Theoretical aspects of stuttering 5 1 The essence of stuttering 5

Methodology of N. A. Vlasova and E. F. Rau

The authors of the first domestic method of speech therapy work with preschool children, N. A. Vlasova and E. F. Rau, built an increase in the complexity of speech exercises depending on the varying degrees of speech independence of children. At the same time, the authors recommend mandatory rhythmic and musical classes with children and explanatory work with parents.

N. A. Vlasova distinguishes 7 “types of speech”, which, in order of gradualness, must be used in classes with preschool children:

1) conjugate speech

when the child follows the speech therapist and pronounces phrases together with him. This is the easiest form of speech for people who stutter. In the case of even very severe forms of stuttering, the child speaks completely freely. This is due to the fact that with this form of speech, he actually only copies someone else’s phrase (its construction, manner of pronunciation), and even pronounces it not independently, but with outside help. The degree of independence here is practically reduced to zero.

2) reflected speech

involves (unlike the conjugate) only the child repeating the phrase after the speech therapist without pronouncing it together. The child here also fully uses someone else’s phrase construction, its pace, intonation, and manner of pronunciation, but he is already partially deprived of help in the form of pronouncing it together. This is also a form of speech that is usually accessible to all children who stutter. Here elements of independent speech already appear. True, these are still separate, independently inserted words, and at the same time it is also, as it were, half-reflected speech. After all, the answer to a specifically posed question allows the child to use both a certain sentence structure and almost all the words contained in the question, adding only 1-2 words.

3) answers to questions based on a familiar picture

. It is more difficult for a child who stutters to give detailed answers to questions like: what is the boy (or someone else) doing, why, for what? The child is forced to answer such questions with a detailed phrase and more than one. But he no longer has the opportunity to rely on the question posed. Such answers bring the child closer to independent speech.

4) independent description of familiar pictures

;

5) retelling

listened to a short story. Retelling further complicates the speech of a stutterer, since it requires him to immediately utter not 1-2 phrases, but much more. Here you can find not only simple, but also complex phrases. And they need to be consistently and coherently conveyed to the listener. The retelling also contains some moments that make it easier for a stuttering child to speak. This is, first of all, material presented by someone: a retelling of a fairy tale, a story, a filmstrip seen, etc. This means that there is already some kind of sample. It is enough to remember the sequence of presentation, individual constructive examples - and now there is help.

6) spontaneous speech (story based on unfamiliar pictures);

A story is a completely independent presentation of material on some topic: from a picture, from impressions left from an excursion, walk, etc.

7) normal speech (conversation, requests)

- the most difficult for people who stutter, because it involves natural and active verbal communication with others: questions, requests, appeals, messages, exchange of thoughts, expression of desires, etc.

E.F. Rau divided all classes according to the degree of increasing complexity into 3 stages.

1. – exercises are conducted in joint and reflected speech and in the pronunciation of memorized phrases and rhymes. Recitation is widely used.

2. – exercises are carried out in the oral description of pictures in questions and answers, in composing an independent story based on a series of pictures or on a given topic, in retelling a fairy tale or story.

3. – final, consolidation of acquired fluent speech skills.

Taking into account all the above conditions, speech exercises are constructed in the following sequence:

memorized text;

rehearsed out loud;

mentally thought out;

unfamiliar text, impromptu.

The methods of N. A. Vlasova and E. F. Rau are characterized by a certain similarity - they are based on different degrees of speech independence of children. The methods of N.A. Vlasova and E.F. Rau are based on different degrees of speech independence of children. The undoubted merit of these authors is that they were the first to propose and use a step-by-step sequence of speech exercises in working with young children, and developed instructions for individual stages of the speech correction system for stuttering preschoolers. For many years, the proposed method has been one of the most popular in practical work with children who stutter. Currently, speech therapists use many of its elements (2, 4).

Treatment of stuttering in children and adults (+DVD)

This is an excellent practical guide to using comprehensive techniques, programs and devices to eliminate stuttering. A description is given of both traditional, time-tested and highly effective methods of stuttering correction, as well as new methods that have appeared in recent years.

On sale here: www.labirint.ru/books/294599/

Video materials for these techniques are presented on the attached DVD. Also on the disk is the Zaikanie.NET program for the correction of stuttering and logoneurosis, offered free of charge to readers within the framework of a cooperation agreement between the UNESCO Institute of Information Technologies in Education and the Biocybernetics Research Center (Moscow). Using a personal computer, a microphone and headphones, you or your loved ones who have a stuttering problem, today, with the help of this program, you can get tangible benefits and begin to restore fluency of speech.

The book is intended for parents, high school students and students who are faced with the problem of stuttering. Undoubtedly, the publication is of interest to professionals: speech therapists, neurologists, students of medical and pedagogical universities.

See also the section: Speech development, speech therapy for preschoolers. There are other publications on stuttering correction.

Additional checks and studies

Prerequisites for the occurrence of a speech defect can be traumatic brain injuries, intoxication, diseases (hypertrophy, rickets) and severe infections (measles, encephalitis, meningitis, typhus, etc.).

The causes of the disease also include nervous shock and prolonged psycho-emotional stress.

MRI and CT

To identify organic lesions in the central nervous system, MRI and CT are performed.

MRI allows you to diagnose injuries, diseases and tumors that could cause a speech disorder. A CT scan of the brain can detect aneurysms and other pathologies.

Encephalogram (EEG)

An EEG is performed to determine the causes of the disorder and allows to exclude organic lesions of the central nervous system. When studying the results, the doctor determines the location and extent of damage to the central nervous system.

Rheoencephalography

The examination is necessary to identify disorders in the blood vessels of the brain and assess the state of blood circulation. The results of the REG record the degree of blood supply to a certain area, the speed of blood flow and blood viscosity. An examination is carried out for stuttering to identify concomitant diseases.

History taking

The medical history includes the following information:

• health status and presence of speech disorders in parents and immediate relatives;
• analysis of the child’s overall development;
• the presence of diseases in the mother during pregnancy and injuries during childbirth;
• stress and physical trauma in childhood;
• speed of speech formation;
• conditions of upbringing (type of institution and the child’s adaptation to it, learning two or more languages, communication with children who have speech defects);
• psychological climate in the family (conflicts, excessive guardianship, attitude of family members towards the child’s defect);
• the presence of diseases of the organs of vision and hearing.

Articulatory

Exercises for lower jaw mobility

Exercises to strengthen the muscles of the lower jaw are the beginning of a set of articulatory exercises:

1. Open and close your mouth wide, keeping your tongue motionless and calm. Performed both freely and with resistance in the form of a hand placed on the chin.
2. Movement of the jaw back and forth.
3. Movement of the jaw left and right.

Lip charger

The next stage is lip exercises, often the cheeks are also included in the work:

1. Stretch your lips into a wide smile, holding the position for 10 seconds. Two variations of the exercise - when the teeth are visible and when they are not.
2. Pull your lips forward in the form of a tube. Hold the position for 10 seconds. There are also two types of execution with tightly closed lips and with visible teeth in the resulting hole.
3. The following exercise trains both the lips and the lower jaw. Having stretched your lips in a smile, open your mouth and fix the position for 5-10 seconds, then close it.

To strengthen the muscles of the tongue

The new training complex is aimed at strengthening the tongue muscles:

1. Smile and open your mouth slightly and place your relaxed, flat tongue on your lower lip. The upper one bites it rhythmically, saying “five-five-five.”
2. Clicking your tongue from the roof of your mouth, imitating the clatter of a horse's hooves, with your mouth slightly open.
3. Using a wide tongue, lick your lips in a circle, starting from the top.
4. Smile and open your mouth slightly, “clean” your upper teeth from the inside with your tongue, then from the outside, then the lower teeth. The jaw should remain motionless.
5. Slightly stretching your lips and opening your mouth slightly, stroke the palate with the tip of your tongue back and forth.

Useful knowledge about articulatory gymnastics in the video:

https://youtube.com/watch?v=5YFqnmhnK5I

Breathing exercises for the formation of correct speech breathing

All exercises for logoneurosis are used for both adult patients and children.

The category of exercises against stuttering is aimed at developing the correct combination of inhalation and exhalation with pronounced sounds. During the lesson, melodiousness and fluency of pronunciation are trained.

How to breathe correctly when stuttering so as not to stutter?

"Flower shop"

The patient imagines himself in front of a flower shop window.
One of his hands is on his stomach, the other is in a free position at the side. Taking a short, intense breath through his nose, he “smells the flower.” At the same time, the stomach moves forward.

After holding your breath for a second, a long exhalation “pffff” follows through the oral cavity, the stomach and diaphragm go back.

"Candle"

A thin strip of paper about 5 cm wide represents a candle flame. The patient needs to blow on it for as long as possible.

"Singer"

You should sing vowel sounds, then their combination (aaauuuu, oooooooooo, etc.), a combination of sonorant consonants and vowels (laaa, mooo, etc.). Then singing is performed with increasing and decreasing volume of sound.

Psychological for voice development

Logoneurosis is associated with psychosomatics, an unstable nervous system, stress and anxiety, which provoke muscle and respiratory spasms.

When conducting training, it is important that the child or adult is calm and relaxed

A breathing exercise is perfect for this, with which it is recommended to start the lesson: you need to take a comfortable position and close your eyes. Take a deep, long breath through your nose. Hold your breath for a few seconds, counting to five and also exhale deeply. By repeating a simple technique five to seven times, the patient will be prepared for further practice.

Meditation gives effective results. Having taken a comfortable position, you need to relax and close your eyes, imagining something pleasant.

Calm music or sounds of nature in the background will help you achieve peace faster. Take a deep breath and let out a long “mmmmm” as you exhale.

Strelnikova method

The author’s method of A.N. is popular among speech therapists. Strelnikova. The exercises are easy to perform, allowing you to practice on your own at home. The exercises are aimed at activating the functions of the diaphragm and coordinating the rhythm of breathing.

"Palms"

When performed, the patient can stand or sit.
The arms are bent at the elbows, palms are open. As you inhale sharply, you should make a movement with your hands that imitates catching air, quickly clenching them into fists. After this, a long, smooth exhalation occurs.

Alternating inhalations and exhalations according to the following scheme: 4 approaches in a row, followed by a 4-second break.

"Epaulettes"

Performed while standing. Hands are clenched into fists and are at waist level. While taking a short breath, straighten your arms with several pushes, as if pushing the air down, while taking a few more short breaths.

"Pump"

Starting position: standing, feet shoulder-width apart. As you inhale, bend over, and as you exhale, return to the starting position.

Video about the development of speech breathing during stuttering:

Age characteristics

At each age there are features of the course of the disorder. Stuttering occurs in children and adults. In 60% of cases, the defect in preschool children is eliminated, improvements are noted in 19%, remission in 8%. Only 13% have small changes.

In adolescence, improvement in the defect occurs in 82% of cases, in 15% the disorder is completely eliminated, and in 3% there are no changes. In adults, the situation is corrected in 50.8% of cases, and the defect is removed in 14.7%.

The best results in eliminating the defect are shown in preschool age. The sooner help is provided to a child who stutters, the greater the chance of recovery.

For preschool children, the stages of work are as follows: play activities for speech development, education, and post-medical activities. For adults, first psychotherapy, medications, then pedagogy.

General points of correction

Each author uses his own methods of eliminating stuttering. All of them are built on common principles:

• individual approach;
• group work;
• subsequence;
• systematic;
• visibility;
• consciousness.

Work must be done on the intonation side of speech. To do this, use special exercises to develop breathing, voice modulation, and control of expressive means.

Some authors proposed the introduction of a stage of monotonous speech, which made it possible to prepare the ground for further development. It facilitated the acquisition of articulatory postures of sounds.

The goal of correction is to develop a new stereotype of speech production. For this purpose, technical means are used. Biofeedback (biofeedback) allows you to develop new neural connections in the brain. The child gets the opportunity to independently control breathing, voice formation, etc.

To train the smoothness of exhalation, speech, and voice strength, the “Visible Speech” program is used. Graphic games allow you to clearly see the result of actions, which makes learning effective.