Dangerous silence: how to recognize alalia in a child. Motor alalia in a child: symptoms, causes and treatment Childhood alalia disease

Alalia – neurological disease, in which the child has underdeveloped speech or no speech at all. This pathology is accompanied by hearing or brain impairment. Alalia is characterized by congenital or acquired at an early age (up to 3 years) impairment of impressive or expressive speech. More often, the pathology is diagnosed in boys and is detected mainly in preschool children.

In medicine, there are two forms of the disease: sensory and motor. They are classified depending on which part of the speech is affected.

Sensory alalia is a pathological condition of a child in which he cannot normally perceive the speech of others, while his hearing is impaired. in perfect order. This form of the disease is provoked by damage to the part of the cerebral cortex that is responsible for the auditory speech analyzer. Quite often there is a delay in brain development and mental retardation may occur.
Often children with a sensory form of the disease can form primitive words. However, they are not able to use diminutives. In most cases, patients pronounce words in which letters or syllables are rearranged, which makes speech difficult to understand.

Motor alalia is a child’s speech disorder that occurs as a result of dysfunction of the area of ​​the brain where the nerve endings of the speech motor analyzer are closed. In this case, the patient hears and understands the speech of others well, but he himself is not able to master conversational skills. Due to articulation disorders, the child is not able to pronounce letters and syllables and replaces them with simpler (primitive) sounds.

Reasons for the development of alalia

The main reason for the development of alalia is brain injury, which the child may receive during birth. Predisposing factors are asphyxia, the birth of a premature baby, prolonged or rapid labor, as well as the use of obstetric instruments to remove the fetus from the birth canal.

Sometimes brain damage occurs during perinatal development. Most often, the pathology is provoked by the threat of miscarriage, abdominal trauma with damage to the fetus, the presence of somatic diseases in the pregnant woman - hypertension or hypotension, pulmonary, cardiac or respiratory failure. Intrauterine infection of the fetus significantly increases the risk of developing pathology.

Less commonly, alalia develops in the first years of a child’s life (up to 3 years). The reason for this may be a previous neuroinfectious disease and other unfavorable factors. As a rule, these are traumatic brain injury, encephalitis, hypertension, etc. Alalia can also be caused by a history of acute respiratory viral infection, pneumonia with complications, or previous anesthesia. The situation can also be aggravated by an unfavorable social situation - lack of communication, lack of proper education, etc. In some cases, a disorder can provoke pathology metabolic processes And .

Alalia symptoms

The clinical picture of the disease may differ depending on the form and severity of the disease. The most common symptoms of the disease are complete absence speech or speech dysfunction.

The main signs of motor alalia are:

The child’s vocabulary is significantly below the norm typical for a particular age group. As a rule, these are everyday terms that are regularly used in everyday life. Patients remember new words with difficulty. Due to a small vocabulary, the child is not able to compose a long, complete sentence, cannot describe the event and convey the meaning of what is happening.

The main symptoms of sensory alalia:

Diagnosis of alalia

Diagnosis of the disease is performed by a speech therapist and a neurologist; in some cases, additional consultation with a psychologist and ENT specialist is required. The first specialist assesses the degree of damage to the speech apparatus and analyzes its functioning. The doctor clarifies the nature of childbirth, analyzes the timing of speech and psychomotor development.

The neurologist determines what disorders exist in the child’s intellectual development and establishes the patient’s neurotic mood. To assess the extent of brain damage, an EEG, MRI of the head and X-ray of the skull are performed. An otolaryngologist examines hearing function using audiometry and otoscopy.

It is important to differentiate alalia from hearing loss, mental retardation and other pathologies that have similar symptoms.

Alalia treatment

Treatment of alalia is complex and includes several areas. First of all, work is carried out with a speech therapist, the main objective which to correct the child’s speech skills. For this purpose, individual programs designed for a specific child are created. Treatment is carried out in special centers, sanatoriums or in an inpatient neuropsychological hospital.

Drug therapy includes taking vitamin preparations, which must contain vitamins B5 and B12. Drugs that improve brain function are often used.

Additionally, physiotherapeutic procedures are carried out: magnetotherapy, laser therapy, hydrotherapy, acupuncture, etc. Specialists work together to improve memory, attention and normalize behavior. In case of motor alalia, it is artificially replenished lexicon child, speech activity is stimulated and work is carried out on the pronunciation of sounds and the formation of their speech.

During treatment, the child is constantly monitored by a pediatrician and neurologist. This allows you to assess the dynamics of recovery, promptly identify complications and adjust therapy.

Prevention of alalia

Protecting the child's head from injury will help prevent the development of alalia. First of all, this concerns the period of childbirth and newborns. Injuries at this age can lead to irreversible consequences and provoke not only alalia, but also other, more complex pathologies.

Alalia is the absence or underdevelopment of speech due to organic damage to the speech areas of the cerebral cortex in prenatal or early period child development.

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

Etiology and pathogenesis are varied: inflammatory processes and brain injuries, nutritional-trophic, metabolic disorders in the prenatal and early postnatal period of child development.

There are two main variants of alalia.

Alalia motor(motor) - underdevelopment of expressive speech, expressed by difficulties in mastering the active vocabulary and grammatical structure of the language with a fairly intact understanding of speech; based on MA there is a disorder or underdevelopment of the analytical-synthetic functioning of the speech motor of the analyzer, expressed, in particular, by the replacement of subtle and complex articulatory differentiations with coarser and simpler ones; cause- damage to the cortical end of the speech motor analyzer (Broca's center) and its pathways.

Alalia is sensory(feeling, sensation) - underdevelopment of impressive speech, when there is a gap between the meaning and the sound shell of words; The child has impaired understanding of the speech of others, despite good hearing and intact ability to develop active speech; reason SA is a lesion of the cortical end of the auditory-speech analyzer (Wernicke's center) and its pathways.

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

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

1 : all subsystems of the language are in their infancy and functional. abnormal; use non-verb. facilities. M\b single word. sentences and pseudo-sentences, root words; takes advantage of the situation. speech.

2 : the beginnings of common usage. speech (simple phrasal speech; appearance of two-part. offer. Observation words, word formation, agreement, agrammatisms, willow. paraphasia, adv. syllable structure.

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

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

Etiology of aphasia Af may have different etiologies: vascular; traumatic (traumatic brain injury); tumor . Vessel brain lesions have different names: strokes, or cerebral infarctions, or cerebrovascular accidents. They are divided into subtypes. Basics types of strokes (cerebral infarctions, cerebrovascular accidents) ischemia and hemorrhage. The term "ischemia" means "starvation". The term “hemorrhage” is “hemorrhage” (from the Latin gemorra - blood). “Starvation” (ischemia) leads to the death of brain cells, because they are left without the main “food” - blood. Hemorrhage (hemorrhage) also destroys brain cells, but for other reasons: either they become filled with blood, or a blood sac, a hematoma, forms at the site of the hemorrhage. Brain injuries being open and closed. Both of them destroy the brain, including speech zones. When open. brain injuries, they resort to surgical intervention to clean the wounds, for example, from shrapnel bone tissue, blood clots, etc.), when closed. In injuries, surgical intervention (cranial trepanation) can be performed, and conservative treatment can be applied, in which therapy is designed mainly for the resorption of intracranial hematomas .

Brain tumors Mb benign and malignant. Zlokach-e excellent. faster growth. Just like hematomas, tumors compress the substance of the brain, and by growing into it, they destroy nerve cells. The most severe consequences of local brain lesions of any etiology are disorders of: a) speech and other mental functions (orientation in space, the ability to write, read, count, etc.); b) movements. They can be present simultaneously, but they can also appear in isolation: the patient may have movement disorders, but speech disorders may not be present, and vice versa.

Types of af:-

Amnestic, Motor. Dynamic. Sensory. Total.

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

2 .Motor. af.- violated oral speech due to speech apraxia (violation of goal-directed actions, performance of only elementary movements). The articulation (tongue, jaw, lips, larynx) functions normally. It is customary to distinguish between full and partial motors. af. With complete speech, speech is almost completely lost, the patient switches to gesticulation. With partial pronunciation of short, simple words (usually verbs and nouns), words are distorted, some words are skipped, and it becomes difficult to select words to express thoughts. Speech slows down and the same words or sounds are repeated often. MA greatly affects the ability to read and write; the spelling of words fully reflects impairments in oral speech (omission, distortion of words, etc.). The occurrence of MA is associated with damage to the cortex of the third frontal gyrus of the left hemisphere of the brain (Broca's area) and adjacent areas. Therefore, it is often also called Broca's aphasia .

3 .Dynam-aya af.- damage to the scalp. brain in areas adjacent to Broca's center - in the posterior frontal regions of the left hemisphere. The patient cannot utter a long phrase because he is unable to construct long semantic chains of words. Prepositions and pronouns disappear from speech, nouns remain in nominative case.

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

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

Motor alalia is a systemic underdevelopment of expressive speech (active oral utterance) of a central organic nature, caused by damage to the speech zones of the cerebral cortex in the prenatal or early period of speech development. This violation is due to the immaturity of linguistic operations in the process of generating speech utterances with the relative preservation of semantic and sensorimotor operations.

Causes of motor alalia:

Birth injuries and asphyxia.

Intrauterine encephalitis and meningitis.

Unfavorable development conditions.

Fetal intoxication.

Congenital burden.

Intrauterine or early lifetime brain injuries.

Diseases early childhood with burden on the brain.

Motor alalia is not just a temporary delay speech development. The entire process of speech development with this disorder takes place under conditions pathological condition CNS. Individual manifestations of motor alalia appear outwardly similar to normal development child at an earlier stage.

Motor alalia is a complex syndrome, a complex of speech and non-speech symptoms, the relationships between which are ambiguous. In the structure of speech defects in motor alalia, the leading ones are language disorders.

Symptoms of motor alalia:

Speech:

Children suffering from this form of alalia have sufficient pronunciation capabilities, but they are not able to use them. The disorders are phonemic in nature; the operation of selecting a sound to form a speech utterance is impaired. In the speech of motor alalitics, literal paraphasia (replacement of a sound in a word with another), perseveration (obsessive reproduction of sounds or words), and elision (loss of sounds) abound.

There are also violations of the semantic aspect of speech. These children have significantly more words in their passive vocabulary than they use in active speech. There is a predominance of subject vocabulary, while the verb vocabulary is sharply limited, both the understanding of verbs and the use in speech.

Children replace some words with others that are close in meaning and included in the same associative field with them, for example, instead of the word table they say chair, etc. Contamination can be observed in speech when a child in speech combines syllables belonging to different words into one for example, the word “trashet” means the tractor is plowing.

Violation of the grammatical structure of speech is manifested in incorrect agreement of words in number, gender, case, and tense. Children omit prepositions in their speech. Most motor speakers understand spoken speech at the nominative level (they mostly know the names of objects).

Non-speech:

Severe neurological disorders are observed:

· Oral apraxia (motor disorders of purposeful movements and actions of the facial muscles with a disorder of complex movements of the lips and tongue).

· General motor clumsiness; children with motor alalia have impaired balance.

· Impaired fine motor skills.

· Signs of minimal brain dysfunction.

· pronounced vegetative-vascular changes.

Psychopathological symptoms:

· Speech negativism (reluctance to speak) is very characteristic.

· Mental development of children in varying degrees lags behind the norm.

· Higher mental functions (memory, attention, thinking, etc.) are formed unevenly.

· Local lesions of the cerebral cortex also affect nearby speech areas.

· It is difficult to program one’s actions, and there is a decrease in the arbitrariness of actions.

· Children can be inhibited, but more often they are disinhibited and impulsive.

· Poorly adapt to the conditions that surround them.

· There is a pronounced lack of formation of game actions.

· Children are touchy, withdrawn and often aggressive.

IN Lately Speech therapists and neurologists diagnose motor alalia much more often than it should be. Motor alalia is something like a common diagnosis of acute respiratory viral infections and acute respiratory infections; all non-speaking children are automatically registered as motor alalia, although they are not always such.

Alalia in children– in a strict sense means the complete absence or pronounced deficiency of speech, which manifests itself with normal hearing and primary intact intelligence, which allows children to successfully explore the world and learn. Common reasons This disease is caused by damage during childbirth to areas of the left hemisphere of the brain that control language abilities, brain diseases or brain injuries suffered by the baby in infancy, in other words, in the pre-speech period.

Alalia is manifested by the late appearance of speech reactions, agrammatism, poverty of vocabulary, violations of syllabic structure, phonemic processes and defects in sound pronunciation. Determining the area of ​​brain damage is of great importance for identifying the form of alalia. So, for example, when the fronto-parietal part is injured, it is possible to diagnose motor alalia in the baby, if damaged temporal region– sensory alalia. Different forms of speech deficiency are characterized by completely different clinical features and the children’s future capabilities. However, such a division of the disease is conditional, since in clinical practice There are combinations of manifestations of sensory and motor speech alalia.

Alalia symptoms

Impaired functioning certain parts brain leads to the emergence of alalia in children, which can manifest itself as mild speech defects, moderate or severe disorders (the child does not speak until ten, sometimes up to twelve years, or his speech is limited to a rather poor vocabulary and is characterized by ungrammaticality, despite extensive training).

Motor alalia in children is expressed:

- in a disorder of expressive speech against the background of a good understanding of addressed speech;

- in the delayed formation of phrasal speech, which begins to develop after the age of four;

- in the paucity of pre-speech stages, babbling is often completely absent.

This disease is accompanied by gross defects in grammatical structure, manifested in a lack of consistency of words in case, gender and number, rearrangement of syllables within a word, incorrect use of prepositions in speech, absence of verbal forms, etc.

Motor alalia in children is characterized by a pronounced paucity of vocabulary and is the foundation of learning skills disorders such as dysgraphia and dyslexia, spatial gnosis disorders and motor defects in the form of apraxia. In addition, alalia occurs in combination with focal and diffuse neurological symptoms, damage to the dominant hemisphere, which determines the possibility of expressive speech skills. A child with a similar pathology has mental state signs of psychoorganic syndrome are often observed varying degrees severity, which is manifested by impaired performance in combination with defects in intellectual development, attention disorder, and motor disinhibition.

Sensory speech alalia manifests itself in a deficiency in the understanding of addressed speech, a gross disorder of its phonetic aspect with a lack of separation of sounds. Children are characterized by difficulty and slowness in the formation of a comparison between a word and an object. They are unable to comprehend what is being said by their environment, as a result of which they have expressive speech very limited. Such children distort words, confuse sounds with similar pronunciations, do not listen attentively to the speech of the environment, do not respond to calls, but at the same time react to distracted noises. They experience echolalia, auditory attention is severely impaired, and at the same time, the intonation and timbre of speech remain unchanged. IN mental development manifestations of organic brain damage are observed, often they can be found in combination with mental underdevelopment.

Characteristics of alalia. The consequences of alalia can remain for a long time, often even a lifetime. In Alaliks, all speech components appear late. The grammatical structure and vocabulary, pronunciation are formed in a peculiar way, slowly and disharmoniously. By the end of infancy, babies can have a vocabulary of nine to 100 words, but this does not determine the prognosis of the disease. The vocabulary grows very slowly and at each stage of development is quite poor. In addition, distorted word constructions are characteristic:

— permutations (instead of “milk” - “mokolo”);

- perseveration - (instead of “hair” - “vovovosy”);

omissions (“moko”);

contamination (instead of the words “white and yolk” it turns out “white”).

Also, many researchers note a distortion of the syllabic structure of the word. The number of such distortions increases with speech development and as the baby gets tired. There are two types of agrammatisms: impressive and expressive. Alaliks with the motor form almost always exhibit expressive agrammatism, and with the sensory form, impressive agrammatism. The grammatical structure of speech is formed late, disharmoniously and does not have stages.

All forms of alalia are characterized by a discord between verbal and non-verbal structures of mental activity. Non-speech tasks are performed by the baby in accordance with the age period without significant difficulties (meaning and sequence of plot images, graphic analogies, etc.). A slowdown in the rate of speech formation is expressed by the delay in the onset of certain pre-speech stages. Simply put, humming, babbling, individual words and phrases in such babies are formed with a lag, and there is also a reduction in stages or a complete absence. In addition to prolongation of the development of the function, there is a long-term preservation of previously mastered stages of speech formation: egocentric speech, substitution of speech with gestures or loud non-verbal screams. Poor vocabulary, agrammatism and tongue-tiedness are also often observed.

Often, children with alalia have neurotic reactions, which are a response to an existing speech defect. In addition, children suffering from this pathology are characterized by increased fatigue, decreased attention and decreased performance. They have a secondary mental retardation. IN different periods speech formation with motor alalia, there is a lack of fluency of speech and stuttering occurs.

Corrective work for alalia should take into account the specifics of the speech disorder, the child’s personality, his interests and compensatory potential. Much attention is paid to eliminating neurotic aspects in the child’s character and nurturing a conscious, purposeful personality.

Motor alalia

Motor speech alalia occurs due to damage to Broca's center, that is, the frontoparietal region of the brain. This pathology most often occurs in children exposed to overprotection from their close circle. Overprotection may be justified. So, for example, a baby, being a newborn or an infant, suffered serious illness or was injured due to a difficult birth. In such families, children are characterized by excessive stubbornness, increased irritability and capriciousness.

Characteristics of motor alalia.

Motor alalia is manifested by a lag in the development of motor skills of the articulatory apparatus. It is quite difficult for children to make articular movements: raising their tongue up and holding it in that position, licking their lips, etc. In addition, a child suffering from motor alalia lacks self-care skills: tying shoelaces, fastening buttons independently. Movement disorder is also observed. Sick children are unable to jump on one leg, cannot walk along a log, more often stumble and fall, and are unable to move rhythmically to music. The speech of children suffering from motor alalia is characterized by several stages of speech development: from the absolute absence of speech to extensive speech with the presence of small deviations.

The speech of children with alalia of the first stage is completely incomprehensible to the average listener, for example, “you bang” means that the cup fell. To understand a child’s statements, it is necessary to take into account the specific situation, his gestures and facial expressions. Often children with this pathology are not able to express their own feelings using words or indicate what they need.

The second stage of speech development is characterized by the emergence of the ability to express some observations in a form that is clearer to the environment, for example, “tyya kutil syaik,” which means: “dad bought a ball.”

Children with the third stage of speech development use more detailed phrases containing lexical and grammatical errors.

A feature of this form of alalia is that children understand the speech addressed to them. They are able to select the desired picture of an object or living creature that the parent asks to show. Sick children understand only the lexical meaning of words and are not able to perceive their endings, prepositions and prefixes.

Due to children’s adequate response to adults’ requests and their fulfillment of simple instructions, there is a danger of missing and causing an illness. After all, parents believe that since their child understands everything, but does not speak, therefore, he is simply lazy.

Diagnosis of motor alalia is based on working with the child, when his speech potential is revealed. To clarify and supplement the diagnosis, an electroencephalogram is used. The child's hearing abilities and intellectual development are also checked.

Correction of alalia is aimed, first of all, at developing mechanisms speech activity, the creation of a speech base in the baby, which in the future will allow speech to develop spontaneously and form into a system. At all stages of correction, significant attention should be paid to developing the child’s knowledge about environment accordingly his age norm.

Motor alalia, its prognosis depends on the timeliness of diagnosis, the severity of the underlying pathology, the degree of speech impairment, the presence of competent correctional and treatment and rehabilitation work.

Sensory alalia

Children suffering from sensory alalia have the ability to form active speech and intact hearing. However, such children are characterized by a gap between the meaning and sound of words, as a result of which speech understanding suffers. Children do not understand speech, and therefore do not use it, which provokes the occurrence of associated disorders: difficulty establishing contacts with the environment, distortion visual perception, slowdown in mental development.

Often, sick children are given an incorrect diagnosis; for example, they may be diagnosed with or. Due to an erroneous diagnosis, the corrective work carried out will be inadequate.

A child with a sensory form of alalia is inattentive to sounds; he may hear quiet sounds, or may not react at all to acoustic stimuli. Such kids have great difficulty learning individual words. It is difficult for them to store them in memory. The passive vocabulary of children with this pathology is enriched very slowly; there is a dissociation between the designated object and the understanding of the meaning of the word that denotes it.

Children are often better able to perceive surrounding speech in the morning, since immediately after sleep the ability of the cerebral cortex to function is much higher. As fatigue increases, children's understanding of speech deteriorates significantly. Less common are cases where a child perceives speech better in the evening, since after a night's rest an inhibitory background may act.

Children's understanding of speech does not improve with increasing speech volume, which makes it possible to distinguish children with the sensory form of alalia from hearing-impaired children. Strong stimuli provoke the appearance of extremely protective inhibition in the brain, as a result of which underdeveloped cells are excluded from activity. Calm, quiet speech is perceived by a sick baby much better than loud speech or shouting. The use of hearing aids in alalik children also does not improve speech perception.

Often, children with this pathology have hyperacusis, expressed in increased susceptibility to sounds that are indifferent to the environment, for example, the sound of crumpling paper or dripping water. Typically, healthy people who hear such sounds do not react to them. The exception is if a person is tired or irritated.

Children suffering from sensory alalia perceive such sounds acutely and, as a result, react painfully to them: they express anxiety and complaints about ear or headache, are crying.

Alalik children are characterized by high speech activity, manifested by logorrhea, in which the baby incoherently repeats all the words known to him. The baby, not understanding the meaning, pronounces words and phrases that he heard earlier or at the moment, and the words and phrases spoken in this way are not recognized by the children and are not reinforced.

A baby with sensory alalia can listen with delight to his own speech and voice intonations. Alalik's speech is accompanied by lively facial expressions and gestures. The speech itself is characterized by expressive intonation.

Sensory alaliks are not able to control their own speech. Their statements are erroneous in content and not accurate in form. Quite often it is difficult to understand their “fiery” speech. Paraphrasy (substitution) is present in large quantities. Also, speech is filled with omissions, connecting parts different words together. The speech of a sensory alalik, in general, is characterized by increased speech activity, which occurs against the background of reduced attention to what others say and a lack of control over one’s speech. The speech of sensory alaliks cannot be used as a means of communication.

In addition to the listed symptoms, personality disorders are observed in children with a sensory form of alalia; various behavioral difficulties, secondary mental retardation. Speech skills can serve neither as a regulator nor as a self-regulator of the behavioral actions and activities of a sick child.

Corrective work for alalia, first of all, should take into account that in sensory alalia the ability to develop speech is not affected; their ability to learn speech based on hearing is affected. This is the main specificity correctional work.

Sensory alalia and its prognosis are directly dependent on the severity of the disease and the timeliness of the start of correctional work. With competent and adequate intervention from doctors, regular speech therapy classes, as well as appropriate actions from those close to them, children master speech skills at the everyday level, which will provide an opportunity for communicative interaction, learning and knowledge of the world.

Alalia in children

The primary manifestations of alalia, regardless of its form, become apparent in children at the age of two, when areas of the brain are developed to some extent, and children are trying to pronounce words. If treatment is not started in a timely manner, this disease will continue to develop in adolescents.

Significant signs of alalia in children include:

- movement disorder;

- increased irritability;

- misunderstanding of adult speech;

— lack of basic self-care skills;

— errors in cases and declensions, illegibility in numbers;

- slowdown mental development;

— communicative interaction with adults at the level of gestures.

Alalia is an insidious disease. Often, children, not understanding what the environment is saying, begin to move away from them, distance themselves and become uncommunicative, which can lead to an incorrect diagnosis. Often such children are attributed to autism or mental or mental retardation. In addition, sometimes it is not possible to determine the level of hearing.

Therefore, first of all, the task of timely identification of the problem falls on the parents’ shoulders. And to do this, it is necessary to understand the stages of speech development in children.

Also, a significant sign of a speech development defect is too slow development of speech skills, slow progress or its complete absence for a long time.

Differential diagnosis of alalia is based on several comparison criteria presented below:

- with the motor form of alalia, speech perception is intact at the perceptual level, but with the sensory form of alalia, it is deeply impaired;

— in motor alalik children, speech understanding corresponds to their age norm, and in sensory alalik children, speech understanding is impaired, but may improve slightly with visual perception of the articulation of the speaking subject;

— the hearing of children with the motor form of alalia is preserved, but with the sensory form it is impaired;

- motor alalia is characterized by the absence of echolalia; with sensory alalia, on the contrary, echolalia is present;

- motor alaliks have difficulty repeating a word or phrase, sensory alaliks repeat without difficulty, but do not realize the meaning of the spoken word;

- children with the motor form of alalia strive for non-verbal and verbal communication, children with the sensory form of alalia either do not want or simply cannot engage in communication.

Working with children with alalia, especially speech exercises, should be carried out in the form of a game. Only in this form will the correction be noticeable and will not unnecessarily tire the baby. Classes with a speech therapist should focus on developing memory and attention, the ability to distinguish one object from another, the ability to correlate and generalize objects.

Also indispensable for the formation of speech skills physical exercise and any exercises that help develop fine motor skills.

Alalia treatment

In some cases, alalia may go away without treatment as the baby grows older. But it is often impossible to do without medical and speech therapy intervention. If the correction of alalia is carried out competently and at a sufficient level, if it is started in a timely manner, then speech skills are fully formed and also improve mental capacity baby, he adapts better to real world. Timely correction allows children to further establish contacts with peers and adequately interact with adults.

The examination should be carried out comprehensively, with direct interaction between a pediatrician, neurologist and speech therapist. The most important thing is to identify the degree brain damage, since the severity of the pathology depends on this.

A mild degree of alalia is limited to speech therapy classes and home exercises, which allow you to quickly teach the baby words and grammar. Speech therapy correction various forms Alalia helps expand the vocabulary and makes the baby’s speech more literate. However, this type of treatment is only effective with systematic exercise.

In severe cases, when there are severe lesions of the speech centers, therapy may be ineffective.

To achieve maximum effectiveness, alalia is treated with: complex therapy, which includes three components:

— speech therapy sessions;

— speech therapy massage (impact on the articulatory muscles to normalize the tone of the speech muscles, which facilitates the pronunciation of sounds);

— microcurrent reflexology, the purpose of which is to activate the areas of the cerebral cortex responsible for the desire to speak, diction, vocabulary, etc.

Efficiency drug treatment has not been scientifically proven, but work on the formation of speech skills is carried out against the background drug therapy, aimed at activating the maturation of brain components. Physiotherapy, laser therapy, and hydrotherapy are also used. With alalia of any form, it is important to begin work with the development of gross and fine motor skills, the formation of cognitive mental functions, such as memory, mental activity, attention. Of great importance in the treatment of alalia are classes and work with children with alalia at home using visual materials.

All parents eagerly await their child's first words. Already at 6-7 months the baby begins to babble, and by one year he knows and can say 8-10 simple words. By 14-16 months, vocabulary expands rapidly.

If you work with your baby a lot, by this age he will already be able to speak sentences that will be completely understandable. However, there are situations when even a three-year-old child has very poor speech or no speech at all. Read the article for everything you need to know about speech development deviation - alalia in a child.

The essence of the disease

Alalia is a severe underdevelopment of speech or its complete absence, associated with damage to the speech centers of the cerebral cortex. In this case, all components of speech are impaired: both phonetic-phonemic and lexical-grammatical.

Alalia is the initial absence of speech, in which organic damage to the speech centers occurred during intrauterine development or during the first years of a child's life. The disease is diagnosed in 1-2% of preschool children; boys suffer from alalia twice as often as girls.

What are the causes of illness in a child?

All causes of alalia can be divided into 3 groups.

Disorders of intrauterine development:

• bad habits of the mother (smoking and/or alcoholism);
• maternal diseases (heart, pulmonary failure, hypotension or hypertension);
• intrauterine infections;
• hormonal disorders;
• toxicosis;
• stress;
• risk of miscarriage;
• maternal falls with fetal injury;

Complications of childbirth and perinatal pathologies:

• asphyxia of the newborn;
• intracranial birth injury;
• prematurity;
• premature, rapid or prolonged labor;
• use of obstetric aids.

Causes of alalia in early childhood (up to 3 years):

• encephalitis;
• rickets;
• frequent ARVI and;
• surgical interventions under general anesthesia;
• poor social conditions.

Symptoms and classification of alalia in children

Alalia is divided into motor and sensory; there can be a combination of both types - mixed alalia.

Symptoms of motor alalia in a child

This is the most common type of speech deviation. With motor alalia, the baby knows and understands what people are talking about. He also knows exactly what he wants to say. But speech is given to him with great difficulty.

It manifests itself as poor coordination of movements. It is difficult for a child to fasten buttons, tie shoelaces, or put together a mosaic. Such children are clumsy and inactive or, conversely, hyperactive.

The vocabulary of such children is very poor, everything age-related speaking skills appear significantly too late . Everyday nouns in the nominative case predominate. Memorizing and pronouncing new words is very difficult.

The basis of speech is simple short sentences, there is no coherent speech. It is difficult for a child to separate the main from the secondary and determine the sequence of events.
Stuttering is common.

Developmental delay occurs due to speech underdevelopment. If speech can be improved, such an alalik baby will catch up with his peers in all respects.

Sensory alalia in children - signs

With sensory alalia, it is difficult for a child to understand the speech of others, although he hears them well. Children with sensory alalia can speak well, but their speech is an incoherent set of words, they do not understand what they are talking about. They often repeat what they heard, add fragments of words and syllables, their speech is logorrhea - word salad.

In severe cases, speech understanding is completely absent. Sometimes understanding is situational. However, by changing the words in an understandable sentence, adding or replacing words, while maintaining the meaning, understanding is lost.

Severe speech impairments lead to delays in intellectual development.
Such children cannot maintain attention, are often distracted, and get tired quickly. They are impulsive, mobile or, conversely, closed and inert.

Sensory and motor alalia

Purely sensory alaliks are rare. Mixed sensorimotor alalia is more common in children, which indicates a connection between the speech-auditory and speech-motor analyzers.

Diagnosis of the disease

To diagnose alalia, doctors are involved: a neurologist, an otolaryngologist, a psychologist, and a speech therapist.

• Neurologist establishes the degree of brain damage using MRI, EEG, echoencephalography.
• Otolaryngologist identifies hearing problems using audiometry, otoscopy, and examining auditory function.
• Psychologist diagnoses auditory-verbal memory, checks the development of intelligence.
• Speech therapist checks oral speech.

The examination takes into account the course of pregnancy, the history of the newborn, the period early development baby. The timing of psychomotor and speech development is taken into account.

Treatment of alalia in children

The success of alalia treatment lies in an integrated approach. During treatment, they use the services of a psychologist, speech therapist, and use medications aimed at stimulating brain function. Vitamins and vitamin complexes are widely used.

The speech therapist helps the child increase his vocabulary, works on pronunciation and coherent speech. Techniques for comparing objects and actions help sensory learners understand the meaning of speech.

The psychologist helps correct the child’s behavior and explains to parents how they can help the child.
Alalia in children must be constantly corrected, so treatment at home is very effective. Parents should receive guidance on activities to do at home. They will be given by a speech therapist and psychologist.

Finger exercises are very helpful in treating motor alalia in children. It stimulates certain areas of the brain and has a good effect on speaking skills. If you do it correctly and regularly, your baby will start talking faster.

Parents also need to talk a lot with their baby. At the same time, your speech should be leisurely, with pauses. Ask leading questions, ask them to repeat what you said.

For sensory alalia in children, which is characterized by poor understanding of the meaning of speech, accompany your stories with pictures, make them visual and teach them to associate the sounds they hear with what they see, this is very helpful in treatment.

Such children simply need socialization. It is important to visit kindergarten or early childhood development groups.

Preventive measures

Prevention of alalia involves careful pregnancy planning. Take care of your health during pregnancy too. At an early age it is important to treat on time infectious diseases, strengthen the baby's immunity.

If you suspect any delay in your child’s speech development, contact a specialist. The earlier the diagnosis is made, the greater the chances of recovery.

Alalia in a child - video

An integrated approach and regular exercises allow you to achieve good results. Watch the work of a speech therapist with children with alalia.

Don’t ignore your baby’s speech problems; make sure that his psychomotor and speech skills are appropriate for his age. Alalia in children is quite rare, its symptoms will be noticed by every attentive parent, the prognosis for motor alalia is favorable in case of timely comprehensive treatment.