i. Introduction

Speech is a means of communication between people and a form of verbal thinking. The timely development of speech rebuilds the entire psyche of the child, allows him to more consciously perceive the phenomena of the world around him. Any violation to one degree or another can affect the activities and behavior of the child.

The speech of a small child is formed in communication with others. Thus, it is necessary that the speech of an adult be a model for children.

In addition, the presence of pronounced speech disorders in a child develops throughout mental development. After all, any kid learns a lot about the world around him due to the fact that he asks adults a lot of questions on every subject or phenomenon that interests him. Often, with speech disorders, mental development slows down, which will inevitably affect the entire process of his schooling and later life, affect the formation of character, and lead to deviations in his behavior. A lot of trouble for people suffering from speech disorders is caused by the so-called secondary deviations, which often occur as reactions to a speech defect.

Now much attention has begun to be paid to the problem of speech disorders in children, their prevention. One of these serious violations are voice disorders. Therefore, this topic is quite relevant.

ĮĮ. Voice disorders in children

2.1 The concept of voice

The voice is understood as the totality of any sounds emanating from the human larynx, ranging from screaming, moaning, coughing, loud yawning and ending with the well-trained voice of a professional speaker or singer. The voice is an important component of speech formation, since it provides, firstly, the audibility of speech and, secondly, its intonational expressiveness. intonation renders strong impact on the listener. Thanks to it, we understand not only words and phrases directly, but also the subtext hidden under them.

A variety of intonations is achieved by changing the height, strength, timbre of the voice - its main acoustic characteristics. And this means that each person must learn to control his voice and be able to fully use for the purposes speech communication all its rich possibilities. However, children's voice education in families and schools is often neglected, leading to misuse of the voice and related voice disorders. The true value of a voice is known to those who have lost it or who suffer from persistent violations of it.

The strength of the voice is determined by the amplitude of the oscillation of the vocal folds, measured in decibels (db). The pitch of the voice is characterized by the frequency of vibrational movements of the vocal folds. The timbre of the voice is the emotional coloring of the utterance, expressing various feelings and giving speech various shades; surprise, sadness, joy, etc. The timbre of speech, its emotional coloring is achieved by changing the pitch, the strength of the voice when pronouncing a phrase, text.

The timbre is characterized by the main tone - this is the primary sound formed during the vibrations of the entire length of the vocal folds; overtone, which is formed by the vibrations of individual segments of the vocal folds. The more overtones, the richer, more beautiful, brighter the voice.

Some of the sounds produced by the voice are called tonal. They are formed in the almost complete absence of noise, which ensures good audibility of the sound, for example: vowels a, e, and, o, y, s. Some are called sonorous (sonorous). Their quality is determined by the nature of the sound of the voice that plays leading role in their formation, and noise is involved to a minimal extent, for example: consonants m, m, n, n, l, l, p, p, i.

2.2 Anatomical and physiological mechanisms of voice formation

The organs of voice formation belong to the peripheral part of the motor speech analyzer. They are connected through the conductive nerve pathways with the corresponding sections of the cerebral cortex. The stimuli coming from these organs, signaling their position every moment of rest or movement, are analyzed in the cerebral cortex. After that, motor commands come from the brain to the periphery, directly setting these organs in motion.

respiratory organs, providing the jet of exhaled air necessary for voice formation;

extension pipe, that is, the cavities of the mouth and nasopharynx, which play the role of resonators that amplify the sound formed in the larynx and give it an individual timbre coloring.

A resonator is a hollow body filled with air and having a hole. The resonator amplifies the sound and gives it a timbre. The main resonators in the process of speech production are the thoracic, oral and nasal, and the thoracic resonator is often called the "foundation of the voice." Excessive participation of the nasal resonator in the process of speech formation, most often associated with the presence of palatine clefts or paresis of the soft palate, leads to the appearance of a nasal tone of voice - rhinophony, when only the voice suffers, or rhinolalia, where along with the voice, sound pronunciation is also disturbed.

The vocal apparatus is shown in Figure 1. The organ of voice formation is the larynx. The vocal cords, which are located in the larynx, can be in two main positions - closed and open. When we speak, the vocal folds in the larynx close. The exhaled air presses on them, causing them to oscillate. The muscles of the larynx, contracting in different directions, ensure the movement of the vocal folds.

The mechanism of voice formation: when inhaling, a stream of air from the lungs enters the subglottic region of the larynx and creates pressure there, the greater this pressure, the more tension occurs in the vocal folds, the more resistance they exert to this air stream. This occurs as a result of the expansion of the larynx and the tension of the vocal folds.

As the pressure increases, the air begins to break between the vocal folds with an effort of intermittent small shocks, and under the pressure of this air, the vocal folds begin to oscillate rhythmically, thus forming the primary tone.

These vibrations of the vocal folds cause vibrations of air particles in the resonator cavities that communicate with the larynx. All these air-filled cavities amplify the sound coming from the larynx and give it an individual timbre coloring characteristic of each person, depending on the specific size and shape of the resonators. For this reason, the voice of each person is deeply individual and unique, which allows us to easily recognize people by voice. The individual coloring and characteristic sound are given to the voice by the upper resonators: the pharynx, nasopharynx, oral cavity, nasal cavity and its paranasal sinuses.

They form the basis for each sound speech. And additional tones, which, having merged with the main tone, form the sound we hear. When whispering, the breathing of the anterior sections of the vocal folds closes. At the moment of breathing, the vocal folds are in a relaxed state, forming a gap. But it is necessary to take into account the role of the central nervous system in voicing. And the central nervous system ensures the coordinated work of all departments and organs of voice formation.

The energy department is a good air support for voice formation. You need to know the conditions for correct voice formation. The phenomenon of impedance is the creation of a certain pressure in the extension tube, in the supraspinal shell. Given the presence of impedance, the vocal folds operate with low closed energy, but with a good acoustic effect. Impedance is a protective mechanism in the operation of the vocal apparatus. The largest impedance for sounds m, n.

The different sounding of vowels and consonants is determined not only by the fact that the oral cavity can change its shape and volume, but also by the work of the larynx.

When forming vowels (a, e, o, y, s, and) the outgoing stream of air

does not meet in the oral cavity barriers. And, conversely, when consonants are formed, the outgoing air stream encounters various obstacles in the oral cavity. During the formation of vowels, sonorous (sonorous) consonants and voiced consonants, the vocal cords are closed and vibrate, and a voice is formed.

2.3 Periods of voice development

The maturation of the voice covers a long period of time - from birth to maturity. The development of the larynx, and hence the state of the voice function, depends on the functioning of the gonads and other endocrine glands. In this regard, both during puberty and during menopause, people experience significant age-related changes in the voice. In general, the voice function is so closely connected with the somatic and neuropsychic state of a person that it is unmistakable to judge the changes in this state at any given moment by the voice. There are many figurative expressions for describing the voice: "joyful", "excited", "angry", "faded", "friendly", "timid", etc. - so you imagine not only the internal state of a person, but to some extent even his appearance based on any of the words given here.

The voice of a child differs from the voice of an adult in all the main characteristics - in strength, pitch and timbre. This is due to the still incomplete anatomical and physiological maturity of the child's vocal apparatus. The children's larynx is approximately 2-2.5 times smaller in size than the adult larynx, and the vocal cords are correspondingly shorter. The chest resonator is still small in volume and weak, as a result of which the upper resonators play a predominant role in voice formation, giving the voice a “head”, that is, a high sound. The stream of exhaled air is also not strong enough. The vocal cords vibrate only at their edges. For these reasons, along with a high sound, the children's voice is characterized by low power and a small range, and the voices of boys and girls up to a certain age do not have big differences.

Voice mutation is a physiological phenomenon that occurs during puberty and is associated with the transformation of a child's voice into the voice of an adult. This phenomenon is most noticeable in boys. Under the influence of male sex hormones, they have a disharmonious, uneven growth of individual parts of the vocal apparatus. During this period, you need to especially pay attention to the correctness of the voice. It turns out that only a minority of young men suffer from a fracture of the voice, while for the majority this process proceeds almost imperceptibly. The voice mutation is associated with the rapid growth of the larynx. The vocal folds in boys are lengthened by 6-10 mm, that is, by 2/3 of the length. In girls, the vocal folds are only 3-5 mm long.

Boys sometimes experience strained breathing, since the closure of the vocal folds is incomplete, and in order to produce a sound of full strength, the expiratory muscles are forced to work hard.

Normally occurring voice mutation can manifest itself in several forms. So, often the voice changes very slowly, imperceptibly both for the children themselves and for those around them; occasionally, only a slight hoarseness and rapid fatigue of the voice are observed. In other cases (which is more common), the boy's voice begins to break during speech or singing, low notes of the bass timbre appear. Such "jumping" of sounds at first occurs more and more often, then it appears less often, and, finally, the children's timbre is replaced by a man's.

2.4 Types of voice disorders

Changes in voice tone (intonation) at preschool age are extremely diverse and emotional. Excessive voice tension in children preschool age can lead to various persistent violations of it, for example, the voice can become hoarse, loud, excessively high (falsetto) or weak, excessively low, rough.

The causes of voice disorders are very diverse: diseases and traumatic injuries of the larynx and vocal cords; violations of the resonator system; respiratory diseases; diseases of the heart and cardiovascular system; endocrine disorders, in particular thyroid disease; hearing impairments that impede the general "tuning" of the voice-forming apparatus due to the absence or insufficiency of auditory control; prolonged smoking; systematic use of alcohol; exposure to pesticides; frequent stay in dusty rooms; systematic overexertion of the voice, especially if it is used incorrectly; sharp temperature fluctuations, in particular, drinking cold water and especially cold milk and juices in a heated state; mental trauma.

These etiological factors lead to organic and functional voice disorders, it can be difficult to draw a clear line between them, so this division is somewhat arbitrary.

TO organic violations include those that cause a change in the anatomical structure of the vocal apparatus in its peripheral or central sections.

TO peripheral organic voice disorders include voice disorders associated with pathoanatomical changes in the larynx, extension tube, and also due to hearing loss.

1. "Singing nodules", that is, small protrusions on the vocal cords that prevent them from closing tightly. The formation of such nodules is most often associated with overstrain, overwork of the voice.

2. Papillomas are neoplasms in the form of "cauliflower", spreading not only to the areas of the ligaments themselves, but also to other parts of the larynx, the so-called papallomatosis of the larynx. After removal of papillomas, as a rule, scars remain, which also prevent normal voice formation.

4. Stenosis (narrowing of the space) of the larynx as a result of diphtheria, as well as a consequence of a burn, injury or any other injury.

5. Partial or complete removal of the larynx due to malignant neoplasms.

6. Clefts of the soft and hard palate, disrupting the normal interaction of the oral and nasal resonators.

Due to anatomical changes in the larynx and vocal folds, aphonia and dysphonia of organic origin occur. With aphonia, the child speaks only in a whisper. The sound of the voice does not appear even with a cough push. With dysphonia, the voice is monotonous, hoarse, deaf, often with a nasal tint, quickly fading.

If such voice disorders occur in a child at an early age, this leads to significant difficulties in verbal communication, to a narrowing of social contacts. Speech development also suffers. The accumulation of a dictionary, the development of the grammatical structure of speech, and sound pronunciation are delayed. Somatic and mental asthenization are also characteristic, that is, weakness, emotional disorders, violations of self-regulation.

With pathoanatomical changes in the extension tube, there is rhinolalia And rhinophony. Differential diagnosis of rhinolalia and rhinophony does not present a significant difficulty. Rhinolalia is a pathological change in the timbre of the voice and a distorted pronunciation of speech sounds, and rhinophony is a change in the tone, timbre of the voice, due to a violation of the relationship between the nasal cavity and the oropharyngeal resonator during phonation without articulation and pronunciation disorders.

Rhinolalia and rhinophony take place in speech pathology and are manifested by a peculiar violation of the timbre of the voice and the phonetic side of speech.

Rhinolaliks, embarrassed by their speech, try to speak more quietly, as a result of which the voice becomes monotonous, weak, muffled.

T.N. Vorentsova notes a violation of the height, strength, timbre of the voice with rhinolalia. The voice is deaf, with a sharp nasal tone, monotonous, unmodulated, weak.

Violation of the voice during the splitting of the palate M. Zeeman calls dysphonia palatine or palatophony ( palatophony), in contrast to articulatory disorders, that is, palatolalia(palatolalia). The author points to two causes of palatophony: laryngeal hyperfunction and abnormal vocal resonance. M. Zeeman associates the change in the timbre of vowels with a number of anatomical and resonator reasons, as well as with an incorrect movement of the tongue and larynx. Moreover, than older child, the more noticeable and unpleasant is the palatophony.

Violation of the function of the soft palate, regardless of the causes that cause it, leads to a violation of coordination in the activity of the energy, generator and resonator systems and to a decrease in the regulatory role of the central nervous system. There is a fixation of the pathological reflex of voice formation, which complicates speech therapy work even with favorable anatomical and physiological data, that is, after the elimination of the causes that caused nasalization.

There are two types of rhinophony - open and closed. Open due to organic (congenital and acquired) and functional reasons. Closed rhinophony occurs when there is reduced nasal resonance when pronouncing speech sounds.

Peripheral disorders sometimes include voice disorders in hearing-impaired and deaf children. In these cases, the pitch, strength and timbre of the voice changes due to the absence or reduction of acoustic control over speech.

With congenital or early acquired deafness, the pitch, strength and timbre of the voice change due to the lack of acoustic control. Already in infancy, the voice of a deaf person is deprived of its natural timbre and modulation. Children who have the remnants of hearing or who have lost it relatively late have a more sonorous, natural, modulated voice. Therefore, the nature of the voice in hearing loss depends on the state of hearing and the time of its loss.

TO central organic voice disorders include aphonia and dysphonia various forms anartria and dysarthria (bulbar, pseudobulbar, cerebellar and subcortical).

Dysarthria in children is manifested by two main syndromes - a violation of the phonetic side of speech and its rhythmic-medical-intonation coloring. In the clinical characteristics of dysarthria, a commonality of motor and speech disorders is found, that is, a pathology of the efferent and afferent regulation of the processes of speech and voice formation. The heterogeneity of the clinical picture of dysarthria reveals the peculiarity of the voice disorder in this speech disorder.

Violation of the prosodic side of speech is the main and most persistent symptom of dysarthria. It is the melodic-intonation disorders that most affect the intelligibility, intelligibility, emotional expressiveness, and even the semantic structure of the patient's speech.

The following clinical forms of dysarthria are identified based on the leading syndrome of damage to speech motor skills:

spastic-paretic (decrease in the strength and amplitude of arbitrary articulatory movements);

spastic-regid (change in muscle tone along with the phenomena of spastic paresis);

spastic-hyperkinetic (phenomena of spastic paresis are combined with athetoid and choreic hyperkinesis;

spastic-atactic (articulatory movements lose their accuracy, coordination);

atactico-hyperkinetic.

This classification has been developed taking into account the peculiarities of the activity of the central nervous system. The cerebral cortex functions in close connection with the extrapyramidal system (subcortical formations), the reticular formation and the cerebellum. The defeat of the extrapyramidal system at any level leads to a violation of voluntary movements, including articulatory motility. Given the close functional dependence of various levels of the extrapyramidal system, the allocation of mixed forms of dysarthria can be considered justified. Dysphonia in various forms of dysarthria in children is characterized by a peculiar and complex violation of the pitch, strength and timbre of the voice with many neurodynamic layers.

Functional voice disorders are not associated with organic damage to the vocal apparatus, but are due only to a change in its function. This group of voice disorders is also divided into central and peripheral. These disorders are less common in children than in adults.

TO central Functional voice disorders include such voice disorders that are of a psychogenic origin, mainly as a result of a psychotrauma. However, it is very difficult to draw a clear line between organic and functional voice disorders, since long-term functional disorders lead to persistent organic changes in the larynx. An example of this may be the formation of "singing nodules" on the vocal cords as a result of sometimes quite prolonged misuse of the voice. The impossibility of correct voice formation with organic damage to the vocal apparatus is obvious. As for functional voice disorders, especially those that are centrally conditioned, the mechanism of their origin must be explained. Most often there is a combination of three adverse factors following one after the other.

Firstly, even before the onset of a voice disorder, the patient develops a kind of predisposition to it in the form of a neurotic state that has already arisen, a neurotic background. In this regard, we can draw some parallel here with the predisposing causes of stuttering, in the presence of which only a small external "impulse" becomes sufficient for the onset of a breakdown.

Secondly, there is always some kind of "starting moment" that causes a primary violation of normal voice formation. A variety of life circumstances can play such a role in different cases: colds and the fear that the voice will remain hoarse forever; strong mental shocks, stressful situations and many others.

Thirdly, instantaneous loss of voice or incorrect voice formation, once occurring or repeatedly occurring, is fixed in the form of a pathological conditioned reflex and in the future is the basis for the existence of a functional voice disorder.

In addition to dividing voice disorders into organic and functional, given their causation, these disorders can also be classified according to external signs, that is, according to the features of the direct manifestation of voice disorders. In accordance with this last principle, the following most common voice disorders are distinguished.

hysterical mutism- sudden and complete loss of voice with the impossibility of even whispering speech, associated with mental trauma.

Aphonia - the absence of a sonorous voice in the presence of whispered speech. Its immediate cause is the lack of closure or incomplete closure of the vocal cords. It can be caused by both organic and functional causes. With functional aphonia, unlike organic, the patient has a sonorous cough, which once again indicates the possibility of normal voice formation. The instability, "nonstationarity" of pathological changes in the larynx is also characteristic here: the existing reporting, redness, thickening of the vocal cords and insufficiency of their closure are transient, while, for example, with organically caused paralysis or paresis of the vocal cords, they occupy one and the same place with each laryngoscopy examination. the same position. In addition, all functional voice disorders are characterized by the presence of sensory disorders - a feeling of dryness, heaviness or foreign body in the throat, and often pain. There are always general neurotic symptoms expressed in the behavior of the patient, in the thoughts that haunt him about the incurability of the voice disorder, in increased irritability, suspiciousness, mood instability, sleep disturbances, etc.

Dysphonia - voice disorder, expressed in violation of its main characteristics - height, strength and timbre. Unlike aphonia, with dysphonia, the voice is formed, but becomes inferior. It can be weak, hoarse, hoarse, breaking, trembling, falsetto, monotonous, "mumbling", deaf, strangled, "croaking", "metallic", with a nasal tint, etc.

With dysphonia quality characteristic the voice suffers unevenly, often changing depending on the action of various external and internal factors (the patient's well-being, his mood, season, time of day, weather, etc.). Dysphonia manifests itself in a peculiar way with overstrain of the voice and hysterical neurosis.

Dysphonia can be based on both organic and functional causes. If you do not pay attention to this in time, then the violation can become protracted and lead to organic changes in the vocal apparatus.

Phonasthenia - violation of the voice, expressed in its rapid fatigue, interruption and accompanied by unpleasant sensations in the throat. Most often, phonasthenia is an occupational voice disease in people with a large voice load, especially if the voice is used incorrectly. It is customary to refer to it as a functional voice disorder, but in essence it stands, as it were, on the border between functional and organic disorders, since pathological changes in the larynx gradually increase with it, nodules appear on the vocal cords. In children, phonasthenia can occur as a result of screaming and improper learning to sing.

Functional disorders also include pathological mutation vote. The pathological nature of the mutation may be due to endocrine disorders or non-observance of voice hygiene: early smoking, drinking alcohol or other drinks that irritate the mucous membrane of the larynx during the period of voice mutation that has already begun, overloading the vocal apparatus, continuing singing, infectious diseases, harmful factors (dust, smoke) , dysfunction of the thyroid gland. This voice disorder can be classified as borderline between organic and functional disorders.

2.5 Types of directed corrective work for voice disorders

Examination of patients with voice disorders is of a complex medical and pedagogical nature. An otolaryngologist, a neuropathologist, a speech therapist (phoniatrist), and a psychologist are required to participate in it. The main task of the examination is to find out the cause and mechanism of the voice disorder and, on this basis, to determine the most rational ways of corrective action.

The issues of voice restoration methodology were developed by E.V. Lavrova, S.L. Taptapova, O.S. Orlova and others. Corrective speech therapy work is built differently depending on the pathological manifestations of each type of voice disorder. However, the initial link is always a psychotherapeutic conversation, the main purpose of which is to convince the child of the possibility of restoring his voice, to establish contact with him, to include him in active work, explaining the goals and objectives of the correction.

When collecting an anamnesis, the prescription and features of the very first manifestations of the voice disorder, as well as the nature of its further course, are especially carefully clarified. The latter is more characteristic of functional voice disorders. A mandatory examination of the larynx and vocal cords is carried out using a special laryngeal mirror (laryngoscope), as well as a hearing test. Possible deviations in the emotional-volitional sphere, the adequacy of his attitude to the existing voice disorder and the possibility of overcoming it are revealed. To overcome both organic and functional voice disorders, a complex effect on the patient is used, the specific content of which varies depending on the existing pattern of disorders.

The goal of psychotherapy is the conscious, active, volitional inclusion of the child in the process of corrective work. Psychotherapy helps to re-educate the child's personality as a whole, stimulate and activate it to overcome difficulties and fight for a speedy recovery. It involves an individual approach to a sick child, taking into account his age, the course of the disease, the characteristics of the child's personality, the nature of the violation of his speech and voice. Psychotherapy is carried out in the form of a conversation, during which the child's complaints are revealed, an idea is made of the circle of his interests, inclinations, attitude towards the defect; personal and work contact is established.

With functional voice disorders in children, speech therapy work is determined by the fact that with this defect there are no visible anatomical changes in the structure of the vocal folds. Pathological symptoms (hyperemia, swelling of the mucous membrane of the larynx) are often temporary and disappear after treatment and orthophonic (voice) exercises.

The main task of speech therapy work in the restoration of functional voice disorders is to overcome a persistent fixed pathological reflex of voice formation. Therefore, conducting psychotherapeutic conversations is a necessary guarantee of success in the work. great attention may have a demonstration of tape recordings of children's voices before and after treatment, personal meetings and conversations with children who have already completed a course of speech therapy classes. If necessary, general strengthening treatment is carried out, which is also designed to strengthen the patient's nervous system, since the state of the latter has a great influence on the overall effectiveness of speech therapy work. Following the conversations, there is a silence regime for 10-14 days, after which correctional speech therapy classes begin. They include articulation and breathing exercises and voice exercises, as well as physiotherapy exercises. Much attention is paid to breathing and articulation exercises, since full-fledged speech breathing and the correct articulation of sounds in themselves contribute to better sounding of the voice and greater intelligibility of speech. Articulatory gymnastics relieves tension from the child's articulatory apparatus and contributes to a more active participation of the organs of articulation in the process of voice formation. Therefore, the goal of articulatory gymnastics is to develop clarity, correctness, dexterity of movements of the articulatory apparatus and coordinated work with the respiratory organs and voice formation. Breathing exercises develop phonation breathing, especially elongated, strong exhalation.

Then they move on to the so-called orthophonic exercises, the ultimate goal of which is to restore a single, coordinated activity of the respiratory, vocal and articulatory apparatus, as well as speech function in general. All work is of a purely special nature, requires professional knowledge.

A positive effect on the muscles of the larynx and its mucous membranes has a massage and physiotherapy procedures that help regulate blood circulation and reduce the amount of mucus. Against the background of these general health measures, the patient is asked to strictly observe the voice mode, avoiding overloading the vocal apparatus. Sometimes even for a while, complete silence or a transition to whispered speech is recommended.

After the end of treatment, the patient is recommended to observe a sparing regimen for some time and adhere to the necessary preventive measures.

In case of organic voice disorders, medical measures occupy a large place in the general complex of impact on the patient - medication and other treatment, cauterization, inhalation, surgery, etc. Even special devices are used: for example, "artificial larynx" for patients with a hit larynx or obturators. The psychotherapeutic influence here retains its importance, but it acquires a slightly different direction.

The effectiveness of overcoming voice disorders is largely determined by their causation. In the presence of gross anatomical changes in the voice-forming apparatus, as well as in organic paralysis and paresis, in most cases only one or another degree of improvement is achieved. Functional voice disorders are often amenable to complete elimination. However, far from the last role in this matter is played by the personal characteristics of a person suffering from a voice disorder, his own organization and perseverance in achieving the goal.

When restoring functional disorders, prevention and hygiene of the voice acquire a special role. Personal prevention of voice disorders consists of creating certain conditions of life, family, recreation, and the child's lifestyle.

Among the preventive measures for dysphonia is the prohibition to sing, recite loudly and in every possible way overstrain the voice. With an acute onset of the disease, it is important to give complete rest to the voice for 10-14 days.

Special conditions must be observed during mutation. The period of the formation of the voice requires an attentive, sensitive attitude on the part of teachers and parents, since the puberty period proceeds against the background of physical and mental changes in the personality of a teenager. During this period, you need to spare the voice-forming apparatus, do not shout, do not sing loudly, especially in damp or unventilated, smoky rooms. If there are frequent breakdowns of the voice, discomfort during phonation, you should consult a doctor - a phoniatrist. Persons whose profession requires a long voice load are recommended to have a special production of speech voice, which protects against overwork.

For the prevention of voice disorders, a kindergarten and a family must constantly monitor the condition of the children's nasopharynx and the correct use of the voice, and comply with the above requirements. This is of particular importance in relation to children who have just had diseases of the upper respiratory tract. For some time, such children should not be given a big load on their voice, that is, they should not be required to speak loudly and sing.

Parents and teachers should know the basic rules for protecting children's voices. If a voice disorder occurs, especially if it becomes chronic, the child should be referred for a consultation with an otolaryngologist, and, if necessary, for classes with a speech therapist.

ĮĮĮ. Conclusion

The vocal cords have the ability to come into a state oscillatory motion. Due to the vibration of the vocal cords, when the air stream passes through the larynx, the primary sound of the voice is formed in it. This sound is very weak and does not resemble a normal human voice. It receives the strength and color habitual for our ear thanks to the oral and nasal resonators.

Various diseases and traumatic injuries of the larynx and vocal cords, violation of the resonator system, diseases of the respiratory system, diseases of the cardiovascular system, endocrine disorders, hearing impairment, harmful factors can lead to voice disorders.

All causes of speech disorders are usually divided into two large groups - organic and functional. They, in turn, are also divided into central and peripheral.

Organic disorders include those that cause a change in the anatomical structure of the vocal apparatus in its peripheral or central sections.

Functional voice disorders are not associated with organic damage to the vocal apparatus, but are due only to a change in its function. This group of voice disorders is also divided into central and peripheral. These disorders are less common in children than in adults.

The restoration of voice function in children is carried out in a complex joint effort of medicine and a specialized field of speech therapy - phonopedia. Articulation, breathing and voice exercises are combined with psychotherapy, physical therapy and drug treatment. Children receive specialized assistance in ENT departments and speech therapy rooms polyclinic.

Therefore, it is very important to detect and eliminate speech disorders in a timely manner. It is imperative to bring the child's speech back to normal from the very beginning, so that nothing prevents him from fully studying, working and living.

In order to prevent voice disorders, the voice of a child at preschool age should be protected, children should not be allowed to speak too loudly, loudly, sing loudly, scream in the cold. In a timely manner, consult a doctor with any visible violations. After all, a healthy voice of a child is the key to his successful development, upbringing and education.

IV. Literature

1. Almazova E.S. Speech therapy work for restoring the voice of children. Second revised edition. M.: Iris-press, 2005. - 192 p.

2. Paramonova L.G. speech therapy for everyone. M.: OOO Publishing House AST, St. Petersburg: Delta, 1997. - 464 p.

3. Filicheva T.B., Cheveleva N.A., Chirkina T.V. Fundamentals of speech therapy. M.: Education, 1989.

4. Fomicheva M.F. Parenting in children correct pronunciation. M.: Enlightenment, 1989. - 240 p.

5. Rau E.F., Sinyak V.A. speech therapy. M.: Enlightenment, 1969. - 126 p.

Educational Establishment "State Center for Correctional and Developmental Education and Rehabilitation of the City of Polotsk"

Prepared by:

Defectologist teacher

Stankevich Olga Stepanovna

Introduction

In our country, much attention is paid to correctional and pedagogical work with children suffering from speech disorders. Significant progress has been made in addressing the issues of early diagnosis of speech disorders, methods and organization of correctional education and training of preschool children.

By means of special influences on children, in many cases it is possible to prevent or slow down the appearance of various deviations from the norm in them, in particular speech pathology.

Timely prevention of speech disorders in children is closely related to the prevention of neuropsychiatric abnormalities in the state of health. It is provided by a set of measures, including therapeutic, pedagogical and social impacts.

Specialists of children's polyclinics, along with constant dynamic monitoring, conduct preventive examinations of children from 0 to 14 years old, not only in the polyclinic, but also in children's preschool institutions and schools. Collaboration doctors and teachers in children's pedagogical institutions allows early detection of deviations from the norm in the state of health of children, congenital and acquired diseases that affect the development of speech or contribute to the emergence of speech pathology.

Of great importance in developing the problem of prevention of speech disorders is the study of factors that ensure the normal development of speech in children. This knowledge is directly related to the hygiene of speech development, which is the most important indicator of a child's neuropsychic health. Its tasks are mainly reduced to the study of the age stages of speech ontogenesis and the identification of conditions (including the external environment and social conditions) that positively or negatively affect speech development. Recommendations and standards are being developed on the psychophysiological conditions of raising children, incentives for the child's mental development and the possibilities of their application are scientifically substantiated, mass propaganda of psychological and pedagogical knowledge among the population is organized.

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

This special branch of speech therapy faces the following tasks:

a) prevention of speech disorders - primary prevention;

b) preventing the transition of speech disorders into chronic forms, as well as preventing the consequences of speech pathology - secondary prevention;

c) social and labor adaptation of persons suffering from speech pathology - tertiary prevention.

Primary prevention

speech disorder mental speech therapist

1. The implementation of the preventive direction of health care and special pedagogy begins even before the birth of a child by creating the most favorable conditions for the expectant mother during pregnancy, regulated by relevant laws and provided by the entire maternal and child health service.

The health of the younger generation depends on a number of conditions related mainly to the environment, its influence on the immune, nervous and endocrine systems. Pollution of air, water, soil entails the growth of acute and chronic (especially allergic) diseases, a decrease in the body's resistance to harmful influences. Along with this, the role of stressful psychological influences also increases, which in turn worsens neuropsychological health and immunity in children. It is clear that the quality of all aspects of the health of parents also continues to decline, and with aggravated heredity, children are 2-3 times more likely to suffer from the same ailment as their parents.

In cases where a family history of any pathology is detected, parents should be well informed about the possible manifestation of the disease in a child, as well as about what preventive measures will prevent or alleviate the symptoms of a hereditary disease.

The opinion of parents who believe that personality traits and deviations in the development of children arise and form after birth is deeply erroneous. In fact, everything happens much earlier, during the period of intrauterine development of the fetus.

It often happens that the pregnancy was not planned and in the first months the expectant mother does not even know what happened and sometimes allows the use of alcohol, nicotine; uses at home or at work various chemical substances adversely affecting the body of the unborn child; undergoes mental shocks and suffers from various diseases. These factors, affecting the fetus for the first time for 12 weeks, can lead to a severe speech disorder - rhinolalia, characterized by cleft lips, hard and soft palate, since it is in the first trimester of pregnancy that the facial region of the head, the organs of hearing and vision, and the nasal cavity are laid in the embryo and mouth.

A pregnant woman needs to control the work of the cardiovascular and endocrine systems, as well as protect herself from viral and infectious diseases, since viruses and bacteria instantly multiply in the mother's body and cause severe disturbances in the development of the fetal brain.

The consequence of this are such speech disorders as dysarthria (speech (articulation) disorder, expressed in difficult pronunciation individual sounds, syllables and words), often against the background of cerebral palsy (cerebral palsy is a group of motor, speech and mental disorders due to brain damage during the prenatal, birth or postpartum period), alalia (absence or limitation of speech due to underdevelopment or damage to speech zones hemispheres brain), a neurosis-like form of stuttering (due to underdevelopment of brain cells).

A woman during pregnancy should eat right, since a lack or, conversely, an excess of certain nutrients and trace elements can have an adverse effect on the fetus.

Thus, future mother should be very careful about her body throughout the entire period of bearing a child, lead a healthy lifestyle, follow the rules of nutrition and general hygiene, the implementation of which contributes to the normal development of the fetus and the preparation of a woman for childbirth.

v During pregnancy, a woman should avoid physical overwork, lifting and carrying heavy loads, and working in night shifts. Moderate work has a beneficial effect on the physical and mental state.

v A long stay in the open air is recommended, but without tiring walks. In the summer it is useful to go out of town.

v Sleep should last at least 8-9 hours a day, during the day - preferably no more than 2 hours.

v It is useful to do special light physical exercises.

v Thermal effects - hypothermia, extreme heat, stuffiness should be avoided.

v Comfortable clothes and shoes should be worn.

v It is very important to avoid infectious diseases and mental stress.

Myself birth processalso largely depends on the woman herself. The reasonable and correct behavior of the expectant mother during pregnancy largely determines the normal course of childbirth.

With the birth of a child, the responsibility for his neuropsychic, physical and speech development falls on the family, which makes the psychological and pedagogical education of young parents especially relevant.

The formation of the character and personality traits of the child begins from a very early age. Already the early period of postnatal development is of great importance for the subsequent stages of the formation of his psyche. Sleep, cry, movements and other physiological reactions of the newborn's body reflect the safety and level of maturity of the central nervous system. Therefore, parents, together with doctors, should carefully monitor the course of the formation and development of these reactions, take the necessary preventive measures in case of their deviations from the norm.

Concern for the physical and neuropsychic health of the child and the safety of his speech organs is expressed in the following:

v Head injury prevention.

v Prevention of various diseases and childhood infections that occur with a high temperature (observance of the terms of preventive vaccinations, exclusion of direct contact with patients, etc.).

v Protection of articulatory organs, consisting of the following:

a) prevention (and treatment) of rickets and the possible appearance of anomalies in the bone parts of the speech apparatus;

b) exclusion of cases of sucking a finger or constantly placing a hand under the cheek during sleep (the latter can lead to the formation of the so-called crossbite);

c) early prosthetics of teeth in case of their premature loss, since the loss of teeth in children causes a significant deformation of neighboring teeth and jaws (here we do not mean age-related change of teeth);

d) timely operation of cleft lip and palate;

e) timely cutting of the short frenulum of the tongue (no later than 4-5 years, since by this time those sounds should appear in the speech, the correct articulation of which interferes with the short frenulum);

v Protection of the vocal apparatus from colds, dust ingress, voice overload (excessive screaming, excessively loud and tense speech, etc.).

v Protection of the nervous system of the child (exclusion of loud shouts, scary stories and all sorts of intimidation, a gentle approach to the child during any illness and for some time after its completion, the fight against roundworms, etc.).

Great responsibility in organizing measures to prevent neuropsychiatric disorders leading to speech disorders in children rests with preschool institutions. In the process of upbringing and educational work, they consistently carry out the tasks defined by the program in the field of physical, mental, moral and aesthetic development preschool child. To date, there are scientifically substantiated psychological and pedagogical recommendations on the regimen of preschoolers and on educational influences.

However, in a number of cases there are individual reactions of children, indicating a violation of the child's adaptation to new living conditions. Thus, the initial period of a child's stay in a nursery is sometimes accompanied by a delay and even a regression of the development achieved earlier. In the first days after admission to the nursery, some children have a sharp decrease in speech activity, which undoubtedly delays the formation of speech. This period can last for younger children up to 4 months, for older children up to 2 months. It is most difficult to adapt to a children's institution if the child enters it at the age of 9 months to one and a half years. The least painful it occurs at the age of 6-7 months and after a year and a half.

Therefore, at an early age, it is essential psychological aspect prevention of neuropsychiatric speech disorders, in particular, is the direction of the child in a children's institution in the age period in which he can more easily adapt to new living conditions.

Another way of adaptation of the child is the preliminary approximation of the home regime to the conditions of the children's institution. It is necessary to teach him to stay away from home without loved ones. Being outside the family, his adaptation to these conditions develops cognitive mechanisms, his interest in new objects and people, which makes the child not only calm, but also active. Both at home and in kindergarten, the regime should be built in compliance with hygiene rules, one of which is the development of physical activity in children.

Care for the correct speech development of the child should be expressed in the following:

v Ensuring a favorable speech environment as a necessary role model (in terms of the absence of speech disorders among people around the child). It is the speech of parents that becomes a model for the speech development of children, and therefore, in some cases, it is necessary to limit speech communication with a child by persons suffering from speech pathology. For the purpose of primary prevention of speech disorders in a child from a family aggravated by speech pathology, it is necessary to start speech therapy classes at preschool age.

v Encouragement of the baby's babble with facial expressions of joy.

v Raising a focus on the perception of the speech of others, for which you need to talk with the child as much as possible starting from the first days of his life. It is known that at the earliest stages of the postnatal development of a child, his communication with his mother is not silent, they conduct a “dialogue”. This “dialogue” evokes reactions in the infant in the form of revitalization of general movements, smiles, pronunciation of sounds and consonances (echopraxia, echolalia).

v Slow and clear pronunciation by adults simple words associated with a particular life situation, as well as the naming of the surrounding objects and the actions performed, which will help the child "start" to the gradual mastery of speech. The people around the child, with their smooth, clear articulation and construction of the phrase, calm speech encourage him to such an imitation of the design of a speech statement. If a child develops a fast rate of speech, “choking” with words, an “avalanche-like” development of accumulation vocabulary and the development of phrasal speech, a special speech mode is needed with a restriction on the introduction of new words and concepts into the child's lexicon and, in general, the speech load.

In the initial period of speech development, one should not overload the child with the assimilation of words that are difficult to pronounce and incomprehensible, by memorizing poems and songs that are not appropriate for age.

v A clear pronunciation by adults of words incorrectly spoken by the child, calculated on the unobtrusive and gradual correction of his incorrect pronunciation.

v Teaching a child to look during a conversation in the face of an interlocutor, because visual perception articulation contributes to its more accurate and faster assimilation.

v The complete exclusion of cases of "lisping" with a child, depriving him of the right role model. In those cases when the surrounding adults have an incorrect pronunciation or, having fun, copy the child’s speech (“lisping”), the process of mastering the correct sound pronunciation is difficult, abnormally pronounced speech sounds are fixed, and in the future such a child may need special corrective training from a speech therapist.

v Rhythm, music and singing lessons; the latter contributes to the development of correct breathing and a sufficiently flexible and strong voice, and also prevents slurred speech.

v The development of fine manual motor skills playing extremely important role in mastering speech.

5. The transition to teaching children at school from the age of 6 makes new demands on the child's body. Psychophysiological studies of 6-year-old children show that this age is a special turning point. It was at this time that the ability to follow certain rules of behavior is formed, to establish personal interactions with peers and adults, to coordinate one's actions with the actions of other people, to be able to listen and follow the instructions of adults (V. S. Mukhina, 1975). These psychological features associated with the new, compared to younger age, a step in the maturation of the main physiological systems, which is the most important condition for restructuring of an adaptive nature (both physiological and psychological).

If a child has speech disorders, the need for timely diagnosis of the degree of functional readiness for schooling increases. Only with specialists of various profiles can the question of whether a child enter school or be granted a deferment be decided with some certainty.

The school plays an important role in protecting the mental health of children. Of particular importance in this regard are the first weeks of the child's stay at school. A lot of new impressions and previously unfamiliar requirements fall upon him, such as strict observance of the rules of behavior, a long stay in a relatively immobile position, intense mental activity, etc. into a new diverse group of peers. Changing the habitual way of life, adaptation to new conditions of social existence require a significant tension of all functional systems of the body.

In children with speech disorders, the adaptation period is often painful: the instability of attention, memory, and distractibility increase. They become irritable, often extremely excitable, restless, lose their appetite, sleep poorly, and have difficulty getting in touch with the teacher. Only gradually these phenomena are reduced. The criteria for the onset of adaptation are the reduction of fatigue, the restoration of appetite and sleep, the establishment of normal relationships with the teacher and comrades. The correct behavior of the teacher in this difficult period for the first grader, his patience and goodwill, the gradual inclusion of children in teaching load, individual approach facilitate adaptation to school.

The most important task of school mental hygiene remains the prevention of overwork and mental trauma in children, the creation at school of conditions that protect the nervous system of students from excessive stress. In this regard, great responsibility for the state of speech development of children and adolescents falls not only on the speech therapist, but also on the teacher, educator and class teacher.

It must be remembered that the student's oral speech (especially lower grades) must be developed not only in terms of expanding the vocabulary and designing its grammatical side, but also in terms of special training for its external sound design: the education of rhythm, clarity of sound pronunciation, intonational expressiveness, i.e., everything that helps to strengthen motor speech stereotypy as a basal component of expressive speech.

Secondary prevention

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

Deep speech disorders (alalia, aphasia) in one way or another limit mental development in general. This happens both due to the functional unity of speech and thinking, and as a result of a violation of normal communication with others. The latter impoverishes knowledge, emotions and other mental manifestations of the personality.

There are four levels of predominant neurotic disorders in children:

Somato-vegetative - 0-3 years of life.

Psychomotor - 4-7 years of life.

Affective - 7-10 years of life.

Emotional-ideational - 10-15 years of life.

The first level of neurotic disorders includes appetite disorders, dysfunctions of the gastrointestinal tract, thermoregulation, and sleep. The second level is associated with the appearance of hyperdynamic syndrome, tics, stuttering, mutism and other motor and speech disorders. At the third level of reactivity in children, fears and depressive experiences are observed. At the fourth level - neurotic anorexia, hypochondriacal overvalued formations to one's "physical self".

The degree and nature of speech insufficiency and mental stratification determine the child's ability to learn and actively participate in the social life of the school. School performance is hampered by the inability to ask, answer, tell or read in time and clearly. Due to children suffering from speech disorders, the dynamics of the lesson are often delayed, discipline is violated (laughter, mimicry, complaints, etc. occur in the class).

Underdevelopment of the sound side of speech, insufficient formation phonemic processes and sound pronunciation hinder the timely formation of prerequisites for spontaneous mastery of practical skills of analysis and synthesis of the sound composition of a word. This state can be considered as the first consequence that creates significant difficulties on the way to children's literacy. The second consequence can be considered the difficulties that arise in children in the process of mastering literacy.

Thus, the attention of the teacher-speech therapist should be focused as much as possible on the timely prevention of possible secondary, more distant consequences of speech pathology. The state of the sound side of speech should be especially carefully analyzed from these positions, because the insufficient formation of phonemic processes, even with fully compensated defects in sound pronunciation, can lead to shortcomings in mastering the skills of writing and reading.

In the process of raising children with speech disorders, parents and teachers need to constantly comprehend their behavior and their positions. Mutual understanding, encouragement, mutual respect, observance of order, interaction both between family members and between teachers and parents play a serious role in the prevention of psychogenic reactive phenomena in children suffering from speech pathology. In particular, this provision is relevant for stuttering schoolchildren.

In cases where children experience psychological complications such as personal experiences associated with the presence of a speech defect, fear of speech, avoiding situations that require verbal communication, etc., the speech therapist needs to significantly increase the psychotherapeutic emphasis in his work. Each time, this emphasis and forms of psychotherapy will depend on the age of the child and the characteristics of the individual psychological response.

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

Tertiary prevention

Some speech defects limit the choice of profession. Career guidance and training of persons suffering from speech pathology is included in the tasks of tertiary prevention of the consequences of speech disorders.

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

The purpose of labor education of school students for children with severe speech disorders is to form a strong conviction among the younger generation that work is the main sphere of personality realization. The school must prepare students for socially useful activities and participation in productive work.

For the pronunciation of speech sounds, as a physiological act, a normal structure and coordination of the functions of both the central and peripheral speech apparatuses are necessary, and for the perception of speech by ear, the normal state of the auditory sensory system is necessary.

What you need to know about the formation of a child's voice?

The development of a child's voice is conditionally divided into several periods: preschool up to 6-7 years, pre-mutation from 6-7 to 13 years, mutation 13-15 years and post-mutation 15-17 years. Phonation by preschool children is carried out due to the marginal tension of the vocal folds and the sound range is 5-6 notes.

In the pre-mutation period, in parallel with the growth of the organs of voice formation, the development of the receptor apparatus of the larynx ends. The child's voice gradually develops and its range expands to 11-12 notes.

Voice mutation (the transition of a child's voice to an adult) is observed during puberty at 13-15 years. In boys, the vocal apparatus at this time grows rapidly and unevenly, in girls the larynx develops slowly. During puberty, the male and female larynx acquire clear distinctive features.

In boys, the thyroid cartilage begins to increase, forming a bulge along the neck - the "Adam's apple", the vocal cords lengthen 1.5 times (in girls by 1/3). Mutation can proceed slowly, then the voice changes gradually. In the acute course of the mutation, the voice of the boys drops by an octave, hoarseness appears, the sounds of the bass timbre suddenly slip into falsetto. There is a "breaking" of the voice. The duration of this period is from one to several months to 2-3 years.

During this period, redness of the vocal cords, the mucous membrane of the entire larynx is characteristic, sometimes there is a non-closure of the vocal cords, there are violations of the coordination of the muscles of the larynx, breathing and voice formation. At this time, the voice suffers the most.

The voice mode during the mutation is assigned individually, depending on the severity of the ongoing process. With severe swelling of the mucous membrane of the larynx, complete silence may be recommended. During the period of mutation, it is necessary to spare the voice apparatus of a teenager. Speech load should be moderate, you can not overstrain, force the voice. A teenager should be helped to learn to calmly, gradually master the voice of an adult. To facilitate the period of mutation, it is useful to dose physical activity, to correctly distribute the work and rest of a teenager.

Various diseases and traumatic injuries of the larynx and vocal cords, violation of the resonator system, respiratory diseases, diseases of the cardiovascular system, endocrine disorders, hearing impairment, harmful factors can lead to voice disorders.

To prevent various voice disorders, it is very important to protect and educate the voice from early childhood. Each teacher should know that the development of the voice is gradual, that the children's voice apparatus is still weak and forcing the voice can cause irreparable harm. Screaming singing in a range that does not correspond to a child's voice causes an overstrain of the vocal apparatus, which can lead to functional and organic disorders. Children from an early age should hear soft, melodious voices with precise and expressive intonations. Possessing great imitation, they easily learn the intonation and the way the adults around them voice.

So the first rule is don't scream! Learn to speak with restraint, demanding the same from the child. You should not talk on the street in severe frost. Do not try to shout over the noise (industrial or traffic): if there is no urgent need to say something immediately, it is better to wait until the noise subsides or you yourself find yourself in a quieter place.

For the correct formation of speech, the child must develop in a normal speech environment. The speech of parents and teachers should be clear and grammatically correct. It is unacceptable to adapt to children's speech ("lisping"), because the child gets used to the incorrect pronunciation of words. It is necessary to teach the child to speak slowly, loudly, but without shouting, so that there is no overstrain of the vocal folds, leading to a violation of the voice.

In no case should you overstrain your voice with respiratory diseases, not only at the height of the disease, but also when things are on the mend. You should beware of colds. Observations show that "small colds" have a negative effect on the vocal apparatus, in which people continue to work, straining their voices.

It is necessary to teach children to breathe through the nose, as mentioned above, nasal breathing provides warming, moisturizing and purification of the inhaled air. Violation of nasal breathing (difficulty or its complete shutdown in diseases) has Negative influence on the activity of the nervous system of children, leads to the development of a closed rhinolalia. It is not recommended to instill various drugs “for the common cold” into the nose on your own, without the appointment of a specialist doctor, since many drugs are not used in pediatric practice or are used only in older children, since they can damage the nasal mucosa.

The voice is also affected by foods that are irritating, containing spices, a lot of salt and vinegar. Please note that excessive fullness is harmful not only in itself, but also affects the voice. To protect the voice, persons of vocal professions must remember that smoking, alcohol, and the abuse of hot and very chilled food are unacceptable, because this irritates the mucous membrane of the pharynx and larynx.

To prevent inflammatory diseases of the upper respiratory tract, hypothermia should be avoided and the body of children should be hardened. Hardening with water, air, sun has a stimulating effect on the entire body, reduces its sensitivity to low temperatures, colds and infectious diseases. It is necessary to carry out sanitary and educational work in preschool institutions, schools, with parents to explain the causes that contribute to the occurrence of diseases.

Needless to say, extremely negative influence tobacco. It is noticed that the use of beer affects the voice negatively.

A 4-5-year-old child requires special attention when he begins to sing. The performance of songs should not go beyond the permissible volume, otherwise it can lead not only to hoarseness, but also to more significant, persistent voice disorders. We have to face the facts when parents allow children, as they say, to yell at the top of their voices. Note that children singing in choirs, as well as students of music schools, should be under the constant supervision of medical specialists ... When the voice begins to "break" during the mutation period (at 13-14 years in boys), even loud reading aloud should be prohibited. If suddenly the voice disappears, it is required to maintain complete silence for 2-3 days, sometimes it is allowed to speak in a whisper. When the voice is overloaded, nodules may appear on the vocal folds.

Of great importance for the normal development of speech is the state of the child's hearing, so early detection of the slightest shortcomings in auditory function is necessary. To eliminate defects in voice and speech, it is necessary to timely contact specialist doctors, as well as conduct special exercises under the guidance of speech therapists,.

The full-fledged activity of teachers largely depends on the performance of their vocal apparatus, the ability to correctly and effectively use it for professional purposes. The ability to own one's voice for this category of specialists is no less important and essential than a high professional level.

To be strong and enduring enough for intense daily work for several hours for decades;

Sufficiently wide in range, i.e. not less than an octave;

Speech should be legible, clear, emotional, flexible and melodic.

In addition, the teacher should be able to independently adequately assess their voice capabilities, prevent overstrain of the vocal apparatus, and, if necessary, promptly seek help from specialists - a phoniatrist and a speech therapist.

1. Correctly build classes, alternate periods of stress and rest.

2. Avoid forced sound, hard sound attack, squealing, screaming.

3. Avoid long, monotonous speech, leading to the accumulation of static stress, whispering speech.

4. Quit smoking, drink alcohol in moderation.

5. Eliminate, if possible, side noise in the audience during speech loads.

6. Timely treat acute respiratory infections, tracheitis, if possible, take an exemption from work for this time.

7. Work in a clean environment with sufficient

8. Avoid contact with dust and harmful chemicals.

9. Avoid sudden temperature changes, drinking cold drinks when overheated.

10. Carry out general strengthening, tempering procedures.

11. In case of diseases of the ENT organs, contact specialists in a timely manner and without delay.

The most radical measure to prevent diseases of the vocal apparatus can be considered the production of a speech voice.

Thus, proper speech breathing and careful attitude to your vocal apparatus is the key to a full-fledged person of speech professions.

Author information

Pirogova Anna Nikolaevna

Place of work, position:

teacher-speech therapist MDOU " Kindergarten No. 6 "Yaroslavl

Yaroslavl region

Resource characteristics

Levels of education:

Preschool education

Item(s):

speech therapy

The target audience:

caregiver

The target audience:

Brief description of the resource:

Prevention of voice disorders in preschool children

Pirogova A.N. teacher speech therapist

MDOU "Kindergarten No. 6", Yaroslavl

Due to anatomical and physiological features, a child's voice has qualities that distinguish it from adults. These are shorter vocal cords, a smaller volume of the lungs, and the predominance of head resonators. Preschool children mostly speak in falsetto.

Currently, there is a huge range of voice disorders from complete loss of voice to its minor changes. The specificity of violations depends on a number of factors: the degree of violation, which department suffered, when the violation occurred, etc. The pronunciation of speech sounds is a complex physiological act, the implementation of which requires the normal structure and coordinated function of the central speech apparatus and peripheral organs of voice formation and articulation.

Naturally, any developmental defects, diseases and damage to any part of the speech apparatus can be the cause of voice and speech production disorders. They can manifest themselves, for example, in chronic diseases of the larynx, with nodules, fibromas, papillomas, with cleft lip and palate, with an incorrect structure of the jaws and teeth, with nasal breathing disorders, with neuromuscular disorders in the oral cavity, pharynx and larynx, and with other defects of the peripheral speech apparatus. And also with brain lesions that can occur due to cerebral hemorrhage, infectious diseases, tumors.

Diseases of the larynx, nasopharynx, bronchi, upper respiratory tract;

Hearing loss;

With the characteristics of the character of the child;

Paresis and paralysis of the muscles of the tongue, larynx, vocal cords, impaired tone and muscle mobility;

Insufficient palatopharyngeal closure (nasality of speech);

Allergic diseases (swelling of the respiratory tract);

The voice of children with speech problems can sound different. For children with stuttering, the following are mainly characteristic: insufficient voice power, narrowing of the voice range, impoverishment of the intonational side of speech, hoarseness of voice.

Children with motor alalia and dysarthria are characterized by: hoarseness of voice, insufficient modulation, nasalization, lack of logical stresses.

For children with dyslalia and normal speech development all voice problems are usually associated with diseases of the upper respiratory tract.

The most common voice defect is spastic dysphonia, which occurs due to tension in the voice. Often it occurs in children who speak loudly or shout a lot. On the vocal folds, they form knots of "screamers". It is typical for such children that the voice is normal in the morning, and hoarseness appears in the evening.

Preventive measures to prevent voice disorders:

Prevention of colds, runny noses, tonsillitis, laryngitis, etc. Here the hardening of the child's body plays an important role. Children should not be accustomed to excessive heat, they should not be wrapped up, because in this case the body loses the ability to adapt to changes in external temperature, becomes sensitive to even its slight fluctuations, and the child easily catches a cold at the slightest cooling and draft. Of course, when hardening, care must be taken: the body should be accustomed to cooling gradually, hardening procedures should be started in the summer, teaching children to walk barefoot, swim in cool water. With any disease, hardening should be stopped and started again only after recovery;

Removal special attention physical education And available species children's sports;

During nasal breathing, the air is cleaned of mechanical impurities, warmed and moistened. If breathing occurs through the mouth, then the elimination of the harmful properties of exhaled air is carried out to a lesser extent. Therefore, the removal of obstacles that interfere with normal nasal breathing is important not only to eliminate nasality, but also to restore the protective function of the nasal mucosa. However, even in the presence of free patency of the nasal cavity, in some cases breathing is carried out through the mouth, for example, during speech and singing, as well as when walking and running fast. Therefore, you can not go out hot (after a bath, outdoor games) into the cold air and at the same time talk. For the same reason, in cold and damp weather, one should not sing in the street, walk quickly and run, since in all these cases breathing occurs through the mouth;

Compliance with medical measures to eliminate defects in voice and speech caused by anatomical disorders. However, such organic defects of the speech apparatus are quite rare. In addition, not every violation of the structure of the speech organs leads to a violation of pronunciation. If the anatomical defect is not very pronounced, then speech may be normal;

Much more often in children there are functional speech disorders that occur in the absence of any noticeable anatomical changes in the speech apparatus. In most of these children, speech disorders are due to improper upbringing. In this regard, the enormous role of proper upbringing in the family and in the preschool educational institution becomes obvious precisely in the period when the development of speech occurs most intensively and when the defects that have arisen for some reason have not yet had time to gain a foothold. The speech of adults should be clear, clear, grammatically correct. It is unacceptable to adjust to the children's speech "lisping"; - prevention and treatment of allergic diseases, tk. there may be swelling of the respiratory tract and inflammation of the mucous membrane of the larynx, which leads to nasality;

Early detection of hearing impairments and their elimination. Very important high degree hearing preservation. For the normal and independent development of the child's speech, there must be a high degree of hearing preservation. Even a slight decrease in hearing, remaining unnoticed, can lead to defects in pronunciation and a violation of the grammatical structure of speech. Timely detection of such hearing defects is of great importance for the prevention of speech disorders;

The role of the teacher is great in instilling the skills of skillful use of one's speech apparatus. The teacher should teach children to breathe correctly during speech, to speak slowly, clearly, loudly enough and without loudness. Excessive volume of the voice leads to overstrain of the vocal cords, resulting in hoarseness, weakness of the voice; - with a runny nose or the slightest sign of hoarseness, children should speak as quietly and as little as possible, free from singing;

Systematic singing exercises, in which the vocal folds are strengthened, which contributes to the development of the vocal apparatus. Screaming singing causes an overvoltage of the vocal apparatus;

Limiting and eliminating exposure to tobacco smoke on the delicate mucous membrane of the larynx can lead to chronic laryngitis in children (inflammation of the mucous membrane);

Bibliography:

Almazova E.S. Speech therapy work on the restoration of voice in children. M.: Iris-press, 2005.

Arkhipova E.F. Erased dysarthria in children. M.: AST: Astrel, 2008

Vygodskaya I.G. Etc. Elimination of stuttering in preschoolers in the game. -M., 1984

Ivanovskaya F.A. Collection of speech therapy exercises for voice disorders. M.: Uchpedgiz, 1961.

Kalmykova I.G. The mysterious world of sounds. Phonetics and culture of speech in games and exercises. - Yaroslavl: Acad. Development, 1998

Neiman L.V., Bogomilsky M.R. Anatomy, physiology and pathology of the organs of hearing and speech. - M.: VLADOS, 2001.

Povarova I.A. Workshop for stutterers. - St. Petersburg: SOYUZ, 1999.

Shilenkova V.V., Karelina I.B. Speech and voice disorders in children, adolescents and adults. - Yaroslavl, 2005

With central paralysis and lesions of the recurrent nerve trunk, treatment is carried out aimed at eliminating the underlying cause that caused the paralysis. In case of paralysis and paresis of individual laryngeal muscles, in addition, electrotherapeutic and thermal procedures (for example, faradization, galvanization, diathermy), massage, gentle voice mode, voice exercises aimed at a gradual transition from whispered speech to sonorous. Bilateral paralysis of the muscles that expand the larynx may require urgent surgery (tracheotomy).

3.5. Prevention of voice and speech disorders in children

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

To prevent chronic diseases of the vocal apparatus, it is very important to protect children from frequent colds, sore throats, acute laryngitis and other colds. Here the hardening of the child's body plays an important role. Children should not be accustomed to excessive heat, they should not be wrapped up, because in this case the body loses the ability to adapt to changes in external temperature, it becomes sensitive to even its slight fluctuations, and the child easily catches a cold at the slightest cooling or draft. Of course, when hardening, care must be taken: the body should be accustomed to cooling gradually, hardening procedures should be started in the summer, teaching children to walk barefoot, swim in cool water. With any disease, hardening should be stopped and started again only after complete recovery.