Severe speech disorders are characterized by various deviations in its development of a persistent nature. Recently, the percentage of children with similar pathologies has been growing, accounting for 10% of the total number of dysfunctions of the articulatory apparatus.
The disorder requires an integrated approach to eliminate it. Despite the absence of hearing problems, patients may stutter, have difficulty reading and writing, and their vocabulary is poor.
General speech underdevelopment (GSD) is manifested by specific deviations of a persistent nature. The degree of the defect in children with severe speech impairments is determined by their environment: the more time they spend and communicate with them, the less pronounced it is. Such a child does not understand how to inflect words in phrases or form sentences. It is more difficult for him to learn writing and grammar compared to ordinary children. Against the backdrop of declining academic performance, he has problems adapting to society. If the speech impairment is severe, this affects the state of the child’s psyche.
Reasons for appearance
A child with speech defects is observed by doctors of various specialties: psychologists, speech therapists, neurologists, defectologists. Its functions can be influenced by both internal and external factors. Even during the development of the embryo, oxygen deficiency, severe toxicosis, and injuries during labor can have a negative impact. Bad habits of the mother, diseases of the endocrine system and certain medications can also affect the child’s articulatory apparatus. Speech dysfunctions sometimes occur under the influence of a hereditary factor.
If parents are overly active in raising their child, he does not feel the need to voice requests and maintain dialogue. They will give and bring everything to him anyway. In the opposite situation, the baby simply withdraws within himself when no attention is paid to his speech.
Insufficient development of the muscles of the articulatory apparatus is also associated with the nature of the baby’s nutrition. You cannot replace all vegetables and fruits with mashed potatoes from jars and your own preparation; the child must learn to chew.
Children who have had encephalitis and infectious diseases before one year of age are relatively at risk. Parents need to prevent concussions and other traumatic brain injuries. The external environment and poor microclimate in the family also affect the baby’s speech. Disruption of speech functions is more often observed at 1-2 years of age, when registering in a preschool educational institution or before school at 6-7 years of age.
Classification by type
TNR in speech therapy for preschool children is classified according to clinical symptoms and psychological and pedagogical characteristics. Speech disorders according to biological manifestations are divided into the following groups:
- voice (dysphonia and aphonia);
- pathologies of tempo (tachylalia and bradylalia);
- problems with reading and writing;
- sound (dysarthria and stuttering).
The method for correcting the disorder is selected in accordance with these characteristics. The pedagogical classification divides TNR into two groups. The first includes general, phonetic and phonemic developmental deviations. The second is stuttering. This formulation also allows the speech therapist to create a treatment plan for the child.
The baby begins to learn the basics of vocabulary and grammar at the age of 1.5-3 years. After the preschool stage, his speech is shaped by his immediate environment, which largely depends on the culture and upbringing of adults. Its violations may concern the pronunciation of sounds, phonemic perception, vocabulary size, and the ability to compose sentences correctly. Speech disorders are expressed in sound defects, insufficient vocabulary, problems with phonemic hearing, and inability to compose sentences. There are four types of OHP:
- Level I is the most critical, a 4-5 year old child is not able to communicate verbally. His speech function consists of a set of sounds, while he can actively gesticulate.
- II degree - despite the presence of distorted words and similar grammatical forms, the speech is difficult for others to understand. Characterized by a significant deviation from the age norm.
- Level III – there is an extended form of speech using phrases; children can maintain a dialogue. However, compared to their peers, they do not speak fluently.
- Level IV – there are grammatical errors in sentences, violation of the pronunciation of individual letters.
If parents are deaf, pronunciation defects are inevitable.
Technology and methods of teaching students
Along with general requirements, schools are faced with more in-depth tasks to help children with speech disorders. Among them:
- correction of oral and written speech;
- in the process of eliminating defects, take into account the mental development of each child;
- professional training.
The educational process involves the allocation of significant time devoted to the work activities of schoolchildren. Thanks to this approach, several problems are solved simultaneously. First of all, the adaptation of children with disabilities to society, the formation of personality and preparation for life outside of school. This aspect also includes the physical development of children with SLD.
Education of children with special needs
This category includes children with disorders:
- hearing;
- vision;
- speeches;
- musculoskeletal system.
The teaching methodology includes:
- identification of various developmental pathologies;
- after the diagnosis is made, immediately provide psychological and pedagogical support;
- create a special rehabilitation program;
- identify developmental features and create a self-education plan;
- involve the child’s family and environment in the recovery process;
Expert opinion
Margarita Sergeevna S.
Speech pathologist and speech pathologist with 15 years of experience working in various speech correction centers with children of different ages.
Education of children with special needs is carried out in special schools and boarding schools.
Technology of compensatory education
Statistics indicate that more than 20% of children have various delays. If you do not start eliminating defects in time, the child will lose adaptation in the educational process.
The following sensory systems act as compensatory functions in children with SLI:
- tactile sensations;
- hearing (provided there are no impairments);
- vision (if no problems are identified);
- motor function.
Success in eliminating speech defects directly depends on the state of the listed systems and the ability to use them.
Equally important for children with SLD is pedagogical work aimed at:
- voluntary training;
- adapted content of educational material;
- additional classes;
- involvement of the child’s compensatory capabilities in the learning process;
- the pace of delivery of material depending on the speed of assimilation.
The main elements of successful rehabilitation are considered to be a loyal and understanding attitude towards students.
Signs and symptoms
Speech abnormalities can be expressed by one or more symptoms. Based on their combination, a final diagnosis is made. A child with SLD does not perceive educational material well and lags behind his peers in intelligence. Due to impaired motor skills, he looks clumsy, his mental state is unstable (impulsivity is replaced by isolation). Irritation over small things leads to difficulties in communicating with peers.
Correction of the defect is necessary because dysfunction of the speech apparatus leads to phonetic, grammatical and lexical disorders. In addition to problems with thought processes, the child has difficulties communicating with others. When children use amorphous root words (“you bang” - the cup fell), simple phrasal speech, and agrammatic statements, their meaning is not clear to an outsider.
Intelligence suffers secondary to severe speech deficiency. Children cannot concentrate on new material and have difficulty switching from one topic to another. The topic studied is quickly forgotten, especially those related to the plot and sequence of events. Often they do not know how to generalize and draw conclusions. It is easier for them to work with visual material. The existing movement disorder leads to rapid general fatigue and decreased tone. All of the above signs cause deviations in the emotional-volitional sphere. Children with SLD are characterized by passivity, resentment and lack of motivation to achieve results.
Deviation from the normal rate of speech is also a pathology. A child with such defects may speak in phrases from cartoons or those he heard from his parents the day before. Due to difficulty chewing food, he may choke on even a small piece. You should also pay attention to such symptoms as a constantly open mouth and increased salivation.
What are the dangers of TV and modern gadgets? An uncontrolled flow of information enters the brain, while the baby does not puzzle himself with mental activity.
Treatment methods
If speech disorders are detected, it is necessary to correct the child’s condition; over time, their manifestations will only intensify. Speech defects are divided into OSD, phonetic and phonetic-phonemic. Diagnosis of deviations is carried out by medical specialists and teachers. If the primary mental retardation is due to severe neurological diseases, the child may be issued a disability.
The most positive results can be achieved with early identification of the problem in preschool children. Therapy is always based on an integrated approach: medication, physiotherapeutic procedures, classes with a speech therapist and speech pathologist. Laser and magnetic therapy are the most effective; kinesiological exercises improve attention and memory, helping to harmonize processes in the brain.
Depending on the severity of the manifestations of speech impairment and the presence of concomitant pathologies, children are educated according to the regular school curriculum or in special institutions. In general education institutions, training is carried out in two directions: in the first, children with severe speech development disorders are taught, in the second, with severe stuttering. To correct pathologies, the primary school program is compiled separately, and later they switch to general education. During therapy, it is necessary to regularly visit a speech therapist.
Severe speech impairment in children is treated according to a certain scheme:
- develop breathing and voice;
- learn to distinguish sounds from each other;
- train muscles;
- reinforce correct sound pronunciation;
- form communication skills.
This is achieved through breathing exercises according to Strelnikova, and the development of fine motor skills in drawing and mosaic lessons. The visual teaching method makes it easier to learn the material. Coherent speech is also developed with the help of speech therapy didactic games. The teacher teaches the children information in the form of a poem, accompanying their action with hand movements. In addition, in the process of learning, the child’s vocabulary increases and the constraint in communication decreases. Dance movements and practicing facial expressions help stimulate coordination.
At home, parents must provide the child with adequate nutrition and normalize his daily routine. Just speech therapy classes are not enough, he needs communication with friends, a cultural program will be useful.
Treatment for Specific Disorders
Treatment methods differ depending on the characteristics of the deviation. To cure stuttering, you need to create a comfortable and calm environment. You cannot focus on this defect; the child needs psychological support. Try not to rush him, let him speak loudly and clearly.
When sensory alalia is diagnosed, the child, on the contrary, is protected from excessive communication with others and is excluded from watching TV. Only after the onset of “visual hunger” can a speech therapist begin corrective work. Dysarthria is treated through the development of motor skills; it is necessary to monitor the child’s routine. Motor activity is formed by encouraging the baby to self-care (he must dress, comb his hair, eat on his own).
Violation of voice timbre and sound pronunciation is called closed rhinolalia. It is caused by defects of the nasal septum, after the elimination of which the speech impediment disappears. The open form occurs due to clefts in the hard and soft palates. To treat it, a restoration operation is performed, and speech therapy sessions will also be required.
When working with your child at home, remember that a lot depends on your positive attitude. You must reassure the child of the success of the treatment and help him get rid of his complexes. In preschool age, the chances of successful correction are higher compared to older children.
Severe speech disorders (SSD) article on speech therapy on the topic
SEVERE SPEECH IMPAIRMENTS (SDI)
Speech is formed in the process of the child’s general psychophysical development. The conditions for the formation of normal speech include a normal central nervous system, the presence of normal hearing and vision, and a sufficient level of active verbal communication between adults and the child. In cases where a child has preserved hearing and is not impaired in intelligence, but there are significant speech impairments that cannot but affect the formation of his entire psyche, they speak of a special category of abnormal children - children with speech impairments. The branch of defectology, speech therapy (from the Greek logos - word and paideia - education) deals with the study, prevention and correction of speech disorders. Speech therapy has historically developed as an integrative field of knowledge about mental and, more specifically, human speech activity, speech and language mechanisms that ensure the formation of speech communication in normal and pathological conditions. The pedagogical foundations of speech therapy science were developed at the IKP RAO in the works of prof. R.E. Levina and her employees and the period from 1965 to 1980. The development of speech therapy in our country is also associated with the names of M.E. Khvattsev, O.P. Pravdina, R.E. Levina and others. The current stage of development of speech therapy is associated with the development of scientific ideas about various forms of speech disorders, as well as the creation of effective methods for overcoming them. Speech disorders are a collective term to denote deviations from the speech norm accepted in a given language environment, completely or partially preventing verbal communication and limiting the possibilities of a person’s social adaptation. As a rule, they are caused by deviations in the psychophysiological mechanism of speech, do not correspond to the age norm, cannot be overcome independently and can have an impact on mental development. To designate them, specialists use various, not always interchangeable, terms - speech disorders, speech defects, speech deficiencies, speech underdevelopment, speech pathology, speech deviations. Children with speech impairments include children with psychophysical abnormalities of varying severity, causing disorders of the communicative and generalizing (cognitive) functions of speech. They are distinguished from other categories of children with special needs by normal biological hearing, vision and full-fledged prerequisites for intellectual development. The identification of these differentiating features is necessary to distinguish them from speech disorders observed in children with mental retardation, mental retardation, the blind and visually impaired, children with early childhood autism, etc.
Speech disorders, having arisen under the influence of any pathogenic factor, do not disappear on their own and, without specially organized speech therapy work, can negatively affect the entire process of the child’s mental development. In this regard, it is extremely important to distinguish between:
— pathological speech disorders;
- possible speech deviations caused by age, some speech characteristics of the family, bilingualism in the family.
Forming in a child as he masters his native language, speech goes through several stages of development, gradually turning into an expanded system of means of communication and mediation of various mental processes.
Expressive and impressive forms of speech are distinguished as two main independent types.
Expressive speech is an utterance (oral or written) that begins with a program, goes through the stage of internal speech, and only then moves into the stage of a detailed external speech utterance (oral or written).
Impressive speech is the process of understanding a speech utterance (oral or written). It begins with the perception of a speech message (through hearing or vision), goes through the stage of highlighting informational moments and, finally, ends with the formation of a general semantic scheme of the message in internal speech and inclusion in a certain semantic context (understanding itself).
Four independent forms of speech activity can be distinguished:
1. expressive oral speech - speaking;
2. expressive written speech – letter;
3. impressive oral speech – understanding of spoken oral speech;
4. impressive written language - reading.
All these forms of speech represent a complex but unified functional system with many characteristics. The complexity of this system is due to the fact that each of the four subsystems included in it has not only a certain autonomy, but also different periods of formation.
In speech therapy, on equal terms, there are two classifications of speech disorders: psychological-pedagogical and clinical-pedagogical.
The psychological and pedagogical approach distinguishes: general speech underdevelopment (GSD) and phonetic-phonemic speech underdevelopment (FFN).
The clinical and pedagogical approach identifies the following speech disorders: dysphonia, dyslalia, rhinolalia, dysarthria, stuttering, alalia, aphasia, dysgraphia and dyslexia.
Dysphonia is a voice disorder due to pathological changes in the vocal apparatus. The voice of a person suffering from dysphonia is perceived as hoarse, hoarse, dry, exhausted, with a small range of vocal modulations. The complete absence of voice is called aphonia. Voice disorders occur in both adults and children. May be due to reasons of both central and peripheral nature. Age-related changes in voice occur in adolescents aged 13-15 years; this is due to endocrine changes during puberty. This period of voice development is called mutational. At this time, the teenager needs a protective speech regime. You can’t overstrain or force your voice. Persons whose profession is associated with long-term vocal stress are recommended to have a special positioning of their speech voice, which protects it from overstrain.
Dyslalia is a pronunciation disorder with normal hearing and intact innervation of the speech apparatus. There are mechanical and functional dyslalia.
Mechanical dyslalia is associated with a violation of the structure of the articulatory apparatus: malocclusion, impaired tooth growth, low or too high dome of the hard palate, abnormally large or small tongue, short frenulum of the tongue. These defects make it difficult to produce speech sounds normally.
Functional dyslalia - may be associated with: immaturity of phonemic perception due to delayed psycho-speech development, improper speech education of the child in the family, incorrect sound pronunciation of adults in the child’s immediate environment, pedagogical neglect. Sometimes functional dyslalia can be observed in children who at an early age master two languages at once, and a mixture of speech sounds of two language systems may be observed.
A child with dyslalia may have impaired pronunciation of one or more sounds that are difficult to articulate: whistling, hissing, R, L. Sound pronunciation disorders may manifest themselves in the absence of certain sounds, distortion of sounds, or their replacement.
Normally, the formation of correct pronunciation occurs gradually and is completed by the age of four. If a child after four years has defects in sound pronunciation, the help of a speech therapist is recommended. However, for some types of speech pathology, such work must begin much earlier.
Rhinolalia is a violation of pronunciation and voice timbre associated with a congenital anatomical defect in the structure of the articulatory apparatus. The anatomical defect manifests itself in the form of a cleft on the upper lip, gum, hard and soft palate. As a result, there is an open cleft (hole) between the nasal and oral cavities, or a cleft covered by a thinned mucous membrane. Often clefts are combined with various dental anomalies. The speech of a child with rhinolalia is characterized by slurredness due to a nasal voice and impaired pronunciation of many sounds. In severe cases, the child’s speech is completely incomprehensible to others. Children suffering from rhinolalia need early medical examination, orthodontic and surgical treatment. Speech therapy assistance for such children needs to begin very early: even in the preoperative period. After surgery to restore the integrity of the articulatory apparatus, speech therapy work must be continued. At the same time, the assistance provided to the child must be systematic and long enough.
Dysarthria is a violation of the sound-pronunciation and melodic-intonation aspects of speech, caused by insufficient innervation of the muscles of the speech apparatus. Dysarthria is associated with organic damage to the nervous system, as a result of which the motor side of speech is impaired. This disorder can occur in both a child and an adult. The cause of dysarthria in children is damage to the nervous system, usually due to cerebral palsy. With dysarthria, disorders of sound pronunciation, voice formation, tempo-rhythm of speech and intonation are observed. The degree of severity of dysarthria can be different: from unclear pronunciation imperceptible to the listener (erased dysarthria) to the complete inability to pronounce speech sounds (anarthria), which depends on the nature and severity of damage to the nervous system.
As a rule, with dysarthria, children's speech develops with a delay. Most often, the pronunciation of sounds that are difficult to articulate suffers - S, Z, Ts, Sh, Shch, Zh, Ch, R, L. In general, the pronunciation of sounds is unclear, blurred, “porridge in the mouth.” The voice is often weak and hoarse. Speech is poorly intonated and inexpressive. The pace of speech can be either accelerated or slow. Phonemic perception is not sufficiently formed. There is also a poverty of vocabulary and insufficient knowledge of grammatical structures. The process of mastering writing and reading is difficult for such children. The handwriting is uneven, the letters are disproportionate, and dysgraphia is often observed. Reading aloud has no intonation, reading speed is reduced, and understanding of the text is limited. A large number of reading errors are allowed - dyslexia. Children suffering from dysarthria need an early (before four years of age) start of speech therapy work and long-term correction of the speech defect.
Stuttering is a disturbance in the fluency of speech caused by muscle spasms of the speech apparatus. It usually begins between the ages of two and six years. Often appears in children with delayed speech development as a result of damage to certain structures of the central nervous system. However, it can also occur in children with advanced speech development as a result of excessive speech load, mental trauma,
The main manifestation of stuttering is muscle spasms of the speech apparatus, which occur only at the moment of speaking or when trying to start speaking. The convulsive speech of people who stutter is usually accompanied by accompanying movements: closing the eyes, flaring the wings of the nose, nodding movements of the head, stamping feet, etc. At the age of 10-12 years, a persistent fear of verbal communication begins to form with an obsessive expectation of speech failures - logophobia. Despite speech and psychological difficulties, neither a kindergarten teacher nor a school teacher should avoid situations that encourage the child to speak or replace the oral responses of stuttering children with written ones. This can negatively affect the formation of all aspects of oral speech, and most importantly, verbal communication. To overcome the defect, a child who stutters requires systematic help from a speech therapist, and in cases where stuttering is protracted, also the help of a psychologist, and possibly a psychotherapist.
Alalia is the absence or underdevelopment of speech in children, caused by organic damage to the speech areas of the cerebral cortex. This speech pathology is characterized by: late appearance of speech, its slow development, significant limitation of both passive and active vocabulary. Speech development in this disorder follows a pathological path. Depending on the predominant symptoms, two forms of alalia are distinguished: expressive alalia and impressive.
With expressive (motor) alalia, the sound image of the word is not formed. The oral speech of such children is characterized by: simplification of the syllabic structure of words, omissions, rearrangements and replacements of sounds, syllables, as well as words in a phrase. The acquisition of grammatical structures of the language suffers significantly. The speech development of such children can be different: from the complete absence of oral speech to the possibility of coherent statements in which various errors are observed. These children understand everyday speech well and respond adequately to adults addressing them, but only within the framework of a specific situation.
Impressive (sensory) alalia is characterized by a violation of the perception and understanding of speech with full physical hearing. The leading symptom is phonemic awareness disorder. It can be expressed to varying degrees: from complete inability to distinguish speech sounds to difficulty perceiving oral speech by ear. Due to the fact that children with such speech pathology do not understand the speech of others addressed to them, they are often perceived as mentally disabled. In children with alalia, speech does not develop without special corrective intervention. They need early, long-term and sufficiently qualified speech therapy help.
Aphasia is a complete or partial loss of speech caused by organic local lesions of the brain. There are several forms of aphasia. In severe cases of aphasia, a person’s ability to both understand the speech of others and speak is impaired. Most often it occurs in older people as a result of injuries, strokes, and brain tumors. Aphasia leads to severe disability. Adults, as a rule, lose their profession and have difficulty adapting to everyday life. The inability to express one’s desires and misunderstanding of the speech of others cause behavioral disorders: aggression, conflict, irritability.
The possibilities for compensating for speech and mental disorders in aphasia are sharply limited. Speech therapy assistance must necessarily be combined with a whole range of rehabilitation measures. Help for people with aphasia is provided through the health care system.
Written language disorders are referred to as dyslexia and dysgraphia. Dysgraphia manifests itself in persistent and repeated writing errors. These errors usually manifest themselves in mixing and replacing letters, distortion of the sound-syllable structure, disruption of the unity of spelling of individual words in a sentence - breaking a word into parts, spelling words together; agrammatisms, mixing of letters by optical similarity. Writing can be impaired if almost any part of the cortex of the left hemisphere of the brain is damaged: the posterior frontal, inferior parietal, temporal and occipital regions. Each of these cortical zones provides a certain condition necessary for the act of writing to occur. The frontal lobes of the brain provide the general organization of writing as a complex speech activity. An extreme degree of impairment of written speech—agraphia—is a complete inability to master the skill of writing.
Dyslexia is a reading disorder associated with damage or underdevelopment of certain areas of the cerebral cortex. Manifests itself in numerous repeated errors in the form of substitutions, rearrangements, and omissions of letters when reading. This leads to a slow, often guessing nature of reading, incorrect reproduction of the sound form of a word, and misunderstanding of even the simplest text. Errors in dyslexia are persistent. Children with dysgraphia and dyslexia need speech therapy classes, which use special methods for developing writing and reading skills.
Children with speech disorders usually have functional or organic abnormalities in the nervous system. These children, as a rule, do not tolerate heat, stuffiness, riding in public transport, swinging for long periods of time, and often complain of headaches, nausea, and dizziness. There are often disturbances in balance, coordination of movements, and lack of differentiation of finger movements and articulatory movements.
Such children quickly become exhausted and become fed up with any type of activity. They are characterized by irritability, increased excitability, and motor disinhibition. Many of them are emotionally unstable, with rapid and not always justified changes in mood in the form of aggression, obsession, and anxiety. As a rule, such children have instability of attention and memory, especially speech. Also quite common is a low level of understanding of verbal instructions, insufficiency of the regulatory function of speech, a low level of control over one’s own activities, impaired cognitive activity, and low mental performance.
Children with functional abnormalities in the central nervous system are emotionally reactive, easily giving neurotic reactions in response to a remark, a bad grade, or disrespectful attitude from the teacher or children. Their behavior can be characterized by negativism, increased excitability, aggression or, on the contrary, increased shyness, indecisiveness, and timidity. All this indicates a special state of the central nervous system of children suffering from speech disorders.
LITERATURE
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2. Lapshin V.A., Puzanov B.P. Fundamentals of defectology. – M.: Education, 1991.
3. Special preschool pedagogy: Textbook / E.A. Strebeleva, A.L. Wenger, E.A. Ekzhanova and others; Ed. E.A. Strebeleva. – M.: Publishing House, 2002.
4. Special pedagogy / L.I. Aksenova, B.A. Arkhipov, L.I. Belyakova, etc.; Ed. N.M. Nazarova. – M.: Publishing House, 2004.
