Review of methods for correcting speech breathing for dysarthria

Ivanishcheva Alina Sergeevna

Master's student at Krasnoyarsk State Pedagogical University. V.P. Astafieva.

Review of methods for correcting speech breathing for dysarthria.

Dysarthria is a violation of the pronunciation side of speech, caused by insufficient innervation of the speech apparatus. (According to L.S. Volkova).

The leading defects in dysarthria are disturbances in the sound-pronunciation aspect of speech and prosody, as well as disturbances in speech breathing, voice and articulatory motor skills. Speech intelligibility in dysarthria is impaired, speech is blurred and unclear.

Speech breathing in children with dysarthria develops pathologically, which is explained by organic damage to the speech motor mechanisms of the central nervous system. During the speech process, children with erased dysarthria exhibit such features as uncontrolled breath holdings, excessive tension in the muscles of the diaphragm and chest, and additional breaths. The pronunciation of individual words can occur in different phases of breathing - both during inhalation and exhalation. Phonation breathing with dysarthria is characterized by weakness of the muscles involved in the breathing process and small lung volume. In preschoolers of this category, upper thoracic breathing prevails, accompanied by raising the shoulders. Children in this category do not know how to rationally use speech exhalation and gain it in the process of speech utterance. The rhythm of breathing is not regulated by the semantic content of speech. At the time of speech it is often rapid. In this case, active exhalation is shortened and usually occurs through the nose, despite the constantly half-open mouth. A mismatch in the work of the muscles that carry out inhalation and exhalation leads to the fact that the child has a tendency to speak while inhaling. This further impairs voluntary control of respiratory movements, as well as coordination between breathing, phonation and articulation.

D. K. Wilson, A. P. Zilber, A. G. Khripkova studied the characteristics of speech breathing as a special system of psychomotor reactions.

M. F. Fomicheva, A. E. Khvattsev, O. V. Pravdina dealt with issues of speech exhalation. The leading role of speech breathing for the formation of full sound pronunciation is noted by A. G. Ippolitova.

There are quite a large number of techniques aimed at correcting speech breathing in dysarthria. In the process of their use, problems such as normalizing the breathing rhythm, increasing endurance and strength of the respiratory muscles, and improving air conduction of the pulmonary system are solved. During the performance of specially selected exercises, breathing in general is optimized, the overall level of the child’s health increases, which has a positive effect on speech development.

The use of corrective techniques is preceded by a diagnosis of speech breathing.

The process of diagnosing speech breathing is most fully presented in the methodology of E.F. Arkhipova and in the methodology of A.I. Maksakov. It is these techniques or their derivatives that are most often used to conduct ascertaining experiments.

Diagnosis according to E. F. Arkhipov involves determining the type of breathing at rest, studying the ability to differentiate nasal and oral breathing, studying the purposefulness of the air stream, studying the strength of the air stream, and studying the characteristics of phonation breathing. A point system is proposed to evaluate the results.

Diagnostics according to the A.I. Maksakov system includes identifying the duration and strength of non-speech inhalation through the mouth, determining the strength of exhalation, the ability to purposefully send an air stream, identifying the duration of speech (phonation) exhalation - the duration of pronouncing vowel sounds on one exhalation. To evaluate the results, a scoring system is proposed, one of the main criteria is the length of speech exhalation.

Belyakova L.I., Goncharova N.N. and Shishkova T.G. in the Methodology for the development of speech breathing in preschoolers, as part of the diagnosis of speech breathing disorders, they propose determining the volumetric peak velocity of forced exhalation using the Peak Flowmeter device, determining the volume of air in the lungs using a spirometer, the duration of phonation exhalation using a stopwatch when observing the pronunciation of vowel sounds with appropriate instructions. Speech breathing is assessed by the duration of speaking a given speech segment during one exhalation. Each speech segment (isolated syllable - word - phrase) is measured by the number of syllables.

The basis of many methods for correcting speech breathing is the paradoxical breathing exercises of A.N. Strelnikova. It is from a complex that includes 8 exercises. The sequence of execution is as follows: the first stage is a warm-up, containing several preparatory breaths, steps and squats. The next stage is exercises for the head (turns, rocking, nodding) and main movements. The system is completed with a special “bathed breathing” training. According to many experts, this breathing exercise has a fairly wide range of effects and helps with a lot of different diseases of organs and systems. With dysarthria, this complex has a significant impact on the development of speech breathing and helps children achieve noticeable success in correcting this disorder.

Belyakova L.I., Goncharova N.N. and Shishkova T.G offer a correction technique consisting of five stages:

Preparation for the development of the thoraco-abdominal type of breathing using the traditional method (4 exercises, including detailed instructions, speech material)

Development of the thoraco-abdominal type of breathing with the inclusion of elements of breathing exercises by A.N. Strelnikova

(three sets of exercises with speech material

om, instructions and

photo).

Development of phonation exhalation. The stage includes seven exercises, during which children’s attention is directed not to “quick inhalation”, but to the sound of the voice during the exhalation process.

Development of speech breathing. Is basic. It is closely associated with speech therapy work on the formation of planning of speech utterances. In the process of exhalation, children learn to pronounce first syllables and individual words, then phrases of two, and then of three or four words, short poetic texts. Includes five sets of exercises.

Development of speech breathing in the process of pronouncing prose text

Assessing the results obtained, Belyakova L.I., Goncharova N.N., Shishkova T.G. note that after the work, the children’s performance in both phonation and physiological breathing increased significantly. The vital capacity of the lungs increased, and, thanks to this, a fairly long phonation exhalation was established for pronouncing a speech unit. The rhythm and depth of breathing improved, differentiation of nasal and oral inhalation and exhalation occurred, and the air stream acquired noticeable strength and direction. The correction carried out led to positive results in speech tests.

The method of E. M. Mastyukova and M. V. Ippolitova at the initial stage involves general breathing exercises aimed at increasing the volume of breathing and normalizing its rhythm, and then implementing a complex of speech breathing exercises. Detailed technical instructions are defined, but speech and stimulus materials are not offered.

According to E. N. Almazova, to overcome breathing problems with dysarthria, the orthophonic method should be used, which involves the combination of articulatory, breathing and vocal exercises. Its goal is the formation of automaticity in the functioning of the larynx in the respiratory and oral systems.

G.V. Dedyukhina developed a correction system using V.F. Frolov’s apparatus (a portable device designed for training voluntary regulation of air and respiratory muscles). By creating resistance (positive pressure) during the inhalation and exhalation phases using this device, you can act on the diaphragm and respiratory muscles, preventing the effect of expiratory closure of the airways.

Despite the fact that the importance of the formation of speech breathing for overcoming dysarthria is recognized by many authors, the currently available information on the problem of correcting speech breathing is insufficient. Therefore, this problem is relevant and significant to this day.

Article:

Dysarthria (from the Greek dys - a prefix meaning disorder, arthroo - I pronounce clearly) is a pronunciation disorder caused by insufficient innervation of the speech apparatus with lesions of the posterior frontal and subcortical parts of the brain. At the same time, due to restrictions on the mobility of the speech organs (soft palate, tongue, lips), articulation is difficult, but when it occurs in adulthood, as a rule, it is not accompanied by the collapse of the speech system. In childhood, reading and writing, as well as the general development of speech, may be impaired. To correct dysarthria, first of all, it is necessary to establish close contact with the child, treat him carefully and with care. Training consists of correcting oral speech defects and preparing for the acquisition of literacy. When teaching arithmetic, special attention is paid to developing understanding of the text of problems. The ways of compensation depend on the nature of the defect and the individual characteristics of the child. METHODS FOR CORRECTION OF SPEECH BREATHING
IN DYSARTHRIA Breathing disorders are invariably present in the clinical picture of dysarthria. Non-speech breathing of dysarthrics has its own characteristics. It is, as a rule, superficial, its rhythm is not stable enough, and is easily disrupted by emotional stress. Speech breathing is a highly coordinated act during which breathing and articulation are strictly correlated in the process of speech utterance. In dysarthric people, this coordination is often disrupted even in the process of fluent speech. Before speaking, dysarthrics take an insufficient amount of breath, which does not ensure a complete pronunciation of the intonation-semantic segment of the message. Often, dysarthric people (not only children, but also adults) speak while inhaling or in the full exhalation phase. When correcting dysarthria in practice, as a rule, regulation of speech breathing is used as one of the leading methods for establishing fluency of speech.

Breathing gymnastics A.N. Strelnikova

In speech therapy work on speech breathing of children, adolescents and adults, breathing exercises by A.N. are widely used. Strelnikova. This gymnastics is the only one in the world in which a short and sharp breath is taken through the nose using movements that compress the chest. Exercises actively involve all parts of the body (arms, legs, head, abdominals, shoulder girdle) and cause a general physiological reaction of the whole organism, an increased need for oxygen. All exercises are performed simultaneously with a short and sharp inhalation through the nose (with absolutely passive exhalation), which enhances internal tissue respiration and increases the absorption of oxygen by tissues, and also irritates that vast area of receptors on the nasal mucosa, which provides reflex communication of the nasal cavity almost with all organs. That is why this breathing exercise has such a wide range of effects and helps with a lot of different diseases of organs and systems. It is useful for everyone and at any age. In gymnastics, the focus is on inhalation . The inhalation is very short, instantaneous, emotional and active. The main thing, according to A.N. Strelnikova, is to be able to hold your breath, to “hide” your breath. Don't think about exhaling at all. The exhalation goes away spontaneously. When teaching gymnastics A.N. Strelnikova advises following 4 basic rules . Rule 1 . “It smells like burning! Anxiety!" And sharply, noisily, throughout the entire apartment, sniff the air like a dog trail. The more natural the better. The worst mistake is to pull the air in order to take in more air. The inhalation is short, like an injection, active and the more natural the better. Just think about inhaling. The feeling of anxiety organizes active inhalation better than reasoning about it. Therefore, without hesitation, sniff the air furiously, to the point of rudeness. Rule 2. Exhalation is the result of inhalation. Do not prevent the exhalation from leaving after each inhalation as much as you like, but better through your mouth than through your nose. Don't help him. Just think: “It smells like burning! Anxiety!" And just make sure that the inhalation occurs simultaneously with the movement. The exhalation will go away spontaneously. During gymnastics, the mouth should be slightly open. Get carried away with inhalation and movement, do not be boring and indifferent. Play savage like children play, and everything will work out. The movements create sufficient volume and depth for short inhalations without much effort. Rule 3. Repeat the breaths as if you were inflating a tire at the tempo of a song and dance. And, training movements and breaths, count by 2, 4 and 8. Tempo - 60-72 breaths per minute. Inhalations are louder than exhalations. The lesson norm is 1000-1200 breaths, and more is possible – 2000 breaths. Pauses between doses of breaths are 1-3 seconds. Rule 4. Take as many breaths in a row as you can easily take at the moment. The whole complex consists of 8 exercises. At the beginning - warm-up. Stand up straight. Hands at your sides. Feet shoulder width apart. Take short, injection-like breaths loudly, sniffing your nose. Do not be shy. Force the wings of the nose to connect as you inhale, rather than widening them. Train 2 or 4 breaths in a row at a walking pace of “a hundred” breaths. You can do more to feel that the nostrils are moving and listening to you. Inhale, like an injection, instantaneous. Think: “It smells like burning! Where?" To understand gymnastics, take a step in place and simultaneously inhale with each step. Right-left, right-left, inhale-inhale, inhale-inhale. And not inhale and exhale, as in regular gymnastics. Take 96 (hundred) steps-breaths at a walking pace. You can stand still, you can while walking around the room, you can shift from foot to foot: back and forth, back and forth, the weight of the body is either on the leg standing in front, or on the leg standing behind. It is impossible to take long breaths at the pace of your steps. Think: “my legs are pumping air into me.” It helps. With every step - a breath, short, like an injection, and noisy. Having mastered the movement, lifting your right leg, squat a little on your left, lifting your left leg on your right. The result is a rock and roll dance. Make sure that the movements and breaths go at the same time. Do not interfere or help the exhalations to come out after each inhalation. Repeat the breaths rhythmically and frequently. Do as many of them as you can easily do. Head movements

Turns. Turn your head left and right, sharply, at the pace of your steps. And at the same time with each turn, inhale through your nose. Short, like an injection, noisy. 96 breaths. Think: “It smells like burning! Where? Left? On right?". Sniff the air..
"Ears". Shake your head as if you were saying to someone: “Ah-ay-ay, what a shame!” Make sure your body doesn't turn. The right ear goes to the right shoulder, the left ear to the left. Shoulders are motionless. Simultaneously with each sway, inhale.
"Small Pendulum" Nod your head back and forth, inhale and inhale. Think: “Where does the burning smell come from? From below? Above?".

Main movements

"Cat". Feet shoulder width apart. Remember the cat that sneaks up on the sparrow. Repeat her movements - squat a little, turn first to the right, then to the left. Shift the weight of your body either to your right leg or to your left. To the direction you turned. And noisily sniff the air to the right, to the left, at the pace of your steps.
"Pump". Hold a rolled-up newspaper or stick in your hands like a pump handle and think that you are inflating a car tire. Inhale - at the extreme point of the inclination. When the tilt ends, the breath ends. Do not pull it while unbending, and do not unbend all the way. You need to quickly inflate the tire and move on. Repeat the inhalations and bending movements frequently, rhythmically and easily. Don't raise your head. Look down at an imaginary pump. Inhale, like an injection, instantaneous. Of all our inhalation movements, this is the most effective.
“Hug your shoulders.” Raise your arms to shoulder level. Bend your elbows. Turn your palms towards you and place them in front of your chest, just below your neck. Throw your hands towards each other so that the left one hugs the right shoulder, and the right one hugs the left armpit, that is, so that the arms go parallel to each other. Step pace. Simultaneously with each throw, when your hands are closest to each other, repeat short, noisy breaths. Think: “The shoulders help the air.” Do not move your hands far from your body. They are close. Don't straighten your elbows.
"Big Pendulum" This movement is continuous, similar to a pendulum: “pump” - “hug your shoulders”, “pump” - “hug your shoulders”. Step pace. Bend forward, hands reaching towards the ground - inhale, bend back, hands hug your shoulders - also inhale. Forward - back, inhale, inhale, tick-tock, tick-tock, like a pendulum.
"Half squats." One leg is in front, the other is behind. The weight of the body is on the leg standing in front, the back leg slightly touches the floor, as before the start. Perform a light, barely noticeable squat, as if dancing in place, and at the same time with each squat, repeat a short, light breath. Having mastered the movement, add simultaneous counter movements of the arms.

This is followed by a special training of “latent” breathing : a short inhalation with a tilt, the breath is held as much as possible, without straightening, you need to count out loud to eight, gradually the number of “eights” pronounced on one exhalation increases. With one tightly held breath, you need to collect as many “eights” as possible. From the third or fourth training, the pronouncing of “eights” by dysarthric patients is combined not only with bending, but also with “half squats” exercises. The main thing, according to A.N. Strelnikova, feel your breath “caught in a fist” and show restraint, repeating out loud the maximum number of eights while holding your breath tightly. Of course, the “eights” in each workout are preceded by the entire complex of exercises listed above.

Exercises for developing speech breathing

The following exercises are recommended in speech therapy practice:

Choose a comfortable position (lying, sitting, standing), place one hand on your stomach, the other on the side of your lower chest. Take a deep breath through your nose (this pushes your stomach forward and expands your lower chest, which is controlled by both hands). After inhaling, immediately exhale freely and smoothly (the abdomen and lower chest return to their previous position).

Take a short, calm breath through your nose, hold the air in your lungs for 2-3 seconds, then exhale long, smoothly through your mouth.
Take a short breath with your mouth open and, with a smooth, drawn-out exhalation, pronounce one of the vowel sounds (a, o, u, i, e, s).
Smoothly pronounce several sounds on one exhalation:

aaaaa aaaaaoooooooo aaaaauuuuuu

Count on one exhalation up to 3-5 (one, two, three...), trying to gradually increase the count to 10-15. Make sure you exhale smoothly. Count down (ten, nine, eight...).
Read proverbs, sayings, tongue twisters in one breath. Be sure to follow the instructions given in the first exercise.

The drop and the stone are chiseling. They build with their right hand and break with their left. Whoever lied yesterday will not be believed tomorrow. Toma cried all day on a bench near the house. Don't spit in the well - you'll need to drink the water. There is grass in the yard, there is firewood on the grass: one firewood, two firewood - do not cut wood on the grass of the yard. Like thirty-three Egorkas lived on a hillock: one Egorka, two Egorkas, three Egorkas...

Read the Russian folk tale “Turnip” with correct inhalation during pauses.

Turnip.

Grandfather planted a turnip. The turnip grew very, very big. Grandfather went to pick turnips. He pulls and pulls, but he can’t pull it out. Grandfather called grandma. Grandma for grandpa, grandpa for the turnip, they pull and pull, but they can’t pull it out! The grandmother called her granddaughter. Granddaughter for grandma, grandma for grandfather, grandfather for turnip, they pull and pull, they can’t pull it out! The granddaughter called Zhuchka. The bug for the granddaughter, the granddaughter for the grandmother, the grandmother for the grandfather, the grandfather for the turnip, they pull and pull, they can’t pull it out! Bug called the cat. Cat for Bug, Bug for granddaughter, granddaughter for grandmother, grandmother for grandfather, grandfather for turnip, they pull and pull, they can’t pull it out! The cat called the mouse. Mouse for the cat, cat for the Bug, Bug for the granddaughter, granddaughter for the grandmother, grandmother for the grandfather, grandfather for the turnip, pull and pull - they pulled out the turnip!

Practiced skills can and should be consolidated and fully applied in practice. “Whose steamer sounds better?” Take a glass vial approximately 7 cm high, neck diameter 1-1.5 cm, or any other suitable object. Bring it to your lips and blow. “Listen to the buzzing of the bubble. Like a real ship. Can you make a steamboat? I wonder whose ship will hum louder, yours or mine? Whose is longer? It should be remembered: for the bubble to buzz, the lower lip must lightly touch the edge of its neck. The air stream should be strong and come out in the middle. Just don’t blow for too long (more than 2-3 seconds), otherwise you’ll get dizzy. "Captains". Place paper boats in a bowl of water and invite your child to ride on a boat from one city to another. In order for the boat to move, you need to blow on it slowly, pursing your lips like a tube. But then a gusty wind blows in - the lips fold as if to make the sound p . Whistles, toy pipes, harmonicas, inflating balloons and rubber toys also contribute to the development of speech breathing. The tasks become more complex gradually: first, long speech exhalation training is carried out on individual sounds, then on words, then on a short phrase, when reading poetry, etc. In each exercise, children’s attention is directed to a calm, relaxed exhalation, to the duration and volume of pronounced sounds . “Skits without words” help normalize speech breathing and improve articulation in the initial period At this time, the speech therapist shows the children an example of calm expressive speech, so at first he speaks more during classes. “Skits without words” contain elements of pantomime, and speech material is specially kept to a minimum in order to provide the basics of speech technique and eliminate incorrect speech. During these “performances” only interjections are used ( Ah! Ah! Oh! etc.), onomatopoeia, individual words (names of people, names of animals), and later short sentences. Gradually, the speech material becomes more complex: short or long (but rhythmic) phrases appear as speech begins to improve. The attention of beginning artists is constantly drawn to what intonation should be used to pronounce the corresponding words, interjections, what gestures and facial expressions to use. During the work, children’s own imaginations are encouraged, their ability to choose new gestures, intonation, etc.

Features of breathing disorders in preschool children with an erased form of dysarthria

The article explains the relevance of studying the problem of breathing disorders and their correction in children with dysarthria. The results of studying the state of speech breathing in preschool children with dysarthria are presented.

Key words: educational environment, disorder, dysarthria, speech therapy, breathing, correction, diagnosis.

Today, one of the problems of modern speech therapy is the problem of dysarthria in preschool children. Such speech impairment in preschoolers is a pressing problem due to the fact that correction of this disorder is difficult. This is due to the fact that breathing is an important life support function for humans. For this reason, breathing correction is necessary in children with similar speech disorders.

Dysarthria is a speech disorder caused by organic damage to the nervous system. Dysarthria in a child is formed due to insufficient supply of nerve endings to the organs of the speech apparatus. The connection between the speech organs and the central nervous system deteriorates, and the child experiences difficulty in correctly pronouncing sounds.

Most often, children with speech disorders have various breathing disorders. Many authors in their methods attach great importance to the development of this indicator. Speech breathing is the process of breathing during speech. Namely, the ability to take a short, deep breath while speaking and gradually use the air to logically complete a sentence or phrase. Properly organized speech breathing allows the vocal apparatus to work without excessive tension, using logical stops to relax the ligaments, maintains fluency of speech, allows the use of the whole variety of intonation means of expressiveness, observe pauses, etc. With dysarthria, speech breathing is impaired due to the pathology of the innervation of the respiratory muscles [3].

D.K. Wilson, A.P. studied the characteristics of speech breathing as a special system of psychomotor reactions. Zilber, A.G. Khripkova. Issues of speech exhalation were dealt with by M.F. Fomicheva, A.E. Khvattsev, O.V. Pravdina. The leading role of speech breathing for the formation of full sound pronunciation is noted by A.G. Ippolitov [1].

Breathing is part of a complex functional speech system. The peripheral organs of hearing, breathing, voice, and articulation are inextricably linked and interact with each other at different levels under the control of the central nervous system. Each of the speech organs has its own function. According to A.R. Luria, a violation of one of them will affect the activities of other organs. This determines the relevance of the fact that in speech therapy practice, important importance is given to the production of sound pronunciation. When developing various techniques, the authors attach great importance to voice delivery and voice guidance.

To conduct the practical part of the study, the preschool institution MBDOU kindergarten No. 45 in Orel was selected. The study was conducted in a group of preschoolers aged 5-6 years. The subjects were 10 children of senior preschool age with dysarthria.

When conducting the study, elements of A.I.’s methodology were used. Maksakova.

The purpose of the technique: to determine the type of breathing, the purposefulness and strength of the air stream, the duration of non-speech exhalation, the characteristics of phonation breathing, methods for studying external respiration.

The chosen method allows us to determine important characteristics of speech breathing in children: the force of non-speech exhalation, type of breathing, rhythm of inhalation and exhalation, volume of speech breathing. Also, the positive aspects of this technique are its simplicity, relatively short time spent on implementation, and a convenient game form that interests children.

The study showed the fact that in case of insufficient speech breathing in children, the volume of speech and its clarity suffer. Insufficient speech breathing affects the volume and force of exhalation. Also, in children with dysarthria, there is insufficient differentiation of oral and nasal inhalation and exhalation, and unclear diction.

Based on the results of the experiment, the main results of the observations were summed up:

Physiological respiration. In children taking the drug during the experiment, spasticity of the respiratory muscles during breathing and associated convulsions of inhalation and exhalation were observed. The differentiation of oral and nasal inhalation and exhalation in the observed children is rather weak.
The onset of exhalation in the observed children occurs in an accelerated manner. That is, we can say that the onset of the exhalation phase is accelerated by these children, which leads to the appearance of convulsions of inhalation and exhalation and weakening of speech exhalation. As a result, these children exhibit poor directionality of the air stream.
In the process of pronouncing phrases by these children, they experience phonation (voiced) exhalation, which leads to the breaking of phrases and their unevenness during pronunciation. This reduces the duration of the phrase.
The study showed that these children have a disorder of coordination between breathing, articulation and phonation, and excessive air intake during the inhalation phase. In addition to this, it is worth noting that when these children pronounce phrases, pronunciation is carried out on exhalation and speech exhalation is weakened in this case.

Children who have been diagnosed with a speech disorder need breathing training. It is necessary to develop their respiratory functions. All exercises for training and correction of breathing in children with dysarthria are aimed at normalizing the breathing rhythm and increasing the strength of the respiratory muscles. The author's methods for breathing correction and training are aimed at improving breathing functions in children. By improving respiratory function, the respiratory system becomes healthier. Thanks to this, the overall level of health of the child increases, which subsequently, of course, affects speech breathing.

Such breathing correction exercises must be carried out systematically. This period will last quite a long time. Subsequently, this will improve the motor skills of the articular apparatus and develop articulatory movements. The job of a speech therapist is to overcome monotony and disturbances in speech rate in a child with dysarthria. Subject to successful work, full-fledged phonemic perception develops.

Most often, in speech therapy work, breathing exercises by A.N. are used to correct breathing in children with dysarthria. Strelnikova. This technique was formed in the last century. A similar technique was developed by the author in order to restore the singing voice, since Strelnikova was a singer. But given the practical significance of this technique and its effectiveness, it has become very often used in the correction of various breathing disorders. In particular, this technique is very effective in correcting breathing in children with dysarthria.

Carrying out his activities to correct breathing in children with dysarthria, the speech therapist selects individual programs for the correction and development of breathing. Work can be carried out both individually and through individual and group classes. The speech therapist uses generally accepted methods, makes any changes to existing exercises, and selects individual development methods. The implementation of breathing correction activities is carried out through the organization of a developing subject-spatial environment in the group.

If activities to correct breathing in children with dysarthria are successful, subsequently it is necessary to constantly monitor and monitor the correct breathing of these children.

That is why it is necessary to carry out periodically repeated exercises in order to consolidate the results obtained. Work to correct breathing in children with dysarthria should be carried out on the basis of a preschool institution together with teachers who carry out the educational function of these children.

Literature:

Voroshnina L.V. Development of speech and communication of children who do not attend preschool: practical work. manual for academic bachelor's degree [Text]. / L.V. Voroshnina. // 2nd ed. - M.: Yurayt Publishing House, 2021. - 158 p.
Galasyuk I.N. Fundamentals of correctional pedagogy and correctional psychology. Supervision of the family of a special child: textbook. manual for open source education [Text]. / I.N. Galasyuk, T.V. Shinina. - M.: Yurayt Publishing House, 2019. - 179 p.
Kolesnikova G.I. Fundamentals of special pedagogy and special psychology: textbook. manual for open source education [Text]. / G.I. Kolesnikova. // 3rd ed., revised. and additional - M.: Yurayt Publishing House, 2021. - 176 p.
Yashina V.I. Theory and methods of children's speech development. [Text] / V.I. Yashina. - M.: Publishing House, 2007. - 149 p.

Dysarthria is one of the most common speech disorders in children.

Depending on the preservation of pronunciation abilities, the following degrees of severity of dysarthric disorder are distinguished:

erased dysarthria (one or more groups of sounds are disturbed, usually of late ontogenesis);
dysarthria (a large number of sounds are disturbed, speech is poorly understood, “porridge in the mouth”);
anarthria (articulation of not only consonants, but even vowels suffers; speech is impossible and consists of inarticulate sounds). Anarthria is quite rare: it often accompanies cerebral palsy or is observed after strokes or traumatic brain injuries.

However, the symptoms of dysarthria are not limited only to problems with sound pronunciation. Common manifestations of this speech disorder are the following symptoms:

blurred, unclear diction;
lack of expressiveness of speech;
short, weak speech exhalation, which forces the child to pause frequently.

In some cases, these disorders are supplemented by disorders of the sound-syllable structure of the word, immaturity of phonemic perception (discrimination of sounds) and lexico-grammatical structure of speech. Then we are talking about general speech underdevelopment (GSD), complicated by dysarthria. What mechanisms cause dysarthria? Most often, pseudobulbar dysarthria occurs in children (approximately 90% of cases of dysarthria in children). It occurs as a result of a violation of the tone of the movable organs of articulation (tongue, lips, soft palate). A risk factor for such dysarthria is the presence of pyramidal insufficiency syndrome in a child in the early period of life.

Pyramidal insufficiency syndrome is a neurological diagnosis that is made by a neurologist in the first months of a child’s life. You can find out about its presence by reading the first notes of this specialist in the child’s medical record.

Pyramidal insufficiency syndrome is often observed in children with perinatal encephalopathy (PEP). Signs confirming the presence of pyramidal syndrome are a variety of muscle tone disorders:

hypertonicity (increased muscle tone);
hypotonia (decreased muscle tone); - muscular dystonia (both increased and decreased muscle tone). Muscle tone disorders can be unilateral or affect both halves of the body.

Children with increased muscle tone may begin to stand early (due to high tone of the extensor muscles), walk on tiptoes, without resting on the foot, without bending their knees. With a pronounced decrease in muscle tone, a delay in psychomotor development may be observed - the child later begins to hold his head, sit down, stand, and walk. In a later period, children with impaired tone experience clumsiness and motor awkwardness. Similar problems arise due to bilateral damage to the pyramidal tract.

The pyramidal tract is a neural pathway consisting of neurons (nerve cells) running from the motor areas of the cerebral cortex to the spinal cord. The neurons that form the pyramidal tract are giant (pyramidal) cells (Betz cells). They have very long axons (processes), along which motor impulses from the cortex are delivered to the organs of movement. Part of this pathway is represented by a bundle of cells forming the corticobulbar (corticonuclear) pathway. It starts from the cerebral cortex and ends not in the spinal cord, but higher up - in the medulla oblongata. It is in it that the nuclei of the cranial nerves are located, innervating (supplying nerve impulses) the organs of articulation. Therefore, very often a pathogenic factor that damages motor neurons of the corticospinal pyramidal tract causes disturbances in the corticobulbar tract, which leads to the appearance of dysarthria.

Damage to the corticobulbar tract may manifest itself in the following symptoms:

1. Violation of the tone of the tongue, lips, soft palate.

With increased muscle tone (spasticity), the tongue is tense and sometimes pulled back. It is difficult to perform exercises to spread the tongue (“spatula”). The articulation of many consonants is impaired, and their pronunciation is often softened (“Syabaka and Koska zivut nedroznya”). With reduced tone (pareticity), on the contrary, the child cannot narrow the tongue (“needle”), and it is difficult to lift the tip of the tongue upward (licking the upper lip, upper teeth). A paretic state of the tip of the tongue can lead to interdental pronunciation of whistling, hissing, t, d, n, l. When the lateral edges of the tongue are weak, instead of normal ones, “squelching” sounds are pronounced - l'kh (dog - “l'habaka”). If the tone of the lips is impaired, the clarity of pronunciation of the labial consonants and vowels O, U disappears. A decrease in the tone of the muscles of the soft palate leads to the appearance of a nasal tint (rhinophonia) in speech. With a unilateral decrease in the tone of the muscles of the soft palate, the small tongue (uvula) deviates to the healthy side when pronouncing the sound A.

2. There is hypersalivation (salivation).

Hypersalivation increases blurring and unclear diction.

3. Synkenesis (friendly movements) are observed. The most common synkinesis are:

throwing back the head when raising the tip of the tongue upward;
closing the mouth when raising the tip of the tongue upward,
movement of the tip of the tongue from side to side following eye movements to the right and left;
movements (raising) of the fingers when raising the tip of the tongue upward.

However, it would be wrong to say that all children with pyramidal insufficiency syndrome will sooner or later develop dysarthria. It all depends on how many nerve cells are damaged, on the area of localization of damage (damage to the corticobulbar tract) and on the possibilities of compensation in case of minimal disturbances. However, the presence of pyramidal syndrome should be perceived as a risk factor for dysarthria.

Children with pyramidal insufficiency syndrome must undergo mandatory medical examination by a neurologist - 2 times a year, and early speech therapy diagnosis.

The timing and effectiveness of rehabilitation treatment and the effectiveness of speech therapy work will depend on the thoroughness of implementation of the neurologist’s recommendations (drug and physiotherapy, massage, exercise therapy).

Author: Elena Moiseenko, 2016

Dysarthria

The speech of patients with dysarthria is slurred, unclear, and incomprehensible (“porridge in the mouth”), which is due to insufficient innervation of the muscles of the lips, tongue, soft palate, vocal folds, larynx, and respiratory muscles. Therefore, with dysarthria, a whole complex of speech and non-speech disorders develops, which constitute the essence of the defect.

Impaired articulatory motor skills in patients with dysarthria may manifest as spasticity, hypotonia, or dystonia of the articulatory muscles. Muscle spasticity is accompanied by constant increased tone and tension in the muscles of the lips, tongue, face, and neck; tightly closed lips, limiting articulatory movements. With muscle hypotonia, the tongue is flaccid and lies motionless on the floor of the mouth; the lips do not close, the mouth is half open, hypersalivation (salivation) is pronounced; Due to paresis of the soft palate, a nasal tone of voice appears (nasalization). In the case of dysarthria occurring with muscular dystonia, when attempting to speak, muscle tone changes from low to increased.

Sound pronunciation disturbances in dysarthria can be expressed to varying degrees, depending on the location and severity of damage to the nervous system. With erased dysarthria, individual phonetic defects (sound distortions) and “blurred” speech are observed.” With more pronounced degrees of dysarthria, there are distortions, omissions, and substitutions of sounds; speech becomes slow, inexpressive, slurred. General speech activity is noticeably reduced. In the most severe cases, with complete paralysis of the speech motor muscles, motor speech becomes impossible.

Specific features of impaired sound pronunciation in dysarthria are the persistence of defects and the difficulty of overcoming them, as well as the need for a longer period of automation of sounds. With dysarthria, the articulation of almost all speech sounds, including vowels, is impaired. Dysarthria is characterized by interdental and lateral pronunciation of hissing and whistling sounds; voicing defects, palatalization (softening) of hard consonants.

Due to insufficient innervation of the speech muscles during dysarthria, speech breathing is disrupted: exhalation is shortened, breathing at the time of speech becomes rapid and intermittent. Voice disturbances in dysarthria are characterized by insufficient strength (quiet, weak, fading voice), changes in timbre (deafness, nasalization), and melodic-intonation disorders (monotony, absence or inexpressibility of voice modulations).

Bulbar dysarthria

Bulbar dysarthria is characterized by areflexia, amymia, disorder of sucking, swallowing solid and liquid food, chewing, hypersalivation caused by atony of the muscles of the oral cavity. The articulation of sounds is slurred and extremely simplified. All the variety of consonants is reduced into a single fricative sound; sounds are not differentiated from each other. Nasalization of voice timbre, dysphonia or aphonia is typical.

Pseudobulbar dysarthria

With pseudobulbar dysarthria, the nature of the disorder is determined by spastic paralysis and muscle hypertonicity. Pseudobulbar paralysis manifests itself most clearly in impaired tongue movements: great difficulty is caused by attempts to raise the tip of the tongue upward, move it to the sides, or hold it in a certain position. With pseudobulbar dysarthria, switching from one articulatory posture to another is difficult. Typically selective impairment of voluntary movements, synkinesis (conjugal movements); profuse salivation, increased pharyngeal reflex, choking, dysphagia. The speech of patients with pseudobulbar dysarthria is blurred, slurred, and has a nasal tint; the normative reproduction of sonors, whistling and hissing, is grossly violated.

Subcortical dysarthria

Subcortical dysarthria is characterized by the presence of hyperkinesis - involuntary violent muscle movements, including facial and articulatory ones. Hyperkinesis can occur at rest, but usually intensifies when attempting to speak, causing articulatory spasm. There is a violation of the timbre and strength of the voice, the prosodic aspect of speech; Sometimes patients emit involuntary guttural screams.

With subcortical dysarthria, the tempo of speech may be disrupted, such as bradyllalia, tachylalia, or speech dysrhythmia (organic stuttering). Subcortical dysarthria is often combined with pseudobulbar, bulbar and cerebellar forms.

Cerebellar dysarthria

A typical manifestation of cerebellar dysarthria is a violation of the coordination of the speech process, which results in tremor of the tongue, jerky, scanned speech, and occasional cries. Speech is slow and slurred; The pronunciation of front-lingual and labial sounds is most affected. With cerebellar dysarthria, ataxia is observed (unsteadiness of gait, imbalance, clumsiness of movements).

Cortical dysarthria

Cortical dysarthria in its speech manifestations resembles motor aphasia and is characterized by a violation of voluntary articulatory motor skills. There are no disorders of speech breathing, voice, or prosody in cortical dysarthria. Taking into account the localization of lesions, kinesthetic postcentral cortical dysarthria (afferent cortical dysarthria) and kinetic premotor cortical dysarthria (efferent cortical dysarthria) are distinguished. However, with cortical dysarthria there is only articulatory apraxia, while with motor aphasia not only the articulation of sounds suffers, but also reading, writing, understanding speech, and using language.