The materials presented below (for examining a child 4-5 years old) do not have to be used in full. Each child is examined individually. During an introductory conversation, the specialist identifies the level of speech and general development of the child, and depending on this, selects the material necessary for a particular child. The speech therapist makes sure that the child does not become overtired and alternates types of activities.
During the diagnosis, the level of formation of the child’s phonetic system (sound pronunciation, sound-syllable structure, dynamic organization of speech), phonemic functions, lexico-grammatical structure of speech, speech motor skills, and coherent speech is determined. The data obtained helps to understand the cause of the disorder and plan correctional work in such a way as to help the child as much as possible.
Speech therapy examination of children 4-5 years old (explanatory note).
1. Examination of sound pronunciation (C 2-14).
The child names the objects shown in the pictures.
2. Examination of the sound-syllable structure of the word (C 15).
3. Examination of the state of phonemic perception (C 16-19).
Invite your child to play “parrot”. You speak, and the parrot repeats.
Repetition of syllables with opposition sounds:
Differentiation of oppositional sounds that are not mixed in pronunciation(based on pictures). Show me where the bowl is? Where is the bear?
Pictures: bear - mouse, duck - fishing rod, crust - slide, barrel - kidney, grass - firewood.
Differentiation of oppositional sounds mixed in pronunciation(based on pictures). Show me where the cancer is? Where's the varnish?
Pictures: cancer - varnish, soup - tooth, cups - checkers, evening - wind, eyes - thunderstorm, goat - scythe, garlic - puppy, bowl - bear, raspberry - Marina, flower - Svetik.
4. Survey of the state of phonemic analysis of synthesis (C 20).
Isolating a given sound from words.
Isolating [m] (“mooing of a calf”) or [r] (“motor”) from the words: mouse, mosquito, board, window, frame, house, fish, firewood, table, ball.
5. Study of vocabulary and grammatical structure of impressive speech (C 21 - 22).
We check the volume and accuracy of understanding the meaning of words.
Understanding different grammatical forms (from pictures):
- differentiation between singular and plural nouns
Pictures: cup - cups, mushroom - mushrooms, ball - balls.
Understanding phrases and simple sentences.
Show me a pencil with a stick, a pencil with a stick.
Understanding simple common sentences, interrogative sentences.
6. Study of vocabulary and grammatical structure of expressive speech (C 23-37).
Nouns. Name subject pictures on lexical topics and generalizing concepts. From 4 years old - toys, dishes, animals; from 5 years old - the same shoes, vegetables, fruits, family.
Name geometric shapes.
Verbs. What is he doing? (based on pictures)
(Bird - flies, fish - swims, snake - crawls, frog - jumps, plane - flies, boat - swims, car - drives, dog - barks, bites, eats, plays...)
Selection of definitions for the word: hedgehog - what?, sun - what?, candy - what? socks - what kind? etc.
in the nominative case singular and plural. Game “One - Many” (based on pictures).
Pictures: table - tables, ball - balls, ball - balls, hand - hands, doll - dolls, tree - trees, lion - lions, chair - chairs.
Use of nouns in indirect cases without a preposition.
I have a pencil. I don't have a pencil. I draw with a pencil.
Formation of names of baby animals: duck, goose, fox, cat.
7. Examination of coherent speech (C 38-40).
Invite your child to look at a story picture (a series of story pictures) and tell what is drawn on it (them).
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Examination and dynamic observation of a child who stutters
Classes with a team create conditions for active work all children. The requirement for an individual approach does not mean opposing the individual to the collective. Only knowing well the capabilities of each child can you organize collective work.
Group, collective speech therapy sessions for people who stutter have justified themselves through many years of practice. An individual approach to speech therapy work is expressed, first of all, in a thorough study of each person who stutters before and during the process. speech therapy work with him and in the choice of means of correctional and educational work, depending on his psychological characteristics and speech abilities.
Age stutterers determines the selection of didactic material and forms of work. The psychophysical characteristics of preschoolers, schoolchildren, adolescents and adults require that the speech therapist, when choosing forms of influence and material, in one case focus on the education and training program in kindergarten and play activities, in the other - on school programs and educational activities, in the third - for different types of work activities.
The recruitment of speech therapy groups is carried out taking into account the age of people who stutter. Different ages(and it usually determines the experience of stuttering) necessitates the use of unique methods of speech therapy work, a change in the intensity of the use of individual components of the medical-pedagogical approach to overcoming stuttering as a whole.
For preschoolers, for example, the main place is occupied by speech classes V game form, educational activities, less - medical. In adolescents and adults, on the contrary, the main importance is attached to medical means and psychotherapy (including its suggestive methods), and less to pedagogical ones.
Therefore, with an individual approach in speech therapy work with people who stutter great importance has a primary and dynamic study of a person who stutters during classes. Linguistic, psychological and pedagogical observations are important for a speech therapist. These observations allow you to select the necessary forms corrective influence on a person who stutters, predict the effectiveness of speech therapy work with him.
The control tasks of the primary examination are to get a fairly complete picture of the child’s psychophysical development and his speech capabilities. It consists of collecting anamnestic information and direct examination of his speech.
The speech therapist conducts an examination on the following issues:
1) parents’ health;
2) general development child before stuttering occurs;
3) speech development;
4) features of raising a child in a family;
5) speech environment;
6) when and how stuttering arose;
7) what else speech impediments existed during this period;
8) what features are noted manifestations of stuttering and related disorders;
9) have you previously asked for help?
Child development and history information occurrence of stuttering gleaned from a conversation with his parents. First of all, are the parents themselves healthy: are there any relatives in the family who suffer or have suffered from alcoholism, mental illness or sexually transmitted diseases?
Then the data on the general development of the child is clarified: did the intrauterine period proceed favorably (were there any injuries or serious illnesses in the mother), how did the mother’s birth go (on time, were there any injuries, did the child immediately cry)? When did the child begin to hold his head up, begin to sit, walk, when did he begin (and did he respond correctly) to speech addressed to him? What illnesses did you suffer and were there any complications? What features of behavior and speech characterized his general development in the period up to 5 years, i.e. before stuttering occurs? Were there any sharp mental traumas?
Information about speech development baby: when did the first sounds, humming, babbling, first words, phrases appear, what rate of speech did you use, were there any peculiarities of behavior during moments of verbal communication with others? Here it is important to find out about the child’s speech environment (whether they stutter, speak too quickly, whether the parents themselves or people close to the child are disorganized).
Much attention is paid to studying the issue of raising a child in a family: the attitude of adults towards him (whether there is affection, indulgence in whims or, conversely, unbalanced, harsh treatment, physical punishment, intimidation); help in forming his correct speech(is there any overload in memorizing complex texts or, conversely, a lack of control over the development of correct pronunciation, grammatically correct speech communication, etc.).
When stuttering occurred, have the first signs of it appeared? How was it expressed outwardly? What possible reasons could have caused it?
What other speech deficiencies were observed in the child during this period: pronunciation of sounds, his vocabulary and grammatical construction of phrases, voice, breathing, rate of speech.
How did the child develop? stuttering, what features of its manifestations attracted the attention of parents: are there any accompanying motor disorders (convulsions, tapping with a hand, foot, shaking the head, etc.) or speech defects (extra words, sounds, pronouncing individual sounds and words while inhaling, etc.) ? How does stuttering manifest itself depending on the situation or the people around you? different types activities? How does a child speak alone (for example, with his toys)? What are the periods of deterioration and improvement of speech associated with? How does the child feel about his speech impairment (notices, doesn’t notice, is indifferent, worries, is ashamed, hides, is afraid to speak, etc.)?
Did the parents seek help: where, when, what was recommended, what were the results?
Thus, the answers to all the questions posed above allow us to judge the reasons that caused stuttering and some of the features of its manifestations in a child.
Information about the characteristics of stuttering allows us to determine in each specific case the main focus of the corrective impact on the child. For example, the presence of concomitant motor impairment indicates the need for motor exercises, perhaps even a cycle of exercise classes. physical therapy. Concomitant speech disorders will naturally require additional exercises, special techniques to eliminate the child’s phonetic defects or vocabulary deficiencies, or grammatical deficiencies in phrasal speech.
Peculiarities psychological manifestations of a stutterer will require the lesson leader to provide this plan of influence on him: to distract him from fixation on his defect, rebuild his attitude towards himself, towards his speech, teach him to hear his correct speech, instill and develop in him a feeling of confidence that he can speak beautifully and rightly so.
In case stuttering occurred as a result of incorrect pedagogical methods of raising a child: petting, intimidation, overload, memorizing complex works by heart, lack of assistance in speech development, imbalance in the treatment of the child by adults, inconsistent upbringing - in these cases, a change in the unfavorable conditions surrounding the child, right attitude to the stuttering speech of people close to him or his peers will help prevent and eliminate his stuttering.
Analysis of possible previous attempts get rid of stuttering(classes were conducted with a speech therapist, treatment by doctors) contributes to the choice of conditions for the necessary treatment (classes at home with parents, in kindergarten with teachers, or the organization of specialized care in an outpatient or inpatient setting).
After clarifying information about the development of the child, the history of the occurrence and characteristics of his stuttering, a direct examination of his speech is carried out. It complements the anamnestic information about stuttering child and allows us to objectively establish the presence of deficiencies in his speech and behavior.
A speech examination is necessary in order to specifically determine the child’s speech capabilities, i.e. preserved aspects of his speech, and outline the scope and direction of upcoming speech classes.
For this examination, a variety of pictures (subject, plot), children's books with poems, fairy tales, stories are used, various toys are selected (dolls, cars, animal figurines, building material, cubes, dominoes, lotto, pyramids), colored pencils, plasticine, masks animals or children's book characters, balls, counting sticks. Variety of material for speech examination stuttering child caused by the need to become familiar with the state of his speech depending on different types of activity and on of varying complexity speech material.
The objectives of the speech examination will be to determine:
1) place of occurrence and form of speech spasms;
2) the frequency of their manifestation and the child’s preserved speech abilities;
3) concomitant speech disorders;
4) concomitant motor disorders;
5) the child’s attitude towards his speech defect, the presence of psychological characteristics.
The location of the occurrence of convulsions (articulatory, respiratory, vocal, mixed) and their form (clonic, tonic, mixed) are determined aurally or visually. Depending on the results of this survey, the primary focus of individual speech exercises .
For example, for tonic convulsions of an articulatory nature, speech exercises based on vowel sounds and muscle relaxation exercises are predominantly used speech apparatus. For vocal spasms, speech exercises with vowel sounds, with different volumes of their pronunciation (from a whisper to loud speech), are advisable.
Frequency of speech cramps in stuttering child is of particular interest to the speech therapist. Determining the frequency of speech spasms depending on the types of speech activity and behavior of the child allows us to judge the preserved areas of speech of each child (his speech capabilities), and therefore, this will directly determine in the future how correctly the material for speech exercises will be selected and the success of the beginning speech therapy sessions.
How to determine the level of free speech of a child who stutters? First of all, we should remember the factors that influence the intensification or disappearance of speech spasms in people who stutter (various degrees of independence of speech, its preparedness, structural complexity, rhythm, loudness, characteristics of speech situations and types of activity of the child). The study of a child’s speech, depending on these factors, is the task of a speech therapist when determining the level of intact speech (speech capabilities) in children in each specific case. Below is Table 3, which allows you to visualize the level to which a stuttering child retains free speech, and therefore, at the same time, understand the directions of the consistent complication of speech and speech situations in speech therapy classes with him. On this table we noted the level of free speech in two children who stutter, conventionally called A (solid line) and B (dashed line). Below the lines, these children’s speech is free, above them it is difficult, hesitating and requires correction.
Studying the level of free speech begins with identifying in a child the dependence of the appearance of stuttering paroxysms on the varying degrees of his speech independence. In a casual conversation with a child about his parents, friends, interests, activities, the peculiarities of his speech behavior and various manifestations are revealed. speech spasms. For the same purpose, the child is asked to compose a story or retell the content of a picture or a familiar fairy tale; The speech therapist reads a story or fairy tale unknown to him and offers to retell it, asks specific questions about pictures, surrounding objects and toys that require simple answers. Then the speech therapist checks the child’s speech state in his reflected and conjugate speech by repeating or jointly pronouncing simple and complex phrases.
It should be immediately noted that the principles of consistent re-education of speech and its examination are different. If in the first case we are talking about a consistent transition from easy to more complex exercises, then when examining speech we should proceed from the opposite, i.e. from difficult to easy.
This is explained by the fact that when moving from easy forms of speech or conditions to more complex ones, the child, by imitation, usually shows higher speech capabilities than they actually are.
Let's explain with an example. Let's say, during the examination stuttering child pronounced together with the speech therapist (conjugate) the proposed phrase freely and easily. This is natural, since for him this is the easiest form of speech. He also freely repeated the following sentences (reflectively) after the speech therapist. The speech therapist then asks the question and he answers correctly again. Meanwhile, it is known that he usually answers questions with a stutter. Why did he say it easily here? Yes, because the speech therapist had already indirectly helped him: using the example of previous tasks, he showed him how to construct a phrase and set a certain pace of speech. The child grasped this sensitively and used it in his answer. That is why the principle from easy to difficult is good for developing correct speech and is insufficient for an objective assessment of the child’s usual state of speech. Therefore, the presence, frequency and absence of speech spasms in a child is initially checked in his spontaneous speech, then in a story, retelling, answers to questions, etc.
In the process of these consistently facilitated types of speech activity, it is very important for the speech therapist to determine the child’s level (or threshold) of free speech, where speech spasms disappear completely or almost completely. For example, depending on the degree of speech independence paroxysms of stuttering in child A they did not appear only in his conjugate and reflected speech, and in child B they did not appear in simple answers to specific questions from the speech therapist. Based on the material of retelling a familiar or unfamiliar fairy tale, the influence of different degrees of preparedness for speech on the disappearance of speech spasms in a child is determined. For example, child A recited a memorized text freely, without hesitation, and child B freely recited a well-known and then an unfamiliar fairy tale.
The absence of paroxysms of stuttering in a child, depending on the structural complexity of his speech, forces the speech therapist to pay attention to how the child pronounces complex and simple phrases, individual words, syllables and sounds. This observation is made on the basis of the above-mentioned conversations with the child, his stories, and answers to questions. The speech therapist must record for himself in which cases the child does not have paroxysms of stuttering. For example, child A freely spoke individual syllables and sounds by imitation and independently, and freely complied with the speech therapist’s request to say how a dog barks, a cat meows, a sheep bleats, etc. Child B also pronounced individual words and simple phrases without difficulty.
When studying the level of free speech of a person who stutters Depending on the degree of its rhythm, the speech therapist immediately becomes familiar with the state of the child’s multimetric speech in the process of conversations and communication with him. When retelling the fairy tales “Kolobok” and “Turnip”, which, in fact, are rhythmic prose, close to blank verse, the speech therapist clarifies the influence of rhythm on the disappearance of paroxysms of stuttering in a child. For the same purpose, he invites the child to recite a poem or sing a song.
The speech therapist obtains information about the psychological characteristics of the child from a conversation with the parents and his behavior during the examination. The speech therapist clarifies information about the child’s contact with others (at home, at school, with peers and adults, acquaintances and strangers), pays attention to the assessment of his own speech (whether he knows or does not know about his speech imperfection, what importance he attaches to it), and the presence of defensive reactions (touchiness, shyness, camouflage, avoidance of verbal communication), on speech behavior during examination (expects help, strives to actively overcome a deficiency or does not understand why classes are needed).
The sum of the information obtained allows one to judge the degree of the child’s painful fixation on his defect.
In cases where the child does not yet notice his defect, speech classes should be carried out as if with the goal of teaching him to speak beautifully, loudly, expressively, without haste. Try not to draw his attention to speech hesitations.
If, however, the child is simply indifferent to his speech, he needs to be encouraged to practice speech. In some cases, it is useful to draw his attention to the fact that he speaks incorrectly, that this can interfere with his life and, therefore, it is necessary to correct his incorrect speech.
In cases of a moderate degree of painful fixation on a defect in a child, it is necessary to cultivate confidence that he can speak well (constant fixation on free speech), that he will definitely speak completely freely if he follows the instructions of the teacher and takes care of himself.
The same tasks are faced by a child with a pronounced degree of painful fixation on his defect. However, there is also a struggle with fear of speech, depressed mood, obsessive states, persuasion, creation joyful emotions, nurturing a sense of one’s own worth, a new attitude towards oneself and one’s speech. Here, consultation and treatment with a neuropsychiatrist and, possibly, a psychotherapist are also advisable.
In conclusion, it should be noted that identify stuttering does not present any particular difficulty for a child, but in order to determine the direction and sequence of speech therapy sessions with him, the speech therapist requires good knowledge individual characteristics stutterer, features of the manifestation of his stuttering.
IN AND. Seliverstov “Stuttering in Children”
Understanding their speech defect, unsuccessful attempts to get rid of it on their own, or at least to disguise it, often give rise to certain psychological characteristics in people who stutter: shyness to the point of timidity, a desire for solitude, fear of speech, a feeling of oppression and constant worries about their speech. Sometimes it’s the other way around: disinhibition, ostentatious looseness and harshness.
Massage is performed to relieve tension and stiffness of speech and facial muscles and, conversely, to increase the tone of weak and flaccid muscles. To relieve tension from your face and relax it, you can use so-called self-massage. Here we will get acquainted with its two types: hygienic and vibration.
Hygienic massage is performed by stroking, which activates the nerve endings located close to the skin. This massage has a dual role: it relieves tension and stiffness in the facial and facial muscles and increases the tone of these muscles if they are weak.
Examination of children who stutter
Stuttering in children is a form of speech pathology, the basis of which is a violation of verbal communication. To adequately plan a program of speech therapy and treatment work with children who stutter, it is necessary to comprehensively examine them, taking into account all the symptoms of this complex speech disorder. The examination of a child who stutters consists of two stages.
Various negative factors The natal and postnatal periods of child development are analyzed and assessed by specialists in order to most fully study the etiology and pathogenesis of stuttering. Along with traditional data, the anamnesis includes information about the presence of stuttering in parents or other close relatives.
The study of psychological and pedagogical documentation complements the anamnestic data and allows us to identify the following features of upbringing and psychological manifestations in a child who stutters:
- the attitude of adults towards him;
— assistance in the formation of correct speech;
- time of stuttering onset, its first external
- features of the manifestation of stuttering depending on the environment
- the child’s attitude towards his speech impairment;
— was help provided to a child who stutters, what was done?
recommended and what were the results.
Second stage - research the most stuttering child.
After clarifying information about the child, the history of the occurrence and characteristics of his stuttering, the actual speech of the stutterer and extra-speech processes that have a direct impact on his speech activity are examined.
A study is conducted of sociability, motor skills, imitation, impressive and expressive speech, gaming, educational activities, and personality traits of a stutterer. There are primary (during the first month of the child’s stay in speech preschool institution, in the first two weeks of stay in a sanatorium for children who stutter, at a school speech therapy center) and the dynamic study of a stutterer in the process of correctional and educational intervention.
The materials for studying children's actual speech are pictures, children's books, and toys.
The objectives of a speech examination of a person who stutters are to determine:
— place of occurrence and form of speech spasms;
— frequency of their manifestations and preserved speech abilities
— concomitant speech disorders, motor disorders;
- the attitude of a stutterer to his speech defect, nali
what psychological characteristics.
The place of occurrence of convulsions (respiratory, vocal, articulatory, mixed) and their form (clonic, tonic, mixed) are determined aurally or visually.
The frequency of seizures is of particular interest to the speech therapist, as it allows us to judge the intact areas of speech. The study of the level of free speech begins with identifying the dependence of the frequency of seizures on different degrees of independence of speech.
In order to study speech behavior and speech spasms, the following techniques are used:
- writing a story or describing the content of a picture;
- retelling the listened text;
- conjugate and reflected repetition of simple and complex
- a story of poetry or rhythmic prose.
To determine the dependence of speech spasms on the level of speech volume, the subject is asked to speak quietly, loudly, or in a whisper.
When examining a child who stutters, it is necessary to pay attention to concomitant speech and motor disorders. When researching play activity children, the nature of games, relationships with peers, the degree of gaming activity, and emotional state are clarified.
During the entire examination, the psychological characteristics of a stuttering child are noted: the nature of contact with others, assessment of one’s own speech, in particular painful fixation on a speech defect, the presence of defensive reactions, speech behavior during the examination.
The information obtained during the examination is summarized in a speech therapy report, which takes into account:
- form of seizures (tonic, clonic, mixed);
- degree of stuttering (mild, moderate, severe);
- rate of speech (slow, accelerated, presence of tachylalia);
- concomitant speech disorders (dyslalia, erased
ma dysarthria, general underdevelopment speech);
— state of motor function;
— presence and severity of mental symptoms of stuttering:
fear of speech (logophobia), motor and speech tricks, embo-
lophrasia, reaction to an emotionally significant situation.
The influence of the complexity of the speech situation, the individual psychological characteristics of a stuttering child, the nature of play activity, and attitude to learning are also noted.
A speech therapy report makes it possible to carry out a differential diagnosis and distinguish stuttering from other speech disorders (tachylalia, dysarthria, stumbling of a physiological nature), as well as distinguish between different forms of stuttering. Data from a comprehensive study of a stuttering child make it possible to establish the nature of stuttering.
1. What is the purpose of a speech therapy examination?
2. What sections make up the content of a speech therapy examination?
3. What is the peculiarity of the examination of coherent speech?
4. What characteristic errors of coherent speech are noted during speech
5. By what principle is lexical material selected for observatory
following vocabulary?
6. What is the uniqueness of vocabulary with speech impediment?
7. What techniques are used to study the grammatical structure of speech?
8. What types of agrammatism are observed with underdevelopment of speech?
9. What is the peculiarity of examining the sound side of the language?
10. What parameters are taken into account when writing a speech therapy report?
11. What is the peculiarity of studying medical and psychological
educational documentation when examining a person who stutters
12. What are the objectives of a speech examination of a person who stutters?
13. What techniques are used to study the speech of people who stutter?
14. What characteristics are taken into account when writing speech therapy
conclusions of a child who stutters?
Volkova G. A. Psychological and speech therapy study of children with speech disorders. - St. Petersburg, 1993.
Methods for examining speech in children / Ed. I. G. Vlasenko and G. V. Chirkina / Comp. T. P. Bessonova. - M., 1996.
Filsheva T. B., Cheveleva I. A. Speech therapy work in a specialized kindergarten. - M., 1987.
Filteva T.E., Chirkina G.V. Preparing children with general speech underdevelopment for school in a specialized setting kindergarten. - M., 1993.
Belyakova L.I., Dyakova E.A. Stuttering: A textbook for pedagogical institutes. - M., 1998.
Speech therapy: Textbook for universities / Ed. L. S. Volkova and S. N. Shakhovskaya. - M., 1998.
Scheme of examination of a child with stuttering
Date of Birth ____________________________________________________________
(For a student: school number, class)___________________________________________
Date and protocol number______________________________________________________________
Speech therapy report from the IPC__________________________________________________________
Family information
Hereditary diseases _________________________________________________
Characteristics of the speech of people around the child ______________________________
Material and living conditions in the family ________________________________________
What kind of pregnancy is it? _________________________________________________
Features of pregnancy _____________________________________________
Features of the course of labor ___________________________________________________
Child’s weight and height at birth _____________________________________________
After discharge from the maternity hospital:
sleep characteristics ____________________________________________________________
features of wakefulness ___________________________________________________
Features of breastfeeding ________________________________________
Past illnesses, injuries, hospital stays:
up to one year ______________________________________________________________
after one year __________________________________________________________
Psychomotor development
Began to hold my head up with ______________________________________________________________
At what time did you start undressing _____________________________________________________
lace up shoes ______________________________________________________________
fasten buttons ________________________________________________________________
excessively mobile ______________________________________________________________
overly inhibited ____________________________________________________________
Time of appearance of humming _____________________________________________________
first words ________________________________________________________________
Features of speech development (violations of sound pronunciation, defects in the syllabic structure of words, etc.) _____________________________________________________
Course of stuttering (constant, progressive, undulating)________________
Does speech change depending on the time of day, year__________________________
Possible reasons for deterioration or improvement of speech___________________________
Are there periods of fluent speech _____________________________________________
Situations when stuttering is most pronounced ___________________________________
As currently spoken in the following situations:
in family ____________________________________________________________________
in communication with peers ___________________________________________________
in kindergarten (or when answering in class)_____________________________________________
in an unfamiliar environment _____________________________________________________
(For schoolchildren: how was learning school material going? ________________________
does stuttering affect school performance ___________________________________)
Child’s attitude towards stuttering ________________________________________________
Is there a fear of speech ________________________________________________________________
Attitudes in the family and at school towards a child’s stuttering
Classes with a speech therapist: where - when _____________________________________________
by what method ________________________________________________________________
How long have you been studying ______________________________________________________________
Reason for relapse ______________________________________________________________
Peculiarities of character, emotional-volitional sphere, behavior, sociability and relationships of the child with other people, with children (according to parents, teachers)_________________________________________________________________________
The student can be asked to answer the following questions independently:
— Where is it more difficult to speak: at school, in a store, etc.?
- What is the speech like with peers, parents, strangers?
— Do you have anxiety or fear of speaking in an unfamiliar environment?
— How does anxiety affect speech?
— Does stuttering persist when no one hears you?
— Does your speech affect your performance at school?
— If you worked with a speech therapist, do you use the techniques you’ve learned before? ___________________________________________________________________________
Objective examination data
Hearing function status
1. Auditory attention ____________________________________________________________
2. Speech perception ________________________________________________________________
State of motor functions
1. Observation of natural movements (as well as posture, gait) ___________________________________________________________________________
2. Completing tasks (walking, running, jumping, playing with a ball, etc.) __________________________________________________________________________
(In the conclusion, characterizing the features of general motor skills, note the range of movements, accuracy, coordination, pace, switchability, accompanying movements, and motor activity of the child.)
1. Kinesthetic basis of finger movements (praxis of “posture”) ____________________
2. Kinetic basis of finger movements (sequentially organized movements)_________________________________________________________________
3. Manipulations with small objects _____________________________________________
Constructive praxis _____________________________________________________
Pencil skills; with a pen __________________________________________
4. For schoolchildren: state of graphomotor skills ___________________________
5. Presence of left-handedness ________________________________________________________________
Facial expressions and articulatory motor skills
1. Facial movements _____________________________________________________
(features of facial expressions during speech ________________________________________________)
2. Single movements and series of movements of the organs of articulation ___________________
The structure of the organs of the articulatory apparatus
State of impressive speech
1. Passive vocabulary ____________________________________________________________
2. Understanding logical-grammatical structures ______________________________
State of expressive speech
1. Sound pronunciation and sound-syllable structure of words ___________________________
2.Active dictionary __________________________________________________________
3. Grammatical structure of speech ________________________________________________
State of phonemic functions
1. Phonemic differentiation _________________________________________________
2. Phonemic analysis _____________________________________________________
3. Phonemic synthesis _____________________________________________________
4. Phonemic representations _____________________________________________
(Schoolchildren’s skills in syllabic analysis and synthesis, analysis and synthesis of sentences are also tested.)
Respiratory status
Breathing type ________________________________________________________________
Breathing rhythm ________________________________________________________________
The nature of inhalation during speech _____________________________________________________
Duration of speech exhalation __________________________________________
State of prosodic components of speech
1. Rate of speech ________________________________________________________________
Rhythm of speech ___________________________________________________________________
Correct use of pauses in the process of speech utterance ________________
Features of modulations _____________________________________________________
3. Intonation of speech (use of main types of intonation) _____________
4. Speech intelligibility ________________________________________________________________
Symptoms of stuttering
A. External (physical) symptoms of stuttering
I. Manifestation of stuttering in various forms of speech (based on conversation, reading short poems, reproducing short stories and fairy tales, telling stories based on pictures, etc.) _____________________________________________________________________________
1. Whispering speech ________________________________________________________________
2. Conjugate speech ______________________________________________________________
3. Reflected speech __________________________________________________________
4. Question-and-answer speech _____________________________________________________
5. Retelling the text you listened to _____________________________________________
(with and without support from the plot picture)__________________________________________
6. A story based on a series of pictures, based on the picture _______________________________________
7. Independent story ___________________________________________________
8. For schoolchildren: reflection of stuttering in writing (reproductive and independent writing) ___________________________________________________________________
Manifestation of stuttering when reading _____________________________________________
(In the conclusion, record data on preserved speech capabilities; frequency, strength, duration and severity of convulsions, dependence of convulsions on speech material: place in a phrase, in a word; when pronouncing individual words, sounds; dependence of convulsions on the sound-syllable structure of words, length phrases, etc.; dependence of seizures on the form of speech, on the volume of speech)_______________________________________________________________________
II. Form of seizures (tonic, clonic, mixed)______________________________
— respiratory (expiratory, inspiratory, respiratory)__________________
- articulatory (labial, lingual, soft palate)___________________________
III. The presence of involuntary movements of the body, face ______
B. Internal (mental) symptoms of stuttering
I. The presence or absence of logophobia (fear of speech in certain situations, fear of pronouncing individual words, sounds, etc.) _____________________________________
a) pronouncing individual sounds and interjections
II. The presence or absence of defensive techniques (tricks), the frequency and effectiveness of their use:
1. Motor ______________________________________________________________
b) pronouncing words and phrases.______________________________________
3. Changing your speaking style__________________________________________________________
III. Degree of fixation on stuttering (zero, moderate, pronounced)_______________________________________________________________
Individual psychological characteristics of the child
1.Contact with others and the nature of sociability, relationships _________________________________________________________________________
2. Features of mental processes of memory, attention, thinking _______________
3. Dynamics of mental activity and behavior of the child:
- activity or lethargy of mental activity, movements, speech (in play, in educational activities) _______________________________________________________
— stability and prevailing mood background ______________________________
— degree of emotional excitability ________________________________________________
4. Other features: ______________________________________________________________
5. Other speech disorders _____________________________________________________
Speech therapy conclusion
Form and localization of seizures _________________________________________________
Severity of stuttering _____________________________________________________
The severity of external and internal symptoms of stuttering _____________________
Degree of fixation on stuttering ________________________________________
Individual psychological characteristics of the child ___________________________
Other disorders of oral and written speech ___________________________________
End date of the survey. ________________________________________________
3.5. Speech therapy examination in the system of comprehensive study of children with developmental disorders
Speech plays exclusively important role in the formation of higher mental functions The child has. Performing the function of communication between a child and an adult, it is the basis for the development of thinking, provides the opportunity to plan and regulate the child’s behavior, organize his entire mental life, and influences the development of the personality as a whole. In this regard, in modern special pedagogy and psychology, the position on the need for early detection and overcoming speech disorders, which are a general pattern of abnormal development, has been established, i.e. occur in most children with various developmental disorders (V.I. Lubovsky) and can affect various components of speech. Some of them relate only to pronunciation processes and are found in a decrease in speech intelligibility without accompanying manifestations. Others affect the phonemic side of the language and are expressed not only in pronunciation defects, but also in insufficient mastery of the sound composition of a word, which entails reading and writing impairments. Still others are communication disorders, which can interfere with a child’s learning at school and his social adaptation.
Children with speech development disorders are a special category of children with developmental disabilities; They have preserved hearing and intelligence, but there are significant speech impairments that affect the formation of other aspects of the psyche.
The psychological and pedagogical characteristics of children with speech impediments are presented in the works of R.E. Levina, T.B. Filicheva, G.V. Chirkina, O.E. Gribova and others.
The most complex speech disorders cover both the phonetic-phonemic and lexical-grammatical aspects of the language, leading to a general underdevelopment of speech, which may have a different mechanism and, accordingly, a different structure of the disorder and is observed in the most complex forms of childhood speech pathology (alalia, dysarthria, etc.). d.). R.E. Levina identified three levels of general speech underdevelopment (GSD), i.e. systemic impairment of all aspects of speech with intact physical hearing.
At the first level, there is a complete or almost complete absence of verbal means of communication at the age of 5 - 6 years, when children without speech pathology have mostly formed speech. The vocabulary consists of sound and onomatopoeic complexes, in most cases incomprehensible to others and accompanied by gestures. Children with such features are classified as so-called “speechless”.
At the second level, commonly used words appear, albeit distorted. A distinction is made between some grammatical forms. At the same time, children's pronunciation capabilities lag significantly behind the age norm.
The third level is characterized by the presence of extensive phrasal speech with elements of lexico-grammatical and phonetic-phonemic underdevelopment. Children come into contact with others, but only in the presence of an adult and with his help. Free communication is extremely difficult.
IN contemporary works there is also a fourth level (T.B. Filicheva), characterized by mild lexical and grammatical disorders that make it difficult for children to master written language at the beginning of school.
Children with general speech underdevelopment have a number of psychological and pedagogical characteristics that complicate their social adaptation and require targeted correction.
Inferior speech activity affects the formation of sensory, intellectual and affective-volitional spheres in children. There is insufficient stability of attention and limited possibilities for its distribution. With relative preservation of semantic memory in children, verbal memory is reduced, and memorization productivity suffers. In the weakest children, low mnemonic activity can be combined with a delay in the formation of other mental processes. Connection between speech disorders and other parties mental development
also manifests itself in specific features thinking. Having complete prerequisites for mastering mental operations accessible to their age, children lag behind in the development of verbal and logical thinking and have difficulty mastering analysis and synthesis, comparison and generalization.
Some children have somatic weakness and delayed development of locomotor functions; They are also characterized by some lag in the development of the motor sphere - poor coordination of movements, decreased speed and dexterity when performing them. The greatest difficulties are identified when performing movements according to verbal instructions. Often there is insufficient coordination of movements of the fingers, hands, and underdevelopment of fine motor skills.
Children with severe speech disorders exhibit deviations in the emotional-volitional sphere. They are characterized by instability of interests, decreased observation, decreased motivation, negativism, self-doubt, increased irritability, aggressiveness, touchiness, difficulties in communicating with others, in establishing contacts with their peers.
A special group of children with speech impairments are children with stuttering, rhinolalia, and dysphonia. With all the variety of pathological manifestations (convulsions during speech act with stuttering, gross violations of sound pronunciation and immaturity of phonemic perception with rhinolalia, disturbances in voice quality with dysphonia) there are a number of common psychological and pedagogical features that characterize these children. These are, first of all, personality disorders - fixation on a defect, difficulties in verbal communication, speech and behavioral negativism, which complicate the structure of speech disorders and lead to difficulties in social adaptation. IN school age These children have a peculiar structure of a coherent utterance, which reduces its information content, and persistent specific errors when writing; disturbances in the emotional-volitional sphere intensify.
So, children with speech disorders also experience difficulties in full-fledged communication activities, the formation of self-regulation and self-control, various deficiencies in cognitive activity and motor skills, as well as disturbances in the emotional-volitional sphere.
The level of speech development is an important diagnostic criterion when assessing the general level of development of a child. Therefore, a speech examination is an integral part of the psychological and pedagogical study of a child with developmental problems.
The study of speech is carried out as part of a speech therapy examination and includes the study of oral and written speech.
Studying oral speech
In domestic speech therapy, the main methodological principle for the analysis of speech disorders is the principle of system analysis, developed by R.E. Levina. The basis of this analysis is modern ideas about speech activity as a complex, multi-level functional system, the components of which mutually determine each other. The primary immaturity in a child of one of the language components involved in the development of speech entails secondary, tertiary, etc. changes in the speech system. Thus, a speech therapy examination includes the study of the main components of the speech system:
- coherent independent speech;
— vocabulary (vocabulary);
- grammatical structure of speech;
- sound pronunciation aspect of speech (sound pronunciation, syllabic structure of the word, phonemic perception).
In the process of speech therapy study, certain goals are set:
- identify the scope of the child’s speech skills;
- compare it with age norms, as well as with the level of mental development;
— determine the relationship between the disorder and the compensatory background, speech activity and other types of mental activity.
The approximate stage of the speech therapy examination begins with the study of special documentation and a conversation with parents. The task of this stage is to supplement the anamnestic data with information about the progress of the child’s speech development. The following main points of speech development are noted:
— time of the beginning of humming, babbling, first words, phrasal speech;
- whether speech development was interrupted (if interrupted, then for what reason and how speech was restored);
— the nature of the speech environment (features of speech of loved ones, bilingualism, requirements for the child’s speech from adults, etc.);
- the child’s attitude towards his speech defect;
— whether speech therapy assistance was provided and what were its results.
Since speech disorders are sometimes caused by hearing loss, it is necessary to ensure that the child being examined is completely intact.
When examining hearing, it is recommended to use sounding or voiced toys (drum, tambourine, cat, bird), as well as specially selected pictures. It is necessary to check how the child hears whispered and spoken speech. The child is placed with his back to the speech therapist at a distance of 6 - 8 m. The speech therapist exhales completely and in a whisper at normal volume names the words that the child must repeat, for example, school, kettle, car, suitcase, etc. In case of difficulty in perception, the speech therapist repeats the same words at a distance of 4 m, and then 3 m. In conclusion, it is necessary to indicate at what distance the child perceives the whisper.
With normal hearing, a child should hear and repeat words and phrases spoken in a whisper at a distance of 6 - 7 m. When testing hearing, visual perception of speech should be excluded. The perception of a whisper at a distance of no more than 3 m indicates the need for special consultation at a hearing aid center to clarify the state of hearing.
It is much more difficult to examine hearing in children who have no speech at all or are just beginning to speak. In such cases, it is recommended to use pictures with simple and familiar objects drawn on them. The child is asked not to repeat the words spoken by the speech therapist, but to show the corresponding picture. First, the speech therapist offers to show where the doll, ball, cat are, being next to the child, then gradually moving away from him. If hearing loss is detected, the subject is sent for an audiometric examination to a specialist.
A speech examination involves studying both the child’s own (expressive) active speech and his understanding of the speech of others (impressive). The examination procedure is difficult to divide according to the specified types of speech. This is due to the complex systemic structure of the speech function. Therefore, it is advisable to alternate techniques aimed at identifying the features of both one and the other speech.
The main types of tasks during the examination impressive speech are:
naming objects, their parts, qualities, actions with them on the pictures presented by the speech therapist (examination of word understanding);
fulfillment of auditorily presented instructions of varying complexity (sentence comprehension test);
choosing an object or picture in accordance with the grammatical form named by the speech therapist (examination of understanding of grammatical forms);
retelling the text, answering questions about it, working with deformed text, etc. (text comprehension survey).
The characteristics of the level of development of impressive speech are further reflected in the speech therapy report:
understanding of the addressed speech is fully formed;
understanding of addressed speech at the everyday level;
understanding of addressed speech is limited (within the limits of the situation);
does not understand spoken speech.
Survey active (expressive) speech begins with a conversation with the child, the purpose of which is to reveal his general outlook and mastery of a coherent statement.
Analysis of the child’s answers during the conversation allows us to formulate a preliminary hypothesis and determine further stages of the examination. Thus, if a child does not have elementary phrasal speech, studying such components of the speech system as the grammatical structure of speech and phonemic processes is not possible. If, during the preliminary conversation, the child somehow demonstrates mastery of an independent coherent statement, then the need arises to determine the degree of formation of developed independent speech and establish its compliance with age norms. In this case, the speech examination is carried out according to the traditional scheme and involves the study of all components of the speech system.
The examination of coherent speech can be carried out during a conversation and includes a series of tasks for an in-depth study of a detailed independent statement:
compiling a story based on a plot picture;
compiling a story based on a series of plot pictures;
composing a story based on a presentation.
Criteria for assessing coherent speech. When assessing the state of coherent speech, it should be remembered that in the fourth year of life, children master a simple common sentence. By the age of 3–4 years, children begin to use compound and complex sentences. After 4 years, they can retell a simple familiar fairy tale and readily recite poems. By the age of 5, children can retell short texts after listening to them twice. After 5 years, they talk in detail and consistently about what they saw and heard, and can explain cause and effect. After 6 years, children can compose their own story, detailed and logical in content.
Characteristic features of coherent speech in speech underdevelopment:
poverty and monotony of syntactic structures; in independent speech the child uses mainly simple sentences;
inability to spread the proposal by homogeneous members;
the child is limited to listing objects or actions;
violation of the logic of the story: by talking about the unimportant, the child omits the main thing.
identify dictionary matches or mismatches age norm; characterize the active vocabulary (presence of nouns, verbs, adjectives, use of other parts of speech);
find out the accuracy of the use of lexical meanings of words.
The survey must include:
nouns denoting an object and its parts (teapot, lid, spout, bottom);
nouns with similar lexical meanings (dress - sundress);
generalizing words (vegetables, fruits, dishes, clothes, etc.);
names of seasons;
names of animals and their babies;
verbs denoting actions with objects;
verbs denoting states, feelings, phenomena.
Verbs are presented not only in the form of the infinitive (run, wash, draw), but also in various tense forms with different prefixes (ran - came running), in various voices (my - washes).
the size of objects (tall, low, narrow);
color (primary and its shades);
shape (round, oval, square);
quality (milky, fluffy, smooth);
seasonal signs (summer, autumn, winter, spring).
The dictionary of signs also includes the use of adverbs such as: fast, slow, loud, high.
In addition to this, it will be examined antonym dictionary.
The simplest method of examining vocabulary is to name objects and qualities based on specially selected thematic (toys, furniture, transport) or situational (shop, workshop, class) pictures.
Criteria for assessing vocabulary. When assessing lexical capabilities, it is necessary to remember that with normal speech development of a child and favorable upbringing conditions, his active vocabulary increases very quickly. At the age of 3 - 4 years, the vocabulary ranges from 600 to 2000 words. Children correctly name the objects and phenomena around them and speak a sufficient number of words denoting the qualities of objects and actions.
At the age of 4 years, they actively use both specific and generic concepts, antonyms, synonyms; freely use in speech nouns with diminutive suffixes (finger, bunny, forehead, doll, dress).
At the age of 5-6 years, children’s mastery of word formation skills allows them to use in speech words denoting the qualities of objects (iron, wood, plastic), as well as words of different parts of speech formed from the same root (swim - swimmer - floating).
Predominant lexical errors in speech underdevelopment:
replacing the name of a part of an object with the name of the object itself as a whole (collar, sleeve - shirt; spout, bottom - teapot);
replacing the name of an object with the name of an action (laces - to tie);
replacing words with others that are similar in situation and external characteristics (panama, hat, beret - hat; chair, stool - chair; hems - sews);
replacing specific concepts with generic ones (chamomile, bell, rose - flower);
replacing the names of features (narrow - non-narrow; short - small; long, wide - large);
the use of general concepts, mainly of an everyday nature (toys, dishes, clothes, flowers);
non-use of antonyms, rare use of synonyms.
An important point in the speech therapy examination is the study of the formation of the grammatical structure of speech. Revealed:
correctness of the grammatical structure of the sentence;
the nature of the use of case forms of nouns;
correct use of the gender of nouns, singular and plural forms;
correct coordination of different parts of speech;
the nature of the use of prepositional constructions;
degree of proficiency in word formation and inflection skills.
When examining the grammatical structure of speech, the following tasks are used:
make a sentence based on the plot picture (in this case, the predominant number of words in the sentences is noted, the correspondence of the sequence of words in the sentence to the grammatical norm);
make a sentence based on a picture, the plot of which involves the use of given grammatical forms (“The children saw an elephant, a lion, a monkey, a squirrel in the zoo”);
insert the missing preposition or word in the required case form (“The plane is flying in the forest”; “The ball is lying on the table”);
convert the given grammatical form of the singular into the plural (“One table, but many.”);
form singular and plural forms of the genitive case (“There is a tree in this picture, but isn’t there something in this one?” (tree, trees);
agree adjectives and numerals with nouns.
When examining the grammatical structure of speech Special attention attention should be paid to identifying word formation skills. The main types of tasks here are:
formation of nouns using diminutive suffixes (chair, spoon, eyes, etc.);
formation of adjectives from nouns (glass glass - glass, wooden table - wooden, etc.);
formation of the names of baby animals in the singular and plural (for a squirrel - baby squirrel, squirrels; for a horse - foal, foals);
forming verbs using prefixes.
Criteria for assessing the grammatical structure of speech. When assessing the state of formation of the grammatical structure of speech, it should be remembered that when normal development In speech, children by the age of 5 correctly use nouns and adjectives in all singular and plural cases. Some difficulties relate to rarely used nouns in the genitive and nominative plural cases (chairs, trees, wheels, pencils).
The assimilation of prepositional forms proceeds in the following sequence. At 3-4 years old, children correctly use all simple prepositions (y, in, on, under, with, from, to, for, by, after), and use them freely in their statements.
At 5-6 years old, complex prepositions are correctly used in speech (because of, from under, etc.).
The first word-formation skills are formed at 4 years of age. This is the formation of nouns using diminutive suffixes.
By the age of 5, children cope with tasks to form adjectives from nouns by analogy. At the same age, the correct use of combinations of adjectives with nouns and numerals in the nominative case is formed.
Specific errors in the grammatical design of speech in speech underdevelopment. Violation of understanding and use of grammatical means of a language is defined by the term "agrammatism" .
Accordingly, impressive and expressive agrammatism are distinguished. Impressive agrammatism manifests itself in insufficient understanding of the change in the meaning of words when a prefix, suffix, etc. is changed. Expressive agrammatism is characterized by the following specific errors in the grammatical design of speech:
violation of the order of words in a sentence (inversion);
incorrect use of case forms;
errors in the use of gender of nouns;
errors in agreement of adjectives and numerals with nouns;
replacing or omitting a preposition;
undeveloped word formation skills.
Along with the study of coherent speech, vocabulary, and the grammatical structure of speech, a speech therapy examination includes the study of the sound-pronunciation side of speech, which must begin with an examination of the syllabic structure and sound content of words.
For this purpose, words with different numbers and types of syllables are selected: words with a combination of consonants at the beginning, middle and end of the word. When pronouncing these words, both reflected and independent naming of pictures is offered.
To determine the degree of mastery of the syllabic structure of a word, the main types of tasks are the following:
repetition, following the speech therapist, of words of varying structural complexity (Christmas tree, spider, table, closet, cannon, grandmother, pencil, motorcycle, TV, bicycle, aquarium, etc.);
independent naming of pictures specially selected by a speech therapist. The words vary depending on the sound content (currant, pig, dragonfly, teacher, foal, lizard, pyramid);
repetition of sentences that include a given word that is difficult in syllable structure (“The librarian gives out books,” “The plumber fixes the water pipe”).
In case of gross violation of the syllable structure and sound content, it is necessary to offer a number of syllables for switching:
from different vowels and consonants (tamoku);
from different consonants, but the same vowel sounds (mabata);
from different vowels, but the same consonant sounds (kakoku);
from the same consonant and vowel sounds, but with different stress (pa-papa, papa-papapa, papa-pa, etc.);
and also tap out the rhythmic pattern of the word: // /// /// //.
Errors in the syllable structure of the word and sound filling in speech underdevelopment:
reducing the number of syllables, more often when there is a combination of consonants in a word (tol - table, wok - wolf);
adding extra sounds and syllables (limont - lemon, glaziki - eyes);
rearrangement of sounds and syllables (kolovoda - frying pan);
replacement of sounds and syllables (saf - closet);
perseveration (stuck) of syllables (hokist - hockey player);
anticipation (anticipation) of syllables (astobus - bus).
An important link in the general system of studying speech activity is the examination of sound pronunciation, which includes the study of not only the pronunciation aspect of speech, but also the level of perception of sounds and the ability to differentiate them by ear.
First of all, it is necessary to study the structure and mobility of the organs of the articulatory apparatus: lips, tongue, teeth, jaws, palate. It is noted how their structure corresponds to the norm. During examination, the following anomalies can be detected:
lips - thick, fleshy, short;
teeth - sparse, crooked, small, outside the jaw arch, large, without spaces between them, with large spaces; missing incisors, upper and lower;
jaws (bite) - open anterior, open lateral one-sided or two-sided; prognathia (protrusion of the upper jaw); progeny (protrusion of the lower jaw);
palate - high, gothic, narrow, flat, shortened, low;
tongue - massive, small, shortened frenulum, mottled.
When checking the mobility of the organs of articulation, the child is offered various imitation tasks:
lick your lips with your tongue;
reach with your tongue to your nose, chin, left and then right ear;
make the tongue wide, spread out, and then narrow;
raise the tip of your tongue up and hold it in this position for as long as possible;
move the tip of the tongue either to the left or to the right corner of the lips, change the rhythm of movement;
stretch your lips forward like a tube, and then stretch them into a wide smile, etc.
At the same time, the freedom and speed of movements of the organs of articulation, their smoothness, as well as how easy the transition from one movement to another is made.
When examining the pronunciation of sounds, the child’s ability to pronounce a particular sound in isolation and use it in independent speech is revealed. Possible shortcomings of sound pronunciation should be noted: replacement, confusion, distortion or absence of individual sounds - in isolated pronunciation, in words, in phrases.
To study the pronunciation of sounds in words, you need to have a set of special subject pictures. The simplest technique for examining sound pronunciation is the following: for naming, the child is presented with pictures depicting objects in the names of which the sound under study is in different positions - at the beginning, end, middle and in a combination of consonants.
Next, it is checked how correctly the child pronounces the sounds being tested in the speech stream. To do this, you should offer to pronounce several phrases in a row in which the sound being studied may be repeated frequently.
When examining phonemic perception, it is necessary to find out how the child distinguishes individual sounds by ear. First of all, this applies to sounds that are similar in articulation or similar in sound. The discrimination of all correlating phonemes from the groups is checked:
whistling and hissing (sa-sha, za-zha, sa-za, sa-tsa, sa-cha, etc.);
voiced and unvoiced (ta-da, pa-ba, ga-ka, etc.);
sonorous (ra-la, ri-li, etc.);
soft and hard (sa-xia, la-la, etc.).
The main technique is to repeat, following the speech therapist, various oppositional syllables such as sa-sha, sha-sa, ach-ashch, sa-tsa, ra-la, sha-zha, etc. If the child’s pronunciation of certain sounds is impaired, then he is asked to respond with some action (raise his hand, clap his hands) if he hears a pre-agreed syllable in a series of syllables containing oppositional sounds.
When studying phonemic perception, the ability to distinguish words that sound similar is also revealed: beetle-book-bow; tom-dom-com; bear-bowl; goat-braid; day-shadow-stump. For this purpose, the child is asked to choose the desired picture or explain the meaning of each of the paired words containing mixed sounds.
Characteristics of sound pronunciation during normal development. At 3-4 years old, the child correctly pronounces vowels and consonants of early ontogenesis. At this time, softening of speech sounds is allowed. The sounds s, z, sh, zh are not pronounced clearly enough, are skipped, and are replaced by the sounds t, d, f, v; affricates h, sch on t, ts, s; the sounds r, l can be skipped or replaced with l.
At 4 - 5 years old, the softened pronunciation of sounds disappears, the replacement of whistling and hissing sounds with sounds etc. Sibilants may not be pronounced clearly enough. Not all children have formed the r sound yet.
At 5-6 years old, voiced, voiceless, hard, whistling, hissing sounds and affricates are pronounced correctly. There may be errors in differentiation, sonorant sounds are not sufficiently formed.
At 6-7 years of age, under conditions of proper speech education and in the absence of organic disorders of the central and peripheral speech apparatus, children correctly use all the sounds of their native language.
The data obtained on the state of the child’s speech development should be comprehensively analyzed based on sufficient a large number of examples of children's speech and dynamic observation.
The results of a comprehensive speech examination are summarized in the form of a speech therapy report, which indicates the level of the child’s speech development and the form of speech disorder (level III OSD in a child with dysarthria; level II ONR in a child with alalia; level II - III ONR in a child with open rhinolalia, etc.). P.).
The speech therapy report reveals the state of speech and aims to overcome the child’s specific difficulties caused by the clinical form of the speech anomaly. This is necessary for proper organization individual approach in frontal and subgroup classes.
Examination of children with dysarthria
Dysarthria is a violation of the pronunciation side of speech, caused by insufficient innervation of the speech apparatus. The leading defect in dysarthria is a violation of the sound pronunciation and prosodic aspects of speech associated with organic damage to the central and peripheral nervous system. Pronunciation disorders in dysarthria manifest themselves to varying degrees and depend on the nature and severity of damage to the nervous system. In mild cases, there are individual distortions of sounds, “blurred speech”; in more severe cases, distortions, substitutions, and omissions of sounds are observed, the tempo, expressiveness of speech, and modulation suffer. In general, pronunciation becomes slurred.
Speech therapy examination of children with dysarthria is based on a general systematic approach developed in domestic speech therapy, taking into account the specifics of both speech and non-speech disorders, the general psycho-neurological state of the child and his age. How younger child and the lower the level of his speech development, the greater the importance in diagnosis of the analysis of non-speech disorders.
Currently, based on the assessment of non-speech disorders, techniques have been developed early diagnosis dysarthria. Most often, the first manifestation of dysarthria is the presence of pseudobulbar syndrome, the first signs of which can be noted already in a newborn. This is a weakness of a cry or its absence (aphonia), a violation of sucking, swallowing, the absence or weakness of some innate unconditioned reflexes (sucking, searching, proboscis, palmo-orocephalic). The cry of such children for a long time remains quiet, poorly modulated, often with a nasal tint, sometimes in the form of individual sobs that are produced at the moment of inspiration.
Children latch on poorly, suck sluggishly, choke when sucking, turn blue, and sometimes milk flows out of the nose. In especially severe cases, children do not take the breast at all in the first days of life; they are fed through a tube, and swallowing disorders are also noted. Breathing is shallow, often rapid and arrhythmic. These disorders are combined with facial asymmetry, leakage of milk from one corner of the mouth, and drooping of the lower lip, which prevents latching on the nipple or pacifier.
As the child grows, the lack of intonation expressiveness of the cry and vocal reactions becomes more and more apparent. The sounds of humming and babbling are characterized by monotony and appearing in more late dates. The child cannot chew or bite for a long time, chokes on solid food, and cannot drink from a cup. Congenital unconditioned reflexes, which were suppressed during the neonatal period, also manifest themselves to a significant extent with age, complicating the development of voluntary articulatory motor skills. Speech symptoms are becoming increasingly important - persistent pronunciation disorders, insufficiency of voluntary articulatory movements, vocal reactions, incorrect position of the tongue in the oral cavity, its violent movements, disturbances in voice formation and speech breathing, delayed speech development.
The study of the speech of a child with dysarthria in each age period must begin with monitoring the state of the facial muscles. The examination begins with observation of the facial muscles at rest. At the same time, the severity of the nasolabial folds and their symmetry, the nature of the lip line and the density of their closure are noted. It is determined whether there are violent movements (hyperkinesis) of the facial muscles. The child’s ability to keep his mouth closed, close his eyes (both and each eye separately), frown his eyebrows is checked, and the appearance of friendly movements (syncinesia) is noted.
Examination of motor functions is recommended to be carried out under various loads and repeated repetitions. At the same time, the qualitative side of each movement, its usefulness or inferiority is noted. In the latter case, the time of inclusion in the movement, the exhaustion of the movement, changes in its tempo and smoothness, volume, and the appearance of friendly movements are recorded. With repeated movements, erased forms of paresis can be identified. With such a load, there may be drooling, which accompanies dysarthria.
The examination includes the study of the following components of articulatory motor skills:
lip movements: bow, grin, pulling forward;
movements of the lower and upper jaw: opening and closing the mouth;
tongue movements: back and forth, up and down, left and right, spreading, sticking out with a “sting”;
condition of the soft palate: raising the palate when vigorously pronouncing the sound “a”, the presence or absence of air leakage through the nose when pronouncing vowel sounds, the uniformity of the leakage, the presence or absence of a pharyngeal reflex (the appearance of gag movements when lightly touching the soft palate with a spatula).
In very severe cases of bulbar palsy, voluntary movements of the lips, tongue and other organs of articulation may be absent; in this case, it is necessary to detect some reflex movements. For example, parting the lips when smiling, withdrawing the tongue when touched with a spatula, moving the soft palate when coughing, yawning, etc.
The pronunciation of sounds is examined according to generally accepted methods. At the same time, the features of articulation, the clarity of movements included in the articulatory pattern of sounds, the smooth transition from one sound to another in a combination of consonants, and the appearance of overtones are noted. In addition to defects in sound pronunciation, it is important to pay attention to the level of proficiency in the syllabic structure of the word.
After examining sound pronunciation, the features of distinguishing sounds are revealed. The child is asked to repeat after the speech therapist syllable series with oppositional sounds, for example: ta-da-ta, sha-sa-sha, ra-la-ra. Since children often do not pronounce these sounds, the child is given tasks that exclude the pronunciation of the sounds being studied and are designed to recognize and isolate them.
When examining children suffering from dysarthria, it is important to identify the features of distinguishing not only frequently mixed consonant sounds, but also vowels (they are usually poorly differentiated in articulation).
School-age children are tested for sound analysis skills, the ability to read individual letters, words of different syllables, specially selected texts, and to comprehend what they read.
The level of development of the lexical and grammatical aspect of speech is examined using techniques developed for children with SLD. When examining vocabulary, it is necessary to take into account the significant difficulties that the very name of objects poses for children with dysarthria. Therefore, if a child refuses to name an object, they check whether this word is in his passive dictionary.
As a result of the examination, the speech therapist gets an idea not only of articulation and sound pronunciation disorders, but also of the level of general speech development.
The diagnosis is made jointly by a doctor and a speech therapist. In the speech chart of a child with dysarthria, along with a clinical diagnosis, reflecting, if possible, the form of dysarthria, there should also be a speech therapy conclusion based on the principle of a systematic approach to the analysis of speech disorders. For example:
pseudobulbar dysarthria, phonetic defect;
pseudobulbar dysarthria, phonetic-phonemic underdevelopment of speech;
pseudobulbar dysarthria, phonetic-phonemic underdevelopment, articulatory-acoustic dysgraphia (a schoolchild may have this option);
pseudobulbar dysarthria, general speech underdevelopment (level III).
Knowledge of the structure of speech impairment in various forms of dysarthria, the mechanisms of violation of general and speech motor skills will allow for complete correction of existing disorders.
What disorders are leading in dysarthria?
What are the manifestations of dysarthria at an early age?
What is the peculiarity of studying speech motor functions in dysarthria?
What is the role of a speech therapist in making a diagnosis of dysarthria?
Speech therapy / Ed. L.S. Volkova. - M., 1989.
Levchenko I.Yu., Prikhodko O.G. Technologies for teaching and raising children with musculoskeletal disorders. - M., 2001.
Filteva T.B., Cheveleva N.A., Chirkina G.V. Speech disorders in children. - M., 1993.
Examination of children who stutter
Stuttering in children is a form of speech pathology, the basis of which is a violation of verbal communication. To adequately plan a program of speech therapy and treatment work with children who stutter, it is necessary to comprehensively examine them, taking into account all the symptoms of this complex speech disorder. The examination of a child who stutters consists of two stages.
The first stage includes the study of anamnestic data, medical and psychological-pedagogical documentation.
Various negative factors of the natal and postnatal periods of child development identified during the study of anamnesis are analyzed and assessed by specialists in order to most fully study the etiology and pathogenesis of stuttering. Along with traditional data, the anamnesis includes information about the presence of stuttering in parents or other close relatives.
The study of psychological and pedagogical documentation complements the anamnestic data and allows us to identify the following features of upbringing and psychological manifestations in a child who stutters:
the attitude of adults towards him;
assistance in the formation of correct speech;
time of occurrence of stuttering, its first external signs;
features of the manifestation of stuttering depending on the situation;
the child’s attitude towards his speech impairment;
whether help was provided to a child who stutters, what was recommended and what were the results.
The second stage is the study of the stuttering child himself.
After clarifying information about the child, the history of the occurrence and characteristics of his stuttering, the actual speech of the stutterer and extra-speech processes that have a direct impact on his speech activity are examined.
A study is conducted of sociability, motor skills, imitation, impressive and expressive speech, gaming, educational activities, and personality traits of a stutterer. There are primary (during the first month of a child’s stay in a speech preschool institution, in the first two weeks of stay in a sanatorium for children who stutter, at a school speech therapy center) and dynamic study of a stutterer in the process of correctional and educational intervention.
The materials for studying children's actual speech are pictures, children's books, and toys.
place of occurrence and form of speech spasms;
the frequency of their manifestations and the preserved speech capabilities of the stutterer;
concomitant speech disorders, motor disorders;
the attitude of a stutterer to his speech defect, the presence of psychological characteristics.
The place of occurrence of convulsions (respiratory, vocal, articulatory, mixed) and their form (clonic, tonic, mixed) are determined aurally or visually.
The frequency of seizures is of particular interest to the speech therapist, as it allows us to judge the intact areas of speech. The study of the level of free speech begins with identifying the dependence of the frequency of seizures on different degrees of independence of speech.
In order to study speech behavior and speech spasms, the following techniques are used:
writing a story or describing the content of a picture;
retelling the listened text;
conjugate and reflected repetition of simple and complex phrases;
a story of poetry or rhythmic prose.
To determine the dependence of speech spasms on the level of speech volume, the subject is asked to speak quietly, loudly, or in a whisper.
When examining a child who stutters, it is necessary to pay attention to concomitant speech and motor disorders. When studying children's play activities, the nature of games, relationships with peers, the degree of play activity, and emotional state are clarified.
During the entire examination, the psychological characteristics of a stuttering child are noted: the nature of contact with others, assessment of one’s own speech, in particular painful fixation on a speech defect, the presence of defensive reactions, speech behavior during the examination.
form of seizures (tonic, clonic, mixed);
degree of stuttering (mild, moderate, severe);
rate of speech (slow, accelerated, presence of tachylalia);
concomitant speech disorders (dyslalia, erased form of dysarthria, general speech underdevelopment);
state of motor function;
the presence and severity of mental symptoms of stuttering: fear of speech (logophobia), motor and speech tricks, embolophrasia, reaction to an emotionally significant situation.
The influence of the complexity of the speech situation, the individual psychological characteristics of a stuttering child, the nature of play activity, and attitude to learning are also noted.
A speech therapy report makes it possible to carry out a differential diagnosis and distinguish stuttering from other speech disorders (tachylalia, dysarthria, stumbling of a physiological nature), as well as distinguish between different forms of stuttering. Data from a comprehensive study of a stuttering child make it possible to establish the nature of stuttering.
What is the purpose of a speech therapy examination?
What sections make up the content of a speech therapy examination?
What is special about the examination of coherent speech?
What characteristic errors of coherent speech are observed with speech underdevelopment?
By what principle is lexical material selected for vocabulary examination?
What is the uniqueness of vocabulary in speech underdevelopment?
What techniques are used to study the grammatical structure of speech?
What types of agrammatism are observed with speech underdevelopment?
What is the peculiarity of examining the sound side of the language?
What parameters are taken into account when writing a speech therapy report?
What is the peculiarity of studying medical and psychological-pedagogical documentation when examining a child who stutters?
What are the objectives of a speech examination of a person who stutters?
What techniques are used to study the speech of people who stutter?
What characteristics are taken into account when writing a speech therapy report for a child who stutters?
Volkova G.A. Psychological and speech therapy study of children with speech disorders. - St. Petersburg, 1993.
Methods for examining speech in children / Ed. I.G. Vlasenko and G.V. Chirkina / Comp. T.P. Bessonova. - M., 1996.
Filicheva T.E., Cheveleva N.A. Speech therapy work in a specialized kindergarten. - M., 1987.
Filicheva T.E., Chirkina G.V. Preparing children with general speech underdevelopment for school in a specialized kindergarten. - M., 1993.
Belyakova L.I., Dyakova E.A. Stuttering: A textbook for pedagogical institutes. - M., 1998.
Speech therapy: Textbook for universities / Ed. L.S. Volkova and S.N. Shakhovskaya. - M., 1998.
Studying writing
Writing and reading are special forms of speech activity that have a complex psychological structure.
The formation of writing and reading skills is closely related to the development of oral speech. Therefore, with underdevelopment of oral speech, there is a need to examine not only the level of development linguistic means, speech skills and abilities, but also the state of writing and reading.
Since writing at the initial stages of learning is impossible without a conscious analysis of the sound complex that makes up the spoken word, and reading is impossible without the ability to merge individual sounds into combined phonemic groups, an examination of writing and reading in children begins with studying the process of analysis and synthesis of the sound composition of a word.
Sound analysis cannot occur without the participation of phonemic perception processes; complete preservation of phonemic hearing is required. In addition, the formation of speech hearing is carried out with the active participation of the articulatory apparatus in the process of articulatory experience.
For diagnostic purposes, first of all, it is necessary to identify the characteristics of the child’s speech activity, determine whether there are any pronounced deviations in the formation of the sound side of speech, and whether he can differentiate sounds by ear and pronunciation.
Only after this the subject of examination becomes the child’s ability to consciously navigate the sound composition of a word and perform complex operations on its elements. The sound analysis process involves:
the ability to isolate phonemes from the sound composition of a word based on their auditory-pronunciation differentiation;
mastering the educational (mental) action of sequentially isolating all sounds from a word.
First of all, it is necessary to identify the level of sound analysis accessible to the child. For this purpose, a technique is used to determine the number of sounds in a word. First, phonetically simple, one- and two-syllable words are offered (poppy, fur coat), then words with a large number of syllables (card, photograph). In all cases, words must contain sounds that children may have difficulty pronouncing or distinguishing.
The next stage of the task is the sequential identification of all sounds in a word. The material for examining this sound operation are words of different sound-syllable complexity (house, cat, window, bag, nest, friendship, cake). In case of difficulty, the examiner himself clearly pronounces the word, thereby demonstrating the method of isolating sounds through their intoned pronunciation. For the same purpose, you can use the technique developed by D.B. Elkonin, when chips denoting sounds are placed in the cells of the diagram in the sequence in which the sounds are found in the word.
An indicator of the level of development of sound analysis is the ability not only to consistently identify the sound elements of a word, but also to independently determine them. The main methodological techniques for this are:
transforming words by replacing, rearranging or adding sounds and syllables (sok - bough, mark - frame);
naming the second, third, fifth and other sounds in a word;
independent naming of words where a certain sound would be in the second, fourth, seventh, etc. place;
determining the number of vowels and consonants in the analyzed word;
naming the sounds in a word that come before or after a specific sound.
From the very beginning of its formation, sound analysis is a voluntary activity. To analyze a word, a child must retain it in memory, distribute his attention between its sound elements, concentrate on determining the position of a sound in a word, etc., therefore the last group of techniques is aimed at identifying the state of this aspect of the child’s activity. The following techniques are distinguished in this group:
highlighting the last sound in a word and naming such words with this sound so that it stands in second, third and other places (horns - sleigh; hut - cat). Words ending in both a vowel and a consonant are offered;
determining the third sound in a word (vowel or consonant) and naming words with it, where it would appear at the beginning, in the middle and at the end;
naming words consisting of 3, 4, 5 sounds and highlighting the sound sequence in them;
selection of subject pictures, the name of which begins with a certain sound, but with the obligatory following vowel “a”;
naming words that include two oppositional sounds at once (sushki, teacher).
For writing and especially for reading, not only analysis is of great importance, but also synthesis of sound elements of a word . For this purpose, the child is presented with individual sounds and asked to reproduce the resulting syllable. The material for the examination is straight syllables (sa, pu); reverse syllables (am, he); closed syllables (sas, lam); syllables with a combination of consonants (one hundred, one hundred), etc. A lightweight version of this technique is synthesis following analysis, when a child is orally presented with a syllable, he identifies the sounds, its components, and then names the syllable consisting of these sounds.
Comparison of the results obtained based on the use of a system of techniques allows us to identify and evaluate how general state sound analysis, and the immaturity of its individual components, as well as factors delaying its development. This will allow timely prevention of writing and reading disorders in children.
Writing disorders in children, these are special specific difficulties that are caused by systemic underdevelopment of certain aspects of the child’s speech activity. In children with normal hearing and intelligence who have reached school age, this underdevelopment manifests itself primarily in the insufficient formation of ideas about the sound and morphological composition of a word. In this case, the child turns out to be unprepared for the implementation of sound analysis and speech synthesis and, as a result, for the transition to a more mature stage language development- mastery of literacy and spelling. As emphasized by R.E. Levin (1961), this is evidenced by special writing disorders, which can have different structures and degrees of severity. A diagnostic sign of writing disorders that are of interest to a speech therapist is the presence of specific errors associated with insufficient development of speech processes. The acquisition of writing skills can be caused not only by speech disorders, but also by other factors (irregularity of schooling, pedagogical neglect, decreased hearing, vision, intelligence, etc.). The object of speech therapy intervention is writing disorders caused by disorders in the development of speech.
In this regard, the task of speech therapy examination of written speech becomes the identification of specific errors as the main diagnostic indicator of writing disorders.
The first idea about the level of development of writing and the nature of errors can be obtained after viewing school notebooks. To clarify the structure of the violation, a special examination must be carried out, including three sections:
copying from printed text.
The first section includes an auditory dictation test, consisting of a series of gradually more difficult tasks.
The examination begins with writing letters, syllables, words, and ends with the presentation of more complex forms of written speech (depending on the child’s level of learning - this is a presentation based on a picture or an essay on given topic). Children who have just started learning are offered to write letters under dictation. Individual sounds are dictated to the child, a graphic representation of which he must record. This series of tests allows us to determine whether the child clearly perceives speech sounds by ear and whether he correctly encodes them into corresponding graphic images.
The next step is to examine the writing of individual syllables under dictation. The child is dictated direct syllables (na, sa, sy, tu, mo, etc.), reverse syllables (an, um, ot), with a combination of consonants (sta, dro, squaw), oppositional syllables (sa-za, sa-sha, ra-la, ba-na, ri-ry). Instead of writing, the student can form syllables using the letters of the split alphabet. The purpose of these tests is to determine how correctly the child distinguishes and selects individual elements included in the sound complex.
To determine the level of writing accessible to the child, following the indicated tests, writing of individual words and short phrases is offered. First, simple words are dictated, and then phonetically more complex words (house, balls, nail), as well as small phrases (a stream is babbling, there are puddles near the porch).
In addition to writing individual words and phrases by ear, during the speech therapy examination, independent writing from pictures of varying complexity is also checked. The material for the examination can be pictures depicting objects familiar to the child (a ball, a watch, a teapot, a girl, etc.). It is suggested to write the names of these items or compose and write them down yourself. individual offers from the pictures.
At a more advanced level of writing, the central stage of the examination becomes an auditory dictation, consisting of a series of phrases selected in such a way that they meet the program requirements for the Russian language, and also include a large number of words with sounds whose pronunciation is usually impaired.
independently compose and write down a short story based on a series of pictures;
write down in writing a story you have heard or read independently;
write an essay on a given topic.
You can also offer simpler tests that also reveal the dependence of the acquisition of writing on the general development of speech: composing sentences or a short story using reference words and deformed text.
Analysis of students’ independent writing allows us to identify both errors in the sound composition of a word and different kinds agrammatism.
The third section of the speech therapy examination of writing includes the study of the ability to copy text from a presented sample, and, in case of difficulties, individual words, syllables, and letters. Visual dictation is also used as a technique, when the child must independently read a word or sentence and then write it down from memory. Here it is checked whether the child has any difficulties in the motor technique of writing.
Summarizing the results of the examination of written speech, it is necessary:
compare and analyze all types of writing errors; draw up a summary table, classifying errors by type and quantity (Table 3);
correlate the analysis of errors in writing with the characteristics of the child’s oral speech.
A sample speech card includes material for assessing children who stutter.
The material is useful for beginning speech therapists.
Preview:
FOR EXAMINATION OF CHILDREN WITH STUTTERING
Date of birth______________________ Received from _________________________________
Home address ________________________________________________________________________
By decision of the IPC dated_________________ Protocol No. __________Adopted for a period of _________________
Diagnosis upon admission ________________________________________________________________
Family information.
Characteristics of the speech of people around the child___________________________________________
Material and living conditions in the family______________________________________________________________
What is the pregnancy? ________ Features of pregnancy (toxicosis, falls, injuries, psychoses, infections)________________________________________________________________
Features of the course of labor (early, urgent, rapid, rapid, dehydrated) ________________________________________________________________________________________________
Weight and height of the child at birth__________________________________________________________
Stimulation (mechanical, chemical, electrical) ____________________________________________
Asphyxia ____________________ When I screamed ___________________________________
After discharge from the hospital:
Features of breastfeeding_______________________________________________________________
Past illnesses, injuries, hospital stays:
Up to one year__________________________________________________________________________
after one year______________________________________________________________________________
Early psychomotor development.
Began to hold his head up with __________________________ Sit_________________________________
Stand __________________________ Walk ________________________________________________
At what time did you start undressing ____________________ Getting dressed ___________________________
Putting on shoes _____________________ Fastening buttons______________________________
Features of motor skills: excessively mobile ________________________________________________
overly inhibited ________________________________________________
Early speech development.
Time of appearance of humming____________ Babbling_________________
First words_________________ Phrases__________________
Features of speech development________________________________________________________________
Have you worked with a speech therapist ________________________________________________________________
Time of appearance of stuttering _________________ Probable causes _______________________
How did stuttering manifest itself? ________________________________________________________________
Course of stuttering (constant, progressive, wave-like)______________________________
Does speech change depending on the time of day, year________________________________________________
Possible reasons for deterioration or improvement of speech _____________________________________________ _____________________________________________________________________________________________________________
Are there periods of fluent speech?__________________________________________________________
Situations when stuttering is most pronounced ________________________________________________
As currently spoken in the following situations:
In communication with peers_________________________________________________________
In d/s ______________________________________________________________________________
In an unfamiliar environment______________________________________________________________
Child’s attitude towards stuttering________________________________________________________________
Is there a fear of speech_____________________ Fear of communication __________________________
Family attitude towards a child’s stuttering________________________________________________
Peculiarities of character, emotional-volitional sphere, behavior, sociability and relationships of the child with other people, with children (according to parents) ____________
Breathing type _________________________ Rhythm ____________________________
Nature of inhalation during speech_________________________________________________ Duration of speech breathing ___________________________________________
State of prosodic components of speech.
Rate of speech______________________________ Rhythm of speech______________________________
Correct use of pauses in the process of speech utterance __________________
Timbre______________________ Features of modulations______________________________
Intonation of speech (use of main types of intonation)___________________
A. External (physical) symptoms of stuttering.
I Manifestation of stuttering in various forms of speech (based on conversation, reading short poems, reproducing short stories and fairy tales, telling stories based on pictures, etc.)
Whispered speech________________________ Conjugate speech_______________________
Reflected speech____________________ Question-and-answer speech_____________________ Retelling of the listened text (with and without support for the plot picture)__________________________________________________________________________
A story based on a series of pictures, based on a picture___________________________________________
Features (record data on preserved speech capabilities; frequency, strength, duration and severity of seizures, dependence of seizures on speech material: place in a phrase, in a word; when pronouncing individual words, sounds; dependence of seizures on the sound-syllable structure of words, phrase length etc.; dependence of seizures on the form of speech, on the volume of speech)_____________________________________________
Form of seizures (tonic, clonic, mixed)______________________________
Degree of stuttering ______________________________________________________________
III. Presence of concomitant spasms of the body, face (tics, grimaces) _____________________
B. Internal (mental) symptoms of stuttering.
I. The presence or absence of logophobia (fear of speech in certain situations, fear of pronouncing individual words, sounds, etc.)_______________________________________
II. The presence or absence of defensive techniques (tricks), the frequency and effectiveness of their use:
a) arbitrary ______________________________________________________________
b) involuntary ____________________________________________________________
a) pronouncing individual sounds and interjections__________________________________________
b) pronouncing words and phrases_________________________________________________
3. Changing the style of speech______________________________________________________________
III. Degree of fixation on stuttering (zero, moderate, pronounced)__________
IV. Forms of speech and situations when stuttering is most pronounced _____________________
Individual psychological characteristics of the child.
Contact with others and the nature of sociability, relationships __________ ______________________________________________________________________________
Features of mental processes of memory, attention, thinking_________________
Dynamics of mental activity and behavior of the child:
– activity or lethargy of mental activity, movements, speech (in play, in educational activities)_________________________________________________________________
– stability and prevailing mood background________________________________________________
– degree of emotional excitability_________________________________________________
Study of non-speech mental functions.
1. Study of auditory attention:
a) differentiation of sounding toys ________________________________________
b) determining the direction of sound _____________________________________________
2. Perception and reproduction of rhythm __________________________________________
3. Visual perception study:
a) color recognition ________________________________________________________________
b) selection of pictures for a given background _____________________________________________________
4. Study of visual-spatial gnosis and praxis:
a) right, left ________________________________________________________________
b) top, bottom, back, front ___________________________________________________
c) folding cut pictures _____________________________________________________
d) folding figures from sticks:
- according to the sample ______________________ - from memory _________________________
5. study of general motor skills:
Strength ________________________________ Accuracy ________________________________
Pace ___________________________________ Coordination ____________________________
6. Study of fine motor skills:
Leading hand _____________________ Precision of movements ________________________
Tempo ___________________ Synchronicity of right and left hands ____________________
Study of the anatomical structure of the articulatory apparatus.
Lips (thick, thin, cleft, scars...) ___________________________________________
Teeth (sparse, crooked, small, outside the jaw arch, missing teeth) _________________________
Bite (progenia, prognadia, open lateral, cross, open anterior) ______________
Hard palate (high, narrow, gothic, flat, shortened, cleft) ___________________
Soft palate (short, bifurcated, lacking a small uvula) _______________________
Tongue (massive, small, shortened hyoid ligament) ______________________________
Study of speech motor skills.
1. Condition of facial muscles.
Raise your eyebrows (surprise) _________________Frown your eyebrows ____________________
Squint your eyes _____________________ Pull your cheeks in __________________________
Puff out the cheeks __________________ Smooth the nasolabial folds ______________
2. State of articulatory motor skills (performing exercises – “Pendulum”, “Hippopotamus”, “Swing”, “Grin - Proboscis” and others)
a) presence or absence of movements _________________________________________________
b) tone (normal, sluggish, tense) ____________________________________
c) pace of movements (fast, slow, normal) ___________________________
d) switching from one movement to another _________________________________
e) range of movements (full, incomplete) _____________________________________________
f) accuracy of execution ______________________________________________________________
g) duration of holding the given position ________________________________
h) replacement of movements ______________________________________________________________
i) additional and unnecessary movements _____________________________________________________
j) presence of tremor _______________________ salivation ________________________
Study of the sound-syllable structure of a word.
1. Reproduction of words:
tomatoes ________________ draft ________________ whistle _________________
temperature ___________________________ curdled milk _________________________
policeman _________________________________ birdhouse __________________________
medicine ________________ frying pan ________________ aquarium _______________
2. Playing sentences:
The boys made a snowman _________________________________________________
A plumber fixes a water pipe _____________________________________________
Hair being cut in a hairdresser ________________________________________
A traffic controller stands at the intersection _____________________________________________________
Study of the state of phonemic functions (perception, analysis, synthesis, representation).
1. Repetition of syllables:
pa-ba ________ ba-na _________ wa-ta __________ ta-da __________ na-ga __________
ka-ga ________ ba-ma _________ sa-sha _________
ba-ba-pa _____________ ta-da-ta ____________ ha-ka-ha ____________
2. Differentiation of oppositional sounds that are not mixed in pronunciation (show where the fishing rod is, and where the duck is, etc.) ___________________________________________________
3. Differentiation by hearing of sounds mixed in pronunciation:
Bowl - bear ______________________ Rat - roof _______________________
River - radish _______________________ Evening - wind ________________________
4. Isolating a given sound against the background of a word (can you hear ___ sound in the word?):
5. Isolating the stressed vowel at the beginning of a word (what is the first sound?):
6. Definition of consonant sound
- at the beginning of the word ____________________________________________________________
- at the end of the word ______________________________________________________________
- place of a given sound in a word (beginning, middle, end) _________________________
— sequences of sounds ___________________________________________________
— number of sounds __________________________________________________________
— neighbors of a given sound _____________________________________________________
— what is the given sound ________________________________________________
8. Make up a word
— with a given sound __________________________________________________________
— with a given number of sounds _____________________________________________
A Study of Speech Comprehension (Impressive Dictionary).
1. Passive dictionary:
Accuracy of understanding the meaning of words _____________________________________________________
Tasks: show the doll, put the doll on a chair, etc.
2. Understanding phrases and simple sentences: _____________________________
a) understanding phrases
- use the key to show the pencil - where is the owner’s dog?
- show the key with a pencil - where is the dog’s owner
b) understanding simple sentences: __________________________________________
The girl picks flowers. A girl waters flowers. A girl plays with a ball.
c) understanding interrogative sentences: ___________________________________
Who is the girl catching? Who catches the butterfly?
3. Understanding complex sentences and complex lexical and grammatical structures: _________________________________________________________________
Misha catches up with Petya. Who runs first? ________________________________________
Olya lost the pencil she took from Vova. Whose pencil was this? _____________
Study of vocabulary and grammatical structure (expressive speech).
I. Active vocabulary research: ______________________________________________
a) subject dictionary (name pictures by topic: “Toys”, “Utensils”, “Animals”, etc.) ____________________________________________________________
b) generalizing concepts (name in one word) _________________________________
c) parts of objects (objects) _________________________________________________
2) Verb dictionary
Using verbs when answering questions: What do you do during the day? Who is screaming? Who's doing what? ______________________________________________________________
a) naming the color ________________________________________________________________
b) name of the form __________________________________________________________
4) Selection of antonyms (from 6 years old)
Good - ______________ Sorrow - ______________ High - ________________
Give - _____________ Friend - ______________ Buy - _______________
II. Inflection state:
a) nouns in the nominative singular case. and many more numbers
Elephant - ____________ Doll - ____________ Ear - ____________ Window - ____________
Stump - ____________ Sparrow - ____________ Tree - ____________ Mouth - ____________
b) nouns in indirect cases
I have (pencil) _________________ I don’t have _______________
I'm drawing _______________
c) genitive plural form. numbers (a lot of what?)
Ball - ____________ Table - ____________ Sheet - ____________ Pencil - ____________
Ball - ____________ Key - ____________ House - ____________ Chair - ____________
d) agreement of nouns with adjectives (what color):
ball _____________ bucket ____________ shoes _____________ car _____________
e) agreement of numerals 2 and 5 with nouns
House – 2 ____________ 5 ____________ Doll – 2 ____________ 5 ____________
Bug – 2 ____________ 5 ____________ Fish – 2 ____________ 5 ____________
Key – 2 ____________ 5 ____________ Bucket – 2 ____________ 5 ____________
f) Use of prepositions ___________________________________________________
III. State of word formation
a) Nouns with diminutive suffixes
Table - _____________ Ball - _____________ House - _____________ Wardrobe - _____________
Sparrow - ____________ Mushroom - ____________ Leaf - ____________ Flower - ___________
b) naming baby animals
For a cat - ____________ For a duck - ____________ For a squirrel - ____________
For a cow - ____________ For a dog -___________ For a horse - _____________
c) formation of adjectives from nouns
Wood - _______________ Paper - _______________ Straw - _______________
Blueberries - ________________ Snow - _______________ Wool - _______________
d) formation of possessive adjectives
Mom's bag - ____________ Fox's tail - ____________ Bear's den _____________
e) formation of prefixed verbs
f) formation of perfective verbs
Drew – _______________ Wrote – _______________ Made – _______________
State of coherent speech.
Date of examination: __________________ Speech therapist:__________________________
Main stage.
1. The concept of the general structure of stuttering syndrome: primary and secondary stuttering.
2. Clinical manifestations of stuttering:
· Neuromotor disorders as the main symptom of stuttering. Classification of seizures according to I.A. Sikorsky.
· Violations of the prosodic aspect of speech.
· Motor impairments.
3. Psychopathological disorders in stuttering:
· Neurotic manifestations: asthenic syndrome (asthenia itself, vegetative manifestations, sleep disorders).
· Obsessive states: obsessions, impulses, phobias.
· Psychopathological disorders of a depressive nature.
4. Clinical features of the syndrome in neurotic and neurosis-like forms of stuttering.
5. Features of stuttering during hysteria.
6. Features of stuttering in mental retardation.
7. Types of stuttering and phases of its development. Features of the manifestation of symptoms in preschoolers, adolescents and adults.
8. Degrees of severity of stuttering symptoms.
1. Students in working groups of 3-4 people analyze medical documentation, speech cards, psychological and pedagogical characteristics of stutterers or medical histories, determine the form of stuttering (neurotic or neurosis-like).
Literature:
1. Belyakova L.I., Dyakova E.A. Stuttering. – M., 1998. – 304 p.
2. Diagnosis and correction of speech disorders / Methodological materials scientific-practical conference / resp. Ed. M.G. Khrakovskaya. – St. Petersburg, 1997.
3. Speech therapy / Ed. L.S.Volkova – 2nd edition. In two books. M.: Education, Vlados, 1995.
4. Missulovin L.Ya. Pathomorphosis of stuttering. Changes in the pattern of occurrence and course of stuttering, features correctional work: Tutorial. – St. Petersburg, 2002. –320 p.
5. Conceptual and terminological dictionary of speech therapist / Ed. V.I. Seliverstova. - M.: Vlados, 1997.
6. Reader on speech therapy (extracts and texts): In 2 vols. T.1 / Ed. L.S. Volkova and V.I. Seliverstova. - M., 1997.
Teacher: Ph.D., Associate Professor. Altukhova T.A.
PLAN
for full-time (correspondence) students,
Subject: Psychological and pedagogical examination of people who stutter.
Tasks:
1. To consolidate, deepen and update students’ knowledge about the content and methods of a comprehensive examination of people who stutter.
2. Create conditions for the development of practical skills in examining people who stutter.
Form of work: classroom lesson.
Equipment: case histories of children who stutter, material for examination, examination scheme for a child who stutters.
Lesson plan:
Preparatory stage:
1. Study the material given in the Study Guide by L.I. Belyakova, E.A. Dyakova “Stuttering” (paragraph 3.1 “Psychological and pedagogical examination of people who stutter”, pp. 116-130). Write down in your workbook the main directions for examining people who stutter; features of examination of stuttering preschoolers, junior schoolchildren and adults.
2. Study the material given in the manual “Methods for examining children’s speech” / Under general. ed. prof. G.V. Chirkina (G.G. Voronova, A.V. Yastrebova Chapter “Examination of children with stuttering” – pp. 112-131.). Write down in your workbook the main directions for examining children who stutter. Analyze the specifics of the organization and content of this survey option. Justify how this survey implements the communicative approach to understanding the essence of stuttering, proposed by R.E. Levina.
3. Draw up a diagram of the examination of a stuttering child in your workbook (see Appendix).
Main stage:
Theoretical part:
1. Implementation of the principle of complexity in the examination of people who stutter.
2. Objectives of examining people who stutter.
3. Stages of examination of people who stutter. The concept of dynamic examination for stuttering.
5. Specifics of examination of stuttering preschoolers, primary schoolchildren and adults.
Practical part:
1. Clinical, psychological and pedagogical analysis of the medical history of 1-2 children
· medical examination(somatic, neurological and mental state of the child);
· psychological, pedagogical and speech therapy examination (general development of the child, state of motor functions, general speech development, level of independent speech accessible to the child, general and speech state and behavior of the child, features of attention and memory, performance);
2. Organization of a business game with simulation of speech therapy for a child who stutters.
A) the teacher explains the task - modeling the situation of speech therapy for a child who stutters;
B) the roles are distributed as follows: 1st speech therapist student; 2nd student “mother of the child”; 3rd student – “child who stutters”;
C) according to the rules of the game “speech therapist” poses questions aimed at identifying signs of neurotic or neurosis-like stuttering, “mother” gives a detailed description of the early motor and speech development of the child, the conditions of his upbringing, time of occurrence, proposed causes and course of stuttering, psychological and pedagogical characteristics child, “child” - in response to an “examination” conducted by a “speech therapist”, he gives a description of psychomotor skills and speech, features of stuttering.
During the game, all students in the group must carefully follow the game “Child Reception by a Speech Therapist”, participate in the analysis and assessment of the psychomotor and speech development of the “stuttering child”, and in determining its nosological affiliation.
1. Belyakova L.I., Dyakova E.A. Stuttering, M.: V. Sekachev, 1998 – 304 p.
2. Del S.V. Study of nonverbal means of communication in primary schoolchildren with stuttering // Speech therapist. 2005. No. 3. P.36–38.
- Mironova S.A. Examination of stuttering preschoolers // Preschool education 1979 №8.
- Examination of children with stuttering // Methods for examining children's speech: A manual for the diagnosis of speech disorders / Ed. ed. prof. G.V. Chirkina. – M.. 2003. – P.112-131.
- Rychkova N.A. Speech therapy rhythm. Diagnosis and correction of voluntary movements in children suffering from stuttering / Guidelines. – M., 1997.
- Cheveleva N.A. Speech therapy examination of children who stutter // Correction of stuttering in schoolchildren during the learning process. A manual for speech therapists. M.; 1982.
- Seliverstov V.I. Stuttering in children. M.: VLADOS, 1994 – 200 p.
- wavy (stuttering increases and decreases in different situations, but does not disappear);
- constant (stuttering has a relatively stable course)
- recurrent (stuttering occurs again after a period of speech well-being).
Teacher: Candidate of Pedagogical Sciences, Associate Professor T.A. Altukhova
practical lesson on the course
“Speech therapy” (section “Impairments in the tempo and rhythm of speech. Stuttering”),
students in specialty 050715.65 Speech therapy
Subject: Comprehensive psychological and pedagogical rehabilitation of people who stutter.
1. Consider in historical retrospect the formation of the main approaches to stuttering correction.
2. To consolidate students’ knowledge of the need to implement the principle of an integrated approach in organizing the prevention and overcoming of stuttering.
3. Discuss the tasks, content, forms of therapeutic and health work for stuttering.
4. Discuss the tasks, content, forms of psychological and pedagogical (speech therapy) work for stuttering.
5. Develop initial skills in conducting rational psychotherapy with a person who stutters.
6. To develop initial skills in developing recommendations for the prevention and prevention of relapse of stuttering for the social environment of a stutterer (family, teachers).
Lesson plan.
Methodology for speech therapy examination of a child who stutters.
The examination of a person who stutters is carried out comprehensively (by a speech therapist, a neurologist, a psychologist), with the involvement of other specialists as necessary: a pediatrician, a therapist, a psychiatrist, an ophthalmologist, an otolaryngologist, etc.
The examination includes the study of anamnestic information, pedagogical, psychological and medical documentation and examination of the stutterer himself.
From a conversation with parents, the speech therapist finds out the most significant events that happened in the family, ABOUT EVERYTHING! REMEMBER!
After clarifying information about the child, an examination of the stuttering person’s speech and extra-speech processes that have a direct impact on his speech activity is carried out.
A study is being conducted of his sociability, motor skills, imitation, impressive and expressive speech, gaming, educational, production activities, and personality traits of a stutterer. A distinction is made between primary and dynamic study of a person who stutters in the process of correctional and educational intervention. To study the speech of children, pictures, books with poems, fairy tales are used, and toys are selected
Specific The objectives of the speech examination are is to determine:
Place of occurrence and form of speech spasms;
the frequency of their manifestations and the preserved speech capabilities of the stutterer;
Associated speech disorders; movement disorders;
The attitude of a stutterer to his speech defect, the presence of psychological characteristics.
The place of occurrence of convulsions (respiratory, vocal, articulatory, mixed) and their form (clonic, tonic, mixed) are determined aurally or visually. The frequency of seizures in people who stutter is of particular interest to the speech therapist. The study of the level of free speech begins with identifying the dependence of paroxysms of stuttering on varying degrees of speech independence. In a conversation about his parents, friends, interests, etc., the peculiarities of his speech behavior and speech spasms are revealed.
It is necessary to monitor the appearance of speech spasms depending on whether the child pronounces a complex or simple phrase, individual words or sounds. It is being determined whether speech cramps depend on the level of speech volume. During the examination, the speech therapist pays attention to concomitant speech and motor disorders. When studying the play activities of children, the nature of their games, relationships, the degree of play activity, and emotional state are clarified. It is noted that they have psychological characteristics, in particular, a painful fixation on their speech defect. The speech therapist clarifies information about his contact with others. In addition to conversations with people who stutter, their parents, studying psychological, pedagogical and medical documentation, methods are used to create experimental game and educational situations; methods are used as a valuable source of information to complete the diagnostic picture, for a more nuanced understanding of psychological characteristics of a person who stutters. The quantitative and qualitative information obtained with their help is subject to interpretation on the basis of a comprehensive psychological and pedagogical study of the subject.
The speech therapy report takes into account: the form of stuttering, the type of convulsions, the degree of stuttering, the rate of speech, dyslalia accompanying stuttering, an erased form of dysarthria, general underdevelopment of speech, the state of motor function, the presence and severity of mental symptoms of stuttering:
fear of speech, motor and speech tricks, embolophrasia, change in speech style, etc., the presence of anxiety in the process of stuttering, reaction to anxiety.
The prognosis for overcoming stuttering depends on many conditions, primarily on its mechanisms, on the timing of the onset of complex influence and the completeness of its application, on age, etc. We can assume that what younger age, how
the more active and cheerful the general behavior is, the fewer parts of the speech apparatus are captured by the spasm and the weaker the spasm itself, the fewer mental layers, the more favorable the prognosis.
EXAMINATION OF A CHILD STUTTERING AND CONSULTATION OF PARENTS
In order to create a plan for individual work with a child, it is necessary to carry out a complete
psychological, pedagogical and speech therapy examination. The objectives of this survey are: 1) to evaluate
classifier severity of stuttering; 2) find out whether the child, in addition to stuttering, has other
speech defects; 3) determine the level intellectual development; 4) establish the presence or
absence of concomitant psychopathological complexes of a stutterer. Often moms and dads
they ask the question: “Why do you need to undergo an examination? We were examined and treated in many places.
The diagnosis was made a long time ago.” The fact is that each technique needs its own, specifically
selected correctional material, which is formed as a result of the examination, therefore
different techniques involve different examinations, and some specialists create
they needed their own scale for assessing the severity of stuttering, which is what we did.
We believe that stuttering can be assessed on a scale from 0 to 10. classifier
severity.
Classifier of stuttering severity
0 points. There are no signs of stuttering.
1 point. Speech is easy, free, understandable for others, varied intonation
single clones of the first sounds and syllables in the amount of 1 clone per 25 words. Breath
normative.
2 points. Speech is easy, free, understandable for others, varied intonation
painted. Situationally, as a reaction to an alarming or traumatic situation,
single clones of the first sounds and syllables in the amount of 1 clone per 15 words. Aspirations before
the beginning of speech.
3 points. Speech is free, understandable to others, and intonationally colored. arise
single clones of the first sounds and syllables in the amount of 1 clone per 5 words. Marked
surmountable respiratory spasms. Breathing is shallow.
4 points. Speech is difficult, understandable to others. The intonation is monotonous and impoverished.
Single clones of the first sounds and syllables appear in the amount of 1 clone per 5 words. Marked
surmountable respiratory and articulatory spasms. Breathing is shallow.
5 points. Speech is difficult, understandable to others. The intonation is poor. IN
in the communicative process, surmountable respiratory and articulatory spasms are noted,
both multiple clonic and tonic, with surmountable tonic convulsions
occur in the amount of 1 per 1 minute of speech. Breathing is shallow, discrete. Possible
autonomic disorders, embolophrasia.
6 points. Speech is difficult, the meaning of what is said is clear, but the information content of the speech flow
reduced. In the communicative process, surmountable respiratory, articulatory
surmountable tonic convulsions occur in the amount of 1 per 10 seconds of speech. Breath
superficial, discrete, discoordinated. Autonomic disorders are observed,
accompanying movements, embolophrasia, logophobia.
7 points. Speech is difficult, the meaning of what is said is clear in general terms, informative
speech flow is reduced. There are surmountable respiratory, articulatory and vocal
convulsions, with surmountable tonic convulsions occurring in the amount of 1 per 3 seconds
speech. Breathing is shallow, discrete, uncoordinated. Vegetative
disorders, accompanying movements, embolophrasia, logophobia, tachycardia.
8 points. Speech is difficult, the meaning of what is said is not always clear, the information content of speech
flow is significantly reduced. Marked irresistible respiratory, articulatory,
in the amount of 1 per 5 seconds of speech, causing short pauses. Shallow breathing
discrete, discoordinated. Developed autonomic disorders are observed,
accompanying movements, embolofrasia, logophobia, tachycardia.
9 points. Speech is seriously difficult, the meaning of what is said is not always clear, information content
speech flow is reduced by half. There are irresistible respiratory problems,
predominate and occur in the amount of 1 per 2 seconds of speech. Shallow breathing
discrete, discoordinated. Multiple autonomic disorders are observed,
Tears, crying, anger. There is a refusal to speak after an unsuccessful attempt or an insurmountable
convulsions.
10 points. Speech is an uninformative sequence of syllables and words,
pronounced with constant multiple irresistible convulsions of all types.
The meaning of the speech is unclear. Speech is interrupted for a long time. Breathing is shallow, discrete,
discoordinated. Multiple autonomic disorders are observed,
accompanying movements, embolophrasia, logophobia, tachycardia, emotional disorders
Tears, crying, anger. Possible hypersalivation, tics, situational hearing and vision impairments,
fainting. An early refusal to speak is likely.
So, we determine the severity of stuttering in points using the classifier, examining all forms
speech (reading, retelling, whispering, poetic, conjugate, reflected, conflicting,
spontaneous). It is the assessment obtained from the classifier that makes it possible to organize a correction
process taking into account the characteristics of the child’s stuttering and do it in advance right choice most
effective in in this case correctional components of the technique. Thus it is planned
"direction of the main attack."
During the examination, we make sure to find out whether the child, in addition to stuttering, has other
speech defects. Very often, speech therapists refuse to correct sound pronunciation
with stuttering children, telling parents: “Correct your stuttering first, and we’ll give you the sounds later.”
we'll put it on." Children who stutter find themselves without speech therapy for a long time.
assistance, while against the background of defective pronunciation the severity of stuttering increases. We
We believe that it is impossible to correct stuttering if sound pronunciation is impaired.
Stuttering is a severe complex defect, each component of which is an integral part
stuttering stereotype and, therefore, a component of a stable pathological condition.
What has been said primarily relates to incorrect pronunciation, which, being
uncorrected, can restore memory of pathological condition. That's why, before
Before starting to correct stuttering, it is necessary to completely correct the defective
sound pronunciation.
During the examination, we determine the child’s level of intellectual development, the presence or
absence of mental retardation, correspondence between the volume of knowledge and ideas about the world
age standard. This information also plays an important role in the selection of correctional
material. There is a myth among parents about the exceptionally high intelligence of people who stutter.
children. The mother of six-year-old Artem S. told us: “Of course, it’s bad that my son stutters, soothes
only that he is smart.” When I asked why she got this idea, my mother replied:
“The literature says that children who stutter are smarter than children who do not stutter.” I hasten to reassure you: this
just a myth. The presence of stuttering does not predetermine high intellectual development.
Stuttering is observed in children with high, normal, and low intelligence. Unfortunately,
stuttering as a disease, in our opinion, is not a stimulator of intellectual growth.
During the examination, we necessarily establish the presence or absence
psychopathological complexes of a stutterer. One of these complexes is a complex of its own
inferiority - is especially pronounced in adolescents. When such a complex is identified
we are organizing a special pedagogical work to overcome and eliminate it.
After the examination, a mandatory conversation and consultation with parents is carried out, we
inform them about the results; find out additional necessary information about the child (history,
problems of behavior, family relationships, etc.); We explain what stuttering is and why it is
– a disorder of the tempo-rhythmic aspect of speech, caused by repeated convulsions in the articulatory, vocal or respiratory parts of the speech apparatus. Stuttering in children is characterized by “getting stuck” on individual sounds, their repeated, involuntary repetition, accompanying movements, speech tricks, logophobia, and vegetative reactions. Children with stuttering should be examined by a neurologist, speech therapist, psychologist, or psychiatrist. Correction of stuttering in children includes a medical and health complex (compliance with the regime, massage, hydrotherapy, exercise therapy, physical therapy, psychotherapy) and a system of speech therapy classes.
General information
Stuttering in children is unintentional stops and hesitations in oral speech that arise as a result of a convulsive state of the speech muscles. According to scientific data, about 2% of children and 1.5% of adults suffer from stuttering. Stuttering occurs 3-4 times more often in boys than in girls. In addition to speech convulsions, stuttering in children is accompanied by a disorder of higher nervous activity, which in some cases may be associated with a neurotic reaction, in others with organic damage to the central nervous system. Therefore, it would be wrong to consider stuttering in a child as purely speech problem; the study and correction of stuttering in children is impossible without the integration of knowledge from the fields of speech therapy, neurology, and psychology.
Classification of stuttering in children
Depending on the pathogenetic mechanisms underlying convulsive stuttering, there are 2 forms of stuttering in children: neurotic (logoneurosis) and neurosis-like. Neurotic stuttering in children is a functional disorder; neurosis-like is associated with organic damage to the nervous system.
Based on the severity of speech convulsions, there are mild, moderate and severe degrees of stuttering in children. Mild stuttering in children is characterized by convulsive hesitations only in spontaneous speech; the symptoms are subtle and do not interfere with verbal communication. With moderate severity, hesitations occur in monologue and dialogic speech. With severe stuttering in children, speech spasms are frequent and prolonged; hesitations occur in all types of speech, including conjugate and reflected; accompanying movements and embolophrasia appear. In the most extreme cases, stuttering can make speech and communication nearly impossible. The severity of stuttering may vary for the same child in different situations.
Depending on the nature of the course, the following variants of stuttering in children are distinguished:
Causes of stuttering in children
All factors contributing to the occurrence of stuttering in children are traditionally divided into predisposing and producing. Predisposing (background) causes include hereditary predisposition, the neuropathic constitution of a stuttering child, and intrauterine damage to the central nervous system. Hereditary predisposition to stuttering in children is most often determined by congenital weakness of the speech apparatus. Children who stutter often exhibit enuresis, night terrors, increased anxiety and vulnerability. Perinatal brain damage in children may be associated with toxicosis of pregnancy, hemolytic disease of the fetus, intrauterine hypoxia and asphyxia during childbirth, birth injuries, etc. Children who are physically weakened, with an underdeveloped sense of rhythm, general motor skills, and facial expressions are more susceptible to the development of stuttering and articulation.
Increased incidence of stuttering observed in last years, is directly related to the rapid implementation in daily life video games, various computer technologies that unleash a huge stream of audiovisual information on the fragile nervous system of children. It should be remembered that the processes of maturation of the cerebral cortex and the formation of functional asymmetry in brain activity are generally completed by the age of 5, therefore exposure to any stimulus that is excessive in strength or duration can lead to a nervous breakdown and stuttering in children.
Such extreme irritants (or producing causes) of stuttering in children can be severe infections (meningitis, encephalitis, measles, whooping cough, typhus, etc.), head injury, malnutrition, rickets, intoxication, etc. The immediate causes of stuttering in children also include immediate mental shocks or long-term mental trauma. In the first case, it may be short-term fear, fright, excessive joy; in the second - protracted conflicts, authoritarian parenting style, etc. Imitation of stutterers can lead to stuttering in children, early learning foreign languages, overload with complex speech material, relearning left-handedness. The literature indicates a connection between stuttering in children and left-handedness and other speech disorders (dyslalia, tachylalia, dysarthria, rhinolalia). Secondary stuttering in children can occur against the background of motor alalia or aphasia.
Comparative characteristics of neurotic and neurosis-like stuttering in children
Neurotic stuttering in children is based on strong traumatic experiences, so speech impairment occurs acutely, almost instantly. In this case, parents, as a rule, accurately indicate the time of the onset of stuttering in the child and its cause. Neurotic stuttering usually occurs between 2 and 6 years of age, i.e., at the time of development of the disorder, children have extensive phrasal speech.
Children with neurotic stuttering experience a decrease in speech activity, pronounced logophobia and fixation on difficult sounds; respiratory-vocal convulsions predominate. Sound pronunciation, as a rule, is impaired, but the lexical and grammatical side develops normally (FFN occurs). Children often accompany their speech by flaring the wings of the nose and accompanying movements. The nature of the course of neurotic stuttering in children is wavy; Speech deterioration is provoked by traumatic situations.
In the case of neurosis-like stuttering that occurs against the background of organic damage to the central nervous system in the perinatal or early period development of the child, the disorder develops gradually, gradually. There is no obvious connection with external circumstances; Parents find it difficult to determine the cause of stuttering in children. Neurosis-like stuttering in children appears from the moment speech begins or at the age of 3-4 years, i.e. during the period of formation of phrasal speech.
The speech activity of children is usually increased, but they are not critical of their defect. Speech hesitations are caused primarily by articulatory spasms; speech is monotonous, inexpressive, the pace is accelerated; sound pronunciation is distorted, the lexico-grammatical aspect of speech is disrupted (OHP occurs). Children with neurosis-like stuttering have impaired general motor skills: their movements are awkward, constrained, and stereotyped. Characterized by sluggish facial expressions and poor handwriting; Dysgraphia, dyslexia and dyscalculia often occur. The course of neurosis-like stuttering in children is relatively constant; Speech deterioration can be caused by fatigue, increased speech load, and somatic weakness. A neurological examination reveals multiple signs of central nervous system damage; according to EEG data - increased convulsive readiness.
Symptoms of stuttering in children
The main symptoms of stuttering in children include speech convulsions, disorders of physiological and speech breathing, accompanying movements, speech tricks and logophobia.
When stuttering, children experience hesitation when trying to start speaking or directly in the process of speaking. They are caused by spasms (involuntary contraction) of the speech muscles. Speech spasms can be tonic or clonic in nature. Tonic speech spasms are associated with a sharp increase in muscle tone in the lips, tongue, and cheeks, which is accompanied by the inability to articulate and a pause in speech (for example, “t---rava”). Clonic speech spasms are characterized by repeated contractions of the speech muscles, resulting in the repetition of individual sounds or syllables (for example, “t-t-grass”). Children who stutter may have tono-clonic or clono-tonic seizures. According to the place of occurrence, speech convulsions can be articulatory, vocal (phonational), respiratory and mixed.
Breathing during stuttering is irregular, shallow, thoracic or clavicular; Discoordination of breathing and articulation is noted: children begin to speak while inhaling or after a full exhalation.
The speech of children with stuttering is often accompanied by involuntary accompanying movements: twitching of the facial muscles, flaring of the wings of the nose, blinking, swaying of the body, etc. Quite often, people who stutter use so-called motor and speech tricks aimed at hiding their hesitations (smiling, yawning, coughing, etc. ). Speech tricks include embolophrasies (the use of unnecessary sounds and words - “well”, “this”, “there”, “here”), changes in intonation, tempo, rhythm, speech, voice, etc.
Difficulties in speech communication cause logophobia (fear of speech in general) or sound phobia (fear of pronouncing individual sounds) in children with stuttering. In turn, obsessive thoughts about stuttering further worsen speech problems in children.
Stuttering in children is often accompanied by various kinds of autonomic disorders: sweating, tachycardia, blood pressure lability, redness or pallor skin, which intensify at the time of speech convulsions.
Diagnosis of stuttering in children
Examination of children with stuttering is carried out by a speech therapist, pediatrician, child neurologist, child psychologist, child psychiatrist. For all specialists, an important role is played by the study of anamnesis, hereditary burden, information about early psycho-speech and motor development children, clarifying the circumstances and time of stuttering.
Correction of stuttering in children
Speech therapy has adopted a comprehensive approach to the correction of stuttering in children, which involves carrying out therapeutic, health-improving and psychological-pedagogical work. The main goal of the treatment and pedagogical complex is to eliminate or weaken speech spasms and related disorders; strengthening the central nervous system, influencing the personality and behavior of a stutterer.
The therapeutic and health-improving area of work includes general strengthening procedures (hydrotherapy, physiotherapy, massage, exercise therapy), rational and suggestive psychotherapy.
The actual speech therapy work for stuttering in children is organized in stages. At the preparatory stage, a gentle regime and a friendly atmosphere are created, speech activity is limited, and examples of correct speech are demonstrated.
At the training stage, work is carried out to master children various forms speech: conjugate-reflected, whispered, rhythmic, question-answer, etc. It is useful to use various forms in the classroom manual labor(modeling, designing, drawing, games). At the end of this stage, classes are transferred from the speech therapist’s office to a group, class, public places, where children consolidate their free speech skills. At the final stage, the skills of correct speech and behavior in various speech situations and activities are automated.
During the work, important attention is paid to the development of the main components of speech (phonetics, vocabulary, grammar), voice delivery, and prosody. Logorhythmic exercises, speech therapy massage, breathing and articulation exercises play an important role in the correction of stuttering in children. Speech therapy classes to correct stuttering in children are conducted in individual and group formats.
To correct stuttering in children, many original methods have been proposed (N.A. Cheveleva, S. A. Mironova, V.I. Seliverstova, G.A. Volkova, A.V. Yastrebova, L.Z. Arutyunyan, etc.).
Forecast and prevention of stuttering in children
With proper organization of treatment and health work, stuttering completely disappears in most children. Relapses of stuttering are possible at school age and puberty. The most consistent results are observed when correcting stuttering in preschoolers. The longer the stuttering experience, the more uncertain the prognosis.
To prevent the occurrence of stuttering in children, it is important to have a favorable course of pregnancy, care for the physical and mental well-being of the child, his speech development, and the selection of educational and entertainment material according to age. In order to prevent relapses of stuttering in children, it is necessary to follow all the recommendations of the speech therapist at the stage of correctional work and after it, to create favorable conditions for the child for harmonious development.
The examination of a person who stutters is carried out comprehensively (by a speech therapist, a neurologist, a psychologist), with the involvement of other specialists as necessary: a pediatrician, a therapist, a psychiatrist, an ophthalmologist, an otolaryngologist, etc.
The examination includes the study of anamnestic information, pedagogical, psychological and medical documentation and examination of the stutterer himself.
From a conversation with parents, the speech therapist finds out the most significant events that occurred in the family, and in connection with this, clarifies the features of the child’s general, motor and speech development.
The main points of the prenatal (prenatal) period are assessed: the age of the mother (less than or more than 35 years) at the birth of the child, neuropsychic health, illnesses of the mother, father, and the course of pregnancy. Data on the health of the father and mother before the birth of the child allows us to determine possible deviations in his somatic and neuropsychic state. Identification of unfavorable factors in intrauterine development will help determine their indirect impact on the subsequent speech development of the child.
Identified deviations and various negative facts of the natal and postnatal periods of child development are analyzed and assessed by specialists in order to most fully study the etiology and pathogenesis of stuttering.
In conversations with parents, information about the child’s speech development is clarified: when the first sounds, humming, babbling, first words, phrases appeared, what rate of speech he uses, whether there were any peculiarities of behavior during moments of verbal communication with others. It is also important to find out about the child’s speech environment (whether parents or people close to the child speak too quickly).
Attention is paid to studying the issue of raising a child in a family: the attitude of adults towards him (whether there is affection, indulgence in whims or, conversely, unbalanced, harsh treatment, physical punishment, intimidation); assistance in the formation of his correct speech (is there any overload in memorizing complex texts) or, conversely, lack of control over the development of his correct pronunciation, grammatically correct speech communication, etc.
When did stuttering begin, and did its first signs appear? How was it expressed outwardly? What possible reasons could have caused it? How did it develop, what features of the manifestations attracted the attention of the parents: are there any accompanying motor disorders (convulsions, tapping with a hand, foot, shaking the head, etc.) or speech defects (extra words, sounds, pronunciation of individual sounds and words while inhaling, etc.). )? How does it manifest itself depending on the situation or the people around you, on different types of activities? How does a child speak alone (for example, with his toys)? What are the periods of deterioration and improvement of speech associated with? How does the child feel about his speech impairment (notices, doesn’t notice, is indifferent, worries, is ashamed, hides, is afraid to speak, etc.)?
Did the parents seek help: where, when, what was recommended, what were the results?
Information about the characteristics of stuttering allows us to choose the main form of therapeutic and pedagogical intervention in each specific case. The presence of concomitant motor impairment indicates the need for motor exercises, perhaps even a cycle of physical therapy exercises.
The peculiarities of psychological manifestations in a stutterer require the speech therapist to provide for this plan of influence on him: to distract him from fixation on his defect, rebuild his attitude towards himself, towards his speech, teach him to hear his correct speech.
After clarifying information about the child, the history of the occurrence and characteristics of his stuttering, an examination of the speech of the stutterer and extra-speech processes that have a direct impact on his speech activity is carried out.
A study is being conducted of his sociability, motor skills, imitation, impressive and expressive speech, gaming, educational, production activities, personality characteristics of a stutterer. There are primary (during the first month of a child’s stay in a speech preschool institution, in the first two weeks of stay in a sanatorium for children who stutter, at a school speech therapy center) and dynamic study of a stutterer in the process of correctional and educational intervention.
To study children's speech, pictures, books with poems, fairy tales are used, and toys are selected (dolls, cars, animal figurines, building materials).
The specific objectives of the speech examination are to determine:
Place of occurrence and form of speech spasms;
The frequency of their manifestations and the preserved speech capabilities of the stutterer;
Associated speech disorders; movement disorders;
The attitude of a stutterer to his speech defect; presence of psychological characteristics.
The place of occurrence of convulsions (respiratory, vocal, articulatory, mixed) and their form (clonic, tonic, mixed) are determined aurally or visually.
The frequency of seizures in people who stutter is of particular interest to the speech therapist. It allows us to judge the preserved areas of speech, and, therefore, how correctly and successfully the first speech lessons with the child will begin will directly depend on it. The study of the level of free speech begins with identifying the dependence of paroxysms of stuttering on varying degrees of speech independence. In a conversation about his parents, friends, interests, etc., the peculiarities of his speech behavior and speech spasms are revealed. The child is asked to compose a story or describe the content of a picture, retell a familiar fairy tale; The speech therapist reads the story and offers to retell it, etc. Then he checks the state of reflected and conjugate speech by repeating or jointly pronouncing simple and complex phrases.
The level of free speech of a stutterer depends not only on the varying degrees of her independence, but also on her preparedness.
It is necessary to monitor the appearance of speech spasms depending on whether the child pronounces a complex or simple phrase, individual words or sounds. Based on the material of the retelling of the text, it is recorded in what cases speech spasms occur: only at the beginning of the story, at the beginning of phrases, on individual words or sounds. It is being determined whether speech cramps depend on the level of speech volume. For this purpose, the subject is asked to speak quietly, loudly, or in a whisper.
The influence of different degrees of rhythm on the speech of a stutterer can be tested as follows: he talks about what is drawn in the pictures, conveys the content of a fairy tale, which is rhythmic prose, and recites a poem.
During the examination, the speech therapist pays attention to accompanying speech and motor disorders: extra words or sounds, pronouncing individual sounds, words and even sentences while inhaling, incorrect pronunciation of speech sounds, deficiencies in the vocabulary and grammatical structure of speech, tempo, tics, myoclonus (involuntary movements), various auxiliary (voluntary) movements and some features of speech behavior: stiffness and tension of general movements or, conversely, their sharpness, chaoticness, lack of composure, “looseness.”
When studying the play activities of children, the nature of their games, relationships, the degree of play activity, and emotional state are clarified.
Attention is drawn to how stuttering schoolchildren use various forms of speech in and outside the learning process. It is noted that they have psychological characteristics, in particular, a painful fixation on their speech defect.
Information about the psychological characteristics of a person who stutters is gleaned from conversations with parents. The speech therapist clarifies the information O his contact with others (at home, at school, with peers and adults, acquaintances and strangers), pays attention to the assessment of his own speech (whether he knows or does not know about his speech imperfections, what importance he attaches to it), to the presence of defensive reactions (touchiness, shyness , camouflage, avoidance of verbal communication), on speech behavior during examination (expects help, strives to actively overcome a deficiency or does not understand why speech classes are needed). The study of the stutterer continues during the correction course. In addition to conversations with people who stutter, their parents, studying psychological, pedagogical and medical documentation, methods are used to create experimental game and educational situations, psychodiagnostic methods (Rorschach method, thematic apperception test (TAT), S. Rosenzweig’s technique, “test-conflict” technique , unfinished sentence technique, rating scales, tests of mental functions and motor skills, etc.). These methods are used as a valuable source of information to complete the diagnostic picture, for a more nuanced understanding of the psychological characteristics of a stutterer. The quantitative and qualitative information obtained with their help is subject to interpretation on the basis of a comprehensive psychological and pedagogical study of the subject.
The speech therapy report takes into account:
form of stuttering (tonic, clonic, mixed), type of convulsions (respiratory, vocal, articulatory, mixed), degree of stuttering (mild, moderate, severe), rate of speech (slow, accelerated, rapid speaking, presence of tachylalia), dyslalia accompanying stuttering, erased a form of dysarthria, general underdevelopment of speech, the state of motor function, the presence and severity of mental symptoms of stuttering: fear of speech (logophobia), motor and speech tricks, embolophrasia, changes in speech style, etc., the presence of anxiety during the process of stuttering, reaction to anxiety. Fixation of attention on the speech process and its influence on stuttering, the influence of the complexity of a speech situation on stuttering, individual psychological characteristics of a stutterer, the nature of gaming activities, attitude towards educational activities, the range of situations in which stuttering manifests itself (in all, in most, in some cases ).
A speech therapy report makes it possible to carry out a differential diagnosis and distinguish stuttering from other speech disorders (tachylalia, dysarthria, stumbling of a physiological nature), as well as to separate different forms of stuttering from each other. Data from a comprehensive study of a stutterer allows us to establish its nature.
The presence of different manifestations of stuttering, psychological characteristics and behavior of each stutterer also determine the features of the choice of means, techniques and direction of speech therapy work individually for each stutterer in the conditions of general step-by-step speech therapy work with the entire group.
Forecast overcoming stuttering depends on many conditions, primarily on its mechanisms, on the timing of the onset of complex influence and the completeness of its application, on age, etc. We can assume that the younger the age, the more active and cheerful the general behavior, the fewer departments of speech the apparatus is captured by a spasm and the weaker the spasm itself, the fewer mental layers, the more favorable the prognosis. For stuttering that develops due to congenital aggravation or acquired neuropathy, as well as one that appears without visible external influences, the prediction is less favorable. Relapses are more common here. Respiratory convulsions are eliminated more successfully than vocal convulsions; clonic forms disappear more easily than tonic ones. Consequently, they are easier to influence through the II signaling system than tonic ones, characteristic of excitation of the subcortex, which is more difficult to influence. The prognosis largely depends on the child’s personality and on the personality and skill of the speech therapist.
The most favorable age is 2-4 years (it is easier to create favorable conditions, short stuttering experience). The least favorable age is 10-16 years, puberty (exacerbated mental vulnerability, desire for freedom, independence, unsociability and other negative personal qualities). Often, disappeared stuttering potentially persists and is ready to appear when unfavorable conditions arise.
In most cases, the prognosis for stuttering is favorable and social adaptation stuttering is carried out to a fairly high degree.
Prevention stuttering in our country is carried out comprehensively and consistently. Initially, it is carried out with parents before the birth of the child in order to prevent negative effects on the child after birth (protect the head from bruises, keep the nasopharynx and oral cavity in order, prevent chronic diseases, carry out timely treatment, remove adenoid growths). Since oral speech develops by imitation, persons with stuttering, tachylalia, stumbling and other speech disorders can play an unfavorable role for the child. Children should be encouraged to communicate, but kept from producing too much speech. Those who are nervously predisposed need to create a calmer environment: limit verbal communication and noisy games, do not pamper them with new toys, and, if possible, avoid large groups of people around them.
When entering school, a child may experience stuttering or relapse. Therefore, prevention of stuttering is necessary in school years. Unexpected calls on children and forcing them to respond quickly should be avoided; create a favorable environment in the classroom around the person who stutters; communicate speech therapy knowledge to parents, teachers, etc.
During the puberty period, attention is paid to the state of the adolescent’s nervous system, to his relationships with others, to adequate ways of asserting himself as an individual, etc. Various deviations in the neuropsychic state of the adolescent, overstrain of nervous activity, emotional-volitional sphere, incorrect self-esteem, the predominance of negative personality traits can cause stuttering or its relapse.
Particular attention is paid to the prevention of relapse, based on their causes. The following reasons for relapse of stuttering can be indicated: poor social and living conditions (nervous environment, rough treatment of a child, overload of the nervous system with teaching, extra classes, work, mental stress); insufficient consolidation of success in the process of speech therapy classes, lack of medical examination; insufficiently deep re-education of the personality of a stutterer, incomplete elimination of secondary mental layers, the “ground” on which stuttering arose, for example, infringed, suppressed emotions, tense relationships with others, sluggish current chronic diseases etc.; diseases that deplete the nervous system; mental trauma; insufficient attention from others to a child who has freed himself from stuttering; violations of activity patterns, as well as sleep, nutrition, and rest patterns; an unresolved traumatic, constantly acting factor, for example, a mother or father who stutters, etc.
Knowing the above and others possible reasons relapses of stuttering, the speech therapist constantly carries out preventive work both during speech therapy sessions and after their completion.
Speech therapy: Textbook for students of defectology. fak. ped. universities / Ed. L.S. Volkova, S.N. Shakhovskaya. -- M.: Humanite. ed. VLADOS center, 1998. - 680 p.