Traditional medicine

Alalia in children: symptoms of the disease and possible treatments. Motor alalia and its prevention Development of children with motor alalia

Alalia is a persistent specific speech underdevelopment caused by damage to the cortical parts of both hemispheres of the brain. Some authors call this pathology childhood“congenital aphasia”, or “developmental aphasia” by analogy with the same speech pathology in adults. There is a significant difference here - in adults, already formed speech disintegrates, and in children there is speech underdevelopment due to damage to the speech zones of the cerebral cortex (Broca's area). Similar changes occur during fetal development or early childhood.

The following types of alalia are distinguished: motor, sensory and sensorimotor. Let's look at them in more detail below.

Causes of alalia

The severity of the pathology depends on the time of brain damage. The most severe damage occurs during intrauterine development, at 3–4 months of pregnancy. Causes of damage to speech areas:

maternal intoxication;
toxicosis of pregnancy;
incompatibility of mother and baby by blood type and Rh factor;
birth trauma, asphyxia during fetal development and at birth;
neuroinfections;
deep prematurity;
traumatic brain injuries in early age;
consumption of alcohol and nicotine by a pregnant woman;
hereditary predisposition.

The bottom line is that when there is organic damage to the brain, the maturation process slows down. nerve cells. This factor helps to reduce the excitability of neurons and reduce the conductivity of nerve impulses.

Motor alalia

About the fact that when motor alalia both hemispheres of the brain are affected, the following circumstance suggests that this pathology is not compensated spontaneously, without special corrective work and medical support. The ontogenesis of the disorder involves complex encephalopathic disorders of the cerebral cortex and subcortical structures.

The disease belongs to the third group clinical species general underdevelopment of speech, occurs in approximately 1% of preschool children, 0.6% of school-age children. An officially recorded diagnosis is the basis for disability.

Characteristic signs of alalia are underdevelopment of absolutely all aspects of speech:

phonetics;
vocabulary;
syntax;
morphology.

Motor (expressive) alalia in a child received its name because this defect is based on a deficiency in the motor part of speech. An electroencephalopathic study of children with motor alalia diagnoses local damage to the tissues of the cortex, as well as the hypothalamus, subcortical ganglia, thalamus optic, and brain stem. In most cases, dysfunction of the midbrain structures is observed.

Clinical picture and behavioral characteristics of children

With motor alalia, a child may have a large passive vocabulary, but finds it difficult to name even well-known words. Children cannot repeat even simple words after an adult, despite having a developed articulatory apparatus. In words they rearrange and replace syllables, omit sounds. These substitutions are not permanent; in some circumstances, children replace syllables, in others, they replace sounds in the same word.

It is especially difficult for them to pronounce words expressing abstract concepts and generalization words. Children with alalia are aware of their shortcomings. Child with high intelligence He is more critical of his speech; when communicating with others, he replaces words with facial expressions and gestures. When parents have excessive demands on pronunciation, when the speech therapist tries to “introduce” sounds, despite the fact that those around him do not understand him, he shows negativism.

The paucity of phrasal speech is very noticeable - children speak simple sentences or sentences consisting of only subjects. If you don't work with your baby, he won't be able to learn grammatical structure speech. Children make mistakes in agreeing nouns with prepositions and use case endings incorrectly.

With age, more and more automation of speech is required, and afferent motor alalia in children only increases the child’s problems. Children suffering from this pathology are diagnosed with disorders of attention, memory, thinking, analysis and synthesis of words and phenomena, emotions, will, and behavior.

The symptoms of alalia exclude balanced behavior - it is not often found in children with this speech disorder, usually they are either inhibited or too excited. Most children have impaired fine and gross motor skills, are clumsy, and their movements are disinhibited or slow.

A child with alalia has little desire to understand the surrounding reality; he is inattentive and often distracted. Visual and auditory memory in such children is reduced, to intellectual activity such children do not strive. In the process of completing tasks, they do not strictly follow instructions and therefore often make mistakes.

Sensory alalia

At sensory alalia the perception of other people’s speech is impaired due to damage to the speech-hearing analyzer. Sensory alalia is very rare, perhaps due to imperfect diagnostics.

Features of the pathology:

Many children with this pathology do not even respond to given name, do not understand speech addressed to them.
Children may understand individual words but lose the meaning of statements with the same words.
In other cases, they understand the instructions for completing the task, but outside of this situation they cannot understand the task.
Sometimes he incoherently repeats words he knows - logorrhea develops.

Information reaches children's brains in fragments, because they perceive it very poorly by ear. This results in incomprehensible, distorted speech, although the speech activity of such children is quite high.

Realizing their defect, many children become shy, although they do not lose the desire to communicate. Other alaliks are excitable and irritable, and may exhibit negativism and affective outbursts.

In some cases it is diagnosed complex disorder- sensorimotor alalia.

Diagnostic and treatment methods

Children with any form of alalia need the help of a speech therapist, neurologist and psychologist. Neurological diagnostics helps to identify the extent of brain damage using an electroencephalogram and MRI. To exclude hearing loss, otoscopy and audiometry are performed, and in order to differentiate the symptoms of alalia from similar symptomatic pathologies, such as delayed speech development, dysarthria, autism, speech therapists and psychologists are involved in the work of the neurologist.

Sensorimotor alalia requires speech therapy examination. The speech therapist determines the following parameters:

level of speech understanding;
determining the number of words in a dictionary, including all speech manifestations;
identifying opportunities for speech imitation;
identifying the possibility of using prepositions;
identifying the state of the organs of articulation and sound pronunciation;
determining the maximum volume of sentences used;
research into the possibility of changing words by numbers.

In alalik children with minimal damage speech development, determine the ability to retell a simple fairy tale and answer questions about its content, the ability to compose a story from a series of pictures. Diagnosis is carried out in the presence of parents, using large quantity stimulus material (toys, pictures). The speech therapist strives to establish close contact with the child.

Correction of the defect is carried out in a complex manner. Treatment of alalia in children requires the use of medications that stimulate the maturation of brain structures:

vitamins B5 and B12;
Cogitum;
Gammalon.

(gallery-0)

To eliminate sensory and motor alalia, physiotherapy and microcurrent reflexology are prescribed. Drug treatment of motor alalia will be more effective if carried out together with correctional classes with a speech therapist, speech pathologist, psychologist. Specialists work on the development of speech and other higher mental functions: attention, memory, thinking.

Massage technique

When treating alalia, speech therapy massage is very effective, stimulating speech zones. A full massage cannot be performed without qualifications and the use of special probes. Under the guidance of a specialist, parents can learn the simplest techniques of massaging the face, hands, lips, tongue and carry them out at home on their own. To do this, you can use teaspoons with smooth edges, clean warm hands moms. Elements of the massage are performed 5 times, all exercises begin and end with stroking.

Sequence of massage movements:

stroking the forehead from the center to the temples, temples clockwise using the convex side of a spoon or hands;
the eye sockets are ironed in the same way;
cheeks are stroked in a circle;
then the space between the eyebrows is massaged;
The nose is rubbed, the lip and tongue are massaged.

Hand and face massage is carried out in a warm room. The massage therapist's hands are pre-treated with an antiseptic.

By massaging a child's hands, he develops fine motor skills associated with brain function and speech. It can be performed not only with your hands, but also with rubber balls, prickly curlers, Su Jok. Hand warm-up begins with the little finger, first with it outside. Then it is recommended to move up along the finger, gently pressing on the pads, then rubbing them. After warming up the palm, its inner side is massaged.

Corrective work of a speech therapist

The speech therapist carries out step-by-step work on the formation oral speech. Every new stage work is built on the basis of the achievements of the previous stage.

Sequence of training:

Stimulating imitative activity, expanding the volume of understood speech, forming a one-word sentence from amorphous root words.
The appearance of the first forms of words, teaching children the ability to construct two-word sentences, expanding the scope of understanding the speech of others.
Learning to build grammatically correct offer of 2–3 words, reproduction of 3-syllable words.
Constructing sentences of 3–5 words, developing the simplest skills of coherent speech, developing correct sound pronunciation.
Expanding the volume of sentences, teaching inflection, and the ability to construct complex sentences.

If there are no complex lesions of the cerebral cortex, after completion of correctional work, children master grammatically correct colloquial speech. With any form of alalia, early literacy training is necessary, since reading and writing help consolidate the learned material and control oral speech.

Silence mode when correcting sensory alalia

The speech therapist recommends to parents how to properly organize the baby’s speech and sound modes. Temporarily, adults are asked to talk to the child as little as possible, organizing quiet time or hearing rest day. During this time, it is necessary to eliminate unnecessary sounds in the children's room: a playing TV, a computer, a tablet; sometimes it is recommended to remove sounding visual stimuli (toys, books). This sound mode helps to increase children's sensitivity to sounds.

The next stage is the awakening of interest in the sounds surrounding the child, the emergence of interest in imitation and perception of one’s own speech.

In the first lessons, the speech therapist develops attention, helping the child to focus on sound stimuli, teaching him to distinguish between two or three sounding objects, for example, a pipe, a tambourine and spoons. Then he is given the opportunity to play various games that will help him develop correct, smooth, diaphragmatic breathing.

At the next stage of correction, the main task of the speech therapist is to draw the child’s attention to laughter, crying and other reactions of people around him, to develop perseverance and the ability to copy the emotional reactions of others. If he is tired, the lesson stops. For the work of a speech therapist to be successful, correction is carried out from 2.5-3 years. The specialist must systematically influence each component of speech.

Prognosis and prevention

With properly organized and carefully carried out work to correct motor alalia, you can begin schooling almost completely compensate for this defect and overcome the danger of further speech and intellectual underdevelopment. But such children have high risk the appearance of dysgraphia and dyslexia during their schooling. Children with complex damage to brain structures or for whom correctional work began late will not be able to overcome this pathology of speech development. Therefore, in the future they are sent to special schools to continue correctional work.

To prevent the appearance of such a complex pathology, it is necessary to carefully screen the health status of pregnant women, rationally manage childbirth, and protect children from contracting neuroinfections and injuries.

That's all. Now you know how the forms of alalia differ and how to treat it, and whether this disorder can be cured without the services of specialists. If you have any questions, ask them in the comments or just write to us - we have experience working with such children.

“And my dad only spoke at six - why be afraid?” Young mothers often brush aside advice from friends to take their silent child to a speech therapist. Many parents mistakenly believe that the first word spoken by the baby is a sign that his speech will develop normally in the future. Moms and dads prefer not to think too much about the fact that by relying on blind chance, you can miss a serious childhood illness - alalia.

The correspondent tried to figure out whether the disease is really as terrible as experts portray it to be?

Alalia– underdevelopment of speech due to damage to the speech areas of the cerebral cortex. It is perhaps one of the most insidious problems of childhood. The trickiness of this speech pathology is that recognizing its symptoms is not as easy as the manifestations of other ailments. And if the parents do not have a doctor’s diploma (or at least a certificate of completion of nursing courses) in their closet, determining that the child is sick with alalia is often only possible for doctors.

“Unfortunately, due to problems with diagnosing alalia at home and parents’ inattention to their own children, quite often this disease in children is discovered too late. Alalia is already much more difficult to treat at 5-7 years of age than at older ages. early stages“, - Anzhelika Zabolotnaya, a psychotherapist of the highest category at the Republican Scientific and Practical Center of Otorhinolaryngology, commented on the problem.

Myths about alalia

The main alalia myth circulating among parents is that the only sign of this disease is a delay in speech development.

In fact, children talk during alalia. They just don’t do it quite the same way as their healthy peers.

Alalia does not arise on its own. This is a consequence of damage to one of the two speech centers of the baby’s cerebral cortex - Wernicke (responsible for understanding speech) or Broca (responsible for the motor skills of speech muscles).

Depending on which center is damaged, there are two main types of alalia: sensory And motor respectively.

With sensory alalia, children lack understanding of the meaning of other people's speech. True, such children can speak quite fluently, easily reproduce and subsequently repeat any of your words. Another thing is that, being unable to understand the meaning of spoken words and phrases, such children, as a rule, speak at random. Their speech is a jumble of completely unrelated words.

With another type of alalia - motor - the child is able to normally grasp the meaning of what others say. But problems arise at the stage of information reproduction. Motor alalia is expressed in underdevelopment of speech, difficulty in mastering an active vocabulary and grammatical structure language.

How to recognize the disease?

In each individual case, alalia occurs with its own characteristics. But in general, recognize in a child serious problems knowledge of speech development norms can help with speech. According to the generally accepted rules that determine the appearance of sound and word pronunciation in a baby, at two months the child develops a characteristic hum. At 3-4 - babble. And at 6-8 months - the first words. By the age of one year, a child should be able to construct entire phrases. If, say, by two years vocabulary child is calculated in a few words - it’s time to start sounding the alarm.

One of the most obvious signs, which can warn of alalia is the underdevelopment of the baby’s speech. This is noticeable, for example, if the child pronounces only the first or last syllables of words: ma... (the word “mother”), ... tka (crib), etc. Another factor indicating an illness is speech that is developing too slowly , lack of obvious speech progress.

How to treat?

Even in the most severe cases of alalia, the situation is not hopeless: if treatment was started on time, the disease can be overcome. The whole secret is in the inherent plasticity of the children's brain. This means that healthy brain cells can take over the functions of damaged ones and actually replace them.

As for the development of speech in a child with alalia, in each specific case the treatment is individual and will be carried out under the supervision of specialists. But there are some things parents can do to help their beloved child at home.

Doctors often say that “a baby’s speech is at his fingertips.” This phrase, incomprehensible at first glance, can be explained by the connection between fine motor skills and some speech centers. Thus, the better developed a child’s fingers, the better his speech develops. A finger massage will bring tangible benefits to your baby.

However, it wouldn’t be superfluous to do finger gymnastics. To do this, you can give the baby the opportunity to manipulate various small objects (string beads, put together mosaics, build with a construction set, choose multi-colored peas from a box and sort them, etc.)

So that you don't have to treat

However, no one has canceled good old prevention either. We publish a list of situations in which it is better for parents to double control over their child’s speech. Below we attach a list of measures recommended to prevent the development of alalia.

At risk:

mothers who have had infectious and somatic diseases during pregnancy;
mothers suffering from pregnancy anemia (in this case, the child does not receive enough oxygen, glucose and other nutrients);
mothers who suffered during pregnancy (especially during early stages) viral infection(it is during this period that the nervous system baby);
mothers who have suffered difficult births;
mothers who gave birth too quickly. According to norms, labor should last 18-20 hours. And if a woman gives birth too quickly, the bones of the baby’s skull do not have time to adapt to birth canal, the brain may be damaged;
mothers who have suffered a long anhydrous period. According to norms, a woman should give birth within 2-3 hours after effusion amniotic fluid. If labor is delayed, the child is left without the necessary normal development nutrient medium;
mothers with a narrow pelvis.

How to minimize risks?

Doctors did not find any special recipes to prevent the development of alalia. But, according to psychotherapist Angelika Zabolotnaya, “a healthy lifestyle familiar to all of us from childhood is effective against alalia”:

1. It is very important that the pregnancy is desired and planned, and the child is expected and loved. At the same time, no matter how ideal your health is, you need to prepare for pregnancy (sanitize foci of infection, normalize hemoglobin and blood pressure). During pregnancy, avoid contact with infectious patients, eat a nutritious and varied diet.

2. You should breastfeed your baby for as long as possible.

3. It is important to protect the baby from infectious diseases.

4. Show your child to the pediatrician in a timely manner and narrow specialists. Be sure to follow the advice of doctors, because timely treatment will minimize problems in the future, including speech problems.

And, most importantly, remember: there is nothing wrong with playing it safe by once again showing the child to a specialist, only to hear: “Everything is fine... You’re worrying in vain, mom!” It’s much worse to delay and receive a disappointing answer from the doctor: “What a pity that you came so late...”.

Vova, catch Nina. Nina, catch Vova. Katya, take Olya’s hand. Olya, take Katya’s hand.

Katya, give the ball to Vova. Vova, give the ball to Katya.

Where does a hare run away from a wolf, and where does a wolf run away from a hare?

Where did the fox catch the chicken, and where did the chicken catch the fox?

Where is the boy riding a horse, and where is the horse riding a boy?

Where does the cat catch the mouse, and where does the mouse catch the cat?

Where is the girl carrying a bear on a sled, and where is the bear carrying a girl?

Where does the girl give hay to the goat, and where does the goat give hay to the girl?

Where does the girl feed her animals, and where do the animals feed the girl?

Practical learning of prepositions in a situation familiar to the child: children put objects on the table, in the closet, take out toys, books from the closet, take out a ball that has rolled there from under the closet.

“Take the pencil that is in the box (on the box, near the box).”

“Show me where the car left the garage (it’s near the garage)”

“Where the cat climbed onto the sofa (under the sofa, behind the sofa)”

“From the object pictures, select everything that you will need if you draw, if you go for a walk, if you want to eat, etc.”

“Show who rides a bike and who rides bicycles”

“Show who is riding a horse and who is riding horses”

“Show me where the girls sit on the chair and where they sit on the chairs.”

“Show the vases standing on (one) table, show the vases standing on the tables”

Big – small

Narrow – wide

Long – short

Low – high

Thick – thin

Down (below) – up (above)

Far (close)

Forward (ahead)

Back (back)

At a verbal request, perform actions such as: “raise your hands up”, “put your hands down”, “look up - look down”, “stand behind a friend - in front of a friend”, “throw the ball high - low; far - close."

"Recognize the vegetable." The speech therapist shows how to make a long one correctly, deep breath: smoothly, slowly, without raising the shoulders.

A blindfolded child sniffs and recognizes the vegetable offered to him by its smell.

"Autumn Leaves" The child stands in front of leaves suspended on strings. Slowly draws in air through the nose so that the shoulders do not rise. He stretches out his lips with a tube and blows on the leaves without puffing out his cheeks.

“Let’s blow up the balloon.” Stand straight without straining. To control the movement of the diaphragm, place your right hand on top part belly. Exhale slightly and hold the breath for 2 seconds. Inhale through your nose (5 seconds).

Hold the air in your lungs (2-3 seconds). Exhale, rounding your lips, simulating inflating a balloon - smoothly, without jolts, only with the movement of the diaphragm (3-4 seconds, the speech therapist counts to three or four). Then

The duration of exhalation can be increased to 5-6 seconds (counting to five, six).

"Steamboats". The child takes in air through his nose and begins to slowly and smoothly blow on the sail of the boat, which is in a basin of water at the level of the child’s mouth.

"Count the vegetables." The child is asked to count vegetables while exhaling. Inhale (3 seconds), while exhaling, count out loud, slowly: “One, two, three, four, five.”

Do this exercise again, then breathe in air (1 second) diaphragmatic breathing(shoulders motionless), as you exhale, say: “Five vegetables.”

“Count the fruits”, etc.

“Continue the sentence.” Take a breath, and as you exhale say the following phrases:

The boy is coming. Etc.

"Wind". Take a breath, and as you exhale, say for a long time with a louder voice: “U-u-u-u-u-u-u-u,” imitating the howling of the wind.

"Echo". The picture shows children shouting “Aw!” in the forest.

The child is asked to scream loudly and then quietly, like an echo.

"Nice smell." The child approaches a vase with a peeled orange, tangerine, etc., smells it, and exhales saying: “Good,” “Tasty,” “Nice smell.”

"Blizzard" The child is standing, his back is straight; takes a deep breath, and as he exhales he begins to say: oooh... A strong blizzard - the child increases the strength of his voice, the blizzard subsides - the strength of his voice decreases.

“Who will win?” The speech therapist puts two children opposite each other, and at the speech therapist’s signal, the children begin to first quietly, then loudly draw out vowels: A, O, etc. Whoever pulls out longer without taking an additional breath wins.

"Quiet - loud." The speech therapist makes a sentence based on the picture and pronounces it quietly. The child repeats loudly and vice versa.

"Ladder". Singing vowels with raising and lowering the voice and moving along the “ladder”.

Speaking sentences like:

Asya washes herself.

Allah is gone.

Inna is coming.

Reading K. Chukovsky’s fairy tale “Confusion” (children pronounce only onomatopoeia).

"Want!" - angry, sad, happy, irritated, depressed.

“Know by intonation.” First the speech therapist, and then the children portray a sick, angry, sad, surprised, cheerful person. At the same time, short words are pronounced with a certain intonation: “Ay-ay-ay”, “Oh-oh-oh”, “Oh-oh-oh”, etc.

Reflected pronunciation of sentences.

Complete the face (pictogram) so that you can see: joy, sadness, anger, surprise.

The child is asked to depict the emotions that arise in him in a certain situation (when listening to the text).

"Autumn Rain" The child is asked to listen to a rhythmic series of strokes in the palm of his hand and “clap” the proposed rhythm: // ///; // //; // // //.

"Feed the birds." The speech therapist conveys the rhythm of how hens and chicks and other birds peck together, tapping the table with their fingertips, and then asks the child to repeat:

Hen with chicks: // ///

Duck with ducklings: // //

Goose with goslings: / / ///

The child is asked to repeat.

Speech therapist: The birds sat on the trees and sang:

“Ti-ti, (pause) ti-ti-ti, (repeats the child)

ti-ti-ti, (pause) ti.”

Ti-ti-ti, ti-ti-ti,

Ti-ti-ti, ti-ti-ti.

"Merry Builders" The child repeats the sounds that come from the construction site: “Knock-knock-knock, knock-knock-knock.”

"Moms and Babies." The condition of the game is that the birds “speak” in an important, low voice, slowly, and the chicks “answer” them faster, in a thin, high voice.

The goose teaches the gosling: “GA-GA-GA” (With a lowering tone of voice, slowly.)

The little gosling answers: “Ha-ha-ha” (With a rising tone of voice, faster.)

Duck: “QACK-QACK, QACK-QACK-QACK.”

Duckling: “Quack-quack, quack-quack-quack.”

Chicken: “KO-KO-KO, KO-KO.”

Chicken: “Ko-ko-ko, ko-ko.”

The child is invited to listen and recognize the sounds that are coming from outside the window, from the corridor, from the neighboring group.

“Guess what musical instrument sounds like?”

“What object makes such a sound?”

"Noise boxes." There are 5 pairs of identical boxes with different fillings (sand, paper clips, cereal, paper balls, small pebbles). The child chooses boxes that sound the same.

“Guess who called you “Aw”?” Children take turns calling the child (driver), he determines who called him.

“Where is the steamer humming?” “Oooh” - far (quiet) or close (loud).

"Who said 'Meow'?" ("Moo", "Be-e")

The speech therapist pronounces onomatopoeia now low, now in a high voice. The child shows a picture of an animal or its baby.

The child is invited to clap his hands (raise the green circle) if he hears correct name what is shown in the picture. “Vakon – wagon – wagon – wagon – fakon – wagon.”

Pictures are displayed on the typesetting canvas, the names of which sound very similar: crayfish, poppy, varnish, tank, juice, bough, house, lump, goat, braid, etc. The child is asked to select the named pictures.

“Who (what) is this? What (he, she) is doing?”

Dad sits, walks, stands.

The girl is jumping, crying, reading.

Mom sews, cooks, irons, writes, reads.

Grandfather is sleeping, lying, reading.

The boy writes, reads, runs, draws, swims.

The dog sleeps, sits, lies, bites, jumps.

The bird is jumping and flying.

The plane is flying, buzzing.

“Who will bring the picture faster?”

Pictures depicting actions are laid out on the table (a girl is reading, a cat is sitting, etc.). The speech therapist calls two children. He clearly states who should bring which picture. By handing over the picture, children answer the following questions:

“Who (what) is this? What is he/she doing?

coming Who? What?(mom, dad, grandfather, grandmother, boy, girl, snow, rain).

Costs Who? What?(mother, girl, grandmother, horse, cow, cat, rooster, table, chair, cabinet, vase, plate, cup).

sitting Who?(girl, boy, mother, cat).

Runs Who?(boy, girl, dog, cat, horse).

Jumping Who?(girl, boy, cat, dog).

Sleeping Who?(mother, girl, dog, cat).

lies Who? What?(mother, girl, boy, horse, dog, cat, book, notebook, spoon, fork).

Hanging What?(picture, lamp, towel, coat, dress).

flies Who? What?(bird, dove, fly, beetle, butterfly, wasp, plane, rocket).

Rides What?(car, train, bus, bicycle).

Reads Who?(mom, dad, grandfather, girl, boy).

The child is asked to select from the subject pictures on which a dog, a girl, a cat, a locomotive, a boy is drawn, the one who can read;

Find in the room what hangs, what stands, and what flies;

Look at the street and say who is walking, who (what) is driving, and who is running.

Boy (girl) washes, bathes, rides, swings, dresses, undresses, puts on shoes, washes, wipes, combs his hair.

Boy coming– boys are coming.

Boy runs– boys are running.

Girl costs– girls are standing.

Boy sleeping- children sleep.

Girl sings- children sing.

The speech therapist invites one of the children to give a command to another child to do something, for example: “Kolya, give the command to Tanya: Tanya, sleep.” Another child states: “Tanya is sleeping.”

Children independently pronounce the highlighted words.

Rain, rain, drop and drop!

Wet paths.

We can't go walk,

We'll get wet legs.

The sun is shining into the window.

Shines on our room.

We'll clap in the palms,

We are very happy about the sun.

I love your horse.

I'll comb her fur smooth.

Comb I'll smooth my ponytail

And on horseback I'll go visit.

The child easily steps on his toes on the sheets of tiles laid out on the floor and pronounces the highlighted words.

Who's stomping on the roof?

- Top-top-top.

Whose footsteps do I hear all night?

- Top-top-top.

I can hardly sleep now.

- Top-top-top.

Maybe the cats were shod?

- Top-top-top.

The child performs characteristic actions and pronounces highlighted words.

Rain, rain...

Drip-drip. (He taps on the table with his index fingers.).

And in the garden beds..

Tick-tap.(All fingers are tapping on the table).

Along the path...

Top top. (Index fingers tapping on the table).

And through the puddles...

Slap-slap. (Palms slap on the table).

Between the spruce trees soft paws (stroking the table surface with fingertips)

Rain... drip-drip-drip(tapping fingers on the table).

Where the twig has long since dried up,

Grey… moss, moss, moss(touching the table with the first and fifth fingers of the open hand).

Where leaf sticks to leaf,

Grew up... mushroom, mushroom, mushroom(raising your hands above the table, fingers either folded together or spread wide).

Who found his friends? ( Touch index finger right hand all fingers of the left hand in turn.)

This… me, me, me! (Squeezing all fingers of the left hand except the little finger, showing it.)

They were scared of the hare.

We (point to ourselves)

Walked (three steps)

For mushrooms, ( make a mushroom with your hands)

They were scared of the hare, ( For each syllable, the ears on the top of the head tilt and rise)

They ran away behind the oak trees, ( palms at face level)

Lost ( sharply unclench your fists and “throw”)

All ( wave open palms)

mushrooms ( make a mushroom with your hands),

And then they laughed :( draw a smile from ear to ear with your fingers)

They were scared of the hare ( the ears on the top of the head move with every syllable).

Massage the fingers, starting from the thumb to the little finger: rub the fingertip first, and then slowly rise to the base.

Massage with “rosary beads”: finger the rosary beads, combining them with counting.

Massage with a hexagonal pencil:

- “Iron” ( roll a pencil across the table surface);

- “Making Fire” ( roll the pencil between your palms from your fingertips to your wrists);

- "Slide" ( roll the pencil from the back of the hand, holding it with the other hand).

"Palm" ( fingers, and then palms “hello”).

"Piano" ( The speech therapist “plays” the child’s finger on the piano, releases the finger, the child plays the piano with the same finger of the second hand).

Games with counting sticks.

Laying bean patterns on a plasticine surface.

One, two, three, four, five. ( Bend your fingers.)

We will collect leaves.( They clench and unclench their fists.)

(The first word is pronounced by the child, bending his fingers, starting with the thumb; the rest of the text is read by the speech therapist.)

Leaves birch trees

leaves rowan,

leaves poplars,

leaves aspens,

leaves we will collect oak,

mom autumn bouquet we'll take it.

"Fists."

Fists we are together let's add (fists pressed against each other),

To our fingers we'll help

Straighten up and rise (the fingers gradually unclench, the palms are pressed together and directed upward).

“The fingers say hello.” ( On one hand thumb“hello” with the index, middle, ring, and little fingers. The fingers of the same name on both hands are greeted.)

"Okay."

Okay, okay!

Grandma baked pancakes.

I poured oil on it.

For the kids gave.

Dasha – two, Pasha - two,

Vane – two, Tane – two.

The pancakes are good

At our grandmother's.

(Hands are on the table. The palm and then its back side. The palm of one hand covers the other. Then place your hands on your elbows, the fingers of both hands are straightened and bent in twos: index and middle, ring and little fingers. Finish with a thumbs up.)

A serious developmental disorder that occurs quite often is sensorimotor alalia in children, which is expressed in severe speech disorder. In the most severe cases, speech may be completely absent. The main reason The development of the defect is considered to be damage to the cortical centers responsible for the development of speech, located in the brain. Pathology can occur when intrauterine development, as well as after the birth of a child, during the first three years.

Signs of motor alalia in a child

At its core, alalia is a complete or partial absence the child's speech functions. All cases of this disease are observed from the moment of birth and throughout preschool age. This pathology is characterized by its own bright and specific manifestations. Alalia manifests itself in two forms, sensory and motor. An integrated approach to treatment allows you to successfully correct the pathology. Given that timely diagnosis and acceptance necessary measures, such children can easily study in a regular school.

The presence of sensory alalia is manifested by impaired speech perception, while the child’s hearing is completely normal. In this state, children are unable to perceive speech or react to it in an extremely limited way. They show an adequate response to various types sound signals, make distinctions between characteristic noises - knocking, rustling, squeaking and others. Sensory alalia is distinguished by the presence of echolalia, when the child repeats someone else’s words completely thoughtlessly. Often children do not answer the question posed, but simply repeat it verbatim.

The main sign of alalia is considered to be impaired phonemic awareness, varying degrees gravity. The child may not be able to distinguish speech sounds at all or may have difficulty perceiving them. In practice, this disease is quite rare, more widespread received a simplified form of the disease – motor alalia. In this case, children understand speech addressed to them very well, but their own speech differs persistent violations. The vocabulary is quite meager, words are used mainly in nominative case, and grammatical forms are formed with gross violations.

Often words can be replaced by others that sound similar. Sick children are simply unable to pronounce complex and long words. This becomes one of the causes of stuttering and disorders intellectual development. Subject to availability light form short phrases are used for communication; the sequence of words may be disrupted, however, such speech as a whole will be understandable.
A severe form of motor alalia manifests itself in a child in the ability to only copy any sounds, accompanied by gestures and active facial expressions.

In addition to the main disorder, it is additionally detected a whole series neurological abnormalities. First of all, these are underdeveloped fine motor skills, clumsiness, increased fatigue, attention disorder. In some cases, memory is impaired and general perception. Motor alalia can be suspected in the absence of characteristic baby babble and other signs indicating the primary development of speech.

Causes of alalia in children

The main causes of alalia are associated with intrauterine and birth injuries, as well as various complications of pregnancy. Certain areas of the brain responsible for speech can be damaged as a result of fetal hypoxia, acute cardiac and pulmonary insufficiency pregnant. The cause of brain damage can be intrauterine infection of the fetus.

Difficult labor also often results in speech disorders. These factors may be late or premature birth, asphyxia, birth injuries, medical errors and others. It should be noted that alalia rarely occurs under the influence of any one traumatic factor. In many cases, pathology occurs under the influence of a combination of causes. However, her further development associated with individual characteristics female body, timely and high-quality treatment, qualified assistance during childbirth.

After birth, young children find themselves defenseless against many negative phenomena, including head injuries. They are the ones that most often lead to speech disorders. However, pathology can occur under the influence of meningitis and encephalitis affecting the brain, as well as colds, occurring in severe form and accompanied by complications. Among some experts there is an opinion about the influence hereditary predisposition to alalia.

Classification

Alalia in preschool children is approximately 1%. IN school age this figure drops to 0.2-0.6%. This pathology affects boys twice as often and is clinical diagnosis in the form of general speech underdevelopment (GSD).

The disease is classified according to its manifestations, development mechanisms and the degree of speech underdevelopment. Currently, there are three main types of pathology:

Motor or expressive alalia.
Sensory or impressive alalia.
Mixed alalia, which has signs of the two above pathologies, manifested to varying degrees.

The motor form arises as a result organic damage in the speech motor analyzer, namely in its cortical section. IN in this case There is a stop in the development of the child’s own speech. However, he retains the ability to understand other people's speech. Depending on the area of damage, motor alalia is divided into afferent and efferent forms. In the first case, the postcentral gyrus, located in the inferior parietal region of the left hemisphere, is affected. This leads to serious violations oral and writing. In the second case, the premotor cortex, located in the posterior third of the inferior frontal gyrus, is affected. This pathology also causes significant speech impairments.

The occurrence of sensory alalia is associated with damage to the cortical region located in the speech-auditory analyzer, in the posterior third of the superior temporal gyrus. This disease is accompanied by disorders of higher cortical analysis and synthesis speech sounds. Therefore, with preserved physical hearing, the child does not perceive the speech of other people at all.

Treatment of sensory alalia in children

If the diagnosis of the disease is confirmed, treatment should be started as early as possible. All therapeutic measures are prescribed depending on the severity and form of the identified pathology.

Treatment is carried out in several areas:

Speech therapy exercises. Can be carried out individually or within a special school. Positive results can only be achieved through systematic, long-term practice. Under the guidance of a speech therapist, the child gradually masters the pronunciation of individual syllables and words and recognizes speech by its sound. With the help of various pictures, the skills of linking them with specific words are acquired. When certain progress has been made, the child is already able to name one or another object shown in the picture. Gradually, the baby masters the correct endings of words, cases and declensions. Additionally, classes are conducted that develop fine motor skills using drawing, modeling, cutting, and construction sets. The success of treatment largely depends on home exercises. Exercises conducted with a speech therapist should be constantly reinforced with the direct participation of parents.
Speech therapy massage. Considered an effective addition to exercise. It develops individual muscles of the oral cavity responsible for correct pronunciation. The procedure is performed manually or using a special probe. Additionally speech muscles are developed with the help of specific exercises designed specifically for these purposes.
Physiotherapeutic procedures. They are prescribed in the form of specific courses, depending on the child’s condition. They can be supplemented with hydrotherapy, magnetotherapy, laser therapy and other procedures.
Reflexology. Its essence is to stimulate the necessary areas of the brain with electrical impulses. This leads to the formation of new neural connections that facilitate learning. Applies to children over 9 years of age.
Drug therapy. Includes the use of drugs that stimulate blood flow to the brain. Additionally, vitamins B12 and B15 are prescribed. Much attention is paid balanced diet nutrition.

Forecast

The prognosis of sensorimotor alalia in children depends on early treatment, integrated approach and systemic impact on all speech components. Speech processes must be formed together with mental functions. The most favorable prognosis is for motor alalia. Sensory and sensorimotor pathology often has an uncertain outlook, depending on the extent of brain damage.

Alalia is a disorder speech function, in which the child cannot speak partially (with a poor vocabulary and problems in constructing phrases) or completely. But what is characteristic of the disease is that mental abilities are not violated, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Despite its rarity, the disease is more often diagnosed in boys than in girls. May have varying degrees the severity of the course - from the most serious, in which speech appears only after ten years, to a lighter one, similar to underdevelopment of speech. The most important thing is to distinguish this disorder from. Basically, children do not have developmental disorders (it can only be disrupted under the influence of public and peer oppression). At untimely treatment at an early age, in the future the child will have problems with social adaptation, difficulties in finding one’s place in society.

Etiology

Since this disease can form in the womb or in the early years of life, the reasons for its appearance also differ in intrauterine and external influences.

The first group of factors includes:

unsuccessful attempts by the expectant mother to get rid of the fetus;
threat of miscarriage;
uncontrolled use of medications by the expectant mother;
complicated in the mother, manifested by and;
insufficient oxygen supply to the fetus;
unhealthy lifestyle that a woman led while pregnant;
direct trauma to the abdomen or falling on it during pregnancy;
various diseases of a woman that accompanied the period of bearing a child, including insufficiency, or, or, etc.;
premature or complicated birth, obstetric intervention in the process.

Among the reasons influencing the formation of alalia in children under the age of three years, highlight severe course ailments such as:

. May appear from an insect bite or contact with a poisonous plant;
caused by bacteria or fungi;
various traumatic brain injuries;
disturbances in the functioning of the central nervous system;
double-sided;
insufficient attention on the part of parents to teaching the child simple words or phrases;
surgical intervention performed under anesthesia.

Doctors note that alalia does not arise from one factor, but from the simultaneous influence of several causes.

Varieties

IN medical field There are many classifications of the disease, but nowadays speech therapists use the following division of speech disorder:

sensory alalia- characterized by the fact that the child does not perceive what is said to him, he simply does not understand someone else’s speech, but at the same time he can hear, make sounds and pronounce simple words. His flow of speech is incoherent and unintelligible;
motor alalia– in the case of the progression of this type of illness, the child pronounces words quietly and indistinctly, but in most cases children cannot speak at all. Understanding of what other people say is not impaired; the child can even show understanding of the meaning of words using gestures;
sensorimotor alalia– the most severe form of the disorder, combining the inability to understand speech and reproduce it.

Symptoms

Signs of the disease depend on the form of the disease. So, the symptoms of motor alalia are:

violation of fine motor skills. The child cannot fasten buttons or tie shoelaces on his own;
frequent mood changes;
excessive activity may be replaced by lethargy and inactivity;
absent-minded attention;
low performance;
increased fatigue;
complete absence of speech or unclear reproduction of sounds;
poor vocabulary, which leads to an incomplete understanding of what others say;
pronounced facial expressions and gestures.

The following symptoms are characteristic of sensory alalia:

increased sensitivity to sounds, since children are unable to understand anything else;
a meaningless and incoherent set of sounds and words that the child reproduces;
widespread use of facial expressions and gestures in communication;
speech disorders in the form of missing letters in words, incorrect endings, or combining two words into one;
slight memory impairment, children remember new words very difficultly or generally not at all;
impulsiveness is replaced by isolation, and activity by passivity.

Against the background of the fact that the child cannot distinguish the speech that is spoken to him, he develops the ability to read words by lips.

Diagnostics

Since alalia occurs against the background of problems with the functioning of the brain, diagnostic methods will be aimed at studying the extent and assessment of damage in the brain. To do this, the little patient needs to go through:

electroencephalography – which evaluates impulse transmission and brain activity;
echoencephalography - the study of brain pathologies, which is carried out using ultrasound;
X-ray of the skull;

To exclude motor alalia and, accordingly, confirm sensory alalia, additional diagnostic methods are carried out, including:

otoscopy, which is performed to examine ear canal and eardrum;
audiometry – with the help of which hearing acuity is assessed and the minimum sound intensity that a child can hear is determined.

In addition, it is necessary to consult a speech therapist who diagnoses and evaluates auditory-verbal memory and speech. You may also need consultations with pediatric doctors such as a neurologist, otolaryngologist and psychologist.

Treatment

Therapy of this disorder is based on test results and the degree of manifestation of symptoms, and therefore will be developed individually for each little patient. The most favorable age for treating the disease is considered four years old; it is during this period that the child shows the greatest interest in the world around him.

Common treatments include:

courses with a speech therapist, which are often combined with appointments medicines. Classes with a doctor will be effective for all forms of the disease. The treatment regimen is drawn up for each child separately - it takes into account general condition health, age and degree of disorder. The task of a speech therapist is to develop speech ability, teach how to correctly pronounce words and construct phrases, and also increase vocabulary. Taking medications is aimed at improving the nutrition of the brain (a complete supply of vitamins and nutrients);
carrying out therapeutic speech therapy massages faces. This treatment helps to tone and relax the facial muscles, which can reduce the appearance of some symptoms.
physiotherapy, the purpose of which is to influence certain areas of the brain with electrical impulses. This method of treatment does not harm health and is completely painless, so it can be performed on children under the age of one year.

If you carry out timely, and most importantly, well-chosen treatment, the child will get rid of all the symptoms of the disease or learn to control them. But the main thing is that he will be able to study in secondary school and adapt to society.

Parental support plays an important role in therapy, since it is important for the child to know that his successes in treatment do not go unnoticed by those closest to him; this will provide an additional incentive for a speedy recovery, which further facilitates treatment.

Prevention

Prevention of alalia mainly consists of:

for a favorable pregnancy, it is best if during this period of life the woman stays at a resort or sanatorium;
refusal bad habits the expectant mother is still at the stage of pregnancy planning;
timely treatment of infectious diseases, the symptoms or complications of which may harm the fetus;
protection from consumption medicinal substances for no apparent reason or doctor's orders;
enriching the diet with vitamins and nutrients that should reach the fetus;
regular visits to the obstetrician-gynecologist.