Erased dysarthria

A child with mild dysarthric status has impaired motor sphere, sound pronunciation, and prosodic aspect of speech. However, all these defects are minimally expressed, in an erased form, and therefore are detected only with a careful neurological and speech therapy examination. Typically, erased dysarthria is diagnosed at 5-6 years of age. Before this, speech disorders were regarded as polymorphic dyslalia, and only the extraordinary persistence of sound pronunciation defects forces specialists to take a deeper look at the problem.

In general physical development in children with MDD there is a slight lag behind the age norm. Patients may be short, underweight, or have a narrow chest. They are clumsy, quickly tire during physical activity, and have difficulty performing movements in a synchronized manner. Along with the general motor sphere, fine motor skills suffer. Due to the fact that differentiated movements of the fingers are disrupted, children have difficulty mastering self-care skills (fastening buttons, tying shoelaces), feel awkward during creative work (drawing, appliqué, modeling), and do not like toys with small parts (puzzles, construction sets). Schoolchildren's graphomotor skills suffer: illegible handwriting and low writing speed.

Damage to the facial and articulatory muscles is indicated by hypomimicness of the face, laxity of the lips, pareticity of the tongue, asymmetry of the nasolabial folds and corners of the mouth. When performing articulation tests, hyperkinesis, synkinesis, slight cyanosis and deviation of the tongue appear. During speech activity, hypersalivation is noted. It is difficult to perform articulatory movements, hold a pose, and smoothly switch from one articulation to another. The neuropsychic status of children with erased dysarthria reveals vegetative disorders (sweating and cyanosis of the extremities, persistent dermographism). The child may be easily excitable, fussy or inhibited, lacking initiative. Characterized by reduced performance, poor switching ability, instability of attention, and decreased memory capacity.

Violation of sound pronunciation is multiple in nature - phonetic defects affect two or more groups of sounds (usually whistling, hissing and sonorant). Abnormal pronunciation in most cases is represented by sound distortions (interdental and lateral sigmatism, throat rhotacism), often combined with the absence and replacement of sounds, defects in voicing/voicing and softening. Even having achieved the normative isolated sound of a phoneme, it is difficult to automate the disrupted sound and introduce it into speech. Along with sound pronunciation, the prosodic aspect is disrupted: the voice is fading, intermittent, unmodulated, nasalized, and the intonation expressiveness of speech is reduced. In general, the child’s speech is “smeared” and poorly intelligible.

Examination of children with dysarthria. Diagnosis of erased or minimal manifestations of dysarthria

Olga Maksimova

Examination of children with dysarthria. Diagnosis of erased or minimal manifestations of dysarthria

Examination of children with dysarthria. Diagnosis issues.

To distinguish erased dysarthria from complex dyslalia, a comprehensive medical and pedagogical study is necessary: analysis of medical and pedagogical documentation, study of anamnestic data.

Particularly difficult is the diagnosis of erased or minimal manifestations of dysarthria. In terms of external manifestations, erased dysarthria differs little from dyslalia and is often mixed with it, however, even erased dysarthria is based on pathological changes specific to the mechanism of occurrence, overcoming which sometimes causes significant difficulties.

Main diagnostic criteria:

• The presence of mild but specific articulatory disorders in the form of a limitation in the volume of the most subtle and differentiated articulatory movements, in particular the insufficiency of bending the tip of the tongue upward, as well as the asymmetrical position of the tongue extended forward, its tremor and restlessness in this position, changes in configuration.

• The presence of synkinesis (movement of the lower jaw when moving the tongue upward, movements of the fingers when performing articulation exercises).

• Slow, intermittent pace of articulatory movements.

• Difficulty maintaining articulatory posture.

• Difficulty in switching articulatory movements.

• Persistence of violations of the pronunciation of sounds and the difficulty of automating the delivered sounds.

• Violation of the prosodic aspect of speech.

In some cases, so-called functional tests help to diagnose minimal manifestations of dysarthria.

Sample No. 1.

The child is asked to open his mouth, stick his tongue forward and hold it motionless along the midline and at the same time follow the moving object with his eyes. The test is positive and indicates the presence of dysarthria if, at the moment of eye movement, there is a slight deviation of the tongue in the same direction.

Sample No. 2.

The child is asked to make articulatory movements with his tongue while placing his hands on his neck. With the most subtle differentiated movements of the tongue, tension in the neck muscles is felt, and sometimes there is a visible movement with the head thrown back, which indicates the presence of dysarthria.

When examining children with dysarthria, special attention is paid to the state of articulatory motor skills at rest, during facial and general movements, especially articulatory ones. At the same time, not only the main characteristics of the movements themselves are noted (their volume, tempo, smoothness, switchability, exhaustion, etc.), but also the accuracy and proportionality of the movements, the state of muscle tone in the speech muscle tour, the presence of violent movements and oral synkinesis.

The state of articulatory motor skills correlates with the child’s general motor capabilities; even minor motor disorders are noted. A more clear and accurate picture of the manifestation of erased dysarthria is provided by the following examination techniques:

Often children are sent to a speech therapy group. Children enter the kindergarten with external symptoms similar to manifestations of complex dyslalia, aggravated by phonemic underdevelopment. However, the lateral pronunciation of many phonemes, the appearance of excess saliva at the time of speech, the inability to hold one or another articulatory posture for a long time, the lower articulation of some upper sounds should alert the speech therapist and force them to conduct a particularly thorough examination of the mobility of the speech organs, as well as the quality of tongue movements, their accuracy and strength, because these are signs of dysarthria and should be taken into account during correctional work.

For this purpose it is necessary:

1. Carefully study the position of the tongue and its behavior in the oral cavity at rest. In this case, you can find that the position of the tongue is constantly changing: it either lies calmly, then retracts inside the mouth, then bends upward, or deviates to the side.

Consequently, with dysarthria, special attention is paid to exercises to relax the muscles of the organs of articulation. Self-massage of the tongue.

2. If you ask a child to lift his tongue up, you can observe a lot of unnecessary movements (the tongue sticks out sharply forward, becomes long and narrow before the tongue takes the desired position. This indicates changes in the tone of the tongue muscles.

3. The quality of tongue movements can be easily checked by asking the child to repeatedly perform the following exercises: lift the tongue up, then stretch it forward, turn it to the left ear and, finally, to the right. At the same time, it is easy to detect inaccuracy and insufficient strength of tongue movements, and sometimes its lethargy. Such phenomena are caused by hyperkinesis of the tongue. Constantly moving, as if unable to find the right position.

With dyslalia, tongue movements are of better quality. When correcting dysarthria, great attention is paid to the movements themselves (volume, tempo, smoothness, switchability) and the accuracy and proportionality of the movements.

4. Next, you should check your tongue for fatigue. For this purpose, you can offer the child 1-2 minutes. show how the cat laps milk, i.e. ask him to make quick movements of his tongue forward. By carefully observing the behavior of the tongue, you can detect a slowdown in the pace of movements and their inaccuracy. This confirms the dysarthric component.

5. If, after such exercises, you ask the child to stick his tongue forward. Then the tongue will noticeably deviate to the side and will not be able to remain in a calm state. All this indicates the presence of muscle and innervation insufficiency in the organs of articulation.

6. And yet, in children with erased dysarthria, in addition to impaired sound pronunciation, there is a violation of the voice and its modulations, weakness of speech breathing, and pronounced prosodic disturbances.

If a child names the objects depicted in the pictures and at the same time the articulation of many sounds is inaccurate, as if blurred, is not corrected with repetition, and after repeated repetition of words noticeable fatigue sets in, articulation becomes slow, incomplete, or many sounds are characterized by lateral pronunciation, then the listed symptoms do not indicate dyslalia, but an erased form of dysarthria.

When performing correctional work, a speech therapist must clearly distinguish between complex dyslalia and dysarthria and take into account all the differences in the work to correct sound pronunciation.

In studies devoted to the problem of speech disorders in erased dysarthria, it is noted that disturbances in sound pronunciation and prosody are persistent and in many cases cannot be corrected. This negatively affects the development of the child, the processes of his neuropsychic development in preschool age, and later can lead to school maladjustment. These disorders have a negative impact on the formation and development of other aspects of speech, complicate the process of schooling for children, and reduce its effectiveness. A relationship has been established between the pronunciation disorder itself and the formation of phonemic and grammatical generalizations, the formation of vocabulary, and coherent speech.

Classification

Patients with erased dysarthria are divided into three groups according to the degree of speech development impairment:

Communication ability is developed, but there are problems with the perception and use of prepositions and complex verbs. Speech communication is good, the vocabulary is sufficient for the child’s age. It is difficult to pronounce words that are difficult to articulate. Spatial orientation may be difficult.
In addition to impaired pronunciation of sounds and undeveloped intonation ability, there is a change in phonemic perception. Mistakes are made in pronouncing similar phonemes and words. Vocabulary is insufficient for the age group. It is difficult to form words and coordinate parts of speech when constructing a sentence.
Severe speech and phonemic impairment is noted. Vocabulary is low. Problems arise when constructing syllables. Grammatical rules are not followed.

This conditional classification is necessary to separate children in preschool and school institutions for therapy.

Articulation gymnastics

Erased dysarthria can be eliminated through gymnastics; treatment should be carried out regularly. It strengthens the facial muscles, develops the skill of correct pronunciation, and produces a strong and even air flow necessary for the correct production of sounds.

Gymnastic exercises are carried out according to the principle of imitation. The speech therapist shows how to move the tongue and jaws, and the little patient repeats. In classes, objects are often used that are designed to be squeezed by teeth or lips.

Through articulation gymnastics:

tense facial muscles relax;
articulation organs are toned;
a strong voice is put on;
correct pronunciation is developed;
facial and tongue muscles are strengthened;
blood circulation in facial tissues improves.

With regular classes with a speech therapist and at home, correct and clear pronunciation of sounds and words is formed.

Complications

Violations of sound pronunciation and prosody cause changes in phonemic perception. Moreover, the patient finds it difficult to perceive not only sounds that are close, but also sounds that are distant in sound and articulatory formation.

As a result, difficulties arise in understanding the syllabic division of words and word formation. There are grammatical errors, lexical scarcity, inhibition of the thought process, and poor understanding of semantics. A schoolchild with a speech development defect cannot normally assimilate the educational program, as a result of which dysgraphia develops - a violation of the writing process.

Features of the formation of the prosodic aspect of speech in children with an erased form of dysarthria

Yulia Vladimirovna Lykhenko, student, Omsk State Pedagogical University, Omsk [email protected] Scientific supervisor: Svetlana Nikolaevna Vikzhanovich, Ph.D., Associate Professor, Omsk State Pedagogical University, Omsk

Features of the formation of the prosodic aspect of speech in children with an erased form of dysarthria

Abstract. The article reveals the uniqueness of prosody disorders in children with an erased form of dysarthria, as well as the features of the formation of the prosodic side of speech in children with the pathology under study. Based on experiments and studies conducted by scientists, the author describes the level of speech development of children with erased dysarthria, the reasons for violations of the prosodic side of speech in such children. This material will be useful to specialists in the field of defectology, pedagogy and psychology, students of defectology faculties. Key words: erased form of dysarthria, prosodic side of speech, voice, intonation.

In the literature, descriptions of disturbances in the development of prosody in children with erased dysarthria are few. This happens because prosody disturbances in this form of dysarthria are of an erased nature. The second reason is that research on the speech of people with dysarthria has mainly been carried out on adults, not children.L. V. Lopatina writes [5] that erased dysarthria is a speech pathology that occurs as a consequence of brain damage, which is microorganic and unexpressed. Pathology manifests itself in disorders of phonetics and prosody. It is these components of the speech system that are significantly impaired in the erased form of dysarthria, being the leading ones in the structure of the defect. Also, children with this pathology are characterized by such disorders as: Violations of vocabulary and grammar of the language; Motor skills disorder (it concerns both general and fine motor skills); Motor disorders of articulation and facial expressions;

Prosody disturbances in children with dysarthria were studied in detail by R.E.Ides and G.V. Babin [1]. The authors examined the features of using the voice and described the following peculiarities of disorders: – inability to operate with a high voice when pronouncing short phrases, automated statements. The child cannot emotionally imitate the speech of fairy-tale characters; high voices are replaced by low or medium ones, and high voices are replaced by loud ones. Difficulty in conveying the characteristics of low and medium pitched voices and their interchanges. There is a shift in the voice to the middle register towards the end of the sentence. – replacement of a loud voice with a medium one, gradual fading of the voice towards the end of the phrase (the child pronounces loudly only the first words of the sentence); – dominance of a quiet voice; – inability to pronounce a phrase at a fast pace, manifested in its replacement with a medium one or slow. There is a violation of the use of a slow tempo in speech (the child usually replaces it with a medium or slightly accelerated tempo). – low dynamic potential of the voice: 1) complete inability to change the pitch of the voice, voluntarily switch from a low voice to a high one, from medium to low, the inability to smoothly transition different sound ranges; 2) complete inability to change the strength of the voice (the child uses speech with average strength), fixation on the same volume with which the utterance began. Children can switch from whispered speech to medium strength and vice versa; it is also possible to have a short loud beginning of speech with a sharp, contrasting jump to medium, then to quiet pronunciation. 3) lack of connotation in statements (impossibility of conveying positive (surprise, delight, joy) and negative connotations (fear, anger, resentment)); the inability to determine the intonation of speech, accordingly, the lack of understanding of the meaning of the statement; inability to differentiate the most and least contrasting intonation patterns of sentences and connotations (joy-sadness, question-narrative answer, order-request, joy-surprise) inadequacy of the implementation of connotation in speech (manifested in replacing fear with anger, joy with surprise); As a result of the study by R.E. . Eades and G.W. Babina [1] formulated a number of reasons for the violations described above:

lack of speech experience;

low level of development of dialogical speech;

the presence of disturbances in the physical properties of the voice;

low degree of development of pronunciation components of speech; According to G.V. Chirkina [7], the shortcomings of the intonation of the voice are due to a violation of facial expressions. In children with an erased form of dysarthria, the following features in the functioning of the articulatory apparatus are usually revealed: 1) Pareticity of the muscles of the articulation organs is observed: the facial muscles are flaccid, the lips do not take the required position during articulation. The tongue is usually thin, flaccid, inactive, located at the bottom of the oral cavity. 2) In another case, spasticity of the muscles is noted: the facial muscles are tense, hard, it is amicable (the lips are always half-smiling, children show an inability to give the lips the desired articulatory position). The tongue is most often thick, inactive, and does not have a pronounced tip. 3) With dysarthria, hyperkinesis (shaking, tremor of the vocal cords and tongue), apraxia (inability to perform certain articulatory postures or the inability to switch them) often appear. A possible violation is deviation, manifested in the deviation of the tongue from the midline. It is usually combined with a smoothed nasolabial fold and asymmetrical lips. Hypersalivation is also noted. Often erased dysarthria is combined with disturbances in sound pronunciation [6]. When initially communicating with a child, his sound pronunciation is considered dyslalia. Upon further examination, the following is revealed: distortion of sounds, confusion, replacement and absence of sounds, which has a certain similarity with dysarthria. However, unlike dyslalia, in addition to these disorders, prosody also suffers in the erased form of dysarthria. The most common violation of sound pronunciation in dysarthria is a defect that extends to hissing and whistling sounds, their interdental and lateral pronunciation. Quite often, eliminations are observed in the combination of consonants, a reduction in the sound content of the word and its syllabic structure. In connection with the above, children with dysarthria can be divided into groups according to general speech development [3]. The first group includes children who have disturbances in both sound pronunciation and prosody. Children are at a good level of speech development, have a rich vocabulary, speak coherent speech, but experience difficulties in mastering words with a complex syllabic structure and prepositions. These children have impaired discrimination of spatial orientation (right to left, top to bottom, etc.). The second group consists of children who, in addition to disturbances in sound pronunciation and prosody, have deficiencies in the formation of phonemic hearing (single errors in the perception of oppositional sounds, syllables, words with such sounds). The third group includes children who, in addition to a persistent violation of sound pronunciation and prosody, have severe underdevelopment of phonemic hearing. As a result of the examination, the speech therapist notes an inability to make a coherent statement, a poor vocabulary, persistent errors in reproducing grammatical structure and words with different syllabic structures. Let us consider in more detail the features speech formation in children with the pathology in question. Up to one year, children with dysarthria have underdeveloped various intonation and facial reactions of the voice. According to E. N. Vinarskaya [2], this is due to local lesions of the facial, respiratory and vocal muscles. At an early age, the perception and discrimination of emotional reactions is impaired; it is fragmented. In preschool children, the disorder manifests itself in deficiencies in the melodic organization of utterances, disturbances in speech tempo, timbre, and a nasal tone of the voice and its rapid exhaustion. At older preschool age, children exhibit persistent impairments in prosody components. As N.V. points out. Serebryakova and L.V. Lopatin [5], in children there is an incompleteness of the breathing process, which manifests itself in an incorrect type of breathing (mainly abdominal type of breathing, high frequency and insufficient depth of inspiration). Physical stress increases breathing speed, resulting in distortions. Rapid breathing leads to disruption of the fluency of speech and its rhythm, which explains the appearance of distortions in speech utterances. Even the child’s inability to breathe through the mouth is reflected in the pronunciation - speech while inhaling, omissions of sounds, “blurred” speech, lack of emotions in speech, a nasal tone of voice, disturbances in the tempo-rhythmic organization of speech [5]. Based on the above, we can conclude that the erased Dysarthria is a complex speech disorder that includes persistent disturbances in facial expressions, voice, articulation, breathing, and prosodic components of speech. Consequently, the speech of children with these disorders does not perform the function of communication, does not provide the interlocutor with information about the intonation differences in phrases, or about the speaker’s attitude to the information being communicated[4].

Links to sources 1. Babina, G.V. Workshop on the discipline of speech therapy: Dysarthria / G.V. Babina, R.E. Ides. M.: Prometheus, 2012. 108 p. 2. Vinarskaya, E.N. Early speech development of a child and problems of defectology: Periods of early development. Emotional prerequisites for language acquisition / E.N. Vinarskaya. M.: Education, 1987. 165 p. 3. Lopatina, L.V. On the differentiation of groups of preschool children with an erased form of dysarthria. Identification and correction of neuropsychiatric and speech disorders in children / L.V. Lopatina. M.: Publishing House of the Academy of Pedagogical Sciences, 1985. 95100 p. 4. Lopatina, L.V. Peculiarities of perception and reproduction of the intonation structure of sentences by preschoolers with erased dysarthria. Speech activity in normal and pathological conditions: Proceedings of the interdisciplinary scientific and methodological conference/L.V. Lopatina. M.: Publishing House of the Academy of Pedagogical Sciences, 1999. 5359 p. 5. Lopatina, L.V. Characteristics and structure of speech defects in preschool children with erased dysarthria. Features of the mechanisms, structure of speech disorders and their correction in children with intellectual, sensory and motor disabilities / L.V. Lopatina. M.: Publishing House of the Academy of Pedagogical Sciences, 1996. 2536 pp. 6. Fomicheva, M.F. Education of children's correct sound pronunciation: Workshop on speech therapy: Textbook. manual for students of pedagogy. special schools No. 03.08 “Preschool education” / M. F. Fomicheva. M.: Education, 1989. 239 p. 7. Chirkina, G.V. Fundamentals of speech therapy: Textbook. manual for pedagogical students. institutes for special Pedagogy and psychology / T.B. Filicheva, G.V. Chirkina. M.: Education, 1989. -223 p.

Causes of erased dysarthria in preschool children

The main reason for the erased form of dysarthria is a violation of the innervation of the muscles of the lips, tongue, and soft palate.

Such disorders are caused by organic brain damage in various periods of child development:

During the prenatal period, the fetus can be negatively affected by infectious diseases of the mother (herpes infection, rubella, toxoplasmosis, viral hepatitis, cytomegalovirus infection). Immunological incompatibility of the fetus and mother, toxicosis, decompensated diabetes mellitus or gestational diabetes play a role. As a result of these conditions, fetoplacental insufficiency develops, the fetus experiences oxygen deficiency, that is, hypoxia;
During childbirth, traumatic injury is possible as a result of rapid or protracted labor or the use of obstetric forceps. A long anhydrous period has a negative effect;
In the postpartum period and in the first year of a child’s life, damage to the central nervous system can occur due to injuries, infectious and other severe diseases, inflammatory diseases of the substance and cerebral cortex.

All of these factors lead to damage to the nerves that innervate the muscles of the articulatory organs: trigeminal, facial, glossopharyngeal, sublingual. Each nerve has its own characteristics. For example, damage to the trigeminal nerve is indicated by limited movements in the lower jaw, lips, tongue, facial nerve - facial muscles, glossopharyngeal nerve - root and back of the tongue, hypoglossal nerve - impaired tongue motility, difficulty raising the tongue to the palate.

Erased dysarthria. Structure of the defect. Article on speech therapy on the topic

Erased dysarthria. Structure of the defect.

Erased dysarthria occurs very often in speech therapy practice. Complaints with erased dysarthria: slurred, inexpressive speech, poor diction, impaired pronunciation of words with a complex syllabic structure, etc.

Erased dysarthria is a speech pathology that manifests itself in disorders of the phonetic and prosodic components of the speech functional system and arises as a result of unexpressed microorganic damage to the brain (L. V. Lopatina)

Erased dysarthria is most often diagnosed after 5 years.

General motor skills. Children with erased dysarthria are motorically awkward, their range of active movements is limited, and their muscles quickly tire under functional loads. They stand unsteadily on one leg, cannot jump, etc. They imitate movements poorly: how a bird flies, how a soldier walks. Motor awkwardness is especially noticeable in physical education and music classes, where children lag behind in tempo, rhythm of movements, and also when switching from one movement to another.

Fine hand motor skills. Children with erased dysarthria learn self-care skills late and with difficulty. During drawing classes, they don’t hold a pencil well and their hands are tense. Motor clumsiness of the hands is especially noticeable during applique classes and with plasticine.

School-age children in the 1st grade experience difficulties in mastering graphic skills.

Features of the articulatory apparatus. In children with erased dysarthria, the following pathological features of the articulatory apparatus are revealed.

Pareticity (flabbiness) of the muscles of the articulatory apparatus. Spasticity (tension) of the muscles of the organs of articulation. Hyperkinesis with erased dysarthria manifests itself in the form of trembling, that is, tremor of the tongue and vocal folds. Apraxia is the inability to perform any voluntary movements with the hands and organs of articulation; in the articulatory apparatus, apraxia manifests itself in the inability to perform certain movements or when switching from one movement to another. Deviation, i.e. deviation of the tongue from the midline. Hypersalivation - increased salivation is detected only during speech.

When examining the motor function of the articulatory apparatus, in some children with erased dysarthria, the ability to perform all articulatory movements is noted, i.e., children perform all movements according to instructions, for example, they can pout their lips, click their tongue, etc. When analyzing the quality of performing these movements noted: blurredness, unclear articulations, weak muscle tension, arrhythmia, decreased range of motion, decreased range of motion, rapid muscle fatigue, etc. Thus, under functional loads, the quality of articulatory movements drops sharply.

Sound pronunciation. When examining sound pronunciation, confusion, distortion of sounds, replacement and absence of sounds are revealed. Speech with erased dysarthria also has disturbances on the prosodic side. Impaired pronunciation and prosody affect speech intelligibility, intelligibility, and expressiveness. The examination reveals that many children who distort, omit, mix or replace sounds in speech can pronounce these sounds correctly in isolation. The most common disorder is a defect in the pronunciation of whistling and hissing sounds. Children with erased dysarthria distort and mix not only articulatory complex sounds that are close in place and method of formation, but also acoustically opposed ones.

Prosody. The intonation and expressive coloring of the speech of children with erased dysarthria is sharply reduced. Voice modulations in pitch and strength suffer, speech exhalation is weakened. The timbre of the voice is disturbed, and sometimes a nasal tone appears. The pace of speech is often accelerated.

General speech development. Children with erased dysarthria are divided into three groups.

First group. Children who have impaired sound pronunciation and prosody. As a rule, these children have a good level of speech development. But many of them have difficulty mastering, distinguishing and reproducing prepositions. Children confuse complex prepositions and have problems distinguishing and using prefixed verbs. At the same time, they speak coherently and have a good vocabulary, but may have difficulty pronouncing words with a complex syllabic structure.

Second group. These are children in whom a violation of sound pronunciation and the prosodic side of speech is combined with the incomplete process of forming phonemic hearing. In this case, children encounter isolated lexical and grammatical errors in their speech. Children make mistakes in special tasks when listening and repeating syllables and words with oppositional sounds. Thus, in some children it can be stated that auditory and pronunciation differentiation of sounds is unformed. The vocabulary lags behind the age norm. Many children experience difficulties in word formation, make mistakes in agreeing nouns with numerals, etc. Sound pronunciation defects are persistent and are regarded as complex, polymorphic disorders.

Third group. Children who have a persistent polymorphic disorder of sound pronunciation and a lack of prosodic aspect of speech are combined with underdevelopment of phonemic hearing. They have a poor vocabulary, pronounced errors in grammatical structure, the impossibility of making coherent statements, and significant difficulties arise when mastering words of different syllabic structures. They ignore prepositions in speech.

All children with erased dysarthria are a heterogeneous group. Depending on the level of development of linguistic means, children are sent to specialized groups: with phonetic disorders, with phonetic-phonemic underdevelopment, general speech underdevelopment.

To eliminate erased dysarthria, a complex intervention is required, including medical, psychological, pedagogical and speech therapy.

Prognosis and prevention

Any speech defect, including an erased form of dysarthria in preschool children, entails psychological disorders. If the disorder is not detected in time, diagnosed and therapy is not started, the baby will grow up with this pathology, and others will join it. In such situations, it is difficult for a person to live in society: he is limited in his choice of profession and self-realization. Because of this, he may feel depressed, which can further lead to depression.

Prevention of erased dysarthria begins during pregnancy planning. The expectant mother needs to undergo examination at this stage and prepare for conception: undergo a course of treatment, if there are any problems, eliminate deficiency conditions (anemia, hypovitaminosis).

After pregnancy, you need to be careful about your food choices and daily routine. The expectant mother should have enough rest, walk, avoid physical strain, injury, and stress.

It is important to competently manage labor and avoid injuries and hypoxia. During the newborn period, follow the doctor’s recommendations and undergo examinations on time. If you suspect any developmental abnormality, tell your doctor. Timely diagnosis and therapy are mandatory conditions for the earliest possible recovery and a guarantee that the disorder will not affect the baby’s development in the future.

Dysarthria is a disorder of sound pronunciation, voice formation and prosody, caused by insufficient innervation of the muscles of the speech apparatus: respiratory, vocal, articulatory.

With dysarthria, the motor mechanism of speech is disrupted due to organic damage to the central nervous system. The structure of the defect in dysarthria is a violation of the entire pronunciation aspect of speech and extra-speech processes: general and fine motor skills, spatial representations, etc. The structure of the defect has been sufficiently studied in the specialized literature. The treatment of this group of children is also widely represented in the medical literature. Mild degrees of dysarthria (MDD - minimal dysarthric disorders) are very common in children with ODD (50-80%); in children with FFN (30-40%); in some children with an initial diagnosis of “complex dyslalia,” a thorough examination reveals erased dysarthria (10%). Erased dysarthria (mild dysarthria, MDD - minimal dysarthric disorders) in speech therapy practice is one of the most common and difficult to correct disorders of pronunciation of speech. G. Gutsman is the first to identify among children with polymorphic sound pronunciation disorders a category of children in whom articulation is blurred and for whom the process of correcting sound pronunciation is extremely difficult. In the future, Pravdina-Vinarskaya and Eidinova analyze cases of motor impairment. The abbreviation “MDR” was introduced by G.V. Chirkina and I.B. Karelina to designate a low (erased) degree of dysarthria. Mild “erased” dysarthria was identified by Pravdina and Melekhova when examining children with complex dyslalia. They identified functional, mechanical dyslalia, as well as organic cerebral dyslalia, which later began to be classified as mild dysarthria and began to be called erased dysarthria. The authors note that with organic cerebral disorders of sound pronunciation (erased dysarthria), there is insufficient mobility of individual muscle groups of the speech apparatus (lips, soft palate, tongue), general weakness of the entire peripheral speech apparatus due to damage to certain parts of the nervous system. Studying the anamnesis of children with erased dysarthria, Mastyukova, Lopatina, Arkhipov, Karelin and others identify the following factors: unfavorable course of pregnancy; asphyxia, low Apgar score at birth, the presence of a diagnosis of PEP - perinatal encephalopathy - in the vast majority of children in the first year of life. In the infant period from 0 to 1 year, pathological pre-speech symptoms are not detected in psychomotor development, because Screening examination of psychomotor functions of children has not yet been introduced into practice. And, as a result, there is no psychological, pedagogical and correctional speech therapy support for infants with PEP. A study of the anamnestic data of young children indicates a delay in locomotor functions (motor clumsiness when walking, increased exhaustion when performing individual movements, inability to jump, step up stairs, grasp and hold a ball). There is a late appearance of finger grasping of small objects, and a long-term persistence of the tendency to grasp small objects with the entire hand. The medical history notes difficulties in mastering self-care skills, dislike of drawing; Many children do not know how to hold a pencil correctly for a long time. In the future, they continue to have persistent difficulties in the formation of graphomotor skills. Interesting data are presented in Lopatina’s study on the psychomotor skills of children with MDD (minimal dysarthric disorders). When studying the psychomotor skills of children with erased dysarthria, tests proposed by N.I. Ozeretsky, E.Ya. Bondarevsky, M.V. Serebrovskaya were used. 1. A test for static coordination of movements shows that violation of statics is manifested in significant difficulty (and sometimes impossibility) in maintaining balance, in limb tremor. When holding a pose, children often sway, trying to maintain balance, lower their raised leg, touching it to the floor, and rise on their toes. They maintain their balance better when standing on their right foot. Having difficulty maintaining balance (mainly standing on the left leg), they try to hold on to the back of a nearby chair with their hands. 2. Test for dynamic coordination of movements. The dynamic test shows that in more than a third of cases, children throw the ball at the target not “from the turned shoulder”, without a swing, but from below. At the same time, at the moment of throwing with one hand, the other is tense and brought towards the body. The number of times the ball hits the target is significantly greater when performing movements with the right hand. In most cases, the test for the right hand is successful on the first attempt, while for the left - on the second and third. Most children with erased dysarthria are able to jump over a tight rope from a standing position, without a running start. At the same time, the task is not always completed on the first try. When the test is performed on the second or third attempt, the rope is noted to touch the rope when jumping with the feet and landing on the heels. In isolated cases, falling or touching the floor with hands after a jump and not jumping, but stepping over a rope were recorded. Performing test tasks to study dynamic coordination of movements is characterized by insufficiently coordinated activity of various muscle groups, “jerking”, and clumsiness of the movements performed. 3. Test to study the speed of movements. Completing a task to study the speed of movement shows that more than half of the children find it difficult to sit on the floor and stand up without using their hands. Basically, the task is performed at a slow pace. Children are able to sit on the floor without using their hands, but cannot get up without this help. They rest on either one or both hands. In less than half of the cases, children are able to quickly and correctly complete this task on the first try without using their hands. The inability to perform this test was noted in isolated cases. The nature of the children's performance of the task confirms the insufficient development of dynamic coordination of movements and motor maneuverability, discovered when performing other tests. 4. Motor memory tests. A motor memory test, in which the experimenter's movements program the sequence of their execution and at the same time have a confusing effect, causes significant difficulties for most children. When reproducing movements, their tempo slows down or, conversely, accelerates. Disruptions in the motor program began already from the third or even from the second movement, and difficulties were noted in the transition from one motor element to another. The error-free execution of this test on the first attempt was recorded only in isolated cases. 5. Test for simultaneous movements. The greatest difficulty to perform is the test for simultaneous movements. Simultaneous performance of movements for both limbs is observed in a small number of children. More often, there are either pronounced difficulties in performing these movements (mainly for the left hand), or their execution at different times. During the time allotted for completing the task, most children change the pace of winding the thread more than three times, while the pace of this movement does not correspond to the pace of walking. 6. Test to identify synkinesis (i.e. friendly, unnecessary movements). The motion clarity test is performed more successfully. The overwhelming majority of children perform it at a sufficient pace (for both limbs) without the occurrence of synkinesis. At the same time, cases were recorded of performing movements at a slow pace, with a violation of the amplitude (mainly for the left hand), with tension in the fingers when holding a pencil, with numerous synkinesis: lip movements, tongue protrusion, head tilts forward, etc. These tests are aimed at identifying maturity of the level organization of movements according to N.A. Bernstein. Lopatina's research confirms that children with erased dysarthria at almost all levels (according to Bernstein) show deviations from the norms in psychomotor skills. Violations of the function of static balance (level A), dynamic coordination (level B), violations of tempo and dexterity of movements (level B and C) are detected; decreased motor memory (level D). These studies not only reveal the mechanism of the disorder and the structure of the defect in erased dysarthria, but also define new directions in the psychological, pedagogical, medical and speech therapy aspects of influence, aimed at correcting the psychomotor skills of children. Children with erased dysarthria do not stand out sharply among their peers, and do not even always immediately attract attention. However, they have some peculiarities. So, these children speak unclearly and eat poorly. They usually do not like meat, bread crusts, carrots, or hard apples as they find it difficult to chew. After chewing a little, the child can hold the food in his cheek until adults reprimand him. Often parents make concessions to the baby - they give soft food so that he can eat. Thus, they, unwittingly, contribute to a delay in the child’s development of movements of the articulatory apparatus. It is necessary to gradually, little by little, teach the child to chew solid food well. It is more difficult for such children to develop cultural and hygienic skills, which require precise movements of various muscle groups. The child cannot rinse his mouth independently, since his cheek and tongue muscles are poorly developed. He either immediately swallows the water or pours it back. Such a child needs to be taught to puff out his cheeks and hold the air, and then pump it from one cheek to the other, retract his cheeks with his mouth open and lips closed. Only after these exercises can you teach your child to rinse his mouth with water. Children with dysarthria do not like and do not want to fasten their own buttons, lace up their shoes, or roll up their sleeves. You can't achieve anything here with orders alone. Fine motor skills should be gradually developed using special exercises. You can teach your child to fasten buttons (first large, then small) on a doll’s clothes or on a removed dress or coat. At the same time, the adult not only shows the movements, but also helps to make them with the hands of the child himself. After such training, children will be able to fasten buttons on clothes they are wearing. To train the ability to lace shoes, various shapes (square, circle, etc.) cut out of thick cardboard are used. Holes are made along the edges of the figure at a distance of 1 cm from each other. The child must sequentially thread a long cord with a metal end through all the holes over the edge, as if stitching the edges. To ensure that your child’s interest in the exercises does not wane, you can stick some picture in the middle of the figure and say that by threading the colored cord correctly, the child will make a toy in this way and will be able to give it to anyone he wants. Then he is asked to lace up his shoes, first taken off his feet, then directly on his feet. Dysarthric children also experience difficulties in visual arts. They cannot hold a pencil correctly, use scissors, or regulate the pressure on the pencil and brush. In order to teach a child how to use scissors faster and better, you need to place his fingers together with your own in the rings of the scissors and perform joint actions, consistently practicing all the necessary movements. Gradually, developing fine motor skills of the hands, the child develops the ability to regulate the strength and accuracy of his movements. Such children also have difficulty performing physical exercises and dancing. It is not easy for them to learn to correlate their movements with the beginning and end of a musical phrase, and to change the nature of movements according to the beat. They say about such children that they are clumsy because they cannot clearly and accurately perform various motor exercises. It is difficult for them to maintain balance while standing on one leg, and they often do not know how to jump on their left or right leg. Usually an adult helps a child jump on one leg, first supporting him at the waist, and then in front with both hands, until he learns to do it independently. A study of the neurological status of children with erased dysarthria reveals certain abnormalities in the nervous system, manifested in the form of a mild, predominantly unilateral, hemisyndrome. Paretic symptoms are observed in articulatory and general muscles, which is associated with impaired innervation of the facial, glossopharyngeal or hypoglossal nerves. (G.V. Gurovets, S.I. Mayevskaya) In cases of dysfunction of the hypoglossal nerve, deviation of the tip of the tongue towards paresis is noted, and mobility in the middle part of the tongue is limited. When the tip of the tongue and the middle part of the tongue are raised tooth-to-tooth, the middle part quickly falls to the side of the paresis, causing the appearance of a lateral air stream. In some children, dysfunction of the glossopharyngeal nerve predominates. In these cases, the leading symptoms of disorders are phonation disorders, the appearance, nasalization, distortion or absence of back-lingual sounds. A violation of muscle tone is often detected. The voice suffers significantly with dysarthria. It becomes hoarse, tense or, conversely, very quiet and weak. Thus, unintelligible speech in dysarthria is caused not only by a disorder of articulation itself, but also by a violation of the coloring of speech, its melodic-intonation side, i.e. violation of prosody. Dysarthria is characterized by inexpressiveness of speech, monotony of intonation, and a nasal tone of pronunciation. At the same time, erased dysarthria can be complicated by phonetic-phonemic underdevelopment, general speech underdevelopment, stuttering and other speech disorders. Studies by Lopatina et al. revealed in children with erased dysarthria disturbances in the linervation of facial muscles: the presence of smoothness of the nasolabial folds, asymmetry of the lips, difficulties in raising the eyebrows, and closing the eyes. Along with this, characteristic symptoms for children with erased dysarthria are: difficulty switching from one movement to another, reduced range of movements of the lips and tongue; Lip movements are not performed in full, they are approximate, and there are difficulties in stretching the lips. When performing exercises for the tongue, selective weakness of some muscles of the tongue, imprecision of movements, difficulties in spreading the tongue, lifting and holding the tongue at the top, tremor of the tip of the tongue are noted; In some children, the pace of movements slows down when performing a task repeatedly. Many children experience: rapid fatigue, increased salivation, and the presence of hyperkinesis of the facial and lingual muscles. In some cases, a deviation of the tongue (deviation) is detected. Features of facial muscles and articulatory motor skills in children with erased dysarthria indicate neurological microsymptoms and are associated with paresis of the hypoglossal and facial nerves. These disorders are most often not detected primarily by a neurologist and can only be identified during a thorough speech therapy examination and dynamic observation during correctional speech therapy work. A more in-depth neurological examination reveals a mosaic of symptoms of the facial, glossopharyngeal and hypoglossal nerves, which determines the features and variety of phonetic disorders in children. Thus, in cases of predominant damage to the facial and hypoglossal nerves, disorders of the articulation of sounds are observed, caused by inadequate activity of the labial muscles and muscles of the tongue. Thus, the nature of speech disorders depends on the state of the neuromuscular apparatus of the organs of articulation. Currently, the problem of erased childhood dysarthria is being intensively developed in clinical, neurolinguistic, psychological, pedagogical and correctional speech therapy aspects. To distinguish erased dysarthria from complex dyslalia, a comprehensive medical and pedagogical study is necessary: analysis of medical and pedagogical documentation, study of anamnestic data. By comparing the symptoms of speech and non-speech signs in children with dyslalia and dysarthria, diagnostic significant differences can be determined. Thus, in children with erased dysarthria, in addition to impaired sound pronunciation, there is a violation of the voice and its modulations, weakness of speech breathing, and pronounced prosodic disturbances. At the same time, general motor skills and fine differentiated hand movements are impaired to varying degrees. The identified motor clumsiness and lack of coordination of movements cause a delay in the formation of self-care skills, and the immaturity of fine differentiated movements of the fingers causes difficulties in the formation of graphomotor skills. In studies devoted to the problem of speech disorders in erased dysarthria, it is noted that disturbances in sound pronunciation and prosody are persistent and in many cases cannot be corrected. This negatively affects the development of the child, the processes of his neuropsychic development in preschool age, and later can lead to school maladjustment. These disorders have a negative impact on the formation and development of other aspects of speech, complicate the process of schooling for children, and reduce its effectiveness. A relationship has been established between the pronunciation disorder itself and the formation of phonemic and grammatical generalizations, the formation of vocabulary, and coherent speech. In the work of O.Yu. Fedosova makes a comparison between dyslalia and erased dysarthria. With complex functional dyslalia: • articulation of only consonant sounds suffers; • a clear violation of the articulation of certain sounds in various conditions of their implementation; • fixing the formed sounds does not cause difficulties; • there are no violations of the tempo-rhythmic organization of speech; • breathing changes are not typical; • phonation disorders are not observed; • there is no discordination of breathing, voice production and articulation. With a mild degree of pseudobulbar dysarthria: • possible blurred, unclear pronunciation of vowel sounds with a slight nasal tint; • sounds can be preserved in isolation, but in the speech stream they are pronounced distortedly and unclearly; • the automation process is difficult: the supplied sound may not be used in speech; • characterized by an accelerated or slow pace of speech; • breathing is shallow, speech is noted during inhalation, phonation exhalation is shortened; • coordination of these processes suffers. In order to understand and explain the nature and mechanism of violation in the erased dysarthria, it is necessary to turn to the provisions of the doctrine of the mechanisms of speech of A.R. Luria, P.K. Anokhin, etc. The mechanisms of speech are associated with the integral, hierarchical organization of the brain activity, including several links, each of the links, each of the which makes its specific contribution to the nature of speech activity. The first link in the speech functional system is the hearing, vision, sensitivity receptors that perceive the initial information. The initial receptive link systems include kinesthetic sensations that signal the position of the articulation organs and the whole body. With insufficiency of speech kinesthesia, speech development is disturbed. The second link is complex cortical systems that process, the storage of incoming information, the development of the reciprocal action program and the translation of the initial semantic thought into the scheme of the open speech utterance. The third link in the speech functional system is re -analyzing the transmission of speech messages. This link has a complex sensorimotor organization. In case of damage to the third link of the speech functional system, the innervation of the speech muscles is disturbed, i.e. The motor mechanism of speech is directly upset. E.F. Sobotovich and A.F. Chernopolskaya distinguish four groups of children with erased dysarthria. 1 group these are children with the lack of some motor functions of the articulatory apparatus: electoral weakness, the pareinity of some muscles of the language. The asymmetric innervation of the language, the weakness of the movements of one half of the tongue determine such disorders of sound pronunciation as the lateral pronunciation of soft whistling sounds [s] and [z], the afflicas [c], soft antennial [t] and [d], posteriorly speaking [g], [to ], [x], the lateral pronunciation of vowels [e], [and], [s]. Asymmetric innervation of the anterior edges of the tongue causes the lateral pronunciation of the entire group of whistling, hissing, sounds [p], [d], [t], [n]; In other cases, this leads to the interdental and lateral pronunciation of the same sounds. The causes of these violations, according to Sobotovich, are unilateral paresis of the sub -language (XII) and facial (VII) nerves, which are erased, unexpressed. In a small part of the children of this group, a phonemic underdevelopment is observed, associated with the distorted pronunciation of sounds, in particular, underdevelopment of the skills of phonemic analysis and phonemic representations. In most cases, children have the level of development of the lexical and grammatical structure of speech.

Group 2 In children of this group, no pathological features of general and articulatory movements were revealed. During speech, sluggish articulation, unclear diction, and general blurred speech are noted. The main difficulty for this group of children is pronouncing sounds that require muscle tension (sonorants, affricates, consonants, especially plosives). Thus, children often skip the sounds [r], [l], replace them with fricatives, or distort them (labial lambdacism, in which the stop is replaced by a labiolabial fricative); single-beat rhoticism resulting from difficulty vibrating the tip of the tongue. There is a splitting of affricates, which are most often replaced by fricative sounds. Violation of articulatory motility is mainly observed in dynamic speech-motor processes. The general speech development of children is often age appropriate. Neurological symptoms manifest themselves in the smoothness of the nasolabial fold, the presence of pathological reflexes (proboscis reflex), deviation of the tongue, asymmetry of movements and increased muscle tone. According to Sobotovich and Chernopolskaya, children of groups 1 and 2 have erased pseudobulbar dysarthria. Group 3 In children, the presence of all the necessary articulatory movements of the lips and tongue is noted, however, difficulties are observed in finding the positions of the lips and especially the tongue according to instructions, imitation, based on passive displacements, i.e. when performing voluntary movements and in mastering subtle differentiated movements. A feature of pronunciation in children of this group is the replacement of sounds not only in place, but also in the method of formation, which is inconsistent. In this group of children, phonemic underdevelopment of varying degrees of severity is noted. The level of development of the lexico-grammatical structure of speech ranges from normal to pronounced OHP. Neurological symptoms manifest themselves in increased tendon reflexes on one side, increased or decreased tone on one or both sides. The nature of articulatory movement disorders is considered by the authors as manifestations of articulatory dyspraxia. Children in this group, according to the authors, have erased cortical dysarthria. Group 4 This group consists of children with severe general motor impairment, the manifestations of which are varied. Children exhibit inactivity, stiffness, slowness of movement, and a limited range of movements. In other cases, there are manifestations of hyperactivity, anxiety, and a large number of unnecessary movements. These features are also manifested in the movements of the articulatory organs: lethargy, stiffness of movements, hyperkinesis, a large number of synkinesis when performing movements of the lower jaw, in the facial muscles, the inability to maintain a given position. Violations of sound pronunciation are manifested in replacement, omissions, and distortion of sounds. A neurological examination of children in this group revealed symptoms of organic damage to the central nervous system (deviation of the tongue, smoothness of the nasolabial folds, decreased pharyngeal reflex, etc.). The level of development of phonemic analysis, phonemic representations, as well as the lexico-grammatical structure of speech varies from normal to significant OHP. This form of disorder is defined as erased mixed dysarthria. Lopatina's (1986) studies presented three groups of children with erased dysarthria. The criteria for differentiation of groups are the qualities of the pronunciation side of speech: the state of the sound pronunciation, prosodic side of speech, as well as the level of formation of linguistic means: vocabulary, grammatical structure, phonemic hearing. General and articulatory motor skills are assessed. Common to all groups of children is a persistent violation of sound pronunciation: distortion, replacement, confusion, difficulties in automating the given sounds. All children in these groups are characterized by a violation of prosody: weakness of the voice and speech exhalation, poor intonation, monotony of speech: some violations of general and fine motor skills.

First group. Violations of sound pronunciation are expressed in multiple distortions and absence of sounds. Phonemic hearing is fully formed: children correctly perform tasks on auditory and pronunciation differentiation of sounds. The syllabic structure of words of varying complexity is not disturbed. The quality and volume of active and passive vocabulary correspond to the age norm, children successfully master the skills of inflection and word formation. Coherent monologue speech of children of the first group is formed in accordance with age standards. There are no structural or morphemic agrammatisms in the speech of children in this group. If we consider the first group of children with erased dysarthria within the framework of the psychological and pedagogical classification (R.E. Levina), then we can classify them as a group with phonetic underdevelopment (PH). Second group. Expressive speech is rated satisfactorily. Violation of sound pronunciation is in the nature of multiple substitutions and distortions. Phonemic hearing is impaired to a greater or lesser extent. Children have insufficiently developed auditory and pronunciation differentiation of sounds. When teaching their sound analysis, difficulties arise. When reproducing the syllabic structure of complex words, rearrangements and other errors occur. Active and passive vocabulary lags behind the age norm. There are errors in the grammatical formatting of speech (morphemic agrammatisms). Particular difficulties arise when coordinating neuter nouns with numerals and using prepositions in word formation. Coherent monologue speech is characterized by the use of two-word, uncommon sentences. According to the psychological and pedagogical classification of R.E. Levina, these children with erased dysarthria belong to the group with phonetic-phonemic underdevelopment (FFN). Third group. The expressive speech of children in this group with erased dysarthria is unsatisfactorily formed. Impressive agrammatisms are noted, i.e. difficulties in understanding complex logical and grammatical sentence structures. Violation of sound pronunciation is polymorphic in nature, i.e. sounds of different phonetic groups suffer. Multiple substitutions, distortion, and absence of sounds are noted. Severe phonemic hearing impairment: auditory and pronunciation differentiation of sounds is not sufficiently formed, which does not allow mastering sound analysis. The violation of the syllabic structure of words is more pronounced. Active and passive vocabulary lags significantly behind age standards, and lexical and grammatical errors are numerous and persistent. This group of children with erased dysarthria does not master coherent speech. According to the classification of R.E. Levina, this group of children corresponds to general speech underdevelopment (GSD). The identification of three groups of children with erased dysarthria in Lopatina’s research allows them to be correlated in terms of the level of development of linguistic means with the three groups identified by R.E. Levina: FN - phonetic underdevelopment FFN - phonetic-phonemic underdevelopment OHP - general underdevelopment of speech. V.A. Kiseleva’s research is devoted to the analysis of the reasons for children’s school failure. Studying children with dysgraphia and dyslexia, the author identified mild impairments in sound pronunciation and phonetic hearing in most of them. An examination together with a neurologist and neuropsychologist confirmed the presence of erased dysarthria. Erased dysarthria as an initial defect leads to insufficient phonemic perception, analysis, and synthesis, which causes specific errors in writing and reading. As Levina points out, disruption of speech kinesthesia due to morphological and motor lesions of the speech organs affects the auditory perception of the entire sound system of a given language. This leads to the fact that children with erased dysarthria have underdevelopment of phonemic perception. The blurred, slurred speech of these children does not provide the opportunity for the formation of clear auditory perception and control. This further aggravates violations of sound pronunciation, since failure to distinguish between incorrect pronunciation and the pronunciation of others inhibits the process of “adjusting” one’s own articulation in order to achieve a certain acoustic effect. Kiseleva raises the question of diagnosing and correcting erased dysarthria in preschool age in order to prevent violations of children's written speech and prevent school failure. Conclusions 1. Erased dysarthria is a complex speech disorder characterized by variability in disturbances in the components of speech activity: articulation, diction, voice, breathing, facial expressions, and melodic-intonation aspects of speech. 2. Erased dysarthria is characterized by the presence of symptoms of microorganic damage to the central nervous system: insufficient innervation of the speech organs - the brain, articulatory and respiratory sections; violation of muscle tone of articulatory and facial muscles. 3. With erased dysarthria, as a rule, there are various persistent violations of the phonetic and prosodic aspects of speech, which are leading in the structure of the speech defect, and specific deviations in the development of the lexico-grammatical structure of speech. 4. With erased dysarthria, the state of non-speech functions and mental processes (attention, perception, memory and thinking) has a number of distinctive features. 5. Among the motor functions, the movements of the fingers are of particular importance, since they have a huge impact on the development of the child’s higher nervous activity. The function of hand movement is always closely related to the function of speech, and the development of motor skills will contribute to the development of the pronunciation side of speech. 6. About a third of the entire area of the motor projection of the cerebral cortex is occupied by the projection of the hand, which is located next to the projection of the motor zone; finger movements actually stimulate the maturation of the central nervous system, which, in particular, manifests itself in the acceleration of the child’s speech development. 7. In children with erased dysarthria, both a violation of general motor skills and a lack of fine differentiated movements of the hands and fingers are detected. 8. The complexity of the structure of the defect in dysarthria determines the directions and content of complex corrective action, including medical, psychological, pedagogical and speech therapy aspects.