Alalia is the complete absence of speech or its underdevelopment in children with normal intelligence and hearing. This disorder is the result of damage to the speech areas of the brain during birth. It can also appear due to a disease of the nervous system or a severe trauma to the skull suffered by the child in the pre-verbal period of life. Initially, alalia was called hearing-mutism and was not treated in any way.
Alalia can be of varying degrees - from the most severe, when a child does not speak until the age of 12, to mild, more reminiscent of a general underdevelopment of speech.
Alalia is a disorder associated with brain damage, which manifests itself in a child with a lack of ability to talk. It is important to distinguish such patients from those who have impaired hearing and intelligence - with mental retardation. Children with alalia are able to respond to sounds and perceive information. Mental development can be disturbed in a child only because of alienation, pedagogical neglect, inability to master the curriculum and weak memory.
Classification
There are two main types of alalia - sensory and motor. Both violations can be corrected with an integrated approach. ATIn most cases, with timely diagnosis and compliance with all recommendations, children are able to enroll in a comprehensive school.
Sensory alalia
This problem is characterized by an initial impairment of speech perception in normal hearing. Sensory alalia appears due to damage to the temporal areas of the brain located in the left hemisphere, which are called the Wernicke center.
Children with sensory alalia do not understand speech at all or understand it in a limited way. They are able to adequately respond to sound signals, they distinguish different types of noise (rustle, knock, creak, etc.). In the speech of babies with sensory alalia, echolalia is present - this is an automatic, meaningless repetition of other people's words. Therefore, instead of answering the question, such a child may repeat the question itself.
Leading in sensory alalia is a violation of phonemic hearing, which manifests itself in varying degrees. That is, it can be an absolute indistinguishability of speech sounds or their difficult perception, manifested in the difficulties of distinguishing words that are close in sound, but different in spelling (daughter - barrel, cancer - varnish).
It is important to refer a child with sensory alalia for a consultation to specialists in a timely manner: to an otolaryngologist for a hearing test, to a neuropsychiatrist and a speech therapist.
In practice, cases of sensory alalia are quite rare, more common is a simpler form of the disease - motor.
Second type
Motor alalia is a complex of symptoms, both verbal andnon-speech, where mastery of the language is the leading one. Motor alalia in children is several times more common than sensory. How serious is this problem?
Alalia. Diagnostics and speech signs
Violation of speech in motor alalia captures all its components: lexical-grammatical and phonetic-phonemic side. It is assumed that the first problem is caused by damage to the anterior motor areas in the cerebral cortex, and the second is a dysfunction of the lower parts of the central motor area in the cortex of the dominant hemisphere, where all the irritations from the muscles and ligaments that appear when performing articulatory movements are concentrated.
A child with alalia has difficulty forming fine motor coordination of the speech apparatus. These disorders are of a different nature, ranging from oral apraxia (paralysis), ending with a violation of the sequence or switchability. There is also an inability to perform certain articulatory movements.
Often, children with motor alalia, due to insufficient sound perception, catch only certain elements of the phrase and are unable to link them into a general semantic structure. This limited understanding acts as a secondary manifestation of the underdevelopment of one's own speech. Children with motor alalia usually have a limited vocabulary, but the passive vocabulary is very large.
With motor alalia, the following aspects of speech may be impaired:
- phonemic realization of statements;
- linguisticspeech design;
- rhythmic organization of the word - scanned speech.
Now consider the symptoms of motor alalia. Vocabulary in children with this disorder develops very slowly and is used incorrectly in speech. As a result of the poverty of the stock of lexical-semantic means, substitutions appear by similarity or contrast, for example, erases - washes, a cup - a glass, an ax - a hammer. The set of adjectives and adverbs is small.
At the initial stages of speech development, such a child does not need to communicate using coherent speech, which is due to the underdevelopment of both general and speech activity. Therefore, the baby often uses facial expressions, gestures and monosyllabic words when communicating with an adult.
Non-verbal signs of illness
Children with motor alalia have underdevelopment not only of speech, but also of some mental and motor functions. Neurological symptoms are usually observed, varying in severity: from minimal manifestations of brain dysfunction to severe disorders. Physical insufficiency and general somatic weakness of the body are also often noted.
Children with motor alalia are usually clumsy, uncoordinated, slow or disinhibited. Motor activity is reduced, rhythm is insufficient, dynamic and static balance is disturbed. Fine motor disorders are especially evident.
Children with motor alalia usually have underdeveloped higher mental functions (memory, attention, thinking, etc.) at the level of voluntary and consciousperception.
In some cases, pathological personality traits and the formation of a character according to a neurotic type can develop. Children with motor alalia show withdrawal, self-doubt, irritability, resentment, and a tendency to cry.
There is another kind of ailment - total, or mixed sensory-motor alalia. With this option, both sensory and motor aspects of speech are disturbed. If a child has sensory-motor alalia, he cannot speak. In addition, the patient does not understand the speech addressed to him.
What are the symptoms of mixed alalia? This disease is difficult to diagnose. It is often confused with problems such as autism, hearing impairment, intellectual impairment, etc.
Working with children with total alalia often includes, in addition to classes with a psychologist and speech therapist, drug treatment aimed at activating speech centers in the cerebral cortex.
How does the disease appear?
The main cause of alalia is brain damage during fetal development or in the first year of a child's life.
- In the intrauterine period, the development of the brain can be affected by infections, hypoxia, placental insufficiency, bad habits of the mother. Brain damage to the baby can also occur during childbirth. These include hypoxia, birth trauma, hypothermia.
- In the first year of a baby's life, brain damage is possible due to viral infections or traumatic brain injuries.
Symptoms
Alalia, the diagnosis of which is a complex process, is sometimes almost indistinguishable from some other diseases. It is important to rule out deafness or mental retardation. With alalia, the activity of certain parts of the brain is disrupted in a child. A huge role is played by the defeat of two brain structures: Broca's and Wernicke's speech centers, which are responsible for the formation of one's own speech and its understanding.
Signs of motor alalia
Among the symptoms of the disease are:
- lack of self-care skills;
- disordered movement: children do not jump on one foot, cannot walk on the board, often stumble, unable to dance rhythmically to music;
- there are several standard levels of speech development in this disorder: from its complete absence to the ability to speak in extended phrases;
- the child most often cannot express his feelings and ask for something;
- there is awareness of speech addressed to the patient;
- the kid understands the lexical meaning of the word, but not the endings, prefixes, prepositions.
Signs of sensory alalia
Symptoms of this type of disease can be considered the following phenomena:
- the child does not understand the meaning of the word he heard;
- no connection between specific item and sound design;
- presence of echolalia (automatic repetition of words).
Fix the problem
Let's consider how alalia is corrected. Since it is a medical and psychologicalpedagogical problem, an integrated approach to the formation of the formation of speech and the development of the personality as a whole is needed. Speech therapy work should be carried out against the background of medical and psychotherapeutic treatment. Alalia is a complex disorder that is not easy to diagnose.
Main features of corrective work
- The process is primarily aimed at the formation of a motive, a communicative intention, an internal program of the utterance.
- Attention is paid to fine motor skills: children learn to color, hatch, play with mosaics, tie knots, etc.
- Effective for the development of speech in children with alalia is the use of rhythm and logorhythm. In these classes, music, speech and movement are combined in various exercises and form speech-motor activity. There is also the development of memory and personal development of children.
- To activate speech, it is important to practice communication at a level accessible to the child: operations with words (repeat, show, name), phrases and phrasal material.
- The development of analyzers - visual, auditory and tactile is considered important.
- It is necessary to apply only the game form of work.
- It is obligatory to use visual material: various symbols, environmental materials, pictures, accompanying actions with speech, etc.
- The impact should be aimed at the general system of speech, specification of the dictionary, development of phrasal and connected speech, staging of sounds.
Main steps
- At the first stage of work, speech activity is nurturedand filling a passive vocabulary that is understandable.
- Further, phrasal speech and dialogue are formed.
- At the third stage, special attention is paid to such aspects as coherent speech, communication skills, in addition, grammatical structures are automated.
In the process of fixing the problem, various methods of conducting vocabulary work are actively used. The first option is natural: demonstration of objects, pictures, actions, situations. The second is verbal: correlation of new words with already known ones by similarity and opposite.
They use different types of work on the dictionary, which include the selection of objects for action, for example, show or say who flies, runs, crawls. Such techniques are no less effective: naming individual parts of the whole, for example, a wheel, a headlight, a steering wheel; selection of cognate words, synonyms, antonyms; guessing objects by description; transformation of diminutive words, etc. Also, in parallel with the replenishment of the dictionary on general topics (animals, plants, toys, vegetables, fruits, family, etc.), the skill of using a certain grammatical form of words (cases, singular and plural etc.).
If a child has alalia, how should corrective work be carried out? When performing actions with objects, children should try to voice them with speech, that is, accompany each action with words: pour water, pour water, pour water into a bottle, blow on water, etc. Patients at this stage develop the skill to answer questions and tryask them, come up with sentences first for one word, and then for reference ones, using a series of pictures, guess and make riddles according to descriptions, compare the characteristics of several objects, etc. At this time, diverse and detailed answers are encouraged, which, in turn, turn, contributes to the active search and selection of the appropriate grammatical form of the desired word, fosters interest in speech as a means of communication.
Naturally, no rules are explained to the child, no grammar information is given. The therapy process provides only a game form and practical acquaintance with more frequent models in inflection and word formation, sentence construction.
The whole procedure for working on grammatical categories is based on the following: first, the child must observe how the speech therapist constructs a certain model, and then he is included in the process of imitative speech activity.
If a child has motor alalia, how are classes conducted? The process of practical use of grammatical structures by children with alalia has some peculiarities, since the formation of all concepts is carried out only on the basis of special forms of analysis and synthesis, which as a result lead to abstraction and unnecessary generalizations.
The main task of the work should always be in sight, which includes the formation of the communication process and the active replenishment of the means for communication in the child. The next stage can be considered a gradual transition from dialogue in interpersonal communication to monologue speech with the development of motivation tostorytelling. To do this, the child usually talks about what he saw or conveys some information.
Literacy contributes to the development of the structure of words and phrases, and through reading and writing, a child with alalia controls and corrects his speech. The education of such children is much longer, and it requires the use of special methods and techniques. Often in children with the ailment in question, in the process of mastering written speech, secondary dyslexia and dysgraphia appear.
Does baby have alalia? What are the features of treatment and correction? One of the most commonly used ways to get rid of this problem is to stimulate certain areas of the skin with low-frequency current pulses. Such areas are projections of the speech areas of the brain. As a result of their stimulation, nerve endings are activated. This method of treatment does not have a scientifically based basis, therefore, when correcting an ailment only with its help, there may be no therapeutic effect, therefore, the use of the technique of neurostimulation of speech zones cannot always be justified.
Additional methods
If the patient has alalia, sessions with a speech therapist are very important. They must be carried out regularly. Speech therapy massage is actively used for such a speech disorder as alalia. The treatment is aimed at stimulating the muscles that are involved in the process of sound formation. To do this, massage is carried out with the help of fingers or special speech therapy probes.
Physiotherapy treatment is also used in children with alalia. Among the main methods– laser-, water-, magneto-, acupuncture.
Conclusion
Speech alalia requires a very long treatment and an integrated approach. Most often, therapy takes place in specialized kindergartens and schools where children with speech disorders study. If there are results of treatment, there is a possibility of transferring children to a comprehensive school.
In some cases, the elimination and correction of alalia in a child takes several years, and then constant sessions with a speech therapist are required to maintain the result. Even after successful therapy work, most children require regular sessions to correct dysgraphia and dyslexia. A child with alalia needs psychological help and support. It is difficult for him to make new acquaintances and feel good in the team. Some children experience constant stress when communicating with peers, which can lead to aggression, nervous breakdowns. Therefore, a child with alalia needs help in overcoming the fear of communication, isolation.
