Course work: Voice disorders in children. Prevention of voice disorders Prevention of voice disorders exercises for children

Are you here: Questions and answers

Shouting singing in a range that does not correspond to a child's voice causes overstrain of the vocal apparatus, which can lead to functional and organic disorders. Children from an early age should hear soft, melodic voices with precise and expressive intonations. Possessing great imitability, they easily learn the intonation and method of vocal delivery of the adults around them. The main preventive measures to prevent voice pathology are hardening the body, mastering the skills of the most rational diaphragmatic breathing and a soft attack of vocal delivery.

There are primary, secondary, tertiary prevention of voice disorders.

Primary prevention is carried out from an early age and is carried out by both teachers and parents. It is necessary for representatives of voice-speech professions. In addition to observing the voice regime, it is necessary to remember that smoking, alcohol, and the abuse of hot and very chilled food are unacceptable, since this irritates the mucous membrane of the pharynx and larynx. You should beware of colds. Observations show that “small colds” have a negative effect on the vocal apparatus, during which people continue to work, straining their voice. The most radical measure to prevent diseases of the vocal apparatus can be considered staging the speech voice; all persons who, due to their occupation, have to speak a lot, need it.

Secondary prevention is preventing recurrence of voice disorders or mitigating the manifestations of voice disorders in the event of relapse.

Tertiary prevention (secondary according to Volkova) consists of preventing defects and layers resulting from voice pathology. These are primarily neurotic reactions to a defect, which aggravate the development of the underlying disorder. Social and labor adaptation of persons with severe voice disorders (aphonia).

Tactful, rational psychotherapy, early initiation of correctional speech therapy, and the first, even slight improvement in voice function remove or significantly weaken neurotic manifestations.

Preventive measures are also carried out after voice restoration is completed. Dispensary observation by a doctor and speech therapist continues to monitor the condition of the vocal apparatus and voice quality.

All those who complete the recovery course receive recommendations on how to adhere to the voice regime. Compliance with preventive measures and regular follow-up with specialists prevents relapses of voice disorders and ensures the sustainability of the results achieved.

Particular attention must be paid to vocal hygiene during the mutation period. A room in which people stay for a long time must meet sanitary and hygienic requirements: be well ventilated and subjected to wet cleaning. The room must have certain acoustic capabilities.

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There are many professions where the main instrument is the voice. These include teachers. Unfortunately, upon admission to the institute, applicants do not undergo an examination of the condition of the vocal apparatus. It is not taken into account that only those who are able to withstand prolonged strain on their voice can work as a teacher. But even diseases such as tonsillitis, sinusitis, chronic laryngotracheitis, nodules on the vocal cords can lead to loss of professional fitness.

Large speech loads place increased demands on the speech apparatus. It is necessary to know preventive measures to maintain a healthy voice and look for ways to restore it in cases of voice impairment. The development of otorhinolaryngology is associated with the emergence of an independent science - phoniatrics , studying the treatment and prevention of diseases of the vocal apparatus, pedagogical techniques for voice restoration - phonopedia – developing the skills of correct voice production, gradual activation of the muscular apparatus of the larynx with minimal load.

Before talking about vocal hygiene, let’s briefly look at the structure of the vocal apparatus itself. It includes the lungs, larynx with vocal cords and resonator cavities. The coordination of all functions and elements is carried out by the central nervous system.

The actual vocal production department is the larynx with vocal cords. The cavity of the larynx in the frontal section resembles the shape of an hourglass, the narrowest part corresponds to the location of the vocal cords, which have a white, pearlescent tint. They, together with part of the arytenoid cartilages, form the glottis, which has a triangular shape when inhaling. In men, the length of the vocal folds is 18-20 mm, in women – 16-18 mm, in children it is even shorter.

The pharynx is divided into 3 sections: upper (nasopharynx), middle (oropharynx) and lower (larynx). The nasopharynx has a wider range of resonance and is like a sound filter, where the timbre characteristics of the voice are amplified and finally formed. If there is a tumor or adenoids in the nasopharynx, breathing is sharply disrupted and the timbre of the voice changes, its brightness and lightness of sound are lost, and a closed nasal sound appears. If during phonation the nose is not separated from the nasopharynx by the velum palatine, then a nasal tint appears - an open nasal sound. The nasal cavity has a number of paranasal sinuses. They are all paired. These are the maxillary (maxillary), frontal, main and cells of the ethmoid labyrinth.

The oropharynx communicates with the oral cavity in front through the pharynx. The pharynx is bounded above by the soft palate with the uvula, below by the root of the tongue, and on the sides by the palatine arches. It has been proven that the soft palate has a functional reflex connection with the larynx and plays a large role in the formation of sound. The rise of the soft palate, the tension of the arches and the lowering of the root of the tongue cause a wide opening of the pharynx, which improves the power of sound.

The hypopharynx is located at the level of 4-6 cervical vertebrae. From above it is limited by the upper edge of the epiglottis and the root of the tongue, on the sides by pear-shaped fossae, which pass into the initial section of the esophagus.

The vocal, or phonatory, function is inherent not only to humans, but also to animals that breathe with their lungs. In humans, it has a special meaning, as it is associated with speech function. The voice is formed as a result of the fact that air, pushed out under pressure from the lungs and bronchi, encounters resistance on its way in the form of closed and tense vocal folds. The air stream breaking through causes them to vibrate, resulting in a sound that cannot be considered full-fledged, since it is very weak and primitive. The voice acquires its individual strength and timbre in the extension tube, which includes the laryngeal ventricles, pharynx, oral cavity, nose and paranasal sinuses, which make up the upper resonator. The lower resonator is the lungs and bronchi.

The sound arising in the larynx is characterized by the following characteristics: (1) pitch of the voice, (2) volume of the voice, (3) timbre, (4) range.

The pitch of the voice depends on the vibration frequency of the vocal folds and is regulated by their tension. It is the most important means of transmitting semantic and emotional information during verbal communication between people. The volume of the voice, or its strength, is regulated arbitrarily and depends on the degree of closure and the amplitude of vibration of the vocal folds. Loud spoken speech (medium strength) – 60-70 dB, loud speech – 90 dB, whispered speech – 20-25 dB, pain threshold – 120-130 dB. Timbre, or sound color, is an essential characteristic of voice quality. Timbre depends on the shape of the vibrations of the vocal folds, the number and severity of overtones in a certain sound, which give the voice its individual coloring. The timbre of the voice may have age-related characteristics and depends on the fact that various overtones are mixed into the main tone. In addition, the timbre may vary depending on the state of the extension tube. The number of tones a voice produces is called range. With age, the range gradually increases. The singing voice of an adult produces, on average, 2 octaves of sounds. Thus, the main sound is formed in the larynx, while speech is formed in the extension tube. The formation of sounds into words is associated with the function of the oral cavity and pharynx, which take part in the work of the articulatory apparatus.

The most important condition for speech is proper speech breathing. It differs from ordinary physiological breathing in that it is:

controlled process;
inhalation is done through the mouth (quick and silent), and exhalation is long and smooth.

Diaphragmatic-costal breathing is considered correct, when inhalation and exhalation are carried out by changing the chest. The flow of air during exhalation enters the larynx from the lungs, creates vibrations of the vocal cords, and the articulatory muscles of the oral cavity transform them into speech sounds.

According to recent studies, the most vulnerable organ of the speech apparatus is the larynx.

The larynx performs 3 main functions: respiratory, protective and vocal production. The muscles of the larynx, contracting in different directions, ensure the movement of the vocal folds during breathing and in the process of voice formation. The larynx not only conducts air into the bronchi and lungs, but also takes an active part in the respiratory function. To conduct air, a gap in the glottis is necessary. During quiet breathing, the latter has the shape of an isosceles triangle, while inhalation is accompanied by some divergence of the vocal folds, and exhalation is accompanied by their convergence. Regulation of inhalation and exhalation occurs reflexively.

Larynx with vocal folds during inhalation and exhalation

The protective function of the larynx consists of 2 aspects.

The air passing through the larynx is somewhat warmed, moistened and neutralized to a certain extent, for example, when harmful gaseous vapors are inhaled. In addition, the inhaled air is cleared of small particles that settle on the moistened mucous membrane.
The larynx plays a role in protecting the lower respiratory tract from the accidental entry of foreign bodies and food particles.

The condition of her muscles and elastic tissue varies at different periods of life. It reaches its maximum development by 20–40 years, and from 60 years of age atrophy is observed, because Around 55 years of age, islands of ossification appear in the cartilage of the larynx. Therefore, the load after 50 should be strictly dosed. Hormonal factors play a major role in voice formation. Under the influence of the gonads, the larynx becomes enlarged and the vocal cords lengthen (14-16; 24-26 – male; 16-18; 24-26 – female). Moreover, in women, the gonads have an influence throughout life (menstruation, pregnancy, menopause). It also affects dysfunction of the thyroid gland, as well as N.S. disease. (neuroses). Therefore, your voice must be protected.

What has a harmful effect on our voice:

Colds.
Incorrect distribution of speech load.
Working while sick.
Long breaks in professional activity (muscles become detrained).
Physical fatigue.
Hypothermia or overheating.
Eating cold and hot food.
Tobacco and alcohol. Especially drinks with a significant alcohol content, cold beer and dry wines are less harmful.
Sparkling water.
Spicy seasonings.
Diets and fasting.
Volatile washing powders and other strong-smelling substances.
Dry room air.

The most common voice disorders are associated with functional diseases of the vocal apparatus, that is, when no anatomical changes or gross impairment of motor function are observed. Phonasthenia– voice disorder, weakness of vocal function, which is not always accompanied by visible objective changes in the larynx. It is more often observed in people of voice and speech professions, and develops during their work activity due to constant vocal tension and poor voice production. Sometimes phonasthenia occurs from general fatigue and weakening of the body; it can also develop after mental trauma, various emotional overloads as a result of basic nervous processes. It is characterized by: 1) weak voice strength (fatigue), 2) difficulty carrying a vocal load for a long time (hoarseness, pain in the throat, sometimes in the external muscles of the larynx appears), 3) uneven sound of vowels, 4) small depth of the dynamic range of the voice (difference between forte and piano). With normal voice production, this difference is on average from 15 to 30 dB. With phonation, at best 10 dB, at worst 2-5 dB.

In the initial stages of the disease, indirect (using a mirror) laryngoscopy does not reveal pathological changes, but stroboscopy reveals asynchronous vibrations of the vocal folds with a violation of amplitude and frequency. Subsequently, with a protracted chronic form, a disturbance in the rhythm of movements of the vocal folds appears - delayed closure or earlier even before sound conduction. Failure to detect phonasthenia in a timely manner can cause chronic laryngitis.

To restore normal function of the vocal apparatus, the cause of phonasthenia must be identified. So, if it has developed as a result of constant forcing of the voice, it is necessary to limit and streamline the vocal load, and avoid traumatic situations that can negatively affect the nervous system. Before raising your voice, you need to develop correct diaphragmatic breathing. Constant attention is paid to lengthening the phonation exhalation and finding respiratory support. Functional training comes down to voice training, finding a comfortable pitch with minimal load on the vocal apparatus. There are 3 voice attacks. With normal soft delivery, the moment of speech exhalation and the moment of closure of the vocal folds coincide. With a hard attack, the vocal folds close before speech exhalation occurs (they are roughly torn). Pre-breathing attack: speech exhalation comes earlier, and the ligaments close after exhalation. Excessive consumption of exhaled air – fatigue. In order to correctly select the individual position of phonation, it is proposed to pronounce the sound “M” for a long time (it plays a large role in tactile-vibrational sensations and promotes “reverse afferentation”). We pronounce the sound with the larynx in a calm position, directing it into the “mask”. “M” is the sound of high impedance (back pressure, resistance). In this position, the volume of the oral resonator is increased, and the sound, hitting the hard palate, causes resonance of the overlying cavities. Impedance and resonator phenomena activate the functioning of the vocal apparatus. As you practice, the duration of phonation increases and the voice becomes clearer and louder.

Another group of functional diseases of the vocal apparatus consists of hyperkinetic and hypokinetic dysphonia– voice disorders caused by paresis of the internal muscles of the larynx (myopathic paresis). They arise due to past infections - influenza, acute respiratory infections, and less often after prolonged vocal strain. With hyper and hypokinetic dysphonia, the muscles that close the vocal folds suffer, so only the vocal function is impaired, breathing remains normal. However, loss of function of some muscles entails disruption of the action of their antagonists (contractor muscles). In this regard, people experience pain in the external muscles of the larynx, incoordination of the vocal act occurs and speech exhalation is sharply shortened. Voice defects with myopathic paresis can be expressed differently - from mild hoarseness to severe hoarseness and even aphonia. There is great fatigue of the voice, tension and pain in the muscles of the face, neck, back of the head, and sometimes the chest. The laryngostroboscopic picture is characterized by significant non-closure of the vocal folds, synchronous mobility, but rapid exhaustion during phonation. For people in speech professions, long-term voice impairment creates a psychotraumatic situation, which, in the presence of predisposition and asthenic factors, leads to the development of a neurotic state. Dysphonia is combined with rapid not only vocal fatigue, but also general fatigue, emotional instability, self-doubt, anxiety, insomnia, and low mood. In restoring the voice in hyper- and hypokinetic dysphonia, in addition to breathing exercises, attention should be paid to breathing exercises in the physical therapy room.

COMPLEX.

I.p. – sitting upright or standing on a chair:

inhale and exhale through the nose;
inhale through the nose, exhale through the mouth;
inhale through the mouth, exhale through the nose;
inhale and exhale through the left half of the nose, then through the right (alternately);
inhale through one half of the nose, exhale through the other (alternately);
inhale through the nose, elongated exhale through the nose with intensification at the end;
inhale through the nose, exhale through loosely pursed lips;
inhale through the nose, exhale through the nose in jerks (diaphragmatic).

The exercises are performed as follows. Starting position – sitting on a chair.

Inhale through the nose, exhale through the nose, imitating a groan.
Inhale through the nose, exhale through the mouth with the sound A.
Inhale through your mouth, exhale through your nose, imitating a groan.
Inhale through the nose, exhale extended through the nose, simulating a groan with intensification at the end.
Inhale through the nose, exhale through loosely compressed lips, pronouncing a bilabial, slightly stunned sound B.
Inhale through the nose, exhale through the nose in jerks, imitating a groan.

In parallel with these exercises, you can massage the front of the neck to reduce muscle tension. We stroke the front of the neck (throat) with either the right or left hand from top to bottom, grasping the chin.

Functional occupies a special place aphonia. This disease is not associated with vocal stress. It is based on hysterical disorders. The voice disappears suddenly with intact whispered speech, loud coughing and laughter. The variability of the laryngoscopic picture is characteristic. Most often, non-closure of the vocal folds is observed; sometimes the vocal folds instantly close and immediately return to the vocal folds. The absence of voice is accompanied by complaints of sensations of “grinding”, “sticking of films”, “coma” in the larynx. Treatment is carried out after or in parallel with a psychiatrist. For hysteria, we recommend drinking juice and infusion from the borage herb (“joy of the heart”); juice or decoction of hawthorn fruits. You can drink an infusion of St. John's wort: 1 tbsp. l. St. John's wort pour 1 cup of boiling water, leave in a tightly sealed container in a boiling water bath for 15 minutes, cool at room temperature for 45 minutes, strain, take 1/3 cup 3 r. a day before meals.

You and I cannot walk quickly on cold days after work or talk outside in winter. In general, you can’t go straight out into the street after school. You need to stay in the room for 15 minutes. After eating, immediately begin vocal activity.

Let us pay attention to the fact that we spend 50% of our working time on active work of the vocal apparatus and 30% on passive work. Thus, resting the voice accounts for 20% of the working time. We strive to complete the load within 4 days, but it is more advisable to take a break for a day after 2 days. The school classroom is a source of background work noise that we are forced to drown out with our voices. Fatigue during the working day occurs after 4 hours (with breaks of 15 minutes) and disappears after 1 hour of complete vocal rest. This only applies to teachers who have been working for more than 10 years. Then fatigue sets in after 2-3 hours, and rest lasts up to 2 hours. Fatigue accumulates over time.

How can we help ourselves?

First of all, playing sports (resistance to external stimuli).
Daily routine: sleep 8 hours.
Hardening. Rubbing.
Pine baths and baths with sea salt, prevention of inhalations with herbs, iodine-soda gargles, herbal gargles.
Place 5-6 drops of chamomile infusion into each nostril; Place 5-6 drops of peach, apricot and olive oil into your mouth and nose.
Before the performance, drink a glass of warm tea or Borjomi.
Rinse (nose and mouth) with cold water, lowering the temperature to 12 degrees (from 20).

As we can see, the prevention of diseases of the voice-forming organs is extensive. This includes gradual hardening with fresh air, sun, water, and physical exercise. An important factor in the prevention of voice disorders is air temperature, its cleanliness and degree of humidity. Persons in vocal professions (lecturers, announcers, teachers, singers) often work not completely healthy, which subsequently affects the vocal apparatus - painful sensations arise (tickling in the throat, dryness), fatigue increases, which leads to voice failure. Wherein

You should consult an otolaryngologist. In addition to the course of treatment with medication or physiotherapy, it is necessary to learn the skill of correct voice production. Persons in voice professions in the majority require voice training, which is a preventive measure for most professional voice disorders. With nervous fatigue, even the most ordinary vocal load sometimes becomes difficult. Most often, coordination of breathing and the function of voice formation depend on the general condition of the body and external conditions. Diet has a direct bearing on the sonority of your voice. When resolving conflicts in a raised voice, we often resort to shouting, “affirming” our authority with our voice, we do not spare ourselves and forget that when shouting, the vocal cords tense strongly and sharply. Constant tension in the ligaments leads to the loss of deep, “penetrating” intonation that enchants the interlocutor. It is necessary to give the cords a rest: after returning from work, it is better to remain silent for at least half an hour, trying to exclude telephone calls. In winter, when coming from the street into a room and, conversely, leaving a warm room into the street, let your voice adapt, do not start a loud and harsh conversation.

Learn to control your body (life in the body). The body is the “instrument” of the voice. Learn to communicate actively and effectively, freely express your thoughts through your voice.
Good posture is needed (gives confidence, openness). The correct position of the spine: the tailbone is pointing down, the shoulders are straightened, the absence of muscle tension - all this affects breathing, which seems to nourish the voice.
Learn to breathe correctly. When breathing fully, the diaphragm, abdominal muscles, and intercostal muscles work. Don't hold your breath; you'll need to practice mouth breathing.
Get rid of “junk body movements.” A person often reinforces his speech with gestures. The space of the body is the potential for voice. The sound is created by the whole body, then it is expressive. In a conversation, do not rush to “reinforce” your voice with excessive facial expressions and gestures: by doing this you are robbing it. A teacher must work on his speech technique, on his voice, throughout his life.

Particular attention should be paid to inflammatory diseases of the upper respiratory tract (renitis, sinusitis, pharyngitis, pharyngitis). To prevent them from becoming complicated by voice disorders, it is necessary to use oil solutions that moisturize the mucous membrane. We throw our heads back and drop sunflower or olive oil into our nose (you can pour a teaspoon of oil on the root of your tongue). Oil flows down the nasal passages along the wall. At the same time we pronounce the sound “I”. If the back of the throat is dry, you can use herbal decoctions: chamomile, sage, St. John's wort. For colds, gargling with eucalyptus is recommended. At the same time, vitamins A and A1 (retinol, beta-carotene) are taken. These vitamins support the functional activity of the visual organs, affect the formation of bones, healthy skin, teeth, hair, oral mucosa, nasopharynx, uterus, intestines, urinary tract, and increase immunity. Sources of these vitamins are orange and yellow vegetables and fruits, as well as liver, fish oil, eggs, butter, cheese, spinach, and lettuce.

Some recommendations for inflammation of the mucous membrane of the maxillary sinus - sinusitis. Symptoms: unilateral nasal congestion, mucous or purulent discharge, decreased or loss of sense of smell. A feeling of fullness in the cheek or forehead. Pain when pressing in the area of the maxillary or frontal sinus. Sometimes I have toothaches and fever.

In addition to drug treatment, we use home remedies: heat on the cheek or forehead, bed rest, breathing over the steam of potatoes (boil potatoes in their jackets, drain the water, wrap up; brew 2 tablespoons of fireweed herb in 0.5 liters of boiling water, bring to a boil , leave for 30 minutes and take before meals; for pain in the nose, ears and head, you can instill radish juice into the nose, rinse the sinuses with 5% infusion of calendula flowers.

Pharyngitis, or inflammation of the larynx, can be caused by viral or bacterial microorganisms. Symptoms: pain and swelling of the larynx, fever, chills, headache, cough.

Recommendations: drink plenty of fluids and rest. It is good to use propolis infusion to lubricate the back wall of the pharynx and tonsils in case of chronic pharyngitis (mix 1 hour of 10% alcoholic propolis extract with 2 hours of glycerin or peach oil). It can be instilled into the nose for chronic runny nose.

Rinse your mouth and throat with a decoction of blackberry leaves for inflammation of the oral mucosa, sore throat, pharyngitis, and bleeding gums.

Laryngitis occurs most often with ARVI, influenza and other infectious diseases, as well as with vocal strain.

Mix carrot juice with honey 1:1. Take 1 tablespoon 4 – 5 times a day.

Take 3 teaspoons of chopped onion peel, pour in 0.5 liters of water, let it boil and leave for 4 hours, then strain and use to gargle.

Good results are obtained by gargling with fresh potato juice, carried out regularly 3 - 4 times a day for 3 - 4 weeks.

Inhale with essential oils of mint, thyme, and eucalyptus.

Laryngitis is an inflammation of the mucous membrane of the larynx. A special place is occupied by occupational laryngitis associated with increased vocal load, overstrain and fatigue of the vocal apparatus. In chronic laryngitis, the mucous membrane of the larynx is gray-red in color and thickened in places, especially along the edges of the vocal folds.

Sometimes edematous thickenings of the mucous membrane are formed on the vocal folds, located opposite each other - singers' nodules. With chronic inflammatory processes of the larynx, changes in the tone of its internal muscles may occur. Damage to the neuromuscular system begins with an increase in muscle tone as compensation for developing muscle weakness. At this stage of the disease, the voice practically does not suffer, and people usually do not seek phonopedic help.

People suffering from various forms of chronic laryngitis are subject to dispensary observation by an otolaryngologist. In addition to medication and physiotherapeutic treatment, the task of dispensary observation includes identifying voice failure and timely referral to a speech therapist. Proper voice production relieves tension from the vocal apparatus, improves lymph and blood circulation in inflamed tissues, and organizes phonation breathing. With changes in the neuromuscular apparatus of the larynx, voice production adapts it to the vocal load. In the initial stages of the disease without a change in voice, speech therapy assistance is a preventive measure to prevent disruption of the tone of the vocal folds. Measures: psychotherapy, protective voice mode (no whispering). Speech therapy work: correction of breathing, development of respiratory support, conscious slowing of exhalation.

The fullness of the sound of the voice depends on the phenomenon of support. This begins with performing diaphragmatic breathing while lying down with a voiced exhalation. Place one hand on your chest and the other on your stomach to control the movement of your chest muscles. As you inhale, the front wall of the abdomen rises, the chest should be as motionless as possible. The exhalation is slow with the pronunciation of voiceless consonant sounds “S”, “Sh” for persons with severe voice impairment. The anterior wall of the abdomen gradually retracts. When raising a voice without pronounced dysphonia, it is recommended to pronounce a voiced bilabial V as you exhale. After this exercise is mastered in a lying position, it should be performed sitting and standing. Such training is then carried out independently at least 2 times a day, morning and evening, lasting 1-2 minutes.

To relieve discomfort from chronic laryngitis, you need to perform a light neck massage in the area of the outer surface of the larynx. Stroke the front of the neck (throat) with either the right or left hand from top to bottom, grabbing the chin as you begin massaging. You need to start from the area of the root of the tongue: use your thumb and forefinger in a circular motion going down. The duration of the massage is 2-3 minutes, it should be performed 3-4 times a day. With a long-term chronic process, coughing becomes persistent and persistent. To combat it, you can suggest silently pronouncing the sound “Y”. The sound is imitated with the mouth closed and teeth loosely clenched. At the same time, a slight tension is felt in the throat. You need to repeat the technique 3 times in a row. During the day you can resort to it as needed up to 10-12 times. Massage and physical therapy exercises aimed at establishing respiratory support continue for 7–10 days.

The effectiveness of recovery is directly dependent on the time of start of classes from the moment of illness. Rehabilitation activities must be started early in combination with other types of treatment. Timely start of functional training, subject to the stages of training and strict dosage of loads, more actively mobilizes the compensatory capabilities of the larynx, prevents the formation of a pathological reflex of vocalization and the development of neurotic reactions.

There are phoniatric rooms in Moscow: Moscow Institute of Ear, Throat, Nose named after. Botkin, city phoniatric center on Simferopol Avenue, on Taganka (hospital 23, Internatsionalnaya St.).

Pronouncing speech sounds is a complex physiological act, the implementation of which requires the normal structure and coordinated function of the central speech apparatus and peripheral organs of voice formation and articulation. Naturally, any developmental defects, diseases and damage to any part of the speech apparatus can cause disturbances in voice and speech production. Deficiencies in the voice and pronunciation side of speech can occur, for example, with chronic diseases of the larynx, with nodules, fibromas and papillomas of the vocal cords, with clefts of the upper lip and palate, with irregularities in the structure of the jaws and teeth, with tongue defects, with nasal breathing disorders, with nervous -muscle disorders in the oral cavity, pharynx and larynx and other defects of the peripheral speech apparatus. And also in case of brain lesions, which can occur, for example, due to hemorrhage in the brain (in children, usually as a result of birth trauma or bruises from a fall), infectious diseases, tumors.

To prevent chronic diseases of the vocal apparatus, it is very important to protect children from frequent runny nose, sore throat, acute laryngitis and other colds. Here, hardening the child’s body plays an important role. Children should not be accustomed to excessive heat, there is no need to wrap them up, since in this case the body loses the ability to adapt to changes in external temperature, becomes sensitive to even small fluctuations, and the child easily catches a cold at the slightest cooling or draft. Of course, when hardening, care must be taken: the body should be accustomed to cooling gradually; hardening procedures should begin in the summer, teaching children to walk barefoot and swim in cool water. For any disease, hardening should be stopped and started again only after complete recovery.

Physical education and sports available to children play an important role in promoting health and strengthening the body.

In the origin of chronic inflammation of the mucous membrane of the larynx (chronic laryngitis), exposure to harmful impurities in the inhaled air, in particular tobacco smoke, is of great importance. Everyone knows how often habitual smokers' voices become rough and hoarse. Tobacco smoke has a particularly harmful effect on the delicate mucous membrane of the children's larynx. Therefore, the fight against smoking among children should be carried out especially persistently and energetically; conduct it not only through prohibitive measures, but also through explanatory work, using for this purpose every suitable opportunity during classwork and extracurricular activities.

As already mentioned, when breathing through the nose, the air is cleared of mechanical impurities, warmed and moistened. If breathing occurs through the mouth, then the harmful properties of the inhaled air are eliminated to a lesser extent. Therefore, removing obstacles that interfere with normal nasal breathing is important not only for eliminating closed nasal sounds, but also for restoring the protective function of the nasal mucosa. However, even in the presence of free passage of the nasal cavity, breathing in some cases is carried out through the mouth, for example, during speech, singing, as well as during fast walking and running. Therefore, you should not go out into the cold air while hot (after a bath, after outdoor games) and talk at the same time. For the same reason, in cold and damp weather you should not sing outside, walk or run quickly, since in all these cases breathing occurs through the mouth.

To eliminate voice and speech defects caused by anatomical disorders in the organs of voice formation and articulation, medical measures are usually required in the form of active intervention by doctors (otolaryngologist, dentist, psychoneurologist), as well as special speech therapy work.

However, such organic defects of the speech apparatus are quite rare. In addition, not every violation of the structure of the speech organs necessarily leads to a violation of pronunciation. If the anatomical defect is not very pronounced, then speech may turn out to be normal.

Much more often in children there are functional speech disorders that occur in the absence of any noticeable anatomical changes in the speech apparatus. In most of these children, speech disorders are caused by improper upbringing. In this regard, the enormous role of proper speech education in the family and in preschool institutions becomes obvious in that period when speech development occurs most intensively and when speech defects that have arisen for some reason have not yet had time to take hold. It is very important that a child of toddler and primary preschool age develops in a normal “speech environment.” The speech of parents and educators should be clear, concise and grammatically correct. The practice of adjusting to children’s speech (“lisping”), practiced by many parents and some educators, should be considered unacceptable, because this can have a detrimental effect on the development of the child’s speech.

From the point of view of preventing and eliminating speech development disorders in children, early detection of hearing impairments is of great importance.

Along with correct and timely treatment of the hearing organs (in cases where this is possible), such children also need timely, systematic assistance in their speech development. This help should be provided to them by everyone around them, and first of all by their parents.

Often non-speaking children who lost their hearing at the age of 3-4 years, when they had already developed speech that needed to be preserved and developed, are admitted to schools for deaf children. In schools for hard of hearing children, you can meet children with a relatively slight hearing loss, but with a significant impairment of speech development. At the same time, there are many cases where parents, using the advice and help of a teacher of the deaf or speech therapist, achieve great success in the development of speech in deaf and hard of hearing children.

For normal and independent speech development, a child must have a high degree of hearing preservation. Even a slight decrease in hearing, remaining unnoticed, can lead to pronunciation defects and disruption of the grammatical structure of speech. Timely detection of such hearing defects is of great importance for the prevention of speech disorders, since, knowing that the child’s hearing is impaired, parents will try to speak especially clearly, distinctly and correctly, thereby ensuring the normal speech development of the child. Kindergarten teachers and primary school teachers play a very important role in the prevention and elimination of speech defects in children. Remembering that their speech is the model by which children learn to speak, which they imitate, educators and teachers must first of all take care of improving their speech. In addition, you should actively intervene in the child’s speech development process, teach him to clearly pronounce speech sounds, words and phrases, and express his thoughts grammatically correctly.

The role of the teacher is also great in instilling in students the skills to skillfully use their speech apparatus. The teacher must teach children to breathe correctly during speech, to speak slowly, clearly, loudly enough, but without loudness. Excessive voice volume leads to overstrain of the vocal cords, which can result in hoarseness, weak voice and even aphonia. Therefore, the teacher should not require students to speak too loudly, especially in the first years of education. With a runny nose and the slightest sign of hoarseness, children should speak as little and quietly as possible; in these cases, children should be exempted from singing lessons and from participating in school amateur performances.

If students have one or another pronunciation defect, the teacher should try to eliminate this defect himself by explaining and showing correct articulation. Where this is not possible, as well as in the presence of anatomical defects in the speech apparatus, a speech therapist and a medical specialist should be involved in correcting the defect.

To prevent various voice disorders, it is very important to protect and educate the voice from early childhood. Every teacher should know that voice development occurs gradually, that the child’s vocal apparatus is still weak and forcing the voice can cause irreparable harm. Shouting singing in a range that does not correspond to a child's voice causes overstrain of the vocal apparatus, which can lead to functional and organic disorders. Children from an early age should hear soft, melodic voices with precise and expressive intonations. Possessing great imitability, they easily learn the intonation and method of vocal delivery of the adults around them. The main preventive measures to prevent voice pathology are hardening the body, mastering the skills of the most rational diaphragmatic breathing and a soft attack of vocal delivery.

To protect the voice, people in vocal professions must remember that smoking, alcohol, and the abuse of hot and very chilled food are unacceptable, since this irritates the mucous membrane of the pharynx and larynx. You should beware of colds. Observations show that “small colds” have a negative effect on the vocal apparatus, during which people continue to work, straining their voice. The most radical measure to prevent diseases of the vocal apparatus can be considered staging the speech voice; all persons who, due to their occupation, have to speak a lot, need it.

Secondary prevention consists of preventing defects and layers resulting from voice pathology. These are primarily neurotic reactions to a defect, which aggravate the development of the underlying disorder.

Tactful, rational psychotherapy, early initiation of correctional speech therapy, and the first, even slight improvement in voice function remove or significantly weaken neurotic manifestations.

Conclusions and problems

Based on the etiology and pathogenesis of diseases, based on didactic and methodological principles, speech therapy for voice pathology involves the activation and coordination of the vocal apparatus using pedagogical techniques. The effectiveness of the techniques used has placed phonopedia on par with treatment for most chronic diseases of the larynx. In some cases, special voice training is the only way to overcome violations. Further research into the mechanisms of voice formation will outline new, more effective ways of restorative work. Currently, there is a serious need for a more complete and in-depth study of voice pathology in children, the characteristics of its manifestation and the development of recovery methods.

Test questions and assignments

2. What stages are the development of a child’s voice divided into?

3. Characterize certain forms of functional and organic voice disorders.

4. Determine the main tasks of phonopedia.

5. Compare the tasks of correctional work for hypo- and hypertonic disorders.

Literature

1. Becker K.P., Sovak M. Speech therapy. - M., 1981.

4. Dmitriev L. B. Fundamentals of vocal techniques. - M., 1968.

5. Ermolaev V. G., Lebedeva N. F., Morozov V. P. Guide to phoniatrics. - L., 1970.

6. Zaritsky L.A., Trinos V.A., Trinos L.A. Practical phoniatry. - Kyiv, 1984.

7. Mitrinovic-Modrzejewska A. Pathophysiology of speech, voice and hearing. - Warsaw, 1965.

8. Morozov V.P. Biophysical foundations of vocal speech. - L., 1977.

9. Taptapova S. L. Correctional and speech therapy work for voice disorders. - M., 1984.

10. Taptapova S. L. Restoration of sonorous speech in patients after resection or removal of the larynx. - M., 1985.

11. Reader on speech therapy / Ed. L.S. Volkova, V.I. Seliverstova. - M., 1997. - Part I. - pp. 194-355.

Speech therapy: Textbook for students of defectology. fak. ped. universities / Ed. L.S. Volkova, S.N. Shakhovskaya. -- M.: Humanite. ed. VLADOS center, 1998. - 680 p.

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Federal State Budgetary Educational Institution of Higher Professional Education

"MOSCOW PEDAGOGICAL STATE UNIVERSITY"

FACULTY OF DEFECTOLOGY

DEPARTMENT OF Speech Therapy

Coursework in speech therapy

Moscow, 2014

Introduction:

Chapter 1. Theoretical analysis of literary sources on the prevention of speech disorders.

Chapter 2. Main directions for the prevention of speech disorders.

Conclusion

Bibliography

Introduction

Only man has the greatest gift of nature - speech. But it is not an innate ability. Speech is formed along with the development of the child under the influence of the speech of adults and largely depends on several factors: sufficient speech practice, upbringing and training, as well as on the normal speech and social environment, which stimulates speech development and provides a speech model. And all these factors are important for a child from the very first days of life. Each child’s speech acquisition occurs at different times and in different ways, since this is an individual process that depends on many factors. The reasons for this process can be both the pathology of pregnancy and childbirth, and the action of genetic factors. Damage to the hearing organs and a general lag in mental development, as well as insufficient communication and education can be the reasons for the lag in speech acquisition. For the formation of speech, the development of analyzers, such as speech motor and speech auditory, is extremely important. But all this largely depends on the environment. New vivid impressions and an appropriate environment contribute to the development of movements and speech. If this is not the case, then the child’s mental and physical development is delayed. His psychophysical health is of great importance for the development of a child. From the state of his higher nervous activity, from his attention, memory, imagination and thinking, i.e. higher mental processes, and the somatic or physical state depend on the development of speech.

The active participation of adults in the healthy development of a child’s speech, i.e., the education of speech in normal conditions for it, is the main point of prevention. Unfortunately, this moment in the development of speech, as well as the importance of full speech, is still underestimated in the family and school.

According to statistics, the number of speech disorders has tended to increase in recent years, so great attention must be paid to the prevention of speech disorders - this proves the relevance of the topic I have chosen.

The purpose of the work is to study the main directions of prevention of speech disorders.

In accordance with the goal, the following tasks were set:

1. Study and analyze the state of the problem of preventing speech disorders in the psychological, pedagogical and methodological literature;

2. Characterize the main types of speech disorders;

3. Consider the reasons for the development of speech disorders;

4. Reveal the features of the main directions for the prevention of speech disorders.

Chapter 1. Theoretical analysis of literary sources on the prevention of speech disorders

1.1 Main types and forms of speech disorders

A speech disorder is a disorder, a deviation from the norm in the process of functioning of the mechanisms of speech activity.

Scientifically based ideas about the forms and types of speech disorders are the starting conditions for the development of effective methods for overcoming and preventing them. When developing issues of classification of speech disorders in children, researchers seemed to split into two directions: supporters of one direction retained the traditional nomenclature of speech disorders, which is used in general speech therapy, while supporters of the other direction abandoned the traditional nomenclature of speech disorders for speech therapy and introduced a new grouping.

Thus, currently in domestic speech therapy there are two classifications of speech disorders in circulation, one is clinical-pedagogical, the second is psychological-pedagogical, or pedagogical (according to R.E. Levina).

The clinical and pedagogical classification is based on the traditional collaboration between speech therapy and medicine; in contrast to the purely clinical classification, the types of speech disorders identified in it are not strictly tied to the form of the disease. It is focused mainly on the correction of speech defects, on the development of a differentiated approach to overcoming them and is aimed at the utmost detail of the types and forms of speech disorders. All types of disorders considered in this classification can be divided into two large groups depending on what type of speech is impaired: oral or written.

Oral speech disorders are divided into two types:

1. Phonation (external) design of the utterance, which are called violations of the pronunciation aspect of speech;

2. Structural-semantic (internal) design of the statement, which are called systemic or polymorphic;

1. Disorders of the phonation design of an utterance can be differentiated depending on the disturbed link: voice formation, tempo-rhythmic organization of the utterance, intonation-melodic and sound-pronunciation organization. These disorders can be observed in isolation and in various combinations, depending on which the following types of disorders are distinguished in speech therapy: dysphonia (aphonia), bradyllalia, tachylalia, stuttering, dyslalia, rhinolalia and dysarthria.

2. Violations of the structural-semantic (internal) design of a statement are represented by two types: Alalia and aphasia.

Written speech disorders are divided into two groups depending on the type of impairment. If the productive type is impaired, writing disorders (dysgraphia) are noted, and if receptive writing is impaired, reading disorders (dyslexia) are noted.

The psychological and pedagogical classification arose as a result of a critical analysis of the clinical classification from the point of view of its applicability in the pedagogical process, which is speech therapy. Such an analysis turned out to be necessary in connection with the orientation of speech therapy towards the training and education of children with speech development disorders.

The researchers' attention was focused on developing speech therapy methods for working with a group of children (study group, class). To do this, it was necessary to find common manifestations of the defect in various forms of abnormal speech development in children, especially those that are relevant for remedial education. This approach required a different principle for grouping violations. Speech disorders in this classification are divided into two groups:

The first group is a violation of the means of communication (phonetic-phonemic underdevelopment and general underdevelopment of speech).

The second group is violations in the use of means of communication, which includes stuttering, which is considered as a violation of the communicative function of speech with correctly formed means of communication. A combined defect is also possible, in which stuttering is combined with general speech underdevelopment.

This classification reflects consistent reliance on the principle of a systems approach, on the basis of which two relationships are taken into account: the relationship of disorders in the system of speech activity and the relationship of disorders as one of the mental processes with other aspects of the child’s psyche, the development of which is closely related to speech.

In these classifications, with differences in the typology and grouping of types of speech disorders, the same phenomena are considered from different points of view and are focused on solving different problems of a single, but multifaceted process of speech therapy intervention. Clinical-pedagogical and psychological-pedagogical classifications complement each other and are used both in diagnosis and prevention, and in the correction of speech disorders.

1.2 Causes and risk factors for the development of speech disorders

The cause of speech disorders is understood as the impact on the body of an external or internal harmful factor or their interaction, which determine the specifics of a speech disorder and without which the latter cannot occur.

M.E. Khvattsev was the first to divide all the causes of speech disorders into external and internal, especially emphasizing their close interaction. He also identified organic (anatomical-physiological, morphological), functional, socio-psychological and neuropsychiatric reasons.

Organic causes included underdevelopment and damage to the brain in the prenatal period, at the time of childbirth or after birth, as well as various organic disorders of the peripheral speech organs. They identified organic central (brain lesions) and organic peripheral causes (damage to the organ of hearing, cleft palate and other morphological changes in the articulatory apparatus). Functional causes of M.E. Khvattsev explained the teachings of I.P. Pavlova about disturbances in the relationship between excitation and inhibition processes in the central nervous system. He emphasized the interaction of organic and functional, central and peripheral causes. He included mental retardation, memory impairment, attention disorders and other disorders of mental functions as psychoneurological causes.

M.E. Khvattsev also assigned an important role to socio-psychological reasons, understanding by them various unfavorable environmental influences. Thus, he was the first to substantiate the understanding of the etiology of speech disorders on the basis of a dialectical approach to assessing cause-and-effect relationships in speech pathology. Great achievements in the field of embryology, biology, theoretical medicine over the past decades, advances in medical genetics, immunology and other disciplines have made it possible to deepen the understanding of the etiology of speech disorders and show the importance of exogenous (external) and endogenous (internal) harm in their occurrence. It is important not only to identify organic (central and peripheral) as well as functional causes of speech disorders, but also to imagine the mechanism of speech disorders under the influence of certain adverse effects on the child’s body. This is necessary both for the development of adequate ways and methods for correcting speech disorders, as well as for prognosis and prevention.

In the middle of the 20th century, such a concept as a “risk factor” appeared in the scientific literature, which refers to various conditions of the external sphere (biological and social) and the individual reactivity of the body, which, to a greater or lesser extent, contribute to the development of certain pathological conditions. There is a close interaction between biological and social risk factors.

Biological risk factors for the development of speech disorders are pathogenic factors of intrauterine development and childbirth, brain infections and injuries suffered after birth, and a family history of speech disorders.

The primary defect in newborns can be hearing, vision, or motor impairment, both in an uncomplicated form and in various combinations of several primary defects.

Work with children who have a risk factor for speech disorders is based on the essence of the pathology of the central nervous system.

Early correctional and pedagogical work is necessary from the first days of such a child’s life, since disruption of the development of some functions leads to a secondary delay in the formation of others and subsequently to pedagogical neglect.

Early diagnosis of disorders of the sensory and motor systems of the brain is of great importance in organizing therapeutic, preventive and medical-pedagogical correction of the manifestations of dysontogenesis and the consequences of organic brain failure. In cases where the function of brain structures is “not in demand,” pathoanatomical changes occur in them, sometimes of an irreversible nature. With adequate corrective influences, compensation of organic brain damage is observed due to the formation of new, additional interneuron connections not provided for by the genetic program.

Biological risk factors for speech disorders of a genetic nature include, in particular, a violation of the formation of a psychomotor profile (left-handedness and various variants of incomplete right-handedness). Researchers have noted an asynchrony in the development of certain functions in left-handed children: an advance in emotional and motivational systematogenesis and a lag in the differentiation of lateralized psychomotor mechanisms. Underestimation of the lateral-abnormal constitution of psychomotor function (and this includes speech movements) can lead to the appearance of speech pathology (in particular, stuttering). One of the preventive recommendations may be to prohibit the forced reorientation of left-handers to right-handers.

In some cases, it is possible to prevent the development of left-handedness if, from an early age, the child tries to give objects only to the right hand, carefully but persistently transferring objects from the left hand to the right.

Biological risk factors for speech disorders also include a family history of speech pathologies. Hereditary predisposition to the occurrence of a pathological condition is not fatal. As a rule, speech disorders do not occur against the background of complete health. In cases where, along with a hereditary burden of speech pathology (for example, stuttering), disorders of the central nervous system are diagnosed in children, specialized medical and speech therapy care is needed, taking into account the data on the psychophysical and speech development of the child. If signs of deviations from the norm appear in pre-speech reactions (screaming, humming, babbling) and in speech ontogenesis itself, speech therapy assistance is recommended as early as possible. Parents should consult a speech therapist about the rules of their speech communication with their child. In order to prevent speech disorders in a child from a family burdened with speech pathology, it is necessary to begin speech therapy classes in early preschool age.

Social and psychological risk factors for the development of speech pathology have attracted much attention from researchers in recent years, especially the issues of mental deprivation of children. Deprivation is understood as insufficient satisfaction of basic needs (emotional and sensory). It has been established that all types of deprivation (cognitive and social) significantly affect the child’s speech development.

The separation of a child from his mother at an early age sometimes entails severe disturbances in brain activity and is subsequently one of the main reasons for the development of emotional instability, impulsivity, and behavioral disorders, which, in turn, can be complicated by speech disorders.

After 2.5 years and older, influences such as punishment at home and especially in a child care center, reluctance to attend kindergarten, fear when meeting unfamiliar faces, animals, fear of negative fairy-tale characters, etc., become important.

Neuropsychic health, which ensures normal speech development of a child, depends largely on interpersonal relationships in the family. The following data is of particular importance:

Characteristic characteristics of the mother (anxiety, suspiciousness, infantility, impulsiveness, emotional coldness); rejection from the mother (or other close people); single-parent family; conflictual relationships in the family, changes in the family structure (death, illness, divorce, etc.); Growing up in two homes; a sharp change in life stereotype and type of upbringing; inadequate type of upbringing (“idol”, overprotection, underprotection, inconsistency in the educational positions of parents).

As the child grows and develops, the range of traumatic situations expands significantly due to the increasing importance of environmental influences. These are conflictual relationships with peers and adults, excessive punishment, intimidation, anxiety, a situation of fear, etc.

Taking into account the patterns of action of risk factors allows us to purposefully carry out preventive and correctional pedagogical work.

Chapter 2. Main directions for the prevention of speech disorders

The prerequisites for the normal development of the younger generation are created by measures to protect public health.

One of the important directions in the development of speech therapy assistance to the population is the prevention of speech disorders and the consequences of speech pathology.

This special branch of speech therapy faces the following tasks:

1. Prevention of speech disorders - primary prevention;

2. Prevention of the transition of speech disorders to chronic forms, as well as prevention of the consequences of speech pathology - secondary prevention;

3. Social and labor adaptation of persons suffering from speech pathology - tertiary prevention.

Primary prevention. Prevention of disorders in speech development is based on measures of social, pedagogical and, above all, psychological prevention of disorders of mental functions.

The implementation of preventive health care and special pedagogy begins even before the birth of a child by creating the most favorable conditions for the mother during pregnancy.

The health of the younger generation depends on a number of conditions related mainly to ecology and its influence on the immune, nervous and endocrine systems. Environmental pollution entails an increase in acute and chronic diseases, a decrease in the body's resistance to harmful influences. Along with this, the role of stressful psychological influences is increasing, which in turn worsens the neuropsychological health and immunity of children. The quality of all aspects of parents' health also continues to decline, and with a family history, children more often suffer from the same illness as their parents.

In the system of psychoprophylactic measures, timely genetic counseling of poor parents is essential in order to prevent the development of certain deviations in the neuropsychic and speech development of the child.

Genetic counseling involves clarifying the consequences of the occurrence of genetic diseases in the family, predicting the severity of the disease and the risk of its recurrence, clarifying methods of prevention and its optimal correction.

In cases where a family burden of any pathology is discovered, parents should be well informed about the possible manifestation of the disease in the child, as well as about preventive measures to prevent or reduce the symptoms of the hereditary disease.

With the birth of a child, special responsibility for his mental health falls on the family, which makes the psychological and pedagogical education of young parents especially relevant.

Parents, together with doctors, should closely monitor the formation and development of all physiological reactions, and take the necessary preventive measures in case of their deviations from the norm.

To organize rational methods of preventive pedagogical influence, knowledge of the age-related characteristics of the development of speech function and the psyche as a whole is important.

For the timely development of speech, the mother and other people surrounding the child must constantly communicate with him, trying to evoke a response. In the early stages of a child’s postnatal development, his communication with his mother is not carried out silently, they conduct a “dialogue”, which causes reactions in the baby in the form of revitalization of general movements, smiling, pronouncing sounds and harmonies.

Stimulating the formation of speech function is of great importance for the development of the child. Every effort should be made to ensure that the period of the child’s mastery of motor skills (sitting, crawling, walking, fine hand movements, etc.), and in particular the speech motor apparatus, proceeds favorably. The formation of speech motor function is closely related to the development of general motor skills and in particular with the manipulative activity of the hands.

In children of the first years of life, the development of speech understanding is of particular importance, which largely depends on the speech behavior of adults. A child understands speech by establishing a connection between words spoken by adults and objects surrounding the child.

Mastering two language systems at an early stage of speech development is a difficult task for a child. If a baby hears, in addition to his native language, another language, then his speech may develop more slowly, and in some cases numerous iterations appear, sometimes turning into hesitations of a convulsive nature. In this regard, mutual understanding and a unified approach must be established in the family, which will allow the child to subsequently master two or more language systems.

In the initial period of development, one should not overload the child with mastering words that are difficult to pronounce and obscure, or memorizing poems and songs that are not age appropriate.

When communicating with a child who has already learned to speak, you should ask him simple questions and patiently wait for an answer, be able to listen to the baby and answer him correctly.

The people around the child, with their smooth, clear articulation and calm speech, encourage him to imitate the design of a speech utterance. If a child develops a fast rate of speech, a special speech regime is needed to limit the introduction of new words and concepts into the child’s vocabulary and the speech load in general.

In cases where surrounding adults have incorrect pronunciation or, for fun, copy the child’s speech, the process of mastering correct sound pronunciation becomes difficult, abnormally pronounced speech sounds are reinforced, and in the future such a child may need special corrective training from a speech therapist.

In the process of speech development, children go through physiological hesitations, which manifest themselves in intermittent speech flow, repeated repetition of syllables and words, and pronouncing words during the period of inspiration. These phenomena are associated mainly with the immaturity of coordinating mechanisms in the activity of the peripheral speech apparatus and usually disappear by 4-5 years of life. However, these hesitations can turn into speech pathology if during this period the child is surrounded by a tense psychological situation in the family or his speech education is incorrect. Children should not be punished for errors in speech, mimicked or irritably corrected. During this period, the child must be protected from being in conflict situations; the socio-psychological environment must be specially organized for him in order to stabilize his emotional state. It is necessary to teach the child to speak at a moderate speed. You need to talk to children in a calm tone, pronouncing words clearly and finishing the endings.

Sensory education and the development of play activities are of great importance for the development of speech.

The formation of speech function should be carried out in parallel with the study of the environment. Correct perception of objects, accumulation of ideas and knowledge about them occurs due to the close interaction of speech and sensory development.

The development of differentiated auditory and phonemic perception is a necessary condition for children to successfully learn to read and write in the future. The child’s readiness to learn to write and read is inextricably linked with the ability to understand the sound structure of the language, i.e. the ability to hear individual sounds in a word and their specific sequence. Teaching children to distinguish sounds leads to the development of both attention to the sound side of speech and auditory memory.

One of the tasks of educating a preschooler is to develop skills in voluntary organization of activities based on the programming speech of an adult and the speech of the child himself.

The type of upbringing in the family to a certain extent influences the formation of character traits, speech and the psyche of the child as a whole. Warm relationships with family members, providing a sense of security and emotional comfort, are necessary for the harmonious mental development of the child. Raising a child in a friendly family as an equal member in compliance with all psychological and pedagogical requirements, with an early cognitive, social, and labor orientation, contributes to the formation of character with positive social attitudes with all the diversity of individual characteristics, formed interests and the amount of acquired knowledge.

Understanding the age-related characteristics of a child’s higher nervous activity, knowledge of its physiological changes during critical periods of development of the body of children and adolescents allows parents to consciously ensure a rational psychological regime.

Great responsibility in organizing measures to prevent neuropsychic disorders leading to speech disorders in children rests with preschool institutions. In the process of educational work, they consistently implement the tasks defined by the program in the field of physical, mental, moral and aesthetic development of the preschool child.

However, in a number of cases there are individual reactions of children indicating a violation of the child’s adaptation to new living conditions.

Therefore, at an early age, an essential psychological aspect of the prevention of neuropsychic speech disorders, in particular, is the referral of the child to a child care institution at the age in which he can more easily adapt to new living conditions. Adaptation to a children's institution is most difficult if the child enters it at the age of 9 months to one and a half years. It occurs least painfully before the age of 6-7 months and after one and a half years.

Another way to adapt a child is to first bring the home regime closer to the conditions of a child care facility. It is necessary to accustom him to being away from home without close people. Being outside the family and adapting to these conditions develops cognitive mechanisms, his interest in new objects and people, which makes the child not only calm, but also active. Both at home and in kindergarten, the regime must be built in compliance with hygienic rules, of which one of the important ones is the development of physical activity in children.

For the neuropsychic health of children in kindergarten, the behavior of teachers is of great importance. A friendly facial expression, an equally kind attitude towards all children in the group, pedagogical tact and other positive qualities should characterize the behavioral attitude of the teacher.

The transition to schooling for children from the age of 6 places new demands on the child’s body.

The age of 6 years is a special turning point; it is at this time that the ability to follow certain rules of behavior is formed, to establish personal interactions with peers and adults, to coordinate one’s actions with the actions of other people, to be able to listen and follow the instructions of adults. An essential aspect of mental readiness for school is a sufficient level of emotional and volitional development of the child, at which he can sufficiently fully control his behavior. Forming the ability to comply with disciplinary requirements imposed on children at school occurs through the development of all aspects of the psyche and personality as a whole.

If a child has speech disorders, the need for timely diagnosis of the degree of functional readiness for school education increases. Only with specialists of various profiles can one decide with some certainty the question of the advisability of enrolling a child in school or granting him a deferment.

The school plays a big role in protecting the neuro-mental health of children.

The first weeks of a child’s stay at school are of particular importance in this regard. Changing the usual way of life and adapting to new conditions of social existence require significant stress on all functional systems of the body. In children with speech disorders, the adaptation period is often painful: instability of attention, memory, and distractibility increase. They become irritable, often extremely excitable, restless, lose

appetite, sleep poorly, have difficulty getting in touch with the teacher. Only gradually these phenomena decrease. The correct behavior of the teacher during this difficult period for a first-grader, his patience and kindness, the gradual inclusion of children in the educational load, and an individual approach make adaptation to school easier. The most important task of school mental hygiene remains the prevention of overwork and mental trauma in children, the creation of conditions at school that protect the nervous system of students from excessive stress. In this regard, great responsibility for the state of speech development of children and adolescents falls not only on the speech therapist, but also on the teacher, educator and class teacher.

Class teachers should pay special attention to those students whose speech makes them “difficult” in learning, in relationships with peers and elders, as well as children with increased anxiety, emotional instability, a tendency to self-blame, shyness, isolation, and a tendency to react violently to stress factors.

Such children need to be adapted to a group of peers, to promote the development of contacts between them and the ability to cooperate. In order to overcome feelings of uncertainty and emotional tension in schoolchildren with speech pathology in the process of speech communication, a speech therapist should carry out massive psychotherapeutic work.

Adult family members, educators and teachers must understand the importance of the authority of a teacher for a primary school student, as well as the authority of a peer group for a teenager and the role of self-esteem in early adolescence. Ignorance or ignorance of this information inevitably leads to stress and mental health problems in children, which can affect speech behavior.

Secondary prevention. It is known that speech disorders affect the mental development of the child, the formation of his personality and behavior (secondary disorders).

Profound speech disorders (alalia, aphasia) to one degree or another limit mental development in general. This occurs both due to the functional unity of speech and thinking, and due to a disruption of normal communication with others. The latter impoverishes knowledge, emotions and other mental manifestations of the personality. With organic damage to the brain, the biological conditions for activity change. The child’s new increased capabilities come into conflict with the existing level of requirements for him, with the objective place he occupies.

Since the interaction of biological and social risk factors plays a special role in speech ontogenesis, parents should be maximally involved in correctional work. They should know that a weak or hoarse voice, low motor activity, and a low level of development of the sucking reflex indicate brain damage. Age-related immaturity of the psyche and the symbiotic nature of the relationship between a young child and his parents require the speech therapist to establish trusting contact with them in order to determine their attitude towards the child, their educational attitudes and to involve close people in correctional work.

Society's views on the curability and prognosis of organic brain lesions influence the attitude of parents towards their child. The speech therapist should explain to parents the mechanisms for compensating for the existing organic defect, the significance of such congenital reflexes as echopraxia and echolalia, the first stages of babbling for the development of movements of the articulatory apparatus and the evocation of vocal reactions in the child. Parents should be well aware that the earlier pre-speech correction work is started, the less deviations the speech and intellectual development of children will occur.

Sometimes with children who have speech impairments, parents try to talk less and begin to communicate with gestures, wanting to facilitate mutual understanding. By doing this, they harm the speech and mental development of the child. If a child does not speak, then the close people around him should talk to him as much as possible. Gradually, the child accumulates a vocabulary necessary for his further speech development.

The presence of speech disorders in a child is also often combined with insufficient development and formation of a holistic image of the subject. Therefore, correctional work should be carried out in such a way that first a sensory image of what should subsequently be mediated by a word (the second signal of reality) is created or clarified. Taking into account the individual characteristics of the mental development of children with speech disorders, correctional work is aimed at overcoming both non-speech and speech disorders. The degree and nature of speech impairment and mental impairment determine the child’s ability to learn and actively participate in the social life of the school. Performance at school is hampered by the inability to ask, answer, tell or read clearly and in a timely manner. Because of children suffering from speech disorders, the dynamics of the lesson are often delayed and discipline is violated.

Underdevelopment of the sound side of speech, insufficient development of phonemic processes and sound pronunciation prevent the timely formation of prerequisites for spontaneous mastery of practical skills in the analysis and synthesis of the sound composition of a word. This condition can be considered as the first consequence, creating significant difficulties on the path of children acquiring literacy. The second consequence can be considered the difficulties that children encounter in the process of mastering literacy.

Lagging behind in their studies, schoolchildren who have speech disorders lose interest in learning, moving into the category of discipline violators.

Many speech defects, which are based on organic brain damage, change life prospects. Some disorders of speech function affect not only the acquisition of a profession, but also affect the sustainability of the energy potential of the activity and the preservation of its operational composition.

Thus, the attention of the speech therapist should be maximally concentrated on the timely prevention of possible secondary, more distant consequences of speech pathology. From this standpoint, the state of the sound side of speech should be especially carefully analyzed, since insufficient development of phonemic processes, even with fully compensated defects in sound pronunciation, can lead to deficiencies in mastering writing and reading skills.

In the process of raising children with speech disorders, parents and teachers need to constantly reflect on their behavior and their positions. Mutual understanding, encouragement, mutual respect, maintaining order, interaction both between family members and between teachers and parents play a serious role in the prevention of psychogenic reactive phenomena in children suffering from speech pathology. This provision is especially relevant for students who stutter.

In cases where children experience psychological complications such as personal experiences associated with the presence of a speech defect, fear of speech, withdrawal from situations requiring verbal communication, the speech therapist needs to significantly increase the psychotherapeutic emphasis in his work.

It is necessary to know well and take into account the specific manifestations of a speech defect, as well as the conditions for its full compensation. As a result, a thorough comprehensive study of each child acquires special significance when constructing the optimal option for correctional education and training of children with speech pathology and secondary prevention of complications.

Speech therapy prevention can be effective only if there is complete knowledge of the child’s development (physical, psychological, speech) based on development standards. This will allow the speech therapist to specifically guide upbringing and training, using periods of sensitivity observed at certain stages of ontogenesis. Premature or delayed, in relation to the period of sensitivity, correctional training is less effective, while conscious reliance on the patterns of development of psychophysiological characteristics, psyche and speech allows the speech therapist to achieve significant success.

Tertiary prevention. Some speech impediments limit career choices. Professional guidance and training of persons suffering from speech pathology are included in the tasks of tertiary prevention of the consequences of speech disorders.

The main focus of this stage is a deep consideration of the personal capabilities and interests of each student suffering from severe speech impairment. Such students should have the opportunity to choose, with the help of a teacher, psychologist, and doctors, a learning path that will allow this particular individual to achieve the best results. For this population of students, it is especially important to shift the focus of learning from cognitive development to emotional and social development.

Changes in the health status of children of a negative nature, various chronic diseases, orphanhood, vagrancy, leading to polymorphic deviations in the mental and speech state make it necessary to create centers for medical, psychological and pedagogical rehabilitation, home education centers and other children's rehabilitation institutions. In our country, there is a tendency to abandon the uniform trajectory of children’s education with the organization of new educational institutions, which take into account not only the abilities and inclinations of students, but also their psychophysical state.

speech disorder prevention hearing

Conclusion

With ideal prevention, speech failure would be reduced to a minimum, and, consequently, the need for speech therapy assistance in childhood would also be reduced.

Prevention of speech defects begins, in fact, from the same moment the child’s speech itself begins, i.e., from infancy. And here we must take into account both the moments of speech ontogenesis (the gradual development of speech in a child) and the main components (component parts) that make up our speech. The speech environment is of dominant and decisive importance in the prevention of children's speech disorders.

Preventive work can be defined as preventing speech defects with the help of pedagogical techniques and means and carrying out psychohygienic activities. Children's speech during the period of its intensive development is an extremely vulnerable system, sensitive to negative external influences. In this regard, a mandatory component of preventive activities includes: protecting the neuro-mental and physical health of pupils; ensuring a calm, friendly atmosphere for children’s life, psychological comfort in the educational environment and preventing external influences that stress the child; early identification of risk factors in speech development, deviations from the norm in health status, congenital and acquired diseases that affect speech development; preparing children for possible difficulties at the school stage.

Thus, we can conclude that the prevention of speech disorders is necessary for normal speech development, since delayed speech development complicates the child’s relationship with others, and subsequently affects his literacy, reading and development of other mental functions.

Bibliography

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3. Home speech therapist. Complete reference book. / Ed. Eliseeva Yu.Yu. - M., 2007

4. Zhukova N.S. Formation of oral speech. - M., 1996

5. Speech therapy./ Ed. Volkova L.S., Shakhovskaya S.N. - M., 2002

6. Mastyukova E.M., Ippolitova M.V. Speech impairment in children with cerebral palsy. - M., 1985

7. Methods for examining children's speech. /Ed. Chirkina G.V. - M., 2003

8. Fundamentals of the theory and practice of speech therapy. / Ed. Levina R.E. - M., 1967

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