Erased forms of dysarthria are often confused with dyslalia. However, on closer examination, there are differences.

Arkhipova F.E. developed parameters for comparing children with an erased form of dysarthria and dyslalia, thereby contributing to the issue of differential diagnosis of dysarthria and dyslalia.

5. General motor skills

· dysarthria motor awkwardness is noted \ run badly, often stumble \. lack of coordination of movements.

· dyslalia no impaired motor skills. The neuropathologist during the examination does not detect neurological symptoms in him.

6. fine motor skills

• A child with dysarthria develops self-education skills late. Poorly hold a pencil, strongly strain the muscles of the hand. And, on the contrary, due to a decrease in the tone of the muscles of the hands, the child does not press the pencil enough, the lines of the drawing are sluggish. When working with a cut-out picture, the folded pattern moves from its place, its parts do not exactly shift from one another. It seems that the child is sloppy when doing work, but in fact this is a violation of motor skills. For the first time, a defect of disorientation appears on a sheet of paper due to a violation of spatial representations. At school age, this leads to mirror writing, insufficient orientation in the notebook. Children may experience difficulties in the drawing lesson at an older age when performing geometric tasks. During the examination, the child does not perform finger exercises. Characteristic is the search for movements that require fine differentiated work of the fingers: “lock”, “goat”.
• In a child with dyslalia, there are no such violations on the part of motor skills.

7. articulatory apparatus

• A child with erased dysarthria has:

Hypertonicity: the child's face is mask-like, the muscles are hard on palpation; lips - the position of the upper lip is characteristic - it is stretched and pressed against the upper gum, and during speech it is motionless; the tongue is always thick (or changes the shape of the "autumn cucumber"); the voice is weakened, there are no modulations (cannot portray how the cow mooes); does not complete the task "Echo"; speech is slightly accelerated; weakened speech exhalation; consonants and vowels suffer.

Hypotonicity: the face is hypomimic (facial expression is insufficient); on palpation, the muscles of the face are flabby; mouth open; the child does not hold the position of the closed mouth (but it is necessary to exclude lorpathology); speech breathing is superficial; the child does not finish the endings of words, as if allowing grammatical errors, consonants usually suffer.

Hypersalivation: (increased salivation) especially with increased exercise. In this case, it is necessary to exclude diseases of the gastrointestinal tract (gastritis, hunger).

Deviation of the tongue (deviation of the tongue from the midline) with a functional load on the speech apparatus. For example, when performing the “pendulum” exercise, you need to look in which direction the tongue deviates.

Hyperkinesis: (violent movements of the tongue) degrees of hyperkinesis are distinguished: severe (tongue twitches in the anterior-posterior direction), medium (waves run through the tongue, sometimes in the longitudinal, then in the transverse direction, sometimes, this is observed only with a functional load), light ( tremor of the tip of the tongue during functional loading, sometimes accompanied by cyanosis - blue).

Violation of the quality of articulatory movements: movements are performed, but their quality suffers; weakened muscle strength (cannot make many clicks of the tongue, rhythm suffers); the time of holding the articulatory posture has been reduced.

• A child with dyslalia usually does not have these symptoms.

8. Sound pronunciation

· With erased dysarthria, the production of sounds is carried out according to the classical scheme, i.e. the same methods, techniques, you can use phonetic rhythm. And here the sounds are set easily, but the process of automation is lengthy. Sometimes, you have to work out in spontaneous speech each position of the sound in the word.

With dyslalia, sound production is also carried out according to the classical scheme, but the delivered sound is absorbed in the child’s speech for a long time and does not require long process automation.

1. General speech development

• Children with erased dysarthria can be conditionally divided into three groups:

Children who have impaired sound pronunciation, prosody, but they have good phonemic hearing, rich vocabulary, the grammatical structure of the language is not violated - FN (the violation is borderline with dyslalia, it is difficult to differentiate them).

Children who have not completed the process of forming phonemic hearing. This is the FFN group + an erased form of dysarthria. Such children can be up to 50%.

Children in whom the underdevelopment of phonemic hearing affects the underdevelopment of the syllabic structure of the word; poor vocabulary, aggramatisms in speech. At 5 years old, such a child may say "on the sled" instead of "on the sled." This group of children who develop OHP + an erased form of dysarthria. There may be 80% of them in the group with OHP.

1. Prosody

• In children with an erased form of dysarthria, slurred, unintelligible speech is noted - "porridge in the mouth." Poor intonation, quiet voice, sometimes nosal tone of speech. More often, the pace of speech is fast, accelerated, the child does not finish the endings of words and greatly reduces the pronunciation of vowels (reduces to a minimum). The child has a fading voice, begins to speak loudly, subsides as the speech load increases. The intonation is deteriorating. Children with dysarthria are characterized by a deterioration in the quality of speech with an increase in load.
• In dyslalia, with repetition of exercises, speech quality improves.

Differential diagnosis of dyslalia from dysarthria . Dyslalia: 1. In somatically weakened children. No organic matter 2. Neurological symptoms are absent. 3. Motor sphere without pathology, tendon reflexes are alive, uniform. 4. Only sound pronunciation suffers. The prognosis is favorable. 5. The voice is sonorous, loud, richly modulated. 6. Speech activity is increased. 7. The child is critical of his defect. 8. Vegetative disorders are manifested in sweating of the extremities, in red dermographism of the skin. 9. Hygienic skills are developed quickly, held firmly; outwardly the child is neat. 10. Sleep calm without night fears and dreams. 11. Diaphragmatic speech breathing is normal. 12. In contact, the child enters easily, the behavior is adequate. 13. Memory, attention, working capacity, thought processes, intelligence are normal, ZPR is rarely observed. 14. The child is active, mobile, willingly engaged, without much difficulty switches from one type of activity to another. Erased form of dysarthria: 1. Associated with the defeat of the central nervous system. 2. Pronounced asymmetry of the face, tongue, soft palate; the mouth at rest is ajar due to a cut on the lips; smoothness of the nasolabial folds. 3. General, fine and articulatory motor skills suffer. 4. Along with sound pronunciation, prosody suffers; the set sounds are difficult to automate. 5. The voice is deaf, weak, strangled, fading, intermittent. 6. Speech activity is reduced. 7. It is indifferent to the defect. 8. Vegetative disturbances are roughly expressed: bluish, cold, wet extremities. 9. Hygienic skills due to motor disorders are developed with difficulty, the child is untidy. 10. Sleep disorders, night terrors, dreams are observed. 11. Superficial, clavicular, diaphragmatic-speech breathing - not formed. 12. Behavior is uneven, mood swings are frequent. 13. Memory is reduced, short-term; attention is unstable; low performance; intelligence is reduced (ZPR, oligophrenia) 14. Slow or disinhibited, shy away from classes, complain about headache difficult to switch from one activity to another.

Children with an erased form of dysarthria resemble dyslalia. However, the examination reveals unfavorable factors in the anamnesis, organic microsymptoms in the neurological status, as well as difficulties in carrying out speech therapy activities. If, with dyslalia, a speech defect is associated with the incorrect pronunciation of individual sounds or groups, then with dysarthria, not only sound pronunciation suffers, but also voice, tempo, smoothness, modulation, breathing, etc. Correction of pronunciation in the functional form of dyslalia takes place without much difficulty in a short term (from several lessons to one month). The new pronunciation is easily acquired by the child, and he forgets about his correct pronunciation

51. Examination of persons with dysarthria. Scheme of speech therapy examination of a child with dysarthria.

52. Methodology of speech therapy work with dysarthria.

53. The system of speech therapy work with dysarthria:

54. Methods of work with various forms of dysarthria and with varying degrees of manifestation of disorders of the motor, mental and speech spheres of people with dysarthria.

55. Correction of violations of the pronunciation side of speech with erased dysarthria.

56. Tasks for demonstrating techniques for identifying and overcoming speech disorders (for example, demonstrate and explain methods for diagnosing minimal manifestations of dysarthria, methods of working on the formation of auditory perception in preschoolers; a set of exercises for passive articulatory gymnastics, techniques for the formation of vowels and consonants by the article in children with open rhinolalia, etc.).

Table 17 (end)

6.2. Differential diagnosis of dysarthria according to the degree of damage

The most common form of dysarthria is pseudobulbar(96%). The pseudobulbar form of dysarthria is differentiated according to the degree of damage (Table 18).

Table 18

Differentiation of pseudobulbar dysarthria

Table 18 (end)

Knowledge of the neurological foundations of speech therapy will help the speech therapist to meaningfully qualify the defect, understand its structure, etiology, mechanisms, pathogenesis, which in turn will allow you to choose the most optimal, adequate corrective technique, taking into account the reserve, compensatory capabilities of each child individually, which will provide a personality-oriented approach to the correction of speech disorders.

6.3. The main indicators of the diagnosis of dysarthria

The main indicators in the diagnosis of dysarthria according to the degree of damage are facial expressions, breathing, voice formation, reflex movements of the tongue, its shape, retention of the articulatory posture; arbitrary movements of the tongue, lips; soft palate, hyperkinesis, oral synkinesis, sound pronunciation (Table 19).

Table 19

Indicators for the diagnosis of dysarthria

Table 19 (end)

6.4. Differential diagnosis. Distinctive features of erased forms of dysarthria from dyslalia

A broad analysis of practice has shown that the erased forms of pseudobulbar dysarthria are quite often mixed with dyslalia (Table 20). However, the correction of sound pronunciation in dysarthria causes certain difficulties. For the first time, G. Gutsman drew attention to this. He noted that these disorders are characterized by blurring, blurring of articulation.

Table 20

Differential diagnosis of dyslalia and dysarthria

Summarizing the analysis of the literature data, M. B. Eidinova and E. N. Pravdina-Vinarskaya explain the violations of the articulation apparatus by its insufficient innervation and consider these cases as dysarthria. Despite the fact that hissing, whistling and sonorous groups of sounds are more likely to suffer in both dysarthria and complex dyslalia, correct isolated pronunciation of sounds is possible for dysarthria, but blurring, palatalization, nasalization, and violation of the prosodic side of speech are noted in spontaneous speech. Children often say the end of the phrase while inhaling, the voice is hoarse, weak, quiet, fading.
A child with dysarthria gives a "diagnosis on the face", is visible visually, without a special examination. First of all, this is an inexpressive facial expression, the face is amimic, smoothness of the nasolabial folds is observed, the mouth is often ajar due to paresis of the circular muscle. Possible asymmetry of the face, skull, mouth, palpebral fissures.
Discoordination of general motor skills, manual and oral praxis is observed, resulting in blurred pronunciation, difficulties in drawing, writing, mastering cultural and hygienic skills: such children eat for a long time, are untidy, have difficulty fastening buttons, lacing up shoes. Characterized by fatigue, exhaustion of the nervous system, low performance, impaired attention and memory.
The nature of speech disorders is closely dependent on the state of the neuromuscular apparatus of the organs of articulation. We examined 673 children. An analysis of the data obtained on the speech and psychoneurological state of children showed that their phonetic disorders are due to paretic phenomena in certain groups of muscles of the articulatory apparatus.
As a result, interdental, lateral pronunciation of whistling and hissing in combination with throat pronunciation of the sound predominates in children. R. The spasmodic tension of the middle back of the tongue makes the whole speech of the child softened. With spasticity vocal cords there is a defect in voicing, and if they are paretic, a defect in stunning. Hissing sounds with dysarthria symptoms are formed in a simpler lower version of pronunciation. Not only phonetic, but also respiratory, prosodic speech disorders can be observed. The child speaks on the breath.
There is quite frequent mixing bulbar form of dysarthria with pseudobulbar (Table 21).

Table 21

Differential diagnosis of similar speech pathologies of the bulbar form of dysarthria from pseudobulbar

The bulbar form of dysarthria is rare. Pseudobulbar is the most common (96% of children).
According to their manifestations, cortical dysarthria is sometimes confused with motor alalia, since the focus of localization is the cerebral cortex (Table 22).

Table 22

Comparative characteristics pronunciation in children with alalia and dysarthria

Thus, Alalik children are characterized by a sonorous voice, a fairly well-preserved sound pronunciation. Intermittent substitutions of sounds dominate in pronunciation disorders. Children with alalia distort predominantly sounds that are complex in articulation. Interchanges of sounds are comparatively frequent. Facial expressions, the speech of alaliki is lively and expressive, increased speech activity.
Children with cortical dysarthria resemble children with motor alalia, as the syllabic structure is primarily disturbed. compound words.
The difference is that the child's face is amimic, the voice is monotonous, fading; shallow, clavicular breathing; there are no violations in the development of the lexical and grammatical structure.
The pronunciation is blurry, the same type of disturbances predominate, where distortions dominate (interdental, lateral, nasal sigmatism, etc.). Omissions of articulatory complex sounds are possible. The entire prosodic side of speech suffers (tempo, timbre, etc.).

7. Interaction of specialists

There is safety in numbers.

The diagnostic results determined the choice of tactics and strategy. Target was to create and test a model of interaction between teachers, parents and doctors in the process of correctional and developmental educational activities, in removing contradictions, changing parental attitudes, unjustified ambitions, increasing the professional competence of teachers and teaching parents new forms of communication and pedagogical support for the child, organizing an objective correctional and developmental environment that stimulates the speech and personal development of the child.
The content and structure of pedagogical support, rehabilitation largely depended on the diagnosis, defect structure, etiology, compensatory abilities of the child, "the zone of his actual and immediate development", and a student-centered approach.
To achieve the goal, we set tasks:
1) creation of a complex integrated model of correctional and developmental activities of specialists as a condition speech development child;
2) modeling, designing and constructing the organizational, content and methodological aspects of the preventive, correctional and developmental activities of specialists;
3) development of personality-oriented forms of interaction between the subjects (children, parents, specialists) of the institution, causing an increase in the level of professional competence of specialists and mastering integrated methods for developing the child's personality and correcting speech disorders.
Leading ideas for the rehabilitation of children with speech disorders:
1) personality-oriented interaction of specialists on an integrative basis;
2) individualization of correctional and developmental activities;
3) taking into account the compensatory and potential abilities of the child;
4) integration of methods of correctional and developmental education, efforts and capabilities of parents, teachers and doctors.
The model of correctional and developmental activity is an integral system. Its goal is the organization of educational and educational activities of a medical or educational institution as a system that includes diagnostic, preventive and correctional and developmental aspects that provide a high, reliable level of speech, intellectual and mental development of the child.
The content of correctional and developmental activities is built taking into account the leading lines of speech development - phonetics, vocabulary, grammar, coherent speech - and ensures the integration of speech, cognitive, environmental, artistic and aesthetic development of the child.
The implementation of this attitude is ensured by the flexible use of traditional and non-traditional means of development: puppet and fairy tale therapy, kinesitherapy (movement therapy), brain kinesiology, psycho-gymnastics, articulatory, finger and breathing exercises, acupressure and segmental massage, relaxation, physio-, phyto-, aroma- , chromo-, music therapy, speech therapy rhythms, kinesiological and hydrotherapy, etc.
The system of correctional and developmental activities provides for individual, subgroup and frontal exercises, as well as the independent activity of the child in a specially organized spatial and speech environment.
Graphically, the model of interaction between specialists in the correction of speech disorders is shown in fig. 10.
All specialists in the creation of the model work under the guidance of speech therapist, who is the organizer and coordinator of all correctional and developmental work, conducts medical and pedagogical consultations, draws up a block integrated calendar and thematic plan together with colleagues, sets up diaphragmatic speech breathing, corrects defective sounds, automates them, differentiates them, introduces them into independent speech, contributes to speech therapy of regime moments and classes, the practical mastery of word formation and inflection skills by children, which helps personal growth child, the formation of confident behavior, a sense of dignity, adaptation in the society of peers and adults, in the end - successful learning At school.
educators consolidate the acquired knowledge, practice skills to automate skills, integrating speech therapy goals, content, technologies into everyday life children (in play, labor and educational activities), in the content of other classes (mathematics, fine arts, speech development and familiarization with others through observations of natural phenomena and social life), during the regime moments.
Psychologist conducts trainings for confident behavior, relaxation, psycho-gymnastics, which teaches children to control their mood, facial expressions, maintain a positive emotional tone, conflict-free behavior, a favorable microclimate in the institution and at home; kinesiology of the brain, which helps to overcome the interhemispheric asymmetry of the brain, correct impaired functions, turn on compensatory and develop the potential of the child, etc.

Rice. 10. Model of interaction between specialists in the correction of speech disorders

Musical director carries out the selection and implementation of music therapy works in the daily life of the child, listening to which contributes to the normalization of falling asleep, awakening; creates a musical background in the process of gaming, labor and learning activities, which minimizes behavioral and organizational problems, significantly increases the performance of children, stimulates their attention, memory, thought processes.
In logorhythmic classes, general and fine motor skills are improved (coordination of movements, manual praxis, articulatory muscles), expressiveness of facial expressions, plasticity of movements, they worked on staging diaphragmatic speech breathing, voices, the prosodic side of speech (tempo, timbre, expressiveness, voice power).
The most priority are the forms of interaction between specialists: teachers' councils, consultations, trainings, workshops, medical-psychological-pedagogical consultations, business games, round tables, questioning, viewing and analysis of classes, etc.
Teacher training going on perspective plan work at seminars, practical and lecture classes, consultations, teachers' councils, through self-education without leaving the main place of work and, of course, at refresher courses.
Increasing professional competence equips employees with theoretical and practical knowledge in the field correctional pedagogy and speech therapy, forms the necessary skills, activates the exchange of information, practical experience, develops the need for continuous self-education and self-improvement.
Taking into account the fact that not all educators have developed a desire for this, it is better to select teachers for speech therapy groups on a competitive basis, taking into account their speech characteristics, knowledge, skills, personal potential (kindness, love for the profession, children, ability to work with parent group).
This encourages teachers to improve their professionalism, their qualification category.
Organization of correctional and developmental educational environment includes the creation of a comfortable environment that stimulates the child's speech development. Speech zones are equipped with mirrors for mimic and articulatory gymnastics, visual and illustrative material is selected according to lexical topics, the main phonetic groups; plot pictures for working on a phrase, toys for improving diaphragmatic speech breathing, various manuals for manual praxis, developing visual memory and improving phonemic hearing.
On the recommendations of the teacher, parents at home also organize corners that stimulate the speech development of children, the development fine motor skills and others. In a speech therapy room in a group for children, corners are arranged for puppet therapy, fairy tale therapy, a zone for relaxation, psycho-gymnastics is organized.
Speech therapy groups, speech therapists' offices, a wellness and compensation center, it is desirable to concentrate in one wing, which will facilitate organizational issues, increase work efficiency.
The regrouping of children for the purpose of personalized, differentiated learning is carried out taking into account the structure of the speech disorder, the degree of damage, and the compensatory capabilities of each child.
The relationship of specialists especially a speech therapist with teachers, consists in speech therapy of sensitive moments
and occupations. Educators in everyday life systematically develop fine motor skills of the hand and articulation apparatus in children. This work is carried out in the form of "Tales of the Merry Tongue", finger gymnastics, folk games, shadow theater. To normalize facial expressions, mimic gymnastics, “mood screens” are used, on which children reflect their mood with the help of pictograms. This awakens a kind, caring and attentive attitude towards people around.
For the development of verbal memory, visual supports in the form of letter schemes are effective, which are compiled by isolating the first sound from a generalizing word, then - specific concepts. The transformation of phonemes into graphemes prompts children to "encrypted" words, significantly expands the amount of verbal memory, instills confidence in their abilities, increases self-esteem, contributes to the formation of phonemic hearing, mastering sound-letter analysis, literacy.
Serious work is being done to automate the set phonemes and to practically master the skills of word formation and inflection.
The approach to determining the sequence of correction of sound pronunciation may differ from the traditional one. Comparison of the data obtained experimentally with the results of the traditional method shows its advantages: corrective work, reducing energy costs on the part of the child and the teacher.
With the aim of prevention of violations writing systematically in game form special work is carried out, as a result of which preschoolers master the rules of the Russian language.
For an unstressed vowel:“If a vowel is in doubt, you rather put it under stress.” Children select test words: at home - house, fields - field, water - water; river - rivers, wall - walls, forests - forest, etc .;
To stunning consonants at the end and middle of a word: tooth - teeth, flag - flags, garden - gardens, already - snakes; mug - mug, booth - booth, etc.
Communication of speech therapy with math were widely implemented by teachers not only in the classroom, but also in everyday life. So, for example, in the process of getting acquainted with mathematics, you can work out lexical and grammatical categories(agreement in gender, number, case), size concepts(high - low, long - short, thick - thin, narrow - wide, etc.), which, as practice shows, are very often quite poorly differentiated by children and are often designated unambiguously (large - small). The weak link is temporary concepts(quickly - slowly), children also mix concepts such as today - yesterday - tomorrow, days of the week, months, seasons).
Orientation in space is often also disturbed (above - below, before - behind, under - above, right - left, between, because of, from under, etc.), which makes it difficult to master prepositional case constructions.
Counting, counting operations, problem solving help children master the coordination of numerals with nouns in gender (one cat, one fish, one towel, etc.), number (one chair, three chairs, five chairs; one window, two windows, five windows; one bun, two buns, five buns).
The development of coherent speech, its prosodic side (expressiveness, timbre, tempo, voice power) can be successfully implemented through the regional component, for example, when familiarizing preschoolers with the life and history of the Don Cossacks (experience of L. V. Gavrilchenko, A. R. Krasikova, G. G. Chebanyan). For example, in the child development center No. 49 "Olenenok" in Rostov-on-Don, there is a site designed in the spirit of a Cossack room. The interior, Cossack household items help to convey to the minds of children who the Cossacks are, how they appeared on the banks of the Don. In everyday work, it is possible to expand children's ideas about the historical past of the Cossacks, its traditions, the way of life of the Don man. Children learn about the wide expanses of the Don steppe, that it stretches from the Kalach Upland in the north to the expanse Kuban steppes in the south, from the ancient Lukomorye in the west to the semi-deserts of Kalmykia in the east.
The Don region has a bright and rich history. Our region knew the invasion of the Huns, experienced the blows of the Batuyevs and the Tamerlane hordes. On the Don land, the warriors of Svyatoslav crushed the Khazars, the brave Russians of Igor blocked the field with red shields, covering the Russian land from the Polovtsians. More than once the Don steppe blazed with the flames of Cossack and peasant uprisings led by S. Razin, K. Bulavin, E. Pugachev.
The speech material is selected taking into account the pronunciation capabilities of children, who not only feel the flavor of the speech of the Don Cossacks, but also use it in their speech. Riddles, proverbs, sayings, songs, dances, chants, tunes - these are the pearls of folk wisdom that are easily perceived by a child, develop his verbal memory, and contribute to speech development. They reflect humor, sadness, love for the Fatherland.
Great help at work doll therapy And fairy tale therapy, which contribute to the development of coherent expressive speech, overcoming existing speech disorders, logophobia, provide children with the opportunity to feel self-confidence, relax, love theatrical activities (G. V. Bedenko, T. N. Golubtsova, A. R. Krasikova, G. G Chebanyan, G. V. Gorshkova, L. A. Rudova).
Puppet therapy - this is a section of art therapy, which is used as the main method of psycho-correctional influence on the doll as an intermediate object of interaction between an adult and a child. The goal of puppet therapy is to eliminate painful experiences, strengthen mental health, improve social adaptation, develop self-awareness, resolve conflicts in a collective environment. creative activity.
Teachers share their experience of using real life toys that help relieve aggression, promote creative self-expression, weaken negative emotions; consider methods such as the technique of psychodrama, the technique of the non-game type "Grandfather Shchukar", the technique of indirect suggestion, the use of a didactic doll in speech therapy work.
Puppet therapy allows you to solve such important correctional tasks as overcoming uncertainty, shyness, expands the repertoire of the child's self-expression, allows you to achieve emotional stability and self-regulation, corrects relationships in the "parent-child" system.
The psychologist, together with a speech therapist and educators, is engaged in diagnostics, reveals compensatory opportunities, difficulties in personal development and intellectual and cognitive activity of the child, conducts trainings for confident behavior, introduces teachers and parents to technologies for helping problem children who experience difficulties in social adaptation ( interpersonal relationships, speech communication, etc.). Elements of educational kinesiology of the brain successfully activate the potential and compensatory abilities of the child, contribute to overcoming the interhemispheric asymmetry of the brain, correction and prevention of speech disorders, including disorders of written speech (motor dysgraphia).
Peculiarities visual activity children with dysarthria general underdevelopment speech (OHP) help us in the differential diagnosis of speech pathologies. The technical skills of children, especially hatching, the ability to regulate direction, pressure, range of motion are an indicator of the muscle tone of the leading hand. All visual activities (sculpting, appliqué, designing, drawing) are corrective, as they contribute not only to the development of fine motor skills of the hand, planning the functions of speech, but also orientation in space, the development of thinking, creativity.
Integrative connections of speech therapy with swimming and physical education classes described by the teacher-instructor A. M. Mashchits. These classes heal the child's body, contribute to the formulation of diaphragmatic-speech breathing, improve the coordination of the main types of movements, fine motor skills of the hand, articulatory motor skills, overcome interhemispheric asymmetry of the brain, enrich vocabulary, the formation of positive personal qualities in the child's behavior: sociability, the ability to calculate one's strength, self-control education, courage, determination, perseverance, modesty, self-criticism, responsiveness, camaraderie, etc.
The creation of a single cohesive team, the coordination of actions is helped by monthly medical-psychological-pedagogical consultations, where topical issues of prevention, speech correction are discussed, continuity between specialists is ensured, which stimulates speech therapy of regime moments and the content of other classes, the penetration of speech therapy into everyday life.
Thanks to this approach, it is possible to establish continuity, to achieve the necessary interaction of all persons interested in correctional and developmental education, which positively affects the quality of work (96% of graduates of the development center go to school with pure speech), reduces the time of correctional work by one third, practically reduces minimize possible relapses.
Important for the successful correction of speech disorders, especially in children under school age, having an erased form of dysarthria, has competent selection of linguistic material.
When choosing it, the following requirements must be observed: first of all, it must be significant for the pupil, in demand, accessible in content and, most importantly, correspond to his pronunciation capabilities.
In the course of the work, the selection and sequence of presentation of linguistic material in the process of automating sounds according to the structure of the defect are substantiated; the ways of mastering the skills of word formation, the peculiarities of children's understanding of the relations that exist between the various elements of the lexical system and manifested in the language in such categories as polysemy, synonymy And antonymy; regularity and frequency of use of these lexico-semantic groupings of words in speech are analyzed.
Studying the patterns of assimilation of the semantics of a word, experts rely on the provisions of modern linguistics: the meaning of each lexical unit is determined by its correlation with other units of the same level. When selecting linguistic material for speech correction, the principles of correctional pedagogy are taken into account.

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COURSE WORK

Comparative analysis dyslalia and erased dysarthria.

Performed:

4th year student

Correspondence department

Faculty of Defectology

404 groups

Lebedeva V.V.

Checked work:

Assoc. Edes R. E.

Introduction

1. Dyslalia. Historical aspect

2. Clinical and pedagogical characteristics of children with dyslalia

2.1 Simple and complex dyslalia

2.2 Forms of dyslalia

2.3 Features of phonetic disorders in children with dyslalia

2.4 Sensory and motor dyslalia

2.5 Levels of impaired pronunciation

3.Methodology of logopedic influence in case of dyslalia

3.1 Main stages of work

4. Erased dysarthria. Historical aspect

4.1 Clinical and pedagogical characteristics of children with erased dysarthria

4.2 Features of phonetic disorders in children with erased dysarthria

4.3 Features of the formation of phonemic hearing in children with erased dysarthria

4.4Features of motility in erased dysarthria

4.5 Features of the formation of vocabulary, violations of the formation of the grammatical structure, the morphological system of the language and the syntactic structure of the sentence with erased dysarthria

4.6 Prosody

5. Methodology of speech therapy work with children with erased dysarthria

5.1 Methods for correcting speech breathing in dysarthria

5.2 Speech correction for dysarthria

6. Comparative analysis of dyslalia and erased dysarthria

Conclusion

Literature

Introduction

Speech sounds are special complex formations inherent only to humans. They are produced in a child within a few years after birth. This process includes complex brain systems and the periphery (speech apparatus), which are controlled by the central nervous system. Hazards that weaken it adversely affect the development of pronunciation.

Children with speech disorders are children who have deviations in the development of speech with normal hearing and intact intelligence. Speech disorders are diverse, they can manifest themselves in violation of pronunciation, grammatical structure of speech, poverty of vocabulary, as well as in violation of the pace and fluency of speech.

Among the various speech disorders in childhood functional dyslalia and a mild form of dysarthria present a great difficulty for differential diagnosis and speech therapy.

There are numerous indications in the literature that in the practice of speech therapy there are pronunciation deficiencies that, in their external manifestation, resemble dyslalia, but have a long and complex dynamics of elimination.

So the choice of topic term paper due to its relevance and insufficient study of the problem, which requires special consideration in the scientific and methodological aspects.

The purpose of this work is a comparative analysis of dyslalia and erased dysarthria.

Research objectives: to study the psychological and pedagogical literature on these disorders, compare and draw a conclusion.

1. Dyslalia. Historical aspect. The term "dyslalia". Causes

Dyslalia(from the Greek. dis - a prefix meaning a partial disorder, and lalio - I say) - a violation of sound pronunciation with normal hearing and intact innervation of the speech apparatus.

Among the violations of the pronunciation side of speech, the most common are selective violations in its sound (phonemic) design during the normal functioning of all other utterance operations.

These violations are manifested in defects in the reproduction of speech sounds: their distorted (abnormal) pronunciation, the replacement of some sounds with others, the mixing of sounds and - less often - their omissions.

The term "dyslalia" was one of the first in Europe to be introduced into scientific circulation by the professor of Vilnius University, doctor I. Frank. In a monograph published in 1827. The study of this problem in Russian speech therapy is reflected in the works of M. E. Khvattsev, A. M. Smirnova, O. V. Pravdina, S. S. Lyapidevsky, R. E. Levina and other equally well-known scientists.

Dyslalia is one of the most common pronunciation defects. Statistical data of domestic and foreign researchers indicate that 25-30% of preschool children (5-6 years old) have pronunciation deficiencies, 17-20% of school-age children (I-II grades). For older students, pronunciation deficiencies occupy no more than 1%. This indicates that there are temporary violations that are overcome in the course of the speech development of children and in the process of schooling.

Causes- biological and social: general physical weakness of the child due to somatic diseases, especially during the period of active formation of speech; mental retardation (minimal brain dysfunction), delayed speech development, selective impairment of phonemic perception; unfavorable social environment that impedes the development of the child's communication (limited social contacts, imitation of incorrect speech patterns, as well as educational deficiencies when parents cultivate imperfect children's pronunciation, thereby delaying his development of sound pronunciation).

dyslalia hearing speech therapy dysarthria

2. Clinical and pedagogical characteristics of dyslalia

2.1 Simple and complex dyslalia

Depending on how many sounds are defectively pronounced, dyslalia are divided into simple and complex. Simple (monomorphic) include disorders in which one sound is defectively pronounced or sounds that are homogeneous in articulation, complex (polymorphic) include violations in which sounds are defectively pronounced different groups(whistling and sonora).

Along with the so-called "pure" forms, there are combined forms of acoustic-phonemic, articulatory-phonemic and articulatory-phonemic dyslalia. M. E. Khvattsev defined such disorders as diffuse, or general, tongue-tied tongue and pointed out its connection with the underdevelopment of speech. These combinations of disorders are special group, not reducible to dyslalia as a selective disorder of the sound design of speech; they are combined with the underdevelopment of other aspects of speech and are observed against the background of organic lesions of the central nervous system and mental development.

2.2 Fforms of dyslalia

Allocate two main forms of dyslalia depending on the localization of the violation and the reasons for the defect in sound pronunciation; functional and mechanical(organic).

In cases where there is no organic damage(peripherally or centrally conditioned), they talk about functional dyslalia. With deviations in the structure of the peripheral speech apparatus(teeth, jaws, tongue, palate) speak of mechanical(organic) dyslalia.

Functional dyslalia occurs in childhood in the process of mastering the pronunciation system, and mechanical dyslalia occurs at any age due to damage to the peripheral speech apparatus. With functional dyslalia, the reproduction of one or more sounds may be disturbed, with mechanical dyslalia, a group of sounds usually suffers. In some cases, there are combined functional and mechanical defects.

Functional dyslalia. It includes defects in the reproduction of speech sounds (phonemes) in the absence of organic disturbances in the structure of the articulatory apparatus.

With functional dyslalia, there are no organic disorders of the central nervous system that impede the implementation of movements. Unformed are the specific speech skills to arbitrarily take the positions of the articulatory organs necessary for the pronunciation of sounds. This may be due to the fact that the child did not form acoustic or articulatory patterns of individual sounds. In these cases, it turns out that one of the signs is not learned by them. given sound. Phonemes do not differ in their sound, which leads to replacing sounds. The articulatory base is not complete, since not all the auditory-motor formations (sounds) necessary for speech have been formed. Depending on which of the signs of sounds - acoustic or articulatory - turned out to be unformed, sound substitutions will be different.

In other cases, the child turns out to have formed all the articulatory positions, but does not have the ability to distinguish between some positions, that is, to correctly select sounds. As a result, phonemes are mixed, the same word takes on a different sound appearance. This phenomenon is called confusion or interchanges sounds (phonemes).

Often there are cases of abnormal reproduction of sounds due to incorrectly formed individual articulatory positions. The sound is pronounced as unusual for the phonetic system mother tongue in terms of acoustic effect. This phenomenon is called sound distortion.

mechanical dyslalia- impaired sound pronunciation due to anatomical defects in the peripheral apparatus of speech (organs of articulation). She is sometimes called organic. The most common pronunciation defects are due to:

1) anomalies of the dento-jaw system: diastema between the front teeth;

2) the absence of incisors or their anomalies;

3) irreparable position of the upper or lower incisors or the relationship between the upper or lower jaw (bite defects). These anomalies may be due to developmental defects or be acquired due to trauma, dental disease, or age-related changes. In some cases, they are due to the abnormal structure of the hard palate (high vault).

Among the violations of pronunciation in such cases, defects of whistling and hissing sounds (they acquire excessive noise), labial-tooth, anterior-lingual, explosive, less often - r and r are observed in such cases.

Quite often, the pronunciation of vowel sounds is also disturbed, which become unintelligible due to excessive noise of consonants and insufficient acoustic opposition of vowels.

However, not always dental anomalies lead to defects in pronunciation: with some deformation of the teeth, it may turn out to be normal.

The second significant group in terms of prevalence is made up of sound-producing disorders caused by pathological changes in the language: too large or little tongue, shortened hyoid ligament.

With such anomalies, the pronunciation of sibilants and vibrants suffers, and lateral sigmatism is also observed. In some cases, the intelligibility of pronunciation as a whole suffers.

However, not in all cases of linguistic anomalies, the pronunciation of sounds suffers. This has been repeatedly noted by linguists. (R. O. Yakobson, M. V. Panov) and specialists in the field of speech pathology (G. Gutzman, R. A. Yurova, etc.).

The facts of normal sound pronunciation with anomalies of the tongue and teeth indicate compensatory possibilities that allow the formation of normal pronunciation even under disturbed conditions for the realization of sounds; the same acoustic effect can be obtained in different ways.

Sound pronunciation disorders caused by labial anomalies are much less common, since congenital defects (various deformities) are overcome surgically in early age. Thus, the speech therapist meets mainly with the consequences of deformations of traumatic origin, in which the pronunciation of labial sounds is mainly disturbed due to incomplete closure of the lips, as well as labio-dental sounds. Sometimes there are defects in the pronunciation of labialized vowels (o, y).

Mechanical dyslalia can be combined with functional phonemic dyslalia.

In all cases of mechanical dyslalia, consultation (and in some cases treatment) of a surgeon and an orthodontist is necessary.

2.3 Features of phonetic disorders in children with dyslalia

The listed types of violations: substitution, mixing and distortion of sounds - in traditional speech therapy are considered as adjacent. In modern speech therapy research, based on the provisions of linguistics, they are divided into two different levels. Substitutions and mixings of sounds qualify as phonological(F.F. Pay), or (which is the same) phonemic(R. E. Levina) defects, in which the system of language is violated. Sound distortions qualify as anthropophonic(F.F. Pay), or phonetic defects, in which the pronunciation norm of speech is violated.

2.4 Sensory and motor dyslalia

In the domestic and foreign literature the division of dyslalia into two forms is accepted, depending on which psychophysiological mechanisms involved in the implementation of speech processes are violated. Allocate sensory and motor dyslalia (K. P. Becker, M. Sovak, M. E. Khvattsev, O. A. Tokareva, O. V. Pravdina, etc.). This division of dyslalia directs attention to the mechanism, the correction of which must be carried out.

There are three main forms of dyslalia: acoustic-phonemic, articulatory-phonemic, articulatory-phonetic.

Acoustic phonemic dyslalia . It includes defects in the sound design of speech, due to the selective unformedness of phoneme processing operations according to their acoustic parameters in the sensory link of the speech perception mechanism. Such operations include identification, recognition, comparison of acoustic features of sounds and decision making about a phoneme.

The violation is based on the insufficient formation of phonemic hearing, the purpose of which is to recognize and distinguish the phonemes that make up the word. With this violation, the system of phonemes in the child is not fully formed (reduced) in its composition. The child does not recognize this or that acoustic sign of a complex sound, according to which one phoneme is opposed to another. As a result, during the perception of speech, one phoneme is likened to another on the basis of the commonality of most features. In connection with the ignorance of one or another sign, the sound is recognized incorrectly. This leads to a misperception of words (mountain - "bark", beetle - "pike", fish - "fish"). These shortcomings interfere with the correct perception of speech by both the speaker and the listener.

Indistinction, leading to identification, likening, is observed in dyslalia mainly in relation to phonemes with one-dimensional acoustic differences. For example, in relation to noisy phonemes, differing in terms of deafness-voicedness, some sonorous phonemes (r - l) and some others. In cases where one or another acoustic feature is differential for a group of sounds, for example, deafness-sonority, the perception of the entire group is defective. For example, voiced, noisy, which are perceived and reproduced as deaf pairs (w - w, d - t, g - k, s - s, etc.). In a number of cases, the opposition in the group of explosive or sonorous consonants is violated.

With acoustic-phonemic dyslalia, the child does not have hearing impairment. The defect comes down to the fact that the function of auditory discrimination of some phonemes is not selectively formed in him.

From acoustic-phonemic dyslalia should be distinguished more gross violations, extending to the perceptual and semantic levels of speech perception processes and leading to its underdevelopment.

Articulatory-phonemic dyslalia . This form includes defects caused by the unformed operations of selecting phonemes according to their articulatory parameters in the motor link of speech production. There are two main types of violations. In the first case, the articulatory base is not fully formed, reduced. When choosing phonemes, instead of the desired sound (absent in the child), a sound is selected that is close to it in terms of a set of articulatory features. The phenomenon of substitution, or the replacement of one sound with another, is noted. The sound is simpler in articulation as a substitute.

In the second variant of the violation, the articulatory base is fully formed. All the articulatory positions necessary for the production of sounds have been mastered, but when selecting sounds, an incorrect decision is made, as a result of which the sound image of the word becomes unstable (the child can pronounce the words correctly and incorrectly). This leads to mixtures of sounds due to their insufficient differentiation, to their unjustified use.

Substitutions and mixing in this form of dyslalia are carried out on the basis of the articulatory proximity of sounds. But, as in the previous group of disorders, these phenomena are observed mainly between sounds or classes of sounds that differ in one of the signs: whistling and hissing with - w, h - w (rat - "roof"), between explosive noisy front-lingual and posterior lingual t - k, d - g (Tolya - “Kolya”, goal - “dol”), between lingual hard and soft phonemes paired in articulation with - s, l - l, t - t (garden - “sit down”, onion - “hatch”, tuk - “bale”), etc. These phenomena can be observed among sounds that are the same in the way of formation, between the affricates c and h (“chicken” - chicken, “shout” - shout), sonors r and l (“lyba” - fish, “brine” - paw).

With this form of dyslalia, the child's phonemic perception is most often fully formed. He distinguishes all phonemes, recognizes words, including words-paronyms. The child is aware of his defect and tries to overcome it. In many cases, this auditory-guided self-correction is successful. This is evidenced by some comparative data on the prevalence of mixtures and substitutions of sounds at different age stages of children's development. For example, substitutions p - l at 5 years old account for 42% of all sound disorders p, at 6 years old - 34%, at 7 years old - 18%, at 8-9 years old - 18%; substitutions l - p in 5 years are 9%, in 6 years - 5%, in 7 years and subsequent years are not observed; substitutions w - s, w - h in 5 years account for 50% of all violations of hissing, in subsequent years - 23--26% (Data from M.A. Aleksandrovskaya). The tendency to overcome the substitutions and mixing of sounds in children in the process of their development is noted in the works of many researchers (A. N. Gvozdeva, V. I. Beltyukov, O. V. Pravdina, etc.). At the same time, the authors note that not all children achieve complete overcoming of shortcomings. Among students secondary school(Grades I-II) pronunciation deficiencies of the phonemic order are at least 15%. By the end of training in the initial link, they meet singly.

Defective pronunciation in this form of dyslalia is not due to motor disorders proper, but to a violation of the operations of selecting phonemes according to their articulatory features. The child copes with tasks to imitate complex speech sounds requiring for their implementation certain ways of speech organs; often produces sounds that are more complex in motor terms and replaces with them the missing sounds that are the simplest in articulation.

Articulatory-phonetic dyslalia . This form includes defects in the sound design of speech, due to incorrectly formed articulatory positions.

Sounds are pronounced irregularly, distorted for the phonetic system of a given language, which is formed in a child with this form of dyslalia, but phonemes are realized in unusual variants (allophones). Most often, the wrong sound in its acoustic effect is close to the right one. The listener correlates this variant of pronunciation with a certain phoneme without much difficulty.

Another type of distortion is also observed, in which the sound is not recognized. In such cases, they speak of a skip, an elision of sound. The case of missing sounds with this form of dyslalia is a rare phenomenon (more common with other, more severe defects, for example, with alalia). In dyslalia, an analogue of sound, purely individual in its acoustic effect, performs the same phonemic function in the child's speech system as the normalized sound.

Not all sounds are disturbed: for example, with various individual features pronunciation, the acoustic effect during the pronunciation of labial (plosive and sonorous) consonants, as well as front-lingual explosive and sonorous consonants, is within the normal range. There are almost no distortions of the labio-dental f - f, c - c.

The main group of sounds in which distorted pronunciation is observed are front-lingual non-plosive consonants. Defective pronunciation of posterior lingual explosive consonants and middle lingual is less often observed.

Front-lingual non-explosive consonants are sounds that are complex in articulation, mastering their correct pattern requires subtle differentiated movements. When pronouncing, the child cannot rely on those movements that he had previously formed in connection with biological acts, for example, when mastering labial consonants or explosive front-lingual ones. These sounds are formed in him later than others, because he must master new sets of movements intended for pronunciation.

In the course of mastering pronunciation skills and abilities, the child, under the control of his hearing, gradually gropes for those articulatory positions that correspond to the normal acoustic effect. These positions are recorded in the child's memory and later reproduced as needed. When finding the correct patterns, the child must learn to distinguish patterns that are close in pronunciation of sounds, and develop a set of speech movements necessary for the reproduction of sounds (F. F. Pay). The process of developing speech movements is associated with specific difficulties, since adequate and inadequate sounds act as intermediate links, which in the Russian language do not have a meaningful function. In some cases, such an intermediate sound-substitute for the development of pronunciation, close to the desired sound in terms of acoustic effect, begins to acquire a semantic (phonemic) function. It is accepted by the child's phonetic hearing as normalized. His articulation is fixed. In the future, the sound usually does not lend itself to self-correction due to the inertia of articulatory skills. These defects, in contrast to the defects of the previous groups, tend to be fixed.

To indicate the distorted pronunciation of sounds, international terms are used, formed from the names of letters Greek alphabet with the suffix - ism:rotacism- pronunciation defect R And R, lambdacism -- l And l,sigmatism- whistling and hissing sounds, iotacism - iot(j), cappacism - to And k, gamacism - g And g, hitism-- X And X. In cases where a sound replacement is noted, the prefix is ​​added to the name of the defect. pair:pararotacism, parasigmatism, etc.

The grouping of pronunciation defects and the terms by which they are designated are not suitable for describing violations of the Russian pronunciation system. For example, two terms are superfluous to designate a violation of back-lingual consonants, but they are appropriate for those languages ​​in which geeks turn out to be different in the way they are formed. To characterize a number of consonants, this system is insufficient: there is no name for defects in fricative sibilant sh and zh, for defects in affricates. Since in the phonetic system Greek there were no such sounds, there were no corresponding names. In this regard, they were conditionally combined into a group of sigmatisms, in addition to defects in the pronunciation of whistling, and defects in other sounds - fricative sibilants and affricates.

A distorted pronunciation disorder is characterized by the fact that, for the most part, a homogeneous defect is observed in groups of sounds that are similar in articulatory characteristics. For example, in a pair of deaf-voiced sounds, the distortion turns out to be the same: s is violated in the same way as s, and w as w. The same applies to hardness-softness pairs: s is violated as s. The exception is the sounds r and r l and l: hard and soft are violated in different ways. Hard ones can be broken, while soft ones are not broken.

2.5 Atlevels of impaired pronunciation

Many authors note that in a number of cases children correctly use sound in isolation, in syllables, and sometimes in words and in reflected speech, and in independent speech do not use (M. A. Alexandrovskaya). Similar phenomena are noted in the works of M. E. Khvattsev, O. V. Pravdina, K. P. Becker, and others. These data indicate that the pronunciation skills of children correlate with the degree of complexity of the type of speech activity.

O. V. Pravdina identifies three levels of impaired pronunciation:

Inability to correctly pronounce a sound or a group of sounds;

Incorrect pronunciation of them in speech with the correct pronunciation in isolation or in light words;

Insufficient differentiation (mixing) of two sounds close in sound or in articulation with the ability to correctly pronounce both sounds.

The selected levels reflect the stages of sound assimilation in the process of child development, identified by A. N. Gvozdev. These data indicate that a child with impaired pronunciation goes through the same stages of sound acquisition as a normal child, but at some of the stages he may linger or stop.

K. P. Becker and M. Sovak distinguish sound, syllabic and verbal dyslalia. More justified is the level division of dyslalia, and not the division into different forms, since the facts indicate that we should talk about the degree of formation of skills in the same form.

3. Mmethod of speech therapy impact on dyslalia

The main goal of speech therapy influence in dyslalia is the formation of skills and abilities for the correct reproduction of speech sounds. In order to correctly reproduce speech sounds (phonemes), a child must be able to: recognize speech sounds and not mix them in perception (i.e., recognize sound by acoustic features; distinguish normalized pronunciation of sound from non-normalized; exercise auditory control over their own pronunciation and evaluate the quality sounds reproduced in one’s own speech; take the necessary articulatory positions that provide a normalized acoustic effect of sound: vary the articulation patterns of sounds depending on their compatibility with other sounds in the speech stream; accurately use the desired sound in all types of speech.

The speech therapist must find the most economical and effective way to teach the child pronunciation.

With the correct organization of speech therapy work, a positive effect is achieved with all types of dyslalia. With mechanical dyslalia, in some cases, success is achieved as a result of joint speech therapy and medical intervention.

A prerequisite for success with speech therapy is the creation of favorable conditions for overcoming the shortcomings of pronunciation: emotional contact of a speech therapist with a child; an interesting form of organizing classes, corresponding to the leading activity that encourages the cognitive activity of the child; a combination of work methods to avoid his fatigue.

3.1 Basic etapasspeech therapy workwith dyslalia

There is no consensus in the literature on the question of how many stages the speech therapy effect is divided into in dyslalia: in the works of F. F. Pay, two are distinguished, in the works of O. V. Pravdina and O. A. Tokareva - three, in the works of M. E. Khvattseva - four.

Since there are no fundamental differences in understanding the tasks of speech therapy in dyslalia, the allocation of the number of stages is not of a fundamental nature.

Based on the goals and objectives of speech therapy impact, it seems justified to single out the following stages of work: preparatory stage; the stage of formation of primary pronunciation skills and abilities; the stage of formation of communicative skills and abilities.

I. Preparatory stage

Its main goal is to include the child in a targeted speech therapy process.

One of the important general pedagogical tasks is the formation of a mindset for classes: a speech therapist must establish a trusting relationship with the child, win him over, adapt him to the environment of the speech therapy room, arouse his interest in classes and the desire to join them.

II.The stage of formation of primary pronunciation skills and abilities.

The purpose of this stage is to form in the child the initial skills of the correct pronunciation of sound on specially selected speech material. Specific tasks are: staging sounds, developing skills for their correct use in speech (automation of skills), as well as the ability to select sounds without mixing them together (differentiate sounds).

The need to solve these problems in the process of logopedic work follows from the patterns of ontogenetic mastery of the pronunciation side of speech.

Setting the sound is achieved by applying the techniques described in detail in the literature. In the works of F. F. Pay, three methods are distinguished: By imitate(imitative), mechanical And mixed.

III. Stageformation communication skills and skills

Its purpose is to form in the child the skills and abilities of the unmistakable use of speech sounds in all situations of communication.

In the classroom, texts are widely used, and not individual words, various forms and types of speech are used, creative exercises are used, material is selected that is saturated with certain sounds. This material is more suitable for sound automation classes. But if at this stage the child works only on specially selected material, then he will not master the selection operation, since the frequency of this sound in special texts exceeds their normal distribution in natural speech. And the child must learn to operate with them.

4. Erased dysarthria. Historical aspect.The term "erased dysarthria"

The term "erased" dysarthria was first proposed by O.A. Tokareva, who characterizes the manifestations of "erased dysarthria" as mild (erased) manifestations of pseudobulbar dysarthria, which are particularly difficult to overcome.

A different definition of such a speech disorder was proposed by A.N. Root. He defines this disorder as selective, non-rough, but rather persistent violations of sound pronunciation, which are accompanied by mild, peculiar disorders of the innervation insufficiency of the articulatory organs.

Erased dysarthria (mild degree of dysarthria, MDD - minimal dysarthria disorders) in speech therapy practice is one of the most common and difficult to correct violations of the sound-producing side of speech.

A study of the neurological status of children with erased dysarthria reveals certain abnormalities in the nervous system, manifested in the form of a mild predominant unilateral syndrome. Paretic symptoms are observed in the articulatory and general muscles, which is associated with a violation of the innervation of the facial, glossopharyngeal or hypoglossal nerves (G.V. Gurovets, S.I. Maevskaya).

Erased dysarthria is very common in speech therapy practice. The main complaints in erased dysarthria are slurred, inexpressive speech, poor diction, distortion and replacement of sounds in words that are complex in syllabic structure, etc.

Erased dysarthria is a speech pathology manifested in disorders of the phonetic and prosodic components of the speech functional system and resulting from an unexpressed microorganic lesion of the brain (L.V. Lopatina).

Diagnosis of erased dysarthria and methods of corrective work have not yet been developed enough. In the works of G.G. Gutsman, O.V. Pravdina, L.V. Melekhova, O.A. Tokareva, R.I. Martynova discusses the symptoms of dysarthric speech disorders, in which there is "washing out", "erasing" of articulation. The authors note that erased dysarthria in its manifestations is very similar to complex dyslalia. In the works of L.V. Lopatina, N.V. Serebryakova, E.Ya. Sizova, E.K. Makarova and E.F. Sobotovich raises issues of diagnosis, differentiation of education and speech therapy work in groups of preschoolers with erased dysarthria.

Among the causes of erased dysarthria, various authors have identified the following:

1. Violation of the innervation of the articulatory apparatus, in which there is a deficiency of individual muscle groups (lips, tongue, soft palate); inaccuracy of movements, their rapid exhaustion due to damage to certain parts of the nervous system.

2. Movement disorders: difficulty in finding a certain position of the lips, language, necessary for pronouncing sounds.

3. Oral apraxia.

4. Minimal brain dysfunction.

The anamnesis of children with erased dysarthria, Mastyukov, Lopatin, Arkhipova, Karelina and others reveal the following factors: unfavorable course of pregnancy; asphyxia, low Apgar score at birth, the vast majority of children in the first year of life diagnosed with PEP - perinatal encephalopathy.

4.1 Clinical and pedagogical characteristics of children with erased dysarthria

Erased dysarthria is a complex speech disorder characterized by the variability of violations of the components of speech activity: articulation, diction, voice, breathing, facial expressions, melodic-intonational side of speech.

Erased dysarthria is characterized by the presence of symptoms of a microorganic lesion of the central nervous system: insufficient innervation of the speech organs - the head, articulatory and respiratory sections; violation of muscle tone of the articulatory and mimic muscles.

To diagnose this disorder, it is necessary to pay attention to the presence of neurological symptoms and conduct dynamic monitoring in the process of corrective work: if during an outpatient examination, a psychoneurologist immediately detects organic neurological symptoms, then such forms can rightfully be attributed to dysarthria. Often there are children who have no symptoms during a single examination.

For the first time, an attempt to classify the forms of erased dysarthria was made by E.N. Vinarskaya and A.M. Pulatov based on the classification of dysarthria proposed by O.A. Tokareva. The authors singled out mild pseudobulbar dysarthria and noted that pyramidal spastic paralysis in most children is combined with a variety of hyperkinesias, aggravated during speech.

In the studies of E.F. Sobotovich and A.F. Chernopolskaya for the first time noted that the shortcomings of the sound side of speech in children with "erased dysarthria" are manifested not only against the background of neurological symptoms, but also against the background of a violation of the motor side of the process of sound pronunciation. Depending on the manifestations of violations of the motor side of the process of pronunciation and taking into account the localization of paretic phenomena of the organs of the articulatory apparatus, the authors identified four groups of children and identified the following types of erased dysarthria:

Igroup: Violations of sound pronunciation caused by selective inferiority of some motor functions of the speech-motor apparatus;

IIgroup: Weakness, lethargy of the articulatory muscles.

These two groups belong to the erased form of pseudobulbar dysarthria.

IIIgroup: Clinical features of sound pronunciation disorders associated with difficulty in performing arbitrary motor acts;

IVgroup: Defects in the sound side of speech in children with various forms of motor insufficiency.

4.2 Features of phonetic disorders in children with erased dysarthria

At the initial acquaintance with the child, his sound pronunciation is assessed as complex dyslalia or simple dyslalia. When examining sound pronunciation, the following are revealed: mixing, distortion of sounds, replacement and absence of sounds, i.e. the same options as with dyslalia. But, unlike dyslalia, speech with erased dysarthria has violations of the prosodic side.

Sounds with erased dysarthria are set in the same ways as with dyslalia, but for a long time they are not automated and are not introduced into speech. The most common violation is a defect in the pronunciation of hissing and whistling. Children with erased dysarthria distort, mix not only articulatory complex and similar in place and method of formation sounds, but also acoustically opposed ones.

Quite often, interdental pronunciation, lateral overtones are noted. Children experience difficulties in pronouncing words of a complex syllabic structure, simplify the sound filling, omitting some sounds when consonants collide.

Many researchers note that phonetic disorders are common, leading in the structure of a speech defect in children with erased dysarthria.

But with erased dysarthria, the cause and mechanism of disorders are different than with dyslalia. With erased dysarthria, disturbances in sound pronunciation and prosodic components of speech are due to organic insufficiency of innervation of the muscles of the speech apparatus. With dyslalia, there are no violations of the innervation of the muscles of the speech apparatus.

Most authors believe that all children are characterized by polymorphic impairment of sound pronunciation. The prevalence of impaired pronunciation of various groups of sounds in children is characterized by certain features that are due to the complex interaction of speech-auditory and speech-motor analyzers and the acoustic proximity of sounds.

In the studies of L.V. Lopatina provides static data and polymorphic data are given as follows:

Violation of two phonetic groups of sounds - 16.7%;

Violation of three phonetic groups of sounds - 43.3%;

Violation of four or more phonetic groups of sounds - 40%.

The most preserved are the posterior lingual and the sound "j".

The most common in schoolchildren with erased dysarthria are violations of the pronunciation of whistling sounds. They are followed by violations of the pronunciation of hissing sounds. Less common are violations of the pronunciation of the sonor "r" and "l".

The nature of the violation of the sound pronunciation of sounds in children with erased dysarthria, according to Lopatina, is determined by the ratio of the acoustic and articulatory characteristics of various groups of sounds. Groups of acoustically close sounds are assimilated worse than groups of sounds that are acoustically more distant, although more complex in articulation. This confirms the presence in children of certain disorders of auditory perception of speech and phonemic hearing, in connection with which the acoustic proximity of sounds has a negative effect on the acquisition of correct pronunciation.

Research by O.Yu. Fedosova show that the features of sound pronunciation in children with erased dysarthria proceed as follows: violations manifest themselves depending on phonetic conditions and are in some cases intermittent. Depending on this, the sound can be pronounced differently: in some cases, the sound is pronounced correctly, in others it is distorted or even replaced. The nature of pronunciation depends on the place of the sound in the word, on the length of the word and on the syllabic side of the word, on the expansion of the context.

The most favorable for the correct pronunciation of sounds is the strong (shock) position of the sound, its presence at the beginning of a word and in words of a simple syllabic structure.

4. 3 Features of the formation of phonemic hearing in children with erased dysarthria

Violations in the formation of phonemic hearing in children with erased dysarthria may be secondary. Such disorders are observed in the pathology of speech kinesthesias that occur with motor lesions of the organs of speech, a violation of phonemic hearing of a secondary nature manifests itself in children with erased dysarthria, and the degree of its severity depends on the severity of the dysarthria itself. Children perform poorly exercises in distinguishing words that are similar in sound (on the basis of pictures), in selecting pictures for a given sound, in recognizing syllables, etc.

Due to the presence of pathological symptoms in the articulatory apparatus, motor skills are disturbed, which has a negative effect on the formation of phonemic hearing.

Violation of the clarity of articulation during speech does not allow the formation of a clear auditory perception. Often children do not control their sound pronunciation. Violation of kinesthetic control and auditory differentiation is the cause of persistent violations of the phonetic and prosodic aspects of speech.

In the majority of children in the study of rhythmic abilities in the perception and reproduction of rhythmic series, errors are noted both in determining the number of beats and in transmitting the rhythmic pattern of samples. At the same time, pronounced motor awkwardness is expressed.

All children experience pronounced difficulties in differentiating syllables and phonemes. Only after several attempts do children manage to differentiate the vowel from a number of other vowel sounds. When differentiating syllables with oppositional consonants, all children are untenable.

In some children, the main difficulties are revealed only when playing a chain of syllables (based on preserved sounds). Typical violations are expressed in the likeness of the second syllable to the first, in permutations of syllables in a chain of words.

4. 4 Features of motility in erased dysarthria

The general motor sphere of children with erased dysarthria is characterized by slow, awkward, constrained, undifferentiated movements.

There may be a limitation in the range of motion of the lower and upper limbs, mainly on the one hand, there are synkenesias, muscle tone disorders, extrapyramidal insufficiency of the motor sphere. Sometimes the mobility is pronounced, the movements are unproductive aimless.

Also impaired motility of the articulatory apparatus. This manifests itself:

1) in the difficulties of switching from one to another articulation;

2) in a decrease and deterioration in the quality of articulatory movement;

3) in reducing the time of fixation of the articulatory form;

4) in reducing the number of correctly performed movements.

Children with erased dysarthria learn self-care skills late and with difficulty: they cannot fasten a button, untie a scarf, etc. In drawing classes, they do not hold a pencil well, their hands are tense. Many children do not like to draw. Particularly noticeable motor awkwardness of the hands in the classroom for applications and with plasticine. In many children, movements are performed at different times.

The following pathological features of the articulatory apparatus are distinguished:

Paresis of the muscles of the organs of articulation is manifested in the following: the face is hypomimic, the muscles of the face are flaccid on palpation; many children do not hold the position of the closed mouth, tk. the lower jaw is not fixed in an elevated state due to the lethargy of the masticatory muscles; lips are flaccid, their corners are lowered; during speech, the lips remain sluggish and the necessary labialization of sounds is not produced, which worsens the prosodic side of speech. The tongue with paretic symptoms is thin, located at the bottom of the oral cavity, sluggish, the tip of the tongue is inactive. With functional loads (articulation exercises), muscle weakness increases.

Spasticity of the muscles of the organs of articulation is manifested in the following: the face is amimic, the muscles of the face are hard and tense on palpation. The lips of such a child are constantly in a half smile: the upper lip is pressed against the gums. During speech, lips do not take part in the articulation of sounds. Many children who have similar symptoms do not know how to perform the “tube” articulation exercise, i.e. pull your lips forward. The tongue with a spastic symptom is changed in shape: thick, without a pronounced tip, inactive.

Hyperkinesis with erased dysarthria manifests itself in the form of tremor, tremor of the tongue, vocal cords. In this case, the child cannot keep the tongue out of the mouth. Hyperkinesis of the tip of the tongue is more often combined with increased muscle tone of the articulatory apparatus.

Apraxia in erased forms of dysarthria manifests itself in the impossibility of simultaneously performing any voluntary movements with the hands and organs of articulation, i.e. Apraxia is present at all motor levels. In the articulatory apparatus, apraxia manifests itself in the inability to perform certain movements or when switching from one movement to another. Kinesthetic apraxia is noted, when the child makes chaotic movements, “groping” for the desired articulatory position.

Deviation, i.e. deviation of the tongue from the midline, also manifests itself with articulation tests, with functional loads. The deviation of the tongue is combined with the asymmetry of the lips when smiling, with the smoothness of the nasolabial fold.

Hypersalivation, i.e. increased salivation, determined only during speech. Children do not cope with salivation, do not swallow saliva, while the pronunciation side of speech and prosody suffer.

4. 5 Features of the formation of vocabulary, violations of the formation of the grammatical structure, the morphological system of the language and the syntactic structure of the sentence with erased dysarthria

N.V. Serebryakova revealed the features of vocabulary: the limited volume of the dictionary, especially the predicative one; a large number of substitutions on a semantic basis, indicating the lack of formation of semantic fields, the insufficiency of highlighting the differential features of the meanings of words; ignorance or inaccurate use of many commonly used words denoting visually similar objects, parts of objects, parts of the body; replacement of semantically close words; replacement by derivational neologisms; replacement with words of the same root and words similar in articulation; a large degree of unmotivated associations.

Lopatina identifies three groups of children that differ in the structure of the defect. These groups, identified by the author, differ in the degree of formation language tools and accordingly correlate with the group:

FN - phonetic disorder;

FFN - phonetic-phonemic disorder;

ONR - general underdevelopment of speech.

Thus, the first group (FN) is characterized by the fact that the quality and volume of the active dictionary corresponds to the age norm.

The second group with erased dysarthria (FFN) - the vocabulary is poorer than that of the first group of children.

Third (ONR) - the quality and volume of the dictionary did not meet the age norm.

Violation of the grammatical structure in children is characterized by heterogeneity, variability of symptoms: from a slight insufficiency in the formation of the morphological and syntactic system of the language to pronounced agrammatisms in expressive speech.

The main mechanism of the unformed grammatical structure of speech in children with erased dysarthria is a violation of the differentiation of phonemes, which causes difficulties in distinguishing the grammatical forms of words due to the fuzziness of the auditory and kinesthetic image of the word and especially the endings. In this regard, the morphological system of the language mainly suffers, the formation of which is closely related to the opposition of endings according to their sound composition.

The following irregular forms of a combination of words in a sentence in children with erased dysarthria (OHD) are distinguished:

Incorrect use of generic, numerical, case endings of nouns, pronouns, adjectives (“many spoons”);

Incorrect use of case endings of cardinal numbers ("there are no two buttons");

Incorrect agreement of the verb with nouns and pronouns (“children draws”);

Misuse of numbers and generic endings verbs in the past tense ("the tree fell");

Incorrect use of prepositional case constructions (“under the table”).

At the same time, both general and specific agrammatisms (occasional forms) are revealed in children. General occasionalisms are characteristic of both normal and impaired speech development.

There is a process of inflection, frequent mixing of morphemes.

Violation of the syntactic structure of a sentence is usually expressed in the omission of sentence members, most often predicates, in an unusual word order, which manifests itself even when sentences are repeated. Complex sentences are especially difficult.

As a result of the analysis of the survey data on the grammatical structure of children with erased dysarthria, the following generalizing conclusions can be drawn:

They allow omissions of words and whole parts of the sentence, distort the meaning of the sentence, permutations of words and replacement are allowed;

Many children do not notice their mistakes at all and do not correct them accordingly;

Failure to use a preposition, inability to choose the correct ending of a noun, inability to form plural nouns;

Sentence writing tasks cause difficulties, except for the simplest ones, etc.

Thus, the lack of formation of the grammatical structure of speech in children with erased dysarthria is characterized by the variability of symptoms from a slight lag in the formation of the morphological system of the language to pronounced agrammatism in expressive speech.

Deviations in the development of the grammatical structure of speech turn out to be derivative and are in the nature of secondary disorders in children with erased dysarthria.

4. 6 Prosody

Erased dysarthria is characterized by impaired pronunciation and the prosodic side of speech, which are due to the presence of neurological microsymptoms. In children, prosodic disorders affect the intelligibility, intelligibility, and emotional pattern of speech.

The perception and independent reproduction of the intonation structure, which in this case involves the auditory differentiation of narrative and interrogative intonation, cause significant difficulties for children. At the same time, the process of auditory differentiation of intonation structures is more disturbed than the process of their independent implementation. Common to children is a violation of the prosodic side of speech, which is a diagnostic criterion for differentiating erased dysarthria and dyslalia.

The intonation-expressive coloring of the speech of children with erased dysarthria is sharply reduced. The voice suffers, voice modulations in height and strength, speech exhalation is weakened. The timbre of speech is disturbed and sometimes a nasal shade appears. The pace of speech is often accelerated. When speaking, the poetic speech of the child is monotonous, gradually becomes less legible, the voice fades away. The voice of the children during speech is quiet, the modulation in height, in the strength of the voice is not possible, imitating the voices of animals: cows, dogs, etc. The children's speech is not expressive, the diction is fuzzy. Difficulties in playing the rhythm.

The reasons for the violation of prosody in erased dysarthria lie in the pathology of the efferent and afferent parts of the control of intonation and prosody in general.

5. Methods of speech therapy work with children with erased dysarthria

Many specialists dealt with the correction of dysarthria: O.V. Pravdina, E.M. Mastyukova, K.A. Semenova, L.V. Lopatina, N.V. Serebryakova, E.F. Arkhipova. All authors note the need for specific targeted work on the development of general motor skills, articulatory motor skills, fine motor skills of the fingers, as well as finger gymnastics, breathing and voice exercises.

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As for the condition of the internal organs, no gross changes were observed in both forms. In neurological status, there is a big difference between these speech disorders. So, with dyslalia, we did not observe gross lesions of the central nervous system, but only in some cases organic microsymptoms were determined. More often there was a violation of the autonomic nervous system in the form of Khvostek's symptom, persistent red dermographism, etc.

With dysarthria, neurological symptoms with the presence of paresis, hyperkinesis, with the involvement of V, VII, IX, X and XII pairs of cranial nerves in the process, were rude. The defeat of these nerves caused phonetic defects in speech, irregularity of breathing, pulse, salivation, chewing, as well as voices expressed to varying degrees.

With functional dyslalia, only the phonetic side of speech suffers predominantly; respiration, cardiac activity, motility and voice, as a rule, are not disturbed. Only in cases of rhinolalia (mechanical dyslalia), when there are anatomical defects in the palate, speech happens with a nasal tone, voice and breathing are disturbed. However, such cases are easy to differentiate from dysarthria, since there are defects in the palate or other organs of articulation. In the neurological status of such children, gross lesions of the central nervous system usually do not occur.

On the part of the psyche, dyslalics generally did not show any deviations from the age norm. Sometimes there were temporary delays in mental development. In some cases, dyslalia proceeded against the background of oligophrenia. With dysarthria, mental retardation of the organic type, and sometimes oligophrenia, are more common. The emotional-volitional sphere and character) of dyslalics suffer only in some cases, in dysarthria, in most cases, difficult behavior is observed with an unstable mood, accompanied by crying, often there are affective outbursts ...