Individual speech therapy program for a child with Down syndrome

Socialization is very important for children with Down syndrome, and speech plays a big role in this process. Problems may lie in the length of time it takes to accumulate vocabulary, children understand words much faster than they pronounce them, speech may not be very intelligible with distorted pronunciation of sounds, and there may also be problems with articulation and phonetics. Speech therapists should work with this, as well as parents, who should learn speech therapy techniques. In developing speech, the main thing is to be patient and talk a lot with children, correcting their mistakes. Patience and perseverance should lead to improved speech so much that the child will be able to express his thoughts without problems and communicate freely with peers. Correct speech will help you make new acquaintances and open up new horizons in learning and professional growth.

Tasks

Objectives of speech therapy work:

• a dictionary must be formed that will include basic concepts that are often used in communication;
• attention and auditory perception should develop to a level at which communication becomes effortless, the child will not need to think for a long time about what he heard and how he should express his thoughts;
• improved pronunciation, increased clarity of conversation;
• development of articulatory muscles;
• improvement of visual perception and visual memory allows you to better describe from memory the object or phenomenon you saw;
• memory development will allow you to better replenish your vocabulary, short-term memory helps in the perception of long sentences;
• the development of fine motor skills of the hands will expand the child’s range of movements, which has a positive effect on speech development;
• to increase the clarity of speech, you can adjust the structure of syllables in a word;
• training in sound analysis;
• improving coherent speech.

To implement these tasks, you must first perform a speech diagnosis and listen to the child. At the second stage, the information received must be compared with modern speech therapy techniques. The speech therapist can make a decision on how the child will learn independently, or consult with other doctors if options for eliminating the problem are possible. The next stage involves the implementation of the assigned tasks, during which it is necessary to record the dynamics of speech development.

It must be remembered that a child can improve any skill through repeated repetition and systematic practice. You can strive for the child to receive the same level of development as ordinary children, but a more correct tactic would be work that in the long term will help the child surpass his peers who do not have Down syndrome. If you try to improve the average statistical indicators on individual children, then some things may turn out worse, and some abilities may well develop much better than in ordinary children. To identify factors that will help a child achieve success, at the first stage you need to try to work in different directions - the development of oral, written speech, sound perception, and other skills.

Down syndrome symptoms

Carrying a fetus with Down syndrome is associated with an increased risk of miscarriage: spontaneous abortion occurs in approximately 30% of women at 6-8 weeks. In other cases, children with Down syndrome, as a rule, are born full-term, but have moderate hypoplasia (body weight is 8-10% below average).

Most children with Down syndrome have typical external signs that suggest the presence of pathology already at the first examination of the newborn by a neonatologist.

Children with Down syndrome may exhibit some or all of the physical characteristics described below.

80-90% of children with Down syndrome have craniofacial dysmorphia: flattened face and bridge of the nose, brachycephaly, short wide neck, flat back of the head, deformation of the ears; newborns - a characteristic skin fold on the neck. The face is distinguished by a Mongoloid shape of the eyes, the presence of an epicanthus (a vertical fold of skin covering the inner corner of the eye), microgenia, a half-open mouth often with thick lips and a large protruding tongue (macroglossia). Muscle tone in children with Down syndrome is usually low; there is hypermobility of the joints (including atlanto-axial instability), deformation of the chest (keeled or funnel-shaped).

Characteristic physical signs of Down syndrome are meek limbs, brachydactyly (brachymesophalangy), curvature of the little finger (clinodactyly), a transverse (“monkey”) fold in the palm, a wide distance between the 1st and 2nd toes (sandal cleft), etc. When examining children with the syndrome Down's reveals white spots along the edge of the iris (Brushfield spots), gothic (arched palate), malocclusion, and grooved tongue.

With the translocation variant of Down syndrome, external signs appear more clearly than with simple trisomy. The severity of the phenotype in mosaicism is determined by the proportion of trisomic cells in the karyotype.

Children with Down syndrome more often than others in the population have congenital heart disease (patent ductus arteriosus, VSD, ASD, tetralogy of Fallot, etc.), strabismus, cataracts, glaucoma, hearing loss, epilepsy, leukemia, gastrointestinal defects (esophageal atresia, stenosis and duodenal atresia, Hirschsprung's disease), congenital hip dislocation. Typical dermatological problems of puberty are dry skin, eczema, acne, and folliculitis.

Children with Down syndrome are often ill; They suffer more severely from childhood infections and more often suffer from pneumonia, otitis media, ARVI, adenoids, and tonsillitis. Weak immunity and congenital defects are the most likely cause of death in children in the first 5 years of life.

Patients with Down syndrome are prone to developing obesity, constipation, hypothyroidism, alopecia areata, testicular cancer, early onset Alzheimer's disease, etc. Men with Down syndrome are usually infertile; Women's fertility is markedly reduced due to anovulatory cycles. The height of adult patients is usually 20 cm below average. Life expectancy is about 50-60 years.

Sound pronunciation

Development of sound pronunciation and perception, this stage includes the development of attention, the formation of clear pronunciation, and increased attentiveness. Visual memory improves through the use of visual aids.

First you need to work on the sounds that come out better, then you need to move on to more problematic areas of speech. First you need to practice open syllables, then work with words that will form small sentences of up to five words. Speech therapy training in its stages is similar to teaching reading to a first-grader.

You need to do articulatory gymnastics, repeating (or trying to repeat) sounds that are difficult to pronounce over a certain period of time. Of course, it is better to conduct such classes in the form of rhymes or tongue twisters, in which attention is concentrated on one sound.

You can also do breathing exercises, but not so much for the effectiveness of training, but for relaxation, because the respiratory organs and sound pronunciation are subjected to increased stress during training. Breathing exercises can be done in the form of games, for example, blowing on rotating blades, or organizing competitions to see who can bring a ball or ball from one end of the table to the other to the other the fastest. You can also blow soap bubbles - who will have more bubbles, or who will have a larger bubble.

You can also do finger gymnastics, because it is accompanied by rhymes and games. In addition to articulation, finger gymnastics is also accompanied by the development of fine motor skills. There is no need to concentrate too much time on finger exercises, because they can easily be replaced by more practical activities - for example, making dumplings, sewing, embroidery, even if it is a simple activity, but with a practical result. And having a result is the best motivation for both the child and the parents.

Conversational skills

Children may have weak short-term memory, and they do not understand long sentences and phrases very well. But this can be fixed; we need to work on developing our understanding of spoken language. It is better to do this by memorizing short phrases that need to be gradually turned into short poems. Memory in children with Down syndrome can develop quite well, and this should be used to improve speech perception.

Vocabulary without reading skills can be expanded through descriptive lessons, in which the child needs to tell a lot, confirming his words with illustrations, visual aids, or simply objects discussed in the lesson. It is advisable to conduct part of the lessons on the street; you can talk about everything that comes across on the road, pointing to the named objects. Housework, such as cooking, can also be commented on.

Such seemingly simple activities in a relaxed atmosphere have a very great effect, because it is much more interesting for a child to communicate with a loved one than, for example, to watch a themed cartoon or a children's program on a TV or computer screen. The baby will try to ask something, and this will develop his thinking and language. Vocabulary will not only be replenished, but also used immediately; intensive lessons conducted in a practical atmosphere (for example, communication while cleaning the house) do not cause fatigue and provide a positive educational effect that will influence the child’s entire life.

After learning to perceive information, you need to teach the child to reproduce it - you need to teach children to tell what is shown in the picture. First, you can take pictures with individual objects, groups of objects, then you can go on to describe the home environment from the picture, or simply describe what is in the classroom or room. The most difficult thing is to describe industrial landscapes, for example a city street, where there are many cars, shops, people, and buildings. Describing ordinary, natural landscapes is a simpler task, so it is better for the child to draw and describe all the elements of the drawing himself.

The next stage of learning is communication in the form of dialogue. At first, you can simply communicate on the question-answer principle. Then dialogue communication can be reproduced in the form of small scenes and performances. The main thing is that it is not for show for adults. There may be spectators, of course, but it should be interesting for children.

Stages, tasks, methods of correctional and speech therapy work with children with Down syndrome.

Table No. 2.
A long-term plan for correctional and speech therapy classes for children with Down syndrome and general speech underdevelopment of level II.

Targeted speech therapy work can help most children with Down syndrome master verbal means of communication, but early speech therapy intervention in the child’s development process is considered the most effective.

Applications of the program of correctional and speech therapy rehabilitation for children with Down syndrome:

· Appendix No. 2 “Breathing exercises”.

· Appendix No. 3 “Finger game training”.

· Appendix No. 4 “Breathing exercises”.

· Appendix No. 5 “Complexes of articulatory gymnastics.”

· Appendix No. 6 “Automation of sounds using gaming techniques.”

The appendices describe simple and accessible exercises that can be performed with a baby with Down syndrome from birth during routine moments, games, and activities.

Writing and reading

The final stage of speech training is learning to read and then write. Of course, it is better to combine these two types of activities. You can start learning letters quite early - oddly enough, children with Down syndrome can distinguish all the letters of the alphabet already at the age of two. This once again suggests that with diligent work, children with the syndrome can in many cases be ahead in development of children who do not have a congenital disease, but also do not have such an advantage as intensive training.

Reading makes it possible to orally analyze the composition of a word, the written form of speech gives even more time to improve speech, because the process is slow, and you can repeat sounds, syllables, words many times, improving pronunciation. In the process of learning to write, one develops the ability to correlate letters and sounds, because words are often written a little differently than they are pronounced.

At this stage, the child learns to form compound words, as well as change simple ones. Not only pronunciation is developed, but the ability to insert words in the correct form based on other forms in the sentence. Also, reading and writing are a good opportunity to add difficult words to your vocabulary that are not so often found in spoken language.

Classes with a speech therapist or parent should last about half an hour every day, maybe half an hour in the morning and half an hour in the evening.

In conclusion, we can say that in order for a child to communicate correctly and effectively, he needs to communicate a lot with ordinary children. At the same time, difficulties are overcome that the child will face in one way or another all his life - misunderstanding, perhaps the reluctance of other children to make contact. Parents should take care that the child’s level of development is sufficient to attend a regular school and a regular kindergarten, because the child’s behavior is often imitative - he develops well in a team, and at the same time socialization is difficult if the circle of communication is limited to relatives or children who also have difficulty communicating.

Article:

Parents of children with Down syndrome know very well that the causes of this genetic anomaly lie in the presence of just one extra chromosome in each cell of their child.
We are talking about a random failure in the process of cell division, which means it is clear that this “game of nature” is no one’s fault. And still, sometimes many days and months in such a family are spent on self-flagellation, inaction and bitter reflections about “heavenly punishment.” But this time is so necessary for a newborn baby! He is able to master much of what ordinary children do if his development is addressed in time. And it is the parents who are the first to help him with this.

For children with Down syndrome, medical support is very important, because the health and even the life of the baby depends on how seriously and competently it is carried out. From the very beginning, it is very important to listen to the advice of doctors, strictly follow their recommendations - take medications, undergo hospital treatment if necessary, conduct examinations and procedures. Because the most important thing is to strengthen the overall health of the baby.

From the very first months, the child’s lag behind his peers will become noticeable. For various reasons, including due to decreased tone, he quickly gets tired, is little awake, and does not fix his gaze well. He quickly loses interest in toys and reacts little even to his parents. And all this is not because he doesn’t love them - he just has very limited opportunities to express his feelings and emotions. Motor development also lags behind - on average, such children begin to hold their head up by three months, sit no earlier than 9-12 months, and walk closer to two years.

It seems that the child’s body is half asleep and is not particularly eager to develop. But in fact, he wants to grow - and is only waiting for outside help. Of course, we must say right away: it is impossible to completely eliminate the lag, since the main cause remains - the syndrome. But by regularly and purposefully working with a child, we will ensure that he develops faster and more quickly realizes the potential inherent in him by nature. On the contrary, by protecting the baby from activity, we will reap the fruits of even later development.

The most important question is: what kind of effort will be useful for a child? The best answer to this is a personal defectologist who could observe your baby from birth. Therefore, start looking for such a specialist as early as possible - contact local rehabilitation centers, medical and psychological consultations.

The goal of correctional work with children with Down syndrome is their social adaptation, adaptation to life and possible integration into society. It is necessary, using all the cognitive abilities of children, and, taking into account the specifics of the development of mental processes, to develop in them vital skills so that, as adults, they can take care of themselves, perform simple work in everyday life, and improve the quality of their lives and the lives of their parents.

Today, there are known cases of psychological and pedagogical rehabilitation of individual children with Down syndrome, when, as a result of the enormous efforts of psychologists and defectologists, they became full-fledged members of society. This suggests that working with such children is not a hopeless task, but it requires special knowledge and great mental and physical costs.

The structure of mental underdevelopment of children with Down syndrome is unique: speech appears late and remains underdeveloped throughout life, speech understanding is insufficient, and vocabulary is poor. Particularly noteworthy is the lag in the development of motor skills and speech. However, by the age of three or four they become more active and begin to walk. At this stage, they develop speech and show love for loved ones. However, even then speech develops extremely slowly and with great difficulty.

Communication of children with Down syndrome.

Communication is a holistic phenomenon; it includes not only speech (verbal characteristics), but also facial expressions, gestures, and other nonverbal ways in which a person can express himself and influence others. This self-expression may be intentional or unintentional. In addition to speaking, proficiency in the language of communication presupposes: perception and understanding, reaction to the speech of others, the ability to take turns in conversations with other people.

These skills can be assessed in both infants and children, who are still very far from being able to speak. As communication skills develop, the child acquires:

• The ability to satisfy a range of needs through language - social, emotional and material;
• The ability to communicate - first with gestures, later with individual words, then with phrases.
• The ability to more accurately express one’s thoughts using grammatically correct formatting of sentences: the use of case endings of nouns and adjectives, the construction of prepositional constructions, etc.;
• Ability to clearly pronounce a variety of sounds;
• The ability to start and maintain a conversation, in both cases expecting the interlocutor’s reaction and responding to his words. This ability consists of the above-mentioned skills of listening, understanding, responding and taking turns.

Communication is just as important for children with Down syndrome as it is for everyone else. And they begin to communicate from a very early age - through crying, smiling and gestures. Of course, in infancy they do not yet understand that they are communicating with us in this way, but our reactions help them understand what these facial expressions, smiles, and vocalizations are for.

Despite their innate desire to communicate, children with Down syndrome often have certain physical and cognitive characteristics that make it difficult for them to acquire language and speech. These characteristics may include, but are not limited to, fluid accumulation in the ear; frequent middle ear infections; hearing loss; low tone of facial muscles, muscles inside and around the mouth; relatively small size of the oral cavity compared to the relatively large size of the tongue; as well as delays in intellectual development. In addition, children with Down syndrome have small and narrow ear canals. All this negatively affects auditory perception and the ability to listen, that is, hear consistent consistent sounds of the environment, concentrate attention on them and recognize them.

During the development of speech, tactile sensations both inside and outside the mouth are essential. Children often have difficulty recognizing their sensations: they have little idea where the tongue is and where it should be placed in order to pronounce this or that sound. Children with Down syndrome do not know how and cannot integrate their sensations - simultaneously concentrate attention, listen, watch and react and, therefore, do not have the opportunity to process signals from more than one stimulus at a given time.

Some children with Down syndrome have such slow language acquisition that learning through interaction with others is extremely difficult. Due to the difficulty of expressing their thoughts and desires, these children often worry and feel unhappy. The ability to speak develops, as a rule, later than the ability to perceive speech. Children with Down syndrome have difficulties in mastering the grammatical structure of speech, as well as semantics, that is, the meanings of words. They do not differentiate the sounds of surrounding speech for a long time, and do not learn new words and phrases well. Children with Down syndrome often speak quickly or in separate sequences of words, without pauses between them, so that the words overlap each other.

Some of these features are common to a larger number of children with Down syndrome, some to a smaller number, but in general there is no such thing as “the speech of children/people with Down syndrome.” All the factors that affect the speech of people with Down syndrome can manifest themselves in the life of a person without the syndrome. This means that experts know how to help overcome these problems. Some of the problems described above can be eliminated medically (middle ear infections, for example), while others can be reduced with the help of special speech therapy exercises (for example, increasing muscle tone).

Children with Down syndrome typically have more difficulty learning due to developmental delays. This manifests itself quite clearly in speech acquisition. Speech is primarily associated with such thought processes as logic, understanding, and memory. These problems often interfere with the child, but you can work on them throughout your life, constantly improving the result.

Practical advice on developing children's active speech.

It is important to communicate with your child all the time, from the very first day. Tell him about your actions. Ask him, and if he himself still cannot answer, then answer and show for him. During a conversation, you need to look the baby in the eyes. Facial massage is very useful for speech development, because babies feel their mouths as if they were “numb when frozen.” Massage should be done from birth, very gently and carefully. 1-2 times a day for 3-5 minutes. “External” massage (lightly stroke the face with your fingertips, slowly, smoothly, without moving the folds of the skin):

• stroking the forehead from the middle to the temples;
• stroking the cheeks from the nose to the ears;
• stroking from the chin to the ears;
• kneading the zygomatic and cheek muscles is carried out with the index and middle fingers of both hands, in the direction from the temple along the zygomatic and cheek muscles to the chin.

Stroking, rubbing, kneading and vibrating the lips are carried out:

• from the middle of the upper lip to the corners of the lips;
• from the middle of the lower lip to the corners;
• stroking the nasolabial folds from the corners of the mouth to the wings of the nose;
• pinching lips.

After the massage, it is important to talk to your baby about sounds that he can later imitate.

To encourage imitation of speech sounds, you can do the following exercises. Look at the child. Tap your open mouth to make a “wa-wa-wa” sound. Tap your hand on your child's lips to encourage him to make the same sound. To further demonstrate, bring his hand to your lips. Build the skill by tapping your child's mouth and making a sound. The repetition of vowel sounds A, I, O, U is facilitated by imitation of motor reactions. In addition to facial massage, gymnastics and finger massage are very important.

Proper breathing has a great influence on the quality of your voice. In children with Down syndrome, breathing is shallow and occurs primarily through the mouth, since frequent colds make it difficult to breathe through the nose. In addition, a large, flaccid, hypotonic tongue does not fit in the oral cavity. Therefore, in addition to preventing colds, it is necessary to train the child to close his mouth and breathe through his nose.

The production of a good air stream is facilitated by air-blowing exercises, which also rely on the child’s ability to imitate. The tasks are completed in a relaxed playful manner. Any efforts of the child should be supported until he begins to do things correctly. For example: blowing on hanging feathers or other light objects; play the harmonica, making sounds when inhaling and exhaling; blow away feathers, cotton wool, torn tissues, table tennis balls; blow out a match or candle fire; play toy trumpets and flutes, blow on wind wheels; inflate rolled up paper snakes and balloons; blow through a straw into soapy water and blow bubbles; blow on a mirror or glass and draw something there. These and other exercises can vary in different play forms according to the age of the child. Music and singing are absolutely necessary for the development of the baby. But it is very important that there are no toys with electronic music. But toys based on the hurdy-gurdy principle, where the sound is produced by touching the pins on the drum, are very good. Children have a great sense of rhythm. To develop the ability to hear and listen to music, instruments are important for them: xylophone, piano, guitar, bells of different sounds, flute, wooden spoons, rattles, cello.

TV is dangerous for all children, but especially for ours. It paralyzes the will and accustoms one to passive experiences.

Children need to realize that the sounds and gestures they know can

influence the behavior of others, that they are able to help them to a certain extent influence what happens around them. With sounds and gestures you can say hello, say goodbye, ask for some things that are difficult to reach, ask for help, share various information, refuse unloved food, unwanted toys or activities, etc.

A baby who begins to speak learns to take turns not only in pronouncing sounds or performing actions, but also in pronouncing words. The best way to learn new words is imitation. To satisfy his social, emotional and material needs, the child gradually begins to use words rather than sounds and gestures.

To master speech, a child needs more than just a good vocabulary. Of course, we want him to learn a lot of words, but we also need to be sure that these words will allow him to talk about a variety of things. A baby may know, say, 50 words, but if all these words are nouns (car, ball, house, dad, apple, etc.), then he will not be able to say what these people or things are, where they are are what they are doing. He will not be able to combine these words into sentences that make sense.

In the process of training the speech development of children in this category, it is necessary to use a wide variety of methods and techniques: excursions, observations, dramatizations, didactic games, reading and retelling texts, fairy tales, reciting poetry, watching videos, etc. This contributes to the formation of various aspects of the child’s speech activity. Under the influence of correctional training, the speech of special children develops and improves and, although it does not reach the level of normal development, provides the child with communication with the people around them.

When conducting classes on children’s speech development, it is important to remember the basic rules:

• Give your child time to respond.
• Listen.
• Wait.
• Talk to your child about what interests him.
• During planned lessons, attract your child’s attention to the words and objects you have chosen for lessons.
• Try to naturally develop the conversation you have started, thereby encouraging the child and encouraging him to continue the conversation.

Studying the experience of specialists and parents raising children with Down syndrome convinces that the level of capabilities of these children should be assessed only individually. Therefore, any generalizations (regarding any quality, property, ability) are fundamentally erroneous, since knowledge of the physical or mental state of an individual cannot be separated from an understanding of his individuality. Today it is absolutely clear that when teaching and raising a child with Down syndrome, teachers and parents need to rely on his stronger abilities, which will make it possible to overcome his weaker qualities.

Correction of the phonetic aspect of speech in children with Down syndrome

Work on the development of the phonetic side of speech should occupy an important place in the correction of the intellectual development of children with Down syndrome both in preschool and school age.

Children with Down syndrome aged three to five years often experience deviations in the development of the sound aspect of speech. These deviations are based on both defects in the articulatory apparatus and disorders of phonemic perception. Exercises offered to children with Down syndrome at this age should be aimed at differentiating various speech and non-speech sounds, developing the correct pronunciation of vowels and some consonants, developing correct speech breathing, a voice of normal volume,

education of stability of auditory attention. The development of auditory attention is given special importance, because under his control the formation of the pronunciation side of speech is carried out. Work to improve pronunciation can be carried out by evoking sounds, sound combinations and clarifying their pronunciation by imitation.

For many children with developmental disorders, pronunciation is a stumbling block, even in cases where their ability to communicate may otherwise be fully developed.

I will give several examples of successful work on correcting sound pronunciation in children with Down syndrome.

Work with children was based on a complex (polysensory) impact on the child’s personality: a session with a speech therapist, fairy tale therapy, a music lesson.

Speech therapy work was divided into two stages:

• establishing emotional contact, examination and drawing up an individual program for each child.
• correction of speech disorders.

In the process of speech therapy work to overcome phonetic disorders, the following tasks must be solved:

• Formation of psychophysiological mechanisms that ensure mastery of the phonetic side of speech (sensory and motor parts of the speech process).
• Development of auditory perception and attention.
• Formation of speech skills of phonetically correct speech.
• In the process of work, the implementation of these tasks is carried out in their unity and interconnection.

The lesson consisted of several parts:

Articulation gymnastics

Exercises to develop gross and fine motor skills

Games and tasks aimed at activating children's own speech.

A group of children of different ages (4-8 years) and different levels of speech development was examined:

• Non-speaking;
• Children speaking single words;
• Children using simple phrases.

In the process of correctional work, almost all children showed positive developmental dynamics:

• improved auditory attention and perception;
• tongue movements and fine motor skills of the fingers have become more accurate.

Conclusion

Correctional classes are extremely necessary not only for the social adaptation and survival of these children in society, but also for society itself to educate and understand the problems of people different from us.

Comparative studies have shown that the children with whom they studied, by the time they entered school, were already able to do much more than those who were not affected by them. Children with Down syndrome learn to read and write and communicate with the normally developing peers around them. They master these skills not because they are given some kind of “cure”, but because they were taught what they need, when they need it, and in the way they need it. In our country, centers for early pedagogical assistance are being created and attempts to integrate the education of such children are beginning. Achieving the set goals ensures the solution of the following main tasks:

1. Development of children’s mental functions in the process of work and the earliest possible correction of their deficiencies.

2. Raising children with Down syndrome, developing correct behavior in them. They must be able to express a request, be able to protect themselves or avoid danger. Much attention must be paid to external forms of behavior.

3. Labor training, development of self-service skills and preparation for feasible types of household work.

Corrective education can lead to significant positive changes in the development of a child, which should affect his future destiny.