Neurology. Violation of articulation as one of the reasons for the deviation of speech development and its condition in young children

The structure of the speech defect, constitutes a violation of the sound impact side of speech. For dysarthriacharacteristic: violation of the articulation motility in the form of a change in the tone of the articulation muscles, limit the volume of their arbitrary movements, coordinator disorders, various kinds of synclosy, tremor, hyperkinesis of the language, lips; respiratory disorders; Voicing disorders. Speech with dysarthritia, fuzzy.
Spasty - increase the tone in the muscles of the language, lips, face and neck. In case of spasticity, the muscles are tense. Language "lump" is drawn back, the back of it is spasting is bent, raised to the top, the tip of the tongue is not expressed. The tense back of the tongue lifted to the solid sky contributes to mitigating consonant sounds.
(palatalization). Sometimes a spastic language "sting" stretched in front. Increasing the muscle tone in the circular muscle of the mouth leads to spastic tension of the lips, a dense closure of the mouth (an arbitrary melting closure is difficult). In some cases, in the spastic state of the upper lip, the mouth can be ajar. In this case, there is an increase in the salivation (hypersion). Active movements in spasticity of articulation muscles are limited.
Hypotania- reduction of muscle tone.
In hypotension, the language is thin, melted in the oral cavity; The lips are sluggish, can not be tightly closed. The mouth is usually half-open, hypersion can be expressed. Soft Sky muscle hypotension collapse to sufficient promotion of the sky curtains
up and its pressed to the rear wall of the throat; Air jet comes out through the nose. The voice acquires a nasal shade (nasalization).
Distonia- changing the nature of the muscular tone. A low muscle tone can be observed at rest, when trying to speech and at the moment of speech, the tone increases sharply. Dystonia distorts the articulation. The peculiarity of sound-proof with dystonia is the impermanence of distortion, replacement and skipping sounds.
In children with neurological pathology, the mixed and variable nature of the tone disorders in the articulation muscles is often noted (as well as in skeletal). For example, in the pagan muscles, spasticity can be marked, and in facial and luminous hypotension.
Violation of the mobility of the articulation muscles.
The limited mobility of the muscles of the articulation apparatus is the main manifestation of the pan of these muscles.
The insufficient mobility of the articulation muscles of the language and lips causes a violation of sound suspension. With the damage to the muscles of the lips suffers from pronunciation and vowels and consonant sounds. The articulation in general is violated. Especially rudely broken sound prevention with a sharp limitation of the muscles of the language.
The degree of violation of the mobility of the articulation muscles can be different - from the full inability to a minor reduction in the volume and amplitude of the articulation movements of the language and lips. First of all, the most thin and differentiated movements are disturbed (lifting up).
Specific sound suspension disturbances:
- a persistent nature of sound-proof disorders, the special difficulty of overcoming them;
- specific difficulties of automation of sounds (duration of automation time). In the untimely end of speech therapy classes, acquired speech skills often disintegrate;
- pronunciation of not only consonants, but also vowel sounds (averaged or reduction of vowels);
- the predominance of the intersubolic and lateral pronunciation of whistles with s, c, and hissing sh and the sounds;
- Stunning ringing consonants (ringing sounds are pronounced with insufficient participation of the voice;
- mitigation of solid consonant sounds (palatalization);
- Violations of sound suspensions are especially expressed in the speech stream. With an increase in speech load, it is observed, and sometimes the overall sound of speech is increasing.
Depending on the type of violation, all defects of sound-proof with dysarthria are divided into two categories: anthropophonic (sound distortions) and phonological (replacement, mixing). With a dysarthritric disorder, the most typical violation of the sound system is distorting sound.
Breathing disorders are due to the insufficiency of the central regulation of breathing. Violated breathing rhythm: at the moment it is expensive. There is a violation of coordination of inhalation and exhalation (superficial breath and shortened weak exhalation). Exhaust often occurs through the nose, despite the half-open mouth. Respiratory disorders are especially expressed in the hyperkinetic form of dysarthria.
Voices violations are due to changes in muscle tone and restriction of mobility of the muscles of the larynx, soft sky, voice folds, tongue and lips. Most often there is an insufficient voting force (quiet, weak, dried) and variations of voice timbre (deaf, nasalized, squeezed, hoarse, intermittent, tense, wounded).
Disorders of the request (melody-intonational and pace-rhythmic characteristics of speech).
Melodic-intonation disorders often refer to one of the most persistent signs of dysarthria. They have a greater extent affect the intelligibility, the emotional expressiveness of speech. Weak severity or no voice modulation is observed (the child cannot arbitrarily change the height of the tone). The voice becomes monotonous, low or non-modulated. Violations of the speech pace are manifested in its slowdown, less often - in acceleration. Sometimes there is a violation of speech rhythm (chandeliness "chopped" speech when an additional amount of stress in words is observed).
Insufficiency of the kinesthetic sensations in the articulation machine.
In children with dysarthria, there is a weakness of the kinesthetic sensations of articulation poses and movements.
With dysarthritia there are vegetative disorders.
A frequent vegetative disorder is hypersion. Enhanced salivament is associated with the limitation of the movements of the muscles of the language, a violation of arbitrary swallowing, a cut of lump muscles. This disorder is taken due to the weakness of the kinesthetic sensations in the articulation apparatus and a decrease in self-control. There is a vegetative disorder, like redness or pallor skin Pokrov, Increased sweating during speech.
In children with dysarthria, the act of meals is often hampered, and in difficult cases there is no chewing of solid food, biting from a piece. Often there are accumulations, choking when swallowing. Difficult to drink from a cup. There is a violation of coordination between breathing and swallowing.
Dysarytric violations may be accompanied by syntincions.
Sinknesia. - involuntary associated movements when performing arbitrary articulation movements (additional movements of the lower jaw and the bottom lip up when trying to raise the tip of the tongue)
Oral syncinosis - opening of the mouth with any arbitrary movement or when trying to perform it.
Increasing the pharyngeal (vomit) reflex.
Violation of coordination of movements (ataxia)
Ataxiamanifests itself in dysmetric, asyngic violations and in the chantion of speech rhythm.
Dommetry- This is a disproportion, inaccuracy of arbitrary articulation movements. It is most often expressed in the form of hypermetry, when the desired movement is implemented by more implanted extended, slow motion than it is necessary (excessive increase in motor amplitude) also observes a violation of coordination between breathing, voice formation and articulation (asinigria).
Ataxia is noted in Atactic Dysarthria.
The presence of violent movements (hypercines and tremor) in articulating muscles.

Hyperknesia. - involuntary, neulty, violent movements of the muscles of the language.

Tremor- trembling tip of the tongue (most pronounced at targeted movements). It is observed in Atactic Dysarthria.

Currently, the problem of dysarthria children's age It is intensively developed in clinical, neurolynguistic, psychological and pedagogical directions. It is described in the most detailed in children with cerebral paralysis (M. B. Eidinova, E. N. Poddina-Vinar, 1959; K. A. Semenova, 1968; E. M. Mastjukova, 1969,1971,1979,1983; I. I. Panchenko, 1979; L. A. Danilova, 1975, etc.). IN foreign literature It is represented by the works of G. Bohme, 1966; M. Climent, T. E. Twitchell, 1959; R. D. Neilson, N. Oh ". Dwer, 1984.
1. Badalyan L.O. Children's neurology. - M.: Medicine, 1984. - 575С.
2. Spent / Ed. L.S. Volkovka, R.I. Lalaeva, E.M. Mistikova., M.: Enlightenment, 1989. - 527c.
3. Mastiukova E.M., Ippolitova M.V. Violation of speech in children with cerebral paralysis. - M.: Enlightenment, 1985. - 192c.
4. Speech therapy. Methodical Heritage / Ed. L.S. Volkova: in 5 kN. Kn.I.. Part 2. Rinolalia. Dysarthria. - M.: Vlados, 2003. - 303c.
5. Atlas Nervous Human System Building and Violation/ Ed. V.M. Astapova, Yu.V. Mikadze - M.: Par SE, 2011. - 79c.

Undeveloped mouth muscles or weak muscle tone facial are one of the causes of deviations. speech Development.

Based on the position of N.A. Bernstein on the level organization of arbitrary movements and actions, a number of specialist researchers in this area (in particular Sheremetyevoy E. V.), it was assumed that articulation, as the highest symbolic level of arbitrary movement, can be formed while preserving all underlying levels of arbitrary movement. The peripheral part of the articulation is exhausted above the subject level of oral movements carrying out the life-supporting nutritional needs: sucking, biting, chewing, swallowing. Therefore, the potential possibility of articulation, they considered it possible to evaluate, observing the subject level of movements of articulators - lips, language, lower jaws - in the process of food intake and the state of the facial expressions in free activities.

After analyzing the results of the research E.V. Sheremetyeva, in the oral articulation base, precursors were determined by speech underdevelopment (indicators of deviations from the normal course of speech development) at an early age:

failure to hard food: a child prefers homogeneous well-chopped masses. Often such children so that they are not hungry, parents bring yogurt to kindergarten, curd masses etc. Such food behavior may have a different causality: later the introduction of solid dust; Parents for a long time (up to the year, and then two) crushed the food of the child to homogeneous mass; maintaining a sucking reflex (breastfeeding) to two, two and a half years; impairment of innervation of the mandibulastic muscles;

difficulties in the process of chewing and, as a result, spinning, which is associated with the innervation of the corresponding muscle groups. With such a decline exercise Muscles, lifting and holding down the lower jaw, and language muscles weaken;

general ammia in the process of food intake: the child sits over a plate for a very long time or with a piece in his hand, then slowly brings the spoon to the mouth or blesses, begins to lazily chew (no pleasure, "written" on the face from the power process);

liquid food or liquid due to insufficient formation of a lipstick: the child does not grasp the lower lip edge of the spoon, the cups (liquid sheds) or captures pieces of food from a spoon directly to teeth. They say about such: "Eats not careful." In fact, the innervation of luminous muscles is disturbed and, as a result, their strength, dexterity and coordination.

increasing the threshold of the recipe sensitivity of the skin of the ocular space, which also indicates a violation of the innervation of the relevant muscle groups: the child drinks kefir or kissel, the remains of which, due to insufficient automation of the substitution, remain around the lips. It does not try to reduce irritation from the residues of the liquid. About such children they say: "very untidy".

If the perceiving sensitivity of the ocular space is preserved, and the innervation of the paternal muscles is broken, then in similar conditions, the following is observed:

lack of circular licking movements of the language when a thick drink or liquid porridge on lips or a ocular space: a child wipes in such cases upper Guba subwoofers;

tightening the back of the tongue up with an unfinished tip of the tongue in similar conditions;

reduction of irritation of the skin surface of the lips with the help of a lower lip or other means;

lifting the tip of the tongue to the level of the corner of the lips while trying to lick the top lip.

In general, in chewing muscles there is a limitation of the mobility of the lower jaw; A minor or fairly pronounced shift of the lower jaw in the direction of rest, with chewing and in articulation; In the pathology of the tone of chewing muscles, there is a decrease in the intensity and volume of chewing movements, the discoordination of the movements of the lower jaw during articulation; Violation of the process of biting from a piece (which can also be complicated by the anomalies of the dental system); Sinknesia is detected in the motility of the lower jaw with the movements of the language (especially when picked up the tongue to the upper lip or when drawing it to the chin).

E.G. Chiginteva is also noted on features in the pagan muscles: observed pathological conditions muscular tone, which in some cases are accompanied by the characteristics of the structure of the language (during spasticity, the language is more often a massive, deepened by a lugby oral cavity or elongated "sting", it can be combined with the shortening of the bridle represented in the form of a dense tight; In case of hypotension, the language in most cases is thin, sluggish, melt at the bottom of the oral cavity, which can be complicated by the shortening of the sub-speaking fold, on the type of thin and translucent); There are violations of the position of the language (alone and when driving) in the form of deviation to the side, the proven language of the mouth, labeling the language between the teeth; A minor or fairly pronounced limitation of the mobility of the pagan muscles is revealed; hypercines, tremor, fibrillar twitching of the language; Raising or decrease in pharyngeal reflex. In the musculature of soft nose, there is a sagging curtain (under hypotension); Deviation of ulules (tongue of soft nose) from the midline. In the vegetative nervous system, mosaic violations are observed in the form of easily emerging spasms of the face (redness or pale), the cyanicity of the language, hypersion (intensive salivation, which can be permanent or strengthen under certain conditions).

To affecting the formation of speech function factors G.V. Chirkina also relates to the later defeats of the CNS of traumatic or infectious genesis, intoxication, severe somatic infections complicated by psychotrambulating situations (separation with mother, pain shock), even if they had temporary, not permanent character).

In a child with Rinolalia, even with a one-sided, complete or partial cleft, inhale is carried out more actively through crevice, i.e. through the mouth, and not through the nose. Congenital cleft contributes to the "vicious adaptation", namely the wrong position of the language, its root, and only the tip of the language remains free, which is pulled into the middle part of the oral cavity (the root of the language is overly raised up, covers the crevice, and at the same time the sipset). The tip of the language is at the bottom of the mouth in the middle part, approximately at the level of the fifth tooth of the lower row.

Food through crevice in the nose, apparently, also contributes to the excessive development of the root of the tongue, which covers the crevice. So, in a child with congenital cleft, the most important, the most vital functions stabilize the position of the excessively raised root of the tongue. As a result, the air jet at the exit from the drowsy space is sent almost perpendicular to the nebu. This makes it difficult for the mouth exhale in the speech act and creates a nasal shade of voice. In addition, the constant position of the raised root of the tongue will slow down the movement of the entire language. As a result, the implementation of the necessary movements of the language to articulate speech sounds in rinolalics fails; In addition, a weak exhaust jet, not falling into the front of the oral cavity, does not stimulate the formation of various articulation bows in the upper part of the speech apparatus. Both specified conditions lead to severe pronunciation. To improve the pronouncement of one or another sound, the rinolalicles direct all the tension on the articulation apparatus, reinforcing the stress of the linguistic, lingual muscles, involving the muscles of the wings of the nose, and sometimes all the facial muscles.

In the process of speech disonatogenesis, adapted (compensatory) changes in the text of the articulation bodies are formed:

· High rise of the root of the tongue and shift it into the rear zone of the oral cavity; relaxed, lowactive tip;

· Insufficient participation of lips when pronouncing labialized vowels, lip-lifting and lifting-dental consonants;

· Excessive stress of mimic muscles;

· The emergence of additional articulation (larrganization) due to the participation of the pharynx walls.

L.P. Borsch notes that a short bridle - a malfunction, expressed by the formation of the folds of the mucous membrane, fixing the tongue sharply the konons, sometimes almost to the teeth. It is often detected from parents or close relatives of children, which can be considered a family feature; Anomalies and bite are similar. When studying medical maps The development of children with the pathology of the bridle of the tongue The author revealed that in 94.7% there is a syndrome of motor disorders; in 52.7% - dysplasia hip joints; 69.4% - the retreat of psychomotor development; In 38.4% - injury cervical department spine; 8.8% - children's cerebral paralysis.

In newborns with a short bridle of the language, anxiety is observed during feeding. It is explained by difficulties in sucking, swallowing. Kids do not suck the norm. Sleep in such children's superficial, intermittent, restless, they cry much.

If the correction has not been carried out on time, it is aggravated with age in the fact that it is formed with deviations; child do not understand peers; Adults, seeking to correct sounds, cause negative emotions. He closes in himself, prefers to speak less, play alone, begins to form a "incompleteness complex". This often contributes to the development harmful habits. They are characterized by a decrease in the emotional-volitional sphere, the mood lability. Such children are unbalanced, hyperbands, with difficulty calm down. They are very touchy, fusive, and sometimes aggressive. These children with difficulty come into contact, refuse to accept certain movements in the tongue.

By the beginning of school, the speech remains fuzzy, the pronunciation of several groups of sounds is broken. This is inexpressive, the intonation color of the voice is poor. This makes such children more vulnerable, closed, although their intellectual abilities are sufficiently developed. More children are self-critical.

The identified features of the oral motor framework of articulation made it possible to assume that in the absence of timely correctional assistance at best there would be impaired sound testing and overall lubrication in the speech stream.

Early diagnosis is carried out on the basis of the evaluation of non-violations, which include the following:

violation of the tone of the articulation muscles (persons, lips, language) by type of spasticity (increase in muscle tone), hypotension (reduction of tone) or dystonia (changing nature of muscle tone);

restriction of the mobility of the articulation muscles (from the almost complete impossibility of the implementation of articulation movements to minor restrictions of their volume and amplitude);

violation of an act of meals: a violation of an act of sucking (weakness, lethargy, inactivity, neuroticness of sucking movements; leakage of milk from the nose), swallowing (embarrassing, choking), chewing (lack or difficulty chewing of hard food), biting a piece and drinking from a cup;

hypersion ( increased salivation): The reinforced salivation is associated with the limitation of the movements of the muscles of the tongue, the violation of arbitrary swallowing, the paresis of luminous muscles; It is often dried by the weakness of the kinesthetic sensations in the articulation unit (the child does not feel the flowing saliva); hypersion can be constant or intensified under certain conditions;

oral syncinosis (the child opens his mouth widely with passive and active movements and even when trying to perform them);

breathing Disruption: Infantyl Schemes of Breath (the predominance of abdominal breathing after 6 months), rapid, shallow breathing; Discordination of inhale and exhalation (superficial breath, shortened weak exhalation); Stridor.

In the course of the development of the speech, systemically managed supervisory formations are formed, which are real, material signs of the language. To actualize them, the existence of an articulator base and the ability to form syllables are needed. The articulator base is the ability to bring articulation organs in the position necessary for education, the formation of sounds, regulatory for this language.

In the process of assimilation of pronunciation skills and skills under the control of their hearing and kinesthetic sensations, gradually finds and maintains in memory those articulation injections that provide the necessary, corresponding acoustic effect. If necessary, these articulatory positions are reproduced and secured. When finding the right instructions, the child must learn to distinguish the articulation stacked, similar to the pronunciation of sounds, and develop a complex of the spellings necessary for the formation of sounds.

E.F. Arkhipova, characterizing children with erased dysarthria, reveals the following pathological features in the articulation machine. It is indicated on the parethrough of the muscles of the articulation bodies, which are manifested in the following: the face of hymomamically, the muscles of the face with palpation are sluggish; Pose of closed mouth Many children do not hold, because The lower jaw is not fixed in the highlight of the state due to the lethargy of chewing muscles; The lips are sluggish, their corners are omitted; During speech, the lips remain sluggish and necessary labialization of sounds are not produced, which worsens the selection side of speech. The tongue with parethomic symptomatology is thin, is located at the bottom of the oral cavity, sluggish, the tip of the language is lowactive. With functional loads (articulation exercises), muscle weakness increases.

L.V. The shovel is observed by the spasticity of the muscles of the articulation organs, manifested in the following: the face amomically, the muscles of the face with palpation are solid, stressful. The lips of such a child are constantly in the semi-jacking: the upper lip presses to the gums. During speech, lips do not take part in the articulation of sounds. Many children who have similar symptoms do not know how to perform an articulating exercise "tube", i.e. Pull the lips forward, etc. Language in a spastic symptom is more often changed in shape: thick, without a pronounced tip, sedentary

L.V. Lopatin points to hypercines with erased dysarthritia, which are manifested in the form of trembling, tremor of the tongue and voice ligaments. Tremor language manifests itself with functional samples and loads. For example, when specifying a wide tongue on the bottom lip on the account, 5-10, the language cannot save the condition of rest, trembling and light cyanosis appears (i.e., the scintion of the tip of the tongue), and in some cases the language is extremely restless (waves rolled in the language longitudinal or in the transverse direction). In this case, the child cannot hold the tongue outside the oral cavity. Language hyperkers are more often combined with increased tone Muscles of the articulation apparatus. During the examination motor function The articulation apparatus in children with erased dysarthria is noted the possibility of performing all articulation samples, i.e. Children on the instructions perform all articulation movements - for example, inflate the cheeks, click on the tongue, smile, pull the lips, etc. When analyzing the quality of these movements, it is possible to note: lubricacy, fuzziness of articulation, weakness of muscle voltage, arrhythmia, reduction of the amplitude of movements, the short-term retention of a certain posture, decreased movement volume, fast muscle fatigue, etc. Thus, with functional loads, the quality of the articulation movements sharply Falls. This leads to a speech to distort the sounds, mixing them and deterioration in general as a general side of speech.

E.F. Arkhipova, L.V. Logatina highlight the following violations Articulations that manifest themselves:

in the difficulty of switching from one articulation to another;

in reducing and worsening the quality of the articulation movement;

in reducing the time of fixing the articulation form;

in reducing the number of proper movements.

Research L.V. Lopatina and others revealed in children innervation innervation of the Mimic Musculatory: the presence of the smoothness of the nasolabial folds, the asymmetry of the lips, the difficulties of lifting eyebrows, grinding the eyes. Along with this characteristic symptoms for children with erase dysarthria, the difficulties of switching from one to another movement, reduced volume of lip and language movements; The movements of the lips are not fully implemented, they are approximate in nature, there are difficulties in tensile lips. When performing exercises for the language, there is a selective weakness of some muscles of the language, the inaccuracy of movements, the difficulties of language molding, lifting and holding the tongue at the top, the Tremelor tip of the tongue; Part of the children is slowing down the movement rate when the task is re-executed.

Many children have: rapid fatigue, the increase in sowing, the presence of hyperkinesis of the muscles of the face and the paternal muscles. In some cases, the deviation of the language (deviation) is detected.

Features of the mimic muscles and articulation motility in children with dysarthria testify of neurological microsypes and are associated with rails of subwage and facial nerves. These violations are most often not detected in primary neurologist and can only be installed in the process of careful speech therapy examination and dynamic observation during correctional speech therapy work. With a more in-depth neurological study, the mosaic of the symptoms of the facial, languagehilic and sub-speaking nerves, which determines the features and diversity of phonetic disorders in children are revealed. Thus, in cases of the prevailing lesion of the facial and sub-speaking nerves, there are disorders of the articulation of sounds, due to the infallible activity of luminous muscles and muscles of the language. Thus, the nature of speech disorders depends on the state of the neuromuscular apparatus of the articulation organs.

In order for the human speech to be ai-part and understandable, the movement of the speech bodies should be natural, accurate and automated. In other words, a necessary condition for the implementation of phonetic design of speech is a well-developed motility of the articulation apparatus.

When using various sounds, speech organs occupy a strictly defined position. But since in speech, the sounds are pronounced not isolated, but ply, smoothly following one by one, then the organs of the articulation apparatus are quickly moving from one position to another. A clear pronunciation of sounds, words, phrases is possible only under the condition of sufficient mobility of the organs of the speech apparatus, their ability to quickly rebuild and work clearly, strictly coordinated, differentiated. What implies accuracy, smoothness, ease of movement of the articulation apparatus, pace and resistance of motion.

Thus, impaired motor capabilities of the articulation apparatus is one of the reasons for the deviations of the speech development of children early age. Analysis of studies on the state of articulation in young children with the deviations of speech development allowed us to allocate the following features:

· There is an insufficient mobility of muscle muscles, lips, lower jaws;

· Articulation features are manifested in the difficulties of switching from one articulation posture to another, in the difficulties of holding articulation poses;

· To study the state of articulation of young children is possible when observing the food behavior of the child.

Conclusions by I Chapter

The development of articulation is an important component of normal speech development. Articulation is the work of the speech organs (articulation apparatus) when pronouncing syllables, words, phrases; This coordination of speech bodies when pronouncing speech sounds, which is carried out by speech zones of the cortex and subcortical formations of the brain. When pronouncing a certain sound, auditory and kineette, or speech control is realized.

In order for the speech to be ai-part and understandable, the movement of the speech bodies should be natural, accurate and automated. In other words, a necessary condition for the implementation of phonetic design of speech is a well-developed motility of the articulation apparatus. The articulation apparatus is an anatomy-physiological system of organs, including larynx, voice folds, language, soft and solid packed, teeth of the upper and lower jaw, lips, nasopharynk and resonator cavities involved in the generation of speech and voice sounds. Any violations in the structure of the articulation apparatus of a congenital or early acquired character (under the age of 7 years) invariably entail the difficulties in the formation and development of speech.

All movements of the articulation organs are determined by the operation of the motor analyzer. Its function is perception, analysis and synthesis of irritations going to the Cora from the movement of speech bodies. In the retging zone there is a complex and thin differentiation of speech movements, the organization of their sequence.

In ontogenesis, the process of developing the articulation is formed sequentially: a cry, ground, early baking; Late syllated bowl; first words, phrases; Further subtle differentiation of articulatory styles.

Food behavior is one of the indicators of the development of articulation. If the child prefers soft food solid, the articulation organs are not enough during meals, this indicates the insufficiency of the muscle development of the mouth and lips.

Deviations of speech development at an early age are the underdevelopment of the cognitive and linguistic components of the speech formation due to a violation of psychophysiological prerequisites and / or non-compliance with the microsococilities of the child's capabilities. It is manifested in the difficulties of forming an initial children's lexicon and phrase speech. It may be an independent speech pathology or part in the structure of any form of deviating development.

Studying the state of articulation in early age children with deviations of speech development possible in organizing observation of the child's food behavior.

Language deviation is its deviation to the right or left from the midline. If a healthy man Ask to flaunt the tongue, he will easily do it, and it will be located exactly in the middle of the oral cavity. In the event that somehow it works incorrectly, the deviation of the speech organ can be obvious.

It is violations in functioning nervous system They lead to problems in work and sometimes face. Most often, such changes occur due to brain diseases, for example, due to the suffered stroke.

What is a stroke?

Stroke is a brain circulation disorder associated with which they do not pass for several months. This is very serious diseaseIn which the fourth cases comes in a quarter of cases. The same part of patients becomes the first degree disabled. And some of the people who have undergone stroke are gradually returned to normal life. However, it takes a lot of time, because in most cases, patients need to re-learn to move and speak. Often patients are chained to bed and cannot care for themselves.

The deviation of the language at stroke is only one of the symptoms that can manifest. As a rule, hemorrhage into the brain is very much reflected on the neurotic state of the patient, and in addition to the deviation of the speech body, atrophy of the face muscles may arise, the inability to move the limbs on the one hand, sometimes complete paralysis of the body or its individual parts. The deviation of the language at OMK leads to a serious violation of speech. Is it possible to completely rehabilitate, get rid of the disease and how to do it?

What could be the causes of the new language deviation?

Why is the deviation of the language left? The reasons for this goes roots in neurology. Deviation can occur due to improper work of the sub-speaking nerve. In this case, the muscles of the speech organ on the left side are becoming significantly weaker than with the right. Therefore, when pushing out the tongue from the oral cavity, its displacement occurs in more weak side. Similarly, the deviation of the language is right.

Also, deviation may appear due to the irregularities of the person, when on the one hand are much stronger. In such cases, when prolonging the language, it will also move into one of the parties. In some cases, this happens quite unnoticed, and sometimes pathology is visible very well. However, the language itself is functioning normally at the same time, and its muscles on both sides have the same force.

Diagnosis of deviation of language

Diagnose the presence of the deviation of the language is not always easy. But in most cases the patient is just enough to narrow it. Seeing the deviation, the doctor can conclude what exactly the side of the muscles is weaker. For example, if the deviation of the language is observed, the causes are in the fact that this area of \u200b\u200bthe face is less severe.

However, the deviation is not always associated with the diseases of the brain. Sometimes similar deviations can be explained by the insufficient development of the facial muscles on the one hand.

To determine what exactly the doctor is dealing with the patient, as a rule, ask to make a rapid movement of the language in both directions. In this case, it will be visible, with what force these manipulations are made.

If such measures do not help, then the patient should be asked to put pressure on both cheeks with inner In turn. For example, a specialist conducts the diagnosis of the right side. He testifies the force of pressure from the outside of the right cheek, trying to counteract the strength of the tongue. In this case, the specialist will be able to appreciate how his muscles work, and understand whether the deviation of the language is right.

Treatment of language deviation

It should be noted that deviation is not an independent disease, it is only a symptom manifested by other diseases. Therefore, the disposal of such manifestation is entirely depends on the treatment of illness, which caused it. If the reason is a stroke, which happens most often, it is necessary to eliminate the blood supply disorders of the brain. As soon as this problem It will be eliminated, the nerves will come to normal, and, consequently, the symptoms associated with neurology will also disappear. If the case is in the facial muscles of the face, then you need to consult with your doctor and with the help of special exercises to develop muscles that are lagging behind the other side.

Deviation of the child's tongue

A stroke or curvature of the face muscles is an unprecedented phenomena, but children also face the deviation of the language. As a rule, the cause of such a symptom is the dysarthria or erased dysarthria.

This disease is caused by a violation of the signal supply from the brain to the muscles of the articulation apparatus. In this case, the wrong nervous signal can reflect both on the muscles of the child's face and in the language.

There are not many children with a similar phenomenon. However, still cases were fixed. Most of those who suffer from such violations look like quite healthy children, and only the doctor is able to determine that the child is dysarthria.

Symptoms of Dysarthria in a child

In case of violations of the transmission of the nervous signal, the child's face becomes slightly excreted and does not express any emotions with the help of facial expressions. The patient's lips are often fit, the corners are lowered down, such an expression of the person remains in a child almost constantly.

In severe cases, due to the disease, the child cannot close the mouth and keep the tongue in the oral cavity. Also, during dysarthritia, the patient often has the deviation of the language. If you ask the baby to drain the speech organ, then it will be possible to notice that it is difficult to keep it on the midline. Language is slightly shaking and deviates to the side.

Difference of the dysarthria from the erased dysarthria

As a rule, with the dysarthria, there is a pronounced facial farewell, which is very easy to notice on the face of the child. There can also be noted other signs, such as breach of coordination in the movements of the hands and disorientation in space. Basically, children with dysarthria do not like to draw painting, laying out of plasticine or any other type of activity requiring the use of shallow motors of the hands.

However, children are increasingly meeting who perfectly cope with any kind of activities, love to draw and engage in creativity. At the same time, they have mobile facial expressions, they smile a lot, laugh and do not differ from the usual healthy child. The only thing that gives the presence of dysarthritia is the deviation of the language. As a rule, in children suffering from this disease, the language is quite thick. If you ask the child to launch his mouth, then you can see that the language is shaking and deviates to the side. The manifestation of such symptoms in medicine is called an erased dysarthria.

Combines both diseases. The child can whine, swallow some sounds. At the same time to understand what the child says is quite difficult. It is extremely illegible and intense.

How does Dysarthria affect the child's psyche?

Basically, all children suffering from an erased or pronounced dysarthria have an unstable psyche. They are characterized by frequent mood changes, throwing out of extremes to extremes. The child may be, on the one hand, is overwhelming, constantly crying because of the trifles, on the other hand, it can become aggressive, prude as adults, conflict with peers. Such children rarely have good disciples, as a rule, they are inattentive and do not understand the essence of training.

How to get rid of the deviation of the child's tongue?

In order to get rid of the deviation of a child in a child, it is imperative comprehensive treatment. Many parents believe that with an erased dysarthria, there will be only hiking to the speech therapist, which will help the child to pronounce words correctly. However, the diagnosis in this case puts a neurologist and he should also prescribe treatment. As a rule, the child is prescribed not only classes with a speech therapist and workout properly pronunciation of sounds, but also a neck massage course, a collar zone and chin. Also often in therapy is used face massage with hands and probe massage of the language. It is simply impossible to achieve results with any medicines in this case, it is necessary to regularly affect the source of the nervous pulse.

Treatment of the deviation of the language, both in an adult and the child, primarily consists in treating the disease that caused the rejection of the language from the midline. It is impossible to get rid of this problem without comprehensive measures. Often, doctors recommend combining therapy aimed at the disease itself, as well as symptomatic treatment, which mainly includes massages and training. These measures will allow as soon as possible to return the language and muscles of the face into normal condition. It is necessary to pay special attention to the deviation of the language in the child, as it is often possible to determine the presence of the disease only on this basis.

The main thing is timely treatmentSince, otherwise complications may develop. The most common are - the production of inseparable speech, difficulties in the pronunciation of words, the inability to pronounce any words (speech loss).

(What you need to know the parents)

Timely examination of the child

Language is a relatively small body of the human body, however, it is in it that causes the reasons associated not only with sound-proof problems, but also with health as a whole.

All parents are interested in making their child to be healthy, so that he has sounds in a timely manner, and the speech was free and expressive. Therefore, the dentist's surgeon should thoroughly examine the mouth of the child back in the maternity hospital, as a last resort, in the first month of life.

In the future, such inspections should be carried out at least once a year, better - once every six months.

Pathology in the structure of the language

What can be special in the structure of the language? Parents understand it difficult. The dentist will immediately notice a malfunction. For example, a pathologically small language ( microglossia), or exorbitantly large language ( macrogness).

Microglossia it leads to difficulties with feeding: the kid has a sucking, chewing and swallowing processes, problems with digestion begins, the child does not have the necessary weight and every month more and more lags behind their psycho-physical development from peers, often sick. Subsequently, such a child begins to speak late, he has multiple sound-proof defects. The small tongue is not able to take the necessary articulation position: the amplitude of its movements is too small.

In the case of a microglosium, a children's surgeon dentist makes plastic language. At what age? This decides only the doctor. After the operation - the rehabilitation period and classes with the speech therapist.

Macrogness , or, as speech therapists say, is a massive language. This language does not fit in the oral cavity and literally falls out from the mouth. For proper sound testing and eating, it is also a big minus. A surgeon dentist comes to the rescue, he makes a decrease operation muscular mass Language, that is, plastic.

Some parents pull for a long time with the holding of such an operation: they are sorry for the child. What does such a wire lead to? Imagine a seven-year-old child, who has been constantly opened, a language hangs out of it, lying, face amomically. Who will like it? Even classes with the speech therapist do not give tangible results: a massive language cannot be removed into the oral cavity, it is so bad that it cannot normally pronounce a single sound and moves, like clumsy bear in Berorgan. The child begins to shy his appearance, his speech, with age he appears complexes and neurosis.

Yes, the operation is trauma, after some time there will be problems with food, but all these phenomena are temporary, but then the normal appearance And the correct sound ishing, of course, subject to further speech therapy.

It happens that the child is born with a split language (the so-called "snake language"). At the time of the Middle Ages, the fate of a person with such pathology was unenviable: such a language was considered an attribute unclean power. Nowadays, this mistake of nature no longer causes panic fear among others and eliminates with the help of a plastic surgery. If parents do not solve the operation and leave everything as it is, in addition to difficulties with the welcome, there will be problems with sound help.

Language - Map of Internal Problems

Unfortunately, the problems associated with the tongue are not limited to the examples above.

The attention of parents should also attract too pale, loose and sluggish language of the child. In this language, a muscular tone is lowered ( hypotone ), His movements are slow and fuzzy, adopt the necessary articulation posture to utter one or another sound is sometimes impossible. Hence the errors in sound suspension: "Porridge in the mouth".

If the language is too tense, why his back is taken away, as if "hump", and in the tongue, the language shines, the tip of the tongue is deviating to the side, - there is hypertonus . And in the first, and in the second case, it is necessary to show the child to a children's neurologist, possibly similar phenomena - a consequence of generic injury, encephalopathy or some other diseases.

What else can "tell" the tongue of the child? Lately Increasingly there are children with a "geographical language". The surface of this language is covered with divorces of white, brown and pink flowers, outlines resembling the mainland card, hence the name. At the same time, the mucousness of the language is brilliant, as if polished, flavoring nipples are weak on it. This is the state of the language talk about the need to visit the allergist and the gastroenterologist. Visit to the speech therapist is also desirable. As a rule, the sensitivity of such a tongue and mobility is essentially limited, so it is necessary to conduct articulate gymnastics and setting some sounds.

Sometimes the surface of the tongue is cursed by deep grooves, as if wrinkles. Singful tongue-old. It is painful dry and minor, which adversely affects sound-proof. A similar feature occurs in failures in the endocrine system, so it is not necessary to postpone the visit to the endocrinologist.

Than previously, parents They will see the "linguistic problem" of their child, the more successful it will be possible to decide by contacting the specialists.

Podulty bridle

The bridle (bunch) under the tongue of the child is unacceptable short, or is it not at all? In the latter case, the tongue is jelly and cushy, as if devoured muscular mass. This language does not cope with the right pronouncement of sounds. The operation here will not help, all hope for speech therapist: With the help of special articulation exercises, it is possible to achieve a lot: increase the mobility of the language, prepare it to correctly utter sounds.

Discern the sublingual bridle of the child is not easy. Well, if this procedure is conducted by a dentist. Parents themselves are grabbed for the language and raise it is not worth it. First, the child is unlikely to suffer such an appeal, and secondly, without sufficient knowledge and skills, the mucous membranes of the oral cavity can be seriously injured. Demonstrate the plying bridle should have a child himself, and voluntarily. We will have to take advantage of small tricks.

The first cunning: "My tongue rises highly high!" Adult widely opens his mouth and pulls the tip of the tongue to the nebu. "And you have?" - He promotes. It begins the competition, during which you try to consider the sublard bridle of the child.

The trick is the second: "Who is calling with a tongue?" Clicks are produced only with the wide open mouth. The tongue of the upper surface is firmly embroidered to the nebu. This is the shortest moment of happiness, when the ply-off bridle appears to the eye of parents in all its glory. But this moment this quickly passes, and the language with a ring-clicking breaks away from the nose. Did not have time to see the bundle? Ask a child to repeat the exercise once again or take advantage of the third cunning.

The third trick: "Mushroom grows in your mouth?" "And I have grown!" - With the intriguing intonation, he says adult and demonstrates the wonders of the articulation: suits the tongue to the nebu and holds it in this position for some time. The child admires the resulting "fungus". "Let's grow a fungus in your mouth," says adult. Together with the child, sitting in front of the mirror and "Lepit" the fungus from his language. Immediately may not work. But when the fungus, finally, "grows up," it will be possible without a rush and the bustle of seeing his "leg", - that the most sublard bridle.

Its structure and sizes are the most diverse. Very rare, but you can find a split bridle, even triple.

Podium bridle can be a practically imperceptible transparent film that does not interfere with the work of the language. Or maybe dense, massive and short so much that the kid is not able to even raise the tongue to the tongue.

Consider several of the most common deviations from the norm in the structure of the sub-surround bridle:

• Ø The bridle is thin, almost transparent, but the lingerie is still hampered.
• Ø Bridle thin, as if parchment paper. Its front edge is attached close to the tip of the tongue. Because of this, the tongue (its tip) is used in the heated position (its tip).
• Ø The bridle is a dense short litigation, consisting of tendon fibers. It is attached close to the tongue of the tongue of the language up is substantially limited. When trying to narrow the tongue from the mouth, its tip is wrapped, and the back of the language "blows".
• Ø Tight short litter bridle tightly processed with the muscles of the language, it is attached to almost the tip of the tongue. All language movements are dramatically limited.
• Ø where the bridle, and where the language is difficult to understand, they are one. It seems that the language has agrees with the bottom of the oral cavity. With this language, it is not what to say is impossible!

All of these deviations from the norm in the structure of the approaching bridle at first will impede the process of feeding the child, and subsequently will prevent the timely appearance of not only sounds [p] - [p '], but also whistling [C], [s], [C]; hissing [sh], [f], [h], [sh]; Sonorov [th], [l], [l '], posterhable [k], [g], [x].

Parents most of them do not like to listen to the arguments in favor of the operation on the sub-public bridle. They relieve exercises with which a short bridle is allegedly stretched. Such a delusion is also marked among the speech therapists. We want to disappoint: the bridle in the process of speech therapy work is not stretched, although with the help of special articulation exercises you can significantly increase the mobility of the language, due to which the impression is created that somewhere there is something "stretched". In fact, the time of the sound of sounds is stretched, the strength and child, and the speech therapist are wrapped.

It is necessary to state: in all five cases discussed above cases, the operation is necessary. In the first, second and third versions, only dissection of the bridle under local anesthesia will have. Perhaps in two or three receptions. In the fourth and fifth case, surgical intervention is more complex. It is likely to even surgery under general anesthesia and plastic language. Yes, parents will talk about psychotrame, stress and so on. We will not argue, we will list only the basic consequences of the refusal of the operation:

- Formation of incorrect bite: progress (the lower jaw is advanced), oblique bite, front open bite, lateral open bite;

- Incorrect formation of a baby-pharyngeal ring: the voice of the child acquires a vile shade;

- violation of physiological and speech breathing; Formation of resistant oral respiration; infinite colds;

- Disorders of the posture: the stuff and the curvature of the spine.

- complex discharge (numerous violations of sound suspension, or violation of sound suspension in all phonetic groups).

This is a far from a complete list of problems.

The child is easier to survive a small discomfort in the process of operation than the whole life suffering from the complex of inferiority due to its inadvertising and unavoidable speech.

Of course, the choice is for parents. If they still decide to surgery, they should visit the speech therapist, pediatrician and a dental surgeon. The latter gives directions to:

— clinical analysis blood with hemosinder;

- Clinical urine analysis.

After the operation, the child must undergo a rehabilitation course from the speech therapist, it will include special articulation exercises. If they do not do, the result of all the torment will be zero.

Podium Nerve - Muscular, the first neurons it is located in the lower departments of the front central winding. From here, the fibers pass the path common with corticouclear, and ends in the core of the approximate nerve of the opposite side (NUCl. N. Hypoglossi). Kernel N. Hypoglossi is located at the bottom of the diamond pits, dorsally, in the depths of TriGonum P. Hypoglossi. Fibers overlooking the kernel go in the central direction in Sulcus Lateralis Anterior oblong brain Between Oliva and Pyramid, from where the nerve leaves 10-15 roots, leaves the skull cavity through the canalis hypoglossi channel. At the entrance to the canal, the nerve is surrounded by venous plexus. After leaving the channel, the sub-speaking nerve is first located medial and rear wandering nerve and internal yarem Vienna, then envelopes them, forming an arc (Arcus Hypoglossi), and ends in the muscles of the language.

Terms characterizing the pathology of the sub-surge nerve:
Hemigloslegia - paralysis of half of the language.
Glossoplegia - paralysis of the language.
Dysarthria is a violation of a self-parting speech. Bolna explains this violation by the feeling of something outsiders in the mouth ("Porch in the mouth").
Anarteria is the impossibility of a self-parting speech.

Complaints of the patient: to the difficulty in pronunciation of words, promote the food lump in the oral cavity.
When examining the language in the oral cavity And when proving is drawn, attention is drawn to the presence of deviation of the language, atrophy and fibrillar twitching. It should be borne in mind that a number of patients with progress arbitrarily deflect the language towards the examining physician. In such cases, in order to solve the question, this deviation is true or not, the patient is asked the tongue of the tongue to get the top lip, control the position of the language in the mouth. In the absence of pathology, the language and tip of the language occupy the average position.

We must also forget that atrophy Language can be caused by the local process in the language. For example, we had to observe the patient who had the tongue atrophy was caused by a large cancer, which was located at the root of the language. This example demonstrates the need for a thorough examination of the language if there are trophic violations in it.

Distinguish central and peripheral neuropathy Podium nerve. Under the central neuropathy, there is a damage to the corticuclear pathways of an approaching nerve (from the bark to the kernel XII p. CN). Under the defeat of this path there is a deviation of the tongue when tying and in the oral cavity towards the paretic limbs. Central neuropathy XII n. CN as a rule coincides with central neuropathy VII p.

Peripheral paralysis Podium nerve develops with damage to its kernel, the intracerebral part of the root, nerve itself. It is usually one-sided, but in a number of patients, especially in the pathology of the nuclei, possibly bilaterally damage to the muscles of the language. For any of the levels under consideration, patients have a different degree of severity of atrophy of 1/2 or language as a whole. Language (1/2 language) becomes flabby folded. In severe cases, it is limited or impossible.

With one-sided defeat language In the oral cavity deviates into a healthy side, when prolonged - in the patient. With nuclear deception, along with atrophies, fibrillar tweers occur. They should not be confused with the muscle twitching of the muscles, which appear in healthy persons at the tension of the language, for example, when tying or when the patient is tightened with muscle in the oral cavity. In such cases, the patient is asked to relax language - twitching, in the absence of organic, the organic disappear. In doubtful cases differential diagnosis It is necessary to resort to electromyographic study.

Nuclear Defeat XII Couples accompanied by atrophy of the circular muscle of the mouth, so it is difficult to fold the sick of the lips in the "tube", whistling, "blend a candle". This symptomatics finds an explanation in the fact that the circular muscle of the mouth partially gets innervation from the core of the sub-speaking nerve (not only from the core VII CU). With extracranial pathological processes, in the course of the loop of the sub-surround nerve ( traumatic damage Neck, tumors, stratifications of carotid arteries on the neck with the formation of aneurysm, etc.) there are peripheral paralysis of the muscles of the language in combination with the horner syndrome (Collular-Martille-Hoffman syndrome).

Processes at the level brain barrelsubjected to the destruction of the kernel or the intramedullary part of the XII pair root may be accompanied by alternating syndromes (see TAPIA syndrome).