Dysarthria in children: criteria for early diagnosis, treatment and prognosis

Dysarthria in children is one of the most frequent speech disorders that occurs even in the early stages of a baby's life. And if you miss this little moment at a young age, while studying at school it can turn out to be a big problem. Moreover, given that the pathology occurs against the background of serious lesions of different parts of the brain, which affects not only communicative, but also in other areas of the child's life, as evidenced by a variety of symptoms.

A little about the dysarthria itself

Before we look for effective methods to combat pathology, it is important to understand what we are dealing with. For this, let us recall what is dysarthria, and how it manifests itself in children of different ages.

Dysarthria is an organic lesion of the brain, negatively affecting the work of some parts of the central and peripheral nervous system, resulting in articulatory, speech, neurological and mental symptoms. It is the presence of neurological symptoms that this pathology differs from a similar dyslalia.

[1], [2],

Causes of the dysarthria in the child

The causes of development of dysarthria in children are pathologies of intrauterine development, as well as traumatic factors in the natal and postnatal period. Most often, the dysarthria is identified as one of the syndromes characteristic of cerebral palsy (cerebral palsy).

For more details on the causes of dysarthria development in children, read here.

[3], [4]

Symptoms of the dysarthria in the child

There are also 4 degrees of severity of the pathology, differing in the intensity of the symptoms. With mild degree of dysarthria, the speech side is weakly broken, and there is no neurological symptomatology at all, but with the most severe fourth one it is already an ataxia peculiar to children with cerebral palsy.

Dysarthria is characterized by a close interlacing of verbal and neurological symptoms, which may differ slightly in different periods of a child's life. Most often, some symptoms are visible at an early age, though enthusiastic parents do not always pay attention to such "trivia" as:

• later the beginning of some independent actions: begins to hold the head to 5-7 months, sit and crawl - to 8-12 months, walk - at 1.5 years and later. The first sounds and words also appear later accepted and differ noticeable monotony and weakness of pronunciation.
• weakness of the sucking reflex, because of which the child quickly gets tired during feeding and does not hold the breast well, often choking. Milk with sucking breasts or nipples can flow from the corners of the lips or spout of the baby, which indicates the weakness of the muscular system of the articulatory apparatus due to insufficient innervation.
• lack of interest in the environment, in particular toys,
• inadequate reaction to the appearance of the parents (does not rejoice: does not smile, does not actively move the legs and handles, does not walk).

In the future such neurologic abnormalities are of a nature:

• incorrect grasping movements (excessively strong or very weak grip of the object, uncoordinated actions),
• violations of visual-spatial perception (the location of objects, their shape and size),
• underdevelopment of motor reactions (awkward movements, difficulty in performing various oral tasks, performing physical exercises, dancing, imitative movements, molding from plasticine or clay),
• lack of grapho-motor skills (inability to normally hold a pen or pencil, draw a straight line, draw a graphic figure, etc.)
• excessive tension (increased tone) of the muscles of the face and articulatory apparatus,
• uncoordinated action of various parts of the speech apparatus,
• emergence of arbitrary violent movements,
• the scarcity of vocabulary,
• absence of mimicry, and in some cases emotional reactions such as laughter or crying),
• specific reactions (strongly linked lips or, conversely, their lack of locomotion, dumping of the tongue from the slightly opened mouth, drooling, especially when talking, the inability to pull the sponge into the tube, and perform movements with the tongue up and down, etc.).

And, of course, there are various disorders of speech:

• Wrong pronunciation of vowels and consonants,
• replacement or omission of sounds in words,
• the addition of unnecessary sounds at the confluence of consonants,
• change voice timbre, "nasal" pronunciation of sounds, squeaky or deaf, a squeaky voice in the baby,
• violation of rhythm and melody of speech,
• attenuation of speech to the end of the sentence,
• breathing disorders and fatigue during a conversation,
• monotony or discontinuity (chanting rhythm) of speech,
• absence or inadequacy of emotional coloring of speech, voice modulations,
• indistinct pronunciation of words and sentences, etc.

At the same time, it is very difficult to overcome the difficulties of sound reproduction to a child. To do this, so that the speech of the baby became clear to others, it will take a lot of effort and time. And in order to determine the effective measures for overcoming difficulties in pronouncing sounds, it is necessary to make sure that this symptomatology is associated with dysarthria, and not with other pathologies.

[5]

Forms

In childhood, it is possible to diagnose mainly 4 types of dysarthria:

• Pseudobulbar
• Cerebellar
• Cork
• Subcortical.

All these species can have a characteristic symptomatology and proceed in various forms :

• erased dysarthria (with mild symptoms),
• a typical dysarthria,
• atactic dysarthria, or ataxia (with characteristic speech intelligibility or lack of speech and lack of coordination of movements).

[6], [7], [8]

Diagnostics of the dysarthria in the child

Diagnosis of dysarthria in children begins even before the trip with the baby to the doctor. Attentive parents are able to independently note some violations in the development of the child, peculiar to this pathology already in the first year of his life. These deviations are called pseudobulbar syndrome.

Usually, nursing infants inform parents about their desires and "problems" with a loud and sonorous scream. This is considered normal, since it indicates a sufficient development of the neuromuscular system of the speech apparatus. But a deaf and weak cry, turning into a squeak, and sometimes the absence of voice signals in general, are cause for concern and close observation of the further development of the baby.

Weakness of the sucking reflex and breast capture, difficulties with swallowing, constant choking and flowing of milk from the mouth and nose of the baby during feeding indicate the underdevelopment of the articulatory apparatus. And if these signs are joined by a lack of interest in the environment (the baby does not follow moving objects, does not look for relatives' eyes, does not try to take toys over the crib, etc.), difficulty breathing (it is confused and superficial), nibbling and chewing, drinking from a cup - this clearly speaks about the development of pseudobulbar syndrome. But it is his symptoms that make it possible to assume a dysarthria in a child even before he began to speak.

Some babies who have been adversely affected during the intrauterine period or during childbirth may even be registered with a neurologist within a year. But in the absence of pronounced deviations in physical and intellectual development, children are removed from the register, after which all responsibility and control over the health and development of the child falls on the shoulders of the parents.

With the gradual development of speech skills, the problem becomes more and more clear, and this is an occasion to turn to a speech therapist, and he will, if necessary, send again to a neurologist who will voice the true name of the pathology. Nevertheless, the diagnosis is still too early. The thing is that dysarthria in children is associated with organic brain damage in the prenatal period and in early childhood, which can not be corrected. Treatment of pathology is reduced to speech correction and the development of missing skills. But due to the compensatory functions of the brain, many defects by 4-5 years can disappear.

If this does not happen, and vice versa, other problems in the development of speech and motor function that interfere with the future successful education of the child in school are diagnosed, the doctor diagnoses "dysarthria" and prescribes appropriate treatment.

The main criteria for setting such an unpleasant diagnosis are:

• slow speech due to delayed intermittent movements of the articulatory apparatus,
• difficulties in retaining and changing the articulatory postures,
• gross and persistent violations of pronunciation of sounds, resulting in speech becomes vague,
• lack of expressiveness and intonational coloring of speech,
• violation of tempo, melody of speech and voice modulation,
• slowed automation of sounds (the child speaks with effort, before the sounds are said, there is a rather long period of preparation, when the baby exercises only uncoordinated movements with lips and tongue, etc.)
• increased, decreased or constantly changing tonus of the muscles of the face and speech device,
• insufficient volume of performance of fine differentiated movements of the tongue, decreased mobility of the tip of the tongue,
• incorrect position of the tongue in the extended position (the tongue is shifted from the center to the right or left),
• trembling or uncontrolled violent movements of the tongue in an extended position,
• the appearance when the tongue moves during the speech of friendly movements with the fingers and hands, the lower jaw,
• Insufficiency of motor and graph-motor functions.

Functional tests for the diagnosis of dysarthria in children

One of the most insidious species of dysarthria is an erased dysarthria in children, in which the diagnosis can cause certain difficulties due to the lack of expression of the main symptoms. In such a case, functional tests are used to determine the dysarthria:

1. Check the asymmetry of the position of the language. The baby is asked to open the mouth, stick the tongue forward and hold it in this position, following the eyes of the moving object (toy, pendulum or hand of the doctor). If the movement of the eyes is accompanied by a friendly movement of the tongue (deflecting it towards the movement of the object), this indicates a positive result, i.e. It's about dysarthria, not another deviation.
2. Determination of muscle tone with articulation. The kid is offered to make various articulatory movements with his tongue (open his mouth, stick his tongue out, lift his tongue up, deflect him, etc.). At this time, the doctor puts his hands on the neck of the child to feel at what point the muscles are straining more. In dysarthria, this occurs at the time of performing delicate differentiated movements with the tongue, sometimes these movements are accompanied by a throwing over of the head.

If both samples are positive, you can speak with great certainty about dysarthria, which in children 3-5 years can easily be confused with dyslalia or alalia, manifested as a speech disorder or inability to speak normally.

[9], [10], [11],

Intonation examination in children with dysarthria

Disturbances in sound production in dysarthria are determined by hearing. But this is not the reason for the final diagnosis, because such violations are typical for other speech disorders, in particular for dyslalia. More information gives an examination of the prosodic side of speech (intonation) in children, especially in children with an erased dysarthria.

The survey program includes several important points:

• The study of the sense of rhythm - the definition of the ability of the child to determine the number of individual simple strokes, accented (loud and quiet) blows, a series of different strokes and correlate them with the images on the cards.
• The study of the reproduction of rhythm by ear - the definition of the child's ability to imitate, in particular, the repetition of the rhythm of various strokes without reliance on visual support.
• The study of perception of intonation by ear - the identification of the ability to distinguish between different intonational structures in the perception of speech by ear (narrative, interrogative and exclamation intonations in sentences).
• The study of the ability to reproduce intonation - the definition of the child's ability to use various intonations in his speech when repeating the same or different short sentences.
• The study of the perception of the logical stress - the study of the perception of the expressiveness of the child's speech and skill will highlight the main thing by ear and by visual perception.
• The study of the ability to reproduce the logical stress - the definition of the ability to highlight the main in his speech by means of a louder and lengthened utterance of the selected word.
• The study of voice modulations (height and strength) is a study of a child's ability to own his voice, change it by loudness and height while uttering the same sounds and sound combinations. This is necessary to determine the width of the voice range of a child with dysarthria.
• Determination of the nasal voice of the voice - an estimate of the violation of the timbre of pronunciation on a 5-point scale in the ordinary conversation and uttering words with a clamped nose:

• 4 points - a normal timbre,
• 3 points - a loud or squeaky voice (slight violations),
• 2 points - rough or croaking voice (moderate violations),
• 1 point - a deaf, guttural or sharp voice (pronounced pathology),
• 0 points - barely audible speech in the form of a whisper (aphonia).

• The study of the perception of timbre - the study of the child's definition of the sound of the voice by ear and correlating them with pictures expressing different emotions. Score on a 5-point scale:

• 4 points - tasks are executed qualitatively and in full
• 3 points - tasks are performed qualitatively, but at a slow pace
• 2 points - there were errors at performance, but the child and has consulted them independently
•  1 point - tasks are performed only with the active participation of adults
• 0 points - tasks are not performed even after additional or repeated instructions.

• The study of the reproduction of the voice of the voice - the determination of the possibility of changing the color of the voice for the transmission of the emotional state or imitation of various sounds of the surrounding world, which is practically absent in the case of dysarthria in children.
• The study of breathing during speech activity and at rest is the determination of the type of breathing (surface, thoracic, diaphragmatic), the strength and direction of the air stream, the rhythm of inspiration-exhalation, the differentiation of oral and nasal inspiration and expiration, and features of background breathing.
• The study of the features of the tempo-rhythmic organization of speech - the determination of the number of syllables pronounced by the child in a given time interval, as well as the perception of the tempo of speech by ear.
• Study of the state of control of speech by ear. The child performs tasks for rhythm, reproduction of sounds, syllables, words and sentences with words of different structure, etc., and he himself evaluates the correctness of the tasks.

The fulfillment of such tasks makes it possible to reveal how violent the disturbances in the sound and speech of the baby are, but do not yet point to the development of the dysarthria, for which neurological symptoms that affect the quality of articulatory and facial movements are also characteristic.

The study of mimicry and articulation in dysarthria

On the development of dysarthria in children may indicate some violations of facial motility. The fact is that these babies have difficulty with cheeks inflating and squinting, it is difficult for them to wrinkle the nose or raise the edges.

To test the overall mimic and speech motility, Quint's tests in the Helnitz modification are used, which are adapted for different ages. Such diagnostic exercises are perceived by the kids as a game. The child is asked:

• to depict the surprise, raising his eyebrows up,
• lower eyelids, first clamping them lightly, and then tightly, so that it becomes dark,
• squint "from the bright sun,
• squeeze the sponge,
• pull the sponge forward, as if going to play on the pipe,
• slightly open your mouth, open as much as possible and close,
• show how he chews, imitating chewing food,
• puff up your cheeks together, and then alternately,
• pull your cheeks in,
• squeeze the teeth, having built from them a "fence"
• pull out sponges and blow "hot milk"
• pull out "wide", and then "narrow" language, try to keep the language in the given position on the account to 5,
• bite the tip of the tongue,
• stick out "sharp" tongue and move it from the upper lip to the bottom and vice versa,
• perform the exercise "Clock" (the child in a smile should alternately move the tongue from one corner of the mouth to the other),
• lick your lips, as if after a tasty jam or honey,
• show how the cat laches milk,
• perform the following articulatory exercises: pulling the corners of the mouth when pronouncing x sound "and", rounding the lips for the sound "o", pulling the lips for the sound "y".

Each of the exercises must be repeated 3 times. To assess the quality of their implementation, a three-point scale is used:

• 1 point - the exact performance of all tasks in the right amount
• 2 points - fuzzy performance of mimic and articulatory exercises or insufficient volume of performance due to fast fatigue of the articulatory apparatus and inconsistency of breathing, and also if 6 or less exercises are not performed
• 3 points - failure to complete 7 tasks or more, considerable difficulties in performing tasks.

As a result of such studies, the doctor has a complete picture of the existing disorders in order to clarify the diagnosis and distinguish the dysarthria from the same dyslagia. During the execution of tasks in children with dysarthria salivation is observed, rapid fatigue, which is manifested in the weakness and slow pace of articulatory movements, changes in the tone of the muscles of the tongue (for example, the appearance of arbitrary movements when lifting the tongue upwards), hyperkinesia. Attention is paid to the state of muscle tone of the face and speech device at rest and when performing articulatory movements.

Differential diagnosis

All the above tests and tests, including oral communication with the child on different topics, when determining the dysarthria in children, are considered to be the most effective methods of differential diagnosis of this pathology.

An important role is also played by studying the anamnesis and talking with the child's relatives who are engaged in his upbringing and development. It is necessary to ask in detail the parents of the child about how the pregnancy and childbirth took place, what diseases the mother had during this period, how the baby developed in the first years of life, how often it was sick and what diseases. An analysis of the facts and anamnesis can shed light on the origins of pathology.

Information will also be useful about the home development of the baby in early childhood:

• when he began to hold the head, sit, crawl, walk,
• at what age did he say the first words and how his vocabulary grew,
• what are the cognitive features of the baby, does he show interest in toys and the surrounding world, how he reacted and reacts to the appearance of his parents, etc.

To instrumental diagnostics doctors resort not to determine the dysarthria itself, but to identify the cause that caused verbal and neurological disorders in children.

The main method of studying babies with dysarthria is MRI or computed tomography of the brain, which allows to determine the nature and localization of various organic brain lesions. Additional methods of investigation include neurosonography, electroneurography, EEG, electromyography, magnetic stimulation, etc.

Familiar laboratory tests for dysarthria in children can be conducted only in connection with the need for drug treatment.

Treatment of the dysarthria in the child

Violation of the pronunciation part of speech and motor skills in children with dysarthria is associated with organic lesions of the brain and central nervous system. This suggests that only one of the activities with a speech therapist treatment of this pathology should not be limited. In this case, an integrated approach to solving the problem plays an important role in the later life of the baby.

An integrated approach to the treatment of dysarthria in children involves the use of various methods of therapeutic effects:

• drug therapy
• Exercise exercises
• breathing exercises
• logopedic massage, self-massage articulation apparatus
• lessons with speech therapist
• psychological help for children with speech impairments
• medical baths
• sand therapy
• dolphin therapy
• acupuncture and reflexology
• hippotherapy
• classes with parents on the development of fine motor skills and graph-motor skills, the development of skills of self-service.

Drug therapy with dysarthria has as its goal the improvement of the child's mental and intellectual activity. There are no special medicines for this disease, so doctors have to do with nonspecific means from the group of nootropics that are safe for babies. To such drugs that improve memory and attention, stimulate mental and cognitive activity, positively influence the formation and development of intellectual skills, improve the learning ability of the child, you can include:

• Fenibut
• "Hopanthenic acid"
• Encephabol
• "Cortexin" and others.

The remaining drugs (anticonvulsant, vascular, metabolic and sedative) are prescribed to small patients only in connection with the underlying disease, against which a dysarthria develops, for example, in cerebral palsy.

Correction of dysarthria in children

Corrective work with children who are diagnosed with "dysarthria" is not only to make their speech understandable to others, but also to improve lexical stock, learn reading and writing skills, develop spatial thinking.

The program of corrective sessions for dysarthria in children consists of the following stages:

1. Formation of the lexical-grammatical and phonetic components of speech
2. Correction of the communicative function of speech
3. Correction of the letter
4. Development of visual-spatial thinking.

Usually, such exercises are conducted by a speech therapist in specialized children's institutions. At an easy degree of a dysarthria children simply pass a course of correction of speech and come back home with the subsequent training in usual school. If lesions of the brain and the central nervous system are difficult, as, for example, in cerebral palsy, children are trained in specialized institutions (boarding schools) on a permanent basis under the supervision of specialists.

The science of speech therapy correction of dysarthria in children with cerebral palsy takes on a new beginning in the middle of the 20th century. At the same time, the basic phonetic principles for eliminating speech disorders were formulated:

• In the work on soundproofing, the main emphasis should be placed on the semantics and acoustic characteristics of the word, and not on the articulation with which children under cerebral palsy experience significant difficulties
• The main efforts should be directed at improving the quality of acoustic perception of sounds of varying strength, height and duration, phonemic perception and kinematic perception of articulation
• The main components of the movement must be developed with the participation of large and then small muscle groups
• The flow chart for clarity can be formed on one organ, and then transferred to another
• The child should be allowed to reproduce sounds in a way that is accessible to him, not relying on the formation of new articulatory skills, but using the already available ones. The pores need to be made on the acoustic properties of the sounds.
• It is necessary to clearly automate the movements for the formation of motor stereotypes, which will prevent distortion of sounds.

Moments that must be taken into account in corrective work in cerebral palsy:

• The main direction of the work is the formation of the phonetic-phonemic aspect of speech, but considerable attention is also paid to the general mental activity of the child
• The motor function of speech should develop in parallel with the phonemic ideas of the child
• Obligatory conditions for the successful work of a speech therapist is the formation of positive motivation, stimulating the child to improve his speech
• Classes on the development of phonetic perception of individual sounds and speech in general should be a little ahead of the lessons of correct reproduction.
• Articulatory exercises should be available for children with dysarthria, and the formation of the correct pronunciation should be done with an emphasis on its acoustic characteristics.
• The formation of articulatory praxis should be consistent, starting with the formation of an air jet, connecting it to the voice, and ending with the development of articulatory skills.

[12], [13]

Massage with dysarthria

To overestimate the importance of logopedic massage in children with dysarthria is very difficult, because speech disorders in them are most often associated with an increased or greatly reduced tonus of the facial muscles and articulatory apparatus. This makes it difficult for various corrective measures to develop speech in children. To ensure that the logopedic correction of dysarthria brings good results, it is recommended to begin each such exercise with a massage, if necessary adding elements of articulatory gymnastics.

Speech massage at dysarthria in children includes such directions:

• Mimic (relaxing) facial and neck massage
• Point massage of individual zones of the articulatory apparatus
• Massage of the tongue with the hands and a probe
• Self-massage or performing passive facial and articulatory exercises.

Massage in the absence of contraindications is carried out by a specially trained specialist. Although some elements of massage are available to the parents of the baby after the speech therapist or the paramedic, who has mastered the elements of the massage, will show how to properly perform them.

Massage is often done in courses of 10 to 20 procedures, the duration of which gradually increases from 5 to 25 minutes.

By means of massage it is reached:

• Normalization of the muscle tone (general, facial musculature and articulation apparatus)
• Reduction of the probability of paresis and paralysis of the musculature of the speech apparatus
• Variety of articulatory movements and increase in their amplitude
• Stimulation of muscle groups with insufficient contractility due to impaired innervation
• Formation of coordinated voluntary movements of the speech organs.

Speech therapies for dysarthria in children

Classes with a speech therapist play a big role in the development of speech in children with dysarthria. With an integrated approach, taking into account the severity of the disease and accompanying pathologies, you can achieve good results.

Logopedic classes for dysarthria in children are held in a game form and consist of a series of special exercises described in the individual speech card of a small patient. These exercises are selected taking into account the characteristics of the patient's speech, associated with violations of certain parts of the brain. The duration of the course of speech therapy classes depends on the speed of mastering speech skills to the baby, and, of course, on the severity of the pathology itself.

Common types of exercises used to correct speech in children with dysarthria:

• Exercises for the development of fine motor skills, which include elements of therapeutic gymnastics and finger games.
• Exercises for the development of articulation, which includes a logopedic massage, supplemented with passive and active articulation gymnastics.
• Employment of respiratory gymnastics for correction of physiological and speech breathing.
• Correction classes on correcting the sound reproduction, plus fixing the skills of correct speech.
• Exercises to form the skills of expressive emotionally colored speech (correct perception and reproduction of the timbre, rhythm, intonation of speech and evaluation of speech by ear, ability to own one's voice).
• Exercises for the development of verbal communication (the ability to communicate verbally) and a sufficient vocabulary in the child.

Classes with a speech therapist can be held individually or in specialized groups and classes of kindergartens and schools, as well as in specialized educational institutions. Lessons are held in the following sequence:

1. Preparatory stage (massage, articulatory and breathing exercises)
2. Formation of primary (basic) pronunciation skills
3. Consistent formation of communicative skills.

Articulatory gymnastics with dysarthria

The complex of articulatory exercises for dysarthria in children can include both exercises for general development of speech, and a special series of exercises aimed at correcting the pronunciation of individual sounds.

The main complex of articulatory gymnastics for children consists of 10 exercises with game titles, attractive for kids:

• Exercise "Frog" is a tense smile with a slightly open mouth and closed teeth, which must be kept, not pushing the lower jaw forward, until the speech therapist counts to 5.
• Exercise of the proboscis is nothing more than a maximum extension of the lips forward with closed teeth and lips on account to 5.
• Exercise "Frog-proboscis" is an alternation of the two exercises described above.
• Exercise "Window" is the alternate opening and closing of the mouth for "one-two".
• Exercise "Spatula": a smile with an open mouth, from which an extended "wide" tongue hangs on the lower lip. Exercise should be performed without tension of the lower lip, keeping the position on the score to 5.
• Exercise "Needle": a smile when the mouth is open, but the tongue is exposed sharp. In doing so, you should try not to bend the tongue up.
• Exercise "Spatula-Igolochka" - alternating execution on the account of "one-two" of the above exercises.
• Exercise "Clock" is used both for diagnosis and correction of dysarthria. During a smile with an open mouth, the tongue moves to the right and left, touching one or another corner of the mouth.
• Exercise "Swing": in the same position to rest on the tip of the tongue in the upper, then in the lower teeth at the expense of "one-two."
• Exercise "Horse" - flipping the tip of the tongue as an imitation of the clutching of horse's hooves.

[14]

Formation of speech breathing in children with dysarthria

Respiratory failure in dysarthria in children is manifested in the wrong type of breathing and short speech expiration. Exercises for the correction of respiratory function are aimed at the formation of speech and physiological breathing in children with dysarthria.

The purpose of respiratory gymnastics is to increase the volume of breathing, the normalization of its rhythm, the development of a smooth, long and economical exhalation.

The complex of exercises consists of various series, including:

• classical exercises on the formation of physiological respiration,
• exercises and games for the development of speech breathing without the use of speech,
• respiratory-vocal games on the basis of vowel sounds,
• identical exercises using consonant sounds,
• breathing-voice games using words,
• games aimed at forming an elongated exhalation with simultaneous pronouncing of phrases of varying length and complexity.

As in the case of articulatory gymnastics, exercises for the development of speech breathing have attractive names for children, are conducted in a play form, understandable to the child, by a speech therapist who has experience working with such children. Kids are offered to blow out a "candle", inflate a "bonfire," reproduce the horn of a locomotive or the hiss of a cat, play on homemade wind instruments made from pen caps or markers, etc. The main emphasis is on making the child interested in the class and making him feel like a full-fledged person.

[15],

Development of phonemic hearing in children with dysarthria

To comprehensively form the speech of a child with dysarthria, it is important to teach the child not only to speak, but also to hear the speech by ear. If the child does not know how to listen and correctly understand the speech of others, then it will be much easier for him to form the correct pronunciation of sounds and words.

The purpose of the exercises on the development of phonemic hearing in children with dysarthria is:

• the consolidation of the skills to differentiate (distinguish) the sounds of native speech,
• development of auditory attention,
• the formation of the ability to coordinate movements with the text, depending on the dynamics and pace of presentation,
• the development of the ability to navigate in space without the help of sight,
• the improvement of phonemic hearing: the search for words with a given sound, the definition of the place of sound in the word, the selection of words with a certain sound when composing a sentence, the division of words into syllables, the construction of simple and complex sentences, the definition of incorrectly pronounced words,
• the development of self-control over the utterance of sounds and words.

Usually, such classes are conducted in groups to increase the interest of the children in the classroom and in practice to teach them various ways of communication. But the formation of the correct sound production occurs already during individual lessons.

[16], [17]

Prevention

Prevention of dysarthria is a relative concept, since it is simply impossible to exclude all risk factors of development in children of this pathology, because everything does not depend on the mother or doctors. On the other hand, the mother must make every effort to have her baby born and grow up healthy and strong.

[18], [19], [20]

Forecast

If, despite all the efforts, the baby has some manifestations that indicate a developing dysarthria, one can not give up. Such a child needs to pay more attention, talking and communicating with him, developing cognitive abilities, reading to him books and telling about the properties of objects. In the future, some effort will be required to teach the child the skills of self-service and develop grapho-motor skills. And the sooner the mother turns to the specialists for help, the more favorable the prognosis of the disease will be.

As a rule, dysarthria in children, flowing in an erased or mild form, is quite easy to treat and correct. After the course of treatment, such children can later successfully study in ordinary schools. By the way, as a result of regular and correctly selected activities with the child, it is possible to achieve impressive results even with severe brain damage.

[21], [22]