Shortened hypoglossal ligament.

Macroglasia - large tongue

Microglasia - small tongue

Forked tongue

Unformed tip of the tongue

Prognathia - the upper jaw protrudes strongly forward.
Progeny - the lower jaw protrudes forward
Open bite - closure between the teeth of the upper and lower jaws.

(anterior open bite)

Lateral open bite

Irregular structure of teeth and dentition.

Incorrect structure of the palate. interferes with the correct articulation of many sounds.

Thick lips with a drooping lower lip, or a shortened, inactive upper lip make it difficult to clearly pronounce labial and labiodental sounds. makes proper articulation difficult.

Functional dyslalia. Her reasons
Functional dyslalia is a type of incorrect sound pronunciation in which there are no defects in the articulatory apparatus. That is, there is no organic basis.

One of the common causes of functional dyslalia is improper education of the child’s speech in the family. Sometimes adults adapt to the child’s speech for a long period. As a result, the development of correct sound pronunciation is delayed for a long time.

Dyslalia can also occur in a child by imitation. As a rule, constant communication with young children who have not yet formed the correct sound pronunciation is harmful for the child. Often a child imitates the distorted sound pronunciation of adult family members. Children are especially harmed by constant communication with people whose speech is unclear, tongue-tied or too hasty, and sometimes with dialectal peculiarities.

Bilingualism in the family also has a bad effect on children's speech. When speaking different languages, a child often transfers the pronunciation features of one language to another.
The child’s speech is not subject to the necessary systematic influence from adults, which inhibits the normal development of pronunciation skills.

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  Dislalia functional And mechanical. Reasons. Mechanical(organic) dyslalia is a type of incorrect sound pronunciation that is caused by organic defects of the peripheral speech apparatus...


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  Dislalia functional And mechanical. Reasons. Mechanical(organic) dyslalia name the type of incorrect sound pronunciation that causes.


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  Dislalia functional And mechanical. Reasons.
  M.E. Khvattsev defined such disorders as diffuse, or general, tongue-tied and pointed out its connection with speech underdevelopment.


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  She identified only two forms: functional And mechanical, the latter also included rhinolalia.
  Refusal of the general term " tongue-tied"Because this is a symptom. There are currently 2 forms left. dyslalia


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  Cause- an anomaly in the structure of the articulatory apparatus or features of speech education. Distinguish mechanical And functional dyslalia. Mechanical dyslalia caused by a violation of the structure of the articulatory apparatus, malocclusion...


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  Motor functional dyslalia. Phonological and anthropophonic defects. DYSLALIA- speech impairment. At the core dyslalia may lie or functional(reversible) neur.


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  Dislalia functional And mechanical. Reasons. Mechanical(organic) dyslalia name a type of incorrect sound pronunciation that causes ... more ”.


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  Principles 1 because violation functional other complex effects are used only with mechanical Articulatory-phonetic dyslalia. (due to incorrectly formed articulatory positions.)


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  Formation of the articulatory base of sounds during functional dyslalia carried out in a shorter time than with mechanical dyslalia.


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  Principles 1 because violation functional other complex.impacts are applied only with mechanical dyslalia 2 areas of systemicity 3 areas of etiopathogenetic 4 areas of development (they give a prognosis, 1 month of work is given for 1 sound.

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Functional dyslalia.

Functional dyslalia is a type of incorrect sound pronunciation in which there are no defects in the articulatory apparatus. In other words, there is no organic basis.

One of the common causes of functional dyslalia is improper education of the child’s speech in the family. Sometimes adults, adapting to the child’s speech, being touched by his amusing babble, “lisp” with the baby for a long period. As a result, the development of correct sound pronunciation is delayed for a long time.

Dyslalia can also occur in a child by imitation. As a rule, constant communication with young children who have not yet formed the correct sound pronunciation is harmful for the child. Often a child imitates the distorted sound pronunciation of adult family members. Children are especially harmed by constant communication with people whose speech is unclear, tongue-tied or too hasty, and sometimes with dialectal peculiarities.

Bilingualism in the family also has a bad effect on children's speech. When speaking different languages, a child often transfers the pronunciation features of one language to another.

Often the cause of dyslalia in children is the so-called pedagogical neglect, when adults do not pay any attention to the child’s sound pronunciation, do not correct the child’s mistakes, and do not give him a model of clear and correct pronunciation. In other words, the child’s speech is not subject to the necessary systematic influence of adults, which inhibits the normal development of pronunciation skills.

Sound pronunciation defects in children can also be caused by underdevelopment of phonemic hearing. In this case, the child has difficulties in differentiating sounds that differ from each other by subtle acoustic features, for example, voiced and voiceless consonants, soft and hard whistling and hissing consonants. As a result of such difficulties, the development of correct sound pronunciation is delayed for a long time.

At the same time, deficiencies in sound pronunciation, especially in those cases when they are expressed in the replacement of sounds or in mixing them in words, can, in turn, complicate the formation of phonemic hearing and subsequently cause general underdevelopment of speech and impairments in writing and reading.

Dyslalia can also be a consequence of insufficient mobility of the organs of the articulatory apparatus: tongue, lips, lower jaw.

It can also be caused by the child’s inability to hold the tongue in the desired position or quickly move from one movement to another.

Dyslalia in children can also be caused by hearing loss. Up to 10% of cases of sound pronunciation disorders occur due to hearing loss. Most often, there is difficulty in differentiating hissing and whistling sounds, voiced and voiceless consonants.

The cause of severe and prolonged dyslalia may also be insufficient mental development of the child. In over 50% of cases, oligophrenic children have problems with sound pronunciation.

Dysarthria

Dysarthria is a violation of the sound-pronunciation side of speech, caused by organic insufficiency of innervation of the speech apparatus. The term “dysarthria” is derived from the Greek words arthson - articulation and dys - particle meaning disorder.

The main manifestations of dysarthria are a disorder of articulation of sounds, disturbances in voice formation, as well as changes in the rate of speech, rhythm and intonation.

These disorders manifest themselves to varying degrees and in various combinations depending on the location of the lesion in the central or peripheral nervous system, the severity of the disorder, and the time of occurrence of the defect.

Articulation and phonation disorders, which make it difficult and sometimes completely prevent articulate sonorous speech, constitute the so-called primary defect, which can lead to secondary manifestations that complicate its structure.

Clinical, psychological and speech therapy studies of children with dysarthria show that this category of children is very heterogeneous in terms of motor, mental and speech disorders. The causes of dysarthria are organic lesions of the central nervous system as a result of the influence of various unfavorable factors on the developing brain of a child in the prenatal and early periods of development. Most often, these are intrauterine lesions that are the result of acute, chronic infections, oxygen deficiency (hypoxia), intoxication, toxicosis of pregnancy and a number of other factors that create conditions for the occurrence of birth trauma. In a significant number of such cases, asphyxia occurs during childbirth and the child is born premature.

The cause of dysarthria may be Rh factor incompatibility. Somewhat less frequently, dysarthria occurs under the influence of infectious diseases of the nervous system in the first years of a child’s life.

Dysarthria is often observed in children suffering from cerebral palsy (CP). According to E.M. Mastyukova, dysarthria with cerebral palsy manifests itself in 65 - 85% of cases.

The classification of clinical forms of dysarthria is based on identifying different locations of brain damage. Children with various forms of dysarthria differ from each other in specific defects in sound pronunciation, voice, and articulatory motor skills; they require different speech therapy techniques and can be corrected to varying degrees.

Rhinolalia

In the figure, the movement of the soft palate: A - the soft palate is raised and pressed tightly against the back wall of the pharynx. The timbre of the voice when pronouncing all speech sounds, except nasal ones, is normal; B - the soft palate is raised and pressed against the thickened posterior wall of the pharynx. Voice timbre is normal; B - the soft palate is not raised enough. There is no contact between the soft palate and the walls of the pharynx. Exhaled air freely penetrates into the nasal cavity. Voice timbre: nasal

Forms of rhinolalia

Depending on the nature of the dysfunction of the velopharyngeal closure, various forms of rhinolalia are distinguished.

Closed rhinolalia

Closed rhinolalia (The term “rhinolalia” is appropriate only in cases where there are other disorders of the articulation of sounds. In other cases, the term “rhinophonia” is used.) is characterized by reduced physiological nasal resonance during the pronunciation of speech sounds. The strongest resonance is normally observed when pronouncing the nasal m, m "n, n". During the articulation of these sounds, the nasopharyngeal valve remains open and air enters the nasal cavity. If there is no nasal resonance, these phonemes sound like oral b, b, d, d.

In addition to the pronunciation of nasal consonants, with closed rhinolalia, the pronunciation of vowels is impaired. It takes on an unnatural, dead hue.

The causes of closed rhinolalia are most often organic changes in the nasal space or functional disorders of the velopharyngeal closure. Organic changes are caused by painful phenomena, as a result of which the nasal passage decreases and nasal breathing becomes difficult. Anterior closed rhinolalia occurs with chronic hypertrophy of the nasal mucosa, mainly the posterior parts of the inferior conchae, with polyps in the nasal cavity, with a deviated nasal septum and with tumors of the nasal cavity. Posterior closed rhinolalia in children is most often the result of large adenoid growths, occasionally nasopharyngeal polyps, fibroids or other nasopharyngeal tumors.

Functional closed rhinolalia occurs frequently in children, but is not always correctly recognized. It is characterized by the fact that it occurs with good patency of the nasal cavity and undisturbed nasal breathing. With functional closed rhinolalia, the timbre of nasal and vowel sounds may be more disturbed than with organic rhinolalia. The reason is that the soft palate rises above normal during phonation and pronunciation of nasal sounds and blocks sound waves from accessing the nasopharynx. Similar phenomena are more often observed in neurotic disorders in children.

With organic closed rhinolalia, the causes of obstruction in the nasal cavity are first eliminated. As soon as correct nasal breathing appears, the defect disappears. If, after eliminating the obstruction of the nasal cavity (for example, after adenotomy), closed, rhinolalia or rhinophonia continues in the usual form, resort to the same exercises as for functional disorders. With functional closed rhinolalia, children are systematically trained in pronouncing nasal sounds. Preparatory work is being carried out to differentiate oral and nasal inhalation and exhalation.

Open rhinolalia

Normal phonation is characterized by the presence of a seal between the oral and nasal cavities, when vocal vibration penetrates only through the oral cavity. If the separation between the nasal cavity and the oral cavity is incomplete, the vibrating sound penetrates into the nasal cavity. As a result of disruption of the barrier between the oral and nasal cavities, vocal resonance increases. At the same time, the timbre of sounds, especially vowels, changes. The timbre of the vowel sounds and and, y changes most noticeably, at the articulation of which the oral cavity is most narrowed. The vowel sounds e and o sound less nasally, and the vowel a is even less disturbed, since when it is pronounced the oral cavity is wide open.

In addition to the timbre of vowel sounds, with open rhinolalia the timbre of some consonants is disrupted. When pronouncing hissing sounds and fricatives f, v, x, a hoarse sound is added that occurs in the nasal cavity. The plosive sounds ga, b, d, t, k and g, as well as sonorant l and r, sound unclear, since the air pressure necessary for their accurate pronunciation cannot be generated in the oral cavity. With prolonged open rhinolalia (especially organic), the air flow in the oral cavity is so weak that it is insufficient to vibrate the tip of the tongue, which is necessary to produce the sound p.

Open rhinolalia can be organic and functional.

Organic open rhinolalia can be congenital or acquired.

The most common cause of the congenital form is a cleft of the soft and hard palate.

Acquired open rhinolalia is formed due to trauma to the oral and nasal cavities or as a result of acquired paralysis of the soft palate.

The causes of functional open rhinolalia can be different. For example, it occurs during phonation in children with sluggish articulation of the soft palate. The functional open form manifests itself in hysteria, sometimes as an independent defect, sometimes as an imitative one.

One of the functional forms is habitual open rhinolalia, observed, for example, after removal of large adenoid growths, and occurs as a result of long-term restriction of the mobility of the soft palate.

A functional examination of open rhinolalia does not reveal organic changes in the hard or soft palate. A sign of functional open rhinolalia is also the fact that the pronunciation of only vowel sounds is usually impaired, while when pronouncing consonants, the velopharyngeal closure is good and nasalization does not occur.

The prognosis for functional open rhinolalia is more favorable than for organic one. The nasal timbre disappears after phoniatric exercises, and pronunciation disorders are eliminated by the usual methods used for dyslalia.

Rhinolalia, caused by congenital nonunion of the lip and palate, represents a serious problem for speech therapy and a number of medical sciences (dentistry surgery, orthodontics, otolaryngology, medical genetics, etc.). Cleft lip and palate are the most common and severe congenital malformations.

As a result of this defect, children experience serious functional disorders during their physical development.

In children with congenital nonunion of the lip and palate, the act of sucking is very difficult. It presents particular difficulties in children with a through cleft lip and palate, and with bilateral through clefts this act is generally impossible.

Difficulty feeding leads to a weakening of vitality, and the child becomes susceptible to various diseases. Children with clefts are most susceptible to upper respiratory tract catarrh, bronchitis, pneumonia, rickets, and anemia.

Often, such children experience pathological changes in the ENT organs: curvature of the nasal septum, deformation of the wings of the nose, adenoids, hypertrophy (enlargement) of the tonsils. They often experience inflammatory processes in the nasal area. The inflammatory process can move from the mucous membrane of the nose and pharynx to the Eustachian tubes and cause inflammation of the middle ear.

Frequent otitis media, often taking a chronic course, cause hearing loss. Approximately 60 - 70% of children with cleft palate have hearing loss of varying degrees (usually in one ear) - from a slight decrease that does not interfere with speech perception, to significant hearing loss.

Deviations in the anatomical structure of the lip and palate are closely related to underdevelopment of the upper jaw and malocclusion with defective arrangement of teeth.

Numerous functional disorders caused by defects in the structure of the lip and palate require constant medical supervision.

In our country, conditions have been created for complex treatment in specialized centers at the Research Institute of Traumatology, at the departments of surgical dentistry, as well as in other institutions where a lot of medical and preventive work is carried out.

Doctors from various specialties observe children and jointly decide on a comprehensive treatment plan.

During the first years of a child’s life, the leading role belongs to the pediatrician, who manages the feeding and daily routine of the baby, carries out prevention and treatment, and, if necessary, recommends outpatient or inpatient treatment.

Surgery to restore the upper lip (cheiloplasty) is recommended in the first year of a child’s life; it is often performed in maternity hospitals in the first days after birth.

In cases of cleft palate, the orthodontist uses various devices, including an obturator, which facilitate nutrition and create conditions for speech development in the preoperative period. The otolaryngologist identifies and treats all painful changes in the ear, nasal cavities, nasopharynx and larynx and prepares children for surgery.

Left-sided cleft lip and alveolar ridge

Left-sided cleft palate

In case of deviations in mental development and the presence of pronounced neurotic reactions, the child is consulted by a neurologist.

Palate restoration surgery (uranoplasty) is performed in most cases in preschool age.

According to the state of mental development, children with cleft palate are divided into three categories: children with normal mental development; children with mental retardation; children with oligophrenia (of varying degrees). During a neurological examination, signs of significant focal brain damage are usually not observed. Some children have individual neurological microsigns. Much more often, children experience functional disorders of the nervous system, sometimes significantly pronounced psychogenic reactions, and increased excitability.

In addition to all of the above, congenital cleft palates have a negative impact on the development of a child’s speech.

Cleft lip and palate play different roles in the formation of speech underdevelopment. This depends on the size and shape of the anatomical defect.

The following types of clefts are found:

1) cleft lip; upper lip and alveolar process;

2) clefts of the hard and soft palate;

3) clefts of the upper lip, alveolar process and palate - one-sided and two-sided;

4) submucosal (submucosal) cleft palate.

With cleft lips and palates, all sounds acquire a nasal or nasal tone, which grossly interferes with the intelligibility of speech.

It is typical to superimpose additional noises on nasal sounds, such as aspiration, snoring, larynx, etc.

A specific disturbance in voice timbre and sound pronunciation occurs.

To prevent food from passing through the nose, a child from a very early age acquires the habit of raising the back of the tongue to block the passage into the nasal cavity. This tongue position becomes habitual and also changes the articulation of sounds.

Alalia

Alalia is one of the most severe speech defects, in which the child is practically deprived of linguistic means of communication: his speech is not formed independently and without speech therapy assistance.

Alalia (from Greek a - a particle meaning negation, and Lat. lalia - speech) - absence of speech or systemic underdevelopment of speech due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of a child’s development (before speech formation).

Alalik children represent a pedagogically heterogeneous group and differ in the severity of the defect and the productivity of correctional work.

Alalia is observed in children with intact peripheral hearing and articulatory apparatus, who have sufficient intellectual capabilities for speech development.

Lack of speech sharply limits the child’s full development and communication with others. And this, in turn, leads to a gradual lag in mental development, which in this case is of a secondary nature. Alalik children differ significantly from oligophrenics (mentally retarded): as speech develops and under the influence of special training, the intellectual lag gradually disappears.

The causes of speech formation disorders are associated with organic lesions of the central nervous system. These include: inflammatory, traumatic brain lesions (complications after meningo-encephalitis, rubella, trauma); cerebral hemorrhages due to difficult and rapid labor; metabolic disorders during the period of intrauterine development of the fetus, during labor, as well as during the early development of a child aged from one month to one year (N. N. Traugott, V. K. Orfinskaya, M. B. Eidinova, etc. .). In addition, the occurrence of alalia is possible in children who have suffered severe rickets, complex diseases of the respiratory system, sleep and nutrition disorders in the early months of life (E. Frechels, Yu. A. Florenskaya, N. I. Krasnogorsky, etc.).

Depending on the predominant localization of damage to the speech areas of the cerebral hemispheres (Wernicke's center, Broca's center), two forms of alalia are distinguished: motor and sensory.

Motor alalia is associated with a disruption of the speech-motor analyzer, and sensory alalia is associated with a disruption of the speech-auditory analyzer. However, such a division currently no longer exhausts the variety of manifestations of alalia in children.

Motor alalia

Motor alalia is the result of an organic disorder of a central nature. Such an unhealthy neurological background, combined with a severe delay in speech development, leads to a decrease in speech activity, the emergence of speech negativism (reluctance to speak), and a gradual lag in mental and intellectual development. The famous researcher of children's speech A. B. Bogdanov-Berezovsky pointed out that children's aphasia (alalia) is not only associated with disorders of certain areas of the brain, resulting in a disorder of the entire speech function, but is also necessarily reflected in the general sphere of intelligence.

Manifestations of neurological deficiency are often accompanied by an incorrect educational approach on the part of parents, most often caused by an overly careful, gentle attitude towards an unhealthy, weak child. Requirements for such children are reduced; relatives try to protect them from even necessary and completely feasible work. And this, in turn, aggravates the child’s negative personality traits: he often becomes more stubborn, capricious, and irritable.

These children's independent household self-care skills are insufficient: they dress poorly, do not know how to button buttons, lace shoes, tie a bow, etc. General motor skills are also impaired: children move awkwardly, stumble and fall more often than usual, cannot jump on one leg, walk along a log, move rhythmically to music, etc. The development of motor skills of the articulatory apparatus lags behind. It is difficult for the child to reproduce certain articulatory movements (raise the tongue up and hold it in this position, lick the upper lip, click the tongue, etc.), as well as switching.

Children with alalia are characterized by insufficient development of higher mental functions such as attention and memory.

The weakened psychophysical state of children suffering from motor alalia is aggravated by increased fatigue and low performance.

N.N. Traugott noted that mental passivity, lethargy, and lack of initiative give alalik children the appearance of mentally retarded, which does not always correspond to the true state of their intelligence.

A characteristic feature of motor alalia is the predominance of expressive speech disorders (Expressive speech (from Latin express) - expression, statement), i.e. a sharp decrease in the ability to make independent coherent statements. Children have difficulties in mastering active vocabulary, grammatical structure of speech, sound pronunciation and syllabic structure of words.

These manifestations are observed against the background of a relatively full understanding of speech.

With motor alalia, different levels of speech development can be observed, identified and described by Professor R. E. Levina: from the complete absence of common speech to extensive phrasal speech with elements of lexico-grammatical and phonetic-phonemic underdevelopment (For a detailed description of each level of speech development, see Chapter VII of this manual.)

Thus, the state of speech in alalik children is characterized by great diversity and depends on the severity of the neurological disorder, the conditions of upbringing and the speech environment, the time and duration of speech therapy, and largely on the compensatory capabilities of the child: mental activity, state of intelligence and emotional-volitional sphere .

The speech of Alalik children is mostly incomprehensible to a non-specialist during short-term communication. Amorphous formations of the “cha bang” type; “deka mo” (the cup fell; the girl is washing) can only be understood in the immediate situation, when speech is supported by appropriate gestures and facial expressions. A child at the first level of development cannot express actions, events or desires that are not related to a visual momentary situation and thus finds himself outside of verbal communication.

The second level of speech development gives the child the opportunity to express his individual observations and judgments in a more accessible form for others. For example: “Sec. Ipyata. Shabaka bisit goki. Matiki is melting, izya, syanka, kanka” - Snow. Guys. The dog runs down the hill. Boys ski, sled, skate; “Baby daddy was fired up. Papa kuti syain Katya. Katya ait syak. Yes, here and there. Syaik izi a virgin. Baby Patya. Atik daya syik” - The girl and dad were walking. Dad bought a balloon for Katya. Katya plays with a ball. The ball is flying here. The ball lies on the tree. The girl is crying. The boy gave the ball.

The speech of children with the third level of speech development includes more detailed statements. However, when analyzing them, errors in lexico-grammatical and phonetic design are clearly identified. For example: “Visiting Grandma Anya. My tota Nada, she is boteya, deevne, zivot. Katoski soyai, kat berries. Babuti Koev has both geese and manenka syanyata” - Was at Grandma Anya’s. My aunt Nadya, she was sick in the village. Stomach. Potatoes were sown. Red berries. Grandma has a cow and geese and little pigs.

With motor alalia, as mentioned above, understanding of speech addressed to the child is relatively intact. Children respond adequately to verbal requests from adults and carry out simple requests and instructions. Often, parents, in a conversation with a teacher and at an appointment with a speech therapist, speak about their child like this: “He understands everything, but he just doesn’t say anything.” However, a more thorough and targeted psychological and pedagogical examination of these children allows us to conclude that their understanding of speech is often limited only to everyday situations. For alalik children, tasks that involve understanding the singular and plural forms of verbs and nouns are difficult (“Show who they are talking about swimming and about whom they are swimming”; “Give me a mushroom, and take mushrooms for yourself”); forms of masculine and feminine past tense verbs (“Show me where Sasha painted the plane, and where Sasha painted the plane”); individual lexical meanings (“Show who is walking down the street and who is crossing the street”); spatial arrangement of objects (“Put the pen on the book, put the pen in the book”); establishing cause-and-effect relationships.

Errors in performing such tasks are explained by the fact that children primarily focus on the lexical meaning of the words that make up the instructions, and do not take into account grammatical and morphological elements (endings, prepositions, prefixes, etc.) that clarify the meaning.

Difficulties in understanding speech persist for a long time; special training is required to eliminate them. The appearance of a child’s successful understanding of the speech addressed to him is usually created by parents due to the usual conditions of communication and the use of everyday speech cliches (“Put the pencils in a box”; “Pour milk into a cup”, etc.).

However, such a state of speech limits full participation in classes for an ala-lika child attending a general kindergarten and delays the assimilation of the program.

Such a gap between the level of a child’s own speech and the requirements imposed by a general preschool institution often leads to neurotic reactions, negativism, and sometimes serves as the basis for conflict for such a child both with peers and with the teacher. Knowing the reasons for these communication difficulties, the teacher must show patience and sensitivity, tactfully help children formulate speech statements, and protect them from negative assessments from fully developing peers.

In classes and outside of school hours, the teacher must take into account the delay of a child with alalia, take into account his individual characteristics and select the types of tasks available for him.

Violations of the semantic aspect of speech in children with motor alalia require long-term and systematic correction. This defect cannot be overcome without special training. The teacher is obliged to refer children with motor alalia to a speech therapist for subsequent placement in a special kindergarten.

Sensory alalia

In sensory alalia, the main structure of the defect is a violation of the perception and understanding of speech (the impressive side of speech) with full physical hearing. Sensory alalia is caused by damage to the temporal regions of the brain in the left hemisphere (Wernicke's center).

Children either do not understand speech addressed to them at all, or understand it extremely limitedly. At the same time, they respond adequately to sound signals, and after a little training they can distinguish noises of different natures (knocking, grinding, whistling, etc.). At the same time, children experience great difficulty in determining the direction of sound.

Children with sensory alalia experience the phenomenon of echolalia - automatic repetition of other people's words. Most often, instead of answering a question, the child repeats the question itself.

In a number of cases, children try to name the objects or pictures presented to them and, at the same time, incorrectly fulfill the request to give (show) the same objects or pictures.

The leading defect for this rare category of children is a violation of phonemic hearing (perception of phonemes of the native language), which manifests itself to varying degrees. It can cause complete indistinction of speech sounds, i.e., the child’s failure to understand the speech addressed to him, and in milder cases, difficulty in perceiving speech material by ear.

Lack of phonemic hearing may manifest itself in the fact that children do not distinguish words that are similar in sound but different in meaning (daughter - barrel; mouse - bowl; cancer - varnish), and do not catch the difference in grammatical forms.

Children suffering from sensory alalia are often confused with children who are hard of hearing (see chapter “Speech impairments in children with hearing impairments”), with sensory aphasics (see chapter “Aphasia”).

The teacher should avoid drawing too categorical conclusions about the mental development of a child with sensory alalia. Failure to understand and fail to complete a speech task may be mistaken for intellectual disability. Therefore, in such cases, it is advisable to invite the child to complete a practical task based on a model, for example, to build a turret with a given alternation of elements, taking into account their shape, color, size, or to lay out a geometric figure from a mosaic. It is important to find out how the child navigates the didactic material, whether he accepts the help of the teacher, and whether he imitates other children. The responsibilities of the educator include timely identification of such a child and referral to a consultation with an otolaryngologist (at the hearing aid center) to examine hearing using objective methods, and then to a neuropsychiatrist and speech therapist.

Stuttering

Stuttering is one of the most severe speech defects. It is difficult to eliminate, traumatizes the child’s psyche, slows down the correct course of his upbringing, interferes with verbal communication, and complicates relationships with others, especially in children’s groups.

Externally, stuttering manifests itself in involuntary stops at the moment of utterance, as well as in forced repetitions of individual sounds and syllables.

These phenomena are caused by muscle spasms of certain organs of speech at the time of pronunciation (lips, tongue, soft palate, larynx, pectoral muscles, diaphragm, abdominal muscles).

In modern speech therapy, stuttering is defined as a violation of the tempo-rhythmic organization of speech, caused by a convulsive state of the muscles of the speech apparatus.

Prevalence of stuttering among children. At the end of the 19th century. Our domestic psychiatrist I.A. Sikorsky was the first to establish that stuttering occurs in most cases between the ages of 2 and 5 years, and therefore called it a “childhood disease.”

According to scientists, both Soviet and foreign, approximately 2% of the total number of children stutter. Moreover, stuttering occurs four times more often in boys than in girls.

Dyslalia is a pathology that is associated with incorrect reproduction of sounds in the presence of normal hearing and innervation of the articulatory apparatus. The main risk group is children of preschool and primary school age. The causes of the disease will differ depending on its type, but the fundamental factors are abnormalities in the structure of the tongue, lips, teeth or jaws, as well as the influence of social factors.

Establishing a correct diagnosis requires consulting a large number of specialists from various fields of medicine. Laboratory and instrumental diagnostic measures are not provided.

Treatment of pathology consists of several stages, which is why it takes a lot of time and requires serious work not only by the doctor, but also by the small patient.

In the International Classification of Diseases, Tenth Revision, such a disorder is classified as “specific disorders of the development of speech and language” - ICD-10 code – F80.

Etiology

There are a large number of predisposing factors that can lead to the occurrence of such a disease, which is why they are usually divided into several categories.

The first group is based on organic defects that lead to the appearance of a mechanical form of the disease. It follows from this that the causes of mechanical dyslalia include:

• incorrect structure of the components of the peripheral articulatory apparatus - these include the tongue and lips, teeth and jaws;
• short frenulum of the tongue, less often the upper lip;
• massive or, conversely, excessively small and narrow language;
• thick and sedentary lips;
• shortening of the hyoid ligament;
• malocclusion;
• anomalies in the structure of the dentition;
• narrow, low or flat upper palate.

Such disorders can be either congenital or acquired. In the second case, diseases and injuries of the dental system play a fundamental role. It is necessary to take into account that the presence or not does not lead to dyslalia, but becomes the cause of another type of speech dysfunction called rhinolalia.

The main difference between mechanical dyslalia and functional dyslalia is that in the second case the structure of the components of the articulatory apparatus is not disturbed. This means that there is completely no organic basis, which can lead to incorrect sound pronunciation.

The most likely causes of functional dyslalia are:

• illiterate speech education of a child - this includes imitation of children’s speech and constant “lisping”;
• raising a child in a family in which several foreign languages ​​are spoken - in this case there is a frequent transition from one pronunciation to another, and the borrowing of some syllables or words is often noted;
• underdevelopment of auditory perception of sounds;
• pedagogical neglect;
• ignoring the fact that the child pronounces some syllables or words incorrectly;
• low mobility of the speech apparatus, which leads to the inability to correctly pronounce certain sounds;
• mental development disorders;
• weakened immunity of the child - clinicians have noted that it is often sick children who suffer from such a disorder.

It is worth noting that this form of speech impairment is considered one of the most common in speech therapy, since it occurs:

• approximately every third child of preschool age, i.e. five to six years old;
• in 20% of cases among primary schoolchildren;
• in 1% of all cases in children over eight years of age.

Classification

Depending on the severity of the disease, dyslalia is divided into:

• simple– characterized by incorrect pronunciation of only one group of sounds, for example, hissing or whistling;
• complex dyslalia– differs in that more than two groups of sounds are reproduced defectively. In such cases they talk about polymorphic dyslalia.

Depending on the causes of occurrence, the pathology has several forms:

• mechanical dyslalia– has an organic basis;
• functional dyslalia– is caused by the influence of social factors or the presence of reversible neurodynamic disorders in the cerebral cortex.

Each of the above forms has its own classification. Thus, the mechanical form of such a speech disorder is divided into:

• sensory dyslalia– is formed against the background of neurodynamic changes with localization in the central parts of the speech-hearing apparatus. In such cases, the child cannot distinguish similar sounds;
• motor dyslalia– is caused by similar changes in the speech motor analyzer. This means that the baby is not moving his lips or tongue correctly.

In addition, the following forms of functional dyslalia are distinguished:

• articulatory-phonemic– expressed in replacing sounds with the most similar ones;
• articulatory-phonetic– differs in that the child cannot correctly identify all the constituent words by ear;
• acoustic-phonemic– characterized by distorted pronunciation of sounds.

Phonetic disturbances in the pronunciation of sounds that belong to different groups in dyslalia are often designated by terms derived from letters characteristic of the Greek alphabet. Thus they are expressed as:

• rotacism;
• lambdacism;
• sigmatism;
• iotacism;
• gammatism;
• Kappacism;
• hitism.

This classification also includes disorders of voicing and deafening, as well as softening and hardness. In the presence of such a speech disorder, in the vast majority of cases, the presence of complex combined defects is observed.

Speech therapists identify physiological dyslalia - it is explained by age-related ramifications of phonemic perception. This type of disorder disappears on its own at about the age of five.

Symptoms

The characteristic clinical manifestations of the disease are:

• omission of some sounds - in this case, clinicians imply the complete absence of one or another position, which can be located in any part of the word;
• replacing letters in a word with similar ones - such a persistent substitution occurs against the background of the inability to distinguish phonemes;
• distortion of the sound of a word - this is most characteristic of the functional form of dyslalia.

Despite the presence of such disorders, the child’s tongue-tiedness does not affect:

• vocabulary and grammar, which progresses with age;
• syllabic structure of the word;
• vocabulary – it is quite rich and often corresponds to the patient’s age category;
• correct use of cases;
• differentiating the plural from the singular;
• formation of coherent speech – it is at a high level.

Diagnostics

Establishing the correct diagnosis begins with general activities, which involve the clinician working with the patient’s parents and include:

• collecting a life history of a small patient, as well as studying data regarding the course of pregnancy and labor. In addition, it is very important for the doctor to find out what diseases the child has suffered. This often makes it possible to determine the causes and type of the disease;
• visual inspection – necessary to study the structure and mobility of the organs that make up the articulatory apparatus;
• a detailed survey of the patient’s parents regarding the first time of occurrence and severity of the characteristic symptoms of dyslalia in children.

Speech therapy examination is aimed at:

• assessment of the performance of some imitation exercises;
• studying the state of sound pronunciation - this will identify defectively pronounced sounds. In order to obtain relevant information, the doctor uses specific tests and asks you to repeat and draw what you heard. This is what will allow us to identify the nature of the violation, in particular the absence, replacement, confusion or distortion of sounds.

In addition, additional consultations with specialists from the following areas of medicine may be necessary:

• dentistry;
• child neurology;
• otolaryngology.

Some forms of dyslalia, in their clinical picture, may resemble other pathologies. It is for this reason that such a disease is, first of all, differentiated from an erased form of dysarthria.

Treatment

Correction of dyslalia is carried out using conservative methods and consists of several stages:

• preparatory;
• phases of formation of primary pronunciation skills;
• creation of communication abilities.

At the preparatory stage the following is carried out:

• elimination of anatomical disorders associated with the structure of the articulatory apparatus - this is indicated for organic dyslalia;
• articulatory gymnastics and speech therapy massage - when diagnosing the motor form of functional dyslalia;
• development of phonemic processes – in the presence of sensory functional speech impairment;
• improvement of fine motor skills;
• development of processing of sound pronunciation.

The phase of developing primary pronunciation skills is aimed at:

• production of a single sound;
• automation of sounds in a syllable, word, sentence and text;
• development of the ability to differentiate sounds.

At the last stage of treatment for dyslalia, the skills of error-free use of sounds are consolidated, regardless of the communication situation.

It is very important that classes with a speech therapist are held regularly, namely at least three times a week. Not least important is home therapy, aimed at completing tasks set by the clinician and performing articulatory gymnastics exercises. The duration of such treatment can vary from one month to six months, depending on the form and degree of neglect of the disease.

Prevention

Specific preventive measures to prevent the development of such speech impairment include:

• rational management of pregnancy and regular visits to an obstetrician-gynecologist;
• timely detection of anatomical disorders in the structure or functioning of the speech organs;
• surrounding the child with examples of correct, competent and complete speech, which he could imitate;
• parents providing the child with comprehensive care, full physical and mental development;
• control over the baby’s health;
• undergoing regular examination by a pediatrician.

Dyslalia is a speech disorder that in the vast majority of cases can be corrected and successfully treated. This is expressed in the complete absence of any speech disorders in adults who suffered such an illness in childhood. The duration and outcome of therapy is dictated by several factors, including the age category of the patient, the complexity of such a speech defect and the individual characteristics of the young patient.

Functional dyslalia - (Greek dysfunction - disorder + Greek Lalia - speech) a violation of sound pronunciation in the absence of organic disorders in the structure of the articulatory apparatus. Causes of functional dyslalia:

Incorrect education of a child’s speech in the family. Sometimes adults “babble” with the baby for a long time. As a result, the development of correct sound pronunciation may be delayed for a long time;

Functional dyslalia can occur by imitation. As a rule,

Constant communication with young children who have not yet developed correct sound pronunciation is harmful for the child. Often a child imitates the distorted sound pronunciation of adult family members. The development of children's speech is also harmed by constant communication with people whose speech is unclear, too hasty, or with dialectal features;

Bilingualism in the family does not always have a good effect on the development of children’s speech. When speaking different languages, a child often transfers the pronunciation features of one language to another;

Pedagogical neglect, when adults do not pay attention to the child’s sound pronunciation and do not correct his mistakes;

Sound pronunciation defects can be caused by underdevelopment of phonemic hearing. In this case, the child has difficulty in differentiating sounds that differ from each other by subtle acoustic features, for example, voiced and dull, soft and hard whistling and hissing;

Another cause of functional dyslalia may be insufficient mobility of the organs of the articulatory apparatus: tongue, lips, lower jaw. It can also be caused by the child’s inability to hold the tongue in the desired position or quickly move from one movement to another;

Functional dyslalia can also be caused by hearing loss. Most often, there are difficulties in differentiating hissing and whistling sounds, voiced and voiceless consonants;

Another cause of functional dyslalia may be insufficient mental development of the child. In children who are oligophrenic, in half of the cases there is a violation of sound pronunciation.

Rhinolalia.
Rhinolalia - (Greek rhinoceroses - nose + Greek Lаlia - speech) a violation of the timbre of the voice and sound pronunciation, caused by anatomical and physiological defects of the speech apparatus. Synonyms: nasality (obsolete), palatolalia. Rhinolalia is sometimes considered as a type of organic (mechanical) dyslalia, but more often it is distinguished as an independent speech disorder due to the pronounced nasal (that is, nasal, from the Latin chir - nose) timbre of the voice.

With rhinolalia, the articulation of sounds and phonation differ significantly from the norm.
With normal phonation, in addition to nasal sounds, a person experiences separation of the nasopharyngeal and nasal cavities from the pharyngeal and oral cavities. These cavities are separated by the palatopharyngeal closure. During speech, the soft palate continuously lowers and rises to different heights depending on the sounds being spoken. During normal pronunciation of the nasal sounds “m” - “m”, “n” - “n”, the air stream freely penetrates into the space of the nasal resonator. When the function of velopharyngeal closure is impaired, a nasal tone of speech appears, specific to rhinolalia. Depending on the nature of the dysfunction of the velopharyngeal closure, various forms of rhinolalia are distinguished: open rhinolalia, in which a change in timbre and distortion of pronunciation is explained by insufficient rise of the soft palate, which leads to the entry of a significant part of the air into the nasal cavity, and closed rhinolalia, in which the timbre of the voice changes due to decreased physiological nasal resonance. When a combination of nasal obstruction with insufficiency of velopharyngeal closure is observed, the so-called mixed form of rhinolalia dysarthria is distinguished.

Dysarthria (from the Greek words: dis - negation and arthgoo - to pronounce articulately) is a violation of the pronunciation aspect of speech, caused by insufficient innervation of the speech apparatus. It occurs when the tongue, lips, palate, vocal cords, and diaphragm cannot move fully. The cause of immobility is paresis (Greek paresis is a decrease in the strength or amplitude of movements caused by a violation of the innervation of the muscles of the articulatory apparatus. Thus, dysarthria is a symptom of organic damage to the central nervous system of the brain, those parts of it that make up the speech motor zone. This is a severe disorder of all speech activity. First of all, speech motor skills, all components of the speech motor act, suffer. With dysarthria, not only sound pronunciation is disrupted (almost all groups of sounds), but the entire prosodic organization of the speech act, the so-called speech prosody, including voice, intonation, tempo, rhythm, and also intonation, suffers. rhythmic side and emotional coloring of speech. Common manifestations of disorders in dysarthria are:

Pseudobulbar syndrome, expressed in impaired breathing, swallowing, voice formation, limited mobility of the entire articulatory apparatus, especially the tongue and lips;

Dystonia - unstable, changing tone;

Synkinesis, i.e. additional, involuntary movements joining voluntary ones, in particular, oral synkinesis.

There are bulbar, pseudobulbar, subcortical (extrapyramidal,

hyperkinetic), cortical, cerebellar and so-called “erased” forms of dysarthria.

Anarthria: Speech impairment in the most severe lesions of the central nervous system, when speech becomes almost impossible due to complete paralysis of the speech motor muscles, is called anarthria. When classifying dysarthria according to the degree of intelligibility of speech for others (1st degree, in which speech impairments can only be identified by a specialist, 2-a, in which speech is understandable to others, but disturbances in sound pronunciation are also noticeable to everyone, 3-a, when speech is understandable only to loved ones child and partially to others), anarthria belongs to the fourth, most severe degree and in turn can be divided into a severe form of anarthria, when speech and voice are completely absent, moderate, in which some sound reactions may be present, and mild, in the presence of a certain sound - syllable activity.

Tongue-tied: Previously, a now obsolete term was used to denote dysarthria and (only) the outwardly similar dyslalia: tongue-tiedness.

Dysarthria - neurological diagnosis. A speech therapist deals with the correction of impaired speech functions, and drug treatment is prescribed by a neuropsychiatrist.
Treatment of dysarthria is possible only by using a complex method that combines different types of therapeutic effects:

Medicines.

Physiotherapy, exercise therapy, acupuncture to normalize muscle tone and increase the range of motion of the articulation organs.

General supportive and hardening treatment to strengthen the body.

Treatment of concomitant diseases.

Speech therapy work on the development and correction of speech.

In all types of treatment for a child with dysarthria, parents play an extremely important role. First of all, this applies to speech therapy classes. Parents should know why certain exercises are done and understand their content.
and present expected results.

Speech therapy for dysarthria is aimed at developing the organs of articulation. It includes:

Massage of articulation organs;

Articulation gymnastics;

Correction of pronunciation of speech sounds;

Work on the expressiveness of speech.

Speech therapy work for dysarthria is very labor-intensive, multifaceted and requires

systematic exercises with professionals and home exercises with parents.

General speech underdevelopment (GSD) and speech development delay (SDD)
(Differential diagnosis)

The issues of distinguishing general speech underdevelopment (GSD) from temporary reversible conditions, usually interpreted as delayed speech development (SDSD), are resolved differently by different researchers. Some authors, understanding by ONR the insufficient formation of all language systems, include more reversible states in this concept. But a dialectical approach to the problems of speech disorders in children makes it necessary to distinguish between various speech development disorders depending on the dynamics of their manifestation and overcoming. Some children who at a certain age have immaturity in all aspects of speech, with systematic speech therapy classes, can completely overcome their speech defect and subsequently study in a public school. The other part of children with similar speech disorders, even after systematic sessions with a speech therapist, in some cases are unable to completely overcome their speech impairment, subsequently study in special schools for children with speech disorders and continue to have severe speech disorders. It follows from this that, both in practical and theoretical terms, it is advisable to separate more reversible conditions into a special group of speech disorders.

First of all, it is necessary to distinguish between the general underdevelopment of speech and the delay in the rate of its formation. So, the development of a child’s speech with delayed speech development differs from normal only in its pace. In addition, children with delayed speech development are capable of independently mastering language generalizations (for example, a child understands that a coat, a hat is clothing, a cup, a plate are utensils, etc.), which is inaccessible to children with SLD (children with SLD master language generalizations mainly only in the process of speech therapy sessions).
General speech underdevelopment (GSD) and delayed speech development in children with hearing impairment (differential diagnosis)

The exclusive role of hearing in the development of children's speech determines the need to differentiate general speech underdevelopment from speech disorders caused by

hearing impairment (formerly called hearing loss).

Disturbances in speech development caused by hearing impairment are largely associated with the time of hearing loss, as well as with the nature of the hearing defect. Based on the time of occurrence, all hearing impairments are divided into three groups:

Congenital,

Occurred during childbirth,

Acquired after birth.

The latter are divided into periods:

Up to 3 years, when hearing defects that arise disrupt the formation of speech or completely stop its development,

After 3 years, when speech function may decline due to hearing defects.

Insufficiency of the auditory analyzer function leads to a disruption in the development of all aspects of speech - phonetic, lexical, grammatical, semantic, and in some cases to a complete absence of speech. The degree of speech impairment depends not only on the severity of the hearing defect, but also on the time of its appearance and on the conditions of the child’s development.

Currently, methods have been developed for objective assessment of hearing status, starting from the neonatal period, using electrocortical audiometry. An important criterion for the risk of hearing impairment in children is medical history. It is known that rubella, measles, influenza, herpes virus in the mother in the first trimester of pregnancy and other viral and infectious diseases of the mother during pregnancy adversely affect the child’s hearing system. Hearing impairment is more common in prematurity. The cause of hearing impairment may also be maternal alcoholism during pregnancy, incompatibility of the blood of mother and fetus according to the Rh factor, incompatibility of the blood group of mother and fetus, causing jaundice in the newborn or neurological disorders, clinically designated as bilirubin encephalopathy. In addition, the risk group for hearing impairment includes children with various otolaryngological diseases (adenoids, otitis, etc.), as well as children with various chromosomal and hereditary diseases. The risk group also includes children with parents or relatives with congenital hearing impairments. Attention should also be paid to frequent inflammatory diseases of the middle ear - recurring otitis media that occur during critical periods of development of the auditory and speech systems.

Alalia

Alalia(from the Greek: “a” - negation and “lalio” - I say, speech; translated as absence of speech) - absence or underdevelopment of speech resulting from organic damage to the central nervous system. The causes of alalia are most often birth injuries, as well as injuries and brain disease in children under 1.5 years of age, leading to damage to the speech areas of the cerebral cortex. Depending on which speech centers were affected, motor alalia (expressive), characterized by persistent underdevelopment of speech with partially preserved understanding of someone else's speech, is distinguished, and sensory alalia (impressive), in which speech understanding is primarily impaired. Alalia is a systemic underdevelopment of speech, in which all its components are disrupted: the phonetic-phonemic side, the lexical-grammatical structure.

In a child with alalia, speech does not develop at all or develops with gross deviations. With sensory alalia, children do not understand someone else's speech well, and they do not recognize the sounds of speech: they hear that a person is saying something, but do not understand what exactly. Likewise, we do not understand those who speak a foreign language unknown to us. With motor alalia, the child cannot master the language (its sounds, words, grammar). Speech impairment that combines motor and sensory symptoms

alalia is called sensorimotor alalia.

The essence of speech therapy work is not to teach alalik the rules of grammar, writing, reading, but to instead of the disturbed channels of speech activity, include those that have been preserved, make them work harder, perform double or even triple the workload. Such a complex task requires frequent use of various pre-language skills. These are gestures, rhythmic movements, drawing, imitation of non-speech sounds, for example, the howling of the wind, the voices of animals. As these skills are mastered, the child is introduced to speech-like sounds and words that gradually become more complex in meaning. Techniques for such work are available only to highly qualified specialists, and parents can only help speech therapists here, but not replace them. Speech therapy work for alalia should begin early, as soon as a child’s lag in speech development is noticed, because Speech cannot be formed independently and without the help of a speech therapist. In any case, the absence of speech by the age of 2 is already an alarming signal.

Aphasia

Aphasia (from the Greek: “a” - denial and “phasis” - speech) is a complete or partial loss of speech caused by damage to the cortex of the dominant cerebral hemisphere in the absence of disorders of the articulatory apparatus and hearing.

The causes of aphasia are cerebral circulation disorders, trauma, tumors, and infectious diseases of the brain. Aphasia of vascular origin most often occurs in adults. Aphasia is one of the most severe consequences of brain damage, in which all types of speech activity are systematically impaired. The complexity of the speech disorder in aphasia depends on the location of the lesion, the size of the lesion, and the characteristics of the residual and functionally preserved elements of speech activity.

The following forms of aphasia are distinguished (P.A. Luria):

Acoustic-gnostic aphasia

Afferent motor aphasia

Efferent motor aphasia

Acoustic-mnestic aphasia

Semantic aphasia

Dynamic aphasia

The basis of any form of aphasia is one or another primary impaired neurophysiological and neuropsychological prerequisite. For example, a violation of dynamic or constructive praxis, phonemic hearing, apraxia of the articulatory apparatus, etc., which leads to a specific systemic violation of the understanding of speech, writing, reading, and counting. With aphasia, the implementation of different levels, aspects, types of speech activity (oral speech, speech memory, phonemic hearing, speech understanding, written speech, reading, counting, etc.) is specifically systematically impaired.

Functional dyslalia is a type of incorrect sound pronunciation in which there are no defects in the articulatory apparatus. In other words, there is no organic basis.

One of the common causes of functional dyslalia is improper education of the child’s speech in the family. Sometimes adults, adapting to the child’s speech, being touched by his amusing babble, “lisp” with the baby for a long period. As a result, the development of correct sound pronunciation is delayed for a long time.

Dyslalia can also occur in a child by imitation. As a rule, constant communication with young children who have not yet formed the correct sound pronunciation is harmful for the child. Often a child imitates the distorted sound pronunciation of adult family members. Children are especially harmed by constant communication with people whose speech is unclear, tongue-tied or too hasty, and sometimes with dialectal peculiarities.

Bilingualism in the family also has a bad effect on children's speech. When speaking different languages, a child often transfers the pronunciation features of one language to another.

Often the cause of dyslalia in children is the so-called pedagogical neglect, when adults do not pay any attention to the child’s sound pronunciation, do not correct the child’s mistakes, and do not give him a model of clear and correct pronunciation. In other words, the child’s speech is not subject to the necessary systematic influence of adults, which inhibits the normal development of pronunciation skills.

Sound pronunciation defects in children can also be caused by underdevelopment of phonemic hearing. In this case, the child has difficulties in differentiating sounds that differ from each other by subtle acoustic features, for example, voiced and voiceless consonants, soft and hard whistling and hissing consonants. As a result of such difficulties, the development of correct sound pronunciation is delayed for a long time.

At the same time, deficiencies in sound pronunciation, especially in cases where they are expressed in the replacement of sounds or in mixing them in words, can, in turn, complicate the formation of phonemic hearing and subsequently cause general underdevelopment of speech and impairments in writing and reading.

Dyslalia can also be a consequence of insufficient mobility of the organs of the articulatory apparatus: tongue, lips, lower jaw.

It can also be caused by the child’s inability to hold the tongue in the desired position or quickly move from one movement to another.

Dyslalia in children can also be caused by hearing loss. Up to 10% of cases of sound pronunciation disorders occur due to hearing loss. Most often, there is difficulty in differentiating hissing and whistling sounds, voiced and voiceless consonants.

The cause of severe and prolonged dyslalia may also be insufficient mental development of the child. In over 50% of cases, oligophrenic children have problems with sound pronunciation.

Varieties of dyslalia

Incorrect pronunciation can be observed in relation to any consonant sound, but those sounds that are simple in their method of articulation and do not require additional movements of the tongue are less likely to be disrupted, for example m, n, t, p.

Most often, the pronunciation of sounds that are difficult to articulate is disrupted: lingual, for example r, l, whistling (s, z, c) and hissing (w, f, h, sch)

Typically, hard and soft consonant pairs are violated to the same extent. For example, if a child pronounces sounds incorrectly s, s, then their soft pairs also turn out to be defective, i.e. With" And h"The exception is sounds r And l. Soft pairs of these consonants are most often pronounced correctly, since they are simpler in their method of articulation than their hard variants.

Violations of sound pronunciation in children can manifest themselves either in the absence of certain sounds, or in their distortion, or in substitutions.

Let's consider each of these cases in detail. The absence of a sound in speech can be expressed in its loss at the beginning of a word (for example, instead of fish the child says "yba"), in the middle (steamer- “pahod”) and at the end (ball- “sha”)

Sound distortion is expressed in the fact that instead of the correct one, a sound is pronounced that is not in the phonetic system of the Russian language. For example, velar p, when the thin edge of the soft palate, or uvular, vibrates p, when a small tongue vibrates, interdental With, lateral w, bilabial l etc.

The sound can be replaced by another sound available in the phonetic system of the language. These replacements can be as follows:

1) replacement of sounds that are identical in the method of formation and differ in the place of articulation, for example, the replacement of plosive back-lingual k and g with plosive front-lingual T And d(“tulak” instead of fist,"dudok" instead beep etc.);

2) replacement of sounds that are identical in place of articulation and differ in the method of formation, for example, the fricative anterior lingual With anterior lingual plosive T(“tanks” instead sled);

3) replacement of sounds that are identical in the method of formation and differ in the participation of the organs of articulation, for example With labiodental f(“fumka” instead bag etc.);

4) replacement of sounds that are identical in place and method of formation and differ in the participation of the voice, for example, voiced sounds with voiceless sounds (“pulka” instead of bun,"subs" instead of teeth);

5) replacement of sounds that are identical in the method of formation and in the active organ of articulation and differ in hardness and softness, for example, soft with hard and hard with soft (“ryaz” instead of once,"pula" instead saw).

Based on the number of disrupted sounds, dyslalia is divided into simple and complex. If there are up to four defective sounds in the pronunciation, it is simple dyslalia, if there are five sounds or more, it is complex dyslalia.

If the defect is expressed in a violation of the pronunciation of sounds of one articulatory group (for example, whistling), this is monomorphic dyslalia. If it extends to two or more articulatory groups (for example, rhotacism, sigmatism and lambdacism), it is polymorphic dyslalia.

In accordance with the nature of the pronunciation defect related to a certain group of sounds, the following types of dyslalia are distinguished:

1. Sigmatism (from the name of the Greek letter sigma, denoting sound With)- shortcomings in the pronunciation of whistling sounds (s, s", z, z", c) and hissing (w, f, h, sch) sounds. One of the most common types of pronunciation disorders.

2. Rotacism (from the name of the Greek letter ro, denoting sound p)- deficiencies in pronunciation of sounds r And r".

3. Lambdacism (from the name of the Greek letter lambda, denoting sound k)- deficiencies in pronunciation of sounds l And l".

4. Defects in the pronunciation of palatal sounds: cappacism - sounds To And To", gammacism - sounds G And G", hitism - sounds X And X", iotacism - sound th(from the names of Greek letters kappa, gamma, chi, iota, denoting sounds respectively k, g, x, i).

5. Voicing defects - deficiencies in the pronunciation of voiced consonant sounds. These defects are expressed in the replacement of voiced consonant sounds with paired unvoiced sounds: b-p, d-t, v-f, z-s, w-sh, g-k etc.

This deficiency is common in children suffering from hearing loss.

6. Mitigation defects - shortcomings in the pronunciation of soft consonant sounds, consisting mainly of replacing them with paired hard ones, for example d"-d, p"-p, k"-k, r"-r etc.

The only exception is sounds sh, f, c, not having soft vapors, and sounds h, sch, i, which are always pronounced softly and do not have hard pairs.