Making sounds for dysarthria

Article:

Dysarthria is a speech disorder. It occurs due to damage to the parts of the brain that are responsible for connections with the articulatory apparatus. One of the most common and simplest forms is erased dysarthria. It is diagnosed when the child reaches 5 years of age. The baby's speech is slurred, he distorts or replaces sounds, he has poor diction - these are the signs of this disease.

In the article we will talk about correctional work for dysarthria, features of sound production, complex treatment and prevention of the disease.

Principles of speech correction for dysarthria

Speech therapists use several principles when working with children. Here they are:

Individual approach. The specialist evaluates the compensatory capabilities of the little patient - what articulatory movements have been preserved, what sounds and syllables the baby pronounces correctly;
From simple to complex. Correction always begins with those sounds that the child pronounces best. This sequence of sound production for dysarthria allows you to achieve better results.
Long practice of each sound. Speech correction in children with dysarthria requires much more time than other speech therapy problems.

Corrective work includes the following stages: production, automation and differentiation of sounds. But the very first task of a speech therapist is to teach the child to distinguish them by ear.

What to do if a child is diagnosed with dysarthria: advice from a speech therapist

Some parents are faced with the fact that their child - natural or adopted - has speech problems and, hearing the word “dysarthria”, feel confused. What is dysarthria, why does it occur and how to correct it, says Resource specialist, speech therapist of the highest category, member of the Russian Dyslexia Association Galina Orlova.

− Dysarthria is a disorder of the pronunciation side of speech, which is associated with damage to the central part of the speech motor analyzer and a violation of the innervation of the muscles of the articulatory apparatus. Simply put, the child cannot fully perform the movements necessary for speech. Sound pronunciation suffers from this, explains Galina. - In milder cases, this is a distortion of certain sounds. In severe cases of the diagnosis, omissions and replacement of sounds may be noticed. The pace and expressiveness of speech are impaired.

Dysarthria can also be characterized by the presence of paralysis and paresis of the organs of articulation. In this case, incomprehensible speech is a consequence of the diagnosis, up to the absence of speech due to complete paralysis of the speech motor muscles - anarthria.

The causes of dysarthria can be different - deviations from the norm during intrauterine development due to toxicosis, hypertension, nephropathy in the mother, infectious diseases suffered by a woman during pregnancy, as well as asphyxia of newborns, rapid or prolonged labor, mechanical obstetrics, a long anhydrous period in childbirth

From the very first days of life, such children are observed by a neurologist. They are often prescribed medication, massage and other rehabilitation procedures.

− How to recognize dysarthria?

− An attentive parent may suspect it by the child’s unusual facial expressions, profuse salivation, the shape and position of the tongue, the ability to fix an articulatory position, and sound pronunciation.

− When should you start working with dysarthrics?

− It is advisable to begin speech therapy work with any speech disorder in early preschool age. The earlier the disease is diagnosed, treatment and corrective classes are started, the greater the chances of success.

− What should parents do if their child is diagnosed with dysarthria?

— The first step, of course, is an examination by a neurologist. There are no special medications to combat dysarthria. The doctor only corrects some neurological symptoms with the help of medications. It is also important to consult a speech therapist who knows the technique of speech therapy massage, who, after a full examination, will give a conclusion and recommendations.

In addition, experts advise developing fine motor skills. You can assemble puzzles and Lego sets, sculpt from plasticine - there are many games that develop little fingers. You can use non-traditional methods of influence, such as su-jok therapy. The simplest method of su-jok therapy is training with special massage balls.

Logorhythmics classes are recommended for children two to three years old, for example, according to Zheleznova’s method. To correct dysarthria in children five years old, a speech pathologist is involved in the classes.

− What is the focus of the speech therapist’s work in the classroom?

— The specialist is engaged in the development of the prosodic side of speech - rhythm, strength, timbre, melody, tempo, logical stress, diction, as well as articulation and sound pronunciation, auditory attention, phonemic hearing, correction of speech breathing. The speech therapist will also pay attention to the normalization of muscle tone in the articulatory muscles and the development of voluntary facial movements.

If you do not have the opportunity to visit a speech therapist, then you can work with your child at home on your own, having previously completed a course with a specialist.

I will give examples of some elements of speech therapy massage and self-massage: take turns puffing out our cheeks, retracting our cheeks; close and open your mouth, click your teeth; suck on a small piece of sugar or candy; imitate the resorption of a lollipop; lick your lips; We hold a piece of bandage or gauze with our teeth for a long time; the adult’s task is to try to carefully remove the fabric.

It is also important to perform a complex of articulatory gymnastics - these are the “Proboscis” exercises (pull your lips forward, teeth and lips are closed, hold for five seconds), “Fence” (lips in a smile are tense with the mouth slightly open, teeth are clenched, the lower jaw is in a calm state, hold for five seconds) and their alternation, “Window” (with each count we open and close our mouth), “Spatula” (when smiling with an open mouth on a relaxed lower lip, place the tongue flat, hold for five seconds), “Needle” (smile with an open with our mouth, we put our tongue forward, trying not to bend it upward), “Needle shovel” (alternating exercises), “Clock” (we smile with our mouth open, stick out our tongue and make movements to the right and left, while touching the corners of our mouth with our tongue), “ “Swing” (smile with an open mouth, the tip of the tongue resting either on the upper or lower teeth), “Horse” (we click the tip of the tongue, imitating the clatter of hooves).

Over the years of work, I have often met children diagnosed with dysarthria of varying severity. This type of speech disorder has become a global problem in recent years, so it is extremely important to identify disorders in time and consult a specialist. But parents should know that correctional work with dysarthric children should not be limited to classes with a speech therapist. For the best results, this work should be continued at home, on a walk and in any joint activities.

Press service of the Department of Labor and Social Protection of the Population of Moscow

Stages of correction of sound pronunciation disorders

The speech therapist adheres to a strict sequence of sound production for dysarthria. Corrective work consists of 6 stages.

First: the specialist prepares the articulatory base for the production and pronunciation of palatal, sonorant, hissing and whistling sounds. When the baby masters some of them, the speech therapist moves on to working on them. It involves kinesthetic, auditory and visual control. Here is an example of a speech therapist’s instructions to a small patient: “Look in the mirror and repeat after me,” “Look in the mirror and do the exercise,” “Look at yourself in the mirror, stretch out your lips.” This feature of sound production gives good results.

This approach is necessary to reduce the apraxic disorders that accompany dysarthria. In general, the first stage is the foundation for the further development of sound pronunciation skills.

Second: the speech therapist determines the sequence of correction. He assesses which articulatory structure the patient has “mature”. Many children with motor and speech disorders are better at producing more complex sounds, such as hissing sounds. But the patient can master lighter whistling sounds, with which it is recommended to begin correction, later.

Third: the specialist stimulates or plays a certain sound. When staging, he uses classical techniques - staging by imitation, mechanical or mixed method.

Fourth: consolidation, or automation. This is the most difficult stage in all correctional work. It takes the most time. Often children master a sound and pronounce it in isolation, but make mistakes in speech. Therefore, after the production stage, the speech therapist focuses on working on isolated sound pronunciation, and then connects words with different syllable structures. Thus, the child pronounces the sound at the beginning, middle or end of words. Then the speech therapist connects sentences in which the sound being studied is concentrated.

The speech therapist selects lexical material individually. It must be appropriate for the baby’s age and capabilities, and also not include sounds that he cannot yet pronounce or distort.

Fifth: separation of delivered and oppositional sounds. First, the speech therapist suggests 2 syllables, then increases to 3. for example, sa - sha, sta - shta, etc. After this, he works on pairs of words with different syllable structures.

Sixth: developing communication skills. Another difficult stage. Often children communicate in a speech therapist’s office, but in front of other people and outside the office, the acquired speech skills are lost, and the child begins to speak “the old fashioned way.” In order to develop communication skills, the painstaking work of a speech therapist is necessary, but without the desire of the child himself, success cannot be achieved either.

The development of communication skills in dysarthria is facilitated by techniques such as memorizing rhymes, retelling or writing stories.

Speech therapy program

Dysarthria is a pathology that requires persistent, long-term work by the speech therapist, the patient, his relatives and caregivers. A speech map of a speech therapy examination for dysarthria is drawn up. The speech therapy support program is approved after receiving a speech therapy report for dysarthria and recommendations from a neurologist who treats the disease that has caused speech impairment. Speech therapy classes for dysarthria begin as early as possible.

There are the following main areas of speech therapy work for dysarthria:

Normalization of motor skills of the articulatory apparatus;
Development of articulatory movements;
Formation of the ability to voluntarily switch movable organs of articulation from one movement to another at a given pace;
Overcoming monotony and speech tempo disturbances;
Full development of phonemic awareness.

The importance of the early start of speech therapy work for dysarthria cannot be overestimated. Speech therapists at the Yusupov Hospital begin to work on restoring speech in patients who have suffered a stroke or acute traumatic brain injury, immediately after the patient’s consciousness has been restored. For demyelinating diseases of the nervous system, speech therapy work is included in the rehabilitation program.

When carrying out correctional speech therapy work, the following speech therapy methods are used:

Voice and breathing exercises;
Active and passive articulatory gymnastics;
Differentiated speech therapy massage (relaxing or stimulating);
Acupressure, probe, brush, manual massage;
Artificial local contrastothermy (combination of exposure to low and high temperatures).

Speech therapy for dysarthria is based on compliance with the following principles:

Systematic approach to the analysis of speech defects;
Stage-by-stage interconnected formation of all components of speech;
Regulation of children's mental activity through the development of generalizing and communicative functions of speech.

In the process of systematic long-term training, a gradual normalization of the motor skills of the articulatory apparatus, the development of articulatory movements, and the formation of the ability to voluntarily switch the movable organs of articulation from one movement to another at a given pace are carried out. Monotony and disturbances in the tempo of speech are overcome, and full-fledged phonemic perception develops. This prepares the basis for the development and correction of the sound side of speech.

Gymnastics for making sounds

Finger games must be included in the correction program for dysarthria. They can be done at home with your parents. For example, these:

Reading book “Finger Boy, Where Have You Been?” The child opens his palm and, for each line of the rhyme, touches each finger with his thumb - index, middle, ring and little fingers.
"We depict animals." This is an analogue of the “Shadow Theatre”. The kid opens his palm, sticks his thumb up - imitates a dog. Raises and lowers the little finger - the dog barks. And if you press your ring and little fingers with your thumb to your palm, and raise your middle and index fingers up, you will get a bunny that moves its ears.
Hand massage. The technique depends on the tone of the hands.

If you have spasticity, you need to relax: stroke your arms: from your fingertips up to your palms and to your shoulders. Then repeat the movement from top to bottom.

When hypotonicity occurs, muscles need to be strengthened. To do this, parents actively knead and rub their fingers and palms. Stimulating movements.

Stages of speech therapy work

Speech therapy work for dysarthria is carried out in stages. The main goal of the first, preparatory stage is to prepare the articulatory apparatus for the formation of articulatory patterns, correction of breathing and voice. An important task at this stage is the development of sensory functions, especially auditory perception and sound analysis, as well as the perception and reproduction of rhythm. Speech therapy work is carried out against the background of medication and physiotherapeutic treatment, massage and physical therapy.

At the second stage, primary communicative pronunciation skills are formed. Its main goal is the development of speech communication and sound analysis. The speech therapist works to correct articulation disorders. In case of spasticity, they work on relaxing the muscles of the articulatory apparatus. Control over the position of the mouth is developed, articulatory movements develop, speech breathing is corrected, the voice, sensations of articulatory movements and articulatory praxis develop.

The formation of sound pronunciation in dysarthria includes the production and consolidation of sounds in speech. The first group of sounds includes phonemes that are the easiest in terms of articulation and acoustically distant from each other. These are the sounds a, y, p, m, n, k, s, x, v, o, l, t, s. These sounds, being the simplest ones, are worked out to the norm. Along the way, these phonemes are used to develop phonemic perception and sound analysis skills (identifying sounds from a number of others, from syllables, in simple words).

Tongue twisters for dysarthria are a phonetic means of developing the mobility of the articulatory apparatus. When using tongue twisters, adhere to the following recommendations:

The work begins with simple, short, rhyming phrases (“White sheep beat the drums”);
The principle of selection of didactic material is observed (the tongue twister should not contain words with sounds that are poorly pronounced by the patient;
Tongue twisters are best used in games.

An individual approach to the selection of means and methods of speech therapy work at each stage of treatment for dysarthria allows specialists at the Yusupov Hospital to achieve speech restoration in patients who were abandoned in other rehabilitation centers.

A set of articulation exercises

The exercise includes 5 exercises and can also be done at home.

“Horse” - clicking the tongue. This is a very useful and effective exercise. Not all children get it right away.

“Pancakes” - the baby opens his mouth slightly, spreads his tongue into a flat pancake.

“Snake” - the child imitates the sting of a snake - the tongue is just as sharp. Then he sticks it back and forth.

“Tube” - the baby tries to roll his tongue into a tube.

Another exercise is to try to reach the tip of your tongue to your nose and then to your chin.

Front-lingual sounds

With dysarthria, all groups of sounds often suffer. For example, “D”, “T” and their soft pairs. Various techniques are used for correction. Before this, the mobility of the lower jaw must be developed. The tip of the tongue should rise towards the upper teeth.

To produce the sound “D” in a child with dysarthria, the following technique is used: they are asked to pronounce “B” for a long time and at this time the tip of the tongue is carefully lifted with a spatula. Afterwards, attention is focused on auditory perception.

Sometimes correction of the “T” sound in the interdental position is allowed. To do this, ask the preschooler to tap his tongue between his teeth and say “ta.” Over time, the tongue will retract itself behind the teeth.

For each group, staging techniques may be different. For example, it is advisable to insert back-lingual ones (“K”, “G”, “X” and soft pairs) with a special probe that will move the tongue deeper into the mouth.

A set of breathing exercises

Includes 2 exercises. Parents can easily do them with their baby at home.

"Racing" . Place two cotton balls on the table. The parent blows on one balloon, the child on the other. The one who moves his ball the greatest distance wins.

"Magic Breath" . Insert pieces of cotton wool into the baby's nostrils. The main thing is not deep! Ask him to exhale and at the same time hold the cotton wool - it should not fall out.

Another version of breathing exercises is according to A.N. Strelnikova. The essence of gymnastics is to take a sharp breath through your nose every second and do the exercises at the same time. The inhalation is noisy and strong, and the exhalation is natural, imperceptible.

There are several rules: with each inhalation, lower your shoulders and close your nostrils tightly, as if someone is pressing on them.

Gymnastics should be a joy, so you need to do it until the first signs of fatigue. There is no need to force your child if he does not want to study.

Gymnastics is designed for adults, so the duration of the lesson and the number of approaches is best agreed upon with a speech therapist.

Preparatory activities

Before you start producing any sound and performing automation, you need to create the conditions for its appearance. To do this, you need to develop speech breathing.

When any phoneme is reproduced, all the air goes into the oral cavity. If it is weak or absent, then there will be no clear pronunciation. To develop it, Strelnikova’s gymnastics and various types of exercise equipment are used.

Their operating principle is the same. For example, a picture of a meadow with flowers is placed in front of a preschooler. A ladybug cut out of paper sits on a daisy. It needs to be blown off carefully.

The student’s attention is concentrated on the fact that he needs to inhale through his nose and exhale forcefully through his mouth. If the actions are carried out correctly, the ladybug will be blown away from the picture.

It is necessary to ensure that the child does not puff out his cheeks. If this happens, you can lightly hold them with your palms.

It is useful to blow on plumes, wind blowers, and feathers. In short, everything that can show air movements. Under no circumstances should a lesson be conducted without visualization. A preschooler simply will not understand what is required of him.

Articulation gymnastics

To produce the sound “R” for dysarthria and others, it is necessary to prepare the speech organs. Due to increased or decreased tone, poor level of sensitivity of movements, it is difficult for the child to perform some positions. For example, raise the tip of the tongue to the dental alveoli.

Gymnastics is always performed in front of a mirror! The child must get used to visual control!

A set of exercises is selected individually for each group of sounds.

For example, for whistlers it includes:

“Pancake” - a flat tongue is placed on the lower lip and slightly bitten with the tongue. The process is accompanied by the pronunciation of the sound “pppppppp”.
“Shovel” - a wide tongue is placed on the lower lip and held for several seconds.
“Watch” - the mouth is open, the tongue does not touch the lips and teeth, it moves from side to side.

Gymnastics are carried out until there is perfect reproduction. This stage cannot be neglected. Without the ability to make a “cup” (when the mouth is open, the tongue protrudes and its edges rise), it is impossible to talk about the pronunciation of “Sh”.

We train to navigate in space

“Whose traces?” . Pictures with traces of hands and feet are needed. The baby must determine which arm or leg is right and which is left.
"Supermarket" . The parent asks the child to arrange the goods: “on the shelf”, “near the cash register”, “to the right of the cookies”, “under the counter”.
Counting sticks. Can be replaced with matches. The parent makes some figure out of them, and the baby makes a similar one according to the image.

This complex can also be performed at home.

Methods for diagnosing dysarthria

Dysarthria is usually preceded by a primary neurological disease, such as cerebral palsy. Therefore, before starting classes with a speech therapist, you need to consult a neurologist. Only he can diagnose the disease.

Diagnosis includes electroencephalography, MRI of the brain, electroneurography or other examinations. After this, the neurologist refers the patient to a speech therapist. In turn, the specialist, based on speech therapy tests, will determine the form and degree of the speech disorder.

Making the sound “e”, “y” and other vowels

The production of the sound “y” for dysarthria, as well as the sounds “u”, “e”, “o”, “a”, “i” is carried out first. The speech therapist clarifies the articulation of vowel sounds. Then work begins with soft sonars, then with their hard sound pairs. Speech therapy massage, articulation gymnastics, and breathing exercises are performed beforehand. The doctor invites the child to take a deep breath through the nose, open his mouth slightly with a smile, and point the tip of his tongue toward the lower incisors. Exhale and whisper the sound “e”, then repeat the exercise with your voice.

Complex treatment of the disease

Only an integrated approach gives good results. Here are the activities included in treatment:

Speech therapy classes: development of fine motor skills of the hands, breathing, motor skills of the speech apparatus, voice (timbre, intonation, strength), training in correct sound pronunciation;
Physiotherapeutic procedures: physical therapy, massage, acupressure, etc.;
Drug treatment. Nootropic drugs are prescribed;
Psychotherapy. This group includes sand therapy, play therapy, and isotherapy.

If parents notice speech impairments in time and seek help from doctors, the baby has every chance of getting rid of the disease. But provided that there are no pronounced lesions of the nervous system.

Logorhythmic influence

Logorhythmic work with patients suffering from dysarthria includes therapeutic exercises in classes. It is built depending on the speech therapy correction course. It is divided into 3 periods.

The tasks of the first period are as follows:

Education of static movements;
Development of fine motor skills of the fingers;
Development of general movements of the upper and lower extremities, torso with the gradual introduction of exercises with objects;
Development of muscles that provide facial expressions;
Development of various types of memory, auditory and visual attention;
Gradual formation of normal diaphragmatic skill;
Overcoming prosodic disturbances in dysarthria.

To activate the prosodic components of speech, singing is used primarily. The development of the prosodic side of speech in dysarthria is carried out with the help of dramatizations of songs, during the performance of which it is necessary to change the strength, timbre, and pitch of the voice. To normalize vocal function, articulatory and breathing exercises and movements for the muscles of the neck and head are performed.

In the complex of medical and speech therapy effects, logorhythmic classes contribute to:

Development of the articulatory apparatus;
Voice training (pitch, timbre, strength, range, strength);
Breathing development (inhalation depth, duration of speech inhalation and exhalation).

Systematic work started in a timely manner contributes to the rapid restoration of speech function.

Methods for preventing the disease

Due to the biological factors in the development of the disease, it is worth thinking about its prevention during pregnancy and childbirth. Difficult pregnancy, intrauterine infections, asphyxia, complicated childbirth, injuries in the first months of a newborn’s life - all this can cause speech disorders in the future.

We list the main methods of preventing the disease after the birth of the baby.

First, develop your reflexes. These include gaze fixation and object tracking, auditory concentration, motor activity, and the oral automatism reflex - all of them are very important in the development of the newborn.

Secondly, communicate with the baby. Tactile, visual, auditory sensations - all this is extremely important for its development. Smile at him, talk to him, carry him in your arms, stroke him.

Third, be always there. This is especially true for mom. After all, a newborn needs her closeness, the opportunity to touch her, see her, feel her, and receive a return hug.

Fourth, stimulate the sucking reflex. The more actively and longer the baby suckles at the breast, the better its muscles develop - they become stronger and more flexible.

Fifth, encourage the baby's attempts to communicate. Humming and babbling - this needs to be stimulated.

Sixth, develop fine motor skills. Speech is directly related to fine motor skills and the more dexterous the baby’s hands are, the better. Introduce him to different textures.

Seventh, speak to your baby in your native language. Speak clearly and competently. And encourage him to communicate. Even if he doesn't talk, still try to make him make sounds. If he wants something and shows it with gestures, provoke him to ask for it verbally.

conclusions

Dysarthria is not just a failure to pronounce certain sounds. And you certainly shouldn’t expect a child with such a diagnosis to “talk” like the neighbors’ daughter. This speech disorder is much deeper and more complex, but it is not always a death sentence. The main thing is not to waste time.

This is why turning a blind eye to the problem is a huge mistake as parents. Of course, it is difficult to accept the fact that your child has some kind of impairment. But this must be done precisely for the benefit of the future of your baby. An untreated disease will bring many problems to an adult in social life - from communication to work.

If the disease is detected at an early stage of development, it can be cured. An integrated approach to therapy gives good results. Of course, if there are no gross disorders of the nervous system.

It is even better if it was possible to diagnose the disease when it has not yet made itself felt, that is, before the baby’s first attempts to speak. Such early corrective work will become effective prevention.