Stuttering is not a disease, but a manifestation of the disease, one of its symptoms. Accordingly, in order to talk about treatment tactics for stuttering, it is necessary to establish exactly what disorder it is a manifestation of...
A large number of methods have been developed to get rid of stuttering. It is difficult to say which technique is suitable in each specific case. Today we bring to your attention the technique described in V.M. Lykov’s book “Stuttering in Preschool Children” (M., 1978).
The essence of stuttering
Stuttering is a fairly common phenomenon. However, everyday observations show that adults do not have a clear idea of stuttering, a clear understanding of the psychology of people who stutter, or knowledge of evidence-based ways of prevention and treatment.
Stuttering is not only a complex speech disorder, but also a disease of the entire body. And therefore, along with pedagogical measures, children who stutter need special restorative treatment.
Surveys of parents showed that for the most part they understand stuttering as a kind of “mechanical breakdown” of sound pronunciation and do not associate it with complex mental processes. Hence the purely formal approach to the education and training of people who stutter.
How does modern science interpret this phenomenon? Based on the teachings of I.P. Pavlov, stuttering is considered as a particular type of neurosis - logoneurosis (speech neurosis), resulting from a functional disorder of higher nervous activity.
It is known that two interconnected and interdependent processes continuously occur in the cerebral cortex - excitation and inhibition. Normally, balancing each other, they create peace and well-being for the entire body, the so-called state of comfort. But when the mutual balance of these processes is disrupted, a phenomenon arises that I. P. Pavlov figuratively called a “collision.”
The diseased focus formed as a result of such a “collision” changes the interaction between the cortex and subcortex. Having escaped the control of the cortex, subcortical formations begin to send random impulses to the cortex, including the speech production zone, causing the appearance of convulsions in various parts of the speech apparatus (larynx, pharynx, tongue, lips). As a result, some of its components fire earlier, others later. The pace and smoothness of speech movements is disrupted - the vocal cords close or open tightly, the voice suddenly disappears, words are pronounced in a whisper and prolongated (elongated) - pp-field, bbb-be-birch, which is why the thought is expressed vaguely, is not brought to the end, and becomes incomprehensible to those around you.
In this regard, the question arises: “What factors negatively affect the normal course of excitation and inhibition?”
There are several reasons. But the main one is the weakness of the nervous system, most often caused by infectious diseases (complications after measles, scarlet fever, meningitis, encephalitis), sluggish chronic pathology - rheumatism, pneumonia, etc.
Sometimes children are born with a weakened nervous system, which is the result of an unfavorable pregnancy.
We have named a group of causes of a pathogenic nature, but there is also another group - defects in education. An abnormal household environment, quarrels between parents in the presence of a child, an uneven attitude towards him (shouting, intimidation, punishment), and finally, different demands in the family hurt the child’s psyche and lead to a speech disorder.
Many other factors are known to science and practice, for example, left-handedness, imitation, hesitations in speech, impaired sound pronunciation, speech underdevelopment, etc. By the way, it is undesirable to both lag and excessively rapid development of speech, encouraging children to master complex words and sentences . It also happens that a child, imitating the sloppy speech of those around him, tries to quickly express his thoughts, gets confused, gets confused in sounds and begins to stutter.
However, the listed factors are not enough for stuttering to occur. A kind of impetus, a trigger for stuttering, are irritants such as fear, conflict situations, and difficult emotional experiences. From here it becomes clear why children more often begin to stutter after illnesses: a weakened nervous system reacts sharply to strong stimuli, to a rude shout, etc.
Stuttering in most cases is associated with fear (animal attacks, car collisions, fires, drowning, rooster crowing, punishment, emotional stress). Indeed, about 70 percent of stuttering cases are associated with mental trauma.
They may object: “Many children get scared, but not all of them stutter.” What is true is true. To be or not to stutter depends entirely, as we have noticed, on a number of incidental circumstances - the state of the nervous system at the time of mental trauma, the strength of the traumatic stimulus, etc.
Stuttering usually develops in children between two and five years of age, i.e., during the most rapid period of speech development. In the system of other mental processes, speech is the most fragile and vulnerable due to its “youth”, and therefore loads on the nervous system directly or indirectly affect speech activity. Young children lack strong inhibitory reactions. Babies are easily excited, and excitement can lead to convulsions, including convulsions of the speech apparatus - stuttering. Stuttering occurs three times more often in boys than in girls. Scientists explain this phenomenon by the fact that boys, due to their more active lifestyle, are exposed to more frequent traumatic opportunities. Rural schoolchildren exhibit stuttering less frequently than urban students. In rural areas there are fewer traumatic factors, there is a calmer and more measured rhythm of life.
The mechanism of occurrence of semantic-pragmatic speech impairment
Child behavioral neurologist Charles Njokiktjen summarized data from various studies on brain development in ontogenesis and described the process of normal development of speech and personality in this way:
- In the pre-speech period of development (from birth to 1.5-2 years), the cortex of the right hemisphere of the brain develops most actively, where the formation of the body diagram, spatial representations and the image of “I” occurs. For the formation of these internal constructs, the correct processing of sensory information at the level of subcortical nerve nodes and pathways, an adequate external subject, psychological and information environment is of utmost importance (we all remember the “hospital syndrome”, when the child’s development is delayed due to sensory and communicative, emotional deprivation). Moreover, the image of “I” stems from the image of the body, on which an emotional and communicative “cover” is superimposed (the mother and close relatives interact with the child, verbalize their actions, sing songs to him, read books, tell nursery rhymes, often this speech is rhythmic). Thus, the child begins to realize that he is an individual with the ability to influence the world around him (this is already the stage of the so-called normal childhood ego, that is, the child, at the beginning of self-awareness, believes that the whole world revolves around him and this is NORMAL). At the same stage, the first reflected speech (normal echolalia) and the first voluntary words appear. This is why children’s nursery rhymes often remain in speech after damage to the left temporal lobe in adults (after a stroke or tumor) - they are localized in the right hemisphere.
- With the advent of the phrase, speech as a mental function moves to the left hemisphere in the process of lateralization, that is, an increase in interhemispheric asymmetry. With age, this asymmetry intensifies: the right hemisphere is responsible for spatial representations, holistic perception of objects, intonation, the emotional component of perception and expression, and the left hemisphere is responsible for analysis, signs, symbols, diagrams, perception and the production of speech.
At what point does the process “break down” so that a semantic-pragmatic speech disorder occurs? This is not yet known for certain, but there are scientific assumptions that the reason is the malfunction of mirror neurons, which are responsible for the innate processes of simulating the actions of others. That is, mirror neurons help the child develop social interaction at the pre-speech level, thereby adequately forming his internal image of “I”. If emotional development has been disrupted, then even with normal development of the speech areas of the brain, the content of speech will be inadequate.
C. Njokiktjen also mentions that semantic-pragmatic disorder may be associated with damage to the white matter of the brain, for example, in hydrocephalus. In this case, the mechanism of occurrence will be somewhat different.
Symptoms of stuttering
Stuttering occurs in different ways, but identifying the disease is not difficult. It manifests itself either in the obsessive repetition of sounds and syllables, or in involuntary stops and delays, often accompanied by convulsions of the speech organs. The spasms affect the vocal cords, muscles of the pharynx, tongue, and lips. The presence of spasms in the speech stream is the main phenomenon of stuttering. They vary in frequency, location and duration. The severity of stuttering depends on the nature of the seizures. The tension in the organs of pronunciation does not allow a person who stutters to conduct a conversation accurately, clearly, and rhythmically. The voice also becomes upset - in people who stutter, it is uncertain, hoarse, and weak.
There is an opinion that the basis of stuttering is blocking (turning off) voice production. Indeed, a number of experiments confirm this idea. When a child stutters, he spends a lot of physical strength. When speaking, his face becomes covered with red spots and sticky cold sweat, and after speaking he often feels tired.
Individual sounds, syllables, words become so difficult that children avoid using them, as a result of which speech becomes impoverished, simplified, becomes inaccurate, and incomprehensible. Particularly great difficulties arise when reproducing coherent stories. And to make their situation easier, kids begin to use sounds, words or even whole phrases that have nothing to do with the subject of the statement. These "alien" sounds and words are called gimmicks. “A”, “e”, “here”, “well”, “and” are used as speech tricks.
In addition to speech, children who stutter also develop motor tricks: children clench their fists, step from foot to foot, wave their arms, shrug their shoulders, sniffle, etc. These auxiliary movements make it easier for the child to speak, and later, when they become established, they become an integral part of the speech. speech act. Extra movements disrupt coordinated motor skills and load the psyche with additional work.
Some preschoolers develop a fear of speaking. Even before starting a conversation, the child begins to worry that he will stutter, that he will not be understood, that he will be judged poorly. Uncertainty in speech, wariness, and suspiciousness appear.
Children are painfully aware of the difference between themselves and their peers. If, in addition, their comrades laugh at them, imitate them, and adults scold them for speaking incorrectly, stuttering children withdraw into themselves, become irritable, fearful, and they develop a feeling of inferiority, which further depresses the psyche and aggravates stuttering.
Psychological layers can be so pronounced that first of all one has to direct efforts to streamline behavior, and only then to fight stuttering.
People who stutter have poor coordination in their movements. Some have motor restlessness and disinhibition, others have angularity and stiffness. This is why people who stutter usually avoid crafts that require fine finger movements. But the signs of stuttering do not end there. People who stutter develop undesirable character traits - irritability, tearfulness, resentment, isolation, distrust, negativism, stubbornness and even aggressiveness.
Preschoolers who stutter are more susceptible to colds than ordinary children; their sleep and appetite are more often disturbed. If we talk about the dynamics of stuttering, it is striking in a number of characteristic features - the variability of the clinical picture, adaptability and variability. Often a more complex form of speech is pronounced more freely than a simplified one.
In the spring-summer period, stuttering smoothes out, in the autumn-winter period it intensifies. In an unfamiliar environment it manifests itself more strongly than in a familiar one. The severity of stuttering is also influenced by the situation in which the child finds himself. In kindergarten it gets worse; when surrounded by friends and family, the child feels freer. In labor classes, speech is much more confident than in native language classes.
Stuttering gets worse as fatigue increases. At the beginning of the day the defect appears less grossly than at the end. Hence the conclusion that classes with stutterers should be conducted in the morning.
When a child is alone, he does not stutter. Children do not stutter when singing, reading poetry, or reciting memorized stories. From the foregoing, we can conclude that in order to correct the defect, it is necessary to influence not only the speech of the stutterer, but also the personality as a whole.
SYSTEMATICITY AND CONSISTENCY OF Speech Therapy Activities
The didactic principle of systematicity and consistency in speech therapy classes with stutterers is reflected primarily in the logical arrangement of the content of these classes, when the imparting of certain knowledge and the development of correct speech skills in them occurs in a strictly systematic and sequential order, taking into account their speech capabilities, when the entire learning process is ongoing from simple to complex, from known to unknown, from easy to difficult.
The speech of a stutterer is influenced by varying degrees of independence.
This means that the frequency and strength of speech
you convulsions depends on whether he speaks himself (asks questions, spontaneously expresses his thoughts, desires) or does it for someone else’s benefit. Help is expressed in the hint of a sample phrase and in pronouncing it together.
Depending on the degree of independent speech, several gradually more complex stages can be distinguished:
Conjugate speech: the stutterer follows the speech therapist and pronounces phrases together with him. Even in the case of a very severe degree of stuttering, a person speaks fluently, since someone else’s phrase (its construction, manner of pronunciation) is actually copied. The degree of independence is minimal.
Reflected speech: a person who stutters repeats phrases after the speech therapist. Here he also uses someone else’s phrase construction, its tempo, intonation, and manner of pronunciation. This is also a form of speech that is usually accessible to all people who stutter.
The next, more complex form of speech for a stutterer is answers to questions, first simple, then expanded. Unlike reflected speech, elements of independent speech appear here. Answering a question allows people who stutter to use a certain sentence structure and almost all the words of the question, adding only 1-2 words. It is more difficult for a person who stutters to give detailed answers to questions.
Retelling complicates speech even more, since you need to say not 1-2 phrases, but much more. In the retelling there are some moments that make speech easier: retelling a fairy tale, a story, or a film strip seen by adults.
The story is an independent presentation of the material based on the topic, the picture, the impressions of the excursion,
walks, etc.
And finally, spontaneous speech (spontaneous, independent) is the most difficult for people who stutter. It involves natural and active verbal communication with others: questions, requests, appeals, messages, exchange of thoughts, expression of desires, etc.
Thus, free independent speech in people who stutter can be developed in speech classes in the following sequence:
1) conjugate-reflected speech; 2) answer-question form of speech; 3) retelling, story; 4) spontaneous speech.
Another factor influencing the condition
The speech of people who stutter varies in the degree of its preparation -
&sti.
It is easier for a person who stutters to speak when the text has been learned.
he has it by heart or the necessary material has been rehearsed in advance, out loud or pre-mentally thought out what he wants to say and in what order. Manifestations of stuttering intensify when the text is unfamiliar and you need to speak impromptu.
Speech exercises are constructed in the following sequence:
1) memorized text; 2) rehearsed out loud; 3) mentally thought out; 4) unfamiliar text, impromptu.
The next factor influencing the manifestation or disappearance of speech spasms in a stutterer is the different complexity of the speech structure.
Typically, people who stutter easily pronounce individual sounds, especially vowels, less often syllables, and even less often words. Difficulties for them, as a rule, arise at the beginning of the presentation (it is difficult to start speaking), at the beginning of a semantic segment of an expanded phrase (after a breathing or semantic pause), or at the beginning of a simple phrase. Stopping and stumbling often occur on certain specific (“difficult”) sounds.
Free and loud speech
for those who stutter, this is achieved through successive speech exercises, which they pronounce first silently, then in a whisper, quietly, loudly, in a normal voice.
Smoothness and rhythm of speech have a beneficial effect on the speech of people who stutter. When singing, rhythmic poetic speech, speaking in a sing-song voice, speech convulsions are either completely absent or significantly reduced.
People who stutter experience certain relief when they accompany their speech with rhythmic movements. Then the skills of free communication from rhythmic speech are transferred to multimetric, i.e., ordinary speech.
Thus, smoothness
and
the rhythm of speech
in people who stutter can be developed in the following sequence:
1) singing; 2) singing with movements; 3) rhythmic speech (poetry, then prose) accompanied by movements; 4) rhythmic speech (poetry, prose) without movements; 5) reliance on vowel sounds; 6) multimetric speech.
The task of teaching correct speech to a person who stutters also involves training correct speech in different emotional states.
A speech therapist teaches a stutterer to control himself and his speech, regardless of his mood, emotional arousal or depression. A person’s emotional state and speech are influenced by the environment,
the nature of its activities and people. Therefore, in classes it is important to provide for the gradual complication of not only speech exercises, but also various situations,
in which they are held.
Depending on the situation, the sequence of speech exercises may be as follows: training correct speech in a familiar, familiar environment; in an unfamiliar one; in the unfamiliar, alien.
Taking into account the public environment - alone; with loved ones and friends; with teachers; with unfamiliar people; with strangers, although various options are possible here depending on the reaction of stutterers to the participants and the conditions of communication.
And finally, the activities of a stuttering child can also affect the quality of his speech, depending on: a) its type; b) degree of complexity (elementary actions, complex actions); c) its relation to speech in time (description of what is, was or will be).
The existence of various factors influencing the speech state of a stuttering child allows the speech therapist to combine various types of speech exercises and situations in such a way as to predict the possibility of speech spasms and avoid them.
The principle of systematicity and consistency includes not only the logical, but also the organizational side of speech therapy influence on people who stutter, since the acquisition of certain knowledge, skills and abilities is carried out systematically, regularly and according to plan. Only in this case does regular training of nervous processes occur, which actually underlies the treatment of neuroses.
The course of speech therapy classes represents a complete system of work with people who stutter, complete in time, tasks and content, and is divided into periods (preparatory, training, consolidation). In each period, a number of stages can be distinguished (for example, silence, conjugate, reflected speech, speech-manual mode, etc.). Each stage of speech therapy work consists of interrelated activities.
The tasks of the preparatory period include creating a gentle regime, preparing the child for classes, and showing examples of correct speech.
The gentle regime is to protect the child’s psyche from negative factors; create
a calm environment, a friendly and even attitude; avoid fixation on incorrect speech - determine and maintain a daily routine; provide calm and varied activities; Avoid noisy, active games and overload with activities.
It is also necessary to calm a stuttering child, distract him from painful attention to his defect and relieve the associated tension. It is advisable, if possible, to limit the speech activity of a stutterer and thereby somewhat weaken the incorrect speech stereotype.
To attract a child to classes, it is necessary to use radio broadcasts, tape recordings or records, conversations about literary works, draw the attention of the stutterer to the expressive speech of people around him, to positive examples, demonstrate tape recordings of children’s speech before and after classes, especially in cases where they are aware of their existing stuttering.
The contrasts between poor speech at the beginning of classes and correct, free speech at the end make children want to learn to speak well. For this purpose, you can use speeches and dramatizations of children who have completed the course.
From the first lessons, the speech therapist works with the child on the necessary qualities of correct speech: volume, expressiveness, leisurelyness, correct form of phrase, sequence of presentation of thoughts, the ability to speak confidently and freely, etc.
The objectives of the training period include the child mastering all forms of speech that are difficult for him in different speech situations. Based on the knowledge, skills and abilities that the child acquired in the first period, work is being done to develop the skills of free speech and correct behavior in different forms of speech and a variety of speech situations.
In the most difficult cases of stuttering, the training period begins with conjugate-reflected speech. If all the requirements of correct speech are well and easily fulfilled at this stage, the speech therapist refuses to speak phrases together with the child and gives him the opportunity to independently copy the sample phrase.
At the stage of conjugate-reflective speech, different texts are used:
well-known fairy tales memorized, questions and answers, unfamiliar fairy tales, stories.
speech classes are conducted in the office or at home with a speech therapist or with parents. Conditions become more complicated if strangers, peers, who can be present silently or take part in classes, are invited to classes.
The next step in speech therapy work with a child is the stage of question-and-answer speech. During this period, the child gradually frees himself from duplicating phrases according to patterns and makes the first progress in independent verbal communication. It is advisable to start with reflected answers, when an adult asks a question, answers it himself, and the child repeats the answer. Gradually, he moves from short answers to questions to more complex ones. The child, using previously received examples, learns to independently construct complex sentences. To prevent the artificiality of speech exercises, they should be carried out on a wide variety of material related to the child’s daily life and program material: questions during the game, etc. It is useful to accompany with questions various types of activities organized in general education classes: observation of others, work, modeling , drawing, designing, playing with toys, etc.
The child’s answers initially reflect his simple actions, simple observations made at the present time (I am drawing a house. There is a vase of apples on the table.).
Then - in the past tense, about a completed action or an observation made (I
went to the zoo with my dad yesterday. We saw a rhinoceros there.).
Finally - in the future tense, about the proposed action
(We will go to the children's park now. Tanya and Vova are waiting for me there. We will play hide and seek.).
In this case, from concrete comprehension and transmission of his immediate observations and actions, the child moves to generalizing conclusions and descriptions of expected situations and actions.
A variety of activities help children transfer correct speech skills into their daily lives.
If the child stumbles, you should ask him to repeat the phrase again, arguing that the answer was not pronounced loud enough (or too quickly, or inexpressively). The child will repeat the phrase freely. If the speech spasm was strong and the child could not overcome it, it is advisable to ask a leading specific question that will allow him to change or streamline the construction of the phrase.
When choosing speech exercises, you need to know in what cases (difficult sounds, beginning of a phrase, setting) a child may experience speech spasms in order to be able to prevent them or come to the rescue in time. An indicator of a well-prepared and conducted lesson with a child is the complete absence of speech convulsions.
After the child learns to freely answer simple questions, retelling and storytelling are used in classes. Following the sequence of transition from answers to questions to retellings and stories, the speech therapist first invites the child to compose and pronounce simple independent phrases from the pictures, then ask questions about the new picture and answer them.
From simple phrases you can move on to more complex ones, related in meaning, and then to a retelling of a well-known text (fairy tale, story), an unfamiliar one (recently or just heard), to a description of facts from the life around you, to stories about your walk, excursion, classes, etc.
Accordingly, as the forms of speech become more complex, the classroom environment becomes more complex. Classes are held not only in the office or at home, but also outside them. In the office, preparations are being made for going out into public places, the upcoming excursion is being rehearsed, the speech therapist asks questions about imaginary or surrounding objects or phenomena. For example: “You see a house in front of you. How many floors does it have, what color is the roof? What flower grows in the flowerbed? Who is sitting on the bench? Who plays ball? Who is sitting on the branch? What is the weather today?" In the future, these questions become more complex, the child talks about what he saw, heard or did and, finally, participates in conversations.
After mastering the speech material, an excursion is taken, during which the child is asked the same questions.
During classes outside the classroom, the child learns to calmly react to the environment and people, not to be shy and correctly answer questions from the speech therapist, peers, and ask questions himself. Classes outside the classroom are of great importance for the formation of correct speech in children who stutter. Underestimation of these activities usually leads to the fact that a child in the office, i.e., in his usual conditions, can speak completely freely, but outside the office his speech continues to have spasms.
The tasks of the reinforcement period include automating the correct skills acquired by the child.
ovens and behavior in various situations and types of speech activity. The named tasks are most actively implemented using the material of spontaneous speech that arises in a child under the influence of internal impulses (appealing to others with questions, requests, sharing impressions).
The degree of participation of the speech therapist in speech classes with a stuttering child is gradually changing. In the first stages, the leader speaks more; in the last stages, the role of the speech therapist comes down mainly to choosing the right topic for a speech lesson, directing its progress and monitoring the child’s independent speech activity. Classes gradually take on the character of conversations about the day spent, a fairy tale listened to, a TV show seen, etc.
Creative games are used on themes from everyday life: “Guests and the hostess”, “At the table”, “At the doctor’s appointment”, “Shop”, “Mother and daughter”, etc., dramatization games based on the plots of famous fairy tales.
During the consolidation period, the main attention of the speech therapist and parents is directed to how the child speaks outside of class. Therefore, you should not miss the opportunity to correct him when necessary, in a conversation while walking, at home when preparing for dinner, during the morning toilet, etc.
Structural parts of a separate lesson. The principle of consistency in each lesson is expressed in the correlation of its structural parts: preparatory, main and final.
The preparatory part of the lesson includes organizing a children's group, psychological conversations, speech exercises, repeating and consolidating the speech material covered in the previous lesson, and preparing the child for the upcoming work.
The main part of the lesson contains a new type of speech exercises or new conditions in which they are carried out.
In the final part of the lesson, the speech therapist consolidates new material, sums up the children’s work, draws attention to their successes, gives advice and tasks for speech training outside of speech therapy classes.
This structure of a separate speech therapy lesson allows us to see it among others, which generally make up a single consistent chain of targeted and systematic correctional and pedagogical influence on a stuttering child.
Overcoming stuttering
Before moving on to specific recommendations for overcoming stuttering, it would be useful to recall some general provisions. The first thing parents should do is consult with a psychoneurologist and speech therapist, together with them, based on the child’s personality characteristics, outline and implement a program of medical and pedagogical influence.
Currently, a comprehensive method of overcoming stuttering has become widespread, in which parents play a prominent role. What is its essence?
Structurally, it consists of two interconnected parts - therapeutic and health-improving and correctional and educational. Each of them, complementing each other, pursues its own goals and objectives: therapeutic and health-improving is aimed at normalizing neuropsychic processes, at improving the nervous system; correctional and educational - to develop and consolidate correct speech skills.
To improve the child’s health, various activities are carried out, sedatives, calcium supplements, and various vitamins are prescribed. Drug therapy is combined with physiotherapy and climatotherapy, sleep, etc.
It is extremely important for parents to create a favorable, calm environment for the baby, instill cheerfulness in him, and distract him from unpleasant thoughts. The speech of adults should be friendly, leisurely, and simple. Jerking, shouting, and punishment are not allowed.
Since the body of a stuttering child is weakened in most cases, he really needs a correct and solid daily routine, a rational alternation of work and rest. A measured rhythm of life helps to normalize the functioning of the body and, in particular, higher nervous activity. In this case, sleep plays an important role. Children who stutter should sleep 10-12 hours at night and 2-3 hours during the day.
The daily routine includes time for games and walks. Moreover, it is important to choose calm games for active children, and fun, active ones for inert ones.
Parents should pay close attention to the child’s nutrition - make it varied, sufficiently high in calories, well fortified with vitamins. People who stutter are recommended to eat four meals a day with regular meal times.
Hardening procedures—rubbing, dousing, bathing—have an exceptionally beneficial effect on a child’s health. Walking, sledding and skiing are required. We should not forget about morning exercises and physical exercises, which contribute to the development of coordination of movements and improve the functioning of the cardiovascular and respiratory systems. The daily routine should also include elements of child labor: the child can bring dishes, remove spoons and pieces of bread from the table, tidy up the children's corner, and prepare items for play. The child is entrusted with caring for plants, etc.
Medical and health activities create a physiological foundation for conducting special speech classes. Corrective and educational measures are aimed at normalizing the tempo, smoothness and rhythm of speech, developing the ability to work purposefully, enhancing speech communication, as well as eliminating defects in sound pronunciation.
The program of correctional and educational activities is implemented in the process of the child’s daily activities, and is as close as possible to his needs, interests, hobbies, in a word, speech correction should take place in natural conditions. Under no circumstances should you force a child to complete certain tasks. He must do everything without much coercion.
presentation “Formation of coherent speech in children with stuttering” presentation on speech therapy on the topic
Slide 1
Formation of coherent speech in children with stuttering Teacher - speech therapist Shpigareva O.N.
Slide 2
Difficulties in the formation of full-fledged speech in preschoolers: 1 - The child’s inability to immediately correctly formulate in words his thought, which he must convey to the listeners. This may depend on: insufficient understanding of a particular moment, the phenomenon that he wants to talk about (loses the logical sequence of presentation, confusion of speech appears) on a limited vocabulary (difficulties in choosing the right word, expression) 2 - Inability to correctly distribute the material when presenting his attention between his mental content and verbal expression. 3 – Deficiencies in sound pronunciation interfere with the correct formation and flow of children’s speech. 4 — The influence of external conditions, the child’s environment at the time of speech communication on the occurrence of speech hesitations. The degree of fixation on one’s speech defect. The nature of the child's sociability.
Slide 3
Goal: to form the speech of a stuttering child clear, meaningful, phonetically and grammatically correct, expressive. Areas of work on speech development: Expanding children's concepts and ideas while simultaneously increasing their vocabulary. Educational work to prevent and eliminate speech hesitations in children is to instill the ability to consistently express their thoughts and desires. Formation of the child’s ability to speak slowly and calmly. Work to improve the phonetic and grammatical aspects of a child’s speech. Creating the most comfortable psychological environment when communicating with a child.
Slide 4
Basic principles in organizing work with children: Principle of activity. The leading activity is a game. The principle of systematicity, consistency and age consideration. The implementation of this didactic principle, according to which the study of new things is prepared by the previous one, makes the process of learning and correction continuous, carried out without jumps. Systematicity and consistency is expressed in the logical arrangement of the content of speech therapy classes, and also includes their organizational side. The principle of taking into account the individual characteristics of people who stutter allows us to organize work in such a way that the motor functions of stuttering children are normalized, their sociability and imitation develop, and their play activity increases.... The implementation of these basic principles allows us to consistently complicate the speech material, plots and methods of conducting classes.
Slide 5
Stages of speech therapy work: Speech restriction stage Conjugate speech Reflected speech Question-and-answer speech Independent speech Story stage Consolidating active behavior and free communication of children
Slide 6
Contents of speech therapy classes at different stages of speech therapy work for preschoolers: Stage of speech restriction (silence mode and whispered speech) Development of auditory attention and auditory memory; Development of visual attention and visual memory; Development of voluntary behavior through the development of personal qualities (control, attention, imitation through learning games, game rules...); Activation and replenishment of passive vocabulary
Slide 7
Game "Scouts"
Slide 8
Conjugate speech (4-5 weeks) With conjugate pronunciation, children learn the prosodic components of speech: pace, rhythm, melody, intonation, expressiveness, pausing, logical stress; They learn to merge syllables and words with each other so that the phrase is pronounced as one word, smoothly, with expressive intonation. Objectives: Formation of conjugate pronunciation of speech breathing; lengthening of exhalation, soft vocal delivery, unity of vowel sounds in onomatopoeia and words, prosodic side of speech, imitation, activity, elements of creativity through teaching the rules of games. Correction of motor skills disorders, sound pronunciation disorders. Activation and replenishment of the dictionary. Important: Proper organization of classes. Teaching parents how to communicate properly with children. Material: words, phrases, phrases, poems, finger games, songs...
Slide 9
Theme "Fruits - vegetables"
Slide 10
Reflected speech (4 – 5 weeks) The program material is absorbed by children in the process of conjugate-reflected speech. The teacher uses elements of question-and-answer speech followed by a monosyllabic answer, which is repeated by the children conjugately or reflectedly. All types of games are used in leisure time, but creative ones are still educational in nature. Objectives: Formation of reflected speech. work on the phrase and prosodic components of speech (breathing, voice, cohesion, tempo and rhythm of speech). Development of motor skills (ability to relax muscles). Continued training in games and game rules (learning to communicate with a partner, the ability to monitor the play of others). Education of voluntary behavior (to fulfill the requirements coming not only from adults, but also from comrades). Correction of sound pronunciation disorders. Activation and replenishment of the dictionary. Material: words, phrases, phrases, poems, songs, finger games, stories, games.
Slide 11
Theme "Garden"
Slide 12
Question-and-answer speech (8-10 weeks) Periods: The child answers a specific question with a complete phrase, his answer begins with the words of the questioner. In fact, this is a complicated form of reflected speech. For example: “What did mom buy?” the child answers: “Mom bought vegetables.” The question is asked in such a way that it does not include all the words the child needs when answering: “What are children doing?” - “Children picking apples.” During the same period, children are taught to answer in one or two words, i.e. close to the conversational manner of communication “Where are the children?” - “To the garden.” Objectives: Continued work on the prosodic components of speech. Development of a long exhalation, soft beginning of the voice, continuous pronunciation of a phrase, correct pausing, tempo, rhythm, intonation expressiveness. Formation of the ability to answer a question with a complete phrase (1st period), in one word (2nd period), work on dialogical speech. Nurturing personal qualities: activity, initiative, independence, creativity. Continued work on correcting sound pronunciation disorders. Development of the lexical and grammatical side of speech. Activation and replenishment of the dictionary.
Slide 13
Working on dialogue
Slide 14
Independent speech (8-14 weeks) sections: - Development of prepared independent speech based on retelling material. Development of independent speech based on story material. Objectives: Development of independent speech based on retelling material: training in word-for-word retelling of a prepared text with subsequent dramatization, retelling of events, actions based on materials from various games. Development of activity, independence, voluntary behavior in all types of games. Continuation of work on the correction of sound pronunciation disorders, on the development of the lexical and grammatical aspects of speech. Activation and replenishment of the dictionary.
Slide 15
Retelling the text using a picture diagram
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Story stage (4-6 weeks) Types of work: teaching descriptive story, story from memory, creative story. A description of the appearance of an object, a toy, plants, tools... A descriptive story is modeled on the story of a speech therapist. The technique of comparative description of two objects or toys is used... Then, we move on to teaching a descriptive story based on a picture and a series of paintings. Learning to tell stories from memory consists of: Compiling a story based on collective experience. Compiling stories based on individual experiences. By the fifth week and beyond, children learn to write creative stories. In the process of teaching storytelling, the speech therapist draws children’s attention to identifying the most important thing in the story, teaches them to compose first a short, then a more common story. At this stage, previously developed material is used, and a large number of new game situations are created, which organically includes one or another type of work on the story.
Slide 17
Writing a descriptive story
Slide 18
Strengthening active behavior and free communication of children. Objectives: to promote the further development and consolidation of organizational qualities in children, active, creative beginnings, further development of the ability to analyze the behavior of comrades in the classroom and give an assessment, consolidation of the ability to independently organize and conduct games with speech material of any complexity. The leading activity at this stage is creative games and dramatizations (finger games, musical games, games with building materials, role-playing games…..)
Slide 19
The significance of the game for children who stutter: - During the games, children train and consolidate correct speech and behavior skills in difficult conditions. These games serve as a necessary bridge for transferring new speech skills from special conditions (place of practice) to ordinary conditions. In games, a child acquires the skill to behave correctly in speech situations that are different for his activity, he develops the correct attitude towards others and towards his place in the team.
Speech classes
Speech classes are built in the form of conversations, viewing didactic materials, filmstrips, and working on crafts.
During classes you should use books, toys, and board games. At the same time, parents should monitor their children’s speech, help them express their thoughts correctly, without focusing on the speech defect. Speech classes should be conducted regularly and in accordance with the principle from simple to complex, from familiar to unfamiliar. From the simplest situational forms to a detailed statement - this is the way to overcome stuttering. This is a very difficult task, and success here accompanies those parents who are not stopped by the first failures.
Typically, overcoming stuttering in preschoolers at home takes 3-4 months. All this time you need to be close to the child and “live” with him all the stages of speech re-education. Never give up hope of improving your stuttering. Remember: stuttering is a removable disease.
The course of overcoming stuttering is conventionally divided into three periods: preparatory, training, consolidative.
Preparation period
This period includes medical, recreational and protective measures: visiting a doctor, speech therapist, organizing a work and rest regime. At this time, it is necessary to limit the speech communication of a stuttering child with other children. Family members should carefully ensure that their own speech is clear, expressive and unhurried. It is necessary to draw up a plan for working with your child every day and make notes on its implementation. They have casual conversations with the child about how together (with mom and dad) he will learn to speak correctly and beautifully, and tell interesting fairy tales or stories. At the same time, play a children's record for your child or let him listen to a tape recording of the fairy tales “Teremok”, “Kolobok”, “Three Bears” and others. Games, drawing, and modeling help to prepare him for the upcoming speech work. Practice correct speech while walking and playing outdoors.
During the preparatory period, simple speech classes are organized - three to four times a day, lasting 10-15 minutes each. It is better to start classes with speech exercises. The child is asked to count to five, to ten, and then, following his parents, say short phrases: “I am learning to speak slowly.” "I'm learning to speak loudly."
Excerpts from children's poems can serve as material for speech exercises. The purpose of speech exercises is to prepare the child for the upcoming lesson, to make him feel that he can speak correctly. It is important that during a conversation the child does not tense up, does not raise his shoulders, and breathes silently and calmly.
After exercise, speech classes begin, which consist of special exercises that normalize speech. Speech exercises are built in a certain sequence - from simple forms of speech to complex ones.
Conjugate speech is the easiest for children who stutter. The child and his parents simultaneously name the objects shown in the pictures, the letters of the alphabet, speak short phrases (based on the pictures), and recite poetry. The training method is quite simple. While looking at the picture, at the same time as your child, smoothly and leisurely say: “This is Mishka. The bear is bathing. Mishka has big paws."
You can take any toy and tell what parts it consists of: “This is a Lena doll. Lena has eyes, a mouth, a nose. Lena has a new dress and white shoes.” Seeing objects in front of him, the child expresses his thoughts easier and more confidently.
The lesson can end with playing lotto with pictures or reading a poem. As soon as the child is fluent in conjugate speech, move on to the next form of speech.
Reflected speech is a more complex form that allows storytelling based on objects, pictures, toys. The parents say the phrase, the child repeats: “I have a pencil.” "I'm drawing". “Once upon a time there was a goat, and she had seven kids.” With children it is advisable to recite “Teremok”, “Kolobok”, M. Prishvin’s story “The Brave Hedgehog”, A. Barto’s poems “Bunny”, “Bear”. With older preschoolers you need to learn the alphabet, and you should also teach them to read and write using the ABC.
During this period, exercises for coordinating words with movement are introduced. March in a circle with your child: “We learned to count: one, two, three, four, five.” And so three times. Or another exercise. Give your child a ball and count each time the ball is thrown on the floor. The lesson ends with a speech board game. For example, you can prepare any subject lotto. Show your child the picture and calmly say: “I have a squirrel.” Then you just show the picture and the child names it.
This is a schematic lesson plan for the education of the reflected form of speech, based on which you can create subsequent lessons yourself.
During this period, learn N. Naydenova’s poem “Spring” with your child. Use days of the week, months, seasons of the year as speech exercises. If your child reads, choose folk tales and interesting poems for him.
After two or three lessons, the child himself begins to be active and confidently repeats the text, willingly plays, throws the ball up, hits the floor or wall. The movement is accompanied by words. Counting rhymes, jokes, and riddles are especially convenient for such exercises (they can be found in the magazines “Funny Pictures” and “Murzilka”).
This concludes the preparatory period. Its duration may vary depending on the success of mastering the conjugate-reflective form of speech. Fluency in them provides the basis for the transition to the next period - training. There are often cases when, already at the initial stage, certain forms of stuttering (especially mild ones) are successfully overcome. For preventive purposes, classes should be continued. However, the daily routine and gentle regime should remain the same. After a month, the child can be taken to a regular kindergarten.
Lesson No. 3 (5 - 6). Conjugate speech
Purpose of the lesson: practicing breathing, voice, articulation, smooth, slow speech, sense of rhythm, general relaxation.
Benefits: the same as on the previous two, plot pictures, poems, counting rhymes.
Breathing, vocal, articulation, relaxation exercises, rhythmic exercises are given above. You can take several new ones or repeat the previous ones.
Breathing exercises: blow off the cotton wool on the table, increasing the distance to it. We blow on a boat made of foam plastic and blow soap bubbles. We practice the duration of exhalation.
Voice exercises: practicing vowels A. O. Pull A - cradle the doll - a-a-a-a. Pull O - teeth hurt - o-o-o-o. We pronounce sounds quietly and loudly.
Articulation exercises: for the tongue - back and forth, to the sides - “clockwise”, “bumps” - with the tongue on the cheeks. Lick your upper lip. “Horse” – let’s click our tongue. Let's bite the wide tongue. “Bell” - tap the tongue on the upper alveoli - la-la. “Hammer” - tap the tongue on the upper alveoli, pronouncing - dddd. For the lips - “tube” - oh, “smile” - and in the dynamics we pronounce both sounds together oi, oi. For the lower jaw, open your mouth wide several times.
Relaxation exercises: “rinsing clothes” - lean forward, lower your arms down Practicing conjugate speech:
1. Picture “Family at dinner.” We try to select a sentence with the conjunction “I”.
Brief summary of the picture.
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Rhythmic exercises: marching to a count, while singing a marching song.
3. Game "Children's dominoes". The chips can depict animals, birds, toys, etc. For example, lotto animals. We put a chip with a picture of a bunny and a squirrel and say “I’ll put a bunny and a squirrel.” The child looks at his chips and puts the appropriate one: “I put a squirrel and a fox,” etc.
We make sure that the child speaks smoothly, slowly and smoothly without tension.
We pronounce rhymes both with the ball and while marching.
For logorhythmic exercises, you can use the following techniques:
1. We play the game “Ladder”. We draw flights of stairs in profile (sheet no less than 30×20) - “ladder”. And at each step we put aside the word - we pronounce it. We explain to the child that when we go up or down the stairs, we constantly move our feet without stopping. Therefore, the phrase sounds continuous and rhythmic.
2. You can play the game “Gorka”. On a sheet of paper (30 x 20) draw a slide. We explain to the child that when we roll down a hill, we cannot stop right away. Therefore, words that “roll” downhill in a sentence are pronounced together.
To build up the phrase, we increase the number of steps of the ladder and the length of the slide.
These activities have elements of play, which has a positive effect on the child’s behavior. He makes contact easily, and the lesson takes place on a high emotional level. Such activities are especially recommended for children of primary preschool age.
Purpose of the lesson: teaching correct speech skills, i.e. compliance with speech rules when pronouncing several elongated phrases together
Aids: ball, tambourine, objects for the development of long exhalation (cotton wool, strips of paper, serpentine for blowing, harmonica, etc.), plot pictures, short stories, fairy tales, rhymes, counting rhymes. Breathing exercises: the dog is hot, the hamster is lying on its back. When you inhale, inflate your tummy (stick it out), and when you exhale, pull it in. Game: when you inhale, the belly is forward (the ball is inflated), when you exhale, the belly is inward (the ball bursts). To control the mobility of the abdominal wall, you can place a book on it and watch how it rises when you inhale and falls when you exhale.
You need to learn how to perform this exercise clearly and without much stress. The child must independently control the correct inhalation, inhaling air through the “stomach” and exhaling for a long time (maintain a strip of paper in a horizontal position for a long time when exhaling).
In initial classes, much attention is paid to teaching the child how to inhale and exhale correctly.
Voice exercises: exclamation of admiration - “AAAAH” (in the chest register and do not shout - pronounce it softly). An exclamation of regret - “EEEEH.” Exclamation of surprise - “OOOOH”, “UUUUH”. It is advisable to convey the intonation difference. You can do this using examples: “AAAAH, how nice it is in the forest,” etc.
Articulation exercises: perform various exercises for the tongue, lips, lower jaw. You can select and come up with exercises yourself, together with your child.
Relaxation exercises: “Sailor’s gait” - place your feet shoulder-width apart and shift your body weight to one foot or the other. Perform at a slow pace, several times in one direction and the other.
Rhythmic exercises: hitting the ball while counting. The exercise can be complicated: throw the ball in front of you, and on your right side with a slight turn, and on your left side. On one exhalation, up to 3, 4, 5, 6, 7, 8 and...
Stepping, counting in a circle, figure walking (figure eight, snake, etc.).
1. Working out a story based on a plot picture.
Picture “Spring in the garden”.
When presenting the content, complex sentences are selected. Brief summary of the picture.
The story is processed in conjugate speech mode. All speech rules and guidelines given above are observed. 2. Practicing a story without visual support.
During the lesson you can play subject lotto. When working with texts based on pictures and listening, you can use the techniques of the game “Ladder” and “Slide”.
We conduct various games: children's lotto, dominoes. Children's lotto consists of various thematic sets of cards with pictures. One or two large pictures are distributed, which can depict thematic objects: furniture, transport, animals, etc. They are accompanied by pictures that depict these objects in a reduced form. You ask the child and the players, for example: “Who has the table?” The child finds a square with a picture of a table in the large picture and places his small card with a picture of a table on this square. At this stage, the game is played silently, although if the child shows speech activity, then in this case he needs to correctly formulate the sentence: “I have the table.” Next comes building up the phrase. But we will move on to independent phrases only at the question-and-answer stage.
At the stage of conjugate speech, we set the goal of learning to correctly use speech together with parents, that is, parents pronounce the phrase together with the child. Parents help the child focus on breathing, voice, articulation, rhythm, smoothness, and relaxation during speech. The child develops confidence and courage in completing the task.
Here is an approximate course of practice when practicing conjugate speech. Depending on the age, speech material is also selected. If speech skills are difficult to form, then you can increase the number of classes with new material or repeat each lesson several times until certain skills are formed. The main thing is not to rush, be patient with your child’s efforts, encourage him, and do not skimp on praise when he successfully completes a task.
In addition to the special task, parents can conduct other educational, emotional games and fairy tales on their own.
So, classes in conjugate speech can continue until the child performs them easily and naturally. There is no limit on the number of tasks or time, the main requirement is SYSTEMATICITY. You should always remember that your child’s recovery, first of all, depends on you.
As soon as speech skills (breathing, rhythm due to the emphasis of stressed vowels in each word and vocal pronunciation - the continuous pronunciation of words in a sentence as one whole) in conjugate speech are practiced, we move on to the next stage of training: reflected speech.
At this stage of speech classes, speech work comes down to the following: you pronounce a phrase or short phrase at a slightly slower pace, observing speech rules, and ask the child to repeat it independently after you. It should easily and correctly convey the rhythmic and intonation pattern of the phrase or phrase you propose. For example: “This is a big ball”, “Pavlik and Kolya are fishing.” Then ask the child to repeat this himself, following the speech rules. After each phrase you say: “Now you repeat it yourself.” The child repeats, and you watch how he completes the task.
At first, simple phrases are given, then they are gradually built up and then move on to complex composed or subordinate ones. The speech rules remain the same as in tasks for practicing conjugate speech.
Task No. 1 (1 - 2). Reflected speech
At each lesson, rhythmic exercises are required to develop a sense of rhythm, breathing, voice and articulation exercises, logorhythmic exercises and relaxation exercises.
The purpose of the classes: to practice articulation, breathing and voice, slow tempo, a feeling of relaxation in reflected speech.
Aids: the same as those used in previous classes. Ball, tambourine, tape recordings of music, songs at a slow, medium, fast pace, various thematic lotto games, plot pictures, series of plot pictures, collections of children's poems, stories and fairy tales.
All articulation, voice and breathing exercises are listed.
The marching includes the following: four steps of the hand forward, four steps of the hand up, four steps of the hand to the sides and four steps of the hand to the waist. The child constantly walks in a circle (the perimeter of the room) and performs these sequences in four counts several times without interrupting the rhythm of walking. You should first use a slightly slower pace to practice motor and vocal synchronization; four steps and immediately change the position of the hands. Hands forward - one, two, three, four steps; hands up - one, two, three, four steps; arms to the sides - one, two, three, four steps; and hands on the belt - one, two, three, four steps. And so continuously repeat several times until easy, clear execution. In the future, this exercise will become more difficult each time. It aims to include the left and right hemispheres of the brain in synchronous work: speech plus movements.
If classes are held in a group, then each child repeats the phrase separately, but in no case all together! In conjugate speech, all children, together with the speech therapist, repeat the phrase, and in reflected speech, each child repeats it independently.
The child repeats the phrase after you and monitors whether it sounds the same in terms of rhythmic and melodic parameters. He is already beginning to independently feel the speech rhythm, melody, and vocal performance. Confidence in one’s abilities to speak like parents appears, and then there is a desire to communicate with others. But this does not happen immediately. You can start working on the following topics: “Furniture”, “Dishes”, “Clothing”, “Transport”, “Animals”, etc., generalizing concepts, playing with size, color, shape, smell, etc.
All these classes are carried out in a logorhythmic mode: with the hand, with a ball in stepping, in the game “Slide”, “Ladder”, clapping.
You can play subject lotto and dominoes. For example: the game is fruit and berry dominoes, the cards of which depict berries and fruits. You put a card and say: “I put an apple and a plum,” and the child repeats the phrase, changing one word in it: “I put an apple and a cherry.” And so on until you finish the game.
Lotto and dominoes may have different vocabulary depending on the topic. These exercises help to form not only speech rules, but also to develop lexical knowledge.
To develop memory and attention, teach your child small rhymes and count glasses, which are also played in logarithmic mode.
Say the rhyme with clapping (for kids), with your hand, with a ball. The verse goes to the count of one, two, three. Start each line after a short breath. Inhale calmly, without noise, without raising your shoulders.
Task No. 2 (3 - 4). Reflected speech
With each lesson, we try to introduce more and more complex forms of sentences into the child’s speech for repeating after you: from simple to complex.
The purpose of the lesson: to develop the skills to easily and freely, without tension, independently reproduce your speech, expressed in sentences of varying complexity.
At the same time, you need to ensure that he controls his speech himself, that is, compares his and your speech in terms of parameters.
The tasks also include articulation, breathing, vocal, rhythmic, relaxation, and logorhythmic exercises. All of these exercises are listed above.
Now let's get back to marching. In the 1st lesson, we stretched our arms forward for four counts, then up, to the sides, to the waist. Now we perform the same exercise (counting and marching with movements) in two counts: hands forward - one, two, hands up - one, two, hands to the sides - one, two and hands on the belt - one, two. Then the same exercise is carried out only on the count of one - arms forward - one, arms up - one, arms to the sides - one, hands on the belt - one, i.e. four counts and four changes of movements in a row. At the beginning of the exercise, we changed one movement for four counts, then for two counts, and the last phase of such an exercise is more difficult, because in it the change of movement changes for each count.
This exercise develops in the child a sense of rhythm, attention, coordination of complex movements accompanied by an independently voiced rhythm, i.e. he sets the rhythm with his counting. With this exercise, the right and left hemispheres begin to work actively and synchronously. These exercises are very useful for children with neurotic stuttering, as well as with neurosis-like stuttering.
This exercise is performed in constant motion for at least 2-4 minutes. Bring execution to automaticity, to ease and synchronicity, clarity and rhythm.
Work on visual support. Story-based, serial pictures, objects (children's dishes, furniture, etc.), role-playing games (dolls).
| In the reflected speech task, speech rules are constantly followed, which you demonstrate to the child using your example and ask him to do this on his own. All types of logorhythmic exercises are used in the lesson. During the lesson you can change the forms of various parts of speech:
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The material of the lessons on reflected speech can be repeated several times so that the child can easily fulfill the requirements at this stage. You can also use your own material in these classes. Next we move on to more complex question-and-answer speech (dialogue).
What is our task at this stage? We teach the child to answer questions with one word or an extended phrase. We teach him to ask questions on his own. This work is carried out both with visual support (visual analyzer) and with auditory support (auditory analyzer). We teach the ability to independently plan their actions, expressing their own thoughts out loud. Breathing, vocal, articulatory, rhythmic, logorhythmic, relaxation exercises are selectively carried out in classes at the question-and-answer stage. The skills of speech physiological rules are still being practiced - to begin speech only after a short breath, to highlight the stressed vowel in an important word and to pronounce all the words in a sentence together, i.e. the voice, and this is the ligament closure, sounds constantly, without interruption (voice leading).
At this stage, we constantly remind the child of this while completing the task; he should feel your support at any moment.
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