Stutter at children – the frustration of the tempo-rhythmic party of the speech caused by the repeating spasms in articulation, voice or respiratory department of organs of articulation. Stutter at children is characterized by "jamming" on separate sounds, their numerous, involuntary repetition, the accompanying movements, speech tricks, a logofobiya, vegetative reactions. Children with stutter have to be examined by the neurologist, the logopedist, the psychologist, the psychiatrist. Correction of stutter at children includes a medical and improving complex (observance of the mode, massage, balneotherapy, LFK, FTL, psychotherapy) and system of logopedic occupations.
Stutter at children
Stutter at children – the inadvertent stops, halts in oral speech arising owing to a convulsive condition of speech muscles. According to scientific data, about 2% of children and 1,5% of adults have stutter. Stutter occurs at boys by 3-4 times more often than at girls. Except speech spasms, stutter at children is followed by violation of higher nervous activity which in one cases can be connected with neurotic reaction, in others – with organic defeat of TsNS. Therefore it would be wrong to consider stutter at the child as purely speech problem; studying and correction of stutter at children are impossible without integration of knowledge from the field of logopedics, neurology, psychology.
Classification of stutter at children
Depending on the pathogenetic mechanisms which are the cornerstone of convulsive halts allocate 2 forms of stutter at children: neurotic () and nevrozopodobny. Neurotic stutter at children is functional frustration; nevrozopodobny is connected with organic defeat of nervous system.
On expressiveness of speech spasms distinguish easy, average and heavy degree of stutter at children. Easy degree of stutter at children is characterized by convulsive halts only in the spontaneous speech; symptoms are hardly noticeable and do not interfere with speech communication. At moderate severity of a halt arise in the monological and dialogical speech. At heavy stutter at children speech spasms are frequent also long; halts happen in all types of the speech, including interfaced and reflected; there are accompanying movements and an embolofraziya. In the most extreme cases because of stutter the speech and communication become almost impossible. The same child can have a changeable severity of stutter in various situations.
Depending on character of a current allocate the following options of stutter at children:
- wavy (stutter amplifies and weakens in various situations, but does not disappear);
- constant (stutter has rather stable current)
- recuring (stutter arises after the period of speech wellbeing again).
The stutter reasons at children
All factors promoting developing of stutter at children traditionally share on contributing and making. It is necessary to refer hereditary predisposition, the neuropathic constitution of the stammering child, pre-natal defeat of TsNS to the contributing (background) reasons. Hereditary predisposition to stutter at children most often is defined by congenital weakness of organs of articulation. At the children having stutter enuresis, nightmares, the increased uneasiness and vulnerability often comes to light. Perinatal injuries of a brain at children can be connected with pregnancy toxicoses, a hemolytic disease of a fruit, a pre-natal hypoxia and asphyxia in labor, patrimonial injuries etc. The children who are physically weakened with insufficiently developed feeling of a rhythm, the general motor skills, a mimicry and articulation are more subject to development of stutter.
The increase in frequency of cases of stutter observed in recent years directly contacts rough introduction in everyday life of video games, various computer technologies which are bringing down a huge flow of audiovisual information on weak nervous system of children. It is necessary to remember that processes of maturing of bark of big hemispheres, registration of functional asymmetry of activity of a brain generally come to the end by 5 years of life therefore influence of any excessive on force or duration of an irritant can lead to a nervous breakdown and stutter at children.
Stutters at children can act as such extraordinary irritants (or the making reasons) heavy infections (meningitis, encephalitis, measles, whooping cough, typhus, etc.), ChMT, a hypotrophy, rickets, intoxications and so forth. At children also carry one-stage mental shocks or a long travmatization of mentality to immediate causes of stutter. In the first case it can be short-term fear, a fright, excessive joy; in the second – the long conflicts, authoritative style of education, etc. At children can lead imitation to developing of stutter the stammering, early training in foreign languages, an overload complex speech material, a levorukost reeducation. In literature it is indicated communication of stutter at children with a levshestvo, other speech violations (dislaliy, takhilaliy, dizartriy, rinolaliy). Secondary stutter at children can arise against the background of a motor alaliya or aphasia.
The comparative characteristic of neurotic and nevrozopodobny stutter at children
At children the strong psychoinjuring experiences therefore violation of the speech arises sharply, almost in one stage are the cornerstone of neurotic stutter. In this case parents, as a rule, precisely specify time of emergence of stutter in the child and his reason. Neurotic stutter usually arises in 2-6 years, i.e. at the time of development of violation in children there is a developed phrase speech.
At children with neurotic stutter decrease in speech activity is noted, the logofobiya and fixing on difficult sounds is expressed; respiratory and voice spasms prevail. The sound pronunciation is, as a rule, broken, however the lexical and grammatical party develops normally (takes place of FFN). Children often accompany the speech with inflating of wings of a nose and the accompanying movements. Character of a course of neurotic stutter at children wavy; deteriorations in the speech are provoked by the psychoinjuring situations.
In case of the nevrozopodobny stutter arising against the background of organic defeat of TsNS in the perinatal or early period of development of the child, frustration develops gradually, gradually. Obvious communication with external circumstances is not traced; parents are at a loss in definition of the reason of stutter at children. Nevrozopodobny stutter at children develops from the moment of the beginning of the speech or at the age of 3-4 years, i.e. during formation of the phrase speech.
Speech activity of children is usually increased, at the same time to the defect they are not critical. Speech halts are caused by mainly articulation spasms; the speech is monotonous, inexpressive, it is accelerated; the sound pronunciation is distorted, the lexical and grammatical party of the speech is broken (takes place of ONR). At children with nevrozopodobny stutter the general motility is broken: their movements are clumsy, held down, stereotypic. The sluggish mimicry, bad handwriting is characteristic; often there are a dysgraphia, a dyslexia and a diskalkuliya. The course of nevrozopodobny stutter at children is rather constant; deteriorations in the speech can be caused by overfatigue, the raised speech loading, somatic weakening. At neurologic inspection multiple signs of defeat of TsNS come to light; according to EEG – the increased convulsive readiness.
Stutter symptoms at children
Speech spasms, disorders of physiological and speech breath, the accompanying movements, speech tricks and logofobiya belong to the main symptoms of stutter at children.
At halt stutter at children arise in attempt to begin the speech or directly in the course of the speech. They are caused by spasms (involuntary reduction) of speech muscles. In character speech spasms can be tonic and clonic. Tonic speech spasms are connected with sharp increase in a muscular tone in lips, language, cheeks that is followed by impossibility of an articulation and a pause in the speech (for example, "in t---a rava"). Clonic speech spasms are characterized by the repeated reduction of speech muscles leading to repetition of separate sounds or syllables (for example, "t-t-grass"). At children with stutter tono-clonic or klono-tonic spasms can take place. In the place of emergence speech spasms can be artiulyatsionny, voice (fonatsionny), respiratory and mixed.
Breath at stutter spasmodic, superficial, chest or clavicular; the diskoordination of breath and an articulation is noted: children begin to speak on a breath or after a full exhalation.
The speech of children with stutter often is followed by the involuntary accompanying movements: twitching of face muscles, inflating of wings of a nose, blinking, rocking of a trunk, etc. Quite often stammering use the so-called motive and speech tricks pursuing the aim to hide halts (a smile, yawning, a tussiculation and so forth). Embolofraziya (the use of unnecessary sounds and words – "well", "it", "there", "here"), change of intonation, speed, a rhythm, the speech, a voice and so forth belong to speech tricks.
Difficulties in speech communication cause in children with stutter a logofobiya (fear of the speech in general) or a sound phobia (fear of pronouncing separate sounds). In turn the notions of compulsion about stutter promote a bigger aggravation of speech trouble at children.
Stutter at children often is followed by different vegetative frustration: perspiration, tachycardia, lability HELL, reddening or pallor of integuments which amplify at the moment of speech convulsiveness.
Diagnosis of stutter at children
Examination of children with stutter is conducted by the logopedist, the pediatrician, the children's neurologist, the children's psychologist, the children's psychiatrist. For all experts an important role is played by studying of the anamnesis, a hereditary otyagoshchennost, data on early psychospeech and motor development of children, clarification of circumstances and time of developing of stutter.
In the course of diagnostic inspection of the speech at children localization, a form, frequency of speech spasms decides on stutter; features of tempo of speech, breath, a voice are estimated; the accompanying motive and speech violations, a logofobiya come to light; the child's attitude towards the defect becomes clear. At stammering without fail examination of a sound pronunciation, phonemic hearing, the lexical and grammatical party of the speech is conducted.
The logopedic conclusion has to reflect a form and degree of stutter at children; nature of spasms; the accompanying violations of the speech. Differential diagnosis of stutter at children needs to be carried out with a takhilaliya, a spotykaniye, a dizartriya.
Correction of stutter at children
In logopedics the integrated approach to correction of stutter at children assuming carrying out medical and improving and psychology and pedagogical work is accepted. The main objective of a medical and pedagogical complex consists in elimination or easing of speech spasms and the accompanying frustration; strengthening of TsNS, impact on the personality and behavior of stammering.
Actually logopedic work at stutter at children will be organized step by step. At a preparatory stage the sparing mode, the benevolent atmosphere is created, speech activity is limited, samples of the correct speech are shown.
At a training stage work on mastering children various forms of the speech is carried out: it is interfaced - reflected, shepotny, rhythmic, question-answer, etc. On occupations it is useful to use various forms of manual skills (a molding, designing, drawing, games). At the end of this stage of occupation are transferred from the logopedist's office to group, a class, public places where children set skills of the free speech. At a final stage automation of skills of the correct speech and behavior in various speech situations and kinds of activity is carried out.
The important attention in the course of work is paid to development of the main components of the speech (phonetics, lexicon, grammar), golosopodach, prosodies. In correction of stutter at children the large role is played by logoritmichesky occupations, logopedic massage, respiratory and articulation gymnastics. Logopedic classes at children are given in correction of stutter in an individual and group format.
For correction of stutter at children the set of author's techniques is offered (N. A. Cheveleva, S. A. Mironova, V. I. Seliverstov, G. A. Volkova, A. V. Yastrebova, L. Z. Arutyunyan, etc.)
The forecast and prevention of stutter at children
At the correct organization of medical and improving work at most of children stutter completely disappears. A stutter recurrence at school age and the pubertatny period is possible. The steadiest results are noted at correction of stutter at preschool children. Than the stutter experience, especially the uncertain forecast is more.
The favorable course of pregnancy, care of physical and mental wellbeing of the child, his speech development, selection of training and entertaining material according to age is important for prevention of developing of stutter at children. For the purpose of the prevention of a recurrence of stutter at children observance of all recommendations of the logopedist at a stage of correctional work and after it, creation is necessary for the child of favorable conditions for harmonious development.