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

Dysarthria in children is one of the most common speech disorders, which occurs at the early stages of a child's life. And if you miss this small moment at a young age, it can turn into a big problem during schooling. Especially if you consider that the pathology occurs against the background of serious damage to various parts of the brain, which affects not only communication, but also other areas of the child's life, as evidenced by a variety of symptoms.

A little about dysarthria itself

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

Dysarthria is an organic lesion of the brain that negatively affects the functioning 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 distinguishes this pathology from the similar dyslalia.

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Causes dysarthria in a child

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

Read more about the causes of dysarthria in children here.

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Symptoms dysarthria in a child

There are also 4 degrees of severity of the pathology, differing in the intensity of symptoms. With a mild degree of dysarthria, the speech side is slightly impaired, and there are no neurological symptoms at all, but with the most severe fourth, we are already talking about ataxia, characteristic of children with cerebral palsy.

Dysarthria is characterized by a close interweaving of speech and neurological symptoms, which may differ slightly at different periods of a child's life. Most often, some symptoms are already visible at an early age, although enthusiastic parents do not always pay attention to such "little things" as:

• late onset of some independent actions: begins to hold the head at 5-7 months, sit and crawl at 8-12 months, walk at 1.5 years and later. The first sounds and words also appear later than accepted and are distinguished by noticeable monotony and weakness of pronunciation.
• weakness of the sucking reflex, due to which the child quickly gets tired during feeding and does not hold the breast well, often choking. Milk when sucking the breast or nipple may flow out of the corners of the baby's lips or nose, which indicates weakness of the muscular system of the articulatory apparatus due to its insufficient innervation.
• lack of interest in the surroundings, in particular in toys,
• inadequate reaction to the appearance of parents (not happy: does not smile, does not actively move legs and arms, does not coo).

In the future, such neurological deviations are of the following nature:

• incorrect grasping movements (too strong or too weak a grip on an object, lack of coordination of actions),
• disturbances of visual-spatial perception (location of objects, their shape and size),
• underdevelopment of motor reactions (clumsiness in movements, difficulties with performing various oral tasks, performing physical exercises, dancing, imitative movements, modeling with plasticine or clay),
• insufficient graphomotor skills (inability to hold a pen or pencil normally, draw a straight line, depict a graphic figure, etc.),
• excessive tension (increased tone) of the facial muscles and articulatory apparatus,
• lack of coordination of the actions of various parts of the speech apparatus,
• the emergence of arbitrary violent movements,
• poor vocabulary,
• lack of facial expressions, and in some cases, such emotional reactions as laughter or crying),
• specific reactions (tightly clasped lips or, conversely, their non-closure, the tongue hanging out of the slightly open mouth, salivation, especially when talking, the inability to stretch the lips into a tube, as well as to perform up-and-down movements with the tongue, etc.).

And, of course, there are various speech disorders:

• incorrect pronunciation of vowels and consonants,
• substitution or omission of sounds in words,
• adding extra sounds when consonants overlap,
• change in the timbre of the voice, “nasal” pronunciation of sounds, squeaky or muffled, creaky voice in the baby,
• violation of the rhythm and melody of speech,
• fading of speech towards the end of a sentence,
• breathing problems and rapid fatigue during conversation,
• monotony or discontinuity (scanned rhythm) of speech,
• absence or inadequacy of emotional coloring of speech, voice modulations,
• slurred pronunciation of words and sentences, etc.

At the same time, it is very difficult for a child to overcome the difficulties of pronunciation. In order for the child's speech to become understandable to others, it will take a lot of effort and time. And in order to determine effective measures to overcome difficulties in pronouncing sounds, it is necessary to make sure that these symptoms are associated with dysarthria, and not with other pathologies.

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Forms

In childhood, there are mainly 4 types of dysarthria that can be diagnosed:

• Pseudobulbar
• Cerebellar
• Cork
• Subcortical.

All these types can have characteristic symptoms and occur in different forms:

• erased dysarthria (with mild symptoms),
• typical dysarthria,
• ataxic dysarthria, or ataxia (with characteristic complete slurring of speech or its absence and impaired coordination of movements).

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Diagnostics dysarthria in a child

Diagnosis of dysarthria in children begins even before the baby goes to the doctor. Attentive parents are able to independently note some developmental disorders in the child, characteristic of this pathology already in the first year of his life. These deviations are called pseudobulbar syndrome.

Usually, infants inform their parents about their desires and "problems" with a loud and clear cry. This is considered normal, since it indicates sufficient development of the neuromuscular system of the speech apparatus. But a muffled and weak cry, turning into a squeak, and sometimes the absence of vocal signals at all, are a cause for concern and careful observation of the further development of the infant.

Weakness of the sucking reflex and breast latching, difficulty swallowing, constant choking and milk leaking from the baby's mouth and nose during feeding indicate underdevelopment of the articulatory apparatus. And if these symptoms are accompanied by a lack of interest in the surroundings (the baby does not follow moving objects, does not look for relatives with his eyes, does not try to take toys above the crib, etc.), difficulty breathing (it is incoherent and superficial), biting and chewing, drinking from a cup - this already clearly indicates the development of pseudobulbar syndrome. But it is precisely its symptoms that allow us to assume dysarthria in a child even before he begins to speak.

Some children who were exposed to negative influences in the womb or during childbirth may even be registered with a neurologist for a year. But if there are no obvious deviations in physical and intellectual development, the children are removed from the register, after which all responsibility and control over the child's health and development falls on the shoulders of the parents.

With the gradual development of speech skills, the problem becomes more and more clear, and this is already a reason to contact a speech therapist, who, if necessary, will refer you again to a neurologist, who will voice the true name of the pathology. However, it is too early to make a diagnosis. The thing is that dysarthria in children is associated with organic brain damage in the prenatal period and in early childhood, which is not possible to correct. Treatment of the pathology comes down to speech correction and the development of missing skills. But thanks to the compensatory functions of the brain, many defects can disappear by the age of 4-5.

If this does not happen, but on the contrary, other problems in the development of speech and motor functions are observed, which hinder the child’s future successful education at school, the doctor makes a diagnosis of “dysarthria” and prescribes appropriate treatment.

The main criteria for making such an unpleasant diagnosis are:

• slow speech due to slow, intermittent movements of the articulatory apparatus,
• difficulties in maintaining and changing articulatory positions,
• gross and persistent disturbances in the pronunciation of sounds, as a result of which speech becomes slurred,
• lack of expressiveness and intonation of speech,
• disturbances in tempo, melody of speech and voice modulation,
• slow automation of sounds (the child speaks with effort, before pronouncing sounds there is a rather long period of preparation, when the child makes only uncoordinated movements of the lips and tongue, etc.),
• increased, decreased or constantly changing tone of the muscles of the face and speech apparatus,
• insufficient volume of execution of fine differentiated movements of the tongue, decreased mobility of the tip of the tongue,
• incorrect position of the tongue in an 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 of associated movements of the fingers and hands, lower jaw when moving the tongue during speech,
• insufficiency of motor and graphomotor functions.

Functional tests in the diagnosis of dysarthria in children

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

1. Checking the asymmetry of the tongue position. The child is asked to open his mouth, stick his tongue forward and hold it in this position, following the moving object (a toy, a pendulum or the doctor's hand) with his eyes. If, when moving the eyes, there is a friendly movement of the tongue (its deviation in the direction of the object's movement), this indicates a positive result, i.e. we are talking about dysarthria, and not about another deviation.
2. Determining muscle tone during articulation. The child is asked to make various articulatory movements with the tongue (open the mouth, stick out the tongue, lift the tongue up, move it to the side, etc.). At this time, the doctor places his hands on the child's neck to feel at what point the muscles tense up more. In dysarthria, this happens at the moment of performing fine differentiated movements with the tongue, sometimes these movements are accompanied by throwing back the head.

If both tests are positive, we can speak with great certainty about dysarthria, which in children aged 3-5 years can easily be confused with dyslalia or alalia, which manifest as speech impairment or inability to speak normally.

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Examination of intonation in children with dysarthria

Sound pronunciation disorders in dysarthria are determined by hearing. But this is not yet a reason for making a final diagnosis, because such disorders are also characteristic of other speech disorders, in particular dyslalia. More information is provided by examining the prosodic side of speech (intonation) in children, especially in babies with erased dysarthria.

The examination program includes several important points:

• Study of the sense of rhythm – determining the child’s ability to determine the number of individual simple beats, accented (loud and quiet) beats, series of different beats and to correlate them with images on cards.
• Study of the reproduction of rhythm by ear - determination of the child's ability to imitate actions, in particular, repetition of the rhythm of various beats without relying on visual support.
• A study of the perception of intonation by ear – identifying the ability to distinguish between different intonation structures when perceiving speech by ear (narrative, interrogative and exclamatory intonations in sentences).
• Study of the ability to reproduce intonation - determining the child's ability to use different intonations in his speech when repeating the same or different short sentences.
• Studying the perception of logical stress – studying the perception of the expressiveness of a child’s speech and the ability to highlight the main thing by ear and visual perception.
• Studying the ability to reproduce logical stress – determining the ability to highlight the main thing in one’s speech by pronouncing the highlighted word louder and longer.
• Study of voice modulations (in pitch and in volume) – study of the child’s ability to control his voice, change it in volume and in volume while pronouncing the same sounds and sound combinations. This is necessary to determine the width of the voice range of a child with dysarthria.
• Determination of nasal voice timbre – assessment of pronunciation timbre impairment on a 5-point scale during normal communication and pronouncing words with a pinched nose:

• 4 points – normal timbre,
• 3 points – shrill or squeaky voice (mild impairment),
• 2 points – rough or croaking voice (moderate impairment),
• 1 point – muffled, guttural or harsh voice (pronounced pathology),
• 0 points – barely audible speech in the form of a whisper (aphonia).

• Study of timbre perception – study of the child’s determination of the sound of a voice by ear and their correlation with pictures expressing various emotions. Assessment on a 5-point scale:

• 4 points – tasks are completed efficiently and in full
• 3 points – tasks completed well, but at a slow pace
• 2 points – there were errors in execution, but the child solved them independently
• 1 point – tasks are completed only with the active participation of adults
• 0 points – tasks not completed even after additional or repeated instructions.

• Study of vocal timbre reproduction – determination of the possibility of changing the color of the voice to convey an emotional state or imitate various sounds of the surrounding world, which is practically absent in dysarthria in children.
• Study of breathing during speech activity and at rest – determination of the type of breathing (superficial, chest, diaphragmatic), strength and direction of the air stream, rhythm of inhalation and exhalation, differentiation of oral and nasal inhalation and exhalation, features of phonation breathing.
• Study of the characteristics of the tempo-rhythmic organization of speech – determining the number of syllables pronounced by a child in a given time interval, as well as the perception of the tempo of speech by ear.
• Study of the state of speech control by ear. The child performs tasks on rhythm, reproduction of sounds, syllables, words and sentences with words of different structure, etc., and evaluates the correctness of the tasks.

Completing such tasks allows us to identify how severe the child’s pronunciation and speech disorders are, but they do not yet indicate the development of dysarthria, which is also characterized by neurological symptoms that affect the quality of articulatory and facial movements.

Study of facial expressions and articulation in dysarthria

Some disturbances of facial motor skills may also indicate the development of dysarthria in children. The fact is that such children have difficulty puffing out their cheeks and squinting, it is difficult for them to wrinkle their nose or raise their eyebrows.

To examine general facial and speech motor skills, Quint's tests in the Gelnitz modification are used, which are adapted for different ages. Such diagnostic exercises are perceived by children as a game. The child is asked:

• feign surprise by raising your eyebrows,
• lower your eyelids, first closing them lightly, and then tightly, so that it becomes dark,
• squint "from the bright sun"
• purse your lips,
• stretch your lips forward as if you were going to play the trumpet,
• open your mouth slightly, open it as wide as you can and close it,
• show how he chews, imitating chewing food,
• puff out your cheeks together and then alternately,
• draw your cheeks in,
• clench your teeth, building a "fence" out of them,
• stretch your lips and blow on the hot milk,
• stretch out the “wide” and then “narrow” tongue, try to hold the tongue in a given position for a count of 5,
• bite the tip of your tongue,
• stick out your “sharp” tongue and move it from your upper lip to your lower lip and vice versa,
• perform the “Clock” exercise (the child should move his tongue from one corner of the mouth to the other while smiling),
• lick your lips as if after delicious jam or honey,
• show how a cat laps milk with its tongue,
• perform the following articulation exercises: pulling back the corners of the mouth when pronouncing the sound "i", rounding the lips for the sound "o", stretching the lips for the sound "u".

Each exercise must be repeated 3 times. A three-point scale is used to assess the quality of their execution:

• 1 point – accurate completion of all tasks in the required volume
• 2 points – unclear performance of facial expression and articulation exercises or insufficient volume of performance due to rapid fatigue of the articulation apparatus and difficulty breathing, as well as if 6 or less exercises were not performed
• 3 points – failure to complete 7 or more tasks, significant difficulties in completing 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 dysarthria from the same dyslalia. During the performance of tasks, children with dysarthria experience salivation, rapid fatigue, which is manifested in weakness and slow tempo of articulatory movements, changes in the tone of the muscles of the tongue (for example, the appearance of voluntary movements when raising the tongue up), hyperkinesis. Attention is paid to the state of the tone of the muscles of the face and speech apparatus at rest and when performing articulatory movements.

Differential diagnosis

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

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

Information about early childhood development at home will also be useful:

• when he began to hold his head up, sit, crawl, walk,
• at what age did he say his first words and how did his vocabulary increase,
• what are the baby's cognitive characteristics, does he show interest in toys and the world around him, how did he react and reacts to the appearance of his parents, etc.

Doctors resort to instrumental diagnostics not to determine dysarthria itself, but to identify the cause of speech and neurological disorders in children.

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

Routine laboratory tests for dysarthria in children can be carried out only in connection with the need for drug treatment.

Treatment dysarthria in a child

Impaired pronunciation and motor skills in children with dysarthria are associated with organic lesions of the brain and central nervous system. This suggests that treatment of this pathology should not be limited to speech therapy sessions alone. In this case, a comprehensive approach to solving the problem plays a major role in the child's future life.

A comprehensive approach to the treatment of dysarthria in children includes the use of various methods of therapeutic intervention:

• drug therapy
• therapeutic physical training exercises
• breathing exercises
• speech therapy massage, self-massage of the articulatory apparatus
• classes with a speech therapist
• psychological assistance to children with speech disorders
• medicinal baths
• sand therapy
• dolphin therapy
• acupuncture and reflexology
• hippotherapy
• classes with parents to develop fine motor skills and graphomotor skills, and develop self-care skills.

Drug therapy for dysarthria aims to improve the child's mental and intellectual activity. There are no special drugs for this disease, so doctors have to make do with non-specific drugs from the nootropic group, which are safe for children. Such drugs that improve memory and attention, stimulate mental and cognitive activity, have a positive effect on education and development of intellectual skills, and improve the child's learning ability include:

• "Phenibut"
• "Hopantenic acid"
• "Encephabol"
• "Cortexin" and others.

Other drugs (anticonvulsants, vascular, metabolic and sedatives) are prescribed to young patients only in connection with the underlying disease against which dysarthria develops, for example, with cerebral palsy.

Correction of dysarthria in children

Corrective work with children diagnosed with dysarthria involves not only making their speech understandable to others, but also improving vocabulary, mastering reading and writing skills, and developing spatial thinking.

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

1. Formation of 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 classes are conducted by a speech therapist in specialized children's institutions. In case of mild dysarthria, children simply undergo a speech correction course and return home with subsequent education in a regular school. If the damage to the brain and central nervous system is severe, such as in cerebral palsy, children are taught 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 dates back to the middle of the 20th century. At that time, the basic phonetic principles for eliminating speech disorders were formulated:

• When working on pronunciation, the main emphasis should be on the semantics and acoustic characteristics of the word, and not on articulation, which children with cerebral palsy experience significant difficulties with.
• The main efforts should be directed at improving the quality of acoustic perception of sounds of different strength, pitch and duration, phonemic perception and kinematic perception of articulation.
• The basic components of movement must be developed with the participation of first large and then small muscle groups.
• For clarity, the movement pattern can be formed on one organ and then transferred to another.
• The child should be allowed to reproduce sounds in a way accessible to him, relying not on the formation of new articulation skills, but using existing ones. The focus should be on the acoustic properties of sounds.
• Clear automation of movements is necessary to form motor stereotypes, which will prevent distortion of sounds.

Points that need to be taken into account in corrective work for cerebral palsy:

• The main focus of the work is the formation of the phonetic and phonemic aspects 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 child’s phonemic representations
• A prerequisite for the successful work of a speech therapist is the formation of positive motivation that encourages the child to improve his speech.
• Classes on developing phonetic perception of individual sounds and speech in general should be slightly ahead of lessons on their correct reproduction.
• Articulation exercises should be accessible to children with dysarthria, and the formation of correct pronunciation should be carried out with an emphasis on its acoustic features.
• The formation of articulatory praxis should be consistent, starting from the formation of an air stream, connecting the voice to it, and ending with the development of articulatory skills.

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Massage for dysarthria

It is very difficult to overestimate the importance of speech therapy massage for dysarthria in children, because speech disorders in them are most often associated with increased or greatly decreased tone of the facial muscles and articulatory apparatus. This complicates various corrective measures for the development of speech in children. In order for speech therapy correction of dysarthria to bring good results, each such session is recommended to begin with massage, if necessary adding elements of articulatory gymnastics.

Speech therapy massage for dysarthria in children includes the following areas:

• Mimic (relaxing) massage of the face and neck
• Point massage of individual zones of the articulatory apparatus
• Tongue massage using hands and a probe
• Self-massage or performing passive facial and articulatory gymnastics.

Massage, in the absence of contraindications, is performed by a specially trained specialist. Although some elements of massage are also available to the baby's parents after a speech therapist or a medical worker who has mastered the elements of massage perfectly shows how to perform them correctly.

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

Through massage the following is achieved:

• Normalization of muscle tone (general, facial muscles and articulatory apparatus)
• Reducing the likelihood of paresis and paralysis of the muscles of the speech apparatus
• Diversity 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 therapy classes for dysarthria in children

Classes with a speech therapist play a major role in the development of speech in children with dysarthria. With a comprehensive approach, taking into account the severity of the disease and associated pathologies, good results can be achieved.

Speech therapy sessions for dysarthria in children are conducted in a playful manner and consist of a series of special exercises described in the individual speech card of the little patient. These exercises are selected taking into account the patient's speech characteristics associated with disorders of certain parts of the brain. The duration of the course of speech therapy sessions depends on the speed of the child's acquisition of speech skills, and, of course, on the severity of the pathology itself.

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

• Exercises for the development of fine motor skills, which include elements of therapeutic gymnastics and finger games.
• Exercises for the development of articulation, which include speech therapy massage, supplemented by passive and active articulation gymnastics.
• Breathing exercises to correct physiological and speech breathing.
• Corrective classes to improve pronunciation plus reinforcement of correct speech skills.
• Exercises for developing skills of expressive, emotionally charged speech (correct perception and reproduction of timbre, rhythm, intonation of speech and evaluation of speech by ear, the ability to control one’s voice).
• Exercises to develop speech communication (the ability to communicate verbally) and a sufficient vocabulary in a 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. Classes are held in the following sequence:

1. Preparatory stage (massage, articulation and breathing exercises)
2. Formation of primary (basic) pronunciation skills
3. Consistent development of communication skills.

Articulation exercises for dysarthria

A set of articulation exercises for dysarthria in children can include both exercises for general speech development and special series of exercises aimed at correcting the pronunciation of individual sounds.

The basic complex of articulation gymnastics for children consists of 10 exercises with playful names that are attractive to children:

• The “Frog” exercise involves a tense smile with an open mouth and clenched teeth, which must be maintained without pushing the lower jaw forward until the speech therapist counts to 5.
• The proboscis exercise is nothing more than maximally extending the lips forward with the teeth and lips closed for a count of 5.
• The exercise "Frog-Proboscis" is an alternation of the two exercises described above.
• The “Window” exercise involves alternately opening and closing the mouth “one-two”.
• Exercise "Spatula": smile with an open mouth, from which an extended "wide" tongue hangs down onto the lower lip. The exercise should be performed without straining the lower lip, holding the position for a count of 5.
• Exercise "Needle": smile with your mouth open, but stick your tongue out sharply. Try not to bend your tongue upwards.
• Exercise "Spade-Needle" - alternate execution of the above-mentioned exercises on the count of "one-two".
• The "Clock" exercise is used both in diagnostics and in correction of dysarthria. During a smile with an open mouth, the tongue moves to the right and left, touching one corner of the mouth and then the other.
• Exercise "Swing": in the same position, press the tip of your tongue against the upper and lower teeth, counting "one-two".
• Exercise "Little Horse" - clicking the tip of the tongue to imitate the clicking of a horse's hooves.

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Formation of speech breathing in children with dysarthria

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

The goal of breathing exercises is to increase the volume of breathing, normalize its rhythm, and develop a smooth, long and economical exhalation.

The set of exercises consists of various series, including:

• classical exercises for the formation of physiological breathing,
• exercises and games for developing speech breathing without using speech,
• breathing and voice games based on vowel sounds,
• identical exercises using consonant sounds,
• breathing and voice games using words,
• games aimed at developing an extended exhalation while simultaneously pronouncing phrases of varying length and complexity.

As in the case of articulatory gymnastics, exercises for the development of speech breathing have names that are attractive to children, and are conducted in a playful, understandable form for the child by a speech therapist who has experience working with such children. The little ones are asked to blow out a "candle", fan a "bonfire", reproduce the whistle of a steam locomotive or the hiss of a cat, play homemade wind instruments made from pen caps or felt-tip pens, etc. The main emphasis is on getting the child interested in the activities and making him feel like a full-fledged person.

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Development of phonemic hearing in children with dysarthria

For the comprehensive development of speech in a child with dysarthria, it is important to teach the child not only to speak, but also to perceive 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 develop the correct pronunciation of sounds and words.

The purpose of exercises to develop phonemic hearing in children with dysarthria is:

• consolidation of the ability to differentiate (distinguish) the sounds of native speech,
• development of auditory attention,
• developing the ability to coordinate movements with the text depending on the dynamics and pace of presentation,
• development of the ability to navigate in space without the help of sight,
• improving phonemic hearing: searching for words with a given sound, determining the place of a sound in a word, selecting words with a certain sound when composing a sentence, dividing words into syllables, constructing simple and complex sentences, identifying incorrectly pronounced words,
• development of self-control over the pronunciation of sounds and words.

Usually such classes are held in groups to increase the children's interest in the classes and to teach them various communication methods in practice. But the formation of correct pronunciation occurs during individual classes.

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Prevention

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

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Forecast

If, despite all efforts, the infant shows some signs indicating developing dysarthria, one should not give up. Such a baby needs more attention, talking and communicating with him, developing cognitive abilities, reading books to him and telling him about the properties of objects. In the future, some efforts will need to be made to teach the child self-care skills and develop graphomotor skills. And the sooner the mother seeks help from specialists, the more favorable the prognosis for the disease will be.

As a rule, dysarthria in children, occurring in a latent or mild form, is quite easy to treat and correct. After undergoing a course of treatment, such children can subsequently study quite successfully in regular schools. By the way, as a result of regular and correctly selected classes with a child, impressive results can be achieved even with severe brain damage.

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