Causes of speech disorders in the elderly. Speech disorders: classification of pathology, symptoms and methods of treatment. Causes of slurred speech

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FEATURES OF SPEECH DISORDERS IN ADULTS

1. THE CONCEPT OF SPEECH DISTURBANCE

2. ETIOLOGY AND PATHOGENESIS OF SPEECH DISORDERS

3. FEATURES OF SPEECH DISORDERS IN ADULTS

CONCLUSION

BIBLIOGRAPHY

INTRODUCTION

Relevance. Speech disorders in adults are the breakdown of already established speech in adults caused by various diseases. The causes of speech disorders in adults can be: stroke, dynamic circulatory disorders, head trauma, tumors, slowly occurring neuropsychiatric diseases characterized by dementia.

However, speech defects can also form later as a result of physical and mental overwork, prolonged vocal loads, various diseases and physical injuries.

As a rule, people rarely have perfect speech data that does not require correction. The causes of deviations from the norm are organic and functional. Organic include serious anatomical and physiological disorders of the mechanism of speech. This is an imperfection in the structure of the tongue (a shortened hyoid ligament, a massive tongue, etc.), shortcomings of the dentoalveolar system (an open anterior or open lateral bite, an upper or lower jaw that is too forward, an imperfect structure of the palatine curtain, etc.). Functional causes are characterized by the normal physiological structure of speech mechanisms and can manifest themselves in violations of the ratio of the processes of excitation and inhibition in the central nervous system. Severe forms of functional speech disorders are as difficult to correct as organic ones.

Disorders of the pronunciation side of speech are diverse. You can divide them into groups depending on the suffering link. These are defects: sound pronunciation (dyslalia, dysarthria), voice (dysphonia), tempo-rhythmic side of speech (accelerated tempo - takhilalia, slow tempo - bradilalia, stuttering). These disorders can occur in isolation and in various combinations.

According to statistics, the number of speech disorders tends to increase. For example, in the 1990s, the number of people suffering from stuttering in the country exceeded 5 million people.

Speech disorders in the neurorehabilitation clinic can be associated not only with aphasia, but also with pseudoaphasia that occurs when the subcortical regions are affected dominant hemisphere without direct damage to the cerebral cortex. IN Russian literature it is designated by the term "subcortical aphasia". The mixed nature of speech disorders is characteristic (sensory-motor disturbances and a fast pace of recovery).

Violation of oral and writing common in patients with stroke. These two concepts are not synonymous, since reading and writing are equally important speech functions.

Since the 1940s, a new understanding of aphasia has emerged in connection with the advent of a new science - neuropsychology. The founder of this direction A.R. Luria for the first time moved from a simple description of aphasia, characteristic of classical neurology of the 19th century, to its analysis and qualification of the defect.

In adults, we can talk about self-correction. Without independent work, without the manifestation of personal interest, activity and initiative of the trainees themselves, it is impossible to achieve high results.

Based on the foregoing, it is obvious that more and more attention should be paid to speech correction, which determines the relevance of this course work.

Goal of the work. To study the features of speech disorders in adults.

Work tasks. To achieve this goal, it is necessary to solve the following tasks:

To reveal the concept of speech disorder;

To identify the main causes of speech disorders;

Give a brief overview of the main speech disorders in adults and determine the directions for their correction;

To study the methods of diagnosing peripheral speech disorders in adults.

Subject of research in this term paper there is a speech disorder.

object Causes of speech disorders in adults.

The degree of development of the topic. Many well-known scientists, for example, N.S. Zhukova, E.M. Mastyukova, L.N. Efimenkova, A.V. Yastrebova, G.V. Chirkina, T.B. Flerina and many others. etc. Nevertheless, there are many unresolved issues here as well. When writing this work, the studies of Bolshakova S.E., Krause E.N., Polyakova M.A. were used. and etc.

Work structure is conditioned by the goals and objectives set and consists of an introduction, three chapters of the main part, a conclusion and a list of references.

1. THE CONCEPT OF SPEECH DISTURBANCE

Functional systems that provide speech are a complex and multi-stage mechanism, including the activity of many structures and pathways of the central nervous system, auditory, visual and motor-kinesthetic analyzers, muscles of the speech apparatus. For normal speech, the coordinated functioning of the entire brain is necessary, and above all the cortical speech zones located in the dominant hemisphere (in right-handed people in the left).

There are two types of speech. Expressive (motor) oral speech can be expressed in the form of a dialogue (most often) and a monologue. Oral speech, in contrast to accurate and detailed written speech, is characterized by abbreviations, a large role in it belongs to intonation, facial expressions, and gestures. Impressive (sensory) speech has the function of understanding the meaning of words and sentences. In the implementation of expressive speech, the normal functioning of the lower frontal sections of the dominant hemisphere, where the motor program of speech utterance is formed, is important. The normal speech process occurs with close interaction of the temporal and frontal sections of the dominant hemisphere, as well as their interconnection through the corpus callosum with the cortical structures of the subdominant hemisphere (in right-handed people) and the underlying brain formations using the limbic-reticular complex. The latter is the most important integrative system of the body. This system is important in the formation of motivation for verbal utterance, without which there can be no verbal communication.

Speech disorders are communication disorders that are associated with structural (gross defects) or functional (mild impairments) defects. Such disorders can be formed with anatomical underdevelopment of the organs of the ear, throat, nose and mouth, decay of voice and speech after any disease. The concept of "speech disorders" also includes various deviations from the norm adopted in a given language environment, which fully or partially prevent verbal communication and limiting the possibilities of social adaptation of a person.

It so happened that both doctors (neurologist, psychiatrist, otorhinolaryngologist, neurosurgeon, dentist) and teachers (speech therapists, psychologists, defectologists, neuropsychologists, oligophrenopedagogues) deal with voice and speech disorders. In this regard, two classifications are used in practice.

Speech and spontaneous speech production are the main functions necessary for both social communication and intellectual life. Loss of speech due to brain damage exceeds the severity of blindness, deafness and paralysis.

The concept of pronunciation and speech are complex and little studied activities of the brain. These terms are not synonymous.

Speech in the narrow sense of the word is understood as the use of acquired vocal, manual, auditory and visual skills in communication. These skills include the ability to pronounce words, distinguish between stress, intonation, and melody; reproduce written signs with a certain spatial orientation, pick up speech by ear and distribute it in relation to the speaker, visually recognize handwritten or printed text, features of visual search when viewing text, as well as other less specific features. A lack of such skills makes it difficult to communicate independently of other speech disorders; if these skills are preserved, only the basic needs of communication are satisfied, this is reminiscent of a conversation between two people in different languages.

For the implementation of motor oral speech, cortical control of the movements of the speech muscles using descending cortico-bulbar tracts, as well as the perception and analysis of afferent motor impulses that occur during the contraction of the muscles of the speech apparatus in the process of speech activity, is necessary. Based on this analysis, the performed action is compared with the initially specified program. In case of discrepancy between these programs from ts.n.s. additional nerve impulses(corrections), coordinating the work of the motor speech mechanism. In this way, speech praxis is formed - purposeful automatic speech movements that form the basis of the motor side of speech.

With the defeat of the central link of the speech-motor analyzer (cortical speech zones) during the period when oral speech is formed, the ability to use one's own speech is completely or partially lost. With underdevelopment or damage to the same parts of the cerebral cortex in the early period of development, systemic underdevelopment of speech alalia occurs. With damage to the left frontal lobe (in right-handed people), motor alalia develops, a violation of the formation of oral speech when it is understood; with damage to the left temporal lobe (in right-handed people), sensory alalia is a violation of speech understanding while maintaining its elementary auditory perception.

With a focal lesion of the cortex of the dominant hemisphere of the brain, agraphia may develop, a violation of written speech, the ability to write correctly in meaning and form in the absence of violations motor function hands and intellect. Agraphia is often combined with aphasia. In children with alalia, there is a specific difficulty in the formation of written speech, dysgraphia. Agraphia is usually combined with alexia with a reading disorder or difficulties in its formation in children with developmental dyslexia. In adults, alexia is often combined with sensory aphasia.

The most severe speech disorders are observed with widespread brain lesions with involvement of the cortex and subcortical-stem sections in the pathological process. In the genesis of speech disorders in cerebral palsy, along with damage to certain brain structures great importance has secondary underdevelopment or later formation of those parts of the central nervous system that develop most intensively after birth, the premotor-frontal and parietal-temporal cortex big brain. It is known that in functional organization of these departments, afferent impulsation from the speech and skeletal muscles, visual-auditory and auditory-visual-motor-kinesthetic connections play a decisive role. Integrated perception of sensory signals and their processing, generalization and formation of concepts are possible only with the joint activity of the right and left hemispheres. Therefore, with focal lesions of the brain, a slowdown in the rate of its maturation, a mismatch in the activity of the hemispheres, various disorders of speech formation are noted.

To a large extent, speech disorders are due to the low employment of sick children in subject-practical activities, relatively little life experience and communication with a very limited circle of people. In the most important periods of life for the development of speech, a child with cerebral palsy is in various medical institutions. If they do not pay enough attention pedagogical work, speech development of the child lags behind normal. Negatively affect the development of speech and reactive states, sometimes occurring in sick children in connection with a change in their usual way of life.

Significant mistakes sometimes made by parents in the process of education have an adverse effect on the development of speech. If parents overprotect the child, strive to do a lot for him, prevent all his desires or fulfill them in response to a gesture and a look, the need for activity, in particular in speech, fades away. In such cases, the child is deprived of verbal communication, which is important for him, which is a prerequisite for the development of speech. All of these factors, in combination with motor pathology that limits the ability to move, determine the specifics of pre-verbal and speech development children with cerebral palsy. The life experience of a child with cerebral palsy is extremely poor, and the objects and phenomena of reality surrounding him are so diverse that without the help of an adult and special training, he cannot comprehend what his senses perceive. The verbal designation of surrounding objects is fixed with difficulty because of the weakness of the sensation of the "motor image of the word" by the organs of articulation. Owing to oculomotor disorders, weakness of groping hand movements, as well as the APT reflex, the simultaneous functioning of vision and touch is difficult, associative connections between the visual and motor-kinesthetic analyzers are not formed. In connection with this, as well as with the violation of manipulative activity and the weakness of kinesthetic sensations, already from the first years of life, an abnormal development of the process of sensory cognition of the surrounding reality is noted. Phonetic and phonemic disorders that slow down the overall pace of the child's speech development increase the specific difficulties in developing a holistic view of the subject in him, which contributes to the underdevelopment of the lexico-semantic system of the language.

Speech in the broad sense of the word (language) has a broader meaning, it involves the choice and arrangement of individual words in accordance with the rules that allow a person to use speech modalities to change from one manner of speaking to another and to express that poorly understood type of brain activity called thinking. A speech disorder in a disorder of brain activity, usually occurring together with a violation of the ability to verbal communication, is called aphasia, or more precisely dysphasia.

2. ETIOLOGY AND PATHOGENESIS OF SPEECH DISORDERS

All causes of speech disorders are usually divided into two large groups - organic and functional.

Organic causes include those causes whose action can lead to a violation of the anatomical structure of the speech apparatus in its peripheral or central sections. In particular, organic damage to the speech sections of the brain can be caused by a violation normal conditions intrauterine development of the fetus, some types of mechanical assistance during childbirth, the state of prolonged asphyxia of the newborn, etc. Anomalies in the structure of the peripheral part of the speech apparatus can be caused by heredity or be the result of an unfavorable course of pregnancy (the facial skeleton is laid in the second or third month), and can also be acquired after the birth of the child.

It is customary to refer to functional reasons as those whose action does not lead to a change in the very structure of the speech apparatus, but only disrupts its normal operation (function). The role of such causes can be various kinds of stressful situations, frequent and prolonged illnesses of the child in early age, debilitatingly acting on his nervous system and the organism as a whole, incorrect methods of re-educating left-handed people (the very expediency of such re-education is now denied by most experts), a social environment that is unfavorable in terms of speech, etc.

However, the distinction between the causes of speech pathology into organic and functional is purely arbitrary and is most applicable only in cases of gross organic damage to the speech organs.

Such a distinction is especially difficult when it comes to the central section of the speech apparatus: it is difficult to imagine purely functional changes in a completely normal structure of the brain. Apparently, in many cases, organic changes in it can be so insignificant that they simply cannot be detected by modern research methods. Therefore, it is no coincidence that recent decades so much is said about minimal brain dysfunction with its characteristic microorganic lesions of the medulla.

According to I.P. Pavlov, we can talk about functional disorders of the brain cell only when it is not deeply damaged and is still able to get out of the inhibitory state, that is, when its change is reversible. If favorable conditions are provided, this cell can still return to normal functioning. In organic lesions, cell damage is irreversible.

It is especially important to take into account the following: long-term functional disorders can become irreversible and thus, as it were, become organic.

Thus, the question of the causes of speech pathology is rather complicated and requires simultaneous consideration of many factors. adverse factors in their interaction, which must be taken into account by speech therapists.

We have 60% of the adult population with speech defects. Speech was generally taken lightly. Listen to how monstrous they say even on radio and television. Speech is a complex mechanism in which four vital elements are involved: intellect, emotions, intuition, and energy. And if speech is disturbed, this indicates that there is disorder in the inner kingdom of a person, instead of harmony there is disharmony.

Violation of sound pronunciation - dyslalia - comes from childhood, stuttering - often too. The third category of speech defects in adults are disorders resulting from injuries, mainly to the head, or diseases, such as stroke.

A pronunciation defect can be mild, when only individual sounds are not obtained, and organic, associated with damage to the central nervous system after a birth injury or a hereditary factor. A typical example of an organic speech disorder is "porridge in the mouth." Now very often there is such a violation as late speech development. And there are more and more children who start talking late every year. Moreover, these are children normal intelligence and an absolutely normal psyche, and then, it simply accompanies a person in adulthood.

Over the years, a defective "r" or another sound turns into an additional psychological burden, a person begins to complex. No psychiatrist will help here, you have to go to a speech therapist and put on the sound. Sound pronunciation depends on the mobility of the tongue. In order to activate the tongue, it is necessary to massage it, put it in the correct position, which the speech therapist does in several sessions with the help of special tools.

Let's say, to get "r" out of the throat, the tongue is held with a probe in a certain position, which the person must feel. Further, a speech therapist automates pronunciation using special material, makes this sound native - this is how a person masters it. For adults, this is more difficult than for children, the process sometimes drags on for many months.

In some people, the hyoid ligament (bridle) is too short, causing the tongue to not reach the upper palate and correct pronunciation the same "r" is impossible. The only way is to cut this bundle. A simple operation - hooking - is done by dentists.

As for stuttering, then, first of all, you need to decide that this is not a disease, because it cannot be treated with medicines or through surgical intervention. This is a condition that depends on the characteristics of the nervous system. It happens barely noticeable or functional, when speech is simply not developed, or when hesitation provokes bilingualism and insufficient lexicon. In adults, this defect is associated with a very common psychiatric diagnosis today - panic syndrome. Someone begins to stutter after an injury, when the speech center is affected. Stuttering has a wave-like character - at some age it weakens, at some it intensifies, somewhere it may completely disappear, but one way or another it will manifest itself again. There are more boys and men among those who stutter. This is due to the peculiarities of their more vulnerable nervous system.

It is difficult to cope with stuttering in adulthood, because a person has developed a character and attitude towards speech impairment. Some people manage to make it part of their image, although they are still unable to fully accept it. A neuropathologist can remove the general nervous background, but only a speech therapist will really help.

3. FEATURES OF SPEECH DISORDERS IN ADULTS

Difficulties also lie in the fact that the same violation can be caused by different reasons and, conversely, the same reason can cause various speech disorders. So, for example, tongue-tied tongue may occur due to improper functioning of the peripheral speech apparatus, or it may be caused by more serious, organic disorders of the central or peripheral speech apparatus.

The classification of speech disorders is usually based on the reasons by which these disorders are caused. Therefore, it is very important to find out the very nature of these causes. This makes it possible to better understand the classification of speech disorders.

Speech disorders include tachilalia and bradilalia. These defects can be expressed in varying degrees. Mild and moderate degrees are of little concern. In a severe degree, the communication process is disrupted, and speech tempo disorders are defined as pathological. The development, manifestations and methods of correction of these defects are different. Studies show that takhilalia and bradilalia can only be an external manifestation of a change in brain processes. Therefore, to overcome them, a neurological examination and a complex effect are necessary: medication, psychotherapy, speech therapy.

Tahilalia is a pathologically accelerated rate of speech (in this case, instead of 10-12 sounds per second, 20-30 sounds are pronounced), not accompanied by sharp distortions of sound pronunciation. Speech is characterized by uncontrollable speed. With haste, disorders of speech attention, hesitation, repetition, swallowing, rearrangement of syllables, words, ambiguity in the pronunciation of phrases, etc. may appear. However, when attention is drawn to the speech, the hesitation disappears.

Depending on the situation of verbal communication, the severity of symptoms in tachilalia changes. The greatest difficulties are experienced in life significant situations, in dealing with authoritarian people, in an unfamiliar environment, in moments of excitement, argument.

Tahilalia is often accompanied by disorders of general motor skills, the autonomic nervous system, lexical processes, and emotional-volitional spheres.

Therefore, overcoming tachilalia should begin with the normalization of general movements:

slowing down their pace;

Coordination training;

Formation of rhythm, smoothness.

Regular sports activities, traditional restorative procedures (physiotherapy, hardening, etc.) in combination with medications recommended by the doctor, consultations of a psychotherapist are useful. It is important to pay attention to the daily routine and restful sleep.

In parallel, it is necessary to perform special exercises to train visual, auditory, speech attention, memory, and logic of thinking.

Speech work to overcome takhilalia involves the formation of:

Slow, smooth, rhythmic breathing;

Rhythmic reading at a slow pace;

Smooth, "clean", "error-free" writing;

Calm, intelligible, ordered speech with correct intonation, pause and setting of logical stresses;

New general and speech behavior in the team;

Attention to speech, overcoming difficulties in choosing words and expressing one's thoughts.

Bradilalia - an unnaturally slow pace of speech, reading and writing, monotony of voice, long pauses between words, extended pronunciation of speech sounds. When eliminating bradilalia, speech therapy techniques are aimed at educating: faster and clearer speech movements, the pace of writing and reading, the correct rhythm, pauses, and stress.

Medical, psychological assistance, sports, exercises for coordination, accuracy, change in speed and rhythm of movements, activation of mental activity (non-verbal and verbal thinking, rapid verbal formulation of thoughts), attention, memory, perception, switching are also recommended.

Stuttering is a violation of the tempo-rhythmic organization of speech, due to the convulsive state of the muscles of the speech apparatus. Most often, stuttering occurs in childhood against the background of early mental and speech development, emotional instability, general weakness, and neurological changes.

Therefore, the treatment of stuttering should be carried out in a complex manner, with the participation of a psychotherapist, neuropathologist, psychologist, speech therapist. But the decisive factor is the participation of the stutterer himself in the rehabilitation process, his attitude towards treatment and independent work over your speech.

Logopedic work has the following goals:

Relieve stress from the organs of the articulatory apparatus;

Practicing correct speech breathing;

Training of "difficult" sounds: vowels, consonants, "energy" sounds - I, E, E, Yu, I;

Development of clarity of pronunciation;

Improving the intonational expressiveness of speech;

A stutterer needs to master the skills of general muscle relaxation. It is better to master it first by contrast, through tension. In this case, the tension should be short, and the relaxation should be long.

It is important to remember the pleasant state of relaxed muscles.

The use of autogenic training techniques also helps to relieve general and psychological stress, fatigue, helps to control oneself, one's speech, regardless of the emotional state.

Regular sports activities (swimming, skiing, running, skating, gymnastics), carried out for a long time under the supervision of a coach, relieve autonomic disorders (general tension, excitability, exhaustion, tendency to sweating, redness, trembling) and normalize brain processes.

Since the stuttering organs of the articulatory apparatus are in a state of tension, increased tone, special attention should be paid to relaxing exercises. Relaxation of the lower jaw and tongue should be brought to full automatism.

Another important view work - exercises on intonation.

The development of various speech intonations is carried out in a certain sequence. First you need to train the intonation of the order, demand, call. Gradually, you can move on to intonations of persuasion, invitation. At the end, you need to deal with intonations of request and greeting.

Finally, the most difficult type of speech work with stuttering is speech training in different situations. As a rule, there are a certain number of situations that are difficult for stutterers in speech and psychological terms. We offer to think over your behavior and speech, rehearse and act out the following plots:

Interview: answers to questions that usually provoke stuttering;

Telephone conversation: call-information, message, warning, invitation, threat, etc.;

Conversations in the store, at the institute, in a cafe, on the street, in transport;

Situations at work: take a vacation at your own expense from an annoyed boss in the summer; a dispute with an uninitiated person, with a non-specialist who does not want to understand you;

Order a plane ticket when there are no tickets;

Acquaintance with a girl;

Persuade the interlocutor;

Stop a person screaming at you, using not the volume and power of the voice, but the acquired skills;

Explain on a noisy street or in case of poor telephone hearing how to get somewhere

Dysarthria is a violation of the pronunciation side of speech, due to a lack of innervation of the speech apparatus ("innervation" - the supply of nervous energy).

Such a violation occurs due to paresis (incomplete paralysis) of the organs of articulation: tongue, lips, soft palate, vocal folds, respiratory muscles. Dysarthria can manifest itself after a stroke, traumatic brain injury, neuroinfection.

The main defect in dysarthria is a violation of sound pronunciation. To form sounds, subtle, coordinated movements of the organs of articulation are necessary. When this is not possible, speech becomes fuzzy, slow, sounds distorted.

Expression also suffers. This is manifested in the monotony of intonation, monotony, some "scanning" of speech.

The veil of the palate is either weakened or overly tense, and speech takes on a nasal tone.

Due to paresis of the muscles of the diaphragm, bronchi, lungs, speech breathing is carried out incorrectly. A lot of air during speaking goes "for nothing", it is not enough until the end of the phrase.

With dysarthria, disturbances in the tempo and rhythm of speech can also appear (pathological acceleration, "stumbling", "torn" speech with unexpected cries, etc.).

The listed disorders of the pronunciation sphere may be accompanied by non-verbal symptoms: increased salivation, choking when eating, violent laughter or crying.

These disorders manifest themselves to varying degrees and depend on the nature and severity of the damage to the nervous system: from mild "blurring" to the complete impossibility of speech. In each case, an examination by a neuropathologist and a speech therapist is necessary to determine the type of dysarthria and, accordingly, the nature of speech disorders.

Work to overcome these disorders should be carried out under the supervision of a speech therapist. Each session usually begins with a massage. As practice shows, its use reduces the time of speech work by several times. Massage improves blood circulation and metabolic processes in tissues, normalizes muscle tone, coordinates their movements, and has a beneficial effect on the nervous system.

These disorders are referred to as "dyslalia".

Dyslalia is a violation of sound pronunciation with normal hearing and intact innervation of the speech apparatus. Among the violations of the pronunciation side of speech, the most common are selective violations in its sound design during the normal functioning of all other utterance operations.

These violations are manifested in defects in the reproduction of speech sounds: their distorted (abnormal) pronunciation, the replacement of some sounds by others, in their omissions.

The main goal of speech therapy influence in dyslalia is the formation of skills and abilities for the correct reproduction of speech sounds. In order to reproduce them correctly, one must be able to recognize the sounds of speech and not mix them in perception (i.e., distinguish one sound from another by acoustic features); distinguish normalized pronunciation of sound from non-normalized; exercise auditory control over their own pronunciation and evaluate the quality of the sounds reproduced in their own speech; take the necessary articulatory positions, providing a normalized acoustic effect of sound; vary the articulation patterns of sounds depending on their compatibility with other sounds in the speech stream; unmistakable use of sound in all types of speech.

As a rule, dysarthria is not a consequence of pathological changes in the cortical centers. Patients with dysarthria are able to understand what they hear, read and write, although they cannot articulate a single word.

Spastic and rigid dysarthria are more common than yaaretic. Pathological processes involving the corticobulbar tract, usually due to vascular pathology or damage to a motor neuron, simultaneously or gradually lead to pseudobulbar palsy. A patient who has previously had a small stroke with a unilateral lesion of the corotiobulbar fibers may not develop speech and swallowing disorders, since all the muscles innervated by the nuclei of the medulla oblongata appear to be present in the cerebral cortex on both sides. If a stroke occurs that affects the remaining corticobulbar tract and possibly the corticospinal tract at the level of the pons, midbrain, or internal capsule, the patient develops anarthria or dysarthria and dysphagia. In addition, bilateral weakness of the facial muscles often develops. Unlike bulbar palsy in peripheral motor neurons, this condition does not cause atrophy or fasciculations in the paralyzed muscles; jaw and other facial reflexes are revived; reflexes from the soft palate are preserved; notes poor control of emotions (pathological laughter and crying); at times, periodic (chain-stokes) breathing occurs. If only the frontal operculum is affected, the speech disorder may be characterized by isolated dysarthria, usually without changes in the emotional sphere. Initially, total anarthria and aphonia may be noted, but if the patient's condition begins to improve or the lesions are not so extensive, speech becomes slow, hoarse and unintelligible, resembling that of incomplete bulbar palsy.

Aphasia is a condition in which there is mainly a loss of productive speech and / or understanding of reversed speech. It occurs as a result of acquired brain damage. More often, a less severe disorder called dysphasia occurs.

Most of the lesions leading to aphasia affect the region surrounding the Sylvian sulcus (frontal, temporal, and parietal) of the dominant hemisphere, i.e., the left side in right-handers. The localization of the lesion can be established using computed tomography (CT) or magnetic resonance (MRI) research methods. Lesions of the superficial gray matter of the brain lead to more significant neurological deficits than lesions white matter: tumors located predominantly in the white matter usually reach a significant size before speech disorders occur. Heart attacks or traumatic injuries, in which the lesion has a diameter of 1 cm or more, lead to a temporary neurological speech deficit, which is smoothed out to a functionally insignificant state within a few weeks or months.

The combination of disorders, the ability to speak and understand speech, is less associated with the defeat of certain formations. According to morphological features, speech disorders can be divided into two large groups. Extensive lesions of the anterior regions, including most of the frontal operculum (the area that lies under the insula) and the insula itself, lead to agrammatism, characterized by a reduction in sentence structure, the absence of most monosyllabic words, and the preservation of words that provide predominantly predicative, exclamatory and substantive functions. The patient can only say "hey", "no", "hello" or use simple nouns, such as ball, top, key. With extensive lesions of the formations lying posterior to the Sylvian furrow, almost the opposite symptomatology occurs with the confusion of simple elements of speech or their replacement, in which what is expressed only approximately resembles what is desired (paraphasia). These errors may include incorrect pronunciation (literal paraphasias) or erroneous choice of words (verbal paraphasias). Verbal paraphasias can manifest themselves in replacing the desired word with similar sounds or similar-sounding words (formal verbal paraphasias), for example, "stock" (stock - trunk) instead of "stop" (stop), or similarity in meaning (semantic verbal paraphasias), for example " slow" (slow - slow) instead of "stop" (stop - delay). In both cases, there is a violation of the understanding of oral and written speech.

Lesions located at a considerable distance from the Sylvian sulcus do not cause such disorders or lead to secondary speech disorders. An example of the latter is the defeat of the anterior frontal lobes, especially in the middle lobe and orbital part, in which all types of motor activity and often there is a loss of attention and receptivity (aboulia), which resembles a state of akinetic mutism. Speech is concise, with long pauses between statements, there is an inability to conduct a monologue and talk about something in detail. With extensive lesions in the occipital region, the reading process is disrupted and the use of all visual lexical stimuli is reduced. When the thalamus and deep parts of the brain are affected, the level of alertness changes and states of inattention and disorientation periodically occur, which leads to fragmentation of words (neologisms) and phrases, as well as to a long uncontrolled conversation (logorrhea). Powerful stimulation causes an instant increase in the level of alertness and wakefulness, which indicates the safety of the mechanisms of speech.

The subdominant hemisphere controls imitation motor responses, social anticipation (smiling, shaking hands) and self-care (washing, eating); behavioral changes in response to suprathreshold stimuli; the ability to visually coordinate text and unks. It follows from this that the texts that reveal these features of behavior do not testify to the functions of the dominant hemisphere.

Some speech disorders can cause voice changes. Paresis of the respiratory muscles, as occurs in poliomyelitis and acute infectious polyneuritis, as well as incoordination as part of an extrapyramidal lesion, affect the strength of the voice, since there is not enough air for phonation and speech production. As a rule, when the excursion of the respiratory muscles is limited, the strength of the voice decreases, the patient can only speak in a whisper. Speech close to a whisper is also a characteristic sign of stupor, but in this case, intense suprathreshold irritation can lead to an increase in voice.

Paresis of both vocal cords leads to complete aphonia. The voice disappears, becomes silent. Since the vocal cords normally diverge during inhalation, the impossibility of this in the case of paralysis can lead to inspiratory stridor. With paralysis of one vocal cord, the voice becomes hoarse, low and creaky. Unilateral involvement of the vagus nerve, for example by a tumor, can result in a nasal tone of voice, as the posterior nasal passages do not close during phonation. The consonants "b", "p", "n" and "k" arise when air passes through the nasal passages. Pathological changes in the voice may be less pronounced in a person who is in a prone position, and intensify when the head is tilted forward. Hoarseness can also occur with organic changes in the vocal cords caused by smoking, chronic inflammatory processes, polyps, etc.

The little-studied neurological diseases similar to dystonia include spastic dysphonia in most middle-aged and older patients (otherwise healthy), the ability to speak calmly and smoothly is gradually impaired. Any attempt to speak causes a contraction of the muscles of the speech motor apparatus, which leads to distortion of the voice and makes phonation difficult. Such people do not suffer from neurosis, so psychotherapy and speech therapy classes are not useful. This condition differs from stridor, which occurs due to spasm of the muscles of the larynx during tetany. Spasmodic dysphonia is not progressive, but may be associated with extrapyramidal diseases that limit muscle mobility, such as blepharospasm and spastic torticollis. Surgical transection of the superior laryngeal nerve on one side has been found to at least partially reduce stiffness.

CONCLUSION

The most dangerous speech disorders are considered disorders in children, because along with the loss of normal speech, their adaptation to the outside world is disrupted, since it is difficult for them to perceive speech by ear, and, accordingly, in the future, to read and write. In this regard, it is easier with adults. In adults, speech disorders do not destroy the perception of speech by ear. Just as a person heard and understood what was said, so after acquiring some organic speech disorder, he understands everything. And he reads just like he used to. And the disease did not affect his writing abilities. Speech has changed.

The causes of speech impairment in adults can be due to several factors.

First, it is a stroke (impaired circulation in the brain). This is the most common cause of speech impairment in adults. Other causes include vascular disorders, inflammation and tumors of the brain, Alzheimer's disease (gradual destruction of the central nervous system), Parkinson's (chronic progressive disease of the central nervous system), Huntington's (genetic disease of the nervous system). Multiple sclerosis and asthenic bulbar palsy can be added to this list.

Much less often, speech impairment occurs as a result of head trauma, poisoning (lead or carbon monoxide), or an overdose of medication. Complete this list of infections and toxins caused by the use of drugs and alcohol. As you can see, unlike children, dysarthria in adults can also arise from "conscious" acts.

We outlined the causes of speech disorders, and then the same story as in children. The speech apparatus, both in a child and in an adult, requires the coordinated simultaneous operation of a number of systems. And a violation in any link of the system (or interaction of systems) can lead to dysarthria.

The main method of treatment various violations speech in adults - the treatment of the disease that caused it. But more often than not, this is not enough. It is best to immediately start training all the systems involved in the formation of speech.

In order to strengthen (train) the respiratory system, exercises of the A.N. Strelnikova. This respiratory system is also called paradoxical. What is its paradox? In that it goes against the conventional breathing exercises. We are used to the fact that bending down - we exhale. And straightening up - inhale. With Strelnikova, the opposite is true: a tilt, and a sharp breath; straightening up - exhale.

The articulation system is also trainable. We have already described several complexes articulation exercises, with the help of which you can "teach" the correct actions of the organs of speech production. Of course, you need to do massages: with muscle spasm, relaxing; with excessive muscle relaxation, on the contrary, we activate.

The central nervous system also "trains", no matter how strange it sounds. Her trainings take place simultaneously with the training of the articulatory and respiratory systems. Parallel and imperceptible to the eye. That is, performing articulation and breathing exercises, damaged connections between brain regions are automatically "created".

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articulate speech disorder dementia

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Symptoms and manifestations

This pathology can be expressed either in the complete absence of speech, or in violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

there is fuzziness and slowness of speech, it is illegible;
the patient finds it difficult to choose words and correctly name things;
fast and without hesitation speech is possible, but completely meaningless;
there is haste and incoherence of thinking;
a person strongly separates syllables and puts stress on each of them.

Causes in adults

Sudden or gradual development of speech disorders is possible. There are such main reasons that can lead to this pathological process:

improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movement of the muscles of the body and for speech);
brain injury caused by stroke or thrombosis;
head injury;
the presence of tumors in the brain;
the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
Lyme disease;
excessive consumption of alcoholic beverages;
weakness of the muscles of the face, for example, Bell's palsy;
too weak or tight fastening of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

Phonation (external) design of the utterance - this includes speech pronunciation disorders;
Structural-semantic (internal) design of the utterance is a systemic or polymorphic speech disorder.

Violations of the process of speech of the phonation of the utterance can be both separate and combined. Based on this, the following types of violations are distinguished in speech therapy:

Aphonia and dysafonia - is a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, height and timbre of the voice or the complete absence of phonation. Aphonia and dysafonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of a child's development.
Bradilalia is a pathological slowing of the speech rate. A characteristic feature is the slow implementation of the articular speech program.
Tahilalia is a pathological acceleration of the speech rate. The accelerated implementation of the articulatory speech program is characteristic.
Stuttering is a violation of the organization of speech, in which the muscles of the speech apparatus are in a convulsive state. Pathology is centrally conditioned and appears, as a rule, in the process of speech development of the child.
Dyslalia - pathology is a disorder of the pronunciation of sounds, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifested in the form of a distorted sound design of speech, while there is an incorrect pronunciation of sounds or their replacement and mixing.
Rhinolalia is a violation of the pronunciation of sounds and the timbre of the voice, due to anatomical and physiological disorders of the speech apparatus. A pathological change in the timbre of the voice is characteristic, accompanied by the passage of a vocal air stream on exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of a resonance in the latter.
Dysarthria is a violation of pronunciation, a distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy, which appeared at an early age of the child.

Difficulties in speech of structural and semantic design are divided into two varieties: alalia and aphasia.

Alalia - is the absence or insufficient development of speech, provoked by damage to the areas responsible for speech, located in the cerebral cortex in the process of intrauterine development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the operation of selection and analysis at all stages of birth, as well as the reception of speech utterance, as a result of which the child's speech activity is not fully formed.

Aphasia is a complete or partial loss of speech, which is caused by local lesions of the brain. The ability to speak normally can be lost due to traumatic brain injury, neuroinfection or brain tumors, after the formation of speech.

Diagnostics

First of all, it is necessary to analyze the complaints made by the patient, as well as the history of the disease. It is important to take into account how long ago there were complaints of quiet, slow speech and difficulty in pronouncing words and phrases, as well as whether the patient's next of kin have similar manifestations.

Then it is necessary to undergo an examination by a neurologist, which consists in checking the mandibular and pharyngeal reflexes, examining the pharynx, and the presence of thinning (atrophy) of the muscles of the tongue. In addition, it is important to check the reflexes of the lower and upper extremities.

You need to be examined by a speech therapist, the doctor will be able to assess speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronouncing specific sounds.

An examination by an otolaryngologist helps to exclude various volumetric processes (abscesses and tumors) in the nasal cavity, since they can also affect the voice.

With the help of computed tomography and magnetic resonance imaging of the head, it is possible to conduct a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these can be tumors, foci of impaired blood circulation, abscesses, foci of myelin decay, the main protein of the nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy of speech disorders consists in the treatment of the main disease, which provoked dysarthria:

the tumor must be removed surgically;
resection of a hematoma (hemorrhage) is possible if it is located on the surface;
abscesses are surgically removed from the cranial cavity, and then antibacterial drugs are prescribed to stop the infectious process as soon as possible;
normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any kind of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

Speech disorders in modern world are quite common in both adults and children. For the proper functioning of speech, in addition to the absence of problems in the vocal apparatus itself, the coordinated work of visual and auditory analyzers, the brain and other parts of the nervous system is necessary.

A speech disorder is a disorder of speech skills that can be caused by various reasons. Consider the most common diseases:

Stuttering

Stuttering, or logoneurosis, is one of the most common disorders. This disorder is expressed in the periodic repetition of individual syllables or sounds during a conversation. In addition, convulsive pauses may occur in a person’s speech.

There are several types of stuttering:

Tonic appearance - frequent stops in speech and stretching of words.
Clonic view - repetition of syllables and sounds.

Stuttering can be provoked and aggravated by stress, emotional situations and shocks, for example, speaking in front of big amount of people.

Logoneurosis occurs in adults and children. It can be caused by neurological and genetic factors. With timely diagnosis and treatment, it is possible to completely get rid of this problem. There are many methods of treatment - both medical (physiotherapy, speech therapy, medication, psychotherapy), and methods of traditional medicine.

A disease that is characterized by slurred speech and problems with the articulation of sounds. Appears due to disorders in the central nervous system.

One of characteristic features This disease can be called reduced mobility of the speech apparatus - lips, tongue, soft palate, which complicates articulation and occurs due to insufficient innervation of the speech apparatus (the presence of nerve endings in tissues and organs, which provides communication with the central nervous system).

Types of violation:

Erased dysarthria is not a very pronounced disease. The person has no problems with hearing and speech apparatus, but has difficulty in sound pronunciation.
Severe dysarthria is characterized by incomprehensible, slurred speech, disturbances in intonation, breathing, and voice.
Anarthria is a form of a disease in which a person is unable to speak clearly.

This violation requires complex treatment: logopedic correction, medical intervention, exercise therapy.

Dyslalia

Tongue-to-tongue is a disease in which a person pronounces some sounds incorrectly, skips them or replaces them with others. This disorder, as a rule, occurs in people with normal hearing and innervation of the articulatory apparatus. As a rule, treatment is carried out by speech therapy intervention.

This is one of the most common disorders of the speech apparatus, which is found in about 25% of children. preschool age. With timely diagnosis, the violation is quite successfully amenable to correction. Preschool children perceive correction much easier than schoolchildren.

A disease that often occurs in people who have had an epileptic seizure. It is characterized by an impoverishment of the vocabulary or a simplified construction of sentences.

Oligophasia can be:

Temporary - acute oligophasia caused by an epileptic seizure;
Progressive - interictal oligophasia, which occurs with the development of epileptic dementia.

Also, the disease can occur with disorders in the frontal lobe of the brain and some mental disorders.

Aphasia

A speech disorder in which a person cannot understand someone else's speech and express their own thoughts using words and phrases. The disorder occurs when the centers responsible for speech are affected in the cerebral cortex, namely, in the dominant hemisphere.

The cause of the disease can be:

hemorrhage in the brain;
abscess;
traumatic brain injury;
cerebral thrombosis.

There are several categories of this violation:

- a person is not able to pronounce words, but can make sounds, understand someone else's speech.
Sensory aphasia - a person can speak, but cannot understand someone else's speech.
Semantic aphasia - a person's speech is not impaired and he is able to hear, but cannot understand the semantic relationships between words.
Amnestic aphasia is a disease in which a person forgets the name of an object, but is able to describe its function and purpose.
Total aphasia - a person is not able to speak, write, read and understand the speech of another.

Since aphasia is not a mental disorder, it is necessary to eliminate the cause of the disease in order to treat it.

Akatophasia

A speech disorder characterized by necessary words words that are similar in sound but not the same in meaning.

schizophasia

Psychiatric speech disease, which is characterized by speech fragmentation, incorrect semantic structure of speech. A person is able to form phrases, but his speech does not make any sense, is nonsense. This disorder is most common in patients with schizophrenia.

Paraphasia

A speech disorder in which a person confuses individual letters or words and replaces them with incorrect ones.

There are two types of violation:

Verbal - replacing words that are similar in meaning.
Literal - caused by sensory or motor speech problems.

A developmental disorder in children in which there are shortcomings in the use of expressive means of speech. At the same time, children are able to express their thoughts and understand the meaning of someone else's speech.

Symptoms of this disorder also include:

small vocabulary;
grammatical errors - incorrect use of declensions and cases;
low speech activity.

This disorder can be transmitted at the genetic level, and is more common in men. It is diagnosed during examination by a speech therapist, psychologist or neurologist. For treatment, mainly psychotherapeutic methods are used, in some situations, medication is prescribed.

Logoclonia

A disease that is expressed in the periodic repetition of syllables or individual words.

This disorder is provoked by problems with the contraction of the muscles that are involved in the speech process. Muscle spasms are repeated one after another due to deviations in the rhythm of contractions. This disease can accompany Alzheimer's disease, progressive paralysis, encephalitis.

Most speech disorders can be corrected and treated if detected early. Be attentive to your health and contact a specialist if you notice deviations.

Treatment of speech disorder

For many, the ability to talk is a means of communication with other people and the outside world.

Therefore, if a person loses this ability, he must first find out the cause, and then undergo complex treatment.

If you do not catch on in time, then the patient may forever have a dysfunction of the speech apparatus.

Causes of speech disorders in adults

Speech impairment in adults is a pathology that manifests itself in the complete or partial absence of speech.

In a conversation with a person suffering from such an ailment, it is impossible to understand what he is talking about or asking for, his words are illegible and fuzzy.

This pathology manifests itself differently in each person. For some people, such violations cause hasty, but completely meaningless speech, while others, on the contrary, build sentences logically and constructively, but at the same time they speak very slowly and unhurriedly.

The main causes of speech impairment in adults:

Previously suffered brain injury;
The presence of benign or malignant tumors in the brain;
Parkinson's disease;
Multiple sclerosis;
Wilson's disease;
Alcohol abuse.

Ordinary dentures can also be the cause. With improper fixation in the elderly, dysfunction of the speech apparatus is observed.

Another violation of speech in an adult can occur due to diseases that cause paresis of the muscles of the face.

Paresis is a neurological syndrome that indicates a decrease in strength. These diseases include Miylard-Jublé syndrome, Möbius syndrome, muscle agenesis, Beck's disease, and Sjögren's syndrome.

Myasthenia gravis can also cause disturbances. This is an autoimmune neuromuscular disease, which is characterized by pathologically rapid fatigue of the transverse sucking muscles.

Some diseases cause not only paresis facial muscles, but also impaired articulation and speech in adults.

This pathology occurs with Foix-Chavan-Marie syndrome. With this disease, the basin of the middle cerebral artery is affected.

One of the most common causes of speech impairment in adults is Alzheimer's disease.

With this disease, dementia (acquired dementia), partial memory loss, articulation difficulties are observed. Most often, this disease affects people over 65 years of age.

There are such types of speech disorders in adults:

Dysphonia;
Aphonia;
Bradilalia;
Tahilalia;
Stuttering;
Dyslalia;
Alalia;

Spasmodic dysphonia

This pathology is more common in people aged 30 to 40 years. Dysphonia is a voice disorder characterized by hoarseness.

Spasmodic dysphonia occurs due to prolonged overexertion of the vocal cords.

Also, the cause of the appearance of this pathology may be the transferred mental trauma.

With this form of dysphonia, pain is observed in the neck and head muscles, and the timbre of the voice also changes significantly. The disease manifests itself in illegibility of speech and difficulty in pronouncing certain sounds.

Aphonia

Aphonia is a pathological condition with loss of voice sonority.

With this pathology, a person still has the opportunity to talk in a whisper, but when talking, he experiences a sore throat.

Aphonia occurs due to diseases of the bronchi or laryngitis. Also, this pathology can occur with prolonged crying or intubation.

Bradilalia

Bradilalia - violations of the tempo of speech production. In other words, with this disease, a very slow pace of speech. Articulation in bradilalia is indistinct.

This disease occurs due to Parkinson's disease, tumors in the brain, meningitis and encephalitis.

Also, bradilalia can be inherited or manifested after brain injuries.

tahilalia

Tahilalia is a disorder that manifests itself in a fast pace of oral speech.

With this ailment, a person does not make grammatical or phonetic errors in pronunciation.

The causes of tachyhalea can be:

Chorea disease.
Epilepsy.
Oligophrenia.
Skull trauma.
Heredity.
Education in the brain.
Myelitis.
Tetanus.
Arachnoiditis.

Stuttering

Stuttering is a disease that manifests itself in the form of impaired speech function.

When stuttering, a person stretches syllables, pronounces words incorrectly.

Causes of occurrence:

Brain damage.
Stress.
Heredity.

Dyslalia

With dyslalia, a person does not reproduce sounds correctly. This ailment appears due to the presence of a defect in the structure of the speech apparatus (malocclusion, shortened hyoid frenulum, irregular structure of the palate, and others).

Also, dyslalia occurs due to illiterate speech education or in connection with deviations in mental development.

Most often, this disease manifests itself in children, but among adults it also occurs. In adults, dyslalia appears due to the low mobility of the speech apparatus.

Dysatria occurs due to damage to the central part of the motor speech analyzer.

With this disease, there is a disorder of articulation, phonation and speech.

Dysatria occurs due to cerebral palsy, neurosyphilis, multiple sclerosis and myotonia.

There is a similar speech disorder in adults with a stroke and after neurosurgical operations.

Alalia

Alalia is an underdevelopment of speech, due to damage to the speech centers of the brain.

The main reasons for the appearance of alalia in people over 20 years of age are operations with the use of general anesthesia, traumatic brain injuries and malnutrition.

Aphasia is the complete or partial loss of the ability to reproduce words and sounds. This disease appears due to damage to the cerebral cortex.

Aphasia appears due to circulatory disorders in the brain, with the formation of a brain abscess, after strokes and heart attacks.

Also, the cause of the development of the disease can be epilepsy or acute intoxication with toxic substances.

A patient with aphasia has difficulty recognizing speech, he has impaired concentration, problems with reading and memorizing.

Treatment of speech disorders

Treatment of speech disorders in adults is selected based on the type of the disorder itself.

Basically, the treatment involves massage, physiotherapy, exercise therapy and medication.

Medical

Treatment of dysarthria involves exercise therapy and medication. It is very important that the treatment of the patient is accompanied by a speech therapist.

Drugs for the treatment of dysarthria:

"Piracetam".
Finlepsin.
"Lucetam".

If an adult has stunted speech after a stroke, that is, dysarthria, then it is necessary to do daily exercises for the tongue.

For the treatment of aphasia, nootropic agents and drugs that improve microcirculation in brain tissues are used.

Preparations:

Vinpocetine.
"Piracetam".

With aphasia, work with a speech therapist is mandatory. Usually, to fully restore the ability to speak, you will need to be treated by a speech therapist for at least 3 years.

For the treatment of dysphonia, stimulant medications are prescribed:

Prozerin.
Tranquilizers.

Other drugs for the treatment of speech disorders:

Vinpotropil.
"Cavington".
"Memotropil".
"Nootropil".

Medical therapy should include drugs that improve memory, enhance metabolic processes in the central nervous system.

Very rarely, surgery is used to treat such diseases. The operation is necessary to remove tumors and other formations that provoked disorders.

Speech impairment in an adult after stress requires not only exercise therapy and medicines but also a visit to a qualified psychotherapist or psychologist. It is likely that the person himself, after the transferred situation, on a subconscious level, put a barrier to speech reproduction.

Treatment at home

Traditional medicine can also be used to treat speech disorders.

If a person has dysarthria, then the following recipe will help: 1 tbsp. l. dill seeds are poured with boiling water and infused for 15 - 20 minutes.

Then the infusion is filtered and cooled. It is worth taking it 15 minutes before meals in the amount of 1 tsp. The remedy is used no more than 5 times a day.

If an elderly person has slow speech, for example, after a stroke, then you can make a tincture of ginseng, buckwheat and mordovnik.

Exercise therapy plays an important role in the treatment of speech disorders. The patient should do exercises daily if paresis of the facial muscles became the cause of the disorder.

exercise: stretch your lips, twisting them into a tube. Hold in this position for 5 seconds, then repeat;
exercise: the lower jaw should grab the upper lip, fix for 3 seconds, then release;
exercise: close your mouth. The tongue reaches to the palate.

Conclusion

Treatment of a speech disorder is a lengthy process. It is very important that, along with doctors and speech therapists, the patient is helped at home.

People with such problems should clearly and slowly express their thoughts, not show negativity and neglect.

Stuttering

There are several types of stuttering:

Tonic appearance - frequent stops in speech and stretching of words.
Clonic view - repetition of syllables and sounds.

Stuttering can be triggered and aggravated by stress, emotional situations, and shocks, such as speaking in front of a large number of people.

A disease that is characterized by slurred speech and problems with the articulation of sounds. Appears due to disorders in the central nervous system.

One of the characteristic features of this disease can be called reduced mobility of the speech apparatus - lips, tongue, soft palate, which complicates articulation and occurs due to insufficient innervation of the speech apparatus (the presence of nerve endings in tissues and organs, which provides communication with the central nervous system).

Types of violation:

Erased dysarthria is not a very pronounced disease. The person has no problems with hearing and speech apparatus, but has difficulty in sound pronunciation.
Severe dysarthria is characterized by incomprehensible, slurred speech, disturbances in intonation, breathing, and voice.
Anarthria is a form of a disease in which a person is unable to speak clearly.

This violation requires complex treatment: speech therapy correction, drug intervention, physiotherapy exercises.

Dyslalia

This is one of the most common disorders of the speech apparatus, which is found in about 25% of preschool children. With timely diagnosis, the violation is quite successfully amenable to correction. Preschool children perceive correction much easier than schoolchildren.

Oligophasia

A disease that often occurs in people who have had an epileptic seizure. It is characterized by an impoverishment of the vocabulary or a simplified construction of sentences.

Oligophasia can be:

Temporary - acute oligophasia caused by an epileptic seizure;
Progressive - interictal oligophasia, which occurs with the development of epileptic dementia.

Also, the disease can occur with disorders in the frontal lobe of the brain and some mental disorders.

The cause of the disease can be:

hemorrhage in the brain;
abscess;
traumatic brain injury;
cerebral thrombosis.

There are several categories of this violation:

Motor aphasia - a person is not able to pronounce words, but can make sounds, understand someone else's speech.
Sensory aphasia - a person can speak, but cannot understand someone else's speech.
Semantic aphasia - a person's speech is not impaired and he is able to hear, but cannot understand the semantic relationships between words.
Amnestic aphasia is a disease in which a person forgets the name of an object, but is able to describe its function and purpose.
Total aphasia - a person is not able to speak, write, read and understand the speech of another.

Since aphasia is not a mental disorder, it is necessary to eliminate the cause of the disease in order to treat it.

Akatophasia

Speech disorder, which is characterized by the replacement of necessary words with words that are similar in sound, but not suitable in meaning.

schizophasia

Paraphasia

A speech disorder in which a person confuses individual letters or words and replaces them with incorrect ones.

There are two types of violation:

Verbal - replacing words that are similar in meaning.
Literal - caused by sensory or motor speech problems.

Symptoms of this disorder also include:

small vocabulary;
grammatical errors - incorrect use of declensions and cases;
low speech activity.

Logoclonia

A disease that is expressed in the periodic repetition of syllables or individual words.

Most speech disorders can be corrected and treated if detected early. Be attentive to your health and contact a specialist if you notice deviations.

Classification of speech deviations

There are several main forms of speech disorders in adults encountered in medical practice. Depending on the type of speech defect, specific work is always required to eliminate deviations, since the lack of competent treatment at any time can lead to a complete loss of speech function or psychological deviations.

The main classification of speech disorders includes several forms of deviations in the development of speech:

One of the main types of deviations in speech is stuttering. The reasons for the development of this pathology are factors such as stress, fear, neurological abnormalities, genetic disposition, severe emotional shock.

Speech dysfunction is characterized by such signs as constant disruptions in the rhythm of speech caused by spasms or convulsions of some parts of the speech apparatus. When a person stutters, there are difficulties in pronouncing words and sounds, as a result of which he is forced to constantly make long pauses and repeat the same sound or syllable several times.
Due to a violation of the voice timbre, nasality may develop. The main reason for the development of deviations is pathology in the region of the nasal septum.
Violation of oral speech, which occurs as a result of malocclusion or damage to certain parts of the brain responsible for the speech apparatus, provoke the development of dyslalia. The main symptom of this deviation is that the patient has disturbances during the pronunciation of certain sounds or words. Misperception and distortion individual sounds, slurred speech or "swallowing" sounds is also commonly called tongue-tied among the people. This pathology is not associated with hearing impairment or damage to the patient's central nervous system.
Slowness of speech as a result of difficulty in pronunciation and deviations in the pace of pronunciation is called bradilalia. May be the result of congenital disposition, diseases of the central nervous system or psychological deviations of the patient.
Aphasia is a speech disorder, which is a systematic disruption in the rhythm of already formed speech, which is caused by lesions in the speech areas of the brain. Characteristic signs of deviation is the inability of the patient to understand the speech of other people and express their thoughts through voice. This speech disorder is not the result of any mental illness. The main causes of this disease are pathologies such as trauma to the head, cerebral hemorrhage, abscess or thrombosis of cerebral vessels.
Bradyphrasia is a slow speech, which is due to the patient's weak and inhibited thinking, caused by mental abnormalities during the course of brain pathologies. characteristic feature is the stretching of words and sounds, fuzzy articulation, long and inaccurate formulations of thoughts. This form of speech disorder is most often found in people suffering from mental illness or oligophrenia.
With a partial or complete absence of speech urges, alalia develops. Pathology occurs due to the mental underdevelopment of the patient or damage to the areas of the brain responsible for speech function. These are extremely severe forms of pathology, during the development of which the patient may not perceive the speech of other people at all, and is not able to master the language, since there are problems with the assimilation and understanding of sounds and syllables.
A very fast and rapid pace of speech flows is called takhilalia. The main signs of the disease are such manifestations as a fast pace of speech, constant stammering during pronunciation, "swallowing" individual letters and sounds, and their distortion. The main reasons for the development of the disease are: hereditary disposition, hyperreactivity, brain pathologies, mental disorders.
Dysarthria can cause a violation of oral speech. It is a disorder of the pronunciation of speech, which is associated with pathologies of areas of the speech motor and muscular articulatory apparatus (for example, damage to the vocal cords, dysfunction of the facial or respiratory muscles, restriction of mobility of the tongue, lips or palate). Pathology develops in the course of damage to the parts of the brain (posterior frontal and subcortical). Dysfunction is expressed in difficult pronunciation, distortion of some sounds and syllables.

Many deviations are associated with disorders of expressive speech. Most often, the pathology develops in children. Moreover, this speech disorder can occur against the background of a favorable mental and mental development sick.

The pathology of expressive speech is characterized by such features as: a small vocabulary of the patient, which is by no means the norm for this age; problems with verbal communication; weak ability to express one's thoughts with the help of words; misuse of prepositions and word endings; active use of gestures. The main causes of expressive speech have not been fully identified in medicine, however, the participation of genetic factors can influence the process of development of deviations; psychological disorders; untimely formation of the relationship between the speech sections of the cerebral cortex and neurons.

With lesions of the central nervous system, mutism can develop - the complete absence of speech reflexes. This can be facilitated by diseases such as epilepsy, damage to parts of the brain, some types of mental illness (schizophrenia, depression, hysteria).

In order to identify the form of the disease, it is necessary to understand what reasons serve as an impetus for the development of deviations in speech.

Reasons for the development of deviations in adults

There are many internal and external factors that provoke deviations in speech pronunciation. Moreover, depending on the cause of speech impairment, the process of development of deviations can be both hasty and gradual. The most common causes of dysfunction are:

It should be remembered that the causes of speech disorders can be both physiological and social and psychological in nature.

Signs of deviations

It should be noted that more severe cases of speech disorders that occur with dementia and some psychological abnormalities in the body, regardless of the age of the patient, can provoke dumbness. Therefore, it is very important to recognize the primary signs in a timely manner in order not to allow the disease to progress.

Main symptoms:

It should be noted that the intellectual-mnestic functions, which are various forms mental disorders are of a degrading nature. Often, with this form of disorder, brain cells are affected, which negatively affects the patient's speech function. As a result of such complex pathologies as a heart attack or stroke of the brain, an adult patient, over time, may develop a severe impairment of speech functions, up to complete numbness. Therefore, it is so important at the slightest manifestation of symptoms to consult a specialist in a timely manner.

Treatment

As soon as the cause of the pathology is identified and a diagnosis is made, the doctor will prescribe the appropriate treatment, the basic principle of which is to eliminate the causes that caused speech dysfunction.

As for children, a speech therapist can help correct speech defects at an early age. But only if the deviations are not associated with mental disorders and mechanical damage to the head. It is important to understand here that the older the patient and the more complex the cause of deviations in speech, the longer the process of treatment and correction of speech deviations will be.

Treatment methods are as follows:

The choice of a specific method of treatment, medications and the appropriateness of the operation is determined by the doctor, depending on the form of the pathology and the stage of concomitant diseases.

There is a separate branch of psychology that deals with the study of people suffering from deviations in speech functions - logopsychology. The psychology of persons with speech disorders requires a systematic and thorough study of the symptoms, signs and mechanisms of development of this deviation. Due to this, it is possible to achieve positive results through the development of special methods psychological help and appropriate treatment regimens in each case.

It should be understood that any defects and speech disorders, as well as damage to parts of the speech apparatus, with untimely or incorrect treatment, can lead to underdevelopment of speech, reduced communication and attentiveness, as well as to limiting the patient's logical and mental conclusions.

Speech for a person is the main means of communication and interaction, therefore, speech disorders that increase gradually or occur suddenly, significantly affect the state of health and quality of life in general. Speech dysfunctions, both in oral speech and in writing, can be caused by the most various factors, the number of which naturally increases with age.

Speech disorders in the elderly are conditionally divided into two main types, depending on the causes of this dysfunction. Distinguish organic speech disorders, when the cause of the violations are:

Traumatic brain injury
Stroke or pre-stroke condition
brain tumors
Thrombosis
Acute viral infections, neuroinfections (meningitis, encephalitis, etc.)
The defeat of the active organs of speech: the larynx, nasopharynx, tongue, teeth, lips.
Hearing Aid Diseases
Botulism
Alzheimer's disease

There are also functional speech disorders that are not directly related to the damage to the speech apparatus, but disrupt its normal functioning. Functional speech disorders occur as a result of exposure to factors such as:

Presence of neuroses
Severe or prolonged stress
Depression
Long-term use of antidepressants or tranquilizers

The division into organic and functional disorders is rather arbitrary, since it is not always possible to determine the presence of organic disorders if they are insignificant, in turn, functional disorders can often lead to organic disorders.

The occurrence of any problems with speech, both oral and written, is a reason to seek the advice of specialists (in particular, a neurologist, ENT and speech therapist) in order to determine the cause of the violations.

Impairments can be manifested not only by difficulty in pronunciation, but also in the perception of the speech of other people, as well as with difficulties in forming words into whole sentences and in accuracy in expressing thoughts.

The most common cause of speech impairment in the elderly is stroke. Other common causes of speech problems are various vascular disorders.

Treatment of speech disorders implies not only the elimination of the causes that directly cause speech dysfunction, but also the adoption of measures to maintain all systems involved in the formation of speech.

It is advisable that the treatment of speech disorders take place with the participation of a doctor, this is especially true in rehabilitation after a stroke. Depending on the established diagnosis and taking into account other concomitant factors, the specialist prescribes the appropriate treatment, which may include the following aspects:

Exercise therapy classes, including for development, which is directly related to human speech functions
Therapeutic massage that improves blood circulation and metabolic processes in tissues, and also has a beneficial effect on the nervous system
Adequate breathing exercises for this case
Exercises to maintain the articulatory system; tongue, lips, throat
Various physiotherapy treatments
Necessary

Close people of an elderly person with speech disorders require patience when communicating: they should speak clearly and slowly enough, in turn, one should not rush a person and, moreover, show disregard for his difficulties in speech.

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