Alalia is an insufficiency (deficiency) of speech that is not associated with somatic hearing or intellectual impairments. It occurs against the background of damage to the speech lobes of the brain during childbirth or in the prenatal period.
The most severe degrees of the disease are manifested by a complete lack of speech or incoherent babbling. A mild degree of impairment is characterized by difficulties in mastering writing and reading skills, a limited vocabulary and other deviations in the use of speech structures.
Causes and risk factors
Damage to the speech centers of the cerebral cortex, causing the development of alalia, occurs during pregnancy or at an early age, i.e. even before speech formation begins. Factors that significantly increase the risk of pathology include:
- problems during pregnancy: hypoxia, toxicosis, infections (especially the TORCH complex), injuries, chronic diseases and bad habits in the mother;
- birth injuries, asphyxia, pathological course of labor (protracted, fleeting);
- premature birth;
- severe illnesses in the first years of life: acute respiratory viral infections, pneumonia, conditions requiring the use of anesthesia;
- traumatic brain injuries;
- unfavorable social situation in the family.
Often, not one, but several pathological factors are involved in the formation of alalia, leading to the development of minimal brain dysfunction (MCD). This is a complex disorder manifested by mental retardation, including impaired speech functions.
Causes of the disease
Sensorimotor alalia develops due to damage to areas of the brain that are responsible for understanding and reproducing speech.
A damaging factor can affect different periods of a child’s development:
- In the prenatal period, infectious diseases in a woman, the threat of miscarriage, polyhydramnios or oligohydramnios, premature rupture of water, entanglement in the umbilical cord, bad habits, taking medications, concomitant diseases, vitamin deficiencies have a negative impact;
- During childbirth, there is an increased risk of birth injuries and hypoxia, in which the brain experiences oxygen deficiency or is damaged. The use of forceps and rapid labor are dangerous;
- After childbirth and the first years of the baby’s life, brain damage can occur as a result of injuries, encephalitis and meningitis, and severe concomitant diseases.
Relationships with parents play an important role in the development of sensorimotor alalia. It has been proven that children whose parents are distant towards their baby ignore his needs for love, communication, care, and lag behind their peers in development. This also applies to speech development.
Classification: forms of alalia in children
The development of alalia in a child can be caused by damage to various parts of the cerebral cortex. Depending on the location of the pathological focus, the symptoms of the disease may vary, which allows us to distinguish three main forms:
- motor (expressive): the area responsible for speech production suffers; at the same time, the child understands the words addressed to him, can follow commands, but is not able to pronounce articulate sounds; within this form, afferent and efferent varieties of alalia are also distinguished; in the first case, the child cannot control the functioning of the speech apparatus and pronounces sounds incorrectly; in the second, there is difficulty in switching articulatory acts, i.e. It is difficult for the child to follow the sequence of speech movements.
- sensory (impressive): occurs when the auditory-speech analyzer is damaged, i.e. the child cannot understand speech addressed to him, and, accordingly, cannot speak;
- mixed: signs of both forms are observed; Depending on the predominance of certain symptoms, sensorimotor and motosensory varieties of alalia in children are distinguished.
Classes at the clinic
Alalia can be cured in specialized clinics. This method is one of the most effective, since children are trained using a specially developed method:
- development of cognitive function;
- formation of morphological and sound analysis;
- restoration of semantic aspects of speech, etc.
In such clinics you can get advice from a speech therapist, neurologist, psychoneurologist, or psychiatrist. They will be able to give advice on treatment, nutrition and diet of the child during illness. In this case, meals should be fractional and correct; the child needs to eat more vegetables and fruits, as well as lean meats: chicken, turkey, rabbit, beef.
Symptoms of motor alalia in children
Signs of motor alalia in children are divided into neurological, psychological and speech therapy. Neurologists, first of all, note a violation of coordination of movements and fine motor skills. The child often falls and has great difficulty performing small tasks, such as fastening buttons or putting together a jigsaw puzzle.
Psychological symptoms include characteristic behavioral patterns. The baby alternates between periods of excessive activity and severe lethargy; performance and perseverance suffer significantly. There is a decrease in memory, especially for sounds, as well as lack of attentiveness.
Speech skills in the motor form of alalia are formed much later than in other children. The child has difficulty pronouncing sounds and often distorts words: omits or adds syllables, swaps them or even replaces them with ones that sound similar.
The vocabulary is significantly impoverished, since the baby does not always understand the meaning of a particular word and often uses unfamiliar concepts inappropriately. Sentences usually consist of 1-3 syllables, do not have verbs, adjectives or adverbs, and nouns are often used in the nominative case. Strong difficulties arise when trying to retell a text or talk about an event.
In severe form, speech as such is absent, replaced by babbling and onomatopoeia, which are complemented by gestures and facial expressions.
Massage technique for alalia
Massage has a positive effect on the motor type of the disease. It has a number of positive effects: reduces increased muscle tone;
- coordinates the muscles of the face and tongue;
- improves articulation;
- improves tissue sensitivity;
- reduces salivation (excessive salivation, drooling).
The massage should be done with your fingers. Movements should be slow and careful. There should be at least 10 such sessions per course. The massage technique includes tapping on the lips, tongue, and inner surface of the cheeks.
You also need to carry out circular and pressing movements along the surface of the cheeks. It is worth seeking help from specialists who will prescribe a course of speech therapy massage and determine its features, frequency, and specific movements.
Symptoms of sensory alalia
Sensory alalia in children is associated with a violation of the analysis of heard speech in the central nervous system, which determines its symptoms.
The child constantly “talks” a lot and actively gestures. His speech is a set of syllables, sounds and even individual words that are pronounced unconsciously. Experts call this symptom “logorrhea.” The second important symptom indicating sensory alalia is lack of speech understanding. In relatively mild cases, the child perceives individual words or phrases. In this case, it is enough to change the wording of the sentence so that the sentence becomes meaningless for the baby. In severe cases, even minimal understanding is absent.
The psychological development of the child suffers significantly. Experts note a pronounced delay in intellectual development, secondary personality and behavior disorders. The child is often impulsive, hyperactive, or, conversely, withdrawn.
It is important to understand that in most cases, children have symptoms of both sensory and motor alalia; this allows doctors to diagnose such a child with a sensorimotor or motor-sensory form of the disease.
Possible complications and consequences
If parents do not take a child with alalia to a specialist or do not follow his recommendations, the condition progresses. If we are talking about the motor form of the disease, the baby may encounter problems such as:
- speech negativism (reluctance to speak);
- stuttering;
- dysgraphia and dyslexia (reading and writing disorders).
Any form of speech impairment without correction causes delayed intellectual development, significant difficulties in learning and socialization of the child.
Clinical picture and behavioral characteristics
In the absence of verbal communication with children or adults, the child experiences psychological discomfort. Children from a very early age use gestures to express their emotions and desires.
Gradually, they begin to connect speech to this, which becomes more complex as they grow older.
A child with alalia does not have this opportunity; it is difficult for him to explain what he wants from an adult. The degree of difficulty may vary, but there are three levels of underdevelopment of the speech apparatus:
- Complete lack of speech.
- There are initial signs of speech development. The baby has some words or sounds in its reserve and can make words from them, but such a reserve is extremely limited.
- There is an extended speech with fragments of weak development of the speech system. The vocabulary in this case is large, but the words are pronounced in a distorted way, and there are defects in the pronunciation of certain sounds.
These levels are not related to the child's age. At 5 years old he can be at the first level. These impairments inevitably affect oral speech and, later, the ability to write and read.
Children have difficulty remembering letters and numbers. They confuse them, interfere with each other. This further complicates the development of speech ability. The child understands everyday speech. It is simple for him and does not require grammatical rules.
The child can understand simple requests, such as closing the door or taking a book, based on the current situation. He understands that if the door to the room is closed, and his mother suddenly spoke about it, then some manipulations need to be done with it.
Intuitively, the baby will open the door. But whether he understands exactly the meaning of words at this moment depends on the severity of the disease. At difficult stages, he may not understand at all what adults tell him.
Diagnostics
Any form of speech impairment, regardless of the severity and severity of the symptoms, requires a comprehensive examination with the participation of a neurologist, psychologist, speech therapist, otolaryngologist and other specialists. A neurological examination is aimed at searching for a pathological focus in the cerebral cortex, as well as excluding other causes of speech impairment. The study usually includes:
- electroencephalography (EEG);
- Ultrasound of the brain (echoencephalography);
- MRI of the brain;
- X-ray of the sella turcica.
The ENT examines the hearing organ: otoscopy, audiometry and other tests aimed at identifying hearing loss, and also evaluates the condition of the oral cavity and larynx. It is mandatory to evaluate auditory-verbal memory, diagnose the structure of speech, etc. During consultations, it is necessary to tell doctors in detail about the progress of pregnancy and childbirth, injuries and illnesses suffered, as well as all the features of the physical and mental development of the baby.
Treatment of alalia in children
Treatment methods for sensory, motor and mixed forms of alalia in children depend on the severity of symptoms, the severity of the disease, and the presence or absence of signs of other disorders. Depending on the specific situation, doctors may prescribe drug therapy and physical therapy to stimulate adequate brain function.
In parallel, constant work is carried out with a psychologist and speech therapist, with regular attendance at classes and consolidation of the results at home. The training is aimed at developing fine motor skills, improving the pronunciation of specific sounds and individual words.
If necessary, the chosen treatment regimen is adjusted and supplemented with massage, physical therapy, and psychotherapy.
Prognosis and prevention
The prognosis depends on the severity of the disease, as well as the time of initiation of correction.
If you contact a specialist in a timely manner and regularly and carefully follow all recommendations, the likelihood of successful correction increases. The motor form of alalia is easier to eliminate, but with the sensory and sensorimotor forms the prognosis is not always favorable. Prevention of alalia means following all doctor’s recommendations during pregnancy, regular activities with your baby, and minimizing the risk of injuries and diseases.
Home therapy for alalia
In addition to classes with specialized specialists, you can conduct additional classes at home. To get rid of the disease, the parent must focus as much as possible on his baby and help him. There are some effective methods designed specifically for patients:
- The baby must learn to understand speech by ear. The parent names the object, the child must show it. If he showed it wrong, you need to show it correctly. This exercise is repeated many times for alaliks before he understands what is required of him. Bright toys and colored figurines are suitable for such activities.
- If the vocabulary is wide, train him to pronounce the names of objects by showing them.
- You need to talk to children suffering from alalia more often. Parents' speech should be clear, correct and not too fast. With sensory alalia, words must be accompanied by a demonstration of corresponding pictures.
- Show the letters. And then say words starting with these letters. Ask your child to show the letter with which the word begins and pronounce the whole word.
Take your child a few books with bright illustrations and get him interested in reading. Tell interesting stories and show what the main characters look like. Educational games with adults can help.
