Child psychiatry

Alalia in children - motor, sensory, symptoms, treatment

Alalia in children - in the strict sense meansComplete absence or pronounced deficiency of speech, which manifests itself at a hearing that corresponds to the norm, and the primary intact intellect, which allows the children to successfully learn the world and learn. Frequent causes of this ailment is damage in the birth of areas of the left hemisphere of the brain, which control language abilities, brain diseases or trauma, suffered by the baby in infancy, in other words in the pre-war period.
Alalia appears late appearance of speechReactions, agrammatism, poor vocabulary, violations of the syllabic structure, phonemic processes and defects in soundproofing. A significant value for identifying the shape of alalia is the definition of the zone of brain damage. So, for example, when the frontal parietal part is injured, it is possible to diagnose motor alalia in crumbs, if the temporal region is damaged, sensory alalia. Different forms of speech scarcity are characterized by completely different clinics and the possibilities of toddlers in the future. However, this division of the ailment is conditional, since in clinical practice there are combinations of manifestations of sensory and motor speech alalia.

Symptoms of Alalia

Violation of the functioning of certain partsThe brain leads to the birth of alalia in children, which can be manifested by slight speech defects, moderate or severe disorders (the child does not speak until ten, sometimes up to twelve years, or his speech is limited by a rather poor vocabulary and is characterized by agramaticity, despite prolonged training).
Motor alalia in children is expressed by:
- in the disorder of expressive speech on the background of a good understanding of speech;
- in the belated formation of the phrase speech, which begins to develop after four years of age;
- in the scarcity of pre-trial stages, often babble is completely absent.
This ailment is accompanied by gross defectsGrammatical structure, manifested in the lack of consistency of words in the case, gender and number, rearrangement of syllables within a word, incorrect use of prepositions in speech, lack of verbal forms, etc.
Motor alalia in children is characterized byThe pronounced scarcity of the vocabulary and is the foundation of violations of educational skills in the type of dysgraphia and dyslexia, disorders of spatial gnosis and motor defects in the form of apraxia. In addition, alalia occurs in combination with a focal and diffuse neurological clinic, a defeat of the dominant hemisphere, which determines the possibilities of expressive speech skills. A child with a similar pathology in his mental state often has signs of a psychoorganic syndrome of varying degrees of severity, which are manifested by a disruption in performance in combination with intellectual development defects, attention deficit disorder, motor disinhibition.
Sensory speech alalia is manifested inThe scarcity of understanding speech, the gross disorder of its phonetic aspect with the absence of separation of sounds. Children are characterized by difficulty and slowing down the formation of a comparison between a word and an object. They are not able to comprehend what is said by the environment, as a result of which their expressive speech is very limited. Such babies distort words, confuse sounds similar in pronunciation, do not listen to the speech of the environment, do not respond to the call, but at the same time, the distracted noises react. They are noted echolalia, auditory attention is sharply disrupted, along with the intonation and timbre of speech remain unchanged. In the mental development, there are manifestations of organic brain damage, often they can be found in combination with mental underdevelopment.
Characteristics of alalia. The consequences of Alalia can remainA long time, often even a lifetime. Alaliki all speech components appear late. Grammatical structure and lexical stock, pronunciation are formed in a peculiar way, slowly and disharmoniously. By the end of the infancy period, babies can have a stock of words from nine to 100, but this does not determine the prognosis of the disease. The dictionary is replenished very slowly and at every stage of development it is rather poor. In addition, distorted word designs are typical:
- permutations (instead of "milk" - "mokolo");
- perseveration - (instead of "hair" - "wovose");
Omissions ("moko");
Kontominatsii (instead of the words "protein and yolk" it turns out "beltok").
Also many researchers note a distortionSyllabic structure of the word. The number of such distortions increases with the development of speech and as fatigue crumbs. There are two types of agrammatism: impressive and expressive. Alaliki with motor form reveals almost always expressive agrammatism, and with sensory - an impressive agrammatism. The grammatical structure of speech is formed late, disharmonious and has no staging.
All forms of alalia are characterized by a disorder betweenVerbal and non-verbal structures of mental activity. Non-primary tasks are performed by a toddler in accordance with the age period without expressed difficulties (meaning and sequence of plot images, graphic analogies, etc.). The slowing down of the pace of the formation of speech is expressed as a delay in the onset of certain pre-war stages. Simply put, walking, babbling, individual words and phrases in such crumbs are formed with a backlog, also the coarseness of stages or complete absence is noted. In addition to stretching the timing of the development of the function, it is inherent in the continued preservation of previously mastered stages in the formation of speech: egocentric speech, the substitution of speech with gestures or with loud non-verbal cries. Also, there is often a scarcity of vocabulary, agrammatism and tongue-tie.
Often in children with AlaliaNeurotic reactions, which are a response to the present speech defect. In addition, children suffering from this pathology are characterized by increased fatigue, reduced attention and reduced efficiency. They have a secondary delay in the development of the psyche. In different periods of speech formation in motor alalia, there is a lack of fluency in speech and stammering occurs.
Correction work in alalia should take into accountSpecificity of speech disorder, personality of the baby, his interests and compensatory potential. Much attention is paid to the elimination of neurotic aspects in the character of crumbs and the education of a conscious, purposeful personality.

Motor Alalia

Motor voice alalia is due toThe defeat of Broca's center, that is, the frontal-parietal region of the brain. A similar pathology often occurs in toddlers exposed to hyperopeak from the side of a close environment. A hyperopeak can have grounds. Thus, for example, a crumb, being a newborn or an infant, suffered a serious illness or was injured due to heavy births. In such families, babies are characterized by excessive stubbornness, increased irritability and capriciousness.
Characteristics of motor alalia.
Motor alalia is manifested by a lag inDevelopment of motor function of the articulatory apparatus. It is quite difficult for children to make articular movements: to raise their tongue and hold it in such position, to lick their lips, etc. In addition, a child suffering from motor alalia has a lack of self-service skills: tying of shoelaces, independent fastening of buttons. Movement disorders are also observed. Sick children can not jump on one leg, can not walk on a log, often stumble and fall, rhythmically unable to move to music. The speech of children with motor alalia is characterized by several stages of speech development: from absolute absence of speech, to expanded speech with the presence of small deviations.
Speech of toddlers with alalya of the first stage for the privateThe listener is completely incomprehensible, for example, "the bah" means that the cup has fallen. To understand the child's statements, it is necessary to take into account the specific situation, his gestures and facial expressions. Often kids with this pathology are not able to express their own feelings with words, to indicate what they need.
The second stage of speech development is characterized by the emergence of the ability to express in a clearer for the environment form of some observations, for example, "Tyutya kutil syayk", which means: "Dad bought a ball."
Children with the third stage of speech development use more detailed phrases containing errors of lexical and grammatical orientation.
A feature of this form of alalia is understandingChildren of speech addressed to them. They are able to choose the right picture with the object or living being, which the parent asks to show. Sick babes understand only the lexical meaning of the word and are not able to perceive their endings, prepositions and prefixes.
In connection with the adequate response of children toTreatment of adults, the performance of simple orders, there is a danger of missing and launching ailment. After all, parents believe that since their child understands everything, but does not speak, therefore, he is simply lazy.
Diagnosis of Alalia motor form is based onWork with a child when his speech potential is revealed. To clarify and supplement the diagnosis, an electroencephalogram is used. The child's auditory capabilities and intellectual development are also tested.
Correction of alalia is directed, in the first turn, toThe development of mechanisms for speech activity, the creation of a speech base for the baby, which in the future will allow speech to develop spontaneously and form into the system. At all stages of correction, considerable attention should be given to the formation of knowledge in the child about the environment according to its age norm.
Motor alalia prediction of it depends on the timeliness of diagnosis, the severity of the underlying pathology, the degree of speech impairment, the availability of competent corrective and therapeutic and recovery work.

Sensory Alalia

Toddlers suffering from sensory alalia haveAbility to form active speech and undamaged hearing. However, such children are characterized by the presence of a gap between the meaning and sound of words, as a result of which the understanding of speech suffers. Kids do not understand speech, and therefore do not use it, which triggers the occurrence of concomitant disorders: difficulty in establishing contacts with the environment, distorted visual perception, slowing down in mental development.
Often, sick children are diagnosed incorrectly, for example, they can diagnose
. Due to an erroneous diagnosis, the corrective work will be inadequate.
A child with a sensory form of alalia is inattentive toSounds, he can hear soft sounds, and may not react at all to acoustic stimuli. Such kids with great difficulty learn a few words. It is difficult for them to save them in memory. Passive dictionary of children with this pathology enriches very slowly, there is a dissociation between the indicated object and understanding the meaning of the word that it stands for.
Often children are better able to perceiveSurrounding speech in the morning, since immediately after sleep, the ability to work the cortex is much higher. As the fatigue intensifies, the children's understanding of speech deteriorates significantly. Less often there are cases when the child perceives speech better in the evening, as after a night rest the brake background can act.
Understanding of speech by children does not improve withIncreasing its loudness, which makes it possible to distinguish children from the sensory form of alalia from hearing-impaired children. Strong stimuli provoke the appearance in the brain of prohibitively protective inhibition, as a result of which underdeveloped cells are excluded from activity. Calm quiet speech is perceived by a sick crumbler much better than a loud speech or a shout. The use of hearing aids in children-alalikov also does not contribute to improving speech perception. Often in children with this pathology, there is a hyperacusis, expressed in increased susceptibility to sounds that are indifferent to the environment, for example, the sound of crumpled paper or dripping water. Usually in healthy
, Hearing such sounds, there is no reaction to them. An exception is the exhaustion of a person or an irritated state.

Children suffering from Alalia with a sensory form, perceive such sounds are acute, therefore they react painfully to them: they express anxiety and complaints about the ear or headache, cry.
Children-alaliki are characterized by high speechActivity, manifested by the logrorey, in which the crumb incoherently repeats all the words known to him. The kid, not understanding the meaning, utters the words and phrases previously or at the moment heard by him, and the words and phrases pronounced in this way are not realized by the children and are not fixed.
Crumbs with alalia of a sensory shape can with delightListen to your own speech and voice intonation. Alalik's speeches are accompanied by a live facial expression and gestures. The speech itself is characterized by expressive intonation.
Sensory alaliki are not able to controlOwn speech. Their statements are erroneous in content and not precise in form. Quite often, it is difficult to understand their "fiery" speech. Paraphrase (replacement) is present in large numbers. Also, the speech is filled with skips, connecting parts of different words with each other. Speech of the sensory Alalik, in general, is characterized by increased speech activity, which occurs against a background of reduced attention to the spoken by others and the lack of control over their speech. Speech sensory alaliki can not be used as a means of communication.
In addition to the listed symptoms of toddlers with sensoryThe form of alalia shows personality disorders; Various difficulties of behavior, a secondary lag in mental development. Speech skills can not serve as a regulator, nor a self-regulator of behavioral actions and activities of a sick child.
Correction work with alalia, in the first turn,Should take into account that sensory alalics do not suffer from the possibility of speech development, they are affected by the possibility of verbal learning on the basis of hearing. This is the main specificity of correctional work.
Sensory alalia forecast it hasDirect dependence on the severity of the ailment and timeliness of the beginning of the corrective work. With competent and adequate intervention of doctors, regular speech therapy sessions, as well as appropriate actions of a close environment, children master speech skills at the everyday level, which will give an opportunity for communicative interaction, education and knowledge of the world.

Alalia in children

The primary manifestations of alalia, regardless of itsForms become apparent in children at the age of two, when the brain regions are to some extent developed, and the babies try to pronounce the words. If you do not start treatment in time, then this ailment will continue to develop in adolescents.
Significant signs of alalia in children include:
- violation of movement;
- increased irritability;
- lack of understanding of adult speech;
- lack of basic skills of self-service;
- mistakes in cases and declensions, illegibility in numbers;
- retardation of mental development;
- communicative interaction with adults at the gesture level.
Alalia is an insidious disease. Often, children, not understanding what the environment says, begin to distance themselves from them, distance themselves and become uncommunicative, which can lead to incorrect diagnosis. Often such children are credited with autism or mental or mental retardation. In addition, sometimes you can not detect the level of hearing.
Therefore, in the first turn, it is on the parents' shoulders that the task of timely revealing the problem lies. And for this it is necessary to learn the stages of speech development of children.
Also an essential sign of a defect in speech development is too slow development of speech skills, slow progress or its complete absence for a long time.
Differential diagnostics of alalia is based on several comparison criteria, presented below:
- with the motor form of alalia at the perceptive level, the perception of speech is preserved, and when the sensory form of alalia is deeply disturbed;
- motorized children-alalikov understanding speechCorresponds to their age norm, and in sensory alalikov, understanding of speech is disrupted, but it can improve slightly with a visual perception of the articulation of the speaking subject;
- hearing in children with motor form of alalia is preserved, and with sensory - is broken;
- motor alalia is characterized by the absence of echolalia, with sensory alalia, on the contrary, echolalia is present;
- motor alaliki have difficulty in repetition of words or phrases, sensory alaliki repeat without difficulty, but do not realize the meaning of the spoken word;
- children with motor form of alalia seek nonverbal and verbal communication, kids with a sensory form of alalia either do not want, or simply can not enter into communication.
Work with children with alalia, especially speechExercises should be conducted in the form of a game. Only in this form the correction will be noticeable, and will not unnecessarily tire the baby. Classes with a speech therapist should be focused on the development of memory and attention, the ability to distinguish some objects from others, the ability to correlate and generalize objects.
Also for the formation of speech skills are irreplaceable physical activity and any exercises that promote the development of fine motor skills.

Treatment of Alalia

In some cases, alalia can pass without treatment forThe growing up of crumbs. But often it is impossible to do without medical and logopedic intervention. If the correction of alalia is carried out correctly and at a sufficient level, if it is started in a timely manner, then the speech skills are formed completely, the mental abilities of the baby are also improved, it is better adapted in the real world. Timely correction allows crumbs to further establish contacts with peers and adequately interact with adults.
The survey should be carried out in a comprehensive manner, withDirect interaction of pediatrician, neurologist and speech therapist. The most important is the detection of the degree of brain damage, because the severity of the pathology depends on this.
The mild degree of alalia is limitedSpeech therapy and home exercises, allowing you to quickly learn crumbs words and grammar. Logopedic correction of various forms of alalia promotes the expansion of the vocabulary and makes the speech crumbs more literate. However, this kind of treatment is effective only in systematic studies.
In severe cases, when there are gross lesions of speech centers, therapy may be ineffective.
To achieve maximum effectiveness, a complex therapy is used to treat alalia, which includes three components:
- logopedic classes;
- logopedic massage (influence on the articulatory muscles for the normalization of the tonus of the speech muscles, which facilitates the pronunciation of sounds);
- Microcurrent reflexotherapy, whose goal is to activate the cortical areas responsible for the desire to speak, diction, vocabulary, etc.
The effectiveness of drug treatment is not scientificallyIt is proved, but the work on the formation of speech skills is conducted against the background of drug therapy, aimed at activating the maturation of brain components. Physiotherapy is also used with laser therapy, hydrotherapy. With alalia of any form, it is important to start working with the development of general and minor motor skills, the formation of cognitive mental functions, such as memory, thought activity, attention. Great value in the therapy of alalia has classes and work with children with alalia at home using visual materials.

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