Psychological and pedagogical classification of speech development disorders. Problems of further improvement of the classification of speech disorders.

Speech disorders are varied in nature and depend on the degree of their manifestation, on the localization of the impaired function, on the duration of the pathology, on the presence of secondary disorders that appear under the influence of the primary defect. Speech therapy diagnostics involves studying the problem of speech development not only by pediatricians and speech therapists, but also by psychologists, speech pathologists, and specialized medical specialists. Neurologists, psychiatrists, otorhinolaryngologists and audiologists study the causes and manifestations of defects. This explains the difference in approaches to the typology of speech disorders and the difficulties of interdisciplinary interaction between specialists. To date, the scientific community has not developed a unified classification of speech disorders in children.

Currently, the following classification is generally accepted: 1) clinical-pedagogical and 2) psychological-pedagogical . Both clearly demonstrate the appropriate approach to the problems of speech therapy disorders and to the selection of adequate correction techniques.

It is necessary to distinguish speech pathology itself from other underdevelopment caused by age-related or purely individual developmental characteristics, or unfavorable environmental conditions (speech defects of close relatives, bilingualism in the family, insufficient literacy, low social status of parents). In this case, we are talking about pedagogical neglect, which is made up for by other non-speech therapy methods and techniques.

Clinical and pedagogical classification

Since speech defects have been the subject of study in medical and biological disciplines for a long historical period, it is natural that the first classifications had a clinical and etiopathogenetic basis.

Goal: clear detailing of the types of disorders, taking into account the interstructural influence of speech defects with their underlying causes and resulting mechanisms, including those of a natal and prenatal nature. It is based on a number of psychological, linguistic, medical, clinical and etiopathogenetic factors that have a complex impact. All types of speech impairments are divided into two groups: disorders of oral and written speech (clickable diagram).

A completely different view on the systematization of children’s deviations in the development of speech activity was proposed by R.E. Levina. Her views marked the beginning of speech therapy for children, which later developed into a full-fledged scientific direction with its own object of study.

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Classification of speech disorders in children

In recent years, advances in the field of pediatrics, psychiatry, pathopsychology, psycholinguistics, in a number of other medical and psychological-pedagogical disciplines, as well as in speech therapy itself, have forced specialists to reconsider traditional views on the classification of speech disorders. Currently, in speech therapy there are two classifications of speech disorders - clinical-pedagogical and psychological-pedagogical (pedagogical). There are no contradictions between these classifications - they seem to complement each other and reflect a certain approach to a specific speech disorder and the choice of appropriate means of its correction. These classifications have been developed primarily in relation to primary speech impairment in children, that is, in relation to children who do not have hearing or intellectual impairments.

The positive thing about the clinical-pedagogical classification is that it is based on features that maximally differentiate the types of speech disorders, allowing the speech therapist, based on an integrated approach, to qualify a speech defect in various forms of abnormal development and carry out speech therapy intervention with

maximum consideration of the child’s individual characteristics. In turn, the principles that form the basis of the psychological and pedagogical classification will help in organizing speech therapy work for different forms of anomalies, but with common manifestations of speech defects.

In the clinical-pedagogical classification, in contrast to the purely clinical one, the identified types of speech disorders are not strictly tied to one or another form of the disease. The leading role is given to psycholinguistic criteria. Based on them, the picture of a speech disorder is described in terms and concepts that help the speech therapist to focus on those features of the speech disorder that should be the object of speech therapy intervention.

All types of speech disorders considered in the clinical and pedagogical classification can be divided into two large groups: oral speech disorders and written speech disorders.

Oral speech disorders

in turn, can be divided into two types: 1) violations of the phonation (external) design of the pronunciation side of speech and 2) structural-semantic (internal) systemic or polymorphic speech disorders.

Phonation (from Greek - sound, voice; phonation - voice formation) speech disorders are differentiated depending on the damage to one or another link: a) voice formation, b) tempo-rhythmic organization of the utterance, c) intonation-melodic, d) sound pronunciation. These disorders can be observed in isolation and in various combinations. Depending on this, the following types of violations are distinguished, for which traditionally established terms are used:

Dysphonia (aphonia) (from the Greek (Iz - a prefix denoting a disorder, and a voice; a - a particle denoting negation) - the absence or disorder of phonation due to pathological changes in the vocal apparatus. (Synonyms: voice disorder, phonation disorder, phonatory disorders, vocal disorders.) Manifests itself either in the absence of phonation (aphonia), or in a violation of the strength, pitch and timbre of the voice (dysphonia). It can be caused by organic or functional disorders of the voice-forming mechanism of a central or peripheral nature and occurs at any stage of the child’s development. The disorder can be independent (isolated) or be part of a number of other speech disorders.

Bradylalia (from Greek - slow and Lat. - speech) is a pathologically slow rate of speech. (Synonym: bradyphrasia.) Manifests itself in slow articulation caused by disturbances of the speech centers in the cerebral cortex. May be organic or functional in nature.

Tahilalia (from

Greek - fast, lat. - speech - rate of speech. (Synonym: tachyphrasy.) Manifests itself in accelerated articulation. Is centrally determined, organic or functional in nature. At a slow pace, speech turns out to be drawn out, sluggish, monotonous, at an accelerated pace - hasty, impetuous, assertive. Accelerated speech may be accompanied by agrammatisms. These phenomena are sometimes identified as independent disorders - battarism (from the French - to beat, hit), paraphrase. In cases where pathologically accelerated speech is accompanied by unreasonable pauses, hesitations, and stumbling, it is designated by the term “poltern.” Bradylalia and tachylalia are combined under the common name - impaired speech tempo. The consequence of a violation of the tempo of speech is a violation of the smoothness of the speech process, rhythm and melodic-intonation expressiveness.

Stuttering is a violation of the tempo-rhythmic aspect of speech, caused by the convulsive state of the muscles of the speech apparatus. (Synonym: logoneurosis.) It is centrally conditioned, has an organic or functional nature, occurs most often during the child’s speech development during the transition to phrasal speech and is associated with a sharp emotional negative reaction of the child to any external stimulus. Insufficient stability of the nervous system, sometimes associated with organic brain damage, contributes to the occurrence of stuttering. The cause of disturbances in the tempo-rhythmic aspect of speech during stuttering is convulsions of various parts of the peripheral speech apparatus - respiratory, vocal, articulatory. Stuttering in itself, as a rule, does not lead to a violation of the semantic aspect of speech, but can often be associated with other speech and intellectual defects.

Dyslalia (from Greek - a prefix denoting a disorder, and Lat. - speech) is a violation of sound pronunciation with normal hearing and intact innervation of the speech apparatus. (Synonyms: tongue-tied (obsolete), sound pronunciation defects, phonetic defects, phoneme pronunciation defects.) Manifests itself in incorrect sound (phonemic) design of speech: distorted pronunciation of sounds, replacement of sounds or their confusion. The defect may be due to the fact that the child has an incompletely or incorrectly formed articulatory base (the set of articulatory positions necessary to pronounce sounds). It is traditionally accepted to distinguish between mechanical dyslalia, associated with anatomical defects of the articulatory apparatus, and functional, the causes of which lie in unfavorable conditions for speech development or in phonemic hearing disorders.

Rhinolalia (from Greek - nose, Latin - speech) is a violation of voice timbre and sound pronunciation caused by anatomical and physiological defects of the speech apparatus. (Synonyms: nasality (obsolete), palatolalia.) Manifests itself in a pathological change in voice timbre and distorted sound pronunciation due to disruption of the normal participation of the nasal cavity (nasal resonator) in voice formation. Through the cleft in the soft and hard palate, the air stream during sound formation passes not only through the mouth, but also through the nasal cavity. In this case, all speech sounds become excessively nasalized (nasal), and speech is poorly intelligible and monotonous. This form of rhinolalia is usually called open, in contrast to closed rhinolalia, which manifests itself when the normal patency of the nasal cavity is disrupted due to adenoids, tumors of the nasopharynx, deviated nasal septum, and chronic inflammatory processes of the nasopharynx. With closed rhinolalia, the nasal resonator is completely or partially excluded from the sound production process and the voice in this case loses a number of overtones, sounds dull, and the nasal sounds “m” and “n” sound distorted.

Dysarthria (from the Greek - a prefix denoting a disorder - articulation) is a violation of the pronunciation side of speech, caused by an organic insufficiency of innervation of the speech apparatus. (Synonyms: tongue-tied (obsolete), slurred speech.) With dysarthria, there is an immaturity of all parts of the sound pronunciation mechanism, which results in vocal and articulatory-phonetic defects. In severe dysarthria (anarthria), the pronunciation side of speech is completely absent. In mild cases, when the defect manifests itself primarily in articulatory-phonetic disorders, they speak of an erased form of dysarthria. In this case, it should be differentiated from dyslalia (this can only be done by a speech therapist).

Dysarthria is a consequence of damage to the central nervous system in cerebral palsy, but it can also occur at any stage of a child’s development as a result of neuroinfections and other brain diseases.

Violations of the structural-semantic (internal) design of a statement are represented by two types of systemic disorders: alalia and aphasia.

Alalia (from Greek - a particle denoting negation, and Lat. - speech - absence or underdevelopment of speech due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of a child’s development. (Synonyms: dysphasia, early childhood aphasia, developmental aphasia, hearing-muteness (obsolete).) One of the most complex speech defects, in which selection and programming operations are disrupted at all stages of perception and reproduction of a speech utterance. The system of linguistic means (phonemic, grammatical, lexical) is not formed. The control of speech movements is impaired, which affects reproduction sound and syllabic composition of words.

Alalia occurs when the speech areas of the cerebral hemispheres (Broca's center and Wernicke's center) are damaged. In this regard, a distinction is made between motor and sensory alalia. With motor alalia, understanding of addressed everyday speech is largely preserved and the ability to produce speech is sharply impaired. With sensory alalia, the understanding of spoken speech is severely impaired.

Of great importance in the practice of speech therapy is the delimitation of alalia (as a primary defect) from secondary disorders of speech development in mental retardation and hearing impairment.

Aphasia (from Greek - denial and - speech) is a complete or partial loss of previously formed speech associated with local brain lesions: vascular disorders, inflammatory processes, traumatic brain injuries. (Synonyms: decay, loss of speech.) As a rule, speech impairment is classified as aphasia if it occurs after the age of three. In contrast to adult aphasia, childhood, or early, aphasia is distinguished.

Depending on the affected area, as with alalia, there are two main forms of aphasia - motor

and
sensory.
With motor aphasia, the motor speech center (Broca's center) is affected and, mainly, the expressive side of speech is disrupted, i.e. the child loses the ability to speak, or the ability to pronounce only individual words and short phrases is retained. With sensory aphasia, the sensitive (sensory) center of speech (Wernicke's center) is affected, which leads to a violation of the impressive side (understanding) of speech. The perception of non-speech sounds is usually not impaired.

Writing disorders

are divided into two groups depending on what type of disorder it is - productive (violation of the act of writing itself) or receptive (reading disorder).

1. Dyslexia (from the Greek - a prefix denoting a disorder, and - I read) is a reading disorder associated with damage or underdevelopment of certain areas of the cerebral cortex. It manifests itself in difficulty in recognizing and recognizing letters, in merging letters into syllables and syllables into words, which leads to a slow, often guessing nature of reading, incorrect reproduction of the sound form of a word, and incorrect understanding of even the simplest text. A severe degree of this disorder is alexia - a complete inability to master the skill of reading.

2. Dysgraphia (from the Greek - a prefix meaning disorder, and - I write) is a partial specific disorder of the writing process. It manifests itself in unstable optical-spatial images of letters, in distortions of the sound-syllable composition of the word and the structure of the sentence. Dysgraphia in children is usually based on underdevelopment of oral speech (except for optical form), in particular the inferiority of phonemic hearing, and pronunciation deficiencies that prevent mastery of the phonetic (sound) composition of a word. The most severe degree of this disorder - agraphia - is a complete inability to master the skill of writing.

Psychological and pedagogical classification

arose in connection with the need for speech therapy intervention in the conditions of working with a group of children (group, class). To do this, it was necessary to find common manifestations of speech defects in various forms of abnormal speech development in children. This approach requires constructing a classification based on linguistic and psychological criteria, among which the structural components of the speech system (sound aspect, grammatical structure, vocabulary), functional aspects of speech, and the ratio of types of speech activity (oral and written) are taken into account.

Speech disorders in this classification are divided into two groups.

The first group is a violation of the means of communication (phonetic-phonemic underdevelopment and general underdevelopment of speech).

Phonetic-phonemic underdevelopment of speech is a violation of the processes of formation of the pronunciation system of the native language

children with various speech disorders due to defects in the perception and pronunciation of phonemes.

its sound and semantics is impaired.

side. Common signs include: late onset of speech development, poor vocabulary, agrammatisms, pronunciation defects, and phoneme formation defects. This underdevelopment can be expressed to varying degrees, from the absence of speech or its babbling state (alalia) to extensive speech, but with elements of phonemic and lexico-grammatical underdevelopment (dyslalia). Depending on the degree of formation of speech means in a child, general speech underdevelopment is divided into three levels.

The second group is violations in the use of means of communication,

which includes stuttering, which is considered as a violation of the communicative function of speech with correctly formed means of communication. A combined defect is also possible, in which stuttering is combined with general speech underdevelopment.

This classification does not distinguish writing and reading disorders as independent speech disorders. They are considered as part of phonetic-phonemic and general speech underdevelopment as their systemic, delayed consequences. This classification reflects consistent reliance on the principle of a systematic approach, which is based on the relationship of speech disorders as one of the mental processes with other aspects of the child’s psyche, the development of which is closely related to speech.

Main types of speech therapy assistance for children.

For children
with
severe speech impairments, there are schools and boarding schools where children aged 7-12 years with normal hearing and primary intact intelligence are accepted. Schools for children with severe speech impairments have two departments.

The first department admits children with severe general speech underdevelopment. First of all, children with alalia, aphasia, dysarthria, rhinolalia, as well as those with general speech underdevelopment in a milder form, but accompanied by stuttering, are enrolled. When enrolling in the first department, the level of speech development is taken into account, revealed as a result of an individual test of pronunciation, vocabulary, and proficiency in independent detailed (descriptive-narrative) speech; In previously trained children, the degree of proficiency in reading and writing skills is also revealed.

The second department accepts children suffering from severe stuttering with normal development of other components of speech.

Every year in our country the network of preschool institutions for children with speech disorders is increasing. These are kindergartens and nurseries with 24-hour and daytime (12-hour) stays for children. It is also allowed (if there is a sufficient contingent) to open preschool groups for children with speech impairments in kindergartens, nurseries, general preschool children's homes, and in boarding schools for children with severe speech impairments.

Currently, the network of speech therapy centers at public secondary schools is increasing, which will make it possible to identify and correct mild degrees of various speech pathologies at an early stage and cover a much larger contingent of children with speech therapy examinations.

Speech therapy assistance is also provided through the Ministry of Health of the USSR through a network of speech therapy rooms at children's psychoneurological clinics by speech therapists.

Questions

and
tasks
1. Describe the concept of speech disorder.

2. What is the principle of a systematic approach to speech disorders?

3. Name the levels of speech underdevelopment.

4. Define the clinical-psychological classification.

5. Name the types of speech disorders using the clinical and psychological classification.

6. Define the psychological and pedagogical classification and give examples of speech disorders according to this classification.

7. List the main types of speech therapy assistance in our country.

Literature

1. Speech therapy/Ed. L. S. Volkova. - M., 1989.

2. Fundamentals of the theory and practice of speech therapy / Ed. R. E. Levina. - M., 1968.

3. Pravdina O. V. Speech therapy. - M, 1973.

4. Speech disorders in children and adolescents / Ed. S. From Lyapidevsky.— M, 1969.

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Psychological and pedagogical classification

The approach has opened up tremendous opportunities for the introduction into practice of scientifically based frontal methods of correction of not only speech disorders and concomitant disorders of the mental function of children.

Goal: to identify the most adequate ways to help people with speech pathology. Speech therapy disorders with this approach are grouped according to the principle from particular to general. Classification involves relying on a number of linguistic and psychological factors, which take into account the structural components of the entire language system. Such components include articulatory motor skills, sound pronunciation processes, lexical and grammatical structure, coherent speech, as well as non-speech mental functions. The symptoms of the defect are determined by various types of speech underdevelopment in children. As a result, the levels of formation of individual components of the language system of a speech reader are grouped (the diagram is clickable).

The main focus is on the question of a new understanding of the underachievement of a child with speech pathology and in building an individual route to help this child from the position of knowing his characteristics within the framework of a general pedagogical approach.

Dysgraphia and dyslexia are not defined as independent defects, since they are included in the structure of FFND and ODD as their secondary manifestations. But, in practice, reading and writing defects most often act as an independent problem. In this case, monitoring and correction of dysgraphia occurs regardless of anamnestic data.

At the beginning of the article, a classification of speech disorders is given (table according to O.V. Pravdina).

Information for parents

More and more often, parents turn to a speech therapist because the child is already 2 or 3 years old, but he does not speak or speaks very little. Is there any reason to worry or should we just wait and everything will work itself out?

As you know, the timely development of speech in a child is the key to the development of his personality. Speech is formed in several stages.

Dynamics of speech formation.

It is known that the speech development of boys and girls differs. Girls usually begin to speak earlier than boys, and their vocabulary of words that denote objects quickly grows. Boys speak “their” language more often; unlike girls, they have a larger stock of words denoting actions.

If the child is physically developed, there are no neurological diseases, he repeats after you everything he hears, actively uses his speech, listens to his speech and tries to correct his mistakes himself, then there is nothing to worry about.

If there are any suspicions, it is important to know the reasons for speech underdevelopment.

The main reasons are:

• hypoxia (can develop if the mother had a heart defect, early toxicosis, anemia, umbilical cord pathology);
• birth injury;
• asphyxia;
• intrauterine infection or infection in the first weeks of the baby’s life;
• surgical operations up to 3 years;
• blood transfusion, blood problems in a newborn;
• impaired growth and development in the first year of life;
• “prolonged jaundice” (high levels of bilirubin negatively affect the brain, hearing, vision, and nervous system);
• hearing problems;
• mental retardation;
• traumatic brain injury; fell often; was seriously ill in the first years of his life;
• one of the relatives had mental illness or speech problems.

Delays in speech development can also be caused by improper parenting methods. These include such extremes as insufficient attention to the child and excessive care. In the second case, the child simply has no incentive to speak; he is already understood.

If the child is 2 years old, and he knows only a dozen babbling words, does not know how to construct phrases from 2-3 words, does not know how to show where a bunny, a tree, etc. is drawn in the picture.

If at 3 years old a child cannot follow 2 commands in a row (go to the kitchen, bring a cup), does not answer the questions “who?”, “where?”, cannot construct a sentence of 3-4 words, then you need to contact a specialist. The sooner they start working with the child, the faster the results will be.

The most effective period for speech correction is considered to be between 2.5 and 5 years of age, when speech function is actively developing. If you miss this period, then it will be more difficult and the child may have problems with school performance.

Experts pay special attention to the development of fine motor skills of the hands. At the fingertips there are active points associated with the speech centers of the brain. Classes with construction sets, mosaics, modeling from clay and plasticine will help here. Facial massage stimulates lazy articulatory muscles, and then even the most difficult sounds come easy. But still, the main thing is your communication with your baby, your personal example. You need to do more with your baby: talk, sing, recite rhymes, nursery rhymes, read books, play, imitate various sounds.

At the same time, you need to voice all your actions and the actions of the child, make sure that the child looks at you when you speak, introduce new words every day, repeat them often so that he remembers them faster. Tell your child what certain things are for, what can be done with them, and what cannot be done. During games, use simple commands such as “pick up the ball”, “throw the ball”. Under no circumstances force your child to repeat after you if he doesn’t want to, otherwise, over time, all the tasks that you set for him that require verbal actions from him will be ignored or rejected by him.