In recent years, various types of dysarthria are increasingly observed in children of different ages. This diagnosis is very common, however, it frightens many parents. It manifests itself in the form of dysfunctions of the speech apparatus during sound pronunciation due to insufficient communication between tissues and cells and nerve endings. In addition, insufficient lability of facial expressions and other organs of speech are common symptoms of various types of dysarthria. Such restrictions significantly impede full articulation.
Because of what happens
The causes of delayed speech development can be different factors, therefore, at the first signs of the development of this defect, it is necessary to contact narrow-profile specialists and begin appropriate treatment.
In most cases, dysarthria, as a type of speech development disorder, occurs against the background of cerebral palsy and has the same causes of development. Lesions in the central nervous system occur at different stages of embryonic development, during childbirth or in the early stages of a child's development.
CNS lesions and speech development in children
The main factors for the development of various types of dysarthria in children are complications during pregnancy: toxicosis, threatened miscarriage, chronic pathologies in the mother, pathologies during pregnancy, fetal hypoxia or birth asphyxia and other undesirable conditions.
The severity of articulation disorders is directly related to the degree of impairment of motor functions in cerebral palsy. So, for example, with hemiplegia, dysarthria or anarthria is diagnosed in almost all patients.
The causes of the development of various types of dysarthria in cerebral palsy can be infectious diseases, intoxications and injuries during pregnancy or a conflict between the Rh factors of the mother and fetus, as well as CNS lesions in early childhood that occur after neuroinfections, purulent otitis media, hydrocephalus, traumatic brain injury and intoxication.
Speech disorders in adults
Different types of dysarthria in adults can appear after the development of a stroke, brain injury, surgery and neoplasms in the brain. Speech disorders can occur in patients with some forms of sclerosis, myasthenia gravis or syringobulbia. Dysarthria is common in Parkinson's disease, myotonia, neurosyphilis, and mental retardation.
Types of speech defects
Various speech disorders have several varieties and depend on the location of the lesion. There are the following types of dysarthria:
- Bulbarnaya. Characterized by the defeat of a large numbernerve endings, leading to paralysis of the muscles involved in sound pronunciation and facial expressions. This dysfunction is accompanied by difficulty in swallowing food.
- Pseudobulbar. It occurs when damage and dysfunction of some parts of the brain leads to paralysis of the muscles of the speech apparatus. The main difference between this violation is the monotony and inexpressiveness of the speech.
- Cerebellar. Disturbances due to damage to the cerebellum of the brain. In this case, the instability of the structure of speech is characteristic - the stretching of spoken words with a constantly changing volume.
- Cork. Occurs with unilateral damage to the cerebral cortex, with a violation of some structures. In this case, the general structure of sound pronunciation remains, but the child's conversation contains incorrect pronunciation of syllables.
- Subcortical (sometimes called hyperkinetic and associated with extrapyramidal). Occurs due to damage to the subcortical nodes of the brain. This type of dysarthria in children is characterized by slurred speech with a nasal tinge.
- Extrapyramidal. There is damage to the areas of the brain that are responsible for the activity of the facial muscles.
- Parkinsonian. Occurs with the development of Parkinson's disease and manifests itself in the form of monotonous, slow speech.
- Erased form. Accompanied by violations in the process of pronunciation of hissing and whistling sounds.
- Cold. It is a symptom of myasthenia gravis (neuromuscular pathology). This type of dysarthria is characterized by difficulty in speech due to changes in the ambient temperature of the place wherethere is a child.
For the diagnosis of speech disorders and difficulties in sound pronunciation, various methods are used. Only after determining the exact diagnosis, an appropriate course of treatment is prescribed, since types of dysarthria differing in localization manifest themselves in different ways and require individual treatment in each case.
Main signs and symptoms of dysarthria
Only a qualified specialist can characterize the present violations of the sound pronunciation of a child, however, parents themselves can identify some manifestations of dysarthria. Usually, in addition to speech disorders, a small patient has inconsistent speech with changes in the tempo and melody of speech. Common characteristics of all types of dysarthria can be such manifestations:
- Violation of speech breathing is clearly noticeable: by the end of the phrase, speech seems to fade, and the child begins to choke or breathe more often.
- Voice disturbances are heard: usually in children with dysarthria it is too high or squeaky.
- Violations of the melodiousness of speech are noticeable: the child cannot change the pitch, speaks monotonously and inexpressively. The flow of words sounds too fast or vice versa slow, but in both cases it is not clear.
- Child seems to be talking through his nose, but there is no sign of a runny nose.
- There are different types of sound pronunciation disorders in dysarthria: the pronunciation is distorted, skipped or replaced by other sounds. And this is notrefers to a single sound - several sounds or sound combinations may not be pronounced at once.
- Severe weakness of the articulatory muscles can manifest itself in different ways. If the mouth is open, then the baby's tongue spontaneously falls out, the lips may be too compressed or, on the contrary, be too sluggish and not closing, and there may be increased salivation.
Some signs of sound pronunciation disorders are noticeable even in early childhood. Therefore, most attentive parents turn to specialists in a timely manner, which allows them to successfully prepare their child for school. With effective treatment of some forms of dysarthria, the child can freely study in a regular school. For other cases, there are special correctional training programs, since with severe violations in the development of the speech apparatus, it is impossible to fully develop reading and writing skills.
Dyslalia and rhinolalia: causes and types
Examination of dysarthria often reveals other types of sound pronunciation disorders that are characteristic of children and adults with normal hearing and preserved innervation of the speech apparatus. In this case, functional or mechanical dyslalia may be identified.
Functional speech disorders in the case of dyslalia are associated with a dysfunction in the acquisition of the pronunciation system in childhood. The causes of this disorder may be related to:
- general physical weakness of the body due to frequent diseases during the formationspeech apparatus;
- deficiency in the development of phonemic hearing;
- pedagogical neglect, unfavorable social and speech conditions in which the child develops;
- bilingual communication with a child.
Functional dyslalia is divided into motor and sensory. They are due to the appearance of neurodynamic shifts in the parts of the brain responsible for speech (in the first case) and for the hearing apparatus (in the second case).
Depending on the manifestations of certain signs, there are such types of dyslalia as acoustic-phonemic, articulatory-phonemic and articulatory-phonetic.
Mechanical dyslalia can appear at any age due to damage to the peripheral system of the speech apparatus. The reasons for the appearance of this form of violation of sound pronunciation can be:
- deficiencies and defects in the structure of the jaws and dentition;
- anomalies in the structure of the frenulum of the tongue;
- changes in the structure and form of the tongue;
- violations in the structure of the hard and soft palate;
- Atypical lip structure.
Correction of dyslalia
Usually, dyslalia is successfully eliminated. However, the effectiveness and period of correction depend on the age and individual characteristics of the patient, as well as on the regularity and completeness of classes with a speech therapist and the participation of parents.
It is known that in young children this defect is eliminated much faster and easier than in high school students.
Rhinolalia: causes andclassification
Violations of timbre, tempo and melodiousness of the voice, as well as difficulty in sound pronunciation can be associated with anatomical and physiological defects of the speech apparatus. Rhinolalia occurs with congenital physiological anomalies in the structure of the hard or soft palate and nasal cavity. Such defects change the structure and functions of the speech apparatus, and hence the mechanism for the formation of sound pronunciation.
Speech therapists distinguish open, closed and mixed forms of rhinolalia. In addition, this defect may be mechanical or functional.
Open rhinology is characterized by changes in the communication between the nasal and oral cavities. This phenomenon causes the simultaneous free passage of the air flow through the nose into the mouth, which leads to the appearance of resonance during phonation. This defect has a mechanical nature of education (may be congenital or acquired).
Closed rhinolalia is due to the presence of an obstacle that limits the exit of the air stream through the nose. In the mechanical form, sound pronunciation disorders are associated with physiological dysfunctions of the pharynx and nasopharynx, resulting from the formation of polyps, adenoids, or a curvature of the nasal septum. The functional form of rhinolalia is due to the presence of hyperfunction of the soft palate, which blocks the path of the air stream into the nose.
The mixed form of rhinolalia is characterized by obstruction of the nose and insufficiency of the palatopharyngeal closure. In this case, there is a lack of nasal phonemes and a nasal voice.
Correctionrhinolalia
Disorders underlying rhinolalia require participation in the elimination of this defect of the complex interaction of specialists from different fields: dental surgeons, orthodontists, otolaryngologists, speech therapists and psychologists.
Functional rhinolalia in most cases has a favorable prognosis and is corrected with the help of special phoniatric exercises and speech therapy classes. However, in this case, the positive result of treatment depends on the period of contact with specialists, the completeness of the impact and the interest of the parents. The effect of overcoming the organic form is largely determined by the results of surgical intervention, the timing of the start and completeness of classes with a speech therapist.
Correction of speech disorders
Dysarthria, as a type of speech development disorder, requires a comprehensive therapeutic and pedagogical impact. In this case, a combination of speech therapy correction, drug treatment and exercise therapy is carried out.
Speech therapy classes
During classes with children suffering from various types of dysarthria, specialists pay special attention to the overall development of all aspects of the child's speech: replenishment of the vocabulary, development of phonetic hearing and the correct grammatical construction of phrases.
Today, special speech therapy groups are being created for this in kindergartens and speech schools. Here, mainly game corrective techniques are used using interactive simulators and special programs that allow you to quickly get rid of the problems found inpresent speech.
In addition, speech therapy massage and articulatory gymnastics are used to strengthen the muscles of the speech apparatus.
Medication treatment
To eliminate almost all types of dysarthria, special drug treatment regimens are used. The main drugs used in the elimination of speech disorders are nootropics. These funds contribute to the improvement of the higher functions of the brain: they stimulate brain activity, facilitate learning processes and improve memory. The most popular among neurologists who observe children with various speech disorders have received such drugs as Pantogam (in other words, hopantenic acid), Phenibut, Magne-B6, Cerebrolysin, Cortexin, Cerepro and many other drugs that improve the functioning of the vascular system and the brain.
Therapeutic exercise and massage
In the treatment of various types of dysarthria, special methods of therapeutic exercises are also used. These include exercises aimed at improving general motor skills and stimulating articulatory capabilities, developing auditory perception and improving the functioning of the respiratory system.
Forecast
The effectiveness of the treatment of various types of dysarthria, identified in early childhood, in most cases is uncertain. This is due to possible irreversible damage to the brain and central nervous system. The main objective of the ongoing treatment of difficult sound pronunciation- teach the child to speak so that others understand him. In addition, the complex impact further improves the perception of elementary skills of writing and reading.
