Systemic underdevelopment of speech in a child with dysarthria. "Systemic speech disorder: alalia
Systemic speech underdevelopment (SNR) is a complex of speech behavior disorders, in which there is a dysfunction of language components: phonemic and grammatical development, lexical area.
The diagnosis of “Systemic underdevelopment of speech” is made to a child after 5 years.
Causes of systemic underdevelopment of speech
A number of reasons can lead to the development of systemic underdevelopment of speech in children. They are divided into internal and external. The internal ones include fetal hypoxia, severe toxicosis, pregnancy at a too young or vice versa late age, various maternal diseases, including gynecological ones, abortions, and of course the use of toxins, drugs, alcohol, and smoking. Also, systemic underdevelopment of speech is observed in children who were injured during the birth process. External causes - a number of diseases and injuries received by the child in the first years of life. These include severe cases of SARS, asthenia, various pathologies of the central nervous system, cerebral palsy, rickets. The environment surrounding the baby can also make its “contribution” to the development of CHS: an incorrectly chosen method of education, constant stress within the family, excessive pressure on the child or neglect of his requirements, lack of communication. The child may imitate the lisping manner of communication towards himself. Hence the incorrect pronunciation of individual sounds and words.
Delayed speech development may be the result of improper functioning of other body systems. This is a violation of the functioning of the hearing organs, autism or mental retardation. The first signs of impaired speech development are observed even in infancy: the baby reacts poorly to the appeals of adults, does not strive to imitate them, does not make any sounds, cannot point a finger at an object of interest to him.
Symptoms of systemic underdevelopment of speech
With CHP, the child's speech is confused, illogical, with many sound errors. The child begins to speak much later than his peers, at 4-5 years old. It is at this age that the baby pronounces his first meaningful word. But for the most part, the speech of the child remains incomprehensible even to parents. Slurred speech persists up to 5-6 years of age. The child understands the essence of words and phrases, but cannot give an answer or express his point of view.
Forms of systemic underdevelopment of speech
A mild degree of systemic underdevelopment of speech is characterized by minor disturbances in sound pronunciation. The child begins to stutter only when he tries to say a complex phrase. He loses secondary semantic lines in an attempt to convey the main idea. The kid cannot appeal with prepositions, “loses” conjunctions, does not always build the “noun-adjective” chain correctly, gets confused in quantitative characteristics. Vocabulary is less than that of peers.
With an average degree of systemic underdevelopment of speech, the child “floats” in cases, childbirth, does not coordinate them with each other. As for speech, the violation is fixed only when trying to pronounce the sounds of one group. Complex everyday words remain an unconquered peak for the baby. Words united by one semantic line, the child designates with one word. For example, a sofa, a wardrobe, a TV, a carpet are all “home”.
Severe form of systemic underdevelopment of speech.
The child cannot form a phrase from words, hence incoherent speech. One sound can mean both “mother” and “eat”. The problem is the pronunciation of several sound groups at once: voiced, deaf, hissing, voiced - all are pronounced incorrectly. The child is slow in perceiving speech. In speech there are incorrect use of cases, numbers.
Systemic underdevelopment of speech against the background of mental retardation is complemented by increased physical activity, inability to concentrate, and poor memory.
Why parents choose ACME Center
For more than 10 years, the Akme Center has been helping young patients get rid of the diagnosis of “systemic speech underdevelopment”, providing a full range of services for a speedy recovery.
Any work begins with a diagnosis. All the necessary specialists are connected to its setting. The Akme Center employs highly qualified speech therapists, neurologists, psychologists, speech pathologists and other related specialists with vast experience. After the diagnosis is confirmed, painstaking work begins on the development of a rehabilitation and recovery program: a recovery plan is drawn up individually for each patient based on age indicators. The individual psychological traits of the patient are also taken into account.
Treatment begins from the first minutes of the child's stay at the Center. Having crossed the threshold, the baby is surrounded by warmth and care. No white coats and hospital corridors. Mom is always there. The child does not feel fear of the doctor, because our specialists never put pressure on patients. Classes are held in a playful way and at first are always aimed at establishing a trusting relationship with the patient.
The Akme Center works according to its own author's methodology, which does not involve the use of medicines. Medicines can be prescribed by a doctor only in exceptional cases and as an element indispensable for recovery.
The treatment process at the Akme Center is not only the work of a doctor and a patient, but also the active participation of the parents and relatives of the child. “Homework” is as important as the treatment process within the walls of the Center, so our specialists always support the desire and zeal of parents to help their child.
More than a thousand patients have become full members of society, got rid of the fear of communication and complexes. Babies who have undergone a course of treatment at the Akme Center live a full life of a healthy child.
If your little one needs help and support, call us at 8-495-792-1202 or fill out the form below and we'll call you back within 15 minutes.
ACME Center - we work to bring harmony and happiness to your family!
CLASSIFICATIONS OF SPEECH DISORDERSTo date, a unified classification of speech disorders has not been developed, although numerous attempts have been made to create one (M. E. Khvattsev, O. V. Pravdina, R. A. Belova-David, M. Zeeman, R. E. Levina, F. A. .Rau, S.S. Lyapidevsky, B.M. Grinshpun and others). Difficulties in the classification of speech disorders are due, on the one hand, to the fact that the mechanisms for generating speech and voice are to a certain extent not specific, but organs and systems adapted to provide speech function, initially solving other physiological problems. On the other hand, speech activity is integrative in nature, and its disorders reflect the developmental features of other higher mental functions (primarily thinking and perception), which makes it difficult to isolate speech pathology into a separate category.
For practical purposes, Russian speech therapy traditionally uses two typologies of speech disorders, built on different principles: clinical and pedagogical and psychological and pedagogical.
Clinical and pedagogical classification(F.A. Rau, M.E. Khvattsev, O.V. Pravdina, S.S. Lyapidevsky, B.M. Grinshpun) is built on the principle of “from general to particular”, i.e. follows the path of detailing speech violations. This classification, in fact, is a significantly revised and supplemented classification of the German neurologist Adolf Kussmaul, which he began to develop in 1877. It is based on the etiology and pathogenesis of speech disorders.
All types of speech disorders considered in the clinical and pedagogical classification are divided into two large groups depending on what type of speech is impaired (oral or written). Disorders of oral speech (a total of nine are described), in turn, are classified into two types: disorders of the phonation (external) design of the statement, which are called violations of the pronunciation side of speech, and disorders of the structural-semantic (internal) design of the statement, which are called systemic in speech therapy. or polymorphic speech disorders.
Disorders of written speech (there are two of them in this classification) are divided into two groups depending on what type of written speech is violated: in violation of the productive type - writing disorders, in violation of receptive written activity - reading disorders.
Psychological and pedagogical classification(RE Levina) is built on the principle of grouping from the particular to the general; speech disorders are classified by the author, taking into account the more effective organization of corrective work with preschool children. This classification does not reflect the etiology and pathogenesis of speech disorders, but is based on linguistic and psychological criteria, among which, first of all, the structural components of the speech system (sound side, grammatical structure, vocabulary), functional aspects of speech, the ratio of types of speech activity (oral and written).
However, there are other approaches to the typology of speech disorders. In accordance with the Order of the Ministry of Health of Russia dated 27.05.97. No. 170 was introduced into healthcare practice throughout the Russian Federation in 1999 International Statistical Classification of Diseases and Related Health Problems(English International Statistical Classification of Diseases and Related Health Problems) is a normative document that ensures the unity of methodological approaches and international comparability of materials. The International Classification of Diseases of the Tenth Revision (ICD-10, ICD-10) is currently in force.
CLINICAL AND PEDAGOGICAL CLASSIFICATION AND ICD-10
Let us consider the correlation of each type of speech pathology described in the clinical and pedagogical classification with a similar speech pathology according to ICD-10.
Disorders of phonation (external) design, which can be observed both in isolation and in various combinations, are divided into groups depending on the disturbed link: voice formation; tempo-rhythmic organization of the utterance; intonation-melodic organization of the utterance; sound organization.
Violations of the tempo-rhythmic organization of speech
1. Bradilalia - pathologically slow rate of speech, which manifests itself in the slow implementation of the articulatory speech program. Bradilalia is centrally conditioned and can be both organic and functional. In the pathogenesis of bradilalia, the pathological intensification of the inhibitory process, which begins to dominate the process of excitation, is of great importance (ME Khvattsev).
In ICD-10, bradylalia is not singled out as an independent nosological unit and, accordingly, does not have a statistical code in ICD-10.
2 .tahilalia - a pathologically accelerated rate of speech, which manifests itself in the accelerated implementation of the articulatory speech program. Tachilalia is centrally conditioned and can be both organic and functional.
In cases where pathologically accelerated speech is accompanied by unreasonable pauses, hesitations, stumbling, it is denoted by the term poltern.
In ICD-10, takhilalia corresponds to code F98.6 Speech excitedly. Diagnostic criteria - a fast pace of speech with fluency disorder, but without repetition or hesitancy in such a way that the intelligibility of speech is reduced - meet the diagnostic criteria for takhilalia. Dysrhythmic speech is usually punctuated by "stops and bursts of speech".
F98.6 includes:
Tahilalia;
poltern.
Excluded:
Stuttering (F98.5);
Tiki (F95.x);
Neurological disorders causing speech dysrhythmias (G00 - G99);
Obsessive-compulsive disorders (F42.x).
3.Stuttering - violation of the tempo-rhythmic organization of speech, due to the convulsive state of the muscles of the speech apparatus. The main symptom of stuttering is speech convulsions that occur during oral speech or when trying to start it, which are distinguished by type (tonic, clonic, tono-clonic, clonotonic); localization (respiratory, vocal, articulatory) and severity.
When stuttering, breathing disorders are observed; accompanying movements that accompany speech; violation of the smoothness, tempo and partially melody of speech; embolophrasia; limitation of speech activity.
In the ICD-10, the described violation corresponds to the code F98.5 Stuttering (stammering).
Included:
Stuttering due to psychogenic factors;
Stuttering due to organic factors.
Pronunciation disorders
In the ICD-10, dyslalia corresponds to the code F80.0. Specific disorder of speech articulation.
The diagnostic guidelines meet the diagnostic criteria for dyslalia isolated from MMR.
According to the etiological principle, dyslalia is divided into two types: mechanical (organic) and functional.
The ICD-10 emphasizes that a diagnosis can only be made when the severity of the articulation disorder is outside the limits of normal variation corresponding to the mental age of the child; non-verbal intellectual level within the normal range; expressive and receptive speech skills within the normal range; articulation pathology cannot be explained by a sensory, anatomical, or neurotic abnormality; mispronunciation is undoubtedly abnormal, based on the characteristics of the use of speech in the subcultural conditions in which the child is located.
In code F80.0. Specific speech articulation disorder includes:
Voice disorders
In the CCP, the terms "dysphonia" and "aphonia" reflect only the degree of manifestation of the disorder: aphonia - the complete absence of voice, and dysphonia - partial violations of pitch, strength and timbre. Qualitative characteristics of pathological changes in the voice-forming organs - the larynx, extension tube, bronchi, lungs - and systems that affect their function (endocrine, nervous, etc.) are absent in these terms. In addition to the loss of strength, sonority, timbre distortion, dysphonia is accompanied by vocal fatigue and a number of subjective sensations (itchiness, lump in the throat, etc.).
In ICD-10, dysphonia and aphonia have different codes: R49.0 Dysphonia; R49.1 Aphonia.
Dysphonia can be caused by organic causes (anatomical changes or chronic inflammatory processes of the vocal apparatus, paresis, paralysis of the larynx, tumors and conditions after their removal) or functional disorders of the voice-forming mechanism (voice fatigue, poor voice production, various infectious diseases and the influence of mental factors). Dysphonia can occur at any stage of a child's development and into adulthood.
Voice disorders can be expressed in one of two forms: hypotonic and hypertonic. In the hypotonic variant, dysphonia (aphonia) is usually caused by bilateral myopathic paresis, i.e. paresis of the internal muscles of the larynx, which lead to the fact that at the time of phonation the vocal folds do not completely close, a gap remains between them, the shape of which depends on which pair of muscles is affected. Pathology of the voice can manifest itself from mild hoarseness to aphonia.
In the hypertonic variant, at the moment of phonation, tonic spasm predominates, which can cover the vocal and vestibular folds, which leads to the disappearance of the voice or a significant distortion of its characteristics.
Systemic speech disorders .
Alalia - absence or pronounced deficiency (underdevelopment) of speech production or perception due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of child development with primary intact intelligence and peripheral hearing. The accepted division of alalia into motor and sensory in the ICD-10 corresponds to disorders of expressive (F80.1) and receptive speech (F80.2) from section F80 "Specific disorders of the development of speech and language."
Expressive speech - active oral speech or independent writing. Expressive speech begins with the motive and intention of the utterance, then the stage of inner speech follows (the idea of the utterance is encoded into speech patterns) and ends with a detailed speech utterance.
Receptive (impressive) speech - understanding of oral and written speech (reading). The psychological structure of impressive speech includes the stage of primary perception of a speech message, the stage of message decoding (analysis of the sound or letter composition of speech) and the stage of correlation of the message with certain semantic categories of the past or one's own understanding of an oral (written) message.
motor alalia - systemic underdevelopment of expressive speech (active oral utterance) of a central organic nature, caused by damage to the speech zones of the cerebral cortex (fronto-parietal areas of the cortex of the left hemisphere of the brain - Broca's center) in the prenatal or early period of speech development.
In the ICD-10, motor alalia is coded as F80.1. Disorder of expressive speech. Underdevelopment of speech in motor alalia is systemic, covering all its components: phonetic-phonemic and lexical-grammatical aspects. According to the prevailing symptoms, a group of children is distinguished mainly with phonetic and phonemic underdevelopment and a more common group with severe lexical and grammatical underdevelopment. An important diagnostic criterion is the presence of intact peripheral hearing and the articulatory apparatus, as well as the presence of sufficient intellectual capabilities in the child for the development of speech. As a result of a violation of the selection and programming operations at all stages of the generation of a speech utterance, speech activity as such, including the control of speech movements, is unformed, which is reflected in the reproduction of the sound and syllabic composition of the word.
In code F80.1. Disorder of expressive speech, in addition to motor alalia, includes:
delays in speech development by the type of general speech underdevelopment (OHP) of I-III levels;
developmental dysphasia of the expressive type;
developmental aphasia of the expressive type.
sensory alalia - lack of understanding of speech (underdevelopment of impressive speech) in the presence of the opportunity to speak.
In the ICD-10, sensory alalia is coded as F80.2. Receptive speech disorder.
With sensory alalia, the connection between the meaning and the sound shell of words is broken; despite good hearing and preserved ability to develop active speech, the child does not understand the speech of others. The cause of sensory alalia is the defeat of the cortical end of the auditory-speech analyzer (Wernicke's center) and its pathways.
In code F80.2. Receptive speech disorder, in addition to sensory alalia, includes:
Developmental receptive type dysphasia;
Developmental receptive aphasia;
incomprehension of words;
verbal deafness;
Sensory agnosia;
Congenital auditory immunity;
Wernicke's developmental aphasia.
In practice, there is a combination of sensory and motor alalia (mixed defect).
Aphasia - complete or partial loss of speech due to local lesions of the brain. The generally accepted is the neuropsychological classification of A.R. Luria, according to which 6 forms are distinguished:
Acoustic-gnostic sensory
Acoustic-mnestic
Amnestic-semantic
Afferent kinesthetic motor
Efferent motor
Dynamic
The ICD-10 assigns several codes to aphasia: R47.0 Aphasia NOS; F80.1 Disorder of expressive speech (if the existing speech disorder can be regarded as "developmental aphasia of the expressive type"); F80.2 Receptive speech disorder (in case the existing speech disorder can be regarded as "developmental receptive aphasia").
Obviously, the encoding of one or another type of aphasia should be carried out depending on which type of speech (motor or sensory, in other words, expressive or receptive) is predominantly impaired.
Code F80 stands out separately. 3 Acquired aphasia with epilepsy (Landau-Klefner syndrome) is a disorder in which a child, having a previous normal development of speech, loses both receptive and expressive speech skills, while maintaining general intelligence. The onset of the disorder (most often between 3 and 7 years of age) is accompanied by paroxysmal EEG abnormalities (almost always in the temporal lobes, usually bilaterally, but often with wider disturbances) and, in most cases, epileptic seizures. In the diagnostic criteria, it is noted that the following is very characteristic: the impairment of receptive speech is quite profound, often with difficulties in auditory understanding at the first manifestation of the condition.
Please note that aphasia that has arisen against the background of various disintegrative disorders and in autism should be coded in separate rubrics: aphasia due to disintegrative disorders of childhood (F84.2 - F84.3); aphasia in autism (F84.0x, F84.1x).
Writing disorders
In the case of an unformed writing process, they speak of agraphia.
In ICD-10 dysgraphia code F81.1 Specific spelling disorder.
The definition of "spelling" comes from the English word spell(writing or spelling words) and involves the process of translating spoken language into written language and vice versa.
Code F81.1 Specific spelling disorder includes:
Specific delay in mastering the skill of spelling (without reading disorder);
Optical dysgraphia;
Spelling dysgraphia;
Phonological dysgraphia;
Specific spelling delay.
The diagnostic guidelines draw attention to the fact that this writing disorder is not solely due to low mental age, visual acuity problems, and inadequate schooling. Both the ability to spell words orally and to spell words correctly are impaired. Children whose problems are solely poor handwriting should not be included here; but in some cases spelling difficulties may be due to writing problems.
In domestic speech therapy, the classification of dysgraphia is considered the most reasonable, which is based on the unformedness of certain operations of the writing process (developed by the staff of the Department of Speech Therapy of the Leningrad State Pedagogical Institute named after A.I. Herzen).
Agraphia has the code R48.8, and the combination of a writing disorder with a reading disorder should be regarded as a spelling difficulty combined with a reading disorder (F81.0).
It is worth noting that a violation in the formation of writing skills due to pedagogical neglect, long interruptions in learning and similar named reasons is not included in the section under consideration and should be coded as spelling difficulties, determined mainly by inadequate training (Z55.8).
Dyslexia - partial specific violation of the reading process, due to the lack of formation (violation) of higher mental functions and manifested in repeated errors of a persistent nature.
The ICD-10 code for dyslexia is F81.0 Specific reading disorder. The ICD-10 states that the main feature of this disorder is a specific and significant impairment in the development of reading skills that cannot be explained solely by mental age, visual acuity problems or inadequate schooling. Spelling difficulties are often associated with a specific reading disorder and often remain in adolescence, even after some progress in reading. Children with a history of specific reading disorder often have specific language developmental disorders, and comprehensive examination of language functioning to date often reveals persistent mild impairment, in addition to lack of progress in theoretical subjects.
Several classifications of dyslexia have been developed (O.A. Tokareva, M.E. Khvattsev and others). The most common classification takes into account the disturbed operations of the reading process (R.I. Lalaeva).
PSYCHOLOGICAL AND PEDAGOGICAL CLASSIFICATION AND ICD-10
The second classification of speech disorders, traditionally used in Russian speech therapy, is the psychological and pedagogical classification of speech disorders (R.E. Levina). This classification arose as a result of a critical analysis of the clinical classification in terms of its use in the correctional process.
The attention of researchers was directed to the development of speech therapy methods for working with a group of children (group, class), for which it was necessary to find a common manifestation of the defect in various forms of abnormal speech development. This approach required a different principle of grouping violations: not from the general to the particular, but from the particular to the general.
In the psychological and pedagogical classification (PPC), violations are divided into two groups:
Violation of the means of communication (phonetic-phonemic underdevelopment and general underdevelopment of speech)
After analyzing the diagnostic criteria for phonetic and phonemic underdevelopment, it can be stated with a high degree of certainty that in the ICD-10 phonetic and phonemic underdevelopment corresponds to the code F80.1 Disorder of expressive speech. The ICD-10 notes that with this specific developmental disorder, the child's ability to use expressive spoken language is markedly below the level corresponding to his mental age, although speech understanding is within the normal range. In this case, there may or may not be articulation disorders.
With FFN, children have difficulties in analyzing sounds that are disturbed in pronunciation; with formed articulation, there is a lack of distinction between sounds belonging to different phonemic groups, as well as the inability to determine the presence and sequence of sounds in a word.
General speech underdevelopment (OHP)- this is a systemic polyetiological disorder, in which all components of the language system are not formed: phonetics, vocabulary, grammar.
OHP can exist as an independent (primary) disorder, or concomitant with alalia, dysarthria, stuttering, rhinolalia. As common features, a late onset of speech development, a poor vocabulary, agrammatisms, pronunciation defects, and phoneme formation defects are noted.
Underdevelopment can be expressed in varying degrees: from the absence of speech or its babble state to expanded, but with elements of phonetic and lexical and grammatical underdevelopment. Depending on the degree of formation of speech means in a child, general underdevelopment is divided into 4 levels.
R.E. Levina defined and characterized 3 levels of speech development,
T.B. Filicheva singled out the 4th level of speech development - residual manifestations of unsharply expressed elements of underdevelopment of all components of the language system.
General speech underdevelopment (according to AUC) corresponds to the code F80.1 Expressive speech disorder, in the explanation of which it is said that speech development delays of the type of general speech underdevelopment (OHP) are included in this heading.
Violations in the use of means of communication.
Thus, in the psychological and pedagogical classification, violations of writing and reading are not distinguished as separate nosologies. They are considered as part of phonetic-phonemic underdevelopment (FFN) and general speech underdevelopment (OHP) as their systemic delayed consequences, due to the lack of formation of phonemic and morphological generalizations, which are one of the leading signs.
None of the classifications we have considered reflects the features of the speech development of mentally retarded children, although speech pathology caused by a persistent decrease in cognitive activity has been studied by many authors (M.E. Khvattsev, R.E. Levina, G.A. Kashe, R.I. Lalaeva, E.F. Sobotovich, V.G. Petrova, M.S. Pevzner). The specificity of speech disorders in children with intellectual disabilities is determined by the characteristics of their higher nervous activity and mental development. To code these speech disorders in the ICD-10, it is recommended to use a heading that includes articulation disorder due to mental retardation - F70 - F79.
During the transition to the second level speech development, the speech activity of the child increases. The active vocabulary is expanded due to everyday subject and verb vocabulary. Possible use of pronouns, conjunctions, and sometimes simple prepositions. In the independent statements of the child there are already simple uncommon sentences. At the same time, there are gross errors in the use of grammatical constructions, there is no agreement between adjectives and nouns, and there is a mixture of case forms. The understanding of addressed speech is developing significantly, although the passive vocabulary is limited, the subject and verbal vocabulary associated with the labor activities of adults, flora and fauna has not been formed. Ignorance is noted not only of shades of colors, but also of primary colors.
Gross violations of the syllabic structure and sound-filling of words are typical. In children, the insufficiency of the phonetic side of speech (a large number of unformed sounds) is revealed.
Third level speech development is characterized by the presence of extended phrasal speech with elements of lexical-grammatical and phonetic-phonemic underdevelopment. There are attempts to use even sentences of complex structures.
The child's vocabulary includes all parts of speech. In this case, inaccurate use of lexical meanings of words can be observed. The first word formation skills appear. The child forms nouns and adjectives with diminutive suffixes, verbs of motion with prefixes. Difficulties are noted in the formation of adjectives from nouns. Multiple agrammatisms are still noted. The child may use prepositions incorrectly, make mistakes in matching adjectives and numerals with nouns.
Undifferentiated pronunciation of sounds is characteristic, and substitutions can be unstable. Deficiencies in pronunciation can be expressed in the distortion, replacement or mixing of sounds. The pronunciation of words with a complex syllabic structure becomes more stable.
A child can repeat three- and four-syllable words after an adult, but distorts them in the speech stream. Comprehension of speech approaches the norm, although there is insufficient understanding of the meanings of words, expressed by prefixes and suffixes fixes.
Fourth level speech development () is characterized by minor violations of the components of the child's language system. There is insufficient differentiation of sounds [t-t "-s-s"-ts], [rr "-l-l" -j], etc.
Peculiar violations of the syllabic structure of words are characteristic, manifested in the child's inability to retain in memory the phonemic image of the word while understanding its meaning.
The consequence of this is the distortion of the sound-filling of words in various variants. Insufficient intelligibility of speech and fuzzy diction leave the impression of "blurring". Errors remain when using suffixes (singularity, emotionally tinted, diminutive).
Difficulties in the formation of complex words are noted. In addition, the child experiences difficulties in planning the utterance and selecting the appropriate language means, which determines the originality of his coherent speech. Of particular difficulty for this category of children are complex sentences with different subordinate clauses. Severe movement disorders, limited social contacts, features of the cognitive sphere, sensory disturbances, often associated with cerebral palsy, lead to a limitation in the child's knowledge of the world around him, which, of course, negatively affects the formation of his vocabulary.
Compared with the age norm, children with general underdevelopment of speech have features in the development of sensorimotor, higher mental functions, and mental activity.
In recent years, the number of children with severe forms of cerebral palsy, accompanied by severe
·
polymorphic violation of sound pronunciation; the absence of both complex and simple forms of phonemic analysis, a limited vocabulary (up to 10-15). Phrasal speech is represented by one-word and two-word sentences, consisting of amorphous root words. Forms of inflection and word formation are absent. Connected speech is not formed. Severe impairment of speech comprehension.
·
Logopedic characteristic:
Pronounced agrammatisms, manifested in the incorrect use of noun endings in prepositional and non-prepositional syntactic constructions, in violation of the agreement of the adjective, verb and noun; unformed word-formation processes (nouns, adjectives, verbs); absence or gross underdevelopment of coherent speech (1-2 sentences instead of retelling)
·
Logopedic characteristic:
There are only difficulties in determining the number and sequence of sounds in complex speech material; vocabulary is limited; in spontaneous speech, only single agrammatisms are noted, a special study reveals errors in the use of complex prepositions, violations of adjective and noun agreement in oblique plural cases, violations of word formation forms; in the retellings there are main semantic links, only minor omissions of secondary semantic links are noted, some semantic relations are not reflected; there is a pronounced dysgraphia.
Children with intellectual disabilities have systemic underdevelopment of speech.
· Severe systemic underdevelopment of speech in mental retardation
Logopedic characteristic:
polymorphic violation of sound pronunciation; the absence of both complex and simple forms of phonemic analysis, a limited vocabulary (up to 10-15). Phrasal speech is represented by one-word and two-word sentences, consisting of amorphous root words. Forms of inflection and word formation are absent. Connected speech is not formed. Severe impairment of speech comprehension.
· Systemic underdevelopment of speech of an average degree with mental retardation
Logopedic characteristic:
polymorphic violation of sound pronunciation; gross underdevelopment of phonemic perception and phonemic analysis and synthesis (both complex and simple forms); limited vocabulary.
Pronounced agrammatisms, manifested in the incorrect use of noun endings in prepositional and non-prepositional syntactic constructions, in violation of the agreement of the adjective, verb and noun; unformed word-formation processes (nouns, adjectives, verbs); absence or gross underdevelopment of coherent speech (1-2 sentences instead of retelling)
· Systemic underdevelopment of speech of a mild degree with mental retardation
Logopedic characteristic:
violations of sound pronunciation are absent or are monoform in nature; phonemic perception, phonemic analysis and synthesis are basically formed;
There are only difficulties in determining the number and sequence of sounds in complex speech material; vocabulary is limited; in spontaneous speech, only single agrammatisms are noted, a special study reveals errors in the use of complex prepositions, violations of the agreement of the adjective and noun in indirect cases of the plural, violations of word formation forms; in the retellings there are main semantic links, only minor omissions of secondary semantic links are noted, some semantic relations are not reflected; there is a pronounced dysgraphia.
In children with cerebral palsy, there is a poverty of vocabulary, which leads to the use of the same words to refer to different objects and actions, the absence of a number of words-names, the unformedness of many specific, generic, and other generalizing concepts. The stock of words denoting signs, qualities, properties of objects, as well as various types of actions with objects is especially limited. Most children use phrasal speech, but sentences usually consist of 2-3 words; words do not always agree correctly, are not used or are not fully used prepositions.
There is also a peculiarity in the understanding of speech: insufficient understanding of the ambiguity of words, sometimes ignorance of objects and phenomena of the surrounding reality. Often it is difficult to understand the texts of works of art, arithmetic problems, program material.
The melodic-intonation side of speech in cerebral palsy is also impaired: the voice is usually weak, fading, unmodulated, intonations are inexpressive.
Violation of speech development may occur due to improper conditions for raising a child with cerebral palsy in the family. Significant is the development of the communicative side of speech, i.e. communication. Speech develops only in the process of communication, in connection with the need for communication. A child with cerebral palsy is often deprived of the opportunity to communicate with peers and adults. Often parents deliberately limit the circle of his communication, wanting to protect the child from possible mental trauma. Hyper-custody on the part of parents who are trying to alleviate the child's condition, trying to fulfill all his requests and anticipate desires, negatively affects the development of speech. In this case, there is not even a need for communication.
Thus, with cerebral palsy, all aspects of speech are impaired, which negatively affects the mental development of the child as a whole.
Regardless of the degree of motor defects in children with cerebral palsy, there are violations of the emotional-volitional sphere,behavior.
Features of the emotional-volitional sphere in children with cerebral palsy
Among the types of abnormal development of children with cerebral palsy, developmental delays of the type mental infantilism. Psychic infantilism is based on the disharmony of the maturation of the intellectual and emotional-volitional spheres with the immaturity of the latter. Mental development in infantilism is characterized by uneven maturation of individual mental functions. However, as he notes, “in all forms of infantilism, underdevelopment of the personality is the leading and defining symptom.” The main sign of mental infantilism is the underdevelopment of higher forms of volitional activity. In their actions, children are guided mainly by the emotion of pleasure, the desire for the present moment. They are self-centered, unable to combine their interests with the interests of others and obey the requirements of the team. In intellectual activity, the predominance of emotions of pleasure is also expressed, intellectual interests proper are poorly developed: these children are characterized by violations of purposeful activity. All these features, according to (1973), together constitute the phenomenon of "school immaturity", motor disinhibition, emotional instability predominate, poverty and monotony of play activity, easy exhaustion, and inertia are observed. There is no childish liveliness and immediacy in the manifestation of emotions. In the neuropathic variant of mental infantilism, children with cerebral palsy are distinguished by a combination of lack of independence, increased suggestibility with inhibition, fearfulness, and self-doubt. They are usually overly attached to their mother, have difficulty adapting to new conditions, and take a long time to get used to school. Emotional-volitional disorders and behavioral disorders in children with cerebral palsy in one case are manifested in increased excitability, excessive sensitivity to all external stimuli. Usually these children are restless, fussy, disinhibited, prone to outbursts of irritability, stubbornness. These children are characterized by a quick change of mood: sometimes they are overly cheerful, noisy, then they suddenly become lethargic, irritable, whiny.
A large group of children, on the contrary, is characterized by lethargy, passivity, lack of initiative, indecision, and lethargy. Such children find it difficult to get used to a new environment, they cannot adapt to rapidly changing external conditions, they have great difficulty establishing interaction with new people, they are afraid of heights, darkness, and loneliness. At the moment of fear, they have a rapid pulse and breathing, increased muscle tone, sweat appears, salivation and hyperkinesis increase. Some children tend to be overly concerned about their health and the health of their loved ones. More often, this phenomenon is observed in children who are brought up in a family where all attention is focused on the child’s illness and the slightest change in the child’s condition causes parents to worry.
Many children are highly impressionable: they react painfully to the tone of voice, notice the slightest change in the mood of loved ones, and react painfully to seemingly neutral questions and suggestions.
Often, children with cerebral palsy have a sleep disorder: they do not fall asleep well, sleep restlessly, with terrible dreams. In the morning the child wakes up lethargic, capricious, refuses to study. When raising such children, it is important to observe the daily routine, he should be in a calm environment, before going to bed, avoid noisy games, exposure to various harsh stimuli, and limit TV viewing.
It is important that the child begins to realize himself as he is, so that he gradually develops the right attitude towards his illness and his abilities. The leading role in this belongs to parents and educators: from them the child borrows an assessment and idea of himself and his illness. Depending on the reaction and behavior of adults, he will consider himself either as a disabled person who has no chance
Children with Down syndrome
About 20% of severe forms of lesions of the central nervous system are associated with genetic disorders. Among these diseases, the leading place is occupied by Down's syndrome. "Down syndrome" is the most common form of chromosomal pathology known today, in which mental retardation is combined with a peculiar appearance. First described in 1866 by John Langdon Down under the title "Mongolism". Occurs with a frequency of one case per 500-800 newborns, regardless of gender
Features of the development of the cognitive sphere of children with Down syndrome
A characteristic feature of a child with Down syndrome is slow development. At present, there is no doubt that children with Down syndrome go through the same stages of development as ordinary children. The general principles of education are developed on the basis of modern ideas about the development of preschool children, taking into account the specific characteristics inherent in children with Down syndrome.
· These include:
Slow formation of concepts and development of skills:
Decrease in the rate of perception and slow response formation;
the need for a large number of repetitions to master the material;
low level of generalization of the material;
Loss of those skills that are not in demand enough.
low ability to operate with several concepts at the same time, which is connected with: the difficulties that a child has when he needs to combine new information with already studied material;
Difficulties in transferring learned skills from one situation to another. Replacing flexible behavior that takes into account circumstances with patterns, i.e., the same type, memorized repeatedly repeated actions;
Difficulties in performing tasks that require operating with several features of an object, or performing a chain of actions;
Violation of goal-setting and action planning.
· - the uneven development of the child in various areas (motor, speech, socio-emotional) and the close relationship of cognitive development with the development of other areas.
· a feature of subject-practical thinking, characteristic of this age, is the need to use several analyzers at the same time to create a holistic image (vision, hearing, tactile sensitivity, proprioception). The best results are obtained by visuo-corporeal analysis, that is, the best explanation for the child is the action that he performs, imitating an adult or together with him.
Impairment of sensory perception, which is associated with reduced sensitivity and frequent visual and hearing impairments.
Children with Down syndrome have different starting levels, and the pace of their development can also vary significantly. The program of cognitive development was based on: object-oriented thinking of preschoolers, the need to use their sensory experience, reliance on visual-effective thinking as the basis for a further transition to visual-figurative and logical thinking, the use of the child’s own motivation, learning in a playful way, as well as the possibility of an individual approach to each child, taking into account his characteristics, preferences and speed of learning.
Children with Down syndrome have speech development deficiencies (both in the pronunciation of sounds and in the correctness of grammatical structures). Speech delay is caused by a combination of factors, some of which are due to problems in speech comprehension and in the development of cognitive skills. Any delay in the perception and use of speech can lead to a delay in intellectual development.
General features of the lag in the development of speech:
· smaller vocabulary, leading to less broad knowledge;
Gaps in the development of grammatical structures;
the ability to learn new words rather than grammatical rules;
Greater than usual problems in learning and using common speech;
Difficulties in understanding assignments.
In addition, the combination of a smaller oral cavity and weaker mouth and tongue musculature makes it physically difficult to pronounce words; and the longer the sentence, the more problems with articulation.
For these children, language development problems often mean that they actually get fewer opportunities to participate in communication. Adults tend to ask them unanswerable questions and also finish sentences for them, without helping them speak for themselves or giving them enough time to do so. This results in the child receiving:
less speech experience that would allow him to learn new words of sentence structure;
less practice to make his speech more intelligible.
Thinking.
The profound underdevelopment of the speech of these children (pronounced damage to the articulatory apparatus, stuttering) often masks the true state of their thinking and creates the impression of lower cognitive abilities. However, when performing non-verbal tasks (classification of objects, counting operations, etc.), some children with Down syndrome may show the same results as other pupils. In the formation of the ability to reason and build evidence, children with Down syndrome experience significant difficulties. Children have a harder time transferring skills and knowledge from one situation to another. Abstract concepts in academic disciplines are inaccessible to understanding. The ability to solve practical problems that have arisen can also be difficult. Limited ideas, insufficiency of inferences underlying mental activity make it impossible for many children with Down syndrome to study separate school subjects.
Memory.
Characterized by hypomnesia (reduced memory capacity), it takes more time to learn and master new skills, and to memorize and memorize new material. Insufficiency of auditory short-term memory and processing of information received by ear.
Attention.
Instability of active attention, increased fatigue and exhaustion, Short period of concentration, children are easily distracted, exhausted.
Imagination.
The image does not arise in the imagination, but is perceived only visually. They are able to correlate parts of a drawing, but cannot combine them into a whole image.
Children with disabilities have physical and (or) mental development disorders of different nature and severity, ranging from temporary and easily remedied difficulties to permanent deviations that require an individual training program adapted to their capabilities.
Currently, the following categories of children with developmental disabilities are distinguished in the Educational Institution:
1. These are children with potentially safe opportunities for intellectual and personal development, mild speech and movement disorders. | Children capable of independent, active, meaningful activity, full mastery of the educational program with its slight correction. |
2. Delayed children psychomotor development and general underdevelopment of speech (1, 2,3,4 levels), dysfunction of the musculoskeletal system of moderate severity |
The structure of the speech defect in children of primary school age with systemic underdevelopment of speech with mental retardation
A normal child in most cases is prepared for the beginning of schooling. He has well-developed phonemic hearing and visual perception, oral speech is formed. He owns the operations of analysis and synthesis at the level of perception of objects and phenomena of the surrounding world. A normally developing child comes to school with a developed conversational and everyday speech and easily communicates with adults. In a mentally retarded child, by the time they enter school, the practice of verbal communication is small (3-4 years), and colloquial everyday speech is poorly developed. Violation of the activity of analyzers and mental processes in mentally retarded children leads to the inferiority of the psychophysiological basis for the formation of written speech. Therefore, first-graders experience difficulties in mastering all the operations and actions that are included in the processes of reading and writing.
G.E. Sukhareva distinguishes two groups of oligophrenia: 1) oligophrenia with underdevelopment of speech; 2) atypical oligophrenia, complicated by a speech disorder.
The first group of mentally retarded children has speech underdevelopment, entirely due to the level of intellectual underdevelopment; in the second group, in addition to underdevelopment of speech, various speech disorders are noted.
In younger students with mental retardation, all forms of speech impairment can be observed (dyslalia, dysarthria, rhinolalia, dyslexia, dysgraphia, etc.). A feature of speech disorders in mentally retarded children is that a semantic defect is predominant in their structure.
R.I. Lalaeva notes that speech disorders in mentally retarded children are manifested against the background of a gross violation of cognitive activity, abnormal mental development in general.
Speech disorders in these children are systemic in nature, i.e. speech as an integral functional system suffers. With mental retardation, all components of speech are violated: its phonetic-phonemic side, vocabulary, grammatical structure. There is a lack of formation of both impressive and expressive speech. In most cases, primary school students of a correctional school have impairments in both oral and written speech.
In this category of children, all stages of speech activity are unformed to a greater or lesser extent. There is a weakness of motivation, a decrease in the need for verbal communication; the semantic programming of speech activity is violated, the creation of internal programs of speech actions. Due to a number of reasons, the implementation of the speech program and control over speech, the comparison of the result obtained with the preliminary plan are violated.
With mental retardation, many levels of generating a speech statement are violated to varying degrees: semantic, linguistic, sensorimotor. At the same time, the most underdeveloped are highly organized complex levels (semantic, linguistic), requiring the formation of operations of analysis and synthesis, abstraction, generalization and comparison.
Speech disorders in mentally retarded children have a complex structure. They are diverse in their manifestations, mechanisms, persistence and require a differentiated approach in their analysis. The symptoms and mechanisms of speech disorders in these children are determined not only by the presence of general, diffuse underdevelopment of the brain, which causes a systemic speech disorder, but also by local pathology of areas directly related to speech, which further complicates the picture of speech disorders in mental retardation.
Speech disorders in mentally retarded children are characterized by persistence, they are eliminated with great difficulty.
To indicate the lack of formation of speech as a system in mentally retarded children of primary school age, the following formulations are recommended:
Severe systemic underdevelopment of speech in mental retardation. Logopedic characteristic. Polymorphic violation of sound pronunciation. Gross underdevelopment of phonemic perception and phonemic analysis and synthesis (both complex and simple forms), Limited vocabulary. Pronounced agrammatisms, manifested in the violation of both complex and simple forms of inflection and word formation, in the incorrect use of case forms of nouns and adjectives, in violation of prepositional case constructions, in agreement between an adjective and a noun, a verb and a noun. Lack of word formation. Lack of coherent speech or severe underdevelopment (1-2 sentences instead of retelling).
Systemic underdevelopment of speech of an average degree with mental retardation. Logopedic characteristic. Polymorphic or monomorphic pronunciation disorder. Underdevelopment of phonemic perception and phonemic analysis (in some cases, there are the simplest forms of phonemic analysis, while performing more complex forms of phonemic analysis, significant difficulties are observed). Agrammatisms, manifested in complex forms of inflection (prepositional-case constructions, agreement of an adjective and a noun in the neuter gender of the nominative case, as well as in oblique cases). Violation of complex forms of word formation. Insufficient formation of coherent speech (in the retellings there are omissions and distortions of semantic links, a violation of the sequence of events). Severe dyslexia, dysgraphia.
Systemic underdevelopment of speech of a mild degree with mental retardation. Logopedic characteristic. Violations of sound pronunciation are absent or are monomorphic. Phonemic perception, phonemic analysis and synthesis are basically formed, there are only difficulties in determining the number and sequence of sounds in complex speech material. Vocabulary is limited. In spontaneous speech, only single agrammatisms are noted. A special study reveals errors in the use of complex prepositions, violations of the agreement of the adjective and noun in oblique cases of the plural, violations of complex forms of word formation. The retellings contain the main semantic links, only minor releases of secondary semantic links are noted, only some semantic relations are not reflected. There is a pronounced dysgraphia.
Aksenova A.K. indicates that the violation of the activity of analyzers and mental processes in mentally retarded children leads to the inferiority of the psychophysiological basis for the formation of written speech. Therefore, first-graders experience difficulties in mastering all the operations and actions that are included in the processes of reading and writing.
The greatest difficulties in mastering the skills of reading and writing by children of this contingent are associated with impaired phonemic hearing and sound analysis and synthesis. First-graders have difficulty in differentiating acoustically similar phonemes and, therefore, do not remember letters well, since each time they correlate a letter with different sounds. In other words, there is a violation of the system of transcoding and encoding a letter into sound and sound into a letter.
The imperfection of analysis and synthesis leads to difficulties in dividing a word into its constituent parts, identifying each sound, establishing the sound range of a word, mastering the principle of merging two or more sounds into a syllable, and recording in accordance with the principles of Russian graphics.
Violation of pronunciation exacerbates the shortcomings of phonetic analysis. If in children with normal development, incorrect pronunciation of sounds does not always lead to inferiority of auditory perception and incorrect choice of letters, then in mentally retarded schoolchildren, impaired pronunciation is, in most cases, impaired perception of sound and its incorrect translation into a grapheme.
Many studies related to the state of sound analysis and synthesis in normal children and those with mental retardation have shown that a normal child with impaired pronunciation skills retains the focus of cognitive activity on the sound side of speech and interest in it.
Another picture is observed in mentally retarded children: they have no interest in the sound shell of the word. Comprehension of the sound structure of a word does not manifest itself even when the experimenter specifically directs the attention of schoolchildren to the sound analysis of the word. So, to the question: “The boy said “oshka”. What is his mistake? - mentally retarded students could not give the correct answer, although the picture with the painted cat was in front of their eyes. Failure to understand that a word is not only the name of an object, but also a certain sound-letter complex, delays the process of mastering literacy, since the performance of the acts of writing and reading presupposes the obligatory combination of two operations: understanding the meaning of a word and its sound-letter analysis - before recording; perception of the letters of the word and awareness of its semantics - when reading.
“Children cannot understand,” writes V.G. Petrova , - that every word consists of combinations of the very letters that they teach. Letters remain for many students for a long time something that should be remembered as such, regardless of the words denoting familiar objects and phenomena.
Thus:
Speech disorders in mentally retarded children of primary school age are systemic in nature, i.e. speech as an integral functional system suffers.
With mental retardation, all components of speech are violated: its phonetic-phonemic side, vocabulary, grammatical structure. There is a lack of formation of both impressive and expressive speech.
In most cases, primary school students of a correctional school have impairments in both oral and written speech.
The greatest difficulties in mastering the skills of reading and writing by children of this contingent are associated with impaired phonemic hearing and sound analysis and synthesis.
LIST OF USED LITERATURE
Aksenova A.K. Methods of teaching the Russian language in a special (correctional) school: textbook. for stud.defectol. fak. Pedagogical Universities. - M.: Humanitarian. ed. center VLADOS, 2004. - 316 p.
Buslaeva E.N. The state of phonemic hearing in primary school students with intellectual disabilities // Defectology, 2002, No. 2-p. 17
Differential diagnosis of speech disorders in children of preschool and school age: Guidelines / team of authors: L.V. Venediktova, T.T. Sparrow, R.I. Lalaeva and others - Publishing house of the Russian State Pedagogical University named after. A.I. Herzen, 1998.
Lalaeva R.I. Speech disorders and the system of their correction in mentally retarded schoolchildren. - L .: 1988.
Petrova V.G. The development of speech of secondary school students. - M., 1977.
Any deviation that occurs in the process of development causes anxiety in parents. When speech functions are violated, the child does not have the opportunity to fully communicate with members of his own family and people around him. In severe cases, we are talking about such a pathology as systemic underdevelopment of speech.
Let's consider this pathology in more detail.
General characteristics
Speech underdevelopment of a systemic nature is a complex dysfunction in a child, which is characterized by the lack of formation of the processes of speaking and receiving speech messages.
In this case, the following may be violated:
- Phonetics - the child pronounces some sounds incorrectly.
- Vocabulary - the child does not own the volume of vocabulary that he had to master for a given period of his development.
- Grammar - there are violations in the selection of case endings, in the preparation of sentences, etc.
The concept of "systemic underdevelopment of speech" was introduced by R. E. Levina and is used in the diagnosis of speech functions in children who have mental retardation. For patients with organic brain lesions, which are characterized by a secondary speech disorder, speech therapists most often make a similar diagnosis against the background of this pathological condition. Children with intact hearing and intellect are diagnosed with "general underdevelopment of speech".
The true diagnosis can be made after the child is seen by three specialists: a neurologist, a psychologist and a speech therapist. In addition, such a diagnosis is not made to those children who have not reached the age of five.
Reasons for the development of pathology
It is rather difficult to single out the main cause of systemic underdevelopment of speech, since often not one factor, but a whole combination of them, matters.
The main such factors are:
- head injuries that were received by the child during childbirth or in the first years of life;
- difficult course of pregnancy, and this category of causes includes serious infectious diseases during the period of bearing a child, the use of alcoholic beverages, smoking, severe infections of a chronic nature, etc.;
- fetal hypoxia;
- unfavorable situation in the family - inattentive and rude attitude towards the child, frequent quarrels between relatives, overly strict methods of education, etc.;
- childhood diseases, which include asthenia, cerebral palsy, rickets, Down syndrome, complex pathologies of the central nervous system.
In certain cases, systemic speech underdevelopment develops mildly as a reaction to a bacterial or viral infection.
Signs and symptoms
How to understand what and suspect that in this case there is a delay in speech, mental or intellectual development even before he is five years old?
Initial alarming signs in children with systemic underdevelopment of speech can be observed even in the first year of life. Such situations should be alerted when, in response to certain words spoken by adults, the child does not try to reproduce them.
At the age of one and a half years, the child must learn to imitate the sounds uttered by people around him, as well as point to objects at their request. If this is not observed, parents need to think. The next milestone is the age of two. Here the child needs to be able to pronounce words and even phrases spontaneously at will.
At the age of three, children should understand about two-thirds of what adults say, and vice versa, adults - children. By the age of four, the meaning of absolutely all words should be mutually understood. In cases where this does not happen, you should seek the advice of a specialist.
At the age of five, when the question is about making such a diagnosis as a systemic speech disorder, the symptoms may be as follows:
- the child's speech remains slurred, it is extremely difficult to understand;
- there is no consistency between expressive and impressive speech - the child understands everything, but cannot express himself independently.
Classification
This violation has several degrees of systemic underdevelopment of speech:
- Mild degree - insufficient vocabulary for a certain age, a violation in the pronunciation of sounds, inaccuracy in the use of indirect cases, prepositions, plurals and other difficult points, dysgraphia, insufficient awareness of causal relationships.
- Systemic underdevelopment of speech of an average degree - difficulties in perceiving too long sentences, words that are used in a figurative sense. Difficulties with the construction of semantic lines during retelling are also noted. Children do not know how to agree on gender, number, case, or they do it with mistakes. They have underdevelopment of phonemic hearing, weak active speech, poor vocabulary, impaired coordination of language movements in the process of articulation.
- Severe systemic underdevelopment of speech - perception is severely impaired, there is no coherent speech, there are violations of fine motor skills, the child cannot write and read, or it is given to him with great difficulty, there are only a few dozen words in the vocabulary, the intonation is monotonous, the power of the voice is reduced, word formation is missing. At the same time, the child cannot conduct a constructive dialogue, as it is difficult to answer even simple questions.
The diagnosis, as well as the identification of the degree of the disorder that is observed in a particular child, is carried out only by a specialist, and not by parents, other relatives or teachers.
Other classification
There is another classification of general underdevelopment. Wherein:
- 1st degree - speech is absent.
- 2nd degree of systemic underdevelopment of speech - there are only initial speech elements with a large amount of agrammatism.
- The 3rd degree is characterized by the fact that the child can speak phrases, but the semantic and sound sides are underdeveloped.
- The 4th degree involves individual violations in the form of residual disorders in such sections as phonetics, vocabulary, phonetics and grammar.
The general underdevelopment of speech of an average degree, for example, corresponds to the second and third levels of this classification.
We examined the levels of systemic underdevelopment of speech.
Mental retardation
Such a pathological phenomenon as severe systemic underdevelopment of speech with mental retardation is due to the following symptoms:
- The development of the speech system is significantly behind the norm.
- There are memory problems.
- There are difficulties in defining simple concepts and relationships between them;
- Increased motor activity.
- The child cannot concentrate.
- There is no conscious will.
- Underdeveloped or absent thinking.
In the case of systemic underdevelopment of speech with mental retardation, the psycho-emotional functions of children are developed incorrectly, which negatively affects not only communication, but also other necessary social skills.
What does success depend on?
The success of corrective measures depends on the degree of the violations themselves, as well as on the timeliness of the assistance provided by specialists to the child. In this case, the goal of parents is to note deviations in speech or intellectual development in time and visit a specialist with the child.
Systemic underdevelopment of expressive speech
Disorders are a general underdevelopment of speech functions in children against the background of sufficient mental development in understanding what others say.
This disorder manifests itself as a small vocabulary that does not correspond to the age of the child, difficulties in verbal communication, insufficient ability to express one's opinion with words.
Also, children who have expressed expressive speech disorders to some extent are characterized by difficulties in learning grammatical rules: the child cannot agree on the endings of words, uses prepositions inadequately, cannot decline nouns and adjectives, does not use conjunctions or uses them incorrectly.
The desire to communicate
Despite the above-described violations of speech functions, children with such disorders strive to communicate, use non-verbal cues and gestures to convey their thoughts to the interlocutor.
The first signs of expressive speech disorders can be noticed even in infancy. By the age of two, children with a similar pathology do not use words, by the age of three they do not compose primitive phrases consisting of several words.
Therapy and correction
In mild and moderate stages of disorders, the prognosis is usually quite positive; in severe forms of pathology, treatment is longer and more complex, but it also gives good results.
Therapeutic measures are carried out by a speech therapist if speech disorders are accompanied by other disorders. The work also includes a psychologist and other specialists.
Classes should take place in different forms - both in the form of constant repetition of sounds, rules for constructing endings, words, sentences, etc., and using progressive modern methods, during the development of which children learn to remember, ask questions, understand speech, master the meaning of certain concepts , train memory, develop motor skills.
An interesting form of presentation of the material, bright pictures, a favorable atmosphere in the medical institution where the correction is carried out, are a combination of components designed to help the patient cope with the existing disorders faster.
As a rule, physical exercises are also included in the process of general therapy - children do not sit still, but actively train the motor center.
Serious Approach
Systemic underdevelopment of speech is a disease that requires a serious approach. You should not rush to determine the child for correction to the first doctor who comes across. At the same time, it is necessary to study whether he has a positive experience with such children, as well as the ability to establish psychological connections with “difficult” patients.
Corrective methods include not only psychotherapy and special exercises, often disorders arise as a result of an incorrect approach to the organization of the educational process, so you have to correct it as well.
