Speech therapy album of games and exercises for stuttering

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Stuttering

- this is a violation of the tempo and rhythm of speech, caused by a convulsive state of the articulatory apparatus.

Stuttering is a discoordination convulsive speech disorder that occurs in the process of communication through the mechanism of systemic speech-motor neurosis, and is clinically represented by primary disorders that often become dominant in adults... Psychological, socio-psychological and biological factors take part in the mechanisms of development of this speech-motor neurosis. In many cases of stuttering, the so-called organic “soil” is noted in the form of cerebral deficiency of various origins (V.M. Shklovsky).

There is no single approach or single concept to solving the issue of stuttering.

Stuttering and stumbling outwardly manifests itself in the form of convulsions and spasms, which differ from convulsions in epilepsy.

Differentiation of the concepts stuttering and logoneurosis

Stuttering does not arise as a neurosis (as in childhood), but as a phenomenon that disrupts the prosody of speech (the melody is disturbed).

Almost all stutterers have neurotic manifestations: vegetative, situational.

Logoneurosis is secondary to stuttering: the child begins to react neurotically to his defect after 6-7 years - the individual has neurosis.

The concept of Logoneurosis is much broader than stuttering, because includes functional aphonia and dysphonia, mutism, fear of public speaking.

Stuttering can occur without neurosis.

Card index of literature on stuttering

Natalya Arepyeva

Card index of literature on stuttering

Shklovsky V. M.

Psychotherapy in a complex system of therapy for logoneuroses. // Guide to psychotherapy M - 1974 P. 197-209.

Anokhin P.K.

Essays on the physiology of functional systems. M. -1975.

Harutyunyan L.Z.

How to treat stuttering . M. - 1993.

Asatiani N. M.

Stuttering in adults . // Stuttering . Ed. N. A. Vlasova, K. P. Becker. M. - 1983. S. 180-221.

Belyakova L. I.

A problematic approach to the analysis of pathogenetic mechanisms of stuttering . // Stuttering :

problems of theory and practice. Ed. Belyakova L.I.M. - 1992. P. 3-20.

Belyakova L. I., Dyakova E. A.

Speech pauses in normal speech and in stuttering . // Questions of psychology. No. 3, 1993. pp. 88-94.

Belyakova L. I., Dyakova E. A. Comparative analysis of speech-language parameters of streets with normal speech and those who stutter . // Psycholinguistics and modern speech therapy. Ed. Khalilova L. B. M. -1997. pp. 156-169.

Yastrebova A V.

Correction of stuttering in secondary school students A manual for speech therapists M - Education 1980.—P. 5-14

Blysina I. V., Kovshikov V. A.

Massage in the correction of articulatory disorders. St. Petersburg — 1995.

Boldyreva T. A.

Dynamics of personality formation in people who stutter . // Stuttering . Problems of theory and practice. Ed. Belyakova L. B. M - 1992. P. 76-87.

Vessart O.V.

Linguistic factors that provoke the occurrence of stuttering when stuttering . // Sat. Stuttering . Experimental research and methods of rehabilitation. M. - 1986. P. 37-45.

Wilson D.K.

Voice disorders in children. M. - 1990.

Vlasova N. A.

Speech therapy work with stuttering preschoolers . M. - 1959.

Volkova G. A.

Game activity in eliminating stuttering in preschool children . M. - 1983

Raising and teaching children with speech disorders. Ed.

OS. Lyapidevsky and V.I. Seliverstov. M., Education, 1968.

Vygodskaya I. B., Pellinger E. A., Uspenskaya L. P.

Eliminating stuttering in preschoolers through play. A manual for speech therapists. M. -1984.

Vygodsky L. S.

Development of higher mental functions. M. - 1960.

Griner V. A.

Speech therapy rhythm for preschoolers. M., 1958.

Group psychotherapy. Ed. Karvasarsky B. D., Leder S. M. - 1990.

Danilov I.V., Cherepanov I.M. Pathophysiology of logoneuroses. L. -1970.

Drapkin B.Z.

Psychotherapy in the complex treatment of stuttering in adolescents . // Clinic and therapy of stuttering . M. -1984.

Dyakova E. A.

Speech errors and features of the speech formation process in people who stutter . // Stuttering . Problems of theory and practice. Ed. L. I. Belyakova. M. -1992. pp. 38-50.

Zhinkin N. I.

Speech as a conductor of information. M., 1982.

Stuttering in adolescents . Book for speech therapist. From work experience. // Comp. Buyanov M.I. - M. - 1989

Stuttering : problems of theory and practice. Ed. Belyakova L.I.M. - 1992.

Zimnyaya I. A

. Fundamentals of the theory of speech activity. M. -1974.

Games in speech therapy work with children: A book for speech therapists // Ed. comp.

V. I. Seliverstov. M., 1987.

Kalacheva I. O.

The use of family psychotherapy in the process of rehabilitation of young children

age, suffering from stuttering . // Stuttering : problems of theory and practice. M. -1992. pp. 100-107.

Clinic and therapy for stuttering . Ed.

G. V. Morozova. M. - 1984.

Clinic, differential diagnosis and principles of complex treatment of protracted forms of stuttering in adults in a hospital setting. Guidelines. Compiled by: Asatiani N.M., Kazakov V.G., Lubenskaya A.D., Oganesyan E.V. M - 1980.

Kozlyaninova I. P., Chareli E. M.

Speech voice and its education. M. - 1985.

Kochetkova I. I.

Paradoxical gymnastics by Strelnikova. M. - 1989.

Krapivina L. M.

Methodological recommendations for the organization and content of speech therapy classes with

preschool stutterers

age. // Stuttering : problems of theory and practice. Ed. BelyakovaL. THEM. —1992. pp. 126-141.

Kuzmin Yu. M.

Models of normal speech process and mechanisms of speech disorders. // In the collection:

Mechanisms of the speech process and rehabilitation of patients with speech disorders. Sat. scientific works 1989.

pp. 5-24.

Levina R. E.

Stuttering in children . // In the book: Overcoming stuttering in children . Ed. Levina R. E. M., 1975. - P. 3-22.

Leontyev A. A.

Psycholinguistic units and the generation of speech utterances. M., 1969.

Mironova S. A.

Correcting stuttering in preschoolers during the learning process. // Overcoming stuttering in preschoolers . Ed. Levina R. E. M. - 1975. P. 23-135.

Missulovin L. Ya.

Treatment of stuttering . // M. - 1988.

Myasishchev V. N.

Personality and neuroses. L. - 1960.

Nekrasova Yu. B.

Psychological foundations of the process of socio-rehabilitation of stutterers . Author's abstract. diss. Doctor of Psychological Sciences. M., 1992.

NosenkoE. L.

Emotional state and speech. Kyiv. — 1981.

Training and education of stuttering preschoolers : Program for special preschool

institutions. M. -1983.

Oganesyan E. V.

Speech therapy rhythm. M. - 1998.

Sikorsky I. A.

About stuttering . S. -Pb. 1889.

Stanishevskaya N. N.

Psychological study of the personality of adult patients suffering

stuttering _ // In: Clinic and therapy of stuttering . Collection of scientific works Ed. Morozova G.V.M., 1984.—S.

98-106.

Chistyakova M I.

Psychogymnastics M - 1990.

Yastrebova A V.

Correction of stuttering in secondary school students A manual for speech therapists M - Education 1980.—P. 5-14

Historical aspect of the problem of stuttering

The forefather of stuttering was Cicero - he was the founder of rhetoric.

Demosthenes invented a way to combat stuttering ( speaking loudly, in the mouth with stones on the seashore

): if an adult stutterer changes his mode of speaking, he will stop stuttering. An adult will repent out of habit.

Kusmaul (1789) believed that stuttering is a spasm.

Sikorsky described, classified and categorized the spasms that occur in stuttering.

Netkachev and Tipugin made a great contribution to the development of the doctrine of stuttering.

Vlasova and Lyapidevsky used standard methods within the didactic approach in their correctional work.

Yu. Nekrasova proposed a method of hypnotic influence.

Drapkin's works are devoted to working with teenagers.

Asatiani and Kazakov use drug treatment and didactic techniques in correction.

Shklovsky used the method of shock hypnosis (out of 10, 1 lasts for a short time). This method is not often resorted to, considering it not reputable.

Preface

The textbook examines issues of the etiology and pathogenesis of stuttering from the standpoint of modern achievements of psychophysiology, psychology and correctional pedagogy; the clinical and psychological-pedagogical characteristics of neurotic and neurosis-like forms of stuttering are analyzed in detail; modern ideas about the rehabilitation of people who stutter are outlined; for the first time, speech therapy technologies for the formation of fluent speech in people who stutter are presented in an integrative manner; Methodological developments are given for organizing the educational process with students and practitioners mastering this section of speech therapy. The book presents the author's position on the problem of stuttering.

The book is intended for students of defectology faculties, speech therapists, psychologists, and doctors.

This book is intended for students of defectology departments of pedagogical institutes and speech therapists. It is aimed at improving the training of teaching staff and speech therapy assistance to people who stutter. The material in the book corresponds to the program and curriculum for the speech therapy department of defectology faculties.

Currently, stuttering is one of the most pressing problems in speech therapy. It is recognized throughout the world that stuttering is a complex problem in both theoretical and practical aspects. The problem of stuttering has been intensively studied and covered in the literature throughout the 20th century. The scientific development of the problem of stuttering in domestic speech therapy is associated with the names of famous psychiatrists I.A. Sikorsky, N.G. Netkachev and V.A. Gilyarovsky.

Currently, interest in the problem does not decrease; moreover, since 1994, International symposiums dedicated only to the problem of stuttering have been regularly held. These scientific congresses bring together more than a thousand scientists from countries around the world. The international special magazine “Fluen y Disorders” is regularly published, which is also dedicated to this monoproblem. The enormous interest of scientists around the world in the problem of stuttering indicates its relevance.

In domestic speech therapy, an original approach to assessing the clinical picture of stuttering has been developed. Identification of two clinical forms of stuttering - neurotic and neurosis-like - allows us to most fully assess not only convulsive manifestations in the speech of people who stutter, but also personality characteristics both in the initial period of development of stuttering and during its chronicification. In addition to convulsive stuttering, stuttering includes disorders of higher nervous activity, associated in some cases with organic damage to the central nervous system, in other cases with a neurotic reaction. The chronification of the process observed during stuttering usually causes secondary neurotization as a personality reaction to the underlying disease, which makes stuttering a complex pathological process that can accompany a person throughout his life.

Currently, a speech therapist is required not only to know practical techniques for correcting speech for stuttering, but also to understand the holistic clinical and psychological-pedagogical picture of this complex pathological condition, as well as knowledge of the clinical manifestations of neurotic and neurosis-like conditions. Only under this condition can psychophysiological, psychological and psychological-pedagogical data on people who stutter be correctly interpreted, which determines the direction of rehabilitation as well as preventive measures.

This book is an attempt to highlight various aspects of the study of stuttering that are relevant for broad speech therapy practice. In their presentation, the authors rely not only on literature data, but also on the results of many years of research conducted in the “Laboratory of Speech Pathology” of the All-Russian Research Institute named after. V.P. Serbsky and at the Department of Speech Therapy of Moscow Pedagogical State University.

The structure and arrangement of the four chapters of the book corresponds to its main task - to facilitate students' assimilation of the curriculum for the course “Stuttering”.

The first chapter of the textbook “Basic mechanisms of oral speech” gives ideas about its anatomical and physiological mechanisms. A brief description of the respiratory, phonatory and articulatory sections of the peripheral speech apparatus is given; the main structures of the central nervous system and their functions that ensure speech activity are presented; The acoustic characteristics of oral speech are given, which, as a rule, are disturbed when stuttering.

Modern ideas about the systemic organization of speech are presented through a description of the functional system of the speech motor act. Analysis of the violation of the action program (oral speech) through the prism of ideas about the functional system makes it possible to identify the pathogenesis link that leads to stuttering.

The same chapter describes age-related features of the functional system of oral speech. It substantiates the age-related instability of speech motor stereotypes in preschool age and explains the reasons for the selective fragility of the speech system under the influence of various harmful factors.

Chapter two is devoted to stuttering itself: its phenomenology, etiology, clinical and psychological-pedagogical characteristics of stutterers with neurotic and neurosis-like forms of stuttering.

Today, many specialists working in the field of stuttering believe that successful practical work on the rehabilitation of stutterers is hardly possible without careful clinical and psychological-pedagogical differentiation of stutterers. This chapter highlights the most relevant issues of differential diagnosis for broad speech therapy practice. This chapter also presents an analysis of stuttering from a psycholinguistic perspective, since such an analysis makes it possible to consider in a single complex the violation of the speech process during stuttering from the concept to the motor implementation of the utterance. At the end of the chapter, a modern view of some pathogenetic mechanisms of stuttering is given with the rationale for the main directions of corrective action for different forms of stuttering.

The third chapter is devoted to the main directions of comprehensive psychological and pedagogical rehabilitation of people who stutter. It reveals the main content of the tasks of speech therapy work. In this regard, a number of speech therapy technologies are covered in detail: inhibition of pathological speech motor stereotypes; regulation of emotional state; development of the body's motor systems; formation of speech breathing, skills of rational vocal delivery and vocal performance; development of the prosodic side of speech; development of the planning function of speech. Speech therapy technologies are revealed through the content of specific techniques and exercises.

This chapter covers in detail the issues of psychological and pedagogical examination of stutterers of different ages, and also presents various author’s systems of complex psychological and pedagogical influences (Vlasova N.A., Pay E.F., Seliverstov V.I., Cheveleva N.A. , Mironova S.A., Andronova L.3., Nekrasova Yu.B., Shklovsky V.M., etc.). The chapter ends with a description of stuttering prevention methods.

Chapter four is devoted to the organization of the educational process in the “Stuttering” course, which will allow both students and teachers to optimize the educational process on this problem.

The textbook on the section of speech therapy “Stuttering” ends with material that reflects various aspects of practical work with people who stutter.

The textbook is intended for students of defectology faculties, speech therapists, psychologists and doctors.

L. Belyakova E. Dyakova

March, 1998 Moscow

Speech therapy correction of stuttering in children. Author's technique. Practical aids.

Kozlova Marianna Vadimovna

Moscow

Center for Speech Pathology and Neurorehabilitation

speech therapist

Speech therapy correction of stuttering in children.

Author's technique. Practical aids.

Kozlova Marianna Vadimovna. Speech Pathology and Neurorehabilitation Center. Speech therapist. Moscow.

Logopaedic correction of stammering in children.

Author's methodology. Practical handbooks.

Key words: stuttering, fluency, speech breathing, pauses, rhythm, syllable reading, utterance planning.

Key words: stammering, fluency of speech, speech breathing, pauses, rhythmicity, reading by syllables, planning of utterance.

The presented methodology for speech therapy correction of stuttering in children includes: formation of fluency of speech using the “thread” method; the use of rhythmic speech methods, based on the age characteristics of the child and the severity of stuttering; training and automation of syllable reading skills; consistent learning to plan your own statement.

The presented logopedic children's stammering correction methodology includes: development of speech fluency using the method called “thread”; the use of rhythmic speech methods, based on the age specifics of the child and the severity of stammering; learning and automation of the reading by syllables skill; step-by-step training in planning self-sustained statements.

Stuttering is “one of the most severe speech defects. It is difficult to eliminate, traumatizes the child’s psyche, slows down the correct course of his upbringing, interferes with verbal communication, and complicates relationships with others, especially in children’s groups”[1]. “According to scientists, both Russian and foreign, in the 90s of the last century, approximately 2% of the total number of children stuttered”[1]. Seliverstov [2] in 2001 provides the following data: “the results of a speech examination among schoolchildren do not always give the same picture of the prevalence of stuttering among them: from 0.75 (M.V. Serebrovskaya, A.L. Kapustin) to 7.5% ( Shelting)".

Based on personal experience of working with children who stutter, the following data can be cited for comparison. Over the three years from 1990 to 1992 inclusive, 291 children with stuttering were treated at the Moscow Speech Pathology Center. At the same time, children from all over Russia were accepted for treatment, who came in the summer for an intensive course. Over seven years, from 2011 to 2021, 2,771 children aged 3 to 14 years were treated here. All children were only with Moscow registration. There was no refusal of necessary assistance due to an insufficient number of specialists either in the 90s or now. When collecting statistical data, treatment with initial stuttering was not taken into account, when positive results were achieved against the background of drug treatment and protective measures. Thus, we see that on average in the 90s there were 97 requests per year, and currently - 396, and only in Moscow. This gives us reason to assert that over the past 25 years, the prevalence of stuttering has increased at least 4 times. Therefore, the issue of stuttering correction remains more relevant than ever. I would also like to note that if in the 90s the onset of stuttering in children most often occurred at the age of 3-5 years, then the last 10 years have been 2-3 years. And another very relevant topic arises - the correction of stuttering in children from such a young age. Since we all know very well that the shorter the “stuttering experience”, the easier it is to say goodbye to this speech problem forever.

Specialists at the Moscow Speech Pathology Center have been dealing with the problem of stuttering in children and adults for more than 40 years. The work to provide assistance to stutterers was based on the principle of complex treatment developed by V.M. Shklovsky. The main approaches to this problem were identified and methods were developed (Wiesel T.G. [3], Reznichenko T.S. [4]).

In our day hospital department for children with stuttering, TsPRiN, there are psychiatrists, a neurologist, a psychotherapist, psychologists, speech therapists, logorhythmists, an occupational therapist, and a massage therapist. It is the interaction of these specialists that produces positive results. Therefore, we will not once again discuss the importance and necessity of complex influence, but will focus specifically on the consideration of speech therapy work for stuttering. It is also advisable to discuss a differentiated approach to children of different age categories. And the choice of method of influence depending on the severity of stuttering.

Povarova I. A. [5] o

Practicing speech therapists have the opportunity to actively study the theoretical aspect of stuttering correction. But until now there has not been a single manual that could be used to consistently work on this problem. ​And at the initial stage of speech therapy correction of stuttering, specialists ask many questions:

— How can you explain to a small child that you need to speak smoothly?

— How to work with the tempo of speech and teach a child to feel it?​

— How to work with the development of long speech exhalation?​

— How to teach to distribute air evenly throughout the entire phrase?

— How to give a child an understanding that he needs to speak in one speech exhalation?​

— How to form pauses to avoid shortness of breath when speaking a story?​

— How to avoid the formation of accompanying movement?

— What is the best way to remind a child to speak in a new way, without stuttering?​

— How to create motivation to speak in class without stuttering?​

— Is correction with rhythmic speech available at any age?

— Is it possible to combine methods for correcting rhythmic and smooth speech?

-Is it possible to form rhythms in young children through teaching syllable reading and does this affect the effectiveness of stuttering correction?​

— How to teach syllable reading to children from 3 years old?​

I really hope that in this article and the developed manuals, interested specialists will find answers to questions that will make it easier to work with such a complex problem as stuttering.

The methodology for correcting stuttering, presented in this article, was formed during the author’s practical work over three decades. And in the last ten years, when more than 700 children aged 3 to 14 years received classes with the author using the developed exercises, the subtleties of this approach were refined by observing the primary and long-term results. Based on this, methodological and practical manuals were developed and published in the “School of Beautiful Speech” series: “Formation of fluency of speech” [6], “Automation of fluency of speech” [7], “Formation of rhythmic speech (prepared for publication)”, “Learning read" [8] in 2 parts.

The presented technique is based on the basic principles of stuttering correction:

1. Consciously slowing down the rate of speech is the basic principle of all corrective measures, according to M. Zeetan (1962), despite their apparent diversity. When speech slows down in people who stutter, the correct coordination of respiratory, vocal and articulatory movements is established, and muscle tension and cramps are significantly reduced. Some researchers believe that slowing down the rate of speech is not only necessary, but also a sufficient therapeutic effect. (R. A. Resick, R. Wendiggensen, S. Ates, V. Meyer, 1975)

The technique presented here uses a slower rate of speech in the form of smoothness or rhythm, depending on the age of the child and the severity of the stutter.

2. The principle of “gradual education of speech from conjugate pronunciation to normal speech” (Vlasova 1959)

Speech therapy work is carried out from conjugate speech, reflected, dialogical, stories, retellings to spontaneous speech.

3. “...speech exercises become more complicated depending on the varying degrees of independence of speech, its preparedness, structural complexity, and the types of activities during which speech communication occurs,” writes Seliverstov V.I.

Structural complexity - we begin to work from sound to word, phrase. From a simple phrase to a common one to complex sentences. From phrase to story and retelling.

Various preparedness - from a phrase based on a question heard to independently composing a sentence with a given word, from pronouncing a prepared text based on pictures-symbols to independent imagination.

Various types of activities - from organized speech in a classroom setting to trainings - speeches in front of strangers with prepared material of varying complexity. And to independent spontaneous trainings.

4. “Since people who stutter have specific disturbances in the fluency of speech, features of its tempo-rhythmic organization..., there is a need to form a rhythmic intonation organization of oral speech, which is one of the important links in the complex method of stuttering correction,” notes I.A. Povarova. [5].

The tempo-rhythmic organization of speech occurs in logorhythmics classes, in speech therapy classes in speech rhythmization exercises (depending on the age of the child and the severity of stuttering), as well as when teaching syllable reading.

This article uses several concepts. Such concepts as: speech with self-control, speech with external control, speech with external assistance, speech with accompanying movement. To make it easier to understand, let's discuss what each means.

- Speech is self-controlled. The child has accepted a new speech skill without stuttering, has mastered it and is trying to speak in a new way, listening to his speech and applying the skills given in class.

— Speech with external control . The child has accepted a new speech skill without stuttering, has mastered it and is trying to speak in a new way, but it is difficult for him to independently apply the skills given in class. To use the ability to use “beautiful speech,” he needs a reminder (very soft and tactful) from an adult, be it a speech therapist or a parent. Or such a “reminder” could be the atmosphere of the office, the view of the building where classes are held, or a certificate on the wall that was presented by a speech therapist (from parents’ stories). Also, one mother said that her son had a very strong stutter both at home and on the way to classes, but as soon as he entered the gate on the territory of the Speech Pathology Center, his speech changed dramatically, and the boy began to speak calmly and without stuttering. This is a very clear example of external control.

- Speech with external help. The child actively tries to use the methods of speech taught by his speech therapist, but so far he can speak without stuttering only with external help. Such help can be various options for moving the fingers or hand(s), or the sound of a metronome (possibly in headphones).

- Speech with accompanying movement. This is the type of speech that we will try not to form in the child. We talk about accompanying movement when a child can speak without stuttering, he does not need external help , but there is a stable fixation of speech accompanying movement. This option sometimes appears on its own. The child felt that it was easier for him to speak when he accompanied his speech with some kind of movement, and through numerous repetitions he recorded this himself. Another option is the formation and automation of speech with accompanying movement in stuttering correction classes. This happens when at the first stage there is a need for external help , but then, while reducing the severity of stuttering and expanding the ability to speak, the stage of automating “beautiful speech” without movement-assistance was not carried out. And the child firmly formed the understanding that “beautiful speech” is speech with movement. Such movements may include tapping the foot, rocking the body, “conducting,” or moving the head and/or nose.

So, the technique is presented in the manuals of the “School of Beautiful Speech” series: “Formation of fluency of speech” [6], “Automation of fluency of speech” [7], “Formation of rhythmic speech (prepared for publication)”, “Learning to read” [8] in 2 parts and using the “Entertaining ABC Book” by T. S. Reznichenko. [9].

First, I will present the main points of this technique, and then I will dwell in detail on the use of each method of correctional influence depending on the age of the child, based on my many years of experience and effectiveness.

The presented manuals describe for the first time how to explain to a child how to speak in a new way. And a new method called “threads” is introduced. The proposed exercises are designed to work with children starting from 3 years old. But they are universal for correctional work with children of any age. The specialist can choose which correction method to start with, how long to perform the exercises of each manual, and when to move on to the next stage. This depends on: age, severity of stuttering, the child’s acceptance of the proposed method, the ability to learn new skills and the time of their automation by each specific child.

The book “Formation of Fluency of Speech” [6] offers exercises for correcting stuttering, starting with sounds, words, phrases of varying complexity, exercises for developing long speech exhalation, as well as for forming correct pauses so that the child can master the skill of correct speech breathing in coherent speech. Each exercise is accompanied by comments, which tell in accessible language how to explain the task to the child and why it is necessary. It is also explained to parents that under no circumstances should the child’s attention be focused on the fact that he must take a breath before speaking and speak as he exhales. “Breathing exercises should be organized in such a way that the child does not focus on the process of inhalation and exhalation,” writes L.I. Belyakova. [10]. And many parents say that the speech therapist gave clear instructions during classes: take a breath, then speak. And after which the child’s stuttering intensified, most often in the form of a respiratory spasm, or a deliberately noisy inhalation appeared, on which the child is now fixed, or an accompanying movement of the nose and head was formed. In order to avoid such mistakes, the manual “Formation of Fluency of Speech” offers exercises using drawing a “string”, which provides visual support for the formation of a long speech exhalation. The concept of “the thread has broken” is also introduced. It is clear to an adult that this means a lack of speech exhalation to pronounce the phrase. And the child will be able to understand and feel how to control his breathing in order to speak the entire phrase without additional intake of air or switching to speech while inhaling in the middle of the phrase. Based on our own extensive practice and analysis of the results of examinations in the children's stuttering department of the Center for Stuttering, we can say that a very small percentage of children speak only while inhaling. But a significant number have dysrhythmia of breathing, that is, shortened exhalation, when, after a lack of air, an additional intake of air is made or a transition to speech while inhaling. Therefore, the conclusion is clear - you need to develop a long speech exhalation. But the instructions - inhale and speak as you exhale - make no sense, especially for the youngest children.

When a child has developed sufficient exhalation, he is in a hurry, trying to say several phrases without stopping, which leads to “choking”, and either provokes a convulsion, or switches to speech while inhaling. And these are the majority of children. If you teach how to pause correctly, then after it the child physiologically takes a breath and continues to speak while exhaling, evenly distributing the available air. Pauses are also formed using the “string” method.

The main point in correcting stuttering is the formation of fluency of speech. Fluency of speech is not an end in itself, but serves as a starting point for creating a new speech program. When the child gets the feeling of how to speak without stuttering and the opportunity to “switch” to a new “beautiful speech” appears, there is no need to insist on fluent speech, since control over the tempo of speech, the ability to pronounce a phrase on one exhalation, and correct pauses have already been formed. But it is necessary to continue classes further in order to achieve automatism, so that conscious control passes into the unconscious.

At the initial stage, during classes, it is quite easy to explain to a student what the speech therapist wants from him and how to speak. But the younger the child, the more difficult it is. And now there are a lot of children who need correctional work already at the age of 3-4 years.

How to explain that you need to speak smoothly? Speech therapists use a sample of their speech for this. But most children, especially the youngest ones, cannot grasp this fluency, accept this new speech and understand how to pronounce it the same way. Then the specialist uses smooth hand guidance together with speech. Children pick up on this with great diligence, and thus a concomitant movement is formed. And the skill of “beautiful speech” will be clearly associated with hand movement. If a child is subsequently asked not to accompany his speech with a movement of his hand, saying that he already knows how to “speak beautifully,” then he begins to sway his whole body. So how can you explain to a child at the first stage and let him feel the fluency of speech? For this purpose, the “thread” method has been developed, which is presented in sequential exercises.

I present a new method of stuttering correction - “threads”, thanks to which:

- the child develops a sense of fluency of speech;

- an adult can influence the rate of speech by moving the child’s hand slowly along a sheet of paper;

— accompanying movements are not formed . After a period of developing a new speech skill, children easily give up drawing boring “strings” and independently control “beautiful speech.” No pencil - no movement.

- the child understands how he can speak in one breath, that is, on one “thread”, without interrupting it;

- the possibility of developing a long speech exhalation ;

— there is visual support for speaking in one speech exhalation.

— the child learns to distribute air evenly throughout a whole phrase and does this consciously, thanks to the “thread.”

- it becomes possible to work with pauses in complex sentences, poems and stories, which allows you to take a breath on time without receiving verbal instructions from an adult. Thanks to this, there is no interference in the physiological process of breathing, but its development is very gentle.

— seeing pauses also helps you learn to feel and do them;

— a conventional symbol : “say it beautifully, as if on a string,” thanks to which the child “switches” to a new type of speech, which is noted by almost all parents;

— long-term work with the “thread” makes it possible to develop motivation to speak in a new, “beautiful” way, and self-control is formed . This happens when we allow ourselves not to draw a “thread”, but to speak “beautifully” on our own, controlling the pace and smoothness. In order not to draw already boring lines, the child “turns on” his own desire to “speak beautifully.”

- after children have mastered the skill of speaking smoothly, drawing “strings”, and can already speak independently, “including” the skill of “beautiful speech”, it is very useful to continue these exercises at almost every lesson in the form of a warm-up . As noted by experts and parents, these exercises calm the child well, make it possible to remember how beautifully he speaks and set him up for further speech exercises.

Reznichenko T.S. [4] writes that “speech action can be defined as programming an utterance, implementing a program, and also a comparison of both.” A child who stutters must “overcome difficulties such as choosing linguistic units and combining them into sequential series.” And it is precisely on the formation of programming of speech utterances that the emphasis is placed in the presented books. At the first stage - learning to form a phrase and its activation. Then learning to plan a narrative story, retelling using pictures-symbols. And at the final stage - independent compilation of a coherent text, drawing sequentially each sentence for visual support, in order to then develop the child’s ability to mentally imagine visual images when spontaneously planning his own statement. This is formed by performing the exercises presented in the books “Automation of Fluent Speech” [7] in two parts, which are a consistent continuation of the correction process after the initial stage of fluency formation. They continue to work at the phrase level, but the tasks become more complicated. And work begins on automating speech without stuttering in coherent speech in the form of composing a descriptive story, using pictures-symbols, composing a story based on a series of pictures, also using symbols to form a plan of expression, retelling. Exercises for conducting training outside the classroom are offered. Thanks to a long, consistent period of automation of the skill of speaking without stuttering, conscious control of speech becomes unconscious. This means that the old program is being replaced with a new one, where there is no stuttering in speech.

The book “Formation of Speech Rhythm” presents a set of sequential exercises for working with rhythms. Not all children have the ability to cope with stuttering using fluency alone, so it is necessary to include rhythm. But we also know from experience that not all children accept rhythms, and the younger they are, the worse. Therefore, an individual approach in correctional work remains important.

If it is necessary to work with rhythms, at the initial stage we use support with hand movements so that the child tactilely feels the rhythms and there is external help. But as soon as the opportunity arises to speak rhythmically under self-control, we remove any movements so as not to automate the accompanying movements.

During classes, first, words and simple phrases are slammed on the table with the left and right hands alternately. Then the rhythms are formed using “pies”, that is, clapping the syllables with the palms, but switching the grip of the hands from right to left and back. For most children of senior preschool and primary school age, this set of exercises is enough to switch to rhythmic speech without tactile assistance, using self-control. If external help is needed, exercises are suggested with beating a rhythm with the thumb on a hand clenched into a fist. But more often, children prefer to help themselves by tapping their index finger on the table, thigh, or arms folded on their chest. For children of senior school age, exercises with word-by-word rhythm are offered.

The sequence and duration of the proposed exercises in the manuals “Formation of fluency of speech” [6], “Automation of fluency of speech” [7], “Formation of rhythmic speech” is not mandatory. The specialist varies individually depending on the severity of stuttering, the possibility of switching to speech without stuttering when using one or another method of correction, as well as on the time of formation and automation of the skill of each individual child.

Reznichenko T.S. [4] in her dissertation work proved that there is a significant “effectiveness of teaching reading in overcoming stuttering in preschoolers.” “Teaching reading can act as a necessary component of speech therapy classes, which has been statistically confirmed in comparative studies: the number of stuttering preschoolers who have achieved the main criterion for effectiveness - complete adaptation in micro- and macrosociety - is three times higher among those who have undergone a course of treatment that includes training reading, compared with children who stutter who were simultaneously taking the same course without reading instruction.”

Therefore, we introduce mandatory syllable reading training into the correctional speech therapy course. It is this technique of syllable reading that is the softest and most accessible way to introduce a child to reading. This method allows you to develop speech rhythms, which has a beneficial effect on the further acquisition of oral speech, and is also the basis of speech therapy work to correct various speech disorders in children, including stuttering. And the correctness of this approach has been proven by our numerous long-term observations. To teach syllable reading we use “An Entertaining Primer” by T.S. Reznichenko [9]. But not all children are easily able to perceive and memorize syllables, as well as distinguish them. Therefore, the manual “School of Beautiful Speech” has been developed. Learning to read” [8], where children are asked to remember the name of a syllable, relying on a word that begins with this syllable, in the form of a picture-symbol. The child perceives the syllable as a picture, memorizing it as a rhyme: MA - car, SHA - ball, etc. Next, we teach how to name only the syllable, explaining that the picture is our secret, our eyes are watching, but we don’t tell the secret to anyone. This condition is quickly accepted by the child, and then he reads words and phrases from these syllables, where the picture-symbol is preserved in order to have visual support, and the baby does not have to painfully remember how this syllable sounds, but the feeling is formed that reading is easy and interesting. In this manual, syllables only with the vowel “a” are taken. After such preparatory training, we continue to work using the “Entertaining ABC Book” [9].

Now it is necessary to discuss how to use the presented correctional methods depending on the age of the child and the severity of stuttering. Based on many years and very numerous experience, the following principles have been developed in my practice:

— for children 3-4 years old, the main work should be speech correction through the formation of fluency. Rhythmic speech at this age is not accepted by children. They are most often tense and scared. Therefore, only with severe stuttering, when fluency exercises do not help, can rhythms be used, and then only in the form of slapping the table. “Pies” do not give any effect, since motor skills have not yet been formed at the required level, and cause tension.

We are also starting to learn syllable reading using the manual “School of Beautiful Speech. Learning to read. Part 1".

- for children 4-5 years old, the main method is also fluency of speech, that is, the “string” method. But in the absence of logorhythmics classes, it is recommended to warm up in the form of exercises with rhythmic speech.

We begin to introduce syllable-by-syllable reading with the manual “School of Beautiful Speech. Learning to read. Part 1". Then we continue working on the “Entertaining Primer” by T. S. Reznichenko.

- for children 5-7 years old (preschoolers), you can start the course with rhythmic speech: slapping the table with the left and right hand alternately, then moving on to speech with “pies” and then independent rhythmic speech without the help of hands. As soon as we see that the child can speak without external help, we remove our hands so as not to form accompanying movements. Then we move on to teaching smooth speech. We use rhythmic speech only as a warm-up at the beginning of the lesson. In individual cases, when a child can only speak “with rhythm” without stuttering, it may be necessary to leave rhythmicity at the core of speech, but at the same time add smoothness.

Syllable-by-syllable reading - according to the "Entertaining Primer" plus reading tables of syllables for different types of differentiation according to the book "School of Beautiful Speech. Learning to read. Part 2".

- for younger schoolchildren, at the beginning of the course, we actively and for a long time use rhythmic speech, starting with a series of syllables of different lengths, poems, and phrases. Then reading, retellings, stories, dialogues, trainings. The stages of formation of rhythmic speech are the same as described above. If a child is very fixed on his problem and can only speak by helping himself with movement, and he needs external help, which also includes moving his hand, then we leave him the opportunity to help himself, but we are looking for a way to do this. Often the child himself chooses the method that is more acceptable to him from those suggested by the specialist. This is slapping a rhythm with your thumb against a closed fist, which you can hide in your pocket. Or with your index finger across folded arms on your chest. Sometimes the child prefers to beat out the rhythms with some object that he twirls in his hands. Here you need to provide the opportunity to choose to make it comfortable. There is no need to encourage kicking your feet and swaying your body to the rhythm of speech; in the future, this becomes very active and causes negative emotions in the people around you.

If a child can cope with stuttering when speaking “on rhythm” without the help of his hand, then we begin to develop fluency. This is very relevant, because it is at this age that most children “rebel” against speech “on a rhythm”, calling it “like a robot”. They argue their protest by saying that they won’t be able to talk like that at school, and everyone will laugh. When a child learns smoothness, which is still based on rhythm, he accepts this method more easily and uses it more actively to overcome cramps, and even agrees that he can speak with this type of speech anywhere.

Also, at the initial stage of correction, we work with syllable-by-syllable reading using the tables “School of Beautiful Speech. Learning to read. Part 2", "School of beautiful speech. A manual for schoolchildren." Then reading phrases and texts.

— senior schoolchildren (12-14 years old). In the beginning, I prefer to take various speech exercises using a metronome. Then - “pies” and rhythmic speech under self-control without hands. Then, even in a group setting, it is often necessary to work using individual techniques.

We definitely use fluency of speech, but as practice shows, teenagers are reluctant to use it. They feel that rhythms help them more, but at the same time they do not want to say so, because the syllable rhythm feels lifeless. Although the training in the form of rappers is carried out willingly and cheerfully. The word-by-word rhythm most often turns out to be the most acceptable for children, when pauses should be made not after each syllable, but after each word. The word rhythm method gives them the feeling that they are speaking like speakers from a podium, and at the same time great joy that they can speak and cope with stuttering. And it is at this age that you can and should talk openly with your child about his stuttering, calling everything by its proper name.

For very severe stuttering, when it is possible to speak only with a strong external stimulus - a metronome, we work with headphones. The child inserts one earphone into his ear, where a metronome sounds. Nowadays, no one is surprised by people wearing headphones, so the child’s reaction to this type of help is positive. And during classes we train by changing the speed of the metronome rhythm. Of course, at the first opportunity to speak without such a trick, we continue the correction with “pies” and further, as far as possible.

In order for the correction process to be successful, several stages must be implemented in speech therapy work.

1. The speech therapist needs to understand what correction method a particular child needs, based on his age and severity of stuttering. This is not always immediately clear, sometimes only by observing the manifestations of stuttering in dynamics and trying different approaches, it is possible to select the necessary methods and techniques.
2. During classes, the child must understand what the speech therapist wants from him, that is, how to speak in a new way.
3. A very important point. The child must not only understand, but also accept what he is being taught. Many children reject the new style of speech, and therefore, in this case, it is necessary to invent ways of motivation and encouragement for each specific individual.
4. The stage of automating speech without stuttering under external control , which can be a speech therapist, a parent, an office situation, or something else that will provoke the child to “turn on” a new skill.
5. The child must want to speak in a new way. This happens when he feels that using a new method makes it much easier for him. Many parents at this stage note that their baby begins to speak, then stops and seems to “switch” to a new style of speech. That is, the child, feeling that a cramp is beginning to appear, intuitively switches to a way of speaking when he can overcome it, as his experience in the classroom tells him. The speech therapist, together with parents, works out how to give motivation to speak not only in class, but also at home with parents, and in other situations.
6. The stage when the child consciously independently uses the skill of “beautiful speech” and gets pleasure from it, that is, we have self-controlled speech . This happens only when the skill is formed, automated, and the right motivation is created on the part of relatives.
7. And the last, most long-awaited stage is when, after consciously controlled speech without stuttering, unconscious control appears. Moreover, this last stage in young children can occur without the stage of conscious control. But the older the child is, and thus the more “experience” of stuttering, the longer the stage of conscious control will be.

Thus, the presented methodology for speech therapy correction of stuttering in children includes:

- formation of fluency of speech using the “thread” method, thanks to which the child develops a feeling of fluency with the help of visual support, the rate of speech is reduced and controlled, a long speech exhalation is formed, and work is done on pausing; it becomes possible to form conscious self-control over one’s speech.

- the use of rhythmic speech methods, based on the age characteristics of the child and the severity of stuttering.

— training and automation of syllable reading skills.

- consistent learning to plan your own statement.

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Bibliography.

1. Filicheva T.B., Cheveleva N.A., Chirkina G.V. Speech disorders in children: A manual for preschool teachers.. - M.: Professional education, 1993. - 232 p.
2. Seliverstov V.I. Stuttering in children: Psychocorrectional and didactic foundations of speech therapy: Textbook. aid for students higher and average ped. textbook Establishments. 4th ed., add. — M.: Humanite. ed. VLADOS center, 2001.
3. Wiesel T.G. Correction of stuttering in children. AST, 2009. - 224 pages.
4. Reznichenko T.S. Teaching reading as a means of correcting systemic speech disorders in preschool children. Abstract of the dissertation for the scientific degree of candidate of pedagogical sciences. M., 2007
5. Povarova I. A. Correction of stuttering in games and trainings. St. Petersburg: Peter, 2004
6. Kozlova M.V. School of beautiful speech. Formation of smoothness. M.: V. Sekachev, 2021.
7. Kozlova M.V. School of beautiful speech. Automation of smoothness. M.: V. Sekachev, 2018
8. Kozlova M.V., Razuvaeva E.V. School of beautiful speech. Learning to read. M.: V. Sekachev, 2021.
9. Reznichenko T.S. An entertaining primer for children with severe speech impairments. M. Gnome, 2002
10. Belyakova L.I., Dyakova E.A. Stuttering. Textbook for students of pedagogical institutes in the specialty “Speech Therapy” - M.: V. Sekachev, 1998

Article:

Stuttering is a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus. A little history The problem of stuttering can be considered one of the oldest in the history of the development of the doctrine of speech disorders. In middle times, stuttering was predominantly seen as a disease associated with the filling of moisture in the brain (Hippocrates) or incorrect correlation of parts of the articulatory apparatus (Aristotle). The possibility of disturbances in the central or peripheral parts of the speech apparatus during stuttering was recognized by Galen, Celsus, and Avicenna. At the turn of the 17th-18th centuries. They tried to explain stuttering as a consequence of imperfections in the peripheral speech apparatus. For example, Santorini believed that stuttering occurs when there is a hole in the hard palate through which mucus leaks and makes speech difficult. Other researchers have associated stuttering with disturbances in the functioning of the speech organs: convulsive closure of the glottis (Arnot, Schulthess); excessively rapid exhalation (Becquerel); inconsistency of thinking and speech (Blume); etc. In Russia, most researchers considered stuttering as a functional disorder in the sphere of speech, convulsive neurosis (I. A. Sikorsky 1889; I. K. Khmelevsky 1897, etc.) or defined it as a purely mental suffering, expressed by convulsive movements in the speech apparatus (Chronicle Laguzen, 1838; G. D. Netkachev, 1909, 1913), as psychosis (Gr. Kamenka, 1900). By the beginning of the 20th century, all the diversity of understanding of the mechanisms of stuttering can be reduced to three theoretical directions: 1. Stuttering as a spastic neurosis of coordination, resulting from irritable weakness of speech centers (syllable coordination apparatus). This was clearly formulated in the works of G. Gutzman, I. A. Kussmaul, I. A. Sikorsky. They further explained stuttering in terms of neuroticism. 2. Stuttering as an associative disorder of a psychological nature. Supporters of the theory are A. Liebmann, G. D. Netkachev, Yu. A. Florenskaya. 3. Stuttering as a subconscious manifestation that develops due to mental trauma and various conflicts with the environment. Proponents of the theory A. Adler, Schneider. Thus, at the end of the 19th and beginning of the 20th centuries, the opinion that stuttering is a complex psychophysical disorder became more and more definite. By the 50-60s of the 20th century, the mechanism of stuttering began to be considered based on the teachings of I. P. Pavlov about the higher nervous activity of man and, in particular, about the mechanism of neurosis. Stuttering, like other neuroses, occurs due to various reasons that cause overstrain of the processes of excitation and inhibition and the formation of a pathological conditioned reflex. Stuttering is not a symptom or a syndrome, but a disease of the central nervous system as a whole. A nervous breakdown in the activity of the cerebral cortex may be due, on the one hand, to the state of the nervous system, its readiness for deviations from the norm. On the other hand, a breakdown may be caused by unfavorable exogenous factors. A reflection of a nervous breakdown is a disorder in a particularly vulnerable and vulnerable area of ​​the child’s internal nervous system—speech, which manifests itself in impaired coordination of speech movements with the phenomena of arrhythmia and convulsions. Violation of cortical activity is primary and leads to a distortion of the inductive relationship between the cortex and subcortex and a disruption of those conditioned reflex mechanisms that regulate the activity of subcortical formations. Due to the created conditions under which the normal regulation of the cortex is distorted, negative shifts occur in the activity of the striopallidal system. Its role in the stuttering mechanism is quite important, since normally this system is responsible for the rate and rhythm of breathing, and the tone of the articulatory muscles. Stuttering does not occur due to organic changes in the striopallidum, but due to dynamic deviations in its function. The desire of Russian researchers to consider stuttering from the perspective of Pavlovian teaching finds numerous followers abroad: in the Czech Republic, Bulgaria, Poland, Germany. Causes of stuttering Currently, two groups of causes can be distinguished: predisposing ("ground") and producing ("shocks"). At the same time, some etiological factors can contribute to the development of stuttering and directly cause it. Predisposing factors (“soil”): Neuropathic aggravation of the parents: nervous, infectious and somatic diseases that weaken or disorganize the functions of the central nervous system. Neuropathic characteristics of the person who stutters: night terrors, enuresis, increased irritability, emotional tension. Hereditary aggravation: stuttering that develops due to congenital weakness of the speech apparatus, which is inherited as a recessive trait. In this case, it is necessary to take into account the role of exogenous factors when a predisposition to stuttering is combined with unfavorable environmental influences. Damage to the brain during various periods of development under the influence of many harmful factors: intrauterine and birth injuries, asphyxia; postnatal infectious, traumatic and metabolic-trophic disorders in various childhood diseases. Unfavorable conditions: Physical weakness of children. Age-related features of brain activity; The cerebral hemispheres are mainly formed by the 5th year of life, and by the same age functional asymmetry in brain activity takes shape. The speech function is ontogenetically the most differentiated and late maturing, especially fragile and vulnerable. Moreover, its slower maturation in boys than in girls causes more pronounced instability of their nervous system. Accelerated development of speech (3-4 years), when its communicative, cognitive and regulatory functions quickly develop under the influence of communication with adults. During this period, many children experience repetition of syllables and words (interpretation), which is physiological in nature. Hidden mental impairment of the child, increased reactivity due to abnormal relationships with others. Lack of positive and emotional contact between adults and children. Insufficient development of motor skills, sense of rhythm, facial and articulatory movements. The group of unfavorable causes includes: Anatomical and physiological causes: physical diseases with encephalopathic consequences a) injuries (intrauterine, natural, often with asphyxia, concussion); b) organic brain disorders, in which subcortical mechanisms regulating movements may be damaged; c) exhaustion or overwork of the nervous system as a result of intoxication and other diseases that weaken the central apparatus of speech (measles, typhus, rickets, worms, whooping cough, diseases of internal secretion, metabolism, imperfection of the sound-pronunciation apparatus in cases of dyslalia, dysarthria, mental retardation). Mental and social reasons: a) short-term - one-time - mental trauma (fear, fear); b) long-term mental trauma, which is understood as improper upbringing in the family: spoilage, uneven upbringing, imperative upbringing, long-term negative emotions in the form of persistent mental stress or unresolved, constantly reinforced conflict situations; c) improper formation of speech in childhood: speech while inhaling, rapid speaking, impaired sound pronunciation, rapid nervous speech of parents; d) overload of young children with speech material, age-inappropriate complexity of speech material and thinking (abstract concepts, complex phrase construction); e) imitation of people who stutter (two forms of such speech induction are distinguished: passive - the child involuntarily begins to stutter when hearing the speech of a stutterer; active - he copies the speech of a stutterer), f) retraining left-handedness. Speech Speech has proven itself very effectively in the treatment of stuttering for more than 12 years. The center is located in the resort town of Belokurikha, and also works using the author’s method (patent No. 2497555) remotely throughout Russia and the world. The method is based on the formation of new speech, breathing, articulation and voice, individual psychological work is carried out to destroy reflexes and old habits. The lesson process is designed to be as comfortable and harmonious as possible, which is suitable for both adults and children over 5 years old. The course of treatment is designed for 10-12 days, depending on the complexity and form of stuttering, and consists of daily work on the speech apparatus, because the root of the problem is convulsive contraction of the muscles of the speech apparatus. Another advantage is the provision of accommodation in a resort area with clean mountain air, thermal mineral water, an atmosphere of comfort, calm and tranquility, which allows you to fully concentrate on achieving a positive result and get correct, confident speech. Symptoms of stuttering Conventionally, there are two groups of symptoms that are closely related. 1. Physiological (biological) symptoms: speech convulsions, disorders of the central nervous system and physical health of the child. The main external symptom of stuttering is convulsions during the speech act. Their duration varies: from 0.2 to 90 seconds (in severe cases). Convulsions vary in form (tonic, clonic and mixed), in localization (respiratory, vocal, articulatory and mixed) and in frequency. With tonic convulsions, a short jerky or prolonged spasmodic muscle contraction is observed - tone: “t-opol” (the line after the letter indicates a convulsively prolonged pronunciation of the corresponding sound). With clonic convulsions, there is a rhythmic, with less pronounced tension, repetition of the same convulsive movements - muscles - clonus: “this-that-poplar”. That. The entire respiratory-vocal-articulatory apparatus is affected. Depending on the predominance of convulsions in certain organs of speech, respiratory, vocal and articulatory organs are distinguished. When stuttering, 3 forms of breathing disturbance are noted: expiratory (convulsive exhalation), inspiratory (convulsive inhalation, sometimes with sobbing), respiratory (convulsive inhalation and exhalation, sometimes with a break in the word). Convulsions in the vocal apparatus are characterized as follows: Closing (convulsively closed vocal folds cannot open in a timely manner - the voice is suddenly interrupted or a clonic or prolonged convulsion is formed - an intermittent bleating (“A-a-a-anya”) or a jerky vowel sound (“A-a-a-anya”) or a jerky vowel sound is produced. a-a-a-a"). Opening (the glottis remains open - in this case there is complete silence or whispered speech). Vocal, characteristic of children (stretching out vowel sounds). In the articulatory apparatus, convulsions are distinguished - labial, lingual and soft palate. They appear more often and more sharply when pronouncing consonant plosives (k, g, p, b, t, d); less often and less intensely - fricative sounds. In the expressive speech of children who stutter, phonetic-phonemic and lexico-grammatical disorders are noted. Prevalence of phonetic-phonemic disorders among preschoolers is, according to the latest data, 66.7%, among primary schoolchildren - 43.1%, middle school - 14.95% and senior - 13.1%.The manifestation of stuttering is characterized by various violations of speech and general motor skills, which can be violent (speech spasms, tics, myoclonus in the muscles of the face and neck) and arbitrary tricks. Tricks include auxiliary movements that stutterers resort to to disguise or facilitate their speech. General motor tension, stiffness or restlessness, disinhibition, incoordination or lethargy are often noted. 2. Social (psychological) symptoms. One of the main phenomena from which a neurotic disorder develops is a feeling of inferiority, fixation on a defect. And the more attention is fixed on the defect, the more persistent it becomes. 1. Zero degree of fixation. Children do not feel disadvantaged by the awareness of the defect or do not notice it at all. There are no elements of embarrassment, touchiness for one’s incorrect speech, or any attempts to overcome the defect. 2. Moderate degree of painful fixation. Older schoolchildren and teenagers experience their defect, are embarrassed by it, hide it, resort to various tricks, and try to communicate less. They are aware of their stuttering, experience a number of inconveniences from it, and try to disguise their deficiency. 3. Severe degree of painful fixation. Worries about one’s defect result in a constant painful feeling of one’s own inferiority, when every action is interpreted through the prism of one’s defect. Most often these are teenagers. They focus on speech failures, experience them deeply, and are characterized by morbid suspiciousness and fear of speech, people, and situations. Degrees of stuttering There are 3 degrees of stuttering: 1) mild - they stutter only in an excited state and when trying to quickly speak out. In this case, delays are easily overcome, those who stutter speak without being embarrassed by their defect; 2) average - in a calm state and in a familiar environment they speak easily and stutter little. In an emotional state, severe stuttering appears; 3) severe - they stutter throughout the entire speech, constantly, with accompanying movements. Types of the course of stuttering The following types of course of stuttering are distinguished: - permanent type (stuttering, having arisen, manifests itself relatively constantly in various forms of speech and situations); - wavy (stuttering sometimes intensifies and sometimes weakens, but does not completely disappear); - recurrent (having disappeared, stuttering appears again, i.e. a relapse occurs, the return of stuttering after quite long periods of free, hesitating speech). Concomitant diseases Most authors who have studied the pathogenesis of stuttering note various autonomic disorders in stutterers. M. Zeeman believes that 84% of people who stutter have autonomic dystonia. Of 100% of people who stutter, 20% have increased intracranial pressure and extrapyramidal disorders. In 100% of cases, they experience mydrosis (dilation of the pupils); in normally speaking people, the width of the pupils does not change during speech or some narrowing occurs. Practicing neurologists working with people who stutter note (according to neurological data): 1. Segmental insufficiency at the level of the cervical spine is observed in 60% of patients (out of 100%). This could be torticollis, hypotonia of the muscles of the upper shoulder girdle with forward rotation of the shoulders and distance of the shoulder blades, protective tension of the cervical-occipital muscles, signs of early osteochondrosis, or spinal pathology. 2. Violation of stem functions was found in all patients without exception. 3. Non-orthopedic pathology occurred in 50% of children who stutter, including: poor posture, flat feet, pathological alignment of the feet. 4. Autonomic dysfunction was detected in 20% of patients, including VSD and weakness of the vestibular apparatus. 5. Disturbance of venous blood flow from the cranial cavity was found in 65% of children. 6. Hemodynamic signs of vertebrobasilar insufficiency in 48%. 7. Extrapyramidal insufficiency was detected in 80%. Prevalence of stuttering The prevalence of stuttering is determined by age, gender, type of activity, place of residence and other factors. Most often, stuttering occurs between the ages of 2 and 4 years, during the period of the most intensive development of the speech functional system and the formation of the child’s personality. Then the tendency to stutter decreases, and over the next 10 years (4-14) there are approximately the same number of stuttering cases as from 1 to 3 years. In the period before puberty, the number of people who stutter increases upon entering school due to relapses. The increase in stuttering is due to a change in the leading activity (instead of playing - educational), increased, increased demands on the child, on his speech skills. Stuttering may worsen during puberty. Among children living in rural areas, stuttering is less common than among their urban counterparts. Some scientists note the influence of climatic conditions on the intensification of stuttering, for example, in autumn and spring (M. Zeeman). Stuttering is more common in developed countries. In England, the USA and Russia there is approximately the same percentage of people who stutter. According to statistics, in the former USSR there were 6 million stutterers out of 250 million inhabitants. In African countries there are much fewer people with this disease. In China - even less (but here the point is not in development, but in a different language system). As a rule, stuttering affects people with a fairly high level of intelligence. Prognosis The prognosis for overcoming stuttering depends on many conditions, primarily on its mechanisms, on the timing of the onset of complex influence and the completeness of its application, on age. Practice shows that the younger the age, the more active and cheerful the general behavior, the fewer parts of the speech apparatus affected by the spasm and the weaker the spasm, the fewer mental layers, the more favorable the prognosis. For stuttering that develops due to congenital aggravation or acquired neuropathy, as well as one that appears without visible external influences, the outcome of correction is less favorable. In this case, relapse is more likely. Respiratory convulsions go away more successfully than vocal convulsions. Clonic forms disappear more easily than tonic ones, because Clonic convulsions are characteristic of stimulation of the cerebral cortex. Therefore, it is easier to influence them through a 2 signaling system than on tonic, characteristic of the excitation of a subcortex, which is more difficult to give in to this effect. The most favorable is the age of 2-4 years (it is easier to create favorable conditions and small stuttering experience). The least favorable age of 10-16 years, puberty. Often the disappeared stutter is potentially preserved and is ready to manifest itself in the event of adverse conditions. N. A. Vlasova believes that stuttering that arose as a result of infection, mental injury or as a result of imitation is eliminated more successfully. This is explained by the fact that infections in most cases cause only functional shifts, do not give organic changes in the central nervous system. When stuttering, which arose as a result of psycho -trauma, there are only single facts of fright of stuttering (a boob of a steam locomotive, bite or barking of a dog, etc.). Less effectly and successfully eliminating the disease in cases where it arose due to the belated development of speech, imitation of parents. According to the same author, from preschool children 70% completely get rid of the disease, 30% have residual phenomena. Statistical data according to E.F. RAU: in 60%, complete success is achieved, in 19% a significant improvement, in 13% - the lack of success, in 8% - relapses. According to G. A. Volkova: at stuttering children 4-7 years old at the end of classes, speech without stuttering was noted in 70.2% of cases, a significant improvement-in 26.3%, a noticeable improvement-in 3.5% of cases. According to V. I. Seleverstov: in stuttering agents from 6 to 17 years after being in a special sanatorium, speech was noted without stuttering in 39.7% of children, a significant improvement in 47.8%, and a slight improvement in 12.5% . Correction indicators are less effective among schoolchildren. According to M.E. Dryattsev: 15% of students are completely exempted from stuttering, 82% of students improve their speech to varying degrees, 3% do not give a positive result. According to the observations of S. S. Lyapidevsky and V.I. Seleverstov, in cases of recurrence of stuttering, the complexity of its manifestations does not reach the original state from which correctional work has begun. With an organic basis of stuttering, the results are much worse than with functional. The effectiveness of overcoming stuttering is affected by a different degree of severity, which is based on a different degree of painful fixation of the patient on his defect. The results of speech therapy work are better in case of a mild degree of stutter (zero degree of painful fixation). Methods of overcoming stuttering speech therapy classes are only an integral part of a comprehensive healing and pedagogical effect on stuttering. A set of measures is required: drug treatment, physiotherapy, psychotherapy, normalization of a micro -social environment. In this case, the adequacy and differentiation of the selected methodology matters. The selection of the methodology should be strictly individual. Parents should realize that stuttering is necessary in a certain system, the form of a disposable campaign in this case is unacceptable! The rules and exercises in smooth speech some researchers and speech therapists consider it advisable to inform the stuttering, and then regularly repeat the rules for the exercise in smooth speech with them. It is assumed that as the speech therapy course passes through the speech, the rules of speech will be executed automatically and contribute to the normalization of their speech. For the first time, 12 rules for the exercise in smooth speech were developed by A. Gutzman and G. Gutzman in 1924. But their use is relevant today, is widely used in practice and gives results. 1. Speak slowly and calmly, i.e. Say the syllable after the syllable, the word for the word, the sentence for the sentence. 2. Always understand what and how you will say. 3. Do not speak either too loudly, nor too quiet. 4. When talking, stand or sit straight. 5. Before you start talking, quickly and deeply inhale with your mouth. 6. Come on your breath economically. During the conversation, try to hold your breath if possible. 7. Always go decisively and definitely to the position for pronouncing vowels. 8. Direct the exhalation not to the vowel, but to the consonant sound. 9. Never click on the consonants; If necessary, speak below the ordinary tone and slightly stretch all the vowels. 10. When the word begins with the vowel, then start it quietly and in a slightly reduced tone. 11. Stretch the first vowels for a long time in the sentence and tie all the words of the sentence among themselves, as if the whole sentence is one multi -sized word. 12. Always try to speak clearly and harmoniously. The first signs of stuttering in order to help the child in time, it is very important not to miss the first signs of stuttering: if the child suddenly falls silent, refuses to speak (this can last from two hours to a day, after which the child begins to speak again, but already stuttering) - if you have time to contact a specialist until the stutter occurs, he can be prevented; the use of unnecessary sounds (a, and) before individual words; repetition of the first syllables or whole words at the beginning of the phrase; forced stops in the middle of the word, phrases; difficulties before the start of speech. Knowledge of these reasons should help parents notice anxiety signs in time and timely contact specialists (psychologist, psychoneurologist, speech therapist), since stuttering is easier to warn than to treat. If the family has a stuttering child, it is important to remember: 1. A stuttering child must always be under the supervision of a speech therapist and a neuropsychiatric man. In view of the fact that stuttering children and children of the risk group weakened the nervous system, they require an individual approach, a calm atmosphere in the family, the correct general speech regime. 2. You cannot read many books that do not correspond to their age. Reading terrible fairy tales at night is harmful, as this can cause a child of constant fear in the child: he is afraid to see the woman Yaga, goblin, hell, etc. 3. You should not be allowed often and for a long time watching television programs. This tires and overtakes the nervous system of the child. Particularly negatively apply programs that do not correspond to his age and viewed before bedtime. 4. You can’t pamper children excessively, to perform any of their whims, since in this case a mental trauma for a child can be a slight contradiction to him, for example, a refusal of something desired. The requirements for a child must comply with his age, always be the same, permanent from everyone around them, both in the family and in kindergarten, at school. 5. Do not overload the child with a large number of impressions (cinema, reading, viewing television programs, etc.) during the recovery after the disease. 6. You can not intimidate the child, punish, leaving one in the room, especially poorly lit. In the form of punishment, you can make him sit quietly on a chair, deprive him of participation in his favorite game, etc. 7. Talking with such a child must be clearly, smoothly (without tearing one word from another), not in a hurry, but in no case in syllables and not losing. 8. You need to always be equally even and demanding of the child. 9. Such a child should be brought together with the most balanced, well -speaking children, so that, imitating them, he learned to speak expressively and smoothly. 10. You cannot involve stuttering children in games that excite and require participants in individual speech performances. 11. For a stuttering child, music and dancing are very important, which contribute to the development of proper speech breathing, a sense of pace, rhythm. Additional singing classes are useful. Literature 1. Zhinkin N.I. Speech mechanisms. - M., APN RSFSR, 1958. 2. L. de nil and hg bosshardt Studying startering from Neurological and Cognitive Processing Perspective. ProCeeDings of the Third World Congress of Fluence Disorders in Nyborg, Denmark, PP 53 - 59, 2000. 3. Nosenko E. L. Features of speech at emotional tension. - Dnepropetrovsk, 1975. 4. Shklovsky V. M. Psychotherapy in a comprehensive system for the treatment of logoneurosis (guide to psychotherapy). Ed. V.E. Rozhnova. - M., 1974. 5. Lowen A. Joy. - Minsk, 1999. 6. Kognovitskaya T. S. The frequency of the main tone of voice in children suffering from stuttering. - In Sat. Issues of the pathology of voice and speech, Niilor, M., 1983. 7. Arutyunyan L. Z. How to treat stuttering. - M., 1993. 8. Bekhtereva N.P. Healthy and sick human brain. - L., Science, 1988. 9. Bekhtereva N.P., Kabarova D.K., Pozdeev V.K. The stable pathological condition for diseases of the brain. -L., Medicine, 1978. 10. Volkova G. Game activity in eliminating stuttering among preschoolers, series: Correctional pedagogy [338] Publishing house: field, creative center, childhood-press, 2003. 11. Smirnova L. N. “ Speech therapy when stuttering: classes with children 5-7 years old in kindergarten: a manual for speech therapists, educators and ... my world is M., children's literature. 12. Paramonova L. "On stuttering: prevention and overcoming the disease." 13. Cheveleva N. A. Correction of speech at stuttering schoolchildren. - M.: Education, 1966. - 96 p.