Dysarthria of speech in a child is a disease resulting from damage to the central and peripheral parts of the nervous system. It is characterized by a wide range of speech and movement disorders.
Main reasons
Dysarthria is rarely a separate pathology, often occurs against the background of various disorders of the nervous system. The reasons for its occurrence can be:
- CP;
- meningitis;
- encephalitis;
- neurosyphilis;
- traumatic brain injury;
- stroke;
- purulent otitis media;
- neoplasms in the brain;
- multiple sclerosis;
- myasthenia gravis;
- cerebral atherosclerosis;
- oligophrenia.
Often the disease is a symptom of cerebral palsy. Accordingly, the causes of the onset of the disease are similar to the causes of cerebral palsy.
Therefore, dysarthria in preschool children may result from:
- intrauterine hypoxia;
- toxicosis;
- Rh conflict;
- birth injury;
- presence of a somatic disease in a woman;
- genericpathology;
- asphyxia;
- hemolytic disease;
- prematurity.
Causes of the post-embryonic period
In the postembryonic period, the development of this disease can be caused by a neuroinfection, for example:
- meningitis;
- hydrocephalus;
- severe intoxication of the body;
- traumatic brain injury.
Also cause dysarthria are multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, myotonia, myasthenia gravis, cerebral atherosclerosis.
Symptoms
There are certain factors that will help parents see the presence of this pathology in a child.
Of course, it is necessary to consult a specialist in any case.
Symptoms of dysarthria include:
- The presence of weakness of the articulatory muscles. You can see it by various factors, for example, if the child's mouth is open and the tongue falls out, the lips are strongly compressed, or, conversely, salivation is increased.
- Feeling like the baby is talking through the nose (no runny symptoms). There is a distortion of sounds in words, which is why speech is not entirely clear.
- Speech breathing is impaired, when talking, the child may suffocate and begin to breathe rapidly.
- Voice changes, it becomes high and squeaky.
- Difficulties arise with the melodiousness of speech. Children with this diagnosis cannot change pitch, their speech is monotonous, and they speak too quickly orslowly, but almost always their speech is incomprehensible.
Parents' task
Parents should be very attentive to the development of their child. At a very early age, speech disorders in a child can already be detected. The sooner the violation is detected, the better, because there will be more time to contact doctors and prepare for school. Some forms of the disease (through treatment) allow children to be educated in schools, and for the rest there are certain educational programs.
Classification
The classification of this pathology in children is rather controversial. This is due to the fact that CNS disorders acquired in utero or in early childhood are significantly different from pathological changes in adulthood.
Also of great importance is the fact that impairments to speech and motor skills are superimposed on the period of their active development.
There are several types of classifications of dysarthria in children, but they also have common features. For example, almost all doctors do not distinguish bulbar dysarthria, which is present in the adult classification. This is due to the fact that the dysfunction of the medulla oblongata observed in this pathology is incompatible with the life of the newborn. For all types of dysarthria, the following symptoms are characteristic:
- Disturbances in the articulation of speech and its motor skills.
- Change or underdevelopment of speech tempo and voice formation.
- Impaired muscle tone resulting in difficulty in facial expressions.
- Speech slowdowndevelopment.
- Sometimes the clinical picture is supplemented by movement disorders, changes in various types of perception, mental disorders, intellect.
Some doctors classify children's dysarthria according to speech disorders.
Speech defects are invisible to others. They can only be established by a speech therapist through special examinations. The following stages are distinguished here:
- Speech impairments are noticeable to strangers, but generally intelligible.
- Speech is slurred. Only relatives can make it out.
- Speech is missing or so incomprehensible that no one can make it out.
Localization
There is also a classification of the disease by location:
- pseudobulbar;
- subcortical;
- cortical;
- cerebellar.
However, this approach is more applicable to the classification of pathology in adults.
Characteristics of clinical forms
Dysarthria is a group of speech disorders associated with pathological changes in the nervous system. Patients have a fuzzy blurred articulation, a violation of the pace and volume of speech. Forms of dysarthria in children:
- Bulbar dysarthria. Associated with lesions of the nuclei of the glossopharyngeal, trigeminal, facial, vagus, hypoglossal nerves. Patients have areflexia (violation of the integrity of the reflex arc), amimia (difficulty in facial expressions). Patients complain of increased salivation, difficulty in chewing, swallowing food. Speech is slurred. Allconsonants are reduced to a single fricative sound. Sound differentiation is not possible. There may be nasalization of timbre, dysphonia (weakness, hoarseness of voice) or aphonia (loss of sonority of the voice while maintaining the ability to speak in a whisper).
- Pseudobulbar obliterated dysarthria in children. Violations occur as a result of spastic paralysis and muscle hypertonicity. Among the symptoms of difficulty in raising and lowering the tongue, moving it from side to side, increased salivation. Changing articulatory positions is difficult. There are violations of some voluntary movements. Speech is slurred and slurred. Whistling and hissing sounds are difficult.
- Subcortical dysarthria. The main symptom is the presence of hyperkinesis (involuntary muscle movements). Observed including in the area of facial muscles. Occurs at rest and when trying to speak. Patients complain of a change in the timbre and strength of the voice. Sometimes they may make involuntary guttural sounds.
- Cerebellar dysarthria. It is manifested by violations of speech coordination, as a result of which jerky chanted speech occurs. Sometimes individual sounds, screams can be observed. Patients complain of tremor of the tongue. Anterior lingual and labial sounds are difficult. There is ataxia (impaired balance, unsteady gait).
- Cortical erased dysarthria in children. It is characterized by the presence of deviations in arbitrary articulation. There are violations of timbre and voice. There are no prosody. In various forms of this pathology, there may be difficulties in sound pronunciation, impaired reading, writing,speech comprehension.
Diagnosis
Specialists do not diagnose dysarthria until they study the characteristics of the child's psyche. The above study should fully evaluate the developmental picture and determine the deviation in the work of the central nervous system. To identify, you need to know the features of the stages of formation of the central nervous system of the child.
There are three stages:
- The first stage at the age of six months. During this period, in he althy children and in children diagnosed with dysarthria, involuntary motor reflexes are observed, for example, a stepping reflex, a grasping reflex. The body of the child is compressed, the arms are tense, the legs are bent. At the end of the first stage in he althy children, there is a transition to the normalization of movements. If this does not happen, then the disorder of the central nervous system is specified in the child.
- Second stage at the age of six months to 11 months. This stage in he althy children is characterized by a transition from involuntary to active movements, for example, a child can sit independently, distinguish sounds, people, the meaning of words, objects. The baby develops babble from individual vowels.
- The third stage at the age of one to three years. At this stage, a he althy child has subtle hand movements. At the beginning of the stage, he crawls, and at the end he begins to walk. Begins to accumulate words. In children with erased dysarthria, speech is formed. If the child develops normally, then when pronouncing words, breathing is smooth and without inexplicable pauses. If at the end of the third stage the child does notthe above signs are detected, then we can talk about a disorder of the central nervous system.
The above steps allow you to timely identify violations of speech development in a child. Treatment of dysarthria in children is carried out only after diagnosis!
Correction
Correction of the characteristics of children with dysarthria can be prescribed by a neurologist, and the procedure itself involves taking measures to eliminate articulate speech disorders, because the disease itself leads to impaired pronunciation, and sometimes to difficulties with articulation. Correction of dysarthria should be carried out in a complex, including drug treatment and physiotherapy.
The neurologist usually prescribes to such patients:
- vascular preparations: "Cavinton", "Vinpocetine", "Instenon", "Gliatilin";
- nootropic drugs – Pantocalcin, Nootropil, Encephabol, Picamilon;
- metabolic drugs - Cerebrolysate, Actovigin, Cortexin, Cerebrolysin;
- vitamin complexes - "Milgamma", "Neuromultivit";
- sedatives - Persen, Novopassit, Tenoten.
One of the most effective methods of physiotherapeutic correction of dysarthria is massage. It is done with great care, because forceful pressure can lead to the restoration of the oral reflex.automation.
Recommendations
Working with children with dysarthria includes:
- Massaging the nasolabial folds. To do this, make from 5 to 7 movements from the nose to the lips, light tapping on the nasolabial folds. You can also massage this part with zigzag, wavy and spiral movements. Acupressure can be done at the corners of the lips.
- Massage lips. It is done with two fingers from the middle of the upper and lower lips to the corners. Additionally, you can make spiral movements along the upper and lower lip, similar movements along the middle part of the lips. It is also recommended to tingle on the middle part of the lips.
- Massage of the sky. To do this, with the help of two fingers, the sky is massaged, starting from the front teeth to the middle of the oral cavity. Before the procedure, hands should be wrapped in gauze.
Also do tapping from the incisors, zigzag, undulating, circular motions. In addition, massaging the tongue, which uses the movements described above, will be useful.
Forecast and prevention
A positive prognosis for correcting pronunciation in dysarthria can only be obtained with timely initiation of treatment. The success of treatment largely depends on the clarity of the set therapy regimen and the diligence of the patient himself.
Erased dysarthria has a positive prognosis for complete normalization after a full correction. Patients with this dysarthria can attend mainstream schools after correction.
Acute forms of dysarthria completelyare not corrected. In patients with such dysarthria, only an improvement in speech function is possible. Prevention of dysarthria in children is reduced to the use of such methods of correction as echolalia and echopraxia.
The phenomenon of dysarthria manifests itself in newborns after a month of life. Therefore, if at birth there are hereditary diseases that can cause illness, then the development of the child from the first days should be organized so that everything contributes to the correct formation of his movements and psyche.
Prevention in this case consists in the constant communication of the child with adults, which will contribute to the development of his speech abilities.
Prevention of dysarthria in children with brain lesions is to prevent neuroinfections, brain injuries, toxic effects.
