Speech therapy: diseases — симптомы, диагностика и лечение

Delayed speech development is a condition in which a child’s speech is formed noticeably later and slower than that of his peers, with intact hearing and without gross intellectual impairment. The most common mistake parents make here is not panic, but the opposite - waiting. The advice “wait until three years old, boys always talk later” sounds soothing and is passed down from generation to generation, but it is the one that most often deprives a child of the most productive time for help. The speech areas of the brain are most plastic in the first three years of life, and classes started at two years old have an incomparably greater effect than the same classes at five years old. At the same time, it is important to understand: not every delay means a serious problem - some children actually catch up with their peers. The task of adults is not to guess, but to check.

Stuttering is a violation of the fluency of speech, in which a child repeats sounds and syllables, stretches them out, or gets stuck on a word, unable to start it. Most often, it appears between the ages of two and five years, during a period of rapid speech development, when the child’s thoughts run faster than articulation can cope. The good news is that for most children, such hesitations go away on their own within a few months or a year or two. The bad news is that it is impossible to predict who exactly will be in this majority, and the behavior of adults in the first months influences the outcome much more strongly than is commonly thought. And one more thing: stuttering does not arise “from fright” - this is the most persistent and most harmful misconception on this topic.

Alalia is a severe underdevelopment or lack of speech in a child with normal hearing and intact intelligence. The reason lies in the work of the speech zones of the cerebral cortex, damaged in the prenatal period, during childbirth or in the first years of life. In the motor form, the child understands spoken speech, but hardly speaks: the vocabulary is tiny, the words are simplified to syllables, the phrase does not form. In the sensory form, he hears sounds, but does not connect them with meaning, so the speech of others is like an unfamiliar language to him. Alalia does not go away on its own: the key to the result is the early start of systematic classes with a speech therapist and observation by a neurologist.

Aphasia is the loss of already formed speech due to damage to the speech areas of the brain. A person can understand those around him, but not find the words, or vice versa - speak fluently, but in a set of meaningless phrases, without understanding the questions asked. Most often, aphasia develops after a stroke, less often after a traumatic brain injury, with a tumor or neurodegenerative disease. Intellect and personality are preserved, and it is impossible to treat a person as unreasonable. Recovery is possible: speech returns most actively in the first months, but systematic exercises also help in the long term.

Dysarthria is a pronunciation disorder caused by damage to the nervous system, which controls the muscles of the lips, tongue, soft palate, larynx and breathing. A person understands speech and knows what he wants to say, but the words sound slurred, blurred, slow, with a nasal tint or a changed voice. In children, dysarthria is most often associated with perinatal brain damage and cerebral palsy; its mild form is called erased dysarthria. In adults, the causes are stroke, traumatic brain injury, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, myasthenia gravis. Sudden slurred speech is a possible sign of a stroke and a reason to immediately call 103. With gradual development, an examination by a neurologist and regular sessions with a speech therapist are needed.

Dysgraphia is a persistent writing disorder in which the child makes specific, repeated errors that are not related to ignorance of the rules. He skips and rearranges letters, writes them in mirrors, merges words, confuses characters that are similar in sound or style, and can recite the rule by heart. Such errors do not disappear from rewriting and reproaches, because the reason lies in the immaturity of speech and visual-spatial functions, and not in diligence. Dysgraphia is often combined with dyslexia and can be easily corrected if you start classes in elementary school, and not after several years of failing grades.

Dyslalia is a violation of the pronunciation of individual sounds in a child with normal hearing and intact functioning of the nervous system. The most famous manifestations are burring, when the “r” sounds incorrectly, and a lisp when whistling and hissing sounds are disturbed. Sounds may be skipped, distorted, or replaced by others. Until the age of 4–5 years, many inaccuracies in pronunciation are considered the age norm, because the articulatory apparatus is still maturing. The causes of dyslalia include improper imitation of the speech of others, structural features of the jaws and teeth, short frenulum of the tongue, and phonemic hearing disorders. Dyslalia itself is not dangerous to health, but it can interfere with communication, cause ridicule from peers and difficulties with writing. It lends itself well to correction in classes with a speech therapist.

Dyslexia is a persistent selective reading disorder with intact intelligence, normal vision and hearing, and normal learning. It is difficult for a child to associate a letter with a sound and merge sounds into a word, so he reads slowly, syllable by syllable, rearranges and skips letters, guesses endings and does not understand what he read well. At the same time, in oral conversation he argues no worse than his peers. The reason is not laziness or lack of effort, but the peculiarities of the functioning of the speech areas of the brain. Dyslexia cannot be “outgrown” without help, but regular sessions with a speech therapist significantly improve reading technique and understanding.

Psychomotor development delay (PDD) is a lag of a young child in mastering motor, speech, cognitive and social skills compared to age norms. Such a baby later begins to hold his head up, sit, walk, babble, speak his first words, and interacts worse with others. ZPR is not a final diagnosis, but a description of a condition that may have various causes: prematurity, damage to the nervous system during pregnancy and childbirth, genetic syndromes, hearing and vision impairment, hypothyroidism, lack of communication and stimulation. The sooner the delay is noticed and help is started, the better the child develops. Parents should not expect that the baby will “outgrow”: if in doubt, they should be examined by a pediatrician and a pediatric neurologist.

General speech underdevelopment (GSD) is a speech therapy conclusion given to children with normal hearing and intact intelligence, who have impaired all aspects of speech: sound pronunciation, vocabulary, grammar and coherent speech. Such a child begins to speak later than his peers, he has a poor vocabulary, he distorts words, does not coordinate them in sentences, and has difficulty retelling them. OHP is not a separate disease, but a description of a speech condition, which may be associated with dysarthria, alalia, consequences of perinatal damage to the nervous system, frequent illnesses and lack of verbal communication. Without correction, OHP often leads to difficulties in learning to read and write. With timely help from a speech therapist, most children significantly improve their speech by school.