Speech development delay (SDD) as a condition or a confirmed diagnosis is noted in children from an early age. The first signs become noticeable to parents when comparing the spoken speech of their own child and his peers.
At the age of two years the difference is insignificant, but obvious. In each subsequent six months, the lag behind the norm becomes more and more obvious.
Causes of speech delay
Speech problems in children are not an independent diagnosis. This condition is often a consequence of the child’s developmental characteristics, as well as a side effect of existing diseases.
Intrauterine development
Intrauterine processes and the course of childbirth contribute to a greater extent to the delay in speech development. Neuroinfections of the mother during pregnancy (herpes, CMV, toxoplasmosis, rubella, etc.), tonsillitis, influenza, childbirth with any kind of complications (urgent or protracted labor) often cause developmental disorders in children.
Toxicoses in the first half of pregnancy, which affect the subcortical activity of the developing baby, also have a negative impact. A large percentage of children with subsequent communication difficulties are observed among premature infants.
Infant diseases
In addition to these reasons, the future characteristics of the child’s body can be affected by diseases and injuries experienced in infancy. This is especially true for complex infections, traumatic and infectious brain injuries.
Heredity
There is also a hereditary factor (neurological and speech problems in parents), which can result in alalia in the child. Experts note that, as a rule, boys are more susceptible to alalia than girls. Children who are lagging behind in motor development are also lagging behind in speech.
It is important to understand that speech development disorders are usually accompanied or become both consequences and causes of mental retardation. These two functions are closely related, and delay is highly undesirable.
It is advisable to seek treatment from a specialist at the first symptoms of alalia, because if you do not start speech promptly, you can worsen the development of the child’s mental abilities.
Help for non-speaking children is provided by speech therapists, whose task is to establish the exact cause of the developmental delay in a particular child. Next, an individual development program is developed with the goal of developing normal speech processes.
Features of diagnostics and correctional classes for speech with mental retardation
Treatment of alalia and correction of any form of speech delay begins after a specialist’s diagnosis, based on the results of which the diagnosis is clarified, the form of speech development delay is differentiated, the level of development of higher mental functions in the child is taken into account, and possible other factors that influenced the present condition are determined. All these aspects are very important to take into account in order to develop the correct method of speech correction for mental retardation.
In certain cases (most often with preschool children), it is recommended to first undergo a course of correctional classes with a neuropsychologist for subsequent effective work with a speech therapist.
Children under 3 years old
It is important to understand that if a non-speaking child is under 3 years of age, then after a diagnostic examination of the baby and a conversation with the parents based on the medical history, the speech therapist is immediately able to give an opinion about the delay in speech development and explain to the parents how speech will be initiated in non-speaking children.
Children over 3 years old
If speech problems occur in a child over 3 years of age, then a more serious speech disorder such as alalia may occur, which requires a diagnosis from a neurologist. In these cases, the speech therapist will be able to give his conclusion no earlier than 3 weeks after the start of correctional work with the child (5-6 lessons).
During this time, children “open up”, adapt and get used to speech therapy classes, so the specialist has the opportunity to give the correct conclusion on the presence of alalia, to isolate it from other largely similar speech disorders.
The method of correcting and launching speech for children is selected by a speech therapist individually for each child according to the indications. An important factor is the organization of communication in the family, so the speech therapist must give appropriate recommendations to parents and hopes for close cooperation with them.
The relationship between the specialist and the parents is a necessary component of successful treatment.
With correct diagnosis and the right correction strategy, even non-speaking children begin to speak if the reason for the silence can be corrected. One of the features of starting speech in children at our Center is that during classes the speech therapist-defectologist simultaneously pays attention to the development of the child’s higher mental functions (attention, memory, thinking).
Psychological and speech therapy examination of speechless children
The examination of a speechless child should begin with an examination of the psychological status. The speech therapist must have an idea of the state of various types of perception: visual, tactile, auditory.
1. Study of perception.
a) visual perception:
To study the state of subject gnosis, it is recommended to use the following techniques. [1, pp.38–39]
Presentation of object pictures. The speech therapist lays out 2 to 5 pictures in front of the child, offers to look at them and then, according to the speech therapist’s speech instructions, show the named picture.
Presentation of the outline. The child is asked to recognize the depicted object by its outline. 2 object pictures are laid out in front of the child and he is asked to look at them carefully, then the speech therapist lays out the outline of one of the images under them and asks the child to show the picture that he recognized from the proposed image.
Submission of an incomplete drawing. The child is asked to look at a drawing of a familiar object without a significant detail by which the image can be easily recognized, for example, a car without wheels. Instructions: “Show me the car.”
Presentation of crossed out figures. The speech therapist places 3-4 images in front of the child, crossed out with different lines - horizontal, vertical, wavy.
Presentation of superimposed images of objects. For children with alalia, the speech therapist shows only two contrasting images, for example, a Christmas tree and an apple. Instructions: “Look carefully at this picture and circle with your finger what you see in it.”
To study the state of color gnosis, the following techniques are used.
Presentation of colored figures. The speech therapist lays out 6 squares with primary colors in front of the child. Instructions: “Show the red (yellow, green, etc.) square.” The next task is to select a picture to match a color background.
b) auditory perception: [1, p.39]
When studying auditory gnosis, sounding toys are used.
Determining the direction of sound. Game "Where did they call?" The speech therapist behind the child rings the bell at the top, bottom, right, left and asks him to show with his hand where he heard the sound.
Differentiation of sounding toys. Two contrasting-sounding toys (tambourine - rattle) are placed in front of the child, the speech therapist produces sounds in front of the child, and the child himself can play with the sounding toys. Then the child turns away, the speech therapist causes the sound of one toy from the pair. The child shows a toy.
2. Spatial praxis. [1, p.40]
When examining the body diagram, the speech therapist asks the child to show his right and left hand to himself, then to the speech therapist. This activity is intended for children aged 5 years and older. Examining the child’s visual orientation in space, the speech therapist asks him to clap his hands in front of him, behind him, above, below.
When demonstrating actions with objects, the speech therapist asks to place one object in relation to another behind, in, on, under, between.
3. Constructive praxis.
The speech therapist uses the following techniques:
— Folding a pyramid;
— Folding cut pictures from 2, 3 parts, cut vertically, then horizontally.
— Folding figures from 2-4 sticks according to the pattern.
4. Dynamic praxis
Reproduction of simple and complex rhythms is used; test: fist - rib - palm.
5. Motor study
The state of general, manual and finger motor skills is examined. For example.
Gross motor skills: walk along a line drawn on the floor; Jump alternately on one leg and the other.
Manual motor skills: clench your fists, unclench your fists, clap your hands, clench your fist with your right hand and hit it on the palm of your left hand, then vice versa.
Finger motor skills: show the 2nd and 3rd fingers first on the right hand, then on the left hand, on both hands; 2nd and 5th fingers; tie a bow.
Note the coordination of movements of the arms and legs; sense of balance; range of movements; switching movements; independence of execution; accompanying movements.
6. Study of visual memory
The child is asked to remember 3-4 images of objects, then they are laid out in a row with other images (no more than 10). The speech therapist asks the child to show the pictures that he previously remembered. Remember and show what has changed in a row of 2, 3, 4, 5 objects.
State of intelligence
1. Folding a pyramid
It is used to identify the state of visual-effective thinking. It is necessary to have several pyramids consisting of 4, 6, 8 rings and a cap. [2, p.113]
The child is shown a pyramid and asked: “Take it apart,” accompanying the instructions with the appropriate gesture. If the child does not start work, the speech therapist himself dismantles the pyramid and invites the child to assemble it. If a child begins to act and assembles the pyramid in disarray, they do not stop him until the end of the work, then they say: “Wrong.” The speech therapist disassembles the pyramid again, selects the largest ring and puts it on the rod. Invites the child to continue to act. If the child chooses the next ring incorrectly, the speech therapist stops him, says: “Wrong,” takes the next, smaller ring, and puts it on the rod himself. This continues until the entire pyramid is completed. Then the speech therapist once again invites the child to disassemble and assemble the pyramid himself. Does not interfere with the progress of work. A conclusion is made whether the child is learning the method of action.
For children with normal intelligence, starting from the age of 4, folding a pyramid does not cause difficulties (trials and trying on are acceptable). Children over 5 years old use the visual correlation method. Chaotic manipulations with rings, performing a task using the “trial and error” method while repeatedly folding the pyramid on your own most often indicates a decrease in intelligence.
2. Folding cut pictures
It is used to identify the state of visual-figurative thinking. Cut pictures of varying difficulty are used. The speech therapist obtains the basic facts by analyzing the method of action that the child uses in the process of putting together a picture. These can be chaotic, purposeless manipulations, purposeful actions in a visually effective way (trial and error method), and purposeful execution of a task in a visually figurative way (visual correlation).
Children with normal intelligence easily cope with pictures cut out along the contour from 5-6 parts, composing a drawing, mainly by first visually trying on the parts to each other.
An inadequate way of acting is expressed in the fact that the child acts chaotically, without a specific goal, placing parts of the picture without meaning, for example, putting a tail to the head of an animal. And if a child stubbornly does not accept the help of an adult, if it turns out to be impossible for him to correctly fold a cut picture even after repeated visual demonstration, this cannot but raise doubts about his intellectual development. [2, p.115]
3. "Mailbox"
This method is widely used when examining children of different ages, starting from three years old. It is used to study visual and effective thinking and allows us to identify a child’s ability to comprehend a new method of action.
4. Visual counting
A counting examination is of great importance for characterizing children with speech impairments.
The visual counting method does not require the participation of the child’s speech, therefore it is convenient when examining speechless children. In addition, this method can be used to identify the state of the operations of analysis and synthesis, and the child’s logical conclusions. It is revealed how the child correlates objects by quantity and solves the simplest visual problems. [2, p.117]
5. Establishing the sequence of events
The technique is intended to identify the possibility of establishing spatio-temporal connections using a series of plot pictures. To conduct the examination, it is necessary to have several series consisting of 2–5 pictures. This task in most cases does not cause significant difficulties for children with initially intact intelligence. If the layout of the series is incorrect, as a rule, a little help from a speech therapist is enough for them: pointing out the incorrect layout, laying out the first picture, a leading question. Having mastered the method of establishing a sequence using the example of one series, these children perform similar tasks independently, revealing a clearly expressed ability to “transfer.” In rare cases, mentally retarded children cope independently with even simple series of pictures and have difficulty using the help of a speech therapist. Having created an arbitrary order, they do not try to think about the fact that such an order contradicts the content of the pictures, they consider the work completed, and do not pay attention to the speech therapist’s critical comments. This nature of the work indicates uncritical thinking. [2, p.118]
6. Classification of objects
The subject classification method is used to study the processes of generalization and abstraction. It consists of distributing objects into groups depending on their similarities and differences. Children with primary intact intelligence, in most cases, after jointly analyzing two or three (sometimes one) pictures, grasp the principle of classification and then perform the work independently or with isolated errors.
7. Eliminating Items
The technique is intended to study the ability to make generalizations and provide a logical basis for the correctness of generalizations.
Impressive Speech Research
The given tasks are offered to children with alalia aged 5 years and older. [3, pp.33–37]
1. Understanding coherent speech. The speech therapist emotionally reads a short story to the child and conducts a conversation; the conversation is accompanied by the display of plot and subject pictures.
2. Understanding common sentences based on plot pictures: “Show the girl who catches a butterfly.”
3. Understanding of various grammatical forms: constructions with various case forms using simple plot pictures (“Show me how the girl catches the butterfly?”, “Who is the girl catching?”, “Who is catching the butterfly?”); prepositional constructions with prepositions; differentiation of units and many more number of nouns; differentiation of verbs with different prefixes.
4. Understanding complex sentences.
5. Study of passive vocabulary: understanding general words with details; understanding the names of young domestic and wild animals.
Literature:
1. Volkova, G. A. Methods of psychological and speech therapy examination of children with speech disorders. Issues of differential diagnosis [Text] / G. A. Volkova - St. Petersburg: Detstvo-Press, 2003. - pp. 35–49
2. Vlasenko, I.T., Chirkina, G.V., Bessonova, T.P. Methods for examining speech in children [Text]/ I.T. Vlasenko, G.V. Chirkina, T.P. Bessonova - M .: Republican Institute for Advanced Training of Education Workers Institute of Correctional Pedagogy, 1992. - pp. 111–128
3. Balobanova, V.P., Bogdanova, L.G. Diagnosis of speech disorders in children and organization of speech therapy work in a preschool educational institution [Text] / V.P. Balobanova, L.G. Bogdanova - St. Petersburg: Children's Press, 2001. - pp. 29–37
Correction methods
Delayed speech development and alalia in a child are complex problems, so correction of these conditions requires a systematic approach to treatment, during which the child not only acquires speech, but also develops as a person. In the approach to correction, the speech therapist requires a well-thought-out methodology and a step-by-step structure of work with children.
At the initial stage of correctional classes, the speech therapist-defectologist:
- relies on the child’s intact functions, that is, the basic components of speech, vision, hearing, sensory development, as well as fine and gross motor skills identified during the diagnosis of neuropsychic development;
- balances the processes of excitation-inhibition, organizes activity (establishes contact and order in actions; plays games with him to retain and switch attention, to auditory-verbal attention);
- teaches the implementation of instructions or requests, since this is the basis for all subsequent correctional activities. More often this happens in a playful way, through training to play by the rules and involvement in story-based games.
- stimulates elementary imitative activity, leading the child from non-speech to speech activity (manual imitation, bodily imitation, asymmetrical imitation; imitation of oral actions; practicing 5-6 vowels; differentiation of consonants; repetition of syllables, etc.);
- teaches orientation in space and rhythmic activities (games with hoops, balls, tape, water, bells, etc.), and also works with fine motor skills (function of the hands and fingers).
- promotes the expansion of active and accumulation of passive vocabulary;
- at the end of the initial stage of work, he introduces work with a mirror and articulatory gymnastics (simple exercises).
After completing the formation of the psychophysiological basis of speech in a child, the speech therapist-defectologist moves on to the next stages of treatment, which includes the formation of phrasal speech and the complication of the dictionary. The child is taught to pronounce more common, grammatically structured sentences, conduct small dialogues and make descriptive stories.
At the end of correctional work with a speech therapist, non-speaking children learn more complex communicative activities and skills that form coherent speech.
Article:
After the 2010 smog in Moscow, cases of parents and children turning to speech therapists and speech pathologists with a diagnosis of severe speech underdevelopment (SSD) became more frequent. Many children born in the period 2010-2011 in the Moscow region and other regions did not even pronounce syllables, let alone words, by the age of two, did not understand spoken speech, and did not react to external stimuli. The toxic-hypoxic factor experienced by the child in utero was immediately attributed to the etiological causes of speech underdevelopment. As a result, the number of children with sensory alalia, speech development delay (SSD) and early childhood autism (ECA) has increased significantly. At the same time, old methods of treating these pathologies are outdated and did not have a positive result. The sensory integration method has recently become popular and effective, which we will discuss in this article. Causes of severe speech underdevelopment The causes of delayed speech development in children, as mentioned above, are poor ecology, which resulted in toxic poisoning of the fetus during pregnancy. But when studying the brain using EEG, one common feature was revealed in such children - they had underdeveloped subcortical brain structures, which are responsible for motivation and the functioning of sensory systems: smell, touch, taste, hearing and vision. These children had no speech because the prerequisites for its occurrence were not formed. As you know, a small child begins to explore the world through the senses, but due to the fact that the senses “did not respond” to the child’s age-related needs, speech did not develop at all. In addition, for the normal development of children's speech, a sufficient amount of RAM and the ability to imitate the speech and non-speech actions of an adult are necessary, which have also suffered as a result of adverse environmental influences. Also, many children had articulatory apraxia, that is, they did not feel the position of their tongue (upper or lower rise), lips and teeth. These organs play a crucial role in the production of speech, without feeling their movement, the child finds it difficult to pronounce certain sounds, or to switch the organs of articulation from one position to another. In connection with this, specialists in the field of neuropsychology and defectology proposed a method of sensory integration, based on the fact that for the initial launch of speech it is necessary to “stir up” the senses by influencing them with various gustatory, olfactory, tactile, auditory and visual stimuli. The development of the body’s sensory systems contributes to the further development of the subcortical structures of the brain, which are responsible for the child’s cognitive abilities and increase the amount of RAM. Symptoms of severe speech underdevelopment Children with sensory dysfunction have a number of common external signs that appear in early childhood: walking on tiptoes, sniffing people and objects, lack of eye contact, excessive disgust or, conversely, a desire to play with dirt, persistent taste preferences. Children with SLI have difficulty understanding speech from birth. Normally, a 7-8 month old child finds the desired object with his eyes, studies it, examines it, and the adult names it, developing object correlation. By 10 months, the child begins to understand actions and corresponding verbs: give, na, hold, clap, wave. Initially, the child learns these verbs in the imperative mood, and later an understanding of the names of these objects arises. An adult’s intonation plays a major role in the formation of speech understanding. Often the reasons for underdevelopment are associated with the fact that adults anticipate the child’s actions, bringing the desired object as soon as they see someone looking at it or hear a characteristic sound. Early symptoms of RRD are the absence or slight activity of humming and the same type of vocalizations. Children with this symptomatology experience difficulty breastfeeding, breast refusal without good reason, difficulty chewing and swallowing food at one year of age, and increased salivation. Often such children have a slightly open mouth, echolalia is observed - aimless repetition of phrases spoken by adults; by the age of 2, the child cannot connect two or three words into a meaningful phrase. By the age of 2, the child does not understand spoken speech so much that he cannot follow simple instructions: show where, bring, give. The pace of speech is very fast, the child swallows the endings of words, makes grammatical errors, and does not pronounce most consonant sounds. Among the children who turn to specialists, there are also those who do not have the above symptoms. Upon careful examination, it turns out that their motivation to speak is impaired; the child simply does not want to speak. For the same reason, he does not want to imitate the actions of an adult or engage in joint activities. The areas of the brain responsible for motivation do not function or are underdeveloped. Sensory Integration Method The Sensory Integration Method was first proposed by American child development researcher Jean Ayres. Later, this method began to be successfully used in Russia and around the world. The main goal of working with non-speaking children at the first stage is to arouse the child’s desire to imitate and activate speech in the form of any sounds. Usually, parents turn to a speech therapist when a child with mental retardation or alalia turns 3-4 years old, but it is necessary to start working with him in the same way as with a child 1-2 years old. The main principle of the sensory integration method is the development of the basic levels of the hierarchical system of interaction of sensations: tactile, olfactory, proprioceptive, gustatory. Therefore, the atmosphere both in the speech therapist’s office and at home should be relaxed, rich in various color, audio effects, and smells. Objects should be in a place accessible to the child at eye level. The main task at the first stage is to increase the volume of visual and auditory attention through fixation on certain objects, sounds, smells, touches. You can attract attention both verbally and non-verbally. For example, dropping toys in front of the baby, hiding them under a scarf, blowing out candles of different colors, kneading dough, rolling plasticine, pouring cereal, pouring water, etc. In a word, the adult first begins to play with himself, trying with all his might to interest the child. Communication should take place at the highest possible emotional level, using different intonations, repeated repetition of instructions, and adults performing wordless tasks themselves. Developmental items can be pine cones, colorful buttons (under the supervision of an adult), candles, a spray bottle of water, clothespins, kinesthetic sand, a bath of water for transfusion, watercolors, various aromatic fruits and vegetables: orange, kiwi, lemon, apple, cucumber, garlic, onions (if the child does not have an allergic reaction to them), etc. Outdoor activities with the child and parents are also encouraged, for the purpose of additional oxygen saturation, using natural materials. Class time should be structured and systematized so that the active stimulation of the child’s nervous system is subject to a certain rhythm. At home, it is also better for parents to study with him at certain hours; the duration of the lesson depends on the individual characteristics of the child. For a child with articulatory apraxia, it is very important to “stir up” the organs of articulation, using mechanical shaking of the cheeks, stretching the adult lips into a smile with the hands, then squeezing them into a tube, kissing, manual massage of the tongue, tapping the teeth, flicking the tongue, licking plates, spoons, and upper lip. , chewing pacifiers. It is necessary to teach the child to imitate onomatopoeia: the coachman’s “tprrrrrru”, “turkey” - “blah-blah-blah” - quick movements of the tongue on the upper lip, the woodpecker knocks: quick blows with the tip of the tongue behind the upper teeth with the sound: “d-d-d- d-d." Speech material is also selected according to the complexity of the syllabic structure of the word, starting from disyllabic ones with an open syllable (S-consonant, G-vowel, S-consonant, G-vowel), for example, fly, lips. Then the monosyllabic SGS - house, poppy, cat, then SGSSGSG - dog, paper, SGSSG - threads, slippers, SGSSGS - broom, rooster. All words are selected based on a picture or toy and should not contain sounds that are difficult for the child, such as “R”, “Sh”, “Zh”. Also, quasi-homonyms, words that differ in one sound, should not be used: house-smoke, bow-luk, poppy-bak. Any manifestation of a child’s speech activity is encouraged with praise, a sweet prize, a sticker, or a sticker. An adult should not force the child to repeat after him; he first uses conjugate speech - speaking with the child, then the child’s reflected and independent speech. At the first stage, it is important to overcome speech negativism using the principle of a polysensory approach. A prerequisite for classes is the repeated repetition of instructions in a friendly tone in order to achieve absolute understanding of speech. To develop motivation, you can attract a wizard doll, which on its own behalf will conduct a conversation with the child, for example, a baby elephant, a bear cub, a bunny. We can say that the wizard loves to give gifts to children who do well. Thus, in case of failure, the child will not be offended by the adult, but will transfer the negative emotion to the toy. If successful, the wizard doll rewards him with a gift or a sweet surprise. It is important to use any means to arouse the child’s interest in activities, while at the same time not overloading his psyche with an abundance of sensory stimuli and instructions. Sensory material is selected depending on the child’s sensory dysfunction. In order to activate attention, it is necessary to use a constant change of activity, a change of sensory material, using either a su-jok, or a spray bottle with water, or prickly cones, or a light feather. Spelling out words can be combined with swinging on a swing or hanging hammock, jumping on a trampoline, or rolling on a ball to simultaneously stimulate speech and basic levels of sensory integration. The pronunciation of words is accompanied by clapping rhythm, which contributes to the development of kinesthetic sensations. With the advent of motivation for activity, the child gradually develops subject relevance, understanding of instructions, vocabulary is enriched, and grammatical categories of words are formed. When the first onomatopoeias appear, it is necessary to repeatedly fix them on various materials. Next, work is built on the formation of the syllabic structure of the word through laying out visual rows of multi-colored pebbles, while simultaneously stimulating the development of fine motor skills of the hands. Speech material should be accessible and simple. Systematic classes and influence on the baby’s senses through play activities sooner or later trigger speech in any non-speaking child. The effectiveness of the method has been repeatedly tested in practice. Advice for parents Parents need to take care of their child’s “sensory diet” from the first days of birth, that is, fill the room with the necessary amount of sensory stimuli without oversaturating or making the child “starve.” Various sounds, pleasant smells, soft and hard toys, and a beautiful interior can be a good help for the baby’s sensory development. Later, when the child begins to crawl, allow him to touch acceptable objects, including tearing the wallpaper, chewing the baseboard, smearing the new hallway, spilling cereal or beans, knocking on the new door frame, scratching the upholstery of the sofa, etc. From this way of understanding the world, the child develops according to his age, and first of all, his motivation, thinking and speech are formed. When the child begins to walk, allow him to manipulate such currently “forbidden” objects as water, let him pour it from one container to another, watercolors, gouache - let him draw on wallpaper, doors, walls, carpets. Be sure to knead the dough with him, roll it out, it doesn’t matter that he’ll be covered in flour from head to toe, but then he’ll do well in school. In a playful form, you can even make artificial rain by spraying it on an open umbrella from a spray bottle, let your clothes get wet (which can be dried), but the child will receive excellent emotional education, squealing with delight. You shouldn’t limit a two-year-old child’s interests to watching cartoons and playing on a tablet. This type of activity does not develop those areas of the brain that are responsible for the formation of speech, memory and imagination. Give your baby more time. One year of consistent, sensory-rich playtime together can save money on visits to a speech therapist or speech pathologist later in life.
