Scientific and theoretical foundations of speech therapy
Elena Tashlykova
Scientific and theoretical foundations of speech therapy
SCIENTIFIC AND THEORETICAL FOUNDATIONS OF Speech Therapy.
The scientific and theoretical basis of speech therapy is determined by the pedagogical nature of this science, that is, speech therapy , as well as the essence of its subject, goals, and objectives. The scientific and theoretical foundations include the provisions of various sciences.
The first theoretical basis of speech therapy is the position of psychology - about speech, its types, functions, as well as the connection of speech with other mental processes. Speech is considered as a HMF; therefore, it is provided by the complex structure of the functional system. Speech formation during life depends on the social situation of the child’s development. Speech is the highest mental function, which is the main means of expressing thoughts.
Speech is a voluntary function and in the process of ontogenesis develops from simple forms of oral speech to complex types of speech activity, both oral and written.
Speech is divided into impressive (perception, understanding, reading)
and expressive
(i.e. own speaking, writing)
form. The largest division of speech into types is its division into oral and written, represented by reading and writing. Oral speech is divided depending on the complexity of its construction:
1. Dialogue speech - two or more partners interact.
2. Monologue speech – a coherent speech utterance by one person.
For speech therapy , it is important to identify other types of speech:
-Reflected speech; conjugate speech (choral)
; independent speech.
Speech performs the following functions:
1st basic – communicative function (within the communicative function, informational and regulating speech is distinguished)
. The communicative function of speech appears very first in ontogenesis. It is this function that suffers primarily in various oral speech disorders, but it suffers especially severely in OHP (1-2 level of speech development, open rhinolalia, pseudobulbar dysarthria, stuttering.
2nd function of speech – cognitive (cognitive)
.
Speech begins to be used by a child for cognition at an early age of 3 years (Why)
. Speech becomes a means for the development of thinking.
The 3rd function of speech is metalinguistic. Metalanguage is language, speech is about speech. Using speech to indicate its patterns and rules. The metalinguistic function normally begins to develop in preschool age, this is especially evident at 6-7 years of age and then continues to develop at school age. Its development is facilitated by language learning.
In speech therapy , the use of the metalinguistic function is very important in the process of correcting speech deficiencies in children. This function is formed in children in a complex and time-consuming manner.
First of all, speech is connected with thinking, therefore any underdevelopment of the intellect has a negative impact on the underdevelopment of speech. Manifests itself in children with mental retardation and disability.
Speech is associated with other cognitive processes, namely memory, different types of perception, and imagination. Speech impairment, especially in the form of OHP, negatively affects the development of these cognitive mental processes. Deficiencies in memory, especially operational memory, as well as auditory and visual memory, in turn, complicate speech development (in particular, this negatively affects the development of vocabulary)
.
Deficiencies in visual perception, as well as in the functions of spatial analysis and synthesis, can cause reading and writing disorders.
Thus, the psychological aspect of the theoretical basis of speech therapy is important :
Firstly, for the correct approach to distinguishing impaired speech development from normal speech development or from ontogenesis.
Secondly, to implement a systematic approach to the diagnosis and correction of speech disorders.
Thirdly, to take into account the role of other mental functions in the correction and development of speech (in particular, taking into account the personal component, that is, the attitude of a child or adult to his deficiency and the motivation for correctional work to overcome this disorder).
The second theoretical basis of speech therapy is the position on the anatomical and physiological foundations of speech .
According to this position, speech is realized by complex structural formations or functional systems into which the central and peripheral sections are combined.
The central section is represented by the brain, cerebral cortex, subcortical and stem formations, the main function of which is to program and clarify programs for various speech actions.
The frontal prefrontal regions of the cerebral cortex provide general semantic programs for speech utterances, their sequence, purposefulness and control. The temporal regions of the cortex of the left hemisphere provide phonemic perception, therefore, the recognition of linguistic units in oral speech. The motor departments provide the choice of articulatory programs and switching from one articulation to another during the speaking process. The occipital cortex of the left hemisphere performs the function of letter discrimination. Pathways connecting the cerebral cortex with the nuclei of the cerebral nerves (located in the medulla oblongata)
ensure the transmission of speech motor programs, the clarification of which occurs in the cerebellum
(motion coordination)
.
From the nuclei of the brain nerves begins the peripheral path to the executive organs, to the peripheral muscles of the peripheral apparatus (respiratory, vocal, articulatory)
. The vagus nerve regulates respiratory function. The glossopharyngeal and vagus nerves are the muscles of the larynx and vocal folds, pharynx and soft palate. In addition, the glossopharyngeal nerve is the sensory nerve of the tongue, and the vagus nerve innervates the muscles of the respiratory and cardiac organs. The trigeminal nerve innervates the muscles that move the lower jaw. Facial nerve - facial muscles, including the muscles that carry out lip movements, puffing out and retracting the cheeks. The accessory nerve innervates the muscles of the neck. The hypoglossal nerve supplies the muscles of the tongue with motor nerves and gives it the possibility of a variety of movements.
Through this system of cranial nerves, nerve impulses are transmitted from the central speech apparatus to the peripheral one. Nerve impulses move the speech organs.
The peripheral speech apparatus consists of three sections: 1) respiratory; 2) voice; 3) articulatory (or sound-producing)
.
The respiratory section includes the chest with the lungs, bronchi and trachea. The vocal section consists of the larynx with the vocal folds located in it. The main organs of articulation are the tongue, lips, jaws (upper and lower, hard and soft palate, alveoli. Of these, the tongue, lips, soft palate and lower jaw are mobile, the rest are fixed. Thus, the anatomical and
physiological principles give an idea of the normal structure speech functional system, which is important both for the diagnosis and correction of speech disorders, with simple defects in sound pronunciation, and with complex disorders such as stuttering, sensory and motor alalia.
The 3rd basis is the psycholinguistic basis .
Psycholinguistics studies speech activity from the point of view of the relationship between the processes of speech production and speech perception in connection with the personality, that is, it studies the features and patterns of language use in the speech activity of the individual. From a psycholinguistic point of view, an assessment is made of the role of motivation in speech activity, the role of conditions that contribute to increasing the child’s speech motivation, and the role of communicative and social factors in overcoming speech deficiencies. In the same direction, mechanisms of self-control and self-correction of speech deficiencies are considered.
4th neuropsychological basis for understanding the brain organization of speech.
Neuropsychology provides information about the current understanding of the brain mechanisms of speech disorders.
For example: it has been established that writing impairment in primary schoolchildren can be caused not only by specific deficiencies in phonemic perception, hearing, visual-spatial analysis and synthesis, but also by the immaturity of regulatory mechanisms that are provided by the third functional block of the brain. In this connection, the regulatory form of dysgraphia is distinguished. For example, T.V. Akhutina (2001)
from the perspective of a neuropsychological approach, she identified variants of writing difficulties that are often found in children, but mechanisms that are rarely discussed in
speech therapy (pedagogical)
literature.
In particular, the author identified writing difficulties of the type of regulatory dysgraphia, caused by the immaturity of voluntary regulation of actions (planning and control functions)
.
5th neurological basis of speech pathology (neuropathology and psychopathology)
.
Data from neuropathology and psychopathology are taken into account in the analysis of speech disorders in the clinical picture of various neurological and psychiatric disorders: stuttering, aphasia-type speech breakdown, with RDA, with early forms of schizophrenia, with stroke.
The 6th theoretical basis of speech therapy is linguistic provisions about the phonetic, lexical, and grammatical systems of the language; about the laws of structure and rules of use of linguistic means. Linguistic foundations are important for determining the content and sequence of work on various language units and various language activities.
For example: garden-garden-gardener. (word formation)
The 7th theoretical basis of speech therapy is the provisions of special psychology on the structure and patterns of dysontogenesis for the theory and practice of speech therapy .
According to the provisions of special psychology, a deficiency of one impaired function, in this case speech, is considered a primary defect. In the absence or insufficient effectiveness of correctional work, this primary defect can cause secondary disorders: a delay in intellectual development, distortions in personality development.
The provisions of special psychology are important for the correct assessment of the relationship between the current level of development of a child with a speech disorder and his potential capabilities, subject to the provision of special correctional assistance.
The 8th basis of speech therapy is the pedagogical foundations of raising and teaching children with speech disorders:
Special correctional pedagogy is a generic concept of speech therapy , therefore speech therapy uses all the principles of correctional pedagogy. She uses methods adopted in special pedagogy for teaching and raising children with speech disorders.
Thus, the scientific and theoretical foundations of speech therapy are interdisciplinary in nature, which can be designated as clinical-psychological-pedagogical , anatomical-physiological and linguistic.
Theoretical foundations of speech therapy. Principles and methods
Speech therapy as a science
Speech therapy is the science of speech disorders, methods of identifying, eliminating and preventing them by means of correctional training and education. It is one of the branches of defectology. The term is derived from the Greek logos (word, speech), peideo (educate, teach) - translated as “education of speech.”
Currently, there has been significant progress in the development of speech therapy. Based on psychological analysis, important data were obtained on the mechanisms of the most complex forms of speech pathology (aphasia, alalia and general speech underdevelopment, dysarthria). Speech disorders are studied in complicated defects: in mental retardation, in children with visual, hearing, and musculoskeletal impairments. Modern neurophysiological and neuropsychological research methods are being introduced into speech therapy practice. The relationship between speech therapy and clinical medicine, child neuropathology and psychiatry is expanding.
Speech therapy at an early age is developing intensively: the features of pre-speech development of children with organic damage to the central nervous system are being studied, criteria for early diagnosis and prognosis of speech disorders are being determined, techniques and methods of preventive (preventing the development of a defect) speech therapy are being developed. All these areas of research have significantly increased the effectiveness of speech therapy work.
Due to the fact that correct speech is one of the most important prerequisites for the further full development of the child and the process of social adaptation, the identification and elimination of speech disorders must be carried out at an earlier date. The effectiveness of eliminating speech disorders is determined largely by the level of development of speech therapy as a science.
The subject of speech therapy as a science is speech disorders and the process of training and education of persons with speech disorders. The object of study is a speech disorder in a specific subject.
The structure of modern speech therapy consists of preschool, school speech therapy and speech therapy for adolescents and adults. The fundamentals of preschool speech therapy as a pedagogical science were developed by R. E. Levina and are based on the teachings of L. S. Vygotsky, A. R. Luria, A. A. Leontiev.
The main goal of speech therapy is to develop a scientifically based system of training, education and re-education of people with speech disorders, as well as the prevention of speech disorders.
Domestic speech therapy creates the most favorable conditions for the personality development of children with speech disorders. The successes of domestic speech therapy are based on numerous modern studies by domestic and foreign authors, indicating the great compensatory capabilities of the developing children's brain and the improvement of ways and methods of speech therapy correction. I.P. Pavlov, emphasizing the extreme plasticity of the central nervous system and its unlimited compensatory capabilities, wrote: “Nothing remains motionless, inflexible, but can always be achieved, changed for the better, as long as the appropriate conditions are met” [11, p. 188].
Based on the definition of speech therapy as a science, the following tasks can be distinguished:
study of the ontogenesis of speech activity in various forms of speech disorders;
determination of the prevalence, symptoms and severity of speech disorders.
identifying the dynamics of spontaneous and directed development of children with speech disorders, as well as the nature of the influence of speech disorders on the formation of their personality, on mental development, on the implementation of various types of behavioral activities.
study of the characteristics of speech formation and speech disorders in children with various developmental disabilities (with impairments of intelligence, hearing, vision and the musculoskeletal system).
clarification of the etiology, mechanisms, structure and symptoms of speech disorders.
development of methods for pedagogical diagnosis of speech disorders.
systematization of speech disorders.
development of principles, differentiated methods and means of eliminating speech disorders.
improvement of methods for preventing speech disorders.
development of issues related to the organization of speech therapy assistance.
These tasks define both the theoretical and practical orientation of speech therapy. The theoretical aspect is the study of speech disorders and the development of scientifically based methods for their prevention, identification and overcoming. The practical aspect is prevention, identification and elimination of speech disorders. The theoretical and practical tasks of speech therapy are closely related.
To solve the tasks it is necessary:
ensuring the relationship between theory and practice, connection between scientific and practical institutions for faster implementation of the latest scientific achievements into practice;
implementation of the principle of early detection and overcoming speech disorders;
dissemination of speech therapy knowledge among the population for the prevention of speech disorders.
The solution to these problems determines the course of speech therapy intervention. The main focus of speech therapy is speech development, correction and prevention of speech disorders. In the process of speech therapy work, the development of sensory functions is provided; development of motor skills, especially speech motor skills; development of cognitive activity, primarily thinking, memory processes, attention; formation of the child’s personality with simultaneous regulation and correction of social relationships; impact on the social environment.
Speech therapy uses knowledge of general anatomy and physiology, neurophysiology about the mechanisms of speech, the cerebral organization of the speech process, the structure and functioning of analyzers that take part in speech activity.
Speech is a complex functional system, which is based on the use of the sign system of language in the process of communication. The most complex system of language is the product of long-term socio-historical development and is acquired by the child in a relatively short time.
The speech functional system is based on the activity of many brain structures of the brain, each of which performs a specific operation of speech activity. A.R. Luria identifies 3 functional blocks in brain activity.
The first block includes subcortical formations (formations of the upper trunk and limbic region) and ensures normal tone of the cortex and its wakeful state.
The second block includes the cortex of the posterior sections of the cerebral hemispheres, receives, processes and stores sensory information received from the external world, and is the main apparatus of the brain that carries out cognitive (gnostic) processes. Its structure includes primary, secondary and tertiary zones.
The third block includes the cortex of the anterior sections of the cerebral hemispheres (motor, premotor and prefrontal areas), provides programming, regulation and control of human behavior, regulates the activity of subcortical formations, regulates the tone and wakefulness of the entire system in accordance with the assigned tasks of activity.
Speech activity is carried out by the joint work of all blocks. At the same time, each block takes a certain, specific part in the speech process.
In the process of written speech, various parts of the occipital and parieto-occipital regions of the cerebral cortex also take part.
Thus, different areas of the brain are involved in the speech process in different ways. Damage to any part of it leads to specific symptoms of speech disorders. Data on the cerebral organization of the speech process make it possible to clarify ideas about the etiology and mechanisms of speech disorders. These data are especially necessary for the differential diagnosis of various forms of the disorder (aphasia) with local brain lesions, which makes it possible to more effectively carry out speech therapy work to restore speech in patients.
The organization of the speech therapy process makes it possible to eliminate or mitigate both speech and psychological disorders, contributing to the achievement of the main goal of pedagogical influence - human upbringing. Speech therapy intervention should be aimed at both external and internal factors causing speech impairment. It is a complex pedagogical process aimed primarily at the correction and compensation of speech impairments.
Theoretical foundations of speech therapy. Principles and methods.
Speech therapy is based on the following basic principles: systematicity, complexity, development principle, consideration of speech disorders in connection with other aspects of the child’s mental development, activity approach, ontogenetic principle, principle of taking into account etiology and mechanisms (etiopathogenetic principle), principle of taking into account the symptoms of disorders and the structure of speech defects , the principle of a workaround, general didactic and other principles.
The methods of speech therapy as a science can be divided into several groups.
The first group is organizational methods: comparative, longitudinal (study over time), complex.
The second group consists of empirical methods: observational (observation), experimental (laboratory, natural, formative or psychological-pedagogical experiment), psychodiagnostic (tests, standardized and projective, questionnaires, conversations, interviews), praximetric examples of activity analysis, including speech activities, biographical (collection and analysis of anamnestic data).
The third group includes quantitative (mathematical-statistical) and qualitative analysis of the data obtained; machine data processing using a computer is used.
The fourth group is interpretive methods, methods of theoretical study of connections between the phenomena being studied (the connection between parts and the whole, between individual parameters and the phenomenon as a whole, between functions and personality, etc.).
Technical means are widely used to ensure the objectivity of the study: intonographs, spectographs, nasometers, video speech, phonographs, spirometers and other equipment, as well as X-ray cine photography, glottography, cinematography, electromyography, which make it possible to study the dynamics of integral speech activity and its individual components.
It is important in speech therapy to distinguish between the concepts of normal and speech disorders. The norm of speech refers to the generally accepted options for using language in the process of speech activity. With normal speech activity, the psychophysiological mechanisms of speech are preserved. A speech disorder is defined as a deviation in the speaker’s speech from the language norm accepted in a given language environment, caused by a disorder in the normal functioning of the psychophysiological mechanisms of speech activity. From the point of view of communication theory, speech disorder is a violation of verbal communication. The relationships that objectively exist between the individual and society and are manifested in verbal communication are upset.
Speech disorders are characterized by the following features:
they do not correspond to the age of the speaker;
are not dialecticisms, illiteracy of speech and an expression of ignorance of the language;
are associated with deviations in the functioning of the psychophysiological mechanisms of speech;
often have a negative impact on the further mental development of the child;
are sustainable and do not disappear on their own;
require a certain speech therapy intervention depending on their nature.
This characteristic makes it possible to differentiate speech disorders from age-related characteristics of speech, from its temporary disturbances in children and adults, from speech characteristics caused by territorial dialect and sociocultural factors.
The terms “speech disorder”, “speech defects”, “speech deficiencies”, “speech pathology”, “speech deviations” are also used to denote speech disorders. A distinction is made between the concepts of “speech underdevelopment” and “speech impairment”.
Underdevelopment of speech implies a qualitatively lower level of formation of a particular speech function or the speech system as a whole.
A speech disorder is a disorder, a deviation from the norm in the process of functioning of the mechanisms of speech activity. For example, with underdevelopment of the grammatical structure of speech, a lower level of assimilation of the morphological system of the language and the syntactic structure of the sentence is observed. Violation of the grammatical structure of speech is characterized by its abnormal formation and the presence of agrammatisms.
In psychology, there are two forms of speech:
a) external (written and oral (dialogue, monologue);
b) internal .
Dialogical speech is the psychologically simplest and most natural form of speech; it occurs during direct communication between two or more interlocutors and consists mainly of exchanges of remarks.
Monologue speech is a consistent, coherent presentation by one person of a system of knowledge. Three types: narrative; description; reasoning.
With speech defects, monologue speech is impaired to a greater extent than dialogic speech.
Written speech is graphically designed speech, organized on the basis of letter images. The full assimilation of writing and written speech is closely related to the level of development of oral speech. During the period of mastering oral speech, a preschool child unconsciously processes language material, accumulates sound and morphological generalizations, which create readiness to master writing at school age.
Internal form of speech : (speech to oneself) - silent speech that occurs when a person thinks about something, mentally makes plans. It is formed in a child on the basis of external factors and represents one of the mechanisms of thinking. The transfer of external speech into internal speech is observed in a child at the age of about three years, when he begins to reason aloud and plan his actions in speech. Gradually, such pronunciation is reduced and begins to take place in inner speech.
The development of a child’s speech can be presented in several aspects related to the gradual acquisition of language:
development of phonemic hearing and formation of skills in pronouncing phonemes of different languages;
mastery of vocabulary and syntax rules. Active mastery of mechanical and grammatical patterns begins in a child at two to three years old and ends by seven. At school age, acquired skills are improved based on written speech;
mastery of the semantic side of speech. It is most pronounced during schooling.
In the psychological development of a child, speech is of enormous importance and performs communicative, generalizing and regulatory functions.
A lack of speech development should be understood as a deviation from the normal formation of linguistic means of communication. Changes in speech (considered in speech therapy) should be distinguished from age-related features of its formation. This or that difficulty in using speech can be considered as a disadvantage only taking into account age norms.
Speech therapists determine the next stages of a child’s speech development from birth to six years
:
At 2 months of life, humming and croaking (b, p, m, k, d, x) of reflex origin begins to appear, independent of the child’s will.
3 – 4 months the character of the noise changes. It acquires different intonations and gradually begins to turn into babbling.
5th month - unconscious repetition of sounds after others.
6th month - repetition of individual syllables begins, gradually they are fixed in the child’s memory.
Up to 1 – 1.5 the period of preparation of the child for speech takes place. Communication occurs mainly through facial expressions, gestures, and “own words.”
From the age of 2 years, the discrimination of all sounds of speech communication begins.
By the age of 3–4 years, the child begins to realize his mistakes and shortcomings in comparison with the speech of others. Drawbacks are possible (loudness, individual sounds, replacement of sounds with simpler ones, etc.).
By the age of 5–6 years, the child masters normal pronunciation.
Knowledge of anatomical and physiological mechanisms of speech
, i.e. the structure and functional organization of speech activity allows:
firstly, to imagine the complex mechanism of speech in normal conditions;
secondly, take a differentiated approach to speech pathology;
thirdly, to correctly determine the paths of corrective action.
We have already found out that speech is one of the complex higher mental functions of a person. In order for a person’s speech to be articulate and understandable, the movements of the speech organs must be natural and accurate and at the same time automatic.
