Symptoms of motor and sensory alalia in a child. Alalia - what is it? Alalia: correctional work Alalia in children, symptoms, forecasts

The most difficult in terms of treatment and symptoms among speech disorders in children is the development of alalia. Alalia or lack of speech is a condition associated with brain damage, manifested by the child’s lack of ability to speak. At the same time, such children must be distinguished from children with hearing loss and children with mental retardation. In the first case, a distinctive feature of children with alalia will be the child’s response to sounds, and in the second case, children with mental retardation have reduced intelligence, which is not restored when medical rehabilitation. In children with alalia, the mental development disorder is secondary and is associated with their alienation from the team due to lack of speech, poor perception of educational material and poor memory. When carrying out medical rehabilitation of such children, their intelligence is restored, and in most cases they become able to study according to the school curriculum.

Causes of alalia

The causes of alalia in children are associated with brain damage. This can occur both during intrauterine development and in the first year of a child’s life, when the brain is being formed, which means its structures may be susceptible to pathological effects.

During pregnancy, brain development can be affected by various factors. intrauterine infections, chronic fetal hypoxia, uteroplacental insufficiency, maternal smoking and alcohol abuse. Damage to the baby's brain can also occur during childbirth. During this time, brain damage is associated with development acute hypoxia newborn This can occur with prolonged standing of the baby's head in the pelvis, early rupture of amniotic fluid, weakness of labor, rapid labor, entanglement of the umbilical cord around the baby's neck, birth trauma, hypothermia of the baby and lack of nutrients in the first hours after birth. In the first year of a child’s life, brain damage may occur due to severe viral infections (meningo-encephalitis, rubella), traumatic injury brain (bruises, closed craniocerebral injuries).

The optimal time for diagnosing a child is 2.5-3 years of age. It is at this age that the child should develop basic vocabulary forms, he begins to correctly use numerals and case moods. In more early age Alalia can only be suspected, since the child’s speech during this period is still developing, in some children faster, in others slower. If a child exhibits any symptoms of alalia before the age of 3 years, he should be observed by a speech therapist for help in speech formation and, if there is no effect of treatment, for referral to a specialized kindergarten.

Alalia symptoms

For alalia to develop, a child must experience disruption in certain areas of the brain. Damage to two structures is of great importance in the development of this pathology. cerebral hemispheres brain: Broca's and Wernicke's centers. These brain structures are responsible for the formation of speech and understanding the speech of others. Depending on which center is affected in the child, it is customary to distinguish between motor and sensory alalia.

Motor alalia is associated with damage to Broca's center, which is responsible for speech formation. This condition most often occurs in children whose parents are overprotective of their child. This care may be associated with an illness at an early age or with a difficult birth. Children in such families are stubborn, irritable, and capricious. Children with motor alalia lack self-care skills: they cannot tie their own shoelaces or bows, they are not able to dress themselves or fasten buttons. Noteworthy general disorder movements in children: they cannot jump on one leg, are not able to walk along a log, very often stumble and fall, and cannot move rhythmically to music. Children with motor alalia are characterized by several levels of speech development: from complete absence of speech to the presence of extensive phrasal speech with minor deviations.

The speech of children with motor alalia of the first level is completely incomprehensible to the average listener: “you bang” - the cup fell. It helps to understand what the child is talking about, the specific situation in which the phrase is pronounced, the child’s facial expressions, and gestures. Most often, a child cannot express his feelings, say what he needs, so such children remain outside of verbal communication.

The second level of speech development with motor alalia is characterized by the emergence of the ability to express individual observations in a more understandable form for others: “Daddy was having fun with Katya” - Dad bought a ball for Katya.

Children with the third level speech development use more detailed statements, but they contain lexical and grammatical errors.

Distinctive feature motor alalia is the understanding of speech addressed to the child. He can choose the correct picture of the animal that he is asked to show. But there is a violation in the understanding of numbers and case declensions words The child cannot figure out what is being asked of him when he is asked to show in pictures where “the dog is bathing” and where “the dogs are bathing.” This is explained by the fact that children understand only the lexical meaning of a word and cannot perceive endings, prefixes, and prepositions. To eliminate such deviations, it is necessary to conduct classes with the child in specialized kindergartens and schools, since such children are not able to comprehend the general education school curriculum.

Sensory alalia is associated with damage to Wernicke's center, which is responsible for correctly understanding the speech of others. In this case, the child’s lack of speech is due to the fact that he does not understand the meaning of the word he heard and cannot connect it with a specific object. In this case, an incorrect diagnosis often occurs, and such children are included in the ranks of the hard of hearing, although their hearing is completely preserved. Very often, with sensory alalia, a phenomenon called echolalia is observed. In this phenomenon, the child repeats the word he just heard. However, instead of answering asked question the child simply repeats the question addressed to him. Since children do not understand the words addressed to them, they cannot correctly choose a picture of an animal from those presented, but at the same time they independently show the animal and try to name it.

To exclude hearing impairment due to sensory alalia, the child is referred to an audiologist, who tests the child’s hearing using special equipment. After ruling out hearing impairment, the child is sent to a psychiatrist and speech therapist to prescribe treatment. To exclude mental retardation in a child, a series of tests are performed, during which the child is asked to reproduce a structure based on a model. It could be a tower with bricks different color and sizes, lined with various mosaics geometric figures. A child with mental retardation is not able to cope with the task.

Children with sensory alalia are quite rare, but this condition is very difficult to correct. Only a partial improvement in the condition is possible to prepare the child for education in specialized schools for children with speech disorders.

Alalia treatment

One of the most commonly used methods of treating alalia in children is stimulation of certain areas of the skin with low-frequency current pulses. These areas of the skin are a projection of the speech areas of the brain and when they are stimulated, nerve endings are activated. However, this method of treatment does not have a scientifically proven basis and when used only this method for the treatment of children does not have any therapeutic effect, so the use of neurostimulation of speech zones is not always justified.

The most acceptable method of treatment is speech therapy massage, aimed at stimulating the muscles involved in the process of sound formation (muscles of the tongue, lips, cheeks). To do this, direct massage of these muscles is carried out using fingers or special probes, or carried out with the child. special exercises: raise your tongue up and hold it in this position, puff out your cheeks, stretch your lips into a tube.

We must not forget about physiotherapeutic treatment. In children, laser therapy, magnetic therapy, and hydrotherapy can be used; for older children, acupuncture can be used. Physiotherapeutic treatment is carried out in courses. Prescribing these procedures on an ongoing basis is unacceptable.
The treatment process is very long and requires a good knowledge of this pathology by the speech therapist who corrects the child’s speech. Most often, treatment is carried out in specialized kindergartens and schools for children with speech disorders.

Pediatrician Litashov M.V.

Motor alalia is underdevelopment or absence of speech, which is caused by organic damage to the brain (cortical speech centers) that occurred in the prenatal period of development or in children of the first years of life. In this case, the child understands someone else’s speech, but cannot reproduce it independently. This pathological condition is diagnosed in approximately 1% of children before school age, as well as in 0.2–0.6% of schoolchildren. Boys are more susceptible to motor alalia, in whom the disease is registered approximately twice as often as in girls.

Speech is an important component of a child’s neuropsychic development. The formation of speech occurs during the first years of a child’s life; in the future, this determines the quality of speech in all age periods. The speech act is carried out through a system of organs that belong to the speech apparatus. The speech apparatus consists of central and peripheral parts. The central part of the speech apparatus is represented by structures nervous system(speech areas of the cerebral cortex, cerebellum, pathways, subcortical nodes, nerves that innervate the vocal, articulatory, respiratory muscles, etc.). The peripheral part of the speech apparatus consists of the vocal apparatus (larynx with vocal cords), articulatory (lips, tongue, upper and mandible, hard and soft sky) and respiratory sections ( rib cage with trachea, bronchi and lungs).

Violations in one or another of these structures lead to the development of different types of speech disorders. The main causes of the development of motor alalia include pathologies of Broca's center and the pathways related to it. Broca's center is a region of the cerebral cortex that is located in the posterior inferior part of the third frontal gyrus of the left hemisphere of the brain in right-handed people and provides the motor organization of speech.

Causes and risk factors

Motor alalia is a polyetiological pathological condition, i.e. one that may be due to the negative impact of many factors. The main reasons that may cause organic damage speech centers of the cerebral cortex include:

infectious diseases that are contracted in utero or during childbirth;
injury to the fetus (for example, when a pregnant woman falls);
high risk of spontaneous abortion;
presence in a pregnant woman chronic diseases(arterial hypo- or hypertension, cardiac or pulmonary failure, etc.).

In addition, prematurity, newborn asphyxia, and intracranial birth trauma can lead to the development of motor alalia. In children of the first years of life, the causes of pathology include genetic predisposition, encephalitis, meningitis, some somatic diseases that lead to depletion of the central nervous system. Risk factors for the development of motor alalia may include: frequent illnesses in children of the first years of life (endocrinological pathologies, acute respiratory viral infections, pneumonia, rickets), carrying out surgical interventions under general anesthesia, insufficient speech contacts, pedagogical neglect, hospitalism (a set of somatic and mental disorders that are caused by a long stay in a hospital, separated from loved ones and home).

Motor alalia in children can lead to impairments in written speech (dyslexia and dysgraphia). In addition, patients may develop stuttering, which manifests itself as the child develops oral speech skills.

Alalia forms

According to the classification according to V. A. Kovshikov, the following forms of alalia are distinguished:

motor (expressive);
sensory (impressive);
mixed (motosensory or sensorimotor, depending on the predominance of the developmental disorder of expressive or impressive speech).

Motor alalia, in turn, depending on the location of the damaged area, is divided into:

afferent– the lower parietal parts of the left hemisphere are affected, which is accompanied by kinesthetic articulatory apraxia;
efferent– the premotor parts of the cerebral cortex are affected.

Symptoms of motor alalia

Motor alalia is characterized by the presence of both non-speech and speech symptoms.

Non-speech manifestations of pathology, first of all, include motor disorders such as insufficient coordination of movements, clumsiness, and poor development of motor skills of the fingers. Motor alalia in a child may also be accompanied by difficulties in developing self-care skills (for example, lacing shoes, fastening buttons), as well as in performing precise small movements with the hands and fingers (folding puzzles, construction sets, mosaics, etc.). Also, children with motor alalia often have disorders of memory (in particular, auditory-verbal), perception, attention, emotional and volitional spheres of personality. Patients with alalia may experience both hyperactive and hypoactive behavior. Patients typically experience fatigue and decreased performance. In addition, patients with alalia often experience disturbances in the movements of the facial muscles, increased irritability and aggression, and poor adaptation to the conditions of the surrounding world.

Speech symptoms of motor alalia in patients include:

erroneous replacement of sounds in words with others (literal paraphasia);
loss of sounds from words (elision);
persistent repetition of a word or phrase (perseveration);
limitation of vocabulary (primarily verbs, verbal forms);
combining syllables of different words (contamination); replacing words with ones that are similar in meaning or sound;
loss of prepositions from a phrase, incorrect agreement of words in a phrase.

There is an absolute predominance in the speech of a patient with alalia of nouns in the nominative case. In addition, with this pathology, complete or partial refusal of speech (speech negativism) may be observed. Against the background of the main symptoms of the pathology, the child may develop stuttering.

With afferent motor alalia, the patient is potentially able to perform various articulatory movements, but sound pronunciation is impaired.

In the case of efferent motor alalia, the main speech defect is the inability to perform a series of successive articulatory movements; this is accompanied by a strong distortion of the syllabic structure of words.

Boys are more susceptible to motor alalia, in whom the disease is registered approximately twice as often as in girls.

The vocabulary of a patient with alalia is significantly poorer age norm. The patient has difficulty learning new words; the active vocabulary consists largely of words and phrases of everyday use. Insufficient vocabulary can lead to misunderstanding of the meaning of a word and inappropriate use of words. Patients with alalia, as a rule, express themselves in simple short sentences, which leads to a gross disruption of the formation of coherent speech in the child. Patients have difficulties in determining cause and effect, main and secondary, temporary connections, conveying the meaning of events, and presenting them sequentially. In some cases, with motor alalia, the child has only onomatopoeia, babbling words, the use of which is accompanied by active facial expressions and/or gestures.

Impaired mental development in patients with alalia occurs due to speech impairment. As speech develops, these disturbances are gradually compensated.

All stages of the formation of speech skills (walking, babbling, words, phrases, contextual speech) are delayed in a patient with alalia. The development of speech skills in patients with alalia is influenced by a number of factors, among which the most important are the degree of damage to the child’s brain, the age at which the pathology was diagnosed, general development, regularity of parental activities with the child. In some cases, after prolonged speech negativism, the child begins to speak and quickly masters speech; in other patients, an early onset of the formation of speech skills is observed, but in the future speech is still long time remains scarce, other options are also possible.

Diagnostics

To diagnose motor alalia, it is necessary to examine the child by a pediatric otolaryngologist, neurologist, speech therapist, or psychologist.

When conducting a speech therapy examination of a child, significant attention is paid to collecting a perinatal history and characteristics early development patient. To diagnose motor alalia, it is necessary to assess the child’s desire to speak, determine the presence of difficulties in repeating what he heard, auditory perception, active use of facial expressions and gestures, perception and understanding of speech, and the presence of echolalia. In addition, the level of active and passive vocabulary, syllabic structure of words, pronunciation of sounds, grammatical structure of speech and phonemic perception are noted.

To assess the severity of brain damage, it may be necessary to conduct electroencephalography, echoencephalography, magnetic resonance imaging of the brain, x-ray examination skulls

For differential diagnosis with sensory alalia and hearing loss, audiometry, otoscopy and some other methods of studying auditory function are used.

Differential diagnosis with dysarthria, autism, mental retardation, and delayed speech development is required.

Motor alalia is diagnosed in approximately 1% of children preschool age, as well as in 0.2–0.6% of schoolchildren.

Treatment of motor alalia

Treatment of motor alalia is complex. The formation of speech skills is carried out against the background of drug therapy, the main purpose of which is to stimulate maturation brain structures. Patients are prescribed nootropic drugs and vitamin complexes.

Physiotherapeutic methods such as electrophoresis, magnetotherapy, laser therapy, decimeter wave therapy, transcranial electrical stimulation, acupuncture, electropuncture, and hydrotherapy are effective in the treatment of motor alalia.

An important role in the treatment of motor alalia is given to the development of the child’s gross (gross) and manual (fine) motor skills, as well as memory, thinking, and attention.

Speech therapy correction of motor alalia includes work with all aspects of speech and includes not only classes with a speech therapist, but also regular specially selected exercises at home. At the same time, the child’s active and passive vocabulary is formed, work is carried out on phrasal speech, grammar, sound pronunciation, and coherent speech develops. Good result They also provide speech therapy massage and logorhythmic exercises.

Possible complications and consequences

Motor alalia in children can lead to impairments in written speech (dyslexia and dysgraphia). In addition, patients may develop stuttering, which manifests itself as the child develops oral speech skills.

Forecast

Successful correction of alalia is most likely with early treatment (starting from 3-4 years), integrated approach and systemic impact on all components of speech. With timely and adequate treatment, the prognosis is favorable.

The degree of organic damage to the patient’s brain is of no small importance. With minor injuries, the pathology is completely curable.

Prevention

In order to prevent the development of motor alalia, all necessary conditions should be provided for the normal course of pregnancy, childbirth, as well as the health and development of the child. To achieve this, women during pregnancy are recommended to take a number of preventive measures:

When pregnancy occurs, you should register on time, undergo all necessary examinations in a timely manner and follow the doctor’s recommendations;
minimize the risk of contracting infectious diseases, promptly treat existing diseases;
avoid traumatic activities;
avoid excessive physical activity;
give up bad habits;
perform a set of gymnastics exercises for pregnant women.

To ensure normal development of the child, it is recommended:

regularly visit the pediatrician and other doctors (as necessary);
give your child the age-appropriate vaccinations (if there are no contraindications);
perform developmental exercises with your child that are appropriate for his age;
avoid injuring the child, especially head injuries;
communicate kindly with the child, pay attention to him, talk to him;
maintain normal psychological climate in family.

Video from YouTube on the topic of the article:

Alalia is a speech function disorder in which the child cannot speak partially (with a poor vocabulary and problems in constructing phrases) or completely. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Despite its rarity, the disease is more often diagnosed in boys than in girls. May have varying degrees the severity of the course - from the most serious, in which speech appears only after ten years, to a lighter one, similar to underdevelopment of speech. The most important thing is to distinguish this disorder from. Basically, children do not have developmental disorders (it can only be disrupted under the influence of public and peer oppression). If treatment is not timely at an early age, the child will later have problems with social adaptation, difficulties in finding one’s place in society.

Etiology

Because the this disease can form in the womb or in the early years of life; the reasons for its appearance also differ in intrauterine and external influences.

The first group of factors includes:

unsuccessful attempts by the expectant mother to get rid of the fetus;
risk of miscarriage;
uncontrolled use of medications by the expectant mother;
complicated in the mother, manifested by and;
insufficient oxygen supply to the fetus;
unhealthy lifestyle that a woman led while pregnant;
direct trauma to the abdomen or falling on it during pregnancy;
various diseases of a woman that accompanied the period of bearing a child, including insufficiency, or, or, etc.;
premature or complicated birth, obstetric intervention in the process.

Among the reasons influencing the formation of alalia in children under the age of three years, highlight severe course ailments such as:

. May appear from an insect bite or contact with a poisonous plant;
caused by bacteria or fungi;
various traumatic brain injuries;
disturbances in the functioning of the central nervous system;
double-sided;
insufficient attention on the part of parents to teaching the child simple words or phrases;
surgical intervention performed under anesthesia.

Doctors note that alalia does not arise from one factor, but from the simultaneous influence of several causes.

Varieties

IN medical field There are many classifications of the disease, but nowadays speech therapists use the following division of speech disorder:

sensory alalia- characterized by the fact that the child does not perceive what is said to him, he simply does not understand someone else’s speech, but at the same time he can hear, make sounds and pronounce simple words. His flow of speech is incoherent and unintelligible;
motor alalia– in the case of the progression of this type of illness, the child pronounces words quietly and indistinctly, but in most cases children cannot speak at all. Understanding of what other people say is not impaired; the child can even show understanding of the meaning of words using gestures;
sensorimotor alalia– the most severe form of the disorder, combining the inability to understand speech and reproduce it.

Symptoms

Signs of the disease depend on the form of the disease. So, the symptoms of motor alalia are:

violation fine motor skills. The child cannot fasten buttons or tie shoelaces on his own;
frequent mood changes;
excessive activity may be replaced by lethargy and inactivity;
absent-minded attention;
low performance;
increased fatigue;
complete absence speech or unclear reproduction of sounds;
poor vocabulary, which leads to an incomplete understanding of what others say;
pronounced facial expressions and gestures.

The following symptoms are characteristic of sensory alalia:

increased sensitivity to sounds, since children are unable to understand anything else;
a meaningless and incoherent set of sounds and words that the child reproduces;
widespread use of facial expressions and gestures in communication;
speech disorders in the form of missing letters in words, incorrect endings, or combining two words into one;
slight memory impairment, children remember new words very difficultly or generally not at all;
impulsiveness is replaced by isolation, and activity by passivity.

Against the background of the fact that the child cannot distinguish the speech that is spoken to him, he develops the ability to read words by lips.

Diagnostics

Since alalia occurs against the background of problems with the functioning of the brain, diagnostic methods will be aimed at studying the extent and assessment of damage in the brain. To do this, the little patient needs to go through:

electroencephalography – which evaluates impulse transmission and brain activity;
echoencephalography - the study of brain pathologies, which is carried out using ultrasound;
X-ray of the skull;

To exclude motor alalia and, accordingly, confirm sensory alalia, additional methods diagnostics, including:

otoscopy, which is performed to examine the ear canal and eardrum;
audiometry – with the help of which hearing acuity is assessed and the minimum sound intensity that a child can hear is determined.

In addition, it is necessary to consult a speech therapist who diagnoses and evaluates auditory-verbal memory and speech. You may also need consultations with pediatric doctors such as a neurologist, otolaryngologist and psychologist.

Treatment

Therapy for this disorder is based on test results and the degree of manifestation of symptoms, and therefore will be developed individually for each little patient. The most favorable age for treating the disease is considered four years old; it is during this period that the child shows the greatest interest in the world around him.

Common treatments include:

courses with a speech therapist, which are often combined with appointments medicines. Classes with a doctor will be effective for all forms of the disease. The treatment regimen is drawn up for each child separately - it takes into account general state health, age and degree of disorder. The task of a speech therapist is to develop speech ability, teach how to correctly pronounce words and construct phrases, and also increase vocabulary. Taking medications is aimed at improving the nutrition of the brain (a complete supply of vitamins and nutrients);
conducting therapeutic speech therapy facial massages. This treatment helps to tone and relax the facial muscles, which can reduce the appearance of some symptoms.
physiotherapy, the purpose of which is to influence certain areas of the brain with electrical impulses. This method of treatment does not harm health and is completely painless, so it can be performed on children under the age of one year.

If you carry out timely, and most importantly, well-chosen treatment, the child will get rid of all the symptoms of the disease or learn to control them. But the main thing is that he will be able to study in a comprehensive school and adapt to society.

Parental support plays an important role in therapy, since it is important for the child to know that his successes in treatment do not go unnoticed by those closest to him; this will provide an additional incentive for a speedy recovery, which further facilitates treatment.

Prevention

Prevention of alalia mainly consists of:

for a favorable pregnancy, it is best if during this period of life the woman stays at a resort or sanatorium;
refusal of bad habits by the expectant mother even at the stage of pregnancy planning;
timely treatment of infectious diseases, the symptoms or complications of which may harm the fetus;
protection from consumption medicinal substances for no apparent reason or doctor's orders;
enriching the diet with vitamins and nutrients that should reach the fetus;
regular visits to the obstetrician-gynecologist.

Many mothers are distrustful of the advice of relatives and friends to take their child to the doctor for speech delays, seeing the baby’s long silence. Other parents are sure that the baby’s first words are a sure sign of proper speech development, but this is an erroneous judgment. By brushing aside problems in this way, you may not notice alalia - a violation of speech development.

Nature of the disease

Alalia in children is a disease that occurs when the areas of the cerebral cortex responsible for speech are damaged, which leads to poor and incorrect formation of speech activity.

Alalia is accompanied by a violation of all components of speech at once - both lexical and grammatical. Violation of the speech centers could be caused by damage during fetal development or in the early development of the child (up to three years).

Alalia has its own prerequisites. Most likely, there was organic damage to the brain in one of its parts: Wernicke’s center, responsible for speech perception, or Broca’s center, responsible for speech motor skills.

Based on the source of damage, alalia is classified into two types: sensory and motor. Let's consider each type separately.

Alalia: types and signs

Motor

Broca's center is responsible for the proper development of speech. Violation of its functions leads to motor alalia. Due to excessive parental care, the child is most susceptible to this condition: increased care is often associated with illness in infancy or problems during childbirth. The child becomes stubborn, capricious and irritable. Difficulties with self-care in such children are a clear external characteristic. It is difficult for them to get dressed or tie their shoelaces, tie a bow, and fasten buttons - tasks that are sometimes impossible for a child with impaired motor function. Coordination of movements is also impaired: children cannot maintain balance, jump on one leg, often fall and do not catch the musical rhythm in the dance. Other movement disorders are also noticeable.

Motor alalia often coexists with a child’s lack of independence according to his age

The development of speech with motor alalia is divided into several levels: from the child’s inability to pronounce words to slight deviations in the ability to construct a detailed phrase (see also:). Levels are classified based on individual characteristics child.

A child with motor alalia understands the words that are spoken to him (we recommend reading:). Among the many pictures, he easily points to the one he was asked to show. Difficulties begin when understanding cases and quantities: the child cannot show with examples where “the picture hangs” and where “the pictures hang.” Thus he perceives the word and not the form. Prepositions or prefixes also remain outside perception. Specialized kindergartens and schools are designed to correct such defects, but regular schools are not suitable for children with such a disease.

Sensory

Sensory alalia is a disorder of speech understanding that is associated with damage to the Wernicke center of the cerebral cortex. The child does not speak because he does not understand the words, he is not able to connect them with objects (more details in the article:). IN similar situations Often a child is misdiagnosed and classified as hard of hearing, when absolute health hearing aid.

Sensory alalia is characterized by the phenomenon of echolalia. The child easily repeats the words he just heard. For example, the child reproduces a question addressed to him in the form of a repetition of this very question.

This type of disease is difficult to cure, despite the fact that children with sensory alalia are a rare phenomenon. Little progress in treatment is achieved by educating such children in specialized schools.

A child with sensory alalia may seem hard of hearing, but the first examination by a specialist refutes this assumption

How to spot something wrong?

Familiarity with the norms of speech development will help to recognize the disease, although each individual case of alalia is individual. The average child should master speech activity in the following order:

at two months the child develops a characteristic hum;
in 3-4 – babble;
6-8 months – first words;
By the age of one year, a child should be able to construct entire phrases.

If the vocabulary of a child under two years old is limited to a few words, you need to think about it. Parents who notice serious deviations from the norm should contact specialists for advice.

Underdeveloped speech - characteristic alalia. Pronunciation of only the first or only the last syllables (pa - in the word dad, ko - in the word milk), as well as poor development of speech in general and the lack of positive dynamics are also included here. These symptoms give a signal to parents to begin an examination so that as much as possible short time heal your beloved child.

Treatment methods

Medical and pedagogical methods

Positive results in the treatment of sensory and motor alalia are achieved only by complex methods that involve psychologists, doctors and experienced teachers. Children with similar diseases are treated in specialized sanatoriums, hospitals, kindergartens and correctional centers.

Treatment medicines, which promotes the active and successful maturation of brain cells and connections, is accompanied by additional procedures that help correct disorders of the brain centers: magnetic therapy, electrophoresis, IRT and others. Combined development of general and manual motor skills, as well as the development of memory, attention and thinking - important conditions for successful treatment.

The systematic nature of the disease itself also determines the corresponding development of all speech skills.

With motor alalia, doctors help increase speech activity, form active and passive vocabulary, and develop coherent speech. Logorhythmics included in the program, like speech therapy massage, is aimed at stimulating the development of speech skills (we recommend reading:).
With sensory alalia, the main achievements will be the discrimination of words and word forms, the ability to compare them with actions and objects, and the perception of speech phrases. Teachers actively form an understanding of the grammatical structure of speech. With the correct development of acoustic and phonemic perception, it is possible to improve the quality of speech and further independent speech activity (see also:).

Both forms of alalia are treated more successfully if the child is taught to write and read at the same time. This form helps to better remember what has been covered and improves control over oral speech.

Let us mention that timely diagnosis and diagnosis guarantee the maximum effectiveness of treatment. You should not postpone a visit to specialists if you notice characteristic symptoms.

Independent activities with a child

The extraordinary plasticity of the child's brain and its ability to quickly adapt in most even the most severe cases ensures a complete recovery from the disease. The ability of individual healthy brain cells to take over the functions of non-working areas is what makes healing possible.

The best thing a parent of a child with alalia can do on their own is to develop the baby’s fine motor skills, which are directly related to the activity of the speech areas of the brain.

Each child with alalia undergoes treatment under the careful supervision of doctors, and the technique in each individual case will be individual. At home, parents can also provide all possible assistance in treating their beloved baby.

Both doctors and parents have long known that the development of fine motor skills is directly related to speech activity. The more often parents work with children’s fingers, helping to make them dexterous and skillful, the faster and better the baby’s speech will develop.
Massage of fingers in a playful way will have great benefit for the body.
Finger games and gymnastics will help stimulate the development of fine motor skills. Simple activities - for example, sorting cereals and legumes, folding puzzles and mosaics, stringing beads - will promote active brain function and train little fingers.

Today you can find a large number of video materials with training and activities for alalia that parents can use at home. Everything must be used possible ways to cure the child as quickly as possible.

Alalia is a severe underdevelopment or complete absence of speech function, which is caused by organic damage to the areas of the cerebral cortex responsible for speech. This damage occurs in the prenatal period or in the first 3 years of a child’s life. With alalia, speech underdevelopment is systemic in nature, i.e. The baby has a late appearance of speech reactions, disturbances in sound pronunciation, syllable structure, phonemic processes, and poor vocabulary.

Speech alalia is diagnosed in approximately 1% of preschool children and 0.2-0.6% of school-age children; in boys, its development is observed 2 times more often. A child with alalia needs psychological, medical and pedagogical influence, which must be comprehensive in nature, include drug therapy, as well as development mental functions, coherent speech, lexico-grammatical and phonetic-phonemic processes.

Causes of alalia

The reasons that lead to the occurrence of alalia are very diverse. During specific periods of early ontogenesis they may be different. In the antenatal period, organic damage to the speech centers of the brain can be caused by fetal hypoxia, intrauterine infection, the threat of spontaneous abortion, and chronic somatic diseases of the pregnant woman.

A complicated pregnancy can lead to complications during childbirth and the occurrence of perinatal pathology. Alalia can be a consequence of premature, prolonged or rapid labor, asphyxia of the newborn, or the use of obstetric instruments.

Among the etiopathogenetic factors of alalia that affect the baby in the first years of life are meningitis, encephalitis, traumatic brain injury, and somatic diseases that lead to depletion of the central nervous system. Researchers note and hereditary predisposition to alalia. Factors that aggravate the effect of certain causes of alalia are frequent illnesses of the child in the first years of life, operations performed under general anesthesia, and unfavorable social conditions. Usually, the history of small patients with alalia reveals the influence of a whole complex of factors.

Organic brain damage leads to delayed maturation nerve cells. The result is a decrease in neuronal excitability, inertia nervous processes and functional exhaustion of brain cells. In alalia, organic lesions of the cerebral cortex are mild but multiple in nature, so the possibilities for independent speech development are very limited.

Alalia classification

Over the entire period of studying the problem, several classifications of alalia have been proposed depending on its manifestation, mechanism, and severity of speech underdevelopment. Today in speech therapy the classification of alalia according to V.A. is used. Kovshikov. According to it, they distinguish:

motor or expressive alalia;
sensory or impressive alalia;
mixed alalia (sensorimotor or motosensory, depending on the predominance of speech development disorders).

The motor form of alalia occurs as a result of early organic damage to the cortical part of the speech motor analyzer. In this case, the child does not develop his own speech, but his understanding of someone else’s speech is preserved. Depending on which area of the brain is damaged, there are 2 types of alalia - afferent motor and efferent motor. With afferent motor alalia, organic damage to the postcentral gyrus (lower parietal regions left hemisphere), which is accompanied by kinesthetic articulatory apraxia. With efferent motor alalia, damage to the premotor cortex (posterior third of the inferior frontal gyrus, Broca's center) occurs, accompanied by kinetic articulatory apraxia.

The sensory form of alalia occurs as a result of damage to the cortical part of the auditory-speech analyzer (posterior third of the superior temporal gyrus, Wernicke's center). In this case, the child’s higher cortical analysis, as well as the synthesis of speech sounds, is disrupted. Despite the fact that his physical hearing is preserved, the child does not understand the speech of those around him.

Symptoms of motor alalia

Motor alalia symptoms can have different symptoms - both speech and non-speech related (neurological, psychological).

Neurological symptoms in this form of alalia are represented primarily by motor disorders, poor coordination, poor development of finger motor skills. Children with motor alalia find it difficult to master even basic self-care skills (tying shoes, fastening buttons) and performing fine motor operations (folding puzzles, mosaics).

Giving psychological characteristics children with motor alalia, disturbances of attention, memory, and perception should be noted. Such children may be hyperactive or, conversely, inhibited and inactive. Children with motor alalia are characterized by high fatigue, decreased performance, and speech negativism. Motor alalia in children leads to the fact that, due to speech insufficiency, the child’s intellectual development suffers secondarily. However, as speech develops, it gradually returns to normal.

With motor alalia, there is a pronounced dissociation between impressive and expressive speech. Understanding of speech is preserved, but one’s own speech does not develop at all or develops with gross deviations. The stages of development of speech skills (namely: humming, babbling, words, phrases, coherent speech) are delayed, and the speech reactions themselves are very simplified.

Despite the fact that a child with afferent motor alalia is theoretically capable of performing any articulatory movements, he has severe disturbances in sound pronunciation. Often, in this case, confusion and persistent substitutions of articulatory disputable phonemes arise, which inevitably leads to the impossibility of reproducing the sound image of a word.

In the case of efferent motor alalia, the main speech defect is the inability to perform a series of successive articulatory movements, which is accompanied by a gross distortion of the syllabic structure of the word. Against the background of motor alalia, the unformed dynamic speech stereotype often leads to the appearance of stuttering.

The vocabulary in motor alalia is quite behind the age norm. The child learns all new words with difficulty; his speech contains mainly everyday terms. A small vocabulary leads to an inaccurate understanding of the meanings of words, their inappropriate use in speech, and substitution based on sound and semantic similarity. A distinctive feature of motor alalia is the predominance of nouns in the nominative case in speech, significant limitation of other parts of speech, difficulties with the formation and recognition of grammatical forms.

Coherent speech with motor alalia is severely impaired. It usually consists of short sentences. A child with speech alalia cannot consistently present events, separate the main from the secondary, convey the meaning of the event, determine cause and effect, and temporary connections.

In severe forms of motor alalia, speech does not develop at all; the child can only imitate sounds and pronounce individual babbling words, accompanying them with facial expressions and active gestures.

Symptoms of sensory alalia

The main defect in sensory alalia is a violation of the perception of addressed speech and understanding of its meaning. At the same time, sensory alaliks fully retain physical hearing. They often suffer from hyperacusis - excessive sensitivity to sounds that are indifferent to others (rustling, creaking).

The child’s own speech activity with sensory alalia is increased. But speech is a collection of meaningless sounds and fragments of words. Often, instead of answering a question, a child with sensory alalia repeats the question itself, i.e. other people's words. In this case, there is so-called echolalia. In general, speech with sensory alalia is meaningless, it is incoherent and incomprehensible to others. There is so-called logorrhea or “word salad”. In addition, in the speech of children with sensory alalia there are omissions of syllables (elision), obsessive repetitions of sounds and syllables (perseveration), combining parts of two words with each other (contamination), sound substitutions (paraphasia). At the same time, children with sensory alalia are very tolerant of their own speech; such a violation does not prevent them from communicating, because for this they use gestures and facial expressions.

In the case of a severe form of sensory alalia, the child’s understanding of speech is completely absent, but in other cases it depends on the situation. But even if the child understands the meaning of the phrase, then if you change the order of words in the sentence, the word form or the pace of speech, understanding is lost. Often, in order to comprehend speech, a child with sensory alalia has to “read” the lips of the speaker. There are children who understand only what they can say themselves, and in order to comprehend speech, they need to pronounce the words. Under other circumstances, they lack understanding.

Insufficient phonemic hearing leads to the fact that a child with sensory alalia does not distinguish between words that have different meanings, but are similar in sound, and also cannot correlate a spoken or heard word with a particular phenomenon or object.

Gross distortion of speech development can also lead to secondary personality disorders and delayed intellectual development. But categorical conclusions should not be drawn. A child’s failure to understand a speech task can easily be mistaken for mental retardation in sensory alalia.

Concerning psychological characteristics children with sensory alalia, they are characterized by increased distractibility, difficulty maintaining attention, instability of memory and auditory perception. Such children may exhibit chaotic behavior, impulsiveness, or, conversely, isolation and inertia. Sensory alalia in pure form is quite rare. Most often, a mixed sensorimotor form occurs, which confirms the functional connection of the speech-auditory and speech-motor analyzers.

Examination of children with alalia

In each specific case, alalia proceeds in its own way. But to determine whether a child has serious problems with speech, you should know the norms of speech development. As a rule, at 2 months the baby develops a characteristic hum, and at 3-4 months - babbling. The child should pronounce his first words at 6-8 months, and by the age of one year he should be able to construct entire phrases. If by the age of 2 the baby’s vocabulary is only a few words, his speech is incomprehensible and incoherent, then it’s time to sound the alarm and go to the doctor: perhaps the child has speech alalia. Detecting it at an early stage will have a beneficial effect on subsequent correction.

Children with alalia definitely need consultation from specialists such as a pediatric neurologist, otolaryngologist, speech therapist, and psychologist.

A neurological examination of a child with alalia is necessary in order to identify and assess the nature and extent of brain damage. In this case, the child may be recommended echoencephalography, EEG, MRI of the brain, and radiography of the skull. In order to exclude hearing loss in case of sensory alalia, it is necessary to conduct otoscopy, audiometry and other hearing tests.

A neuropsychological examination of a patient with alalia consists of diagnosing auditory-verbal memory. An examination by a speech therapist for alalia begins with clarifying the perinatal history, as well as the characteristics of the child’s early development. Wherein Special attention it is necessary to pay attention to the timing of psychomotor and speech development. Diagnosis of a child’s oral speech with alalia (lexico-grammatical structure, impressive speech, phonetic-phonemic processes, articulatory motor skills) is carried out according to the examination scheme for general speech underdevelopment.

Differential diagnosis of alalia is carried out with dysarthria, hearing loss, mental retardation, and autism.

Alalia correction

For children diagnosed with alalia, treatment consists of competent and gradual correction of the child’s speech skills. Necessary help they receive it in specialized preschool educational institutions, correctional centers, hospitals, and sanatoriums.

Correction of alalia is carried out simultaneously with drug therapy, which is aimed at stimulating the maturation of brain structures, as well as physiotherapy (magnetotherapy, laser therapy, hydrotherapy, electrophoresis, electropuncture). With alalia, it is very important to work on the development of motor skills - manual and general, as well as mental functions (attention, memory, thinking).

Considering the fact that the violation is systemic in nature, classes to correct alalia involve working on all aspects of speech. In particular, with motor alalia in children, speech activity is stimulated, work is done on sound pronunciation, vocabulary formation, development of coherent speech, and grammatical design of statements. IN speech therapy classes for alalia, speech therapy massage and logorhythmics are required.

With sensory alalia, first of all, the task is to learn to distinguish between non-speech and speech sounds, differentiate words, relate them to specific objects and actions, understand phrases and speech instructions, and master the grammatical structure of speech. Then, as the vocabulary accumulates, phonemic perception and subtle acoustic differentiations form, you can move on to the development of the baby’s own speech.

Forecast and prevention of alalia

The result of corrective work for alalia depends on many factors. In particular, the key to success is the early start of correction (from 3-4 years), its comprehensive nature, and the impact on all components of speech. An indispensable condition for successful correction of alalia is that the formation of speech processes must be carried out in the unity of all mental functions. For a child with motor alalia, the prognosis is more favorable. With sensory and sensorimotor alalia - rather indefinite. The prognosis is significantly influenced by the degree of organic brain damage. In the future, children with alalia may experience various disorders written speech. It is important to remember that corrective work for alalia helps prevent the occurrence of secondary intellectual disability.

As for the prevention of alalia, to prevent it it is necessary to ensure a favorable course of pregnancy and childbirth, as well as early physical development child.