Speech therapy examination for OHP

General speech underdevelopment (GSD) is a violation of the formation of all aspects of speech (sound, lexico-grammatical, semantic) in various complex speech disorders in children with normal intelligence and full hearing. Manifestations of OHP depend on the level of immaturity of the components of the speech system and can vary from the complete absence of commonly used speech to the presence of coherent speech with residual elements of phonetic-phonemic and lexical-grammatical underdevelopment. OHP is identified during a special speech therapy examination. Correction of OHP involves the development of speech understanding, enrichment of vocabulary, formation of phrasal speech, grammatical structure of the language, full sound pronunciation, etc.

GSD (general speech underdevelopment) is the immaturity of the sound and semantic aspects of speech, expressed in gross or residual underdevelopment of lexical-grammatical, phonetic-phonemic processes and coherent speech. Among children with speech pathology, children with OSD make up the largest group - about 40%. Deep deficiencies in the development of oral speech in the future will inevitably lead to impaired written speech - dysgraphia and dyslexia.

In speech therapy, the terms “phonetic-phonemic underdevelopment” (FFN) and “general speech underdevelopment” (GSD) are used to designate the immaturity of certain structural components of the speech system in various speech disorders. ONR can be observed in the syndrome of dysarthria, rhinolalia, alalia, and aphasia.

OHP classification

According to the clinical composition, the category of children with OHP is heterogeneous, and therefore it is divided into 3 groups:

uncomplicated forms of OHP (in children with minimal brain dysfunction: insufficient regulation of muscle tone, motor differentiation, immaturity of the emotional-volitional sphere, etc.)
complicated forms of OHP (in children with neurological and psychopathic syndromes: cerebroasthenic, hypertensive-hydrocephalic, convulsive, hyperdynamic, etc.)
severe underdevelopment of speech (in children with organic lesions of the speech parts of the brain, for example, with motor alalia).

Taking into account the degree of OHP, 4 levels of speech development are distinguished:

Level 1 of speech development - “speechless children”; there is no common speech.
Level 2 of speech development – the initial elements of commonly used speech, characterized by a poor vocabulary and phenomena of agrammatism.
Level 3 of speech development – the appearance of expanded phrasal speech with underdevelopment of its sound and semantic aspects.
Level 4 of speech development – residual gaps in the development of phonetic-phonemic and lexical-grammatical aspects of speech.

A detailed description of the speech of children with special needs at various levels will be discussed below.

General speech underdevelopment (GSD)

General speech underdevelopment (GSD) is an independent or complex speech disorder in childhood, in which the formation of all components of the speech system is impaired (pronunciation difficulties, difficulties in the formation of lexical, grammatical, phonemic components) with intact hearing and intelligence.

Speech underdevelopment

The term “general speech underdevelopment (GSD)” is a speech therapy definition of speech quality, but not an independent diagnosis by a neurologist. The concept of OHP refers to the speech therapy classification. General speech underdevelopment may be accompanied by a systemic disorder (alalia, autism spectrum disorder, genetic syndromes)

Classification

According to the degree of severity, general speech underdevelopment is divided into four levels:

ONR level 1 - absence of commonly used speech: either a complete absence of speech, or the use of individual sounds and sound complexes in speech;
ONR level 2 - initial elements of common speech: poor vocabulary, pronunciation difficulties, agrammatic phenomena;
OHP level 3 - the appearance of expanded phrasal speech with its phonetic and lexico-grammatical underdevelopment;
OHP level 4 - speech is a full-fledged means of communication, but grammatical and phonetic difficulties remain.

Diagnosis and treatment

Delayed speech development in early childhood often develops into general speech underdevelopment. The diagnosis of OHP is made after 3 years. If OSD is a consequence of neurological disorders (complications during pregnancy and childbirth, consequences of injuries and past illnesses), working with a speech therapist is not enough to treat general speech underdevelopment.

The speech neurologist comes to the fore, who will determine the root cause of the disorder and will treat the cause, not the symptom. To build productive correctional work aimed at overcoming ODD, this diagnosis needs to be clarified and expanded. The neurologist gives the speech therapist an understanding of exactly what difficulties come to the fore. For example, in the case of severe dysarthria, which affects the general development of speech in a child, first of all, it is necessary to overcome the difficulties associated with the innervation of the speech apparatus, and in the case of sensory alalia, the primary task is the development of phonemic hearing.

Work with ODD of any level must be built in a comprehensive manner, so we always involve, at a minimum, a speech therapist, and in the case of ODD of levels I-II, also a neuropsychologist.

If necessary, a neurologist can prescribe medication, a course of massage, osteopathic treatment, or treatment using transcranial magnetic stimulation (TMS).

Characteristics of OHP

The history of children with OHP often reveals intrauterine hypoxia, Rh conflict, birth injuries, asphyxia; in early childhood – traumatic brain injuries, frequent infections, chronic diseases. An unfavorable speech environment, lack of attention and communication further inhibit the course of speech development.

All children with ODD are characterized by a late appearance of their first words - by 3-4, sometimes by 5 years. Speech activity of children is reduced; speech has incorrect sound and grammatical design and is difficult to understand. Due to defective speech activity, memory, attention, cognitive activity, and mental operations suffer. Children with OHP are characterized by insufficient development of motor coordination; general, fine and speech motor skills.

In children with level 1 ODD, phrase speech is not formed. In communication, children use babbling words, one-word sentences, supplemented by facial expressions and gestures, the meaning of which is incomprehensible outside the situation. The vocabulary of children with level 1 SLD is sharply limited; mainly includes individual sound complexes, onomatopoeia and some everyday words. With OHP level 1, impressive speech also suffers: children do not understand the meaning of many words and grammatical categories. There is a gross violation of the syllabic structure of the word: more often children reproduce only sound complexes consisting of one or two syllables. The articulation is unclear, the pronunciation of sounds is unstable, many of them are inaccessible for pronunciation. Phonemic processes in children with level 1 ODD are rudimentary: phonemic hearing is grossly impaired, and the task of phonemic analysis of a word is unclear and impossible for the child.

In the speech of children with level 2 OHP, along with babbling and gestures, simple sentences consisting of 2-3 words appear. However, the statements are poor and of the same type in content; express objects and actions more often. At level 2 OHP, there is a significant lag in the qualitative and quantitative composition of the vocabulary from the age norm: children do not know the meaning of many words, replacing them with similar meanings. The grammatical structure of speech is not formed: children do not use case forms correctly, experience difficulties in coordinating parts of speech, using singular and plural numbers, prepositions, etc. Children with level 2 OHP continue to have reduced pronunciation of words with simple and complex syllable structure , a confluence of consonants. Sound pronunciation is characterized by multiple distortions, substitutions and mixtures of sounds. Phonemic perception at level 2 OHP is characterized by severe insufficiency; Children are not ready for sound analysis and synthesis.

Children with level 3 SLD use extensive phrasal speech, but in speech they use mainly simple sentences, having difficulty constructing complex ones. Speech understanding is close to normal; difficulties arise in understanding and mastering complex grammatical forms (participial and adverbial phrases) and logical connections (spatial, temporal, cause-and-effect relationships). The volume of vocabulary in children with level 3 ODD increases significantly: children use almost all parts of speech in speech (to a greater extent - nouns and verbs, to a lesser extent - adjectives and adverbs); typically inaccurate use of object names. Children make mistakes in the use of prepositions, agreement of parts of speech, use of case endings and stresses. The sound content and syllabic structure of words suffers only in difficult cases. With level 3 OHP, sound pronunciation and phonemic perception are still impaired, but to a lesser extent.

At level 4 OHP, children experience specific difficulties in sound pronunciation and repetition of words with complex syllabic composition, have a low level of phonemic awareness, and make mistakes in word formation and inflection. The vocabulary of children with level 4 ODD is quite diverse, however, children do not always accurately know and understand the meaning of rare words, antonyms and synonyms, proverbs and sayings, etc. In independent speech, children with level 4 ODD experience difficulties in logical presentation of events, they often miss the main thing and get stuck on minor details, repeating what was said earlier.

Methodology for examining children with special needs.

General underdevelopment of speech (GSD ) is a variety of complex speech disorders in which the formation of all components of the speech system related to its sound and semantic side is impaired in children, while hearing and intelligence are devoured.

The speech therapist reveals:

• volume of speech skills,

• compares it with age standards,

• compares it with the level of mental development,

• determines the ratio of the defect and the compensatory background,

• determines the relationship between speech and cognitive activity.

It is necessary to analyze the interaction between the process of mastering the sound side of speech, the development of vocabulary and grammatical structure.

It is important to determine:

• the relationship between the development of a child’s expressive and impressive speech;

• identify the compensating role of preserved parts of speech ability;

• compare the level of development of linguistic means with their actual use in verbal communication.

There are three stages of the examination.

The first stage is indicative. The speech therapist fills out the child’s development chart from the parents’ words, studies the documentation, and talks with the child.

At the second stage, the components of the language system are examined and a speech therapy conclusion is made based on the data obtained.

At the third stage, the speech therapist conducts dynamic observation of the child during the learning process and clarifies the manifestations of the defect.

In a conversation with parents, the following is revealed:

• pre-speech reactions of the child, including humming, babbling (modulated).

• at what age did the first words appear and what is the quantitative ratio of words in passive and active speech.

• when two-word, multi-word sentences appeared,

• whether speech development was interrupted (if so, for what reason)

• what is the child’s speech activity, his sociability,

• desire to establish contacts with others,

• at what age did parents discover a delay in speech development,

• what is the speech environment (features of the natural speech environment).

During the conversation with the child, the speech therapist establishes contact with him and directs him to communicate.

The child is asked questions to help find out:

• his outlook,

• interests,

• attitude towards others,

• orientation in time and space.

Questions are asked in such a way that the answers are detailed and reasoning in nature.

The conversation provides the first information about the child’s speech and determines the direction for further in-depth examination of various aspects of speech. Particularly carefully examined:

• sound-syllable structure of words,

• grammatical structure and

• coherent speech.

When examining coherent speech, it turns out:

• how a child can independently compose a story based on a picture, a series of pictures, a retelling, a description story (by presentation).

Establishing the maturity of the grammatical structure of a language is one of the key aspects of a speech therapy examination of children with general speech underdevelopment.

Revealed:

• the correct use by children of the categories of gender, number, case of nouns,

• prepositional constructions,

• the ability to coordinate a noun with an adjective and numeral in gender, number, and case.

The survey materials are:

— pictures depicting objects and their signs and actions.

To identify the ability to use morphological forms of words, the following is checked:

- formation of the plural from singular nouns

- formation of a diminutive form of a noun from a given word,

- formation of verbs with shades of action.

Basic Techniques:

a) finish the started sentence based on leading questions;

b) make proposals for a picture or demonstration of actions;

c) insert the missing preposition or word in the correct case form.

When examining vocabulary, the child’s ability to correlate a word (as a sound complex) with the designated object, action, and use it correctly in speech is revealed.

Basic Techniques:

• finding (showing) children objects and actions named by the speech therapist (Show: who washes, who sweeps, etc.);

• performing the above actions (draw a house - paint the house);

• children’s independent naming of the shown objects, actions, phenomena, signs and qualities (Who is drawn in the picture? What is the boy doing? What is he making a ball from?);

• children’s naming of specific concepts included in some general theme (Tell me what kind of summer clothes, winter shoes you know);

• combining objects into a generalizing group (How can you call a fur coat, coat, dress, skirt in one word? etc.).

Examination of the structure of the articulatory apparatus and its motor skills is important for determining the causes of a defect in the sound side of a child’s speech and for planning corrective exercises.

The degree and quality of violations of the motor functions of the organs of articulation are assessed and the level of available movements is identified.

To examine sound pronunciation, syllables, words and sentences with the main groups of sounds of the Russian language are selected.

To identify the level of phonemic perception , the ability to memorize and reproduce a syllabic sequence, the child is asked to repeat combinations of 2-3-4 syllables. This includes syllables consisting of sounds that differ in articulation and acoustic characteristics (ba-pa-ba, yes-da-da, sa-sha-sa).

To determine the presence of a sound in a word, words are selected so that a given sound is in different positions (at the beginning, middle and end of the word), so that along with words that include a given sound, there are words without this sound and with mixed sounds. This will allow us to further establish the degree of mixing of both distant and close sounds.

To examine the syllabic structure and sound content, words with certain sounds, with different numbers and types of syllables are selected; words with a combination of consonants at the beginning, middle, and end of the word. Reflected and independent naming of pictures is offered: subject and plot.

If a child has difficulties in reproducing the syllabic structure of a word and its sound content, then it is proposed to repeat rows of syllables consisting of different vowels and consonants (pa-tu-ko); from different consonants, but identical vowel sounds (pa-ta-ka-ma, etc.); from different vowels, but also the same consonant sounds (pa-po-py, tuta-to); from the same vowels and consonant sounds, but with different stress (pa-pa-pa); tap out the rhythmic pattern of the word.

In this case, it becomes possible to set the boundaries of the accessible level from which corrective exercises should subsequently begin.

When examining gross and fine motor skills, the speech therapist pays attention to:

• general appearance of the child,

• his posture,

• gait,

• self-care skills (tying a bow, braiding a braid, fastening buttons, tying shoes, etc.),

• running features,

• performing exercises with the ball,

• long jumps for landing accuracy.

• The ability to maintain balance (standing on the left and right leg), alternate standing, switching movements (right hand to the shoulder, left hand to the back of the head, left hand to the waist, right hand to the back, etc.) is tested.

The accuracy of task reproduction is assessed based on spatio-temporal parameters, retention in memory of the components and sequence of elements of the action structure, and the presence of self-control when performing tasks.

The speech therapy conclusion is based on:

• on a comprehensive analysis of the results of studying the child,

• on a sufficiently large number of examples of children's speech

• on dynamic observation in the process of correctional and pedagogical work.

The speech therapy report reveals the state of speech and aims to overcome the child’s specific difficulties caused by the clinical form of the speech anomaly. This is necessary for the correct organization of an individual approach in frontal and especially in subgroup classes.

Periodization of OHP according to R.E. Levina.

GSD, general speech underdevelopment - various complex speech disorders in which the formation of all components of the speech system is impaired, i.e. the sound side (phonetics) and the semantic side (vocabulary, grammar).

The term OHP was first introduced in the 50-60s of the 20th century by the founder of preschool speech therapy in Russia R.E. Levina.

Causes of general speech underdevelopment

(ONR) are various adverse effects both in the prenatal period of development (intoxication, toxicosis) and during childbirth (birth trauma, asphyxia), as well as in the first years of the child’s life.

General underdevelopment of speech can be observed in complex forms of childhood speech pathology: alalia, aphasia (always), as well as rhinolalia, dysarthria.

Levina identified characteristic features indicating systemic disorders of speech activity:

• Later onset of speech: the first words appear by 3-4, and sometimes by 5 years;

• Severe limitation of vocabulary;

• Sound pronunciation defects;

• Speech is ungrammatical;

• phonemic hearing impairment;

• violation of the rhythmic-syllabic structure of the word;

• Difficulty in distributing simple sentences and constructing complex ones.

R.E. Levina identified three levels of speech development, which reflect the typical state of language components in children with SLD:

• The first level of speech development is characterized by:

• Lack of commonly used speech (the so-called “speechless children”).

• Such children use “babble” words and sound imitations. Depending on the situation, babbling formations can be regarded as one-word sentences.

• Children accompany “statements” with facial expressions and gestures. For example, “bi-bi” can mean an airplane, a dump truck, or a steamship.

• Children use the same complex to designate objects, actions, qualities, indicating the difference in meaning with intonation and gestures.

• There is almost no differentiated designation of objects and actions. The names of actions are replaced by the names of objects (to open - “tree” (door), and vice versa - the names of objects are replaced by the names of actions (bed - “stale”). The polysemy of the words used is characteristic.

• Second level of speech development.

The beginnings of common speech.

• In addition to gestures and “babbling” words, although distorted, fairly constant commonly used words appear. For example, “lyaboka” instead of “apple”.

• Children's pronunciation abilities and vocabulary are significantly behind the age norm.

• The syllable structure is disrupted. For example, the most typical reduction in the number of syllables is “teviki” instead of “snowmen”.

• Children use only simple sentences consisting of 2-3, rarely 4 words.

• Children do not know the names of the color of an object, its shape, size, and replace words with similar meanings.

• There are gross errors in the use of grammatical structures:

- mixing of case forms (“driving a car” instead of in a car;

- often the use of nouns in the nominative case, and verbs in the infinitive or the 3rd person singular and plural form of the present tense;

- in the use of number and gender of verbs, when changing nouns by number (“two taxis” - two pencils, “de tun” - two chairs);

- lack of agreement between adjectives and nouns

— The phonetic side of speech is characterized by the presence of numerous distortions of sounds, substitutions and confusions

- The pronunciation of soft and hard sounds, hissing, whistling, affricates, voiced and voiceless sounds is impaired (“pat book” - five books; “paputka” - grandmother; “dupa” - hand).

— The sound filling of syllables, sounds, replacement and assimilation of syllables (“morshki” - daisies. “kukika” - strawberries) is disrupted. Polysyllabic words are reduced.

• The third level of speech development is characterized by:

• the presence of extensive phrasal speech with elements of lexico-grammatical and phonetic-phonemic underdevelopment

• Characteristic is the undifferentiated pronunciation of sounds (mainly whistling, hissing, affricates and sonorators), when one sound simultaneously replaces two or more sounds of a given or similar phonetic group. For example, the soft sound “s”, which itself is not yet clearly pronounced, replaces the sound s (“syapogi”), sh (“syuba” instead of a fur coat), ts (“syaplya” instead of a heron), ch (“saynik” instead of a teapot), Ш (“mesh” instead of brush); replacing groups of sounds with simpler ones in articulation

• Mixings of sounds are noted when in isolation the child pronounces certain sounds correctly, but in words and sentences replaces them.

• Free communication is difficult. Children at this level come into contact with others only in the presence of acquaintances (parents, teachers), who introduce appropriate explanations into their speech. For example, “my mother went aspak. and then a little girl walked around, there was a link. then my fingers didn't hurt. then they sent a pack” instead of “I went to the zoo with my mother, and then I went where there was a cage - there was a monkey.” Then we didn’t go to the zoo. Then we went to the park.”

55.Characteristics of speech disorders in children with ODD levels 1-4.

Characteristics of children with OHP.

R.E. Levina developed a periodization of manifestations of OHP: from the complete absence of means of communication to expanded forms of coherent speech with elements of phonetic-phonemic and lexical-grammatical underdevelopment. Based on a step-by-step structural-dynamic study of abnormal speech development, specific patterns that determine the transition from a low level to a higher level are also revealed. Each level is characterized by a certain ratio of the primary defect and secondary manifestations that delay the formation of speech components dependent on it. The transition from one level to another is determined by the emergence of new language capabilities, an increase in speech activity, a change in the motivational basis of speech and its subject-semantic content, and the mobilization of a compensatory background.

Speech therapy examination for OHP

At the preliminary stage of a diagnostic examination of speech, the speech therapist gets acquainted with the medical documentation (data from the examination of a child with OSD by a pediatric neurologist, pediatrician, and other children’s specialists), and finds out from the parents the features of the child’s early speech development.

When diagnosing oral speech, the degree of formation of various components of the language system is specified. The examination of children with OHP begins with studying the state of coherent speech - the ability to compose a story from a picture, a series of pictures, retelling, story, etc. Then the speech therapist examines the level of development of grammatical processes (correct word formation and inflection; coordination of parts of speech; sentence construction, etc. .). An examination of vocabulary in OHP allows one to assess the ability of children to correctly correlate a particular word-concept with the designated object or phenomenon.

The further course of the examination of a child with OHP involves studying the sound side of speech: the structure and motor skills of the speech apparatus, sound pronunciation, syllable structure and sound content of words, the ability for phonemic perception, sound analysis and synthesis. In children with OHP, it is necessary to diagnose auditory-verbal memory and other mental processes.

The result of an examination of the state of speech and non-speech processes in a child with OSD is a speech therapy report reflecting the level of speech development and the clinical form of the speech disorder (for example, level 2 OHP in a child with motor alalia). OSD should be distinguished from delayed speech development (DSD), in which only the rate of speech formation lags behind, but the formation of linguistic means is not impaired.

Kozina I.V., teacher-speech therapist, preschool educational institution No. 2099, Moscow

Children entering the speech therapy group undergo a comprehensive examination necessary to clarify the structure of the disorder, determine a correction program, and predict development. The data obtained is recorded in a speech card, which must provide the following conditions: - qualitative analysis of the survey results (accounting for errors, degree of independence, features of completing tasks, etc.); — interpretation of the obtained data in quantitative form (scoring); — the use of unified criteria for assessing the completion of tasks (they minimize the personal factor); - selection of tasks in accordance with age norms (speech tests should be different for 5, 6 and 7 year old children); — building an individual speech profile, which allows you to clearly clarify the structure of a speech disorder and draw up a plan for correctional work; — monitoring the dynamics of speech development and the effectiveness of correctional interventions; — compactness of filling; - a fairly large number of examples of children's speech; — an opportunity for another specialist to analyze the document and continue the intended work. The purpose of this publication is not to provide a detailed presentation of the methodology for examining preschoolers with SEN. We advise the reader to take a creative approach to the material presented. The practicing speech therapist has the right to develop his own examination scheme. The main thing is that it meets all modern requirements. Speech card Personal data Last name, first name of the child ______ Date of birth ____________ Where did he come from ___________ Speech environment _________ Home address, phone number __________________________ Information about parents (full name, age at the time of birth) Mother ____________________ Father ____________________ Anamnestic data From which pregnancy ______ Nature of the pregnancy ______________________ Childbirth ____________________ Past diseases __________________________ Hearing ____________________ Vision __________________ Intelligence _______________ Early physical development: began to hold his head ______ sit ______ crawl ________ stand _______ walk _______ Early speech development: walk ______ babble ______ first words ________________ first phrase ________________ phrasal speech _______________ Features of the articulatory apparatus Teeth ____________________ Bite ___________________ Hard palate ______________ Soft palate ______________ Lips ____________________ Tongue ___________________ Examination parameters 1. General sound of speech. 2. Articulatory motor skills. 3. Sound pronunciation. 4. The syllable structure of the word. 5. Phonemic hearing. 6. Language analysis and synthesis. 7. Grammatical structure. 8. Vocabulary. 9. Word formation. 10. Coherent speech. Speech therapy conclusion ______________________________ Date ______ Speech therapist ______ Plan of individual correctional work ______________________________ Data on the progress of correctional work ______________________________ Memo for the speech therapist on filling out the speech card Anamnestic data Nature of pregnancy - toxicosis, infections, injuries, chronic diseases. Childbirth - early, urgent, fast, rapid, dehydrated, protracted, use of obstetric aids, stimulation, when the child cried, was asphyxia observed. Past diseases - pneumonia, colds, flu, measles, scarlet fever, whooping cough, dysentery, head injuries, infectious and somatic, long-term and causing depletion of the nervous system. Hearing is normal (N), hearing loss. Vision - N, myopia, strabismus, amblyopia, optic nerve atrophy, limited visual field. Intelligence - appropriate for age, below normal. Early physical development - N, with delay (began to hold head - N 2 months, sit - 6 months, crawl - 5-6 months), stand - 7-8 months, walk - 1 year). Early speech development - N, with delay (booming - N 3 months, babbling - 5 months, first words - 1 year, first phrase - 2 years, phrasal speech - 3 years). Features of the articulatory apparatus Teeth - N, sparse, crooked, outside the jaw arch, small, large, dentition disorder, presence of stem. Bite - N, orthognathic, open anterior, lateral: bilateral, unilateral, deep, distal, mesial, straight, cross. Hard palate - N, narrow, high (deep, domed, gothic), flat, low, presence of postoperative scars. Soft palate - long, short, scars, uvula, submucosal fissure, mobile, immobile. Lips - N, thick, thin, short, sedentary, mobile, hypo-, hypertonicity, cheiloskisis (cleft lip), procheilia (increase in the size of the upper lip, overhanging the lower lip). Tongue - normal, macroglossia, microglossia, long, short, wide, narrow, hypertrophy of the tongue root, forked, shortened hyoid ligament, inactive, mobile, hypo-, hypertonicity. Motor sphere General motor skills - N, coordination, tempo, rhythm of movement are slightly impaired, motor clumsiness. Recommended studies 4 years - jump on both legs, do a standing long jump, stomp your feet and clap your hands at the same time, throw a ball from your chest and catch it. 5 years - the same and additionally: jump on your left, right leg, throw a ball from behind your head, jump over a toy. 6 years old - the same and additionally: toss and catch a ball, climb onto a gymnastics wall and get off it. Manual motor skills - N (preserved function), insufficiency of fine motor skills, motor limitations, range of movements (full, incomplete, strictly limited), pace (N, fast, slow), switchability (accurate, inaccurate), coordination (N, minor impairments, broken, incomplete). Leading hand - left-handed, ambidextrous, right-handed. Recommended studies 4 years - put your thumb and index fingers into a ring, alternately bend and straighten your fingers, perform the “Hare” exercise with your right and left hand, change the position of your hands (fist - palm). 5 years - the same and additionally: perform the exercises “Goat”, “Playing the piano”, the “Fist-rib-palm” test with the leading hand. 6 years old - the same and additionally: place the index finger on the middle finger and vice versa, first on the right hand, then on the left, perform the “Playing the piano” exercise, the “Fist - rib - palm” test with the left hand, with both at the same time. Psychophysical processes Attention N (quite stable), low concentration, unstable, superficial, quickly depleted, poor switching. Visual perception - recognition of objects in conditions of overlap, in an incomplete image, in a silhouette image. Tactile. 4 years - guessing an object based on its outline. 5, 6 years - the same and additionally: guessing identical objects based on differential features. Auditory - identification and differentiation of noise. Color - no ideas, compares, distinguishes (highlights by word), names (4 years - red, yellow, blue, green, white, black; 5 years - the same and additionally: orange, blue; 6 years - the same and optional: purple, pink, brown, gray). Form. 4 years - circle, square, oval, triangle. 5 years - the same and additionally: rectangle. 6 years - the same and additionally a polygon. Rhythm - perception, reproduction (4 years - - - ., - . -, . - .; 5 years - . . . -, - . . -, . - - .; 6 years - - - . . ., . . - - ., . - - - .). Temporal representations - orientation is good, insufficient, weak (4 years - parts of the day, seasons; 5 years - the same and additionally: days of the week; 6 years - the same and additionally: months, understanding and use of logical-grammatical structures). Space. 4 years - show objects above, below, in front, behind. 5 years - the same and additionally: left, right. 6 years - the same and additionally: bottom left, top right, top left, bottom right. Body diagram. 4 years - show right, left arm, leg. 5 years - the same and additionally: right, left eye, right, left ear. 6 years old - the same and additionally: show your left eye with your right hand, and your right ear with your left hand. Cut-out pictures - independently, with the help of a teacher, according to a model, by imitation (4 years - 2-4 parts, 5 years - 3-5, 6 years - 4-8). Stick figures. 4 years - a “chair” of four sticks. 5 years old - a “house” of six sticks. 6 years old - “boat” of seven sticks. Memory Parameters of short-term memory: volume and linearity. Thinking Generalization. Level 1 - generalization with a word. Level 2 - grouping according to subjective general characteristics. Level 3 – generic generalization. Level 4 - logical level of generalization. N - by 7 years. Seriation. 4-5 years - arrangement of objects in a row in ascending and descending order. 6 years - correlation with each other according to the leading characteristic of a number of objects. Comparison. Highlights essential features, does not highlight, independently, with help, explains verbally, without explanation. Impressive speech Understanding of addressed speech in full, at the everyday level, limited, within the limits of the situation. Prepositional case constructions. 4 years - in, on, above, under, at, from, to, to. 5 years - before, for, about, in, from, on, with. 6 years - under, from under, for, because of. Verbs with prefixes. 4 years - comes out, moves on, approaches. 5 years - flies out, flies up, flies in. 6 years - leaves, drives away, drives around, drives in. Follow instructions. 4 years - one-, two-stage. 5 years - two-, three-stage. 6 years old - show a notebook with a pen, a pen with a ruler. Understanding sentences. 4 years old - Where is my daughter’s mother? Where is mom's daughter? 5 years old - Who does the girl catch? What does she use to catch a butterfly? Who catches the butterfly? 6 years - understanding of coherent speech, logical and grammatical structures. Sensorimotor level of speech General sound of speech Intelligibility - N (sufficient), reduced, speech is blurred, disturbed, slurred, difficult to understand for others. Tempo - N, fast, slow, tachylalia, bradylalia, hesitation, stuttering (degree, form). Rhythm - N, dysrhythmia, extended, chanted, depends on the manifestation of hyperkinesis. Breathing - free, difficult, superficial, shallow, uneven, clavicular, lower diaphragmatic, oral exhalation is formed, not formed, nasal breathing is difficult, absent, during phonation, oral exhalation is mixed. Voice - N, quiet, weak, non-flying, poorly modulated, monotonous, timbre deviation (dull, compressed, hoarse, trembling, presence of a nasal tint). Score 5 - speech intelligibility is not impaired, breathing is free, voice is modulated, tempo and rhythm are normal. 4 - speech intelligibility is slightly reduced. Minor isolated disturbances in breathing and voice are possible. 3 - speech is slurred, blurred. There may be disturbances in tempo, rhythm, breathing and voice. 2 - intelligibility is impaired, speech is difficult to understand for others. Hyperkinesis, stuttering, and timbre deviation are possible. 1 - speech is understandable only to those close to you. Articulatory motor skills Range of movements - strictly limited, incomplete, complete. Tone - N, increased, decreased. Mobility - sufficient, insufficient, tremor, hyperkinesis, deviation to the left, to the right, kinesthetic apraxia. Switchability, precision of movements - sufficient, insufficient. Salivation - N, increased. Score 5 - correct execution with exact compliance of all movement characteristics. 4 - all movements are available, the volume is full, the tone is normal, the pace of execution and switchability are somewhat slow. 3 - slow and tense execution. 2 - execution with errors: long search for a pose, incomplete range of motion, deviations in configuration, synkinesis, hyperkinesis. 1 - failure. Sound pronunciation N (within the age norm), the phonetic structure of speech is not sufficiently formed, in isolation all sounds are pronounced correctly, but with an increase in speech load, general blurred speech, phonetic defects in sound pronunciation (omissions, distortions), phonological defects (substitutions, confusion) are observed. Score 5 - perfect pronunciation of all sounds in any speech situations. 4 - one or two sounds are correctly pronounced in isolation and in reflection, but are sometimes subject to distortion or substitution (not automated enough). 3 - the pronunciation of three to five sounds is impaired. 2 - six to nine sounds are distorted or replaced in any position. 1 - at least ten sounds are subject to distortion or substitution in all speech situations. The syllabic structure of the word N (not broken), minor defects in the syllabic structure of the word, the structure is broken. Types of violations: elision (omission of sounds, syllables), perseveration (delayed repetition), iteration (adding), anticipation (replacing previous sounds with subsequent ones), rearrangement of sounds, syllables, contamination (connecting the syllabic parts of two words), paraphasia (replacement). Score 5 - correct and accurate reproduction at the pace of presentation. 4 - accurate playback, the tempo is somewhat slow, there may be stutters. 3 - slow, syllable-by-syllable reproduction, with hesitations, one or two words with distortion of the syllable structure. 2 - distortion of the syllabic structure of words. 1 - non-reproduction. Phonemic hearing N (preserved), underdeveloped, impaired. The following sounds are studied: - voiced, voiceless; - oral, nasal; - hard, soft; - front-lingual, back-lingual; - front-lingual-middle-lingual; - middle lingual, back lingual; - labial, anterior lingual; - labio-labial, labio-dental; - whistling, hissing; - anterior lingual occlusives, anterior lingual fricatives; - sibilant affricates, sibilant fricatives; - sibilant affricates, forelingual stops; - sibilant affricates, sibilant fricatives; - vibrants are occlusally passaged oral. Rating 5 - all tasks were completed correctly. 4 - one or two mistakes are made, but they are corrected on their own. 3 - mistakes are made and corrected after replay. 2 - some tasks are inaccessible and require replay when completed. 1 - failure. Language analysis and synthesis N (formed), insufficiently formed, not formed. Score 5 - all tasks completed correctly on the first try. 4 - one or two mistakes are made, but they are corrected on their own. 3 - tasks are executed with errors, one or two tasks are unavailable. 2 - most of the tasks are unavailable. 1 - incorrect answers, refusal to complete. The grammatical structure of speech N (formed), insufficiently formed, not formed. Score 5 – correct, independent completion of all tasks. 4 - isolated errors are corrected independently or with the help of a clarifying question. 3 - most tasks are completed with help (stimulation, expansion of instructions, clarification of the question, hint). 2 - most tasks are not completed. 1 - failure. Vocabulary N (the vocabulary is sufficient, corresponds to the age norm), within the limits of everyday life, is sharply limited. Assessment: the same as when studying the grammatical structure of speech. Word formation N (formed, corresponds to the age norm), in the stage of formation, not formed. Assessment: the same as when studying the grammatical structure of speech. Coherent speech N (corresponds to the age norm), at the stage of formation, requires further development, is not formed. Retelling 4-5 years  There was a puddle near the house. Geese sat on a puddle. The geese were gray. L.N. Tolstoy  The nanny cooked some porridge and gave it to Natasha. Natasha ate, collected the crumbs and poured them out the window. The birds flew in and started pecking at the porridge. Natasha is full and the birds are full. According to I.D. Sytin  They threw the cat near the barn. The cat meowed: “Meow! Meow!" Tanya and Kolya walked past the barn and found a cat. They fed the cat milk and meat. And the cat became as fat as Sharik. I.D. Sytin 5-6 years old  The bunny said to the hedgehog: “What an ugly, prickly dress you have, brother!” “True,” answered the hedgehog, “but my thorns save me from the teeth of the dog and the wolf. Does your pretty skin serve you the same way?” Instead of answering, the bunny just sighed. K.D. Ushinsky  Varya had a siskin. The siskin lived in a cage and never sang. Varya came to the siskin. - It's time for you, little siskin, to sing. - Let me go free, in freedom I will sing all day long. L.N. Tolstoy  The red sun floated into the sky. It began to send out its rays - to awaken the earth. The first ray fell on the lark. The lark rose high, high. There he sang his song. The second beam hit the bunny. A hare jumped across the meadow. I ran to look for some juicy grass for breakfast. According to K.D. Ushinsky Score 5 - the retelling was compiled independently without violating lexical and grammatical norms; the content of the text is fully conveyed, the coherence and sequence of presentation are observed; A variety of linguistic means are used in accordance with the text of the work. 4 - the retelling was compiled with little help (motivation, stimulating questions); grammatical norms are generally observed; There are isolated violations of coherent reproduction of the text, isolated cases of searching for words, the absence of artistic and stylistic elements, and insufficient development of the statement. 3 - the retelling is compiled with the help of (focusing on plot elements, hints, leading questions); omission of parts of the text without distortion of the meaning, poverty and monotony of the language used, and violations of the structure of sentences are noted. 2 - the retelling is based on leading questions; the coherence of the presentation is broken; There are significant abbreviations of the text or distortions of meaning, repetitions, agrammatisms, and inadequate use of words. 1 - retelling is not available even for questions. A story based on a series of pictures 6-7 years old Rating 5 - independently laid out the pictures and compiled a story; has all the semantic links, temporary and cause-and-effect relationships between events are defined; grammatically correct with adequate use of lexical means. 4 - pictures are laid out with stimulating help, the story is composed independently without agrammatism; Developed impressive violations of the coherence and smoothness of the story, insufficient detection, isolated cases of word search. 3 - laying out pictures and compilation of a story with stimulating help; There are agogramatisms, distant verbal replacements, the loss of semantic links, distortion of meaning; The connectedness of the story is broken. 2 - laying out pictures and compilation of a story on leading issues, hints; The inadequate use of lexical means is observed, a significant distortion of meaning or the story is not completed, or is a listing of objects. 1 - the story is not available. List of used and recommended literature Konenkova I.D. An examination of speech of preschool children with mental retardation. M., 2004. NICHEVA N.V. A speech card of a child with general speech underdevelopment (from 4 to 7 years). SPb., 2004. Serebryakova N.V., Solomakh L.S. The examination scheme of the child with the general underdevelopment of speech // Diagnosis of speech disorders in children and the organization of speech therapy work in the conditions of a preschool educational institution. SPb., 2000. Smirnova I.A. Speech therapy diagnosis, correction and prevention of speech disorders in preschoolers with cerebral palsy. SPb., 2004. Filicheva T.B., Chirkina G.V. Elimination of general speech underdevelopment in preschool children. M., 2004. Frekova T.A. Test methodology for diagnosing oral speech. M., 2000.

OHP correction

Speech therapy work to correct OHP is carried out in a differentiated manner, taking into account the level of speech development. Thus, the main directions for level 1 OSD are the development of understanding of addressed speech, activation of children’s independent speech activity and non-speech processes (attention, memory, thinking). When teaching children with level 1 ODD, the task of correct phonetic formatting of statements is not set, but attention is paid to the grammatical side of speech.

At level 2 OHP, work is being done on the development of speech activity and understanding of speech, lexical and grammatical means of language, phrasal speech and clarification of sound pronunciation and evocation of missing sounds.

Speech therapy classes for the correction of level 3 OHP include the development of coherent speech, improvement of the lexical and grammatical aspects of speech, and the consolidation of correct sound pronunciation and phonemic perception. At this stage, attention is paid to preparing children to master literacy.

The goal of speech therapy correction for level 4 OPD is for children to achieve the age norms of oral speech necessary for successful schooling. To do this, it is necessary to improve and consolidate pronunciation skills, phonemic processes, lexical and grammatical aspects of speech, detailed phrasal speech; develop grapho-motor skills and primary reading and writing skills.

Education of schoolchildren with severe forms of ODD levels 1-2 is carried out in schools for children with severe speech impairments, where the main attention is paid to overcoming all aspects of speech underdevelopment. Children with level 3 SEN study in special education classes at a public school; with OHP level 4 – in regular classes.

Forecast and prevention of ANR

Corrective and developmental work to overcome ODD is a very long and labor-intensive process that should begin as early as possible (from 3-4 years). Currently, sufficient experience has been accumulated in the successful training and education of children with different levels of speech development in specialized (“speech”) preschool and school educational institutions.

Prevention of OHP in children is similar to the prevention of those clinical syndromes in which it occurs (alalia, dysarthria, rhinolalia, aphasia). Parents should pay due attention to the speech environment in which the child is raised, and from an early age stimulate the development of his speech activity and non-speech mental processes.