The brain is a unique organ complex functions which - thinking, memory, speech - in fact, make a person a person. From external influences this holy of holies is reliably protected by the cranial bone, and yet the brain remains the most vulnerable human organ.

The fact is that for work it absolutely needs an uninterrupted supply of oxygen. That is why when breathing stops, the brain dies first. Already after 5-6 minutes of clinical death, irreversible changes occur in it; personality ceases to exist.

Few people know that the brain is the first to age. Age-related changes in metabolic processes in its tissues begin from about 25-30 years. It is not for nothing that after thirty, many, fortunately, not all lose their former learning ability and creativity.

Almost everyone experiences other symptoms of brain aging as well. Which of the quite young people is not familiar with the temporary weakening of memory, attention, concentration; irritability and, caused, for example, by stress in the family or rush at work?

Over the years, the functioning of the brain gradually slows down: the speed of reaction decreases, coordination of movements worsens, clarity of thought disappears. We call the final stage of this process senile insanity and hope to avoid it or not survive. But, unfortunately, the work of the brain is often disrupted in the most unexpected and dramatic way.

The worst enemy of the brain

The most formidable enemy of brain activity is a stroke, or an acute violation of cerebral circulation.

This is a real disaster that overtakes three hundred thousand of our compatriots every year.

For about half of them, a stroke is the last event in their lives.

60-80% of the survivors remain disabled until the end of their lives, in need of outside help. And even those who recover to full social and everyday adaptation live under the constant threat of a repetition of the tragedy.

In the famous novel The Count of Monte Cristo, the following is said about a stroke:

"Not only death, old age and madness are terrible. There is, for example, apoplexy - this is a thunderous blow, it strikes you, but does not destroy you, but after it everything is over. It is still you and no longer you; you, who were almost an angel, become a motionless mass, which is already almost an animal..."

At the time of Dumas in Europe they did not know drugs that alleviate the condition of the patient after a stroke. Therefore, an apoplexy meant death or months or years of a semi-vegetative existence. However, even today, a stroke in many cases leads to death or severe disability.

A stroke requires great courage from the patient and a lot of patience and love from his loved ones, because. it causes partial or complete damage to the most important functions of the body - movement, speech, memory; as well as behavioral, mental and emotional disorders, which sometimes take years to deal with.

How does a stroke happen?

Hemorrhagic stroke is usually a complication of hypertension. Unable to withstand the increased blood pressure on the wall, the vessel ruptures. The resulting hemorrhage compresses the tissues, causes swelling - and the brain area dies.

When ischemic stroke the vessel retains its integrity, but the blood flow through it stops due to spasm or blockage by a thrombus, that is, a blood clot that has formed on the wall of a vessel affected by atherosclerosis.

Stress, fluctuations in atmospheric pressure, overwork, bad habits: alcohol and smoking, a sharp fluctuation in blood sugar - these reasons can cause a prolonged spasm of cerebral vessels with all the attributes of an ischemic stroke.

Contrary to popular belief, stroke is not a one-time event, but a process that develops over time and space: from minor functional changes to irreversible structural damage - necrosis.

The disease is insidious in that in the first hours of its development until the onset of paralysis, loss of speech or coma, a person may not experience any pain. The hand, cheek become numb, speech changes slightly, sometimes dizziness or blurred vision appears. Neither the patient himself nor his relatives suspect that a brain catastrophe is taking place, precious time is being wasted. The "therapeutic window", the period when intensive therapy can reverse the disease, is only about six hours.

"Steps to Stroke"

In old age, cerebrovascular accidents in varying degrees overtake each person. But it should be remembered that the first signs of metabolic disorders in brain tissues are detected quite early.

Diseases such as vegetative-vascular dystonia, initial manifestations of cerebrovascular insufficiency encephalopathy, can be considered as different stages of the same process: chronic vascular pathology of the brain. They are not only a serious risk factor for stroke, but in themselves significantly worsen the quality of life.

Frequent headaches, dizziness, impaired coordination of movements, attention, memory, blurred speech, numbness of the extremities, tinnitus, hearing loss, short-term loss of consciousness testify to the existing violations of brain functions.

If two or more of these symptoms are observed at least once a week for at least three months, especially against the background of diseases such as hypertension and atherosclerosis, it is very, very dangerous to neglect this.

One step closer to a stroke are the so-called transient cerebrovascular accidents or transistor ischemic attacks. They differ from strokes only in that they last a few minutes, less often - hours, but no more than a day and end with a complete restoration of impaired functions.

So, what are the main signs of an approaching stroke?

Doctors distinguish focal and cerebral symptoms.

Focal: sudden weakness in one arm and / or leg, short-term speech impairment, numbness of one half of the lip, tongue, one arm. Temporary loss of vision in one eye, severe dizziness, staggering when walking, double vision, slurred speech, and even temporary amnesia are possible.

Cerebral: the appearance of a sharp, dizziness, nausea and vomiting against the background of high blood pressure, while convulsions, changes in consciousness are possible.

If trouble happened

Stroke treatment is the work of doctors: neuropathologists, resuscitators, and sometimes neurosurgeons. The life of the patient often depends on how quickly it is started.

Call an ambulance immediately in case of a stroke!

Neurological ambulance team medical care will carry out a complex of therapeutic measures aimed at maintaining the cardiovascular system, respiratory organs.

In the first three to five days after a stroke, it is desirable for the patient to stay in the neuro intensive care unit, the intensive neurology department, or the acute stroke department. Here, the state of the cardiovascular and respiratory systems of the body will be carefully monitored, doctors will correct the water and electrolyte balance, and will fight brain edema that occurs around the stroke focus.

The patient spends the first two to four weeks in a specialized hospital.

In the first or second week, with the permission of the doctor, they begin to massage the patient, engage in therapeutic exercises with him, breathing exercises, and speech restoration classes. The early start of rehabilitation therapy is very important, because in this case, patients do not get used to being dependent on others, they acquire self-service skills in time.

After discharge, the patient should be observed by a district neurologist at the place of residence. Doctors have developed a program for the gradual adaptation of a person who has experienced a stroke to home conditions. Following it, you can help the patient gradually return to a normal active life.

How to avoid a stroke?

The prevention of a stroke (and its recurrence) consists in the correct mode of work and rest, rational nutrition and sleep regulation, a normal psychological climate in the family and at work, timely treatment of atherosclerosis, coronary heart disease, and hypertension.

Substantial assistance can be provided by drugs that improve vascular microcirculation, as well as prevent hypoxia (oxygen starvation) of the brain. One such remedy is Huato boluses, a modern nootropic phytopreparation that has a clinically proven ability to effectively restore metabolism in brain areas damaged as a result of stroke, vascular ischemia, overwork or injury.

So, the main directions for the prevention and treatment of vascular pathologies of the brain are the elimination of the causes of insufficient blood supply, drug effects on brain metabolism, and, finally, individual symptomatic treatment (physiotherapy exercises; physiotherapy and psychotherapy).

Comprehensive preventive measures reduce the incidence by almost half, and timely and correct treatment significantly increases the patient's chances of returning to a full life.

Discussion

Great article! In 1989 my
Dad had a stroke. I didn't know what it was. And everyone should know this. After all, we have older parents. It happens to them. If there is a knowledgeable relative nearby, children, we will play the main
the role of salvation. Doctors will help further, and
followed by meticulous care. Dad is alive. And we
were able to cope with the disease very quickly. He managed himself. I helped him. First, it gave me hope. He
He couldn't move, couldn't speak, tears were running down his cheeks. After medical assistance, I rubbed him, hands, feet, head, raised
arms and legs, throwing her hands behind the headboard to grab. She did this all the time while sitting next to him. All day.
And there was sensitivity. Then a stir, began to raise his hands, turn his head. Then I picked it up. We fell on the bed. It's heavy and big. I'm small. When
we went out into the corridor, the whole department of the hospital came running to watch. Such an amazing success in such a short time. But even his intestines did not work, there was no stool for half a month. He didn't lie down, he moved all the time. Houses from the third floor went down 5-6 steps lower every day. He only had one eye fixed. He also needed to be trained. But I didn't know about it. We really need knowledge. Thank you! Now he supports his health with Antiox.
It is the strongest antioxidant with Gingo Biloba and Twigs and Purple Grapes. This natural vitamin complex has no equal in the world.
Since I know how to protect myself from a stroke, I also take it.
I also eat Pax to improve memory, this is
also a complex for the brain and stress relief. I have struggled with headaches for many years. Finally, they disappeared.
How I did it, you can see
website http://www.nnabieva.narod.ru/health.html in the section about yourself.
I used a lot of methods and won. Even the ischemia of the posterior wall of the left ventricle of the heart is gone. I changed
lifestyle, thinking, food, I take a lot of vitamins and microelements. From the problem of the brain in the left side, the right eye does not see well. But this problem is also curable. I changed my glasses to smaller diopters.
I am very grateful to you!
Sincerely,
Nina Petrovna
Email: [email protected]

05/04/2001 17:03:53, Nina

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Stroke: when the brain needs help. ... at least three months, especially against the background of such diseases as hypertension and atherosclerosis The patient spends the first two to four weeks in a specialized hospital.

Stroke: when the brain needs help. At the time of Dumas in Europe they did not know drugs that alleviate the condition of the patient after a stroke. However, even today, a stroke in many cases leads to death or severe disability.

Stroke: when the brain needs help. Hemorrhagic stroke is usually a complication of hypertension. numbness of the extremities, tinnitus, hearing loss, short-term loss of consciousness.

Stroke: when the brain needs help. Stroke treatment is the work of doctors: neuropathologists, resuscitators, and sometimes neurosurgeons. After discharge, the patient should be observed by a district neurologist at the place of residence.

Speech rate is one of the expressive means of oral speech, it depends both on the speed of pronunciation of the following one after another speech sounds, and on the frequency and duration of pauses between words and sentences.

Fine talking man pronounces 9-14 sounds in one second, with an acceleration of the rate of speech, it is possible to pronounce 15-20 sounds per second, but the pronunciation does not lose its clarity and intelligibility.

Speech tempo disorder

Violation of the tempo of speech is an excessive slowing down of speech and the same speeding up of it. Most children in preschool age speak quickly; this can be explained by the fact that their inhibitory processes and control over their speech are still weak.

If fast, hasty speech predominates in the family, then the fast pace of speech becomes habitual; in adolescence, it tends to increase even more; in neuropathic children, a fast pace of speech leads to stuttering. Causes speech tempo disorders

intrauterine (perinatal) pathology;

damage during childbirth (natal pathology);

exposure to harmful factors after birth (postnatal pathology).

Intrauterine disorders are caused by maternal diseases during pregnancy, Rhesus or immunological conflict, drug use, medicines, alcohol, smoking, exposure to ionizing radiation, as well as a number of production factors (vibration, microwave). Natal pathology occurs with prolonged or rapid childbirth, tight entanglement of the umbilical cord, caesarean section, and malposition of the fetus.

In the process of speech development, a fast pace interferes with the formation speech differentiation and can lead to the consolidation of children's incorrect sound pronunciation and general sloppiness in speech.

Fast paced speech

tahilalia this is a pathologically accelerated rate of speech, in which instead of 10-12 sounds per second, 20-30 are pronounced. Speech is characterized by uncontrollable speed. With haste, disorders of speech attention, stuttering, repetition, swallowing, rearrangement of syllables, words, ambiguity in the pronunciation of phrases may appear ... However, when attention is drawn to speech, stutters disappear.

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

Tachilalia is often accompanied by impaired general motor skills, mental processes, emotional-volitional sphere, autonomic nervous system. Therefore, overcoming tachilalia should begin with the normalization of general movements: slowing down their pace, training coordination, the formation of rhythm, smoothness.

The causes and mechanisms of tachilalia have been extensively investigated, as this disorder may have been the cause of stuttering. Accelerated speech may be organically caused by a violation of the central speech mechanism. He assigns a significant role in this to heredity and also points to the genetic connection of accelerated speech with stuttering. Accelerated speech occurs when the extrapyramidal system malfunctions.

The cause of takhilalia can be congenital speech motor insufficiency of the speech apparatus, as well as sloppy, uneven speech of others, lack of attention and timely correction of the child's rapid speech.

Symptoms of tachilalia

Speech symptoms of takhilalia are characterized by the following features:

Abnormally fast pace (instead of 10-12 sounds per second, 20-30 sounds are pronounced) of speech without sharp distortions of phonetics and syntax.

Speech is characterized by uncontrollable speed.

With haste, disorders of speech attention, hesitation, repetition, swallowing, rearrangement of syllables, words, distortion of sentences, ambiguity of pronunciation of phrases may appear.

When attention is drawn to speech in those suffering from takhilalia, a quick restoration of balance between internal and external speech occurs, although its pace remains fast compared to the speech of others, the hesitation disappears.

In the symptoms of tachilalia, interverbal acceleration is noted (acceleration of the rate of speech), which manifests itself in polysyllabic words, long phrases and long connected texts. A long word or phrase, a name of several words is pronounced so rapidly that some syllables fall out of the verbal heap, sounds are distorted due to inaccurate and fast articulatory movements.

Interverbal acceleration can be explained by the fact that during the construction of speech, the regulatory influence of the cerebral cortex on the course of speech is temporarily turned off.

Inner speech disorder

Along with the violation of external speech, similar disorders of internal speech, reading and writing are observed. It is the required word that appears in the memory of a person, but it is immediately, even before pronunciation, replaced by another. In writing and in reading, substitutions, rearrangements of letters, sounds, syllables are observed. Whole words are replaced by others that are related in sound or spelling.

In a person with tachilalia, the pace of general movements is disturbed: movements are fast and impetuous (fast walking, quick start and stop, hyperactivity, tics). Motor restlessness is noted even during sleep (children toss and turn in bed). Attention is unstable, switching from object to object is increased, insufficient visual, auditory and motor memory.

The flow of thoughts is faster than the ability of her articulation. Children with takhilalia are quick-tempered, easily excitable. During arousal, vasomotor reactions appear:

redness of the face, ears;

sweat on the face;

coldness and sweating of the hands.

Children become emotionally labile and undisciplined. Rapid speech produces an unfavorable impression on strangers, which is reflected in the child's later life, the formation of his personality.

Bradilalia is an unnaturally slow pace of speech, reading and writing, monotony of voice, long pauses between words, drawn out pronunciation of speech sounds.

Bradilalia can be an independent violation of the rate of speech, and can also be observed in the clinic of some forms of mental illness: with oligophrenia, in a neurological clinic in patients with the consequences of meningoencephalitis, with dystrophic, organic diseases of the central nervous system, injuries, brain tumors, etc. In these cases, it is combined with the following disorders:

bradykinesia (slowness of all movements);

general lethargy;

• weakness.

As an independent disorder, bradilalia occurs most often in phlegmatic, slow, lethargic people. Features of speech similar to bradilalia are observed in the inhabitants of the northern countries, where they are the usual form of speech.

The speech characteristics (symptoms) of bradilalia are diverse: slowness of the tempo of external (expressive) and internal speech, slowness of the processes of reading and writing, monotony of the voice, inter- and intraverbal slowdown (lengthening of pauses between words or slow, stretched pronunciation of speech sounds and lengthening of pauses between the sounds of a word ).

Sounds and words succeed each other less quickly than with normal conditions, although they are formed correctly. If syllables are separated by short pauses, then the speech becomes scanned. The articulation of sounds may be disturbed, but the coordination of syllables or words is not upset.

With bradylalia, the voice is monotonous, loses modulation, constantly maintains the same pitch, sometimes a nasal tone appears. The musical accent also changes when pronouncing individual syllables, the pitch of the voice fluctuates up or down.

Bradilalia in children

Children with bradilalia pronounce a phrase with pauses between words, stretching syllables on vowel sounds, blurring articulation. Such speech is unaesthetic and interferes with communication with others, as it causes them tension and exhaustion of attention, discomfort and fatigue.

The above symptoms are seen in various forms independent speech: in dialogue, retelling from a picture and a series of paintings, retelling a text, a story on a given topic, reading. visual perception text does not contribute to the normalization of the rate of speech when reading. Children pronounce words correctly, but slowly. They also write down words and even more so phrases slowly.

Non-speech symptoms in bradilalia are expressed in the following symptomatology:

General motor disorders;

violation of fine motor skills of hands, fingers, mimic muscles of the face;

slow movements;

motor awkwardness;

amiable face.

Movements are slow, sluggish, insufficiently coordinated, incomplete in volume, motor awkwardness is observed. Amicable face. There are also features of mental activity: slowness and disorders of perception, attention, memory, thinking.

Having focused on one subject, children hardly switch to another. Perceiving the instruction, they do not execute it immediately, but after several repetitions. There is a tendency to stereotypy, perseveration, orientation disorders. With mild bradilalia, these speech and non-speech symptoms are not noticed by the children themselves.

In more severe cases, there is an awareness of speech impairment and associated psychological experiences. Stuttering(logoneurosis), a violation of the rhythm, pace and smoothness of speech due to convulsive contraction of various muscle groups that form the sound design of speech (expressive speech) is one of the most common disorders in childhood and adolescence (in 70-90% of patients it begins at 2-4 - summer age, i.e. at the time of the formation of speech).

Symptoms

Pathology can be expressed in the absence of speech or in violation of pronunciation. This may present with the following symptoms:

• Fuzziness and slowness of speech, its illegibility.
• A person is difficult to select words and incorrectly names things.
• Fast speech, but meaningless.
• Haste of thought.
• Separation of syllables and setting the stress on each of them.

Why does it appear in adults?

Slurred speech in adults can appear suddenly or develop gradually. It can also appear in children. Specialists first find out why this happened, and only then begin treatment. Slurred speech can occur due to several factors. The reasons are as follows:

• Brain disorders.
• Brain injury resulting from a stroke or thrombosis.
• Head injury.
• Tumors of the brain.

• degenerative diseases.
• Excessive alcohol consumption.
• Weakness of the muscles of the face.
• Weak or tight fastening of dentures.

Types of disorders in children

Slurred speech in a child is associated with various ailments. The main ones include:

• The external design of the utterance is a pronunciation disorder.
• Internal design - a systemic speech disorder.

Varieties of violations

Slurred speech of phonation (external) design appears separately, and together with other disorders. In speech therapy, there are the following types of violations:

• Aphonia and dysophonia. There is a disorder or lack of phonation due to pathologies of the vocal apparatus. Usually there is a violation of the height, strength, timbre of the voice.
• Bradilalia. Speech slows down. The peculiarity is the slow implementation of the articular speech program.
• Tahilalia - speeding up the pace of speech. Accelerated articulatory speech program.
• Stuttering. The organization of speech is disturbed when the muscles of the speech apparatus undergo convulsions. Usually seen in children.

• Dyslalia. This pathology is presented in the form of a disorder in the pronunciation of sounds, when hearing and innervation of the speech apparatus in humans are normal. There is a distorted sound design of words. This is slurred speech. The sound may be mispronounced, replaced, or mixed up.
• Rhinolalia. The pronunciation of sounds and the timbre of the voice is disturbed, which is associated with disorders of the speech apparatus. Changes in the timbre of the voice are manifested when the vocal stream of air passes into the nasal cavity during exhalation and pronunciation. This causes resonance.
• Dysarthria. Pronunciation is disturbed, which is associated with insufficient innervation of the speech apparatus. This disease appears due to cerebral palsy, which are detected at an early age.

Structural and semantic design of speech

On this basis, disorders are divided into 2 types: alalia and aphasia. Each type of disease has its own symptoms. Alalia manifests itself in the form of the absence or incomplete development of speech. This occurs due to damage to the areas of the brain that are responsible for it. The disorder may appear during fetal development or at an early age.

With alalia, slurred speech appears. This defect is considered one of the most difficult, since speech activity is not fully formed. Aphasia is called the loss of the ability to speak, which appeared due to local damage to the brain. Why does slurred speech appear with this disorder? This is associated with traumatic brain injuries, neuroinfections and brain tumors.

Features of diagnostics

It is necessary to analyze the complaints that the patient expresses. The history of the disease is also taken into account. Specialists usually ask when slurred speech appeared and whether there are relatives suffering from such an ailment. Be sure to visit a neurologist, to undergo an examination. The doctor will check the mandibular and pharyngeal reflexes, examine the pharynx, make sure there is atrophy of the muscles of the tongue.

The reflexes of the lower and upper extremities are checked. You should be examined by a speech therapist. The doctor evaluates the performance of speech, reveals violations of the pace, complexity. An examination by an otorhinolaryngologist is necessary, which will protect against such processes in the mouth as ulcers and tumors, which can cause disorders.

Computed tomography and magnetic resonance imaging of the head are performed, with the help of which it will be revealed why slurred speech appeared. Causes in adults and children are also determined in consultation with a neurosurgeon. Only after a complete diagnosis, treatment methods are prescribed.

Principles of treatment

If slurred speech is detected, what to do? It is necessary to treat the main disease due to which the violation occurred:

• Tumors are removed surgically.
• Resection of the hematoma, if it is on the surface.
• Surgical removal of abscesses in the skull, followed by the appointment of antibacterial agents.
• Normalization of pressure.
• The use of funds to restore metabolism and cerebral blood flow.

People with various violations you need to visit a speech therapist so that you can correct the deficiency with the help of special exercises. Regular practice is required.

Speech Correction Rules

Speech impairment appears not only due to the pathology of the articulatory apparatus, neurological pathology and the habit of not correct pronunciation. Another factor is psychological reason. With excitement, a person’s speech becomes barely audible and almost incomprehensible.

The activities of a speech therapist to restore speech are based on the following principles:

• Personal orientation.
• Creating an emotionally favorable environment.
• Interaction with parents.
• Positive motivation.

Speech therapy classes involve improving the mobility of the articulatory apparatus. Sounds and restoration are also being worked on. phonemic hearing. Professionals working with children game form, applying speech games, computer. Combined activities are carried out, involving switching attention from one activity to another.

Rules for the formation of speech

Classes with a specialist in children allow you to form competent speech, phonetically clear. But such activities will not be enough. The speech therapist helps only to put the sound. Everything else depends on the child and parents.

In order for speech to be successfully formed, the following rules must be observed:

• The child should not be scolded for slurred speech, you just need to carefully correct it.
• Simple exercises should be shown.
• No need to focus on mistakes, stumbles.
• It is necessary to positively tune in to classes with a speech therapist.
• Parents need to watch their speech.

Forecast and prevention

Speech disorders can be corrected if you start this work with early age or at an early stage. Important role in the improvement of the condition, the surrounding people and the efforts of the person himself influence. If the violation is detected in a timely manner, as well as treatment is started, it is possible to achieve normalization of speech. Such children continue to study in ordinary schools and get along well with the guys.

With complex forms of the disease, it is not easy to achieve improvement in speech. You can only correct the speech function. In such situations, the complex of measures is wider, and the patient needs to visit a specialized institution. It is necessary to observe the continuity of speech therapy organizations: go to special kindergartens, remedial schools. It is also important to be treated in neuropsychiatric hospitals, if this was prescribed by a doctor.

Prevention involves the implementation of effective measures from birth. The child must be protected from neutroinfection, injuries of the skull and brain. It should not be affected by toxic factors.

It must be taken into account that success comes with a systematic approach and complex organization of events. Along with traditional treatment, one should not forget unconventional ways. It is important to carry out activities for physical activity. Using a variety of methods allows you to get excellent results if used correctly.

Molassesвсе записи автора

- Speech disorders in mental illness -
Speech disorders are caused by various reasons and are quite common. From the point of view of a psychiatrist, the most important are those that are directly related to mental disorders themselves - changes in thinking and affect, hallucinations, delusions, dementia, etc. R.'s changes relate to its speed, diction, grammatical structure, and content. Usually they are combined with each other in various proportions in certain forms of speech disorders.

Speech speed disorders manifest itself in its acceleration or deceleration. With a slight degree of acceleration, R. remains quite smooth and consistent. At the same time, the number of words increases significantly - the so-called logorrhea. At the same time, words are often interspersed with consonances of the last syllables (rhymes), sayings, excerpts from poems, aphorisms. Further acceleration of R. leads to the appearance of unfinished phrases, the ease of transition from one topic to another, and as a result, a violation of the sequence of statements. The thinking of such patients is defined as a leap of ideas. R. becomes sketchy, may be interrupted by laughter, whistling, singing, questions that are not related to this situation, to which patients do not expect an answer. At extreme degrees of R.'s acceleration, the so-called verbal okroshka occurs. Most often, accelerated R. occurs in hypomanic, manic, and catatonic states.

When R. slows down, the number of spontaneous utterances decreases until it completely disappears. Patients begin to answer only questions. active stock words become poorer, the grammatical structure of phrases is simplified. Often patients answer only in monosyllables ("yes", "no") and at the same time complain about the absence of thoughts or that one thought haunts them - monoideism. Slow R. can be replaced by complete silence (mutism). Depending on the background on which mutism develops, it is defined as depressive, hysterical, catatonic, reactive, organic. In cases where the slowdown of R. and other mental processes (thinking, quick wits, etc.) occurs against the background of organic brain lesions - epidemic encephalitis, Parkinson's disease, damage to the frontal lobes of the brain (traumatic brain injury, tumors, Pick's disease, etc.) .d.) - they talk about bradyphrenia (bradypsychism).

Violations of diction varied. In some cases, the sound strength increases - R. is capacious with expressive or monotonous intonations (hypomanic and manic states) or, on the contrary, weakens - R. is quiet, whispering, at times barely audible, devoid of modulations (depressive, delusional states, dementia states), when R. is accompanied by a pronounced effective component theatrical, reciting, stilted, pathetic (catatonic, hysterical, psychopathic states, states of speech excitation in progressive paralysis, etc.) or, on the contrary, groaning, with crying and lamentations (anxiety-depressive state) .
Changes in diction may be associated with an emphasis on individual words ah or phrases, chanting, the appearance of childish intonations (hebephrenic state, puerilism, pseudodementia, dementia state). R. herself can become slow, viscous, depleted of words (various organic lesions of the brain). In some patients, intonations sound interest, surprise, curiosity, often interspersed with anxiety and fear, tension and anger (hallucinatory states, states of obscuration of knowledge); in others, intonations of confidence and peremptoryness (paranoid, psychopathic states), evasiveness, omissions and suspicion (delusional states), sweetness, tenderness and humiliation (epilepsy, psychopathy) can dominate.

Grammar violations in their extreme degrees, they are represented by a set of separate, unrelated words. In other cases, unfinished phrases or their fragments are used, phrases devoid of verbs, or, conversely, phrases in which verbs are used in an indefinite mood.
Replace the personal pronoun "I" with others - in the singular and plural("he", "we", "they"). They can talk about themselves in a different way. There is a use of periphrases - instead of designating an object, its description is carried out. This form of R.'s disorder testifies either to the severity of mental disorders, or to the fact that there are deep personality changes caused by some kind of chronic mental illness.

Broken speech accompanied by various degrees of violations of the grammatical structure and the meaning of the expression, or, if the grammatical structure is preserved, its meaning is lost (a state of clouding of consciousness, dementia, schizophrenia).

Violations of the semantic content of speech in the most distinct form are manifested in neologisms - new, created by the sick words themselves. Neologisms are words that make sense and are a means of active verbal communication with others. They are created by the patient as if to more accurately express their experiences. For example, an organization of persons allegedly persecuting a patient is called by him svarnops (“I am being pursued by svarnops”). They occur both in consistent, grammatically correct R., and in R. with a sharply disturbed grammatical structure. Neologisms, which are habitual speech turns, indicate the presence of a chronic mental illness with pronounced personality changes.

passing words (mimorech) is expressed in the fact that the answers of patients are out of any connection with the questions asked: sometimes, quite inopportunely, the answers include individual words of the question (with reactive psychoses, catatonic syndrome, etc.)

Monologue - this is continuous R., although addressed to the interlocutor, but due, first of all, to the internal state of the patient, and not to the need for verbal communication. At the same time, the patient does not pay attention to the questions asked, but continues to speak his own. If the monologue is the usual form of R., this is a reliable sign of a chronic mental illness accompanied by personality changes (for example, in schizophrenia).

Speech pressure expressed in increased speech activity with accelerated R., verbosity. It is difficult for the patient to stop or switch his statements to another topic, to answer the questions asked. Speech pressure occurs in patients with manic-depressive psychosis, schizophrenia, epilepsy, organic brain diseases, psychopathy.

mirror speech - this is the pronunciation of words (read, audible, arising spontaneously) from the end; observed in schizophrenia.

puerile speech observed in an adult using words and speech patterns characteristic of children: the use of diminutive words, lisping, burr, simplified or distorted grammatical structure of phrases, mentioning oneself in the third person, etc. (reactive psychoses, schizophrenia, senile dementia).

Reasoning speech built with a predominance of lengthy, abstract, usually of little content reasoning; patients are prone to superficial analogies, sophisms. Such R. is usually not based on specific facts and is unproven (schizophrenia, psychopathy).

sugary speech expressed in the use of diminutive and laudatory words, pronounced with exaggerated respect, insinuatingly, obsequiously, or with emotion and delight (epilepsy, psychopathy, organic diseases of the brain).

Slip speech manifests itself in statements, the main content of which is suddenly interrupted by side ones that have nothing to do with the main ones, which makes it difficult to understand them (schizophrenia).

stereotypical speech (verbigeration) consists of the same individual phrases, words, cries repeated many times in a monotonous voice (catatonic syndrome, a state of dementia).

echolalic speech (echolalia) It is expressed in the automatic involuntary, single or multiple repetition by the patient of individual words, phrases or phrases (echophrasia) heard by him from others (schizophrenia, Alzheimer's disease, organic diseases of the brain).

Verbal okroshka (verbal salad) - this form of broken speech, in which statements consist of separate words, devoid of grammatical structure and not interconnected in meaning (schizophrenia, a state of clouding of consciousness, an organic disease of the brain).

Anxious verbigeration - monotonous repetition of individual phrases, words, cries against the background of anxiety-depressive affect: reflects existing affective disorders (manic-depressive psychosis, involutional melancholy, schizophrenia, senile dementia).

schizophasia - a form of torn R., in which the expressed phrases, with a preserved grammatical structure, are devoid of any meaning, and the content of the R. reflects delusional disorders (schizophrenia).

Usually, one or another form of speech impairment is combined with other neurological symptoms, with specific facial expressions, movements, and behavior. Based on the totality of these disorders, especially speech disorders, in many cases it is possible not only to correctly qualify the mental status of the patient, but also to make a clinical and topical diagnosis.

Speech disorders can be very different, and they can appear not only in children, but also in adults. Speech disorder - general concept characterizing any deviation associated with oral (and sometimes written) communication. Such defects can manifest themselves in different ways - the inability to pronounce individual letters correctly, incorrect phonetic perception of speech, uncontrolled reproduction of sounds, and others. There are several classifications of such violations.

In adults, speech defects usually differ from those that are characteristic of children. They can be both chronic and unexpected. If the problem arose suddenly, it is better to consult a specialist, as this may be a symptom of a disease.

Symptoms of speech disorders in adults

Communication defects manifest themselves in different ways - it all depends on what causes them. Often there are such manifestations:

• salivation;
• stuttering;
• hoarseness of voice;
• very fast speech
• unreasonably slow pronunciation of phrases;
• stiffness of the muscles responsible for facial expressions;
• difficulty in verbal expression of thoughts;
• fuzzy words;
• too frequent contraction of the vocal muscles.

Usually several of these symptoms develop at once.

Forms of speech impairment

There are several forms of speech defects that develop most often in adults. Among them note:

1. - slowness and fuzziness of the narrative due to muscle pathology or nerve endings responsible for speech;
2. spastic dysphonia - tightness or hoarseness of the voice due to involuntary contractions of the vocal cords (sometimes a person begins to choke during speech);
3. - difficulties in the perception of oral text and the selection of words to express thoughts (sometimes also manifests itself in the form of incorrect pronunciation).

Speech impairment in general - any negative change in the functions of a person's speech apparatus - for example, if the pronunciation of words changes or speech becomes difficult to perceive.

Why communication function can be broken

There can be many reasons for a change in pronunciation or speech perception - it all depends on the specific violation.

For example, if a person has aphasia, it could be the result of a stroke, blood clots, neoplasms in the brain, or head trauma. In some cases, it becomes difficult for adults to select words and interpret them with Alzheimer's disease or senile dementia (dementia).

Communication functions in a person can be impaired in the following pathologies and conditions:

• Parkinson's disease;
• paralysis (including cerebral);
• multiple sclerosis;
• muscle dystrophy;
• jaw pathologies;
• head injury;
• strokes;
• Lyme disease;
• excessive consumption of alcoholic beverages;
• Bell's palsy or other conditions in which facial muscles weaken;
• brain tumors.

The quality of communication can also be affected by dentures - if they are not fitted correctly or too tight, speech can become slurred.

As a result of stress or overstrain, speech problems in a person may appear due to the development of spastic dysphonia. The voice becomes tense or, on the contrary, airy. Some experts argue that this condition develops due to a malfunction of the part of the brain that is responsible for muscle and motor activity voice device.

• oncology of the larynx;
• excessive consumption of coffee, CNS stimulants and antidepressants (substances affect the quality of the voice, making it choked, deaf);
• growths and polyps on the ligaments (they interfere with pure pronunciation);
• too active vocal activity (ligaments are overstressed, and because of this, the voice changes; this often happens with singers).

If the violation did not arise due to neoplasms in the larynx or vocal cords, this is not so dangerous, as it can be easily corrected.

If speech is broken suddenly, you can suspect the presence of serious health problems that require emergency care (for example, if a person has impaired speech perception and pronunciation, he may have a stroke).

Therapy of speech disorders

Specific therapeutic measures depend on the identified disease. Usually, for a quick recovery, specialists prescribe both home procedures and medical assistance.

How can a doctor help

The specialist will accurately determine the pathology, due to which problems with speech began. For this, diagnostic measures are prescribed, which include:

• MRI or CT of the brain;
• x-ray of the cranial cavity;
• neurological tests;
• blood and urine tests;
• analysis of the patient's diction by ear and analysis of speech perception.

In the latter case, the doctor usually talks to the patient to listen to his speech and determine how well the person understands what is being said to him (if difficulties arise with understanding, deviations can be assumed that affect not only the vocal cords, but also the brain).

To normalize speech, a course of classes with a speech therapist may be required. Almost all patients who have any speech disorder are referred to this specialist, regardless of the causes of the condition.

Surgery may be required when there are neoplasms in the vocal cord area. If spastic dysphonia is diagnosed, the spasm is sometimes relieved by Botox injections directly into the ligaments.

How can you help at home

Spasmodic dysphonia can be a serious hindrance to communication. In difficult situations, the patient is selected with special electronic devices that convert the printed text into a speech message. This can facilitate communication until the patient has recovered.

With aphasia, especially if a person has confusion in the perception of reality, it is better to communicate with him in simplified phrases and sentences. In order for the patient to be guided in what is happening around him, it is better to talk about it with him more often, not forgetting to indicate the time and place.

At the time of treatment, it is better to limit external stimuli. It is better not to allow a person with aphasia to be unaccompanied, as he may get lost.

If a person has problems with his voice, the first thing he should do is be careful about the vocal cords and not strain them once again. It is also better to avoid the use of aggressive chemical substances(for example, drugs for depression or coffee, as they can further stimulate overexertion).

If a person has dysarthria, it is better to switch to written communication or sign language when communicating with him. Patients with dysarthria do not always correctly perceive the oral speech of other people, so you need to speak slowly, with pauses - it will be easier for the patient to answer questions.

Speech disorder in children

The child begins to use verbal and non-verbal speech from birth. This helps to assess the degree of his development - whether the child has good enough communication skills for his age.

Signs of developmental delay

• in the first month of life - a cry at any inconvenience;
• by the fourth month - the lack of a baby's reaction to an appeal to him;
• by the fifth - sixth month - does not pronounce separate combinations of sounds and does not follow the objects that adults point to;
• by the seventh month - does not attract attention to itself by the pronunciation of sounds;
• does not pronounce simple syllables by the ninth month;
• by the tenth month does not pronounce syllables and does not respond to gestures (nods, waving a hand in forgiveness);
• by the year - one and a half years of life does not fulfill simple requests and does not utter simple words(mom, dad, give);
• By the second year of life, he cannot speak meaningfully.

But do not take these delays too seriously, all children develop in different ways. If you notice a slight lag, there is nothing to worry about, just keep an eye on it.

At an older age, speech deviations can manifest themselves in fuzzy speech (problems with diction), its complete absence, or the inability to correctly pronounce certain sounds.

Diagnosis of pathology

To accurately determine the nature of the pathology, you need to consult a doctor. The following specialists deal with such violations:

1. a neuropathologist (will determine the state of the baby’s brain, exclude pathologies of the central nervous system);
2. otolaryngologist (will reveal hearing impairments of the child, if any);
3. psychologist (a child specialist is needed: he will determine the state of the child's psyche).

If previous specialists did not reveal any deviations, a speech therapist should take up the development of the baby's speech apparatus.

Causes of violations

Most often, problems with sound pronunciation in children arise due to the following factors:

• genetic disorders (late speech in one of the parents, malocclusion, anomalies of the teeth, palate, stuttering, improper functioning of the brain centers responsible for oral communication);
• diseases that the child had in the first years of life (infectious and bacterial infections, injuries of the throat, palate or oral cavity, head injuries, inflammation of the ears);
• injuries sustained during childbirth (suffocation, low birth weight, injuries due to the narrow pelvis of the mother or medical instruments);
• intrauterine abnormalities (hypoxia, infectious diseases that the mother suffered during pregnancy, trauma, Rh conflict between the child and the mother, premature or overmature of the child, the threat of abortion, bad habits, medication, stress).

The social environment in which the child is located can also influence. If parents do not communicate with the baby, speech can develop very slowly.

Forms of speech disorders

A child may have several types of oral speech deviations at once. Among them:

1. wrong intonation;
2. voice problems;
3. indistinct pronunciation of sounds;
4. incorrect formation of the tempo of speech.

If a child does not have mental disorders that need to be eliminated with the help of specialists, he may develop such communication disorders (provided that the baby understands speech):

• takhilalia - unreasonably fast speech;
• bradilalia - pathologically slow pronunciation;
• dysphonia - deterioration of vocal qualities due to pathology of the ligaments;
• alalia - a speech disorder due to disorders in the brain;
• aphasia - loss of the ability to pronounce words with already formed speech;
• rhinolalia - a violation of the pronunciation of sounds due to anatomical features;
• dyslalia is a violation of communication with normal hearing and the absence of deviations in the structure of the brain.

Therapy of speech disorders in children

For an accurate diagnosis, you should consult a doctor. The specialist will also help you choose a treatment plan that is suitable for the child with his pathology.
Most often, if there are no disturbances in the functioning of the brain, it is enough to perform speech therapy exercises and breathing exercises to improve the functioning of the speech apparatus.

If communication defects are caused by anatomical or mental abnormalities, surgery or long-term drug treatment may be required. In such cases, speech therapy exercises to restore speech are also used.

Pronunciation defects can occur not only in childhood, when the speech apparatus is just developing: due to certain diseases and injuries, the communication skills of adults can also deteriorate. It is important to determine the nature of the pathology in time and eliminate it: then the subsequent recovery will be much easier and faster.