Speech underdevelopment. Norms of child speech development

The term “ONR”, proposed by R. E. Levina and the staff of the Research Institute of Defectology, is defined as follows: “General speech underdevelopment - various complex speech disorders in which children have impaired formation of all components of the speech system related to its sound and semantic side, with normal hearing and intelligence."

In accordance with the definition, the term “ONR” cannot be used in speech therapy diagnosis of speech disorders in mentally retarded children. To indicate the immaturity of speech as a system in mentally retarded children, the following formulations of a speech therapy report are recommended (for preschoolers 5-7 years old).

1. Systemic underdevelopment of severe speech with mental retardation

Speech therapy characteristics: polymorphic disorder of sound pronunciation, absence of both complex and simple forms of phonemic analysis, limited vocabulary (up to 10-15 words). Phrasal speech is represented by one-word and two-word sentences consisting of amorphous root words. There are no forms of inflection and word formation. Coherent speech is not formed. Severe impairment of speech understanding. (FOOTNOTE: Fundamentals of the theory and practice of speech therapy / Edited by R.E. Levina. - M., 1968.)

2. Moderate systemic underdevelopment of speech in mental retardation

Speech therapy characteristics: polymorphic disorder of sound pronunciation, gross underdevelopment of phonemic perception and phonemic analysis and synthesis (both complex and simple forms); limited vocabulary; pronounced agrammatisms, manifested in the incorrect use of noun endings in prepositional and non-prepositional syntactic constructions, in violation of the agreement of adjective and noun, verb and noun; unformed word-formation processes (nouns, adjectives and verbs); absence or gross underdevelopment of coherent speech (1-2 sentences instead of retelling).

General speech underdevelopment and mental retardation;

General speech underdevelopment and delayed speech development.

Psychological and pedagogical study of children with speech disorders in the PMPK

Examination of a child with a delay in speech development or a disorder thereof, the PMPK provides:

· early identification of child developmental features that cause problems in learning and behavior;

· conducting specialized courses of correctional and developmental classes for such children;

· support of children with persistent difficulties in learning and adaptation in society;

· consulting parents and teachers on issues of effective assistance to such children and an individual approach to education.

Based on the results of the child’s examination at the PMPK, the school administration and parents receive a consultation conclusion and recommendations for changing the learning conditions, improving the child’s development situation, and correcting learning and adaptation problems. In addition, if necessary, the child is sent to correctional and developmental groups and to individual lessons with specialists: psychologist, defectologist, speech therapist.

Particularly difficult is the differential diagnosis of the most common speech disorder - general speech underdevelopment and other disorders.

It is necessary to distinguish between general underdevelopment of speech (OND) and a delay in the rate of its formation. The reasons for delayed speech development are usually pedagogical neglect, insufficient verbal communication of the child with others, and bilingualism in the family. The most accurate differentiation of these conditions is possible in the process of diagnostic training. Distinctive signs indicating a more severe speech diagnosis will be the presence of organic damage to the central nervous system, more pronounced deficiency of mental functions, and the inability to independently master language generalizations. One of the important diagnostic criteria is the ability of a child with a slow rate of speech development to master the grammatical norms of his native language - understanding the meaning of grammatical changes in words, the absence of confusion in understanding the meanings of words that have a similar sound, the absence of violations of the structure of words and agrammatisms, which are so characteristic and persistent in general underdevelopment speeches

Differential diagnosis of speech disorders and mental retardation can be difficult, since general mental underdevelopment is always, to one degree or another, accompanied by speech underdevelopment, and on the other hand, with severe speech underdevelopment, the child often experiences delayed or uneven development of his intellect. In some cases, diagnosis can be successful only as a result of a dynamic study of the child in the process of correctional classes. Unlike children with mental developmental disabilities, who have a total intellectual defect that covers all types of mental activity, children with severe speech impairments have the greatest difficulties in tasks that require speech.

Children with ODD do not experience inertia of mental processes, unlike mentally retarded children; they are capable of transferring learned methods of mental action to other, similar tasks. These children need less help in forming generalized modes of action if they do not require a verbal response. Children with general speech underdevelopment have more differentiated emotional reactions, they are critical of their speech insufficiency and in many tasks they consciously try to avoid a verbal response. Their activities are more targeted and controlled. They show sufficient interest and intelligence in completing tasks.

Speech therapy report on examination of schoolchildren with mental retardation

The term “ONR”, proposed by R.E. Levina and the staff of the Research Institute of Defectology, is defined as follows: “General speech underdevelopment is various complex speech disorders in which children have impaired formation of all components of the speech system related to its sound and semantic side, with normal hearing and intelligence” (Levina R.E. ., 1968). In accordance with the definition, the term “ONR” cannot be used in speech therapy diagnosis of speech disorders in mentally retarded children. To indicate the immaturity of speech as a system in mentally retarded children, the following formulations of a speech therapy report are recommended (for preschoolers 5-7 years old).

Systemic underdevelopment of severe speech in mental retardation

Moderate systemic speech underdevelopment in mental retardation

Systemic mild speech underdevelopment in mental retardation

Speech therapy characteristics: polymorphic disorder of sound pronunciation, underdevelopment of phonemic perception and phonemic analysis and synthesis; agrammatisms manifested in complex forms of inflection (in prepositional-case constructions, when agreeing an adjective and a neuter noun in the nominative case, as well as in oblique cases); violation of word formation, insufficient formation of coherent speech, in retellings there are omissions and distortions of semantic links, disruption of the transmission of the sequence of events.

Delayed speech development is the acquisition of basic speech skills somewhat later than the norm generally accepted in speech therapy. Most often, this diagnosis is made in children under the age of 4-6 years.
General underdevelopment of the speech apparatus is diagnosed in a young patient who has exceeded 5 years of age.

Delayed development of the speech system in children in most cases is associated with serious pathological conditions: hearing problems, autism, cerebral palsy, as well as mental retardation and mental retardation (mental development delay).

A baby up to 12 months old practically does not produce any sound combinations and reacts sluggishly to the words of others.
The child’s gestural and fine motor skills are impaired – for example, he does not point at his mother when asked “Where is mother?”
Upon reaching the age of one and a half years, the child does not try to imitate the sounds and words of loved ones.
Children aged 1.5 to 2 years cannot clearly and spontaneously pronounce any words and phrases of their own free will.
A boy or girl may have a rather unusual voice timbre - too squeaky, hoarse.

The main symptoms of speech system disorders:

There is a strong dissonance between expressive and impressive speech - this means that the child can normally perceive the phrases and words of other people, but cannot independently express his thoughts.

Internal reasons:

Brain dysfunctions resulting from birth trauma.

Causes of external origin are most often associated with various diseases of the child himself - asthenia, cerebral palsy, rickets, severe pathologies of the central nervous system. Even common colds and their complications can lead to severe speech disorders.

Also, an unfavorable environment leads to underdevelopment of the child’s speech apparatus - frequent quarrels in the family, lack of attention to children from parents, minimal communication with the child. Harm can be caused not only by a lack of communication with the baby, but also by constant lisping, as a result of which the baby learns to pronounce sounds and individual words incorrectly.

Sound pronunciation disorders are absent or minor;
The vocabulary is not rich relative to age;
The pronunciation of only one group of sounds is impaired;
Underdevelopment of phonemic hearing and phonemic analysis (depending on the complexity of the speech material, the difficulties of phonemic analysis increase);
Two or more groups of sounds are disturbed at the same time, for example, hissing and voiced or whistling, sonorant and voiced.;
Lack of word formation;

Characteristic signs of mental retardation in children:

memory impairment,
increased physical activity,
inability to concentrate on one subject.

With mental retardation, the development of the language system also slows down and lags significantly behind the generally accepted norm.

Treatment of systemic speech underdevelopment in children is prescribed by a speech therapist. Today, to eliminate the disorder, advanced techniques are used, the essence of which is aimed at developing an understanding of speech fundamentals, intensifying imitative activity in the form of repetition of certain sounds and words. This allows you to sufficiently train thinking, memory and attention.

Degrees of systemic speech underdevelopment and their characteristics

Under the condition of normal speech development, a five-year-old child has full command of detailed speech, skillfully wields a variety of constructions of complex, long sentences and phrases, and has a sufficient vocabulary necessary for the correct expression of thoughts and desires. If such processes are disrupted, systemic underdevelopment of speech may occur.

Systemic speech underdevelopment (SSD) represents a whole complex of disorders of the speech apparatus, which are accompanied by dysfunction of the most important language components - grammar, phonemics, vocabulary, as well as the sound part of the lexicon. In some situations, systemic underdevelopment of speech in a child may be a symptom of a more severe and dangerous condition - a pathology of psycho-emotional development.

Delayed speech development (SDD)

SSD is always accompanied by disturbances in the functioning of the most important mechanisms of the speech system - abnormal formation of grammatical composition, low rate of mastering the morphological component of speech. Depending on the severity and complexity of a particular speech disorder, speech therapy distinguishes between delayed speech development and general speech underdevelopment.

Characteristic symptoms of delayed speech development in a child may differ depending on his age category:

With normal speech development in a child, it is believed that parents who constantly communicate with him understand all the words their baby says. At 2 years old, ½ of the child’s entire vocabulary is considered the norm, at 3 years old – 2/3, at 4 years old, all the child’s words should be understood.

Symptoms and causes of speech underdevelopment

SSD is diagnosed in children over 5 years of age and is a type of speech pathology in which the child is diagnosed with severe deviations in the process of formation of all the main components of the language apparatus - phonetics, grammar, vocabulary.

The child speaks his first, clear and conscious word much later than normal - at 4 or 5 years of age.
Children's speech is characterized by ungrammaticality and incorrect phonetic design.
At an older age, after 5-6 years, the child’s speech remains slurred and incomprehensible even to parents.

The reasons for the development of pathologies of the speech apparatus can be quite numerous. There are a number of harmful factors of internal and external influence that have a negative effect on the body and lead to the development of serious pathological processes.

Illnesses of a woman during pregnancy, abortion, gynecological problems, severe toxicosis, diabetes mellitus, first birth at too young or mature age, drinking alcohol and smoking while carrying a child.
Fetal hypoxia is its insufficient supply of oxygen during the intrauterine period, which leads to severe developmental pathologies.

Degrees of systemic underdevelopment

Systemic speech underdevelopment has varying levels of severity - from minor deficiencies of a grammatical, lexical, phonetic-phonemic nature to a complete lack of ability to form long, complex sentences if the systemic speech underdevelopment is severe. There are 3 main degrees of pathology, each of which has its own characteristic features.

Mild SNR

Characterized by the following manifestations:

There is mild dysgraphia;
Phonemic perception, phonemic analysis and reproduction in general without defects, difficulties are revealed only when determining the number and sequence of phonemes with complex speech material;
When retelling, the main semantic line is revealed, there are small omissions of minor semantic lines, semantic relationships may be lost;
In colloquial unprepared speech, minor agrammatisms are identified; special research reveals inaccuracies in the use of complex prepositions;
Violations of complex forms of word formation, violations of the agreement of adjective and noun in indirect plural cases.

Moderate SNR

Agrammatisms manifest themselves in complicated types of inflection (coordination of genders and cases). The child does not understand and does not use various forms of gender, case and form, and cannot use complex words that are present in his everyday life. The baby can call all the elements of one item by its full name - for example, he calls a pocket, collar, sleeve and button “jacket”.

Severe SUD

With a small amount of passive vocabulary, the child tries to name several objects or phenomena with one sound;
Severe underdevelopment of phonemic perception and phonemic analysis and reproduction (both complex and simple forms);
Severe problems with the formation and perception of sentences, manifested in violations of both complex and simple forms of inflection and word formation (incorrect use of forms, numbers and cases of words);
Severe speech perception impairment;
Lack of coherent speech or its severe underdevelopment.

Speech underdevelopment in mental retardation

In some cases, severe systemic underdevelopment of speech develops against the background of mental retardation. Mental retardation (MDD) is a disruption in the normal process of mental development. With such a failure, some psycho-emotional functions lag significantly behind the average statistical norms used for a specific age category. These functions include the speech apparatus, memory, and thinking.

lack of conscious will,
decreased concentration,

Treatment of SNR in children

In the process of treating speech disorders, a thorough study of words in different grammatical forms and the construction of complex sentences, the number of words in which gradually increases, are carried out. With the help of a speech therapist, the child learns not only to give correct, clear and legible answers to a variety of questions, but also to ask them independently, formulating sentences with prepositions and adjectives.

To teach and treat children with varying degrees of systemic speech underdevelopment, interesting, educational techniques are used that will interest the little patient. For example, studying objects, actions and phenomena using bright and colorful pictures. In addition, it is from pictures that children learn to find differences and highlight the specific qualities of each object - large and small, black and white, soft and hard.

Speech disorders in a boy or girl are a fairly serious problem, but have a favorable prognosis. The success and effectiveness of the treatment process directly depends on the persistence and regularity of sessions with a speech therapist. To eliminate systemic underdevelopment of speech, it may take quite a long time - from several months (if systemic underdevelopment of speech is level 1) to 3-4 years (if systemic underdevelopment of speech is severe). Patience, diligence and perseverance - and the child’s speech will become perfectly correct from a lexical, phonetic and grammatical point of view.

Any deviation that occurs during development causes anxiety among parents. When speech functions are impaired, the child is not able to fully communicate with members of his own family and people around him. In severe cases, we are talking about a pathology such as systemic underdevelopment of speech.

Let's take a closer look at this pathology.

General characteristics

Systemic speech underdevelopment is a complex dysfunction in a child, which is characterized by immaturity of the processes of speaking and receiving speech messages.

In this case, the following may be violated:

Phonetics - the child pronounces some sounds incorrectly.
Vocabulary - the child does not have the volume of vocabulary that he should have mastered at this period of his development.
Grammar - there are violations when choosing case endings, when composing sentences, etc.

The concept of “systemic underdevelopment of speech” was introduced by R. E. Levina and is used in diagnosing the speech functions of children who have mental retardation. For patients with organic brain lesions, which are characterized by a secondary speech disorder, speech therapists most often make a similar diagnosis against the background of this pathological condition. Children with intact hearing and intelligence are diagnosed with “general speech underdevelopment.”

A true diagnosis can be made after the child has seen three specialists: a neurologist, a psychologist and a speech therapist. In addition, such a diagnosis is not given to those children who have not reached the age of five.

Reasons for the development of pathology

It is quite difficult to identify the main cause of systemic speech underdevelopment, since often it is not just one factor that matters, but a whole combination of them.

The main factors are:

head injuries sustained by the child during childbirth or in the first years of life;
complex course of pregnancy, and this category of reasons includes serious infectious diseases during pregnancy, drinking alcoholic beverages, smoking, severe chronic infections, etc.;
fetal hypoxia;
unfavorable situation in the family - inattentive and rude attitude towards the child, frequent quarrels between relatives, overly strict methods of education, etc.;
childhood diseases, which include asthenia, cerebral palsy, rickets, Down syndrome, complex pathologies of the central nervous system.

In certain cases, mild systemic speech underdevelopment develops as a reaction to a bacterial or viral infection.

Signs and symptoms

How to understand and suspect that there is a delay in speech, mental or intellectual development even before he turns five years old?

Initial warning signs in children with systemic speech underdevelopment can be observed in the first year of life. We should be alert to such situations when, in response to certain words spoken by adults, the child does not try to reproduce them.

By the age of one and a half years, a child must learn to imitate sounds made by people around him, as well as point to objects at their request. If this is not observed, parents need to think about it. The next milestone is two years of age. Here the child needs to be able to pronounce words and even phrases spontaneously at will.

By the age of three, children should understand approximately two-thirds of what adults say, and vice versa, adults - children. By the age of four, the meaning of absolutely all words should be mutually understood. In cases where this does not happen, you should seek the advice of a specialist.

At the age of five years, when the question is about making a diagnosis such as systemic speech disorder, the symptoms may be as follows:

the child’s speech remains slurred and is extremely difficult to understand;
There is no consistency between expressive and impressive speech - the child understands everything, but cannot express himself independently.

Classification

This disorder has several degrees of systemic speech underdevelopment:

Mild degree - insufficient vocabulary for a certain age, disturbance in the pronunciation of sounds, inaccuracy in the use of indirect cases, prepositions, plurals and other complex issues, dysgraphia, insufficient awareness of cause-and-effect relationships.
Moderate systemic underdevelopment of speech - difficulties in perceiving overly long sentences, words that are used in a figurative meaning. Difficulties with constructing semantic lines during retelling are also noted. Children do not know how to coordinate gender, number, case, or do it with errors. They have underdeveloped phonemic hearing, weak active speech, poor vocabulary, and impaired coordination of tongue movements during the process of articulation.
Severe systemic underdevelopment of speech - perception is severely impaired, there is no coherent speech, there are violations of fine motor skills, the child cannot write and read, or it is given to him with great difficulty, the vocabulary contains only a few dozen words, the intonation is monotonous, the strength of the voice is reduced, there is no word formation. At the same time, the child cannot conduct a constructive dialogue, as he has difficulty answering even simple questions.

Making a diagnosis, as well as identifying the degree of disorder that is observed in a particular child, is carried out only by a specialist, and not by parents, other relatives or teachers.

Other classification

There is another classification of general underdevelopment. In this case:

1st degree - no speech.
2nd degree of systemic underdevelopment of speech - there are only initial speech elements with a large amount of agrammatism.
The 3rd degree is characterized by the fact that the child can speak phrases, but the semantic and sound aspects are underdeveloped.
4th degree involves individual violations in the form of residual disorders in such areas as phonetics, vocabulary, phonemics and grammar.

General moderate speech underdevelopment, for example, corresponds to the second and third levels of this classification.

We examined the levels of systemic speech underdevelopment.

Mental retardation

Such a pathological phenomenon as severe systemic underdevelopment of speech with mental retardation is caused by the following symptoms:

The development of the speech system lags significantly behind the norm.
There are memory problems.
There are difficulties in defining simple concepts and connections between them;
Increased motor activity.
The child cannot concentrate.
There is no conscious will.
Underdeveloped or absent thinking.

In the case of systemic underdevelopment of speech with mental retardation, the psycho-emotional functions of children are not developed correctly, which negatively affects not only communication, but also other necessary social skills.

What does success depend on?

The success of corrective measures depends on the degree of the violations themselves, as well as on the timeliness of specialist assistance provided to the child. The parents’ goal in this case is to timely note deviations in speech or intellectual development and visit a specialist with the child.

Systemic underdevelopment of expressive speech

Disorders are a general underdevelopment of speech functions in children against the background of sufficient mental development in understanding what others say.

This disorder manifests itself as a small vocabulary that does not correspond to the child’s age, difficulties in verbal communication, and insufficient ability to express one’s opinion using words.

Also, children who have more or less pronounced expressive speech disorders are characterized by difficulties in learning grammatical rules: the child cannot agree on the endings of words, uses prepositions inadequately, cannot decline nouns and adjectives, does not use conjunctions or uses them incorrectly.

Desire for communication

Despite the speech dysfunctions described above, children with such disorders strive to communicate and use nonverbal cues and gestures to convey their thoughts to the interlocutor.

The first signs of expressive language disorders can be noticed in infancy. By the age of two, children with such a pathology do not use words; by the age of three, they do not form primitive phrases consisting of several words.

Therapy and correction

In mild and moderate stages of disorders, the prognosis is usually quite positive; in severe forms of pathology, treatment is longer and more complex, but it also gives good results.

Therapeutic measures are carried out by a speech therapist if speech disorders are accompanied by other disorders. A psychologist and other specialists are also involved in the work.

Classes should take place in different forms - both in the form of constant repetition of sounds, rules for constructing endings, words, sentences, etc., and using progressive modern methods, during the development of which children learn to remember, ask questions, understand speech, and master the meaning of certain concepts , train memory, develop motor skills.

An interesting form of presentation of the material, bright pictures, a favorable atmosphere in the medical institution where correction is carried out are a set of components designed to help the patient quickly cope with existing disorders.

As a rule, physical exercises are also included in the process of general therapy - children do not sit still, but actively train the motor center.

Serious approach

Systemic speech underdevelopment is a disease that requires a serious approach. You should not rush to identify your child for correction to the first doctor you see. At the same time, it is necessary to study whether he has positive experience working with such children, as well as the ability to establish psychological connections with “difficult” patients.

Corrective methods include not only psychotherapy and special exercises; often disorders arise as a result of an incorrect approach to organizing the educational process, so it is necessary to correct this too.

1. Systemic underdevelopment of severe speech with mental retardation

2. Moderate systemic underdevelopment of speech in mental retardation

The structure of speech defects in children of primary school age with systemic underdevelopment of speech in mental retardation

In most cases, a normal child is prepared for the start of school. He has well-developed phonemic hearing and visual perception, and oral speech is formed. He masters the operations of analysis and synthesis at the level of perception of objects and phenomena of the surrounding world. A normally developing child comes to school with developed everyday speech and easily communicates with adults. By the time a mentally retarded child enters school, the practice of verbal communication is small (3-4 years), and everyday speech is poorly developed. Disruption of the activity of analyzers and mental processes in mentally retarded children leads to the inferiority of the psychophysiological basis for the formation of written speech. Therefore, first-graders have difficulty mastering all the operations and actions that are included in the processes of reading and writing.

G.E. Sukhareva distinguishes two groups of oligophrenia: 1) oligophrenia with speech underdevelopment; 2) atypical oligophrenia, complicated by a speech disorder.

The first group of mentally retarded children has speech underdevelopment, which is entirely determined by the level of intellectual underdevelopment; in the second group, in addition to speech underdevelopment, various speech disorders are noted.

Primary schoolchildren with mental retardation may experience all forms of speech impairment (dyslalia, dysarthria, rhinolalia, dyslexia, dysgraphia, etc.). The peculiarity of speech disorders in mentally retarded children is that the semantic defect is predominant in their structure.

R.I. Lalaeva notes that speech disorders in mentally retarded children manifest themselves against the background of gross impairment of cognitive activity and abnormal mental development in general.

Speech disorders in these children are systemic in nature, i.e. speech as an integral functional system suffers. With mental retardation, all components of speech are impaired: its phonetic-phonemic side, vocabulary, grammatical structure. There is an immaturity of both impressive and expressive speech. In most cases, primary school students in correctional schools have impairments in both oral and written speech.

In this category of children, all stages of speech activity are unformed to a greater or lesser extent. Weakness of motivation and decreased need for verbal communication are noted; the semantic programming of speech activity and the creation of internal programs of speech actions are disrupted. Due to a number of reasons, the implementation of the speech program and control of speech, comparison of the result obtained with the preliminary plan are disrupted.

With mental retardation, many levels of the production of speech utterances are impaired to varying degrees: semantic, linguistic, sensorimotor. At the same time, the most underdeveloped are the highly organized complex levels (semantic, linguistic), which require the formation of operations of analysis and synthesis, abstraction, generalization and comparison.

Speech disorders in mentally retarded children have a complex structure. They are diverse in their manifestations, mechanisms, persistence and require a differentiated approach when analyzing them. The symptoms and mechanisms of speech disorders in these children are determined not only by the presence of general, diffuse underdevelopment of the brain, which causes systemic speech impairment, but also by local pathology of areas directly related to speech, which further complicates the picture of speech disorders in mental retardation.

Speech disorders in mentally retarded children are characterized by persistence and are difficult to eliminate.

To indicate the immaturity of speech as a system in mentally retarded children of primary school age, the following formulations are recommended:

Systemic underdevelopment of severe speech in mental retardation. Logopedic characteristics. Polymorphic disorder of sound pronunciation. Gross underdevelopment of phonemic perception and phonemic analysis and synthesis (both complex and simple forms), limited vocabulary. Severe agrammatisms, manifested in violation of both complex and simple forms of inflection and word formation, in the incorrect use of case forms of nouns and adjectives, in violation of prepositional-case constructions, agreement between adjective and noun, verb and noun. Immaturity of word formation. Lack of coherent speech or severe underdevelopment (1-2 sentences instead of retelling).

Systemic underdevelopment of moderate speech in mental retardation. Speech therapy characteristics. Polymorphic or monomorphic pronunciation disorder. Underdevelopment of phonemic perception and phonemic analysis (in some cases there are the simplest forms of phonemic analysis, but significant difficulties are observed when performing more complex forms of phonemic analysis). Agrammatisms that manifest themselves in complex forms of inflection (prepositional-case constructions, agreement between an adjective and a noun in the neuter gender of the nominative case, as well as in oblique cases). Violation of complex forms of word formation. Insufficient development of coherent speech (in retellings there are omissions and distortions of semantic links, a violation of the sequence of events). Severe dyslexia, dysgraphia.

Systemic mild speech underdevelopment in mental retardation. Speech therapy characteristics. Sound pronunciation disorders are absent or monomorphic in nature. Phonemic perception, phonemic analysis and synthesis are basically formed; there are only difficulties in determining the number and sequence of sounds in complex speech material. Vocabulary is limited. In spontaneous speech, only isolated agrammatisms are noted. A special study reveals errors in the use of complex prepositions, violations of agreement between adjectives and nouns in indirect plural cases, and violations of complex forms of word formation. In the retellings there are main semantic links, only minor omissions of secondary semantic links are noted, and only some semantic relationships are not reflected. There is mild dysgraphia.

Aksenova A.K. indicates that disruption of the activity of analyzers and mental processes in mentally retarded children leads to the inferiority of the psychophysiological basis for the formation of written speech. Therefore, first-graders have difficulty mastering all the operations and actions that are included in the processes of reading and writing.

The greatest difficulties in mastering reading and writing skills by children of this population are associated with impairments in phonemic hearing and sound analysis and synthesis. First-graders have difficulty differentiating acoustically similar phonemes and therefore do not remember letters well, since they associate a letter with different sounds each time. In other words, there is a violation of the system of transcoding and encoding letters into sound and sound into letters.

Imperfections in analysis and synthesis lead to difficulties in dividing a word into its component parts, identifying each sound, establishing the sound sequence of a word, mastering the principle of merging two or more sounds into a syllable, and recording in accordance with the principles of Russian graphics.

Impaired pronunciation exacerbates deficiencies in phonetic analysis. If in children with normal development, incorrect pronunciation of sounds does not always lead to inferior auditory perception and incorrect choice of letters, then in mentally retarded schoolchildren, impaired pronunciation is, in most cases, impaired perception of sound and incorrect translation of it into a grapheme.

Many studies related to the state of sound analysis and synthesis in children normally and with mental retardation have shown that a normal child with defective pronunciation skills retains the focus of cognitive activity on the sound side of speech and interest in it.

A different picture is observed in mentally retarded children: they have no interest in the sound envelope of a word. Understanding of the sound structure of a word does not appear even when the experimenter specifically directs the schoolchildren’s attention to the sound analysis of the word. So, to the question: “The boy said “ohshka.” What is his mistake? - mentally retarded students were unable to give the correct answer, although a picture with a drawn cat was in front of their eyes. Failure to understand that a word is not only the name of an object, but also a certain sound-letter complex delays the process of mastering literacy, since performing the acts of writing and reading presupposes the mandatory combination of two operations: understanding the meaning of the word and its sound-letter analysis - before writing; perception of the letters of a word and awareness of its semantics - when reading.

“Children cannot understand,” writes V.G. Petrova , - that every word consists of combinations of the very letters that they learn. For many students, letters remain for a long time something that must be remembered as such, regardless of the words denoting familiar objects and phenomena.”

Thus:

Speech disorders in mentally retarded children of primary school age are systemic in nature, i.e. speech as an integral functional system suffers.

With mental retardation, all components of speech are impaired: its phonetic-phonemic side, vocabulary, grammatical structure. There is an immaturity of both impressive and expressive speech.

In most cases, primary school students in correctional schools have impairments in both oral and written speech.

The greatest difficulties in mastering reading and writing skills by children of this population are associated with impairments in phonemic hearing and sound analysis and synthesis.

LIST OF REFERENCES USED

Aksenova A.K. Methods of teaching the Russian language in a special (correctional) school: textbook. for students with defects fak. Pedagogical universities. - M.: Humanitarian. ed. VLADOS center, 2004. - 316 p.

Buslaeva E.N. The state of phonemic hearing in primary school students with intellectual disabilities // Defectology, 2002, No. 2-p.17

Differential diagnosis of speech disorders in children of preschool and school age: Methodological recommendations / team of authors: L.V. Venediktova, T.T. Sparrow, R.I. Lalaeva and others - Publishing house of the Russian State Pedagogical University named after. A.I. Herzen, 1998.

Lalaeva R.I. Speech disorders and the system for their correction in mentally retarded schoolchildren. – L.: 1988.

Petrova V.G. Speech development of auxiliary school students. - M., 1977.

CLASSIFICATIONS OF SPEECH DISORDERS
To date, a unified classification of speech disorders has not been developed, although numerous attempts have been made to create one (M. E. Khvattsev, O. V. Pravdina, R. A. Belova-David, M. Zeeman, R. E. Levina, F. A. Rau, S.S. Lyapidevsky, B.M. Grinshpun, etc.). The difficulties in classifying speech disorders are due, on the one hand, to the fact that the mechanisms for generating speech and voice are, to a certain extent, not specific, but are adapted to provide speech function by organs and systems that initially solve other physiological problems. On the other hand, speech activity is integrative in nature, and its disorders reflect the developmental features of other higher mental functions (primarily thinking and perception), which makes it difficult to isolate speech pathology into a separate category.

For practical purposes, domestic speech therapy traditionally uses two typologies of speech disorders, built on different principles: clinical-pedagogical and psychological-pedagogical.

Clinical and pedagogical classification(F.A. Rau, M.E. Khvattsev, O.V. Pravdina, S.S. Lyapidevsky, B.M. Grinshpun) is built on the principle “from the general to the specific,” i.e., it follows the path of detailing speech violations. This classification, in fact, is a significantly revised and expanded classification of the German neurologist Adolf Kussmaul, which he began to develop in 1877. It is based on the etiology and pathogenesis of speech disorders.

All types of speech disorders considered in the clinical and pedagogical classification are divided into two large groups depending on what type of speech is impaired (oral or written). Oral speech disorders (a total of nine of them are described), in turn, are classified into two types: disorders of the phonation (external) design of utterances, which are called disorders of the pronunciation side of speech, and disorders of the structural-semantic (internal) design of utterances, which in speech therapy are called systemic or polymorphic speech disorders.

Disorders of written speech (there are two of them in this classification) are divided into two groups depending on what type of written speech is impaired: if the productive type is impaired - writing disorder, if receptive writing is impaired - reading disorder.

Psychological and pedagogical classification(R.E. Levin) is built on the principle of grouping from the particular to the general; Speech disorders are classified by the author taking into account more effective organization of correctional work with preschool children. This classification does not reflect the etiology and pathogenesis of speech disorders, but is based on linguistic and psychological criteria, among which the structural components of the speech system (sound aspect, grammatical structure, vocabulary), functional aspects of speech, the ratio of types of speech activity (oral and written).

However, there are other approaches to the typology of speech disorders. In accordance with the Order of the Ministry of Health of Russia dated May 27, 1997. No. 170 was introduced into healthcare practice throughout the Russian Federation in 1999 International Statistical Classification of Diseases and Related Health Problems(English: International Statistical Classification of Diseases and Related Health Problems) - a normative document that ensures the unity of methodological approaches and international comparability of materials. Currently, the International Classification of Diseases, Tenth Revision (ICD-10, ICD-10) is in force.

CLINICAL AND PEDAGOGICAL CLASSIFICATION AND ICD-10

Let's consider the relationship between each type of speech pathology described in the clinical and pedagogical classification with a similar speech pathology according to ICD-10.

Disorders of phonation (external) design, which can be observed both in isolation and in various combinations, are divided into groups depending on the disturbed link: voice formation; tempo-rhythmic organization of utterance; intonation and melodic organization of utterances; sound-pronunciation organization.

This section includes:

Violations of the tempo-rhythmic organization of speech

1. Bradylalia – pathologically slow speech rate, which manifests itself in the slow implementation of the articulatory speech program. Bradylalia is centrally determined and can be either organic or functional. In the pathogenesis of bradyllalia, the pathological strengthening of the inhibitory process, which begins to dominate the excitation process, is of great importance (M. E. Khvattsev).

In ICD-10, bradyllia is not identified as an independent nosological unit and, accordingly, does not have a statistical code in ICD-10.

2 .Tahilalia – pathologically accelerated rate of speech, which manifests itself in the accelerated implementation of the articulatory speech program. Tachylalia is centrally determined and can be either organic or functional.

In cases where pathologically accelerated speech is accompanied by unreasonable pauses, hesitations, and stumbles, it is designated by the term poltern.

In ICD-10, tachylalia corresponds to code F98.6 Speech excitedly. Diagnostic criteria - fast rate of speech with fluency disorder, but without repetition or hesitation to such an extent that speech intelligibility is reduced - meet the diagnostic criteria for tachylalia. Dysrhythmic speech is usually punctuated by “stops and bursts of speech.”

F98.6 includes:

Tahilalia;

half turn

Poltern (stumbling) - pathologically accelerated speech with intermittency of speech tempo of a non-convulsive nature.

Excluded:

Stuttering (F98.5);

Tiki (F95.x);

Neurological disorders causing speech dysrhythmias (G00 – G99);

Obsessive-compulsive disorders (F42.x).

3.Stuttering – a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus. The main symptom of stuttering is speech convulsions that occur during oral speech or when trying to start it, which are distinguished by type (tonic, clonic, tono-clonic, clono-tonic); localization (respiratory, vocal, articulatory) and severity.

When stuttering, breathing disorders are observed; accompanying movements that accompany speech; violation of smoothness, tempo and partially melody of speech; embolophrasia; limitation of speech activity.

In ICD-10, the described disorder corresponds to code F98.5 Stuttering (stammering).

Included:

Stuttering caused by psychogenic factors;

Stuttering caused by organic factors.

Disorders of pronunciation of speech

1.Dislalia – disturbance of sound pronunciation with normal hearing and intact innervation of the speech apparatus.

In ICD-10, dyslalia corresponds to code F80.0. Specific speech articulation disorder.

Diagnostic guidelines correspond to the diagnostic criteria for dyslalia identified in the CCP.

According to the etiological principle, dyslalia is divided into two types: mechanical (organic) and functional.

ICD-10 emphasizes that a diagnosis can only be made when the severity of the articulation disorder is outside the range of normal variations appropriate for the child's mental age; non-verbal intellectual level within normal limits; expressive and receptive speech skills within normal limits; articulation pathology cannot be explained by a sensory, anatomical or neurotic abnormality; incorrect pronunciation is undoubtedly anomalous, based on the characteristics of speech use in the subcultural conditions in which the child finds himself.

In code F80.0. Specific speech articulation disorder includes:

Voice disorders

1.Dysphonia (aphonia) – absence or disorder of phonation due to pathological changes in the vocal apparatus.

In the CPC, the terms “dysphonia” and “aphonia” reflect only the degree of manifestation of the disorder: aphonia is the complete absence of voice, and dysphonia is partial disturbances of pitch, strength and timbre. There is no qualitative description of pathological changes in the voice-forming organs - larynx, extension tube, bronchi, lungs and systems affecting their function (endocrine, nervous, etc.) in these terms. In addition to the loss of strength, sonority, and timbre distortion, dysphonia causes vocal fatigue and a number of subjective sensations (soreness, lump in the throat, etc.).

In ICD-10, dysphonia and aphonia have different codes: R49.0 Dysphonia; R49.1 Aphonia.

Dysphonia can be caused by organic causes (anatomical changes or chronic inflammatory processes of the vocal apparatus, paresis, paralysis of the larynx, tumors and conditions after their removal) or functional disorders of the voice-forming mechanism (voice fatigue, poor voice production, various infectious diseases and the influence of mental factors). Dysphonia can occur at any stage of child development and into adulthood.

Voice disorders can be expressed in one of two forms: hypotonic and hypertonic. In the hypotonic variant, dysphonia (aphonia) is usually caused by bilateral myopathic paresis, i.e. paresis of the internal muscles of the larynx, which leads to the fact that at the moment of phonation the vocal folds do not completely close; a gap remains between them, the shape of which depends on which pair of muscles is affected. Voice pathology can manifest itself from mild hoarseness to aphonia.

In the hypertonic variant, at the moment of phonation, a tonic spasm predominates, which can cover the vocal and vestibular folds, which leads to the disappearance of the voice or a significant distortion of its characteristics.

Systemic speech disorders .

The term "systemic speech disorders" is currently used to refer to various concepts. Some authors call speech disorders systemic if they are one of the components of complex forms of mental dysontogenesis and accompany the disintegration of the development of the sensory-perceptual, cognitive, affective-volitional sphere of the child (Lalaeva R.I., Serebryakova N.V.), others consider speech disorders as systemic if they are included as a symptom in a neurological syndrome (Bezrukova O.A.). In speech therapy, systemic speech disorders are traditionally called alalia and aphasia, i.e. such speech disorders in which the acquisition of language as a sign system is impaired or the skills of its use have disintegrated. The synonym in this case is the definition of “structural-semantic speech disorders.”

Alalia – absence or severe deficiency (underdevelopment) of speech production or perception due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of a child’s development with initially intact intelligence and peripheral hearing. The accepted division of alalia into motor and sensory in ICD-10 corresponds to disorders of expressive (F80.1) and receptive speech (F80.2) from section F80 “Specific disorders of speech and language development.”

Expressive speech - active oral speech or independent writing. Expressive speech begins with the motive and intention of the utterance, then follows the stage of internal speech (the idea of the utterance is encoded into speech patterns) and ends with a detailed speech utterance.

Receptive (impressive) speech - understanding oral and written language (reading). The psychological structure of impressive speech includes the stage of primary perception of a speech message, the stage of decoding the message (analysis of the sound or letter composition of speech) and the stage of relating the message to certain semantic categories of the past or one’s own understanding of the oral (written) message.

Motor alalia - systemic underdevelopment of expressive speech (active oral utterance) of a central organic nature, caused by damage to the speech zones of the cerebral cortex (frontoparietal areas of the cortex of the left hemisphere of the brain - Broca's center) in the prenatal or early period of speech development.

In ICD-10, motor alalia is coded as F80.1. Expressive speech disorder. Underdevelopment of speech in motor alalia is systemic in nature, covering all its components: phonetic-phonemic and lexical-grammatical aspects. Based on the predominant symptoms, a group of children predominantly with phonetic-phonemic underdevelopment and a more common group with pronounced lexical-grammatical underdevelopment are distinguished. An important diagnostic criterion is the presence of intact peripheral hearing and articulatory apparatus, as well as the presence of intellectual capabilities in the child sufficient for the development of speech. As a result of the disruption of selection and programming operations at all stages of generating a speech utterance, speech activity as such is unformed, including the control of speech movements, which is reflected in the reproduction of the sound and syllabic composition of the word.

In code F80.1. Expressive speech disorder, in addition to motor alalia, includes:

delayed speech development according to the type of general speech underdevelopment (GSD) of levels I-III;

developmental expressive dysphasia;

developmental aphasia of expressive type.

Sensory alalia - lack of understanding of speech (underdevelopment of impressive speech) in the presence of the ability to speak.

In ICD-10, sensory alalia is coded as F80.2. Receptive language disorder.

With sensory alalia, the connection between the meaning and the sound envelope of words is disrupted; Despite good hearing and intact abilities to develop active speech, the child does not understand the speech of others. The cause of sensory alalia is damage to the cortical end of the auditory-speech analyzer (Wernicke's center) and its pathways.

In code F80.2. Receptive language disorders, in addition to sensory alalia, include:

Developmental receptive dysphasia;

Developmental receptive aphasia;

Lack of perception of words;

Verbal deafness;

Sensory agnosia;

Congenital auditory immunity;

Wernicke's developmental aphasia.

In practice, there is a combination of sensory and motor alalia (mixed defect).

Aphasia - complete or partial loss of speech caused by local brain lesions. The neuropsychological classification of A.R. Luria is generally accepted, according to which 6 forms are distinguished:

Acoustic-gnostic sensory

Acoustic-mnestic

Amnestic-semantic

Afferent kinesthetic motor

Efferent motor

Dynamic

ICD-10 assigns several codes to aphasia: R47.0 Aphasia NOS; F80.1 Expressive language disorder (if the existing language disorder can be regarded as “developmental aphasia of the expressive type”); F80.2 Receptive language disorder (if the existing language disorder can be regarded as “developmental receptive aphasia”).

It is obvious that the encoding of one or another type of aphasia should be carried out depending on what type of speech (motor or sensory, in other words, expressive or receptive) is predominantly impaired.

The code F80.3 is highlighted separately. Acquired aphasia with epilepsy (Landau-Klefner syndrome) is a disorder in which a child, having previously had normal speech development, loses both receptive and expressive speech skills, while maintaining general intelligence. The onset of the disorder (most often between the ages of 3 and 7 years) is accompanied by paroxysmal EEG abnormalities (almost always in the temporal lobes, usually bilaterally, but often with wider disturbances) and, in most cases, epileptic seizures. The diagnostic criteria note that the following is very characteristic: the receptive language impairment is quite profound, often with difficulties in auditory comprehension at the first onset of the condition.

Please note that aphasia that arose against the background of various disintegrative disorders and in autism should be coded in separate headings: aphasia due to disintegrative disorders of childhood (F84.2 - F84.3); aphasia in autism (F84.0x, F84.1x).

Writing disorders

The previous tendency to consider impairments in written speech as an independent anomaly not related to the development of oral speech has now been recognized as erroneous. It has been established that writing and reading disorders in children arise as a result of deviations in the development of oral speech: lack of fully formed phonemic perception or underdevelopment of all its components (phonetic-phonemic and lexical-grammatical). This explanation of the causes of impairments in written speech is firmly established in speech therapy. It is also accepted by the majority of foreign researchers (S. Borel-Maisonni, R. Becker, etc.).

If the writing process is unformed, they speak of agraphia.

In ICD-10 dysgraphia has code F81.1 Specific spelling disorder.

The definition of “spelling” comes from the English word spel(write or spell words) and involves the process of translating spoken language into written language and vice versa.

Code F81.1 Specific spelling disorder includes:

Specific delay in mastering spelling skills (without reading disorder);

Optical dysgraphia;

Spelling dysgraphia;

Phonological dysgraphia;

Specific spelling delay.

Diagnostic guidelines draw attention to the fact that this written language disorder is not explained solely by low mental age, problems with visual acuity and inadequate schooling. Both the ability to spell words orally and to write words correctly are impaired. Children whose problems consist solely of poor handwriting should not be included here; but in some cases, spelling difficulties may be related to writing problems.

In domestic speech therapy, the classification of dysgraphia is considered the most justified, which is based on the immaturity of certain operations of the writing process (developed by employees of the Department of Speech Therapy of the Leningrad State Pedagogical Institute named after A.I. Herzen).

Agraphia has code R48.8, and the combination of a writing disorder with a reading disorder should be regarded as spelling difficulties combined with a reading disorder (F81.0).

It is worth paying attention to the fact that impairments in the formation of writing skills due to pedagogical neglect, long breaks in training and similar reasons mentioned are not included in the section under consideration and should be coded as difficulties in spelling, determined mainly by inadequate training (Z55.8).

Dyslexia - partial specific violation of the reading process, caused by the immaturity (impairment) of higher mental functions and manifested in repeated errors of a persistent nature.

In ICD-10, dyslexia is coded F81.0 Specific reading disorder. ICD-10 states that the core feature of this disorder is a specific and significant impairment in the development of reading skills that cannot be explained solely by mental age, problems with visual acuity, or inadequate schooling. Spelling difficulties are often associated with a specific reading disorder and often persist into adolescence, even after some progress has been made in reading. Children with specific reading disorder often have a history of specific language development disorders, and comprehensive examination of language functioning at this time often reveals ongoing mild impairments in addition to lack of achievement in theoretical subjects.

Several classifications of dyslexia have been developed (O.A. Tokareva, M.E. Khvattsev, etc.). The most common classification is one that takes into account impaired operations of the reading process (R.I. Lalaeva).
PSYCHOLOGICAL AND PEDAGOGICAL CLASSIFICATION AND ICD-10
The second classification of speech disorders, traditionally used in domestic speech therapy, is the psychological and pedagogical classification of speech disorders (R.E. Levin). This classification arose as a result of a critical analysis of the clinical classification from the point of view of its use in the correctional process.

The attention of researchers was directed to the development of speech therapy methods for working with a group of children (group, class), for which it was necessary to find the general manifestation of the defect in various forms of abnormal speech development. This approach required a different principle for grouping violations: not from general to specific, but from specific to general.

In the psychological and pedagogical classification (PPC), violations are divided into two groups:

Impaired means of communication (phonetic-phonemic underdevelopment and general underdevelopment of speech)

Phonetic-phonemic underdevelopment (FFN)– disruption of the processes of formation of the pronunciation system of the native language in children with various speech disorders due to defects in the perception and pronunciation of phonemes.

Having analyzed the diagnostic criteria for phonetic-phonemic underdevelopment, we can say with a high degree of confidence that in ICD-10, phonetic-phonemic underdevelopment corresponds to code F80.1 Expressive speech disorder. ICD-10 notes that in this specific developmental disorder, the child's ability to use expressive spoken language is markedly below the level appropriate for his mental age, although speech comprehension is within normal limits. There may or may not be articulation disorders.

With FFN, children have difficulties in analyzing sounds that are disturbed in pronunciation; with formed articulation, there is an inability to distinguish between sounds belonging to different phonemic groups, as well as the inability to determine the presence and sequence of sounds in a word.

General speech underdevelopment (GSD) is a systemic polyetiological disorder in which all components of the language system are not formed: phonetics, vocabulary, grammar.

OHP can exist either as an independent (primary) disorder or as a concomitant disorder with alalia, dysarthria, stuttering, and rhinolalia. Common signs include a late onset of speech development, a poor vocabulary, agrammatisms, pronunciation defects, and phoneme formation defects.

Underdevelopment can be expressed to varying degrees: from the absence of speech or its babbling state to extensive speech, but with elements of phonetic and lexico-grammatical underdevelopment. Depending on the degree of development of the child’s speech means, general underdevelopment is divided into 4 levels.

R.E. Levina identified and characterized 3 levels of speech development,

T.B. Filicheva identified level 4 of speech development - residual manifestations of vaguely expressed elements of underdevelopment of all components of the language system.

General underdevelopment of speech (according to the SPC) corresponds to code F80.1 Expressive speech disorder, the explanation to which states that delays in speech development of the type of general underdevelopment of speech (GSD) are included in this category.

Violations in the use of means of communication.

Stuttering- is considered as a violation of the communicative function of speech with correctly formed means of communication. This disorder is a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus. In ICD-10, the described disorder corresponds to code F98.5 Stuttering (stammering). This speech disorder was discussed above.

Thus, in the psychological and pedagogical classification, writing and reading disorders are not distinguished as separate nosologies. They are considered as part of phonetic-phonemic underdevelopment (FFN) and general speech underdevelopment (GSD) as their systemic delayed consequences due to the immaturity of phonemic and morphological generalizations, which constitute one of the leading features.

None of the classifications we examined reflect the features of speech development of mentally retarded children, although speech pathology caused by a persistent decline in cognitive activity has been studied by many authors (M.E. Khvattsev, R.E. Levina, G.A. Kashe, R.I. Lalaeva, E.F. Sobotovich, V.G. Petrova, M.S. The specificity of speech disorders in children with intellectual disabilities is determined by the characteristics of their higher nervous activity and mental development. To code these speech disorders in ICD-10, it is recommended to use the category that includes articulation disorder due to mental retardation - F70 - F79.