Diagnosis "dysarthria": what is it? Mild (erased) form of dysarthria

Man is distinguished from animals by organized and structured speech, which has many functions. Every person is taught speech from birth. If there are various forms deviations and the causes of speech deformation, which are symptoms of diseases, then the child is sent for correction or treatment. Dysarthria is one of these disorders that must be addressed with the help of specialists.

Already in early age it can be noted that the child has a speech disorder. At the stage of formation of the articulatory apparatus given fact difficult to establish, since all children find it difficult to pronounce words and phrases correctly. However, over time it becomes clear. First of all, you can contact a speech therapist to diagnose the child's speech and establish a diagnosis.

What is dysarthria?

What is dysarthria? This is a speech disorder in which the child incorrectly (distorted or difficult) pronounces sounds, words, phrases, syllables. Scientists call the cause of this disorder brain damage or various disorders in the articulatory apparatus:

Innervation of the vocal cords, muscles of the soft palate or facial muscles as a result of various diseases, such as cleft palate or cleft lip.
Absence of teeth.

As a result of speech dysarthria, writing develops when a child cannot learn the correct letter due to the incorrect pronunciation of sounds and syllables. In severe forms, dysarthria takes on the form of speech that is incomprehensible to others. As a result, the child becomes closed and isolated, and the tendency to develop written skills is also disturbed.

Causes of dysarthria

The main cause of dysarthria, doctors call brain damage, resulting in innervation of the articulatory apparatus - the organs that are involved in the creation of speech are not very mobile. These include lips, tongue, palate, vocal cords, etc.

If dysarthria manifests itself in adults, then they do not have a violation of writing and reading. These functions are saved. However, the appearance of dysarthria in children leads to a disorder in writing and reading. The child already initially becomes incapable of any form of speech. At the same time, oral speech is devoid of smoothness, accompanied by a change in tempo (sometimes it accelerates, sometimes it slows down), a downbeat rhythm of breathing.

There is the following classification of dysarthria:

Hidden. It has erased symptoms, so it is confused with dyslalia, from which dysarthria differs by a focus of neurological symptoms.
Expressed. Its main symptoms are incomprehensibility, inarticulateness, inexpressiveness of intonation, breathing, voice, as well as impaired sound pronunciation.
Anartria is the complete absence of sound reproduction.

Other causes of dysarthria in children may include:

Toxicosis during pregnancy.
Improper development of the placenta.
Rh factor incompatibility.
Viral diseases during pregnancy.
Rapid or prolonged labor.
Infectious diseases of the brain in the newborn.

Other causes of dysarthria in adults are:

vascular insufficiency.
Postponed stroke.
Genetic, progressive or degenerative diseases of the nervous system (Huntington's disease,).
Tumor or inflammation of the brain.
Multiple sclerosis.
Asthenic bulbar paralysis.

Dysarthria is divided into degrees of severity:

Mild - violation of fine motor skills, movements of articulatory organs, pronunciation of sounds. Speech is slurred but understandable.
Severe - associated with cerebral palsy.

Less common causes of dysarthria are:

Medicine overdose.
Carbon monoxide poisoning.
Head injury.
Intoxication due to drug or alcohol abuse.

Dysarthria in children

Often dysarthria manifests itself in children, which has peculiar forms of manifestation. It can be recognized by:

Difficulties in pronouncing all sounds. Children distort them, distort them.
Difficulties with chewing and swallowing.
Underdevelopment of fine and gross motor skills: it is difficult to jump on one leg, fasten buttons, cut out paper.
Difficulties in learning to write.
Difficulties in using prepositions and in making sentences.
Disorder of voice formation, changes in intonation, rhythm and tempo of speech.

The combination of all disorders that are observed in a child with dysarthria differs depending on the severity of the disease, the degree, the focus of the lesion of the nervous system and the time of development. Speech, motor and mental disorders in this category of children.

Such children should be taught in specialized schools, where the diagnosis and clarification of the type and degree of the disease are first carried out, after which an individual approach to teaching the baby is applied.

Forms of dysarthria

There are various forms of dysarthria:

Bulbar - manifested in a decrease in muscle tone, atrophy or paralysis of the muscles of the tongue and pharynx. Speech becomes slurred, slow, fuzzy. It occurs due to tumors or inflammation in the medulla oblongata. People with this form of dysarthria have low facial activity.
Subcortical - manifests itself in a violation of tone and involuntary muscle movements (hyperkinesis). In a calm state and in a circle of friends and relatives, the child incorrectly pronounces words, sounds, phrases. The situation is aggravated if the child finds himself in a stressful environment - he cannot utter a single syllable. Changes in intonation, tempo and rhythm. Speech becomes either fast or slow, with a large gap between words. Defects in sound production and communication skills develop. Hearing loss may also develop.
Cerebellar - manifested in chanting or shouting out sounds. Occurs rarely.
Cortical - manifested in the pronunciation of whole phrases and sentences. There are pauses between words, as if stuttering. If speech is intensive, then various modifications of sounds arise. At the same time, the child pronounces individual words without difficulty.
Erased (light).
Pseudobulbar - manifests itself most often due to various injuries during childbirth or intoxication. The mild form is expressed by slow and difficult speech, which is explained by the low mobility of the lips or tongue. The severe form is expressed by complete immobilization of the speech apparatus, amimicity, limited lip movements, in the open mouth.

Erased dysarthria

Erased dysarthria is quite common, in which the main characteristic features are:

Bad diction.
Indistinctness and inexpressiveness of speech.
Replacement and distortion of sounds.

For the first time, this form of dysarthria was described by O. Tokareva, who pointed out that the separate pronunciation of sounds in children does not cause difficulty, but their pronunciation in complex words and phrases already leads to distortion. Speech becomes blurred, fuzzy, blurry.

Damage to the brain leads to the development of erased dysarthria. Usually it is detected at the age of 5. If dysarthria is suspected, the child should be taken to a neurologist who diagnoses the disease and then prescribes treatment. Corrective therapy is poorly developed, but it includes a complex of medicines, psychological and pedagogical work and speech therapy.

In addition to the replacement or complete absence of sounds, the child has an inability to learn self-care skills, impaired gross motor skills, and an inability to keep the mouth closed due to flaccid jaw muscles.

Pseudobulbar dysarthria

Infectious diseases or head injuries transferred at an early age lead to the appearance of pseudobulbar dysarthria, which is characterized by impaired speech motility, sucking reflex, and swallowing. The muscles of the face are sluggish, salivation is observed from the mouth.

According to the severity, the following forms of pseudobulbar dysarthria are distinguished:

The mild form is manifested in inaccurate, slow, unexpressed speech. There are also violations in swallowing and chewing. Sounds are difficult to pronounce and devoid of voice.
The middle form is characterized by amimicity and lethargy of the facial muscles. It is difficult for children to pull their lips forward or puff out their cheeks. Also, the tongue becomes almost immobile. The soft palate also practically does not participate in sound production.
The severe form (anarthria) is manifested by complete paralysis of the muscles. The face is mask-like, the jaw hangs down, the mouth is open. Speech is practically absent, it is inarticulate.

Diagnosis of dysarthria

Dysarthria should not only be diagnosed, but also differentiated from other diseases such as dyslalia and aphasia. The doctor bases his findings on those skills that should already be observed in the child being tested. If the baby is not yet talking, then pay attention to his cry. In those suffering from dysarthria, the cry is quiet and nasal. There may be sagging of the lower lip, asymmetry of the facial muscles. The child may not take breasts in his mouth, choke on milk, turn blue.

Over time, the inability of the child to pronounce sounds manifests itself. He also has trouble swallowing and chewing. The older the child becomes, the more various deviations are noted:

Slow speech.
Weak articulation.
The presence of synkinesis.
prosodic disorder.
Difficulties in holding and switching articulation.
Violation in the pronunciation of sounds and their automaticity.

Treatment of dysarthria

The main direction in the treatment of dysarthria is the restoration of the functions of correct articulation so that the child can further communicate and learn calmly. Everything happens in three ways: medication, exercise therapy and speech therapy. It eliminates the violation of the voice, the disorder of speech breathing and articulation.

Among the medicines, nootropics are prescribed: Encephabol, Glycine, etc. Therapeutic exercises include exercises that develop facial muscles. The main method of treatment is massage, where all the muscles of the articulatory apparatus are worked out. A. Strelnikova's breathing exercises are actively used.

The child should train to pronounce sounds, words and sentences. This can be done both independently and with a speech therapist. In addition, the emphasis is on the development of motor skills and the elimination of other dysfunctions.

Correction of dysarthria

It will not work to cure dysarthria on your own. In addition to therapeutic measures, you can resort to dolphin therapy, sensory therapy, isotherapy, sand therapy, etc. Correction of dysarthria depends on the severity of the disease. Basically, a speech therapist works with the patient, who develops his articulatory apparatus, breathing, facial muscles, etc.

Corrective work is divided into the following stages:

Massage when the muscles of the face are being developed.
Articulation exercises.
Automation in sound pronunciation.
Correct pronunciation of sounds.

Forecast

Dysarthria is cured depending on the measures taken in the treatment. The prognosis remains varied, depending on the causes and the ability of doctors to eliminate the factors of the disease.

Much falls on the shoulders of parents, who must also follow the recommendations of doctors and support their child. One should give him love and understanding, as well as praise for any slightest achievements.

Dysarthria is a speech disorder caused by various diseases of the nervous system. Such phenomena arise due to the peculiarities of the work of the speech apparatus associated with defects in innervation.With dysarthria, the organs of speech are not mobile enough. Weak development of the speech apparatus leads not only to incorrect pronunciation, but also to a general underdevelopment of speech, which makes it difficult to learn to read and write.

Why does dysarthria occur?

In a child, dysarthria is often the result of perinatal factors, cerebral palsy. Often the causes of dysarthria in children under one year old are:

mother's illness;
toxicosis during pregnancy;
birth trauma;
oxygen deficiency (hypoxia) of the fetus;
mismatch of Rh factors;
difficult childbirth, accompanied by pathology, including rapid or protracted;
asphyxia of the baby;
premature birth.

Such a common symptom as toxicosis during pregnancy can also cause

Preschool children may also be at risk. Complications on the central nervous system can give one of the following diseases:

severe infections;
hydrocephalus;
traumatic brain injury;
severe poisoning.

Dysarthria syndrome in children

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Dysarthria is not only defects in pronunciation - it is also expressed in non-speech deviations. In infancy, the following symptoms are present:

it is difficult for the baby to suck;
he often burps;
the baby chokes when feeding;
sucking is sluggish.

The child develops slurred, incomprehensible speech. The disease is accompanied by late development: the baby does not babble, the first word begins to speak between 2 and 3 years. Dysarthria is determined by one or more signs:

The muscles of the face (especially the tongue, lips, neck) are constantly tense. Lips are closed. This phenomenon is called a spasm of the articulatory muscles.
The muscles of the face are sluggish, the mouth is half open, the tongue is inactive. The child speaks through the nose. This phenomenon is called hypotension of the articulatory muscles.
Increased tension in the muscles of the face is replaced by excessive relaxation. This is dystonia of the articulatory muscles.
The pronunciation of sounds is impaired. Depending on the severity of CNS damage, various degrees sound defects. The so-called erased dysarthria is expressed in a fuzzy pronunciation or distortion of certain sounds, speech seems blurred. Replacement or omission of sounds signals a more severe form of the disease, while speech can be inexpressive, slow and incomprehensible. solid sounds soften, hissing child pronounces through his teeth, whistling. Lateral pronunciation is often observed. In severe cases, with the onset of complete paralysis, dumbness is observed.
Breathing disorders during speech. The process of speaking is accompanied by a shortening of breaths, increased breathing, intermittency. The child's voice is quiet, monotonous and weak, often sounds are pronounced through the nose.

If speech requires a strong muscle tension, spasms and difficulty breathing are present - this may well be a symptom of dysarthria

A characteristic feature of dysarthria is the stability of defects, they are very difficult to overcome. A secondary manifestation of dysarthria is a violation of auditory differentiation of sounds. Difficulty in pronunciation leads to insufficient verbal communication, which entails a paucity of vocabulary and an unformed grammatical structure of speech.

Psychological and pedagogical characteristics of children with dysarthria

Toddlers suffering from dysarthria behave differently than healthy children. There are difficulties with the development of fine motor skills of the hands, so children do not like to tie shoelaces, it is difficult for them to fasten clothes with buttons.

The underdevelopment of motor skills also affects the learning process. Sick children do not hold a pencil well, it is difficult for them to write with uniform pressure, the majority form an incorrect, illegible handwriting. They do not like to use scissors, as this also causes them difficulties.

However, you should not self-diagnose the child. Many speech deviations are due to less dangerous causes. A 6-7 year old child may have dyslalia. This speech disorder is not associated with organic damage. If you find speech defects, you just need to immediately consult a doctor.

The disease is accompanied by a violation of musical hearing. This makes it difficult for children to dance. They also find it difficult to exercise.

Classification of dysarthria

Depending on which part of the brain is affected, the symptoms of dysarthria also differ. According to the complex of symptoms and localization of the affected area, several types of the disease are distinguished:

Bulbar dysarthria. A characteristic feature is the lack of facial expressions. Often the disease is accompanied by difficulty swallowing, especially liquid food. Articulation is slurred, sounds are difficult to distinguish. Facial, trigeminal, hypoglossal, glossopharyngeal and vagus nerves are affected.
Pseudobulbar dysarthria in children it is characterized by monotony of speech, often involuntary crying or laughter. The structures of the brain are affected, primarily the cortical-nuclear pathways. Pseudobulbar dysarthria is the most common.
Cortical dysarthria. The child pronounces the syllables incorrectly, but the structure of the words is preserved. Separate areas of the cerebral cortex are affected.
Cerebellar dysarthria in children it causes frequent changes in the volume and tone of the voice, speech is stretched. The cerebellum is damaged.
Subcortical dysarthria. The child speaks through the nose, speech is indistinct and slurred. Possible pathology in the form of spontaneous movements in various muscle groups. The subcortical structures that control the formation of speech are affected.
Cold dysarthria. It manifests itself in the form of speech defects associated with a sharp change in the temperature regime of the environment.
Mixed form of dysarthria. It is often the result of trauma in young children.

There is also a speech therapy classification of the disease. Dysarthria in children varies in degrees:

I - Erased dysarthria. Appears at 4-5 years of age. The erased form is characterized by a mixture or distortion of sounds. Difficulty pronouncing hissing and whistling sounds. It can be observed in children with normal psychophysical development. Diagnosed only by a specialist. Erased dysarthria is easier to treat than others.
II - The child's speech is understandable, but has pronounced defects.
III - The speech of the child is distorted so that it is understandable only to relatives.
IV - Speech is not formed or is incomprehensible.

The lack of facial expressions in a child may be accompanied by a violation of swallowing, difficulty speaking. All of these are considered symptoms of dysarthria.

Diagnosis of the disease

A pediatric neurologist and a speech therapist should make a diagnosis and prescribe treatment. To identify the syndrome of dysarthria, it is necessary to conduct an examination. Basic examination procedures:

MRI of the brain;
electroencephalography;
electromyography;
electroneurography;
transchannel magnetic stimulation.

In parallel with these studies, a speech therapy assessment is also necessary:

speech for the presence of violations: overall assessment, rhythm, tempo, intelligibility of pronunciation, the correctness of the sound of individual sounds, vocabulary;
the functioning of the speech apparatus: the mobility of the lips, the movements of the upper and lower jaws, the range of movements of the tongue, the correctness of breathing, the condition of the soft palate;
writing and oral speech.

Logopedic research is an integral part of diagnostics

Treatment of dysarthria

Treatment must be comprehensive. First of all, it is necessary to deal with the underlying disease that led to the onset of symptoms. Treatment includes medication, speech therapy correction and rehabilitation measures. speech therapy classes for the development of speech skills consist of:

development of fine motor skills;
restoration of articulation with the help of special exercises and massage;
gymnastics for the respiratory organs;
correction of pronunciation of sounds;
work on increasing the expressiveness of speech;
active verbal communication.

The child can study in a group or individually. It is not the form that is important, but the regularity and strict adherence to the doctor's prescriptions. Good results are obtained by attending a kindergarten, school, circles and groups intended for children with speech therapy problems. Dolphin therapy can have a beneficial effect on the treatment process.

The underlying disease should be treated with medication. The use of nootropics is shown. They help improve memory, activate the brain. It is desirable to combine the use of medicines with other activities:

physiotherapy exercises;
massage, including acupressure;
physiotherapy, including therapeutic baths;
acupuncture;
hirudotherapy.

Articulation gymnastics and speech therapy massage are basic classes that can be practiced both at a speech therapist's appointment and at home (see also:)

Therapeutic activities that can be carried out at home

In agreement with a speech therapist and a pediatric neurologist, many therapeutic measures can be carried out at home. Can be done at home simple gymnastics for mimic muscles. Here is a sample list of exercises.

ERASED FORM OF DYSARTRIA AS A STABLE SYMPTOM COMPLEX

MODERN VIEW ON THE PROBLEM

As a special type of speech disorder, an erased form of dysarthria began to stand out in speech therapy relatively recently - in the 50-60s of the XX century.

In her classification of disorders of the sound-producing side of speech, based on the pathogenetic principle, R.A. Belova-David distinguished two main types: dyslalia, associated with the functional nature of the disorder, and dysarthria, due to organic damage to the central nerve - noah system.

Systematizing violations of sound pronunciation in preschoolers, taking into account the pathogenesis of sound pronunciation disorders, E.F. Sobotovich identified shortcomings in sound pronunciation, which manifested themselves against the background of neurological symptoms and had an organic basis, but were of an erased, unexpressed character. She qualified them as disorders of the dysarthria series, while noting that the symptomatology of these disorders differs from the manifestations of those classical forms of dysarthria that occur with cerebral palsy.

Other domestic and foreign researchers also pointed out that there is a group of children with impaired formation of the sound side of speech, whose symptoms and nature do not correspond to either dyslalia or dysarthria.

For a long time, the nature of these disorders remained unclear, which was also manifested in the variability of terminology (apractical dysarthria, articulatory dysarthria, organic, central or complicated - "protracted" - dyslalia, functional dysarthria, minor dysarthria, minimal dysarthria disorders, etc.) . Later, in the studies of E.F. Sobotovich, R.I. Martynova, E.Ya. Sizova, E.K. Makarova, L.Vlopatina and others, these disorders began to be designated as erased dysarthria or as an erased form of dysarthria.

The very term “erased form of dysarthria” was first used by Tokareva O.A., according to which children suffering from this pathology can pronounce most sounds correctly, but in spontaneous speech they are poorly automated and differentiated.

It is obvious that initially the researchers attributed the erased form of dysarthria to the actual sound-producing disorders, but subsequently these disorders were interpreted by many authors as a symptom complex that includes speech and non-speech symptoms. Currently, in the domestic literature, an erased form of dysarthria is considered as a consequence of minimal brain dysfunction, in which, along with impaired sound pronunciation,
On the negative side of speech, mild disturbances of attention, memory, intellectual activity, emotional-volitional sphere, mild motor disorders and delayed formation of a number of higher cortical functions are observed. The literature emphasizes that the erased form of dysarthria in its manifestations is characterized by smoothing of symptoms, their heterogeneity, variability, a different ratio of speech and non-speech symptoms, violations of the sign (linguistic) and non-sign (sensory-motor) levels. Therefore, it presents a significant difficulty for differential diagnosis.

The etiology of the erased form of dysarthria is associated by domestic authors with organic causes acting on brain structures in the prenatal, natal and early postnatal periods. In many cases, there is a chain of hazards in the anamnesis of all three periods of the child's development. The researchers note that when the developing brain is exposed to a harmful factor, damage is widespread and can contribute to a delay in maturation and disruption of the functioning of structures.

Brain.

In foreign literature, for such disorders, the concept of “speech, or articulatory, developmental dyspraxia” (Development apraxia of speech-DAS) is used. Among the causes of DAS are usually called a violation of the innervation of the articulatory apparatus, movement disorders, oral apraxia as a violation of the central program for the temporal coordination of voluntary muscular movements of the articulatory apparatus, minimal

brain dysfunction.

Domestic and foreign researchers note the presence of diverse neurological symptoms in children with an erased form of dysarthria,

Symptoms of an organic lesion of the central nervous system are found in the form of erased paresis, changes in muscle tone, hyperkinesias (excessive involuntary movements), manifested mainly in the mimic and articulatory muscles, in the presence of pathological reflexes, disruption of the autonomic nervous system.

G.V. Gurovets, S.I. Maevskaya, B.A. Arkhipov indicate a violation of the function of the oculomotor nerves in children with an erased form of dysarthria, manifested in unilateral ptosis,

Ema eyeball movements.

In the motor sphere in this category of children, the same development of the functions of both hands and pseudo-left-handedness are observed. Researchers note slowness, awkwardness, insufficiency of movements during

relative preservation of their volume, emphasizing that the limitation of the range of motion of the upper and lower extremities is detected mainly on one side.

It should be noted that the general motor skills of children with an erased form of dysarthria have not been sufficiently studied, in contrast to fine motor skills, the violation of which, along with articulation, is defined by the authors as one of the leading symptoms in an erased form of dysarthria. L.V. Lopatina, N.V. Serebryakova, describing the violations of manual motor skills in these children, note inaccuracy, lack of coordination, insufficient dynamic organization of movements. A.V. Semenovich points to gross violations of reciprocal and synergistic sensorimotor coordination, an abundance of synkinesis.

Studies of articulatory motility have shown that children with an erased form of dysarthria have a dysfunction of the muscles innervated by the lower branch of the trigeminal nerve, facial, hypoglossal and glossopharyngeal nerves. Violations of the functions of the trinitarian nerve (V pair) are manifested in a narrowing of the range of motion of the lower jaw. At the same time, inaccuracy, limited movements, synkinesis of the lips and tongue are noted. Disturbances in the function of the facial nerve (VII pair) in children with an erased form of dysarthria are manifested in smoothness, asymmetry of the nasolabial folds, insufficient volume of facial movements, and lip movements during baring. Violations of the innervation of the hypoglossal nerve (XII pair) are manifested in the impossibility of maintaining a static posture, tremor of the tip of the tongue, difficulty in lifting the tongue up, hyper or hypotonicity of the muscles. Dysfunction of the glossopharyngeal nerve (IX pair) is manifested in insufficient elevation of the soft palate (Uvula), nasalized tone of speech, salivation, limited range of motion of the middle part and root of the tongue.

The authors also point out the difficulties of switching movements, reproducing simultaneous movements of the articulatory organs, perseveration (compulsively repetitive movements), rearrangements when reproducing a series of movements.

The listed motor disorders of the articulatory apparatus determine a variety of phonetic deficiencies, which, according to most researchers, are dominant in the structure of the defect in the erased form of dysarthria. OA Tokareva points out that this category of children has more severe manifestations of sound pronunciation disorders than with dyslalia, requiring long-term speech therapy to eliminate them. Features of sound pronunciation are determined by the nature of innervation disorders, the state of the neuromuscular apparatus of the articulatory organs. According to G.V. Gurovets and S.I. Maevskaya, the most common distortions are lateral, interdental, softened pronunciation of sounds. Children with an erased form of dysarthria often replace complex sounds with articulatory simpler ones, split affricates into components

their components, slotted ones are replaced by occlusive ones, hard ones are replaced by soft ones.

Most researchers note that children with this defect are characterized by a polymorphic impairment of sound pronunciation, which manifests itself in distortions and the absence of mainly three groups of sounds: whistling, hissing, and sonors.

Less pronounced, according to the authors, in this category of children are prosodic (voice) disorders. Deviations in the tempo and dynamic organization of speech are indicated. There are features of the voice timbre (high, loud, noisy, breaking into falsetto or, conversely, quiet, low, weak), insufficient differentiation of various types of intonation. Speech is characterized by low expressiveness, monotony, "blurred" intonation pattern.

In many studies devoted to the study of the problem of an erased form of dysarthria (G.V. Gurovets, S.I. Maevskaya, E.F. Sobotovich, L.V. Lopatina, etc.), it is noted that phonemic perception disorders are common in children of this category . It is difficult for them to distinguish by ear hard-soft, voiced-deaf sounds, affricates and their constituent elements. They are characterized by distortions in the sound-syllabic structure of words, difficulties in mastering sound-syllabic analysis and synthesis, and the formation of phonemic representations.

The question of the mechanisms of phonemic underdevelopment in the structure of a speech defect in an erased form of dysarthria is debatable. According to research by L.V. Lopatina, in preschoolers with an erased form of dysarthria, the existence of fuzzy articulatory images leads to the fact that the boundaries between auditory differential features of sounds are erased, and the lack of clear auditory perception and control contributes to the preservation of sound-producing defects in speech. As R.E. Levina noted, such a phenomenon is observed in violation of speech kinesthesia that occurs with morphological and motor lesions of the speech organs. Thus, in modern defectological literature, phonemic underdevelopment in the structure of a defect in an erased form of dysarthria is considered as a secondary disorder.

Neuropsychological researchers (A.V. Semenovich, L.I. Serova and others) adhere to a different point of view. They also believe that the violation of phonemic perception, along with the insufficiency of the phonetic side of speech, is one of the dominant symptoms in the erased form of dysarthria, however, it is not due to sound-producing disorders, but to a systemic delay and distortion of the cerebrogenesis of the brain systems.

E.F. Sobotovich, L.V. Lopatina note in children with an erased form of dysarthria the underdevelopment of the grammatical structure of speech: from a slight delay in the formation of the morphological and syntactic systems of the language to pronounced agrammatisms in the expressive

speech. One of the reasons for the insufficient formation of the grammatical structure of speech in this category of children, in their opinion, is a violation of the differentiation of phonemes. A similar point of view is shared by N.V. Serebryakova, who points to the presence of lexicogrammatic underdevelopment of speech and violations of coherent speech in preschoolers with an erased form of dysarthria. However, other researchers do not agree with this point of view (R.I. Martynova, G.V. Gurovets, etc.) and argue that these violations are not mandatory, they can manifest themselves in the presence of certain adverse factors.

Researchers-neuropsychologists find in children with an erased form of dysarthria a violation of the correlation of the word-name and the image of the object. In some children, there is a lack of formation and poverty of independent speech production, a delay in the formation of the generalizing and regulating function of the word.

A number of authors (R.I. Martynova, E.F. Sobotovich, L.V. Lopatina and others) reveal the features of the formation of a number of higher mental functions and processes in children with an erased form of dysarthria: weakening of mental activity by the type of asthenization with a pronounced decrease in the functions of attention and memory, difficulties in generalizing, classifying, determining the logical sequence of events in plot series, violations in establishing causal relationships.

Some researchers (O.A. Krasovskoy, A.V. Semenovich and others) singled out defects in the selectivity of visual memory, perception, spatial representations as typical symptoms of an erased form of dysarthria. So, OA Krasovskaya points to violations of visual recognition of objects: fragmentary perception of object images, violations of simultaneous gnosis and insufficiency of visual control. She notes that in the study of drawings in these children, the identified violations are of a different nature: from complete collapse visual-constructive activity, inability to perform a drawing either according to the instructions or according to the model to the distortion of individual details, dimensions, its incorrect location in space (rotation by 90 degrees). A.V. Semenovich speaks about the tendency to inversion of the visual perception vector; m (from right to left, from bottom to top) and left-sided ignoring.

Researchers involved in the study of this problem, conducted observations mainly on children of preschool age. Nevertheless, some of them (R.I. Martynova, M.P. Davydova and others) indicate the possible difficulties of teaching children with an erased form of dysarthria at school. L.V. Lopatina and N.V. Serebryakova write that children with an erased form of dysarthria, even by the age of 7, are not sufficiently prepared for mastering the school curriculum in the Russian language. According to R.I. Martynova, dysgraphic errors are observed in writing in children with an erased form of dysarthria.

G.V. Chirkina also points to writing disorders in children with this defect: “Many children who entered public schools could not master the first grade program at all,”

Thus, the literature notes the presence of the following symptoms of an erased form of dysarthria in children: neurological symptoms, insufficiency of visual gnosis, spatial representations, memory, motor disorders, prosodic side of speech, low level of development of sound pronunciation, phonemic perception, lexico-grammatical sides of speech, connected speech. The mental development of these children proceeds according to a specific type and is characterized by a systemic dynamic delay and distortion in the formation of a number of higher mental functions and processes.

In order to organize effective corrective work, it is necessary to determine the dominant symptoms that are mandatory for the symptom complex with an erased form of dysarthria, and the secondary ones that manifest themselves under certain conditions, as well as a good understanding of the influence of the mental developmental characteristics of this category of children on the formation of reading and writing,

Sometimes we meet people, including children, whose speech is difficult to understand, because. it is indistinct, monotonous, without intonations and voice modulations. In addition, other behavioral features also fall into the eyes. This means that we are faced with a case of dysarthria. From Latin, this term is translated as "a disorder of articulate speech." Erased dysarthria, being one of its forms, has not very clear, erased psychological, neurological and speech manifestations.

ICD-10 code

R47.1 Dysarthria and anartria

Epidemiology

The epidemiology of the disease is such that the examination of preschool children by speech therapists reveals speech defects in half of them. Among disorders, dysarthria is one of the most common, and 60-85% of cases of the disease are caused by cerebral palsy.

Causes of erased dysarthria

Erased dysarthria - echoes of damage to certain parts of the brain - the higher part of the central nervous system (CNS), which has a connection with all tissues and organs of the peripheral nervous system. That is why its failures entail violations of other organs. The causes of erased dysarthria include:

head injury;
infectious diseases(encephalitis, meningitis, etc.);
intoxication of the body with nicotine, alcohol, drugs or medications with improper treatment;
vascular diseases (strokes);
tumors;
other diseases (multiple sclerosis, Alzheimer's, Parkinson's disease);
hereditary diseases;
birth trauma or received during a dysfunctional pregnancy;
cerebral palsy.

Risk factors

Based on the causes leading to erased dysarthria, risk factors are cerebral atherosclerosis, head trauma, bad habits, careless behavior with chemicals (arsenic, nitrogenous compounds), chronic diseases liver and kidney damage to the brain. In children, erased dysarthria occurs due to infection inside the womb, birth trauma, severe toxicosis during gestation, a mismatch between the Rh factor of a woman and a child, fetal hypoxia, and asphyxia during childbirth.

Pathogenesis

At the heart of the pathogenesis is the defeat of the central and peripheral nervous system of a person. The speech mechanism is designed in such a way that a signal goes from the central nervous system along the centrifugal nerves to the receptors of the speech organs to start it. If one of the links in the brain-face chain is damaged, signals from the cerebral cortex do not reach the muscles responsible for articulation, breathing, and voice.

Symptoms of erased dysarthria

Symptoms of erased dysarthria are expressed both in speech defects and in behavioral actions. Speech symptoms are manifested in the incorrect pronunciation of front-lingual, hissing and whistling sounds. At the same time, the voice is monotonous, weak and quiet, the timbre is changed. Auditory perception is reduced. Non-speech symptoms include weakening of voluntary movements, the appearance of pathological reflexes (sweating of the feet, palms), involuntary automatic twitching of the face (hyperkinesis), changes in muscle tone. Increased (spasticity) is given out by tightly closed lips, tense muscles of the neck and face, limited movements of the speech apparatus. With reduced tone (hypotension), the tongue is flaccid and lies at the bottom of the mouth, the lips are half open, saliva flows. The change of one tone to another (dystonia) disrupts breathing during a conversation, at the time of pronunciation of words it is intermittent and rapid. In some cases, memory loss, difficulty concentrating, and mental activity are possible.

The first signs of erased dysarthria are blurring, blurring of spoken words, fuzzy articulation, and distortion of sounds. Often such speech resembles a conversation with a full mouth. With adults, this happens after a stroke, a head injury. In infants, a weak sucking reflex may indicate the first signs of the disease.

The development of the motor sphere in erased dysarthria

The development of the motor sphere with erased dysarthria directly depends on which nerve endings the connection is lost with. So, damage to the trigeminal nerve makes it difficult to open and close the mouth, chewing and swallowing food. Due to the damage to the sublingual, there is a difficulty in controlling the tongue, the facial one - the inability to puff out the cheeks or frown the eyebrows, and the glossopharyngeal - a malfunction of the larynx, palate, which changes the voice, the breath goes astray, etc. But to erased dysarthria most often leads to a violation of the functions of the hypoglossal nerve.

Erased pseudobulbar dysarthria

Erased pseudobulbar dysarthria is more common than others. The reason for its appearance is brain damage that occurred in childhood. This may be a tumor, trauma during childbirth, encephalitis, etc. As a result, no signal is received from the cerebral cortex to the cranial stem nerves that control the speech apparatus. Because of this, motor skills suffer, facial muscles weaken. In such people, the mouth is ajar, saliva flows, the tip of the tongue rises and moves with difficulty, the words are blurred and incomprehensible, nasality appears in the voice. There are three degrees of erased pseudobulbar dysarthria. Mild degree corresponds to minor speech disorders. Most often, r, c, h, w, w are incorrectly pronounced, while voiced sounds do not have sufficient sound content. The average degree is expressed in the immobility of the muscles of the face, difficulty in chewing or swallowing, profuse salivation. The pronunciation of most sounds is distorted, voiced consonants are pronounced muffled, vowels are not voiced enough. Only k, n, m, t, p, x are obtained. A severe degree is characterized by complete immobility of the facial muscles, the mouth is open, chewing and swallowing movements are difficult, speech is absent.

Erased dysarthria in children

Erased dysarthria in children most often occurs as a result of abnormalities during pregnancy, abnormal birth, fetal asphyxia. While the child is not talking, the symptoms are manifested in a weak sucking instinct, refusal to take the nipple in the mouth. In addition, he is somewhat behind in physical development. Poor capture and holding of objects in hand, does not like to play with small toys, collect details of the designer, draw, sculpt. Such a child increased salivation, inactive facial expressions, it is impossible to roll the tongue into a tube. But, in general, his condition does not cause much concern.

Erased dysarthria in preschoolers

At preschool age, deviations associated with general motor skills become noticeable. Children clumsily walk, cannot stand on one leg, quickly get tired of physical activity, poorly imitate movements, at music lessons they react late to changes in positions, tempo and musical rhythm, weakly hold a pen in their hand and do not like to draw. It is difficult for such children to sufficiently serve themselves, fasten or unfasten buttons, tie a scarf. At the age of 5-6, features of the articulatory apparatus appear. With reduced muscle tone, the lower jaw is poorly held in an elevated state, so the mouth does not close, lips and tongue are flaccid. Spasticity of the muscles gives a half-smile of the face, their hardness on palpation. It is difficult for them for a long time keep the same posture: puffed out cheeks, lips with a tube, protruding tongue, because after a while he begins to tremble and twitch. Conventionally, pronunciation errors are divided into three groups:

with violations of the pronunciation of sounds and intonation-expressive coloring of speech (prosodic). Such children pronounce words well, have a large vocabulary, but cause a lot of difficulty. Difficult words. They are characterized by poor spatial orientation;
unformed phonetic hearing joins the first violations. This is expressed in the inability to coordinate various parts of speech in sentences, pronounce complex words, and a weak vocabulary. This group of children is sent to a special kindergarten;
with obvious violations of pronunciation, prosodic, underdevelopment of phonetic hearing. For such children, specialized groups are organized in kindergartens.

Erased dysarthria in adults

Unlike children, adults have already formed a speech apparatus and a conversational skill at the time of the onset of dysarthria. They hear and perceive everything. Defects in the speech production apparatus occur as a result of damage to the central nervous system for one of the above reasons. The respiratory and articulatory systems are involved in the creation of sounds. Respiratory is responsible for voice formation, which is possible due to the ingress of air from the larynx to the resonators, reflecting it to the articulatory apparatus. That, in turn, with the help of such instruments as the tongue, larynx, palate, lips, teeth, gives rise to sound. Failure of any of these chains leads to speech disorders.

stages

The degree of speech deviation from the norm and the severity of damage to the nervous system are directly related. Speech therapists distinguish four stages of dysarthria. At the first, the distortion of sounds is heard only by a speech therapist. At the second stage, the speaker's speech is understandable, although errors in pronunciation are obvious even to outsiders. The third stage has more pronounced defects - distortions, omissions or substitution of sounds. The conversation is slow, the words are inexpressive, indistinct, they are understood only by relatives. The fourth stage is the most difficult, it occurs with complete paralysis of the speech-motor muscles, when speech becomes impossible or completely incomprehensible even to those close to you.

Forms

The types of erased dysarthria are determined by the localization of the CNS lesion, which is responsible for the function of speech, and its symptoms. The following are distinguished:

pseudobulbar, in which cortical-nuclear nerve endings are affected. It is characterized by a violation of the pronunciation of sounds, lethargy of the speech muscles;
corticalcaused by a focal lesion of the cerebral cortex (voluntary movements are difficult);
mixed.

Complications and consequences

The consequences and complications of erased dysarthria are in the social and psychological plane. Serious speech defects that make it difficult to communicate in the family, team, with friends can lead to social isolation. This, in turn, leaves an imprint on emotional condition a person, causes depressed mood, depression.

Diagnosis of erased dysarthria

Diagnosis of erased dysarthria is carried out by a neurologist and a speech therapist. It is necessary to assess the degree of damage to the central nervous system, its localization.

The neurologist in his conclusions relies on instrumental studies. The speech therapy conclusion is based on the assessment of speech and non-speech symptoms: the nature of breathing, the state of the facial muscles, the ability to produce articulatory movements. Analyzed oral speech: pronunciation of words, their intonation, intelligibility, rhythm and tempo.

Written tests are carried out: dictations, writing off texts, reading aloud. In children, erased dysarthria is diagnosed after 5 years.

Blood and urine tests are prescribed to determine the general condition of the body.

Instrumental diagnostics plays an important role in determining the diagnosis, its volume depends on the initial diagnosis made by a neurologist or a pediatric neurologist. The following studies will give the most accurate picture: MRI of the brain, electromyography, electroencephalography, electroneurography.

Differential Diagnosis

The task of differential diagnosis, based on assessments of symptoms, is to separate erased dysarthria from motor allalia, aphasia and dyslalia. All these diagnoses are associated with lesions of the brain foci, so only neurological studies will answer the question.

During the diagnosis of erased dysarthria, it is difficult to distinguish between its mild form and complex dyslalia, because. they have similar symptoms. In the case of dyslalia, speech defects are not associated with CNS damage. Most often, it is caused by the peculiarities of the anatomical structure of the articulatory apparatus. Consider the differential signs of dyslalia and erased dysarthria. The main criteria that guide the definition of erased dysarthria are as follows:

state of articulation (slowness of pace, difficulty in holding or switching articulation);
the presence of changes in intonation and clarity of pronunciation of words;
the appearance of other movements while moving the tongue;
stable nature of violations of the pronunciation of sounds.

Dyslalia is characterized by a violation of the articulation of only consonants, including in various versions of their pronunciation. The sounds formed by the speech therapist are well absorbed, the rhythm and pace of speech are not disturbed, breathing, articulation, and voice formation are coordinated. In contrast, with erased dysarthria, vowels are often pronounced nasally. Separate isolated sounds may sound correct, but are distorted in the word. Their staging causes difficulty, the pace of pronunciation is not stable, breathing is disturbed, speech is made on inspiration. All functions required for correct pronunciation are not coordinated.

Treatment of erased dysarthria

The treatment of erased dysarthria is complex, including drug treatment, the use of physiotherapeutic and pedagogical methods. The goal of treatment is to achieve such a level of pronunciation of words that speech is understandable to others, and the person can adapt to society. For children with erased dysarthria, there are specialized speech therapy groups that are formed depending on the level of development: with phonetic, phonetic-phonemic and general speech disorders. Drug treatment is prescribed by a neurologist and is aimed at enhancing brain activity. These are vascular, nootropic, sedative and metabolic drugs. By using therapeutic gymnastics facial muscles are strengthened, fine and gross motor skills of the hands develop, because it is directly related to the functions of speech. Respiratory gymnastics is also necessary, in this case Strelnikova's gymnastics is effective, facial massage is mandatory. This complex of therapeutic measures is complemented by the continuous work of a speech therapist in the production of sounds.

Methods of correction for erased dysarthria

Correction methods for erased dysarthria include all of the above procedures with the addition of other non-traditional ones. They depend on the severity of the damage to the speech apparatus. At the first stage, facial muscles are strengthened through massage. Next, special exercises are done to establish the correct articulation. This is followed by work on the autonomous production of sounds, then on the correct pronunciation of them in words. If work is carried out with a child, then psychological support in the form of praise and approval is important. In parallel, acupuncture, hirudotherapy, therapeutic baths are used. The method of treatment with the help of communication with dolphins (dolphin therapy), games with the use of sand (sand therapy), game exercises (sensory therapy) gives good results.

Prospective planning for erased dysarthria

Long-term planning for erased dysarthria was developed for preschool children and consists in the development of speech hearing, visual, auditory attention. For this, games are held: for example, with the help of pictures and toys, they offer to remember their location or presence, and then tell what has changed. This strengthens visual attention. To enhance hearing, noise toys are used, for example, you need to guess who owns the voice or where the sound comes from. The next stage is aimed at developing the mobility of the articulatory apparatus. It consists of various exercises for the development of the jaw, strengthening the mobility of the lips, muscles of the tongue, cheeks, breathing exercises. Special gymnastics is done to develop the skills of staging and pronunciation of individual sounds. For this, a visual demonstration is used, where the tongue should be, how the lips are located. In front of the mirror, the skill is being practiced to pronounce whistling, hissing, sound r, l. Further, with the help of games, work is carried out on the correction of sounds, on their accuracy, purity, tempo, and strength. Then there is work on the sound, for which verses, tongue twisters, sayings are memorized and pronounced. Games for recognizing the sound in syllables develop phonemic perception. The great work done is crowned with exercises on the ability to differentiate sounds in syllables, words, phrases, sentences.

Calendar-thematic planning for erased dysarthria

Calendar-thematic planning for erased dysarthria in children provides for an individual work plan with a phased implementation of corrective measures, indicating specific actions and deadlines. This plan is developed for a specific patient, taking into account the age and depth of damage to the speech apparatus. As a rule, it consists of a preparatory and main stage. The first preparatory stage is aimed at forming the interaction between visual, auditory and motor perception, at improving fine motor skills, articulation, memory, and the ability to analyze. The purpose of the main one is the development of speech, the correction of phonetic errors in sounds, the strengthening of the articulatory apparatus.

Logopedic work with erased dysarthria

Drawing up calendar-thematic plans and their phased implementation - this is the speech therapy work with erased dysarthria. Distinctive features This diagnosis is that a speech therapist, in order to correct the pronunciation of sounds, needs to carry out a large and time-consuming preparatory stage. The effectiveness of speech correction in the future depends entirely on the successful work of a speech therapist at this stage.

Exercises for erased dysarthria

Special exercises have been developed for erased dysarthria to strengthen the articulatory apparatus, develop general motor skills, including hands, coordination of movements, normalize voice and breathing during pronunciation of words. Hand exercises include lacing, stringing beads on a string, shading with a pencil, modeling with plasticine. They improve coordination of movements with the help of pantomime: with your hands you need to portray what you heard.

There are other exercises to coordinate movements. Speech breathing and voice are normalized with the help of Strelnikova's gymnastics. Here are a few tricks: take a shallow breath, hold your breath and exhale slowly; inhale, hold the air, pronounce any vowel sound as you exhale; on exhalation, smoothly change one vowel sound to another. Also, playing the pipe, inflating balloons helps a lot. Therapeutic measures for speech correction also include exercises for touching objects, spatial representation. To do this, by touch, by texture and form, they offer to recognize the subject, etc. They give the skills to establish a causal relationship, to generalize.

Staging sounds with erased dysarthria

The production of sounds with erased dysarthria begins with vowels, because. they play a major role in the intelligibility and clarity of pronunciation of words, emotional coloring speech. At first, work is being done on the correction of such sounds: e, a, i, s, o, u. After achieving clarity in articulation, they move on to consonants [m "-m], sonorants [n "-n], [j], [l "-l], [r "-r], bow-explosive [n "-p] , [b"-b], [t"-t], [d"-d], [k"-k], [g"-k], slotted [f"-f], [c"-c] and front-lingual [s "-s], [s" -s], [sh-zh], [x"-x], [u], [h], [c]. First comes the preparatory stage, then the production of sounds.

Articulatory gymnastics for erased dysarthria

A special articulation gymnastics for erased dysarthria using both dynamic and passive exercises.

There is Ermakova's technique for masticatory muscles. Exercises consist in alternately opening and closing the mouth, inflating and retracting the cheeks, pushing forward and towards the jaw, biting the upper lip with the lower lip. Gymnastics Arkhipova is also aimed at strengthening the muscles of the face. It consists in puffing out the cheeks, stretching the lips with a tube, exposing the upper and lower teeth in turn, retracting the lips into the oral cavity, snorting with a “horse”, imitation of rinsing the teeth.

Passive gymnastics for the tongue according to the method of Pravdina involves movements under the influence of another person. Such exercises are carried out in three stages: entry, maintenance and exit from the position. For example, you need to close your lips, an outsider holds them with a finger and offers to blow into them and try to open them. The pronunciation of each group of sounds corresponds to a certain location of the tongue, lips, muscle tension. It is to strengthen these skills that articulatory gymnastics is aimed.

Massage for erased dysarthria

Massage with erased dysarthria is used to strengthen or relax the facial muscles. With hyperkinesis and hypertonicity, a relaxing massage is done. It consists in a short 1-1.5 minute tapping, stroking the face from the temples to the bridge of the nose, forehead, nose, lips. People with low tone are prescribed a firming massage. In this case, the face is longer (3 minutes) and deeply kneaded and rubbed. All movements are directed horizontally from the center to the periphery of the face.

To improve the motor skills of the hands, massage and self-massage of the fingers and hands are carried out. So, in the form of games, children are offered to imitate the movements of an iron, a saw, kneading dough, and others, accompanied by special quatrains on this topic.

Adapted program for erased dysarthria

The adapted program for erased dysarthria is designed for the development and education of preschool children, taking into account their characteristics. It is a plan for the speech therapist and other participants educational process, determines the priorities of training, gives a methodology and its organizational aspects, regulates all types of training and a system for evaluating the results of its assimilation. In addition to the speech therapist, educators are involved in it, on which, within the framework of adapted program entrusted with conducting games, conversations, excursions, music director, specialist in fine arts, an athlete, parents are also involved. The program has been developed for two years and consists of several stages.

At the first initial diagnostic stage, by collecting an anamnesis, psychological and speech therapy tests, the degree of speech damage and tasks for correcting defects are determined, and a speech map is filled out.
At the second stage, organizational and preparatory, a individual program corrections.
The third stage - correctional-technological provides for the implementation of all planned activities.
The fourth one is the final diagnostic one.

Speech therapy studies are carried out to assess the state of the speech apparatus and other functions of the child. Decisions are made to stop classes with a speech therapist in case of positive results, to continue or change the nature of classes.

It's important to know!

Dysarthria is a speech disorder that results in slurred, often difficult to understand pronunciation. This pathology is studied both by neurologists, since the cause of its occurrence is the transformation of the nervous regulation of the speech apparatus, and by speech therapists involved in pronunciation correction.

Violations speech development This is a fairly common problem among children. Such pathological conditions are not always manifested by severe symptoms, and in this case, parents do not pay close attention to them. And completely in vain, because in the absence of adequate correction, such violations can bring a lot of trouble in later life. The most common speech therapy disorders include dysarthria in preschool children in an erased form, the topic of our conversation today will be the symptoms of erased dysarthria and its treatment.

Erased dysarthria is a fairly common pathology that is difficult to correct. Such a violation concerns the pronunciation side of speech, and is usually observed in children of preschool, as well as primary school age.

Symptoms of erased dysarthria

With an erased form of dysarthria in young patients, insufficient mobility of a number of muscle groups in the speech apparatus is fixed, which can be represented by lips, soft palate or tongue. In some cases, there is a general weakness in the entire peripheral speech apparatus due to damage to certain parts of the nervous system.

With erased dysarthria, babies can pronounce most of the isolated sounds correctly, however, in the general speech stream, they poorly automate these sounds and at the same time do not sufficiently differentiate them. Disadvantages of pronunciation can be very different. Most often, with erased dysarthria, blurring and blurring, as well as some fuzziness of articulation, are observed. Such symptoms are especially noticeable in the flow of speech.

With an erased form of dysarthria, children do not have pronounced polymorphic disturbances in sound pronunciation, they also do not have violations of tone and problems in the contractility of the articulatory muscles.

Many pathological features of the articulatory apparatus become classic symptoms of dysarthria. In young patients, paresis of the muscles of the articulatory organs can be observed, which is expressed in the lethargy of the muscles of the face and lips, the drooping of the corners of the lips, and the inability to hold the position of the closed mouth. There is lethargy of the tongue, its tip is not active enough. Exercise leads to increased muscle weakness.

Erased dysarthria in preschool children is sometimes accompanied by muscle spasticity, which manifests itself in facial muscle tension, a constant half-smile of the lips, while the upper lip is pressed against the gums. When speaking, the lips do not participate in articulation in any way, so children with spasticity of the muscles of the face simply cannot pull their lips forward. The tongue becomes thick, it does not have a pronounced tip, and this organ also becomes inactive.

Also, an erased form of dysarthria in children can be manifested by hyperkinesis (trembling of the tongue and vocal cords), apraxia, deviation of the tongue from the midline and hypersalivation ().

How is erased dysarthria corrected, what is the effective treatment of the disease?

The elimination of erased dysarthria implies a complex impact, which includes medical, psychological and pedagogical, as well as speech therapy direction.

Successful treatment of such a pathological condition depends on the full cooperation of specialists and parents. An important role is played by the correct development of articulatory motor skills.
And an excellent effect is given by the correct exercises, selected taking into account the specifics of the identified violation. Complexes of exercises can be selected, both for relaxation and for increasing the tone of problem areas. The speech therapist teaches the correct implementation of the exercises, and parents should practice them.

Correction of erased dysarthria may involve breathing exercises. So the implementation of the complex gives an excellent effect, it effectively develops speech breathing and helps to establish fluency of speech.

With some varieties of dysarthria, the child's mouth may be constantly ajar. At the same time, parents need to teach the baby to control the position of the mouth.

Successful correction of the erased form of dysarthria also includes the adoption of measures for the development of motor skills. Young patients need to perform exercises to overcome motor awkwardness and develop finger motor skills. An excellent effect is given by gymnastics, special exercises for coordination, as well as for balance. Children are encouraged to collect puzzles, mosaics and lacing, as well as perform other similar tasks.

The erased form of dysarthria requires correction of sound pronunciation. A speech therapist helps a preschooler to master the correct pronunciation of sounds, both vowels and consonants. In addition, therapy includes the development of speech from all sides. At the same time, the phonemic and lexico-grammatical side of speech is corrected: phonemic hearing develops, skills sound analysis, vocabulary is expanding, and training is also provided on the competent construction of statements.

An excellent effect with erased dysarthria is given by holding speech therapy massage. It is performed by a certified speech pathologist. This method of correction involves massage of the lips, tongue and cheeks to optimize muscle tone, as well as to stimulate the muscles of the speech apparatus.

In some cases, the correction of erased dysarthria should include classes with a psychologist, for example, if it is necessary to correct the emotional disorders present in a preschooler.