Tongue massage for dysarthria in children

Dysarthria is a speech disorder that results in inarticulate, often difficult to perceive pronunciation. This pathology is studied both by neurologists, since its cause is the transformation of the nervous regulation of the speech apparatus, and by speech therapists who are engaged in pronunciation correction.

Speech therapists classify dysarthria based on the principle of perception of the pronunciation of sounds by others and distinguish three degrees of severity: from practically understandable speech (mild degree) to its complete absence (severe degree - anarthria).

Speech therapy massage for dysarthria has a beneficial effect on pronunciation and speech breathing, voice sonority and emotional mood of the patient. It is successfully used in a complex of medical and pedagogical rehabilitation measures carried out with patients of any age suffering from pronunciation disorder.

Regularly performed speech therapy massage helps to gradually normalize the tone of the muscles of the tongue, palate, lips, facial expressions, spontaneous formation of correct pronunciation, as well as reduce the time of its correction. Even in cases of pronounced neurological symptoms in the patient, the use of only this type of speech correction, especially at the beginning of treatment measures, brings a noticeable positive effect.

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Indications for the procedure

Decreased or increased tone of the muscles of the speech apparatus and respiration, anatomical defects (short lingual frenulum), manifested as slurred pronunciation, underdevelopment or absence of speech in childhood, post-stroke aphasia in adults.

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Preparation

When performing the procedure, the patient's body is provided with a position that allows the articulatory muscles to relax and breathing to normalize, as well as an optimal position for the massage therapist's comfort. A small bolster is placed under the neck of the patient lying on his back so that the shoulders are slightly raised and the head is slightly thrown back. The patient's upper limbs are positioned along the body, the lower limbs are freely straightened or slightly bent at the knees, under which a bolster is also placed. A semi-sitting position is provided by a special chair with a folding high back. For small children, you can use a baby stroller or a chair. You should not place the child on the massage table from the first session. This may cause rejection on his part and unwanted protests. At the beginning of the treatment, while the child is not accustomed to the procedure, he can be provided with the necessary position in the arms of one of the parents.

Before starting the massage, the patient's gag reflex threshold is established. Speech therapy tongue massage is not performed immediately after eating; a gap of at least two hours should be maintained.

In case of spasms of the articulatory muscles, which are much more common with dysarthria, before the session it is recommended to take two or three sips of warm infusion in your mouth and hold it there, prepared as follows: brew a pinch of nettle, St. John's wort, chamomile and tea with a glass of boiling water.

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Technique massage for dysarthria

The procedure is carried out with clean, warm hands so that the patient feels comfortable. The masseur's nails must be carefully cleaned and cut short, no jewelry on the fingers or wrists is allowed.

First, to relax the neck muscles, the massage therapist turns the patient's head from side to side several times, then a facial massage is performed for dysarthria, more often for relaxation, sometimes for toning the facial muscles. The massage movements are repeated five to six times.

The patient lies down, the massage therapist is behind. Stroking is performed in the following directions: from the eyebrows towards the hair; from the center of the forehead along the arc to the temples; above the eyes - from the inner corner along the arc to the outer, under the eyes - from the outer to the inner. In the cheek area, massage the arches connecting the wings of the nose and the cheekbone, then the cheeks themselves in circular motions. The muscles of the lips are massaged from the center above the upper lip to its corners, then in the same way - under the lower; from the corner of the mouth - to the tragus of the ear. Massage, rubbing, the chin; the buccinator muscle - from the zygomatic bone down (with the bones of clenched fingers). In case of facial asymmetry, the affected side is massaged more intensively.

Finger massage of the tongue for dysarthria is performed using a piece of natural fabric, gauze, finger cots (depending on the patient's sensitivity). During the procedure, the massage therapist is comfortable to be on the right side of the patient. Preliminary exercises are performed at a leisurely pace to relax the muscles of the root of the tongue:

• the massage therapist clamps the tongue with his fingers (the thumb is on top, the index and middle fingers are on the bottom) and rotates it several times in one direction, then in the other;
• pulls the tongue towards himself, “winding” it around the index finger, then releases it, unwinding it.

The tongue massage begins with the hollow under the chin - deep pressure with the middle finger, without lifting the finger. To relax the muscles - the movements are performed at a calm pace, to activate the muscles - a more intense massage is used. The cheeks are massaged with circular rubbing movements, then they move directly to the tongue. They perform its "rubbing" with a wide bandage folded in half or a piece of cotton fabric. In this case, the thumb is placed on the upper part of the tongue, the next two - from below. If the tongue muscles are tense, massage from the tip to the root, if relaxed - vice versa, to relax the muscles - the tongue can be shaken.

Exercise "clock" - it is pulled from side to side by the tip, then squeezed from both sides and carried along the sides to the tip.

The “arrow” exercise: squeeze the tongue with your fingers (thumb and index finger), and pull it slightly with the index finger of your other hand from its root to its tip.

Muscle rubbing is performed:

• sublingual;
• lips - thumb inside, index finger outside;
• buccal - index finger inside the mouth, thumb - outside.

Speech therapy massage for dysarthria is performed using auxiliary devices called probes. They are made of metal and plastic, have a wide variety of shapes: a ball, a mushroom, a fork, antennae, a hammer, etc. Probe massage for dysarthria effectively develops the articulatory apparatus, normalizes muscle activity and tongue mobility, and pronunciation becomes clearer and more understandable. Spatulas (metal, wooden) and toothbrushes are also used as massage tools. With their help, massage is done from the tip of the tongue to its root and vice versa, for example, with a ball probe, activating or relaxing the longitudinal muscles of the tongue. Movements from the center of the tongue to its edges tone the activity of the transverse lingual muscles, and point pressure is applied in the same direction. Relaxing movements, on the contrary, are soft and stroking. Circular and spiral movements are made with a probe, brush or spatula.

Prick the tongue around the perimeter with a whisker-shaped probe (for about 10 seconds).

After pinching the tongue, rhythmic patting is performed on the tongue with any device, moving inward from its tip. This normalizes the muscular activity of the vertical tongue muscles, and also massages it, simulating a light vibration, using a toothbrush or spatula.

Stroking is performed on the underside of the tongue in the direction from the depths to its tip using any suitable device, thereby stretching the lingual frenulum.

You can flatten your tongue with a small enema syringe folded in half (the larger part of it), holding it by the tip.

This massage is done daily or at daily intervals. This is an approximate list of exercises, others are possible. They are selected individually depending on the location of the affected muscles.

Relaxation massage for dysarthria is performed using mainly stroking and vibrating movements, and relaxing effects on acupuncture points are also practiced. The patient is usually massaged starting from the collar area, moving to the shoulder area, followed by a facial massage. The procedure ends with a tongue massage. The masseur's movements should be unhurried and sliding. They are performed eight to ten times. In order to relax stiff muscles at home, you can use the following technique:

• stroke the neck from the hairline towards the shoulders;
• using your index, middle and ring fingers, stroke your forehead from the temples to the center, from the hair towards the eyebrows;
• with the tips of the same fingers, stroke the cheeks in a circle;
• then perform stroking movements from the temporal bone towards the wings of the nose (the movement is performed in an arc);
• rub the cheek muscles in a spiral from the auricles towards the wings of the nose;
• from the ears towards the chin, pressing lightly, stroke the cheekbones;
• stroke the upper lip with your fingers, then the lower lip, then knead them, moving from the corners of the mouth to its center;
• simultaneously, with both hands, stroke the area of the face from the wings of the nose towards the chin and in the opposite direction;
• tap the entire surface of the lips with your fingers.

After this, massage the tongue. Without speech therapy probes, at home you can stroke with your index finger from its tip towards the root.

Reduced activity of the articulatory muscles suggests more intensive actions – stroking and rubbing, patting and kneading, pinching and vibrating. Each position is repeated eight to ten times. The first movements are light, then their intensity gradually increases. They are performed with pressure, but should not cause discomfort.

First, the main muscle groups are worked out, then the secondary ones:

• the forehead is stroked with the fingers (index and middle) of both hands simultaneously from the center towards the temples, kneaded with the knuckles of the same fingers, rubbed in the same direction, the treatment of this area ends with light tapping and pinching movements;
• the muscles of the cheeks are worked with rubbing and kneading movements in the direction from the wings of the nose to the ears with the same two fingers, then they are massaged from left to right and in a spiral from the ears to the chin, finishing with random pinching of the skin on the cheeks;
• rubbing with increasing activity in arcuate directions from the chin to the ears and from the corner of the lip to the outer corner of the eyes;
• The muscles of the lips are developed from the center to the corners of the mouth (each lip separately), they are first stroked, then pinched and the fold running from the nose to the lips is carefully massaged.

Toothbrush massage for dysarthria is performed with brushes of different sizes and hardness. The tongue is massaged with both the bristles and the handle of the brush. The movements are similar to those described above.

The development of speech and pronunciation is closely related to fine motor skills of the hands. Therefore, hand massage will be useful for the child from birth. At a very early age (up to three months), after consulting with a neurologist and in the "healthy child" office at the clinic, you can begin to do a light massage of the fingers. It is done with warm, clean hands lubricated with baby oil. Light kneading, rubbing and stroking movements are performed for each finger.

From the fourth month, you can use various objects and toys with protruding parts (cubes, needle balls, cones). Children roll them and feel them with their hands.

For children over one year old, it is recommended to hold each finger in turn with the index and middle fingers of an adult and gently twist them; the child clasps the same fingers on the left and right hand (two thumbs, two index fingers, and so on), and the adult unclasps them; you can help the child massage his fingers in turn, pressing on both sides, independently.

In the speech therapy room, children are given preparatory massages of their fingers. They start the movement from the tip of the little finger. Moving up to the base of the finger, they massage it thoroughly, not missing a millimeter. Having finished massaging all the fingers, they press on the finger bulges and tap them with the end of the nail. Then they stroke the palm in a spiral from the edge to the center and massage it in the same direction.

There are different methods of finger massage, including Tibetan point massage and finger games. To develop fine motor skills, it is useful to sort through cereals and peas with your hands, squeezing and unclenching your fingers. Mix two different cereals and ask your child to sort them into two different plates.

Speech therapy massage with spoons for dysarthria is performed using four clean teaspoons without architectural frills. It can be done at home independently, however, before starting classes, be sure to consult a doctor.

Technique of performing massage with spoons

1. With the convex part of the spoons, stroke the temples clockwise six to eight times; stroke the eye sockets above the eyes from the inner corner to the outer, then under the eyes - vice versa; stroke the cheeks in a circular motion; the temples - in a spiral; then the same - between the eyebrows.
2. Using the side of the spoon, massage your cheeks in the direction from the chin to the eyes.
3. Rub the nasolabial triangle with the end of the spoon. Work on the upper lip, pressing lightly, then the lower lip.
4. Using the convex part of the spoons, massage the chin and cheekbones in a circular motion.

Each movement is repeated six to eight times.

Speech therapy massage should not cause pain. The duration of the session depends on many factors: age, severity of the damage to the articulatory apparatus, individual sensitivity, etc. At first, it lasts from two to six minutes, the number of exercises gradually increases and the procedure is extended to 15-20 minutes. At an early age, it is not recommended to have a session lasting more than 10 minutes, younger preschoolers should not have a massage for more than a quarter of an hour, children over five years old can have a session of up to 25 minutes, teenagers and adults are given from 45 minutes to an hour.

If the child does not want to have a massage, no violence is allowed, the procedure is carried out in a playful manner, the first times you can limit yourself to a massage of the hands and face. It is recommended to distract the child with songs, poems, fairy tales.

An individual approach is developed for each patient of any age and a personal treatment plan is drawn up. The standard course consists of eight to ten sessions. It is repeated at intervals of three weeks. After the second course, a positive effect is already noticeable. For example, if the patient did not speak at all, he begins to speak. Three months after the completion of the second stage of treatment, a third one can be prescribed if necessary.

Speech therapy massage alone is not enough to treat severe degrees of dysarthria; it is used as part of a complex of treatment measures.

Contraindications to the procedure

Absolute - oncological diseases, vascular thrombosis, blood diseases. Temporary are acute infectious and inflammatory processes (tonsillitis, acute respiratory viral infections, stomatitis, conjunctivitis), lymphadenopathy, pronounced pulsation of the carotid artery, exacerbation of chronic diseases, in particular, skin diseases - herpetic and allergic rashes. Caution should be exercised when prescribing and performing massage to children with convulsive syndrome, epilepsy, chin tremor.

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