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Speech disorders are various disorders of speech activity that interfere with full-fledged speech communication and social interaction. Speech disorders are spoken about if there are deviations in the functioning of the psychophysiological mechanisms of speech; inconsistency of the level of speech development with the age norm; speech deficiencies are not overcome on their own and can negatively affect the mental development of the individual. The study and overcoming of speech impairment in children and adults is engaged in pedagogical science - speech therapy, as well as friendly sciences of the medical cycle (neurophysiology, neurology, otolaryngology, dentistry, etc.).

Modern classifications consider speech disorders from the standpoint of etiopathogenesis (clinical and pedagogical classification) and in the aspect of disorders of the psychophysical organization of speech activity (psychological and pedagogical classification).

All the variety of reasons causing impaired development of speech can be divided into biological and social. Thus, biological factors that cause speech disorders can act at different periods of ontogenesis. At the stage of intrauterine development and childbirth, the most adverse effect on the maturation and subsequent functioning of the child's brain structures is fetal hypoxia, intrauterine infections, birth trauma, etc.; in the first months after birth - trauma, brain infections. Speech disorders in older people are usually associated with vascular lesions of the brain (stroke, ruptured cerebral aneurysm), severe head injuries, neurosurgical interventions.

Socio-psychological factors leading to a violation of the development of speech in children can be expressed in the lack of proper attention to the formation of children's speech on the part of adults; incorrect speech of others; the need for a preschooler to master two language systems at the same time; excessive stimulation of the child's speech development that does not correspond to the age-specific possibilities, stress, etc.

Predisposing conditions for the occurrence of speech disorders in children are the so-called critical periods in the development of speech function: 1-2 years, 3 years and 6-7 years. These periods are sensitive for the development of speech: at this time, the most intensive formation of the psychophysiological basis of speech occurs, and the nervous mechanisms of regulation of speech activity are extremely vulnerable. Therefore, any, even seemingly insignificant biological or social factors acting in critical periods, can lead to the occurrence of speech disorders.

Speech disorders are persistent and, having arisen under the influence of one factor or another, do not disappear on their own, without specially organized speech therapy assistance. In addition, speech disorders negatively affect the development of the intellectual sphere, behavior and personality in general. At the same time, in most cases, speech disorders are reversible, and purposeful and timely correction made allows the person to return the joy of communication and prevent the development of secondary mental layers.

Speech therapy assistance to persons suffering from speech disorders is provided in the education system (specialized preschool educational institutions, speech therapy groups, speech therapy centers, schools for children with severe speech impairments, etc.), in the health care system (speech therapy rooms at polyclinics, dispensaries, hospitals, specialized medical centers , orphanages, etc.), private development centers. In these institutions, speech therapists conduct consultations, a comprehensive diagnostic examination and correction of speech disorders.

The course of speech therapy classes is conducted according to a special program in accordance with the specifics of speech disorders. In the classroom for the correction of speech disorders, speech exercises, articulatory and breathing exercises, speech therapy massage, logo rhythmics are used. Speech therapy for speech disorders is actively combined with drug therapy, psychotherapy, massage, physiotherapy, exercise therapy, and, if necessary, surgery.

Prevention of speech disorders begins in fact from the moment a new life is born and continues after birth, throughout life. It includes taking care of the favorable course of pregnancy, the neuropsychic and physical health of pregnant women and children, early identification of risk factors for speech disorders and their elimination. The speech environment is of paramount importance in the prevention of speech disorders in children.

You can familiarize yourself with the main types of speech pathology and forms of speech therapy influence in the sections "Speech disorders" and "Speech therapy" on the site "Beauty and Medicine". We also bring to your attention a directory of organizations providing speech therapy assistance, a convenient service for finding a speech therapist in Moscow with the ability to make an online appointment for consultation and treatment.

In the case of a sudden loss of speech, first of all, it should be determined whether it is anarthria (that is, the impossibility of pronouncing words due to a violation of the coordinated activity of the respiratory, voice-forming and articulatory apparatus due to their paresis, ataxia, etc.) or aphasia (that there is a violation of speech praxis).

This task is not easy, even when the patient is conscious and able to follow instructions, which rarely happens in acute pathology. It is possible to get answers to simple questions like "yes" / "no", which with a probability of 50% are answers at random. Moreover, even with aphasia, patients can grasp the meaning of what they hear exceptionally well using the “key word” strategy, by which they understand the general meaning of the phrase thanks to the available situational (“pragmatic”) skills, which do not suffer from speech impairment.

Examination by simple commands is difficult if the patient has hemiplegia and / or is immobilized. In addition, concomitant apraxia can also limit the physician's options. In the case of oral apraxia, the patient will not be able to follow even simple enough instructions (for example, "open your mouth" or "stick out your tongue").

The ability to read is difficult to investigate, since reading requires intact response to oral gestures and motor skills, but studying written language can help make the right decision. With right-sided hemiplegia, the following test is used: the patient is asked to arrange in the correct order the words of the complete sentence, which he receives in writing on separate sheets of paper, mixed. However, in some cases, even an experienced aphasia specialist may not immediately make the right decision (for example, when the patient does not even try to make at least a sound). It should be remembered that over time the picture can change rapidly, and instead of the aphasia that the patient had at the time of admission, dysarthria, that is, a purely articulatory speech disorder, can quickly come to the fore. When making a diagnosis, the age of the patient plays an important role.

The main reasons for sudden loss of speech are:

1. Migraine with aura (aphatic migraine)
2. Stroke in the left hemisphere
3. Postictal state
4. Brain tumor or abscess
5. Herpes simplex encephalitis
6. Psychogenic mutism
7. Psychotic mutism

Migraine with aura

In young patients, migraine with aura can be suspected first. In these cases, there is the following typical combination of symptoms: acute or subacute loss of speech (more often without hemiplegia), accompanied by a headache that has repeatedly occurred in the patient in the past and which may or may not be accompanied by changes in neurological status. If such a migraine attack occurs in this patient for the first time, a family history (if possible) can provide useful information, since in 60% of cases this disease is family in nature.

The EEG most likely reveals a focus of slow-wave activity in the left temporoparietal region, which can persist for 3 weeks, while neuroimaging does not reveal any pathology. Pronounced focal changes on the EEG in the absence of deviations according to the results of neuroimaging studies on the 2nd day of the disease, in principle, allow a correct diagnosis to be made, with the exception of cases of herpetic encephalitis (see below). The patient should not have a cardiac murmur, which may indicate the possibility of a cardiogenic embolism, which can occur at any age. A possible source of embolism is identified (or ruled out) by echocardiography. Listening to vascular murmurs over the vessels of the neck is less reliable than ultrasound Doppler sonography. If possible, transcranial Doppler ultrasound should be performed. A patient suffering from migraine and belonging to the age group from 40 to 50 years old may have asymptomatic stenosing vascular lesions, but the typical nature of headache, rapid reversal of symptoms and the absence of structural changes in the brain based on the results of neuroimaging research methods in combination with the changes described above the EEG allows you to make the correct diagnosis. If symptoms do not progress, there is no need for CSF testing.

Left hemispheric stroke

When speech is impaired in an elderly patient, the most likely diagnosis is stroke. In most cases of speech impairment in stroke, the patient has right-sided hemiparesis or hemiplegia, hemihypesthesia, sometimes hemianopsia or a defect in the right visual field. In such cases, neuroimaging is the only way to reliably differentiate between cerebral hemorrhage and ischemic stroke.

Loss of speech almost always occurs with a left hemispheric stroke. It can also be observed with a right hemispheric stroke (i.e., with a lesion of the non-dominant hemisphere), but in these cases speech is restored much faster, while the probability of complete recovery is very high.

Mutism may precede the appearance of aphasia when Broca's area is affected; it has also been described in patients with damage to the additional motor area, with severe pseudobulbar paralysis. In general, mutism often develops with bilateral brain lesions: thalamus, anterior cingulate gyrus, damage to the putamen on both sides, cerebellum (cerebellar mutism in acute bilateral damage to the cerebellar hemispheres).

A gross violation of articulation can occur when blood circulation in the vertebrobasilar basin is disturbed, but a complete absence of speech is observed only with occlusion of the basilar artery, when akinetic mutism develops, which is a rather rare phenomenon (bilateral lesion of the mesencephalon). Mutism as a lack of vocalization is also possible with bilateral paralysis of the muscles of the pharynx or vocal cords ("peripheral" mutism).

Postictal state (state after seizure)

In all age groups, with the exception of infants, speech loss can be a postictal phenomenon. The epileptic seizure itself may go unnoticed, and the bite of the tongue or lips may be absent; an indication of a seizure that has taken place may be an increase in the level of creatine phosphokinase in the blood, but this finding is unreliable in terms of diagnosis.

Frequently, the diagnosis is facilitated by EEG: generalized or local slow- and island-wave activity is recorded. Speech is quickly restored, and the doctor is faced with the task of determining the cause of the epileptic seizure.

Brain tumor or abscess

In the history of patients with a tumor or brain abscess, any valuable information may be missing: there was no headache, there were no behavioral changes (aspect, flattening of affect, lethargy). A clear inflammatory process of the ENT organs may also be absent. Sudden loss of speech can occur: due to rupture of a vessel supplying the tumor, and the resulting hemorrhage into the tumor; due to the rapid increase in perifocal edema; or - in the case of a left-hemispheric tumor or abscess - due to a partial or generalized epileptic seizure. Making a correct diagnosis is possible only with a systematic examination of the patient. It is necessary to conduct an EEG study, in which it is possible to register a focus of slow-wave activity, the presence of which cannot be unambiguously interpreted. However, the presence of very slow delta waves in combination with a general slowdown in the electrical activity of the brain may indicate a brain abscess or a hemispheric tumor.

With computed tomography, both in the case of a tumor and in the case of an abscess, it is possible to reveal a volumetric intracerebral process in the form of a low-density focus with or without contrast absorption. With abscesses, there is often more pronounced perifocal edema.

Intracerebral sagittal sinus thrombosis

There is the following typical triad of symptoms that may indicate thrombosis of the intracerebral sinus: partial or generalized epileptic seizures, hemispheric focal symptoms, and a decrease in the level of wakefulness. The EEG records generalized low-amplitude slow-wave activity over the entire hemisphere, extending also to the opposite hemisphere. In neuroimaging, sinus thrombosis is evidenced by hemisphere edema (mainly in the parasagital region) with diapedetic hemorrhages, signal hyperintensity in the sinus (s) area and a deltoid zone that does not accumulate the injected contrast and corresponds to the affected sinus.

Herpes simplex virus (HSV) encephalitis

Because HSV-induced herpetic encephalitis predominantly affects the temporal lobe, aphasia (or paraphasia) is often the first symptom. The EEG reveals focal slow-wave activity, which, upon repeated EEG recording, is transformed into periodically arising three-phase complexes (triplets). Gradually, these complexes spread to the frontal and contralateral leads. With neuroimaging, a zone of low density is determined, which soon acquires the characteristics of a volumetric process and spreads from the deep parts of the temporal lobe to the frontal lobe, and then contralaterally, involving primarily the zones related to the limbic system. Signs of an inflammatory process are found in the cerebrospinal fluid. Unfortunately, verification of HSV infection by direct visualization of viral particles or by means of immunofluorescence analysis is possible only with a significant time delay, while antiviral therapy should begin immediately upon the first suspicion of viral encephalitis (taking into account that lethality in HSV is encephalitis reaches 85%).

Speech difficulty is a speech disorder that interferes with normal verbal communication and social interaction of a person with others. We can talk about the presence of violations when there are deviations in the functioning of the psychophysiological mechanisms of speech, if the level of speech development does not correspond to the age norm, with speech deficiencies that negatively affect mental development, which cannot be overcome on our own. Speech therapists, neurophysiologists, neurologists, otolaryngologists and other specialists study and treat speech difficulties in adults and children.

Symptoms and manifestations

This pathology can be expressed either in a complete absence of speech, or in a violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

• speech is indistinct and slow, it is illegible;
• it is difficult for the patient to choose words and name things correctly;
• quick and without hesitation speech is possible, but completely meaningless;
• there is haste and incoherence of thinking;
• the person strongly separates the syllables and puts emphasis on each of them.

Causes in adults

Possibly sudden or gradual development of speech disorders. There are the following main reasons that can lead to this pathological process:

• improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movement of the muscles of the body and for speech);
• brain injury caused by stroke or thrombosis;
• head trauma;
• the presence of tumors in the brain;
• the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
• Lyme disease
• excessive consumption of alcoholic beverages;
• weakness of the muscles of the face, for example, Bell's palsy;
• too weak or tight fixation of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

1. Fonational (external) design of an utterance - this includes pronunciation disorders;
2. Structural-semantic (internal) design of an utterance is a systemic or polymorphic speech disorder.

Violations of the speech process of phonation design of an utterance can be both separate and combined. Based on this, the following types of violations are distinguished in speech therapy:

1. Aphonia and dysaphonia - is a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, pitch and timbre of the voice or the complete absence of phonation. Aphonia and dysaphonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of the child's development.
2. Bradilalia - is a pathological slowdown of the speech rate. A characteristic feature is the delayed implementation of the articular speech program.
3. Tachilalia is a pathological acceleration of the speech rate. Accelerated implementation of the articulatory speech program is characteristic.
4. Stuttering is a violation of the organization of speech, in which the muscles of the speech apparatus are in a convulsive state. Pathology is centrally conditioned and appears, as a rule, in the process of the child's speech development.
5. Dislalia - pathology is a disorder of the pronunciation of sounds, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifests itself in the form of a distorted sound design of speech, while there is an incorrect pronunciation of sounds or their replacement and mixing.
6. Rinolalia is a violation of the pronunciation of sounds and timbre of the voice caused by anatomical and physiological disorders of the speech apparatus. Characterized by a pathological change in the timbre of the voice, accompanied by the passage of a vocal stream of air on exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of a resonance in the latter.
7. Dysarthria is a violation of pronunciation, a distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy, which appeared at an early age of the child.

Difficulties in speech of structural and semantic design are divided into two types: alalia and aphasia.

• Alalia - is the absence or insufficient development of speech, provoked by the defeat of the areas responsible for speech, located in the cerebral cortex during intrauterine development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the operation of selection and analysis at all stages of birth, as well as the reception of speech utterance, as a result of which the child's speech activity is not fully formed.

• Aphasia is a complete or partial loss of speech, which leads to local lesions of the brain. The ability to speak normally can be lost due to traumatic brain injury, neuroinfection or brain tumors, after the formation of speech.

Diagnostics

First of all, it is necessary to analyze the complaints presented by the patient, as well as the history of the disease. It is important to take into account how long ago there were complaints of quiet, slow speech and difficulty in pronouncing words and phrases, as well as whether there are similar manifestations in the patient's closest relatives.

Then it is necessary to undergo an examination by a neurologist, which consists in checking the mandibular and pharyngeal reflexes, examining the pharynx, the presence of thinning (atrophy) of the muscles of the tongue. In addition, it is important to check the reflexes of the lower and upper extremities.

It is necessary to be examined by a speech therapist, the doctor will be able to assess speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronunciation of specific sounds.

Examination by an otolaryngologist helps to exclude various volumetric processes (abscesses and tumors) in the nasal cavity, since they can also affect the voice.

With the help of computed tomography and magnetic resonance imaging of the head, it is possible to carry out a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these can be tumors, foci of impaired blood circulation, abscesses, foci of decay of myelin - the main protein of nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy for speech disorders consists in treating the main disease that provoked dysarthria:

• the tumor must be removed surgically;
• resection of a hematoma (hemorrhage) is possible if it is located on the surface;
• the abscesses are surgically removed from the cranial cavity, and then antibacterial drugs are prescribed in order to stop the infectious process as soon as possible;
• normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any types of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

For many, the ability to talk is a means of communication with other people and the world around them.

Therefore, if a person loses this ability, he must first of all find out the reason, and then undergo comprehensive treatment.

If you do not catch yourself in time, then the patient may have a dysfunction of the speech apparatus forever.

Causes of speech disorders in adults

Speech impairment in adults is a pathology that manifests itself in the complete or partial absence of speech.

In a conversation with a person suffering from a similar ailment, it is impossible to understand what he is talking about or asking, his words are illegible and indistinct.

In each person, this pathology manifests itself in different ways. In some people, such violations cause hasty, but completely meaningless speech, while others, on the contrary, build sentences logically and constructively, but at the same time speak very slowly and unhurriedly.

The main causes of speech impairment in adults:

1. Previous brain injury;
2. The presence of benign or malignant formations in the brain;
3. Wilson's disease;

Ordinary dentures can also be the reason. In case of improper fastening in the elderly, dysfunction of the speech apparatus is observed.

Another violation of speech in an adult can occur due to diseases that cause paresis of the muscles of the face.

Paresis is a neurological syndrome that means decreased strength. Such diseases include Miyard-Joublé syndrome, Moebius syndrome, muscle agenesis, Beck's disease, and Sjögren's syndrome.

Myasthenia gravis can also cause disturbances. It is an autoimmune neuromuscular disease characterized by abnormally rapid fatigability of the transverse sucking muscles.

Some diseases cause not only paresis of the facial muscles, but also impaired articulation and speech in adults.

This pathology occurs with Foix-Chavan-Marie syndrome. With this ailment, the basin of the middle cerebral artery is affected.

One of the most common causes of speech impairment in adults is Alzheimer's disease.

With this disease, dementia (acquired dementia), partial memory loss, and difficulty in articulation are observed. Most often, this ailment affects people over 65.

There are these types of speech disorders in an adult:

• Dysphonia;
• Aphonia;
• Bradilalia;
• Tahilalia;
• Stuttering;
• Dislalia;
• Dysarthria;
• Alalia;
• Aphasia.

Spasmodic dysphonia

This pathology is more common in people aged 30 to 40 years. Dysphonia is a voice disorder characterized by hoarseness.

Spasmodic dysphonia occurs as a result of prolonged overstrain of the vocal cords.

Also, the reason for the appearance of this pathology may be the postponed mental trauma.

With this form of dysphonia, pain in the neck and head muscles is observed, and the timbre of the voice also changes significantly. The ailment manifests itself in illegibility of speech and difficulty in pronouncing certain sounds.

Aphonia

Aphonia is a pathological condition with loss of vocal sonority.

With this pathology, a person still has the opportunity to speak in a whisper, but during a conversation he experiences a sore throat.

Aphonia occurs due to diseases of the bronchi or laryngitis. Also, this pathology can occur with prolonged crying or intubation.

Bradilalia

Bradilalia - violations of the rate of speech production. In other words, with this ailment, a very slow speech rate. Articulation in bradilalia is indistinct.

This disease occurs due to Parkinson's disease, brain tumors, meningitis and encephalitis.

Bradilalia can also be inherited or manifested after brain injury.

Tahilalia

Tachilalia is a disorder that manifests itself in a rapid pace of speaking.

With this ailment, a person does not make grammatical or phonetic errors in pronunciation.

The reasons for the appearance of tachyhalea can be:

1. Chorea disease.
2. Oligophrenia.
3. Skull trauma.
4. Heredity.
5. Formations in the brain.
6. Myelitis.
7. Tetanus.
8. Arachnoiditis.

Stuttering

Stuttering is an ailment that manifests itself in the form of a violation of speech function.

When stuttering, a person stretches syllables, spells words incorrectly.

Causes of occurrence:

• Brain damage.
• Stress.
• Heredity.

Dislalia

With dyslalia, the person does not reproduce sounds correctly. This ailment appears due to the presence of a defect in the structure of the speech apparatus (malocclusion, shortened hypoglossal frenulum, abnormal structure of the palate, and others).

Dyslalia also occurs due to illiterate speech education or in connection with mental disorders.

Most often, this disease manifests itself in children, but among adults it also occurs. In adults, dyslalia appears due to the low mobility of the speech apparatus.

Dysarthria

Dysatria occurs due to the defeat of the central section of the motor speech analyzer.

With this disease, there is a disorder of articulation, phonation and speech.

Dysatria occurs due to cerebral palsy, neurosyphilis, multiple sclerosis and myotonia.

There is a similar speech impairment in adults with stroke and after neurosurgical operations.

Alalia

Alalia is a speech underdevelopment due to damage to the speech centers of the brain.

The main reasons for the appearance of alalia in people over 20 years old are operations with the use of general anesthesia, traumatic brain injury and malnutrition.

Aphasia

Aphasia is a complete or partial loss of the ability to reproduce words and sounds. This disease appears due to damage to the cerebral cortex.

Aphasia appears due to impaired blood circulation in the brain, with the formation of a brain abscess, after strokes and heart attacks.

Also, the cause of the development of the disease can be epilepsy or acute intoxication with toxic substances.

A patient with aphasia has difficulty recognizing speech, he has impaired concentration, and problems with reading and remembering.

Treatment of speech disorders

Treatment of speech impairment in adults is selected based on the type of impairment itself.

Basically, treatment involves massage, physiotherapy, exercise therapy and medication.

Medication

Treatment of dysarthria implies exercise therapy and medication. It is very important that a speech therapist also accompanies the patient's treatment.

Drugs for the treatment of dysarthria:

1. Piracetam.
2. Finlepsin.
3. Lucetam.

If an adult has inhibited speech after a stroke, that is, dysarthria, then it is necessary to do daily exercises for the tongue.

For the treatment of aphasia, nootropic drugs and drugs are used that improve microcirculation in the tissues of the brain.

Preparations:

• Vinpocetine.
• Piracetam.

With aphasia, work with a speech therapist is mandatory. Usually, to fully restore the ability to speak, you will need to be treated by a speech therapist for at least 3 years.

Piracetam - for effective treatment of speech disorders

For the treatment of dysphonia, stimulating medications are prescribed:

1. Proserin.
2. Tranquilizers.

Other drugs used to treat speech disorders:

• Vinpotropil.
• Cavington.
• "Memotropil".
• "Nootropil".

Medical therapy should include drugs that improve memory, enhance metabolic processes in the central nervous system.

Surgery is rarely used to treat such diseases. The operation is necessary to remove tumors and other formations that provoked the disorder.

Speech impairment in an adult after stress requires not only exercise therapy and medication, but also a visit to a qualified psychotherapist or psychologist. It is likely that the person himself, after the transferred situation at a subconscious level, put a barrier on the reproduction of speech.

Home treatment

Traditional medicine can also be used to treat speech disorders.

If a person has dysarthria, then the following recipe will help: 1 tbsp. l. dill seeds are poured with boiling water and infused for 15 - 20 minutes.

Then the infusion is filtered and cooled. It is worth taking it 15 minutes before meals in the amount of 1 tsp. The agent is used no more than 5 times a day.

If an elderly person has delayed speech, for example, after a stroke, then you can make a tincture of ginseng, sowing buckwheat and muzzle.

Exercise therapy plays an important role in the treatment of speech disorders. The patient should do daily exercises if the cause of the disorder is paresis of the facial muscles.

1. Exercise: Pull your lips out by curling them into a tube. Hold in this position for 5 seconds, then repeat;
2. exercise: the lower jaw should grab the upper lip, fix it for 3 seconds, then release it;
3. exercise: close your mouth. The tongue reaches the palate.

Conclusion

Treating speech disorders is a lengthy process. It is very important that, along with doctors and speech therapists, the patient is helped at home.

People with such problems should clearly and slowly express their thoughts, not show negativity and neglect.

Video: Treatment of aphasia

This is a fairly common phenomenon among both children and adults.

The Greeks and Romans, for whom the public word played an important social role and the teaching of graceful speech and was part of the range of general education subjects, already knew about many speech disorders, which was reflected in the large number of terms used to designate them.

Already in Hippocrates, there are references to almost all forms of speech disorders known to us: loss of voice, loss of speech, tongue-tied, slurred speech, stuttering, etc.

Causes of speech disorders

Among the causes of speech disorders, biological and social risk factors are distinguished. The biological reasons for the development of speech disorders are pathogenic factors that affect mainly during intrauterine development and childbirth (fetal hypoxia, birth trauma, etc.), as well as in the first months of life after birth (brain infections, trauma, etc.). )

Factors such as family burden of speech disorders, left-handedness and right-handedness play a special role in the development of speech disorders. Socio-psychological risk factors are mainly associated with mental deprivation of children. The lack of emotional and verbal communication between the child and adults is of particular importance.

Negative effects on speech development can also be exerted by the need for a child of younger preschool age to master two language systems at the same time, excessive stimulation of the child's speech development, inadequate type of child's upbringing, pedagogical neglect, that is, lack of due attention to the development of the child's speech, speech defects of others.

As a result of the action of these reasons, the child may experience developmental disorders of various aspects of speech. Speech disorders are considered in speech therapy within the framework of clinical and pedagogical and psychological and pedagogical approaches. The mechanisms and symptoms of speech pathology are considered from the standpoint of the clinical and pedagogical approach.

In this case, the following disorders are distinguished:

Types of speech disorders

Dislalia (tongue-tied)

Until a certain age, this violation does not require intervention by specialists. The essence of dyslalia is in violation of sound pronunciation, namely: sounds can be distorted, replaced by others, mixed or simply absent. This diagnosis is made when a child is more than 4 years old, he has good hearing, sufficient vocabulary, correctly constructs sentences, avoiding grammatical errors, but at the same time pronounces sounds in a childish way, like a little one. Such a child will say instead of "hat" - "sapka", not "cancer", but "varnish".

Rhinolalia

This is a violation of the timbre of the voice and sound pronunciation, due to the anatomical and physiological defects of the speech apparatus. In this case, the child speaks as if "in the nose" or nasal. This happens when the hard and soft palate is split, trauma to the oral and nasal cavity, paralysis of the soft palate. With rhinolalia, all speech sounds are distorted.

Such a child is difficult to understand: he speaks in a monotone and illegible. In addition, a change in the timbre of the voice is also possible when a sufficient amount of air does not enter the nasal cavity. This often occurs with adenoids, polyps, curvature of the nasal septum, which greatly complicates nasal breathing. At the same time, the pronunciation of nasal consonants and vowels suffers.

Dysarthria

Due to organic damage to the central nervous system, another speech disorder occurs - dysarthria. In this case, it is not the pronunciation of individual sounds that suffers, but the entire pronunciation side of speech. Dysarthria occurs when the speed, strength, and range of motion of the speech organs are limited. For example, it is difficult for a child to control his tongue, which becomes awkward, disobedient, and protruding outward may deviate to the side.

It is difficult for such a child to do the elementary things: puff out their cheeks, frown or raise their eyebrows, since the muscles of the face are inactive. With dysarthria, all components of the pronunciation side of speech are violated:

But you need to know that this is not an independent disease, but part of the disorders of a wide motor sphere. In this case, the child is treated comprehensively.

Alalia

Speaking of alalia, they mean the complete or partial absence of speech in children with good physical hearing. At the same time, the child is in a speech environment, seeks to communicate with others (but does this with the help of facial expressions and gestures), is not mentally retarded, his speech apparatus is without anomalies, paralysis or paresis.

What is the reason for this? Experts note that the occurrence of this disorder is due to underdevelopment or damage to the speech areas in the left hemisphere of the brain. Moreover, such violations occur even in the prenatal or early period of the child's development.

Alalia is divided into sensory (when the child does not understand and, therefore, cannot reproduce human speech) and motor (in this case, the child understands the speech addressed to him, but cannot master it).

Delayed speech development (RDA)

This diagnosis is usually made in young children. With RRD, the child is quite normal, but much later and more slowly than his peers, he masters speech. Among the reasons for the occurrence of RRD are an inadequate speech environment, poor physical and mental health of a child, or a special, slow rate of maturation of the nerve cells responsible for speech.

Stuttering (logoneurosis)

The mechanisms (causes and essence) of the occurrence of logoneurosis are not fully disclosed. This type of speech disorder is based on repetition of sounds (in most consonants), "stretching" of vowels, stopping speech, repetition of a syllable or word and is often caused by fear. Often, at the same time, the coordination of movements of the speech apparatus and respiration is impaired.

Usually in everyday life in a relaxed state, such children do not stutter, but as soon as they go on stage or stand in front of the blackboard, excitement, and with it stuttering, makes itself felt.

Dysgraphia and dyslexia

If a child has no intellectual or auditory impairments, but he is not able to master writing and reading (or does so with great difficulty), they speak of dysgraphia and dyslexia.

Treatment of speech disorders

Speech disorders (in adults) are a symptom of a number of diseases in which the so-called “speech” zones of the brain are involved in the pathological process.

This can be both a steadily progressing pathology (multiple sclerosis, Apzheimer's disease, a number of degenerative diseases), and the consequences of focal brain damage as a result of a stroke, traumatic brain injury, radically operated tumors, etc.

If in the first case, the therapeutic effect is ineffective, then in the situation of a “dead” cerebral catastrophe, early rehabilitation gives a good clinical result.

The decision on the expediency and complexity of the impact is made after carrying out diagnostic measures, including examination and testing in order to assess the nature of the disorders and the severity of the lost functions.

Rehabilitation of patients with speech pathology consists of a complex effect including:

• drug treatment;
• transcraial magneto-electro stimulation (TCMES);
• speech therapy correction sessions with the patient.

Medical treatment is selected individually, taking into account the existing disease, the degree of impairment of the lost functions, the state of the body as a whole. The goal of drug therapy is to improve the integrative ability of the brain (speech, memory, attention, learning ability) by activating neuroplasticity processes.

Questions and answers on "Speech disorders"

Question: Hello! As a child, I had an injury to the base of the skull, since then I speak poorly, and I myself do not hear defects during a conversation. I worked with a speech therapist for many years, but it did not lead to anything. What treatment methods can you advise?

Question: My child has adenoids. The ENT also recommended to see a speech therapist. Why?

Question: Why does the child speak badly?

Question: How long should you spend with a speech therapist?

Speech impairment

Speech disorders consist in the appearance of various forms of speech disorders, as a result of which the formation of a certain kind of obstacle for full and adequate speech communication, as well as for the corresponding social interaction, is determined. That is, with normal hearing and the patient's level of intelligence, the process of forming the semantic and sound structures of the speech organization is subject to violation in this kind of disorder.

Various factors affecting the body can contribute to the development of speech disorders; as a result of such an impact, a violation of a certain number of links in the chain of speech formation appears.

The main reasons provoking the development of speech disorders are the impact of psychological factors (stress, fear), endogenous factors (for example, hearing impairment), exogenous factors (head trauma, etc.), organic factors (areas of the brain responsible for the process the formation of speech, which can occur with a stroke, tumor, etc.). Separately, it is possible to designate the role of a purely functional factor, with the relevance of which we are talking about the inability of the speech apparatus to implement the corresponding functions, that is, to sound pronunciation.

Complex violations are accompanied not only by incorrect pronunciation, but also by a violation of the ability to distinguish the difference in sounds by ear. This is accompanied by a significant limitation of the vocabulary heard and used in conversation. In turn, actual problems lead to the fact that the process of correct construction of phrases and whole sentences is subject to violation, stuttering develops.

With speech disorders, the ability to clearly express one's own thoughts is lost (or does not develop in a normal way), in general, speech becomes blurry and indistinct, it becomes difficult for most people to understand it. Mooing becomes a frequent companion of attempts to explain. Severe cases of speech disorders are accompanied by the complete disappearance of speech.

The main diseases in which speech disorders occur:

• dysarthria;
• mutism;
• stuttering;
• aphonia;
• logophobia;
• alalia;
• rhinolalia;
• birth injury;
• neurotic pathologies;
• diseases of the nervous system;
• schizophrenia;
• epilepsy;
• attention deficit;
• head trauma;
• long course of somatic diseases, etc.

"Speech impairment" is observed in diseases:

Adentia is a disease that consists in a defect in dental units, which is expressed in their partial or complete absence. The disease can be diagnosed in both adults and children. Since such a deviation is primary and secondary, it is natural that the reasons in each case will be different. There are quite a few predisposing factors, ranging from the death of tooth rudiments to a wide range of dental pathologies.

Alcohol intoxication is a complex of behavioral disorders, physiological and psychological reactions that usually begin to progress after drinking alcohol in large doses. The main reason is the negative effect on the organs and systems of ethanol and its decay products, which cannot leave the body for a long time. This pathological condition is manifested by impaired coordination of movements, euphoria, impaired orientation in space, and loss of attention. In severe cases, intoxication can lead to coma.

Angioma (red mole) is a benign tumor that consists of lymphatic and blood vessels. Most often, the formation is formed on the face, the skin of the trunk and limbs, on the internal organs. Sometimes its appearance and development can be accompanied by bleeding. In most clinical situations, this pathology is congenital and is diagnosed in newborns in the first few days of their life.

A cerebral aneurysm (also called an intracranial aneurysm) appears as a small abnormal mass in the blood vessels of the brain. This seal can actively increase due to filling with blood. Until it bursts, such a bulge is not dangerous or harmful. It only exerts slight pressure on the tissues of the organ.

What is arterial hypertension? This is a disease characterized by blood pressure values ​​above 140 mm Hg. Art. in this case, the patient is visited by headaches, dizziness and a feeling of nausea. Only a specially selected therapy can eliminate all the symptoms that have arisen.

Atypical autism (syn. Autism spectrum disorder, infantile autism) is a neuropsychiatric disease that causes impaired perception and understanding of the surrounding reality. The disease can lead to irreversible mental retardation, or REMD. The development of such a pathological process is due to a violation of the structures of the brain, which in most cases is irreversible.

Alzheimer's disease is a degenerative brain disorder that manifests itself in the form of a progressive decline in intelligence. Alzheimer's disease, the symptoms of which were first identified by Alois Alzheimer, a German psychiatrist, is one of the most common forms of dementia (acquired dementia).

Niemann-Pick disease is an inherited disorder in which fat accumulates in various organs, most often in the liver, spleen, brain and lymph nodes. This disease has several clinical forms, each of which has its own prognosis. There is no specific treatment, high risk of death. Niemann-Pick diseases are equally susceptible to both males and females.

Pick's disease is an irreversible pathological process that leads to complete atrophy of the cerebral cortex, most often in the frontal and temporal lobes. This ultimately becomes the cause of dementia. The disease, as a rule, is diagnosed after the age of 50, however, cases of damage to people of a younger or older age are also possible. Treatment, in most cases, is palliative in nature and is aimed at improving the patient's quality of life.

Fabry's disease (syn. Hereditary dystonic lipidosis, ceramidtrihexosidosis, diffuse universal angiokeratoma, Andersen's disease) is a hereditary disease that causes metabolic problems when glycosphingolipids accumulate in the tissues of the human body. It occurs equally in men and women.

Botulism is a rather serious disease of a toxic-infectious nature, the peculiarities of the course of which lead to damage to the nervous system, spinal cord and medulla oblongata. Botulism, the symptoms of which are manifested when botulinum toxin-containing products, aerosols and water enter the body, as a result of a complex of processes also leads to the development of acute and progressive respiratory failure. As a result of the lack of proper treatment for botulism, the onset of a lethal outcome is not excluded.

Vibration disease is a pathological process that occurs against the background of prolonged exposure to vibration on the body, which ultimately leads to changes in the receptor apparatus and some parts of the central nervous system.

The cleft palate is an abnormal structure of the sky, in the middle of which a gap is clearly visible. Such a pathology is congenital, in the presence of which newborn babies cannot fully eat and their respiratory function is to some extent impaired. This is due to the fact that there is no septum between the cavities of the mouth and nose, from which the food and liquid used get into the nose. Very few children are born with such a disease, for one thousand babies there is only one who has this syndrome.

Hemiparesis, or central paralysis, is manifested in the limited movement of the muscles of the right or left side of the body. This disease progresses due to the negative impact on the neurons and axons of the brain. The stage of the lesion is determined by the doctor according to the identified symptoms. Pathology manifests itself in the right-sided or left-sided, upper or lower limb lesion.

Hemiplegia (syn. Hemiparesis) is the absence of voluntary movements in one half of the body, which is a consequence of a violation of the process of the passage of a nerve impulse directly from the higher centers to the working muscles. In addition to the upper and lower extremities, the muscles of the trunk and face from the side of the lesion may be involved in the pathology.

Hemorrhagic stroke is a dangerous condition characterized by cerebral hemorrhage due to rupture of blood vessels under the influence of critically high blood pressure. According to ICD-10, pathology is coded in heading I61. This type of stroke is the most severe and has the worst prognosis. Most often it develops in persons aged 35-50 years who have a history of hypertension or atherosclerosis.

More than 80% of the world's population is infected with the herpes simplex virus (Herpes simplex virus), but in the body of most people it is in a dormant state and is activated only during periods of decreased immunity. Herpetic infection mainly affects the mucous membranes of the eyes, lips, external genital organs and the skin, and at first glance seems quite harmless, since it is relatively easy to treat, but in especially severe cases of the course of the disease, it can disrupt the functioning of the central nervous system and cause the development of encephalitis.

Hyperesthesia (syn. Hypersensitivity) may indicate increased mental excitability or excessive sensitivity of the skin, less often teeth, parts of the head, to external stimuli. Pathology can develop in both adults and children.

Brain glioma is a neoplasm that forms from a variety of glial cells, which in turn is a tissue that covers neurons and ensures their adequate functioning. The mechanism of development and the predisposing factors leading to the formation of such a neoplasm remain completely unknown, despite the development of neurosurgery technologies.

Deep bite - is a violation of dentoalveolar development, characterized by the overlap of the upper dentition of the lower dental units. A similar pathology in orthodontics occurs in every second patient.

Purulent meningitis is an acute inflammatory disease that affects the pia mater of the brain. Such a dangerous disease can affect a person at almost any age. But the most susceptible to purulent meningitis are people with a weakened immune system, who have previously suffered severe infectious or inflammatory diseases, with head injuries. Premature babies are also at risk.

Dementia defines an acquired form of dementia, within which patients have a loss of previously acquired practical skills and acquired knowledge (which can occur in varying degrees of intensity of manifestation), while at the same time a persistent decrease in their cognitive activity. Dementia, the symptoms of which, in other words, manifest themselves in the form of a breakdown of mental functions, is most often diagnosed in old age, but the possibility of its development at a young age is not excluded.

Cerebral palsy (CP) is a general medical term that is used to refer to a group of movement disorders that progress in infants due to traumatization of various areas of the brain in the perinatal period. The first symptoms of cerebral palsy can sometimes be detected after the birth of a child. But usually, signs of the disease appear in infants in infancy (up to 1 year).

Diabetic coma is an extremely dangerous condition that develops against the background of diabetes mellitus. In the event of its progression, metabolic processes are disrupted in the human body. This condition threatens not only the health, but also the patient's life.

Diabetic polyneuropathy manifests itself as a complication of diabetes mellitus. The ailment is based on damage to the patient's nervous system. Often, the disease is formed in people 15–20 years after the development of diabetes mellitus. The rate of progression of the disease to a complicated stage is 40-60%. The disease can manifest itself in people with both type 1 and 2.

Diastema is an ailment characterized by the development of a visible interdental space separating the central incisors. The upper dentition is affected several times more often than the lower one. The main reasons for the development of pathology remain unknown, however, when studying many observations, clinicians came to the conclusion that the underlying factor is genetic predisposition.

Diathesis in adults and children is a hereditary predisposition of the body to the manifestation of certain ailments or pathological reactions. Most often, this pathology manifests itself in early childhood, but its primary manifestation in adults is not excluded. Based on what kind of diathesis began to progress in a person, he may have a tendency to the progression of ailments of an infectious nature, to allergies, a malfunction of the metabolic process, and so on.

Dysarthria is a pathology of this type, the development of which is due to organic damage to the central nervous system. Dysarthria, the symptoms of which differ from other forms concerning pronunciation, manifests itself in the form of a violation in the patient of completely speech, and not a violation noted in the pronunciation of certain types of sounds.

Distal occlusion is a pathological occlusion disorder in which the upper part of the teeth protrudes strongly forward in relation to the lower dentition. This pathology can lead to a sloping chin, deformation of the face, non-closing of the lower and upper dentition, and, as a consequence, impaired speech and swallowing function.

Dyscirculatory encephalopathy is an ailment characterized by impaired functioning of the brain due to improper circulation of blood through its vessels. Pathological changes simultaneously affect the cortex and subcortical structures of the brain. The disease is accompanied by impaired motor and mental functions, in combination with emotional disorders.

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Symptoms and treatment of human diseases

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Appointment to a doctor:

Speech difficulty is a speech disorder that interferes with normal verbal communication and social interaction of a person with others. We can talk about the presence of violations when there are deviations in the functioning of the psychophysiological mechanisms of speech, if the level of speech development does not correspond to the age norm, with speech deficiencies that negatively affect mental development, which cannot be overcome on our own. Speech therapists, neurophysiologists, neurologists, otolaryngologists and other specialists study and treat speech difficulties in adults and children.

Symptoms and manifestations

This pathology can be expressed either in a complete absence of speech, or in a violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

• speech is indistinct and slow, it is illegible;
• it is difficult for the patient to choose words and name things correctly;
• quick and without hesitation speech is possible, but completely meaningless;
• there is haste and incoherence of thinking;
• the person strongly separates the syllables and puts emphasis on each of them.

Causes in adults

Possibly sudden or gradual development of speech disorders. There are the following main reasons that can lead to this pathological process:

• improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movement of the muscles of the body and for speech);
• brain injury caused by stroke or thrombosis;
• head trauma;
• the presence of tumors in the brain;
• the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
• Lyme disease
• excessive consumption of alcoholic beverages;
• weakness of the muscles of the face, for example, Bell's palsy;
• too weak or tight fixation of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

1. Fonational (external) design of an utterance - this includes pronunciation disorders;
2. Structural-semantic (internal) design of an utterance is a systemic or polymorphic speech disorder.

Violations of the speech process of phonation design of an utterance can be both separate and combined. Based on this, the following types of violations are distinguished in speech therapy:

1. Aphonia and dysaphonia - is a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, pitch and timbre of the voice or the complete absence of phonation. Aphonia and dysaphonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of the child's development.
2. Bradilalia - is a pathological slowdown of the speech rate. A characteristic feature is the delayed implementation of the articular speech program.
3. Tachilalia is a pathological acceleration of the speech rate. Accelerated implementation of the articulatory speech program is characteristic.
4. Stuttering is a violation of the organization of speech, in which the muscles of the speech apparatus are in a convulsive state. Pathology is centrally conditioned and appears, as a rule, in the process of the child's speech development.
5. Dislalia - pathology is a disorder of the pronunciation of sounds, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifests itself in the form of a distorted sound design of speech, while there is an incorrect pronunciation of sounds or their replacement and mixing.
6. Rinolalia is a violation of the pronunciation of sounds and timbre of the voice caused by anatomical and physiological disorders of the speech apparatus. Characterized by a pathological change in the timbre of the voice, accompanied by the passage of a vocal stream of air on exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of a resonance in the latter.
7. Dysarthria is a violation of pronunciation, a distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy, which appeared at an early age of the child.

Difficulties in speech of structural and semantic design are divided into two types: alalia and aphasia.

• Alalia - is the absence or insufficient development of speech, provoked by the defeat of the areas responsible for speech, located in the cerebral cortex during intrauterine development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the operation of selection and analysis at all stages of birth, as well as the reception of speech utterance, as a result of which the child's speech activity is not fully formed.

• Aphasia is a complete or partial loss of speech, which leads to local lesions of the brain. The ability to speak normally can be lost due to traumatic brain injury, neuroinfection or brain tumors, after the formation of speech.

Diagnostics

First of all, it is necessary to analyze the complaints presented by the patient, as well as the history of the disease. It is important to take into account how long ago there were complaints of quiet, slow speech and difficulty in pronouncing words and phrases, as well as whether there are similar manifestations in the patient's closest relatives.

Then it is necessary to undergo an examination by a neurologist, which consists in checking the mandibular and pharyngeal reflexes, examining the pharynx, the presence of thinning (atrophy) of the muscles of the tongue. In addition, it is important to check the reflexes of the lower and upper extremities.

It is necessary to be examined by a speech therapist, the doctor will be able to assess speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronunciation of specific sounds.

Examination by an otolaryngologist helps to exclude various volumetric processes (abscesses and tumors) in the nasal cavity, since they can also affect the voice.

With the help of computed tomography and magnetic resonance imaging of the head, it is possible to carry out a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these can be tumors, foci of impaired blood circulation, abscesses, foci of decay of myelin - the main protein of nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy for speech disorders consists in treating the main disease that provoked dysarthria:

• the tumor must be removed surgically;
• resection of a hematoma (hemorrhage) is possible if it is located on the surface;
• the abscesses are surgically removed from the cranial cavity, and then antibacterial drugs are prescribed in order to stop the infectious process as soon as possible;
• normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any types of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

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Speech disorders: causes, varieties

Without a doubt, these diseases have existed as long as the human word. This is a fairly common phenomenon among both children and adults.

What is it?

Speech disorders have been known since ancient times. Without a doubt, these diseases have existed as long as the human word. This is a fairly common phenomenon among both children and adults. The Greeks and Romans, for whom the public speech played an important social role, and the teaching of fine speech was part of the range of general education subjects, already knew about many speech disorders.

This is reflected in the large number of terms used to designate them. Already in Hippocrates, there are references to almost all forms of speech disorders known to us: loss of voice, loss of speech, tongue-tied, slurred speech, stuttering, etc.

Causes

The reasons for speech impairment can be various factors or their combination:

• Difficulty distinguishing sounds by ear (with normal hearing);
• damage during childbirth of the speech zone located on the vertex;
• defects in the structure of speech organs - lips, teeth, tongue, soft or hard palate. An example is the short frenum of the tongue, the cleft of the upper palate, popularly called the "cleft palate", or the malocclusion;
• insufficient mobility of the lips and tongue;
• delayed speech development due to mental retardation;
• illiterate speech in the family, etc.

What's happening?

With the most serious speech disorders, not only the pronunciation of sounds suffers, but also the ability to distinguish sounds by ear. At the same time, the active (used in speech) and passive (the one that the child perceives by ear) vocabulary of the child is limited, problems arise with the construction of sentences and phrases. All these violations, if not corrected in time, cause difficulties in communicating with others. In the future, they can lead to the development of complexes in the child, preventing him from learning and fully disclosing his natural abilities and capabilities.

In terms of severity, speech disorders can be divided into those that do not constitute an obstacle to learning in a mass school, and severe disorders that require special education. Of the severe speech disorders, the most common are alalia, various types of dysarthria, some forms of stuttering, etc.

Alalia is a complete or partial absence of speech in children with good physical hearing, due to underdevelopment or damage to the speech areas of the brain. With sensory alalia, the child does not understand someone else's speech poorly, moreover, it does not recognize the sounds of speech: he hears that a person is saying something, but does not understand what it is. This is similar to how we do not understand speakers of a foreign language we do not know. With motor alalia, the child cannot master the language (its sounds, words, grammar).

Dysarthria (anarthria) is a pronunciation disorder resulting from damage to the nervous system. With dysarthria, it is not the pronunciation of individual sounds that suffers, but the whole speech. A child with dysarthria pronounces sounds indistinctly, blurry, his voice is quiet, weak, or, on the contrary, too harsh; breathing rhythm is disturbed; speech loses its fluidity, the rate of speech is abnormally accelerated or too slow. Often in children with dysarthria, small hand movements are disturbed, they are physically awkward.

Children with erased forms of dysarthria do not stand out sharply among their peers, they do not even always immediately draw attention to themselves. However, they have some peculiarities. So, these children do not speak clearly and do not eat well. Usually they do not like meat, bread crusts, carrots, hard apples, as it is difficult for them to chew. After chewing a little, the child can hold the food by the cheek until the adults give him a comment. Often parents make concessions to the baby - they give soft food, just to eat. Thus, they, unwillingly, contribute to a delay in the development of the movements of the articulatory apparatus in the child.

Dislalia is a violation of the pronunciation of various sounds, another name for this type of speech disorder is tongue-tied. The types of tongue-tied language are very diverse. To designate them, they usually use the Greek names of those speech sounds, the pronunciation of which is impaired: the distorted pronunciation of the sound "r" was called rotacism, the sound "l" - lambdaism, whistling and hissing sounds ("s", "z", "c", " w "," g "," g "," u ") - sigma (from the Greek letters" ro "," lambda "," sigma "). If the pronunciation of all consonants and sound combinations with the exception of "t" is broken, so that speech becomes completely incomprehensible, then the term "tetism" is used (from the Greek name for the letter "t" (theta)).

Stuttering is a violation of the tempo, rhythm, smoothness of speech, caused by convulsions, spasms in various parts of the speech apparatus. In this case, the child has forced stops or repetitions of individual sounds and syllables in speech. Stuttering occurs most often in children between the ages of two and five. It is very important not to miss the first signs of stuttering: the child suddenly becomes silent, refuses to speak. This condition can last up to several days. In this case, an urgent need to consult a doctor.

Frequently, the cause of stuttering is fear or long-term mental trauma. Speech disorders at preschool age, in the absence of correctional work, will inevitably lead to problems at school, in particular, dysgraphia may develop - a violation of writing, the so-called inarticulateness in writing. As a rule, it manifests itself when the child begins to learn to read and write. The cause of this disorder is underdevelopment or impaired phonemic hearing. By the way, pronouncing aloud all the operations when writing a letter in the required sequence is a rather effective means for teaching a child to think correctly about an action, that is, it can be a prevention of the occurrence of graphic errors in younger students.

In the first grades, a child may also show dyslexia (alexia) - a violation of the process of reading or mastering it when various parts of the cortex of the left hemisphere are affected (in right-handers). Depending on which specific areas are affected, different types of alexia are distinguished.

Treatment

Some speech disorders disappear with age, some of them can be eliminated with little help from a speech therapist in working with parents or at a speech center, in a children's clinic or in a regular kindergarten. Children with severe speech impairments need compulsory long-term assistance of a speech therapist in speech groups of speech therapy kindergartens. Moreover, the earlier you turned to a speech therapist for help, the more successful the correction work with your child will be.

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Causes and types of speech impairment in adults

A disorder of the conversational function in an adult can arise suddenly as a manifestation of a serious illness, develop gradually, or be present in a patient from childhood due to the pathology of the articulatory apparatus left unattended.

Speech impairment in adults, the causes and types of anomalies are very diverse. These can be disorders of both impressive (perception of sounds, reading) and expressive speech (written or oral speech).

General characteristics of speech impairment in adults

Speech is the highest human function. It is connected, in the main, with a person's ability to think, his memory, feelings. The correct pronunciation of sounds directly depends on the work of the brain, respiratory system and organs of the articulatory apparatus (tongue, larynx, oropharynx, teeth, lips).

In general, the physiological mechanisms of speech formation are divided into two forms.

A detailed description of the forms of speech can be found in the table below.

• A person's ability to perceive heard speech, as well as understand written (reading).
• Analyze all sound components of speech (letters, sounds).
• The mechanism of impaired speech on an impressive type is associated with disorders in the work of the brain, auditory and visual apparatus. Patients with this pathology do not grasp the general semantic component of phrases, do not recognize the words addressed to them, which is often the reason for the substitution of sounds in syllabic reproduction. Sometimes a person's speech becomes unrecognizable to others

• Active oral speech.
• Self-writing ability.
• Ability to form words, sentences, pronounce sounds correctly.
• Expressive speech disorder is manifested by a limited vocabulary, immature pronunciation of sounds. Disorders are associated with abnormal work of the brain, organs of the articulatory apparatus, psychological problems

The main symptoms of a malfunction of the articulatory apparatus in adults

Speech disorders are characterized by the following features:

• Stuttering. Violation of the tempo and rhythm of speech. Spasms in the organs of the speech apparatus.
• Vileness. Change the voice tone. The main cause of this anomaly is the pathological process in the area of ​​the nasal septum.
• Slowness, inhibition of speech.
• Distorted pronunciation of sounds.
• Lack of understanding of the general meaning of speech.
• Hoarseness, hoarseness of the voice.
• Inability to express your thoughts.
• Salivation.
• Indistinct diction.
• Rapid speech rate. It is characterized by the swallowing of individual sounds.
• Small vocabulary.
• Complete silence of the patient (mutism).

All manifestations of speech disorders in adults are a significant obstacle to the full communication of patients and require treatment. It is almost impossible to overcome these symptoms on your own.

Important! Any dysfunction of the articulatory apparatus cannot be ignored. Often, speech difficulties can indicate the development of a serious illness (stroke, tumor process in the brain area)

Causes of speech impairment in adults

Speech impairment in adults is divided into two types due to the reasons that provoke it.

For example, such as organic speech impairment (OHP). The cause of this type of speech disorder is craniocerebral trauma (TBI), other painful conditions characterized by damage to the organs of the articulatory apparatus (tongue, lips, nasopharynx, teeth), individual links of the nervous system associated with the spoken function, as well as diseases of the hearing system.

Signs of OHP can appear after such past diseases as:

• Acute viral infections.
• Brain tumors.
• Stroke.
• Thrombosis.
• Birth trauma.
• Alzheimer's disease, Parkinson's. The elderly are suffering. In addition to speech disorders, patients have psychoemotional disorders, memory problems.
• Taking some antibiotics can have an ototoxic effect, lead to hearing loss, and, as a result, speech disorders.
• Neuroinfection (meningitis, encephalitis, Lyme disease).
• Botulism. A severe infectious disease affecting the human nervous system.
• Vascular spasm of the brain.
• Pre-stroke condition.
• Alcoholism.
• Cerebral palsy (cerebral palsy).
• Epilepsy.

Functional speech impairment (FNR). This pathology can occur due to the action on the human body of the following adverse factors:

• Severe stress.
• General speech underdevelopment of the 3rd, 2nd, 1st levels detected in childhood, left without full treatment.
• Mental retardation.
• Neuroses.
• Severe depression.
• Strong fright.
• Hysteria.
• Long-term use of antidepressants, tranquilizers.
• Mental illness.
• Genetic predisposition.

However, it should be noted that the differentiation of speech disorders, starting from provoking factors, is relatively. Often, in patients with FNR, a detailed examination subsequently reveals organic abnormalities.

Types of speech dysfunction

Speech impairment in adults, depending on the manifestations of the disease, is divided into types such as:

• Tahilalia. Too fast speech tempo with stuttering and swallowing sounds. May be a sign of epilepsy, oligophrenia.
• Aphonia. People, due to various reasons (laryngeal pathology, stress), can only speak in a whisper due to the loss of sonority of the voice.
• Dislalia. Disturbance in the pronunciation of sounds in patients with normal intelligence, hearing, articulation apparatus.
• Bradilalia. Slow speech motor skills due to difficult thinking. May be present with encephalitis, severe depression, TBI.
• Rinolalia. It is observed in people with an abnormal structure of the organs of the speech apparatus ("cleft palate", "cleft lip", palate injuries), manifests itself in a variety of defects in the pronunciation of sounds.
• Stuttering. Violation of the tempo and rhythm of speech. It can arise due to genetic predisposition, severe stress, fear.
• Such a speech disorder as dysarthria is characterized by disorders in the pronunciation of sounds, speech motility due to brain damage, and also insufficient innervation of the articulatory apparatus. It occurs with cerebral palsy, stroke, multiple sclerosis, myasthenia gravis.
• Alalia. The complete absence of speech or deep underdevelopment of speech function is most often the result of damage to the areas of the brain responsible for speech. It is observed in diseases such as TBI, stroke, autism.

All of the above symptoms are associated not only with difficulties in pronunciation, but also with the perception of speech, insufficient ability to independently form words, sentences, and the exact formulation of thoughts. That is, they can be a manifestation of inferiority, both impressive and expressive speech.

Diagnosis of the disease

Speech impairments in adults that occur suddenly or develop gradually can be a symptom of various diseases. It is necessary to consult a doctor (therapist, neurologist, otorhinolaryngologist) as early as possible for a complete examination.

Diagnosis of speech disorders includes the following activities:

• Analysis of the patient's conversational function, his complaints.
• Collecting anamnesis. It is necessary to find out when the disorders first occurred, what factors were associated with the first manifestations of speech dysfunction.
• The otorhinolaryngologist examines the organs of the articulatory apparatus. He will prescribe an X-ray examination.
• A neurologist will check reflexes, identify possible psychological disorders. If necessary, prescribe computed tomography (CT), magnetic resonance imaging (MRI) of the brain. He will send you for tests (general blood test, urine test) to identify an infectious process.

Treatment

First of all, the treatment of speech disorders in adults is a correct diagnosis.

To restore both impressive and expressive speech after excluding brain pathologies, mental illness, organic damage to the organs of the articulatory apparatus, you must consult a speech therapist.

Various exercises will be effective for correcting speech, taking into account the individual characteristics of a person.

For example, special breathing exercises, singing will help get rid of stuttering. Physiotherapy will also be of maximum benefit.

For example, such as:

• Transcranial micropolarization. A new method based on the effect of a current of minimum power, close to the physiological processes of the body, on the human brain. Reduces nervous irritability, improves speaking function, memory. Promotes the restoration of vision and hearing.
• Reflexology (acupuncture). Improves the functioning of all organs and systems in the human body.
• Speech therapy massage.

Also, to completely get rid of speech dysfunction, you may need the participation of a psychotherapist, psychologist.

Various psychotherapeutic techniques will help to find possible hidden causes that provoked speech disorders, and will normalize the emotional state of a person.

Patients suffering from speech impairments of varying severity need the help of not only qualified specialists, but the participation of relatives, normal living conditions, understanding of loved ones, good nutrition, which will maximally contribute to the restoration of neuropsychic health and speech apparatus.

In case of speech disorders, it is necessary to contact the following specialists:

The information on the site is provided solely for popular informational purposes, does not claim to be reference and medical accuracy, and is not a guide to action. Do not self-medicate. Please consult your healthcare professional.