Article:
End of the 20th century characterized by deteriorating children's health. According to data provided by Academician of the Russian Academy of Education A.G. Khripkova, only 14% of children are practically healthy, 50% have functional abnormalities, 35-40% have chronic diseases. In our country, much attention is paid to correctional, educational and pedagogical work with children suffering from speech disorders. Significant progress has been made in addressing issues of early diagnosis of speech disorders, methods and organization of correctional education and training of children. By means of special influences on children, in many cases it is possible to prevent or slow down the appearance of various deviations from the norm, in particular speech pathology. Timely prevention of speech disorders in children is closely related to the prevention of neuropsychic abnormalities in health. It is provided by a complex of measures, including therapeutic, pedagogical and social influences. Specialists from children's clinics, along with constant dynamic observation, conduct preventive examinations of children from 0 to 14 years old not only in the clinic, but also in preschool institutions and schools. The joint work of doctors and teachers in children's pedagogical institutions makes it possible to early treat deviations from the norm in the state of children's health, congenital and acquired diseases that affect the development of speech or contribute to the emergence of speech pathology. Of great importance in developing the problem of preventing speech disorders is the study of factors that ensure normal speech development in children. This knowledge is directly related to the hygiene of speech development, which is the most important indicator of a child’s neuropsychic health. Its objectives mainly boil down to studying the age stages of speech ontogenesis and identifying conditions (including the external environment and social conditions) that positively or negatively influence speech development. Recommendations and standards for the psychophysiological conditions of raising children are being developed, incentives for a child’s mental development and the possibilities of their use are being scientifically substantiated, and mass propaganda of psychological and pedagogical knowledge among the population is being organized. The prerequisites for the normal development of the younger generation are created by measures to protect the health of the population as a whole. One of the important directions in the development of speech therapy assistance to the population is the prevention of speech disorders and the consequences of speech pathology. This special branch of speech therapy faces the following tasks : a) prevention of speech disorders - primary prevention; b) preventing the transition of speech disorders to chronic forms, as well as preventing the consequences of speech pathology - secondary prevention; c) social and labor adaptation of persons suffering from speech pathology - tertiary prevention.
Primary prevention .
1. The implementation of preventive health care and special pedagogy begins even before the birth of the child by creating the most favorable conditions for the expectant mother during pregnancy , regulated by relevant laws and provided by the entire maternal and child health service. At the end of the 20th century, the health of the younger generation depends on a number of conditions related mainly to ecology and its influence on the immune, nervous and endocrine systems. Pollution of air, water, and soil leads to an increase in acute and chronic (especially allergic) diseases and a decrease in the body's resistance to harmful influences. Along with this, the role of stressful psychological influences is increasing, which in turn worsens the neuropsychological health and immunity of children. It is clear that the quality of all aspects of parents’ health also continues to decline, and with a family history, children are 2-3 times more likely to suffer from the same illness as their parents. In the system of psychoprophylactic measures, timely genetic counseling of future parents is essential in order to prevent the development of certain deviations in the neuropsychic and, in particular, speech development of the child. In cases where a family burden of any pathology is discovered, parents should be well informed about the possible manifestation of the disease in the child, as well as what preventive measures will prevent or reduce the symptoms of the hereditary disease.
2. With the birth of a child, special responsibility for his mental health falls on the family, which makes the psychological and pedagogical education of young parents especially relevant. The formation of a child’s character and personal characteristics begins from a very early age. Already the early period of postnatal development is of great importance for the subsequent stages of the formation of his psyche. Sleep, cry, movements and other physiological reactions of the newborn’s body reflect the safety and level of maturity of the central nervous system. Therefore, parents, together with doctors, should carefully monitor the formation and development of these reactions and take the necessary preventive measures in case of their deviations from the norm. In the 60s, the concept of “risk factor” appeared in the scientific literature, which refers to various conditions of the external sphere (biological and social) and the individual reactivity of the body, which, to a greater or lesser extent, contribute to the development of certain pathological conditions. There is a close interaction between biological and social risk factors. Biological risk factors for the development of speech disorders are pathogenic factors that act on the body mainly during the period of intrauterine development and childbirth, brain infections and injuries suffered after birth, and a family history of speech disorders. The primary defect in newborns can be hearing, vision, or motor impairment, both in an uncomplicated form and in various combinations of several primary defects. Biological risk factors for speech disorders of a genetic nature include, in particular, a violation of the formation of a psychomotor profile (left-handedness and various variants of incomplete right-handedness). In some cases, it is possible to prevent the development of left-handedness if, from an early age, a child tries to give objects only to the right hand, carefully but persistently transfers objects from the left hand to the right (spoon while eating, etc.), and uses predominantly the right hand when playing. , allowing the child to feel or guess an object with the right hand, etc. Biological risk factors for speech disorders also include a family history of speech pathology. It is known that a hereditary predisposition to the occurrence of a particular pathological condition is not fatal. As a rule, speech disorders do not occur against the background of complete health. In cases where, along with a hereditary burden of speech pathology (for example, stuttering), disorders of the central nervous system are diagnosed in children, specialized medical and speech therapy care is needed, taking into account the data of the child’s psychophysical and speech development. If signs of any deviations from the norm appear in pre-speech reactions (screaming, humming, early stages of babbling) and in speech ontogenesis itself, speech therapy assistance is recommended as early as possible. Parents should consult a speech therapist about the rules of their speech communication with their child. It is the speech of parents that becomes the model for the speech development of children, and therefore, in some cases, speech communication with the child of persons suffering from speech pathology should be limited. For the purpose of primary prevention of speech disorders in a child from a family burdened with speech pathology, it is necessary to begin speech therapy classes in early preschool age. Socio-psychological risk factors have attracted much attention from researchers in recent years, especially the issues of mental deprivation of children . Deprivation is insufficient satisfaction of basic needs (emotional and sensory). There are cognitive and social deprivation (I. Langmeyer, Z. Matejczyk, 1984). It has been established that all types of deprivation significantly affect the child’s speech development. Separation from the mother at an early age, characterological characteristics of the mother (anxiety, suspiciousness, infantility, impulsiveness, emotional coldness); rejection from mother (father); single-parent family; conflictual relationships in the family, changes in family structure (death, illness of loved ones, divorce, etc.); being raised in two homes; a sharp change in life stereotype and type of upbringing; inadequate type of upbringing (“idol”, overprotection, underprotection, inconsistency in the educational positions of parents). After 2.5 years and older, such influences as punishment at home and especially in a child care center, reluctance to attend a nursery or group, fear when meeting unfamiliar faces, animals, fear of negative fairy-tale characters, etc., become important. As the child grows and develops the range of psychotraumatic situations is significantly expanding due to the increasing importance of environmental influences. These are conflictual relationships with peers and adults, excessive punishment, intimidation, experiencing a situation of fear (the sudden appearance of a frightening animal, watching a “scary” movie, a “scary” fairy tale), the birth of another child in the absence of readiness to take the position of an elder, etc. Taking into account the patterns of action of factors risk allows you to purposefully carry out primary preventive correctional and pedagogical work. To organize rational methods of preventive pedagogical influence, knowledge of the age-related characteristics of the development of speech function and the psyche as a whole is important. For the timely development of speech, the mother and other people surrounding the child must constantly communicate with him, trying to evoke a response. It is known that in the very early stages of a child’s postnatal development, his communication with his mother is not silent, they conduct a “dialogue.” This “dialogue” causes reactions in the baby in the form of revitalization of general movements, smiling, pronouncing sounds and consonances (echopraxia, echolalia). Stimulating the formation of speech function is of great importance for the development of the child. Every effort should be made to ensure that the period of the child’s mastery of motor skills (sitting, crawling, walking, fine movements of the hands, etc.), and in particular the speech motor apparatus, proceeds favorably. It is necessary to create conditions for the implementation of various motor reactions, to promote the “games” of the baby with his voice. The formation of speech motor function is closely related to the development of general motor skills and in particular with the manipulative activity of the hands. In children of the first years of life, the development of speech understanding is of particular importance, which largely depends on the speech behavior of adults. A child understands speech by establishing a connection between words spoken by adults and objects surrounding the child. It is necessary to explain to parents that they are doing wrong in cases where they try to guess the child’s wishes by facial expressions and gestures. At the same time, he does not have the need for vocal reactions and utterance of sounds and words. The linguistic education of a child should begin early and in the first years of life should be carried out in the native language (K. D. Ushinsky, 1948-1952; E. I. Tikheyeva, 1981, etc.). Mastering two language systems at an early stage of speech development is a difficult task for a child. If a baby hears, in addition to his native language, another language, then his speech may develop more slowly, and in some cases numerous iterations appear, sometimes turning into hesitations of a convulsive nature. In this regard, mutual understanding and a unified approach must be established in the family, which will allow the child to subsequently master two or more language systems.
3. The family must know the requirements that must be made for the child’s speech. These requirements should be neither too low nor too high. Speech skills need to be developed according to age standards. During the initial period of speech development, one should not overload the child with mastering words that are difficult to pronounce and obscure, or with memorizing poems and songs that are not age appropriate. In cases where surrounding adults have incorrect pronunciation or, having fun, copy the child’s speech (“lisp”), the process of mastering correct sound pronunciation becomes difficult, abnormally pronounced speech sounds are reinforced, and in the future such a child may need special corrective training from a speech therapist. The people around the child, with their smooth, clear articulation and calm speech, encourage him to imitate the design of a speech utterance. If a child develops a rapid rate of speech, “choking” with words, an “avalanche-like” development of vocabulary accumulation and the development of phrasal speech, a special speech regime is needed to limit the introduction of new words and concepts into the child’s vocabulary and, in general, speech load. During this period, the child should be protected from being in conflict situations and from participating in events that are emotionally significant for him. The socio-psychological environment must be specially organized for him in order to stabilize his emotional state. You can help the development of normal speech by learning short rhythmic poems and songs with your child, singing and reciting to accompany movements performed at a certain pace (for example, when marching). It is necessary to teach the child to speak at a moderate speed. You need to talk to children in a calm tone, pronouncing words clearly and finishing the endings. Sensory education and the development of play activities are of great importance for the development of speech. The formation of speech function should be carried out in parallel with the study of the environment. Correct perception of objects, accumulation of ideas and knowledge about them occurs due to the close interaction of speech and sensory development. The most important means of mental development is children's play. Free from the movement of utilitarian, and, up to a certain age, socially prestigious goals, the game has that self-goal and self-worth that direct it to solving creative problems. Children's play is motivated by the needs of cognition and the need to acquire knowledge and skills that they will only need in the future. Children should have a variety of toys and aids for their independent use to develop fine motor skills, design, etc. The inclusion of didactic games promotes the child’s sensory development, forms concepts, develops the ability to learn, improves auditory attention, speech articulation and speech in general. The selection of toys and aids, and techniques for guiding adults in children’s play should be carefully thought out and learned by educators in connection with their influence on the development of children’s speech. The development of differentiated auditory and phonemic perception is a necessary condition for children to successfully learn to read and write in the future. A child’s readiness to learn to write and read is inextricably linked with the ability to understand the sound structure of a language, that is, the ability to hear individual sounds in a word and their specific sequence. Teaching children to distinguish sounds leads to the development of both attention to the sound side of speech and auditory memory.
4. Great responsibility in organizing measures to prevent neuropsychic disorders leading to speech disorders in children rests with preschool institutions . In the process of educational work, they consistently implement the tasks defined by the program in the field of physical, mental, moral and aesthetic development of the preschool child. To date, there are scientifically substantiated psychological and pedagogical recommendations on the regime of preschoolers and educational influences. However, in a number of cases there are individual reactions of children indicating a violation of the child’s adaptation to new living conditions. Thus, the initial period of a child’s stay in a nursery is sometimes accompanied by a delay and even regression of previously achieved development. In the first days after entering the nursery, some children's speech activity sharply decreases, which undoubtedly delays the formation of speech. This period can last for younger children up to 4 months, for older children up to 2 months. Adaptation to a child care institution is most difficult if the child enters it at the age of 9 months to one and a half years. It occurs least painfully before the age of 6-7 months and after one and a half years. Therefore, at an early age, an essential psychological aspect of the prevention of neuropsychic speech disorders, in particular, is the referral of the child to a child care institution at the age in which he can more easily adapt to new living conditions. Another way to adapt a child is to first bring the home regime closer to the conditions of a child care facility. It is necessary to accustom him to being away from home without close people. Being outside the family and adapting to these conditions develops cognitive mechanisms, his interest in new objects and people, which makes the child not only calm, but also active. Both at home and in kindergarten, the regime must be built in compliance with hygienic rules, of which one of the important ones is the development of physical activity in children.
5. The transition to schooling for children from the age of 6 places new demands on the child’s body. Psychophysiological studies of 6-year-old children show that this age represents a special turning point. It is at this time that the ability to follow certain rules of behavior is formed, to establish personal interactions with peers and adults, to coordinate one’s actions with the actions of other people, to be able to listen and follow the instructions of adults (V.S. Mukhina, 1975). These psychological characteristics are associated with a new, compared to a younger age, stage in the maturation of basic physiological systems, which is the most important condition for adaptive changes (both physiological and psychological). If a child has speech disorders, the need for timely diagnosis of the degree of functional readiness for school education increases. Only with specialists of various profiles can one decide with some certainty the question of the advisability of enrolling a child in school or granting him a deferment. The school plays a big role in protecting the neuro-mental health of children. The first weeks of a child’s stay at school are of particular importance in this regard. He is bombarded with a lot of new impressions and previously unfamiliar requirements, such as strict adherence to the rules of behavior, a long stay in a relatively motionless position, intense mental activity, etc. The appearance of a new person in the life of a small schoolchild who has unquestionable authority, as well as the inclusion of into a new diverse group of peers. Changing the usual way of life and adapting to new conditions of social existence require significant stress on all functional systems of the body. In children with speech disorders, the adaptation period is often painful: instability of attention, memory, and distractibility increase. They become irritable, often extremely excitable, restless, lose their appetite, sleep poorly, and have difficulty making contact with the teacher. Only gradually these phenomena decrease. The criteria for the onset of adaptation are a reduction in fatigue, restoration of appetite and sleep, and the establishment of normal relationships with the teacher and friends. The correct behavior of the teacher during this difficult period for a first-grader, his patience and kindness, the gradual inclusion of children in the educational load, and an individual approach make adaptation to school easier. The most important task of school mental hygiene remains the prevention of overwork and mental trauma in children, the creation of conditions at school that protect the nervous system of students from excessive stress. In this regard, great responsibility for the state of speech development of children and adolescents falls not only on the speech therapist, but also on the teacher, educator and class teacher. It must be remembered that oral speech in a schoolchild (especially in the lower grades) must be developed not only in terms of expanding vocabulary and developing its grammatical side, but also in terms of special training in its external sound design: developing rhythm, clarity of sound pronunciation, intonation expressiveness, i.e. that is, everything that helps strengthen speech motor stereotypy as a basal component of expressive speech.
Secondary prevention.
It is known that speech disorders affect the mental development of the child, the formation of his personality and behavior (secondary disorders). Profound speech disorders (alalia, aphasia) to one degree or another limit mental development in general. This occurs both due to the functional unity of speech and thinking, and due to a disruption of normal communication with others. The latter impoverishes knowledge, emotions and other mental manifestations of the personality. Predominant neurotic disorders in young children (V.V. Kovalev, 1976). There are four levels of predominant neurotic disorders in children: 1. Somato-vegetative - 0-3 years of life. 2. Psychomotor - 4-7 years of life. 3. Affective - 7-10 years of life. 4. Emotional-ideational - 10-15 years of life. The first level of neurotic disorders includes disorders of appetite, dysfunction of the gastrointestinal tract, thermoregulation, and sleep. The second level is associated with the appearance of hyperdynamic syndrome, tics, stuttering, mutism and other motor and speech motor disorders. At the third level of reactivity, children experience fears and depressive experiences. At the fourth level - neurotic anorexia, hypochondriacal overvalued formations of one’s “physical self”. The degree and nature of speech impairment and mental impairment determine the child’s ability to learn and actively participate in the public life of the school. School performance is hampered by the inability to ask, answer, tell or read in a timely and clear manner. Because of children suffering from speech disorders, the dynamics of the lesson are often delayed and discipline is violated (there is laughter, teasing, complaints, etc. in the class). Underdevelopment of the sound side of speech, insufficient development of phonemic processes and sound pronunciation prevent the timely formation of prerequisites for spontaneous mastery of practical skills in the analysis and synthesis of the sound composition of a word. This condition can be considered as the first consequence, creating significant difficulties on the path of children acquiring literacy. The second consequence can be considered the difficulties that children encounter in the process of mastering literacy. Lagging behind in their studies, schoolchildren who have speech disorders lose interest in learning and sometimes become categorized as discipline violators. Thus, the attention of the speech therapist should be maximally concentrated on the timely prevention of possible secondary, more distant consequences of speech pathology. From these positions, the state of the sound side of speech should be especially carefully analyzed, since insufficient development of phonemic processes, even with fully compensated defects in sound pronunciation, can lead to deficiencies in mastering writing and reading skills. In the process of raising children with speech disorders, parents and teachers need to constantly reflect on their behavior and their positions. Mutual understanding, encouragement, mutual respect, maintaining order, interaction both between family members and between teachers and parents play a serious role in the prevention of psychogenic reactive phenomena in children suffering from speech pathology. This provision is especially relevant for students who stutter. In cases where children experience psychological complications such as personal experiences associated with the presence of a speech defect, fear of speech, avoidance of situations requiring verbal communication, etc., the speech therapist needs to significantly increase the psychotherapeutic emphasis in his work. Each time, this emphasis and forms of psychotherapy will depend on the age of the child and the characteristics of the individual psychological response. Speech therapy prevention can be effective only if there is complete knowledge of the child’s development (physical, mental, speech, etc.) based on development standards. This will allow the speech therapist to specifically guide upbringing and training, using periods of sensitivity observed at certain stages of ontogenesis. Premature or delayed, in relation to the period of sensitivity, correctional training is less effective, while conscious reliance on the patterns of development of psychophysiological characteristics, psyche and speech allows the speech therapist to achieve significant success.
Tertiary prevention.
Some speech impediments limit career choices. Vocational guidance and training of persons suffering from speech pathology is included in the tasks of tertiary prevention of the consequences of speech disorders. The main focus of this stage is a deep consideration of the personal capabilities and interests of each student suffering from severe speech impairment. Such students should have the opportunity to choose, with the help of a teacher, psychologist, and doctors, a learning path that will allow this particular individual to achieve the best results. For this population of students, it is especially important to shift the focus of learning from cognitive development to emotional and social development. The goal of labor education for students in a school for children with severe speech impairments is to form among the younger generation a strong conviction that work is the main sphere of personal fulfillment. The school should prepare students for socially useful activities and participation in productive work.
Correction and prevention of speech disorders in preschool children
Speech
- This is the result of coordinated activity of many areas of the brain. The organs of articulation only carry out orders coming from the brain.
A sharp discrepancy between the characteristics of pronunciation and its age norms and the persistence of incorrect forms of pronunciation are characteristic of various cases of pathology. They can be caused by both disorders of phonemic hearing and articulatory apparatus, as well as neurodynamic disorders (insufficient differentiation of excitation and inhibition processes in the cerebral cortex), and unformed interanalyzer connections.
“With damage to the lower frontal parts of the sensorimotor cortex, phonemic disorders are characterized by insufficient understanding of the speech of others. In this case, motility is impaired according to the cortical type, inhibitory reactions predominate.” Speech activity is insufficient, the vocabulary is poor, the phrase is short. Phonemic disorders are characterized by distortions or substitutions of sounds.
“When the inferior parietal parts of the sensorimotor region of the cortex are damaged, alalic syndrome of the afferent type occurs.” In this case, phonemic hearing is not formed, there is unclearness, blurred speech, unstable sound substitutions and searches for articulation. An accelerated rate of speech, disruption of the smoothness of the speech flow, and stumbling are observed.
“When the superior temporal parts of the cerebral cortex are damaged, the sense of rhythm is grossly impaired, and it is difficult to combine speech with movement.” With the development of significant speech activity, replacement and loss of syllabic elements, replacement of sounds, rearrangements and omissions of syllables, and disruption of the rhythmic structure of the word are observed.
N.I. Zhinkin noted: “The control of the speech organs will never improve if they themselves do not report to the control center what they are doing... Thus, kinesthesia is nothing more than feedback. By which the central control is informed that the orders that were sent for execution have been completed...” A child with mild manifestations of dysarthria does not perceive the state of tension or relaxation of the muscles of the speech apparatus, or violent movements. He experiences significant difficulties when performing given movements and poses, since he cannot correctly and accurately determine the position and state of the organs of movement. In addition, a decrease in reverse kinesthetic afferentation may delay the integration of various functional systems, such as auditory and visual, related to the speech process.
According to V.A. Sukhomlinsky: “The origins of children’s abilities and talents are at their fingertips. From the fingers come the finest streams that feed the source of creative thought.” The origins of finger games lie in folk pedagogy. Many scientists (M.I. Koltsova, E.I. Isenina, A.V. Antakova-Fomina, etc.) believe that the development of fine motor skills of the fingers has a positive effect on the development of children's speech. It was found that the development of fine movements of the fingers has a positive effect on the functioning of the speech areas of the cerebral cortex.
