Comparative characteristics of Dyslia Rinolalia Dysarthria Table. Comparative characteristics of dislishers and dysarthritia
Currently, the problem of the erased dysarthria of children's age is intensively developed in clinical, neurolynguistic, psychological and pedagogical and correctional and speech therapy aspects. In order to deliver an erased dysarthria from complex disliers, a comprehensive medical and pedagogical study is necessary: \u200b\u200ban analysis of medical and pedagogical documentation, the study of amnetical data. Comparing the symptoms of speech and non-symptoms in children with discharge and dysarthria, you can define diagnostic significant differences.
So, in children with an erased dysarthria, in addition to violation of sound proof, there is a violation of the voice and its modulation, the weakness of speech respiration, expressed prosodic disorders. However in varying degrees Common motor skills and thin differentiated hand movements are disturbed. The identified motor awkwardness, insufficient coordination of movements is the cause of the lagging for the formation of self-service skills, and the non-formation of thin differentiated movements of the fingers of the hands is the cause of difficulties in the formation of graphotor skills.
In the work of O.Yu. Fedosova is a comparison of disliers and erased dysarthria.
With complex functional disliers:
- · The articulation of only consonant sounds suffers;
- · Clear violation of the articulation of certain sounds in various conditions of their implementation;
- · Fixing formed sounds does not cause difficulties;
- · There is no violations of the temp-rhythmic organization of speech;
- · Respiratory changes are not typical;
- · Lancture disorders are not marked;
- · Discoordination of respiration, voice formation and articulation is absent.
With erased dysarthria:
- · Perhaps a lubricated obscure pronunciation of vowels with a slight nose shade;
- · Isoolately sounds can be saved, and in the speech stream is pronounced distortion, it is unclear;
- · The automation process is difficult: the sound may not be used in speech;
- · Characterized by an accelerated or slow speech pace;
- · Surface breathing, there is a speech on the breath, the lamination exhalation is shortened;
- · The coordination of these processes suffers.
Analysis of cases of children with discharge and light dysarthria shows that the pathology of speech (sound-proof violation) limits the abilities and social capabilities of the child, reflected in his entire personality, in some cases the cause of separation from the collective. Easy to his speech defect, the child becomes closed, insecure in his abilities and opportunities. Speech defects in most cases are the reason for its impressive in school.
In addition, the weakening of only individual components of the psyche - the attention and memory of the child - adversely reflect on its successes to eliminate the speech defect. Special influence on speech, therefore, mental functions are provided by the presence of organic neurological symptoms. Thus, we came to the conclusion that this approach to the child is most fruitful, in which the attention of the researcher focuses not only on isolated symptoms (speech), but also on the disorder of the holistic complex system of the whole organism. For this purpose, a comprehensive clinical and pedagogical study of children with functional suslavy, light dysarthria and children with a normal speech was carried out.
- 1. The results of the study of physical status. Children with a light form of dysarthria and functional discharge on physical development are somewhat behind children with a normal speech.
- 2. The results of the study of neurological status. In children with normal speech and functional suspension symptoms of organic lesion central nervous system Not noted. Changes from the vegetative nervous system in the form of a sustainable dermographism, grinding of hands of hands, violation of the sweating and humidity of the distal extremities (brushes and stop) was observed in most children with Distilia. Neurological symptoms in children with a light form of dysarthriasis with a one-time study in polyclinical conditions was often not detected and therefore such children were numbered to suspect. With a thorough examination and use of functional loads (repeated movements, power stresses), it is possible to identify the symptoms of organic lesion of the central nervous system in the form of erased paresis, changes in the tone of muscles, hypercines in the mimic and articulation muscles, pathological reflexes. The main violation of the cranial brain nerves is associated with the lesion of the sublingual nerves (XII pairs), which is manifested in the form of some restriction of the movement of the language towards the hyperkinesis ... Repeated movements of the language up, forward and the sides cause rapid fatigue, expressed in slowing the movement rates , and sometimes easy scratching tip of the tongue. All these violations are due to the patient of the muscles of the language. Restriction of the volume of movements of the eyeballs (III - IV - VI pairs) in the form of light abnormalities to the outer spike was observed in some children. In terms of accommodation and convergence, lightweight passage convergences were noted. One child was marked by squint. From the side of the trigeminal nerves (V steam) in children of coarse paresis were not observed. However, with the side movements of the lower jaw, some children appeared synichenezia in the form of a turn of the head, language, less and the lips in the same direction. The asymmetry of facial nerves (VII steam) had children, mainly due to the smoothness of the right or left nasolabial fold. Heavy disorders on the part of the Language and wandering nerves (IX, x pairs) did not observe the examined children. However, there was an insufficient reduction in soft nose. The voice in the children was quiet, deaf with a small nose tint. The listed states of the cranial brain nerves with a light form of dysarthria in most cases are a persistent character, since they are due to the organic lesion of the central nervous system.
On the part of the motor sphere, the children had weakly expressed parires with denervators of muscle tone. The strength of the muscles in children was satisfactory. However, most children did not immediately include in active resistance. Active movements for all surveyed performed in full, but were slow, awkward, undifferentiated. In the reflex sphere, children have the revival of tendon and periosteal reflexes. In some cases, reflexes of oral automatism were observed, as well as non-permanent, depleting pathological reflexes of the Babinsky and Pussepa. In addition to the above violations in neurological status in children with a light form of dysarthria, changes were noted on the part of the vegetative nervous system, which were manifested mainly in the form of palms and stop, precious red demographs.
Thus, it was found that most children with a light form of dysarthria had an easy (erased) neurological symptomatology, which was detected with a thorough study and indicated the organic lesion of the central nervous system.
3. The results of the study of psychological and pedagogical status.
ATTENTION in children with functional discharge and especially with a light form of dysarthria less sustainable than in children with a normal speech. The study of the individual tasks on attention made it possible to reveal a reduced level of stability and switching attention in children with a light form of dysarthria and functional dislibia. The violation of the mechanism of stability and switchability of attention seems to depend on the insufficient mobility of the main nervous, processes in the crust of large hemispheres.
Memory. The nature of the task is to spectatic memory In children with functional discharge and a light form of dysarthria, the results of studying them on switching attention, which is apparently due to a violation of neuro-dynamic relations in the crust of large hemispheres. The weakness of the process of memorizing words in children with functional platform and a light form of dysarthria is associated not only with difficulty conditional reflexes, weakening attention, but also, possibly, with a violation of the phonamatic hearing, resulting from underdevelopment of sound suspension.
Thus, the study of memory in the tasks showed that children with functional suslavy had minor, and in children with a light form of dysarthria, significant deviations that can be explained not only to the violation of their phonmematic hearing, but also an active attention disorder ...
Thinking. Children with normal speech and functional suslavy gave the same number of correct answers. Children with a light form of dysarthria gave a smaller number of correct answers, and the quality of their work was lower. When performing tasks, children with a light form of dysarthria were unsure, passive, quickly depleted, showed negativism. However, some weakening of their mental activity did not carry the nature of mental retardation, but was held by the type of asthenization with a pronounced decrease in the function of attention and memory.
Speech. All children understood the address facing them. Children with a normal speech and functional suslavy had a sufficient dictionary, a complete phrase, a loud voice and a normal speech tempo. In some cases, children with functional discharge, the speech rate was agreed. In children with a light form of dysarthritia, the active dictionary was somewhat limited, the phrase is short, the voice is some quiet, the speech is fast, inevitable. A characteristic feature for both children with functional discharge, and with a slight form of dysarthria was a violation of sound suspension. Phonetic disorders were manifested by the replacement of some sounds by others, mixing sounds, lack of sounds, fuzzy distorted sound pronunciation. In children with a light form of dysarthria, there was a discrepancy between the ability to pronounce the sounds isolated and in the speech stream. Isoolately sounded cleaned, more correctly, in the speech stream - it is unclear, fuzzy, as weakly automated and not differentiated enough. In some children with a light form of dysarthria, in addition to violation of consonant sounds, vowel sounds were not clear, with a slight nose tint. Phoneatic rumor in children in most cases has been reduced.
5. Research psychological features In children with a light form of dysarthria and functional discharge showed that work speech therapist It should not be limited to the formulation and correction of only defective sounds, but should have a wider range of child correction as a whole.
As mentioned above, two groups described speech violations in appearance are similar to each other, since both children are incomprehensible in children, with the wrong pronunciation separate sounds or group of sounds. However, there are also significant differences that are manifested not only by neurological status, but also in mental and speech.
Etiology of Distilia (in this case we are talking about functional form) is far from clear, it is not associated with rude morning and nature injuries, brain diseases, etc. Early infections in children who cause a common delay in development are observed. In some cases, dislélia arises from an unfavorable speech environment (dialects, archaisms).
The causes of the occurrence of dysarthria are severe damage to the nervous system at various stages of development - nature injuries, brain diseases (encephalitis, meningoencephalitis), intoxication.
On the part of the physical status of the suspension, there is much less behind in physical development than the dyslights.
As for the state of the internal organs, under both forms of coarse changes was not observed. In neurological status there is a big difference between these speech violations. Thus, under dischairs, we did not observe coarse lesions of the central nervous system, and only in some cases organic microsypes was determined. More often there was a violation of the vegetative nervous system in the form of a symptom of tapes, resistant red dermographs, etc.
Under dysarthios, neurological symptoms were rude with the presence of paresis, hyperkinesov, with the involvement in the process V, VII, IX, X and XII pairs of alternate nerves. The defeat of these nerves caused phonetic speech defects, the irregularities of breathing, pulse, salivation, chewing, as well as voices expressed in varying degrees.
With functional suslavs, only the phonetic side of speech mainly suffers; Breathing, cardiac activity, motoric and voice, as a rule, are not violated. Only in cases of Riniolaly (mechanical dischairs), when there are anatomical defects of the nose, it happens with a nasal shade, voice and breathing violates. However, such cases are easily derived from the dysarthritia, since the defects of the nose or other articulation organs have. In the neurological status of such children of coarse lesions of the central nervous system, it usually does not happen.
From the psyche of Poslavkov, mainly deviations from the age norm noted. Sometimes there were temporary delays in mental development. In some cases, Dislishers proceeded against the background of oligophrenia. In dysarthri, there are more and mental development delays organic type, and sometimes oligophrenia. The emotional-volitional sphere and character) of suslavics suffer only in some cases, in the dysarthritis, in most cases, there is a difficult behavior with an unstable mood, accompanied by crying, often there are affective flashes ...
Table of contents
Introduction
1. Features of the differential diagnosis of the erased form of dysarthria, dislies
Diagnosis of erased dysarthria
Classification of forms of erased dysarthria
1.3 Features of differential diagnosis of disliers
2. Differential diagnosis of the erased form of dysarthria and dislons
Research of domestic speech therapists on the differential diagnosis of the erased form of dysarthria and dislons
Conclusion
Bibliography
Introduction
Speech is one of the main mental features of a person, any of its violations are the object of studying the various sciences: pedagogy, psychology, speech therapy, neuropsychology, neurolinguistics and others.
Every year, speech therapy science develops and introduces various adjustments to the techniques, documentation, etc. But, nevertheless, the experience of the authors of past centuries remains unchanged, being the base for the development of this science as a whole.
The topic of my course work "Differential diagnosis of the erased form of dysarthria and disliers". The choice of theme is due to its relevance and insufficient problems of the problem, which requires special consideration in scientific and methodological aspects.
For example, after the survey conducted, the speech therapist is facing the task of the diagnosis, and on how it will correct it, all further correctional work will depend on it. But often the speech therapist finds it difficult to do this for the reason that one violation of speech in its etiology is similar to another violation. And for this, first of all, it is necessary to know what manifestations is one violation, and what other.
Thus, I would like to say that the question of the differential diagnosis of the erased form of dysarthria and dislielia is under development, and as a future speech therapist was interesting to make a small clarity into consideration of this problem.
A wide analysis of the practice has shown that the erased forms of dysarthrias are quite often mixed with the suslian. However, with a detailed study there are differences. For the first time, Gutsman drew attention to this, proving that, for example, the correction of sound suspension, in contrast to Dyslia, for dysarthria causes certain difficulties (12, p. 102).
In Ov term paper I did not put the goal to consider the differential diagnosis of each of these violations of speech separately. On the contrary, she tried to show in comparison, which manifestations had an erased form of dysarthria, and what kind of discharge. The resulting data for convenience I grouped into tables that clearly reflect the essence of this issue.
And so what is the erased form of dysarthria? The main manifestations of the erased form of dysarthria? What classifications do you exist? How the differential diagnosis of the erased shape of the dysarthria is varied with disllia, and, on the contrary, than similar. I tried to answer these and many other questions in this course project.
I spent more attention to the issue of the Dysarthria, rather than dilacs. Since the study of disliers is conducted since the 30sXIX. century, then during this time accumulated a large number of Scientific I. methodical material. Many authors considered their duty to contribute to the study of this violation. However, the review of these literature indicates that the erased forms of dysarthria remain not well understood, not developed systems approach To the correction of this speech violation.
Thus, so far the methods of differential diagnosis of the unitryria and similar states (dislons) are not sufficiently systematized.
1. Questions of differential diagnosis of the erased form of dysarthria, dilacs
1.1 Diagnostics erased forms of dysarthria
Common speech violation among preschool children iserased dysarthri which tends to significantly increase. It is often combined with other speech disorders (stuttering, general underdevelopment speech, etc.). This is a speech pathology manifested in the disorders of phonetic and prosoic components.speech functional systemandwHOno due to the unfinished microorganic lesion of the brain (6).
The term "erased" dysarthry was first proposed by O.A. Tokarova, which characterizes the manifestations of the "erased dysarthriti" as light (erased) manifestations of "pseudobulbar dysarthriti", which are distinguished by the special difficulty of overcoming.
Among the reasons that cause an erased dysarthria, the following are allocated by various authors:
1. Violation of the innervation of the articulation apparatus, in which the insufficiency of individual muscular groups (lips, language, soft sky) is noted; Inaccuracy of movements, their fast depletion due to the defeat of those or other departments of the nervous system.
2. Motor disorders: the difficulty of finding a certain position of the lips and the language needed to pronounce sounds.
3. Oral apraxia.
4. Minimum brain dysfunction.
As I have already spoken, the diagnosis of the erased form of dysarthria and the methodology of the correction work is not yet developed. In the works of G.G. Guttsman, O.V. Pravdina, L.V. Melekhova, O.A. Tokareva, I.I. Panchenko, R.I. Martynova is considered issues of symptoms of disartric disorders of speech, under which there is a "cleaning", "spray" of articulation. The authors note that the erased dysarthria on their manifestations is very similar to complex suslav(1, p. 8 - 9).
The differential diagnosis of the erased dysarthria is extremely difficult. Disorders of the phonetic side of speech with erased dysarthria, externally similar to other sound-proof disorders, at the same time have its own specific mechanism. Pronounced violations of sound impacts with erase dysarthria with difficulty can be corrected and adversely affect the formation of the phonumatic and lexico-grammatical sides of speech, the process makes it difficult school learning Children. At the same time, timely correction of violations speech Development is a prerequisite psychological readiness Children for school training, creates prerequisites for the earliest social adaptation of preschoolers with violations of speech (7).
For diagnosis of this violationnecessary Pay attention to the presence of neurological symptoms and conduct dynamic observation in the process of correctional work: if during an outpatient examination, the psychoneurologist immediately detects organic neurological symptoms, then such forms are legitimately attributed to the dysarthria. Often there are children who, with a single survey, any symptoms are not marked.
When diagnosing, it is often very difficult to distinguish the easy degree of dysarthria from the disorders similar to it, since a number of symptoms of dysarthria in form are almost identical to the symptoms of other speech disorders. Difficulties are exacerbated by the fact that dysarthria is often manifested in the structure of various neurological and psychopathological syndromes (children's cerebral paralysis, minimal brain dysfunction syndrome, psychophysical dismissal syndrome, retreat of mental development, oligophrenia, etc.) and at the same time coexist with other speech violations (Alalia , Rinolalia, stuttering). However, this is extremely important, since the choice of adequate directions of the correctional and speakers of the child with a light degree of dysarthria and, accordingly, the effectiveness of this impact, respectively, depend on the setting of the right diagnosis.
I would like to make a comparison of a light degree of dysarthria in principle, with a violation close to it, a severe degree of dysarthria, based on speech and non-Sneven signs.
The erased form of dysarthria is most often diagnosed after five years.
For the early detection of the erased dysarthria and the right organization of the integrated impact, it is necessary to know the symptoms characterizing these violations. The examination of the child begins with a conversation with mom and studying a polyclinic card development card. Analysis of animal information shows that there are: deviations in intrauterine development (toxicosis, hypertension, neuropathy, etc.); asphyxia newborns; rapid or protracted labor. According to Mom, "the child shouted not immediately, the child was brought to feed later than everyone."
During the examination in the clinic in the speech therapist in children aged 5-6 years, the following symptoms are detected with erase dysarthria.
In some cases, functional samples (3, p. 11) help to diagnose the minimum manifestations of dysarthria.
Sample 1. The child is asked to open the mouth, launch the tongue forward and hold it still in the midline and simultaneously monitor the eyes behind the object moving in the lateral directions. The sample is positive and testifies to the dysarthritia, if at the time of the movement of the eye there is some deviation of the tongue in the same direction.
Sample 2. The child is asked to perform articulating movements by the language, while putting hands on his neck. With the most subtle differentiated movements of the language, the tension of the cervical muscles is felt, and sometimes visible movement with the crying of the head, which indicates the dysarthria.
With the help of such a special, in-depth examination, non-leaf paresses of face muscles are detected, which prevent the normal formation of articulation. Thus, all cases of disorders of the sound impact of such pathogenesis should be considered as disorderly disorders.
1.2 Classification of forms of Erase Dysarthria
For the first time attempting to classify the forms of the erased dysarthria was madeE.N. Vinar andA.M. Pulatov Based on the classification of Dysarthria proposed by O.A. Tokareva. In this classification, only the degree of violation speaks to the fore, but mechanisms and nosology are not taken into account.
In researchE.F. Sobotovich and A.F. Chernopolskaya The typology of disorders is determined depending on not only from neurological symptoms, motor disorders, but also of phonderatic and general development in various forms of dysarthria.
Depending on the manifestations of violations of the motor side of the pronunciation process and taking into account the localization of the paretic phenomena of the organs of the articulation apparatus, the authors revealed Four groups of children andallocated the following Views of the erased dysarthria:
violations of sound suspension caused by the election defense of some motor functions of the speakerphone( I. Group);
weakness, lethargy of articulating muscles( II. Group).
These two groups belong to the erased form of pseudobulbar dysarthria.
clinical features of sound-proof disorders associated with difficulty in performing arbitrary motor acts( III Group), the authors belong to the cortical dysarthria;
speech Side Defects, Available in Children with Different Motor Forms( IV Group), are related to the mixed forms of dysarthria.
1.3 Features of Differential Diagnostics of Dyslavlia
Currently, the term Dyslavlia has acquired an international character, although its content, as well as the types of violations determined by them, do not always coincide. These discrepancies are related to what grounds are taken by researchers in describing violations: anatomy-physiological, psychological or linguistic. In traditional descriptions that use clinical criteria, various pronunciation displays such as dislons are often considered as despose. The descriptions of which are based on psychological and linguistic criteria, the concept of dislons includes different forms and types, then phonetic and phonetic-phonmematic violations of sound suspension (for example, in the works of R.E. Levina) (11).
Critical analysis of dislielic teachings with modern scientific positions requires revision of the ideas established in the speech therapy. Pronunciation defects in their neurophysiological and psychological mechanism, according to the causes of their reasons, the role in the general speech development of the child and methods of overcoming are often different (9).
The main goal of the speech therapy effect during disliers is the formation of skills and skills of correct playback of speech sounds. To correctly reproduce the sounds of speech (phonemes), the child should be able to: find out the sounds of speech and not mix them in perception (i.e., to distinguish one sound from another acoustic signs); Destinating the normalized pronouncement of sound from non-normalized: carry out auditory control over their own utterance and evaluate the quality of sounds reproducible in their own speech.
Often, a combination of several symptoms of a different character is often found in the picture of the speech violation, which is reflected in the diagnosis. For example, a sufficiently frequent diagnosis of tie-language, dilacium, stuttering with kosonazych or discharge with stuttering - does not reflect the true picture of the speech state, but is only a symptomatic diagnosis that does not disclose nature neither of skins or stuttering. Since the clinic of speech disorders, relying on the data of such sciences as neuropathology, Pathophysiology and psychology, has won its right to independent existence, primitive division of all cases of logospaters for obliqueness and stuttering is inferior to a deeper understanding of each type of these violations. Now the causal dependence of the form of a speech disorder from its pathogenesis is increasingly focused.
In my opinion, it is not essential to consider each of the forms of disliers, because The essence of each of them was well studied in the writings of many authors M.E. Magtseva, O.V. Pravith, S.S. Lyapidevsky, B.M. Greenshpun and many others. I think it is advisable to group all the forms of dischairs in a table, which reflects the principles of dividing this speech violation (10).
I would like to note that mixed cases in the speech therapy work, when, except for the defect, in the structure of the peripheral speech apparatus there are still erased form of dysarthria. In such cases, the correction of speech slows greatly, and sometimes it is not possible to form a proper pronunciation of all speech sounds.
As for the group of speech disorders, which are sometimes diagnosed as an organic, or central, dilacia, then, when analyzing such forms, a number of difficulties are noted (20). Of course, in cases where a pronounced organic neurological symptomology was revealed by a psychoneurologist with a brief outpatient examination, then these forms are legitimately referred to dysarthri. But it happens not always. In the practice of speech therapy work, we meet with such children-logos, who have a medical (psychoneurological) examination more often notes the symptoms of organic damage to the nervous system and they are diagnosed - Dyslavlia. When the speech therapist begins to systematically work with such a child, then in dynamics it opens a number of features that escape at the first outpatient examination, namely: the different position of the language in the oral cavity is at rest and limited, the inaccuracy and weakness of the language movements.
Correction of pronunciation in the functional form of the dislielia passes without of great difficulty In a short time (from several lessons to one month). A new pronunciation is easily absorbed by the child, and he forgets about his wrong pronunciation (17).
Conclusions:
1. Erased dyarthria is one of the most common speech violations found in speech therapy practice.
2. Questions of diagnosis and content of correctional work with children with erased dysarthria remains not sufficiently developed both in theoretical and practical terms.
3. The complex structure of the speech disorder with an erased dysarthria requires an integrated approach to the organization and conducting correctional measures.
4. The study of the erased dysarthria is a subject of study of medical, pedagogical and linguistic disciplines. At the same time, the problem of the terminology of this violation in different areas of research is interpreted in different ways.
5. Thus, in a special literature, the choice of the term defining an erased dysarthria remains debatable.
In the domestic speech therapy, there was a concept of disliems as such a type of sound-proof disorders, which is not due to organic violations of the central order. It is the most common speech defect (9).
It is important to note that eliminating Dlylalia is needed even in preschool age, because It can entail a number of complications and cause other defects oral and written speech. In the concept of dischairs, functionally determined violations of pronunciation and organically caused violations (with anatomical anomalies of articulation bodies) are divided into independent forms of dislieves. For modern speech therapy continues to be relevant to the search for methodically justified ways to produce proper sound.
One way or another, "Dyslavlia in children depends not so much from the imperfection of the functions of their auditory analyzer, how much from the difficulties of developing relevant articulating stages, i.e. From the difficulties of developing complex coordination of movements of speech articulation organs. "
2. Differential diagnosis of the erased form of dysarthria and dislons
2.1 Research of domestic speech therapists on the differential diagnosis of the erased form of dysarthria and dislons
Among the diverse speech violations in childhood, a functional dislission and a light form of dysarthria represent is a greater difficulty for differential diagnosis and speech therapy.
When choosing an adequate correction technique and to achieve the maximum result of speech therapy work to overcome the phonetic side violations, the issues of differential diagnosis of externally similar to the manifestations of articulatory disorders are relevant.
An overview of these literature indicates that the erased forms of dysarthria remains not well-studied, the question of the differential diagnosis of erased forms of dysarthria and complex disliers is not developed enough, a systematic approach to the correction of this speech violation is not developed (3, p. 11).
In order to accommodate the erased forms of dysarthria from complex disliers, a comprehensive medical and pedagogical study is necessary: \u200b\u200ban analysis of medical and pedagogical documentation, studying anamnestic data.
The study of the differential diagnosis of the erased form of dysarthria and dislons is of interest to neurology and speech therapy, and requires further development of the techniques of early neurological and speech therapy diagnostics, improving the methods of speech therapy work in the Torchevian period and in the first years of life with children having perinatal brain lesions and with groups of groups Risk, improving the methods of correctional work with children 5-6 years, as well as strengthening the relationship in the work of a neurologist and speech therapist.
To consider the differential diagnosis of data from speech violations, it seemed interesting to learn the views of domestic speech therapists, such as Povalyeva MA, Archipova F.E., Martynova R.I. on this problem.
Povalaeva MA
A wide analysis of the practice has shown that the erased forms of pseudobulbar dysarthria are often mixed with Dralia (12, p. 102-103). However, the correction of sound suspension with dysarthria causes certain difficulties. Analysis of cases of children with discharge and light dysarthria showed that in order to understand these speech disorders, there is no study of the characteristics of the actual speech violation. The pathology of speech (violation of sound suspension) limits the abilities and social capabilities of the child, is reflected in his entire personality, in some cases causes separation from the team. Easy to his speech defect, the child becomes closed, insecure in his abilities and opportunities. Speech defects in most cases are the reason for its failure to fail
Povalaeva MAhe considered the question of the similarity of two violations, proving that the erased form of dysarthria can rightly be identified with complex suspension. This was one of the main steps on the way of studying this problem.
Martynova R.I.Thanks to this, a comprehensive clinical and pedagogical study of children with functional suslavy, light dysarthria and children with a normal speech. The results of this study are presented in Table (9).
At the end of the study, you can make several conclusions that:
1. The lag in physical development was detected significantly more in children with a light form of dysarthria than in children with functional dislibe ... and children with a normal speech.
2. In children with a normal speech with the functional dislocation of deviations from the central nervous system, it was not detected. With light forms of dysarthria, neurological symptoms in the speech system was detected Negrib: in the form of erased paresis, hyperkinesis and impaired muscle tone in the articulation and mimic muscles. The violation of the vegetative nervous system was especially noted in children with a light form of dysarthria, to a lesser extent with functional disliers.
3. Comparative study mental processes (attention, the memory of thinking) in the children under study showed that the difference between the studied groups is manifested not only in violation of one local function - violation of speech, but also in the aggregate of all mental processes. Violation of neuropsychiatric functions was significantly more detected at light dimarthry forms than with functional disliers.
4. Such a study of the nervous system and the identification of organic lesion symptoms (with the erased forms of dysarthria) showed that in these cases the rate of mental development of the child is delayed, which requires more active medical and pedagogical impact.
5. The study of psychological features in children with a light form of dysarthria and functional suslavy showed that the work of the speech therapist should not be limited to the formulation and correction of only defective sounds, but should have a wider range of child correction as a whole.
Arkhipova F.E.It is Arkhipova F.E. Developed the comparison parameters of children with the erased form of dysarthria and discharge, thereby contributing to the differential diagnosis of dysarthria and dislons.
In children with a light form of dysarthriamotor awkward is marked. They run badly, embarrassing over the steps of the stairs, often stumble. There is some insufficiency of coordination of movements. The speech therapist in the office during examination the child is bad on one leg, can not jump on one leg.
In a child with a suslavythere are no violations from the motor. The neuropathologist does not detect neurological symptoms from him.
Total motorica
Small motorika
In a child with dysarthriaself-education skills are formed late. Pearly hold a pencil, strongly strain the muscles of the hands. And, on the contrary, due to the reduction of the tone of the muscles of the hands, the child insufficiently presses the pencil, the drawing line is sluggish. When working with a cut picture, a folded pattern is shifted from the place, part of it is definitely not shifted by one on the other. It seems that the child is neakkuten when performing work, but in fact it is a violation of motility. For the first time, a defect of the orientation violation on a sheet of paper due to a violation of spatial representations is manifested. IN school age This leads to a mirror writing, insufficient orientation in the notebook. Children may experience difficulties in the lesson of drawing at older when performing geometric tasks. During the examination, the child does not perform finger exercises. It is characteristic of the search for movements requiring the fine differentiated operation of the fingers: "Castle", "Goat".
In a child with a suslavyfrom the side of motors there are no such violations.
Articulation apparatus
The child with the erased dysarthria is detected:
hypertonus: Child's face masca, muscles with palpation solid; Lips - characterized by the position of the upper lip - it is stretched and pressed to the upper gum, and during speech it is fixed; Language is always thick (or changes the shape of the "autumn cucumber"); The voice is relaxed, missing modulations (can not depict as a cow mice); does not fulfill the task "Echo"; speech slightly accelerated; Weakened speech exhale; They suffer from consonants and vowels.
hypotonus: Person hypomymo (Mimic is insufficient); when palpation face muscle flabby; mouth is ajar; The child does not hold the pose of a closed mouth (but it is necessary to exclude lorpatology); Speech breathing superficial; The child does not agree to the endings of words, as if allowed grammatical errors, they usually suffer from consonants.
hypersion: (increased salivation) especially with increasing load. At the same time, it is necessary to exclude diseases of the gastrointestinal tract (gastritis, hunger condition).
the deviation of the language (deflection of the language from the middle line) at a functional load on the speech apparatus. For example, when performing the exercise, the "pendulum" needs to be viewed in which direction the language is rejected.
hypercines: (violent movements of the language) are distinguished by the degrees of hypercines: heavy (the language is twisted in the front-back direction), the average (in the language there is a wave, then in the longitudinal, then in the transverse direction, sometimes, this is observed only at a functional load), light ( Tremor tongue tongue at a functional load is sometimes accompanied by cyanosis - the formation).
violation of the quality of articulation movements: movements are performed, but their quality suffers; Muscular power is weakened (a lot of clicks can not be done, rhythm suffers); The restraint time of the articulation posture is reduced.
In a child with a suslavythere are no such symptoms.
With erased dysarthriasounds are conducted according to the classic scheme, i.e. Methods are the same, techniques, you can use phonetic rhythm. Moreover, the sounds are easy, but the automation process is long. Sometimes have to work in spontaneous speech Each position of sound in the word.
With dislierssound formulation is also conducted according to the classic scheme, but the sound is assumed in the child's speech for a long time and does not require a long automation process.
Soundless
General speech development
children who have a violated sound impact, request, but they have a good phonderatic hearing, rich vocabulary, is not violated by the grammar system of the Language - FN (violation of border and discharge, they are difficult to differentiate).
children who have ended the process of forming a phonderatic hearing. This is a group of FFN + erased form of dysarthria. Such children can be up to 50%.
children who underdevelopment of phondematic hearing affect the underdevelopment of the syllable structure of the word; poor vocabulary, aggagatism in speech. In 5 years, such a child can say "to Sanok" instead of "on sledding". This group of children is formed by OR + erased form of dysarthria. Their in the group with ONR can be 80%.
Children with erased dysarthriaconditionally can be divided into three groups:
Loosing
In children with erase form of dysarthriathere is a vague, indistinguishable speech - "Porridge in the mouth". Poor intonation, quiet voice, sometimes a nosed shade of speech. More often, the pace of speech is fast, accelerated, the child does not agree to the endings of words and very much reduces the pronunciation of vowels (reduces to a minimum). The child has a fading voice, begins to speak loudly, it falls as a speech load. The intonation color is worse. For children with dysarthria, it is characterized by a deterioration in the quality of speech with an increase in the load.
At Dysliakovwith the repetition of exercises, the quality of speech is improving.
Conclusions:
A number of observations were found that children suffering from unclear, incomprehensible, at first glance, as it were to have identical defects. However, a deep study made it possible to allocate two groups among these children (dysarthria and dislons) having a completely different nature of the speech defect.
A more detailed examination is necessary for dysarthria, because This type of sound-proof disorder is due not only to the violation of the articulation motility, but also a violation of other components of speech. And the motor disorders of the articulation apparatus are coarser and heavy compared to the dilac. In the disliers of coarse disorders of the articulation apparatus, but in some cases, articulation disorders are absent at all.
Under dysrtaria (with the exception of broken forms), neurological symptoms are performing. Children with erase form of dysarthria resemble susliks. However, during the examination, unfavorable factors are found in history, organic microsymptomatics in neurological status, as well as difficulties in conducting speech therapy events. If, during dislons, the speech defect is associated with the incorrect pronunciation of individual sounds or groups, then with dysarthri, not only sound testing, but also voice, pace, smoothness, modulation, breathing, etc.
He summarized the findings of all authors who were engaged in the study of issues dedicated to dysarthria and disliers, we note that the erased dysarthria in their manifestations is very close to complex disliers. It illustrates the table well.
Conclusion
In its course project, I considered the question of the differential diagnosis of the erased form of dysarthria and dislons. The goal to find similarities and differences in the diagnosis of data of violations, I consider it achieved. Issues regarding the erased form of dysarthria, I also lit to the fullest.
As a result of the work carried out, I found out that the erased dysarthria - one of the most common speech violations found in the speech therapy practice and the issues of diagnosis and the content of the correctional work with children with the erased dysarthria remains are not sufficiently developed both in theoretical and practical terms.
It should also be noted that a number of observations were found that children suffering from unclear, incomprehensible, at first glance, as it were, identical defects. However, deep study made it possible to allocate two groups among these children (dysarthrias and disliers) having a completely different nature of the speech defect.
A more detailed examination is necessary in dysarthritia, since this type of sound-proof disorder is due not only to the violation of the articulation motility, but also a violation of other components of speech. And the motor disorders of the articulation apparatus are coarser and heavy compared to the dilac. In the disliers of coarse disorders of the articulation apparatus, but in some cases, articulation disorders are absent at all.
Children with erase form of dysarthria resemble susliks. However, during the examination, unfavorable factors are found in history, organic microsymptomatics in neurological status, as well as difficulties in conducting speech therapy events. If, during dislons, the speech defect is associated with the incorrect pronunciation of individual sounds or groups, then with dysarthri, not only sound testing, but also voice, pace, smoothness, modulation, breathing, etc.
Cases of sound-proof disorders, combined with violation of voice and respiration, cannot be considered as complex suspension or delayed speech development. In these cases, the conclusion is correct: an erased form of dysarthria, in which it is necessary to conduct a special complex correctional work, combined with massage, LFC, special articulation gymnastics aimed at developing and strengthening articulation muscles, a massage of the articulation apparatus.
Thus, the question of the differential diagnosis of the erased form of dysarthria and dislons today remains open and not sufficiently studied. But since the speech therapy science is developing every year, it is not enough likely that in a few years this question will not be problematic.
Bibliography
Fundamentals of the theory and practice of speech therapy / ed. R.E. Levina - M., 1968 - p. 271 - 290
Arkhipova E.F. Erased dysarthria. - M., 2006.
Gurovets G.V., Maevskaya S.I. To the question of the diagnosis of broken forms of pseudobulbar dysarthria // Questions of the speech therapy, - M., 1982.
Karelin I.B. Differential diagnosis of broken forms of dysarthria and complex disliers // Defectology. - 1996. - №5. - P. 10-14
Speech therapy: Educational. For stud. Defectol. Fact Ped. Higher. Ccheban. institutions / ed. L.S. Volkovka, S.N. Shakhovskaya. - 3rd ed., Pererab. and add. - M.: Humanit. ed. Center Vlados, 2003. - 680 p. - (Correctional pedagogy). From 173 - 177.
Speech therapy. Methodical Heritage: Manual for speech therapists and studies. Defectol. Faculties ped. universities / under. ed. L.S. Volkova: in 5 kN. - M.: Humanit. ed. Center Vlados, 2003. - KN. 1: Voice disorders and sound-proof Side of speech: in 2 hours. - C. 2. Rinolalia. Dysarthria. - 304 p. - (library of teacher defectologist). From 293 - 298.
Lopatina L.V. Receptions of the speech therapy examination of preschoolers with an erased form of dysarthria and the differentiation of their training // Defectology. - 1986. - №2. - P. 64 - 70.
Lopatina L.V. Differential diagnosis of erased dysarthria and sound-proof functional disorders. Conference materials "Rehabilitation of patients with speech disorders". - S. - PB., 2000. - from 177-182.
Martynova R.I. Comparative characteristics Children suffering from light shapes of dysarthria and functional discharge // Prestortia by speech therapy: Tutorial for students of higher and secondary special pedagogical educational institutions: 2 tt. T. 1. / Ed. L.S. Volkovka and V.I. Seliverstov. - M.: Humanit. Ed. Center Vlados, 1997. - with. 214-218 (with abbreviations on publication in Sat.: Distribution of speech and methods to eliminate them. / Under. Ed. S.S. Lyapidevsky, S.N. Shakhovskaya. - M.: 1975. - from 79-91.
Martynova R.I. On the psychological and pedagogical features of children - susanikov and dysarthritis. Essays on speech pathology and voices / ed. S.S. Lyapidevsky. - M.: 1967 - from 98 - 99; 109-110.
Melekhova L.V. Differentiation of dischairs. (Analysis of cases based on medical and pedagogical consultation with the defectological faculty of MGPI. V.I. Lenin). // Essays on speech pathology and voices. / Ed. S.S. Lyapidevsky. Vol. 3. - M.: 1967. From 80 - 85.
Povalyaeva MA: Directory of the speech therapist - Rostov - to Don: "Phoenix", 2002.
PRACT PRAIN O.V. Speech therapy. - M.: 1969.
Speech disorders in children and adolescents / Ed. S.S. Lyapidevsky. - M.: 1969.
Pay. E.F. Education of the right pronunciation in children. - M., Medgiz, 1961.
Sobotovich E.F., Chernopolskaya A.F. Manifestations of erased forms of dysarthria and methods of their diagnosis // Defectology. - M., 1974. - №4
Tokareva O.A. Functional disliers. // Speech disorders in children and adolescents / Ed. S.S. Lyapidevsky. - M.: 1969. - from 104 - 107.
Phileeva T.B., N.A. Cheveleva, G.V. Chirkina. Basics of speech therapy - M.: 1989. - 221 p. - from 82 - 85.
Grbetsev M.E. Speech therapy. - M.: 1959.
Shemebel A.G. Mechanical disliers. Speech disorders in children and adolescents / Ed. S.S. Lyapidevsky. - M.: 1969. - from 128-134; 140-144.
Diagnosis of dysarthria in general: the main criterion is the presence of neurological symptoms (and in the speech apparatus, and in the movements of the hands, legs, body as a whole). With dysarthria there are a number of symptom complexes:
· Symptom complex articulation violations. Hyperthonus, hypotonus, hypercinesis, synctanese, hyperometry (limitation of the volume of movements), hypertery (redundancy of movements, for example, if you need to pull the tongue quite a bit, the child lays it completely), asynchronous movements speech apparatus, switchability breakdown (in language, lips, soft niche), violation of the movements (inability to keep the articulation position), hypersion, smoothness of nasolabial folds, lip asymmetry.
· Promotional disorders. First of all, attention is drawn to the voice - stunning / sounding of sounds, speech monotonicity, inexpressiveness, weak voice modulation, open nasal / closed, vanity of speech, pace (slow, accelerated - less often), intermittent speech, chandized speech, etc.
· Violation of ne. speech movements. Handmade motility suffers ( small motorika Hands), General Motoric, Motor Motor Acts of the Body - Total motor awkwardness. Reduced coordination, inexpressiveness, inaccuracy of movements. For a long time, household skills are not formed - to fasten, lump, inaccurate crafts, etc.
As for sound testing - most often distortion. There may be skids in particular in a set of several consonants.
Be sure to treat a neurologist.
| Stirling dysarthri | Difficult dissocia |
| Anamnesis. | |
| 7/10 on apgar - in the risk area; severe pregnancy, perinatal Pathology of the century; As shouted, as a feeding was passed. This, as a rule, appears on time, but initially it is very vigorous and has pathological installations; There is no tendency to improve indity. | Central violation, but is functional nature; The brain cortex is not yet enough formed. However, there is a tendency to improve. More or less prosperous childbirth, prosperous pregnancy, 7-8 / 10 apart. |
| Articulating symptom complex. | |
| There are many different groups of sounds. Those sounds are disturbed, which in dislons are not violated, for example, [t], [d], [n]. Light spacious, distortion prevails. Insecurity of speech increases with the duration of speaking. Neurological symptoms are detected at special sensitized conditions, for example, with a prolonged movement (regardless of whether a static exercise or dynamic), carefully performing movement (it is actually not available). Dynamics of work in dysarthria long and unfavorable, and without treatment and ineffective. | Very often stored [l ']. The replacement is predominant. It is not depends on the time speaking - speech is distinction even with a long conversation. The dynamics is always positive, the correction comes to the norm of pronunciation. |
| Motor features. | |
| Coordination is always checked, the movements of the hands, brushes and fingers. Motor aprages are observed, inexpressiveness, insufficiency, or the redundancy of motor acts. | Correct movements, no motor aprage. Mobility is observed, a frequent mood change is possible. |
Comparative characteristics of disliers and dysarthria
As mentioned above, two groups of speech disorders in appearance are similar to each other, as in the same case, the children have incomprehensible children, with the wrong pronunciation of individual sounds or groups of sounds. However, there are also significant differences that are manifested not only by neurological status, but also in mental and speech.
Ethiology of disliers (in this case we are talking about functional form) is far from clear, it is not related to gross uterine and
natural injuries, brain 3 abs) Levania and T.- P- Early infections in children who cause a general delay in development are observed. In some cases, dislélia arises from an unfavorable speech environment (dialects, archaisms).
The causes of the occurrence of dysarthria are severe damagers of the nervous system at various stages of development - prior injury, brain diseases ( E. N.Cefalitis, meningoen-cefalitis), intoxication.
From the physical status of Distal IKI significantly less behind in physical development than Diz ^ p T.R IKI-
As for the state of the internaloPF. Ahob.> that PR AND Both forms of coarse changes were not observed. In neurological status, there is a big difference between the anniversary of the speech violations. So, under the dislibes we did not observe G.RU BYgX lesions of the central nervous system, and only in from / Elny Cases determined organic microsimptomatia ka- more often there has been a violation of vegetative nervous systems s in video Symptom of hvos stack, resistant red dermograph and Dr
With dysarthri, rudely performed neur ologskye symptoms with the presence of paresis, hypercines, with the involvement in the process V, VII, IX, X and XII pairs of alternating nerves. The defeat of these nerves caused phonetic le $. skty speech, irregular respiration, pulse, salivation, zhv, Annia> but Also voices expressed in varying degrees.
With functional suslavs themAce EUonly the phonetic side of speech is particularly suffering; breathing Nie\u003e Cardiac activity, motor skills and voice, as a rule, NG is broken. Only in cases of Riniolaly (Mechanical Distal ™) " COG.D. but There are anatomical defects of nose, it happens to Osovo. Tint, violated voice and breathing. However, such cases Chai. le.gKO retaining from dysarthria, because here they ^ ÜT Place defects of nose or other organs of articulation. In neurr logical The status of such children of coarse lesions of the central ^ ^ ultimate system is usually no
From the psyche of susliks in about SNNohm deviations from the age norm not noted. Sometimes havedoes the place of temporary delays of mental development. In duties First Cases of disliers proceeded against the background of oligophrenia. With dysarthri, the mental development delays of PS are more commonly found, and other oligophrenia. Emotional-BP left The sphere and character of the Aliks suffer only in some cases, in dysarthritis ■ Turning in cases is observed. noye Behavior with a non-■\u003e mood, accompanying ^ cry, often happenaff *. K1IV flash ...
Medical Pedagogical Multi
Knowledge of clinical and pedagogical features of the flow of disliers and dysarthria makes it possible to a doctor and speech therapist better determine the forecast of speech disorders, assign appropriate treatment and determine the nature of the speech therapy.
Thus, with discharge disliers from drugs, we used conjuncting, vitamins, calcium, bromide preparations, sometimes glutamic acid and phosphin.
The speech therapy work mainly passed in the correction of defective sounds, their automation and differentiation.
Under dysarthriahs due to coarse disorders from the motor sphere and the articulation apparatus, the following drugs were prescribed: Galanamine 0.25% in injections, vitamins BJ.and B. 2 intramuscular, prozerne, dibazole.
In cases where hypercines were prevailed, TRO-Patients and intramuscular injecting atropine were used. Lightedly applied secrets: phosphin, lipocerebrine, calcium preparations. It was carried out by courses of the electric trains, in particular, Jodionization in Burguignon. Daily children received a massage of the common, articulation apparatus and therapeutic physical culture.
Actually, the speech therapy work was out of a number of the main points: 1. Development of general motorcy and especially the articulation apparatus. 2. Fighting with saliva. 3. Developing the right air jet. 4. Development of speech breathing. 5. Sounds.
The speech therapy work was carried out systematically and combined with psychotherapeutic conversations, with the upbringing and learning of the child.
The joint work of the doctor and speech therapist gave the opportunity in all cases to get a positive result.
L. V. Melekhova
Differentiation of disliers
In the speech therapy practice, the question of revising general methodological plants in the direction of their greater differentiation in relation to a variety of types of speech pathology. The effectiveness of the methodological approach
in the speech therapy work, it is primarily provided by the allocation of the main clinical picture of the speech violation, around which subsequent secondary layers are located ...
For a complete understanding of the true picture of the child's speech state, it is necessary to trace each group of symptoms from the moment of their appearance to maximum development and take into account their mutual relationship.
For better understanding of the subject matter, consider the value of the termkosonasia ... The term "obliqueness" is very ancient, folk, for a long time he indicated all the wrong speech. Clarification of the concept of obliqueness arises in the medical literature in the first half of the XIX century, after the stuttering was allocated to an independent group of speech disorders. Later began to distinguish between organic and functional violations of speech. In 1879, A. Kussmauul calls Kososovoia all the shortcomings of speech based on disorder in alphabetic sound formation.
A. Kussmauul distinguishes also kosonazychy congenital and acquired. The latter is more often functional due to improper upbringing and insufficient exercise, but maybe organic. Organic Kosonasching DiSartria Literaalis orcentralis Anarthria Literaalis) as the name itself shows, is one of the forms of the central, organically determined violation of speech. Speech disorders arising from the damages of the development of the peripheral speech apparatus belong to mechanical dislosions. The release of two types of disliers - functional and mechanical - and the separation of these forms from the literal dimarthri ordered the idea of \u200b\u200bthe types of violations of the phonetic side of speech.
Konosonia has two forms:physiological - age-related obliqueness inherent in children aged 2-5 years, andpathological associated with one or another speech violation.
Physiological obliqueness is considered in such authors as I. A. Sikorsky, N. I. Krasnogorsky, M. E. Grovetsev, D. B. Elkonin, F. A. Pay.It is determined by them as the stage of the normal speech development of the child.
During the period of physiological obliqueness, children's speech sounds relaxed as a result of unnecessary softening of consonant sounds. Some sounds are pronounced inaccurately or replaced.
A rapidly developing healthy child in communicating with the surrounding year is developing a phrase speech, and the phonetic side of the speech reaches full development to the 4-5-year age without special training, to imitate the right speech of people surrounding the child. Further development of speech, in
the norm continues in the direction of the development of grammatical forms, the continued expansion of the vocabulary of speech and mastering the entire variety of literary standards of the language.
Observations for the oblique speech of children who came from the age of physiological obliqueness show that some of its species are characteristic of the pathological development of speech, for example: side pronunciation of sounds., Nasal pronunciation of sounds of individual phonetic groups., Violation of the pronunciation of posterior sounds., Sovonditions of consonant sounds., Interdental pronunciation of sounds.
The listed types of obliqueness are not corrected without special training. The speech therapy classes in this case should be started from 3-4 years of age, when speech stereotypes have not yet been reproached, and the speech apparatus is the most plastic and suppliance.
From a group of physiological obliqueness in the process of speech development of a child, pathological forms can be distinguished, which, according to some modern authors, are defined as:
dyslavlia functionality, the nature of which is defined as neurodynamic, expressed in the weakness of differentiation and alternate braking in the spectile and resistant analyzers;
mechanical associated with congenital vices for the development of the peripheral speech apparatus or caused by traumatic damage to it;
organic orcentral independent in the insufficiency of individual muscular groups of the speech apparatus (language, soft nose, lips) or in the overall weakness of the activity of the entire peripheral speech apparatus caused by the defeat of those or other departments of the nervous system.
With a primary survey of the articulation of the child-suslie-ka, the difference in the first two forms of disliers is clearly visible.
As for the group of speech disorders, which sometimes diagnosed asorganic orcentral Dyslavlia, the analysis of such forms there are a number of difficulties. Of course, in cases where a pronounced organic neurological symptomology was revealed by a psychoneurologist with a brief outpatient examination, then these forms are legitimately referred to dysarthri. But it happens not always. In the practice of speech therapy work, we meet with such children-logos, who have a medical (psychoneurological) examination more often notes the symptoms of organic damage to the nervous system and they are diagnosed - Dyslavlia. When the speech therapist is start
single systematic work with such a child, then in dynamics it opens a number of features that escape at the first outpatient examination, namely: the different position of the language in the oral cavity is at rest and limited, inaccuracy and weakness of its movements.
The language is restless, intense, lies with a hill, constantly pulling into the mouth. Sometimes there is a ware on the right or left half of the language, then it is constantly cubed in one direction. Other people have a tendency to narrow the language, which when motivated to action immediately becomes narrow and long. This condition indicates changes to the tone of the muscles of the language in one or both of its half. It often happens that the tip of the language is weakly expressed, i.e. The front edge is not pulled out (with a normal approaching ligament). The child does not know how to move the tongue of the tongue, long does not feel his position in the mouth, which speaks of the parethous state of his own muscles of the language.
In other cases, in the absence of limitation in the movements of the language and lips, there is often inaccuracy and weakness of movements. Loss, the limited movements are caused by hyperkinase-mi, constantly moving, as if not the necessary position. This is especially seen when the language moves forward, upwards and sides. The repetition of movements causes a rapid fatigue, slows down the movement rate, quickly occurs the loss of movement accuracy, sometimes there is a slight formation of the language, trembling appears.
In preschool age, pars are distinguished by increased excitability or, on the contrary, intensity; Often they have a slight lag in general development. They are less active in the team, shy their drawback. Their speech may cause ridicule in peers and critical comments in adults - this even more suppresses them and leads to secondary changes in the character. In such children, irritability, reflectivity, susceptibility can early may develop. They themselves cannot cope with a bad speech and, suffering from this, react to disobedience, aggressive behavior.
In contrast to conventional functional disliers, the described form is fixed slowly. The term of speech therapy occupation increases to several months, and sometimes you need to repeat the course of speech therapy. Analysis of such cases makes it distinguish the specified group as group of complicated disliers with different reasons to be accurately studied, as it is of great importance for the forecast and the term of speech therapy occupation. The specified forms seems to
mu can be interpreted as erased forms of dysarthria, not enough exactly diagnosed with primary medical examination.
F. F. Pay.
Takes to correct deficiencies in the background
The deficiencies of the phonon pronunciation are the characteristic feature of Kosonazychya, which, therefore, can act in some cases as relative to the independent violation of speech, and in others - as a satellite or the foundation of more complex speech violations. Of course, outstanding the ways to overcome tie-up in each particular case, it is impossible not to take into account its nature. The contents and methods of speech therapy work should be significantly modified depending on whether obliqueness is associated with the general underdevelopment of speech or not. It is functional or has an organic base (peripheral, central), it has the advantage of sensory or motor origin, it affects only single phonemes or covers them of their groups, etc. In some cases, an extensive program of speech therapy occupation is planned, including the work on the dictionary, The grammatical system of speech, over the development of phonderatic hearing and pronunciation, overcommodation of difficulties or violations in the assimilation of reading and writing. In other cases, the program includes only the work on pronunciation, only in terms of the refinement of the phramematic hearing and overcoming the violations of the letter. Finally, the program may be limited only to the pronunciation correction.
Despite the fact that purely pronunciation violations of speech themselves may have different nature and require a differentiated speech therapy approach, still technical techniques to correct deficiencies in the background for different types of these drawbacks contain well-known common features.
General information about fixing the profound
Turning to the process of correcting the defects of pronunciation of the background should be allocated in it the stage of primary production
proper articulation and stage of its consolidation in speech. At the first stage, the ability to reproduce the desired background at least isolated or in the simplest syllables.
At the second stage there is a gradual automation of this skill, its transformation into a persistent skill. The formation of new pronunciation skills and skills is associated with the brand of old. It implies the development of differentiation-woks between the newly learned speech movements and movements that underlie the defective pronunciation of this phoneme, as well as the pronunciation of other phones related to the articulation.
There is no sharp border between these steps - the end of the first overlaps the beginning of the second.
Characteristic the feature of the first ^ stage of the work is a wide support for various distros factors "^ Long, visual G.,"cutaneous~ J. Movement), facilitating the reproduction of the desired sample articulation and control over it.
Only in cases where the auditory perception of the phonam or the visual perception of its letter designation reflectically causes the usual defective articulation, it should be refrained for a while, it should be refrained from the support to the sample in the form of the soundproof the soundproof or supports to the corresponding letter-instep.
The second ^ ethane is characterized by a gradual limitation of visual and tactile-vibratory control over pronunciation, and then refusal from it with full switching on the auditory and kinesthetic self-coal
In the primary setting of correctly pronunciation, the background is used by three main ways.
First method based on imitation. Taking advantage of hearing, vision, tactile vibration and muscle sensations, the child perceives the sound and articulation of the phoneme and consciously trying to reproduce the required movements of the speech organs required by the sound. When. This is a direct auditory perception of sound, the perception of visible speech movements, including its own (with the help of a mirror), the feeling of the jet of exhaled air, the vibration of the larynx can be supplemented by displaying the work of the speech organs using various benefits ... imitation based on those or other injuries of primary character addressed to various analyzers are complemented by verbal explanations, the fulfillment of an understanding of the child of verbal instructions.
In cases where it is not possible to obtain the articulation of the appropriate way to imitate, one has to
follow the reproduction of individual items. So, when setting the phoner exercises are done, who are aimed at learning the right form and position position, after which its vibration is already beginning. Loading or insufficient handling of speech organs is sometimes forced sometimes to resort to a whole system of preparatory articulation exercises, to a peculiar articulation gymnastics.
Second way it consists in mechanical impact on speech bodies with any devices (spatula, wire probes) or fingers. At this ohms method Some of the initial articulation and on its basis the mezgatshche - ^ Kim Pooch "T5EC ~ Yoyo organs are passively given to the desired floor of the Amend, 1shg d v and n and e.
Associated with a certain position or movement of river organs. Kinesthetic irritation in combination with the accompanying hearings is fixed in the cerebral cortex in the form of: track systems, which is further a prerequisite for active, arbitrary reproduction of the required articulation. Characteristic of this method in its pure form is that the articulation obtained as a result of mechanical impact may not coincide with the intention of the child
Third way - mixed. With it, the mechanical impact on the speech bodies is used to help the more complete and accurate reproduction of the required articulation, carried out, mainly by imitating and using verbal explanations.
In any of these methods, articulating kinship should be taken into account between the phonemes and when correcting the defective background, to rely on properly pronounced related.
The step of consolidation of acquired utterances involves a certain systematic and sequence of exercises. This applies primarily to the rational distribution of exercises in time, which should provide a well-known measure of the duration of individual classes and intervals between them. The duration of classes may depend on the age of the child and the nature of the defect, but on average it is 15 minutes.
As for the periodicity of classes, they should, as a rule, be daily, including lessons with a speech therapist (at least three times a week) and independent exercises on E.go job.
In the selection of the exercise material, phonetic grasquitations are needed, compliance with the gradual increase in the pronunciation difficulties associated with the reproduction of various types of syllables and words. At the same time, in relation to semantics, speech material (words, phrases) should be accessible to the child and, if possible, borrowed from everyday use.
Already at the first opportunity, meaningful speech material must prevail over purely sound exercises. In cases where the lack of pronunciation of a phonam is expressed in replacing its other foundation, syllated and verbal material becomes particularly important, providing opposition by the corresponding background.
The systematic lift of the exercise rate serves as a necessary means of a speedy automation of the correct pronunciation of the newly learned phonemes in speech.
Special attention deserves a consistent transition in exercises from more simple to more complex species Speech activities - from the elementary repetition of syllables and words for the speech therapist, reading out loud (for competent) to the name of objects, actions, descriptions of the simplest situations depicted in the picture, account, reproduction of the memory of poems, riddles, proverbs and sayings, speakers to the specified background - To the detailed answer to questions, the story on a series of paintings and, finally, to a free conversation.
In cases of complex obliqueness, covering a large number of backgrounds of various types, the question of correcting the non-pronounced phoneme is important.
This order should, obviously, respond to the didactic rule of the sequential transition from lighter to more difficult.
However, however, it should be borne in mind that the relative difficulty of correcting the shortcomings of pronunciation of various phonemes in a very large extent depends on the nature of these shortcomings and from the individual characteristics of the child.
When planning simultaneous work on two or more phonemes, two requirements must be respected. First, it is impractical to select for such a function of the phonam, the articulation of which is characterized by the opposite instructions of the speech organs. This can cause interference, mutual or unilateral inhibition of the movements necessary to reproduce data by the phone ... Secondly, it is necessary to avoid simultaneous work on the phonemes, which, especially at first, is associated with high energy consideration.
Above the description of the methods of speaking sounds, it was indicated that in some cases a special articulation gymnastics is necessary. Such gymnastics may include frequent 1 exercises aimed at developing certain speech movements needed to correctly reproduce a phonam. However, in cases of complex oblique-language, covering different groups in the background associated with the overall deficiency of speech motility (for example, with different types of dysarthritia), the articulation gymnastics should be carried out on a broader program designed to work various muscular groups of the speech apparatus.
Before proceeding to the description of the methods of correcting the deficiencies of pronunciation of specific background, it should be noted that there are those that are in distorting the sound of the phonemes and those that are expressed in replacing one phone game. The disadvantages of the first type are called anthropophonic, and the second - phonological ... Along with the resistant replacement of one phoneme, other phonological defects can wear the character of mixing the phone. In this case, the child owning the articulation of the corresponding background, constantly confuses, mixes them in speech.
At the same time, it is necessary to take into account that when fixing the replacement of one phoneme, another process of fixing the newly learned articulation in speech is often conjugate with the temporary solution of these phonemes or with a phenomenon of so-called hypercorrection, when the newly learned foundation in the speech of which she herself was replaced by .
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