Speech therapy massage with probes: indications, preparation and implementation

Indications for testing

Severe speech disorders are often accompanied by problems with the nervous system. With dysarthria, the parts of the brain responsible for the innervation of muscles are affected. With this pathology, children cannot switch articulatory postures or feel subtle movements of the tongue and lips.

The leading defect is a violation of the phonemic aspect. Child says:

indistinct;
distorting sounds;
unimpressive.

Vocabulary and grammar do not always suffer. When pronouncing a sound, the tongue deviates to the side or is limited in its movements. The tip protrudes between the teeth, that is, interdental pronunciation appears.

In case of severe disorders, asymmetry of the lips and a tense, balled tongue are noticeable (or it may be sluggish and relaxed). The erased form of dysarthria is difficult to determine, since only the pronunciation of 1-2 groups of sounds suffers.

Without probe massage it will not be possible to correct any form of dysarthria. Without it, producing sounds will take several years, and in most cases the result will be zero.

The use of massage probes to correct dyslalia is controversial. If there is a violation, only the pronunciation side of speech suffers. Massage strengthens the muscles of the articulatory apparatus, prepares them, and speeds up sound production. Some speech therapists are of the opinion that this is unnecessary.

With dyslalia, the hyoid ligament may be shortened. It limits the mobility of the tongue, a number of sounds are disrupted (sonoras, hissing). It is advisable to surgically trim it, but not all parents agree to this. Therefore, the frenulum is stretched with a probe; with a mild degree of the defect, its elasticity can be significantly improved.

Speech therapy probe massage is prescribed for alalia. With this problem, certain areas of the cerebral cortex are affected. The child has normal physical hearing, but at 4 years old he does not speak. In the motor form, the baby understands spoken speech, but uses gestures himself.

Massage stimulates the flow of signals into the brain, which promotes the development of the affected areas. After the course of treatment, onomatopoeia appears.

The cause of rhinolalia is defects in the structure of the speech apparatus (cleft lip, gums, palate). After the operation, scars remain that interfere with the mobility of organs. Probes are used to knead the seams and stimulate muscle function.

Dyakova recommends probe massage to correct stuttering. The defect is based on seizures of various origins. Due to muscle tension, it is difficult for a person to say something. Massage is used for relaxation.

The importance of speech development

As the child grows up, he develops speech abilities, learns to construct logical chains and complex sentences. Speech defects adversely affect overall development. In this case, the following are reduced:

thought processes;
functioning of the central nervous system;
writing and reading abilities;
perception of incoming information;
the ability to clearly express thoughts.

Massage of the tongue and other speech organs will help your baby adapt to the world around him and correct pronunciation defects.

General recommendations for conducting

The duration of the course is calculated individually. On average, 10 procedures performed every other day are sufficient. Between cycles there is a break of a month. Some speech therapists prefer to include massage before each session.

The duration of the procedure depends on:

from age;
degree of defect;
personal characteristics.

The minimum time is 5 minutes, the maximum is 25. The impact should not cause pain, slight discomfort is allowed. Children may be afraid of probes because they resemble medical instruments. You can let them touch them, play with them, or have a session with toys.

In case of negativism, hysterics, aggression, the first sessions are kept as short as possible. Start by stroking the lips, cheeks, and tip of the tongue. With a pronounced gag reflex, the effect begins with a light one, gradually moving deeper into the mouth.

Massage sessions are carried out in a well-ventilated area. It should be warm, bright, cozy.

Instructions for processing speech therapy probe substitutes; methodological development

Instructions for processing speech therapy probe substitutes

This instruction has been developed based on instructional and methodological documents regulating disinfection and sterilization activities in dental institutions:

1. OST 42-21-2-85 “Sterilization and disinfection of medical devices. Methods, means, modes";

2. Order of the USSR Ministry of Health dated July 12, 1989 No. 408 “On measures to reduce the incidence of viral hepatitis in the country”;

3. Order of the USSR Ministry of Health dated September 3, 1991 No. 254 “On the development of disinfection in the country”;

4. Order of the Ministry of Health of Russia dated August 18, 1997 No. 170 “On measures to improve the prevention and treatment of HIV infection in the Russian Federation”;

5. Guidelines for disinfection, pre-sterilization cleaning and sterilization of medical devices (MU-287-113 dated December 30, 1998), approved by the Department of State Sanitary and Epidemiological Monitoring of the Ministry of Health of Russia;

6. “Concept for the prevention of nosocomial infections”, approved by the Deputy Minister of Health of the Russian Federation G.A. Onishchenko. 06.12.1999;

7. Guide “Use of ultraviolet bactericidal radiation for disinfection of air and surfaces in premises” (R 3.1.683-98, approved by the Ministry of Health of the Russian Federation);

8. Sanitary and epidemiological rules SP 3.5.1378-03 “Sanitary and epidemiological requirements for the organization and implementation of disinfection activities”;

9. Sanitary and epidemiological rules SP 1.1.1058-01 “Organization and conduct of production control over compliance with sanitary rules and implementation of sanitary and anti-epidemic (preventive) measures”;

10. Guidelines MUK 4.2.1035-01 dated May 23, 2001 “Control methods. Biological and microbiological factors. Control of disinfection chambers";

11. Manual “Organization of disinfection and sterilization regimes in dental institutions, offices” (L.A. Ponomareva, Moscow Disinfection Station No. 7, 1998);

12. Methodological recommendations “On the organization and implementation of anti-epidemic measures in dental service institutions” (candidate of medical sciences P.S. Oparin, Irkutsk disinfection station, Siberia-Vostok magazine, April 2000);

13. Methodological letter of the Central State Medical University in Moscow dated March 21, 1995, No. 12/20/-208 “Organization of sanitary-hygienic and disinfection-sterilization regimes in dental institutions”;

14. A manual on the use of disinfection and sterilization means in health care facilities and the organization of disinfection and sterilization regimes in the departments of endoscopy and dentistry. Moscow, 1998.

Stage 1 (Preparatory):

Immediately after using speech therapy tube substitutes, they must be washed with detergent under running warm water.

Stage 2 (Main):

To disinfect speech therapy instruments, dilute the concentrate at a rate of 1:20 with water. For 1 liter of water 50 ml of Alaminol. Place speech therapy probe substitutes and instruments in a box in the prepared solution until completely immersed for 30 minutes. If the instrument has hidden holes, etc., draw the Alaminol solution into a medical syringe and pour the drug under pressure into the hidden cavities, displacing all the air from them.

Stage 3:

After soaking, the instruments must be rinsed under running warm water.

Stage 4 (Processing of probe substitutes):

We send the probe replacements to a container for further processing with boiling water.

Pour boiling water and wait for about 3 to 5 minutes.

Stage 5 (Final):

After disinfection, rinse the speech therapy probes under boiled water and wipe dry with a disposable towel. Place probe replacements in a clean, dry and airtight container.

Probe kit

Speech therapy probes for producing sounds (authored by Rau) are not suitable for massage. A special set was developed by E. V. Novikova. It includes 8 main probes plus 4 additional ones. A patent for the development was received in 2000.

Probes are used to work with articulatory organs and the forearm. Stimulating the muscles of the dominant hand improves motor skills and promotes handwriting development.

The first tool is a fork , which looks like two blunt needles slightly apart to the side. A slight tingling sensation has an activating effect.

The second instrument is the eight . At the end there is a round loop that “grinds” the muscles.

The third, fourth, fifth tools are “sleighs” of different sizes. The shape of the probes resembles the rounded runners of a sled, hence the name. You can work with either side of the tool.

The sixth tool is a hatchet , which looks like two tightly pressed loops. Used for pressing on the surface of organs, sliding. Normalizes tone and increases muscle mobility.

The seventh is a cross, the loops are rounded and intersecting . It is used to stimulate the muscles of the tongue and develop its elevation.

The eighth tool is a pusher , a small loop raised at a right angle to the probe handle. Allows you to stimulate mobility and elasticity of muscles. When you press on the tongue, it creates tension; after the pressure is removed, the organ relaxes.

The ninth tool (additional) - tweezers , looks like two large rounded loops located parallel to each other. It is convenient to take the tongue with a probe and gently move it.

The tenth tool is a pull-up tool that looks like a low, wide frame. Used to stretch the frenulum.

The eleventh tool is a swan , a small loop, bent at the base, after which there is a small vertical section of the probe, which is bent at a right angle to the probe handle. Massages the palate, eliminates salivation.

The twelfth is sliding, looks like an elongated triangle with round corners. Used for sliding movements.

Some authors made their own adjustments to the set of massage probes. Vorobyova together with Krupenchuk created the author's set. It consists of 9 instruments. The creation of probes with different coils with small edges can be considered an innovation. This tingling sensation can effectively stimulate the nervous system.

Massage speech therapy probes (author Novikova E. V.)

The complete set includes 12 probes. The first 8 probes are the “main set”, probes 9 to 11 are the additional set. 12 probe – “sliding”) Probes are used to massage the muscles of the tongue, lips, cheeks, cheekbones, soft palate, and forearm. The purpose of probe massage is to normalize speech motor skills. Using probe massage, you can specifically influence the affected areas of the articulatory organs, activating and restoring their activity, as a result of which the process of correcting sound pronunciation will be significantly accelerated. Probes can be used to massage the muscles of the right (right-handed) and left (left-handed) forearm. Massage of the forearm muscles restores weakened muscles and improves coordination of movements of the working hand. As a result, the pace of writing increases and handwriting normalizes. The method of performing probe massage is described in detail in the books by E. V. Novikova “Probe massage: correction of sound pronunciation” part 1 and “Probe massage: correction of fine motor skills of the hand” part 2. A detailed description of massage exercises in these books is accompanied by detailed drawings. But at the same time, the speech therapist should be consistent and methodical. Working with probes requires not only desire, knowledge, experience, but also enormous strength and patience. Massage speech therapy probe No. 1 thymus

Participates in the massage of the muscles of the tongue, cheekbones, cheeks, lips, soft palate, and forearm. It is necessary to determine the boundaries of the gag reflex and relieve it. The ends of the probe are blunt, which eliminates muscle damage. The probe is designed to puncture muscles. As a result of this effect, the muscles actively contract. A more intense effect can be achieved by using the injection technique with pumping.

Massage speech therapy probe No. 2 eight

Participates in the massage of the muscles of the tongue, cheekbones, cheeks, lips, and forearm. The probe is designed to “grind” the muscles.

Massage speech therapy probe No. 3, No. 4, No. 5. Sleds large, medium, small

These probes precisely slide over the muscles of the tongue, cheekbones, cheeks, lips, soft palate, and forearm in different directions, causing them to become active. The probes are bent so that they can be used on either side. If on one side there are two points of pressure and sliding, then on the other there are three. The upper part of the probes, which is more often used when pressing on the muscles, also participates in the massage. “Sleds” perform the same massage techniques, but the grip of the massaged area and the intensity of pressure are different. In addition, probe No. 5 (small sled, lower one in the photo) performs screwing and springy return movements.

Massage speech therapy probe No. 6 hatchet

It is actively used in tongue massage, participates in the massage of the muscles of the cheekbones, cheeks, soft palate, forearm, covering a larger surface (compared to other probes) and intensively affecting the muscular system. The probe is designed to perform 2 techniques: pressing firmly and sliding. Under the influence of pressure, muscle tone is normalized, their contractility increases, and mobility increases. The degree of pressure depends on the condition of the muscles: the lower the tone, the more intense the pressure. Gliding improves muscle elasticity and firmness, relieves tension.

Massage speech therapy probe No. 7 cross

Participates in the massage of the muscles of the cheekbones, cheeks, lips, and forearm. Used to massage the middle, root parts of the tongue, it allows you to influence the muscles that ensure the elevation of the tongue. By pressing on the tongue and moving it back, we force the muscles of the indicated areas of the tongue to contract and engage in work. The “cross” can be used to compress the muscles of the tongue, holding them in this position. With its help, pressing, springy return movements, pressing circular movements are performed. The probe is used to produce the sounds K, G, X, as well as Sh, Zh, Shch, Ch, R. Massage speech therapy probe No. 8 pusher

Participates in the massage of the muscles of the cheekbones, cheeks, lips, soft palate, and forearm. It affects the longitudinal, transverse, fan muscles of the tongue, restoring their mobility and elasticity, which provides the ability to take various articulatory positions. There is a loop at the end of the probe. When pressing on the tongue, active muscle contraction occurs; when the probe is removed, tension is relieved, and a relaxation phase begins. A more intense effect can be achieved using the pressing and pumping technique.

A set of new additional massage probes by Novikova E.V. has recently been released.

Massage speech therapy probe No. 9 “Tweezers”

Probe No. 9 “Tweezers” is involved in massaging the muscles of the cheeks, lips, cheekbones, and tongue. It affects the longitudinal and transverse muscles of the tongue, restoring their mobility, elasticity, and switchability. This allows for different articulatory positions. Particularly effective is the compression of the sides of the tongue to the root and back, when arching the back of the tongue, as well as turning the tongue to the right and left, in pulling the tongue forward from the mouth, since it can grab not only the tip of the tongue, but also the middle part of the tongue.

Massage speech therapy probe No. 10 “Pulling”

Probe No. 10 “Tightening” is designed to massage the sublingual ligament and stretch it. If the child cannot lift the tongue up, a probe is used to check the condition of the hypoglossal ligament.

Massage speech therapy probe No. 11 “Swan”

Probe No. 11 “Swan” is intended for massage of the cheeks, cheekbones and soft palate. Restores muscle mobility and elasticity, which makes it possible to take different articulatory positions and helps eliminate drooling.

Probe No. 12 Sliding

This probe can slide over the muscles of the tongue, cheekbones, cheeks, lips, and forearm in different directions, causing them to become active. The probes are made of stainless steel wire. They are well treated with disinfectants (such as Alaminol, Lisetol, etc.), and boiled.

It is recommended that each child have their own set of massage probes. They can be purchased in our store.

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Advantages and disadvantages of the technique

Probe massage allows you to speed up the production of sounds, facilitate the assimilation of articulatory gymnastics, and improve muscle function. Without it, correction of dysarthria will take 5-10 years.

It does not require special conditions, since it can be done by any speech therapist with the appropriate qualifications. In many correctional institutions, it is carried out by specialists as needed.

Massage helps relieve tone, hypersalivation, and improve fine motor skills.

It also has disadvantages. The significance and value of massage is overestimated - it is an auxiliary tool, not a panacea. Low-qualified speech therapists provide probe massage as a cure for all problems. In fact, the impact only provides the basis for producing sounds, which does not cancel the remaining stages of the work.

If used incorrectly, tools cause negativity in the child, since if they are not understood, they can cause serious harm. Some specialists act rudely and incorrectly, which leads to pain and the child’s refusal to study.

Contraindications

Massage courses are prescribed by a neurologist after a complete examination. It should not be used for epilepsy of various forms, as it can provoke seizures.

Temporary withdrawal is given for any infectious or somatic diseases. Probe massage should not be performed for stomatitis, caries, gingivitis, or skin diseases. Herpes and oral infections also serve as a medical outlet for procedures.

It should not be done if there is strong pulsation of the arteries, high blood pressure, or poor physical well-being.

If you have nausea, vomiting, or fatigue, you cannot conduct a session; it is better to reschedule it for another time. A speech therapist examines each child before performing a massage.

Tool processing

Each set of tools is used once. Afterwards, it is soaked in a disinfectant solution, without removing it from it, and treated with cotton swabs for 30 seconds.

Then the instruments are washed under running water using such products as “Progress”, “Biolot”, “Astra”. Do this for 10 minutes.

The probes are washed in distilled water for 30 seconds. Finally, it is dried in a dry oven.

This is a standard method for sterilizing medical instruments. You cannot neglect it, as this is a violation of the law. Children may have various diseases; in the event of mass infection, there will be serious checks and investigations.

Processing and storage of speech therapy probes

It should be noted right away that there are no instructions that would regulate the process of processing speech therapy probes. We have developed this instruction based on instructional and methodological documents regulating disinfection and sterilization activities in dental institutions: