Speech therapy massage with probes: indications, preparation and implementation

Indications for testing

Severe speech disorders are often accompanied by problems with the nervous system. With dysarthria, the parts of the brain responsible for the innervation of muscles are affected. With this pathology, children cannot switch articulatory postures or feel subtle movements of the tongue and lips.

The leading defect is a violation of the phonemic aspect. Child says:

indistinct;
distorting sounds;
unimpressive.

Vocabulary and grammar do not always suffer. When pronouncing a sound, the tongue deviates to the side or is limited in its movements. The tip protrudes between the teeth, that is, interdental pronunciation appears.

In case of severe disorders, asymmetry of the lips and a tense, balled tongue are noticeable (or it may be sluggish and relaxed). The erased form of dysarthria is difficult to determine, since only the pronunciation of 1-2 groups of sounds suffers.

Without probe massage it will not be possible to correct any form of dysarthria. Without it, producing sounds will take several years, and in most cases the result will be zero.

The use of massage probes to correct dyslalia is controversial. If there is a violation, only the pronunciation side of speech suffers. Massage strengthens the muscles of the articulatory apparatus, prepares them, and speeds up sound production. Some speech therapists are of the opinion that this is unnecessary.

With dyslalia, the hyoid ligament may be shortened. It limits the mobility of the tongue, a number of sounds are disrupted (sonoras, hissing). It is advisable to surgically trim it, but not all parents agree to this. Therefore, the frenulum is stretched with a probe; with a mild degree of the defect, its elasticity can be significantly improved.

Speech therapy probe massage is prescribed for alalia. With this problem, certain areas of the cerebral cortex are affected. The child has normal physical hearing, but at 4 years old he does not speak. In the motor form, the baby understands spoken speech, but uses gestures himself.

Massage stimulates the flow of signals into the brain, which promotes the development of the affected areas. After the course of treatment, onomatopoeia appears.

The cause of rhinolalia is defects in the structure of the speech apparatus (cleft lip, gums, palate). After the operation, scars remain that interfere with the mobility of organs. Probes are used to knead the seams and stimulate muscle function.

Dyakova recommends probe massage to correct stuttering. The defect is based on seizures of various origins. Due to muscle tension, it is difficult for a person to say something. Massage is used for relaxation.

General recommendations for conducting

The duration of the course is calculated individually. On average, 10 procedures performed every other day are sufficient. Between cycles there is a break of a month. Some speech therapists prefer to include massage before each session.

The duration of the procedure depends on:

from age;
degree of defect;
personal characteristics.

The minimum time is 5 minutes, the maximum is 25. The impact should not cause pain, slight discomfort is allowed. Children may be afraid of probes because they resemble medical instruments. You can let them touch them, play with them, or have a session with toys.

In case of negativism, hysterics, aggression, the first sessions are kept as short as possible. Start by stroking the lips, cheeks, and tip of the tongue. With a pronounced gag reflex, the effect begins with a light one, gradually moving deeper into the mouth.

Massage sessions are carried out in a well-ventilated area. It should be warm, bright, cozy.

Probe kit

Speech therapy probes for producing sounds (authored by Rau) are not suitable for massage. A special set was developed by E. V. Novikova. It includes 8 main probes plus 4 additional ones. A patent for the development was received in 2000.

Probes are used to work with articulatory organs and the forearm. Stimulating the muscles of the dominant hand improves motor skills and promotes handwriting development.

The first tool is a fork , which looks like two blunt needles slightly apart to the side. A slight tingling sensation has an activating effect.

The second instrument is the eight . At the end there is a round loop that “grinds” the muscles.

The third, fourth, fifth tools are “sleighs” of different sizes. The shape of the probes resembles the rounded runners of a sled, hence the name. You can work with either side of the tool.

The sixth tool is a hatchet , which looks like two tightly pressed loops. Used for pressing on the surface of organs, sliding. Normalizes tone and increases muscle mobility.

The seventh is a cross, the loops are rounded and intersecting . It is used to stimulate the muscles of the tongue and develop its elevation.

The eighth tool is a pusher , a small loop raised at a right angle to the probe handle. Allows you to stimulate mobility and elasticity of muscles. When you press on the tongue, it creates tension; after the pressure is removed, the organ relaxes.

The ninth tool (additional) - tweezers , looks like two large rounded loops located parallel to each other. It is convenient to take the tongue with a probe and gently move it.

The tenth tool is a pull-up tool that looks like a low, wide frame. Used to stretch the frenulum.

The eleventh tool is a swan , a small loop, bent at the base, after which there is a small vertical section of the probe, which is bent at a right angle to the probe handle. Massages the palate, eliminates salivation.

The twelfth is sliding, looks like an elongated triangle with round corners. Used for sliding movements.

Some authors made their own adjustments to the set of massage probes. Vorobyova together with Krupenchuk created the author's set. It consists of 9 instruments. The creation of probes with different coils with small edges can be considered an innovation. This tingling sensation can effectively stimulate the nervous system.

Types of probes

The author of the probes used by most speech therapists and the probe massage system is Elena Novikova. According to her methodology, 11 main types of probes are distinguished:

Probe name	Appearance	Massage areas	Functions	Necessary techniques
1.Fork	fork with two curved points	Tongue (I), soft palate (MN), lips (G), cheeks (CH), cheekbones (C)	promotes intense muscle contraction,	Tingling, tingling with pumping
2.Eight	number "8" or symbol of infinity	I, S, Sh, G	drowns the muscles, makes them work actively, setting the sound “R”	Rubbing movements in place along and across
3,4,5.Sleds (large, medium, small)	resemble a sleigh	I, S, MN, G, SH	stretching the frenulum under the tongue, relaxing and activating muscles	Sliding movements in different directions
6.Hatchet	looks like a razor	mostly language	normalizes muscle tone, increases mobility and muscle contractility	Chopping with firm pressure (frequent, small intervals), sliding movement like a “shaving”
7. Cross	cross with smoothed edges, perpendicular to the handle	I, S, Sh, G	pumping of the tongue muscles, production of the sounds K, G, X, R, Sh, Zh, Shch, Ch, Zh	Scrolling, pressing, pressing the tongue to the root, pushing back with the tongue
8.Pusher	ring perpendicular to the handle	I, MN, SH, G, S	muscle activation and relaxation	Pressing, scrolling, “Spring” exercise with the tongue (to the root)
9.Pliers	2 adjacent, collapsible teardrop-shaped frames on the handles	I, Ш (inside, outside), G, S	warm-up, muscle activation	Bending, turning, rolling of tongue, cheeks
10. Swan	loop on a curved leg	MN, SH, S	the most convenient probe for massaging the soft palate	Pressing, scrolling
11. Bridle	Bridle, horseshoe	hypoglossal ligament	Checking the condition and tightening the hypoglossal ligament	Pull the tongue upward

Most of the devices are used to warm up, stimulate and relax the tongue muscles. Many probes are interchangeable; usually 5-6 tools are enough for massage. In addition to the main probes, speech therapists often use the following types:

staged (narrow elongated loop) - to form a groove when pronouncing whistling sounds;
Koritsky spatula (an oval frame extended to its full length) - for massaging the side edges, as well as the lower part of the tongue, making hissing sounds and “P”;
spatula - for stroking, tapping, passive gymnastics;
ball – for performing various exercises (rolling, spinning a ball), making the sound “P”;
hedgehog (roller with convexities) - for massaging the lips, lingual, zygomatic, chewing muscles with muscle hypotonicity and paresis of the articulatory apparatus.

Advantages and disadvantages of the technique

Probe massage allows you to speed up the production of sounds, facilitate the assimilation of articulatory gymnastics, and improve muscle function. Without it, correction of dysarthria will take 5-10 years.

It does not require special conditions, since it can be done by any speech therapist with the appropriate qualifications. In many correctional institutions, it is carried out by specialists as needed.

Massage helps relieve tone, hypersalivation, and improve fine motor skills.

It also has disadvantages. The significance and value of massage is overestimated - it is an auxiliary tool, not a panacea. Low-qualified speech therapists provide probe massage as a cure for all problems. In fact, the impact only provides the basis for producing sounds, which does not cancel the remaining stages of the work.

If used incorrectly, tools cause negativity in the child, since if they are not understood, they can cause serious harm. Some specialists act rudely and incorrectly, which leads to pain and the child’s refusal to study.

Article "Elements of speech therapy massage using probe substitutes."

Speech therapy massage using probe substitutes is recommended to be used in the structure of the lesson for the productive implementation of articulation gymnastics, reducing the amount of work when producing sounds, which leads to improving the quality of speech therapy care.

A probe substitute is an individual instrument for each child.

Development of lip strength and tongue massage with a giraffe probe substitute:

The child makes a tube with his lips. The adult places the giraffe between the child's lip and nose. The child’s task is to hold the giraffe on his lip for as long as possible without letting it fall.

Massage the tip and back of the tongue: light trampling movements are performed with the head of the giraffe. Now let’s put all four legs of the giraffe on the tongue and walk on it.

Development of the strength of the lips and the tip of the tongue probe substitute "Palma"

We will place the ball part of the probe near the child’s lips and ask him to stretch them out to touch the ball.

Development of tongue mobility. The ball is held at some distance from the child’s mouth; to reach the ball you need to stretch your tongue up, to the sides and down.

Developing strength: If your child is unable to make his tongue narrow, encourage him to reach for the ball with his tongue extended forward.

Massage the back and tip of the tongue with a round probe substitute.

Place the round part of the probe substitute on the tongue and spread it out, making it wide.

Now we place the probe substitute vertically and perform rotational, screwing movements on the tip of the tongue. The ball at the end of the probe substitute is used to make circular, trampling movements.

Probe substitute "Oar"

The child is invited to play a game of who is stronger. To do this, an adult horizontally leans the working part of the oar against the tongue and presses on it. The child must push the paddle away without straining any other muscles.

Probe substitute “Twirler” Development of speech breathing and targeted air flow.

— Blowing from the lips, from the position of the lip like a donut.

- Blowing from the tongue. The tongue is spread out on the lower lip, a cool air stream passes through the center of the tongue, setting the spinner in motion.

Tongue massage. Probe substitute "Temper"

The child sticks out his wide tongue and the head of the tempera rests completely on it. You can perform rotational movements and pushing.

Light tongue massage. Probe substitute “Palm”:

Stroking, spanking, vibration.

Probe substitute “flamingo, palm tree”

Used in cheek massage. Using patting movements we move along the massage lines. The “chopping” technique is used on the side.

Massage with ice cream sticks.

The child sticks out his wide tongue. The sticks are located above and below the tongue. Their edges on the left and right are alternately compressed, massaging the tongue. By applying the influence of two sticks from above and below, you can stretch, lift, and bend the tongue upward into a cup.

Bite the stick horizontally with your teeth and place your tongue on the stick. This technique provides an understanding of the position of the tongue for hissing sounds, guaranteeing the correct pronunciation of sounds with mechanical assistance.

Tongue massage

Contraindications

Massage courses are prescribed by a neurologist after a complete examination. It should not be used for epilepsy of various forms, as it can provoke seizures.

Temporary withdrawal is given for any infectious or somatic diseases. Probe massage should not be performed for stomatitis, caries, gingivitis, or skin diseases. Herpes and oral infections also serve as a medical outlet for procedures.

It should not be done if there is strong pulsation of the arteries, high blood pressure, or poor physical well-being.

If you have nausea, vomiting, or fatigue, you cannot conduct a session; it is better to reschedule it for another time. A speech therapist examines each child before performing a massage.

Tool processing

Each set of tools is used once. Afterwards, it is soaked in a disinfectant solution, without removing it from it, and treated with cotton swabs for 30 seconds.

Then the instruments are washed under running water using such products as “Progress”, “Biolot”, “Astra”. Do this for 10 minutes.

The probes are washed in distilled water for 30 seconds. Finally, it is dried in a dry oven.

This is a standard method for sterilizing medical instruments. You cannot neglect it, as this is a violation of the law. Children may have various diseases; in the event of mass infection, there will be serious checks and investigations.

Processing and storage of speech therapy probes

It should be noted right away that there are no instructions that would regulate the process of processing speech therapy probes. We have developed this instruction based on instructional and methodological documents regulating disinfection and sterilization activities in dental institutions:

1. OST 42-21-2-85 “Sterilization and disinfection of medical devices. Methods, means, modes";

2. Order of the USSR Ministry of Health dated July 12, 1989 No. 408 “On measures to reduce the incidence of viral hepatitis in the country”;

3. Order of the USSR Ministry of Health dated September 3, 1991 No. 254 “On the development of disinfection in the country”;

4. Order of the Ministry of Health of Russia dated August 18, 1997 No. 170 “On measures to improve the prevention and treatment of HIV infection in the Russian Federation”;

5. Guidelines for disinfection, pre-sterilization cleaning and sterilization of medical devices (MU-287-113 dated December 30, 1998), approved by the Department of State Sanitary and Epidemiological Monitoring of the Ministry of Health of Russia;

6. “Concept for the prevention of nosocomial infections”, approved by the Deputy Minister of Health of the Russian Federation G.A. Onishchenko. 06.12.1999;

7. Guide “Use of ultraviolet bactericidal radiation for disinfection of air and surfaces in premises” (R 3.1.683-98, approved by the Ministry of Health of the Russian Federation);

8. Sanitary and epidemiological rules SP 3.5.1378-03 “Sanitary and epidemiological requirements for the organization and implementation of disinfection activities”;

9. Sanitary and epidemiological rules SP 1.1.1058-01 “Organization and conduct of production control over compliance with sanitary rules and implementation of sanitary and anti-epidemic (preventive) measures”;

10. Guidelines MUK 4.2.1035-01 dated May 23, 2001 “Control methods. Biological and microbiological factors. Control of disinfection chambers";

11. Manual “Organization of disinfection and sterilization regimes in dental institutions, offices” (L.A. Ponomareva, Moscow Disinfection Station No. 7, 1998);

12. Methodological recommendations “On the organization and implementation of anti-epidemic measures in dental service institutions” (candidate of medical sciences P.S. Oparin, Irkutsk disinfection station, Siberia-Vostok magazine, April 2000);

13. Methodological letter of the Central State Medical University in Moscow dated March 21, 1995, No. 12/20/-208 “Organization of sanitary-hygienic and disinfection-sterilization regimes in dental institutions”;

14. A manual on the use of disinfection and sterilization means in health care facilities and the organization of disinfection and sterilization regimes in the departments of endoscopy and dentistry. Moscow, 1998.

Immediately after using speech therapy probes, they must be washed with detergent under running water, then pre-sterilization treatment of the instrument is carried out. For this process, special baths and trays are used that are easy to clean and safe to use.

Soaking of probes in a washing solution is carried out by completely immersing the product in the working solution for 30 - 60 minutes, depending on the product used.

If the product, along with detergents, also has disinfecting properties, pre-sterilization cleaning can be combined with disinfection (“Alaminol” (SSC RF NIOPIK, Russia) 5.0% or 8% - 60 minutes, “Veltolen” (AOZT Velt, Russia) 2.5% - 60 minutes, "Deconex Dental BB" (Bohrer Chemi AG, Switzerland) - 30 minutes, "ID-212" (Dürr Dental-Orohim, Germany) 4% - 30-60 minutes, etc.) .

New means for pre-sterilization cleaning of speech therapy probes. Carefully read the instructions for preparing the working solution and exposing the instrument in the solution!

Alaminol (NIO-LIK, Russia), Vapusan-2000 (Nautimex Industry, Sweden), Veltolen (ZAO WELT, Russia), Virkon (KRKL, Slovenia), Dezeffekt (Sanifect-128) ( LiquaTech Industries Inc., USA), Septabik (Abik, Israel), Septodor-Forte (Dorvet Ltd., Israel), Lizafin (Petrospirt CJSC, Russia) - pre-sterilization cleaning of medical products (incl. combined in one process), disinfection of room surfaces, furniture, medical equipment, dishes, linen, plumbing equipment, cleaning equipment.

Deconex 50 FF (Bohrer Chemie AG, Switzerland), Deconex Dental BB (Borsr Chemie AG, Switzerland), Dulbac DTB/L (PFC Pettens-Chemistry, France), Lisetol LF (Schülke and Mayr GmbH) , Germany), Grotanat Borerbad (Schülke and Mayr GmbH, Germany), ID-212 (Dürr-Dengal-Orohim, Germany) - disinfection and pre-sterilization cleaning of medical devices (combined in one process).

Bromosept 50 (Abik, Israel), Nika-extra M (PKF Genix, Russia), Septodor (Dorvet Ltd, Israel) - pre-sterilization cleaning of medical products, disinfection of room surfaces, linen, dishes, care items, plumbing equipment.

Blanisol (JSC Petrospirt, Russia), Vex-Side (Wexford Labs. Inc., USA), Erinox (Orion Corporation NOIRO, Finland) - pre-sterilization cleaning of medical products, including rotating instruments. After washing the speech therapy probes with running water, you can proceed to the next stage: sterilization. The most accessible method of sterilization is boiling probes in distilled water.

Method 1 Hot processing

Sterilization by boiling is usually carried out in a sterilizer - a rectangular metal box with a tight-fitting lid. Speech therapy probes are placed on the mesh in the sterilizer and filled with distilled water. To increase the boiling point and eliminate water hardness, add 1-2% sodium bicarbonate (if tap water).

The sterilizer is closed with a lid and heated. The beginning of sterilization is considered to be the moment the water boils; the boiling time is 15-30 minutes. At the end of sterilization, the mesh with instruments is removed by the side handles with special hooks, and the instruments in it are taken with sterile tweezers or forceps, which are boiled along with the rest of the instruments.

If you work in a medical institution where it is possible to sterilize in an autoclave, then most likely the process of sterilizing your instrument will be carried out by a nurse specially trained for this. Steam sterilization under pressure is carried out in an autoclave. This sterilization method is based on exposing the materials being sterilized to saturated water vapor at a pressure above atmospheric. As a result of such sterilization, both vegetative and spore forms of microorganisms die with a single treatment. It must be said that the plastic balls on the probes for sound P do not withstand autoclaving and often crack during prolonged boiling. Probes made of food-grade plastic are not subject to heat treatment and can only be used as a child’s individual instrument.

Probes treated in this way are sterile and ready for use. It is recommended to store sterile probes in a UV bactericidal chamber. The chamber is designed for storing pre-sterilized medical instruments in order to prevent their secondary contamination by microorganisms. ATTENTION! The chamber is not intended for sterilization and disinfection of instruments! The chamber ensures that speech therapy probes are always ready for use during their long-term (up to 7 days) storage. The camera is placed in the speech therapy room in the work area.

Processing and storage of speech therapy probes

After washing the speech therapy probes with running water, you can proceed to the next stage: sterilization. Soak the probes in a 6% hydrogen peroxide solution. Exposure - 6 hours. If the solution is heated to 40-50 degrees (do not boil!), then the exposure can be reduced to 3 hours. After sterilization, rinse. The probe is ready for reuse. This method can be recommended for processing any probes and probe substitutes (both metal and plastic).

Please note that these instructions are not an official document on the processing of speech therapy probes. We recommend using a set of individual speech therapy tools for each child. Teach parents to sterilize speech therapy tubes daily and store them properly.

Never tell SES employees that you are using a non-disposable tool. Don't show them speech therapy probes. Purchase tools for use only with a hygienic certificate. Keep your instrument perfectly clean!

You can purchase speech therapy probes and other products in our online store “Everything for a speech therapist.”

Carrying out at home

Massage has a serious impact on the body. The person who does it must have an appropriate medical education and constantly improve his qualifications. Speech therapists can only do speech therapy massage, both probe and manual.

You should not try to do it yourself. Before the start of the course, the specialist examines the child, examines the articulation organs, determines the tone, and compiles a selection of exercises. A full set of probes is not always needed; often 4-5 are enough.

It is easier for children to tolerate the procedure in another room. Psychologically, it is easier for them to endure discomfort for a while.

The degree of impact of the instruments is chosen by a specialist. Basic techniques:

pressure;
slip;
compression;
trituration.

The choice of technique is made by a speech therapist. It will be difficult for a parent without special knowledge to choose one. Probe massage can cause harm - tearing the frenulum, causing hypertonicity, strengthening the gag reflex, etc.

Alaminol-preparation for disinfection of speech therapy probes and instruments, concentrated (1 l)

Directions for use: to disinfect speech therapy instruments, dilute the concentrate at a rate of 1:20 with water. Speech therapy probes and instruments - place in the prepared solution until completely immersed for 30 minutes. If the instrument has hidden holes, etc. Take the Alaminol solution into a medical syringe and pour the drug under pressure into the hidden cavities, displacing all the air from them. After disinfecting the speech therapy instrument , rinse the instrument with boiled water and wipe dry with a disposable towel.

The “soaking” box is a convenient equipment for disinfecting speech therapy probes by immersing them in an antiseptic solution. The design of this box is made in such a way that the hands of the speech therapist do not come into contact with the solution. When the box is opened, the bath with probes rises on a “microlift” from the solution. Suitable for any length of speech therapy probes

Quartz sterilizer for speech therapy instruments. The principle of operation is based on the antibactericidal effect of UV radiation. The UV light source is a quartz lamp with a power of 9 watts. The device is stationary and is used for professional activities. Speech therapy probes are placed in a container. The device will be connected to the 220V network. Has a built-in shutdown timer. Sterilization time - 30 minutes. The dimensions of the tray for sterilization are 19.5 cm x 10.5 cm. The depth of the tray is 3 cm. The tray has a mirror bottom - there is no need to turn the instruments over.

Thermal sterilizer for speech therapy instruments Microstop (Italy) - with quartz balls. This sterilizer is distinguished by exceptional build quality, European reliability and guaranteed sterilization of speech therapy instruments. Sterilization temperature 250 degrees, sterilization time 5-10 seconds. Only the working surface of the probes is sterilized by placing it in hot quartz balls. Attention! Do not use instruments containing plastic balls or parts for sterilization! Heating time until ready is 30 minutes. The speech therapist's instrument is placed with its working parts in a container with heated quartz balls. Size(LxWxH): 16x16x17.

The cheapest way to process massager attachments, which I use in my practice on the advice of A. Mamonov: cut off the “fingers” from a disposable medical latex glove that can be put on the attachment, do a massage and throw it away.

We can conclude that whatever processing method you choose,