Speech dysarthria in a child is a disease that occurs as a result of damage to the central and peripheral parts of the nervous system. It is characterized by a wide range of speech and motor disorders.
Main reasons
Dysarthria is rarely a separate pathology, often occurs against a background of various disorders of the nervous system. The reasons for its occurrence may be:
- Cerebral palsy;
- meningitis;
- encephalitis;
- neurosyphilis;
- traumatic brain injury;
- stroke;
- purulent otitis media;
- neoplasms in the brain;
- multiple sclerosis;
- myasthenia gravis;
- cerebral atherosclerosis;
- oligophrenia.
Often, the disease is a symptom of cerebral palsy. Accordingly, the causes of the disease are similar to the causes of cerebral palsy.
Therefore, dysarthria in preschool children can be the result of:
- intrauterine hypoxia;
- toxicosis;
- rhesus factor conflict;
- birth trauma;
- the presence of a somatic disease in a woman;
- generic pathology;
- asphyxia;
- hemolytic disease;
- prematurity.
Causes of the postembryonic period
In the postembryonic period, the development of this disease can be caused by neuroinfection, for example:
- meningitis
- hydrocephalus;
- severe intoxication of the body;
- trauma to the brain.
Also, the cause of dysarthria is multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, myotonia, myasthenia gravis, cerebral atherosclerosis.
Symptoms
There are certain factors that will help parents see the presence of this pathology in the child.
Of course, in any case, you need to contact a specialist.
Symptoms of dysarthria include:
- The presence of weakness in the articulation muscles. You can see it by various factors, for example, if the child has an open mouth and tongue falls out, lips are tightly compressed, or, conversely, salivation is increased.
- The feeling that the child is talking in the nose (there are no symptoms of a runny nose). There is a distortion of sounds in words, because of which speech is not entirely clear.
- Speech breathing is impaired, during a conversation the child may suffocate and begin to breathe faster.
- The voice changes, it becomes high and squeaky.
- There are difficulties with the melody of speech. Children with this diagnosis cannot change the pitch, their speech is monotonous, and they speak too fast or slow, but almost always their speech is incomprehensible.
Parents task
Parents should be very attentive to the development of their child. At a very early age, it is already possible to detect a speech disorder in a child. The sooner the violation is discovered, the better, because there will be more time to go to the doctors and prepare for school. Some forms of this disease (with the help of treatment) allow children to go to school, and for the rest there are certain training programs.
Classification
The classification of this pathology in children is quite controversial. This is due to the fact that CNS disorders obtained in utero or in early childhood differ significantly from pathological changes in adulthood.
Also of great importance is the fact that impaired speech and motor skills are superimposed on the period of their active development.
There are several types of dysarthria classifications in children, but they also have common symptoms. For example, almost all doctors do not emit bulbar dysarthria, which is present in the adult classification. This is due to the fact that the dysfunction of the medulla oblongata observed with this pathology is incompatible with the life of the newborn. The following symptoms are characteristic of all types of dysarthria :
- Violations of the articulation of speech and its motor skills.
- Change or underdevelopment of speech pace and voice formation.
- Violations of muscle tone, leading to difficulty in facial expressions.
- Slowing down speech development.
- Sometimes the clinical picture is supplemented by motor disorders, changes in various types of perception, mental disorders, and intelligence.
Some doctors classify childhood dysarthria according to speech therapies.
Speech defects are invisible to others. Only a speech therapist can install them through special examinations. The following stages are distinguished here:
- Speech disturbances are noticeable to strangers, but in general it is legible.
- The speech is fuzzy, blurry. Only relatives can disassemble it.
- The speech is absent or so incomprehensible that no one can parse it.
Localization
There is a classification of the disease at the place of localization:
- pseudobulbar;
- subcortical;
- cortical;
- cerebellar.
However, this approach is more applicable for the classification of pathology in adults.
Characterization of clinical forms
Dysarthria is a group of speech disorders associated with pathological changes in the nervous system. Patients have fuzzy blurry articulation, impaired pace and volume of speech. Forms of dysarthria in children:
- Bulbar dysarthria. It is associated with lesions of the nuclei of the glossopharyngeal, trigeminal, facial, vagus, sublingual nerves. Patients observed areflexia (violation of the integrity of the reflex arc), amimia (difficulty facial expressions). Patients complain of increased salivation, difficulty in chewing, swallowing food. Speech is slurred. All consonants are reduced to a single slit sound. Differentiation of sounds is not possible. There may be nasalization of the timbre, dysphonia (weakness, hoarseness) or aphonia (loss of sonority while maintaining the ability to speak in a whisper).
- Pseudobulbar erased dysarthria in children. Violations arise as a result of spastic paralysis and muscle hypertonicity. Among the symptoms of difficulty in raising and lowering the tongue, moving it from side to side, increased salivation. Changing articulation poses is difficult. Violations of some arbitrary movements are observed. Speech is illegible, blurry. Wheezing and hissing sounds are difficult.
- Subcortical dysarthria. The main symptom is the presence of hyperkinesis (involuntary muscle movements). Observed including in the area of facial muscles. They arise at rest and when trying to talk. Patients complain of a change in timbre and voice power. Sometimes they may have involuntary guttural sounds.
- Cerebellar dysarthria. It is manifested by impaired speech coordination, as a result of which there is a jerky chanted speech. Sometimes there may be separate sounds, screams. Patients complain of tremor of the tongue. Anterior lingual and labial sounds are difficult. Ataxia (imbalance, unsteady gait) is observed.
- Cortical erased dysarthria in children. It is characterized by the presence of deviations during arbitrary articulation. There are violations of timbre and voice. There are no prosodiki. With various forms of this pathology, difficulties can be observed with sound pronunciation, impaired reading, writing, and speech understanding.
Diagnostics
Specialists do not diagnose dysarthria until they study the characteristics of the psyche of the child. The above study should fully assess the picture of development and determine the deviation in the central nervous system. To identify it is necessary to know the features of the stages of formation of the central nervous system of the child.
There are three stages:
- The first stage before the age of six months. During this period, in healthy children and in children with a diagnosis of dysarthria, involuntary motor reflexes are observed, for example, a step reflex, grasping reflex. The child’s body is compressed, arms are tense, legs are bent. At the end of the first stage in healthy children, there is a transition to normalization of movements. If this does not happen, then the child is specified disorder of the central nervous system.
- The second stage is from six months to 11 months. This stage in healthy children is characterized by a transition from involuntary to active movements, for example, a child can sit on his own, distinguish sounds, people, the meaning of words, objects. The child develops babble from individual vowels.
- The third stage is from one year to three years old. At this stage, a healthy child has subtle hand movements. At the beginning of the stage it crawls, and at the end it begins to walk. Starts to accumulate words. In children with erased dysarthria, speech is formed. If the child develops normally, then when pronouncing the words, breathing is smooth and without inexplicable pauses. If at the end of the third stage the child does not reveal the above signs, then we can talk about the disorder of the central nervous system.
The above steps allow you to timely identify violations of speech development in a child. Treatment of dysarthria in children is carried out only after diagnosis!
Correction
A neurologist can prescribe the features of children with dysarthria, and the procedure itself involves taking measures to eliminate articulate speech disorders, because the disease itself leads to impaired pronunciation and sometimes difficulties with articulation. Correction of dysarthria should be carried out in a complex, including drug treatment and physiotherapeutic procedures.
The neurologist usually prescribes to such patients:
- vascular preparations: "Cavinton", "Vinpocetine", "Instenon", "Gliatilin";
- Nootropic drugs - Pantocalcin, Nootropil, Encephabol, Picamilon;
- metabolic preparations - Cerebrolysate, Actovigin, Cortexin, Cerebrolysin;
- vitamin complexes - Milgamma, Neuromultivit;
- sedatives - Persen, Novopassit, Tenoten.
One of the most effective methods of physiotherapeutic correction of dysarthria is massage. It is done with great accuracy, because power pressure can lead to the restoration of the reflex of oral automation.
Recommendations
Working with children with dysarthria includes:
- Massaging the nasolabial folds. For this, 5 to 7 movements are made from the nose to the lips, light tapping on the nasolabial folds. You can also massage this part with zigzag, wavy and spiral movements. Acupressure can be done in the corners of the lips.
- Lip massage. It is done with two fingers from the middle of the upper and lower lips to the corners. Additionally, you can make spiral movements on the upper and lower lip, similar movements in the middle part of the lips. Tingling is also recommended on the middle of the lips.
- Massage the sky. To do this, use two fingers to massage the palate, starting movement from the front teeth to the middle of the oral cavity. Before the procedure, hands should be wrapped in gauze.
Also make tapping from incisors, zigzag, wavy, ring movements. In addition, it will be useful to massage the language, which uses the movements described above.
Forecast and Prevention
A positive prognosis for the correction of pronunciation for dysarthria can be obtained only with the timely start of treatment. The success of treatment largely depends on the clarity of the treatment regimen and the patient's diligence.
Erased dysarthria has a positive prognosis for complete normalization after a full correction. Patients with such dysarthria, after correction, can attend comprehensive schools.
Acute forms of dysarthria are not completely corrected. In patients with such dysarthria, only an improvement in speech function is possible. Prevention of dysarthria in children comes down to the use of correction methods such as echolalia and echopraxia.
The phenomenon of dysarthria manifests itself in newborns after a month of life. Therefore, if at birth there are hereditary diseases that can cause the disease, then the development of the child from the first days should be organized so that everything contributes to the correct formation of his movements and psyche.
Prevention in this case consists in the constant communication of the child with adults, which will contribute to the development of his speech abilities.
Prevention of dysarthria in children with brain lesions is to prevent neuroinfections, brain injuries, toxic effects.