Dyslalia - forms, causes, treatment, signs, correction

Dyslalia is a defect in the pronunciation of sounds in children who do not have problems with hearing and normal innervation of articulation. Dyslalia in children manifests itself in the form of absence, replacement, or distortion of sounds. The word dyslalia comes from the Greek language, dys - disorder, lalia - speech. For this disease, a speech therapy study is carried out, during which mobility, the structure of the speech apparatus, and phonetic hearing are examined. Consultation with a neurologist, dentist, or otolaryngologist may be required.

General information about dyslalia

This speech disorder is not associated with damage and defects of the central nervous system and hearing. Dyslalia is the most common speech problem in children. It occurs in 25%-30%, and according to some data, in more than 50% of preschool children under the age of 7 years. 17-20% of junior schoolchildren and 1% of older students have various forms. In the structure of this disorder, polymorphic disorders in pronunciation stand out most of all.

They interfere with speech acquisition and are the causes of dysgraphia and dyslexia. This speech disorder is selective, meaning a child can pronounce up to 90% of words and sounds well, but have problems with the remaining 10%. Timely correction can completely rid a child of pronunciation problems.

Symptoms of dyslalia

It is not difficult to see and recognize the symptoms of dyslalia; this can be done by paying attention to your child’s speech. Characteristic symptoms are distortions, replacement of sounds or letters with others. The baby may completely skip some letters in his speech. If substitution occurs, the symptom is a change in the audible sound to another, which is pronounced by the child. For example, a child hears the word “cat”, but pronounces “goshka”. This phenomenon occurs due to the fact that he cannot differentiate sound by articulation and acoustics.

The patient can replace phonemes with arbitrary ones, in a chaotic order, regardless of the structure of the word. There is no division into sizzling, hard, soft and other types. Sometimes a child can pronounce the same word in different ways, including correctly. This indicates incomplete acquisition of phonemes. A child suffering from this disorder can be identified by his speech and pronunciation. They use sounds and letters that are not in the word. This is usually typical for the mechanical type.

If a child has functional dyslalia, one or more sounds in his speech are replaced. Mechanical dyslalia is characterized by problems with the pronunciation of similar phonemes. If there are pathologies in the development of the lower jaw, they will be pronounced by anterior lingual articulation. This occurs due to the inability to hold the tongue on the front teeth. This speech disorder may improve as people get older.

If parents notice such a disorder and seek help from speech therapists, there is a high chance of completely getting rid of this disorder. If he does not receive proper correction, he is also likely to get rid of dyslalia with age. Such children have a rich vocabulary, can break words into syllables, and over time they will develop correct speech. Speech therapists identify physiological dyslalia, which goes away by the age of five.

Symptoms of deviation

Dyslalia is characterized by a wide variety of symptoms represented by omissions (complete loss of speech), substitutions (substitution of a different sound each time it occurs), distortion (abnormal pronunciation) and confusion of sounds (pronunciation is sometimes correct, sometimes incorrect). Various symptoms appear depending on the form of the disease:

• with functional, the pronunciation of one or more sounds is impaired
• with mechanical - a group of sounds similar in articulation;
• with physiological, age-related tongue-tiedness is observed, the cause of which is the immaturity of phonemic hearing and the inability to correctly control the movements of the speech organs, which naturally goes away by the age of 5.

Impaired sound perception

Fluent speech is essential for success in school. It is for this reason that speech needs to be given special attention. The process of formation of the speech apparatus is influenced by several factors, including hearing. Any auditory pathology negatively affects pronunciation. The child hears a word, sound, or letter incorrectly, and accordingly pronounces it incorrectly. Phonetic or sound perception is the ability to correctly hear and distinguish the sounds “P-B”, “S-Sh”, “L-R”.

Often, children with impaired sound perception distort even phonemes that individually they can pronounce correctly. They are unable to analyze their speech well, may make mistakes when writing, and have difficulty reading aloud. Such violations require work and correction by speech therapists and teachers. Many of these disorders can be eliminated in preschool age, preventing them from developing into a persistent form, which will be difficult to correct.

It is important to know that at school age speech develops very intensively, it is flexible and pliable. A child with impaired hearing may not perceive close and similar sounds. There are no words in his vocabulary that contain combinations of letters that are difficult for him to distinguish. This ultimately leads to the fact that he begins to lag behind his peers.

Classification

There are different types of dyslalia, which are classified according to the causes of occurrence, severity, and types of sounds with which the child has difficulty. Considering the causes of pronunciation disorders, mechanical or organic, functional varieties are distinguished. Speech therapists have developed the following classification of dyslalia.

Mechanical

Mechanical dyslalia is caused by the anatomical structure of the articulatory apparatus. The reasons are:

• Disturbed dental system. Prognathia may be observed - protrusion of the upper jaw, which appears due to its too active growth compared to the lower one. The bite of the teeth may be disturbed, the presence of a large gap when closing the jaws or a violation of the structure of the teeth. These deficiencies are corrected by dentists.
• Irregularly formed palate. It can be narrow, high, flat, which creates difficulties with the articulation of many sounds.
• Irregularly shaped lips. Insufficient lip mobility and sagging affect correct pronunciation.
• Short frenulum of the tongue (hyoid ligament);
• Anatomical feature of the structure of the tongue. It can be big, short, small.

Some of these reasons are easily remediable. This type does not affect the correct spelling or vocabulary.

Functional

Functional dyslalia is caused by social factors or correctable neurodynamic pathologies in the brain (brain cortex). There are several varieties - motor and sensory.

Motor type

Dictated by neurodynamic changes in the parts of the brain responsible for speech analyzers. Motor dyslalia is characterized by impaired movements of the tongue and lips, resulting in incorrect pronunciation. This phenomenon is called a phonetic defect.

Touch type

It is formed due to changes in the speech-auditory departments and affects hearing. The patient cannot differentiate sounds that have similar phonemes (hard-soft, voiced-voiceless, hissing-whistling). In speech, this leads to mixing, replacing, and omitting such letters, and in the future these letters can be omitted when writing.

The simultaneous presence of both types is called the sensorimotor type. Due to the unformation of certain sounds, three types of dyslalia can be distinguished:

• acoustic-phonemic,
• articulatory-phonemic;
• articulatory-phonetic.

Acoustic-phonemic

This group includes speech disorders due to the selective immaturity of the analysis of phonemes according to their acoustic parameters. The main violation in this case is insufficient sound perception, which is intended for recognition and differentiation by species. The sound that the child hears is recognized incorrectly by him, and therefore, he also pronounces it incorrectly.

It is important to know that with this type there are no hearing problems. The defect is selective for certain phonemes. Acoustic-phonemic dyslalia should not be confused with severe speech disorders.

Articulatory-phonemic

This group includes defects associated with the immaturity of operations for selecting phonemes according to their articulatory characteristics. There are two types of violations. In the first case, the articulatory base is not fully formed. Instead of the sound needed in this case, the child chooses a sound close to it in its articulatory characteristics.

The second option is characterized by the complete formation of the articulatory base. The child knows all the phonemes that are required for correct pronunciation, but when pronouncing words, some letters are replaced by others according to the principle of substitution. These substitutions occur according to the principle of articulatory proximity of phonemes - “rat” - “roof”.

Articulatory-phonemic

Characterized by defects in the sound design of speech due to improperly formed articulatory positions. Sounds can be pronounced in a distorted form, but this happens in unusual ways. This kind of speech is easy to understand.

Heaviness

Depending on the number of sounds that are pronounced incorrectly, dyslalia can be simple or complex. With a simple type, 1-4 sounds are impaired, with a complex type, more than four sounds are impaired.

Monomorphic type

It is difficult to pronounce one of the groups, for example, only voiced or only hissing.

Polymorphic

Sounds with which there are difficulties belong to different groups. Phonetic defects are designated by terms that are derived from the Greek alphabet:

• rhotacism – problems with the letter “P” and P is soft;
• lambdacism - “L” and “L soft”;
• sigmatism – the pronunciation of hissing sounds (zh, sh, shch, h) and whistling sounds (s, z) is impaired;
• iotacism – difficulties with “Y”;
• gammacism - “G” and “G soft”;
• kappacism - “K”, “K soft”;
• hittism – “X”;
• difficulties with voicing and deafening - replacing voiced consonants with voiceless ones and vice versa;
• softening and hardness defects - replacement of soft with hard ones or vice versa.

There may be complex forms that are combined in nature - the addition of several defects to each other. If there is a phonemic defect, that is, a sound replacement, the prefix “pair” is added to the name of the defect. This is how paralambdacism, parasigmatism and others are formed.

How to treat dyslalia and get rid of tongue-tiedness?

At the first consultation, the doctor will tell you how to treat dyslalia in Saratov in preschoolers and schoolchildren, how to cure dyslalia in Russia in children of preschool and school age, how to get rid of tongue-tiedness , what is articulatory phonemic, articulatory phonemic and phonetic, motor and sensory, mechanical, monomorphic, phonemic, simple, complex dyslalia in preschool children. How is prevention, correction of dyslalia , speech therapy examination of children with dyslalia carried out? Does speech therapy psycho-correctional pedagogical communication work help? How does sound pronunciation suffer with dyslalia? Why is polymorphic dyslalia dangerous, what is cheiloplasty, uranoplasty? What is the etiology and causes of dyslalia, differential diagnosis, exercises, gymnastics, literature, conclusion? What is rhinolalia, dysarthria, FNR, FFN, speech card? What is the prevention of dyslalia ? Sarklinik knows how to treat dyslalia in children in Russia.

Sarclinic provides treatment for aphonia, dysphonia, bradylalia, treatment of stuttering, tachylalia, open and closed rhinolalia, dyslalia, treatment of alalia, dysarthria, treatment of aphasia, nasalization, treatment of speech delay, dysgraphia, treatment of general speech underdevelopment, hyperkinesis, synkenesia, treatment of speech development disorders, SPD, delays in speech and psycho-speech development, dyslexia in children and adolescents in Saratov.

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Text: ® Sarclinic.com \ Ssrlinic.ru Photo: (©) (©) Gekaskr | Dreamstime.com \ Dreamstock.ru The children depicted in the photo are models, do not suffer from the diseases described and/or all coincidences are excluded.

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Forms of dyslalia

There are two forms of dyslalia - functional and organic or mechanical. If the child does not have organic disorders caused by the peripheral or central nervous system, we can talk about functional dyslalia.

This type appears in childhood, when the correct pronunciation of sounds is learned. Mechanical speech can appear at any age due to disturbances in the peripheral speech apparatus.

Functional dyslalia includes defects in the pronunciation of sounds - phonemes, without mechanical articulation disorders. Its causes are: physical weakness due to somatic diseases;

• delayed psychological development (minor disturbances in brain activity);
• delays in speech development;
• disorders associated with phonetic perception;
• social environment (incorrect speech of adults, insufficient communication with other children and adults, insufficient attention to raising the child).

All these reasons are not critical and can be eliminated by the work of qualified psychologists, speech therapists and other child development specialists.

Pathogenesis of dyslalia

The reasons vary for different types. Accordingly, the correction required is different.

Physiological prerequisites for mechanical dyslalia

The mechanical type is caused by physiological and anatomical defects. They do not make it possible to pronounce sounds correctly, the sound that they heard. This usually occurs due to dental defects - bite, incorrect shape and location of incisors, underdeveloped jaws. Doctors consider the main reasons:

• the frenulum of the tongue is too short;
• structural features of the bones of the jaw and face;
• palate defects;
• pathology of the upper lip;

To get rid of mechanical dyslalia, a dentist and an orthodontist are needed. The child must undergo a special correction course. The best results are achieved at the age of 5-6 years.

Causes of mechanical dyslalia

The causes of mechanical dyslalia can be anomalies in the structure of any part of the speech apparatus: the dental system, tongue, lips, various injuries, fractures, muscle tears, tissue scarring.

It is customary to distinguish 3 groups of reasons:

• Defects of the dental system: incorrect positioning of teeth or their absence, malocclusion, jaw defects. These anomalies can be hereditary, acquired during fetal development or as a result of injury, bad habits, or diseases.
• Defects of the hard or soft palate: high or flat arch, absence or splitting of a small uvula.
• Defects in the structure of the tongue and lips: short sublingual ligament, enlarged or shortened tongue, thin or thick lips. Acquired defects include injuries, scarring as a result of mistakes made during surgical or dental procedures.

Sometimes defects are a consequence of birth injuries, rickets and artificial feeding.

Prerequisites for functional dyslalia

This type develops due to the abnormal mental or physical state of the child. Often this diagnosis is made to children experiencing problems with mental development. In this case, the structure of the speech apparatus does not suffer, hearing is normal, and the innervation of the muscles responsible for articulation is not impaired. In children with the speech problem under consideration, the structure of the peripheral speech apparatus is normal, the innervation of the articulatory muscles is not impaired. There are two types of factors that cause this type of dyslalia.

Biological background

This group of factors includes:

• delayed psycho-speech development;
• somatic diseases;
• infectious diseases suffered during the period of active speech development;
• chronic diseases;
• hypovitaminosis;
• nutritional disorders (dystrophy).

These disorders affect neurodynamics, which is responsible for the differentiation of the speech-hearing apparatus and the speech-motor analyzer. With this manifestation, articulatory movements are not accurate enough, and speech kinesthesia may be observed.

Social preconditions

This group of factors includes:

• improper speech education;
• parents copying babbling words;
• consolidation in speech of incorrect sound pronunciation on the part of adults (burr, lisp, dialect).

During the period of speech development, a child may find himself in a bilingual environment, which can also lead to the development of dyslalia. In this case, the pronunciation rules of one language apply to the other.

Pathogenesis

Functional dyslalia is associated with an imbalance and weak dynamics of the nervous processes occurring in the child’s brain. The cortical areas do not have pronounced pathologies, but there is insufficient coordination between speech excitation and inhibition. The nature of the speech disorder is determined by the localization of the neurodynamic disorder in the subcortical region of the brain. If the entire speech department is affected, motor failure occurs, the pronunciation of individual phonemes suffers, and, secondarily, speech hearing.

If the localization is in the sensory zone (Wernicke's center), defects in sound perception primarily appear, which leads to expressive speech. This is how phonemes are mixed and replaced.

Social prerequisites for functional dyslalia

Social preconditions are those associated with adults. These include:

• parents may lisp;
• parents often make mistakes in their speech;
• being in a bilingual environment;
• they do not study enough and pay little attention to it (pedagogical neglect);
• reduced differentiation of hissing and whistling sounds;
• delays in mental development.

All these reasons can be eliminated if appropriate correctional work is carried out by speech therapists, psychologists, and parents.

Features of the course of complex dyslalia

The more complex the combination of disorders, the more difficult it is to cope with it. Accordingly, this affects the general background of the disease. In complex forms, mental and general developmental delays may be observed. It is necessary to engage in in-depth research of the child in the aspect of his psyche, intellectual development, hearing, and vision. Complex dyslalia may be a signal that there are problems with them. People who are hard of hearing often distort or change the “T” sound.

A child with second or third degree hearing loss does not have a metallic tone in his voice. The voice has softness or, in other words, viscosity. Children with vision problems may have dyslalia defects corresponding to its complex types. This is caused by poor visual control. In such patients, sigmatism is observed 4 times more often than in healthy children.

Diagnosis of dyslalia by the nature of speech impairment

Diagnosis of dyslalia begins with finding out all the features of the course of pregnancy, childbirth, and illnesses the mother suffered during this period. What matters are the child’s illnesses that he suffered at an early age and his psychomotor development. Other factors also influence the diagnosis:

• features of speech development at an early age;
• hearing;
• vision;
• condition of the musculoskeletal system.

In order for the specialist to have a complete understanding of this, it is recommended to show all available medical documentation. After identifying these factors, the speech therapist proceeds to examine his patient. He examines the articulatory apparatus and determines their mobility. This happens through special exercises and tasks that the child must complete.

The diagnosis of dyslalia includes analysis of sound pronunciation, determination of speech defects, their nature, depth, and degree of complexity. Particular attention is paid to phonetic hearing - the ability to differentiate sounds into groups. The speech therapist’s conclusion indicates the form of dyslalia, the type (articulatory-phonemic, acoustic-phonemic, articulatory-phonetic), and the type of sound pronunciation (rhotacism, sigmatism, etc.).

If you have mechanical dyslalia, consultation with a dentist and orthodontist is required. For functional – a neurologist and analysis on his part. Diagnostics by an otolaryngologist will also be required to examine the hearing aid. The main goal is to accurately determine the child’s condition and the level of development of his speech apparatus. Correct diagnosis is necessary for accurate and correctly selected correction.

Differential diagnosis of erased dysarthria and dyslalia

There are common symptoms of two speech disorders, which can mislead a specialist when making a diagnosis. The table below presents the main characteristic features that will help differentiate erased dysarthria and dyslalia.

Diagnostics

A speech therapist examines the structure and mobility of the organs of the articulatory apparatus through visual inspection and using special test exercises.

In the process of a speech therapy examination, the nature of the disorder is revealed, namely the absence, replacement, mixing and distortion of sounds in various positions - in isolation, in open, closed or consonant syllables, words at the beginning, middle or end, as well as phrases and texts.

Then the state of phonemic hearing is checked - the ability to auditory differentiate all correlating phonemes.

For mechanical dyslalia, a speech therapist can refer the patient for consultation to an orthodontist or dental surgeon, and for functional dyslalia, to a neurologist.

If hearing loss is suspected, a consultation with an otolaryngologist and a study of the function of the auditory analyzer is carried out.

Prevalence of the problem

Dyslalia is a common problem. There are different estimates on this matter, on average, the number of children suffering from this speech disorder is about 25-30% in preschool age. As you get older, this number decreases. At primary school age this percentage drops to 17-20%. At older ages there are only 1-2% of such children.

The disease is a common occurrence, most common in the practice of speech therapists. According to various estimates, the average number of children with such problems in preschool age is 25-30%, in elementary grades – 17-20%, and in older age – 1%.

More often in the practice of speech therapists there are combined articulation disorders that create a barrier to the development of writing. Children, at the same time, have an extensive vocabulary, the structure of speech is not disturbed. All grammatical laws are observed - cases, declensions, endings.

Diagnosis of dyslalia, dyslalia examination, research

What is the diagnosis of dyslalia ? The examination reveals the level of sound analysis, features of sound pronunciation, state and mobility of the articulatory apparatus, state of hearing, state of vision, features of psycho-speech development, volume and structure of speech, vocabulary, features of grammar, writing, reading, memory, auditory writing, mental development of the child, development of visual perception and gnosis, analysis and synthesis, speech therapy examination .

Methods for correcting dyslalia

Speech therapy correction, depending on the severity of dyslalia, consists of several stages. The duration can take one to six months. Correction stages:

• Preparatory work with the reproduction of phonemes. Here they practice various breathing techniques, phonetic hearing, and work with reference sounds.
• Staging impaired sounds, forming correct articulation. Special tools can be used for this. The result of the work is the pronunciation of sounds without the help of adults.
• Consolidation of the obtained results. First, in individual syllables, and then in words and sentences.

• Differentiation. The patient learns to distinguish and correctly speak the sounds that he himself pronounces.

All methods are aimed at identifying sounds, the ability to distinguish them, improve memory, and develop communication skills.

Preparatory stage

The child must be involved in the speech therapy process. The speech therapist establishes contact and trusting relationships with the child, giving the child time to adapt to new conditions. Also at this stage are:

• development of attention;
• memory;
• thought process;

Staging

The correct sounds are set and the child’s articulation is formed using special materials and exercises. At this stage, sounds differentiation skills are developed. There are three ways to do this:

• First way. The child himself makes conscious attempts to establish correct articulation. An adult should simply help him with this. Tactile, visual, and acoustic exercises can be used.
• Second way. External mechanical influence on the child and his articulatory apparatus. The speech therapist should ask you to repeat the sound several times, and then use probes to place this sound correctly. In the future, improve pronunciation without using a tool.
• The third method is a combination of the first two.

Each of these stages has a varying degree of difficulty and is selected by a speech therapist.

Exercises to eliminate mechanical dyslalia

With this type of dyslalia, the child's speech passes through the teeth. He cannot move his lower jaw, in particular, open his mouth wide. The problem lies in the incorrect forcing of the articulatory apparatus - facial muscles, bite and others. They can be developed with special exercises. They need to be done together with adults, sitting in front of the mirror and observing his (the child’s) actions, controlling and correcting him.

You should start by opening and closing your mouth, gradually increasing the gap between the jaws. A set of exercises is selected directly by the speech therapist for a specific case. There are basic exercises that are used in most cases:

• Smile. The lips should be in a smiling position. The front teeth should be visible and remain in this position for 10 seconds.
• Tube. The teeth are pressed tightly, the lips are pulled forward, taking the shape of a tube, also for 10 seconds.
• Alternate “smile” and “pipe” at least 10 times.
• Funnel. The teeth should be open, the lips should be pulled forward. On the count of “two,” they pull into their mouth, tucking themselves in behind their teeth. Repeat 10 times.
• Timpani. Lips go behind teeth. They need to clap, making the appropriate sound.
• Horse. You need to relax your lips and make movements with them that imitate the snorting of a horse.
• Bolt. Clenched teeth, lower lip should move left and right.
• Hide and seek. Hide your lower lip behind your upper teeth. Only the lip should be visible. Hold this position for 5 seconds. Do the same exercise with the lower lip and alternate them 10 times each.

Speech therapy technique for dyslalia

Zhigmitdorzhieva Galina Viktorovna

Speech therapy technique for dyslalia

The main goal of speech therapy for dyslalia is the formation of skills and abilities to correctly reproduce speech sounds. In order to correctly reproduce speech sounds (phonemes), a child must be able to: recognize the sounds of speech and not confuse them in perception (i.e., recognize a sound by acoustic characteristics; distinguish a normalized pronunciation of a sound from a non-standardized one; exercise auditory control over his own pronunciation and evaluate the quality of the reproduced sounds in one’s own speech; take the necessary articulatory positions that ensure the normalized acoustic effect of the sound; vary the articulatory patterns of sounds depending on their compatibility with other sounds in the flow of speech; accurately use the desired sound in all types of speech.

Speech therapy classes are held regularly, at least 3 times a week. Home activities are required with the help of parents (as directed by a speech therapist )

.
They should be carried out daily in the form of short-term exercises (from 5 to 15 minutes)
2 - 3 times during the day.

To overcome pronunciation defects, didactic material is widely used.

In the case of simple dyslalia, classes last from 1 to 3 months, in case of complex dyslalia, from 3 to 6 months.

Speech therapy intervention is carried out in stages, while at each stage a specific pedagogical task is solved, subordinated to a common goal.

STAGES OF Speech Therapy Treatment

Based on the purpose and objectives of speech therapy , it seems justified to highlight the following stages of work: preparatory stage; stage of formation of primary pronunciation skills; stage of formation of communication skills.

/. Preparatory stage

Its main goal is to include the child in a targeted speech therapy process . To do this, it is necessary to solve a number of general pedagogical and special speech therapy problems .

One of the important general pedagogical tasks is the formation of an attitude towards classes: the speech therapist must establish a trusting relationship with the child, win him over, adapt him to the environment of the speech therapy room , arouse his interest in classes and the desire to get involved in them. Children often experience stiffness, shyness, isolation, and sometimes fear of meeting unfamiliar peers and adults. The speech therapist is required to be especially tactful and friendly; Communication with the child should be carried out without formality and excessive severity.

An important task is the formation of voluntary forms of activity and awareness of the attitude towards classes. The child must learn the rules of behavior in class, learn to follow the instructions of the speech therapist , and actively participate in communication.

The tasks of the preparatory stage include the development of voluntary attention, memory, mental operations, especially analytical operations, comparison and inference operations.

Special speech therapy tasks include : the ability to recognize (recognize)

and distinguish phonemes and the formation of articulatory
(speech motor)
skills.

Depending on the form of dyslalia, these tasks can be solved in parallel or sequentially. For articulatory forms (phonemic or phonetic)

in cases where there are no disturbances in perception, they are solved in parallel.
The formation of receptive skills can be reduced to the development of conscious sound analysis and control over one’s own pronunciation. With the acoustic-phonemic form of dyslalia, the main task is to teach children to distinguish and recognize phonemes based on intact functions.
Without solving this problem, you cannot move on to forming the correct pronunciation of sounds. For work on the correct pronunciation of a sound to be successful, the child must be able to hear it, since the regulator of normal use is hearing. In mixed and combined forms of dyslalia, work on the development of receptive skills precedes the formation of the articulatory base. But in case of gross violations of phonemic perception, it is also carried out in the process of forming articulatory skills.

Work on the formation of the perception of speech sounds is based on the nature of the defect. In some cases, work is aimed at the formation of phonemic perception and the development of auditory control. In others, its task includes the development of phonemic perception and sound analysis operations. Thirdly, it is limited to the formation of auditory control as a conscious action.

In this case, the following provisions must be taken into account.

The ability to recognize and distinguish speech sounds as conscious. This requires the child to restructure his attitude towards his own speech, directing his attention to the external, sound side, which he was not previously aware of. The child needs to be specially taught the operations of conscious sound analysis, without relying on the fact that he will spontaneously master them.

The initial units of speech must be words, since sounds - phonemes exist only as part of a word, from which they are isolated during analysis through a special operation. Only then can they be operated as independent units and observed as part of syllable chains and in isolated pronunciation.

Operations of sound analysis, on the basis of which the skills and abilities of conscious recognition and differentiation of phonemes are formed, are carried out at the beginning of work on material with sounds correctly pronounced by the child. After the child learns to recognize this or that sound in a word, determine its place among other sounds, and distinguish one from another, you can move on to other types of operations, relying on the skills developed in the process of working on correctly pronounced sounds.

Work on developing the perception of incorrectly pronounced sounds must be carried out in such a way that the child’s own incorrect pronunciation does not interfere with him. To do this, at the time of performing sound analysis operations, you need to exclude your own pronunciation, transferring the entire load to the auditory perception of the material.

It is advisable to include the child’s pronunciation in subsequent lessons, when there is a need to compare his own pronunciation with the standardized one.

With phonemic dyslalia, it is necessary to form the missing movements of the organs of articulation; make a correction to an incorrectly formed movement. In cases where the sound is distorted due to disturbances in the method or place of its formation, a combination of both techniques is necessary.

The formation of the articulatory base of sounds with functional dyslalia occurs in a shorter time than with mechanical dyslalia . Before forming the articulatory structure in case of mechanical dyslalia , it is necessary to carry out work that would help determine the position of the articulation organs in which the sound will be closest to the acoustic effect of normalized sound.

To form an articulatory base, types of exercises, didactic requirements and methodological recommendations , and guides for correcting pronunciation have been developed.

With dyslalia there are no gross motor disorders. A child with dyslalia has not developed some speech-specific voluntary movements of the organs of articulation. The process of formation of articulatory movements is carried out as voluntary and conscious: the child learns to produce them and control the correct execution. The necessary movements are first formed by visual imitation: a speech therapist in front of a mirror shows the child the correct articulation of sound , explains what movements should be made, invites him to repeat. As a result of several tests, accompanied by visual control, the child achieves the desired position. If there are difficulties, the speech therapist helps the child with a spatula or probe. In subsequent classes, you can offer to perform the movement according to verbal instructions without relying on a visual model. The child then checks the correctness of execution based on kinesthetic sensations. Articulation is considered mastered if it is performed accurately and does not require visual control.

When working on developing correct pronunciation, it is necessary to avoid mentioning the sound that is being worked on.

As the child completes the task, the speech therapist To do this, he asks the child to exhale ( “blow strongly”

without changing posture.
When you exhale forcefully, an intense noise occurs. If the noise corresponds to the acoustic effect of the desired voiceless consonant, then the pose is taken correctly. If not, then the speech therapist asks the child to slightly change the position of the articulation organs (raise, lower, advance the tongue a little)
and blow again. The search for the most successful position is carried out until a positive result is obtained.

In some cases, listening to the noise produced, the child identifies it with a normalized sound and even tries to independently incorporate it into speech.

Since this does not always lead to positive results, the speech therapist should in such cases divert attention from the sound by switching to another object.

With dyslalia, there is no need for an abundance of exercises for the organs of articulation; those that will result in the formation of the necessary movements are sufficient. Work is being carried out on individual speech movements that have not been formed in the child during development.

Requirements that must be made for articulation exercises:

Develop the ability to take the required pose, hold it, and smoothly switch from one articulatory pose to another.

The system of exercises for the development of articulatory motor skills should include both static exercises and exercises aimed at developing dynamic coordination of speech movements.

Exercises are necessary to combine movements of the tongue and lips, since when pronouncing sounds, these organs are involved in joint actions, mutually adapting to each other (this phenomenon is called coarticulation)

.

Classes should be held briefly, but repeatedly, so that the child does not get tired. During pauses, you can switch it to another type of work.

Pay attention to the formation of kinesthetic sensations, kinesthetic analysis and ideas.

As the speech therapist he moves on to practicing the movements required for other sounds.

Types of articulation exercises

Lip exercises

1. The corners of the mouth are slightly retracted, the front teeth are visible, the range of movement is as when articulating sound and.

2. The lips are neutral, as when pronouncing a.

3. Lips are rounded, as with o, with y.

Alternating movements from a to i, from a to y back.

Smooth transition from i to a, from o to o, from o to y and back.

Articulation of a series with a smooth transition: i - a - o - y and in reverse order.

At the moment of articulation, you can include pronunciation. During the exercises, the speech therapist in front of the mirror explains to the child what position the lips are in when pronouncing this or that sound.

Tongue exercises

Place the tip of the tongue against the lower incisors with the corners of the mouth drawn back. The back of the tongue is curved towards the upper incisors. The position of the corners of the mouth and jaw is not fixed in the child’s mind as an articulatory position: this position is only necessary to facilitate visual control.

The lateral edges of the tongue are raised, forming a round slit necessary for pronouncing whistling sounds; this pose is called “tongue groove”

or
“tube tongue”
.
To make it easier for the child to perform the exercise, you can offer to stick out the spread tongue between the teeth, then round the lips and thus bend the side edges of the tongue. You can use a round probe ( “knitting needle”)
, press it on the base of the tongue
(along the midline)
and ask the child to round his lips.

The tongue is raised to the alveoli, the lateral edges are pressed against the molars (upper)

teeth. The tongue seems to stick to the Articulation of the row with a smooth transition: and - a - o - y and in the reverse order.

At the moment of articulation, you can include pronunciation. During the exercises, the speech therapist in front of the mirror explains to the child what position the lips are in when pronouncing this or that sound.

Consecutive alternation of upper and lower positions of the tongue: the tongue is raised, pressed tightly (sucked)

to the upper jaw, after which it is sharply retracted to the lower position.
At the moment the tongue is lifted, a clicking sound is made, the exercise is called “clicking”
,
“playing horses”
.

When performing the exercise, the speech therapist draws the child’s attention to the lowered, motionless lower jaw.

The tip and anterior part of the back of the tongue are raised to the alveoli ( “spoon tongue”

, or
"cup"
). The exercise is intended for pronouncing sounds, during the articulation of which the middle part of the back of the tongue bends, and the front part and root of the tongue are slightly raised.

Rhythmic movements of the tongue left and right, the tip of the tongue touches the upper alveoli or passes along the border between the upper incisors and alveoli.

Joint movements of the tongue and lips: the tip of the tongue rests on the lower incisors, the lips make a smooth transition from one articulatory pose to another, the teeth are slightly apart. Particular attention is paid to the combination of the position of the tongue with the position of the lips for sound and; the tip of the tongue is in the upper position, the lips make a smooth transition from one articulatory pose to another. Attention is drawn to the combination of the upper position of the tip and the front part of the back of the tongue with the position of the lips for labialized vowels (o and u)

.

//. Stage of formation of primary pronunciation skills

The goal of this stage is to form in the child the initial skills of correctly pronouncing a sound on specially selected speech material. Specific tasks are: setting sounds, developing skills for their correct use in speech (automation of skills, as well as the ability to select sounds without mixing them between by yourself (differentiate sounds)

.

The need to solve these problems in the process of speech therapy work follows from the laws of ontogenetic mastery of the pronunciation aspect of speech.

A number of studies have shown that from the moment a child appears a particular sound, i.e., its first correct pronunciation, until its inclusion in speech, a rather long period of time passes. A. N. Gvozdev called it the period of mastery of sound. It lasts 30-45 days or more and has its own characteristics. At first, the new sound is used in parallel with the old one, which was its substitute (substitute), while the old sound is used more often than the new one. Subsequently, the new sound begins to be used more often than its former substitute, and after a while it displaces the substitute in all positions and is used even in in those cases when the latter acts in its own function, i.e. it completely displaces it from speech, and only after that the process of delineation (differentiation)

a new sound and one that acted as a substitute.

Sound production is achieved by using technical techniques described in detail in specialized literature. In the works of F. F. Pay, three methods are distinguished: by imitation (imitative, with mechanical assistance and mixed.

The first method is based on the child’s conscious attempts to find articulation that allows him to pronounce a sound that corresponds to what he heard from the speech therapist . At the same time, in addition to acoustic supports, the child uses visual, tactile and muscle sensations. Imitation is supplemented by the speech therapist’s of what position the articulatory organ should take. In cases where the articulatory positions necessary for a given sound have been developed, it is enough to remember them. You can use the technique of gradually feeling for the desired articulation. The search often leads to positive results when producing hissing sounds, paired voiced sounds, as well as paired soft ones. Some sounds, for example, sonorant r and r', as well as l, affricates ch and c, back-lingual k, g, x, are more successfully placed in other ways.

The second method is based on external, mechanical influence on the organs of articulation with special probes or spatulas. The speech therapist asks the child to pronounce a sound, repeat it several times, and during repetition, he uses a probe to slightly change the articulatory pattern of the sound. The result is a different sound: for example, the child pronounces the syllable sa several times, the speech therapist places a spatula or probe under the tongue and slightly lifts it in the direction of the upper alveoli, a hissing rather than a whistling sound is heard. With this method, the child himself does not search; his organs of articulation only obey the actions of the speech therapist . After long training, he takes the necessary position without mechanical assistance, helping himself with a spatula or finger.

The third method is based on the combination of the previous two. The leading role in it is played by imitation and explanation. Mechanical assistance is used in addition: the speech therapist explains to the child what needs to be done to get the desired sound, for example, raising the tip of the tongue (in cases where this movement is not performed by the child exactly as needed for normalized sound). With this method, the child turns out to be active, and the posture he acquired with the help of a speech therapist is recorded in his memory and is easily reproduced in the future without mechanical assistance.

Staging sound (if it is distorted)

is carried out based on normally pronounced sounds, the articulatory structure of which has common features with impaired sound.
This takes into account their articulatory “kinship”
, which may not be the same in different groups of sounds.
Thus, when working on voiced consonants, they rely on their voiceless paired sounds, and the task of speech therapy work comes down to supplementing the general articulatory posture with the work of the vocal apparatus.
When working on posterior lingual plosives, the root part of the tongue is included in the work, and the position of the anterior lingual plosive is taken as the starting point and from there the transition to posterior lingual articulation is made. When establishing a language as its initial basis, one should turn not to an isolated preserved sound, but to a sound in a syllabic combination , since a syllable is a natural form of sound for its implementation in speech. The sound is not placed sh, then included in the syllabic environment , but the sound is immediately placed as part of the word sha. This provision is very important due to the fact that when producing an isolated sound, the transition to a syllable is often difficult. It is necessary to provide for possible dynamic changes in the articulation of the same phoneme in different sound environments. This can be achieved without much difficulty, since the schemes (programs)

combinations of sounds in a child with
dyslalia are not impaired .
He can easily introduce a new sound into these circuits by analogy with the basic sounds already included in them. The starting points for producing hard sounds should be the sounds in the syllable with the vowel a, and for soft sounds the sounds in the syllable with the vowel i should be taken. In further work, consonants are added in positions before the remaining vowels. In this case, attention is paid to labialized vowels, since before them many consonants undergo significant articulatory changes. As the sound is placed in one of the syllabic positions , work is underway to automate the sound and incorporate it into speech.

The process of sound automation consists of training exercises with specially selected words that are simple in phonetic composition and do not contain broken sounds. For training, words are selected in which the sound is at the beginning, end or middle. First of all, the sound is practiced at the beginning (before the vowel), then at the end (if the sound is dull)

and lastly - in the middle, since this position turns out to be the most difficult.
From practicing the sound in words of a simple syllabic structure, they move on to pronouncing the sound in words containing a combination of the sound being practiced with consonants (these consonants must be previously formed in the child or sufficiently strengthened). To automate sound, they use the techniques of reflected repetition, independent naming of words from a picture. Useful tasks that direct the child to search for words containing a given sound (inventing words with a given sound)
. Work on sound analysis and synthesis brings great help. You should not limit yourself to just training sounds in words; you need to introduce creative exercises, games, and move from pronouncing individual words to constructing phrases with them and short statements.

Automation work usually involves one sound. In cases of complex dyslalia , two sounds may be involved if they are articulatory contrast; otherwise interference may occur.

When a child has a violation of the contrast between deafness and voicedness of sounds, then all voiced sounds can be included in the process of automation at the same time. If a child experiences difficulties, then the voiced fricatives are practiced first, then the voiceless fricatives.

It often turns out that already in the process of automation, the child begins to freely include the delivered sound in spontaneous speech. If he does not mix it with others, then there is no need for subsequent work on it. In speech therapy practice, there are cases when further continuation of work on sound is required, in particular on its differentiation from other sounds, i.e. differentiation.

The child is presented aurally in pairs with words containing a new sound, as well as a sound that was previously its substitute, or words containing sounds that the child mixes in his pronunciation. Having recognized the presented word, the child names the sound heard in it and reproduces it in the same word. Training in the pronunciation of paronymic words is useful, and it is important to include each of the words in a minimal context. Work is being done to classify words: select pictures whose names contain the sound s, then select those that contain the sound w; arrange the pictures into groups: On the left are pictures following the sound s, and on the right - w. Exercises for independent selection of words containing one or another sound, as well as words that contain both mixed sounds, are useful. Written language is used with school-age children: reading words with differentiated sounds, finding them in the text, correct pronunciation, writing, analysis (preceding or accompanying entry)

. Work on the differentiation of sounds helps to normalize the operation of their selection.

When working on sound differentiation, no more than a couple of sounds are connected at a time. If more sounds of one articulatory group are needed, they are still combined in pairs. For example, when mixing ts, ch, shch, the sounds are combined into pairs: ts - ch, ch - shch, ts - shch. This is explained by the fact that the differentiation process is based on comparison operations, which are carried out most successfully by children.

///. Stage of formation of communication skills

Its goal is to develop in the child the skills and abilities to accurately use speech sounds in all communication situations.

In classes, texts are widely used, rather than individual words, various forms and types of speech are used, creative exercises are used, and material rich in certain sounds is selected. This kind of material is more suitable for classes on sound automation. But if at this stage the child works only on specially selected material, then he will not master the selection operation, since the frequency of this sound in special texts exceeds their normal distribution in natural speech. And the child must learn to operate with them.

New technologies in the correction of dyslalia

The connection between speech therapy and orthodontology has been established for a long time, this is especially true for mechanical dyslalia. In this area, there are modern solutions to problems that lead to such speech disorders. Such an example is myofunctional containers, vestibular plates. Containers appeared not so long ago, and their effect on speech became known only recently - about four years ago. Mechanical dyslalia is caused by malocclusion and abnormalities in the dentofacial apparatus; a speech therapist cannot influence, much less eliminate, this problem.

In 2008, studies were conducted using myofunctional correction tools. These are trainers made of silicone. The results showed that 100% of children regained breathing through their nose, and 99% normalized their speech disorders. Based on this work, it was concluded that the preorthodontic trainer has proven its clinical effectiveness in practice and can be used to correct breathing and occlusion in a child.

Complications

Complications of mechanical dyslalia include difficulties with socialization in childhood, which leads to inability to build relationships in the future.

Burr and nasality can cause ridicule from peers, and this is very painful for children. Psychological trauma underlies subsequent nervousness and complexes.

Mechanical dyslalia at school age causes difficulties with reading and writing, which, combined with psychological discomfort and self-doubt, lead to academic failure, refusal to learn, antisocial behavior and social maladjustment.

Measures to prevent dyslalia

The main preventive measures are:

• For full speech development and the formation of the articulatory apparatus, the child must receive solid food.
• Speech disorders occur in children who receive only soft foods more often than in others.
• It is necessary to develop the child's fine motor skills.
• Identify existing speech disorders and begin to eliminate them.

Attention to the child’s speech problems and adequate correction will help avoid negative consequences and eliminate all problems in a timely manner.

Correction and elimination of dyslalia

Methods for eliminating dyslalia depend on the form and type of disorder and include:

• work aimed at eliminating anatomical defects (with mechanical dyslalia);
• articulation gymnastics;
• speech therapy massage;
• individual lessons with a speech therapist.

Specialists at the First Children's Medical Center determine the treatment method individually for each little patient. All classes with a speech therapist are aimed at developing the baby’s speech motor skills, as well as the development of phonemic processes.

Please note that speech therapy sessions for the correction of dyslalia should be conducted on a regular basis. In addition, to achieve a positive result, it is important to complete the speech therapist’s tasks at home and do articulatory gymnastics.

By contacting our Center, you will receive qualified help from a speech therapist who will pay special attention to your child and give answers to all your questions. We are happy to help you! First Children's Medical Center: Children's health - parents' peace of mind!

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