In recent years, various types of dysarthria are increasingly observed in children of various ages. This diagnosis is very common, however, scares many parents. It manifests itself in the form of dysfunctions of the speech apparatus during sound pronunciation due to insufficient communication between tissues and cells and nerve endings. In addition, the lack of lability of facial expressions and other organs of speech are common symptoms of various types of dysarthria. Such restrictions significantly impede full articulation.
Because of what happens
Different factors can be the reasons for the appearance of a delay in the development of speech, therefore, at the first signs of the development of this defect, it is necessary to turn to narrow-profile specialists and begin appropriate treatment.
In most cases, dysarthria, as a form of impaired speech development, occurs against the background of cerebral palsy and has the same causes. Lesions in the central nervous system occur at different stages of embryonic development, during childbirth or in the early stages of the development of the child.
CNS lesions and the development of the speech apparatus in children
The main factors for the development of various types of dysarthria in children are complications during pregnancy: toxicosis, the threat of miscarriage, chronic pathologies in the mother, pathologies during pregnancy, fetal hypoxia or asphyxia at birth and other undesirable conditions.
The severity of impaired articulation is directly related to the degree of impaired motor function in cerebral palsy. So, for example, with hemiplegia, dysarthria or anarthria is diagnosed in almost all patients.
The causes of the development of various types of dysarthria in cerebral palsy can be infectious diseases, intoxication and trauma during pregnancy or a conflict of the Rh factors of the mother and fetus, as well as central nervous system lesions in early childhood, arising after neuroinfections, purulent otitis media, hydrocephalus, head injuries and intoxication.
Speech Disorders in Adults
Various types of dysarthria in adults can occur after the development of a stroke, brain injury, surgery and neoplasms in the brain. Speech disorders can occur in patients with some forms of sclerosis, myasthenia gravis or syringobulbia. Dysarthria is often found in Parkinson's disease, myotonia, neurosyphilis and oligophrenia.
Speech defects
Various speech disorders have several varieties and depend on the location of the lesion. The following types of dysarthria are distinguished:
- Bulbar. It is characterized by the defeat of a large number of nerve endings, leading to paralysis of the muscles involved in sound pronunciation and facial expressions. This dysfunction is accompanied by difficulty swallowing food.
- Pseudobulbar. It occurs with damage and dysfunction of some parts of the brain leading to paralysis of the muscles of the speech apparatus. The main difference between this violation is the monotony and inexpressiveness of the dialect.
- Cerebellar. Violations due to damage to the cerebellum of the brain. In this case, the instability of the structure of speech is characteristic - stretching of spoken words with a constantly changing volume.
- Cortical. It occurs with unilateral damage to the cerebral cortex, with a violation of certain structures. In this case, the overall structure of sound pronunciation remains, but in the child’s conversation there is an incorrect pronunciation of syllables.
- Subcortical (sometimes called hyperkinetic and is associated with extrapyramidal). It occurs due to damage to the subcortical nodes of the brain. For this type of dysarthria in children, slurred speech with a nasal tone is characteristic.
- Extrapyramidal. Damage occurs to areas of the brain that are responsible for the activity of the facial muscles.
- Parkinsonian. It occurs with the development of Parkinson's disease and manifests itself in the form of monotonous, slow speech.
- Erased form. It is accompanied by violations in the process of reprimanding hissing and whistling sounds.
- Cold. It is a symptom of myasthenia gravis (neuromuscular pathology). This type of dysarthria is characterized by difficulties in speech due to changes in the ambient temperature of the place where the child is.
Various techniques are used to diagnose speech disorders and difficulties in sound pronunciation. Only after determining the exact diagnosis, an appropriate course of treatment is prescribed, since types of dysarthria that differ in localization manifest themselves in different ways and at the same time require individual exposure in each case.
The main signs and symptoms of dysarthria
Only a qualified specialist can characterize the present violations of the child’s sound pronunciation, however, parents themselves can identify some manifestations of dysarthria. Usually, in addition to speech disorders, a small patient has inconsistent speech with changes in the pace and melody of speech. The general characteristics of all types of dysarthria can be such manifestations:
- Disturbance of speech breathing is clearly noticeable: by the end of the phrase, the speech seems to fade, while the child begins to suffocate or breathe more often.
- Voice disturbances are heard: usually in children with dysarthria it is too tall or squeaky.
- Violations of the melody of speech are noticeable: the child cannot change the pitch, speaks monotonously and inexpressively. Word flow sounds too fast or vice versa slow, but in either case it is not clear.
- It seems that the child is talking in the nose, however, there are no signs of a runny nose.
- There are various types of disturbances in the pronunciation of dysarthria: the pronunciation is distorted, skipped, or replaced by other sounds. Moreover, this does not apply to any one sound - several sounds or sound combinations may not be pronounced at once.
- The expressed weakness of articulatory muscles can manifest itself in different ways. If the mouth is open, then the baby’s tongue falls out spontaneously, the lips may be too compressed or, on the contrary, be too sluggish and not closing, and there may be increased salivation.
Some signs of impaired sound are noticeable in early childhood. Therefore, most attentive parents turn to specialists in a timely manner, which allows them to quite successfully prepare their children for school. With the effective treatment of some forms of dysarthria, the child can freely study in a regular school. For other cases, there are special correctional training programs, since in case of severe violations in the development of the speech apparatus, it is impossible to fully develop reading and writing skills.
Dislalia and rhinolalia: causes and types
Examination of dysarthria often reveals other types of disturbances in sound pronunciation, characteristic of children and adults with normal hearing and preserved innervation of the speech apparatus. In this case, functional or mechanical dyslalia can be detected.
Functional speech impairment in case of dyslalia is associated with dysfunction of mastering the pronunciation system in childhood. The causes of this disorder may be associated with:
- general physical weakness of the body due to frequent diseases during the formation of the speech apparatus;
- deficiency in the development of phonemic hearing;
- pedagogical neglect, adverse social and speech conditions in which the child develops;
- bilingualism in communication with the child.
Functional dyslalia is divided into motor and sensory. They are due to the appearance of neurodynamic shifts in the parts of the brain that are responsible for speech (in the first case) and for the hearing apparatus (in the second case).
Depending on the manifestations of certain signs, such types of dyslalia are distinguished as acoustic-phonemic, articulatory-phonemic and articulatory-phonetic.
Mechanical dyslalia can occur at any age due to damage to the peripheral system of the speech apparatus. The reasons for the appearance of this form of violation of sound pronunciation can be:
- deficiencies and defects in the structure of the jaws and dentition;
- anomalies in the structure of the frenum of the tongue;
- changes in the structure and form of the language;
- disturbances in the structure of hard and soft palate;
- atypical lip structure.
Dyslalia correction
Usually dyslalia is successfully eliminated. However, the effectiveness and correction period depend on the age and individual characteristics of the patient, as well as on the regularity and completeness of classes with a speech therapist and the participation of parents.
It is known that in young children this defect is eliminated much faster and easier than in high school students.
Rinolalia: causes and classification
Violations of the timbre, tempo and melody of the voice, as well as difficulties in sound pronunciation can be associated with anatomical and physiological defects of the speech apparatus. Rinolalia occurs with congenital physiological abnormalities in the structure of the hard or soft palate and nasal cavity. Such defects change the structure and functions of the speech apparatus, and hence the mechanism for the formation of sound pronunciation.
Speech therapists emit open, closed and mixed forms of rhinolalia. In addition, this defect may be mechanical or functional.
Open rhinology is characterized by changes in the communication between the nasal and oral cavity. This phenomenon causes the simultaneous free passage of air flow through the nose into the mouth, which leads to the appearance of resonance during phonation. This defect has the mechanical nature of the formation (may be congenital or acquired).
Closed rhinolalia is due to the presence of an obstacle restricting the exit of the air stream through the nose. In the mechanical form, disturbances in sound pronunciation are associated with physiological dysfunctions of the pharynx and nasopharynx arising from the formation of polyps, adenoids, or the curvature of the nasal septum. The functional form of rhinolalia is due to the presence of hyperfunction of the soft palate, blocking the path of the air stream to the nose.
The mixed form of rhinolalia is characterized by nasal obstruction and insufficiency of the palatopharyngeal closure. In this case, there is a lack of nasal phonemes and a nasal voice.
Rhinolalia correction
The disorders that underlie rhinolalia require the participation in the elimination of this defect in the complex interaction of specialists in various fields: dental surgeons, orthodontists, otolaryngologists, speech therapists and psychologists.
Functional rhinolalia in most cases has a favorable prognosis and is adjusted using special phoniatric exercises and speech therapy sessions. However, in this case, a positive result of treatment depends on the period of contacting specialists, the completeness of the impact and the interest of the parents. The effect of overcoming the organic form is largely determined by the results of surgical intervention, the timing of the start and the completeness of training with a speech therapist.
Speech impairment correction
Dysarthria, as a form of speech development disorders, require a comprehensive therapeutic and pedagogical impact. In this case, a combination of speech therapy correction, drug treatment and exercise therapy is performed.
Speech Therapy
During classes with children suffering from various types of dysarthria, experts pay special attention to the general development of all aspects of the child’s speech: replenishing the vocabulary, developing phonetic hearing and the correct grammatical construction of phrases.
Today, special speech therapy groups are being created for this in kindergartens and speech schools. It mainly uses game correction techniques using interactive simulators and special programs that quickly get rid of detected problems in the speech present.
Additionally, speech therapy massage and articulatory gymnastics, which strengthen the muscles of the speech apparatus, are used.
Drug treatment
To eliminate almost all types of dysarthria, special drug treatment regimens are used. The main drugs used in eliminating speech disorders are nootropics. These funds contribute to the improvement of higher brain functions: stimulate brain activity, facilitate learning processes and improve memory. The most popular among neurologists who observe children with various speech impairments are drugs such as Pantogam (aka hopantenic acid), Phenibut, Magne-B6, Cerebrolysin, Cortexin, Cerepro "and many other drugs that improve the functioning of the vascular system and the brain.
Physiotherapy exercises and massage
In the treatment of various types of dysarthria, special therapeutic gymnastics methods are also used. These include exercises aimed at improving general motility and stimulating articulation capabilities, developing auditory perception and improving the functioning of the respiratory system.
Forecast
The effectiveness of the treatment of various types of dysarthria identified in early childhood, in most cases is uncertain. This is due to possible irreversible brain and central nervous system disorders. The main objective of the treatment for difficult sound pronunciation is to teach the child to speak in a way that others understand. In addition, the integrated impact further enhances the perception of basic writing and reading skills.