Overcoming speech pronunciation disorders in patients with efferent motor aphasia. Dysarthria Classes with a speech therapist

EXERCISES TO DEVELOP PRONUNCIATION

AND INTONATIONAL AND EXPRESSIVE SIDE OF SPEECH

1. Reflected speech.The child is asked to repeat, after the adult, a series of words pronounced in ascending order, then phrases, then sentences. For example: “Mom”, “Mom washed”, “Mom washed the frame”, “Mom washed the frame in the morning”, etc.

2. Different intonation.For research, you should ask the child to repeat after an adult phrases spoken with different intonations. For example: “Sanya is sledding”, “Do you want candy?”, “Take the car”, “Oh! The ball fell! and so on.

3. Reading poems. Offer your child ready-made short poems to read, containing different intonation colors. For example: “Our Tanya is crying loudly and dropped a ball into the river. Hush, Tanya, don't cry! The ball won’t drown in the river!”

On the topic: methodological developments, presentations and notes

Speech therapy work on the development of intonation expressiveness of speech of children with speech disorders.

A child’s speech begins with intonation. In this regard, it is necessary to carry out work to develop the perception and understanding of the main components of the intonation design of an utterance (tempo, volume, tone...

Intonation side of speech

This article fully reveals the essence of intonation speech disorders, their diagnosis and correction....

Formation of intonation expressiveness of speech in work with primary schoolchildren with general speech underdevelopment.

The article presents the stages of formation of intonation expressiveness of speech in primary schoolchildren with general speech underdevelopment. This article is relevant for primary school teachers and speech therapists...

Goals: - to promote the formation of intonation expressiveness in students; - to continue work on the formation of colloquial-dialogical speech in students; - to enrich, clarify and activate vocabulary...

• Massage for speech rehabilitation

A stroke causes serious problems in the functioning of the brain. Depending on the location of the lesion, the patient experiences optic nerve atrophy and loss of speech and motor function. The resulting speech impairments may be temporary or chronic.

The optimal recovery time is the first few days after the attack. The course of therapy depends on the type of aphasia. When deciding how to restore speech after a stroke, a neurologist, in close collaboration with a speech therapist, selects the most effective treatment, depending on the type of disorder.

Why do people lose the ability to speak when they have a stroke?

Loss or deterioration of speech due to stroke is called aphasia. The cause of pathological changes is an acute disruption of the blood supply to the brain, causing tissue atrophy, especially in the departments directly responsible for the perception of information.

Lack of speech is observed immediately after the attack. The localization of the lesion is concentrated in the cortical lobes of the prefrontal regions. Atrophy and necrotic manifestations are irreversible. Therefore, to restore speech impairment after a stroke, it will take a long period of time for speech functions to learn to be performed by undamaged areas of the brain.

How long does it take for speech to be restored?

The period of time during which the patient learns to speak again depends on the type of aphasia, as well as the location and extent of the cerebrovascular accident. The prognosis for rehabilitation is also influenced by the speed of first aid. It is necessary to develop speech as early as possible.

It is customary to distinguish several types of disorders, depending on the stage of development of the pathology:

• Total aphasia - occurs in the first few days after a stroke. At this moment, the patient does not understand the direct address, does not remember anything or anyone.
• Motor aphasia after a stroke - under favorable circumstances, total impairment is replaced by motor dysfunction. At this stage, the patient understands the speech addressed to him, but is unable to respond; at best, confused speech may come from the patient.


• Sensory aphasia - a feature of speech dysfunction is the complete or partial inability to analyze speech sound. The patient ceases to recognize syllables and sounds, does not understand the meaning of individual words and sentences. Even the victim’s native speech sounds like a foreign language.

When diagnosing disorders, a medical protocol is drawn up for studying the speech of a patient who has suffered a stroke. Information recorded in the medical history greatly facilitates further therapy. Using the records, you can track trends towards improvement in the patient’s well-being and, if necessary, adjust the approach to treatment.

How and with what to treat speech impairment after a stroke

A speech therapist deals with the correction of speech disorders. When prescribing therapy, the specialist is guided by the results of preliminary examinations. Thus, patients whose left side of the body is paralyzed have a more favorable treatment prognosis. Typically, paralysis occurs in a mirror image of the damaged area of ​​the brain. Consequently, the brain tissue responsible for speech, located in the left hemisphere, remained intact.

Damage to the speech center of the brain is indicated by right-sided paralysis. Therefore, patients who are paralyzed on the right side have a poorer prognosis.

The timing of speech restoration directly depends on the degree of damage to brain tissue and the location of the hemorrhage. Speech therapy is prescribed immediately after the patient regains consciousness. Early treatment increases the chances of full recovery.

Speech restoration drugs

The time for speech recovery after a stroke can be reduced to a minimum if you start classes with a speech therapist already 1-3 weeks after the attack. Along with speech therapy assistance, special exercises and techniques, medications are prescribed to improve speech.

The course of therapy is aimed at restoring the functions of damaged tissues. New methods of speech therapy for post-stroke patients involve the use of several therapeutic techniques at once to support the patient:

Elimination of violations of extended phrasal speech, even after discharge, takes place exclusively under the guidance of a speech therapist. The use of music therapy and regular use of nootropic protectors brings good results. A sudden slowdown in speech during recovery may indicate a recurrent stroke. Hospitalization and additional examination by a specialist are required.

How to restore speech using folk remedies

In most cases, speech restoration after a stroke is observed at home. Moreover, this happens unexpectedly, both for the patient himself and his close relatives.

Using the following traditional medicine recipes will help restore speech faster after a stroke:

Traditional medicine methods are aimed at restoring the function of brain tissue. Since some herbs and plants have contraindications, you should consult your doctor before use.

Massage for speech rehabilitation

Speech therapy work with patients who have suffered a stroke includes not only work on restoring lost speech functions.

Hemorrhage leads to atrophy of the muscular system. Often the patient experiences numbness of the tongue. The speech therapist carries out regular stimulation of all speech zones. During a stroke, the tongue may take an incorrect anatomical position, which will make it impossible for the patient to pronounce sounds.

Regular speech therapy massage sessions contribute to the patient’s rapid recovery.

What exercises can you do to restore your ability to speak?

After discharge you will need to continue doing articulation exercises. Practical speech therapy classes to restore speech at home will help to gradually improve the patient’s condition, even in cases where the result was not obvious during drug therapy and sessions with a speech therapist.

Exercises for speech recovery and development after a stroke include the following:

Tongue twisters for people after a stroke

Speaking tongue twisters is strongly associated with childhood. Surprisingly, this technique is used not only by pediatric speech therapists. Tongue twisters are used to develop speech.

It is better to leave the selection of texts to the attending physician. He will be able to select phrases that help restore tongue mobility and improve the patient’s diction.

Tongue twisters are usually aimed at pronouncing a specific letter from the alphabet. When selecting phrases for speech development, the speech therapist will select the most suitable ones, taking into account existing diction defects.

An optimistic attitude and close adherence to recommendations, both by the patient and his relatives, significantly improves the chances of a complete restoration of lost speech functions. You should not hope for quick results. It is better to gradually move towards your goal, rejoicing at any success.

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Statistics know and warn

What is a stroke, how does it occur and, accordingly, what can be done to prevent it? For the normal functioning of the brain, it is necessary to provide it with sufficient oxygen. And it is delivered to the organs by blood. If a blockage or rupture of blood vessels occurs, the cells become deficient in oxygen and die. But the brain is a regulator of certain body functions. Let’s say that if the area of ​​the brain responsible for the movement of the right hand is damaged, then it is this function that will be impaired.

We'll talk about prevention a little lower. But why is the topic of timely and complete recovery after a stroke so important?

In our country, this disease accounts for an average of 175 deaths for every 100 thousand people. In absolute numbers, the statistics are as follows: about half a million people suffer a stroke in Russia every year. And half of them die. Of those who survive, about 90% (even more) become disabled.

There are other impressive figures: only 8 percent of survivors of the “blow” are able to return to work. About 31 percent need help from others, and 20 percent can't even walk on their own. The situation in the world as a whole is little better: 6 million deaths a year and even more disabilities with paralysis of limbs, serious impairments of speech and other functions.

Types of strokes, signs and basics of prevention

There are two main types of strokes:

• Ischemic is otherwise called cerebral infarction. It results in blockage of blood vessels, which stops blood flow.
• Hemorrhagic is a non-traumatic intracerebral hemorrhage with rupture of a vessel. In this case, the blood flows into the brain tissue.

There are also special cases, much rarer: subarachnoid hemorrhage, atherothrombotic and hemodynamic stroke. I’ll just say a few words about the latter: usually problems occur with high blood pressure, but a hemodynamic stroke, on the contrary, occurs against the background of low blood pressure. All extremes are harmful!

How to understand that it is a stroke? There are several main signs:

• Sharp weakness, feeling of numbness, loss of sensitivity, most often on one side of the body.
• Sudden facial asymmetry.
• Impaired speech and understanding.
• Strong headache.
• Dizziness, loss of coordination, difficulty walking.
• Severe visual impairment, double vision.

The main rule: do not delay contacting a doctor, call an ambulance, otherwise the risk of death or disability increases sharply. Help should come within the first 2-3 hours. Everything is written in detail in the article First Aid for Stroke

Risk factors for stroke, in addition to high blood pressure, are smoking, alcohol, high cholesterol, obesity, diabetes, and arrhythmia.

Recovery process

How long will it take to recover and is it possible to recover after a stroke? It all depends on many factors. What type of stroke is it, how large is the area of ​​the brain affected, which area was affected, how much time passed from the moment of the attack to the time of admission to the hospital, was first aid professionally organized, etc.

Depending on the combination of different conditions, the process can take from 2-3 months to several years. Moreover, if the brain damage turns out to be significant, then only partial restoration of various functions is possible.

Restorative measures begin in a hospital setting. Then this concern is transferred to the shoulders of relatives. You will have to restore blood supply to the limbs and the whole body, work on speech, develop mental abilities, learn to walk again, take care of yourself at least at the level of the simplest skills: dressing, holding a spoon, etc.

Competent recovery is always comprehensive: massage and physical therapy, the use of medications and physiotherapy, acupuncture, exercise equipment and classes with a speech therapist, etc. It will be important to create a comfortable psychological environment and moral support for loved ones. All this together will become techniques for recovering from a stroke at home, and at the same time preventing recurrent attacks and complications.

Restoring motor functions after a stroke

As soon as the days of crisis have passed, still within the walls of the hospital, work begins to restore the ability to move. What procedures are prescribed after a stroke? Usually this is massage, electrophoresis, and other physiotherapy, everything is used so that the muscles do not atrophy and blood circulation does not stagnate.

Physical therapy plays a huge role in this process. Even while lying down, the patient tries to make the simplest possible movements. With the help of family and medical workers, he begins to turn from side to side, raise and lower his limbs, and perform other manipulations. If the lesion is small, the process goes faster, soon the patient is allowed to slowly get up from the bed, and then begin to move around the ward with the help of a walker.

Finding the joy of movement again is extremely important both physically and psychologically: if there is success here, then the mood for further recovery will certainly appear. In addition, we must not forget about such physiological reactions as the accumulation of “joy hormones” as a result of active movements.

It is more difficult for those who have deep brain damage. There is a danger of the formation of bedsores and serious muscle atrophy; here the role of those around you is especially great. Relatives will have to help and take on the functions of “sisters of mercy”.

And all this must be done in strict accordance with the doctor’s recommendations. Especially in terms of individual load. It is harmful to feel unnecessarily sorry for the patient, but to force events, to increase the workload to an unbearable level means exposing your loved one to the risk of another stroke. With even more serious consequences.

The doctor will give precise advice on those specific exercises that are most indicated in your individual case. He will tell you the dose, give other advice, will be in touch, you can and should contact him in case of difficulties.

Exercise therapy (physical therapy) after a stroke. Exercises at home. Video

And now I suggest you watch a set of exercises for recovery after a stroke in the video. The physical therapy doctor tells you what exercises to do at home if the patient can already sit and the first movements of the limbs appear.

The main devastation is definitely in our heads!

And regarding the individuality of loads and the body’s reaction in general, I’ll tell you a real case.

I came to visit a relative in the vascular pathology department. Her roommates turned out to be a colorful grandmother of 84 years old and a woman of about 50. The mature lady constantly whined, pestered her relatives, demanding more offerings and unrealistic displays of care. She annoyed both her roommates and the medical staff with her constant whims and reproaches. She was carried home on a stretcher. The nannies and sisters breathed out a sigh of relief and crossed themselves.

A couple of days after admission, my grandmother had a crisis. I won’t retell the details, it’s not very pleasant, take my word for it: almost everyone, including grandma’s daughters, was sure: that’s it, he wouldn’t get up in the morning. Morning came, grandmother sat down on the bed and loudly indignant: “Well, where are they, they promised fish soup, but they don’t deliver!” And she tried to stand by the window. Then she joked, talked about her turbulent youth and made plans for the next summer season. She went home on her own two feet, albeit with crutches.

Restoring speech after a stroke. Exercises

How to work with speech? The situation is even more complicated with the restoration of speech and thought processes after a stroke. All this takes several years, and is not always completely successful. Here, as in the case of motor skills, persistent, long-term work is required, a system is needed. Not training in fits and starts, but systematic work.

Nerve cells are highly inert, and it will not be easy to “stir” those located in the area of ​​the affected speech center. We need to understand this and be realistic. What exercises can you recommend?

Just talk, try to pronounce phrases, individual words and even sounds. And then recite poetry and turn to other more complex speech structures.

There is no need to start with tongue twisters and simply complex constructions; restoration should proceed logically. How do we work with young children? We learn the alphabet, try to hone individual hard-to-pronounce sounds, then read syllables, and only then master whole words and sentences. So here, the principle is the same.

The skill will return sooner if you try to sing the necessary phrases. Or just sing your favorite hits, so speech comes more naturally and easily.

Sometimes you will need the help of a speech therapist who will help you do special gymnastics of the speech apparatus to restore the necessary functions. So, folding the lips into a tube is useful; moving the tongue back and forth, licking the lips with the tongue in a circle, etc.

Solving memory restoration problems

Restoring and improving memory after a stroke is not an easy but very important task. This work should begin as early as possible, as soon as the risk of a recurrent stroke has been removed.

First of all, doctors resort to modern medications that are designed to support the affected neurons. For this, patients are prescribed intravenous administration of nootropics, that is, those drugs that can significantly improve metabolic processes in the brain and at the same time have a positive effect on memory.

At the stage of outpatient treatment, these drugs continue to be taken, only in the form of tablets. The most frequently prescribed, and also the most effective, nootropics are thiocetam, piracetam, fezam, lucetam, nootropil. Their action is not quick; a long course of treatment is required with gradual accumulation of results. Therefore, a big mistake is made by patients who stop taking medications soon after discharge. The course, as a rule, lasts 3 months, and then, after a short break, it should be repeated.

Functional rehabilitation treatment is also important. This is a constant training of mental skills, especially the ability to remember. It is useful to remember phone numbers, poems, and various board games such as puzzles help a lot. At the same time, fine motor skills of the hands will develop and speech functions will improve.

Overcoming depression

Perhaps the most important and most difficult aspect of recovery from a stroke is coping with a stressful situation. Especially when the attack occurred at working age. A man, at full speed, is forced to stop. He loses his working skills, and at the same time, his self-confidence. Depression begins, sometimes quite deep.

And not everything always “dissolves” on its own. And even the constant support of loved ones is not a guarantee of success, although it is extremely important. You have to seek professional support from a specialist, psychologist or psychiatrist.

And again here I’m talking about the mood of my family, about the need to be patient. Sometimes it seems to us that tearfulness or aggressiveness, sudden mood swings, irritability are the whims of the patient. But these are natural consequences of brain damage, this is what you need to know and not forget about.

After the first energetic emotional reaction, apathy often sets in. As they say, they give up, they don’t want to do anything, the person indifferently expects that somehow everything will sooner or later be resolved by itself. This is the most negative scenario; it is difficult to convince such an “Oblomov”, to encourage him to train, to engage in self-development. What for? He assures himself and those around him that he cannot return to his former health and ability to work, and he does not consider it necessary to constantly strain so that his arms, legs, and brain work at least half as hard.

It is especially difficult for those who have worked a lot and are accustomed to being responsible for themselves and their loved ones. Not everyone is able to overcome this crisis with a painful “breaking” of pride. You will have to involve both specialists and antidepressants.

What will help improve your mood? The same physical activity, feasible chores around the house, dacha, communication with children and grandchildren, communication. It’s great if colleagues don’t forget, they will at least call, consult, and sometimes drop by for a visit. Water treatments, walks, communication with nature, reading, playing with grandchildren - everything works together. The main thing is not to lose the feeling of being needed, not to feel like a burden.

Motivation can come from a hobby for which you never had enough time. Let's say fishing. One thing, of course, you can’t let go of, even if your walking has improved. But a family outing with fishing rods can be a great psychotherapy session. Someone will begin to learn how to weave baskets, make toys, or master other folk crafts.

Again, this needs to be done constantly. Recovery after a stroke is not just a long process, it is lifelong. If you are not afraid of this and tune in to the positive, you can live a full, interesting life for many years, learn new things and please your loved ones, while enjoying life yourself.

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It should be noted that this process is not simple. Modern medicine widely uses stem cells in this area. In addition, the restoration of nerve impulses occurs during classes with a speech therapist.

Application of stem cells

Is it possible to restore speech after a stroke using stem cells? Modern medicine proves that with such therapy the body receives additional mental strength, a person’s desire for recovery increases, and his mood improves. This method is most effective if it was applied in the first days after the stroke occurred.

How to restore speech after a stroke using stem cells? This procedure is performed as an outpatient treatment. Two procedures are required, with a three-month rest period between them. Treatment begins with vascular restoration. Procedures are carried out to eliminate ischemia, atherosclerosis and thrombosis, and spasms are eliminated.

The vessels acquire elasticity, the thickness of their walls and the beds themselves are optimized. In those areas where the vessel was blocked and ruptured, new collateral pathways begin to form.

Speech after a stroke

The timing of recovery of speech function is closely related to the area of ​​damage to the nerve cells in the cerebral cortex that are responsible for speech. The more extensive the damage to the brain, the slower the rate of recovery of the ability to speak. If within a year there is still hope of regaining lost speech, then over time the pace of rehabilitation slows down.

The body of a person who has suffered a stroke gradually adapts to the remaining speech defects. Therefore, people around you should be understanding. Under no circumstances should the patient be allowed to withdraw into himself and be isolated from people. To restore the lost function, a person must communicate more, take part in various discussions, and perform simple exercises.

Types of speech impairment after stroke

Any type of speech impairment after a stroke can be gradually eliminated. In order for rehabilitation to proceed successfully and quickly, you need to understand the specifics of the defect and choose the right treatment method. There are disorders such as sensory and motor aphasia.

With motor aphasia, speech is perceived by the patient by ear and even understandable to him. However, it is extremely difficult for a person to pronounce words independently or formulate thoughts. The patient has difficulty reading and writing. Most often, these functions are completely lost.

What is sensory aphasia? The patient may mutter something incoherently, speech is not subject to his control. The reading skill is not lost, but the meaning of what is written is unclear to the patient. The ability to write words is completely absent.

As a result of a stroke, the patient's speech is characterized by confusion. When speaking, he gesticulates vigorously, includes expressive facial expressions and many different intonations. A person tries to formulate his thoughts, but he fails, since the correct pronunciation and selection of the right words are lost. The patient may show aggression and often cry. His condition is nervous. After a stroke, adequate perception of the surrounding world is lost.

How does speech restoration work?

How to restore speech after an ischemic stroke? After stabilizing the patient’s condition, doctors advise immediately starting measures to help restore speaking skills. In order for the pace of rehabilitation to be rapid, a professional speech therapist must work with the patient, but psychological support from relatives is also extremely important.

How to restore speech after a stroke? Exercises developed specifically for this purpose are widely used by speech therapists. The specialist’s work is based on the gradual return of the lost function through various tasks: working with cards, laying out children’s lotto, pronouncing words syllable by syllable and completely. The doctor can teach the patient to compensate for the lack of verbal expression with gestures.

Classes cannot be suspended even if the desired effect is not achieved for a long time. Sooner or later, the persistent efforts of the doctor and the patient will yield results.

How to restore speech after a moderate stroke? Recommendations on how to carry out exercises to restore it are clear. The main goal of the exercises is to force the cells located in the affected area of ​​the brain to perform lost functions. This is achieved through constant training. The patient needs to hear live speech. You should constantly communicate with him. This will help him start making sounds.

As for the pronunciation of whole words, in the case of a complete lack of speaking skills, the patient is asked to pronounce individual sounds and syllables. For this purpose, a person is told part of a word or phrase. In this case, the endings are not agreed upon. The patient must pronounce them himself.

Singing has a beneficial effect on the development of the ability to reproduce words. If you sing to a patient and invite him to sing along, he will recover his speech much faster. This method has a high level of efficiency.

Restoring the ability to pronounce sounds is very important. Perhaps a person is able to speak, but due to severe disruption of the innervation of the facial and chewing muscles, they freeze.

Exercises to develop muscles

How to restore speech after a stroke? The development of facial muscles is mandatory.

The patient is offered:

• fold your lips into a tube;
• bare teeth;
• push your tongue forward as much as possible;
• lightly bite the upper and lower lips with your jaws;
• lick your lips with your tongue in both directions.

Speech therapist's work

After the patient has been examined and the type of aphasia has been determined, classes with a speech therapist should immediately begin. It should be noted that in a third of people who have suffered a stroke, speech is completely restored at the time of discharge from the hospital. Of course, this is possible if the hospital has a speech therapist who conducts classes with the patient from the very first week of his illness.

What is speech therapy?

Speech therapy is a science that studies speech disorders, develops ways to overcome and prevent them, and methods of correctional work. Patients who, even after classes with a doctor, are discharged with severe speech impairment, with subsequent work carried out regularly, can cope with the shortcomings and begin work.

Methods used by speech therapists

From the very beginning, the speech therapist “unfreezes” impaired speech functions based on previous stereotypes. The doctor checks the patient's reaction to mild stimuli, for example, muffled speaking. The work is based on the principle of increasing the level of tasks from easy to complex.

This takes into account the important nuance that the selection of exercises is carried out individually, taking into account the degree of damage to the patient’s speech apparatus. The type of aphasia is also taken into account.

For one person it will be easy to name objects, for another it will be easy to maintain a dialogue, etc. But you cannot always give easy tasks. Their complexity must steadily increase.

The first session should not be burdensome for the patient. At the beginning of rehabilitation, it is recommended to use material that has emotional significance for the patient. The corresponding semantic load is also selected.

What should not be offered in the initial stages of treatment?

Carrying out the initial stages of treatment is of great importance. It is not recommended to suggest working on individual words out of context and connecting sounds. To restore speech, the speech therapist must create all possible conditions so that the patient can carry on a conversation as quickly as possible.

Application of singing

After a stroke, singing will help restore speech faster. Speech therapist classes with the inclusion of elements of music give positive results. If the patient finds it difficult to finish the sentence that the speech therapist began, then you can suggest listening and singing your favorite songs. It is necessary to find out what songs the patient likes and knows. During the singing process, the words are initially pronounced unclearly by the patient. Gradually their pronunciation improves. Such an assignment should take place in a positive atmosphere. It brings pleasure to the patient.

Immediately after the patient is able to pronounce words, his interest in independent study should be aroused. For example, invite him to insert missing letters or prepositions into sentences.

What methods are used for people with sensory aphasia?

Visual materials are used for people with sensory aphasia. The patient is shown a picture, which is asked to be copied if his condition allows it. Then a word is called that symbolizes the image. All actions carried out by a speech therapist are accompanied by friendly, calm comments: “Let’s straighten the pillow,” “Please raise your head,” “Now you can put your head on the pillow.” This is how you can restore speech after a stroke in the presence of sensory aphasia.

Patients with this disorder have difficulty distinguishing words that sound similar in sound. A suitable exercise is to use drawings. The patient must show the named object. For example, pairs of consonant words such as “tom - house”, “point - kidney”, etc. are selected.

Duration of classes

The duration of classes and the intervals between them depend on the individual capabilities of the patient. The average is 7-15 minutes. After two months, the exercises can be done for half an hour. The load on the patient's speech and hearing apparatus should also be kept under control.

The room should be quiet, the radio or TV should not be turned on.

Help from a speech therapist in the later stages

If the help of a speech therapist was not provided in the first weeks of the disease, then speech disorders are persistent. And in this case, it is possible to restore the lost function, but an aphasiologist who has his own methods must work with the patient.

Support for someone who has had a stroke

It is very important to maintain an optimistic attitude in the patient. The hospital staff, the patient's relatives and the speech therapist should not make the person feel that he is disabled. Otherwise, the person will withdraw into himself and perceive the disease as a death sentence. After a stroke, patients' emotional sensitivity is too high. In this case, affectionate treatment will be the best assistant in restoring the lost ability to speak.

Is it possible to conduct independent classes under the guidance of loved ones?

How to restore speech after a stroke at home? Relatives can conduct independent exercises only with the permission of a doctor. It's important not to overdo it here. You should not unnecessarily overload the patient or give him overwhelming tasks.

Relatives often lack patience and want to achieve the desired result in a short time. Little success in recovery causes them disappointment, which is expressed in facial expressions and gestures. The patient, having caught such a reaction from loved ones, loses optimism and may subsequently refuse treatment. Therefore, the patient’s relatives are not present during classes with a speech therapist.

Important Notes

To restore speech and memory after a stroke, it is recommended to persistently force the patient to pronounce the names of surrounding objects. It has been proven that patients remember objects better than actions.

When communicating with a person who has suffered a stroke, it is important to take into account that during a parallel conversation between several people, the patient has difficulty distinguishing sounds and words.

Those who have suffered a stroke should not watch TV for more than 2 hours a day. You should select only calm, interesting programs. For example, a sports program will encourage sports fans to comment, which will have an impact on speech restoration.

Folk remedies

Can folk remedies restore speech after a stroke? A proven method used by people is to use thinly sliced ​​or grated black radish. It should be kept in your mouth. At the same time, a burning and tingling sensation occurs in the oral cavity. A compress is also made from radish. It is applied to the damaged facial nerve.

Conclusion

The article discussed how to restore speech after a stroke. This process is long and painstaking. It requires the diligence of both the patient and the doctor. Patience, support from loved ones, a calm attitude and strict adherence to the doctor’s recommendations will help a sick person cope with the disease.

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Only a specialist can more accurately determine the type of speech disorder and what type of disturbance occurred in the body. As a rule, this is a professional speech therapist.

During the examination, the doctor can determine the following types of speech disorders:

Any form of post-stroke speech loss should be seen by a speech therapist. The doctor will prescribe special exercises and tell you about effective methods of restoring it.

During the examination, the speech therapist determines the type of general disorder and, based on them, prescribes appropriate options for the full restoration of speech.

The doctor will monitor the dynamics of the process and make appropriate changes aimed at solving the question of how to regain speech.

If recovery processes are started in a timely manner, such unpleasant symptoms as loss of the ability to speak and slurred speech go away quickly enough, and the person begins to fully communicate with others.

With the question of whether it is possible to restore speech after a stroke, everything is clear, but it is quite possible. The next question that patients and their loved ones ask is the beginning of the restoration process, that is, at what time should the process of speech restoration begin.

It can be noted here that on average, quite a lot of time is spent on full or maximum partial restoration of speech after a stroke. In some cases, therapy takes several years; often a positive result can be achieved in about three months.

It is possible to restore speech completely after it has been seriously impaired or completely absent.

The sooner you start treatment and rehabilitation measures, the greater the positive result that can be achieved.

A professional speech therapist can determine the type of speech disorder within two weeks after an attack and, based on it, develops a treatment process. Many techniques can be used in normal home conditions.

The patient will be advised of the features of the exercises, the frequency of exercises, the possibility of combining and alternating different techniques. When restoring speech on your own, it is important to rely on the recommendations of specialists and conduct the first classes under his supervision.

Self-medication in this case will not lead to positive results in resolving the issue of how to restore speech after a stroke.

Speech therapy exercises after a stroke at home, especially in the initial stages, are best carried out under the supervision of specialists. This is important because during the recovery process it is necessary to adhere to certain rules.

Among the most basic rules and conditions that the specialist clearly adheres to are:

Even if the recovery process is difficult at first, you should not give up. Consistency and regularity are important here.

Before starting a speech restoration course at home, under the guidance of a specialist or independently, you need to draw up a program of activities that will be aimed at treating speech impairment.

In the process of drawing up such a scheme, the doctor goes in two directions:

1. Drug treatment when pills are prescribed to improve speech after a stroke. This is a special therapy, the main effect of which is aimed at preventing various complications and relapses, restoring the affected part of the nervous system and improving general brain structures.
2. Speech classes with a speech therapist or under his instructions and under his periodic supervision.

Practical exercises for restoring speech in patients after a stroke are prescribed without fail, since without this it is simply impossible to return normal speech.

It is worth noting that this can be not only words and sentences, but also the restoration of general motor skills. Such exercises also have an impact on the overall speed of speech recovery after an attack.

Modern medicine offers a large number of different techniques aimed at restoring basic speech functions. A professional speech therapist will select a special technique for each specific case.

Here are the most popular and effective exercises that will help quickly restore speech after a stroke:

Quite a serious effect can be achieved in the process of treatment and recovery in group classes.

Stroke patients are much more willing to share information and communicate. All this restores speech functions much faster, moreover, helps to make new acquaintances.

In the process of recovering from an attack, you can do not only exercises aimed at improving the mental process. It is worth doing special gymnastics to develop the speech apparatus.

Among these exercises the following can be noted:

This is an ideal opportunity to quickly restore muscles and flexibility, which has the most positive effect on the overall speech apparatus.

The patient must carry out a full range of well-designed measures. Only after their precise implementation can we talk about obtaining certain positive results.

In order for the recovery process to proceed as quickly as possible, the first time a person who has experienced a stroke should study together with relatives.

The main work aimed at developing speech at the very first time should not exceed 15 minutes. In the future, the duration of classes can reach 30 minutes.

The best option is several approaches throughout the day for 10 minutes.. Outside of class, you should also try to talk as much as possible, for example, describing your actions.

The patient needs to constantly ask questions, first to obtain monosyllabic questions, then more detailed ones.

Relatively little time is spent on exercise, so therapy can be supplemented with treatment and recovery methods such as physiotherapy, acupuncture, and functional biofeedback.

Modern physiotherapy is designed for effective electrical stimulation of the entire speech muscles as a whole. The procedures very well correct general articulation and also improve speech activity.

In the process of restoring speech processes and functions after a stroke, traditional medicine methods can be used. Just like exercises, they need to be coordinated with your doctor, since self-treatment can lead to certain problems that are then very difficult to cope with.

To quickly return and restore speech after an attack, you can use the following folk remedies:

Traditional medicine recipes are designed to restore the original functioning of brain tissue.

In combination with medications, modern physiotherapeutic procedures, as well as speech therapy exercises, traditional medicine recipes are able to have a unique positive effect, allowing the body to recover very quickly.

First aid for myocardial infarction Effective folk remedies for hypertension

We have found that the formation of stable auditory-pronunciation and rhythmic-intonation skills is a long-term process, therefore work on pronunciation should take place at all levels of education. During the study of this work, the most effective exercises aimed at developing auditory and pronunciation skills were identified. They were divided into two large groups:

• 1. Listening exercises.
• 2. Exercises in reproduction.

These two groups are closely related to each other, and they are both necessary for the development of both auditory and pronunciation skills.

Listening exercises. The number of types of actual phonetic exercises in listening is relatively small, and all of them were aimed primarily at developing phonetic hearing and establishing differentiated characteristics of studied or repeated phonemes and intonemes.

Listening was active, so it was always accompanied by a task that focused the student’s voluntary attention on a specific characteristic of a phoneme or intoneme.

The exercises were performed by ear and using a graphic support.

As an example of the first exercises, we can cite the following tasks, which were repeatedly used in lessons in primary school:

Listen to a series of sounds/words, raise your hand when you hear the sound [...]; listen to pairs of sounds and raise your hand when both sounds of the pair are the same; listen to the sentence and say how many times the sound [...] occurs in it. You can turn this task into an interesting game, and when the children heard the sound, they clapped their hands.

Playback exercises. The effectiveness of this group of exercises aimed at developing students’ own pronunciation skills increased significantly if the reproduction was preceded by listening to a sample, regardless of whether new material was being trained or previously learned material was being repeated.

The material for these exercises was individual sounds, syllables, words, phrases, and sentences. They were organized:

Based on the principle of analogy (all examples contained the same feature).

According to the principle of opposition (the examples were selected in such a way that they contrast some feature).

*Or given in any order.

In the first two cases, the exercises performed a training function, and in the last - mainly a control one.

Examples of tasks performed by ear:

Pronounce sounds/syllables/words/phrases/sentences, paying attention to (sign indicated) after the teacher;

remember words containing the sound [...]; repeat the sentence, adding the word suggested by the teacher to it.

In addition to special exercises for substituting, maintaining and improving the students’ pronunciation, the following technique was used: memorizing tongue twisters, rhymes, poems, dialogues, passages of prose and reading aloud passages of texts studied from the textbook. These types of work pursued two goals: to achieve, firstly, maximum correctness of pronunciation and, secondly, its fluency.

It should be said that the two stages of work differed accordingly.

At the first stage, the text was memorized under the guidance of the teacher, as a result, students received a grade for reading correctly. Only after this did the second stage of work begin, aimed at speeding up the reading of a poem/dialogue/excerpt from a text that had already been learned: the student was required not only to pronounce correctly, but also fluently.

The exercises listed above and similar ones were used at all levels of education, although their purpose was somewhat different: at the initial stage, their goal was to develop auditory and pronunciation skills; at the middle and senior levels they are aimed at preventing mistakes. Therefore, they should be performed when mastering new language material, before appropriate exercises in oral speech and before reading texts.

For the same purposes, at the beginning of each lesson, as we have seen, it is recommended to carry out so-called phonetic exercises. In which we included the most phonetically difficult material from the lesson: one or another rhythmic-intonation model, group of sounds, etc. The exercise included 1-2 tasks of the above types, which were completed by the student and the choir, and in turn.

Exercises aimed at developing rhythmic and intonation skills in various types of sentences: interrogative, imperative, complex and complex sentences.

When assessing the correctness of a student's speech, phonetic and phonological errors were distinguished. The first distorted the sound quality, but did not violate the meaning of the statement; the latter distorted the content of the statement and thereby made the speech incomprehensible to the interlocutor. In accordance with the accepted approximation, the presence of errors of the first type was allowed in the student’s speech and was not taken into account when assessing the answer, while phonological errors were regarded as a violation of the correctness of speech.

We also found out that it is possible to distinguish phonetic exercises by levels of material organization; namely:

• 1. Exercises at the level of individual sounds. The task was set: to practice the pronunciation of isolated sounds, for example, in exercises like Hört zu und sprecht nach. Beachtet...(indicates what to pay attention to): a, e, i, o, u - aus bist du!
• 2. Exercises at the level of sound combinations. The task was set: to prevent “palatalization, etc. The task could be formulated in the same way as in 1:

Didi-dada-dede-dudu; didl-dadl-dumm-dumm; li-li, le-le, la-la, lo-lo, lu-lu, etc.

3. Exercises at the word level. The following task was set: to work on the development of phonemic hearing, for example: Hort zu und sprecht nur die Worter mit nach:

Liegen - legen; Lies - lesen; sehen - sieht; ihr-er, etc.

This included exercises on stress in simple, derivative and complex words.

4. Exercises at the level of phrases. The students had to practice a hard attack. Task as in 1:

Ich auch; aus bist du; ich heive; auch du; das ist, etc. Of particular importance was the work on the intonation design of the phrase, for example:

Hört zu und sprecht nach. Macht keine Pausen in der Mitte: In der Schule; in der Classe; auf dem Tisch, etc.

5. Exercises at the sentence level.

The main task was the following: to work out sounds in a speech whole, a phrasal sentence, etc.

Task as in 1:

Das ist unser Schulhof. Die Kinder Spielen Ball.

6. Exercises at the supra-phrase level:

The task we set was to work out the differentiation of intonation patterns:

Das ist ein Junge. - Ist das Jan? Wie ist das Wetter? - Ist es kalt?

Within this classification, exercises were differentiated according to the operations performed. Thus, all of the above examples of exercises were based on practicing the following operations: perception and reproduction (examples 1, 2, 4, 5), perception, differentiation and selective reproduction (examples 3, 6). The latter require more analysis and independence.

The study revealed that the formation of phonetic skill involves the restructuring of habitual articulation based on the establishment of similarities and differences in the pronunciation of sounds in native and foreign languages, the formation of phonemic hearing, as well as mastering the technique of pronouncing foreign sounds in a word, phrase, sentence and in the speech stream in the process of both speaking and reading.

Mastering foreign language intonation involves the formation of auditory skills in perceiving the intonation pattern and its adequate reproduction in the process of speaking and reading.

We offer the following set of exercises that were used and loved by children:

1) Articulatory gymnastics exercises:

Open your mouth wide and keep your lower jaw still. Alternately press the tip of your tongue into the alveoli of the upper and lower teeth. Lips are free, not tense.

Press the tip of your tongue alternately, with endurance, into the inner surface of the right and left cheeks.

Do both exercises. For four counts, the tongue rests on the alveoli of the upper and lower teeth, and then on both cheeks.

Open your mouth, lower your jaw as much as possible.

Open and close your mouth, covering your upper teeth with your upper lip so that the edges of the lip curl slightly inward.

Pull your upper and lower lips toward your gums, exposing your teeth but not your gums.

Move the corners of your lips back as far as possible and then forward.

Quickly change the position of your lips.

Purse your lips, then relax them.

Pull your tongue forward as far as possible, then pull it back towards the root.

Pronounce the vowels and consonants of the language you are learning, being aware of the articulatory structure (using tactile, motor, auditory and visual analyzers) and feeling the muscular tension of the speech apparatus.

Close the back of your tongue with the soft palate and pronounce the sound, first separately, then in combination with vowels and consonants.

Exhale briefly and pronounce the sounds [p], [t], [k] (inhalation exercise).

2) Exercises for the development of speech (phonemic and intonation) hearing:

Listen to the magnetic recording of the sounds, syllables, words and sentences read by different speakers, and mark the male, female and children's voices with numbers.

Determine whether the speakers' pronunciation is more or less clear. Determine the tempo of the two soundtracks.

From a series of sounds perceived by ear, isolate and record the sounds indicated by the teacher, first observing the teacher’s articulation, then without observing it.

Orally divide what you hear into sounds and name them.

Determine the number of syllables in the words you hear.

Set the number of short vowels in the words you hear.

Note the opposition of sounds in the sounding words.

Select by ear the words with the trained sound from a connected text and write them down in spelling.

Determine the number of words in the sentences you listened to.

Make up a word from the isolated sounds you listen to and write them down in spelling.

Identify pauses in the sounding speech stream.

• 3) Exercises to develop pronunciation skills:
  • * Listen to the sound repeatedly in a phrase, word, then listen to the isolated sound.
  • * Listen to a series of sounds and raise your hand when you hear the given sound.

In a series of words (phrases, sentences), underline the one that the speaker pronounces.

Underline the word in the sentence that is stressed.

Make phonetic markings of the text based on the teacher's voice, then read aloud.

Name words containing a specific sound.

Read the sentences in the affirmative form, and then transform them into interrogative and negative sentences. Test yourself using the key.

Pronounce the words syllable by syllable, paying attention to the pronunciation of vowels (consonants) in the initial (final) position.

Repeat vowel sounds in opposition: voiceless/voiced; nasal/non-nasal; palatalized/non-palatalized.

Name the objects shown in the pictures, paying attention to the pronunciation of the given sound.

Read the text according to the syntagmas after the speaker.

Learn a poem by heart (patter, rhyme, dialogue). Pay attention to clear pronunciation of sounds and intonation.

Take part in a phonetics competition.

Thus, we can say that the decisive factor in creating pronunciation skills, like any other, are phonetic exercises.

So, when compiling and conducting phonetic exercises, it is advisable to proceed from the nature of pronunciation difficulties.

Abstract: This article provides a brief description of disorders of the pronunciation side of speech in patients with efferent motor aphasia. And. The exercises described in the article are suitable for working with patients with moderate and moderately mild severity of the disorder.

Overcoming speech pronunciation disorders in patients with efferent motor aphasia.

The most common consequence of a stroke is speech dysfunction, manifested in the form of aphasia and dysarthria.

The term "aphasia" comes from the Greek. “fasio” (I say) and the prefix “a” (not-) literally means “I don’t say.”

Aphasia is a speech disorder manifested in the complete or partial loss of the ability to use language while maintaining the functions of the articulatory apparatus and hearing, caused by local damage to one or more speech areas of the brain.

Brief characteristics of speech pronunciation disorders in patients with efferent motor aphasia

When the secondary fields of the cortex of the lower parts of the premotor (posterior frontal) zone of the left dominant (in right-handed) hemisphere of the brain are damaged, an efferent motor aphasia, the primary defect of which is efferent motor apraxia.

Efferent articulatory praxis– is the ability to reproduce a series of speech sounds, i.e. the ability to switch from one articulatory posture to another. These switches are complex in the way they are executed. They involve mastering inserted fragments of articulatory actions - coarticulations, which are “connections” between individual articulatory poses.

Without coarticulation, a word cannot be pronounced, even if every sound included in it is available for reproduction. When pronouncing, for example, the word “cat”, at the moment of articulating the first sound (K), we are already preparing the articulatory structure for subsequent sounds and syllables. The word “cat” does not sound like K, O, Sh, K, A, but is represented by a complete chain of articles smoothly flowing into each other.

The most characteristic symptom of this form of aphasia is impaired speech production, due to pathological inertia of articulatory acts. In the speech of such patients, perseverations are frequent, preventing a smooth switch from one articulatory posture to another; omissions, rearrangements, addition of extra sounds, iterations - repetitions of sounds, anticipation - likening one syllable to another are observed.

Overcoming speech pronunciation disorders in patients with efferent motor aphasia

Overcoming disorders of the pronunciation side of speech in efferent motor aphasia is carried out in several stages.

Stage 1: Development of oral-articulatory switches.

Oral praxis underlies articulatory praxis. Therefore, work should begin by developing a smooth switch from one oral-articulatory pattern to another. To do this, use the following types of exercises:

Click your tongue once, blow twice;

Click your tongue 2 times, blow 3 times;

Spit from the tip of your tongue 1 time, click your tongue 2 times;

Spit from the tip of your tongue 2 times, click your tongue 3 times;

Click your tongue at the front upper teeth 1 time, spit 2 times from the tip of your tongue;

Click your tongue at the front upper teeth 2 times, spit 3 times from the tip of your tongue;

Click 1 time, click your tongue 2 times at the front upper teeth;

Click 2 times, click your tongue 3 times at the front upper teeth, etc.

To avoid getting stuck on one oral-articulatory structure, use rhythmic tapping.

Stage 2: Development of articulatory switches within a syllable.

At this stage, smooth switching within a syllable is practiced: first only on vowel sounds, then consonants are added. When working with vowels, a conducting method is used: a hand movement for each sound. Independent reading (or conjugate pronunciation) of practiced syllables.

with vowels contrasting in articulation pattern.

For example: AU IO EU YO OE AO ​​UI /

AUI IOA EUO YOI OEU AOU UIA /

AUIO IOAU EUOA YOIE OEUI AOUY UIAO /

with various vowels, including iotated ones.

For example: YAYE YOI YUYA IE YYO YAY /

YAYOU YYOA YIO YYAI IEY YYOA YAIU /

YAYOUI EYAO YIOYU YYAYIE IEYO YYAU YAIUY /

in a combination of consonants and vowels.

For example: MA BO DU LY VI SHE TE DYA GE (open syllables)

AM ABOUT UD YL IV YESH ET YAD EG (closed syllables)

in combination with consonants contrasting in articulatory pattern.

For example: KPA - PKA / MSO - SMO / GDU - DGU / BLY - LLY

AKP – APK / OMS – OSM / UGD – UDG / YBL – YLB

building up syllables.

For example: RI – THREE – STRI – PSTRI /

CA – DCA – GDCA – BGDCA /

ChE – PChE – KChE – TKChE /

Stage 3: Exteriorization of the sound-rhythmic side of the word.

At this stage, the emphasis is on restoring the ability to analyze the sound-rhythmic side of a word by differentiating words by length and syllabic composition.

Dividing words into syllables.

Independent reading (or conjugate pronunciation) of practiced words with clapping (tapping) of each syllable. Words are selected with a gradual complication of sound and syllabic structure (one-syllable words, two-syllable words with open syllables, three-syllable words with open syllables, four-syllable words with open syllables, two-syllable words with one closed syllable, etc.).

For example:

POK ONION JUICE SON /

KA-SHA BUT-YOU PO-LE BA-NYA /

A-FI-SHA O-HO-TA U-DA-CHA /

KA-NI-KU-LY GU-SE-NI-TSA /

MA-TE-MA-TI-KA PE-RE-NO-SI-CA /

VO-LOS ZA-MOK CITY KO-LOS /

highlighting the stress in a word.

Independent reading (or conjugate pronunciation) of triplets of words with moving stress. Emphasizing the stressed syllable with a more sonorous clap.

For example: PE-NI-E NA-U-KA KO-LE-SO /

LI-NI-YA KA-YU-TA MO-LO-KO /

LI-LI-YA PO-E-MA RE-SHE-TO /

Smooth pronunciation of the outline of a word with emphasis on the stressed vowel.

For example: birch - BIRCH

galoshes - galoshes

caterpillar - caterpillar

selection of words with identical sound-rhythmic structure.

Independent reading (or conjugate pronunciation) of practiced pairs of words. Words are selected with a gradual complication of sound and syllabic structure. You can give a task so that the patient himself selects a pair for a given word.

For example: com – HOME /

daughter - NIGHT /

lady – FRAME /

front sight – DUSHKA /

cabin – CURRENCY /

darkness – COMPLETENESS /

selection of rhyming words.

Independent reading (or conjugate pronunciation) of words with clapping (tapping) of each word.

For example: HALL - BAL - SHAFT - FAILURE - BOUNDED - RENTED - STOLE /

WILL - SHARE - FIELD - AT SCHOOL - IN ROLE /

STEAMER – TRANSITION – ALL-TERRAIN VEHICLE – SEABOAT – TRANSITION /

Stage 4: Consolidating pronunciation in phrases and phrases.

Rhythmic pronunciation of phrases using a metronome.

Independent reading (or conjugate pronunciation) of rhyming phrases in a rhythm convenient for the patient under a metronome.

For example: NOISY Feast – NEW WORLD /

FULL TANK – RED POPPY /

QUICK STEP – WHITE VARNISH /

Tapping the rhythm of a simple phrase.

Independent reading (or conjugate pronunciation) of simple phrases with logical emphasis.

For example: CHILDREN GO TO THE CINEMA /

CHILDREN GO TO THE CINEMA /

CHILDREN GO TO THE CINEMA /

A DOG IS SITTING IN A BOOTH /

A DOG IS SITTING IN A BOOTH /

A DOG IS SITTING IN A BOOTH /

Stage 5: Consolidating pronunciation in poetry.

Reading poetry using the conducting method.

For example:

The leaves in the field have turned yellow,
And they circle and fly;
Only in the forest they ate withered
The gloomy greenery is kept...

All lexical material is selected according to the principle “from simple to complex”, taking into account the individual characteristics of patients, their premorbid level, age, professional and personal interests.

Bibliography:

1. Wiesel T.G. Fundamentals of neuropsychology. – M.: AST: Astrel: Transitbook, 2005.
2. Wiesel T.G. How to get your speech back. – M.: V. Sekachev, 2005.
3. Defectology. Dictionary-reference book/Auth.-comp. S.S. Stepanov; edited by B.P. Puzanova. – M.: TC Sfera, 2005.
4. Lalaeva R.I., Paramonova L.G., Shakhovskaya S.N. Speech therapy in tables and diagrams. – M.: Paradigma, 2012.
5. Misarenko G.G. Didactic material for the development of reading techniques in elementary school: Textbook. allowance. - 3rd ed., revised. - M.: Institute of Innovation in Education named after. L. V. Zankova: Publishing house "ONICS 21st century", 2003.
6. Rodkin A.F. Reverse dictionary of the Russian language: about 29,000 words. – St. Petersburg: “Avalon”, “ABC-Classics”, 2006.
7. Tsvetkova L.S. Aphasia and remedial learning. – M.: Education, 1988.
8. Shklovsky V.M., Vizel T.G. Restoration of speech function in patients with different forms of aphasia. – M.: V. Sekachev, 2012.

Denisova M.I.,
speech therapist GAU NPRC

Taking into account the characteristics and capabilities of children with hyperkinesis, it is necessary to abandon the use of some specific methodological techniques, in particular physical exercises, students’ work at the blackboard, with a typesetting canvas, with letter and syllabic boxes. In some cases, special and individually selected teaching methods and techniques are used: weighted pens for writing, the use of computers, magnetic boards, etc.

For cerebellar Dysarthria is characterized by asynchrony between breathing, phonation and articulation. Speech is slow, jerky, chanting, with impaired modulation and fading of the voice towards the end of the phrase. There is difficulty in reproducing and maintaining articulatory patterns. Phonetically, the pronunciation of those sounds that require sufficient clarity and differentiation of articulatory movements suffers ( front-lingual)

Features of correctional and speech therapy work for cerebellar dysarthria

Cerebellar dysarthria (atactic) is observed in the atonic-astatic form of cerebral palsy.

The main sections of speech therapy work are: developing synchronicity of articulation, breathing and phonation; development of proportionality and accuracy of articulatory movements; strengthening proprioceptive sensations and development of speech praxis; speech game therapy, logorhythmics, singing.

Considering all the features of the disorder in the cerebellar form of dysarthria, several main stages speech therapy work:

1. Formation of correct breathing:

To give a feeling of movement of the diaphragm, intercostal muscles, abdominal muscles in order to develop the skill of speech lower costal diaphragmatic or thoraco-abdominal type of breathing with training of extended exhalation;

Practicing diaphragmatic breathing without speech accompaniment;

Exhalation is accompanied by a long sound with intonation of pleasure and displeasure А______И_______У;

By selecting the appropriate posture and soothing massage, relieve tension in the muscles of the neck and larynx;

Practicing an even, stable, flexible voice and confident sound of any pitch; in this case, raising and lowering the voice is used on the sonorant consonants M, N with pauses and without pauses;

5. Work on developing intonation:

Practicing the intonation of a question, statement, exclamation, command, persuasion, invitation, request, threat;

Practicing intonation using logical stress, highlighting stressed words, pauses, changing the tempo of speech (elements of dramatization and dialogue are widely used).

The main tasks for correcting the pronunciation side of speech in children with dysarthria:

1) development of motor skills of the articulatory apparatus;

2) developing the skills of correct pronunciation and discrimination of sounds;

3) overcoming difficulties associated with the pronunciation of words with a complex syllable structure.

Work on pronunciation traditionally begins with the preparatory stage, which includes:

· passive, passive-active, active articulatory gymnastics,

· formation of phonemic representations.

Speech therapy massage normalizes muscle tone, weakens hyperkinesis, and normalizes speech breathing. The choice of speech therapy massage techniques is carried out differentially, depending on the condition and tone of the speech muscles. (tell the difference between massage)

For dysarthria, along with segmental manual massage, finger acupressure can also be used (to weaken hyperkinesis - cross acupressure by K.A. Semenova).

· In children with severe dysarthria work on speech motor skills begins with the use involuntary movements: yawning, chewing, swallowing, coughing.

Development work tongue mobility in children with severe articulation disorders it begins at an involuntary reflex level:

1) to shorten the tongue, you need to put a piece of sweet on the tip of the tongue or touch the tip of the tongue with a spatula;

2) to develop sideways movements of the tongue, place a piece of sugar between the cheek and teeth;

3) to move the tongue forward to the child’s lips, they pass candy or spread jam on the lower lip.

Root muscle stimulation tongue begins with their reflex contractions by irritating the root of the tongue with a spatula. Consolidation is carried out by voluntary coughing.

For activation of movements of the soft palate teach voluntary swallowing: a speech therapist drops drops of water from a pipette onto the root of the tongue, stimulating cough-like movements and yawning.

Passive gymnastics This form is called when the child makes a movement only with the help of mechanical influence - under pressure from the hand of a speech therapist or an appropriate probe or spatula.

Exercises for the lower jaw:

1) with mechanical assistance: movements of the lower jaw to the right - left, up - down (the speech therapist holds the child by the chin). All movements are performed in front of a mirror;

2) opening the mouth through reflex yawning. An easier technique is to open your mouth with your head slightly thrown back; close - in the position of tilting the head;

3) active movements: opening and closing the mouth, clicking teeth, holding the mouth open while counting.

Lip exercises:

1) holding various objects (for example, plastic tubes) with the lips with a gradual decrease in the diameter of the object;

2) stretching the lips with a “proboscis” - stretching the lips with clenched jaws (first with mechanical assistance);

3) stretching the lips - stretching into a smile with the jaws open;

4) stretching the upper lip along with the tongue (the tongue pushes the upper lip);

5) drawing the lips inside the mouth with a tight press to the lips;

6) biting the lower lip with the upper lips;

7) pulling the upper lip behind the lower lip;

8) rotational movements of the lips extended with a “proboscis”.

Tongue exercises:

1) forward and backward movements of the tongue are carried out by grasping the tip of the tongue through a sterile napkin;

2) biting the tip of the tongue;

3) movements of the tongue to the right - to the left (perform first with mechanical assistance);

4) lifting the tongue by the upper teeth (the tongue moves between the lips, the child smacks his lips and tongue, the lips are moved back by the speech therapist, the tongue is moved inward with a spatula - the result is a snapping of the tongue at the alveoli of the upper teeth);

5) suction of the tongue to the palate, which is first produced with the mouth closed. The speech therapist then lowers the child's lower jaw.

Are being processed voluntary facial movements(furrow your eyebrows, puff out your cheeks, smile).

In parallel with the development of mobility of articulatory muscles at the preparatory stage, active work is underway on breathing correction, voices, the formation of phonemic representations.

The method of sound production and correction is selected individually. The “analog” sound is called For a child with dysarthria, approximate pronunciation of a sound is a certain step on the path to mastering normative articulation. Mastery of a sound analogue is sufficient for the child to be able to operate with it while working on the development of phonemic concepts and sound analysis skills. Features of speech therapy work on the correction of sound pronunciation in dysarthria are:

· significantly longer time to work on each sound;

· the need to simultaneously work on several sounds belonging to different articulatory groups;

· reliance on the child’s compensatory capabilities (intact analyzers, correctly pronounced sounds, involuntary movements, sound combinations);

· adherence to a certain sequence in working on sounds.

G.V. Chirkina points out that the sequence of work on sounds is determined by the following factors:

· the degree of accessibility of sounds for pronunciation and the gradual transition from lesser to greater pronunciation difficulties;

articulatory and acoustic proximity of sounds;

· the ability to select speech material, including sounds.

The degree of accessibility of sounds depends not only on the ease of articulation, but also on the possibility of visual perception of individual elements of articulation and the presence of an “oral image of sound.” The following sounds are considered to have visible articulation: a, o, y, e, i, p, b, m, f, v, w, g, l, s, t, k (according to the degree of decrease in the visible elements of articulation).

Among consonants explosive Consonants are easier to learn than fricatives. Among explosives, the lightest sound is [P]. Among fricatives the lightest sounds [f], [v], [x].

Correction of sound pronunciation for dysarthria is usually combined with work on improving the intonation expressiveness of speech (L.V. Lopatina, N.V. Serebryakova, 2001).