It is no secret that the number of children with speech problems is growing rapidly from year to year. There are not enough speech therapists in kindergartens. And those who do take on a limited number of children, usually only those with severe speech impairments.
All that remains is to look for a private speech therapist.
And then the parents are at a loss: how to find him?
Maybe through free advertisements on the Internet? But there is an opinion that only inexperienced, beginners or “bad” specialists who have a chronic shortage of clients live there.
You often hear from parents: “They only go to a good speech therapist based on recommendations!” But the speech therapist recommended to you by a friend or acquaintance may not meet the deadline in which he corrected the same speech defect in someone else’s child. There are no identical children, just as there are no identical time frames for eliminating speech problems. Hence the subsequent grievances against the speech therapist.
Nowadays it is easy to find a speech therapist. It's harder to know if you've found the right one for you.
What should you pay attention to when choosing a speech therapist?
Here is a sample list of questions that will help you choose the right specialist for you or your child.
When to start worrying and when to just wait?
— It happens that parents complain that the child does not start talking for a long time. What does "long" mean?
“Speechlessness” may have different reasons. Children not only do not speak with speech impairments, but also with hearing impairments, intellectual impairments, and autism spectrum disorders.
“Long” is when the child is one year old, but he does not respond to his name, does not understand simple addresses (“let’s go to bed,” “wash hands,” etc.). Or when, after three years of age, a child understands spoken speech, he has many gestures, but no independent speech.
If at the same time the child is too “independent”, does not look into the eyes, avoids physical contact or, conversely, loves hugs too much, if he has a reduced sense of pain, then you need to quickly contact a specialist.
In these cases, you need to first check your hearing, preferably more than once. Visit a neurologist, get a consultation with a speech therapist at two years. There is such a wonderful study - evoked potentials (a method of studying the nervous system based on recording electrical potentials of the brain in response to any influence - Ed.), it is quite objective.
— What features in the development of a child’s speech should cause concern for parents? When should you immediately contact a specialist, and when is it better to wait?
— When it comes to speech, I don’t like to wait. It is acceptable not to utter a word for up to a year; there may not be a short phrase for up to two years; and an extended phrase for up to three years. If up to two years of age the child is social, communicative, and understands spoken language well, then we observe for another three to four months. But three years is a “Rubicon”. At the age of five, speech completes its development, leaving the opportunity to accumulate a vocabulary throughout life. If the appearance of sound complexes (combinations of sounds, for example “au” - Ed.), words and sentences does not fit into the deadlines, this is a reason to see a doctor and speech therapist.
You should be concerned if a child has a poor vocabulary (a vocabulary that is not appropriate for his age); incorrect use of words - speech agrammatisms; incoherent speech (badly retells fairy tales); failure to pronounce sounds and, possibly, features of the formation of phonemic hearing.
In addition, you need to pay attention to the understanding of spoken language, the ability to communicate and the emotional development of the child.
— Are the most common causes of speech disorders neurobiological, anatomical (structure of the speech apparatus), psychological, or something else?
— Most often it is impossible to name one specific reason. Let's say my mother smoked a pack a day (an example from practice) - this could be the reason.
If these are problems with sound pronunciation, then the reasons may be a violation of the structure of the articulatory apparatus or muscle tone, or combined.
If a child does not speak, for example, with motor alalia (absence or underdevelopment of speech in a child with normal hearing - Ed.), most often this is a pathology of pregnancy and childbirth: rapid or prolonged labor, asphyxia.
Increasingly, cervical-head injuries during childbirth are cited as the root cause of speech disorders.
This was the opinion of, in particular, A.Yu. Ratner and P.G. Zamaratsky. “10-15 minutes is enough. oxygen starvation of the brain, so that this affects its functioning. In 70-80% of newborn children, the cervical spinal cord is affected, in 35-40% - the thoracic and lumbar spine,” wrote Professor Ratner. In the future, this results in headaches, speech problems, difficulties with mastering the curriculum, disobedience, and inappropriate behavior.
Professional experience and qualifications
When choosing a specialist, you must first of all pay attention to the specialty and educational institution from which he graduated. Speech therapists, as a rule, are trained in higher pedagogical educational institutions, about which the specialist diploma must contain a corresponding entry: “Teacher-defectologist, speech therapist.”
In addition, make sure that the specialist you choose regularly undergoes various trainings and advanced training courses to improve their professional level.
If a child is teased for burring or lisping
— How hard can you work with a child on speech development, so as not to cause other problems - psychological?
— Now there is a strong tendency to teach all children as early as possible: “reading from the cradle,” “talking before walking,” etc.
I am categorically against it when a child is developed for prevention: “let the child work out, it won’t get worse.” I think it will be worse.
And the consequences may be delayed. Because those people who in childhood, instead of playing, sat through classes to learn a couple of English words, in adulthood try to “play at life” and “play at being daughters and mothers.”
A preschooler is not required to study; he has another leading activity - play. Before school, a child must be able to play well and a lot, be able to interact in the game, understand the rules, and correspond to the proposed role. As paradoxical as it may sound in the mouth of a speech therapist, it is better to let them have a lisp, but just ride down the mountains and play hide and seek. There will be more benefits for future social life.
The only time a speech therapist should be irreconcilable is if the child has no speech at all and communication is impaired.
— Do parents often complain that their children are teased by their peers because of speech disorders?
— Children do not hear very well and distinguish between sound pronunciation disorders. I had two wonderful boys. Misha did not pronounce [r], he was in the second grade, [r] did not affect his studies, his grades were good. He didn’t want to fix anything—everything suited him. Mom, as motivation for classes, said that I needed to fix it, otherwise the guys would tease me. To which Misha replied: “What kind of friends are they then?”
The second boy, Vitaly, was in the sixth grade, there were a little more sounds for correction, but otherwise the situation was similar. The mother approached her son with the same motivation, the answer was: “Why would they suddenly tease? Why didn’t you tease me before?”
I still recommend putting on the sounds, and preferably before school, so as not to narrow the range of available professions in the future. Speakers, lecturers, politicians - they all must have clear, intelligible speech with the correct sound.
In addition, incorrect sound pronunciation is often accompanied by a violation of phonemic hearing, which means that if not corrected, there will be errors in writing.
Are you both comfortable with the new speech therapist?
Listen to your feelings and those of your child.
Naturally, not every child will make contact with the teacher immediately during the first lesson. In turn, a smart parent will always help build a relationship with a specialist.
But if the speech therapist has not found an approach to the child after three meetings, there is reason to think about the question: “Is it worth further spending time and money?”
And finally, here are two questions that parents most often ask speech therapists.
How to check the professionalism of a speech therapist?
— When can a specialist help a child cope with speech disorders, and when not? How to determine that the problem is unsolvable and stop annoying your child with exercises?
- You can’t give up and give up. They help those families where there is an iron will and perseverance of the parents. The child himself cannot organize his own activities.
As a child, I often went to visit my grandmother in the village. Grandma had a sister. During her pregnancy, she fell from a cart and hit her stomach hard; the child was born sick. I don’t know if this is a family legend or if this is exactly how it all happened, but Volodya, now deceased, was one of those who are kindly called village fools. He did not speak, except for five or ten words. As a professional, I now understand that Volodya could have been helped if they had worked with him to develop his speech in childhood. But then it was impossible, and the parents probably accepted what happened as fate.
At the institute we were taught: “you should make any child fit into the norm.” Of course, not everyone, due to the severity of the problem, will be able to survive, but we must create all the conditions.
— It happens that one specialist helps, but another does not. How can parents build the right “route” when searching for a suitable speech therapist?
— Professionalism is my sore subject. I teach at a university and I know that universities have been shaking for a long time. The programs have been revised and teaching hours have been reduced. But the biggest problem, in my opinion, is the correspondence form of training for speech therapists, when inadmissibly little time is allocated for practice. Clinical cases, specific cases of correction and training - it is impossible to “go through” this on your own.
Let's try to give specific advice on finding a speech therapist:
Specialist education . This is a diploma of higher special (defectological) education, better than full-time education.
Advanced training and additional education . For example, if a specialist positions himself as a professional in the field of speech correction for children with autism, then he must know ABA therapy. If you are involved in the correction of dysarthria (impaired pronunciation of speech due to insufficient innervation of the speech apparatus - editor's note), then you need knowledge to conduct speech therapy massage, the ability to work with prosody (intonation-expressive coloring of speech - editor's note).
Continuity: from whom did the speech therapist study ? A teacher must be a respected person in the profession. Of course, it’s good to have feedback: does the teacher know this specialist, because a student is a “piece” of work. For example, I am a student of Maria Fedorovna Fomicheva.
In which institutions did the specialist work, and where does he work now? There are so-called “branded” places that allow you to judge the status. True, you also need to ask how long the person worked there.
You should ask specific questions about your problem . For example, does the specialist know how to work with a non-speaking child and what systems of work he knows. In speech therapy, strange as it may sound, there is no method for working with alalia. There are methods, techniques, approaches associated with specific names, but there is still no methodology. It is important that the specialist not only name names, but also tell what exactly he is going to do.
It is important how many children were in his practice . A novice speech therapist can work with a child, but a parent has the right to know that his child is a professional start-up. Typically, such a specialist offers diligence in return.
The speech therapist is obliged to give a prognosis and name the number of classes required . Of course, with complex speech disorders it will not be possible to do this right away, but you can set intermediate goals. Parents should not be satisfied with the answer “we’ll see how it goes.” I usually say: give me a few sessions to determine how the child will interact with me. A child, like an adult, may be sleep-deprived, agitated, “not in the mood,” etc. And at the next lesson everything will be different: I got enough sleep, wasn’t capricious, was well-fed and able to work.
Professional interdisciplinary connections are important - with whom the speech therapist collaborates . When a child has a complex diagnosis, an integrated approach to correction is important.
— A free consultation with a speech therapist can only be obtained in a kindergarten or clinic. How do you assess the qualifications of speech therapists working in these institutions?
— Free consultations are available only in government institutions, but there may also be paid ones, this is now allowed. As for qualifications, they, like conscience, either exist or they don’t. The institution itself has nothing to do with it.
It seems to me that the problem is in the formal approach to the work of regulatory authorities, which boils down to checking documentation. The problem is that there are practically no professional associations. There are no sections or round tables in the professional space. And if there are, then they are only paid. Here is the answer. The main criterion is the conscience of a specialist. Only he himself, having paid, can go and learn - or buy a certificate without studying. Choose a topic for self-education and hone your skills - or stop there.
About very specific
— What modern effective methods exist for correcting dysarthria, dyslalia, stuttering, alalia, aphasia, etc., in addition to classes with a speech therapist?
— There are three methods: medical, psychological-pedagogical and hardware (non-drug). The selection of working methods in different areas is important.
To correct dyslalia (violation of sound pronunciation with normal hearing and intact innervation of the speech apparatus, manifested in distorted pronunciation of sounds, in the replacement of sounds or their mixing - editor's note), the knowledge and skills of a speech therapist are sufficient. A speech therapist who deals with dysarthria (impaired pronunciation of speech caused by insufficient innervation of the vocal apparatus - Ed.), rhinolalia (violation of voice timbre and sound pronunciation caused by anatomical and physiological defects of the speech apparatus (congenital cleft palate) - Ed.), stutterer , must know the techniques of speech therapy massage. With dysarthria, it is necessary, in addition to classical techniques for producing sounds, to work with the normalization of muscle tone, the prosodic component, and breathing. For a child who stutters, a relaxing general and speech therapy massage is needed.
With dysarthria and stuttering, it is important to work on establishing a long oral exhalation and establishing a diaphragmatic type of breathing. This function is well trained and stabilized on the BFB-logo simulator; the child himself controls the process.
A very large block of physiotherapeutic procedures is also aimed at correcting speech disorders: amplipulse therapy, laser therapy, transcranial micropolarization.
Speech requires high-quality auditory perception and “phonemic hearing.” Since 1940, there has been hearing therapy using the Alfred Tomatis method. A more modern method is the computer speech correction program Fast ForWord; it develops phonemic awareness, concentration and cognitive functions.
Speech is a coordinated motor act. Therefore, it is important to carry out not only speech therapy, but also therapeutic massage, exercise therapy, cerebellar stimulation (balance exercises), and use a biofeedback-myosimulator.
As for classes at home with parents, here we should talk more about the cooperation of the speech therapist and the family. In a trio: specialist-parent-child, two people must want to study. The specialist a priori wants to help. If the child does not want to, then the professionalism of the specialist and the love of the mother will help to include him in the classes. If the mother does not participate, then the time for correction is extended.
It is very important that parents and their child read a lot, play and complete tasks from various specialists. If a mother takes on the functions of a professional, this most often happens when she receives additional education (speech therapist or psychologist), or in the case when there is no specific specialist at her place of residence.
Professional agencies
With this option, you are guaranteed to find a specialist with good characteristics and sufficiently high professional qualifications. The disadvantage of this option is the fixed payment rate plus agency commissions. Recommendation : opt for small agencies with a psychological and pedagogical focus. A small agency is interested in the quality of customer service, while in a large agency the work is streamlined and there may be a weakening of the individual approach and loss of quality of service. Agency employees, as a rule, are psychologists and teachers who are well versed in the specifics of personnel for the family and home.
How are the psyche and speech connected?
— What psychological characteristics of a child can cause speech disorders? How does this affect the work of a speech therapist?
— Psychological problems arise in completely different people, and they are not triggered by speech problems. But secondary factors associated with speech disorders can sometimes correlate with psychological characteristics.
For example, a child with rhinolalia spends a lot of time in hospitals: operations, rehabilitation. At the same time, the process of his socialization is disrupted. But I know a huge number of children and adults who do not experience any communication problems due to the sound of their voices or traces of previous operations. I had a friend like this when I was a kid who grew up to be successful in business. This also applies to people with stuttering and dysarthria. If a person is the life of the party, then stuttering will not interfere with this.
In the case of verbal negativism (refusal to speak - Ed.), it is very important how the family accepts the child. No matter what conflict situations arise “in the sandbox,” a mother should always be on the side of her child.
As for the work of a speech therapist, his competencies allow him to take into account any characteristics of the child, including psychological ones. A speech therapist must be able to captivate, organize a game, and switch. Nowadays it is difficult to interest a child in pictures cut out in the last century and pasted on gray cardboard. Classes with children require knowledge and ability to use computer training programs, sensory games, modern devices, all sorts of tricks, and a specially organized special workspace.
— If a child had dyslalia or other deviations in speech development, does this mean that in the future it will be difficult for him to learn foreign languages?
— There are no restrictions or special difficulties in learning any other language. Even general speech underdevelopment (GSD) is not an obstacle to this. My work experience has shown that children with ODD at school learn a foreign language (English, German, French) easier than written Russian.
We have a lot in common in the organization of the phonetic system; sounds differ in binary oppositions (dullness - voicedness, hardness - softness, etc.), which means that there can be their replacements in both oral speech and writing.
Relationship with the child
This is perhaps one of the most important components when choosing a speech therapist. It is necessary to make sure that there is a strong psychological contact between the child and the specialist and that the classes are conducted in a friendly manner. Therefore, you should pay close attention to the child’s feedback about the speech therapist. Attend 3-5 classes, this will be enough to make a conclusion about the specialist. If, even after a series of classes, the child feels discomfort and goes to classes as if to hard labor, you should find another speech therapist.
About writing disorders
— What are the most common causes of written language disorders such as dyslexia and dysgraphia?
— The most popular dysgraphia is a violation of language analysis and synthesis and acoustic problems. Not the least negative role here is played by the phonemic teaching method, which has been chosen as the basis for the study of literacy in the last 20-30 years.
Children skip letters and syllables and replace sounds that are similar in sound. Many authors believe that children have impaired phonemic hearing. But there cannot be a total violation. With this logic, hearing-impaired children would never learn to read and write.
With dyslexia, in addition to the main symptoms of the disorder (analysis and synthesis, phonemic hearing), the most common problem is the speed and method of reading. Even if children do not make mistakes, but read slowly and syllable by syllable, “guessing” the endings of words and phrases, this is a dyslexic disorder.
Risk areas
— How can parents detect a problem before the teacher points it out?
— There are so-called risk groups: children with perinatal and natal pathologies, children with delays in speech development, with mental retardation, with a pronounced delay in the formation of graphic skills, bilingual children, retrained left-handers.
What should parents do? If a child has a speech delay before school, then it needs to be corrected, or, if this is not possible, then minimized. Do not teach children to read too early, because they have not developed selective attention, without which reading and writing are impossible, and also their arbitrariness, memory and speech have not been formed.
Memory problems are the result of very early learning, because a system of inadequate demands is created.
The involvement of new brain structures in the organization of attention begins only at 6-8 years, when the frontal lobes actively begin to mature and effective visual differentiation begins to form. If a child begins to read early, then he develops an inadequate reading mechanism, in which several letters are perceived and the gaze runs away, and then returns many times. A so-called “guessing reading” is formed.
When a problem is discovered, you need to go to specialists: a neurologist, psychologist and speech therapist. They will offer medication support, methods and methods of correction, and advise modern rehabilitation methods.
— Are dyslexia and dysgraphia corrected, or will the child simply have to adapt and somehow get around the difficulties that arise when reading and writing?
— If dyslexia or dysgraphia is an independent disorder, without combined problems and secondary disorders in the form of persistent speech problems or cognitive difficulties, then they are perfectly amenable to correction. It's important to start on time.
In my practice, there was a child who had speech problems before school, they were corrected, and in elementary school he coped with the program, doing especially well in mathematics. But by middle school, due to the complexity of the dictionary and the increase in the volume of assignments, serious problems began, and a persistent dislike for the subject “Russian language” formed.
Difficulties manifested themselves in the following cases: when selecting test words; when mastering morphemic analysis of words; when differentiating prefixes and prepositions; when isolating and differentiating according to the meaning of word-forming and formative morphemes. When we achieved success in the process of correctional classes, the child came to the conclusion that the Russian language is not so difficult, and his grades improved.
But there are also those who simply adapt, avoiding writing in every possible way.
