Before describing the process of teaching Helen to speak, it may be well to state briefly to what extent she had used the vocal organs before she began to receive regular instruction in articulation. When she was stricken down with the illness which resulted in her loss of sight and hearing, at the age of nineteen months, she was learning to talk. The unmeaning babblings of the infant were becoming day by day conscious and voluntary signs of what she felt and thought. But the disease checked her progress in the acquisition of oral language, and, when her physical strength returned, it was found that she had ceased to speak intelligibly because she could no longer hear a sound. She continued to exercise her vocal organs mechanically, as ordinary children do. Her cries and laughter and the tones of her voice as she pronounced many word elements were perfectly natural, but the child evidently attached no significance to them, and with one exception they were produced not with any intention of communicating with those around her, but from the sheer necessity of exercising her innate, organic, and hereditary faculty of expression. She always attached a meaning to the word water, which was one of the first sounds her baby lips learned to form, and it was the only word which she continued to articulate after she lost her hearing. Her pronunciation of this gradually became indistinct, and when I first knew her it was nothing more than a peculiar noise. Nevertheless, it was the only sign she ever made for water, and not until she had learned to spell the word with her fingers did she forget the spoken symbol. The word water, and the gesture which corresponds to the word good-by, seem to have been all that the child remembered of the natural and acquired signs with which she had been familiar before her illness. As she became acquainted with her surroundings through the sense of feeling (I use the word in the broadest sense, as including all tactile impressions), she felt more and more the pressing necessity of communicating with those around her. Her little hands felt every object and observed every movement of the persons about her, and she was quick to imitate these movements. She was thus able to express her more imperative needs and many of her thoughts. At the time when I became her teacher, she had made for herself upward of sixty signs, all of which were imitative and were readily understood by those who knew her. The only signs which I think she may have invented were her signs for SMALL and LARGE. Whenever she wished for anything very much she would gesticulate in a very expressive manner. Failing to make herself understood, she would become violent. In the years of her mental imprisonment she depended entirely upon signs, and she did not work out for herself any sort of articulate language capable of expressing ideas. It seems, however, that, while she was still suffering from severe pain, she noticed the movements of her mother's lips.