Methodology for conducting speech therapy examination of children with general speech underdevelopment and evaluation of the results obtained

Article:

OSD is a general underdevelopment of speech.
This disorder affects all aspects of the child’s speech, that is, its sound, lexical, grammatical, and semantic components. Manifestations of OHP depend on the insufficient development of various components of the speech apparatus. They can vary from complete absence of speech to speech, with elements of phonetic, lexical and grammatical underdevelopment. This disease is detected by a special diagnosis by a speech therapist. The correction program and its features are established individually by the attending physician. Among all children with speech disorders, children with ODD make up about 40%. Its strong and profound manifestations may in the future manifest themselves as dysgraphia and dyslexia. Speech therapists use the term phonetic-phonemic development or FFN and OHP to designate the immaturity of the speech system. OHP in children can be observed in the presence of dysarthria, alalia and other disorders.

Classification

According to the clinical picture of manifestations of ONR, it is divided into three groups:

• Uncomplicated form. Such children have minimal brain dysfunction, insufficient regulation of muscle tone, and immature volitional and emotional spheres.
• Complicated form. Occurs in patients with a number of neurological or psychopathic diseases, convulsive, cerebrasthenic and others.
• Gross underdevelopment. Children have lesions in the speech areas of the brain, that is, in the presence of alalia and dysarthria.

OHP also has its own degrees of severity. There are four in total:

• first degree - speechless, with the absence of commonly used speech;
• second degree – there are basic elements of common speech, poor vocabulary, agrammatism;
• third – the presence of phrasal speech, with underdevelopment of sound and semantic components;
• fourth degree – some problems in the phonetic-phonemic and lexical-grammatical aspects of speech.

Depending on the degree of complexity, the duration of correctional work of OHP by a speech therapist is determined.

Characteristics of degrees

Each degree of OSD has a certain relationship between primary and secondary speech defects, which inhibit the formation of its components. The transition from one level to another is determined by the presence of new speech capabilities and changes in its activity. The most persistent manifestations of OHP are observed with motor alalia, and less often with stuttering or rhinolalia. There are only four degrees of OHP.

ONR first degree

This disorder is characterized by a complete absence of speech, and this degree is detected immediately. It manifests itself in the following:

1. Vocabulary is extremely limited. For communication, the simplest babbling words, fragments of words, syllables or onomatopoeia are used. At the same time, the baby loves to communicate, but speaks with the people around him in “his own” language. That is, the child has in his speech such words as “woof-woof”, “meow-meow”, “too-too” and the like.
2. A preschooler with the first degree of OHP actively uses appropriate facial expressions and gestures and carry a semantic load. The child uses these techniques to express himself, and the adult makes every effort to understand them.
3. Speech does not contain sentences or phrases consisting of several words. Only individual amorphous words with a general meaning are observed, for example, the phrase “woof-woof tu-tu” means that the dog rode the train.
4. Passive vocabulary significantly exceeds active one. The baby understands speech addressed to him, but is unable to say anything.
5. Words with complex composition and structure are kept to a minimum, long complex words are simply abbreviated, but their meaning can be understood. For example, the word bus may sound like abus, or tube.

ONR second degree

OHP type 2 differs from the first degree in the presence in the child’s speech of a small number of commonly used words; they may not be pronounced quite correctly. The beginning of the formation of connections between words may also be noticeable, but this is still on an unstable basis. The following symptoms are typical for grade 2 OHP:

1. The child uses one word that denotes an object or some action, but in a modified form. For example, the word "bus" will sound like "abous" in any context.
2. The active vocabulary is very limited; with OHP 2, they do not know all the words denoting some characteristics of an object, for example, a description of its shape, color and other characteristics.
3. The child does not have the skill to combine objects into certain semantic groups, for example, tableware - spoon, fork, plate.
4. The pronunciation of many sounds, words, and phrases is impaired.

Also, characteristic features of type 2 OHP are the presence of rudiments of grammatical changes depending on the complexity of the word itself. The more letters there are in a word, the more mistakes and violations the child makes in it. He actively uses words in his speech, but does not coordinate them with each other. This is how the phrases “mama kupa” appear - “mom is bathing. Thus, prepositions are simply missed or used incorrectly. The patient can make up a short story based on the picture shown and the active assistance of the parent. However, this story turns out to be extremely modest. Usually two or three syllable sentences are used. In OHP 2, the words themselves are greatly distorted, and the pronunciation of words with a polysyllabic structure is impaired.

OHP third degree

This degree is characterized by a delay in the grammatical and phonetic speech components. The child has active expressive speech and is able to construct individual phrases and has a fairly large vocabulary. The problem points of speech are:

• communicates only with parents, with other people only with a “translator”;
• sound pronunciation is not fully formed;
• in independent speech, sounds may sound incorrect;
• more complex sounds are replaced by simple ones;
• has difficulty with hissing, whistling and sonorant sounds;
• one and the same sound can replace several;
• The vocabulary is expanding, but only a small part of it is used.

Grammar is also impaired in grade 3 OHP, but the child tries to construct complex sentences, but difficulties arise with their pronunciation. The child may not formulate sentences correctly, but can create a short story. Another distinctive feature is inconsistent grammatical errors, that is, in one sentence the same error is made, but not in another phrase. The baby may lag behind in his phonetic abilities, manifested in the so-called difficult words. All these factors delay the process of preparing a child for school.

OHP fourth degree

This degree is characterized by the presence of only some difficulties and errors in speech. This creates an overall picture that prevents you from fully mastering speech, sound understanding and pronunciation. The main thing for parents in this case is to contact speech therapy specialists in order to correct all existing deficiencies as quickly as possible. Characteristic signs of OHP type 4 are:

• there are no obvious violations of sound pronunciation, the sounds themselves are delivered correctly;
• speech is slurred with unclear, blurred sound pronunciation;
• there are violations of the structure of syllables, expressed in the replacement of sounds with similar ones;
• incorrect use of certain words denoting characteristics of a particular object;
• the child may not understand or confuse the phrases “long table” and “high table”;
• difficulties in choosing the correct suffixes;
• Agrammatisms may occur, but their number is minimal.

Violations characteristic of level 4 OHP are not so common. Speech is characterized by criticality, and the grammatical structure itself is close to its norm.

Characteristics of OHP

The history of children with OHP often reveals intrauterine hypoxia, Rh conflict, birth injuries, asphyxia; in early childhood – traumatic brain injuries, frequent infections, chronic diseases. An unfavorable speech environment, lack of attention and communication further inhibit the course of speech development.

All children with ODD are characterized by a late appearance of their first words - by 3-4, sometimes by 5 years. Speech activity of children is reduced; speech has incorrect sound and grammatical design and is difficult to understand. Due to defective speech activity, memory, attention, cognitive activity, and mental operations suffer. Children with OHP are characterized by insufficient development of motor coordination; general, fine and speech motor skills.

In children with level 1 ODD, phrase speech is not formed. In communication, children use babbling words, one-word sentences, supplemented by facial expressions and gestures, the meaning of which is incomprehensible outside the situation. The vocabulary of children with level 1 SLD is sharply limited; mainly includes individual sound complexes, onomatopoeia and some everyday words. With OHP level 1, impressive speech also suffers: children do not understand the meaning of many words and grammatical categories. There is a gross violation of the syllabic structure of the word: more often children reproduce only sound complexes consisting of one or two syllables. The articulation is unclear, the pronunciation of sounds is unstable, many of them are inaccessible for pronunciation. Phonemic processes in children with level 1 ODD are rudimentary: phonemic hearing is grossly impaired, and the task of phonemic analysis of a word is unclear and impossible for the child.

In the speech of children with level 2 OHP, along with babbling and gestures, simple sentences consisting of 2-3 words appear. However, the statements are poor and of the same type in content; express objects and actions more often. At level 2 OHP, there is a significant lag in the qualitative and quantitative composition of the vocabulary from the age norm: children do not know the meaning of many words, replacing them with similar meanings. The grammatical structure of speech is not formed: children do not use case forms correctly, experience difficulties in coordinating parts of speech, using singular and plural numbers, prepositions, etc. Children with level 2 OHP continue to have reduced pronunciation of words with simple and complex syllable structure , a confluence of consonants. Sound pronunciation is characterized by multiple distortions, substitutions and mixtures of sounds. Phonemic perception at level 2 OHP is characterized by severe insufficiency; Children are not ready for sound analysis and synthesis.

Children with level 3 SLD use extensive phrasal speech, but in speech they use mainly simple sentences, having difficulty constructing complex ones. Speech understanding is close to normal; difficulties arise in understanding and mastering complex grammatical forms (participial and adverbial phrases) and logical connections (spatial, temporal, cause-and-effect relationships). The volume of vocabulary in children with level 3 ODD increases significantly: children use almost all parts of speech in speech (to a greater extent - nouns and verbs, to a lesser extent - adjectives and adverbs); typically inaccurate use of object names. Children make mistakes in the use of prepositions, agreement of parts of speech, use of case endings and stresses. The sound content and syllabic structure of words suffers only in difficult cases. With level 3 OHP, sound pronunciation and phonemic perception are still impaired, but to a lesser extent.

At level 4 OHP, children experience specific difficulties in sound pronunciation and repetition of words with complex syllabic composition, have a low level of phonemic awareness, and make mistakes in word formation and inflection. The vocabulary of children with level 4 ODD is quite diverse, however, children do not always accurately know and understand the meaning of rare words, antonyms and synonyms, proverbs and sayings, etc. In independent speech, children with level 4 ODD experience difficulties in logical presentation of events, they often miss the main thing and get stuck on minor details, repeating what was said earlier.

Reasons for OHP

The causes of OHP are mainly problems during pregnancy or childbirth, as well as in the first years of the baby’s life. The most basic reasons for OHP:

• infectious diseases of the mother during pregnancy;
• toxicosis;
• birth injury;
• asphyxia, hypoxia;
• incompatibility of mother and child by Rh factor;
• disorders in the central nervous system;
• head injuries of a baby in his first years of life;
• the influence of nicotine, alcohol, drugs;
• deprivation.

Social reasons are also important. This may be due to insufficient communication with the child. Often this form of OHP occurs in children living with their parents who have hearing problems. The attention of adults to it has a noticeable effect on speech skills and should be given a lot of time.

Pathogenesis

OHP should be considered as a systemic disorder that affects language subsystems, that is:

• phonetic-phonemic;
• grammar;
• lexical;
• semantics.

Level 1 OHP in a child causes him to lag behind accepted age norms. This happens across the entire spectrum of indicators, both quantitative and qualitative. Such children have disturbances in the general course of speech development, the timing, and the order in which they master articulatory skills. Experts compare general speech development with linguistic infantility.

The very mechanism of the appearance and development of general speech impairment has a close connection with primary speech defects and their direct causes. In the presence of disorders of cerebral-organic origin, such as alalia or aphasia, severe speech disorder may occur, as well as misunderstanding of the speech of others.

Thus, speech pronunciation and its perception suffer. If there are anatomical defects, insufficient development of the speech apparatus, the syllabic structure of words disintegrates, and the lexical and grammatical basis of statements is disrupted.

Diagnostics

The diagnosis of onr can only be made by conducting a comprehensive study. Diagnosis is carried out at an initial consultation with a speech therapist. The specialist establishes contact with the child, the parents must have medical reports from a neurologist, pediatrician, and the results of the studies. Having received all available information, the specialist studies and determines the speech status of his patient.

Speech therapy research is carried out in two stages - orientation and language examination. The orientation is carried out through a conversation with parents. This way, all the features of the course of the disease are clarified, what reasons accompanied it, and how the speech apparatus developed. The patient himself is also assessed - his ability to make contact, articulatory motor skills.

When examining the language and its components, the formation of speech, its coherence, grammar, and vocabulary are determined. In the case of the presence of OHP of the first degree, there is a gross underdevelopment of all components of the language system, which is explained by the child’s lack of commonly used speech. After this, the specialist can draw up his conclusion and establish the clinical form of the pathology of the speech apparatus.

It is important to distinguish insufficient speech development from other forms, such as speechlessness, autism, mental disabilities, hearing impairments, etc.

Recommended speech therapy examination

It is worth studying in detail the vocabulary of a person suffering from OPD. This will allow you to assess the ability to correlate a word with a specific subject. This is done in several steps:

• Selection of material, divided into individual lexical topics. This determines the child’s ability to communicate with the people around him.
• Pictures with objects are offered.
• Pictures with names of body parts are used.
• Selection of synonyms for the selected word.

During the diagnosis, the speech therapist must give his conclusion, which indicates the level of speech development, the clinical picture, the degree of OHP, and also draw up a plan for correcting the identified disorders.

Speech therapy examination for OHP

At the preliminary stage of a diagnostic examination of speech, the speech therapist gets acquainted with the medical documentation (data from the examination of a child with OSD by a pediatric neurologist, pediatrician, and other children’s specialists), and finds out from the parents the features of the child’s early speech development.

When diagnosing oral speech, the degree of formation of various components of the language system is specified. The examination of children with OHP begins with studying the state of coherent speech - the ability to compose a story from a picture, a series of pictures, retelling, story, etc. Then the speech therapist examines the level of development of grammatical processes (correct word formation and inflection; coordination of parts of speech; sentence construction, etc. .). An examination of vocabulary in OHP allows one to assess the ability of children to correctly correlate a particular word-concept with the designated object or phenomenon.

The further course of the examination of a child with OHP involves studying the sound side of speech: the structure and motor skills of the speech apparatus, sound pronunciation, syllable structure and sound content of words, the ability for phonemic perception, sound analysis and synthesis. In children with OHP, it is necessary to diagnose auditory-verbal memory and other mental processes.

The result of an examination of the state of speech and non-speech processes in a child with OSD is a speech therapy report reflecting the level of speech development and the clinical form of the speech disorder (for example, level 2 OHP in a child with motor alalia). OSD should be distinguished from delayed speech development (DSD), in which only the rate of speech formation lags behind, but the formation of linguistic means is not impaired.

Correction of the disorder

Corrective work on OHP should only be carried out by a qualified specialist. Preschool children with the first degree of speech impairment attend special speech therapy groups in kindergarten. They must enter here at the age of 3-4 years, and the classes themselves are conducted in groups, subgroups and individually. The purpose of correction is to transfer the child to another stage of speech development, to compensate for all existing deviations.

This work is carried out simultaneously in various directions:

1. Speech understanding. This problem can be better solved by conducting classes in a playful way. The child must find toys that the specialist names for him, show the correct pictures, expand his vocabulary, and master the pronunciation of phrases, phrases, and multi-word phrases.
2. Speech activation. Development of onomatopoeia in a child, for example, the voices of various animals, musical instruments. This stimulates his speech activity. Pronouns, verbs, and addressing an adult are gradually introduced into speech.
3. Non-speech development. Correct speech is impossible without the development of auxiliary mechanisms - concentration, development of thinking, memory. Much attention should be paid to the intellectual and mental development of the child. Auxiliary techniques include logorhythmics, speech therapy massage, development of fine motor skills and articulation.

At the last stage, sound pronunciation must be performed with correct grammar and speech format. Treatment of second-degree ODD includes the development of the child’s speech skills, his understanding of adult speech, and training of the lexical and grammatical component. At the third degree, coherent semantic speech is formed, vocabulary and grammar are improved, and correct articulation is consolidated. A lot of time should be devoted to mastering the necessary literacy.

For children with SEN IV, it is important to achieve their age-specific speech standards, which is necessary for successful studies at school. Schoolchildren with severe forms of ODD are trained in schools created to work with children with speech disorders. Here the emphasis is on compensation for all aspects of the manifestation of speech underdevelopment1.

Kozina I.V., teacher-speech therapist, preschool educational institution No. 2099, Moscow

Children entering the speech therapy group undergo a comprehensive examination necessary to clarify the structure of the disorder, determine a correction program, and predict development. The data obtained is recorded in a speech card, which must provide the following conditions: - qualitative analysis of the survey results (accounting for errors, degree of independence, features of completing tasks, etc.); — interpretation of the obtained data in quantitative form (scoring); — the use of unified criteria for assessing the completion of tasks (they minimize the personal factor); - selection of tasks in accordance with age norms (speech tests should be different for 5, 6 and 7 year old children); — building an individual speech profile, which allows you to clearly clarify the structure of a speech disorder and draw up a plan for correctional work; — monitoring the dynamics of speech development and the effectiveness of correctional interventions; — compactness of filling; - a fairly large number of examples of children's speech; — an opportunity for another specialist to analyze the document and continue the intended work. The purpose of this publication is not to provide a detailed presentation of the methodology for examining preschoolers with SEN. We advise the reader to take a creative approach to the material presented. The practicing speech therapist has the right to develop his own examination scheme. The main thing is that it meets all modern requirements. Speech card Personal data Last name, first name of the child ______ Date of birth ____________ Where did he come from ___________ Speech environment _________ Home address, phone number __________________________ Information about parents (full name, age at the time of birth) Mother ____________________ Father ____________________ Anamnestic data From which pregnancy ______ Nature of the pregnancy ______________________ Childbirth ____________________ Past diseases __________________________ Hearing ____________________ Vision __________________ Intelligence _______________ Early physical development: began to hold his head ______ sit ______ crawl ________ stand _______ walk _______ Early speech development: walk ______ babble ______ first words ________________ first phrase ________________ phrasal speech _______________ Features of the articulatory apparatus Teeth ____________________ Bite ___________________ Hard palate ______________ Soft palate ______________ Lips ____________________ Tongue ___________________ Examination parameters 1. General sound of speech. 2. Articulatory motor skills. 3. Sound pronunciation. 4. The syllable structure of the word. 5. Phonemic hearing. 6. Language analysis and synthesis. 7. Grammatical structure. 8. Vocabulary. 9. Word formation. 10. Coherent speech. Speech therapy conclusion ______________________________ Date ______ Speech therapist ______ Plan of individual correctional work ______________________________ Data on the progress of correctional work ______________________________ Memo for the speech therapist on filling out the speech card Anamnestic data Nature of pregnancy - toxicosis, infections, injuries, chronic diseases. Childbirth - early, urgent, fast, rapid, dehydrated, protracted, use of obstetric aids, stimulation, when the child cried, was asphyxia observed. Past diseases - pneumonia, colds, flu, measles, scarlet fever, whooping cough, dysentery, head injuries, infectious and somatic, long-term and causing depletion of the nervous system. Hearing is normal (N), hearing loss. Vision - N, myopia, strabismus, amblyopia, optic nerve atrophy, limited visual field. Intelligence - appropriate for age, below normal. Early physical development - N, with delay (began to hold head - N 2 months, sit - 6 months, crawl - 5-6 months), stand - 7-8 months, walk - 1 year). Early speech development - N, with delay (booming - N 3 months, babbling - 5 months, first words - 1 year, first phrase - 2 years, phrasal speech - 3 years). Features of the articulatory apparatus Teeth - N, sparse, crooked, outside the jaw arch, small, large, dentition disorder, presence of stem. Bite - N, orthognathic, open anterior, lateral: bilateral, unilateral, deep, distal, mesial, straight, cross. Hard palate - N, narrow, high (deep, domed, gothic), flat, low, presence of postoperative scars. Soft palate - long, short, scars, uvula, submucosal fissure, mobile, immobile. Lips - N, thick, thin, short, sedentary, mobile, hypo-, hypertonicity, cheiloskisis (cleft lip), procheilia (increase in the size of the upper lip, overhanging the lower lip). Tongue - normal, macroglossia, microglossia, long, short, wide, narrow, hypertrophy of the tongue root, forked, shortened hyoid ligament, inactive, mobile, hypo-, hypertonicity. Motor sphere General motor skills - N, coordination, tempo, rhythm of movement are slightly impaired, motor clumsiness. Recommended studies 4 years - jump on both legs, do a standing long jump, stomp your feet and clap your hands at the same time, throw a ball from your chest and catch it. 5 years - the same and additionally: jump on your left, right leg, throw a ball from behind your head, jump over a toy. 6 years old - the same and additionally: toss and catch a ball, climb onto a gymnastics wall and get off it. Manual motor skills - N (preserved function), insufficiency of fine motor skills, motor limitations, range of movements (full, incomplete, strictly limited), pace (N, fast, slow), switchability (accurate, inaccurate), coordination (N, minor impairments, broken, incomplete). Leading hand - left-handed, ambidextrous, right-handed. Recommended studies 4 years - put your thumb and index fingers into a ring, alternately bend and straighten your fingers, perform the “Hare” exercise with your right and left hand, change the position of your hands (fist - palm). 5 years - the same and additionally: perform the exercises “Goat”, “Playing the piano”, the “Fist-rib-palm” test with the leading hand. 6 years old - the same and additionally: place the index finger on the middle finger and vice versa, first on the right hand, then on the left, perform the “Playing the piano” exercise, the “Fist - rib - palm” test with the left hand, with both at the same time. Psychophysical processes Attention N (quite stable), low concentration, unstable, superficial, quickly depleted, poor switching. Visual perception - recognition of objects in conditions of overlap, in an incomplete image, in a silhouette image. Tactile. 4 years - guessing an object based on its outline. 5, 6 years - the same and additionally: guessing identical objects based on differential features. Auditory - identification and differentiation of noise. Color - no ideas, compares, distinguishes (highlights by word), names (4 years - red, yellow, blue, green, white, black; 5 years - the same and additionally: orange, blue; 6 years - the same and optional: purple, pink, brown, gray). Form. 4 years - circle, square, oval, triangle. 5 years - the same and additionally: rectangle. 6 years - the same and additionally a polygon. Rhythm - perception, reproduction (4 years - - - ., - . -, . - .; 5 years - . . . -, - . . -, . - - .; 6 years - - - . . ., . . - - ., . - - - .). Temporal representations - orientation is good, insufficient, weak (4 years - parts of the day, seasons; 5 years - the same and additionally: days of the week; 6 years - the same and additionally: months, understanding and use of logical-grammatical structures). Space. 4 years - show objects above, below, in front, behind. 5 years - the same and additionally: left, right. 6 years - the same and additionally: bottom left, top right, top left, bottom right. Body diagram. 4 years - show right, left arm, leg. 5 years - the same and additionally: right, left eye, right, left ear. 6 years old - the same and additionally: show your left eye with your right hand, and your right ear with your left hand. Cut-out pictures - independently, with the help of a teacher, according to a model, by imitation (4 years - 2-4 parts, 5 years - 3-5, 6 years - 4-8). Stick figures. 4 years - a “chair” of four sticks. 5 years old - a “house” of six sticks. 6 years old - “boat” of seven sticks. Memory Parameters of short-term memory: volume and linearity. Thinking Generalization. Level 1 - generalization with a word. Level 2 - grouping according to subjective general characteristics. Level 3 – generic generalization. Level 4 - logical level of generalization. N - by 7 years. Seriation. 4-5 years - arrangement of objects in a row in ascending and descending order. 6 years - correlation with each other according to the leading characteristic of a number of objects. Comparison. Highlights essential features, does not highlight, independently, with help, explains verbally, without explanation. Impressive speech Understanding of addressed speech in full, at the everyday level, limited, within the limits of the situation. Prepositional case constructions. 4 years - in, on, above, under, at, from, to, to. 5 years - before, for, about, in, from, on, with. 6 years - under, from under, for, because of. Verbs with prefixes. 4 years - comes out, moves on, approaches. 5 years - flies out, flies up, flies in. 6 years - leaves, drives away, drives around, drives in. Follow instructions. 4 years - one-, two-stage. 5 years - two-, three-stage. 6 years old - show a notebook with a pen, a pen with a ruler. Understanding sentences. 4 years old - Where is my daughter’s mother? Where is mom's daughter? 5 years old - Who does the girl catch? What does she use to catch a butterfly? Who catches the butterfly? 6 years - understanding of coherent speech, logical and grammatical structures. Sensorimotor level of speech General sound of speech Intelligibility - N (sufficient), reduced, speech is blurred, disturbed, slurred, difficult to understand for others. Tempo - N, fast, slow, tachylalia, bradylalia, hesitation, stuttering (degree, form). Rhythm - N, dysrhythmia, extended, chanted, depends on the manifestation of hyperkinesis. Breathing - free, difficult, superficial, shallow, uneven, clavicular, lower diaphragmatic, oral exhalation is formed, not formed, nasal breathing is difficult, absent, during phonation, oral exhalation is mixed. Voice - N, quiet, weak, non-flying, poorly modulated, monotonous, timbre deviation (dull, compressed, hoarse, trembling, presence of a nasal tint). Score 5 - speech intelligibility is not impaired, breathing is free, voice is modulated, tempo and rhythm are normal. 4 - speech intelligibility is slightly reduced. Minor isolated disturbances in breathing and voice are possible. 3 - speech is slurred, blurred. There may be disturbances in tempo, rhythm, breathing and voice. 2 - intelligibility is impaired, speech is difficult to understand for others. Hyperkinesis, stuttering, and timbre deviation are possible. 1 - speech is understandable only to those close to you. Articulatory motor skills Range of movements - strictly limited, incomplete, complete. Tone - N, increased, decreased. Mobility - sufficient, insufficient, tremor, hyperkinesis, deviation to the left, to the right, kinesthetic apraxia. Switchability, precision of movements - sufficient, insufficient. Salivation - N, increased. Score 5 - correct execution with exact compliance of all movement characteristics. 4 - all movements are available, the volume is full, the tone is normal, the pace of execution and switchability are somewhat slow. 3 - slow and tense execution. 2 - execution with errors: long search for a pose, incomplete range of motion, deviations in configuration, synkinesis, hyperkinesis. 1 - failure. Sound pronunciation N (within the age norm), the phonetic structure of speech is not sufficiently formed, in isolation all sounds are pronounced correctly, but with an increase in speech load, general blurred speech, phonetic defects in sound pronunciation (omissions, distortions), phonological defects (substitutions, confusion) are observed. Score 5 - perfect pronunciation of all sounds in any speech situations. 4 - one or two sounds are correctly pronounced in isolation and in reflection, but are sometimes subject to distortion or substitution (not automated enough). 3 - the pronunciation of three to five sounds is impaired. 2 - six to nine sounds are distorted or replaced in any position. 1 - at least ten sounds are subject to distortion or substitution in all speech situations. The syllabic structure of the word N (not broken), minor defects in the syllabic structure of the word, the structure is broken. Types of violations: elision (omission of sounds, syllables), perseveration (delayed repetition), iteration (adding), anticipation (replacing previous sounds with subsequent ones), rearrangement of sounds, syllables, contamination (connecting the syllabic parts of two words), paraphasia (replacement). Score 5 - correct and accurate reproduction at the pace of presentation. 4 - accurate playback, the tempo is somewhat slow, there may be stutters. 3 - slow, syllable-by-syllable reproduction, with hesitations, one or two words with distortion of the syllable structure. 2 - distortion of the syllabic structure of words. 1 - non-reproduction. Phonemic hearing N (preserved), underdeveloped, impaired. The following sounds are studied: - voiced, voiceless; - oral, nasal; - hard, soft; - front-lingual, back-lingual; - front-lingual-middle-lingual; - middle lingual, back lingual; - labial, anterior lingual; - labio-labial, labio-dental; - whistling, hissing; - anterior lingual occlusives, anterior lingual fricatives; - sibilant affricates, sibilant fricatives; - sibilant affricates, forelingual stops; - sibilant affricates, sibilant fricatives; - vibrants are occlusally passaged oral. Rating 5 - all tasks were completed correctly. 4 - one or two mistakes are made, but they are corrected on their own. 3 - mistakes are made and corrected after replay. 2 - some tasks are inaccessible and require replay when completed. 1 - failure. Language analysis and synthesis N (formed), insufficiently formed, not formed. Score 5 - all tasks completed correctly on the first try. 4 - one or two mistakes are made, but they are corrected on their own. 3 - tasks are executed with errors, one or two tasks are unavailable. 2 - most of the tasks are unavailable. 1 - incorrect answers, refusal to complete. The grammatical structure of speech N (formed), insufficiently formed, not formed. Score 5 – correct, independent completion of all tasks. 4 - isolated errors are corrected independently or with the help of a clarifying question. 3 - most tasks are completed with help (stimulation, expansion of instructions, clarification of the question, hint). 2 - most tasks are not completed. 1 - failure. Vocabulary N (the vocabulary is sufficient, corresponds to the age norm), within the limits of everyday life, is sharply limited. Assessment: the same as when studying the grammatical structure of speech. Word formation N (formed, corresponds to the age norm), in the stage of formation, not formed. Assessment: the same as when studying the grammatical structure of speech. Coherent speech N (corresponds to the age norm), at the stage of formation, requires further development, is not formed. Retelling 4-5 years  There was a puddle near the house. Geese sat on a puddle. The geese were gray. L.N. Tolstoy  The nanny cooked some porridge and gave it to Natasha. Natasha ate, collected the crumbs and poured them out the window. The birds flew in and started pecking at the porridge. Natasha is full and the birds are full. According to I.D. Sytin  They threw the cat near the barn. The cat meowed: “Meow! Meow!" Tanya and Kolya walked past the barn and found a cat. They fed the cat milk and meat. And the cat became as fat as Sharik. I.D. Sytin 5-6 years old  The bunny said to the hedgehog: “What an ugly, prickly dress you have, brother!” “True,” answered the hedgehog, “but my thorns save me from the teeth of the dog and the wolf. Does your pretty skin serve you the same way?” Instead of answering, the bunny just sighed. K.D. Ushinsky  Varya had a siskin. The siskin lived in a cage and never sang. Varya came to the siskin. - It's time for you, little siskin, to sing. - Let me go free, in freedom I will sing all day long. L.N. Tolstoy  The red sun floated into the sky. It began to send out its rays - to awaken the earth. The first ray fell on the lark. The lark rose high, high. There he sang his song. The second beam hit the bunny. A hare jumped across the meadow. I ran to look for some juicy grass for breakfast. According to K.D. Ushinsky Score 5 - the retelling was compiled independently without violating lexical and grammatical norms; the content of the text is fully conveyed, the coherence and sequence of presentation are observed; A variety of linguistic means are used in accordance with the text of the work. 4 - the retelling was compiled with little help (motivation, stimulating questions); grammatical norms are generally observed; There are isolated violations of coherent reproduction of the text, isolated cases of searching for words, the absence of artistic and stylistic elements, and insufficient development of the statement. 3 - the retelling is compiled with the help of (focusing on plot elements, hints, leading questions); omission of parts of the text without distortion of the meaning, poverty and monotony of the language used, and violations of the structure of sentences are noted. 2 - the retelling is based on leading questions; the coherence of the presentation is broken; There are significant abbreviations of the text or distortions of meaning, repetitions, agrammatisms, and inadequate use of words. 1 - retelling is not available even for questions. A story based on a series of pictures 6-7 years old Rating 5 - independently laid out the pictures and compiled a story; has all the semantic links, temporary and cause-and-effect relationships between events are defined; grammatically correct with adequate use of lexical means. 4 - pictures are laid out with stimulating help, the story is composed independently without agrammatism; Developed impressive violations of the coherence and smoothness of the story, insufficient detection, isolated cases of word search. 3 - laying out pictures and compilation of a story with stimulating help; There are agogramatisms, distant verbal replacements, the loss of semantic links, distortion of meaning; The connectedness of the story is broken. 2 - laying out pictures and compilation of a story on leading issues, hints; The inadequate use of lexical means is observed, a significant distortion of meaning or the story is not completed, or is a listing of objects. 1 - the story is not available. List of used and recommended literature Konenkova I.D. An examination of speech of preschool children with mental retardation. M., 2004. NICHEVA N.V. A speech card of a child with general speech underdevelopment (from 4 to 7 years). SPb., 2004. Serebryakova N.V., Solomakh L.S. The examination scheme of the child with the general underdevelopment of speech // Diagnosis of speech disorders in children and the organization of speech therapy work in the conditions of a preschool educational institution. SPb., 2000. Smirnova I.A. Speech therapy diagnosis, correction and prevention of speech disorders in preschoolers with cerebral palsy. SPb., 2004. Filicheva T.B., Chirkina G.V. Elimination of general speech underdevelopment in preschool children. M., 2004. Frekova T.A. Test methodology for diagnosing oral speech. M., 2000.

Prognosis and prevention

Correction of OHP is a long process, the duration of which depends on the severity of the disease, complications and other physiological characteristics of the child. It is necessary to start this work as early as possible, in this case the chances of completely getting rid of it or minimal manifestations increase. As a preventive requirement, it is necessary to follow all instructions during pregnancy.

Formation of grammatical categories in children with special needs development

Grammatical forms in children with ODD appear in the same order as in a healthy child, but with the presence of some features. They may be slower to learn, and there may be disharmony between speech morphology and syntax. Violations in grammatical structure are explained by the underdevelopment of these particular speech components. Such violations lead to a large number of grammatical errors, manifested in incorrect correlation of morphemes, suffixes, endings, and cases.