Dysarthria is a pronunciation disorder that is caused by insufficient innervation of the speech apparatus due to lesions of the posterior frontal and subcortical parts of the brain. The Yusupov Hospital provides comprehensive treatment for this complex and severe disorder of the sound aspect of speech. It includes:
- Drug therapy for the disease that causes dysarthria;
- Physiotherapeutic methods of influence;
- Articulation gymnastics;
- Psychotherapeutic support;
- Speech therapy work.
All complex cases of dysarthria are considered at a meeting of the Expert Council. Candidates and doctors of medical sciences, doctors of the highest category take part in its work. Leading experts in the field of speech defects develop and implement an individual training program for dysarthria. Aphasiologists follow the basic principles of speech therapy work for dysarthria.
Articulatory motor skills
The following types of dysarthria are distinguished:
- Bulbar - caused by local paralysis of the muscles that are involved in articulation, it is accompanied by difficulties in swallowing;
- Cerebellar - occurs in the presence of a pathological process in the cerebellum, characterized by extended speech with constantly changing volume;
- Cortical - is a consequence of damage to the parts of the cerebral cortex that are responsible for the muscles involved in articulation, accompanied by incorrect pronunciation of syllables, but the general structure of the word is preserved by the child;
- Extrapyramidal (subcortical, hyperkinetic) - develops with disorders in the subcortical nodes, characterized by slurred, connected speech with a nasal tint;
- Pseudobulbar - diagnosed with central muscle paralysis, its main symptom is monotony of speech;
- The erased form is characterized by a violation of the pronunciation of hissing and whistling sounds.
With dysarthria, the motor skills of the articulatory apparatus are impaired. Slow, insufficiently precise movements of the tongue and lips appear. There is a disorder of chewing and swallowing. Pronunciation is impaired due to insufficiently clear articulatory motor skills. Speech is somewhat slow, and there is blurring when pronouncing sounds. More often, the pronunciation of sounds that are difficult to articulate suffers: zh, sh, r, ts, ch. Voiced sounds are pronounced with insufficient participation of the voice. Soft sounds are difficult to pronounce and require adding to the main articulation the raising of the middle part of the back of the tongue to the hard palate.
Some patients with dysarthria cannot puff out their cheeks, stretch out their lips, or close them tightly. The movements of the tongue are limited, the patient cannot lift the tip of the tongue up, turn it to the right, left, or hold it in this position. The soft palate is often inactive, and the voice takes on a nasal tone.
The consequence of dysfunction of the articulatory apparatus is a severe pronunciation defect. Speech becomes slurred, slurred, and quiet. Due to the inactivity of the lips and tongue, the pronunciation of vowels becomes unclear; they are pronounced with a strong nasal exhalation.
With severe dysarthria, there is deep damage to the articular muscles and complete inactivity of the speech apparatus. The patient is completely speechless. Sometimes he makes inarticulate sounds.
Speech therapy program
Dysarthria is a pathology that requires persistent, long-term work by the speech therapist, the patient, his relatives and caregivers. A speech map of a speech therapy examination for dysarthria is drawn up. The speech therapy support program is approved after receiving a speech therapy report for dysarthria and recommendations from a neurologist who treats the disease that has caused speech impairment. Speech therapy classes for dysarthria begin as early as possible.
There are the following main areas of speech therapy work for dysarthria:
- Normalization of motor skills of the articulatory apparatus;
- Development of articulatory movements;
- Formation of the ability to voluntarily switch movable organs of articulation from one movement to another at a given pace;
- Overcoming monotony and speech tempo disturbances;
- Full development of phonemic awareness.
The importance of the early start of speech therapy work for dysarthria cannot be overestimated. Speech therapists at the Yusupov Hospital begin to work on restoring speech in patients who have suffered a stroke or acute traumatic brain injury, immediately after the patient’s consciousness has been restored. For demyelinating diseases of the nervous system, speech therapy work is included in the rehabilitation program.
When carrying out correctional speech therapy work, the following speech therapy methods are used:
- Voice and breathing exercises;
- Active and passive articulatory gymnastics;
- Differentiated speech therapy massage (relaxing or stimulating);
- Acupressure, probe, brush, manual massage;
- Artificial local contrastothermy (combination of exposure to low and high temperatures).
Speech therapy for dysarthria is based on compliance with the following principles:
- Systematic approach to the analysis of speech defects;
- Stage-by-stage interconnected formation of all components of speech;
- Regulation of children's mental activity through the development of generalizing and communicative functions of speech.
In the process of systematic long-term training, a gradual normalization of the motor skills of the articulatory apparatus, the development of articulatory movements, and the formation of the ability to voluntarily switch the movable organs of articulation from one movement to another at a given pace are carried out. Monotony and disturbances in the tempo of speech are overcome, and full-fledged phonemic perception develops. This prepares the basis for the development and correction of the sound side of speech.
Article:
Speech therapy work with children suffering from dysarthria is based on knowledge of the structure of speech defects in various forms of dysarthria , mechanisms of violation of general and speech motor skills, and taking into account personal qualities.
Positive results of speech therapy work are achieved subject to the following principles: gradual interconnected formation of all components of speech; systematic approach to the analysis of speech defects; regulation of mental activity of children through the development of communicative and generalizing functions of speech.
In the process of systematic and, in most cases, long-term training, a gradual normalization of the motor skills of the articulatory apparatus is carried out, the development of articulatory movements, the formation of the ability to voluntarily switch the movable organs of articulation from one movement to another at a given pace, to overcome monotony and disturbances in the tempo of speech; full development of phonemic perception.
Questions about the methodology of speech therapy work with children suffering from dysarthria were developed by A. G. Ippolitova, O. V. Pravdina, M. V. Ippolitova, E. M. Mastyukova, G. V. Chirkina, I. I. Panchenko and others. Let’s consider the most used system of correctional work E. M. Mastyukova and modern methods proposed by L. V. Lopatina.
E. M. Mastyukova determines the close relationship between the development of speech, sensory functions, motor skills and intelligence; determines the need for correction of speech impairments in dysarthria in children in combination with stimulation of the development of all its aspects, sensory and mental functions, thereby achieving the formation of speech as an integral mental activity.
The success of speech therapy classes largely depends on their early start and systematic implementation.
Work on sound pronunciation is based on the following provisions:
- dependence on the form of dysarthria , level of speech development and age of the child;
- development of speech communication - the formation of sound pronunciation should be aimed at the development of communications, school and social adaptation of the child;
- development of motivation - the desire to overcome existing violations, the development of self-awareness, self-confidence;
— development of differentiated auditory attention and sound analysis;
- strengthening the perception of articulatory patterns and movements through the development of visual-kinesthetic sensations;
- step-by-step - start with those sounds whose articulation is more intact in the child. Sometimes sounds are chosen on the basis of simpler motor coordination, but always taking into account the structure of the articulatory defect as a whole; first of all, they work on the sounds of early ontogenesis;
— in case of severe disorders, when speech is completely incomprehensible to others, work begins with isolated sounds and syllables . If the child’s speech is relatively clear, and in individual words he can pronounce defective sounds correctly, the work begins with these “key” words. In all cases, automation of sounds is necessary in all contexts and in various speech situations;
— in children with damage to the central nervous system, it is important to prevent severe disorders of sound pronunciation through systematic speech therapy work in the pre-speech period .
Speech therapy work for dysarthria is carried out in stages.
The first stage is preparatory, its main tasks are:
— preparation of the articulatory apparatus and formation of articulatory structures;
— nurturing the need for verbal communication;
— development and refinement of passive vocabulary;
- development of sensory functions, especially phonemic perception and rhythm reproduction.
Methods and methods of work at this stage are differentiated depending on the level of speech development. In the absence of verbal means of communication, initial vocal reactions are stimulated in the child and induce onomatopoeia, which is given a character of communicative significance.
Speech therapy work is carried out against the background of medication, physiotherapy, physical therapy and massage.
The second stage is the formation of primary communicative pronunciation skills. Its main goal is the development of speech communication and sound analysis.
Corrective work at this stage is carried out in the following areas:
1. Normalization of the innervation of the articulatory apparatus.
2. Fight against salivation.
3. Developing control over mouth position.
4. Development of articulatory movements and voice.
5. Correction of speech breathing.
6. Development of sensations of articulatory movements and articulatory praxis.
Normalization of the innervation of the articulatory apparatus is carried out using massage. Work on relaxing the muscles of the articulatory apparatus begins with general muscle relaxation, relaxation of the cervical, chest muscles, and facial muscles. A relaxing massage is carried out in doses.
Developing control over mouth position.
Lack of control over mouth position in children with dysarthria significantly complicates the development of voluntary articulatory movements.
The first stage of work is exercises for the lips, helping to relax them and enhance tactile sensations in combination with passive closing of the child’s mouth.
At the second stage, the mouth is closed in a passive-active way. At first, it is easier for a child to close his mouth when his head is tilted, and easier to open when his head is slightly tilted back.
At the third stage, active opening and closing of the mouth is trained according to verbal instructions.
Articulation gymnastics.
At the initial stages, work is carried out with the maximum connection of other, more secure analyzers. Articulatory gymnastics is differentiated depending on the form of dysarthria and the severity of damage to the articulatory apparatus. The development of articulatory motor skills is carried out systematically, over a long period of time, using a general complex and specific exercises.
Voice development.
For the development and correction of voice in dysarthric , various orthophonic exercises are used, aimed at developing the coordinated activity of breathing, phonation and articulation. Activation of the movements of the soft palate and jaws is of great importance for voice correction.
Correction of speech breathing.
Breathing exercises begin with general breathing exercises. The goal is to increase breathing volume and normalize its rhythm. Breathing exercises are carried out before meals, in a well-ventilated area. The child is taught to breathe with his mouth closed, and exercises are carried out to train nasal exhalation.
Development of sensations of articulatory movements and articulatory praxis.
For the development of articulatory praxis, early speech therapy work , expansion and enrichment of the child’s speech experience, as well as the predominance of special speech exercises over purely articulatory ones are of great importance.
Correction of sound pronunciation.
The principle of an individual approach is used. The method of sound production and correction is selected individually. If the pronunciation of several sounds is impaired, consistency in work . Before calling and staging sounds, it is important to distinguish them by ear. By modeling this or that articulatory structure for the child, the speech therapist stimulates the evocation of an isolated sound, then automates it in syllables, words and in contextual speech.
There are several techniques for producing sounds for dysarthria . The most common method is the so-called phonemic localization. The main methods of work are : motor-kinesthetic and auditory-visual-kinesthetic.
When developing sound pronunciation skills, a speech therapist works to automate and differentiate sounds and develop pronunciation skills in various communication situations. Sounds are fixed in words and sentences.
For automation, the technique of simultaneous pronunciation of a sound and the image of its symbol is used - writing and speaking.
For children who cannot write, the sound is made at the same time as finger tapping or foot tapping. The new sound is then fixed in various syllables. Gradually move from simple exercises to more complex ones, speeding up the pace of exercises.
When working on sound, it is important to identify the child’s intact compensatory capabilities.
Correction of the sound pronunciation aspect of speech is combined with work on its expressiveness.
The work is carried out by imitation. The content and methods of work vary depending on the nature and severity of dysarthria , and the general level of speech development.
In all cases, the main task of speech therapy work for dysarthria is the development and facilitation of speech communication, and not just the formation of the correct pronunciation of sounds.
Lopatina L.V., in the process of speech therapy work to overcome phonetic-phonemic disorders in preschoolers with erased dysarthria , determines the following tasks:
-formation of psychophysiological mechanisms that ensure mastery of the phonetic side of speech (sensory and motor parts of the speech process);
- formation of speech skills of phonetically correct speech, intonation expressiveness.
In the process of speech therapy work, the implementation of these tasks is carried out in their unity and interconnection.
The system for overcoming phonetic-phonemic disorders includes the following sections:
1. development of manual motor skills and motor skills of the articulatory apparatus;
2. formation of correct articulation of sounds and automaticity of their pronunciation in various phonetic conditions;
3. formation of intonation expressiveness of speech;
4. formation of perception of oral speech.
I. Development of manual motor skills and motor skills of the articulatory apparatus.
Work within this area is based on the following provisions:
-level organization of movements, which allows one to decompose a complex motor act into its component components and identify the state of the cerebral levels, their role in the regulation of movements and action;
- the relationship between fine differentiated motor skills of the hands and articulatory motor skills. With normal development, the child masters the sound side of speech simultaneously with the development of general motor skills and differentiated hand movements. Systematic exercises that train finger movements, along with a stimulating effect on speech development, are a powerful means of increasing the performance of the cerebral cortex;
- complex interaction of the kinesthetic and kinetic basis of movements. To carry out a motor act, the presence of two components is necessary: a kinesthetic basis, which provides a differentiated composition of complex movements, and a kinetic structure, which underlies the formation of smooth motor skills that occur over time (A. R. Luria). The kinetic program is ensured by the participation of its brain mechanism for creating a kinesthetic scheme of voluntary movement;
- provisions on the role of kinesthesia in movement control. Voluntary movements and actions require constant comparison of the planned act with the one actually reproduced. Continuous feedback signals must be received from the movement being performed, constituting the content of reverse differentiation and constantly being compared with the planned action.
Work on the development of manual and articulatory motor skills is carried out in two directions.
1. Formation of the kinesthetic basis of movement.
The main objectives of this area of speech therapy work are :
-organization of motor impulses directed to certain muscle groups and clarification of the composition of the motor act;
-development of kinesthetic analysis and synthesis of kinesthetic afferentations of manual and articulatory movements.
In the process of forming the kinesthetic basis of hand movements, the hands and fingers are given different positions, which the child reproduces with his eyes closed (or behind the screen). When forming the kinesthetic basis of articulatory movements for the development of motor-kinesthetic feedback, special exercises are carried out aimed at clarifying the position of the articulatory organs during the pronunciation of correctly pronounced sounds. When performing them, children's attention is constantly drawn to the kinesthetic sensations that arise. Initially, these exercises are based on visual images of movement, which are then eliminated.
2. Formation of the kinetic basis of movement.
The main objectives of the second direction of speech therapy work are :
- unification, generalization of successive impulses into a single, time-organized motor stereotype, transforming individual motor skills into smooth, serially organized ones;
-development of static and dynamic coordination of movements.
In the process of forming the kinetic basis of hand movements, exercises are carried out aimed at developing a system of movements consisting of “main” and “background” components (according to A. N. Bershtein) or a series of similar movements that make up a single motor skill.
The development of dynamic coordination of hand movements is carried out in the process of performing both sequential and simultaneously organized movements.
In the process of forming the kinetic basis of articulatory movements, the main attention is paid to exercises aimed at developing the necessary range of movements, mobility of the organs of the articulatory apparatus, strength, accuracy of movements, and developing the ability to hold the articulatory organs in a given position.
Work on the formation of the kinesthetic and kinetic foundations of manual and articulatory movements will be carried out simultaneously.
II. Formation of correct articulation of sounds and automaticity of their pronunciation in various phonetic conditions.
After the formation of the correct articulatory pattern of sound in the process of performing articulatory exercises, the automaticity of its pronunciation in various phonetic conditions is developed. The implementation of automatic pronunciation of a newly formed sound in all variants of defective pronunciation is recommended to begin with the structure of the syllables GS (vowel - consonant, and then SG (consonant - vowel). This sequence of work is due to the fact that in the structure of a syllable of the SG type, the sounds that make it up are articulatory- acoustic characteristics are fused with each other in such a way that they can more fully contain all phases of articulation.
Automation of sound in combination with any vowel is carried out from syllables to words , and then to sentences in order to quickly and more naturally introduce the sound in a given syllable structure into contexts of varying complexity. After achieving automaticity in the pronunciation of a sound alternately with various vowels in the structure of a syllable of the GS type, the sound is also automated in speech material, including the structure of the SG syllable.
III. Formation of intonation expressiveness of speech.
Since the phonetic side of speech is a close interaction of its main components (sound pronunciation and prosody) and since children with erased dysarthria have violations of a number of prosodic elements of speech, in the process of speech therapy work is done to form intonational expressiveness of speech.
This work is preceded by exercises. They prepare children to perceive intonation expressiveness, contribute to its development, and create the prerequisites for mastering logical stress and correct division of phrases.
Work on rhythm is carried out in two directions: perception and reproduction of various rhythmic structures.
Speech therapy work on the formation of intonation expressiveness of speech is carried out in stages.
Stage 1. Formation of ideas about intonational expressiveness in impressive speech.
The tasks of this stage include:
- show children that human speech has a variety of intonations, which is achieved by changing the pitch, strength, timbre, and modulation of the voice, that intonation gives color to speech and helps express feelings;
-introduce children to various types of intonation and means of indicating them, as well as teach them to distinguish between various intonation structures in impressive speech
In accordance with the identified tasks, work is carried out in five directions:
1) the formation of general ideas about the intonational expressiveness of speech. The speech therapist reads the same story twice. The first time without intonation of the text, the second - expressively. The speech therapist explains to children that the voice can be changed when reading, that the voice can convey questions, joy, threats, etc.
2) familiarity with narrative intonation, the means of its expression and methods of designation. The speech therapist pronounces a sentence with a narrative intonation and invites the children to determine what this sentence expresses.
3) differentiation of intonation structures of sentences in expressive speech. This work is carried out on the material of rhymes, dialogues , and fairy tales. Children must learn to imitate voices.
IV. Formation of perception of oral speech.
Speech therapy work to overcome phonemic disorders in preschoolers with erased dysarthria is carried out taking into account the following provisions:
- modern ideas about the multi-level structure of the speech perception process (N. I. Zhinkin, I. A. Zimnyaya, E. I. Vinarskaya);
- provisions on the relationship between elementary and higher mental functions in the process of child development;
-scientific data on the stages of development of phonemic functions in ontogenesis.
When developing this technique, some techniques and methods described in the works of V. . K. Orfinskaya, D. B. Elkonina, E. F. Sobotovich, R. I. Lalaeva.
Work to overcome phonemic disorders is carried out in stages.
Stage 1. Formation of perception of oral speech at the phonetic level.
The objectives of this stage are:
-development of speech sound recognition;
-development of the stimulating function of the speech-hearing analyzer;
-formation of auditory control over the quality of one’s own pronunciation;
-creation of favorable conditions for the subsequent formation of phonemic functions.
Work at this stage is carried out in two directions.
1) Formation of perception of oral speech in the process of imitation of syllables .
2) Formation of perception of oral speech in the process of distinguishing correctly and distortedly pronounced sounds.
- recognition of distorted pronunciation, different from one’s own, in someone else’s speech;
- recognition of distorted pronunciation similar to one’s own in someone else’s speech.
The development of auditory control is carried out simultaneously with the formation of the correct articulatory structure of sound, using visual perception of tactile and kinesthetic sensations.
Stage 2. Formation of perception of oral speech at the phonological level.
Due to the fact that clear phonemic ideas about the sound composition of the language contribute to the improvement of correct sound pronunciation, the task of this stage includes the development of the functions of the phonemic system.
The formation of phonemic functions is carried out in two directions: the development of phonemic perception (differentiation of phonemes) and the development of phonemic analysis and synthesis.
Work at this stage begins with consistent clarification of the pronunciation and auditory images of the sound being practiced and is carried out in three directions.
1) Clarification of sound articulation based on visual, auditory, tactile perception, and kinesthetic sensations.
When clarifying the correct articulation of a sound, attention is paid to the work of the articulatory organs when pronouncing it. To consolidate the visual image of sound, children are offered symbolic images.
2) Isolation of sound against the background of a syllable.
Children are offered a number of syllables from which they need to select a given sound. Syllables should not contain oppositional sounds.
3) Isolation of sound against the background of a word.
This work is carried out on the material of words containing this sound and not having it. Words with similar acoustic sounds and sounds that are mixed in pronunciation are excluded.
Thus, dysarthria requires early , long-term and systematic speech therapy work . Its success largely depends on the relationship in the work of a speech therapist and a neurologist or neuropsychiatrist, a speech therapist and parents , and in case of obvious motor disorders - a speech therapist and a massage therapist , a specialist in physical therapy.
Stages of speech therapy work
Speech therapy work for dysarthria is carried out in stages. The main goal of the first, preparatory stage is to prepare the articulatory apparatus for the formation of articulatory patterns, correction of breathing and voice. An important task at this stage is the development of sensory functions, especially auditory perception and sound analysis, as well as the perception and reproduction of rhythm. Speech therapy work is carried out against the background of medication and physiotherapeutic treatment, massage and physical therapy.
At the second stage, primary communicative pronunciation skills are formed. Its main goal is the development of speech communication and sound analysis. The speech therapist works to correct articulation disorders. In case of spasticity, they work on relaxing the muscles of the articulatory apparatus. Control over the position of the mouth is developed, articulatory movements develop, speech breathing is corrected, the voice, sensations of articulatory movements and articulatory praxis develop.
The formation of sound pronunciation in dysarthria includes the production and consolidation of sounds in speech. The first group of sounds includes phonemes that are the easiest in terms of articulation and acoustically distant from each other. These are the sounds a, y, p, m, n, k, s, x, v, o, l, t, s. These sounds, being the simplest ones, are worked out to the norm. Along the way, these phonemes are used to develop phonemic perception and sound analysis skills (identifying sounds from a number of others, from syllables, in simple words).
Tongue twisters for dysarthria are a phonetic means of developing the mobility of the articulatory apparatus. When using tongue twisters, adhere to the following recommendations:
- The work begins with simple, short, rhyming phrases (“White sheep beat the drums”);
- The principle of selection of didactic material is observed (the tongue twister should not contain words with sounds that are poorly pronounced by the patient;
- Tongue twisters are best used in games.
An individual approach to the selection of means and methods of speech therapy work at each stage of treatment for dysarthria allows specialists at the Yusupov Hospital to achieve speech restoration in patients who were abandoned in other rehabilitation centers.
Forms of speech therapy work for dysarthria
Forms of speech therapy work with children with dysarthria include:
- drug treatment of the disorder that became the source of the disease;
- physiotherapeutic techniques;
- articulation gymnastics;
- psychotherapeutic support;
- work of a speech therapist.
Speech therapy work with children with dysarthria is carried out gradually. The key task of the initial stage is preparing the articulatory apparatus, straightening the voice, and correcting breathing. The primary task is the formation of sensory functions, especially sound analysis, and in addition the perception and reproduction of tempo. The work of a speech therapist is performed in conjunction with physical therapy, physiotherapeutic procedures, drug therapy and the use of massage.
The second stage is to achieve initial communication skills. Its key goal is to develop sound analysis and communication capabilities. Speech therapy work is carried out to correct pronunciation. In cases of spasm, they work on the muscles of the speech apparatus, relaxing them. Correct respiration (breathing) skills are formed and the vocal cords are trained.
Equally important is a speech therapy examination of a child with dysarthria. A key element is the work of a speech therapist for cerebral palsy. Children with this diagnosis have problems with motor functions. They are caused by an unnatural state of muscle activity and a defect in motor control. Motor lesions are often combined with speech pathology, damage to receptivity, and gaps in the cognitive, volitional and emotional spheres.
Logorhythmic influence
Logorhythmic work with patients suffering from dysarthria includes therapeutic exercises in classes. It is built depending on the speech therapy correction course. It is divided into 3 periods.
The tasks of the first period are as follows:
- Education of static movements;
- Development of fine motor skills of the fingers;
- Development of general movements of the upper and lower extremities, torso with the gradual introduction of exercises with objects;
- Development of muscles that provide facial expressions;
- Development of various types of memory, auditory and visual attention;
- Gradual formation of normal diaphragmatic skill;
- Overcoming prosodic disturbances in dysarthria.
To activate the prosodic components of speech, singing is used primarily. The development of the prosodic side of speech in dysarthria is carried out with the help of dramatizations of songs, during the performance of which it is necessary to change the strength, timbre, and pitch of the voice. To normalize vocal function, articulatory and breathing exercises and movements for the muscles of the neck and head are performed.
In the complex of medical and speech therapy effects, logorhythmic classes contribute to:
- Development of the articulatory apparatus;
- Voice training (pitch, timbre, strength, range, strength);
- Breathing development (inhalation depth, duration of speech inhalation and exhalation).
Systematic work started in a timely manner contributes to the rapid restoration of speech function.
How does erased dysarthria manifest in children?
A feature of erased dysarthria is the lack of expression of symptoms, which is why the disease is called that. Characterized by unclear articulation due to impaired motor skills, distortion of some sounds. The lack of intonation and inexpressive speech and the complexity of automation are noteworthy. The clinical picture may vary depending on the affected area: in one child the phonetic defect predominates, in another the prosodic defect predominates, in the third both components are present in equal volume.
Sound pronunciation disorder affects two or more groups of sounds. For example, hissing, whistling and sonorous. Speech with erased dysarthria is replete with distortions and replacement of sounds. The baby confuses dull, voiced, and soft sounds and cannot use them correctly. Even if you can overcome these problems, it is difficult to achieve automaticity.
At an early age, such children are usually observed by a neurologist. They are diagnosed with “perinatal damage to the central nervous system” and are given medication, courses of physiotherapy and massage. Over time, the child is removed from the register. Only when speech disorders do not go away do parents and doctors begin to look for the cause. As a rule, erased dysarthria is diagnosed in preschool children - at 5 - 6 years old.
Characteristics of the erased form of dysarthria, which parents themselves can notice, are poor facial expressions, lack of tone of the lips, tongue, asymmetry of the nasolabial folds and corners of the mouth. When performing articulation tests, involuntary movements of the tongue, its trembling and cyanosis occur. Increased salivation. It is difficult to keep the speech organs in one position.
It may be difficult for the baby to chew food, and he refuses to eat if it is in pieces. Infants have difficulty sucking milk and swallowing is impaired.
General development
Neurological status has changed. Noteworthy are persistent dermographism and sweating of the hands and feet. Children are easily excitable, restless, and make a lot of unnecessary movements. Or, on the contrary, they are inhibited and slow. Their memory and attention are impaired.
Physically, children lag behind their peers and are short, thin, and asthenic in build. They get tired quickly during physical activity and are clumsy. The synchronization of movements and fine motor skills suffer. It’s hard for a child to fasten a button, tie shoelaces, or do creative work. In physical education lessons he has difficulty completing assignments. Handwriting is impaired, and in general the child writes slowly.
