is an excerpt of a videotaped session of a child
while pertorming a block-design task;
•o.K./Wait/It's so hard/! can't do this/Let me think/
Hmmn/Let me do that again/! can't do
th~s
at all/It's
so hard/What to do?/Let's see/Let's go I like this/Now
let me think/Now what do I do?/Now/Now we have that"
(Watkins, 19 81) •
Children's private speech, as illustrated above, has
commonly been used to refer to all speech that is not
obviously aimed at others.
Its strong connotations of
voluntary use of the meaning of words implicitly excludes
speech which is used involuntarily and/or whose effect on
concurrent action is through the motoric impulse of speech
1
2
Q .
(Zivin, 1979).
Previous works by Soviet psychologists
such as Vygotsky (1934) and Luria (1975), as well as
American investigators like Flavell (1970), and French
psychologist Piaget (1926), have focused on private speech
and the functional role it plays.
The examination of children's private speech has its
roots in decades of theoretical debates concerning the
relationship of language and thought.
Investigators
postulated that through studying this speech, perhaps they
would gain insight into the cognitive processes of the
child.
From this body of research the
impl~cat~ons
/
for
intervention became an important issue to clinicians and
teachers.
One strategy focuses on private speech and the
development and provision of training procedures to guide
the child's cognitive
activ~ties.
The following section will attempt to review the
literature concerning the variables affecting self-regulating speech.
In addition, the situational factors which
aftect speech wili be presented.
Furtnermore,
l~terature
involving the functional implications of speech will be
discussed, as well as the methodological problems which
exist in present studies.
Finally, a rationale for the
choice of population wili be presented.
3
Review of Literature
Variables Affecting Self-Regulating Speech
There are multiple variables which affect the production of self-regulating speech that exist in the present
literature.
Among those which have been investigated are
age and IQ.
In addition, several situational factors which
have been identified as having a significant impact on the
quality and degree of private speech are:
task, setting,
task difficulty, and cognitive style.
~.
Chronological age has been the one determ1nant
of private speech that has received the most attent1on.
While both Piaget and Vygotsky assumed the cognitivedevelopment determination of private speech, they dittered
however in their view of the developmental patternings of
private speech (Kohlberg, Yaeger, and Hjertholm, 1968).
With regard to the phenomenon itself, Piaget (1926)
found what he termed "egocentric" speech to be prevalent
in the spontaneous conversations of children ages 5-6 and
to decline with age.
In a series of semi-experimental
studies, Piaget (1926) reported that egocentric speech
comprises a significant part, 40 to 70 percent, of all
expressions of children, in either peer or adult situations.
Piaget (1926) views egocentric speech as having a positive
social-communication function which the child is unable to
effectively realize.
As the child develops communicative
4
skills, egocentric speech yields to social speech.
There-
fore, a change in cognitive form or speech adequacy takes
place without a basic functional change.
Piaget (l92b)
describes speech without communicative or cognitive intent
as a negative characterization of the functions of egocentric speech.
The most profound criticism of Piaget's theory is
that stated by Vygotsky (1962).
Vygotsky (1934;1962)
hypothesized a curvilinear relat1onship between the occurrence of private speech and age.
According, to Vygotsky,
the age-decline in egocentric speech that is selfdirecting, indicates that it has "gone underground" as
verbal thought, not that presocial speech has been replaced
by socially communicative speech.
Vygotsky (1962) reports
a rise in the percentage of egocentric speech in the
2-to-4-year old period, and suggested that it represents
increasing cognitive development in th1s period.
Kohlberg et al. (1968) present data in support of the
"cognitive development" approach to private speech shared
by Piaget and Vygotsky.
They report age trends which are
consistent with previous assumptions that private speech
is common among young children ranging in age from 4 to 6
years.
Thereafter, there is a decline and private speech
is practically absent in older children capable of intern-
alized logical thought.
'
5
Flavell attempted to replicate Luria's reported age
changes in task performance with a bulb-squeezing task
(Miller, Shelton, and Flavell 1979).
One of the
specit~c
effects that had been predicted by Luria's theory involving
overt self-instructions across age groups were found in
the Flavell study.
Results indicated that the only unequi-
vical positive finding was that the older
ch~~dren
were
considerably more adept at all variations of this simple
two-choice task than the younger ones.
Therefore,
Flavell's study, as well as other attempted replications
of Luria's work, demonstrated a strong increase
w~th
age
across childhood, with general ability to regulate and
guide one's own behavior by internal means (Wozniak,
197 2).
Some evidence indicates that although the absolute
amount of private speech decreases, the proportion of
private speech that is
age.
self-regulat~ng
increases with
For example, Klein (1964) found a significant corre-
lation between age and task-relevant speech.
Beauchidon
(1973) reported that self-regulating speech rose proportionately from 68% for 5 l/2-to-6-year olds to 81% for 6
1/2-to-7-year olds.
Dickie (1973) demonstrated that difterent private
speech categories have different developmental trends.
She reported on two ditterent
categor~es:
(1) a lower
6
level of private speech that included
self-st~mulat~on,
remarks to non-human objects, and describing activity and
(2) a more advanced level that involved
quest~ons
answered
by self self-guiding comments, and inaudible mutterings.
There were functional difterences among each of these
classes of private speech, with the lower levels being
consistent with Piaget•s conceptualization, while the
higher levels were more consistent with Vygotsky's views
of private speech.
IQ.
Investigators have tried to explain the reported
age-related decline in private speech as a result of the
increasing cognitive maturity level of the child.
Kohlberg
et ale (1968) reported mental age data which was consistent
with Vygotsky's hypotheses of a
curvil~near
development of
private speech timed in terms of mental age.
This set of
studies suggest that the age development of private speech
was primarily a function of cognitive level as reflected
in mental age, and was not merely a
logical age.
re~lection
of chrono-
Thus, the developmental shifts of private
speech appeared to be paralleled by mental rather than
chronological factors.
The main effect of higher IQ seems to be to make
young, high-IQ children produce amounts of private speech
equivalent to that for average
sl~ghtly
older children
(Kohlberg, Yaeger, and Hjertholm, 1968; Yaeger, 1978).
7
Dickie (1973) reported that the relationship between
performance on the Peabody Picture Vocabulary Test and
private speech appeared to be dependent on the form of
private speech.
Increasing cognitive development was
associated with a decrease in outward-directed private
speech, but there was no association between cognitive
development and inner-directed speech.
In comparison,
Goodman (1975) found no relationship between IQ and mental
age scores on the Peabody Picture Vocabulary Test ana any
private speech measure.
IQ is positively related to task pertormance for
those children who talk while solving a puzzle, but is
unrelated to task pertormance for those
not talk (Klein, 1964).
chi~dren
who do
On sentence-completion tasks,
which required the correct choice from a pair of words,
high-IQ first graders concentrated their task-irrelevant
speech utterances after they had finished the task
whi~e
low-IQ children distributed these task-irrelevant utterances throughout the task (Roberts, 1977).
This finding
is consistent with Beauchidon•s (1973) data which proposed
that a good pertormance may be due more to the lack of
distracting, task-irrelevant speech than to the presence
of self-regulating speech.
Situational Factors
~.
Experimental tasks which are represented in
8
the private speech literature involve sensorimotor skills
and naturalistic studies, which involve sequential tasks
with varying degrees of problem-solv1ng compounds.
Luria
(1975) originally studied the use of self-instructions on
the rate of bulb-pressing, requiring a motoric response.
This same task has been employed by various investigators
such as Jarvis (1968), Miller, Shelton, and Flavell (1970).
Meichenbaum and Goodman {1969a) employed the same experimental paradigm with finger-tapping to investigate the use
of self-instructions.
Wozniak's (1973) review of the
literature in self-instruction reports that Meichenbaum
and Goodman's (1968a) study was clearly the first Western
replication of the Vygotsky-Luria paradigm of the developmental theory of verbal control.
Setting.
In the tradition of Piaget
(1923;195~)
and
Vygotsky (1934;1962), another form of reseach involves a
naturalistic approach.
These two investigators have
examined preschooler's private speech as it occurs in
activities such as free-play.
These naturalistic studies
frequently employ sequential age groups in order to address
questions regarding differential functions of private
speech.
In an attempt to integrate the confl1cting assump-
tions of Piaget and Vygotsky, works by Klein (1964) and
Kohlberg et al. (1968) continue the developmental and
naturalistic approach.
,,
'
9
Task Difficulty.
The relationship between task
difficulty and private speech has been
number of investigators.
exam~ned
by a
From this work, there has been
support given to Vygotsky's proposal that the incidence of
private speech would increase when the child is faced with
a difficult task.
Data presented by Kohlberg et al. (1968)
demonstrated that the general occurrence of private speech
increased with task demands for cognitive
activ~ty.
The more cognitively demanding the tasks the higher
the evidence of private speech, especially self-guiding
speech.
For example, Dickie (1973) reported a higher
incidence of private speech during puzzle and
tasks than in free-play with toys.
color~ng
Similarily, Klein
(1963) observed spontaneous incidence of private speech of
3-to-7-year old children while doing a puzzle task, and
found an increase in task-relevant private speech with
age.
Interestingly, this increase in speech was positively
associated with success in completing the puzzle.
Beaudi-
chon (1973) observed that school-age children who performed
on Piagetian seriation and
classif~cat~on
tasks, produced
a high proportion of regulatory utterances and that this
incidence was higher for older than younger chiidren.
Deutsch and Stein (1972) clearly demonstrated the
role of difticulty and failure in affecting the occurrence
and content of private speech.
This study involved the
10
manipulation of task difticulty by arranging conditions
for personal failure (due to inadequate performance),
task interruption (due to faulty materials), and success
(completion of task).
The personal failure condition
resulted in more total private speech than the two otner
conditions.
Deutsch and Stein concluded that one ante-
cendent of private speech was that of achievement-related
motives and personal responsibility through personal failure.
Goodman (1975) employed the personal faiiure conaition
of Deutsch and Stein and also demonstrated that the amount
of private speech increased
follow~ng
faiiure.
Goodman
reports a differential effect of failure on the actual
content of the private speech, with an increase of taskrelevant speech, description-of-activity, and unscorable
following faiiure and a decrease with task success.
In an attempt to demonstrate the functional role of
private speech, Zivin (1972) recorded preschool chiidren's
private speech while performing on finger mazes.
She
concluded that private speech tended to occur least often
when the child had a more adequate problem-solving approach
and most often when the child was confused with the task.
The majority of speech occurred immediately after errors.
Lyublinskaya (19.4H) demonstrated the function of
private speech in formulating the problems during
11
difficult periods and the facilitation of planning.
Her
subjects exhibited speech at times of failure as well as
in the beginning of an activity.
Her results suggest that
private speech functions to plan a course of action, and
to formulate the problem when the task becomes ditticult.
Goodman (1975) hypothesized that the function of
private speech should change with the development of
proficiency by the child.
She differentiated pre-school
children based on their jigsaw puzzle abilities.
These
children differed in their task performance in several
ways:
in a trial-and-error fashion or in a mediated,
planned fashion in which they looked at each puzzle piece,
searched the puzzle, and placed each piece.
She found
that children who performed in this latter fashion showed
more instances of private speech, their speech being
characterized as social, task-relevant, description of
activity, questions to self, and self-guiding private
speech.
Cognitive Style.
Based on
the~r
exper~ments
on
verbal control, Luria (1961) and Homskaja (195b) suggest
that hyperactive, impulsive children manifest less verbal
control of their behavior.
This was furtner investigated
by Meichenbaum and Goodman (1971).
Using Kagan's (1966)
Matching Familiar Figures (MFF) Test, in wnich the child
must choose one figure that matches a standard figure from
12
a display of six figures, these investigators looked at
the relationship between impulsivity and inability to
control verbal behavior.
The results demonstrated that
the cognitively impulsive child tends to make several
errors while responding quickly, whereas the cognitively
reflective child tends to respond slowly making fewer
errors.
Meichenbaum (1971) studied a group of preschool
children who had been identified as either reflective or
impulsive, based on the MFF Test.
The
chi~dren
matched for IQ and socioeconomic status.
were
Recording of
private speech was made during a freeplay situat1on.
The
results indicated that the impulsive children had twice as
much private speech as did the reflective
chi~dren,
however
both groups demonstrated equal amounts of social speech.
Moreover, when the private speech was analyzed, it was
revealed that the impulsive children used more selfstimulating private speech; for example, word play,
whereas the reflective children used more self-guiding
private speech; such as describing their own activity.
a similar study, Zivin (1972) discovered that styles of
maze-solving in preschoolers resembled impulsive versus
reflective processing styles and interpreted the more
frequent private speech of reflectives as having the
potential to be self-distracting.
Dickie (1973) further
In
13
investigated the relationship between impulsiv1ty and
private speech by using two measures of impulsivity:
a
picture absurdities test and a game requiring the chiid to
drive a truck slowly along a track while following careful
directions.
Results of this study indicated that the
impulsive children used more self-stimulating and outerdirected private speech, but there appeared no ditterence
between impulsive and nonimpulsive children in the occurrence of inner-directed speech.
A positive relat1onship
between preschooler's matching accuracy and the rate of
self-directed speech em1tted whiie working on puzzies was
found by Kleiman (1974}.
Goodman (1977) used the Kansas Reflection-Impulsiv1ty
Scale for Preschoolers (Wright, 1972} to assess the cognitive style of preschoolers.
She then related pertormance
on this measure to the occurrence of private speech while
doing puzzles.
Using the total population of preschoolers,
there was no general association between the two indicies.
However, when the five most impulsive and five most retlective preschoolers, matched on IQ, sex, and age were compared, the cognitively impulsive preschoolers were observed
to emit a higher percentage of private-speech, especially
in categories of description of activ1ty, questions to selt,
and self-guiding.
14
Camp (1975) examined groups of aggressive ana nonaggressive first-and-second-grade boys by recording occurrences of private speech during a var1ety of nonverbal
performance tasks and the MFF.
Results indicated that the
aggressive-impulsive boys demonstrated signif1cantly more
task-irrelevant, immature instances of private speech and
they were less able to regulate their behavior through
covert private speech.
One variable that possibly influences the functional
value of private speech is the child's ability to listen.
Berner (1971) using a delayed auditory feedback technique,
measured the child's awareness of his or her own verbal
behavior.
This was indicated by the amount of disruption
in the child's speech when the feedback from his or her
own voice was delayed for a fraction of a second.
Berner
discovered that good listeners, measured as those who made
many errors during the disruption from the feedback, used
more private speech on a jigsaw puzzle task than nonlisteners, and the private speech was more often of the
self-guiding form.
Finally Meichenbaum (1975a) suggests that impulsive
children do not characteristically analyze their experiences in mediational terms--these terms being verbal or
imaginal.
He further proposes that a training program
that is designed to teach such mediational sKillS will
15
Q
enhance performance and foster self-control.
Functional Implications
The research reviewed above focuses on the var1ous
correlates of private speech without examining the actual
effect of private speech on the non-verbal aspects of
performance.
Piaget (1955) suggested that private speech
could serve a number of positive, adaptive functions.
In
addition, he stressed the importance of private speech and
it's reflection of the child's inability to ditrerent1ate
between the self and others.
These functions might be
served by the reinforcement of an action on an accompanying
task, or to accelerate an action, or as a perceptual
discriminator to guide and control attention relevant to a
task.
A most vital part of Piaget's theory is that of the
symbolic function of language.
It is this function which
enables thought to become separated from action.
According
to Piaget, language plays a major role in the interiorization of action into thought and this enhances the
child's ability to summarize actions from the past and
anticipate future actions.
The theoretical position of Vygotsky (1962) is a
"cultural-historical" view of the psyche.
There is con-
siderable stress placed on social relat1onships and the
products of the cultural development of society as the
'
16
primary
ness.
determ~nants
of the
chi~d's
developing conscious-
The cultural mediators used in social intercourse,
including language, were viewed by Vygotsky not only as
socially evolved aids in relating to reality and more
complex forms of reflection of the external world, but as
the primary means by which the child learns to regulate
her or his own higher mental functions.
Vygotsky noted
the way in which the adult's speech is initally mimicked
by the child as overt private speech and observed that it
then "goes underground", in the form of inner speech.
In more recent years, Vygotsky's position has been
further elaborated in the Russian work of Luria (1961).
Luria postulates two interrelated and parallel developments
in the verbal regulation of behavior.
The first develop-
ment includes the nature and origin of the
speech.
regulat~ng
Initially, the overt speech of others (usually
adults) can regulate and guide the
chi~d's
actions.
For
example, another person may direct the young child's
attention to various events and objects through verbalization.
Therefore, initially the only speech that can
influence the child's behavior is other-external:
it
comes from another person (other) rather than from the
child, and since the child must hear it in order to be
influenced by it, it ·is overt (external) rather than
covert.
The second step developmentally consists of the
17
gradual transfer of control from otners to tne self.
Luria postulated the process of self-external to mean that
the child would learn to regulate her or his own behavior
by means of internal, inaudible, and perhaps fragmentary
speech.
Following Vygotsky, Luria posits that verbal
self-regulation becomes increasingly internal and abbreviated toward the end of early childhood.
Finally, the
process becomes self-internalized, moving from controlling
overt speech to a covert
manifestat~on.
Luria cites a series of research findings in support
of his developmental model.
For example, in one such
study he employed lights of two different colors which
would flash on in random sequence.
The child is instructed
to squeeze a rubber bulb once whenever the light of one
color comes on (positive stimulus), and not to squeeze the
bulb whenever the light of the other color comes on (negative stimulus).
Luria suggests that private speech functions as an
aid in orienting the child to a situation, mobilizing past
experience, and organizing action.
He therefore concludes
that private speech is one component necessary for a
variety of higher cognitive processes based on his investigation of the role of private speech on the child's
ability to control attention, recall information, form
18
concepts, and solve problems.
A significant problem with Luria's research has been
the difficulty that non-Soviet researchers have had in
replicating his findings.
It is suggested tnat
fai~ure
to
replicate may be due to inappropriate methodology deriving
from misinterpretation of the nature of verbal-inhibitory
phenomena and lack of appreciation for underlying Soviet
psycho-philosophical assumptions (Wozniak, 1972).
In
addition, the age trends and the mediational effects of
experimenter-imposed private speech on motor behaviors
have not been supported by Western researchers.
Shelton, and Flavell (1970) tested young
Lurian bulb-squeezing task situation.
Miller,
chi~dren
in the
At four age levels,
one-fourth of the children were instructed to say botn
"Squeeze• to the positive light (and then to squeeze the
bulb just once) and "Don't squeeze" to the
negat~ve l~ght
(and then to refrain from squeezing), one-fourth to say
"Squeeze" to the positive, and one-fourtn notning to
either light.
Results indicated that none of the specific
effects predicted by Luria's theory were found.
Major
results in this study, did however include a significant
main •age" eftect for all measures, with fewer errors made
by older children.
Miller et al. ( 197 0) argue that "Luria's results are
a function more of his methodology than of any true media-
19
tional processesn (p. 664).
Wozniak (1972) reports exten-
sive indirect evidence for the adequacy of Luria's view of
the development of verbal self-regulation of motor behavior.
Furthermore, he points out the necessity of adequate
assessment of the specific verbal-inhibition-of-persecution
phenomena described by Luria.
In particular, Wozniak
supports the replication of Soviet psychological research
and its recognition of the fundamental ties to a certain
set of philosophical assumptions about the nature of
humans and their relationships to social and physical
reality.
Flavell (1977) has criticized the Lurian theory for
misinterpreting the cognitive process of self-control.
He
suggests that the error lies in interpreting the source
and vehicle of human self control as exclusively or even
primarily verbal.
Furthermore, Flavell has outlined a
number of specific limitations in this area of research.
These methodological problems included;
(1) the private
speech was experimenter-elicited, not spontaneous, (2)
that attributes of speech itselt or its casual antecedents
were not considered, and (3) that affective-motivational
components of private speech were ignored.
Goodman (1981) examined how children's utterances are
sequentially related to the ongoing stream of
behavior.
motor~c
She observed and videotaped preschool children
,, .
20
during jigsaw-puzzle solving.
The results of
study
th~s
indicated that puzzle solutions were accompanied by a high
rate of verbalizations, particularly of plans or thoughts,
and emotional expletives.
Furthermore, a random distri-
bution of verbalizations was not found in
puzzle-solving behaviors.
relat~on
to
Finally, it was demonstrated
that by examining the discrepancies from sequences, and
random verbal motor co-occurrences, one can determine the
specific modes in which children use their speech during
puzzle solving.
Methodological Problems in Categorizing
Pr~vate
Speech
The lack of common process of categorizing private
speech presents a methodological problem among the present
studies in private speech.
The original precedent for
formulating categories of private speech was set by Piaget
(1923;1955).
Piaget established three categories:
monologue, the collective monologue, and mere
the
repet~tion.
The monologue is defined by Piaget, as "the added pleasure
of feeling himself an object of interest to otner people"
(Piaget, 1923;1955), p.31).
Therefore, the others are not
expected to respond, or to understand, and the presence of
others serves only as a stimulus.
These definitions are
consistent with Piaget•s view that the
egocentr~c
quality
of the child's verbalizations is manifested in instances
of private speech.
Q '
21
Luria (1961) postulated an interior1zat1on process to
occur developmentally.
According to Luria, the child
under two years of age is not able to direct his or her own
behavior using speech.
Therefore, it is only the speech
of others that can initiate, direct, and control the
child's behavior.
In the second stage, the child can to
some extent use his or her own speech to control behavior.
It is at this second stage that speech helps to initiate
motor behavior, but will not inhibit it.
Luria furtner
proposes that at this stage the semantic content of the
speech makes no apparent difference.
Finally, in the
third stage, the content of the child's self-speech
becomes primary, and is internalized.
Theretore, on tne
basis of Luria's model, one should expect to observe
changes in the function and content of private speech w1tn
age.
Kohlberg, Yaeger, and Hjertholm (1968) offered four
major categories to classify children's private speech and
furthermore, suggested that these should be seen developmentally.
The Kohlberg, Yaeger, and Hjertholm hierarchy
includes the following categories:
Level I: presocial
self-stimulatory language, including word play, repetition,
animal noises, and singing.
for their own sake.
Repeating phrases or words
Level II: outward directed private
speech, including remarks addressed to nonhuman objects
22
and descriptions of the child's own activ1ty, sim11ar to
Piaget's category of collective monologue.
The description
is in a form which has no task-solv1ng relevance or planning function.
Level III: inward-directed or self-guiding
private speech.
This includes quest1ons answered by the
self, as well as self-guiding comments.
Level IV: external
manifestations of inner speech, th1s includes inaudible
mutterings.
Studying this categorical system, Rubin,
Hurtsch, and Peters (1971) found signif1cant interrater
reliability on four categories: word play, remarks
addressed to nonhuman objects, quest1ons answered by selt,
and inaudible mutterings.
Meichenbaum and Goodman (1971) developed a comprenensive category system that built onto the Kohlberg, Yaeger,
and Hjertholm scheme.
verbalizations by:
This system categor1zed the child's
(A) social speech, which included
utterances addressed to the exper1menter.
speech, which included:
(B) private
word play, description of activity,
comments to absent or nonhuman otners, quest1ons and
answers to self, verbalizations of ongoing cognitive
activity, expletives, and unscorable.
The addition of
expletives was made based on the research of Flavell
(1964) and Klein (1964) who emphasized the importance of
this category.
23
Rationale for Choice of Population
There have been several programs aimed at invoking
private speech, or verbal mediation among
hyperactivity.
chi~dren
with
Studies such as Meichenbaum (1971), and
Kendall and Braswell (1982) have focused on behavioral
treatment using cognitive behavior modification.
Such training has been successful in causing hyperactive children to employ mediational processes and to
develop verbal control of behavior (Meichenbaum and Goodman, 1971).
The goal in such studies is to teach the
hyperactive child to think before acting.
This model
maintains that target behaviors that are not premediated
should first be returned to a deautomatized condition, in
which the habitual maladaptive behaviors and inadequate
performances come to be preceeded by cognitive activ1ty
occurring within the child's awareness.
Furthermore, it
is this forced mediation that increases the separation
between stimuli or task presentation and performance and
thus provides an opportunity for interrupting tne sequence
of behavior.
Therefore, one can impose an interruption of
the response sequence at an earlier stage and promote
production of task-relevant thoughts, images, and behaviors.
Meichenbaum and Cameron (1973) developed a tra1ning
program involving a group of hospitalized schizophrenic
24.
patients, who were trained to talk to themselves in order
to improve their performance on attentional and cognitive
tasks.
The cognitive self-guidance training resulted in a
significantly improved performance on such tasks as a
digit symbol task.
These studies have demonstrated the etfectiveness in
verbal mediational training, both among children with
hyperactivity-attention deficit disorder, and adults with
the diagnosis of schizophrenia.
The subjects in the first
group present attentional, perceptual, ana perceptual-motor
disorders, but do not show overt psychosis, while the
schizophrenic group present the same symptomatology with
the addition of psychosis.
With these results in mind,
investigation into the temporal sequencing of verbal and
motor events of a group of childhood-onset schizophrenics,
may provide a basis for developing effective intervention
using verbal mediation training for use in the classroom,
and other therapeutic environments.
The use of an appropriate control group is crucial in
research aimed at identitying
specif~c
mediational impair-
ments in childhood-onset schizophrenia.
For example,
evidence suggests that some of the neurobehavioral difterences between psychotic and other children can be attributed to differences in levels of cognitive development,
as measured in mental age (Prior, 1979).
Therefore, it is
25
imperative to use a control group of normal chiidren
matched both in chronological and mental age.
The literature reviewed above involved the examination of children's private speech and the functional role
it plays.
Two distinct var1ables were proposed which
affect the production of self-regulating speech: age and
IQ.
The importance of situational factors such as task
and setting, as well as difficulty of task were discussed
in relation to their influence on the amount of speech
emitted.
The cognitive style of the individual was
addressed through a review of research conaucted with
primarily hyperactive children, with emphasis on the
relationship between impulsivity and private speech.
The
actual effect of private speech on performance was reviewed, with the theoret1cal positions of botn Vygotsky
{1962) and Luria {1961) presented.
In addition, criticism
of the Lurian research was discussed.
Finally, the exist-
ing systems used to categorize speech were presented, with
careful examination into the problems in methodology.
In
conclusion, the present review of the literature provides
a basis in which to establish a new categor1ca1 scheme to
use for the examination of temporal sequencing of verbal
and motor behavior.
The purpose of th1s study is to examine the temporal
sequencing of verbal and motor events of a group of child-
26
hood-onset schizophrenics.
This investigation w1ll provide
important data for developing a basic understanding into
the mediational strategies of th1s diagnostic group.
It
is only from a careful analysis of behavioral sequencing,
that one can then proceed with the development of effective
intervention involving verbal mediation training for use
in the classroom.
In attempting to determine the relat1onship between
nonverbal behavior and private speech, it is necessary to
employ a sensitive measure for relat1ng how speech is used
in the process of engaging in a particular task.
To do
this, children's private speech must be categor1zed to
begin to draw inferences as to the integration of speech
and behavior.
This analysis will determine if specit1c
categories of private speech come before, during or after
particular motor acts.
are posed:
The following research questions
Is private speech random or is there a parti-
cular pattern the child displays?
Is th1s pattern altered
in response to failure or success?
Is there a difference
between schizophrenic and normal children's pattern of
distribution of these two streams of behavior (speech and
block design)?
vf
Q
•
CHAPTER 'lWO:
METHODS
The data used in this project were obtained from
existing videotapes of a study
involv~ng
the neuropsycho-
logical assessment of children (Watkins, 1981).
In this
study, Watkins developed and implemented a behavioral
observation instrument for quantifying behaviors which are
associated with performance on the block design.
Within
this instrument, three areas of behavior were assessed:
visual attention, pattern of hypothesis testing, and overt
verbal mediation (see Note 1).
In order to address the questions posed,
th~s
present
study is designed to take advantage of the existing Watkins
(1981) data, with the development of a more finegrained procedure to look at the functional relationship
of spontaneous speech to block design perrormance.
This
new method of behavioral observation will enable the
utilization of a descriptive sequence analysis of speech
and motor behavior.
Such analysis will provide a basis to
carefully examine temporal sequencing of verbal and motor
events, and how it influences specific patterns between
age matched schizophrenic and normal chiidren.
Subjects
Selection
Schizophrenic children.
Ten children with the diagno-
sis of schizophrenia were included in
. 27
th~s
study.
The
28
schizophrenic children were recruited by the UCLA
Cl~nical
Research Center for the Study of Childhood Psychoses, or
selected from the Child Outpatient Clinic of the UCLA
Neuropsychiatric Institute.
At the time of testing, these
children were either living in residential treatment
facilities or with their parents and attending special
programs for emotionally disturbed children.
The diagnosis for four of the subjects was made by a
research case conference conducted by the UCLA Clinical
Research Center for the Study of Childhood Psychoses.
The
data base for the research case conference consisted of:
1) psychological testing; 2) a mental status exam of the
child; 3) parental interviews which provided botn a developmental history as well as a history of the symptoms; and
4) information from other professionals who previously
treated the child.
Five of the subjects received a diag-
nosis of schizophrenia from the UCLA Clinical Research
Center diagnostic team.
This team consisted of a psychol-
ogist, a psychiatrist, and clinical social worker.
A
consensus decision was derived using the Diagnostic Interview for Children & Adolescents {DICA; Herjanik & Reich,
1982).
This instrument provided a developmental history
as well as a history of symptoms derived from interviews
of both the child and parent.
In addition, the team re-
viewed collateral information on the child,
obta~ned
from
J
29
the medical chart before a diagnostic decision was finalized.
One subject was diagnosed by two independent clini-
cians based on their review of a videotape of the
chi~d,
psychological testing, and developmental and symptom
history.
Only those children meeting DSM III (Diagnostic
and Statistical Manual of Mental Disorders 3rd Edition;
American Psychiatric Association, 198u)
criter~a
schizophrenia were included in the present study.
review of the records revealed tant all of the
for
A
sch~zo­
phrenic children had an onset of schizophrenic symptoms
prior to ten years of age.
Only one of the schizophrenic
children was receiving neuroleptic medication at the time
of testing.
Normal Control Children.
Ten normal children were
drawn from regular classrooms in local schools which
included children from a wide range of socioeconomic
backgrounds.
One parent or guardian of each child in the
normal group was given a standardized interview in person
or over the phone to determine the history of prenatal or
postnatal complications, childhood illnesses, accidents or
head injury, seizure disorder, vision or hearing problems,
motoric and sensory deficits, perceptual/learning problems,
and any medication at the time of testing.
Children with
a postitive history above, with tne exception of ordinary
childhood illnesses, were excluded.
30
Chronological and Mental Age Matching
The children in the normal comparison group ranged in
age from 7 years 4 months to 13 years 5 months.
The
schizophrenic children ranged in age from 7 years 4 months
to 13 years 6 months at the time of test1ng.
Table 1
provides a summary of the means and standard deviations
for chronological age, mental age equivalent and standard
score on the Peabody Picture Vocabulary
Test~Revised
(PPVT-R; Dunn & Dunn, 1981) for each group.
In order to
insure that any differences found between schizophrenic
and normal control groups were not merely reflecting
mental age differences,
~
tests were used.
Procedure
Equipment
The experimental equipment consisted of a set of
plastic blocks from the Wechsler Intelligence Scale for
Children (WISC-R; Wechsler, 1978).
Five block designs
reproduced on separate 3 x 4 inch laminated cards were
used.
These designs were developed specifically to vary
in difficulty, number of blocks used and time limitation
for completion (Watkins, 1981).
Since five block designs
were to be administered to the children in a standard
manner, the examiner remained in the testing room and
timed the children.
During the block design task, the
examiner used a Colibri stopwatch that was visible to all
31.
Table 1
Characteristics of Schizophrenic and Normal Control Groups
Group
Schizophrenic
Normal Control
Age at Testing (months)
Mean
SD
l2:l.4
22.0
l2l.6
21.6
9
1
3
101.3
23.2
10:3.3
19.1
134.9
64.0
12!>.1
24.2
Sex
Males
Females
7
PPVT-R
Standard Score Equivalent
Mean
SD
Age Equivalent score
Mean
SD
N- 20
32_
children.
All sessions were recorded on videotape, with
the camera in the same room.
Children did not seem to
exhibit any reservations to the visible camera.
A 10
channel Rustrak event recorder was used to record the
frequency of the verbal and motoric events as scored from
the videotape.
Experimental Task
Each child was seen indiv1dually in a test1ng room at
either UCLA Neuropsychiatric Institute or at their school.
Data were collected by a single female examiner who had
previously spent at least one hour with the child, as part
of a separate session of the Watkins' study.
The
chi~d
was seated at a table in view of the camera so that all
motoric behavior and speech could be videotaped.
The
child was instructed:
"These blocks are all the same.
Some sides are all
red, some sides are all white, and some sides are
half red and half white.
You can use these blocks to
make a design like this card" (Watkins, 1981, p.l3).
The experimenter then placed the blocks randomly on
the table and presented the first design.
The experimenter
then stated:
"I want you to make a design just like this card,
work as quickly as you can, and tell me when you are
33
finished" (Watkins, 1981, p.l4).
The experimenter then began timing with a stopwatch.
Following each of the above instructions, the exper1menter
scrambled the blocks and placed another design in front of
the child.
After designs I, II, and III, the exper1menter
stated:
•Now, make one like this using 9 blocks• (Watkins,
1981).
During each session, the experimenter remained seated
out of the direct visual gaze of the child, on the right
hand side of the table.
This placement of the exper1menter
made it possible to re-score for social interaction since
it required the child to focus to the right of the task
stimulus.
Coding Private Speech
All of the children's speech was recorded on videotape.
Verbalizations were unitized and categorized according to
set guidelines (see Appendices B & C).
Scoring of Block Design Pertormance
A method for scoring block design performance by
assessing the child's pattern of hypothesis testing was
developed by Watkins (1981) and implemented in this study.
For the purpose of th1s study, children's block placement
which were correct, are termed positive placement, whereas
errors are termed negative placement.
The follow1ng
9 •
34
excerpt is the methodology used for scor1ng, as developed
by Watkins (1981):
"Correct - A hypotnesis can be correct for a 4 block
design if it consists of 2, 3, or 4 blocks and the
arrangement of blocks matches part of the design•
(Watkins, 1981, p. 2).
Watkins• (1981) manual provides scoring for these
three types of errors.
However for the purpose of this
study, the categories of:
"Orientation errors", "surtace
errors", and "constructional deviations", will be collapsed
into one error category (see Appendices
c
& D).
Therefore,
errors are scored when:
"a block deviates more than 30°from the or1entat1on
of the model or if one or more of the half red half
white blocks is oriented ditterently than the corresponding block in the model" ••• "Scored for an incorrect
choice of surface" ••• "When an arrangement of blocks
extends beyond the confines of a square format•
(Watkins, 1981, p.2).
Recording of Motor and Verbal Behavior
Using the event recorder, a record of the simultaneously categorized verbal and block design solv1ng behaviors was made (see Appendix C).
Each key was labeled
with a designated speech category, positive or negative
block placement (as defined above), or social speech
35.
(speech directed to the examiner).
Each design was separ-
ately recorded from the original videotape.
From these
records, occurrence of speech and motor behavior was coded
onto separate prepared data summary sheets (see Appendix E).
Data Analysis
From the data summary sheets, descript1ve statistics
were calculated for the two streams of behavior, motor and
verbal.
These two behaviors were analyzed separately and
then together to determine the relationship between the
sequencing of the two behaviors.
Finally,
~
tests were
conducted to determine the significance between the schizophrenic and normal control group.
CHAPTER THREE:
RESULTS
The results of this study will be examined in two
parts.
The first section examines group
character~stics
of private speech, focusing on its distribution (see
Figure 1).
The second part of the results section deals
with the temporal sequential relationship between verbal
and motor behavior.
Characteristics of Private Speecb
Self-Stimulating Speech
-
-
The schizophrenic group emitted 272 occurrences of
this speech category, compared to 0 within the normal
control group.
Schizophrenic subjects were observed to
use word play, as well as making humming and clicking
sounds.
Several children sang
interm~ttantly
during a
task.
Remarks to Nonhuman Others
No significant difterences between groups were found
in this category of data.
Only one subject, a schizo-
phrenic, was observed to talk as it someone else were
present besides the examiner.
Verbal Regulation
Both groups were observed to verbalize using selfguiding comments, as well as questions and answers by
self.
The difference between groups was not
signif~cant,
however the schizophrenic group tended to describe their
36
1/
37
Fi qure
+
I
I
Comparison of Private Speech Between
Schizophrenics & Normal Controls
I
I
160
•
'
I
I
I
I
I
•
•
•
140
I
..
I
I
I
I
I
I
I
I
I
\
I
I
I
\
I
100
I
I
,
>-!
::::1
I
~~
I
I
~~
-.
BD
\
I
•
'
'
'-i
I
I
120
<.-...:''
~;
I
•
\
\
\
\
t
'
I
'I
'I
(
I
\
\
I
I
I
I
I
I
I
60
''
I
•
\
I
\
I
..... ---I
I
\
--""*J
\
I
\
I
I
I
I
I
I
zo
STH·~
Schizophrenics
.-
l~orma1
Control
REt-l.~RKS
PRIVATE SPEEC~
VER REG
so:r;,_
SUE VO:
38
own activity, whereas the normal group emitted more plans ,/
and analysis of the situation.
Emotional Interjection
Difference between groups was not
signif~cant.
Schizophrenics were observed to use more emotional expletives with a higher degree of negative aftect, and tney
attempted to abandon the task before time limit was
achieved.
Normal children expressed botn positive and
negative statements without abandoning the task.
Subvocal iz at ion
Even though the schizophrenic group had a total of
160 subvocalizations, as compared to the 31 total utterances of the normal group,
ficance.
~
tests did not indicate signi-
The high number of subvocalizations emitted by
the schizophrenic group may be due to two suojects wno
each scored above 30.
Social Speech
Speech directed to the examiner was
(p,<.OOl) between groups.
Only one normal child was
observed to interact with the examiner,
this task.
signif~cant
wni~e pertorm~ng
The speech of this child was task-relevant in
that he asked for assistance, and reassurance:
"Could you help me? ••• This isn't right is it? •••
I think that's it, don't you?" (Watkins,
19B~).
The schizophrenics were observed to verbalize both
39.
task-relevant and task-irrelevant speech.
Thought dis-
order was observed in one child during one trial when the
child turned to the examiner and stated:
"Am I gonna start which one each time of the Germees?"
(Watkins, 1981).
To further illustrate the thought disorder
exh~bited
by this child, the conversation that occurred following
the completion of the design is quoted here:
Child:
"Are these blocks from the Coco-Mary of the
Germees? ••• Are these blocks from the Coco-Mary of the
Germees?".
Examiner:
Child:
"What's that?"
"A country in United States, they have a lot
of food and a lot of desserts" (Watkins, 1981).
More relevant social speech consisted of abandonment
of task, as well as expressing difficulty with the task.
Total Private Speech
Comparison of the two groups across the 5 private
speech categories revealed a significant difference (£ <
.05), with the schizophrenics emitting far more instances
of private speech.
Figure 1 displays the distribution
across speech categories between groups, with frequency on
the vertical axis and speech across the horizontal axis.
The private speech categories are arranged according to
the developmental hierarchy discussed by Kohlberg et
v-
@
•
40
al. (1968).
Viewing the data from a developmental per-
spective, the schizophrenics produced developmentally
lower levels of private speech than their mental age
matched peers.
They maintained a higher level of speech
across categories, with a signif1cant increase in total
subvocalizations.
This may actually be additional self-
stimulating speech that is indecipherable, or more likely,
irrelevant and off-task vocalizations.
Verbal and Motor Behavior
Table 2 presents the temporal sequencing of verbal
and motor behavior.
Each cell displays the number of
speech units occurring within a given context of motor
behavior (block placement).
For example, within the
schizophrenic group, a total of 50 speech units occurred
before a positive placement of a block, 45 units during a
negative placement, and 190 units of speech occurred with
no motor behavior.
Before placement of block.
This sequence of behavior,
with speech occurring prior to block placement varied
between groups.
Speech occuring before a positive place-
ment was significant (p < .02) with the schizophrenic group
emitting more than four times as many speech units than
the normal group.
More striking, however is the amount of
speech emitted before a negative placement was made,
producing a significant difference between groups
0
'
Table 2
Temporal Sequencing of Verbal and Motor Behavior
Positive
Before*
Negat1ve
During
After
Before*
Durinq
After
Schizophrenic
50
18
56
123
45
91
Normal Control
12
0
17
13
0
7
*p<.05
..j:::o
........
42
(p < .05) level.
During this temporal sampling, the
schizophrenics were observed to verbalize 123 units of
speech, whereas the normal group produced only 13.
During placement of block.
This temporal relat1onship
was the most revealing of the three sequential categories.
Schizophrenics were observed to emit speech during the
placement of a block, resulting in considerable more: 18
vs. 0 positive, and 45 vs. 0 negative placement.
The
normal control group did not exhibit any speech during the
placement of a block.
Consequently,
~
tests of statist1ca1
significance could not be computed.
After placement of block.
This category provided
data which was significant (£ < e02) following a positive
placement of the block.
The schizophrenic group was
observed to emit 56 units of speech following a positive
placement, whereas the normal control group produced only
17 units.
While speech occurring atter positive placement
by the schizophrenic group was not consistent in specific
category, the normal group's verbalizations consisted
primarily of verbal regulatory speech.
Speech occurring
after a negative placement was not signif1cant between
groups.
No motor behavior,
This category consisted of all
speech emitted independently from any motor behavior.
Using the previously mentioned unitization of speech,
43
speech occurring within a 3 second time sample, with no cooccurring motor behavior was coded separately.
This
analysis proved significant between groups at the (p <
-
.01) level with the schizophrenic group producing spontaneous speech independent from any motor behavior for a
total of 190 units.
In comparison, the normal group
produced a total of 23 speech units which were unrelated
to motoric behavior.
Often the normals were -observed to
plan and analyze the task at hand, while the schizophrenic
group frequently presented irrelevant chatter, selfstimulating speech and noises, as well as
comments.
negat~ve
attect
CHAPTER FOUR: DISCUSSION
The method of unitization and categorization employed
in this study has provided a means to observe the inter-
action of speech and motoric behavior by a group of schizophrenic and normal control chiidren.
The results regarding
the functional relationship between nonverbal behavior and
spontaneous speech are summarized under the headings that
represent the previously stated research questions of the
study.
Is Private Speech Random, or is There a Particular Pattern
Children Display?
Results indicated that the sch1zophrenic produced a
higher level of spontaneous speech which was not related
to motor behavior.
These chiidren emitted far more in-
stances of speech which were random, and did not appear to
serve any regulatory function in relat1onship to suosequent
block design performance.
Furthermore, their speech based
\J
on a developmental perspective, was far below that of the
normal control group in its frequency toward exhibiting
more presocial type speech.
The normal control group
displayed a particular pattern of spontaneous speech, with
verbalizations frequently used for planning and analyzing
the situation.
In addition, based on Kohlberg's et al.
(1968) developmental category scheme, these chiidren
presented a much higher developmental level of verbali-
44-
'
~/
45
zations including inward-directed speech, as well as
apparent external manifestations of inner speech including
inaudible mutterings.
The occurrence of random speech
that was not related to motor behavior apparently interfered with the schizophrenic children's ability to maintain
relevant task behavior.
For example, children in the
normal group were not observed to verbally interact with
the examiner, whereas the schizophrenic children were both
task relevant and irrelevant in their conversat1on w1tn
the examiner.
This type of speech appeared to be very dis-
tracting to the schizophrenics, and at times precipitated
a deterioration of on-task, attention as well as eliciting
more symptomatic responses of tne actual disorder--i.e.
thought disorder.
Is This Pattern Altered in Response to Failure or Success?
Results indicated that the actual result of block
placement, either positive or negative, increased tne
probability of spontaneous speech emitted.
The normal
group was observed to verbalize in relat1onship to botn
positive and negative placement, with a total of 29 units
of speech occurring in relation to a positive placement,
and 20 total units in relation to a negative placement.
Schizophrenics on the other hand, presented far more
speech relating to bo.th success and failure, with 259
total speech units in relation to a negative placement and
p •
46
124 units for a positive placement.
Is There a Difterence Between Schizophrenic and Normal
Children's Pattern of Distribution of These TwO Streams of
Behavior (Speech and Block Design)?
The most striking results of this study involve the
actual sequencing of verbal and motor behavior between
these two groups.
The schizophrenic group produced a
substantial amount of speech
before a positive
occurr~ng
placement of a block, with speech occurring before a
negative placement occurring
tw~ce
as much.
The normal
control group elicited a comparable amount of speech
before both a negative and positive placement of the
block, only these numbers were one-third of the total
before placement speech of the schizophrenics.
A prominent
distinction between these two groups was the occurrence of
speech during block placement produced by the schizophrenic
group.
This simultaneous behavior resulted in both posi-
tive and negative placement, with the negative placement
occurring with twice as much speech than positive placement.
The normals however, did not display any simultaneous occurrence of these two streams of behavior.
Verbalizations occurring after block placement ditxered between groups.
The schizophrenic group produced a sig-
nificant number of speech occurrences
follow~ng
a positive
placement of the block, with an even greater amount occurr-
47
ing after negative placement.
The normal control group
displayed an opposite pattern with more occurrences of
speech following a positive placement, and less follow1ng
a negative placement.
It appears that this normal group
is emitting statements of re1nforcement following a positive placement, and affective statements following a
negative placement.
The schizophrenic group, however do
not appear to have a particular pattern to their sequence
of behaviors.
An inference can be drawn with respect to the particular cognitive strategies of these two groups of children:
it appears that the speech emitted by the normal group is
serving a function in approaching the specific motor act.
Furthermore, these children demonstrate a part1cular
pattern that illustrates a developmental process similar
to the one proposed by Kohlberg et al. (1968).
Implications for Intervention
The schizophrenics are demonstrating a more random
use of private speech, which not only is dysfunctional,
but may elicit certain symptomatic behaviors of schizophrenia.
This information as to the present strategies of
this group, provides a basis for developing intervention
techniques for these children.
Whereas the focus of
verbal mediation training has been to teach children to
employ mediational process, no program has set out to
".
48
invoke private speech focusing on the actual temporal
sequencing of such utterances.
This study has clearly
illustrated that the schizophrenic children have the
ability to spontaneously emit private speech, but do not
use this speech in an adaptive, functional manner.
Training not only should deal with appropriate and taskoriented mediation, but intervention should also involve
specific training in when this mediation is to occur in
relation to a particular motor act.
It is only then that
verbal mediation can be effective with this population.
If in fact the use of speech elicits rather than only preceeds some symptomatic behaviors of schizophrenia, proper
application of verbal mediation training may assist in the
development of verbal control of behavior during cognitive
tasks, as well as reducing interter1ng symptomatology.
If findings here are supported with further research
this study will have provided a basis for the development
of self-guidance training by using a descriptive analysis
of speech and motor behavior with tnese two groups of
children.
Further studies should investigate the medi-
ational strategies of these severely disturbed schizophrenic children by focusing on the following:
(1) speci-
fic categories of speech as related to a part1cular motor
behavior (2) increasing the level of cognitive performance
by invoking task-oriented speech (3) possible generali-
I
49.
zation to different tasks using verbal mediation training;
i.e. reducing schizophrenia symptoms, developing self-help
skills, and academic tasks.
50
Footnotes
lThis study was conducted by John M. Watkins at tne University of California, Los Angeles as part of a doctoral
dissertation in Clincial Psychology.
2The style used in this thesis is in accordance w~th tne
American Psychological Association Style Manual 1984
Edition.
51
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63
Appenaix A
Block Designs
Number of Blocks
Time Lim1.t
I
4
45 seconas
II
4
75 seconas
III
4
75 seconas
IV
9
12U seconas
v
9
12U seconas
Design
64
Appenaix B
Manual of Instruction for
Scor~ng
Speech
65.
Private Speech
Category
Example
Definition
1) Self-stimulating;
word play.
Repeating words or
phrases for the~r own
sake. Singing with
or without words.
"Oma,coma,da
boma".
"Eleanor
Rigby"
2) Remarks to non-
Sounds as if child is
speaking to an object
or another person.
"Get back in
there."
"Hey it
works."
Remarks relevant to
or design,
self-guiding or planning. Analysis of
situat~on, state
reason for action.
"That's the
right
block". "Is
th~s right?"
"Yes".
"Maybe a red
goes there".
Feelings are expressed
about task fai~ure,
success, or frustration positive or
negative.
"This is too
hard".
"Uh, oh".
"Yean".
human/absent
others or objects.
3)
Regulating speech:
description of own
activity. Questions
and answers by
self. Self-guiding
comments including
plans and thoughts.
4) Emotional Inter-
jection
5) Subvocalization
activ~ty
Comments uttered in
such a low voice that
they are indecipherable
to a nearby listener.
Social Speech
Contact
w~th
examiner
"You do this
one".
"Did you
draw these?"
Appendix
c
UNITIZATION
Speech Categories:
either a pause of at least a three
second duration or a complete
sentence or phrase will be designated as a speech unit.
Behavior Categories:
block design pertormance will be
unitized into problem solving
acts. An act will be detined as
the behavior when the child places
a block with anotner block to test
a hypothesis.
67
Appendix D
Categor1zing Motor Behavior
1) Successful placement of block;
the block is correctly placed.
2) Failure due to placement error; the
block is placed incorrectly.
3) No motor behavior.
,, '
68
Appendix E
Data Summary Sheet for
Scor~ng
Spontaneous Speech
69
DATb
SUHMARV SHEET
SUBJECT f - - SEX
DATE OF BIR'l'H - - - - -
AGE AT TESTING - - - -
PPV'~R
STANDARD SCORE·--AGE EQUIVALENT - - BLOCK DESIGN
DESIGN 1
SPEECE
SELF-STIM
BEFORE
+
DURING
.. I
- I
I
AFTER
.. I
-I
REMARKS
VERBAL REG.
E~OTIONAL
SUBVO:.AL.
SOC
70
DESIGlS' 2
S:C..F STH~
BEFORE
+
~~RING
..
I
j
I
I
I
I
I
I
Il!:Slt:iE :3
I
I
I
I
-I
I
+
·DURING
--
- I
AFTER
PE~IC:l'i
BEFORI:
+ .,
$
-I
I
...
I
- I
DURING
. .
AFTER
I
l
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
[
I
I
I
I
i
I
I
I
·I
I
I
I,.
I
'
i
'
I
I
I
I
I
-I
I
+
l
I
..
I
-I
I
I
I
I
l
SOC.
I
I
+
SUI::IVOCAL
I
+
BEFORE
EMCTIONAL
I
AFTER
\~ERBAL REG
REMARKS
I
'
I
I
I
I
I
I
..
71
DESIGN 5
SELF STHl
BEFORE
DURING
REMARKS
soc
SUBVOCAL
+
-
I
+
l
AFTER
EMOTIONAL
VERBAL REG
I
+
TOTALS (ALL SPEECH)
BEFORE PLACEMENT OF BLOCK
DURING PLACEMENT OF BLOCK
AFTER PLACEMENT OF BLOCK
OCCURENCES OF PRIVATE SPEECE:
SELF-STIMULATING
REMARKS OBJ/OTE
VERBAL REGULA.
EMOTIONAL INTERJ
SUBVOCALIZATI ON
'TOTAL PRIVATE SPEECE
'TOTAL SOCIAL SPEECE
l
I
(+)
(-)
l
I
l
I
72
Copyright by
Nancy Rebecca Elliot
(9
1985