Motor Speech Disorders 121imprecise speech sounds and 10 was perfect articulation. The agreed- upon goal was to try to
achieve an 8 or better. The result was more effort and, consequently, improved speech precision.
This therapy was used to improve consonants and vowels.
Freddy was also taught to use the appropriate amount of stress. He tended to stress syllables
and words that did not need it while neglecting to emphasize those that did. On the script, he was
shown where stress was appropriate and how to use the correct amount on syllables and words.
Because Freddy’s voice quality tended to be harsh, he was also shown how to reduce laryngeal
tension.
The big day arrived, and the high school gymnasium where Freddy had been injured was full.
A master of ceremonies was on hand, and door prizes were offered. The performers were ambi-
tious, energetic, and enthusiastic, but no one would confuse them with professionals. The light-
hearted event brought out the best in all who had volunteered to participate. At the eve ning’s end,
Freddy was wheeled to the platform and clearly read his prepared speech to the standing ovation
of the audience.
Case Study 6-2: Alleged Medical Malpractice and
Spastic Cerebral Palsy
Shantell was not the first child born to her upper- middle- class family. There were two older
children, and although her brother Ron was in special education for a mild delay in speech and
language, both children were physically and mentally normal. At the first indication that she
was pregnant, Shantell’s mother, Elizabeth, arranged for the best prenatal care and immediately
stopped drinking alcohol, including her usual glass of wine with dinner. She took pregnancy seri-
ously and responsibly, and when the delivery went tragically wrong, she blamed the obstetrician
for Shantell’s spastic ce re bral palsy. Years of litigation followed.
For 8 months, Elizabeth did every thing she could do to ensure that Shantell would develop
normally. She exercised, took vitamin and mineral supplements, ate well, and visited her
physician regularly. During the final weeks of pregnancy, Elizabeth started to show signs of
premature delivery, and medi cation was prescribed to delay the birth. Elizabeth also complied
with the doctor’s order that she spend most of her time lying down. The day her contractions
began, the doctor promised to meet her at the hospital. This was also the day the nightmare of
miscommunication and allegedly improper medical care forever changed Elizabeth’s life and
Shantell’s future.
When the contractions began in earnest, the doctor was nowhere to be found. No one knows
if her telephone order increasing the medi cation to delay the birth was misunderstood or if she
had simply prescribed the wrong dosage or perhaps the wrong medi cation. Elizabeth spent many
hours in the delivery room trying to postpone the delivery until the doctor arrived. However, the
doctor could not be found, and there was no other obstetrician to help with the birth. Fi nally, when
the doctor arrived, Shantell’s birth was slow and difficult due to the medi cation and several other
unexpected complications involving the umbilical cord and placenta.
Elizabeth nearly died of blood loss, and Shantell experienced stress during birth. According
to the plaintiff ’s expert witnesses, Shantell’s brain was deprived of oxygen during the delivery.
Because she could not be aroused, she was immediately given oxygen and rushed to the pedi-
atric intensive care unit in a f laccid state. She was separated from her mother, and what should
have been a time of joy and bonding was one of anxiety and fear. According to the attorneys,
it was an unnecessary tragedy that better planning and communication could have prevented.
When Shantell was 3 years old, her parents sued the obstetrician for medical malpractice, seek-
ing damages and compensation for therapies and other ser vices she would require for the rest
of her life.