What is erased dysarthria: causes, symptoms and treatment of the disorder. Causes and methods of treating dysarthria in children

Today we will try to understand the essence of the phenomenon called “dysarthria”. What it is? For what reasons does pathology occur? This is especially important, since in children with normal mental development this disease accounts for up to 6% of cases, and there is a tendency for this figure to increase.

Dysarthria is a violation of the pronunciation of sounds caused by damage to areas of the brain and, accordingly, a disorder of the innervation of the muscles involved during speech.

Severe dysarthria - what is it?

Dysarthria is observed in mild and severe forms. The latter is considered as one of the manifestations. Such children receive both speech therapy and medical care in a complex. It is provided by specialized children's institutions (kindergartens and schools for children with speech problems or musculoskeletal disorders).

Erased dysarthria - what is it?

Children with a mild degree of dysarthria (otherwise called “erased”) are, as a rule, educated in general children's institutions.

It manifests itself in a slight impairment of the functions of the organs of articulation, and the speech of such children is unclear, but understandable to others, since the disease is based on only point lesions of the cerebral cortex. This results in paresis of only some of the muscles used for articulation, for example, only one side of the tongue or its tip.

When compared with dyslalia (impaired pronunciation of sounds with normal innervation of the articulatory apparatus), the disorders in question have a completely different cause and

Symptoms of dysarthria

Diagnosis of dysarthria, despite the fact that children affected by it most often do not stand out much among their peers, occurs according to some common signs:

In addition to the problems listed above, children, even with mild dysarthria, suffer from increased excitability and exhaustion of the nervous system. Already from the first year of life, this is manifested by tearfulness and constant demand for attention from loved ones, sleep disturbances, a predisposition to frequent vomiting, and gastric disorders. The condition of such children often depends on meteorological changes.

Treatment of dysarthria

Dysarthria is treated comprehensively, with the participation of both a neuropsychiatrist and a speech therapist. But parents play a significant role in this, so it is extremely important for them to know: the diagnosis of “dysarthria” - what it is, why certain procedures and exercises are carried out, and also to clearly imagine the possible results.

During the treatment process, both therapeutic procedures are used (medicines, physiotherapy and acupuncture to normalize muscle tone, and speech therapy (articulation exercises, voice correction and pronunciation correction, etc.).

ERASED FORM OF DYSARTHRIA AS A STABLE SYMPTOMOCOMPLEX

A MODERN VIEW AT THE PROBLEM

As a special type of speech disorder, the erased form of dysarthria began to stand out in speech therapy relatively recently - in the 50-60s of the 20th century.

In her classification of disorders of the sound pronunciation aspect of speech, based on the pathogenetic principle, R.A. Belova-David distinguished two main types: dyslalia, associated with the functional nature of the disorder, and dysarthria, caused by organic damage to the central nerve - no system.

Systematizing sound pronunciation disorders in preschoolers taking into account the pathogenesis of sound pronunciation disorders, E.F. Sobotovich identified sound pronunciation deficiencies that manifested themselves against the background of neurological symptoms and had an organic basis, but were of an erased, unexpressed nature. She qualified them as dysarthric disorders, noting that the symptoms of these disorders differ from the manifestations of those classical forms of dysarthria that occur with cerebral palsy.

Other domestic and foreign researchers also pointed out that there is a group of children with disorders of the formation of the sound side of speech, the symptoms and nature of which do not correspond to either dyslalia or dysarthria.

For a long time, the nature of these disorders remained unclear, which was also manifested in the variability of terminology (apractical dysarthria, articulatory dyspraxia, organic, central or complicated - “protracted” - dyslalia, functional dysarthria, minor dysarthria, minimal dysarthria disorders, etc.) . Subsequently, in the studies of E.F. Sobotovich, R.I. Martynova, E.Ya. Sizova, E.K. Makarova, L.V. Lopatina and others, these disorders began to be designated as erased dysarthria or as an erased form of dysarthria.

The term “erased form of dysarthria” was first used by O.A. Tokareva, according to whom children suffering from this pathology can pronounce most sounds correctly, but in spontaneous speech they are poorly automated and differentiated.

It is obvious that initially researchers attributed the erased form of dysarthria to sound pronunciation disorders proper, but later these disorders were interpreted by many authors as a symptom complex that included speech and non-speech symptoms. Currently, in the domestic literature, the erased form of dysarthria is considered as a consequence of minimal brain dysfunction, in which, along with disturbances in sound pronunciation,
In the main part of speech, mild impairments of attention, memory, intellectual activity, emotional-volitional sphere, mild motor disorders and delayed formation of a number of higher cortical functions are observed. The literature emphasizes that the erased form of dysarthria in its manifestations is characterized by smoothness of symptoms, their heterogeneity, variability, different ratios of speech and non-speech symptoms, disorders of the sign (linguistic) and non-sign (sensorimotor) levels. Therefore, it poses a significant difficulty for differential diagnosis.

Domestic authors associate the etiology of the erased form of dysarthria with organic causes acting on brain structures in the prenatal, natal and early postnatal periods. In many cases, the history contains a chain of harm from all three periods of the child’s development. Researchers note that when a developing brain is exposed to a harmful factor, the damage is widespread and can contribute to delayed maturation and disruption of the functioning of structures.

Brain.

In foreign literature, the concept of “speech, or articulatory, developmental dyspraxia” (Development apraxia of speech-DAS) is used for such disorders. Among the reasons causing DAS are usually a violation of the innervation of the articulatory apparatus, movement disorders, oral apraxia as a violation of the central program for the temporary coordination of voluntary muscular movements of the articulatory apparatus, minimal

Brain dysfunction.

Domestic and foreign researchers note the presence of diverse neurological symptoms in children with an erased form of dysarthria,

Symptoms of organic damage to the central nervous system are found in the form of erased pares, changes in muscle tone, hyperkinesis (excessive involuntary movements), manifested mainly in the facial and articulatory muscles, the presence of pathological reflexes, and disruption of the autonomic nervous system.

G.V. Gurovets, S.I. Mayevskaya, B.A. Arkhipov point to dysfunction of the oculomotor nerves in children with an erased form of dysarthria, manifested in unilateral ptosis, strabismus, limitation of volume -

Ema movements of the eyeballs.

In the motor sphere, this category of children shows identical development of the functions of both hands and pseudo-left-handedness. Researchers note slowness, awkwardness, and lack of movement during

relative preservation of their volume, emphasizing that the limitation of the range of movements of the upper and lower extremities is detected mainly on one side.

Note that the general motor skills of children with an erased form of dysarthria have not been sufficiently studied, in contrast to fine motor skills, the violation of which, along with articulation, is defined by the authors as one of the leading symptoms in the erased form of dysarthria. L.V. Lopatina, N.V. Serebryakova, describing disturbances in manual motor skills in these children, note inaccuracy, lack of coordination, and insufficient dynamic organization of movements. A.V. Semenovich points to gross violations of reciprocal and synergetic sensorimotor coordination, an abundance of synkinesis.

Studies of articulatory motor skills have shown that children with an erased form of dysarthria have dysfunction of the muscles innervated by the lower branch of the trigeminal nerve, facial, hypoglossal and glossopharyngeal nerves.

The authors also point out the difficulties of switching movements, reproducing simultaneous movements of articulatory organs, perseveration (obsessively repeated movements), and rearrangements when reproducing a series of movements.

The listed motor disorders of the articulatory apparatus determine a variety of phonetic deficiencies, which, according to most researchers, are dominant in the structure of the defect in the erased form of dysarthria. O.A. Tokareva points out that this category of children has more severe manifestations of sound pronunciation disorders than with dyslalia, requiring long-term speech therapy to eliminate them. Features of sound pronunciation are determined by the nature of innervation disorders and the state of the neuromuscular apparatus of the articulatory organs. According to G.V. Gurovets and S.I. Mayevskaya, the most common distortions are lateral, interdental, softened pronunciation of sounds. Children with an erased form of dysarthria often replace complex sounds with articulatory simpler ones, affricates are split into components

their components, slotted ones, are replaced by occlusive ones, hard ones - by soft ones.

Most researchers note that children with this defect are characterized by a polymorphic disorder of sound pronunciation, which manifests itself in distortions and the absence of mainly three groups of sounds: whistling, hissing, and sonorants.

According to the authors, prosodic (voice) disorders are less pronounced in this category of children. Deviations in the tempo and dynamic organization of speech are indicated. Peculiarities of voice timbre are noted (high, loud, shouting, breaking into falsetto or, conversely, quiet, low, weak), insufficient differentiation of various types of intonation. Speech is characterized by low expressiveness, monotony, and a “blurred” intonation pattern.

Many studies devoted to the study of the problem of the erased form of dysarthria (G.V. Gurovets, S.I. Mayevskaya, E.F. Sobotovich, L.V. Lopatina, etc.) note that disorders of phonemic perception are common in children of this category . It is difficult for them to distinguish between hard and soft, voiced and voiceless sounds, affricates and their constituent elements. They are characterized by distortions of the sound-syllable structure of words, difficulties in mastering sound-syllable analysis and synthesis, and the formation of phonemic representations.

The question of the mechanisms of phonemic underdevelopment in the structure of a speech defect in the erased form of dysarthria is debatable. According to the research of L.V. Lopatina, in preschool children with an erased form of dysarthria, the existence of unclear articulatory images leads to the fact that the boundaries between the auditory differential features of sounds are erased, and the lack of clear auditory perception and control contributes to the preservation of sound pronunciation defects in speech. As noted by R.E. Levina, this phenomenon is observed in violation of speech kinesthesia, which occurs with morphological and motor lesions of the speech organs. Thus, in modern defectological literature, phonemic underdevelopment in the structure of the defect in the erased form of dysarthria is considered as a secondary disorder.

Neuropsychological researchers (A.V. Semenovich, L.I. Serova, etc.) hold a different point of view. They also believe that a violation of phonemic perception, along with insufficiency of the phonetic side of speech, is one of the dominant symptoms in the erased form of dysarthria, however, it is not caused by sound pronunciation disorders, but by a systemic delay and distortion of cerebrogenesis of the brain systems.

E.F. Sobotovich, L.V. Lopatina note in children with an erased form of dysarthria the underdevelopment of the grammatical structure of speech: from a slight delay in the formation of the morphological and syntactic systems of the language to pronounced agrammatisms in the expressive system

speech. One of the reasons for the insufficient formation of the grammatical structure of speech in this category of children, in their opinion, is a violation of the differentiation of phonemes. A similar point of view is shared by N.V. Serebryakova, who points out the presence of lexicogrammatical underdevelopment of speech and disorders of coherent speech in preschoolers with an erased form of dysarthria. However, other researchers do not agree with this point of view (R.I. Martynova, G.V. Gurovets, etc.) and argue that these violations are not obligatory, they can manifest themselves in the presence of certain unfavorable factors.

Neuropsychological researchers find in children with an erased form of dysarthria a violation of the correlation between the word-name and the image of the object. Some children exhibit unformed and poor independent speech production and a delay in the development of the generalizing and regulating function of words.

A number of authors (R.I. Martynova, E.F. Sobotovich, L.V. Lopatina, etc.) reveal the peculiarities of the formation of a number of higher mental functions and processes in children with an erased form of dysarthria: weakening of mental activity according to the type of asthenia with a pronounced decrease in the functions of attention and memory, difficulties in generalizing, classifying, determining the logical sequence of events in story series, disturbances in establishing cause-and-effect relationships.

Some researchers (O.A. Krasovskaya, A.V. Semenovich, etc.) have identified defects in the selectivity of visual memory, perception, and spatial representations as typical symptoms of an erased form of dysarthria. Thus, O.A. Krasovskaya points to violations of visual recognition of objects: fragmented perception of object images, violations of simultaneous gnosis and insufficient visual control. She notes that when studying the drawings of these children, the violations identified are of a different nature: from the complete collapse of visual-constructive activity, the inability to carry out a drawing either according to instructions or according to a model, to distortion of individual details, sizes, and incorrect location in space. (rotate 90 degrees). A.V. Semenovich speaks about the tendency towards inversion of the vector of visual perception (from right to left, from bottom to top) and left-side ignoring.

Researchers studying this problem conducted observations primarily of preschool children. Nevertheless, some of them (R.I. Martynova, M.P. Davydova, etc.) indicate possible difficulties in teaching children with an erased form of dysarthria at school.

L.V. Lopatina and N.V. Serebryakova write that children with an erased form of dysarthria, even by the age of 7, are not sufficiently prepared to master the school curriculum in the Russian language. According to R.I. Martynova, dysgraphic errors are observed in writing in children with an erased form of dysarthria.

Thus, the literature notes the presence of the following symptoms of an erased form of dysarthria in children: neurological symptoms, insufficiency of visual gnosis, spatial representations, memory, impaired motor skills, prosodic aspects of speech, low level of development of sound pronunciation, phonemic perception, lexico-grammatical aspects of speech, connected speech. The mental development of these children proceeds according to a specific type and is characterized by a system-dynamic delay and distortion in the formation of a number of higher mental functions and processes.

To organize effective correctional work, it is necessary to determine the dominant symptoms that are required for the symptom complex in the erased form of dysarthria, and the secondary ones that manifest themselves in the presence of certain conditions, and also to have a good understanding of the influence of the mental development characteristics of this category of children on the development of reading and writing,

Humans are distinguished from animals by organized and structured speech, which has many functions. Every person is taught to speak from birth. If various forms of deviations and causes of speech deformation occur, which are symptoms of diseases, then the child is referred for correction or treatment. Dysarthria is one such disorder that needs to be addressed with the help of specialists.

Already at an early age it can be noted that the child has speech impairment. At the stage of formation of the articulatory apparatus, this fact is difficult to establish, since all children find it difficult to pronounce words and phrases correctly. However, over time this becomes obvious. First of all, you can contact a speech therapist so that he can diagnose the child’s speech and establish a diagnosis.

What is dysarthria?

What is dysarthria? This is a speech disorder in which the child pronounces sounds, words, phrases, and syllables incorrectly (distorted or difficult). Scientists call the cause of this disorder brain damage or various disorders in the articulatory apparatus:

Innervation of the vocal cords, muscles of the soft palate or facial muscles as a result of various diseases, such as cleft palate or cleft lip.
Lack of teeth.

A consequence of speech dysarthria is the development of writing, when a child cannot learn to write correctly due to incorrect pronunciation of sounds and syllables. In severe forms, dysarthria takes on the form of speech that is incomprehensible to others. As a result, the child becomes withdrawn and isolated, and the tendency to develop writing skills is disrupted.

Causes of dysarthria

Doctors say that the main cause of dysarthria is brain damage, which results in innervation of the articulatory apparatus - the organs that are involved in creating speech are not very mobile. These include lips, tongue, palate, vocal cords, etc.

If dysarthria manifests itself in adults, then they do not have impairments in writing and reading. These functions are retained. However, the appearance of dysarthria in children leads to disorders in writing and reading. The child initially becomes incapable of any form of speech. In this case, oral speech is devoid of smoothness, accompanied by changes in tempo (it speeds up, then slows down), and a broken breathing rhythm.

The following classification of dysarthria is distinguished:

Hidden. It has blurred symptoms, so it is confused with dyslalia, from which dysarthria differs in the focus of neurological symptoms.
Expressed. Its main symptoms are incomprehensibility, inarticulateness, lack of expression in intonation, breathing, voice, as well as impaired sound pronunciation.
Anarthria is a complete lack of sound reproduction.

Other causes of dysarthria in children may include:

Toxicosis during pregnancy.
Improper development of the placenta.
Incompatibility of Rh factors.
Viral diseases during pregnancy.
Rapid or prolonged labor.
Infectious diseases of the brain in a newborn.

Other causes of dysarthria in adults include:

Vascular insufficiency.
Suffered a stroke.
Genetic, progressive or degenerative diseases of the nervous system (Huntington's disease,).
Tumor or inflammation of the brain.
Multiple sclerosis.
Asthenic bulbar palsy.

Dysarthria is divided into degrees of severity:

Mild – violation of fine motor skills, movements of articulatory organs, pronunciation of sounds. Speech is unclear but understandable.
Severe – associated with cerebral palsy.

Less common causes of dysarthria are:

Overdose of medication.
Carbon monoxide poisoning.
Head injuries.
Intoxication due to drug or alcohol abuse.

Dysarthria in children

Dysarthria often manifests itself in children, which has unique forms of manifestation. It can be recognized by:

Difficulty in pronouncing all sounds. Children distort and distort them.
Difficulty chewing and swallowing.
Underdevelopment of fine and gross motor skills: it is difficult to jump on one leg, fasten buttons, cut out of paper.
Difficulties with mastering written speech.
Difficulties in using prepositions and writing sentences.
Voice disorder, changes in intonation, rhythm and tempo of speech.

The combination of all disorders that are observed in a child with dysarthria differs depending on the severity of the disease, degree, focus of damage to the nervous system and time of development. Speech, motor and mental disorders in this category of children differ.

Such children should be educated in specialized schools, where they first diagnose and clarify the type and degree of the disease, after which an individual approach to teaching the child is applied.

Forms of dysarthria

There are various forms of dysarthria:

Bulbar - manifests itself in a decrease in muscle tone, atrophy or paralysis of the muscles of the tongue and pharynx. Speech becomes slurred, slow, and unclear. Occurs due to tumors or inflammation in the medulla oblongata. People with this form of dysarthria have low facial activity.
Subcortical – manifests itself in impaired tone and involuntary muscle movements (hyperkinesis). In a calm state and in an environment with friends and loved ones, the child pronounces words, sounds, and phrases incorrectly. The situation gets worse if the child finds himself in a stressful environment - he cannot utter a single syllable. Intonation, tempo and rhythm change. Speech becomes either fast or slow, with a large gap between words. Defects in sound production and communication skills develop. Hearing loss may also develop.
Cerebellar - manifests itself in chanting or shouting sounds. Occurs rarely.
Cortical - manifests itself in the pronunciation of entire phrases and sentences. There are pauses between words, as if stuttering. If speech is intense, then various modifications of sounds occur. At the same time, the child pronounces individual words without difficulty.
Worn (light).
Pseudobulbar - most often manifests itself as a result of various injuries during childbirth or intoxication. The mild form is expressed by slow and difficult speech, which is explained by low mobility of the lips or tongue. The severe form is expressed by complete immobilization of the speech apparatus, facial expression, limited lip movements, and an open mouth.

Erased dysarthria

Quite often, erased dysarthria occurs, in which the main characteristic signs are:

Poor diction.
Slurred and unexpressive speech.
Replacement and distortion of sounds.

This form of dysarthria was first described by O. Tokareva, who pointed out that individual pronunciation of sounds in children does not cause difficulty, but their pronunciation in complex words and phrases already leads to distortion. Speech becomes blurred, indistinct, and slurred.

Damage to the brain leads to the development of erased dysarthria. It is usually detected at 5 years of age. If dysarthria is suspected, the child should be taken to a neurologist who will diagnose the disease and then prescribe treatment. Correctional therapy is poorly developed, but it includes a complex of medications, psychological and pedagogical work and speech therapy assistance.

In addition to the replacement or absence of sounds, the child may experience an inability to learn self-care skills, impaired gross motor skills, and an inability to keep the mouth closed due to lax jaw muscles.

Pseudobulbar dysarthria

Infectious diseases or head injuries suffered at an early age lead to the appearance of pseudobulbar dysarthria, which is characterized by impaired speech motor skills, sucking reflex, and swallowing. Facial muscles are flaccid, salivation is observed from the mouth.

Depending on the severity, the following forms of pseudobulbar dysarthria are distinguished:

The mild form manifests itself in imprecise, slow, unexpressed speech. There are also disturbances in swallowing and chewing. Sounds are difficult to pronounce and lack voice.
The average form is characterized by amicity and laxity of the facial muscles. Children find it difficult to stretch their lips forward or puff out their cheeks. The tongue also becomes almost motionless. The soft palate also practically does not participate in sound production.
The severe form (anarthria) is manifested by complete muscle paralysis. The face is mask-like, the jaw hangs down, the mouth is open. Speech is practically absent and inarticulate.

Diagnosis of dysarthria

Dysarthria should not only be diagnosed, but also differentiated from other diseases such as dyslalia and aphasia. The doctor bases his conclusions on the skills that should already be observed in the child being tested. If the baby does not speak yet, then pay attention to his cry. In those suffering from dysarthria, the cry is quiet and nasal. There may be sagging of the lower lip and asymmetry of the facial muscles. The child may not take the breast into his mouth, choke on milk, or turn blue.

Over time, the child's inability to pronounce sounds appears. He also has problems with swallowing and chewing. The older the child gets, the more various deviations are noted:

Slow speech.
Poor articulation.
The presence of synkinesis.
Prosodic disorder.
Difficulty maintaining and switching articulation.
Violation in the pronunciation of sounds and their automaticity.

Treatment of dysarthria

The main direction in the treatment of dysarthria is the restoration of the functions of correct articulation so that the child can continue to communicate and learn calmly. Everything happens in three ways: taking medications, exercise therapy and speech therapy work. Here, voice disorders, speech breathing and articulation disorders are eliminated.

Among the medications prescribed are nootropics: Encephabol, Glycine, etc. Therapeutic gymnastics includes exercises that develop facial muscles. The main method of treatment is massage, where all the muscles of the articulatory apparatus are worked. Breathing exercises by A. Strelnikova are actively used.

The child must practice pronouncing sounds, words and sentences. This can be done either independently or with a speech therapist. In addition, the emphasis is on developing motor skills and eliminating other dysfunctions.

Correction of dysarthria

It is not possible to cure dysarthria on your own. In addition to therapeutic measures, you can resort to dolphin therapy, touch therapy, isotherapy, sand therapy, etc. Correction of dysarthria depends on the severity of the disease. Basically, a speech therapist works with the patient, who develops his articulatory apparatus, breathing, facial muscles, etc.

Corrective work is divided into the following stages:

Massage when the facial muscles are developed.
Exercises to develop articulation.
Automation in sound pronunciation.
Correct pronunciation of sounds.

Forecast

Dysarthria is cured depending on the measures taken during treatment. Prognosis remains varied, depending on the causes and the ability of doctors to eliminate the factors of the disease.

Much falls on the shoulders of parents, who must also follow doctors’ recommendations and support their child. You should give him love and understanding, and also praise him for any small achievements.

The erased form of dysarthria or pseudobulbar is a violation of speech activity due to articulation disorders with lesions of the nervous system. Deviations in this form of dysarthria are difficult to identify without the help of a specialist. A characteristic manifestation is clarity in the pronunciation of isolated sounds, but poor differentiation and automation of pronunciation during speech flow. Obvious symptoms of erased are:

slurred speech;
difficulties with diction;
distorted pronunciation of sounds;
automatic replacement of syllables based on pronunciation adjacency.

What is erased dysarthria?

Modern speech therapy cannot give an unambiguous definition of the term “erased dysarthria.” It is believed that this is a pathological disease, which manifests itself in the distortion of phonetic prosodic components of speech activity, due to the presence of microorganic effects on the brain.

This concept appeared in the scientific literature relatively recently, and it was introduced by O. Tokareva, who designated erased dysarthria as a form of the disease that has mild symptoms. The presence of erased dysarthria can be detected only after reaching 5 years of age. The disease requires long-term complex treatment in combination with individual speech therapy. There are no universal methods of correction work yet, but the presence of the disease can be diagnosed at an early stage of development. The complex of therapy methods includes:

drug treatment;
psychological and pedagogical correctional work;
speech therapy classes.

The most common causes of the disease in children are:

intrauterine development disorders;
infectious diseases of the brain;
injuries received during childbirth.

Symptoms of manifestation

Modern speech therapy identifies symptoms of the disease in children at three levels: general motor skills, fine motor skills of the hands and articulatory apparatus.

Modern speech therapy considers characteristic signs of the development of the disease in children to be unclear pronunciation, involuntary changes in movements and weakness of articulatory muscles in the process of speech activity and exercises.

Pronunciation of sounds

The symptoms of the disease are similar, as is dyslalia (difficulty with sound pronunciation). During the initial examination of children, distortion, replacement and mixing of sounds are observed, but prosodic disturbances occur only in the erased form.

The main difference between the disease is the correct pronunciation of isolated sounds. An obvious sign of the disease is difficulty pronouncing whistling and hissing sounds. The articulatory apparatus is not able to distinguish between sounds according to an adjacent method of formation, therefore overtones of acoustically opposed sounds are observed. The sound content of speech is simplified and assimilation of sound structures occurs.

General development of the speech apparatus

Conventionally, children with erased dysarthria can be divided into 3 groups:

Patients with difficulties in differentiating sounds and prosody. The level of development of the speech apparatus in such children is at a high level, and the disease manifests itself in difficulties in using prepositions. A disorder in the pronunciation of complex syllable structures is accompanied by a lack of spatial orientation.
There is a violation of the development of phonemic hearing against the background of prosody and difficulties with the pronunciation of sounds. The speech contains lexical and grammatical errors. There is no sound differentiation skill.
Polymorphic deviations in the differentiation of sounds and underdeveloped phonemic perception are characteristic of the third group. Vocabulary and lack of knowledge of grammar are combined with difficulties in constructing syllable structures.

Patients are unable to clearly express their thoughts. Against the background of difficulties with articulation, a perception disorder develops, which subsequently leads to the development of mental disorders.

Erased form of dysarthria.

Dysarthria is a violation of the sound-pronunciation side of speech, caused by organic insufficiency of innervation of the speech apparatus. The term "dysarthria" is derived from the Greek words arthson - articulation and dys - particle meaning disorder.

This is a neurological term because... Dysarthria occurs when the function of the cranial nerves of the lower part of the brainstem, responsible for articulation, is impaired.

The erased form is one of the forms of dysarthria.

IN Lately In the process of speech therapy practice, we are increasingly encountering children whose speech disorders are similar to the manifestations of complex forms of dyslalia (dyslalia is a lack of sound pronunciation), but with longer and more complex dynamics of learning and speech correction. A thorough speech therapy examination and observation reveals a number of specific disorders in them:

Movement disorders

Spatial gnosis,

The phonetic side of speech (in particular, the prosodic characteristics of speech),

Phonations,

Breathing

and others, which allows us to conclude that there are organic lesions of the central nervous system.

The experience of practical and research work shows that it is very often difficult to diagnose mild forms of dysarthria, differentiate it from other speech disorders, in particular dyslalia, in determining the ways of correction and the amount of necessary speech therapy assistance for children with an erased form of dysarthria. Considering the prevalence of this speech disorder among preschool children, we can conclude that at present a very urgent problem has arisen - the problem of providing qualified speech therapy assistance to children with an erased form of dysarthria.

Mild (erased) forms of dysarthria can be observed in children without obvious movement disorders who have been exposed to various unfavorable factors during the prenatal, natal and early postnatal periods of development. Among these unfavorable factors are:

Toxicosis of pregnancy;

Chronic fetal hypoxia;

Acute and chronic diseases of the mother during pregnancy;

Minimal damage to the nervous system in Rh conflict situations - mother and fetus;

Mild asphyxia;

Birth injuries;

Acute infectious diseases of children in infancy, etc.

The impact of these unfavorable factors leads to the emergence of a number of specific features in the development of children.

In the early period of development, children with an erased form of dysarthria experience motor restlessness, sleep disturbances, and frequent, causeless crying. Feeding such children has a number of peculiarities: there is difficulty in holding the nipple, rapid fatigue when sucking, babies refuse the breast early, and burp frequently and profusely. In the future, they become poorly accustomed to complementary feeding and are reluctant to try new foods. At lunch, such a child sits for a long time with his mouth full, chews poorly and reluctantly swallows food, hence frequent choking while eating. Parents of children with mild forms of dysarthric disorders note that in preschool age they prefer cereals, broths, and purees to solid foods, so feeding such a child becomes a real problem.

A number of features can also be noted in early psychomotor development: the formation of static-dynamic functions may be somewhat delayed or remain within the age norm. Children, as a rule, are somatically weakened and often suffer from colds.

The anamnesis of children with an erased form of dysarthria is burdened. Most children under 1-2 years of age were observed by a neurologist, but later this diagnosis was removed.

Early speech development in a significant proportion of children with mild manifestations of dysarthria is slightly delayed. The first words appear by 1 year, phrasal speech is formed by 2-3 years. At the same time, for quite a long time, children’s speech remains illegible, unclear, and understandable only to parents. Thus, by the age of 3-4 years, the phonetic aspect of speech in preschoolers with an erased form of dysarthria remains unformed.

A thorough neurological examination of children with similar speech disorders using functional loads reveals mild microsymptoms of organic damage to the nervous system. These symptoms manifest themselves in the form of motor disorders and extrapyramidal insufficiency and are reflected in the state of general, fine and articulatory motor skills, as well as facial muscles.

The general motor sphere of children with an erased form of dysarthria is characterized by awkward, constrained, undifferentiated movements. There may be a slight limitation in the range of movements of the upper and lower extremities; with functional load, conjugate movements (syncenesis) and disturbances in muscle tone are possible. Often, with pronounced general mobility, the movements of a child with an erased form of dysarthria remain awkward and unproductive.

Insufficiency of general motor skills is most clearly manifested in preschoolers with this disorder when performing complex movements that require precise control of movements, precise work of various muscle groups, and correct spatial organization of movements. For example, a child with an erased form of dysarthria, somewhat later than his peers, begins to grasp and hold objects, sit, walk, jump on one or two legs, runs awkwardly, and climbs on a wall bars. In middle and senior preschool age, it takes a long time for a child to learn to ride a bicycle, ski and skate.

In children with an erased form of dysarthria, disturbances in fine motor skills of the fingers are also observed, which are manifested in impaired accuracy of movements, a decrease in the speed of execution and switching from one pose to another, slow initiation of movement, and insufficient coordination. Finger tests are performed imperfectly, and significant difficulties are observed. These features are manifested in the child’s play and learning activities. A preschooler with mild manifestations of dysarthria is reluctant to draw, sculpt, or play ineptly with mosaics.

Features of the state of general and fine motor skills are also manifested in articulation, since there is a direct relationship between the level of formation of fine and articulatory motor skills. Disturbances in speech motor skills in preschool children with this type of speech pathology are caused by the organic nature of the damage to the nervous system and depend on the nature and degree of dysfunction of the motor nerves that ensure the process of articulation. It is the mosaic nature of the damage to the motor conducting cortical-nuclear pathways that determines the greater combinability of speech disorders in the erased form of dysarthria, the correction of which requires the speech therapist to carefully and detailed develop an individual plan for speech therapy work with such a child. And, of course, such work seems impossible without the support and close cooperation with parents interested in correcting their child’s speech disorders.