Dyslalia - forms, causes, treatment, signs, correction

Article:

Dyslalia is a defect in the pronunciation of sounds in children who do not have problems with hearing and normal innervation of articulation. Dyslalia in children manifests itself in the form of absence, replacement, or distortion of sounds. The word dyslalia comes from the Greek language, dys - disorder, lalia - speech. For this disease, a speech therapy study is carried out, during which mobility, the structure of the speech apparatus, and phonetic hearing are examined. Consultation with a neurologist, dentist, or otolaryngologist may be required.

General information about dyslalia

This speech disorder is not associated with damage and defects of the central nervous system and hearing. Dyslalia is the most common speech problem in children. It occurs in 25%-30%, and according to some data, in more than 50% of preschool children under the age of 7 years. 17-20% of junior schoolchildren and 1% of older students have various forms. In the structure of this disorder, polymorphic disorders in pronunciation stand out most of all.

They interfere with speech acquisition and are the causes of dysgraphia and dyslexia. This speech disorder is selective, meaning a child can pronounce up to 90% of words and sounds well, but have problems with the remaining 10%. Timely correction can completely rid a child of pronunciation problems.

Symptoms of dyslalia

It is not difficult to see and recognize the symptoms of dyslalia; this can be done by paying attention to your child’s speech. Characteristic symptoms are distortions, replacement of sounds or letters with others. The baby may completely skip some letters in his speech. If substitution occurs, the symptom is a change in the audible sound to another, which is pronounced by the child. For example, a child hears the word “cat”, but pronounces “goshka”. This phenomenon occurs due to the fact that he cannot differentiate sound by articulation and acoustics.

The patient can replace phonemes with arbitrary ones, in a chaotic order, regardless of the structure of the word. There is no division into sizzling, hard, soft and other types. Sometimes a child can pronounce the same word in different ways, including correctly. This indicates incomplete acquisition of phonemes. A child suffering from this disorder can be identified by his speech and pronunciation. They use sounds and letters that are not in the word. This is usually typical for the mechanical type.

If a child has functional dyslalia, one or more sounds in his speech are replaced. Mechanical dyslalia is characterized by problems with the pronunciation of similar phonemes. If there are pathologies in the development of the lower jaw, they will be pronounced by anterior lingual articulation. This occurs due to the inability to hold the tongue on the front teeth. This speech disorder may improve as people get older.

If parents notice such a disorder and seek help from speech therapists, there is a high chance of completely getting rid of this disorder. If he does not receive proper correction, he is also likely to get rid of dyslalia with age. Such children have a rich vocabulary, can break words into syllables, and over time they will develop correct speech. Speech therapists identify physiological dyslalia, which goes away by the age of five.

Symptoms of deviation

Dyslalia is characterized by a wide variety of symptoms represented by omissions (complete loss of speech), substitutions (substitution of a different sound each time it occurs), distortion (abnormal pronunciation) and confusion of sounds (pronunciation is sometimes correct, sometimes incorrect). Various symptoms appear depending on the form of the disease:

• with functional, the pronunciation of one or more sounds is impaired
• with mechanical - a group of sounds similar in articulation;
• with physiological, age-related tongue-tiedness is observed, the cause of which is the immaturity of phonemic hearing and the inability to correctly control the movements of the speech organs, which naturally goes away by the age of 5.

Impaired sound perception

Fluent speech is essential for success in school. It is for this reason that speech needs to be given special attention. The process of formation of the speech apparatus is influenced by several factors, including hearing. Any auditory pathology negatively affects pronunciation. The child hears a word, sound, or letter incorrectly, and accordingly pronounces it incorrectly. Phonetic or sound perception is the ability to correctly hear and distinguish the sounds “P-B”, “S-Sh”, “L-R”.

Often, children with impaired sound perception distort even phonemes that individually they can pronounce correctly. They are unable to analyze their speech well, may make mistakes when writing, and have difficulty reading aloud. Such violations require work and correction by speech therapists and teachers. Many of these disorders can be eliminated in preschool age, preventing them from developing into a persistent form, which will be difficult to correct.

It is important to know that at school age speech develops very intensively, it is flexible and pliable. A child with impaired hearing may not perceive close and similar sounds. There are no words in his vocabulary that contain combinations of letters that are difficult for him to distinguish. This ultimately leads to the fact that he begins to lag behind his peers.

Classification

There are different types of dyslalia, which are classified according to the causes of occurrence, severity, and types of sounds with which the child has difficulty. Considering the causes of pronunciation disorders, mechanical or organic, functional varieties are distinguished. Speech therapists have developed the following classification of dyslalia.

Mechanical

Mechanical dyslalia is caused by the anatomical structure of the articulatory apparatus. The reasons are:

• Disturbed dental system. Prognathia may be observed - protrusion of the upper jaw, which appears due to its too active growth compared to the lower one. The bite of the teeth may be disturbed, the presence of a large gap when closing the jaws or a violation of the structure of the teeth. These deficiencies are corrected by dentists.
• Irregularly formed palate. It can be narrow, high, flat, which creates difficulties with the articulation of many sounds.
• Irregularly shaped lips. Insufficient lip mobility and sagging affect correct pronunciation.
• Short frenulum of the tongue (hyoid ligament);
• Anatomical feature of the structure of the tongue. It can be big, short, small.

Some of these reasons are easily remediable. This type does not affect the correct spelling or vocabulary.

Functional

Functional dyslalia is caused by social factors or correctable neurodynamic pathologies in the brain (brain cortex). There are several varieties - motor and sensory.

Motor type

Dictated by neurodynamic changes in the parts of the brain responsible for speech analyzers. Motor dyslalia is characterized by impaired movements of the tongue and lips, resulting in incorrect pronunciation. This phenomenon is called a phonetic defect.

Touch type

It is formed due to changes in the speech-auditory departments and affects hearing. The patient cannot differentiate sounds that have similar phonemes (hard-soft, voiced-voiceless, hissing-whistling). In speech, this leads to mixing, replacing, and omitting such letters, and in the future these letters can be omitted when writing.

The simultaneous presence of both types is called the sensorimotor type. Due to the unformation of certain sounds, three types of dyslalia can be distinguished:

• acoustic-phonemic,
• articulatory-phonemic;
• articulatory-phonetic.

Acoustic-phonemic

This group includes speech disorders due to the selective immaturity of the analysis of phonemes according to their acoustic parameters. The main violation in this case is insufficient sound perception, which is intended for recognition and differentiation by species. The sound that the child hears is recognized incorrectly by him, and therefore, he also pronounces it incorrectly.

It is important to know that with this type there are no hearing problems. The defect is selective for certain phonemes. Acoustic-phonemic dyslalia should not be confused with severe speech disorders.

Articulatory-phonemic

This group includes defects associated with the immaturity of operations for selecting phonemes according to their articulatory characteristics. There are two types of violations. In the first case, the articulatory base is not fully formed. Instead of the sound needed in this case, the child chooses a sound close to it in its articulatory characteristics.

The second option is characterized by the complete formation of the articulatory base. The child knows all the phonemes that are required for correct pronunciation, but when pronouncing words, some letters are replaced by others according to the principle of substitution. These substitutions occur according to the principle of articulatory proximity of phonemes - “rat” - “roof”.

Articulatory-phonemic

Characterized by defects in the sound design of speech due to improperly formed articulatory positions. Sounds can be pronounced in a distorted form, but this happens in unusual ways. This kind of speech is easy to understand.

Heaviness

Depending on the number of sounds that are pronounced incorrectly, dyslalia can be simple or complex. With a simple type, 1-4 sounds are impaired, with a complex type, more than four sounds are impaired.

Monomorphic type

It is difficult to pronounce one of the groups, for example, only voiced or only hissing.

Polymorphic

Sounds with which there are difficulties belong to different groups. Phonetic defects are designated by terms that are derived from the Greek alphabet:

• rhotacism – problems with the letter “P” and P is soft;
• lambdacism - “L” and “L soft”;
• sigmatism – the pronunciation of hissing sounds (zh, sh, shch, h) and whistling sounds (s, z) is impaired;
• iotacism – difficulties with “Y”;
• gammacism - “G” and “G soft”;
• kappacism - “K”, “K soft”;
• hittism – “X”;
• difficulties with voicing and deafening - replacing voiced consonants with voiceless ones and vice versa;
• softening and hardness defects - replacement of soft with hard ones or vice versa.

There may be complex forms that are combined in nature - the addition of several defects to each other. If there is a phonemic defect, that is, a sound replacement, the prefix “pair” is added to the name of the defect. This is how paralambdacism, parasigmatism and others are formed.

How to treat dyslalia and get rid of tongue-tiedness?

At the first consultation, the doctor will tell you how to treat dyslalia in Saratov in preschoolers and schoolchildren, how to cure dyslalia in Russia in children of preschool and school age, how to get rid of tongue-tiedness , what is articulatory phonemic, articulatory phonemic and phonetic, motor and sensory, mechanical, monomorphic, phonemic, simple, complex dyslalia in preschool children. How is prevention, correction of dyslalia , speech therapy examination of children with dyslalia carried out? Does speech therapy psycho-correctional pedagogical communication work help? How does sound pronunciation suffer with dyslalia? Why is polymorphic dyslalia dangerous, what is cheiloplasty, uranoplasty? What is the etiology and causes of dyslalia, differential diagnosis, exercises, gymnastics, literature, conclusion? What is rhinolalia, dysarthria, FNR, FFN, speech card? What is the prevention of dyslalia ? Sarklinik knows how to treat dyslalia in children in Russia.

Sarclinic provides treatment for aphonia, dysphonia, bradylalia, treatment of stuttering, tachylalia, open and closed rhinolalia, dyslalia, treatment of alalia, dysarthria, treatment of aphasia, nasalization, treatment of speech delay, dysgraphia, treatment of general speech underdevelopment, hyperkinesis, synkenesia, treatment of speech development disorders, SPD, delays in speech and psycho-speech development, dyslexia in children and adolescents in Saratov.

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Text: ® Sarclinic.com \ Ssrlinic.ru Photo: (©) (©) Gekaskr | Dreamstime.com \ Dreamstock.ru The children depicted in the photo are models, do not suffer from the diseases described and/or all coincidences are excluded.

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Forms of dyslalia

There are two forms of dyslalia - functional and organic or mechanical. If the child does not have organic disorders caused by the peripheral or central nervous system, we can talk about functional dyslalia.

This type appears in childhood, when the correct pronunciation of sounds is learned. Mechanical speech can appear at any age due to disturbances in the peripheral speech apparatus.

Functional dyslalia includes defects in the pronunciation of sounds - phonemes, without mechanical articulation disorders. Its causes are: physical weakness due to somatic diseases;

• delayed psychological development (minor disturbances in brain activity);
• delays in speech development;
• disorders associated with phonetic perception;
• social environment (incorrect speech of adults, insufficient communication with other children and adults, insufficient attention to raising the child).

All these reasons are not critical and can be eliminated by the work of qualified psychologists, speech therapists and other child development specialists.

Pathogenesis of dyslalia

The reasons vary for different types. Accordingly, the correction required is different.

Physiological prerequisites for mechanical dyslalia

The mechanical type is caused by physiological and anatomical defects. They do not make it possible to pronounce sounds correctly, the sound that they heard. This usually occurs due to dental defects - bite, incorrect shape and location of incisors, underdeveloped jaws. Doctors consider the main reasons:

• the frenulum of the tongue is too short;
• structural features of the bones of the jaw and face;
• palate defects;
• pathology of the upper lip;

To get rid of mechanical dyslalia, a dentist and an orthodontist are needed. The child must undergo a special correction course. The best results are achieved at the age of 5-6 years.

Prerequisites for functional dyslalia

This type develops due to the abnormal mental or physical state of the child. Often this diagnosis is made to children experiencing problems with mental development. In this case, the structure of the speech apparatus does not suffer, hearing is normal, and the innervation of the muscles responsible for articulation is not impaired. In children with the speech problem under consideration, the structure of the peripheral speech apparatus is normal, the innervation of the articulatory muscles is not impaired. There are two types of factors that cause this type of dyslalia.

Biological background

This group of factors includes:

• delayed psycho-speech development;
• somatic diseases;
• infectious diseases suffered during the period of active speech development;
• chronic diseases;
• hypovitaminosis;
• nutritional disorders (dystrophy).

These disorders affect neurodynamics, which is responsible for the differentiation of the speech-hearing apparatus and the speech-motor analyzer. With this manifestation, articulatory movements are not accurate enough, and speech kinesthesia may be observed.

Social preconditions

This group of factors includes:

• improper speech education;
• parents copying babbling words;
• consolidation in speech of incorrect sound pronunciation on the part of adults (burr, lisp, dialect).

During the period of speech development, a child may find himself in a bilingual environment, which can also lead to the development of dyslalia. In this case, the pronunciation rules of one language apply to the other.

Pathogenesis

Functional dyslalia is associated with an imbalance and weak dynamics of the nervous processes occurring in the child’s brain. The cortical areas do not have pronounced pathologies, but there is insufficient coordination between speech excitation and inhibition. The nature of the speech disorder is determined by the localization of the neurodynamic disorder in the subcortical region of the brain. If the entire speech department is affected, motor failure occurs, the pronunciation of individual phonemes suffers, and, secondarily, speech hearing.

If the localization is in the sensory zone (Wernicke's center), defects in sound perception primarily appear, which leads to expressive speech. This is how phonemes are mixed and replaced.

Social prerequisites for functional dyslalia

Social preconditions are those associated with adults. These include:

• parents may lisp;
• parents often make mistakes in their speech;
• being in a bilingual environment;
• they do not study enough and pay little attention to it (pedagogical neglect);
• reduced differentiation of hissing and whistling sounds;
• delays in mental development.

All these reasons can be eliminated if appropriate correctional work is carried out by speech therapists, psychologists, and parents.

Features of the course of complex dyslalia

The more complex the combination of disorders, the more difficult it is to cope with it. Accordingly, this affects the general background of the disease. In complex forms, mental and general developmental delays may be observed. It is necessary to engage in in-depth research of the child in the aspect of his psyche, intellectual development, hearing, and vision. Complex dyslalia may be a signal that there are problems with them. People who are hard of hearing often distort or change the “T” sound.

A child with second or third degree hearing loss does not have a metallic tone in his voice. The voice has softness or, in other words, viscosity. Children with vision problems may have dyslalia defects corresponding to its complex types. This is caused by poor visual control. In such patients, sigmatism is observed 4 times more often than in healthy children.

Forecast

With timely and competent correction, in 95% of children the disorder is completely corrected within 4-6 months. The main condition for success is regular classes and strict adherence to the recommendations of the doctor and speech therapist.

Is dyslalia dangerous? Unfortunately, some parents may even be touched by a child with a lisp, and they wait for the child to “outgrow” and magically cope with this problem on his own. But the disorder is dangerous because against its background more complex mixed speech defects easily develop, which require difficult and lengthy correction.

Publication date: 03/10/2020. Last modified: 07/07/2020.

Diagnosis of dyslalia by the nature of speech impairment

Diagnosis of dyslalia begins with finding out all the features of the course of pregnancy, childbirth, and illnesses the mother suffered during this period. What matters are the child’s illnesses that he suffered at an early age and his psychomotor development. Other factors also influence the diagnosis:

• features of speech development at an early age;
• hearing;
• vision;
• condition of the musculoskeletal system.

In order for the specialist to have a complete understanding of this, it is recommended to show all available medical documentation. After identifying these factors, the speech therapist proceeds to examine his patient. He examines the articulatory apparatus and determines their mobility. This happens through special exercises and tasks that the child must complete.

The diagnosis of dyslalia includes analysis of sound pronunciation, determination of speech defects, their nature, depth, and degree of complexity. Particular attention is paid to phonetic hearing - the ability to differentiate sounds into groups. The speech therapist’s conclusion indicates the form of dyslalia, the type (articulatory-phonemic, acoustic-phonemic, articulatory-phonetic), and the type of sound pronunciation (rhotacism, sigmatism, etc.).

If you have mechanical dyslalia, consultation with a dentist and orthodontist is required. For functional – a neurologist and analysis on his part. Diagnostics by an otolaryngologist will also be required to examine the hearing aid. The main goal is to accurately determine the child’s condition and the level of development of his speech apparatus. Correct diagnosis is necessary for accurate and correctly selected correction.

Differential diagnosis of erased dysarthria and dyslalia

There are common symptoms of two speech disorders, which can mislead a specialist when making a diagnosis. The table below presents the main characteristic features that will help differentiate erased dysarthria and dyslalia.

Diagnostics

A speech therapist examines the structure and mobility of the organs of the articulatory apparatus through visual inspection and using special test exercises.

In the process of a speech therapy examination, the nature of the disorder is revealed, namely the absence, replacement, mixing and distortion of sounds in various positions - in isolation, in open, closed or consonant syllables, words at the beginning, middle or end, as well as phrases and texts.

Then the state of phonemic hearing is checked - the ability to auditory differentiate all correlating phonemes.

For mechanical dyslalia, a speech therapist can refer the patient for consultation to an orthodontist or dental surgeon, and for functional dyslalia, to a neurologist.

If hearing loss is suspected, a consultation with an otolaryngologist and a study of the function of the auditory analyzer is carried out.

Prevalence of the problem

Dyslalia is a common problem. There are different estimates on this matter, on average, the number of children suffering from this speech disorder is about 25-30% in preschool age. As you get older, this number decreases. At primary school age this percentage drops to 17-20%. At older ages there are only 1-2% of such children.

The disease is a common occurrence, most common in the practice of speech therapists. According to various estimates, the average number of children with such problems in preschool age is 25-30%, in elementary grades – 17-20%, and in older age – 1%.

More often in the practice of speech therapists there are combined articulation disorders that create a barrier to the development of writing. Children, at the same time, have an extensive vocabulary, the structure of speech is not disturbed. All grammatical laws are observed - cases, declensions, endings.

Diagnosis of dyslalia, dyslalia examination, research

What is the diagnosis of dyslalia ? The examination reveals the level of sound analysis, features of sound pronunciation, state and mobility of the articulatory apparatus, state of hearing, state of vision, features of psycho-speech development, volume and structure of speech, vocabulary, features of grammar, writing, reading, memory, auditory writing, mental development of the child, development of visual perception and gnosis, analysis and synthesis, speech therapy examination .

Methods for correcting dyslalia

Speech therapy correction, depending on the severity of dyslalia, consists of several stages. The duration can take one to six months. Correction stages:

• Preparatory work with the reproduction of phonemes. Here they practice various breathing techniques, phonetic hearing, and work with reference sounds.
• Staging impaired sounds, forming correct articulation. Special tools can be used for this. The result of the work is the pronunciation of sounds without the help of adults.
• Consolidation of the obtained results. First, in individual syllables, and then in words and sentences.

• Differentiation. The patient learns to distinguish and correctly speak the sounds that he himself pronounces.

All methods are aimed at identifying sounds, the ability to distinguish them, improve memory, and develop communication skills.

Preparatory stage

The child must be involved in the speech therapy process. The speech therapist establishes contact and trusting relationships with the child, giving the child time to adapt to new conditions. Also at this stage are:

• development of attention;
• memory;
• thought process;

Staging

The correct sounds are set and the child’s articulation is formed using special materials and exercises. At this stage, sounds differentiation skills are developed. There are three ways to do this:

• First way. The child himself makes conscious attempts to establish correct articulation. An adult should simply help him with this. Tactile, visual, and acoustic exercises can be used.
• Second way. External mechanical influence on the child and his articulatory apparatus. The speech therapist should ask you to repeat the sound several times, and then use probes to place this sound correctly. In the future, improve pronunciation without using a tool.
• The third method is a combination of the first two.

Each of these stages has a varying degree of difficulty and is selected by a speech therapist.

Exercises to eliminate mechanical dyslalia

With this type of dyslalia, the child's speech passes through the teeth. He cannot move his lower jaw, in particular, open his mouth wide. The problem lies in the incorrect forcing of the articulatory apparatus - facial muscles, bite and others. They can be developed with special exercises. They need to be done together with adults, sitting in front of the mirror and observing his (the child’s) actions, controlling and correcting him.

You should start by opening and closing your mouth, gradually increasing the gap between the jaws. A set of exercises is selected directly by the speech therapist for a specific case. There are basic exercises that are used in most cases:

• Smile. The lips should be in a smiling position. The front teeth should be visible and remain in this position for 10 seconds.
• Tube. The teeth are pressed tightly, the lips are pulled forward, taking the shape of a tube, also for 10 seconds.
• Alternate “smile” and “pipe” at least 10 times.
• Funnel. The teeth should be open, the lips should be pulled forward. On the count of “two,” they pull into their mouth, tucking themselves in behind their teeth. Repeat 10 times.
• Timpani. Lips go behind teeth. They need to clap, making the appropriate sound.
• Horse. You need to relax your lips and make movements with them that imitate the snorting of a horse.
• Bolt. Clenched teeth, lower lip should move left and right.
• Hide and seek. Hide your lower lip behind your upper teeth. Only the lip should be visible. Hold this position for 5 seconds. Do the same exercise with the lower lip and alternate them 10 times each.

CORRECTION OF SOUND PRONUNCIATION IN DYSLALIA

Speech therapy work to overcome sound pronunciation disorders is carried out in a certain sequence, step by step. Parents should also understand its general course, since their active and conscious participation in the speech therapy process significantly reduces the work time and increases its overall effectiveness.

The entire content of speech therapy work on the correction of sound pronunciation disorders can be conditionally divided into three main stages, each of which pursues a very specific goal:

1. Sound production

2. Sound automation

3. Differentiation of a newly raised sound from similar ones

Let's look at each of these stages separately.

The production of a sound (the term is somewhat “mechanistic” and does not fully correspond to the essence of the matter) refers to the very process of teaching a child the correct pronunciation of this sound. The child is taught to give his articulatory organs the position that is characteristic of normal articulation of sound, which will ensure the correctness of its sound.

A sound is “re-set” if it is completely absent from speech or replaced with another sound, as well as if there is a defect in pronunciation that cannot be partially “corrected” and brought to normal (for example, with a “burry” R or labial-dental L) . Sometimes they limit themselves to the so-called sound correction, which consists in clarifying only individual elements of its articulation, which is generally close to normal. So, for example, when pronouncing C interdentally, in order to achieve normal articulation, you only need to teach the child to hold the tip of the tongue at the lower incisors and tuck it behind the teeth (another thing is that this may require preliminary articulatory exercises or normalization of the bite). In the future we will talk only about sound production, and not about its correction.

In many cases, sound production cannot be started immediately, because the child cannot give his tongue the necessary position. Let's say we need to teach him the correct articulation of the sound R, but he cannot even raise the tip of his tongue upward, let alone the vibration itself. In such circumstances, preparatory work is necessary. It consists primarily of so-called articulatory gymnastics, the main goal of which is to develop sufficient mobility of the lips and tongue. Typically, such preparation must be carried out for motor functional and mechanical dyslalia, and especially for dysarthria, which is characterized by paresis of the articulatory muscles.

In case of polymorphic disorder of sound pronunciation, general articulatory gymnastics is performed, which includes all the basic movements of the articulatory muscles. The “generality” of the exercises is dictated by the fact that in these cases sounds from different phonetic groups are disrupted and therefore each movement is “useful”, if not for one, then for some other sounds. In addition, the very polymorphism of sound pronunciation disorders in most cases indicates an unfavorable state of speech motor skills, and therefore the need for its serious “training”.

In case of monomorphic disorders of sound pronunciation, the choice of articulatory exercises is determined by two main conditions. Firstly, it depends on the characteristics of the normal articulation of the newly acquired sound. So, for example, when developing the correct articulation of the sound P, it is important to teach the child to raise the tongue upward and develop the mobility of its tip as best as possible, but this is not at all required to produce the sound C, in which the tip of the tongue lies motionless at the lower incisors. Secondly, the choice of articulatory exercises is largely determined by the very nature of the defective sound pronunciation. For example, to develop the correct articulation of the sound L, there is no need to perform special exercises for the lips, since when pronouncing this sound they occupy a neutral position. But if we are dealing with bilabial or labiodental L, then in this case exercises for the lips are absolutely necessary: ​​only by teaching the child to actively move his lips to the sides, we can further ensure their isolation from participation in the formation of sound, and therefore eliminate its “labial” sound.

With mechanical dyslalia, before sounds can be produced, it is often necessary to eliminate anomalies in the structure of the speech apparatus. For example, with a very short frenulum of the tongue, the production of the sound P is possible only after cutting it, or overcoming interdental sigmatism must be preceded by the elimination of an anterior open bite.

With sensory functional dyslalia, during the preparatory period, work is carried out to develop auditory differentiation of sounds, since if it is impaired, the child does not realize the incorrectness of his sound pronunciation and will not be able to control it in the future. Parental help during the preparatory period plays a very important role. It should consist of systematically performing with the child all the articulatory exercises suggested by the speech therapist, as well as exercises in auditory differentiation of sounds. To do this, you don’t need to be a specialist - you just need to get his detailed advice.

After carrying out the necessary preparatory work, they move directly to sound production. It can be done by imitation, with mechanical assistance and in a mixed way. Let's consider only the first of these methods, since the other two require special knowledge.

The method of producing sound by imitation is the easiest for both the speech therapist and the child himself, since it requires minimal effort and time. It consists in the fact that the speech therapist, in the presence of the child, clearly and clearly pronounces the desired sound. A child, hearing a sound and at the same time seeing its articulation, is often immediately able to reproduce it. If this happens, then the production of the sound can be considered complete: the child has learned to pronounce it correctly. This method of sound production can be used by parents themselves - in many cases it will “work”. Staging sounds by imitation is possible only if the child has sufficient mobility of the articulatory organs and their correct structure.

As soon as it is possible to achieve the correct sound of an isolated sound, you need to immediately move on to the next stage of sound pronunciation correction - the automation stage, that is, teaching the child to correctly pronounce the sound in coherent speech. One should not dwell on its isolated pronunciation for long, since our speech is a stream of continuous changes, and the movements of the lips and tongue when pronouncing consonants are not standard, but depend on the part of which complex of movements (that is, in which sound combinations) they are carried out. This determines the importance of incorporating the newly developed sound as quickly as possible into its most typical sound combinations. However, here we cannot go to the other extreme: move to the automation stage prematurely, that is, before obtaining the correct isolated sound. Exceptions in this regard are sometimes allowed only in cases of mechanical dyslalia and severe dysarthria. In general, at the stage of automation, in contrast to the stage of sound production, regardless of any causality of defects in sound pronunciation and any nature of their external manifestation, the work is carried out approximately the same way and in the same sequence: pronunciation of syllables, words, specially selected phrases, texts with new educated sound. This similarity of approach is explained by the fact that in all cases the child already has the correct sound, no matter how different ways and no matter how different times it was obtained.

The need to highlight a special stage of automation is due to the fact that even after mastering the normal articulation of a sound, the child, due to established habit, continues to pronounce it incorrectly in speech. After all, what is defective pronunciation of a sound? This is far from just the pronunciation of the sound. If a child replaces, for example, Ш with S in his speech, then all the stereotypes of words that include this sound are formed accordingly (SKAF instead of SHKAF, SKOLA instead of SCHOOL, SUM instead of NOISE, etc.). Naturally, immediately after sounding, he will not be able to pronounce all words with a given sound correctly.

In order to make this complex task easier for the child, sound automation is carried out gradually: first in a variety of types of syllables and sound combinations (SA, AS, ASA, STO, SKO, STR, KSY, etc.), then in individual words with different its complexity in its sound-syllable structure (SANI, JUICE, NOSE, ARGUMENT, GLASS, OSTRICH, ICICLE), then in specially selected phrases, where the automated sound is contained in each word (SALT SALT, SALT SALT), and, finally, in the texts. If the correct pronunciation of the newly introduced sound is achieved immediately in words, then automation in syllables disappears.

At this stage of work, all articulatory and acoustically close sounds are excluded from the speech material. For example, when automating the sound C, the syllables, words and phrases selected for this purpose should not contain other whistling or hissing sounds. For this reason, here you should take words like BAG, CATFISH, SCALES, SPRING, etc. and exclude words like DRYING, CANDLE, FOCK, COLD. In these cases, it is better not to use words with articulatory complex (albeit acoustically distant) sounds like R, L, since these sounds can also be pronounced defectively. Such “lightweight” speech material allows the child to focus all his attention only on the newly learned sound. It is better to immediately associate this sound with a letter so that the child develops a strong connection between the sound and the letter, which is very important for correct writing (especially if the sound was not distorted, but replaced by some other one). Exercises in the most basic sound analysis are also conducted.

The stage of sound automation can be considered complete only when the child masters the skill of correctly pronouncing a “new” sound in ordinary conversational speech. The reader has to pay special attention to this point, since many children who have already mastered the correct pronunciation of the sound do not use it in their independent speech. Most often this occurs when speech therapy classes are terminated prematurely, which happens mainly through the fault of parents. It is for this reason that adults often turn to speech therapists, since childhood they have been able to correctly pronounce this or that sound, but have never learned to use it in their speech.

Help from the parents to the speech therapist at this stage is simply irreplaceable. First, it should consist of systematically listening to all the syllables, words and phrases with an automated sound pronounced by the child in order to control the correctness of its sound. In the future, exactly the same constant control over the child’s entire speech will be necessary in ordinary life situations: an incorrectly pronounced sound must be corrected every time. This is exactly what will ensure complete automation of sound, and this will be done in the shortest possible time, which will save parents from the need to “take a long time” for their child to see a speech therapist.

In cases where the sound is distorted (and not replaced), the automation stage usually ends the work on correcting sound pronunciation. For example, if a child pronounced the sound P “kartavo” or C interdentally and did not mix these sounds with others, then there is very little likelihood that he will suddenly begin to mix them after correction. When we deal with sound substitutions, they usually make themselves felt for a long time, and special and sometimes quite lengthy work is required to completely overcome them. This is exactly what the third stage of work on correcting sound pronunciation is devoted to.

The main task of the stage of differentiation of sounds is to develop in the child a strong skill in the appropriate use of the newly taught sound in speech, without mixing it with acoustically or articulatory similar sounds. This is achieved through special exercises. The work of distinguishing mixed sounds by a child essentially begins already in the preparatory period and during the period of sound production. Even then, his attention is drawn to the different positions of the lips and tongue and to the different nature of the stream of speech exhalation when articulating the sounds he mixes (for example, S and Sh, Z and Zh). The different sounds of these sounds are also noted (Z is how a mosquito rings, Z is how a beetle buzzes).

The transition to a special stage of sound differentiation can begin only when both mixed sounds can be correctly pronounced in any sound combination, that is, when the ability to correctly pronounce the “new” sound is already sufficiently automated.

As at the previous stage, the complexity of the speech material here also increases gradually. First, the sounds mixed by the child are differentiated in a wide variety of types of syllables (SA-SHA, AS-ASH, STO-SHTO, etc.), which must be pronounced by him without any sound substitutions, then - in words (SANKY-HAT, BOWL-BEAR ), sentences (such as the widely known SASHA WALKED ON THE HIGHWAY AND SUCKED A DRYER) and connected texts, including both mixed sounds. When working with school-age children, written exercises are also necessarily used to overcome letter substitutions in writing. For preschoolers, special work is needed to prevent such substitutions. Both differentiated sounds are necessarily immediately associated with letters.

A necessary prerequisite for both preventing and overcoming letter substitutions in writing is the development in the child of the ability to accurately determine the presence of a “new” sound in a word, find its specific place in it and distinguish it from those existing in the same (or some other) sound. word with sounds similar to it. In other words, it is necessary to develop the child’s ability to perform phonemic analysis of words, which also include sounds mixed with them. Such work begins already at the automation stage, but there it is aimed at “searching” for only one newly delivered sound.

Children aged 6 years can be given tasks to isolate the sound of interest to us from the beginning and end of a word (which is the easiest to do), for example: “What is the first sound you hear in the word FISH? What is the last sound in the word CHEESE? By answering that he hears the sound R here, the child thereby isolates this sound from the general composition of the word and pronounces it in isolation. In the process of special training, more complex types of sound analysis of words can be practiced, associated with a more accurate determination of the place of sound in a word. All of the above exercises teach the child to be attentive to the sound composition of words and at the same time strengthen his skill in auditory differentiation of sounds. This is precisely what is necessary to prevent (in preschool children) or completely overcome (in school-age children) letter substitutions in writing.

The role of parents at the stage of differentiation of sounds is no less important than at the stage of automation, and it consists, firstly, in systematic monitoring of the child’s correct performance of speech therapy tasks, including written ones, and, secondly, in constant monitoring of his speech in ordinary life situations - until the sound substitutions completely disappear in it. All the necessary didactic material for automation and differentiation of sounds, located in the appropriate sequence, starting with syllables and ending with connected texts, is given in our manual “Speak and Write Correctly” mentioned in the list of references.

This is the general sequence of speech therapy work when correcting sound pronunciation defects in children. Compliance with exactly this sequence in work is mandatory, since any violation of it negatively affects the overall result and delays the work itself. So, for example, it is useless to try to immediately make a sound for a child if the state of his articulatory motor skills does not yet allow this. Or it is impossible to start automating a sound with a child who has not learned to pronounce it correctly, etc. (In many cases, parents, even before contacting a speech therapist, exercise their children in reading and memorizing poems for a certain sound in order to “correct” it, which ultimately leads to an even greater strengthening of incorrect articulation of sound).

Let us note the features of the application of the work scheme considered here for forms of sound pronunciation disorders that differ in their causality.

With sensory functional dyslalia, such features are as follows:

1. Preferential development in the preparatory period of the function of the speech-auditory analyzer compared to the speech-motor analyzer (work on auditory differentiation of sounds).

2. Paying due attention to phonemic analysis of words.

3. The obligatory presence of a stage of differentiation (in the child’s speech) of mixed sounds.

4. Purposeful work on eliminating (or preventing) letter substitutions in writing.

Overcoming motor functional dyslalia has the following features:

1. During the preparatory period, primary attention is paid to the development of the child’s articulatory motor skills, the development of sufficiently clear and coordinated articulatory movements. As for the development of auditory perception, it is important to teach the child to distinguish the correct sound from a defective sound (for example, normal P from “burry”).

2. Usually there is no need to specially highlight the 3rd stage of work - the stage of differentiation of mixed sounds.

3. There is no need for special work to overcome (or prevent) letter substitutions in writing.

For sensorimotor functional dyslalia, depending on the predominant symptoms, the work techniques used to overcome motor and sensory functional dyslalia are combined in different ways.

The main feature of overcoming mechanical dyslalia is that in most cases it is not possible to limit oneself to speech therapy assistance only, but a comprehensive medical and pedagogical intervention is necessary. Moreover, even complete elimination of an anatomical defect usually does not lead to normalization of sound pronunciation. The incorrect way of functioning becomes habitual and persists even after the anatomical defect is completely eliminated, which means that the incorrect way of articulating sounds also persists. And even more than that. If, after eliminating the anatomical defect, the old method of improper functioning of the tongue is left unchanged, then it can provoke the return of the previous “pathological form”. Often it is the secondarily impaired function of a healthy organ (in this case, the tongue) that prevents successful orthodontic treatment. For this reason, speech therapy work, and above all active articulatory gymnastics, is important in these cases not only for the correction of impaired sound pronunciation, but also for the sustainable correction of the anatomical defect itself.

As for the sequence of application of medical and speech therapy methods, it can be varied. Although from the point of view of correcting sound pronunciation it would be more expedient to first eliminate the anatomical defect, this is not always possible. For this reason, speech therapy work with a child often has to begin long before the end of orthodontic or surgical treatment, thereby facilitating its more successful completion.

The stage of sound production has the greatest complexity and originality in mechanical dyslalia. Depending on the achieved results of correction of the anatomical defect, the following two staging options may occur:

1. In the case of complete elimination of anomalies in the structure of the articulatory apparatus, sound production is carried out in the usual way, through teaching the child to give his articulatory organs the position that is necessary for normal sound articulation.

2. If it is impossible to eliminate the anatomical defect or achieve only a slight reduction in it, the speech therapist faces the difficult task of educating the correct articulation of sound given the unusual structure of the child’s articulatory apparatus. We can only talk here about the education of the so-called compensatory articulation, in which a defect in the structure of one organ is compensated by the peculiar, unusual arrangement of other articulatory organs. The main guideline here should be the correctness of the sound - you have to achieve a normal (or perhaps closer to normal) sound, while consciously going for the unusual arrangement of the articulatory organs when pronouncing the sound.

Automation of the delivered sound is carried out in the usual way. As for special work on the differentiation of sounds, in many cases with mechanical dyslalia it is not required, since distorted sounds are more often observed here than their complete replacement with other sounds.

New technologies in the correction of dyslalia

The connection between speech therapy and orthodontology has been established for a long time, this is especially true for mechanical dyslalia. In this area, there are modern solutions to problems that lead to such speech disorders. Such an example is myofunctional containers, vestibular plates. Containers appeared not so long ago, and their effect on speech became known only recently - about four years ago. Mechanical dyslalia is caused by malocclusion and abnormalities in the dentofacial apparatus; a speech therapist cannot influence, much less eliminate, this problem.

In 2008, studies were conducted using myofunctional correction tools. These are trainers made of silicone. The results showed that 100% of children regained breathing through their nose, and 99% normalized their speech disorders. Based on this work, it was concluded that the preorthodontic trainer has proven its clinical effectiveness in practice and can be used to correct breathing and occlusion in a child.

Measures to prevent dyslalia

The main preventive measures are:

• For full speech development and the formation of the articulatory apparatus, the child must receive solid food.
• Speech disorders occur in children who receive only soft foods more often than in others.
• It is necessary to develop the child's fine motor skills.
• Identify existing speech disorders and begin to eliminate them.

Attention to the child’s speech problems and adequate correction will help avoid negative consequences and eliminate all problems in a timely manner.

Correction and elimination of dyslalia

Methods for eliminating dyslalia depend on the form and type of disorder and include:

• work aimed at eliminating anatomical defects (with mechanical dyslalia);
• articulation gymnastics;
• speech therapy massage;
• individual lessons with a speech therapist.

Specialists at the First Children's Medical Center determine the treatment method individually for each little patient. All classes with a speech therapist are aimed at developing the baby’s speech motor skills, as well as the development of phonemic processes.

Please note that speech therapy sessions for the correction of dyslalia should be conducted on a regular basis. In addition, to achieve a positive result, it is important to complete the speech therapist’s tasks at home and do articulatory gymnastics.

By contacting our Center, you will receive qualified help from a speech therapist who will pay special attention to your child and give answers to all your questions. We are happy to help you! First Children's Medical Center: Children's health - parents' peace of mind!

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