Massage for stutterers. Massage for stuttering in children

Massage of the articulatory apparatus

and articulation exercises

not only improve motor

the function of lagging brain systems,

but also involved in the work

nearby brain systems.

M.E. Khvattsev

Speech is one of the main higher mental functions.

Timely mastery of correct, pure speech is of great importance for the formation of a full-fledged personality. A person with a well-developed speech easily comes into contact, he can clearly express his thoughts and desires, ask questions, negotiate with partners on joint activities, lead a team. And, on the contrary, unclear speech complicates relationships with others and often leaves a heavy imprint on a person’s character. Correct, well-developed speech is one of the main indicators of a child's readiness for successful schooling. Lack of speech can lead to academic failure, give rise to a child's lack of confidence in their abilities, and this will have far-reaching consequences. Negative consequences. Therefore, it is necessary to start taking care of the correct speech of the child as early as possible. Unfortunately, there is currently a steady increase in the number of children with speech problems and underdevelopment. mental processes, somatically weakened. Speech disorders may be the result of an organic disorder of the central nature (alalia, aphasia, dysarthria, anarthria), or may be due to anatomical defects in the peripheral speech apparatus. In cases where anatomical defects occur, the disorders are organic in nature (of peripheral origin), such as rhinolalia, mechanical dyslalia; in their absence - a functional character (functional dyslalia).

Speech disorders associated with organic lesions of the central nervous system, are corrected with great difficulty and much more slowly than defects of functional origin.

Speech pathology does not exist by itself, in isolation. With the emergence of such disorders, concomitant disorders arise in parallel: various inferiority complexes, behavioral deviations, underdevelopment of mental processes (attention, memory, thinking, etc.), restrictions in choosing a profession.

Corrective work started in time can prevent the occurrence of secondary deviations. Basic, of course, are traditional pedagogical methods, but with the obligatory use of non-traditional ones.

Non-traditional methods are simple, accessible, effective, have no age limits, and a personality-oriented approach in working with a child contributes to the choice of the most optimal, effective complex methodology.

Usage non-traditional methods in a complex correctional and educational process, it improves a child's attention and memory, increases efficiency, normalizes the state of the nervous system, eliminates stress, reduces fatigue, and improves communication function.

Most of these methods came to us from ancient times. And now there is a need to take into account the observations of people verified by millennia, in particular, the impact on the somatic and mental condition baby music, colors, smells. It is known that their combination can have various effects - soothing, relaxing, tonic, stimulating, strengthening, etc. Therefore, the thoughtful use of smells (aromatherapy), colors (chromotherapy), music, sounds (music therapy, sound therapy), puppet therapy, fairy tale therapy, herbal medicine in speech therapy practice can significantly increase the effectiveness of the procedures performed, creating additional potential for the development of the child.

One of the methods of health-improving and correctional-developing measures is speech therapy massage.

Target methodological manual: to promote the formation of correct speech in a child with speech disorders through speech therapy massage.

Main tasks speech therapy massage:

Normalization of muscle tone of the general, mimic and articulatory muscles;

Reducing the manifestation of paresis and paralysis of the muscles of the articulatory apparatus;

Decreased pathological motor manifestations of the muscles of the speech apparatus (synkinesia, hyperkinesis, convulsions, etc.);

Stimulation of proprioceptive sensations;

Increase in volume and amplitude of articulatory movements;

Activation of those muscle groups of the peripheral speech apparatus that have insufficient contractile activity;

Formation of arbitrary, coordinated movements of the organs of articulation.

Although earlier in speech therapy practice elements of massage were used, but very little attention was paid to them. Pedagogical methods of influencing the speech pathologist prevailed, which, unfortunately, could not solve all the problems.

Massage is healing method, which uses mechanical energy transmitted to organs and tissues in the form of stroking, rubbing, vibration, tapping, pressure. Articulation massage has a versatile effect on the body and, above all, on the nervous system. Massage plays an important role in reducing pathological manifestations in the skin, muscles, etc., resulting in a decrease in the flow of pathological impulses to the central nervous system. In the central nervous system, conditions are created for the normalization of the relationship between the cortex, subcortex and underlying departments. It has been proven that under the influence of massage, the excitability of the nervous system can increase or decrease, depending on its functional state and method of exposure. Improve blood circulation, redox and metabolic processes in nervous tissue, which, in turn, has a positive effect on the dynamics of nervous processes. The working capacity of the muscles increases, the tone in the spastic muscles decreases and significantly increases with flaccid paresis of the articulatory muscles, pathological motor synergies, as well as synkinesia, are suppressed, relaxation of the speech muscles is achieved.

In addition, there are positive psychological changes: emotional condition, stiffness decreases, a feeling of pleasant warmth arises, and so on.

To achieve maximum efficiency during articulation massage, a speech therapist should have a good idea of ​​the mechanism of the disorder, as well as know the anatomy of the facial muscles of the face and the area of ​​\u200b\u200bthe skin nerves of the head and neck.

Stuttering is a discoordination convulsive speech disorder that occurs in the process of communication according to the mechanism of systemic motor speech neurosis, and is clinically represented by primary, speech proper, i.e. neuromotor disorders, and secondary, neurotic, disorders that often become dominant in adults. In many cases, stuttering occurs against an organic background in the form of cerebral deficiency of various origins.

Speech disorder in stuttering is expressed in violation of the coordination of speech movements with the phenomena of arrhythmia and convulsions. Violation of cortical activity is primary and leads to a breakdown in the inductive relationship between the cortex and subcortex and a violation of those conditioned reflex mechanisms that regulate the activity of subcortical formations. Due to the created conditions under which the normal regulation of the cortex is disrupted, there are negative shifts in the activity of the striopallidar system.

Striopallidum is an important part of the motor system. It is part of the extrapyramidal system. In the motor zone of the cerebral cortex, the motor - pyramidal - path begins, along which impulses follow to perform a particular movement. The extrapyramidal system, an important component of which is the striopallidum, being included in the motor pyramidal system, is involved in providing voluntary movements.

The striopallidar system is located in the subcortical region, in the thickness white matter hemispheres of the brain. This is an accumulation of gray matter, forming the so-called basal nuclei.

At a time when the cerebral cortex was not yet developed, the striopallidar system was the main motor center that determined the behavior of the animal. With the development of the cerebral cortex, the striopallidar system passed into a subordinate state. The main motor center is the cerebral cortex. The striopallidary system provides a background of "preparedness" for the movement; against this background, fast, precise, strictly differentiated movements controlled by the cerebral cortex are carried out.

To make a movement, it is necessary that some muscles contract and others relax. That is, an accurate and coordinated redistribution of muscle tone is necessary. Such a redistribution of muscle tone is precisely carried out by the striopallidar system. Improving the movement in the process of learning to fulfill them leads to their automation, to the formation of motor stereotypes. This possibility is provided by the striopallidar system.

Motor acts of the newborn are pallidary in nature: they are not coordinated, throwing and often redundant. With age, as the striatum matures, the child's movements become more economical, stingy, automated.

Stuttering is a consequence of dynamic disorders of the strio-pallidar speech regulator caused by strong, sharp emotions or anatomical and pathological brain damage. If the striatum is blocked under the influence of emotions, then the balance of the muscle tone of the articulatory apparatus, vocal and respiratory muscles is disturbed, which is expressed in the form of clonic repetitions or tonic spasm like tics. With violations of the striopallidary system, a disorder of automatism and hypertonicity of the muscles of the speech apparatus occur. Gradually, the pathological reflex is fixed as a conditioned reflex.

As a result of damage to the extrapyramidal region, subcortical dysarthria also occurs. Localization of the lesion and small neurological symptoms in stuttering served as the basis for isolating this disorder into the group of "dysrhythmic dysarthria" with predominant spastic-paretic, spastic-rigid or hyperkinetic symptoms. (Kussmaul - 1878, Gutzmann - 1882, T.G. Wiesel - 1983)

When examining the oral praxis of a stutterer, the following neurological symptoms are revealed: speed, strength, range of motion of the articulatory apparatus are limited, switching from one articulation pattern to another is difficult, hypertonicity, hypermetry, tremor of the tongue and lips, synkinesis, sometimes hypersalivation, impaired reciprocal innervation.

Neuromotor disorders in stuttering have a common pathogenetic basis with movement disorders, are characterized by diversity and stability, like any movement stereotype, fixed by time and experience.

As you know, the severity of stuttering depends on the severity of neuromotor and neurotic components. In most cases, stuttering occurs against the background of focal organic disorders and is primarily a neuromotor disorder.

Against the background of an organic lesion of the central and peripheral nervous system, the innervation of the speech apparatus is disturbed; the prosodic side of speech suffers, i.e. tempo, rhythm, melody, intonation.

Organic disorders in stuttering can occur at different levels.

So, with the defeat of the subcortical-cerebellar nuclei and pathways, changes are observed associated with an increase in muscle tone. The synchrony in the work of the articulatory, respiratory, and vocal apparatuses is disturbed; suffers reciprocal innervation (interaction of muscles of antagonists and agonists), sequence, strength, volume, speed of muscle contractions.

With extrapyramidal disorders, in addition to changes in muscle tone, violent movements (hyperkinesis) appear in the speech muscles.

When the conduction systems from the cerebral cortex to the nuclei of the cranial nerves are damaged, similar symptoms are observed in the brain stem: muscle tone increases, prosody is disturbed, unconditioned reflexes increase, additional reflexes appear.

At the level of peripheral motor nerves innervating the muscles of the speech apparatus (tongue, lips, cheeks, soft palate, lower jaw, pharynx, larynx, diaphragm, chest) metabolic processes are disturbed, the intake of nerve impulses to the muscles, some reflexes disappear. The volume of voluntary movements is limited, with a significant increase in tone in certain muscle groups, an increase in tone is observed.

Against the background of these organic disorders, respiratory, vocal, and articulatory convulsions occur.

RESPIRATORY spasms include inspiratory spasm, expiratory and respiratory or rhythmic.

An inspiratory cramp occurs on inspiration. characteristic feature is a sudden convulsive breath that occurs before the beginning, in the middle of a word, among two sounds of one word. Inspiratory convulsions may follow one another directly without being interrupted by exhalation. Exhalation occurs with the end of the inspiratory spasm, suddenly and inconsistently with the respiratory rhythm.

An expiratory spasm occurs on expiration, more often in the process of speech utterance. For expiratory cramps, pronounced sudden and strong contractions of the abdominal muscles are characteristic. In this case, subjectively there is a painful sensation of unusual compression of the chest.

Respiratory spasm - repeatedly repeated inhalation-exhalation before the beginning of a phrase, phrase, word.

Closing vocal spasm occurs suddenly, stopping voice delivery. It is tonic in type. The glottis is closed, the abdominal muscles are tense, during the entire time of the spasm the air stream exerts pressure on the larynx. Subjectively, there is a feeling of an obstacle when trying to speak in the larynx.

Vocal vocal spasm - is the most painful for the patient, occurs as a result of increased tone of the vocal muscles and involuntary work of the vocal cords. Often this changes the timbre, the pitch of the voice. The voice acquires a bizarre falsetto-like sound.

Tremulous or jerky laryngeal spasm - a spasm is clonic in type. The glottis closes and then opens. There is a trembling sound that is difficult to describe: sometimes it resembles the bleating of a goat, gargling, groaning, etc.

PASSIONS OF THE ARTICULATION APPARATUS - distinguish between facial and lingual spasms. Facial cramps:

The closure cramp of the lips is limited to the circular I muscle of the mouth, is tonic in type; occurs when pronouncing words that begin with labial sounds (n, b, m, c, f);

The labial cramp raises the upper lip and wing of the nose, is tonic in type, a grin appears, disfiguring the face; can be both unilateral and bilateral;

Lower labial cramp - similar to upper labial;

An angular cramp distorts the mouth in the direction of the cramp, radiates to the wings of the nose, the muscles of the eyelids and forehead, the activity of the circular muscle of the mouth is disrupted;

Convulsive opening oral cavity("gaping spasm") - keeps the mouth open for a long time, is tonic in nature.

Tongue cramps:

Convulsive lifting of the tip of the tongue;

Convulsive lifting of the back and root of the tongue;

Sublingual spasm is associated with irradiation of the tone of the tongue;

An expelling spasm of the tongue occurs as a result of tonic or clonic tension of the muscles that push the tongue into the space between the teeth;

Spasm of the soft palate leads to nasalization and palatalization.

Seizures can be expressed both in clonic and tonic types.

During corrective work with children and adults suffering from stuttering, along with speech therapy classes, medication and physiotherapy, a differentiated articulatory massage is carried out.

Against the background of massage, various forms of speech therapy work are carried out: breathing exercises, voice exercises, logarithmic work, etc.

Since articulation massage is of great importance in normalizing the functional state of higher nervous activity child, insofar as it is advisable to start each individual lesson with an articulatory massage. It is expedient to carry it out to calm melodic music, preferably piano.

If a stutterer has pronounced subcortical symptoms with predominant tonic convulsions in violation of switchability and smoothness of movements, slowing down their pace and rhythm, limiting the range of movements of the tongue, the main purpose of the massage is a calming, relaxing effect on the nerve endings. Techniques aimed at improving blood circulation are applied very carefully, always alternating with relaxing, stroking movements.

If stutterers have signs of damage to the corticonuclear pathways (spasticity of the articulatory muscles, limitation of the range of voluntary movements, tremor of the lips, tongue, expelling spasm of the tongue), in these cases, the main goal of massage techniques, in addition to relaxation, is to increase receptor activity. This, in turn, causes the appearance of impulses that reach the corresponding centers of the brain with subsequent regulation of afferent impulses.

Stroking, point vibration, and sometimes kneading techniques are mainly used. At the same time, metabolic processes improve, muscle performance increases. Differentiated afferentation should be applied by a speech therapist to the muscles of the palpebral fissure, oral cavity, chewing muscles, external and internal muscles of the tongue.

After massage, there is a decrease in the tone of spastic muscles and an increase in it in patients with flaccid paresis. Muscle changes indicate an increase in lability, a stimulating effect of procedures on functional state neuromuscular apparatus, which could be due to a violation of trophism and suprasegmental influences.

If a stutterer has hyperkinetic symptoms: changing muscle tone, violent movements, a violation of reciprocal innervation, a sharp increase in tone in a state of excitement, in connection with which the rhythm and pace of speech are sharply disturbed, and convulsions are clonic or clonotonic in nature, massage techniques should be light. Used mainly stroking, aimed at relaxation. You should stroke the muscles of the neck, neck, shoulder girdle, chest, lateral muscles torso.

With selective unilateral paresis, against the background of a relaxing, soothing massage, work is also carried out using rubbing, kneading, jerky and vibrating massage techniques. Thus, the contractile function of individual muscle groups improves, massage movements cause hyperemia, increase blood supply, and activate afferent impulses.

Let us dwell on the technical side of the massage. The hands of a speech therapist should be clean, warm, without abrasions, scratches or any foci of inflammation, with short-cut nails, without jewelry that interferes with the massage. Hands before the massage procedure can be treated with "Children's" cream. Articulation massage is carried out in a clean, comfortable, warm, well-ventilated area. The child can lie on the couch or sit on a chair with a comfortable back; speech therapist is behind him.

The main massage technique is stroking, a mandatory technique with which each procedure begins. This technique alternates with others and completes each massage complex. When stroking, blood circulation increases in superficially located vessels and even in vessels remote from the massaged area; muscle tone decreases, breathing slows down, which in itself is regarded as a manifestation of the processes of inhibition of the higher parts of the central nervous system, followed by a decrease in excitability. Along with this, deeper and more vigorous stroking has a stimulating effect on the central nervous system.

Relaxation of the muscles of the articulatory apparatus begins with the so-called "general muscle relaxation", namely, with the relaxation of the neck, chest muscles, muscles of the arms, shoulder girdle. Then the specialist conducts a relaxing facial muscle massage. Hand movements should be light, gentle, sliding, soothing, matching the musical accompaniment.

Superficial stroking is a soft, "sparing" technique. The specialist's palms should be as relaxed as possible. This technique is used to reduce the tone of the articulatory muscles.

Deep stroking is a more intense technique. It is used to influence the receptors of deeply embedded muscles and blood vessels.

Rubbing - is performed using a significant pressure force on the massaged area. It significantly enhances blood circulation, metabolic and trophic processes in tissues, the contractile function of muscles, and increases tone.

Intermittent vibration or thumping - exerts different action. Weak tapping increases muscle tone, while strong or "staccato" reduces increased tone muscles and nerve excitability.

Tight pressing - improves blood circulation, lymph circulation, metabolic processes, enhances motor reflexes, significantly increases muscle tone.

Since during stuttering there is an increased tone in the articulatory and facial muscles, each massage technique must be completed with stroking.

Speech therapy massage and articulation exercises contribute to the normalization of muscle tone, strengthening the muscles of the articulatory apparatus, improving kinesthetic and dynamic praxis, developing strength, mobility and differentiation of the movements of the organs involved in the speech process.

References:

1. Shevtsova E.E. Articulatory massage for stuttering Creative Center V. Sekachev Moscow 2006

2. Shafeeva A. A Speech therapy massage Methodological guide

Speech therapy massage for stuttering is carried out along with speech therapy classes, psychotherapeutic, drug and physiotherapeutic effects. Speech therapy massage, as a rule, precedes other speech therapy techniques used in the classroom.

Massage is performed mainly in the head, neck and upper shoulder girdle. When conducting speech therapy massage, a speech therapist should have a good idea of ​​the mechanism of the disorder, as well as know the anatomy of the facial and articulatory muscles, neck muscles, as well as the area of ​​\u200b\u200bdistribution of the cranial nerves. In particular, it is important to clearly represent the area of ​​​​innervation of the trigeminal and facial nerves.

When stuttering, it is customary to use mainly two types of massage: segmental and acupressure, as well as their combinations.

Segmental massage technique

Segmental massage allows you to act in isolation on individual muscles that provide speech activity.

Massage is carried out in a clean, comfortable, warm and well-ventilated room.

The hands of a speech therapist should be clean, warm, without abrasions, scratches or any foci of inflammation, with short-cut nails, without jewelry that interferes with the massage. Before massage, hands can be lightly smeared with “Baby” cream or “Baby powder” can be used.

Massage is recommended to be carried out daily or every other day. Usually appoint 10-20 procedures. The duration of the procedure may vary depending on the age of the patient and neurological symptoms. Usually massage starts from 5-7 minutes and can be extended up to 20-25 minutes. In the chronic course of stuttering, repeated courses of massage are recommended.

Massage should begin with the adoption of the correct posture, or posture of rest. Adopting the correct posture helps to relax the muscles and does not make it difficult to breathe.

You can precede the beginning of the massage with phrases that contribute to calm, relaxation.

“Calm down, relax. Breathing is even, calm, rhythmic. You are calm and relaxed. The eyes are closed. Breathe easily and freely. Your muscles are relaxed. Are you resting. You are well and calm.” The voice of the speech therapist should be quiet, soft, soothing.

The following body positions are optimal for segmental massage:

1. the position of the stutterer on the back, arms along the body, legs lie freely, socks are somewhat apart. Under the head is a small flat pillow that reaches the upper edge of the shoulder blades. The specialist takes a position behind the patient's head.

2. posture - half-sitting, in a chair with a high headrest. The specialist takes a position behind the patient.

The main techniques of segmental massage:

1. stroking: a) superficial stroking;

b) deep covering stroking.

2. rubbing.

3. kneading.

4.vibration or tapping.

5. tight pressing.

1. Stroking. This is a mandatory reception with which each procedure begins. It alternates with other techniques and finishes each massage complex. The significance of the reception is as follows: when stroking, blood circulation in superficially located vessels increases, muscle tone decreases, breathing is regulated.

The movements are carried out with a straightened brush, the first finger is abducted, the rest are bent. The applied force should not cause displacement of the skin.

Stroking is divided into superficial and deep (covering). As an auxiliary technique, “rake-like” stroking is used.

a) superficial stroking

This is the most gentle, gentle reception. The specialist's palms are relaxed. The technique is used to reduce the tone of the muscles of the facial and articulatory muscles.

b) Deep stroking - a more intense technique. It is used to influence the receptors of deeply embedded muscles and blood vessels, thereby exerting some stimulating effect on the central nervous system. Deep stroking should be carried out in the muscles available for isolated exposure.

c) "Rake" stroking is mainly used for scalp massage. When performing this movement, the fingers are widely separated. Reception is performed with fingertips in the longitudinal, transverse, zigzag and circular directions.

2. Rubbing - is performed using a significant pressure force on the massaged area, which causes displacement and stretching of the massaged tissues. It significantly enhances blood circulation, metabolic and trophic processes in tissues, the contractile function of muscles, and increases tone. Reception is performed with the fingertips, the edge of the palm or the entire palmar surface. The movement is carried out in a straight or spiral direction.

3. Kneading - maximally activates the work of the muscles. It is carried out by shifting, stretching, kneading tissues. Massage movements are performed in longitudinal, transverse, but more often in spiral directions.

4. Vibration or tapping. Has a different effect. A strong, hard vibration increases muscle tone, and a light, weak vibration reduces their tone.

Vibration is received by one, two or all fingers, giving the tissues oscillatory movements of various frequencies and amplitudes. Movements can be carried out with one hand, two hands simultaneously or sequentially in parallel from two sides. Vibration changes interstitial metabolism, improves tissue trophism.

5. Firm pressing. Improves blood circulation, lymph circulation, metabolic processes. It can be used at the exit points of bundles of nerve endings. These are the so-called "biologically active points". As a rule, any stroking ends with a tight pressing of these places.

The choice of massage techniques is differentiated, depending on the distribution of muscle tone.

When stuttering, techniques such as: superficial covering stroking, weak vibration and tight pressing are mainly used. Other methods are used to a lesser extent.

On one's own individual tricks in the practice of massage, as a rule, they are not used, but are used in the form of complexes of techniques.

Diagnostics of the state of the muscles

For right choice techniques and dosage of corrective speech therapy massage for stuttering, it is necessary to determine the state of muscle tone:

Muscles of the neck and upper shoulder girdle;

Mimic muscles;

Articulatory muscles;

Muscles of the tongue.

This is established by: a) inspection; b) palpation; c) performance of dynamic and static exercises used in the examination of the condition of the indicated muscle groups of the patient.

It is necessary to take into account the emotional state of the stutterer and his personality traits.

General instructions for a relaxing massage

1. Massage is performed at a slow pace.

2. Muscle relaxation is promoted by musical accompaniment (quiet music with a slow, smooth rhythm) or pronunciation by a speech therapist who conducts massage, calmness formulas of autogenic training.

3. Massage should evoke pleasant sensations of warmth and peace in the stutterer.

4. The masseur's hands must be warm.

Relaxation of the neck muscles

Stutterers often have a pronounced tone in the muscles of the neck and upper shoulder girdle. Relaxation of the neck muscles reflexively reduces the tone of the tongue root, promotes the activation of the movements of the lower jaw (removal of “muscle clamps”).

1) Slowly stroke your neck with your palms

both hands from top to bottom:

a) in the throat area alternately with the right, then with the left hand (avoiding pressure on the thyroid gland area);

b) from the parotid region of the face along the lateral surface of the neck to the armpit (relieves tone from the sternocleidomastoid muscle). 2) Put both hands on the back of the neck, close to the back of the head, hands slide along the side of the neck down to the armpit (remove the tone from the trapezoid muscle).

Additionally, after the massage, you can use exercises that help relax the neck muscles:

a) the head was dropped forward - “fell asleep”;

b) the head is slightly thrown back; from this position of movement to the right, left and down.

c) the head was lowered, then “dropped”.

Relaxation of the facial muscles

1) Massage starts from the middle of the forehead towards the temples (Fig. 1).

Variant of movement: from the middle of the forehead to the auricles (Fig. 1a).

2) The second direction of relaxing massage is the movement from the eyebrows to the scalp. Movements are made with both hands evenly on both sides (Fig. 2).

At the end points of the movement, a slight pressure is applied with the fingers.

3. Movement from the chin on both sides to the temporal cavities, with fixation of the fingers in the recesses near the tragus and earlobe (Fig. 3).

4. Movement from the back of the nose to the auricle (Fig. 4).

5. Movement from the middle upper lip before auricles(Fig. 5).

6. Movement from the midline of the forehead down through the temporal cavities along the cheeks to the middle of the chin (Fig. 6).

7. Stroking from the middle of the chin along the lower lip, along the nasolabial fold, along the lateral surfaces of the nose through the bridge of the nose to the middle of the forehead and along the forehead to the temporal cavities, finish the movement by lightly pressing the skin (Fig. 7).

These movements are performed mainly with the index, middle and ring fingers. Each movement ends with a slight pressure with the fingertips at the fixed points of the end of the movement. Movements No. 3, 4, 5 are repeated using light vibration technique.

Massage to relax the circular muscle of the eye

1. Stroking with the pads of the second and third fingers of both hands; simultaneously slide from the temple along lower eyelid to the inner corner of the eye. Having reached the inner corners of the eyes, it is easy to slide the second and third fingers along the eyebrow towards the temple. Finish the movement by lightly pressing the skin on the temples (Fig. 8).

2. Stroking the circular muscles of the eyes. With the pads of the fourth fingers of both hands, simultaneously stroke from the temple along the lower eyelid to the inner corner of the eye. Then smoothly move to the upper eyelid and stroke it very easily, without pressing on the eyeball (Fig. 9).

Relaxing lip muscle massage

Light movements are carried out in the following directions:

1. Along the upper lip from the corner of the mouth to the middle (Fig. 10).

2. Along the lower lip from the corner of the mouth to the middle (Fig. 11).

3. From the middle of the upper lip to the chin (Fig. 12).

4. The speech therapist places the index and middle fingers near the corners of the mouth and slightly stretches the lips, as if smiling. With a reverse movement, the lips return to their original position. The movements are light and smooth (Fig. 13).

5. Stroking the nasolabial folds from the wings of the nose to the corners of the mouth (Fig. 14).

6. With the second and third fingers, light tapping of the circular muscle of the lips clockwise (Fig. 15).

Massage movements are carried out with a different position of the mouth: closed, and slightly ajar.

Larynx massage

Carefully grab the larynx with the thumb, as well as with the index and middle fingers, and make light rhythmic movements in the transverse direction. During the massage, a stutterer can sing vowel sounds.

The sequence of impact on the massaged areas during one massage session can be as follows:

1) neck muscles;

2) muscles of the upper shoulder girdle;

3) mimic muscles;

4) muscles of the lips;

5) region of the larynx.

With stutterers, mainly massage is carried out, aimed at relaxing the muscles and eliminating the so-called muscle clamps.

This type of massage (relaxing) has a beneficial effect, mainly on stutterers with a neurotic form of speech pathology.

With a neurosis-like form of stuttering, residual paretic

phenomena in the articulatory muscles, which can be expressed both by spasticity and flaccidity of the articulatory muscles.

In particular, these phenomena are often observed in the muscles of the tongue. In these cases, a special differentiated massage of the affected muscles is included in the complex of massage movements.

Method of acupressure (Massage of biologically active points)

Impact on biologically active points (BAP) is one of the methods of reflex therapy.

The main purpose of a special acupressure for stuttering is:

Relaxation of the muscles that ensure the functioning of the vocal, respiratory and articulatory apparatus;

Normalization of the emotional state of stutterers.

By pressing the BAP, certain reflex reactions are caused in the corresponding organs or muscles.

One of the conditions for the effectiveness of acupressure is the correct determination of the localization of a biologically active point (BAP).

When determining the desired point, various anatomical formations serve as reference points: cavities, muscles, tendons, bones, etc.

Acupressure techniques for children are the same as for adults, but pressure on the points should not be intense.

The basic techniques of acupressure

There are two main methods for correcting stuttering:

1. Stroking - with the pad of the index, middle or ring fingers circular motions in the BAP area, while the applied force should not cause tissue displacement.

The movement should be slow and continuous, which helps to relax the muscles.

2. Kneading - produce a rotational movement with pressure, the finger should not move from the projection of the point. Rotation speed 30-60 rpm.

Since for stutterers the main task is to relax the muscles involved in the speech process, the impact on the point is made as follows: pressing on the point with the fingertip is easy, rotational movements should be slow, smooth, clockwise, about 30 seconds with a gradual increase in pressure . Then you should slightly weaken the force of pressure. Without removing your finger, you can stop for 1-2 seconds and repeat the movements 3-4 times, so that the impact on one point can last for 3-5 minutes. After the finger is removed from the point, there should not be a noticeable hole in the skin.

Let's consider BAP in a complex according to the principle of influence:

BAT 1 complex - relieving tension from the muscles of the articulatory muscles (Fig. 16):

a) a single point under the nose in the upper third of the vertical furrow on the upper lip;

b) a single point in the center of the chin-labial fold;

c) paired points outward from the corner of the mouth by 1 cm, on a vertical line from the pupil;

The BAP 2 complex is associated with the condition of the muscles of the pharynx and larynx. Helps relieve tension from the vocal apparatus (Fig. 17):

a) a point on the midline of the neck, between the lower edge of the body of the hyoid bone and the upper notch of the thyroid cartilage;

b) a point about 0.7 cm above the upper edge of the jugular notch of the sternum.

BAP 3 - associated with the state of the muscles of the pharynx, larynx and root of the tongue, promotes relaxation of these muscles (Fig. 18). Massage gently, as discomfort easily arises.

The point is located on the midline of the neck or in the middle of the upper edge of the hyoid bone.

BAP 4 - helps to relieve tension from the muscles of the lower jaw (Fig. 19).

Point in the middle of the most protruding part of the chin.

BAT 5 complex - helps to relieve tension from the muscles of the lower jaw (Fig. 20):

a) paired points anterior to the tragus of the ear, in the cavity, which is formed by the lower edge zygomatic bone and notch of the lower jaw;

b) paired points at the level of the lower edge of the attachment of the earlobe.

The BAT 6 complex is aimed at regulating the rhythm of breathing and relieving tension from the muscles of the upper shoulder girdle (Fig. 21):

a) the point is at the level of the palm attached to the collarbones;

b) a point at the level of the location of the nipples in the center of the sternum;

c) paired points are in the resulting recess at the position of the reduced shoulders.

BAT 7 complex - points of general action, affect the muscles of the vocal apparatus, increase efficiency in case of mental fatigue (Fig. 22):

a) paired points below the upper edge of the lateral condyle of the tibial bone by 4 transverse fingers at the anterior edge of the tibial muscle;

b) paired points between the I and II metacarpal bones, closer to the middle of the II metacarpal bone, in the fossa.

BAT 8 - “point of life”.

A single point on the crown of the head, closer to the crown, in the cavity on the “straight parting” - where it will be crossed by a line drawn from ear to ear vertically upward through the upper points of the auricles (Fig. 23).

When conducting acupressure, the following should be considered:

1) In the first sessions, no more than 3-4 points are massaged, gradually increasing their number.

2) Symmetrical points are massaged in pairs and simultaneously.

4) Massage, as a rule, precedes a speech therapy session.

In rare cases, it may constitute the final stage of the lesson.

5) Massage is recommended to be carried out in a course: between the 1st and 2nd course there is a break of 2 weeks; between 2 and 3 the break can be about 3 months. Courses are repeated every 3-6 months. Procedures should be carried out every other day. The break between massage sessions conducted by the course should not exceed 3 days.

6) The child during acupressure should be relaxed and calm. Acupressure for stuttering is useful to carry out against the background of relaxation. For this purpose, you can use specially selected music, as well as massage against the background of autogenic training.

To date, logoneurosis has been successfully treated by specialists in both children and adult patients. Massage for stuttering is carried out by a specialist using a specific technique. He is assigned to complex therapy to eliminate a speech defect, consisting of individual lessons, physiotherapy, respiratory and mimic gymnastics and medication, and is called speech therapy.

The effectiveness of the procedure

Most often, stuttering occurs in children aged 3 to 5 years and is caused by neurotic disorders, although there are individual cases. Sometimes the cause is physiological problems with the speech apparatus. The brain and articulatory organs are not affected. The sooner a problem is treated, the more likely it is to be cured. In adults, the course of massage to achieve the result is longer.

The mechanism of influence of the procedure on speech apparatus looks like this: with a tactile effect on the back, head, neck, shoulders, chest and collar zone, a positive effect on speech activity is exerted, tension is removed from the muscles, and the overall tone of the body increases. A person who suffers from stuttering has excessive tension in the neck and shoulder girdle muscles. With a tactile effect on the zones, the specialist manages to achieve relaxation of the root of the patient's tongue, which contributes to healing.

There are practically no cases when speech therapy massage would be contraindicated.

It is effective at any age, improvements are noticeable immediately after the first session.

by the most effective types procedures for stuttering are recognized as segmental and acupressure massages. The combination of techniques is also practiced in medical therapy.

Point technique

The advantage of this massage technique is high efficiency with relative ease of implementation. Even a non-professional can carry it out at home: a visual consultation with a specialist or watching a training video is enough. The main thing is to master the technique of execution, the procedure for conducting and identify specific points of influence. Depending on the degree and nature of the speech impairment, some acupressure techniques will change, and the effect of exposure may also be different. The general provisions of acupressure in the treatment of stuttering are as follows:

• tool - fingertips, which perform circular pressing on the main points;
• the number of points is 17, they are located on the back and neck;
• the course consists of 15-16 sessions;
• frequency of procedures - daily the first 5-6 times, then - every other day;
• the course is repeated after 3 months, in total there should be 3-4 (depending on the severity of the problem and the dynamics of therapy).

Highly recommended to go full course treatment with acupressure for stuttering, even if it seems that the result has already been achieved. It is necessary to fix the rendered effect. If an exacerbation occurs between courses and stuttering intensifies, you should not pause - immediately proceed to the next step.

Biologically active points on the body

The room for the procedure should be warm, but ventilated, clean. It is important that the patient feels comfortable in it, can relax. This is especially true for young patients: it is necessary that the child is not afraid of a speech therapist. You can not force him to massage by force. Before the session, the specialist washes his hands and puts on comfortable clothes.

Execution technique

Acupuncture massage will save you from stuttering with its calming property. Pressing is performed slowly and smoothly, using two fingers: thumb and middle / index. Then, for half a minute, circular movements are made clockwise with increased pressure on the point so that a hole forms. As soon as the place of pressing is fully restored, you can press again. In just 5 minutes, 4-5 clicks occur. Sudden movements and shocks are not allowed. If 2 points are massaged at once, this should be done synchronously.

To find the desired point, you should alternately press in a dotted manner on different areas, feeling the skin with your fingertips. If the patient feels pain or aches, the performer is on the right track. You need to act carefully and gently. If dizziness occurs, the procedure is stopped.

During the massage of the mouth area, the patient should open it slightly, while rubbing the larynx, the patient pronounces any vowel sound. The main thing is to achieve maximum relaxation in the process.

It is undesirable to conduct a session on an empty and full stomach, after drinking coffee, strong tea, especially alcohol.

Segmental massage

The task of this type of massage is to act on the muscle responsible for the process of speech in humans. The course of treatment lasts 2-3 weeks (depending on the specific case), sessions are carried out daily, starting from 5 minutes. classes, the duration is gradually brought to 20 minutes. Segmental massage is also considered quite effective method treatment of a speech problem. At chronic form disease courses of treatment are repeated during exacerbations.

Carrying out algorithm

The specialist must help the patient to relax - this is very important for the success of the case. The posture he occupies should be comfortable, conducive to maximum relaxation. The following positions are recommended: lying on your back, straightening your legs and stretching your arms along the body, half-sitting, in a chair with a high back. The performer is located behind the head of the patient.

Segmental massage techniques are an important component of the effectiveness of the procedure.

• stroking before the start of the process, during it and at the end to relax the area;
• rubbing activates blood circulation, normalizes metabolic processes;
• kneading enhance muscle processes;
• pressing improves metabolism;
• vibrations/tingles regulate muscle tone.

Conclusion

With the help of speech therapy massage for stuttering, it is possible to establish neuralgic processes in the body. This will be an important part of therapy on the way to fixing the problem.

Stuttering is a speech disorder resulting from mental trauma. The use of acupressure in this type of disease does not lead to complete cure, but the impact on the following points can greatly alleviate the patient's condition (Fig. 1).

Point 1. Symmetrical, located on the inside of the arm on the wrist between the tendons. The patient sits with his hand on the table, palm up. The point is massaged alternately to the right and left.

Point 2. Symmetrical, located on the inside of the forearm 2 cun above the middle crease of the wrist. Massaged like point 1.

Point 3. Symmetrical, located on the outer side of the shoulder 1 cun above the elbow crease of the unbent arm. The patient sits with his hand down. The point is massaged alternately to the right and left.

Point 4. Symmetrical, located on the lower leg 3 cun below the patella and 1 cun back from the anterior edge of the tibia. The patient sits with legs stretched out. The point is massaged simultaneously on both sides.

Point 5. Symmetrical, located on the back one and a half cun away from the posterior midline at the level of the gap between the spinous processes of the V and VI thoracic vertebrae. The patient sits, slightly leaning forward. The point is massaged simultaneously to the right and left.

Point 6. Symmetrical, located on the face in a recess above the zygomatic arch at the base of the ear. The patient sits with his elbows on the table. The point is massaged simultaneously on both sides.

Point 7. Symmetrical, located on the lower leg 3 cun above the inner ankle. The patient is sitting. The point is massaged simultaneously on both sides.

Point 8. Symmetrical, located on the forearm one and a half cun above the middle crease of the wrist, in a depression. The patient sits with his hand on the table. The point is massaged alternately to the right and left.

Point 9. Asymmetrical, located on the posterior midline on the lower border of the scalp. The patient sits with his head tilted slightly.

Point 10. Symmetrical, located on the hand on the border of the inner and outer sides of the palm near the little finger. The patient sits with a slightly bent hand on the table, palm down. The point is massaged alternately to the right and left.

Notes:

* Massage (except point 10) is performed with a soothing method with using a lung pressure. The duration of exposure to each point is 3 minutes or more.

* Point 10 is massaged with a tonic method using deep pressure. The duration of exposure to the point is 0.5-1 min.

* The massage course consists of 12 sessions held every day. If necessary, you can conduct another 2-3 courses with an interval of one week.