Alalia - what's this? Alalia: correctional work. Prognosis for recovery with sensory alalia alalia as speech impairment

Date: 19.07.2019

Alalia is a speech disorder in which the child cannot partially (with poor vocabulary and problems with phrasing) or fully speak. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered complicated childbirth, diseases or brain injuries received in early age... The disease can be cured with prolonged visits to a speech therapist and with the help of medication.

Despite its rarity, the disease is diagnosed more often in boys than in girls. It can have varying degrees of severity of the course - from the most serious, in which speech appears only after ten years, to a lighter, similar underdevelopment of speech. The most important thing is to distinguish this disorder from. Basically, children do not have developmental disorders (it can be disturbed only under the influence of oppression by the public and peers). In case of untimely treatment at an early age, in the future, the child will experience problems with social adaptation, difficulties in finding his place in society.

Etiology

Insofar as this disease can form in the womb or in the early years of life, the reasons for its appearance also differ in intrauterine and external influences.

The first group of factors includes:

unsuccessful attempts of the expectant mother to get rid of the fetus;
risk of miscarriage;
uncontrolled use of medicines by the expectant mother;
complicated in the mother, manifested and;
insufficient oxygen supply to the fetus;
unhealthy lifestyle that a woman led while pregnant;
direct trauma to the abdomen or falling on it during pregnancy;
various diseases of a woman accompanying the period of bearing a child, among which is insufficiency, or, or, etc.;
premature or complicated labor, obstetric intervention in the process.

Among the reasons influencing the formation of alalia in children under the age of three years, there is a severe course of such ailments as:

... May appear from an insect bite or contact with a poisonous plant;
caused by bacteria or fungi;
various traumatic brain injuries;
disturbances in the functioning of the central nervous system;
bilateral;
insufficient attention on the part of parents to teaching the child simple words or phrases;
surgical intervention performed under anesthesia.

Doctors note that alalia does not arise from one factor, but from the simultaneous influence of several reasons.

Varieties

In the medical field, there are many classifications of the disease, but nowadays speech therapists use the following division of speech disorders:

sensory alalia- characterized by the fact that the child does not perceive what he is told, he simply does not understand someone else's speech, but at the same time he can hear, make sounds and pronounce simple words... His flow of speech is incoherent and unintelligible;
motor alalia- in the case of the progression of this type of ailment, the child pronounces the words quietly and indistinctly, but in most cases the children cannot speak at all. The understanding of what other people are saying is not broken, the child can even show understanding of the meaning of words with the help of gestures;
sensorimotor alalia- the most severe form of the disorder, combining an inability to understand speech and reproduce it.

Symptoms

Signs of the manifestation of the disease depend on the form of the disease. So, the symptoms motor alalia are:

violation of fine motor skills. The child cannot button or tie the laces on his own;
frequent mood swings;
excessive activity can be replaced by lethargy and inactivity;
distracted attention;
low efficiency;
increased fatigue;
complete absence of speech or unclear reproduction of sounds;
scarce vocabulary that leads to an incomplete understanding of what others are saying;
pronounced facial expressions and gestures.

Sensory alalia is characterized by the following symptoms:

increased susceptibility to sounds, since children are not able to understand anything else;
meaningless and incoherent set of sounds and words that the child reproduces;
wide use of facial expressions and gestures in communication;
speech disorders in the form of missing letters in words, incorrect ending or joining two words into one;
slight memory impairments, children are very difficult or, in general, do not remember new words;
impulsiveness is replaced by isolation, and activity is replaced by passivity.

Against the background of the fact that the child cannot distinguish the speech that is being spoken to him, he has the ability to read words by lips.

Diagnostics

Since alalia occurs against the background of problems with the functioning of the brain, diagnostic methods will be aimed at studying the degree and assessment of damage in the brain. To do this, the little patient needs to go through:

electroencephalography - in which the transmission of impulses and the activity of the brain is assessed;
echoencephalography - the study of brain pathologies, which is carried out using ultrasound;
X-ray of the skull;

To exclude motor alalia and, accordingly, to confirm sensory alalia, additional methods diagnostics, including:

otoscopy, which is done to examine the ear canal and tympanic membrane;
audiometry - by which hearing acuity is assessed and the minimum sound power that a child can hear.

In addition, it is necessary to consult a speech therapist who diagnoses and evaluates auditory-speech memory and speech. You may also need advice from pediatric doctors such as a neurologist, otolaryngologist and psychologist.

Treatment

Therapy for this disorder is based on the results of tests and the degree of manifestation of symptoms, and therefore will be developed for each small patient individually. The most favorable age for treating an ailment is considered to be four years; it is during this period that the child shows the greatest interest in the world around him.

Common treatments include:

classes with a speech therapist, which is often combined with taking medications. Classes with a doctor will be effective for all forms of the disease. The treatment regimen is compiled for each child separately - taken into account general state health, age and degree of disorder. The task of a speech therapist is to develop speech ability, teach how to pronounce words and build phrases, as well as increase vocabulary. Taking medications is aimed at improving the nutrition of the brain (full supply of vitamins and nutrients);
conducting therapeutic speech therapy face massages. This treatment helps tone and relax the muscles in the face, which can reduce some of the symptoms.
physiotherapy, the purpose of which is to influence certain areas of the brain with electrical impulses. This method of treatment is harmless to health and completely painless, so it can be carried out for babies less than one year old.

If you carry out timely, and most importantly, well-chosen treatment, the child will get rid of all the symptoms of the disease or learn to control them. But the main thing is that he will be able to study in a general education school and adapt in society.

Parental support plays an important role in therapy, since it is important for a child to know that his / her treatment success does not go unnoticed by the closest people, this will give an additional incentive to a speedy recovery, which even better contributes to the treatment.

Prophylaxis

Prevention of alalia mainly consists of:

a favorable course of pregnancy, it is best if during such a period of life a woman is at a resort or in a sanatorium;
rejection of bad habits by the expectant mother even at the stage of pregnancy planning;
timely treatment infectious diseases the symptoms or complications of which may harm the fetus;
protection from consumption medicinal substances for no apparent reason or doctor's orders;
enrichment of nutrition with vitamins and nutrients that should go to the fetus;
regular visits to the obstetrician-gynecologist.

Alalia - the absence or underdevelopment of speech due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of the child's development.

Reasons: polyetiology (according to Kovshikov): pathology of pregnancy + childbirth (asphyxia - 88%) + early age, as well as inflammation. and injuries. GM lesions leading to organ. damage to the central nervous system.

The etiology and pathogenesis are diverse.: inflammatory processes and brain injuries, alimentary-trophic, metabolic disorders in the prenatal and early postnatal period of the child's development.

There are two main types of alalia.

Alalia motor(motor) - underdevelopment of expressive speech, expressed by difficulties in mastering the active vocabulary and grammatical structure of the language with a sufficiently preserved understanding of speech; at the heart of MA there is a disorder or underdevelopment of the analytic-synthetic activity of the analyzer, expressed, in particular, by the replacement of subtle and complex articulation differentiations with coarser and simpler ones; cause- defeat of the cortical end of the speech motor analyzer (Broca's center) and its pathways.

Alalia sensory(feeling, sensation) - underdevelopment of impressive speech, when observing a gap between the meaning and the sound shell of words; children have impaired understanding of the speech of others, despite good hearing and preserved ability to develop active speech; cause SA is a lesion of the cortical end of the auditory-speech analyzer (Wernicke center) and its pathways.

At the same time, this division is arbitrary, since in practice there are combinations of both motor alalia and sensory alalia.

There are 3 degrees of severity (according to Kovshikov) or levels (according to Levina):

1 : all subsystems of the language in their infancy and func. abnormally; use nonverbs. facilities. M \ b one-word sentences and pseudo-propositions, words-roots; enjoys the situation. speech.

2 : rudiments of general consumption. speech (simple phrasal speech; appeared. two-part. sentence. Obs. wordiz-e, word form., cons., grammatisms, willow. paraphasia, pl. syllabic structure.

3 : appears. offer of various types and designs, speech with elements of underdevelopment

49. Aphasia. Definition, etiology. Types of aphasia. Aphasia ( af)is a systemic speech disorder, consisting in complete loss or partial loss of speech and caused by local damage to one or more of the speech areas of the brain. In most cases, af. Arose in adults. people, however, it is possible in children, if the brain damage occurred after speech at least partially formed.

Etiology of aphasia.Af can have different etiology: vascular; traumatic (traumatic brain injury); tumor ... Vessel brain lesions have various names: strokes, or cerebral infarctions, or cerebral circulation disorders. They are divided into subspecies. Basics. types of strokes (cerebral infarctions, cerebrovascular accidents) yavl. ischemia and hemorrhage. The term ischemia means fasting. The term "hemorrhage" - "hemorrhage" (from the Latin. Gemorra - blood). "Fasting" (ischemia) leads to the death of brain cells, because they are left without the main "food" - blood. Hemorrhage (hemorrhage) also destroys brain cells, but for other reasons: either they are filled with blood, or a blood sac - a hematoma - forms at the site of the hemorrhage. Brain trauma being open and closed. Both those and others destroyed the brain, including the speech zones. When open. brain injuries resort to surgical intervention to clean wounds, for example, from splinters bone tissue, blood clots, etc.), when closed. injuries, surgical intervention (craniotomy) can be performed, and conservative treatment can be applied, with the cat therapy is designed mainly for resorption of intracranial hematomas .

Brain tumors m b benign and malignant. Zlokach-e otl. faster growth. Just like hematomas, tumors squeeze the substance of the brain, and growing into it, destroy nerve cells. The most severe consequences of local brain lesions of any etiology are disorders of: a) speech and other HMF (orientation in space, ability to write, read, count, etc.); b) movements. They can be present at the same time, but they can also act in isolation: the patient's movement disorders can be present, but speech disorders can be absent, and vice versa.

Types of af:-

Amnestic, Motor. Dynamic. Sensory. Total.

1 . amnot. Af.- showed the loss of the ability to name things and phenomena while maintaining the ability to describe them. In other words, it is a loss of verbal memory. A patient with aphasia cannot remember the name of the object, but if he is prompted for the first couple of sounds, he can remember. The situation is the same with writing words on paper. The disease is caused by disturbances in the work of the parietal and temporal regions of the cerebral cortex. .

2 .Motor. af.- violation oral speech due to speech apraxia (violation of the purpose of actions, the implementation of only elementary movements). The articulation of the ap (tongue, jaw, lips, larynx) functions normally. It is customary to distinguish a full and partial motor. af. With full speech, it is almost completely lost, the patient switches to gesticulation. With partial pronunciation of short, simplest words (usually verbs and nouns), words are distorted, some words are skipped, it becomes difficult to choose words to express thoughts. Speech slows down, the same words or sounds are often repeated. MA strongly affects the ability to read and write, the spelling of words fully reflects violations of oral speech (skipping, distortion of words, etc.). The emergence of MA is associated with damage to the cortex of the third frontal gyrus of the left hemisphere of the brain (Broca's center) and adjacent areas. Therefore, it is often also called Broca's aphasia. .

3 .Dynamo af.- damage to the cortex of the heads. brain in areas adjacent to Broca's center - in the posterior frontal parts of the left hemisphere. The patient cannot pronounce a long phrase, since he is not able to build long semantic chains of words. Prepositions and pronouns disappear from speech, and nouns remain in the nominative case.

4 .Sensor. af.(Wernicke's aphasia) is a disorder of understanding someone else's speech, the so-called verbal deafness. The patient's hearing is not impaired, he hears someone else's speech, but cannot understand the essence. Speech is perceived as a set of sounds, which cannot be recognized. The patient's own speech is not controlled, there is a continuous stream of words, often without any meaning. Writing and reading words becomes almost impossible: words are skipped, distorted, all meaning is lost. Cause- defeat of the posterior part of the superior temporal gyrus of the left hemisphere. In case of damage to the adjacent area (parietal), a violation of counting occurs.

5. Total aphasia- manifested by complete speech loss, as well as misunderstanding of someone else's speech. This is the most severe, extreme degree of the disease. In this case, the dominant hemisphere of the brain is damaged, as well as several speech areas of the brain at once.

Usually children are distinguished by their talkativeness. Once they learn human speech, they immediately try their communication skills. However, some parents may notice that their children are not talkative. They are shy? Do they have speech problems? Anything is possible that requires investigation, since it may turn out that the children have alalia. This special disease which has a touch and motor view, the symptoms and treatment of which we will consider in this article.

What is alalia?

What is alalia? This is a disease in which a child has a partial or complete absence of speech with preserved intelligence and normal hearing. Some experts consider this disorder a disease, others - a syndrome. At the same time, the underdevelopment of certain parts of the brain, which are responsible for the speech abilities of a person, is noted. This deviation could have developed both during the period intrauterine development, and after the birth of the baby.

Usually alalia has 3 types of its manifestation:

Motor.
Sensory.
Combinatorial (mixed or sensorimotor).

Each is characterized by a zone of its manifestation, the degree and mechanisms of pathology.

Since the baby has retained intelligence and a normally formed speech apparatus, he actively learns the world. The difficulty in identifying alalia lies in the fact that the child does not immediately start talking. It is quite natural that for the first 3 years he may not arouse suspicion in his parents. Only at that age when he should be able to speak well and not close his mouth can these or those signs of speech deficit appear vividly.

Parents may suspect alalia in children for the following reasons:

Illiteracy.
Poor vocabulary.
Defects in sound reproduction.
Late speech reaction.
Violation of the syllable structure.
Violation of phonemic processes.

The first guesses can fall on the wrong teaching of the child. In this case, you should lead to a speech therapist who is engaged in the elimination of speech deficiencies, manifested due to the underdevelopment of the speech apparatus. However, when diagnosing a child, he will identify other reasons for the child's silence, which will require examinations from other doctors.

First signs

The first signs of alalia in children begin to appear at the age of two, when they try to pronounce words, build phrases. If certain signs are observed, it is necessary to quickly begin to treat them, as the disease will develop. By what signs can you determine alalia in children?

Misunderstanding of the words of the parents.
Movement disorder.
Deceleration of mental development.
Communication with adults is carried out by gestures.
Increased irritability.
Errors in declensions and cases, in numbers.
Lack of self-service skills.

Since the disease is expressed in a lack of understanding of human speech, the child can gradually fenced off and move away from adults and other children. Some may mistake this behavior for autism or mental, mental underdevelopment. Wrong diagnosis leads to inappropriate treatment. The problem is aggravated by the inability to determine the hearing level of the baby.

If the parents notice that the child is slowly developing at the word level, does not progress in his skills, remains at the same level, then they should sound the alarm. In order to clearly understand how the speech apparatus develops, it is necessary to study the literature on the peculiarities of its development in babies.

With the development of one or another type of alalia, the following differences are observed:

Perception and understanding of speech, hearing with motor alalia are preserved, with sensory alalia - impaired.
Sensory alalia is characterized by the presence of echolalia, and motor alalia is characterized by the absence.
Repetition of words or phrases becomes impossible with motor alalia, with sensory alalia, it is observed, however, children do not understand the meaning of their words.
Non-verbal or verbal communication methods are observed with motor alalia, and with sensory alalia, they may be completely absent due to a lack of desire to engage in communication.

Speech correction activities should be carried out in a playful way so as not to tire the child.

Motor Alalia

Damage to the fronto-parietal lobe of the brain leads to the development of motor alalia. Often such children are the objects of overprotection, which is not surprising, since they are often injured at birth or suffer from serious illnesses in the first years of his life. That is why these children are often moody, irritable and overly stubborn.

Motor alalia can be identified by the following symptoms:

Underdevelopment of the articulatory apparatus, which is expressed in the inability to move organs oral cavity that are involved in the formation of speech.
Lack of self-care skills that are taught to children at an early age.
Impaired coordination of movements: frequent falls, inability to walk on a log or jump on one leg.
Improper development of speech, which ranges from its complete absence to the pronunciation of phrases with some errors.

Motor alalia manifests itself in 3 stages of development:

In the first stage, people cannot understand the meaning of the child's words. He cannot express his emotions and thoughts through words. Only by facial expressions, gestures and a specific situation can you understand what the baby is talking about.
At the second stage, the child is already able to express his thoughts in words that are more understandable to people.
In the third stage, the baby is able to form sentences using the correct words, but makes grammatical and lexical mistakes.

If parents mistakenly perceive the child's taciturnity or incorrect pronunciation of words for laziness, then they can start the illness. Doctors diagnose the disorder by testing the speech apparatus and its use, electroencephalogram tests, and testing auditory and intellectual skills.

Naturally, the correction of motor alalia occurs in the speech direction, as well as the continuation of the education of the baby and the giving of knowledge about the world around him.

Sensory alalia

Sensory alalia is manifested in the child's misunderstanding of the speech of others. There is a significant gap between the sound and the meaning of the word, which leads not only to misunderstanding, but also to a lack of desire to use speech. That is why soon the child is gradually fenced off from people, it is distorted. visual perception, mental development slows down.

It is these children who are often misdiagnosed, for example, mental retardation or autism, which leads to the wrong treatment.

It is easiest for a child to perceive speech in the morning. In the late afternoon, fatigue occurs, which significantly reduces the child's perception of the speech of others. The child's passive vocabulary is replenished slowly due to the inability to understand the meaning and sound of words. At the same time, he can both react to acoustic quiet sounds, and completely ignore them. That is why, when working with such a child, the volume of the spoken words does not matter. If you raise your voice, you can thus distinguish only a hearing-impaired baby from an alalik. However, this approach will have no effect.

Also, the baby can pay attention to sounds that healthy people usually ignored, for example, birdsong, dripping water. Because the sounds are long-lasting, the baby may complain of a headache or be irritable.

High speech activity is one of the signs of sensory alalik. The kid can repeat the words just heard, trying to make sentences out of them. However, he does not understand their meaning. The meaning of their proposals is incomprehensible not only to those around them, but also to the kids themselves. At the same time, there is clarity of speech, active gesticulation and even interest in their own voice and speech.

In addition, the following signs are observed:

Personality disorder.
Mental underdevelopment.
Difficulty in behavior.

Symptoms

The most striking symptom of alalia is a speech defect, which manifests itself in different forms: complete absence, incoherent speech, grammatical and lexical errors. Sometimes a child's speech is not formed until the age of 12, despite all the developmental exercises and games.

Motor alalia is expressed by the lack of expression in the baby's speech. There may be no babbling at all. At first, the child does not pronounce the words due to a misunderstanding of their meaning, then he tries to make sentences in more understandable words, only at the last stage do attempts to speak correctly arise, however, mistakes are observed. At the same time, all this is accompanied by intellectual backwardness. Vocabulary is scarce and writing skills develop very late.

Sensory alalia is characterized by a misunderstanding of the relationship between the pronunciation of words and the objects they convey. Thus, the delay in the use of words may become apparent. The child then begins to speak, however incoherently and sometimes distorting words, choosing similar ones in sound. He doesn't understand what he is saying. In this case, the baby may not respond to the call, but pay attention to quiet sounds. Here, too, mental retardation is observed.

The vocal apparatus develops very slowly. At the end of infancy, a child may have no more than 100 vocabulary words. This does not give predictions for the further development of the baby, however, it accurately indicates the disease.

In addition to speech defects, the baby has various mental disorders due to illness:

Neurosis.
Irritability.
Reduced focus.
Fast fatiguability.
Low efficiency.
Delay in the development of the psyche.

The problem of alalia is effectively dealt with by specialists on the site of psychotherapeutic assistance site. Diagnostics and treatment should only be carried out by doctors, since parents do not have sufficient knowledge to correct alalik's speech.

Treatment

The problem should not be ignored. In rare cases, it is eliminated by the activities that are carried out by the parents. Often, you cannot do without the help of a specialist. It all starts with diagnostics, which helps determine the correct approach to the treatment of alalia.

Sometimes the activities can be light, which requires only parenting with the baby. Soon, the vocal apparatus will be developed, and the child will be able to be like other children. In any case, therapeutic measures are necessary.

At mild form alalia is about speech therapy classes, where the words and grammar of the child are corrected. Systematic exercises will eliminate all the shortcomings associated with the baby's speech.

At severe forms Alalia is not only a therapy. We are talking about gross damage to a part of the brain, which requires special treatment.

V general treatment alaliya is carried out by the following activities:

Speech therapy massage is an exercise for the development of the muscles of the articulatory apparatus.
Speech therapy classes.
Microcurrent reflexology, in which there is an effect on the parts of the brain responsible for speech, the desire to speak, vocabulary replenishment, etc.

The effect of the use of drugs has not yet been proven, however, studies are being conducted where medicines are being prepared for the formation of brain components (cortexins, gammalones, cogitums, ceraxones, vitamins B12 and B15). Hydrotherapy, physiotherapy, laser therapy are also carried out. The kid goes through classes on the development of fine motor skills and cognitive functions (memory, attention, mental activity). Visual aids are also actively used at home when replenishing vocabulary.

Classes are held both in special institutions and at home, depending on the degree of the disease.

Forecast

The prognosis for the treatment of alalia is ambiguous. Usually, children quickly recover in speech and mental development... However, doctors cannot give guarantees of the measures they will carry out. It all depends on:

Timeliness of disease detection and treatment.
The degree of severity.
The quality of undeveloped speech (how advanced the disease is and how it developed).

Usually, children with sensory alalia heal faster than babies with motor alalia. Alalia does not affect the life expectancy, however, it significantly spoils it for the baby, who not only cannot contact other children and adults, but also develops incorrectly under the influence of his own ailment.

The result of an incurable disease is complete isolation from society, exile. The result of the treatment can be the most incredible - a complete restoration of speech and psyche.

It is important here that the parents know how to avoid such an ailment in a child. If you are expecting a baby, then you should:

Constantly monitored by a gynecologist.
Take prescribed medications and vitamins.
Monitor your pregnancy.
To resort to stimulation of labor, if the term has come.

It should be constantly examined by doctors after the birth of the baby, so that they control the process of its development and formation. The family should have a favorable environment so that the child can develop calmly on the physical and mental levels. When deviations are detected, one should not expect that "everything will resolve by itself." How longer baby do not get medical treatment, the more serious his problem becomes.

Alalia is a neuropsychiatric disease in which children do not develop speech. At the same time, a child over 3 years old cannot say a word completely, make a sentence, confuses letters, swaps them. He is not able to communicate with others, although he has normal hearing, there are no mental abnormalities. Alalia is divided into two types according to the characteristics - sensory and motor, the treatment of the disease consists in classes with a speech therapist and taking specific medications.

Description

Alalia is a speech disorder in which the child is unable to partially (with poor vocabulary and problems with phrasing) or fully speak. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly.

The main causes of the disease are considered complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with prolonged visits to a speech therapist and with the help of medication.

Despite its rarity, the disease is diagnosed more often in boys than in girls. It can have a varying degree of severity of the course - from the most serious, in which speech appears only after ten years, to a lighter, similar underdevelopment of speech. The most important thing is to distinguish this disorder from mental retardation.

Basically, children do not have developmental disorders (it can be disturbed only under the influence of the oppression of the public and peers). In case of untimely treatment at an early age, in the future, the child will experience problems with social adaptation, difficulties in finding his place in society.

Important! The disease occurs due to a violation of the transmission of impulses between the organs of the speech apparatus and the corresponding centers of the brain. There is a so-called "brain dysfunction" caused by delayed maturation of nerve cells.

Causes

Since this disease can form in the womb or in the early years of life, the reasons for its appearance are, respectively, intrauterine and due to external influence. The first group of factors includes:

unsuccessful attempts of the expectant mother to get rid of the fetus;
risk of miscarriage;
uncontrolled use of medicines by the expectant mother;
complicated toxicosis in the mother, manifested by preeclampsia and eclampsia;
insufficient oxygen supply to the fetus;
unhealthy lifestyle that a woman led while pregnant;
direct trauma to the abdomen or falling on it during pregnancy;
various diseases of a woman accompanying the period of bearing a child, including cardiac or pulmonary insufficiency, arterial hypertension or hypotension, etc .;
premature or complicated labor, obstetric intervention in the process.

Among the reasons affecting the formation of alalia in children under the age of three years, there are heavy course such ailments as:

encephalitis - can appear from an insect bite or contact with a poisonous plant;
meningitis caused by bacteria or fungi;
various traumatic brain injuries;
disturbances in the functioning of the central nervous system;
bilateral pneumonia;
ARVI;
rickets;
insufficient attention on the part of parents to teaching the child simple words or phrases;
surgical intervention performed under anesthesia.

Doctors note that alalia does not arise from one factor, but from the simultaneous influence of several reasons.

Important! Alalia has nothing to do with autism - a disease in which the child has no interest in communicating with other people and emotional perception of what is happening around him.

Kinds

There are several types of pathology, which are distinguished by the area of brain damage, the degree and mechanism of development. Official medicine types of alalia is divided into several types.

Motor- improper development of expressive speech. The child understands what is being said, but it is difficult for him to pronounce the words himself. Motor alalia is divided into two more types, depending on the area of brain damage:

afferent - defeat of the lower parietal divisions left hemisphere with kinesthetic articular apraxia;
efferent - abnormal development of the premotor cortex (Broca's center) with kinetic articular apraxia.

Sensory- underdevelopment of an impressive type of speech. Pathology occurs when the cortical part of the Wernicke center (posterior superior temporal gyrus) is damaged. The child hears others well, but does not understand their speech.

Important! There is also an auditory-speech type of abnormality (sensorimotor alalia) - the entire sensorimotor area of the cerebral cortex is affected. Babies with such deviations not only cannot reproduce sounds, but also do not understand what adults are telling them.

Symptoms

Signs appear in children at about 2 years of age, when they begin to communicate more actively with people around them and express their desires with the help of separate sounds or words.

A child whose speech centers of the brain are developed normally, as a rule, at 3-4 years old is very "talkative", willingly and meaningfully repeats simple words, gradually memorizes them and tries to form separate phrases from them.

In the presence of speech pathology, babies are distinguished by their special behavior and inability to learn. Moreover, these differences may be noticeable more or less depending on the degree and type of brain impairment.

Motor

The disease occurs as a result of underdevelopment of the so-called "Broca's area" (the part of the cerebral cortex that is responsible for the reproduction of speech).

With this form of alalia, the child's motor skills are poorly developed. This is reflected in the following:

There is a violation of articulation, that is, the pronunciation of consonants, through the coordinated work of the tongue, lips and teeth, as well as releasing the required amount of air.
The child is not able to perform actions associated with the performance of complex movements with small objects (for example, fastening buttons on clothes, lace up shoes). Therefore, he cannot serve himself.
There are difficulties with making other movements. There is no ability to maintain balance when walking on a log, jumping on one leg. The child cannot feel the rhythm during the dance.
It is difficult for him to concentrate and concentrate his attention on something. He cannot understand the grammatical features of the language, confuses the singular with the plural, does not distinguish between cases, mispronounces the endings of words, the vocabulary is very limited.

With this type of illness, the baby understands well what he is told, but it is difficult for him to reproduce the necessary sounds and remember their sequence. Depending on the complexity of the pathology, the child may not speak until the age of 5-10 years, sometimes in adolescents, in the absence of appropriate treatment, the disease progresses.

Sensory

This type of disease occurs as a result of damage to the "Wernicke's area" of the brain, which is responsible for understanding speech. Babies with this disease do not have problems with hearing and pronunciation of sounds, but at the same time they do not understand the connection between sound and the meaning of words. Therefore, they actually do not understand speech, and therefore cannot reproduce it.

The consequence of this is the difficulty of communicating with other people, personality disorder, distorted perception of reality, lag in the development of mental abilities. Sometimes with this form of alalia, the child is mistakenly diagnosed with "autism" or "mental retardation." In this case, a completely inappropriate treatment is carried out.

With sensory alalia, babies show the following symptoms:

Lack of response to changes in the frequency and volume of sounds (acoustic stimuli).
Existence of big problems with memorizing words.
Misunderstanding of the meaning of the learned word, inability to consciously use it.
Improving speech understanding in some way certain time days. In some children, this happens in the morning after the brain has rested. During the day, as fatigue increases, perception deteriorates. Other children, on the contrary, are more inhibited in the morning, due to the peculiarities of the brain.

Unlike hearing impaired children, who understand better when they speak louder, they sensory alalia they do not equally understand both soft and loud speech. On the contrary, a child perceives a calm, quiet speech better, while a loud conversation or shouting leads to inhibition of the brain center and a complete loss of perception.

Interesting to know! Increased susceptibility to sounds that are usually overlooked: for example, rustling of paper, rustling of leaves. In alalik children, these sounds cause the appearance unpleasant sensations... They may complain of ear pain, cry.

A child with such a disease tends to endlessly repeat familiar words, the meaning of which he does not understand. In words, he skips syllables, groups them with strangers. It is completely impossible to understand his speech, since it makes no sense.

Diagnostics

Children with speech disorders need advice from a neurologist, otolaryngologist, speech therapist, and psychologist. Every doctor, in order to diagnose alalia, must first conduct a series of diagnostic tests. A neurological examination consists of:

echoencephalography (EEG) - non-invasive ultrasound method computer diagnostics, which allows you to determine the presence of pathological processes or changes in the structure of the brain;
X-ray of the skull - it is necessary to detect damage to the skull, hemorrhage;
MRI (Magnetic Resonance Imaging) of the brain - helps doctors detect tumors, aneurysms, and certain problems of the nervous system.

To exclude hearing loss, the otolaryngologist may additionally prescribe other diagnostic tests:

otoscopy (helps to examine ear canal and eardrum);
audiometry (assessment of hearing acuity) or other methods of assessing the functionality of hearing.

The picture is complemented by neuropsychological diagnostics of speech and auditory memory, which is carried out with the help of special tests. To fully understand the situation, the doctor must study the patient's perinatal history, ask the parents about the presence of any deviations in the behavior of a child under one year old.

Important! Specialists pay special attention to the development of the psychomotor and speech apparatus. For this, tests are carried out for the comprehension of oral speech, lexical or grammatical structure, phonetic-phonemic processes, articulatory motor skills.

Differential diagnosis for alalia must be carried out in children with autism, oligophrenia, dysarthria.

Treatment

When working on alalia, you must use A complex approach- participation of doctors, correctional teachers and psychologists.

Children with alalia are trained in specialized correctional educational institutions. They are necessarily assigned drug therapy which stimulates the development of brain structures and physiotherapy.

Medication

Treatment with drugs is done to stimulate the development of certain structures in the brain. Neotropic medicines are prescribed:

"Gammalon" is a drug that helps to restore metabolic processes in the brain, remove toxic metabolic products. "Gammalon" provides the normal dynamics of the formation of neurons, increases the productivity of thinking, improves memory. The pills contain a minimal list side effects, among which only stand out: nausea, insomnia, a slight increase in body temperature.
"Cogitum" - acetylamino-succinic acid (an analogue of a biological compound contained in the brain) is presented as an active component. The drug normalizes the processes of formation of nervous activity, has a psychostimulating effect. The medicine is not prescribed until 7 years of age.
"Cortexin" is a powder for preparing a solution for intramuscular injection... The medicine improves brain metabolism, reduces the amount of free radicals, improves concentration, memory, and increases the ability to learn. Cortexin is contraindicated in case of individual intolerance to the components of the composition.
"Ceraxon" is a clear liquid with a characteristic strawberry odor for oral administration. The drug has a wide range Actions: prevents the formation of free radicals, prevents the death of neurons, restores damaged membranes of brain cells, reduces the rate of action of phospholipases. Due to the lack of clinical data, the drug is prescribed with caution until the age of 18.
"Encephabol" - increases metabolism in the tissues of the brain, improves blood circulation, memory, speech perception. The drug is available in two forms - tablets and oral suspension. The medicine can be used for monotherapy of alalia, starting from the age of two months.

Classes with a speech therapist

The work of a speech therapist plays an important role in setting the correct speech. Corrective action can be carried out in specialized centers or preschool institutions, and in the form of private lessons.

To achieve efficiency speech therapy classes accompanied by home teaching of a sick child.

The work of a speech therapist is aimed at:

stimulation of the child's speech activity;
the formation of a rich vocabulary;
the development of a coherent, articulate speech;
development of mental functions;
elimination of tongue-tiedness;
restoration of articulatory movements;
the formation of sound pronunciation and grammatical correct design statements;
all-round development of the child - teaching motor skills, understanding the meaning of what has been said.

Physiotherapy

Together with drug therapy and speech therapy, doctors will advise parents to take a course of physiotherapy. Efficiency in the treatment of general speech underdevelopment is shown by:

Hydrotherapy - the procedure is based on the chemical, mechanical or temperature effects of water on the body. For alalia, general therapeutic baths, baths or saunas, masks and applications with seafood, pouring or irrigating a child with sea water are recommended.
Laser therapy is a treatment using low-intensity light radiation. The procedure has an immunostimulating, vasodilating effect, increases the body's susceptibility to drug therapy. Alalia is used laser irradiation blood.
General magnetotherapy - a physiotherapeutic effect on the whole body, constant or impulse magnetic field... The procedure improves metabolism and blood circulation, reduces the pain of nerve pulsations.
Decimeter therapy (UHF) is a method based on the effect of a microwave electromagnetic field. UHF treatment helps with chronic diseases- pneumonia, bronchitis, otitis media.
Electrophoresis - injection procedure medications into the body through human skin.
Transcranial electrical stimulation - the effect on the brain stem with an electric current. The procedure normalizes the functioning of the nervous mechanisms, has a calming, neurotrophic effect.
Reflexology (IRT) - the impact on the reflex points of a person located on the skin. The impact on the muscles is carried out using needles, temperature, electric (electropuncture) or magnetic field. The procedure helps to launch the self-healing system in the brain.

Prophylaxis

As preventive measures from alalia, you can use the following tips:

at the time of pregnancy, strictly follow all medical advice, undergo the necessary examinations, eat properly and in a balanced manner;
take care of your baby's health, visit the pediatrician on time;
go with your baby to various developmental activities, to places where his peers are in order to socialize and adapt to society;
do not forget about passing the annual children's medical examination, do not neglect this examination;
read, talk and play with the child as much as possible, for the formation and development of the speech apparatus.

Experts have long established the approximate age of a child at which he should begin to speak. Deviations from the norm may be due to individual characteristics development. However, the phenomenon can also occur as a result of alalia. These are speech disorders that require treatment.

Now let's dwell on this in more detail.

What is Alalia?

Alalia is called a complete lack of speech or a pronounced deficiency. At the same time, the child's intellect and hearing are not damaged. This allows such children to successfully explore the world and learn. Damage to the area of the left hemisphere of the brain that controls language during childbirth is a common symptom of the disease. A similar phenomenon leads to organ disease or trauma, which the child faced in infancy.

The disease is manifested by late manifestation of speech reactions, poor vocabulary, impaired syllable, defects in sound pronunciation and problems with kinematic processes. With the development of pathology, children over the age of 3 years cannot fully pronounce a word or make a sentence. The child confuses sounds, can also change their places. The ability to communicate with others is absent.

The disease develops as a result of impaired transmission of impulses between the organs of the speech apparatus and the center of the brain. The result is so-called brain dysfunction. It occurs due to the slow maturation of nerve cells.

Alalia can lead to a delay in the development of intelligence. Pathology significantly complicates social adaptation. It can cause the development of neuroses.

Interesting fact. Alalia is very similar to. Diseases are often confused. The difference between pathology is that it does not represent the child's initial inability to learn to speak. is a condition in which the patient stops talking after he has learned to communicate normally.

It should be borne in mind that alalia has nothing to do with autism. This name was given to a pathology in which a child loses interest in communicating with other people and cannot emotionally perceive what is happening around him.

Types of alalia

An important role in identifying the forms of alalia is the determination of the area of brain damage. So, if the fronto-parietal part is injured, experts talk about the development of motor alalia in the child. In case of damage to the temporal region, the development of a sensory variety of the disease is possible. The form of pathology is characterized by a different clinic and the possibilities of the child in the future. However, the separation is conditional. In clinical practice, there is a combination of manifestations of motor and sensory alalia - speech alalia.

Motor Alalia

Pathology appears due to the underdevelopment of Broca's area. What is the name of the part of the cerebral cortex responsible for the reproduction of speech. With this form of the disease, the child has poor motor development. The phenomenon is expressed in the following:

The child has impaired articulation. The patient has difficulty pronouncing consonants by using the tongue, lips and teeth, as well as lowering the required amount of air.
The patient cannot perform actions that involve manipulating small objects. For example, such children have a problem with lacing up shoes or buttoning up buttons on clothes. All this leads to the fact that a person suffering from pathology cannot serve himself on his own.
There is also a problem with other movements. The patient is unable to maintain balance when moving along a log or jumping on one leg. Such a child does not feel the rhythm during the dance.
There is a problem with concentration and attention. It is difficult for a child to concentrate on anything. He cannot understand the grammatical features of the language. The patient confuses the singular with the plural. He does not distinguish between cases and mispronounces the endings of words. The child's vocabulary is very limited.

In the case of the development of this type of disease, the child understands well the speech addressed to him. However, it is difficult for patients to remember the correct sequence of sounds and reproduce them. Depending on the complexity of the pathology, the child may not speak until 5-10 years old. If there is no treatment, the disease can progress.

Speech alalia

There is a third type of pathology that combines the features of the first two of them. The disease is called sensory-motor alalia. The mixed type implies the presence of the same symptoms as in the case of the first two types of pathology. The patient needs correction by a speech therapist and a neurologist.

Sensory alalia

Pathologies of the temporal region lead to the development of sensory alalia. Violations arise in the so-called Wernicke center. This cortical region of the brain is responsible for the ability to perceive mixed speech, understand what is said and distinguish between sounds. When a pathology is detected, the child has no speech perception. At the same time, the child's hearing is not impaired.

A variety of pathology is characterized by severe form speech disorders. Sick children can hear speech well, but they practically do not perceive and do not understand the video. They also cannot speak independently. Such children meaninglessly utter sounds or their combinations, as well as gesticulate. Speech in patients is characterized by obsessive repetition of sounds and syllables, as well as sound substitution. Children can repeat other people's words, but do not understand their meaning. The ability to combine separate verbal segments into one whole may be present.

Patients who have a pathology are characterized by increased speech activity. However, their speech reproduction resembles the so-called verbal salad. There is no meaning in what the child says.

If the patient is diagnosed with a milder form of the disease, he can perceive sounding speech. However, there is an understanding not of the indicated sounds, but of timbre, word forms. Sometimes lip reading comes to the rescue of such patients.

The first signs of alalia

Children who have alalia do not have any external abnormalities. Developmental disabilities are also not observed. The child only has problems with the perception of speech and its reproduction. In this case, hearing is not impaired. Mental development is also normal. All this leads to the fact that it is quite difficult to identify alalia before the child speaks. The first sign of pathology may be the patient's silence at the age at which he should begin to speak. When reproducing speech, there may be agrammatism, a violation of the syllable structure of words or a disorder in their search. The child slowly learns the language.

Depending on the type of pathology, the signs may change. So, with a sensory type of violation, an unconscious repetition of other people's words is possible, the combination of several words into one and obsessive meaningless pronunciation of sounds and their combinations. The child does not understand the speech that is addressed to him.

Alalia symptoms

The symptomatology inherent in pathology directly depends on its type. So, motor alalia is characteristic:

the child's mood often changes;
there is a low efficiency and increased fatigue;
it is difficult for the child to concentrate attention;
there is a violation of fine motor skills;
facial expressions and gestures are pronounced;
there is a meager vocabulary, which leads to a lack of understanding of the speech of others;
the child cannot speak, or there is an unclear reproduction of sounds;
excessive activity can quickly give way to lethargy and inactivity.

If sensory alalia is present, characteristic symptoms change. Pathology is accompanied by:

there is a memory impairment;
there is an increased susceptibility to sounds;
the child widely uses facial expressions and gestures in communication;
passivity can quickly be replaced by activity, and impulsivity - by isolation;
the child can skip letters in words, pronounce the endings incorrectly or combine two words into one;
the patient reproduces a set of sounds and words that is meaningless and incomprehensible to those around him.

Children with this pathology have difficulty memorizing new words. In some patients, this process is absent altogether. Due to the fact that the child cannot distinguish speech addressed to him, he has the ability to read lips.

Causes and prevention of alalia

Alalia can be congenital or early acquired. The second type of the disease occurs in a speech form. It is in the first three years of a child's life that intensive formation of cells of the cerebral cortex is observed. If the pathology is congenital, the following factors can lead to its development:

the mother suffered from severe toxicosis during pregnancy;
there was fetal asphyxia;
during pregnancy there was a threat of spontaneous miscarriage;
intrauterine infection of the child has occurred;
the mother had chronic somatic diseases.

In the history of the disease, a number of factors and provocateurs can be traced. Pathology can develop against a background that is burdened by complications during childbirth, premature birth or prematurity. A child can be injured by improper use of obstetric instrumentation. Some researchers have found a connection between the disease and heredity. Operations with application general anesthesia in the first years of life, they can also cause the appearance of alalia. Etiopathogenetic causes can also provoke pathology, the list of which includes:

encephalitis;
traumatic brain injury;
hypotrophy;
complicated viral diseases.

The result is damage to the speech motor analyzer. The child has a delayed maturation of neurons. Very often they remain neuroblastomas. As a result of such violations, there is a decrease in the excitability of nerve endings, functional exhaustion and inertia of the main processes of the brain.

Preventive measures are to provide conditions for a favorable course of pregnancy and childbirth, as well as the early physiological development of the child. If the pathology is nevertheless identified, correctional work to overcome the problem. This will prevent the occurrence of secondary intellectual disability.

Alalia correction

Once a child has been diagnosed with this, it is important to start treatment as soon as possible. Therapy depends on the severity and form of the pathology. Treatment is carried out in several directions. So, the child is prescribed speech therapy exercises... They can be conducted individually or during joint classes. To reach positive result succeeds only in the case of systematic long-term studies. The work is carried out under the guidance of a speech therapist who will help the child master the correct pronunciation of individual syllables and words, and will also allow him to start recognizing speech by its sound.

Additionally, speech therapy massage is performed. The method is considered an effective adjunct to the exercise. It promotes the development of the individual muscles in the mouth, which are responsible for correct pronunciation. The procedure can be performed manually or using a special probe.

Drug therapy is also used. The child is prescribed drugs that stimulate the blood supply to the brain. Vitamins B12 and B15 are also prescribed. Great attention paid to the diet. Nutrition should be balanced.

The child may be referred for physiotherapy. Treatment is prescribed in courses. It is carried out depending on the condition of the child. It is possible to carry out hydrotherapy, laser therapy, magnetotherapy and a number of other physiotherapeutic effects.

Reflexology is sometimes performed. The essence of the method is to stimulate parts of the brain with electrical impulses. This leads to the creation of new neural connections that facilitate learning. However, the method is used only for children over 9 years old.

Further prognosis directly depends on the time of initiation of treatment, approaches to its implementation and the systematic impact on all speech components. The speech processor must be formed along with mental functions. Most favorable prognosis doctors give with motor alalia. In the case of other types of the disease, the prognosis is ambiguous. It all depends on how badly the brain is affected.