Specific speech articulation disorders. Violation of articulation in children and adults violation of speech articulation in children

A group of specific disorders of speech and language development (discharge) is represented by violations in which the leading symptom is a violation of sound suspension during normal hearing and normal innervation of the speech apparatus.

Epidemiology

The frequency of articulation disorders is installed in 10% of children under 8 years and 5% of children over 8 years old. Boys meet 2-3 times more often than girls.

Classification

Functional dilacium - defects of playing sound sounds in the absence of organic violation1 in the structure of the articulation apparatus.

Mechanical discharge - impaired sound-proof, due to the anatomical defects of the peripheral speech apparatus (incorrect bite, thick language, short bridle, etc.).

Causes and pathogenesis of disliers

The cause of articulation disorders is not fully known. Presumably the basis of disorders is the delay in the ripening of neuronal bonds due to organic lesion of the richetic areas of the crust. There are data on the significant role of genetic factors. An unfavorable social environment is a certain meaning, imitation of incorrect speech samples.

Symptoms of disliers

Violations of articulation are expressed in a sustainable inability to apply in accordance with the expected level of speech sound levels, including incorrect reproduction. Skipping, replacements for incorrect or insertion of unnecessary background.

The articulation defect is based on the inability to arbitrarily accept and hold certain positions of the language, the nose, the lips needed to pronounce sounds. Intellectual and mental development of children corresponds to age. You can observe the accompanying disorders in the form of violations of attention, behavior and other phenomena.

Differential diagnosis

The establishment of anatomical defects that could cause a violation of pronunciation in connection with which the counseling of orthodontist is needed.

Differentiation from secondary disorders caused by the deafness, based on the data of an audiometric study and the availability of high-quality pathological signs of speech pathology.

Differentiation of articulation disorders due to neurological pathology (dysarthria) are based on the following signs:

for dysarthritis, a small speech speed is characterized, the presence of violations of chewing and sucking functions;
disorder concerns all the background, including vowels.

In doubtful cases, to carry out differential diagnosis and establishing an anatomical focus of the lesion, instrumental studies are carried out: EEG, echohetephalography (echo), MRI brain, CT brain.

Most speech sounds are purchased by 6-7 years, by 11 years all sounds must be purchased.

Includes three stages:

Dysarthri

Dysarthria - Disorder of the Speech Protecting Organization, associated with the defeat of the central department of the spectavatic analyzer and the innervation of the muscles of the articulation apparatus. The structure of the defect in the dysarthria includes a violation of speech motility, sound-proof, speech breathing, voice and a selection side of speech; In severe lesions, anarterium occurs. With suspected Dysaryry, neurological diagnostics (EEG, EMG, EGG, MRI of the brain, etc.), speech therapy examination of oral and written speech are carried out. Correctional work in dysarthritia includes therapeutic effects (drug courses, lescape, massage, FTL), speech therapy classes, articulating gymnastics, speech therapy massage.

Dysarthri

Dysarthria is a severe violation of speech, accompanied by a disorder of articulation, lamp, speech breathing, a tender-rhythmic organization and intonation color of speech, as a result of which it loses its self-disconnectivity and indity. Among children, the prevalence of dysarthria is 3-6%, but in recent years a pronounced tendency towards an increase in this speech pathology is traced. In the logopedia dysarthria enters the top three most common forms of oral speech disorders, in frequency I give up only disliers and ahead of Alalia. Since the basis of the pathogenesis of dysarthria is organic lesions of the central and peripheral nervous system, this speech violation is also studied by specialists in the field of neurology and psychiatry.

Causes of Dysarthria

Most often (in 65-85% of cases) dysarthria accompanies child cerebral paralysis and has the same causes of occurrence. In this case, the organic defeat of the CNS occurs in the intrauterine, childbirth or early period of the child's development (usually up to 2 years). The most frequent perinatal disartria factors are toxicosis of pregnancy, fetal hypoxia, rhesv conflict, chronic somatic diseases of the mother, pathological flow of birth, generic injuries, asphyxia at birth, nuclear jaundice of newborns, prematurity, etc. The degree of expression of dysarthria is closely related to the severity of motor disorders when Palsy: So, with double hemiplegia, dysarthria either anarterium is detected from almost all children.

In early childhood, the defeat of the central nervous system and dysarthria in a child can develop after suffering neuroinfections (meningitis, encephalitis), purulent medium otitis, hydrocephalus, cranial injury, heavy intoxication.

Classification of dysarthria

The neurological classification of the dysarthria is based on the principle of localization and syndromological approach. Taking into account the localization of the lesion of the speaking machine, distinguish:

bulbaric dysarthria, associated with the defeat of the centered brain nerve nuclear / language, sub-speaking, wandering, sometimes facial, triple / in the oblong brain
pseudobulbar dysarthria associated with the defeat of cortical nuclear conducting
extrapyramidal (subcortical) dysarthria associated with the defeat of the subcortical cerebral nuclei
cerebellar dysarthria associated with the defeat of the cerebellum and its conductive paths
cork dysarthria, associated with focal lesions of the cerebral cortex.

Depending on the leading clinical syndrome, the cerebral, spastic-rigid, spastic-paretic, spastic-hyperkinetic, spasticoctic, attacco-hyperkinetic dysarthria may occur.

The speech therapy classification is based on the principle of understanding speech for others and includes 4 severity of dysarthria:

1 degree (erased dysarthria) - sound-proof defects can only be detected by a speech therapist with a special examination.

2 degree - sound-proof defects are noticeable to others, but in general, it remains clear.

3 Degree - an understanding of the patient's speech with dysarthria is available only to a close surrounding and partially unauthorized people.

4 Degree - there is no question or not even the most close people (anarterium).

Symptoms of dysarthria

Patient speech with dysarthritia is a vague, fuzzy, uninterrupted ("porridge in the mouth"), due to insufficient innervation of the muscles of the lips, language, soft sky, voice folds, larynx, respiratory muscles. Therefore, with dysarthria, a whole complex of speech and non-neutral disorders are developing, constituting the essence of the defect.

Violation of articulation motility in patients with dysarthria can manifest itself in spasticity, hypotension or dystonia articulation muscles. Muscular spacious is accompanied by a permanent elevated tone and tension of the muscles of the lips, language, face, neck; Tight lip closure, limiting articulation movements. With muscular hypotension, the tongue is sluggish, motionless lies at the bottom of the oral cavity; The lips are not closed, the mouth is semi-open, hypercupation is expressed (saliva); Due to the paresis of a soft sky, a nasal shade of voice appears (nasalization). In the case of dysarthritia that flows with muscle dystonia, when trying to speech, the muscle tone varies with low on elevated.

Violations of sound suspension with dysarthria can be expressed to varying degrees, depending on the localization and severity of the damage to the nervous system. With erased dysarthria, individual phonetic defects (sound distortions) are observed, "SVIDULATION" Speech. With more pronounced degrees of dysarthria there are distortion, skipping, replacement of sounds; The speech becomes slow, inexpressive, vague. Total speech activity is noticeably reduced. In the most difficult cases, with full paralysis of the speech motor muscles, the motor implementation of speech becomes impossible.

Specific features of the impact of sound testing in dysarthria serve as defects and the difficulty of overcoming them, as well as the need for a longer period of sound automation period. With dysarthritia, articulation of almost all speech sounds is disturbed, including vowels. For dysarthritis, the interdental and lateral pronunciation of hissing and whistling sounds is characterized; Defects of sound unconditions, palatalization (softening) of solid consonants.

Due to the insufficient innervation of speech muscles in dysarthria, speech breathing is disturbed: the exhalation is shortened, breathing at the moment of speech becomes rapid and intermittent. Voices voices in dysarthria are characterized by its insufficient force (the voice is quiet, weak, running), changing the timbre (deafness, nasalization), melody-intonation disorders (monotony, absence or non-votor modulation).

Due to speech inseparality in children with dysarthria, the auditory differentiation of sounds and phonmethic analysis and synthesis are secondary. The difficulty and insufficiency of speech communication can lead to non-formation of the vocabulary and the grammatical system of speech. Therefore, children with dysarthria may have phonetic-phonematical (FFN) or general underdevelopment of speech (ONR) and related relevant types of disgrave.

Characteristics of clinical forms of dysarthria

For the bulbar dysarthritis, aureflexia, amymia, sucking disorder, swallowing solid and liquid food, chewing, hypersion, caused by the muscle atonium of the oral cavity. The articulation of sounds is insensitive and extremely simplified. All variety of consonants is reduced to a single slit sound; Sounds are not differentiated among themselves. Typical Nasalization Voice timbre, Dismony or Aphony.

With pseudobulbar dysarthria, the character of disorders is determined by spastic paralysis and muscle hypertonus. The most vividly pseudobulberry paralysis manifests itself in violation of the movements of the language: great difficulties cause attempts to raise the tip of the tongue upwards, take to the sides, hold in a certain position. When pseudobulbar dysarthria is difficult to switch from one articulation posture to another. Typically selective violation of arbitrary movements, synctanese (friendly movements); Abundant salivament, strengthening of pharyngeal reflex, accumulation, dysphagia. The speech of patients with pseudobulbar dysarthria was smeared, vague, has a nasal shade; Roughly violated the regulatory reproduction of sonorov, whistling and hissing.

For subcortical dysarthria, the presence of hypercines - involuntary violent muscle movements, including facial and articulation. Hypercines may arise alone, but usually become enhanced when trying to speech, causing articulation spasm. There is a violation of the timbre and the strength of the voice, the proper side of speech; Sometimes patients break into involuntary gestures.

When subcortical Dysarthria may violated the tempo of speech on the type of bradylia, tachilaly or speech design (organic stutter). The sub-barker distemper is often combined with pseudobulbar, bulbar and cerebellar form.

The typical manifestation of the cerebulic dysarthria serves a violation of the coordination of the speech process, the consequence of what is a tremor of the tongue, a pushing, chandented speech, separate shouts. Speech slowed down and vigilant; The pronunciation of advanced and lifting sounds is largely violated. In the cerebelchikovkaya dysarthria, the ataxia is marked (gait, equilibrium disruption, awkward movements).

Cork dysarthria for its speech manifestations resembles motor aphasia and is characterized by a violation of arbitrary articulation motility. Disorders of speech breathing, voices, requests for cortical dysarthritia. Taking into account the localization of the lesions, there is a kinesthetic post-central cortex dysarthria (afferent cortical dysarthria) and a kinetic prime cortical dysarthria (efferent cortical dysarthria). However, with a cortical dysarthria, there is only an articulation apraxia, whereas with motor aphasia suffers not only to the articulation of sounds, but also reading, letter, understanding of speech, the use of means of language.

Diagnosis of dysarthria

The examination and subsequent maintenance of patients with dysarthria is carried out by a neurologist (children's neurologist) and a speech therapist. The amount of neurological examination depends on the intended clinical diagnosis. The most important diagnostic importance is the data of electrophysiological studies (electroencephalography, electromyography, electronics), transcraniac magnetic stimulation, MRI of the brain, etc.

The speech therapy examination of the dysarthria includes the assessment of speech and non-violations. Evaluation of neust symptoms involves the study of the structure of the articulation apparatus, the volume of articulation movements, the state of the mimic and speech muscles, the character of breathing. Special attention to the speech therapist draws a history of speech development. As part of the diagnosis of oral speech, the dysarthria is conducted a study of the pronunciation side of speech (sound-proof, tempo, rhythm, request, intelligibility of speech); synchronism of articulation, respiration and voicing; Phonematics perception, level of development of the lexico-grammatical system of speech. In the process of diagnosing a written speech, tasks are given to the writing off text and the letter under dictation, reading passages and understanding read.

Based on the results of the survey, it is necessary to distinguish between Dysaryry and Motor Alalia, Motor Aphazia, Dislavia.

Correction of Dysarthria

The speech therapy work to overcome the dysarthria should be carried out systematically, against the background of drug therapy and rehabilitation (segmental-reflex and point massage, acupressures, lescape, physiotherapy, physiotherapy, mechanotherapy, acupuncture, hirudotherapy) appointed neurologist. A good background for correctional-pedagogical occupations is achieved by the use of non-traditional forms of reducing treatment: dolphinotherapy, sensory therapy, isotherapy, sand-medicine, etc.

On the speech therapy classes on the correction of dysarthria, the development of small motors (finger gymnastics), motility of the speech apparatus (speech therapy massage, articulation gymnastics) are carried out; physiological and speech breathing (respiratory gymnastics), voices (orthophonic exercises); Correction of violated and consolidate the correct sound; Work on the expressiveness of speech and the development of speech communication.

The procedure for setting and automating sounds is determined by the greatest availability of articulating stages at the moment. The automation of sounds during dysarthria is sometimes transferred until the full purity of their isolated pronunciation is reached, and the process itself requires more time and perseverance than during disliers.

Forecast and Prevention Dysarthria

Only early, the systematic speech therapy work on the correction of dysarthria can give positive results. The therapy of the underlying disease is a big role in the success of the correctional and pedagogical impact, the very patient-dysarthritis and its close surroundings.

Under these conditions, on almost complete normalization of speech function, it is possible to calculate in the case of an erased dysarthria. Having mastered the skills of the right speech, such children can successfully learn in a secondary school, and the necessary speech therapy assistance is obtained in clinics or on school logoptings.

With heavy forms of dysarthria, it is possible only to improve the speech function status. The continuity of various types of speech therapy institutions: kindergartens and schools for children with severe speech disorders, speech departments of psychoneurological hospitals are important for the socialization and education of children with dysarthria. Friendly work of a speech therapist, a neurologist, a psychoneurologist, a masseur, a specialist in therapeutic physical education.

Medical and pedagogical work on the prevention of dysarthria in children with perinatal lesions of the brain should begin with the first months of life. Prevention of dysarthria in early childhood and adulthood is to prevent neuroinfection, brain injuries, toxic effects.

Violation of articulation in children and adults

- "Clean your teeth" smiles, opening the mouth, the tongue tights the lower and the upper teeth alternately;

- "MEISE DOOP" The child smiles, after shelves the tongue between the teeth - "P'-P'-Py", then heats the tip of the tongue to teeth;

- "Cup" - the crumb smiles, widely reveals the mouth, suits a wide tongue and forms a "cup" from it (lifts the tip);

- "Dudochka" - the child must pull the busy lips forward, closer to the teeth;

- "Malay" - a child smiles, open his mouth and the tongue tongue strokes (colors) sky;

- "Mushrooms" - the baby needs to smile, after flying the tongue (as if rides on the horse) and seek a wide language to the sky;

- "Nature" - Kroch smiles in wider, opening his mouth. The tip of his tongue should persuade into the lower teeth, the language at the same time should be hidden so that it overtook the tip in the lower teeth;

- "Swing" - the child smiles, opens his mouth, the tip of his tongue comes for the upper teeth, then behind the lower teeth.

- "Color" the upper arch in the mouth - from a soft sky and up to the base of the upper teeth;

Pronounce vowel sounds, scoring;

Imitate the rinse of the throat;

Develop the lower jaw moving it back and forward, as well as from side to side;

Lower the jaw book with resistance;

Develop cheeks alternately retracting either inflating them;

Rolling the "balloon" from the cheek to the cheek;

Tighten both cheeks so that the "Fish Rot" has been formed and move lips;

Pierce as a horse;

Gently shake the lips;

Pull the tongue with the sharp tip morestantly, after put it relaxed on the bottom of the lip.

Specific speech articulation disorders (dischairs) in children

The frequency of articulation disorders is installed in 10% of children under 8 years and 5% of children over 8 years old. Boys meet 2-3 times more often than girls.

Functional dilacium - defects of playing sound sounds in the absence of organic violation1 in the structure of the articulation apparatus.

Mechanical discharge - impaired sound-proof, due to the anatomical defects of the peripheral speech apparatus (incorrect bite, thick language, short bridle, etc.).

Causes and pathogenesis of disliers

The establishment of anatomical defects that could cause a violation of pronunciation in connection with which the counseling of orthodontist is needed.

Differentiation from secondary disorders caused by the deafness, based on the data of an audiometric study and the availability of high-quality pathological signs of speech pathology.

Differentiation of articulation disorders due to neurological pathology (dysarthria) are based on the following signs:

for dysarthritis, a small speech speed is characterized, the presence of violations of chewing and sucking functions;
disorder concerns all the background, including vowels.

In doubtful cases, to carry out differential diagnosis and establishing an anatomical focus of the lesion, instrumental studies are carried out: EEG, echohetephalography (echo), MRI brain, CT brain.

It does not differ from the prevention of other types of violations of speech development and language.

Articulation Development Disorder

it is characterized by frequent and repeated violation of speech sounds, as a result of which it becomes pathological. Development in the field of language within the normal range. For the designation of these phenomena, a number of terms are applied: infant speech, leptan, dilac, functional speech disorders, infantile entertainment, infantile articulation, delayed speech, whispering, inaccuracy of oral speech, lazy speech, specific violation of speech development, as well as inaccurate speech. In most light cases, intelligence is not very disturbed, and possible spontaneous recovery. In severe cases, there may be completely incomprehensible speech, which requires a long and intensive treatment.

Definition

Articulation disorder is defined as a significant violation of mastering the normal articulation of speech sounds at the appropriate age. This condition cannot be due to a delicate development disorder, mental retardation, violation of internal speech mechanisms or neurological, intellectual violations and violations of the ability to hear. The disorder manifested by the frequent wrong pronunciation of sounds, replacing or passing them creates the impression of "infant speech".

Below are diagnostic criteria for disorders of development, articulation.

A. A significant violation of the ability to correctly use speech sounds that would have to develop at the appropriate age. For example, a three-year-old child has the inability to pronounce n, b and t sounds, and 6-year-old - p, sh, h, f, c.
B. is not related to the delicate development disorders, mental retardation, violation of the ability to hear, disorder the mechanism of oral speech or neurological disorder.

This disorder is not associated with any anatomical structures, auditory, physiological or neurological disorders. This disorder refers to a number of different violations of articulation, varying from lungs to severe forms. It may be completely understandable, partially understandable or incomprehensible. Sometimes the pronunciation of one sound of speech or phonemes is broken (the lowest sound) or many sounds of speech are affected.

Epidemiology

The frequency of articulation development disorders is set approximately 10% of children under 8 years and approximately 5% of children over 8 years old. This disorder is 2-3 times more common in boys than girls.

Etiology

The cause of articulation development disorders is unknown. It is usually believed that a simple developmental delay or delay in maturation of neurological processes, and not organic dysfunction underlies the violation of speech.

A disproportionately high level of articulation disorders was found among children from large families and low socioeconomic classes, which may indicate one of the possible causes - an incorrect speech at home, and reinforcement of a lack of these families.

Constitutional factors are larger than environmental factors affect the fact that the child will or will not suffer from articulation disorder. A high percentage of children with this disorder, in which many relatives suffer from similar disorders may indicate the presence of a genetic component. As shown, poor motor coordination, weak lateralization and right-or-leviculture are not related to the developmental disorder of articulation.

Clinical features

In severe cases, this disorder is recognized for the first time at the age of about 3 years. In less severe cases, the disorder may be unclear up to 6 years of age. The essential features of the development of articulation development include articulation, which is estimated as defective when compared with the language of children of the same age and which cannot be explained by the pathology of intelligence, hearing or physiology of speech mechanisms. In very easy cases, there may be a violation of the articulation of only one phoneme. It is usually disturbed by single phonemes, those that are mastered at an older age in the process of normal languages.

Speech sounds that are most often incorrect are pronounced, are the most late in the sequence of masterful sounds (P, W, C, F, Z, H). But in more severe cases or in young children there may be a violation of the pronunciation of such sounds as l, b, m, t, d, n, x. Can be disturbed by the pronunciation of one or more speech sounds, but the pronunciation of vowels is never disturbed.

A child with a violation of the development of articulation cannot pronounce certain phonemes correctly and can distort, replace or even skip phonemes that it cannot correctly pronounce. When passing the phoneme, there are no fully-for example, "Gooy" instead of "Blue". When replacing, difficult phonemes are replaced with incorrect, for example, "Quolik" instead of "rabbit". When distorted, approximately the correct phonemes are selected, but their pronunciation is wrong. Occasionally something is added to the phonemes, usually vowels.

Skipping are most often found in speech in young children and appear at the end of words or clusters of consonants. Distortions that are found mainly from older children are expressed in sounds that are not part of the speech dialect. Distortions can be the last type of violation of articulation, which remained in the speech of children, whose impaired articulation has almost disappeared. The most frequent type of distortion is "lateral slipping", in which the child pronounces the sounds with a stream of air passing through the language, which produces a whistling effect, as well as the "whisper", at which the formation of sound occurs at a very close language of the language to the sky, which produces a hissing Effect. These violations are often inconsistent and random. The phoneme in one situation can be pronounced correctly, and in the other - incorrectly. Articulation disorders especially often occur at the end of words, in long syntactic complexes and suggestions and during fast speech. Pass, distortion and replacements also appear in normal children, students to talk if normal children quickly correct their pronunciation, children with articulation disorder-no. Even as the child's growing and development, when the profound pronunciation improves and becomes correct, it sometimes concerns new words again, while the words previously learned incorrectly can still be pronounced with an error.

By the third class, children sometimes overcome articulation disorder. However, after the fourth grade, if earlier the lack was not overcome, the spontaneous cure from it is unlikely, therefore it is especially important to correct the disorder to the development of complications.

In most light cases, the restoration of the spontaneous articulation disorders, and often he contributes to the admission of a child in a kindergarten or school. These children are fully shown classes with a speech therapist, aimed at setting the sounds of speech if they have no spontaneous improvement to six years. For children with significant violations of pronunciation, with incomprehensible speech and especially for those who are very worried about their defect, it is necessary to provide an early start of classes.

There are also other specific development disorders, including expressive speech development disorder, recipe development disorder, reading disorder and coordination disorder. It may also be functional enuresis.

Delay in the development of speech, achievement in this development of a certain milestone, for example, the pronouncement of the first word and the first sentence, is also noted in some children with a disorder of articulation development, but most children begin to speak at regular age.

Children with violation of the development of articulation can detect a variety of accompanying disorders of social, emotional and behavioral nature. Approximately in '/ s of these children, there is a mental disorder, for example, hypereactivity with attention disorder, disorder in the form of anxiety when separated with loved ones, disorder in the form of avoiding, violation of adaptation and depression. Those children who have a serious pronounced articulation disorder, or those whose disorder is chronically without remission or re-form a risk group for the development of mental diseases.

Differential diagnosis

Differential diagnosis of articulation development disorder includes three stages: first, it is necessary to determine that the violation of the articulation is quite serious to be considered pathological, and excludes a normal violation of the pronunciation in young children; secondly, it should be noted the absence of physical pathology, which could determine the pronunciation and exclude dysarthria, hearing impairment or mental retardation; Thirdly, it is necessary to establish that the expression language is expressed within the normal range and exclude the disorder of the development of the language and interpretable development disorders. Approximately one can be guided by the fact that a 3-year-old child normally pronounces the m. N, b, p, c, f, g, x, t, d;, and a normal 5-year-old child correctly utters all the sounds.

To exclude physical factors that could determine some types of impaired articulation, it is necessary to produce neurological, structural and audiometric methods of examination.

Children with dysarthriah, in which articulation disorder is due to structural or neurological pathology, differ from children with the development of articulation development in the fact that the dysarthria is extremely difficult to corrected, and sometimes it does not succumb to. A meaningless chatter, slow and non-coordinated motor behavior, violation of chewing and swallowing, as well as cramped and slowing down, and retract language are signs of dysarthria. Small speech speed is another sign of dysarthritia.

Forecast

Recovery is often spontaneous, especially in children who have a violation of articulation includes only a few phonemes. Spontaneous recovery rarely occurs over the age of 8.

Treatment

The speech therapy correction is considered successful for most articulation errors. Correction classes are shown when the articulation of a child is such that his speech is incomprehensible when a child suffering from an impaired articulation, over 6 years old, when speech difficulties clearly cause complications in handling peers, difficulties in study and adversely affect the formation of their own image when violations Articulations are so heavy that incorrectly pronounced a lot of consonants, and when errors include skipping and replacing the phone, and not distortion.

Bibliography

Kaplan G.I., Satur B. J. Clinical Psychiatry, T. 2, - M., Medicine, 2002

Multiple classification of mental disorders in children's and adolescence. Classification of mental and behavioral disorders in children and adolescents in accordance with ICD-10, - M., Meaning, Academy, 2008

What is a specific speech articulation disorder -

In most cases, a non-verbal intellectual level within the normal range.

The frequency of articulation development disorders is installed in 10% of children under 8 years and 5% of children over 8 years old. This disorder is 2-3 times more often in boys than girls.

What provokes / reasons for specific speech articulation disorder:

The cause of articulation development disorders is unknown. Presumably, the violation of the speech is the delay in the development or ripening of neuronal bonds and neurological processes, and not organic dysfunction. The high percentage of children with this disorder, in which many relatives suffer from similar disorders indicates the genetic component. With this disorder there is no thin differentiation of motor kinesthetic stones, sky, lips; The brain basis is the activity of post-central departments of the left hemisphere of the brain.

Symptoms of specific speech articulation disorder:

An essential feature is a defect of articulation, with a steady inability to apply in accordance with the expected level of development of speech sounds, including skipping, replacement and distortion by the phone. This disorder cannot be caused by structural or neurological pathology and is accompanied by the normal development of the language sphere.

In more severe cases, disorder is recognized about 3 years. In easily cases, clinical manifestations may not be recognized up to 6 years. The essential features of the speech articulation disorder is the violation of the acquisition by the child speech sounds, leading to disarcticulation with difficulties for other understanding of his speech. Speech can be assessed as defective when compared with the language of children of the same age and which cannot be explained by the pathology of intelligence, hearing or physiology of speech mechanisms. The pronunciation of speech sounds is often disturbed, which appear later in ontogenesis, but the pronunciation of vowels is never disturbed. The most severe type of violations - skipping sounds. Replacing and distortion - less severe type of disorders. Children with articulation development disorder can detect concomitant disorders of social, emotional and behavioral nature. In 1/3 of these children, there is a mental disorder.

Diagnosis of specific speech articulation disorder:

Includes three stages:

1. Allocation of the severity of articulation disorder.
2. The exception of physical pathology, which could determine the pronunciation, dysarthria, hearing impairment or mental retardation.
3. Exception of expressive speech development disorder, general development disorder.

For violations of articulation caused by structural or neurological pathology (dysarthria), a small speech speed, non-appoded motor behavior, vegetative function disorders, for example, chewing, reusable. Possible pathology of lips, tongue, sky, muscle weakness. Disorder concerns all the background, including vowels.

Treatment of specific speech articulation disorder:

The most successful speech therapy for most articulation errors.

Drug treatment is shown in the presence of concomitant problems of emotional and behavioral nature.

What doctors should be applying if you have a specific speech articulation disorder:

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Specific speech articulation disorder

What is a specific speech articulation disorder

It is characterized by frequent and repeated impaired speech sounds. The use of sounds below the level corresponding to his mental age - that is, the acquisition of speech sounds, either detained, or deviates, leading to disarcticulation with difficulties in understanding his speech, miss, replace, distortions of speech sounds, changes depending on their combination ( Says correctly, then no). Most speech sounds are purchased by 6-7 years, by 11 years all sounds must be purchased.

In most cases, a non-verbal intellectual level within the normal range.

The frequency of articulation development disorders is installed in 10% of children under 8 years and 5% of children over 8 years old. This disorder is 2-3 times more often in boys than girls.

What provokes a specific speech articulation disorder:

Symptoms of specific speech articulation disorder:

Diagnosis of specific speech articulation disorder:

Includes three stages:

1. Allocation of the severity of articulation disorder.

Treatment of specific speech articulation disorder:

The most successful speech therapy for most articulation errors.

Drug treatment is shown in the presence of concomitant problems of emotional and behavioral nature.

F80.0. Specific speech articulation disorder

Specific development disorder, in which the child's use of speech sounds below the level corresponding to his mental age, but in which there is a normal level of speech skills. The diagnosis can be delivered only when the severity of the violation of the articulation is outside the boundaries of normal variations corresponding to the child's mental age; non-verbal intellectual level within the normal range; expressive and receptive speech skills within the normal range; The pathology of articulation cannot be explained by the sensory, anatomical or neurotic anomaly; Incorrect pronunciation is undoubtedly anomalous, based on the specifics of speech consumption in the subcultural conditions in which the child is located.

The development associated with the development of physiological disorder;

Articulation development disorder;

Functional disorder of articulation;

Lept (children's form of speech);

Frustration of phonological development.

F80.1. Disorder expressive speech

A specific disorder of development in which the child's ability to use expressive speaking is noticeably below the level corresponding to his mental age, although the understanding of the speech is within the normal range. In this case, there may be or not to be an articulation disorder.

Often, the insufficiency of spoken speech is accompanied by a delay or violation of verbal and sound pronunciation. The diagnosis should be established only when the severity of the delay in the development of expressive speech goes beyond the limits of normal variations for the mental age of the child; Skills of recipe speech in the normal limits for the mental age of the child (although it often can be slightly lower than the average level). Violation of colloquial speech becomes apparent from infancy without any long-term distinct phase of normal use of the speech. However, it is often found that the use of several individual words, accompanied by a speech regression or a lack of progress, is obviously observed in adults, they are always accompanied by mental disorder and are organically accompanied by mental disorder.

Speech delays in the type of general underdevelopment of speech (ONR) I-III levels;

Associated with the development of expressive dysfassium;

Associated with the development of an expressive type Afasia.

F80.2. Discharge of recipe speech

A specific impairment of development, in which the understanding of the child's speech is below the level corresponding to his mental age. In all cases, expansive speech is also noticeably violated and is often a defect of the verbal and sound pronunciation.

The diagnosis can be established only when the severity of the delay in the development of recipe speech is beyond the limits of normal variations for the child's mental age and when there is no criteria for general development disorder. Almost in all cases, the development of expressive speech is also seriously detained and disturbances of verbal and sound pronunciation are often found. Of all the options for specific violations of the development of speech, with this embodiment, the highest level of accompanying socio-emotional behavioral disorders is noted. These disorders do not have any specific manifestations, but hyperactivity and inattention, social non-

infeitness and isolation from peers, anxiety, sensitivity or excessive shyness are quite common. In children with heavier forms of disruptive speech, a fairly pronounced delay in social development may be celebrated; It is possible to imitate with the misunderstanding of its meaning and restriction of interests can be manifested. Similar speech disorders of the recipe (sensory) species are observed in adults, which are always accompanied by a mental disorder and are organically determined.

The structure of speech disorders is indicated by the second code R47.0.

Recipe type dysfasis related to development;

Receptive type of development associated with development;

articulation Disorder Speech

Universal Russian-English dictionary. Academician. 2011.

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dysarthria - articulation disorder with an ambiguity of pronunciation (especially consonant sounds), slow motion and intermittentness of speech.

In most cases, a non-verbal intellectual level within the normal range.

Etiology and pathogenesis

Prevalence

The frequency of articulation development disorders is installed in 10% of children under 8 years and 5% of children over 8 years old. This disorder is 2-3 times more often in boys than girls.

Clinic

Differential diagnosis

Includes three stages:

1. Allocation of the severity of articulation disorder.

2. The exception of physical pathology, which could determine the pronunciation, dysarthria, hearing impairment or mental retardation.

3. Exception of expressive speech development disorder, general development disorder.

For violations of articulation due to structural or neurological pathology (dysarthria)characterized by small speech speed, non-coordinated motor behavior, frustration of vegetative functions, such as chewing, reusable. Possible pathology of lips, tongue, sky, muscle weakness. Disorder concerns all the background, including vowels.

Therapy

The most successful speech therapy for most articulation errors.

Drug treatment is shown in the presence of concomitant problems of emotional and behavioral nature.

Expressive speech disorder (F80.1).

A pronounced violation of the development of speech, which cannot be explained through mental retardation, inadequate training and which is not associated with the general disorder of development, hearing impairment or neurological disorder. This is a specific impairment of development, in which the ability of the child to use expressive speaking is noticeably below the level corresponding to his mental age. Understanding speech within the normal range.

Etiology and pathogenesis

The cause of expressive speech development disorder is unknown. Minimum brain dysfunction or delay in the formation of functional neural systems is made as possible causes. The presence of family history indicates the genetic determination of this disorder. The neuropsychological disorder mechanism may be associated with the kinetic component, with interest in the process of prime departments of the brain or rearhead structures; With the non-formation of the nominative function of speech or non-formation of the spatial representation of speech (temporal departments and the area of \u200b\u200bthe dark-temporal-occipital crossing) under the condition of the normal left-hand localization of speech centers and functioning disorders in the left hemisphere.

Prevalence

The frequency of expressive speech disorders ranges from 3 to 10% in school children. 2-3 times more often found in boys than girls. More often occurs among children, in the family history of which there are arctications of articulation or other development disorders.

Clinic

Heavy disorders usually manifest up to 3 years. The absence of separate word formations - to 2 and simple proposals and phrases by 3 years - a sign of delay. Later violations - limited dictionary development, the use of a small set of template words, difficulties in the selection of synonyms, abbreviated pronunciation, the immature structure of proposals, syntactic errors, skipping of verbal endings, consoles, improper use of prepositions, pronoun, hinge, leaning verbs, nouns. Lack of smoothness in the presentation, lack of sequence in presentation and during retelling. Understanding speech is not difficult. Characterized by adequate use of non-verbal replicas, gestures, desire for communication. Articulation is usually immature. There may be compensatory emotional reactions in relationships with peers, behavioral disorders, inattention. Coordination development disorder and functional enuresis are often associated violations.

Diagnostics

Expressive speech indicators are significantly lower than the indicators obtained by non-verbal intellectual abilities (a non-verbal part of the test of the ventilation).

Disorder greatly prevents success in school and everyday life requiring expressions in verbal form.

Not related to general developmental disorders, hearing defect or neurological disorder.

Mental disorders are mainly accompanied by obsessiveness, asthenic syndrome, depression, manic states, senthenetics, hypochondriac syndrome, hallucinations, delusional disorders, catatonic syndromes, dementia and resolution syndromes of consciousness. The clinical picture and symptomatics usually depends on factors provoked a mental violation, as well as from forms, stages and types of mental disorders. Children with similar pathologies are usually distinguished by emotional instability. They are characterized by increased fatigue, mood fluctuations, feeling of fear, mannerial, uncertainty, fussiness, familiarity, non-diffened consumption of words, small vocabulary, difficulty in arbitrary operating words, increased vegetative and general excitability, sleep disorder, gastrointestinal disorders. Violations of mental development in children are mainly manifested in the form of distortion (autism), psychopathy, lack of self-determination, personal development damage, problems with cognition and impossibility of mental development. These violations are most often associated with brain dysfunction, and, as a rule, begin to manifest themselves in early childhood. Also, the NPR in children can be accompanied by impatience, impairment, insufficiency of focus, hyperactive behavior (many movements with hands and legs, rotation in place), quiet speech, reduced memory, low memory speed, low productivity, and so on.

This disorder associated with development is manifested in the fact that the use of speech sounds is at a lower level than it is expected by its age, but the level of the child's linguistic skills is normal.

This is quite a frequent phenomenon in young children. It is called molding, whispered, infant speech, poverty, discharge, lazy speech, inaccurative speech.

In most cases, intelligence is not broken.

In severe cases, articulation disorder is detected at the age of 3 years. In easier cases, the violation may not be explicit until 6 years.

Articulation in such children is significantly different from the articulation of their peers. Especially difficult to children are given such sounds as "in", "l", "p", "h", "sh", "f", "c", "b", "t", all or some of them. Sometimes one sound can be disturbed.

A child with an impaired articulation cannot pronounce certain sounds correctly, distorts them, replaces others or misses if it cannot pronounce them correctly.

Distortion is the easiest option of violation of articulation. When disturbing, the child utters approximately the right sounds, but in general, the pronunciation is wrong to facilitate the pronunciation of difficult sounds, between the consonants, the child can add vowels, for example, "Palyka" instead of "stick", "Vazal" instead "took".

When replacing, hard sounds are replaced with incorrect, for example, "Labota" instead of "work", "idle" instead of "good".

The most serious impaired articulation is the skipping of difficult sounds and syllables, for example, "Bono" instead of "pain", "Gavka" instead of "head", "Kotik" instead of the "bell". Pass comes most often are characterized by children of younger.

The child's speech can be understandable, partly understandable or incomprehensible (or understandable only to his parents). In severe cases, the child's speech is completely incomprehensible to parents, and the surrounding and requires long-term treatment.

The frequency of this disorder in children under 8 years is 10%, and children over 8 years old - 5%. In most light cases, children under 8 years have recovered without treatment. But in children over 8 years in itself, this disorder usually does not pass, and a qualified treatment is required.

Although this violation of articulation is more related to the speech therapy, but psychiatrists often have to meet with the consequences of untreated disorder, especially in adolescent and older age, when due to the preservation of the speech defect there are violations of behavior and social deadaption.

Children and adolescents can be shying their shortage, to become the object of ridicule peers, because of this, they have a complex of inferiority, they may refuse to attend classes at school, communicate with peers and exercise protest reactions.

In adults, the speech defect limits their opportunities in professional activities.

Therefore, articulation disorder should be treated since the small years, when treatment is much more successful than adults.