The name of the defect was given by the tenth letter of the Greek alphabet – “kappa”. Capacisms include deficiencies in the articulation of posterior palatal sounds [К-К′], [Г-Г′], [Х-Х′]. Sometimes in classical speech therapy, the last two phonetic defects are separated into independent groups - gammacism and chitism. Kappacisms are less common than sigmatisms and rotacisms. However, in speech therapy practice they are among the most persistent, complex and difficult to correct defects. The replacement of velar sounds with other phonemes of the Russian language is called paracappacism, paragammatism, parachitism.
Reasons for Kappacism
For the normative pronunciation of back-linguals, a high rise of the root of the tongue, its closure with the soft palate and energetic oral exhalation are necessary. If any of the three conditions is not met, then the articulation of posterior palatal sounds becomes defective. The causes of paracapacism are deficiencies in phonemic hearing or hearing loss. Kappacisms are observed in the following conditions:
- Palatal clefts.
Cleft palate (cleft palate) disrupts the anatomical and functional conditions in the oral cavity necessary for the pronunciation of posterior lingual words. The velum does not block the entrance to the nasal cavity, so air leaks. The root part of the tongue moves back, and the walls of the pharynx are connected to the articulation of the posterior palatine. - Gothic sky.
Of the dentofacial anomalies, the most significant for the occurrence of cappacism is the arched palatine vault. In this case, the closure of the root of the tongue with the palate becomes impossible, and mechanical dyslalia develops. - Impaired tone of articulatory muscles.
It is noted in dysarthria. The tongue may be spastic, tense or flaccid, spread out. Such conditions prevent the correct pronunciation of not only back-lingual, but also other sounds according to the method of formation. - Functional dyslalia.
In some cases, distortion of the kappacism type is a consequence of inaccuracy and undifferentiation of articulatory movements, copying of incorrect speech patterns, and infantile swallowing. A similar mechanism is observed in somatically weakened children, bilinguals, and children with pathological oral habits. - Features of the local dialect.
The fricative [G] can be heard in the southern Russian, Ukrainian, and Belarusian languages (gekanye). Paracappacisms (replacing [G] with [X] at the end of a word) are typical for northern dialects (Vologda, Arkhangelsk region, Transbaikalia).
Kappacism
How to treat dyslalia and get rid of tongue-tiedness?
At the first consultation, the doctor will tell you how to treat dyslalia in Saratov in preschoolers and schoolchildren, how to cure dyslalia in Russia in children of preschool and school age, how to get rid of tongue-tiedness , what is articulatory phonemic, articulatory phonemic and phonetic, motor and sensory, mechanical, monomorphic, phonemic, simple, complex dyslalia in preschool children. How is prevention, correction of dyslalia , speech therapy examination of children with dyslalia carried out? Does speech therapy psycho-correctional pedagogical communication work help? How does sound pronunciation suffer with dyslalia? Why is polymorphic dyslalia dangerous, what is cheiloplasty, uranoplasty? What is the etiology and causes of dyslalia, differential diagnosis, exercises, gymnastics, literature, conclusion? What is rhinolalia, dysarthria, FNR, FFN, speech card? What is the prevention of dyslalia ? Sarklinik knows how to treat dyslalia in children in Russia.
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Characteristics of back-lingual
The consonants [К], [Г], [Х] are oral, posterior lingual at the place of formation. [K] and [G] – stop-plosives, paired in voicelessness-voicing, [X] – fricative, voiceless, unpaired.
When articulating [K], the upper and lower teeth are slightly open, the front of the tongue is in a lower position, the tip does not touch the lower incisors. The posterior third of the dorsum of the tongue forms a closure with the velum palatine. When pronouncing a sound, the tongue and palate open under the pressure of the air stream, which creates a characteristic noisy sound when leaving the oral cavity. The articulation of [G] is similar, with the difference that the vocal folds are in a closed position, the sound is ringing.
When articulating [X], the bow is incomplete, leaving a gap between the back of the tongue and the palate. Soft posterior lingual phonemes differ from hard ones by moving the stop or cleft forward, into the middle parts of the palate.
Disadvantages of pronunciation of the sounds k, g, x, k', g', x' (kappacism, gammacism, hitism)
The structure of the organs of articulation. When pronouncing a sound, the lips are neutral and take the position of the next vowel. The distance between the upper and lower incisors is up to 5 mm. The tip of the tongue is lowered and touches the lower incisors, the front and middle parts of the back of the tongue are lowered, the back part closes with the palate. The place where the tongue stops with the palate changes under different phonetic conditions: when it is on the border of the hard and soft palate, when combined with the labialized vowels o and u, the stop appears lower (with the soft palate). The lateral edges of the tongue are pressed against the upper back teeth. The soft palate is raised and closes the passage into the nasal cavity. The vocal folds are open. The exhaled stream explodes the closure between the tongue and the palate, resulting in a characteristic noise.
When articulating g, the participation of the vocal folds is added, the force of exhalation and the tension of the organs of articulation are weakened compared to k.
When articulating the sound x, in contrast to k, the back of the tongue does not completely close with the palate: a gap is created along the midline of the tongue, through which the exhaled air produces noise.
When pronouncing soft k', g', x', the tongue moves forward and makes a stop with the palate (and for x' - a gap). The middle part of the back of the tongue approaches the hard palate. The front part (as with hard k, g, x) is lowered. The tip of the tongue is somewhat closer to the lower teeth, but does not touch them. The lips stretch somewhat and reveal the teeth.
With kappacism and gammacism, the following disorders are observed: sound is formed by the closure of the vocal folds, which sharply diverge when a high-pressure air stream passes through them. Air rushes noisily through the glottis. Instead of k, a guttural click is heard. When pronouncing a voiced sound, a voice is added to the noise. With chitism, a weak guttural noise is heard.
There are cases of replacement of the posterior lingual plosives k and g with the anterior lingual plosives go and d, which are called parakappacism and paratammacism. Occasionally, a type of paracappacism occurs, when the sound k is replaced by x. With gammacism, the replacement with a fricative velar or pharyngeal r is indicated in transcription by the Greek letter (gamma).
Violations of soft g', k', x' are similar to violations of hard g, k, x, but in some cases lateral pronunciation of k' and g' is observed.
Techniques for correcting these sounds come down to placing plosives in the back of the tongue from plosives in the front of the tongue, and fricatives in the back of the tongue from fricatives in the front of the tongue. Soft sounds are placed from soft, and hard sounds from hard. Sounds are produced with mechanical assistance. The child pronounces the syllable ta several times; at the moment of pronouncing, the speech therapist gradually moves the tongue back with a spatula by pressing on the front part of the back of the tongue. As the tongue moves deeper, the syllable cha is heard first, then kya, and then ka. The sound g is also placed from the syllable yes, but it can also be obtained by voicing k. The sound x is placed from the sound using a similar technique: first, xia is heard, followed by hya, and finally ha.
The described methods of producing sounds are used for both functional and mechanical dyslalia. The production of sounds in mechanical dyslalia must be preceded by more preparatory work than in functional dyslalia. During this process, much attention is paid to “pronunciation tests”, which make it possible to find out which of the structures of the articulation organs can produce an acoustic effect that is closest to the normalized sound.
In different phonetic environments, the same phoneme is realized in different articulatory variants, so the most frequent variants of combinations should be practiced.
A condition that promotes the development of standardized sounds and facilitates the child’s process of mastering the skills of sound production of speech is an adequately chosen path of sound production. The most justified is the one that takes into account the articulatory proximity of sounds and the natural ways of its implementation inherent in speech. Relying on this or that sound as a base one, the speech therapist, when setting it up, must proceed from the fact that only a syllable is the minimum unit in which it is realized. Therefore, we can talk about the production of a sound only if it appears as part of a syllable. All attempts to create sounds based on imitation of surrounding noises (the hiss of a goose, the noise of a train, the crackle of a machine gun, etc.) to work on pronunciation with dyslalia can only have an auxiliary value.
Types of Kappacism
There are three main types of kappacism: laryngeal, nasal, lateral. There may also be no sounds.
- Absence of posterior linguals.
The sounds [G], [K], [X] and their soft paired variants are not pronounced at all, “drop out” from the words, which is why speech becomes incomprehensible. - Laryngeal
. With this version of kappacism, instead of sound, a click of the vocal folds is heard, similar to a crack. - Lateral
. It is more common in dysarthria, when air does not escape through the midline of the tongue, but through the lateral parts of the oral cavity. - Nasal
. Characteristic of open rhinolalia, in this case the posterior palatal sounds acquire a nasal coloration.
With paracappacism, the sound [K] is usually replaced with [T] or [X], with paragammatism, [G] should be replaced with [D] or [K], with parachitism, instead of [X], [K], [T], [S] are used ]. Paracapacisms are reflected in writing, causing the phenomena of articulatory-acoustic dysgraphia.
Dyslalia: classification, forms, types
Neurologists, neuropathologists, reflexotherapists , psychoneurologists, and speech therapists distinguish 2 main types of dyslalia: functional and organic. There are 3 main types of functional dyslalia: articulatory-phonetic, articulatory-phonemic, acoustic-phonemic.
Based on the number of disturbed types, experts distinguish 2 types of dyslalia: monomorphic and polymorphic. With monomorphic dyslalia, the pronunciation of 1 sound or one group of sounds is impaired; with polymorphic dyslalia, the pronunciation of two or more sounds or groups of sounds is impaired.
With dyslalia, one or another sound may not be pronounced, one sound may be replaced by another, pronounced in isolation, but absent or distorted in independent speech.
Diagnostics
Since back-lingual deficiencies are often associated with maxillofacial anomalies, their diagnosis requires an interdisciplinary approach with the participation of speech therapists, speech pathologists, dental surgeons, pediatric neurologists, and ENT doctors. It helps to identify cappacism and establish its cause:
- Consultation with a speech therapist.
It consists of several blocks: assessing the condition and mobility of the articulatory organs, checking the phonetic aspect of speech, phonemic hearing, lexical and grammatical structure. Upon examination, clefts of the maxillofacial area, a gothic palate, and paretic/spasticity of the tongue muscles may be detected. The type of kappacism and other sound defects (distortion, replacement of sounds) are determined, and a conclusion is drawn about the nature of the violation of language function. - Assessment of dental status.
To clarify the anatomical defects of the maxillofacial area and prepare for their surgical elimination, a CT scan of the jaws and facial skeleton is performed. To assess the function of the velopharyngeal seal, nasopharyngoscopy is performed. Diagnostic models for early stage treatment are being manufactured. - Neurological diagnostics.
Electroneuromyography, EEG, and, if indicated, MRI of the brain help to identify concomitant neurological pathology. - Audiological examination.
Assessing physical hearing is required to rule out hearing loss, associated paracapacism and other sound substitutions. For this purpose, an audiogram, impedance measurement, registration of auditory EPs, and otoacoustic emissions are performed.
Correction of kappacism
Correction
Medical support
In the presence of defects of the upper palate, staged surgical intervention is indicated: uranoplastic surgery, velopharyngoplasty, and, if necessary, cheilorhinoplasty. Between operations, orthodontic correction is performed. Violation of the tone of the articulatory muscles requires a combination of drug therapy with general massage, physiotherapy (electrical stimulation, SMT therapy), and acupuncture. Hearing impairments are corrected using hearing aid methods.
Speech therapy assistance
The stages of correctional and speech therapy work for cappacism include preparation of the articulatory apparatus, sound production, and automation. At the preparatory stage the following is used:
- Articulation gymnastics.
Its goal is to develop mobility and elevation of the posterior third of the back of the tongue. The exercises “Slide”, “Reel”, “Blow a snowflake off a slide”, “Let’s warm our hands” are performed. Imitation of yawning, coughing, hiccups, and swallowing drops of water from a pipette are useful. - Speech therapy massage.
Aimed at normalizing the tone of the lingual muscles (activation or relaxation). Massage of the articulatory organs is often carried out using speech therapy probes.
Sound production is carried out in an imitative or mechanical way from supporting syllables by moving the tongue deeper into the oral cavity (Ta - Ka, Da - Ga, Sa - Ha). After receiving the standard sound, they move on to the consolidation stage. With kappacismazhs, the work ends here; with parakappacismas, differentiation of mixed sounds is additionally required.
