home Healthy eating Working with stuttering in preschool children. Until now, researchers have been trying to consider the mechanism of stuttering not only from clinical and physiological, but also from neurophysiological, psychological, and psycholinguistic positions.

Working with stuttering in preschool children. Until now, researchers have been trying to consider the mechanism of stuttering not only from clinical and physiological, but also from neurophysiological, psychological, and psycholinguistic positions.

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Introduction

1.1 The essence of stuttering
1.2 Forms of stuttering
1.3 Course of stuttering
Conclusions to Chapter 1
2.2 Methodology N.A. Cheveleva
2.3 Methodology V.M. Shklovsky
2.5 Methodology S.A. Mironova
2.6 Methodology G.A. Volkova
Conclusions to Chapter 2
Conclusion
Bibliography

Introduction

The problem of stuttering can be considered one of the oldest in the history of the development of the doctrine of speech disorders. In the literature of the past, there were very diverse interpretations of the mechanisms of stuttering. This is explained by both the level of development of science and the positions from which different authors have approached and are approaching the study of this speech disorder.

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.

Stuttering is a widespread speech disorder. It occurs in young children during the period of the most active formation of their speech and personality and even at the end of the 19th century. our domestic psychiatrist I.A. Sikorsky first established that in most cases this occurs between the ages of 2 and 5 years.

But, according to most scientists, stuttering is not only a disorder of speech function. In the manifestations of stuttering, attention is drawn to disorders of the nervous system of stutterers, their physical health, general motor skills, actual speech function, presence psychological characteristics. The listed deviations in the psychophysical state of children who stutter manifest themselves differently in different cases, but, nevertheless, one is closely connected with the other, feeds each other, the complication of one inevitably aggravates the other. Guided by Pavlov's teaching on higher nervous activity in humans, stuttering is called a disease of the central nervous system as a whole.

It is now generally accepted that stuttering should be eliminated as soon as it occurs. The more time passes from the moment stuttering begins, the more often it turns into a severe, persistent defect and entails changes in the child’s psyche. In addition, stuttering deprives the child of normal communication conditions and often prevents him from successful studies. Therefore, it is important to eliminate this defect before the child enters school. But it is necessary to influence the speech of a stutterer, but also his personality and motor skills in general. In our country, influencing different aspects of the body, speech and personality of a stutterer using different means is called a comprehensive method of overcoming stuttering.

Speech therapy work with preschoolers with stuttering is presented in the methodological recommendations of N.A. Vlasova and E.F. Pay ("Speech therapy work with stuttering preschoolers." - M., 1959), S.A. Mironova ("Training and education of stutterers" preschool institutions". - M., 1983), G. A. Volkova ("Game activity in eliminating stuttering in preschoolers." - M., 1983).

The basis of the system for overcoming stuttering proposed by S.A. Mironova, the child’s activities are organized into sections: “Acquaintance with the surrounding nature”, “Development of speech”, “Development of elementary mathematical concepts”, “Drawing, modeling, application, design”.

The speech therapist is assigned programmatic and correctional tasks, which are solved during four stages of successively more complex work.

In the method of G.A. Volkova presents a system of comprehensive work with children who stutter, which consists of sections: methods of play activities, logorhythmic activities, educational activities, impact on the microsocial environment of children.

ON THE. Vlasov and E.F. Pay offer to work on a child’s speech, moving from its simple forms to complex ones: from conjugate speech, through reflected and question-answer speech, to describing familiar pictures, retelling a listened text, to spontaneous and emotional speech.

The choice of methods for overcoming stuttering in preschoolers depends on the type of institution in which the children live (speech therapy group in a kindergarten or hospital setting). However, all authors indicate that overcoming stuttering in preschool children is possible only with complex intervention, one of the components of which is speech therapy rhythm.

The topic of my course work is “Methods of speech therapy work with preschoolers who stutter.” This topic is very relevant, since speech disorders are diverse, and the methods for their correction are also diverse.

The purpose of this course work is to study the methodology of speech therapy work with children of senior preschool age to correct stuttering.

The main tasks, I believe, are to consider the main stages, directions, study methods of speech therapy work to correct the symptoms of stuttering in children of senior preschool age.

Chapter 1. Theoretical aspects of stuttering

1.1 The essence of stuttering

Stuttering is a painful, severe speech disorder. It is difficult to eliminate, disorganizes the child’s personality, slows down the correct course of education and training, and complicates the normal inclusion of a preschooler in the children’s team Ya.M. Gorelik. A psychological method for overcoming stuttering. .

That is why educators should seriously think about ways to eliminate this deficiency in their students. It is necessary to understand the nature of stuttering, study the personality of the stutterer and master the available special pedagogical methods. Under such conditions, the teacher can often help the child even more than a speech therapist, due to more intimate and prolonged contact with his pupil and his family.

Stuttering is a functional speech disorder, externally expressed in muscle spasms of certain speech organs at the time of sound pronunciation (lips, tongue, soft palate, larynx, pectoral muscles, diaphragm, abdominal muscles). Speech is interrupted due to a delay in certain sounds and words (Appendix 1).

The problem of stuttering can be considered one of the most ancient in the history of the development of the doctrine of speech disorders. Different understandings of its essence are due to the level of development of science and the positions from which the authors approached and are approaching the study of this speech disorder.

At the turn of the XVII-XVIII 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 supposedly leaks onto the tongue and makes speech difficult. Wutzer explained this by an abnormal depression in the lower jaw, in which the tip of the tongue hides when it moves. 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); spasmodic contraction of the muscles that hold the tongue in the mouth (Itard, Lee, Dieffenbach); inconsistency between the processes of thinking and speech (Blume); imperfection of the human will, affecting the strength of the muscles of the speech-motor mechanism (Merkel), etc.

Some researchers linked stuttering with disturbances in the course of mental processes. For example, Blume believed that stuttering arises from the fact that a person either thinks quickly, so that the speech organs do not keep up and therefore stumble, or, on the contrary, speech movements “leave ahead of the thinking process.” And then, due to the intense desire to equalize this discrepancy, the muscles of the speech apparatus come into a “convulsive state.”

By the beginning of the 20th century. all the diversity of understanding 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, and then in the works of I.A. Sikorsky, who wrote: “Stuttering is a sudden disruption of the continuity of articulation caused by a spasm that occurs in one of the sections of the speech apparatus as a physiological whole.” Proponents of this theory initially emphasized the innate irritable weakness of the apparatus that controls syllabic coordination. They further explained stuttering in terms of neuroticism: stuttering is a spasm-like spasm.

2) Stuttering as an associative disorder of a psychological nature. This direction was put forward by T. Gepfner and E. Frechels. Supporters were A. Liebmann, G.D. Netkachev, Yu.A. Florenskaya. The psychological approach to understanding the mechanisms of stuttering has received further development.

3) Stuttering as a subconscious manifestation that develops due to mental trauma and various conflicts with the environment. Proponents of this theory were A. Adler, Schneider, who believed that stuttering, on the one hand, manifests the individual’s desire to avoid any possibility of contact with others, and on the other, to arouse the sympathy of others through such demonstrative suffering.

By the 30s and in the subsequent 50-60s of the XX century. the mechanism of stuttering began to be considered based on the teachings of I.P. Pavlova about the higher nervous activity of man and, in particular, about the mechanism of neurosis. At the same time, some researchers considered stuttering as a symptom of neurosis (Yu.A. Florenskaya, Yu.A. Povorinsky, etc.), others as a special form of it (V.A. Gilyarovsky, M.E. Khvattsev, I. II. Tyapugin, M.S. Lebedinsky, S.S. Lyapidevsky, A.I. Povarnin, N.I. Zhinkin, V.S. Kochergina, etc.). But in both cases, these complex and diverse mechanisms for the development of stuttering are identical to the mechanisms for the development of neuroses in general. 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 (V.S. Kochergina, 1962). In the occurrence of stuttering, a primary role is played by disrupted relationships between nervous processes (overstrain of their strength and mobility) in the cerebral cortex. 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 nervous breakdown may be caused by unfavorable exogenous factors, the importance of which in the genesis of stuttering was pointed out by V.A. Gilyarovsky. A reflection of a nervous breakdown is a disorder in a particularly vulnerable and vulnerable area of higher nervous activity in a child - 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 of its functions. These views reflect an understanding of the mechanism of neurotic stuttering as a peculiar violation of cortical-subcortical relations (M. Zeeman, N.I. Zhinkin, S.S. Lyapidevsky, R. Luchsinger and G. Arnold, E. Richter and many others).

In young children, according to some authors, it is advisable to explain the mechanism of stuttering from the standpoint of reactive neurosis and developmental neurosis (V.N. Myasishchev, 1960). Reactive developmental neurosis is understood as an acute disorder of higher nervous activity. Stuttering occurs at an early age against the background of delayed physiological tongue-tiedness during the transition to complex forms of speech, to speech in phrases. Sometimes it is the result of speech underdevelopment of various origins (R.M. Boskis, R.E. Levina, B. Mesoni). So, R.M. Boskis calls stuttering a disease, “which is based on speech difficulties associated with the formulation of more or less complex statements that require phrases for their expression.” Speech difficulties can be caused by delays in speech development, transition to another language, cases of pathological personality development with underdevelopment of the emotional-volitional sphere, the need to express a complex thought, etc.

R.E. Levina, considering stuttering as a speech underdevelopment, sees its essence in the primary violation of the communicative function of speech. The problem of organic stuttering remains unresolved to this day. Some researchers believe that stuttering as a whole is included in the category of organic diseases of the central nervous system and disorders of the brain substrate directly affect the speech areas of the brain or systems associated with them (V. Love, 1947; E. Gard "1957; S. Skmoil and V. Ledezich , 1967). Others consider stuttering as a predominantly neurotic disorder, regarding the organic disorders themselves as the “soil” for disruption of higher nervous activity and speech function (R. Luchsinger and G. Landold, 1951; M. Zeeman, 1952; M. Sova K, 1957; M.E. Khvattsev, 1959; S.S. Lyapidevsky and V.P. Baranova, 1963, and many others).

Most authors who have studied the pathogenesis of stuttering note various autonomic changes in stutterers. For example, Zeeman believes that 84% of people who stutter have autonomic dystonia. According to Szondi, out of 100 people who stutter, 20% have increased intracranial pressure and extrapyramidal disorders. He believes that people who stutter are born vasoneurotic. Gerdner objectively showed a change in the neurovegetative reaction in people who stutter during attacks: in 100% of cases they have dilated pupils (mydriosis), in normal talking people The width of the pupils does not change during speech or some narrowing occurs (miosis).

IN severe cases disorders of the autonomic nervous system, stuttering itself recedes into the background, fears, worries, anxiety, suspiciousness, general tension, a tendency to trembling, sweating, and blushing predominate. In childhood, people who stutter experience sleep disturbances: shuddering before falling asleep, tiring, restless shallow dreams, night terrors. Older stutterers try to associate all these unpleasant experiences with speech impairment. The thought of her disorder becomes persistent in accordance with her constantly disturbed state of health. Against the background of general excitability, exhaustion, instability and constant doubts, speech usually can be improved only for a short time. In classes, people who stutter often lack determination and perseverance. They underestimate their own results, since improvement in speech does little to improve their overall well-being.

In the 70s, clinical criteria were proposed in psychiatry for distinguishing between neurotic and neurosis-like disorders and there was a tendency to distinguish stuttering into neurotic and neurosis-like forms (N.M. Asatiani, B.3. Drapkin, V.G. Kazakov, L. I. Belyakova and others).

Until now, researchers have been trying to consider the mechanism of stuttering not only from clinical and physiological, but also from neurophysiological, psychological, and psycholinguistic positions.

Of interest are neurophysiological studies of stuttering in the organization of speech activity (I.V. Danilov, I.M. Cherepanov, 1970). These studies show that in people who stutter during speech, the dominant (left) hemisphere cannot consistently perform its leading role in relation to the right hemisphere.

Studies of the organization of visual function in people who stutter (V. Suvorova et al., 1984) have shown that they are characterized by atypical lateralization of speech and visual functions. The identified anomalies can be considered as a consequence of deficiencies in the bilateral regulation of visual processes and deviations in interhemispheric relationships.

It is relevant to develop the problem of stuttering in the psychological aspect to reveal its genesis, to understand the behavior of people who stutter in the process of communication, to identify their individual psychological characteristics. A study of attention, memory, thinking, and psychomotor skills in people who stutter showed that the structure of their mental activity and its self-regulation were altered. They perform worse in those activities that require a high level of automation (and, accordingly, rapid inclusion in the activity), but the differences in productivity between people who stutter and those who are healthy disappear as soon as the activity can be performed at a voluntary level. The exception is psychomotor activity: if in healthy children psychomotor acts are performed largely automatically and do not require voluntary regulation, then for those who stutter, regulation is a complex task that requires voluntary control.

Some researchers believe that people who stutter are characterized by greater inertia of mental processes than normal speakers; they are characterized by the phenomenon of perseveration associated with the mobility of the nervous system.

It is promising to study the personal characteristics of people who stutter both through clinical observations and using experimental psychological techniques. With their help, an anxious and suspicious character, suspicion, and phobic states were identified; uncertainty, isolation, tendency to depression; passive-defensive and defensive-aggressive reactions to a defect.

It is worthy of attention to consider the mechanisms of stuttering from the perspective of psycholinguistics. This aspect of the study involves finding out at what stage of the generation of speech utterances convulsions occur in the speech of a stutterer. The following phases of speech communication are distinguished:

1) the presence of a need for speech, or communicative intention;

2) the birth of the idea of an utterance in inner speech;

3) sound realization of the utterance.

In different structures speech activity These phases differ in their completeness and duration of occurrence and do not always clearly follow from one another. But there is a constant comparison between what was planned and what was implemented. I.Yu. Abeleva believes that stuttering occurs at the moment of readiness to speak when the speaker has a communicative intention, a speech program and the fundamental ability to speak normally. In the three-term model of speech generation, the author proposes to include the phase of readiness for speech, during which the entire pronunciation mechanism, all its systems: generator, resonator and energy, “break down” in the stutterer. Convulsions occur, which then clearly appear in the fourth, final phase.

1.2 Forms of stuttering

Stuttering is a violation of speech rhythm, often associated with an imperfect rhythm of movements of the whole body (clumsiness, clumsiness in movements). Sometimes the spasms are repeated rhythmically: pe-pe-pe - rooster or p-p-p-rooster; A-a-a-anya. This form of stuttering is typical of young children. It's called a clontescope. Sometimes, due to a cramp, a child is completely unable to utter the desired sound or lingers on it for a long time, painfully overcoming the cramp: p-----rooster, L... (draws out the sound a for a long time) - Anya. This form of stuttering is called tonic. Usually the first sounds of words and phrases are pronounced with such difficulties. The easier, clonic form of stuttering often turns into a more difficult form of stuttering, called tonic, over time. It happens that a person who stutters, before pronouncing a word, convulsively, with a whistle, exhales almost all the air and then, choking, says: xxx (exhale) xya very sick - I’m very sick.

Convulsions manifest themselves primarily in the respiratory apparatus of speech, then in the vocal, then in the articulatory apparatus. For many, stuttering is accompanied by convulsive or habitual movements of the arms, legs, and head.

People who stutter often also have tongue-tiedness.

Simultaneously with convulsive manifestations, a stutterer experiences, mainly at an older age, a variety of painful phenomena. In a conversation, he is worried, afraid in advance that he will not be able to say well. Some people who stutter focus their attention on sounds that are “difficult” to pronounce. Some, usually more developed, are embarrassed, experience a feeling of acute shame in front of others because of their defect, unsuccessfully try to hide their defect from them (avoid conversations, limit themselves to laconic speech and short answers, speak quietly, through clenched teeth, blush, turn pale, cover up). Then).

Such experiences have a bad effect on the child’s psyche and spoil his character (often he becomes irritable, suspicious, painfully touchy, unsociable, and sometimes embittered). They consolidate and intensify stuttering, therefore, the teacher’s close attention to such children is necessary.

Children stutter only in the presence of other people - children and adults, but when alone they speak normally (for example, with toys). They also sing without stuttering. In one situation or in a conversation with certain people, the child does not stutter, but in other circumstances and people he stutters. Much depends on his current attitude towards his interlocutor and the situation.

1.3 Course of stuttering

Stuttering occurs either suddenly, sometimes after a certain period of muteness (from several hours to several days), or gradually, gradually intensifying. The latter occurs most often as a result of diseases that deplete the nervous system and its intoxication.

Under favorable conditions of life and development of the child’s body, it can gradually disappear. But if others in the presence of a child begin to pay intense attention to the speech defect, talk a lot about this “misfortune”, grieve, groan, if the child has a fear of being funny when talking with others, if the nervous system is weakened, then stuttering, on the contrary, intensifies . Stuttering periodically weakens and intensifies, which is generally characteristic of nervous diseases, and depends on changes in external and internal stimuli falling on the child’s brain.

1.4 Causes and mechanisms of stuttering

Stuttering most often occurs between the ages of 2 and 5 years, when the nervous system, auditory motor and speech systems of the brain are not yet strong, so their function is easily disrupted by unfavorable conditions (excessive or too complex stimuli), and then at 7 years (entry to school). ) V.I. Seliverstov. Stuttering - M., 1979. .

Favorable conditions for the occurrence of stuttering are the painful state of the child’s nervous system, caused by a number of circumstances: unfavorable conditions of pregnancy, difficult childbirth, childhood illnesses, especially whooping cough, which causes convulsions in the speech organs, difficult living conditions in the family, etc. As a result, children often turn out to be capricious, restless, irritable, with troubled sleep, and poor appetite.

These are remote, predisposing causes of stuttering that do not always necessarily cause stuttering. But with such a painful state of the nervous system, for the appearance of stuttering, sometimes the action of even not very strong, but unusual, unexpected or prolonged stimuli, which are excessive for a weak nervous system, is sufficient. The closest producing causes of stuttering:

Fright, a sudden change in the situation, fear, even in a dream, fear of darkness, loneliness, expected punishment or the arrival of a scary uncle, with which nannies intimidate a child who cannot sleep, etc.

For example, one child began to stutter after seeing Santa Claus take off his mask and turn into his own dad before his eyes.

Katya, a six-year-old girl, was afraid to be photographed. She was forcibly photographed and began to stutter.

Children may also stutter due to slow speech development or poor pronunciation of certain sounds. In this case, some kind of deficiency in the speech motor systems of the brain causes stuttering. Stuttering in children, especially nervous ones, at an older age can occur due to painful self-hypnosis (pathological fixation), often “with the help” of others and as a result of failures in speech (distortion of sound, difficulty expressing one’s thoughts in words, etc.). Random stops and hesitations make such children confident that this will happen again in the future. For some preschoolers, this happens from extremely fast speech: the child is in a hurry, imitating the fast speech of those around him and trying, due to his increased excitability, to quickly express his thought, stumbles over some sounds - and begins to stutter. This is where the overstrain of nervous processes occurs when quickly following dynamic stereotypes (sounds, syllables, words) and fixing failures.

Children of a weak nervous type, in particular those with unstable cortical speech mechanisms, cannot withstand speech loads that are beyond their strength. It is harmful for them to be overstimulated and forced to talk or recite a lot on any occasion to various people, to listen from morning to night to stories, fairy tales, reading, sometimes with content and language that is difficult for the child.

There may be cases of stuttering occurring during the paradoxical phase of speech reflexes, when self-hypnosis easily arises. This condition is observed with fatigue (exhaustion) of the nervous system, with fear, embarrassment, confusion, cowardice, timidity, etc. In this state, any hesitation in speech can easily and firmly take hold and turn into stuttering.

Physical injuries (head injuries, falls from a height) often also cause impairment of brain function, even in children with strong nerves. And here the effect of nervous trauma is obvious. Stuttering is often caused infectious diseases: whooping cough, which impairs breathing and causes fear of a seizure; worms that deplete the child, irritate nervous system and brain-poisoning toxins (poisons), etc. There are cases of stuttering by imitation: nervous, mentally unstable children, listening to the speech of people who stutter or imitating them, involuntarily, due to the imitation reflex, begin to stutter themselves. It happens that left-handers, when they are forcibly retrained to use their right hand, begin to stutter: the coordination and connection of speech movements already established in the brain with the movements of the hand and the whole body are disrupted.

In most cases, stuttering can be considered a speech neurosis, i.e. disruption, disruption of normal activity as a result of excessive irritants of the nervous system. Such overstrain of nervous activity also includes “errors” of two opposing basic processes of the brain - excitation and inhibition. Stuttering sometimes appears as a result of the simultaneous action of stimuli of an opposite nature. For example, dad invites the child to take a walk around the kindergarten, but mom forbids: “Don’t you dare go to kindergarten - you’ll get covered in dirt again.” As a result, an unbalanced child may experience a nervous breakdown (hysteria) and stutter.

These breakdowns are characteristic of an unbalanced type of nervous system, predominantly weak, and depend not only on its type, but also on many other reasons: the general environment (situation), the nature of the child’s speech and environment, past experience, state of health, mood, age, etc. .P.

Nervous breakdowns under certain conditions cause painful obsessive states: in the cerebral cortex, according to Pavlov, a “sick spot” (persistent pathological connections) is formed. During normal activity of the rest of the brain, stagnation and inertia of the irritative process occurs at this point - as a result, either persistent irritation or inhibition occurs in response to the stimulus coming here. A child who has previously stuttered experiences fear of stuttering again. I.P. Pavlov defines fear as “various degrees of passive defensive reflex.” It arises on the basis of overly sensitive, exaggerated inhibition in the cells of the cortex that were already pathologically weakened by strong irritants.

Often, stuttering under these conditions of brain activity is caused by long-term unpleasant emotional states (anticipation of punishment, jealousy of a child). Occurs according to A.D. Zarubashvili, “pathological anxiety” and painful overstrain of the dynamic capabilities of the second signaling system. The child is unable to properly analyze the complex and difficult situation around him verbal communication and starts to stutter. For example, a gourmet child broke a jar of jam in the buffet in the absence of his parents. A day passes, two, three. The mother does not detect “misfortune,” but the child is nervous, sleeps poorly, and answers inappropriately. On the fourth day, the parents notice that their son has begun to stutter. Sometimes stuttering can also occur due to the jealousy of the firstborn in relation to the new brother or sister.

You should refrain from teaching a foreign language to a person who stutters early - stuttering may worsen (especially with strict requirements from the teacher).

However, it is known that such stimuli do not always cause a child to stutter. Many children get scared, fall from a height, drown, etc., but after that they do not stutter. It all depends on the state of the child’s nervous system. If he is nervously healthy, then in the event of such influences he quickly returns to normal. With nervous weakness, the resulting shock leaves behind indelible traces in the form of a disorder of activity in the speech areas of the brain, which is expressed in stuttering.

Is stuttering hereditary? Many people still think so, but this opinion is wrong. In this case, only inferiority of the nervous system can be inherited. This is why parents who stutter do not always have children who stutter. Moreover, some of them stutter not because of the inherited nervous system, but as a result of imitating the speech of their parents. The fact that stuttering is not hereditary, but an acquired speech disorder, makes it easier to combat it.

So, stuttering is closely related to the state of the nervous system, to the child’s entire personality and his relationships with others. From this situation flow the means to combat it.

Conclusions to Chapter 1

Stuttering is a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus.

The following types of stuttering are distinguished: articulatory, wave-like, vocal, respiratory, fixed, initial, induced, inspiratory, clonic, neurosis-like, neurotic, organic, constant, respiratory, recurrent, mixed, tonic, functional, expiratory.

The main external symptom of stuttering is convulsions during speech.

There are three degrees of stuttering:

Mild - they stutter only in an excited state and when trying to speak quickly. In this case, delays are easily overcome.

Average - in a calm state and in a familiar environment, they speak easily and stutter little; In an emotional state, severe stuttering appears.

Severe - they stutter throughout the entire speech, constantly, with accompanying movements.

The following types of stuttering are distinguished:

Constant - stuttering, having arisen, manifests itself relatively constantly in various forms of speech, situations, etc.

Wavy - stuttering intensifies and 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.

At the end of the 19th - beginning of the 20th centuries. The opinion that stuttering is a complex psychophysical disorder is becoming more and more definite. But some believe that it is based on physiological disorders, and psychological manifestations are secondary (A. Gutzman, 1879; A. Kussmaul, 1878; I.A. Sikorsky, 1889, etc.). Others considered psychological characteristics to be primary, and physiological manifestations as a consequence of these psychological shortcomings (Chr. Laguzen, 1838; A. Cohen, 1878; Gr. Kamenka, 1900; G.D. Netkachev, 1913, etc.). Attempts have been made to consider stuttering as an expectation neurosis, a fear neurosis, an inferiority neurosis, an obsessive neurosis, etc.

Chapter 2. Methods of speech therapy sessions with stuttering preschoolers

2.1 Didactic foundations of speech therapy classes with children who stutter

Didactic foundations of children's speech therapy. The system of correctional education and training of children with impaired speech activity is built on the basis of the general theory of education (didactics), the object of study of which is patterns and principles, methods, organizational forms and means.

In modern pedagogy, it is customary to highlight the following basic didactic principles: individualization and collectivity, systematicity and consistency, conscious activity/visibility, strength, etc. The combination of these principles and the uniqueness of their implementation in relation to children who stutter determine all aspects of correctional education - content, methods and organizational forms.

The variety of currently existing methods of speech therapy work, depending on the form of speech disorder, the different ages of children, and the conditions of speech therapy work, emphasizes the need to develop a fundamental theory of their correctional education. Mutually enriching relationship between the general theory of learning and specific speech therapy techniques unconditional. They are built using the general principles of didactics, and the general theory of learning uses the results of particular methods as material for generalization.

Thus, the basic didactic principles and principles applied to children with impaired speech activity are fundamental. Knowledge of these basics predetermines the success (in general and in particular) of correctional pedagogical work with children who stutter.

Individual approach to children who stutter. Group, collective speech therapy sessions with people who stutter have proven themselves over many years of practice.

Group activities create conditions for active work of all children. The requirement for an individual approach does not mean opposing the individual to the collective. Only knowing well the capabilities of each child can you organize collective work.

An individual approach in speech therapy work is expressed, first of all, in a thorough study of each person who stutters before and during speech therapy work, in the choice of means of correctional and pedagogical work, depending on his psychological characteristics and speech capabilities. The age of people who stutter determines the selection of didactic material and form of work. The psychophysical characteristics of preschoolers, schoolchildren, adolescents and adults require the speech therapist in one case to focus on the “Program of education and training in kindergarten"and play activities; in another - on school curriculum and educational activities, in the third - for different types of work activities (Appendix 2).

The recruitment of speech therapy groups is carried out taking into account the age of people who stutter. Different ages make it necessary to use unique methods of speech therapy work, changing the intensity of individual components of the treatment and pedagogical approach to overcoming stuttering as a whole.

For preschoolers, for example, the main place is occupied by speech classes in a playful form, educational activities, and less by medical ones. In adolescents and adults, on the contrary, the main importance is attached to medical means and psychotherapy (including its suggestive methods), and less to pedagogical ones.

In implementing the principle of an individual approach in speech therapy work with people who stutter, it has great importance primary and dynamic (during classes) study of the child. Linguistic, psychological and pedagogical observations are important for a speech therapist. They allow you to select the necessary forms of correctional influence on a stutterer and predict the effectiveness of speech therapy work with him.

2.2 Methodology N.A. Cheveleva

In speech therapy classes with stuttering schoolchildren, currently, mainly the methodological recommendations proposed for working with children are used preschool age(For junior schoolchildren) or with teenagers and adults (for older students). For example, N.A. Cheveleva in her manual offers a system for correcting speech for stuttering schoolchildren in grades 1-4 in the process of manual activity. Fundamentally, it differs little from the previously proposed system speech therapy sessions with stuttering preschool children. What changes here is mainly the choice and complexity of crafts that are offered for working with schoolchildren. According to the academic quarters, the author identifies four periods of consecutive speech therapy classes:

1) accompanying speech;

2) closing speech,

3) preliminary speech,

4) strengthening independent speech skills.

Classes to correct the speech of stuttering children in the process of manual labor N.A. Cheveleva considers it possible to conduct it at school and outpatient speech therapy centers. In special schools, it is advisable to use manual labor lessons. The author considers it necessary, when correcting stuttering, to work with the child’s parents, his teacher, and have a therapeutic, medical effect on his nervous system.

Children’s ability to use speech without visual support develops. Children learn to plan their work, name and explain in advance each action that they still have to do. Phrasal speech becomes more complex: children learn to pronounce several phrases related in meaning, use phrases of complex construction, and construct a story independently. During this period, they are required to be able to think logically, express their thoughts consistently and grammatically correctly, and use words in their exact meaning.

5) Consolidation of independent speech skills (5 lessons). During this period, it is planned to consolidate the previously acquired skills of independent, detailed, specific speech. Children talk about the process of making this or that craft, ask questions, answer questions, speak out of their own free will, etc.

Thus, in the methodology proposed by N.A. Cheveleva, the principle of sequential complication is implemented speech exercises during one of the activities of a preschool child. The author methodologically substantiates and describes the stages of this sequential work. It clearly shows the possibilities of how, in one section of the “Program of Education and Training in Kindergarten” (namely, in the process of manual activities), correctional work can be carried out to overcome stuttering in children.

On the other hand, the system of consistent complication of speech here follows the line of “gradual complication of objects of activity” through the complication of the number of “individual elements of work into which the entire labor process in the manufacture of a given craft is divided.”

This system for overcoming stuttering in children includes 5 periods.

1) Propaedeutic (4 lessons). The main goal is to instill in children the skills of organized behavior. At the same time, children learn to hear the speech therapist’s laconic but logically clear speech and its normal rhythm. The children themselves have temporary speech restrictions.

2) Accompanying speech (16 lessons). During this period, children’s own active speech is allowed, but only in relation to the actions they simultaneously perform. Constant visual support ensures the greatest situationality of speech. At the same time, there is a constant complication of children’s speech due to a change in the nature of the speech therapist’s questions and the corresponding selection of crafts (identical, repeatedly spoken answers, variant answers for children; monosyllabic, short and complete, detailed answers).

3) Closing speech (12 lessons). In all classes of this period, children use accompanying and final speech (in the latter case, they describe the work already completed or part of it). By adjusting (gradually increasing) the intervals between the child’s activity and his response to what he has done, varying complexity of the final speech is achieved. At the same time, by gradually reducing visual support for the work performed, it becomes possible to make a gradual transition to contextual speech.

4) Preliminary speech (8 lessons). Here, along with accompanying and final speech, a more complex form of speech is activated - preliminary, when the child says that a unique system of correctional work with stuttering preschoolers in the process of manual activity was once proposed by N.A. Cheveleva. The author proceeds from the psychological concept that the development of a child’s connected speech proceeds from situational speech (directly related to practical activities, with a visual situation) to contextual (generalized, related to past events, missing objects, future actions).

Therefore, the sequence of speech exercises is seen in a gradual transition from visual, lightweight forms of speech to abstract, contextual statements. This transition is achieved in the child, according to the author, in a sequence that provides for a different relationship of the child’s speech to his activity over time.

Hence, the “main line of increasing complexity of independent speech” includes the following forms: accompanying, final, and preceding.

2.3 Methodology V.M. Shklovsky

In developed by V.M. Shklovsky’s comprehensive system for overcoming stuttering combines speech therapy sessions and active psychotherapy, combining the use of various variants of suggestive forms with work on restructuring disturbed personal relationships. All work is carried out in close contact with a speech therapist, psychotherapist and neurologist.

The course of stuttering treatment (2.5-3 months) is divided by the author into five stages: preparatory (diagnostic); restructuring of pathological speech skills and disrupted personality relationships; consolidation of achieved results; medical examination and prevention; Spa treatment.

The preparatory (diagnostic) stage lasts 10-15 days. At this time, the patient is studied by a neuropathologist, defectologist and psychotherapist; Anamnestic and clinical data are studied, psychotherapeutic and speech therapy measures are planned, and drug treatment is prescribed.

At the stage of restructuring pathological speech skills and disturbed personality relationships (from 1 to 1.5 months), speech therapy classes are conducted to normalize respiratory and vocal functions, develop speech “standards”, etc. At the same time, autogenic training and rational psychotherapy begin. Then (after 15-20 days) a session of suggestion is carried out in a waking state. After the session, active speech therapy work begins. At the same time, sessions of hypnotherapy, self-hypnosis and rational psychotherapy aimed at consolidating the achieved results are of great importance.

Considering the complex impact on people who stutter as a combination of speech therapy and psychotherapeutic work, V.M. Shklovsky at this stage divides speech therapy work into two parts: preparatory and active training of smooth and continuous speech. The first part includes:

1) correction of breathing, register and timbre of voice;

2) developing the correct rhythm and tempo of speech;

3) mastery of “standards”, “formulas” of speech;

4) identifying the potential speech abilities of people who stutter. Normalization of the patient's speech breathing and voice, rate of speech, mastery of “standards” - all this is the basis for subsequent suggestive and rational psychotherapy.

In the second part of speech therapy work (in the active training of smooth and continuous speech), the skills of continuous speech are consolidated before its automation; People who stutter learn various techniques to help them cope with emerging speech difficulties, and their confidence in their abilities is strengthened. Smooth, coherent speech is achieved by practicing pronouncing a number of vowel sounds, then numbers, individual phrases, etc. In cases where it is not possible to achieve complete normalization of speech, exercises in conjugate and reflected speech, etc. are introduced. Speech therapy work is carried out along with active suggestive psychotherapy.

In total, at least 3-4 hours should be devoted to speech classes during the day (each lesson is 10-15 minutes of speech training).

Psychotherapeutic work at the stage of restructuring pathological speech skills and disturbed personality relationships has important and various forms. Rational psychotherapy is expressed in the form of individual and collective conversations. It helps explain to the patient the causes of stuttering, reveals the importance and necessity of an active attitude and determination for the successful treatment of stuttering.

Hypnotherapy begins 3-4 days after the start of active speech training. It is carried out initially three times a week, and then once every 7-10 days: During suggestion, in addition to general calming formulas, attention is paid to the normalization of the emotional-volitional sphere and the activity of the articulatory-voice and respiratory apparatus. In some cases, hypnotherapy is a good preparation for conducting a suggestion session while awake.

Suggestion while awake is a psychotherapeutic session, during which many techniques can be used: conversations conducted under strong emotional stress of patients, ending with imperative suggestion; imperative suggestion in the waking state with the inclusion of demonstrative moments. The session is carried out with a group of 6-8 people, it is scheduled in advance for a certain day, which is especially anticipated by patients, because it is a turning point in treatment.

Self-hypnosis is not a passive recitation of formulas, but an active desire to imagine oneself speaking well. It is carried out 2-3 times a day. The patient must be able to create images of himself speaking well, without stuttering: at home, in school, at work and in other situations. A self-hypnosis session before bed is especially important.

At the stage of consolidating the achieved results (it lasts a month), speech training is carried out in the patient’s usual living environment. Overcoming speech difficulties in Everyday life, education of speech activity and strengthening in the mind of faith in the ability to independently cope with speech difficulties in the most difficult situations - constitute the main content of the third, final, stage of stuttering treatment.

V.M. Shklovsky, along with the main stages of logopsychotherapeutic work with stutterers, draws attention to the need for clinical examination and prevention as very important sections of work, without which the problem of treating stuttering cannot be solved. Clinical examination and prevention create the prerequisites for reducing the incidence of stuttering and help prevent relapses.

For stutterers with deep neurotic disorders and pronounced vegetative dystonia, it is advisable to organize sanatorium-resort treatment using climatic and balneological influences, exercise therapy and physiotherapeutic measures. In combination with logopsychotherapy, this has a good effect in overcoming stuttering.

In conclusion, it can be noted that all modern systems of speech therapy classes with stuttering adolescents and adults are united by the presence in them (in addition to progressively more complex speech exercises) of various forms of psychotherapy. They differ from each other mainly in the importance and place the authors assign to individual types of psychotherapy (accordingly, they are developed in more detail by the author). For example, a session of imperative suggestion in the waking state in logopsychotherapeutic work with stutterers (L.Z. Andronova, M.I. Merlis, Yu.B. Nekrasova, V.M. Shklovsky), its different place in the course of treatment (with Yu.B. Nekrasova - in the beginning, in V.M. Shklovsky - in the middle); autogenic training and self-hypnosis (A.I. Lubenskaya, SM. Lyubinskaya); rational psychotherapy (L.Z. Andronova).

Speech exercises in systems of logopsychotherapeutic sessions with people who stutter are based on those generally accepted in children's speech therapy, but taking into account the age characteristics of patients.

In addition, and with some features: L.Z. Andronova builds speech exercises based on syllable speech (full form of speech); V.M. Shklovsky and others - for varying degrees of independent speech; Yu.B. Nekrasova attaches particular importance to the development of elements of stage speech, etc.

2.4 Methodology N.A. Vlasova and E.F. Rau

The authors of the first domestic method of speech therapy work with stuttering children of preschool and preschool age are N.A. Vlasov and E.F. Rau built an increase in the complexity of speech exercises depending on the varying degrees of speech independence of children. Hence their recommended sequence:

1) reflected speech;

2) memorized phrases;

3) retelling based on the picture;

4) answers to questions;

5) spontaneous speech.

At the same time, the authors recommend mandatory rhythmic and musical classes with children and conducting explanatory work with parents.

ON THE. Vlasova distinguishes 7 “types of speech”, which, in order of gradualness, must be used in classes with preschool children:

1) conjugate speech;

2) reflected speech;

3) answers to questions based on a familiar picture;

4) independent description of familiar pictures;

5) retelling a short story heard;

6) spontaneous speech (story based on unfamiliar pictures);

7) normal speech (conversation, requests), etc.

E.F. Pay sees the task of speech therapy work as “to, through systematic planned lessons, free the speech of stuttering children from tension, make it free, rhythmic, smooth and expressive, as well as eliminate incorrect pronunciation and cultivate clear, correct articulation.” All classes on speech re-education for stuttering children are divided into 3 stages according to the degree of increasing complexity.

The first stage - exercises are conducted in joint and reflected speech and in the pronunciation of memorized phrases and rhymes. Recitation is widely used.

The second stage - exercises are carried out in the oral description of pictures in questions and answers, in composing an independent story based on a series of pictures or on a given topic, in retelling the content of a story or fairy tale that was read by a speech therapist.

The third stage is the final stage, children are given the opportunity to consolidate the acquired skills of fluent speech in everyday conversation with surrounding children and adults, during games, activities, conversations and at other moments in a child’s life.

Methods of N.A. Vlasova and E.F. Pay are characterized by a certain similarity - they are based on different degrees of speech independence of children. The undoubted merit of these authors is that they were the first to propose and use a step-by-step sequence of speech exercises in working with young children, and developed instructions for individual stages serial system speech correction for stuttering preschoolers.

For many years, the proposed technique was one of the most popular in practical work with children who stutter. And currently, many of its elements and modifications are used by speech therapists.

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Introduction

1. Theoretical aspects the use of correctional and pedagogical exercises in logorhythmics classes with stuttering preschool children

Bibliography

Introduction

Speech occupies a special place in the system of human mental functions. The study of the ontogenesis of children's speech shows its enormous role in the mental development of the child, since the formation of thinking, cognitive functions and the formation of personality are closely related to the emergence and development of speech activity. Like any other functional system, speech turns out to be most susceptible to the influence of unfavorable factors during the period of intensive formation.

Stuttering is one of the most common speech disorders, which is characterized by a complex symptom complex and, in some cases, low treatment effectiveness. Occurring during a sensitive period of development (from 2 to 6 years), stuttering limits the child’s communicative capabilities, distorts the development of personal qualities, and complicates his social adaptation. In the initial stage, stuttering is often mild. But a slight stutter, barely noticeable at first, can intensify over time and cause painful experiences in the child and fear of speaking. The more time passes from the moment stuttering begins, the more often it turns into a permanent defect and entails changes in the child’s psyche. pedagogical logorhythmics stuttering preschool

In this regard, preschool age occupies a special place in the general problem of stuttering. Carefully carried out preventive and corrective work at this age, based on a comprehensive consideration of factors contributing to the occurrence of a defect, can significantly reduce the percentage of schoolchildren, adolescents and adults who stutter. In preschool age, developmental deficiencies are more easily overcome and speech therapy work can be carried out most effectively, covering all components of the speech system.

A special place in working on children’s speech is occupied by music games, singing and moving to music. This is due to the fact that music primarily affects the emotional sphere of the child. Based on positive reactions, children learn the material better and faster, and quietly learn to speak correctly.

Logorhythmic activities are based on the close connection of words, movement and music and include finger, speech, musical-motor and communicative games, exercises for the development of gross and fine motor skills, dancing to the rhythmic declamation or singing of an adult, rhythmic games with musical instruments, poems with movements.

During the classes, the basic pedagogical principles are observed - consistency, gradual complication and repetition of the material, the rhythmic structure of the word is worked out, and clear pronunciation of sounds that are age-appropriate, the children's vocabulary is enriched.

Practice has shown that regular logorhythmic classes contribute to the rapid development of speech and musicality, form a positive emotional attitude, and teach communication with peers.

The practical significance lies in the possibility of using the developed system of differentiated logorhythmic influence in the activities of a speech therapist in speech therapy groups of preschool institutions, a physical instructor, and a music director.

Purpose of the study: to theoretically substantiate and experimentally test the influence of correctional pedagogical exercises on overcoming stuttering.

Object of study: the process of overcoming stuttering in preschool children.

Subject of research: the use of correctional and pedagogical exercises to overcome stuttering.

In accordance with the purpose of the study, the following tasks can be set:

1. Study scientific and methodological literature and practical experience on the problem under study.

2. To experimentally test the influence of correctional pedagogical exercises on overcoming stuttering in preschool children.

The main research method is pedagogical experiment. Additional methods were also used, such as theoretical analysis of speech therapy and psychological-pedagogical literature, observation, conversations, etc.

The course work consists of an introduction, two chapters, a conclusion, a list of references and applications.

1. Theoretical aspects of the use of correctional and pedagogical exercises in logorhythmics classes with stuttering and preschool children

1.1 Types of stuttering, causes

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.

Outwardly, stuttering manifests itself in involuntary stops of utterance, as well as in forced repetitions of individual sounds and syllables.

These phenomena are caused by muscle spasms of certain organs of speech at the time of pronunciation (lips, tongue, soft palate, larynx, pectoral muscles, diaphragm, abdominal muscles).

In modern speech therapy, stuttering is defined as a violation of the tempo-rhythmic organization of speech, caused by a convulsive state of the muscles of the speech apparatus.

There is still no single scientifically substantiated theory with the help of which it would be possible to generalize and systematize experimental data and various hypotheses. Stated by many authors regarding the causes of this speech disorder. At the same time, all researchers agree that when stuttering appears, there is no specific single cause that causes this speech pathology, since this requires a combination of a number of factors.

Based on existing ideas about the etiology of stuttering, two groups of causes can be distinguished: predisposing and producing. Moreover, some etiological factors can both contribute to the development of stuttering and directly cause it.

Predisposing reasons include:

1. a certain age of the child (from 2 to 6 years)

2. state of the central nervous system.

3. Hereditary factor

4. Functional asymmetry of the brain (there are indications that stuttering often occurs when retraining left-handedness to right-handedness, if it is carried to the point of torture)

5. Features of the course of speech ontogenesis - For the onset of stuttering, the period of intensive speech formation is of particular importance. At this time, many children are characterized by the appearance of physiological iterations (from the Latin iterare - repeat)

6. Pace can also play a big role in the development of stuttering. speech development, especially the appearance of phrasal speech: slow or accelerated. During these periods, the speech system is especially susceptible to the influence of unfavorable factors. Of particular importance in these cases is the behavior of adults surrounding the child. Additional speech and emotional stress, fixation on iterations can provoke stuttering;

7. Sexual dimorphism - stuttering occurs on average 4 times more often in boys than in girls.

Producing causes include mental trauma, which can be chronic or acute. Chronic mental trauma is understood as long-term, negative emotions in the form of persistent mental stress or unresolved, constantly strengthened conflict situations. Such conditions are often associated with a tense psychological climate in the family or the difficulty of a child’s adaptation in a children’s institution. Acute mental trauma is understood as a sudden, usually one-time, mental shock that causes a strong emotional reaction. Most often, such trauma causes fear, a feeling of fear.

It is soon after suffering an acute mental trauma or against the background of chronic conflict situations that many children experience stuttering of a convulsive nature. Preschool children, due to their emotional excitability and unpreparedness to process external environmental influences, are more susceptible to violent emotional reactions than adults.

G.A. Volkova distinguishes two types of stuttering based on etiology:

1. Functional stuttering occurs when there are no organic lesions in the speech mechanisms of the central and peripheral nervous system.

Functional stuttering occurs, as a rule, in children aged 2 to 5 years during the formation of developed generalized phrasal speech; It is more common in excitable, nervous children.

2. Organic, when stuttering can be caused by organic lesions of the central nervous system (with traumatic brain injuries, neuroinfections, etc.).

Currently, there are two groups of symptoms that are closely related: biological (physiological) and social (psychological). Physiological symptoms include speech cramps, disorders of the central nervous system and physical health, and general speech motor skills. Psychological symptoms include the phenomenon of fixation on a defect, logophobia, tricks and other psychological characteristics.

The main symptom of stuttering is speech spasms that occur during oral speech or when trying to start it. Convulsions vary in type, location (place of occurrence), and gravity.

It is customary to distinguish two main types of speech spasms: tonic and clonic. Tonic speech spasms manifest themselves in the form of a violent sharp increase in muscle tone, involving several muscle groups at once (tongue, lips, cheeks, etc.). There is a lot of tension in the face of the stutterer (the mouth is half open or, conversely, the lips are tightly closed), and general stiffness of the whole body (tension in the muscles of the shoulder girdle). In speech there is a long pause, stop (s...tol); Clonic speech convulsions manifest themselves in the form of violent, repeated, rhythmic contractions of the muscles of the speech apparatus. In this case, repetitions of sounds or syllables are observed in speech (s-s-s-table, pa-pa-pa-desk).

Usually determined mixed type convulsions, when one stutterer experiences tonic and clonic convulsions (tonic-clonic type or clono-tonic according to the predominant type of convulsions).

We looked at the types of stuttering and the causes of its occurrence and were convinced that the reasons can be very different, so adults need to be very attentive to children, since they themselves can become the cause of this defect.

1.2 Motor impairment in preschool children with stuttering

Researchers have attached particular importance to the connection between the state of general motor skills and speech in stuttering. V.A. Gilyarovsky noted that delayed development of speech may be a partial manifestation of general underdevelopment of motor skills. M.F. Bruns, studying the motor skills of children who stutter, came to the conclusion that they have a pronounced retardation in general motor development. Analyzing the features of motor skills of stuttering schoolchildren, V.I. Dresvyannikov pointed out the parallelism and interconnection of speech and general motor ontogenesis, emphasizing that the development of motor skills and expressive speech occurs in a child in close unity. The author came to the conclusion that motor skills and speech change almost parallel to each other under the influence of correctional work.

M.A. Koltsova proved that there is a connection between the degree of development of fine motor skills of the hand and the level of development of the child’s speech. There is every reason to consider the hand as an organ of speech - the same as the articulatory apparatus. From this point of view, the hand projection is another speech area of the brain.

Noting the importance of studying voluntary movements, A.P. Zaporozhets pointed out that the formation of voluntary movements in humans occurs with the participation of speech, under the influence of the abstracting and generalizing functions of the second signaling system. EAT. Mastyukova emphasized that speech is ontogenetically, anatomically and functionally connected with the motor functional system. Therefore, she considered the principle of motor-kinesthetic stimulation to be one of the main principles of speech therapy work, in particular with children suffering from stuttering.

Thus, the connection between general motor skills and speech makes it possible to develop the necessary qualities of movements of the organs of the articulatory apparatus through the development of similar properties of general motor skills.

When stuttering, as noted by G.A. Volkova, there are various motor disorders.

In some children who stutter, motor talent can be identified as being three months above their age. However, most have a delay in motor development ranging from four months to almost five years. Violations concern not only general, but also facial motor skills and oral praxis.

With general motor talent, children who stutter are found to have a deficiency in facial motor skills. According to V.A. Aristova, it is not always associated with speech and can be classified as “minor organic symptoms,” since some forms of stuttering are based on “damage to the afferent system of kinesthetic speech cells of the brain.” This causes a disturbance in the statics and dynamics of the speech organs. Organic motor dysfunction manifests itself as:

symptoms of loss - inability to produce simple exercises;

· hyperkinesis, tremor, fibrillar and fascicular contractions of the tongue;

· ataxic disorders - the inability to immediately perform one or another movement (implementation is possible only with visual control);

· apraxic disorders (in isolated cases).

If people who stutter have some weakness in the facial muscles, then therapeutic exercises are necessary.

N.S. Samoilenko believes that the development of motor skills in children who stutter can go ahead of speech development or lag behind speech, and there may be stuttering children with special motor talent.

M.F. Bruns discovered a correlation between the form of stuttering (tonic and clonic) and the characteristics of motor skills, emphasizing that “corrective gymnastics should be consistent with the form of stuttering.”

B.I. Shostak revealed in some children limited tongue movements, disturbances in muscle tone, fine motor skills, switching, coordination, tempo of movements, static and dynamic coordination of movements. She associated the violations she discovered with the state of the emotional-volitional sphere, which is subject to large fluctuations in people who stutter, and with unstable tone, which is reflected in the nature of the tempo of movements, in most cases tending to accelerate.

In the studies of G.A. Volkova showed that some children who stutter have impaired motor skills, but most children have various and numerous disorders of general motor skills, fine voluntary motor skills of the hand and fingers, facial muscles and oral praxis. Impairments of motor function predominate in the form of general motor tension, stiffness, slow switchability of movements, there are also disturbances in the form of motor restlessness, disinhibition, lack of coordination, randomness of movements, with the presence of hyperkinesis, with a wide amplitude of movements.

Children with motor tension do not immediately respond to comments and requests from the speech therapist and friends to bring or serve something. They move slowly from one movement to another, drop the ball, hoop and other objects in outdoor games, spend more time playing with collapsible materials - construction materials, turrets, barrels, nesting dolls. In preschool children, motor stiffness manifests itself in awkwardness, clumsiness, and the inability to quickly and correctly perform a particular movement. In schoolchildren, motor tension is more clearly associated with stuttering and manifests itself when trying to comment on their actions. The inability to speak freely about the actions being performed further constrains the child’s movements: lightness and ease in behavior disappear, the pace of movements slows down, and the action is not completed completely. Inhibition is especially pronounced in games when walking and running: children tensely bend their arms at the elbow joints, forcefully press them to the body, run on straight legs without bending them knee joints. Stiffness in the muscles of the neck and shoulders is revealed when children turn their whole body, in motor awkwardness.

The motor disinhibition of children who stutter is reflected in the fact that they are easily excited, fuss during games, jump, squat, wave their arms, thus expressing their excitement. Movements are impetuous, insufficiently purposeful, uncoordinated, subtle voluntary motor acts are formed with a delay, the amplitude of movements has a large scope. After the games, children, trying to discuss its course and results, reproduce its course in numerous uncoordinated movements.

Half of the children who stutter exhibit a wide variety of accompanying movements.

As noted by N.A. Tugov, quite often motor deviations in people who stutter are directly dependent on such mental processes as instability of attention, insufficient flexibility of switching, increased excitability of the child or his inhibition.

The main percentage of disorders in the field of motor skills falls on stutterers with tonic type of seizures. Boys suffer more from their sense of rhythm and coordination of movements, while girls suffer more from switching movements.

Thus, the degree of motor impairment is directly proportional to the severity of stuttering. Moreover, these disorders are different for boys and girls. In the process of logorhythmic exercises, improvement in motor skills and speech occurs almost parallel to each other. General motor skills are closely related to speech and have a great influence on the latter. The difficulties of re-educating the speech of people who stutter are closely intertwined with difficulties in motor coordination. If motor disorders are successfully corrected, then this is a positive prognosis for speech re-education.

Correction of motor skills disorders in people who stutter should be carried out in a comprehensive manner, which must necessarily include classes in logorhythmics with the inclusion of correctional and educational exercises.

As noted by G.A. Volkova, the use of speech therapy rhythms in correctional work with people who stutter is due to the following: there is a close functional connection between the speech function - its motor, executive component - and the general motor system. Normal human speech is ensured by the coordinated work of many central formations. Lesions of certain areas of the cerebral cortex reveal their connection with one or another aspect of the speech function. In order for a function, including speech, to be carried out normally, it is necessary to coordinate in time, in speed, in the rhythms of action and in the timing of individual reactions. This means that coordination in time, the importance of speeds and rhythms of action for the coordinated work of individual components of a complex functional speech system is a prerequisite, and the discrepancy in the activity of these components in time can be a functional cause of speech impairment.

The validity of this view is confirmed by the well-known fact that with any change in the rhythm of speech of a stutterer (reading, recitation), stuttering decreases; by beating a beat with your hand during speech, the convulsive speech of a stutterer is also removed or reduced.

According to V.A. Griner and Yu.A. Florenskaya, the emotional side of speech is closely related to the general psychomotorism of affective expressions. It represents, as it were, the face of the speaker’s speech and receives its expression in its dynamic qualities: rhythm, melody, pauses, tempo, etc.

There is music in the phrase that gives it its own meaning. This is facilitated by such elements of speech as rhythm and melody. It is known that the speech of stutterers, supported by an externally given rhythm (poem, song), receives support in it and restores balance, that is, stuttering disappears.

G.A. Volkova notes that therapeutic and speech therapy rhythms are based on the concept of rhythm, as the beginning of organizing and disciplining, putting every action into a certain form and regulating the patient’s behavior. Moderate physical exercise, received by stutterers during the performance of correctional and educational exercises in speech therapy rhythm classes, excite nervous processes and give a beneficial effect.

Undoubtedly, collective sessions of speech therapy rhythms make it possible to re-educate a stutterer’s attitude towards his defect, to formulate a new attitude towards relationships with others, towards a speech relationship with them. In particular, logorhythmic classes make it possible to put a stutterer in a wide variety of situations: to oppose one to a whole team, to divide the team into groups, and so on, that is, they make it possible to play out various social roles, establish yourself in active, proactive behavior.

Consequently, speech therapy rhythm has a great psychotherapeutic effect on the personality of a person who stutters, promotes the development of its positive aspects and neutralizes its negative ones. Proper conduct of psycho-orthopedic classes contributes to the correction of personality deviations and the development of voluntary behavior.

1.3 Disorders of speech, breathing and intonation in preschool children with stuttering

In modern speech therapy, stuttering is defined as a violation of the tempo, rhythm and smoothness of oral speech, caused by a convulsive state of the muscles of the speech apparatus.

Outwardly, stuttering is expressed in the fact that speech is interrupted by forced stops, hesitations, and repetitions of the same sounds, syllables, and words. This occurs due to spasms in the speech apparatus, which, as a rule, spread to the muscles of the face and neck. They can vary in frequency and duration, form and location. There is no strict pattern in the occurrence of stutters. They can be at the beginning of a phrase, in the middle, at the end, on consonants or vowels. However, hesitations, stops and repetitions that disrupt the smooth flow of speech do not exhaust the concept of “stuttering”. When stuttering, breathing and voice are upset: children try to speak while inhaling and during the full exhalation phase, the voice becomes compressed, monotonous, quiet, and weak.

When stuttering, accompanying movements that accompany speech are also observed (nodding movements of the head, swaying of the body, rubbing fingers, etc.). These movements are not of an emotionally expressive nature, but are violent (reminiscent of hyperkinesis) or are of a camouflage (trick) nature. During the process of speaking, children who stutter suddenly experience increased sweating, facial skin turns red or pale, and the heart rate increases, i.e. vegetative reactions appear, which are also observed in normally speaking people in a state of strong emotional stress.

In the chronic course of stuttering, almost all stutterers use monotonous words or sounds such as “a”, “uh”, “this”, etc. in their speech, which are repeated many times throughout the utterance.

This phenomenon is called embolophrasia, and the words themselves are emboli.

Another characteristic symptom of stuttering is fear of oral speech, a fear of sounds or words that are most difficult for a stutterer to pronounce. Fear of speech is called logophobia. Logophobia includes obsessive experiences, fear of speech convulsions, and fear of verbal communication. Most often, logophobia begins to manifest itself in adolescence. Logophobia often leads to limited verbal communication, isolation, or, conversely, aggression. Such factors complicate the speech, emotional and psychological state of children who stutter.

Oral speech is characterized by many physical parameters. Along with its content side, the prosodic side of speech is of great importance for the listener’s perception. Prosody, according to N.I. Zhinkin, is the highest level of language development.

The main component of prosody is intonation. Through intonation, the meaning of speech and its subtext are revealed. Speech without intonation is slurred and incomprehensible. With the help of intonation, the speaker emotionally influences the listener. Intonation is a complex phenomenon that includes several acoustic components. This is the tone of the voice, its timbre, the intensity or strength of the voice, pause and logical stress, the pace of speech. All these components are involved in the division and organization of the speech flow in accordance with the meaning of the transmitted message.

I.A. Povarova analyzes intonation disorders in children who stutter and notes in them violations of the prosodic organization of speech, including the tempo-rhythmic and intonation structure of utterances. Yu.I. Kuzmin points to a certain slowdown in the tempo of speech, inconsistent rhythm, a violation of the melody of the voice, its weakness, intermittency and monotony. In his works L.I. Belyakova, E.A. Dyakov note that people who stutter have disturbances in speech rhythms at different levels: syllable-by-syllable, word-by-word and syntagmatic. One of the constant signs of stuttering is impaired speech breathing. In addition to the possibility of the appearance of convulsive activity in the muscles of the respiratory apparatus, impaired speech breathing in people who stutter is expressed in the following indicators: insufficient volume of inhaled air before the start of a speech utterance, shortened speech exhalation, immaturity of the coordination mechanisms between speech breathing and phonation. In people who stutter, local tension in the muscles of the vocal apparatus is diagnosed, which worsens the characteristics of the voice. Dysphonic disorders also occur. In 1/3 of preschool children who stutter, V.M. Shklovsky notes the insufficient strength of the voice, its deafness and hoarseness. E.V. Oganesyan differentiates the features of the voice and intonation of speech depending on the clinical forms of stuttering: with neurotic stuttering, a violation of timbre is detected in the form of deafness and hoarseness, changes in strength and volume, and the use of an unusual register; with neurosis-like stuttering - insufficient modulation of speech and stereotypical intonations. This abundance of disorders is caused by the fact that stuttering is a complex speech disorder in which many components of the pronunciation system are affected: speech breathing, voice formation and articulation, which is externally manifested in convulsive activity. The mechanism of the pathology indicates stem-subcortical lesions and a persistent violation of the self-regulation process. (E.E. Shevtsova).

To date, there is no uniform assessment of the severity of stuttering. In speech therapy practice, it is believed that the severity of stuttering is determined by the ability to speak more or less fluently. complex forms speech utterance.

For example, G.A. Volkova considers the severity of the defect as follows. Easy degree - children freely enter into communication in any situations with strangers, participate in group play, in all types of activities, carry out assignments related to the need for verbal communication. Convulsions are observed only during independent speech. Average degree - children experience difficulties in communicating in new and important situations for them, in the presence of people they do not know, and refuse to participate in group games with peers. Convulsions are observed in various parts of the speech apparatus - respiratory, vocal, articular - during independent, question-answer and reflected speech. Severe degree - stuttering is expressed in all communication situations, impedes verbal communication and collective activity of children, distorts the manifestation of behavioral reactions, and manifests itself in all types of speech.

In some cases, the degree of severity is determined by quantitative indicators of the rate of speech, the duration of pauses, and distortion of the speech of people who stutter.

Thus, when stuttering, the entire speech process is disrupted and consistency in speech movements is lost. The pace and fluency of speech is forced and suddenly interrupted.

The course of stuttering and its manifestations largely depend on the characteristics of the child’s psychophysical state and his personality.

2. Organization of work with preschool children to overcome stuttering

2.1 Diagnosis of forms of speech disorder

The main task of diagnosing speech fluency disorders is to determine the form of speech fluency disorder (speech dysrhythmia) in accordance with ideas about the rhythmic function of speech.

An examination of a child’s rhythmic ability is necessary in order to draw a conclusion about the form of fluency disorder, as well as the causes of the speech defect. This section of diagnostics is predominantly speech therapy, in particular, logorhythmic.

In addition to speech therapy examination, psychological and kinesitherapy diagnostics are necessary.

The results of all surveys are compared and analyzed. The final diagnosis is made. Below are examples of diagnostic protocols in the form of diagnostic cards (No. 1--3). They present the tasks presented to the child, the procedures and results of completing the tasks.

I. RHYTHMIC AND LOGORHYTHMIC DIAGNOSTICS

This type of diagnosis was developed by speech therapist T.A. Solovyova and logorhythmist I.V. Punter.

It includes three sections:

Examination of the state of the subcortical iterative rhythm. Its results are considered as fundamentally important for determining the form of speech fluency disorder, drawing conclusions about the functionally deficient zone of the brain, as well as for determining the tasks and stages of correctional work.

In this area of work, an important place is occupied by the diagnosis of the state of musical rhythm in each individual child. Diagnostic methods consist of asking the child:

1. Clap the rhythm according to the pattern at a slow, medium and fast pace (20 claps: 10 claps - pause - another 10 claps).

2. March at a given pace without drums or other types of accompaniment (20 steps).

3. March and run to the appropriate (marching) music, which is performed at different tempos: slow, medium and fast (20 steps).

4. Squat to the beat of simple (bipartite) dance music (10 squats).

5. Swing or make pendulum movements with your hand to the beat of lullaby music (15-20 movements).

If a child is unable to perform these actions or performs them with errors, this indicates that his basic iterative rhythm is not formed - that is, subcortical iterative dysrhythmia.

It makes sense to examine the biological rhythms of such a child (ECG, EEG, etc.). Often, insufficiency of musical and biological rhythms are combined.

Below is a sample of diagnostic card No. 1 for examining the state of the subcortical periodic rhythm.

Diagnostic card No. 1

	Test procedure	Possible results child's test performance	Possible diagnoses
Iterative claps	The child must repeat the claps at a slow, medium and fast pace as shown by the examiner (20 claps: 10 claps - pause - 10 more claps).	Low volume execution (2-3 claps). Uneven clapping.	1. Safety of iterative 2. Violation iterative subcortical iterative dysrhythmia.
Iterative steps with clapping to music.		Execution in small volume (2--3 steps). Uneven pacing
Iterative steps to the drum, tambourine, xylophone.	The child must walk according to the examiner’s instructions at a slow, medium and fast pace (20 steps).	Correct completion of the task. Execution in small volume Uneven pacing
Iterative steps to music	The child must walk as the examiner shows to marching music at a slow, medium and fast pace (20 steps).	Correct completion of the task. Execution in small volume Uneven pacing

Examination of the state of periodic rhythm.

If the basic (subcortical) rhythms are formed, then the child’s state of cortical (right hemisphere) rhythms is examined. The child is asked:

1. “Dance” to the music. It should be noted whether the child feels the musical beat and what movements he performs.

2. Clap the rhythms according to the pattern:

Instructions: “I will clap, you listen carefully, and then do as I do.”

Samples of presented rhythms for children three to four years old:

1) // // 2) / // 3) // / 4) /// ///

Samples of presented rhythms for children four to six years old:

5) / /// 6) /// / 7) / //// 8) //// //

The reason for the unformed musical rhythm may be:

* Lack of mastery of iterative (subcortical) rhythm, which prevents the assimilation of rhythmic groups belonging to a more complex periodic rhythm.

* Insufficient functional activity of the right hemisphere of the brain.

If the right hemisphere, periodic (musical) rhythm in a child is formed according to age, then the conclusion is drawn that the right hemisphere is functionally active, and, therefore, its contact with the left (speech) hemisphere is possible. However, it is also possible that the child’s right hemisphere is functionally hyperactive and opposes the left, is in a certain confrontation. This situation is typical primarily for children with obvious or potential left-handedness, but not necessarily. Right hemisphere may not be hyperactive, but normatively active in functional terms, and the left may have an insufficient degree of activity.

In the case when a periodic right hemisphere rhythm is not formed, a conclusion is drawn that the child has periodic amusic dysrhythmia.

Below is a sample of diagnostic card No. 2 for examining this type of rhythm.

Examination of the ability for rhythmic-semantic coordination

This section of the diagnosis is aimed at identifying the degree of readiness of the child to master the skills of fluent prose speech. The child must first pronounce in conjunction with the examiner, and then reflectively, well-known texts (for example, fairy tales), highlighting semantic accents with his voice and maintaining pauses.

Diagnostic card No. 2

	Test procedure		Possible diagnosis
Clapping symmetrical rhythms according to the pattern:	The child must repeat the given rhythms as shown by the examiner.	Proper execution Refusal to complete a task. Messy clapping. Extra claps.	2. Violation of the right hemispheric periodic rhythm - amusic dysrhythmia.
Clapping asymmetrical rhythms according to the pattern:	The child must clap (tap) the given rhythms as shown by the examiner.	Proper execution Refusal to complete a task. Messy clapping. Extra claps.
Movement to music with a simple rhythm (dance)	The child must, as shown, reproduce a fragment of the dance in bipartite size.	Proper execution Refusal to complete a task Inability to hear the downbeat. Failure to combine Movement with a strong beat.
Movement under rhythm (dance)	The child must show play fragment dance in a given size.	Correct completion of the task. Refusal to execute tasks. Inability to hear rhythmic drawing of musical accompaniment Inability to combine movement with rhythm.	1. Preservation of the right hemisphere periodic rhythm. 2. Violation of the right hemisphere periodic rhythm - amusic dysrhythmia.
Reading poems		Correct completion of the task. Refusal to complete a task.
Rhyming	The child is asked to choose a rhyme for the unfinished line of the couplet.	Correct completion of the task. failure to to rhyming. Incomplete rhyming or selection of non-rhyming words within the meaning of.

The ability to assimilate a way of speaking and reproduce it in reflected and independent speech is regarded as an indicator of normative speech development, the absence of such readiness is considered to be the presence of speech rhythmic-semantic discoordination, which can lead to impaired fluency of speech.

A sample examination of the ability for rhythmic-semantic coordination is reflected in diagnostic card No. 3.

Diagnostic card No. 3

	Test procedure	Possible test results for a child	Possible diagnosis
The ability, in conjunction with the examiner, to recite a well-known text (everyday fairy tale) with the examiner’s “conducting” (method of time steps and highlighting semantic accents with pressure)	The examiner takes the child’s hands and uses a system of light and strong pressures, marking semantic accents and pauses, “conducts” and asks the child to speak with him.	The child strays from the proposed speaking mode. The child does not catch markers and does not take them into account in speech.	1. Preservation of rhythmic-semantic coordination. 2. Violation of rhythmic-semantic coordination (interhemispheric conflict).
The ability to reflectively pronounce a well-known text (everyday fairy tale) under the “conducting” of the examiner (method of time steps and highlighting semantic accents with pressure)		The child easily copes with the task. The child gets lost from the proposed speaking mode. The child doesn't catch markers and does not take into account them in speech.
The same on your own. The child is shown how to “conduct” himself by moving his clasped hands, squeezing them in places of semantic emphasis and pausing.		The child easily copes with the task. The child gets confused proposed speaking mode. The child doesn't catch markers and does not take into account them in speech.

A comparative analysis of the results in all three sections of speech therapy and logorhythmic diagnostics can show that the child has one or another form of speech impairment or a mixed form, represented by a functional deficiency of all three levels of the brain organization of fluent speech, i.e. present:

* Primary subcortical iterative dysrhythmia;

* Right hemisphere amusic dysrhythmia;

* Interhemispheric violation of rhythmic-semantic coordination.

A generalization of the results of diagnostics of children indicates that primary iterative dysrhythmia occurs in children with signs of organic damage to the central nervous system. Two other forms of speech fluency impairment, namely right-hemispheric amusic dysrhythmia and interhemispheric rhythmic-semantic discoordination, are always present in such children.

Isolated right hemisphere amusic dysrhythmia, as a rule, does not have a serious negative effect on the fluency of speech. However, sometimes it is expressed to such a degree that it prevents the maturation of the left hemisphere component of oral speech and thereby increases the risk of linguistic stuttering.

Interhemispheric rhythmic-semantic discoordination most often occurs in the absence of subcortical iterative and right hemispheric amusic dysrhythmia.

II. PSYCHOLOGICAL DIAGNOSTICS

Psychological diagnostics reveals the specific personal characteristics of each individual child, therefore its results are normative for determining a psychocorrectional program.

Impaired fluency of speech, as a rule, leads to difficulties in verbal communication, and indirectly to communication problems in general. Even in children three to seven years old, communication difficulties increase in the presence of a character trait such as isolation (autistic accentuation), which can be accompanied by:

* anxiety;

* emotional coldness, provoking alienation;

* aggressiveness or self-aggressiveness;

* uncertainty in the success of speech actions due to the severity of a speech defect, an inflated level of claims, etc.

This, as a rule, leads to a reluctance to communicate with peers, adults, speak in public, etc. As a result, social maladjustment may occur.

Psychological diagnostics is the first stage in the work of a psychologist, determining the content of his subsequent activities. When working with children who have speech fluency disorders, psychological diagnostics should be aimed at studying:

* motivation to exercise;

* communicative interaction with others;

* emotional and volitional spheres.

When organizing a psychological examination, the following tasks are solved:

* assessment of the compliance of the child’s motivation in relation to age standards;

* determination of the individual course of the child’s mental development in connection with disorders of the emotional-volitional sphere;

* assessment of the child’s emotional state;

* establishing possible causes of deviations in the child’s behavior through the attitude of the environment and the child himself to the defect.

Below are psychological diagnostic techniques that are most important for identifying psychological status a child with speech impairment.

1. Methodology for determining self-esteem “Ladder” (modification by V.G. Shur for children of preschool and primary school age)

The purpose of the technique: to identify the child’s level of self-esteem.

Instructions: “In front of you is a ladder with steps. On the lower steps there are bad, disobedient, unsuccessful children - the lower, the worse, and on the upper steps there are good, obedient, successful children - the higher, the better. At the middle level, children are neither bad nor good. Show me what level you will put yourself on. Explain why you drew it this way.” When analyzing the drawing, the position on the “ladder” chosen by the child himself and how the child explains his choices are taken into account.

In the example given, the child placed a star on the highest step of the ladder. This indicates that he has high level self-esteem.

2. Methodology for studying the emotional state according to the type of shift in color sensitivity (according to E.T. Dorofeeva)

The purpose of the technique: to identify the stability or lability of the child’s emotional state with its subsequent characteristics.

Instructions: the child is given three cards of different colors (red, blue, green) size 7x7 and asked to arrange them in order of preference.

The procedure is carried out three times. At the first presentation, the experimenter tells the subject: “Look carefully. In front of you are three cards of different colors - red, blue, green. Choose the one you like best from them.” When the choice is made, the child is asked again: “Now which color will you choose?” The third and last card is also recorded in the protocol. During the second and third presentations, the instructions do not change: “Choose from the three cards offered to you the one that you like best in color. And of these two remaining ones, which one do you like better?”

Based on the results of the examination, a protocol is filled out for each child. The processing of the research results is recorded in the protocol. To do this, you need to know the assessment (characteristics) of the emotional state according to the type of shift in color sensitivity. (Six types of color shift are possible.)

Assessment of emotional state based on the type of color sensitivity shift:

Color order	Name of emotional state	Characteristics of emotional state
	Active affects. State of affective arousal (AS)	The range of changes is from experiencing a feeling of impatience, indignation to a state of anger, rage.
	Experiencing a state of functional excitation (FE)	Emotions associated with need satisfaction. Range: from experiencing a feeling of satisfaction to delight, jubilation. Dominance of positive emotions.
	State of functional relaxation (FR)	Lack of expressed feelings. It is assessed as a calm, stable state, the most optimal for the implementation of human relationships, contacts, and various types of activities where tension is not required.
	State of functional tension, alertness (FN)	Indicative reactions are characterized by increased attention, activity, and occur in situations where the manifestation of such qualities is required. The best option functioning of the system.
	State of functional inhibition (FT)	Unsatisfaction of needs (sadness, melancholy, tension): from a state of sadness to depression, from preoccupation to anxiety. Polar FV. Dominance of negative emotions. Overstrain of all body systems.
	State of affective inhibition (AT)	It is found mainly in the clinic with deep exogenous depression. Polar AB. Dominance of strong negative emotions.

3. Methodology for determining the ability of emotional response. Projective technique in the form of a diagnostic game “The Lost Monkey” (developed by I.P. Voropaeva).

The purpose of the technique: to identify paralinguistic manifestations emotional sphere(facial expressions, pantomimes, gestures) in complex emotional processes, such as: emotional differentiation, emotional-role identification, mastery of one’s own emotional state.

Instructions: The experimenter says that he wants to meet the child and play the game “The Lost Monkey.” He introduces the child to the essence of the experimental situation, which consists in the fact that the person being diagnosed will play the role of the owner of the missing monkey, and the experimenter will play the role of the godfather, to whom the owner turns in search of the animal. (Diagnosis is carried out individually.)

Kuma, godmother, have you seen my monkey? - says the “hostess”.

What is she like? - asks the experimenter godfather.

Questions are asked in such a way that children, when answering them, use the basic means of emotional expressiveness: facial expressions, pantomime, gesticulation.

Is your monkey big or small?

Is her tail long?

What are her hands like?

How does she jump from branch to branch?

Can she catch flies?

Can she make faces? Show which.

Can she sing? Sing her favorite song.

All paralinguistic emotional means are recorded in an individual map - a characteristic of external emotional expressiveness.

Map - characteristic of external emotional expressiveness

The qualitative characteristics of the manifestations of one or another form of emotional expressiveness during the game are marked with “plus” or “minus” signs. A verbal description of external emotional expressiveness is carried out after communication with the child.

Within the framework of this technique, groups of children are identified that differ in the levels of development of emotional expressiveness.

1st group - complete absence external emotional expressiveness.

Children in this group are characterized by the following manifestations: facial muscles are relaxed, facial expressions do not express anything. The child does not give verbal answers to all the questions asked. There is apathy in the eyes. The body is sluggish, there is no gesticulation.

Group 2 - emotional response at the level of emotional mood.

The following typical manifestations are characteristic of children: pronounced deregulation of motor-motor reactions; facial expressions and inadequacy of facial expressions to the meaning of the situation; difficulties in verbal communication (the use of monosyllabic answers or interjections, and in some cases the use of active gestures instead of a complex answer); unnatural posture (in this group of children the body is either very relaxed or very tense).

Group 3 - partial ability of emotional differentiation.

The following typical manifestations are typical for children: tension, stiffness of motor skills, and sometimes delayed motor reactions.

Filling out individual cards - characteristics of children - allows the teacher to see the most poorly developed elements of external emotional expressiveness both in each individual child and in the group as a whole.

Based on the results of using the methods described above, the child’s anxiety level is determined.

If the level of anxiety is average or high, then there may be a debut of deformation of the child’s personality, in which a speech defect can play a significant role.

In addition to determining the level of anxiety, an important place in the psychological diagnosis of children is occupied by the assessment of motivation for activities, reflecting the level of general and cognitive activity, as well as socialization in general. In this regard, it is advisable to identify the degree of readiness of the child to learn.

4. Kinesitherapy diagnostics of coordination abilities (developed together with kinesiotherapist A.Yu. Patrikeev)

Kinesitherapy diagnostics allows you to obtain important data indicating the child’s ability to coordinate his actions. This ability is associated with the state of the subcortical structures of the brain for the implementation of fluent speech. Therefore, information about the ability to perform various coordinated actions is necessary to build a program of corrective measures.

Tests and control exercises are used to assess the state of various parameters that are basic for the levels of gnostic and praxic functions that are significant for the development of various types of subcortical coordination.

Tactile sense

1. Dynamometry test

Task: compress the dynamometer to a certain value (measured overall strength child and take the average value). The child presses twice while looking at the arrow, and the third time without looking. The hitting error with the right and left hands is measured separately.

Sense of time

2. Stopwatch test

To remember the time period, the child measures 10 seconds twice using a stopwatch. The third time he measures this time without looking. The error is recorded in seconds.

Sense of space

3. Hand movement test

Starting position: standing with your back to the wall. A point is marked on the wall, approximately the length of the child’s arm. His task: in two attempts to raise his straight arm to the point, remember this position of the arm. Then for the third time turn away (or close your eyes) and get into it. An error in cm is recorded. The movements of the right and left hands are measured separately.

4. Leg movement.

Same as in the previous test, but the point is indicated on the floor. And you need to get into it with your big toe. The performance of the right and left legs is measured separately.

5. Arm - leg

Tests 3 and 4 are executed simultaneously. At first right hand- left leg, then left hand - right leg. The error is measured in cm for the arms and legs.

6. Movement of the forearm.

Starting position: sitting at a table, forearm on the table. Movement of the forearm to a certain point, two attempts - looking at the point and one - without looking. The miss was measured in cm.

Sense of balance

7. Turns with eyes closed

Blindfolded, make three turns around your axis and walk in a straight line. The deviation from the line is measured in cm.

8. Finger - nasal test

Starting position: standing with your arms at your sides, with your eyes closed. The child’s task: touch the tip of the nose with the tip of the finger, with the right and left hands in turn. “Plus” means it hits, “minus” means it doesn’t hit.

...

Types of correction

As the problem was studied, speech therapists around the world proposed different treatment regimens. On this moment Several areas of treatment are known:

Drug treatment.
Physiotherapy.
The use of speech correction devices.
Creative development.

When treating, it is advisable to combine different types of therapy, this way the most pronounced effect can be achieved.

Correction methods

To treat stuttering, doctors have invented many correction methods. But this pathology is serious, and it is difficult to overcome it even today, since there is little information about it. Popular methods include:

treatment with;
speech therapy exercises, tongue twisters;
mechanical devices;
surgical intervention;
psychotherapy, etc.

Specialists use technical means during speech correction for stuttering. At the moment, there are 4 types of speech changes that can be made using various devices. Devices can affect muting, amplification of speech, rhythm development, and “delayed” speech. The devices make convulsive manifestations of stuttering less pronounced.

IN Lately Speech therapists began to use neurodynamic rhythmoplasty as a means of stuttering correction. This complex consists of physical therapy and choreography.

It is recommended to use different techniques, this is the only way the effect will be most pronounced. Work to correct stuttering should be carried out under the supervision of a psychotherapist or psychologist. The supervision of a speech therapist is also necessary.

Modern comprehensive methods for stuttering correction

Treatment of stuttering using methods from different specialists can differ significantly.

These specialists were involved in the correction of stuttering in primary schoolchildren. They assumed that to effectively eliminate pathology, you need to give the child exercises different levels difficulties. The goal of this technique is to relieve the child of stress, make his speech free, eliminate incorrect pronunciation and reinforce correct articulation.

According to this technique, there are 3 stages of stuttering correction. At the first stage, the child must memorize phrases. The speech therapist teaches him correct recitation.

The second stage is characterized by an exercise in which the child must verbally describe the pictures and compose his own stories from a series of images or on their theme. Sometimes a person who stutters is asked to retell a text read by a speech therapist.

The third stage is the final one. The child consolidates the acquired skills in conversation with others.

Mironova's scheme

The speech therapist proposed using a scheme in which children with disabilities, as they progress through preparatory groups in kindergarten, will attend additional classes devoted to familiarization with the world around them, basic mathematical concepts, drawing, modeling, appliqué, etc.

Mironova’s stuttering correction method includes 4 stages. For mass kindergartens specialized for children who stutter, it is proposed to introduce a modified program that is based on the speech abilities of children.

The correctional methodology assumes that as a result, children should be able to freely master speech of any complexity.

Cheveleva proposed a unique system for correcting stuttering in preschoolers. She believed that first of all, it was necessary to develop fine motor skills of the hands. According to Cheveleva, for treatment the child must engage in making crafts. The more complex the speech, the more work the baby will have to do.

Her judgment assumes that speech consists of two levels - situational (simpler) and contextual (complicated). First, children use situational, then contextual speech. As we grow older, the two types of speech become mixed.

The system of corrective measures for stuttering included 5 periods. Complication occurs from one level of speech to another.

Seliverstov's scheme

The program is more designed for children in medical institutions. It includes the simultaneous use of different types of speech therapy exercises. According to the author, a speech therapist should be a person with a creative approach, since each child requires an individual approach.

The technique is three-stage. Corrective work for stuttering begins with preparatory stage, in which the child practices rhythm and independence of speech. Then comes the training, more difficult stage. The last stage is the reinforcing stage, at which the baby solves complex speech therapy problems (for example, contextual description).

Correction stages

Different methods involve different quantities stages. But, as a rule, all stages can be combined into three main ones - preparatory, training and consolidation. In all treatment regimens, the child engages in simpler tasks first, and then more complex ones.

Depending on which treatment regimen was chosen, the baby can either engage in creative development, either develop fine motor skills of the hands, or perform exercises to normalize articulatory muscles.

If a child has a stutter, parental support is very important to overcome it. There should be a calm and understanding atmosphere at home. If there is family disharmony, the work of a speech therapist will be useless.

enter a daily routine for the child;
adjust your sleep, it should be at least 8 hours;
you should speak to the child in a calm and quiet voice;
avoid raising intonation and aggressive tone;
do not interrupt the baby when he speaks;
refrain from frequent criticism;
Praise your child for his successes.

The child must understand that he will find support and support in the family. An aggressive environment can have an extremely negative impact on him.

Conclusion

The problem requires an integrated approach, it is advisable to resort to different types treatment. Family harmony is a very important factor. Therefore, you should pay attention to the well-being of the environment in which the child grows up. You cannot treat a child for stuttering on your own; you should always consult with speech therapists, psychologists and neurologists.

Diagnostics and diseases. Medicines from A to Z

Working with stuttering in preschool children. Until now, researchers have been trying to consider the mechanism of stuttering not only from clinical and physiological, but also from neurophysiological, psychological, and psycholinguistic positions.

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Introduction

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.

The speech therapist is assigned programmatic and correctional tasks, which are solved during four stages of successively more complex work.

In the method of G.A. Volkova presents a system of comprehensive work with children who stutter, which consists of sections: methods of play activities, logorhythmic activities, educational activities, impact on the microsocial environment of children.

ON THE. Vlasov and E.F. Pay offer to work on a child’s speech, moving from its simple forms to complex ones: from conjugate speech, through reflected and question-answer speech, to describing familiar pictures, retelling a listened text, to spontaneous and emotional speech.

The topic of my course work is “Methods of speech therapy work with preschoolers who stutter.” This topic is very relevant, since speech disorders are diverse, and the methods for their correction are also diverse.

The purpose of this course work is to study the methodology of speech therapy work with children of senior preschool age to correct stuttering.

The main tasks, I believe, are to consider the main stages, directions, study methods of speech therapy work to correct the symptoms of stuttering in children of senior preschool age.

Chapter 1. Theoretical aspects of stuttering

1.1 The essence of stuttering

By the beginning of the 20th century. all the diversity of understanding the mechanisms of stuttering can be reduced to three theoretical directions:

In the 70s, clinical criteria were proposed in psychiatry for distinguishing between neurotic and neurosis-like disorders and there was a tendency to distinguish stuttering into neurotic and neurosis-like forms (N.M. Asatiani, B.3. Drapkin, V.G. Kazakov, L. I. Belyakova and others).

Until now, researchers have been trying to consider the mechanism of stuttering not only from clinical and physiological, but also from neurophysiological, psychological, and psycholinguistic positions.

Some researchers believe that people who stutter are characterized by greater inertia of mental processes than normal speakers; they are characterized by the phenomenon of perseveration associated with the mobility of the nervous system.

1) the presence of a need for speech, or communicative intention;

2) the birth of the idea of ​​an utterance in inner speech;

3) sound realization of the utterance.

1.2 Forms of stuttering

Convulsions manifest themselves primarily in the respiratory apparatus of speech, then in the vocal, then in the articulatory apparatus. For many, stuttering is accompanied by convulsive or habitual movements of the arms, legs, and head.

People who stutter often also have tongue-tiedness.

Such experiences have a bad effect on the child’s psyche and spoil his character (often he becomes irritable, suspicious, painfully touchy, unsociable, and sometimes embittered). They consolidate and intensify stuttering, therefore, the teacher’s close attention to such children is necessary.

1.3 Course of stuttering

Stuttering occurs either suddenly, sometimes after a certain period of muteness (from several hours to several days), or gradually, gradually intensifying. The latter occurs most often as a result of diseases that deplete the nervous system and its intoxication.

1.4 Causes and mechanisms of stuttering

Fright, a sudden change in the situation, fear, even in a dream, fear of darkness, loneliness, expected punishment or the arrival of a scary uncle, with which nannies intimidate a child who cannot sleep, etc.

For example, one child began to stutter after seeing Santa Claus take off his mask and turn into his own dad before his eyes.

Katya, a six-year-old girl, was afraid to be photographed. She was forcibly photographed and began to stutter.

You should refrain from teaching a foreign language to a person who stutters early - stuttering may worsen (especially with strict requirements from the teacher).

So, stuttering is closely related to the state of the nervous system, to the child’s entire personality and his relationships with others. From this situation flow the means to combat it.

Conclusions to Chapter 1

Stuttering is a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus.

The following types of stuttering are distinguished: articulatory, wave-like, vocal, respiratory, fixed, initial, induced, inspiratory, clonic, neurosis-like, neurotic, organic, constant, respiratory, recurrent, mixed, tonic, functional, expiratory.

The main external symptom of stuttering is convulsions during speech.

There are three degrees of stuttering:

Mild - they stutter only in an excited state and when trying to speak quickly. In this case, delays are easily overcome.

Average - in a calm state and in a familiar environment, they speak easily and stutter little; In an emotional state, severe stuttering appears.

Severe - they stutter throughout the entire speech, constantly, with accompanying movements.

The following types of stuttering are distinguished:

Constant - stuttering, having arisen, manifests itself relatively constantly in various forms of speech, situations, etc.

Wavy - stuttering intensifies and 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.

Chapter 2. Methods of speech therapy sessions with stuttering preschoolers

2.1 Didactic foundations of speech therapy classes with children who stutter

Thus, the basic didactic principles and principles applied to children with impaired speech activity are fundamental. Knowledge of these basics predetermines the success (in general and in particular) of correctional pedagogical work with children who stutter.

Individual approach to children who stutter. Group, collective speech therapy sessions with people who stutter have proven themselves over many years of practice.

Group activities create conditions for active work of all children. The requirement for an individual approach does not mean opposing the individual to the collective. Only knowing well the capabilities of each child can you organize collective work.

2.2 Methodology N.A. Cheveleva

1) accompanying speech;

2) closing speech,

3) preliminary speech,

4) strengthening independent speech skills.

This system for overcoming stuttering in children includes 5 periods.

1) Propaedeutic (4 lessons). The main goal is to instill in children the skills of organized behavior. At the same time, children learn to hear the speech therapist’s laconic but logically clear speech and its normal rhythm. The children themselves have temporary speech restrictions.

Hence, the “main line of increasing complexity of independent speech” includes the following forms: accompanying, final, and preceding.

2.3 Methodology V.M. Shklovsky

The course of stuttering treatment (2.5-3 months) is divided by the author into five stages: preparatory (diagnostic); restructuring of pathological speech skills and disrupted personality relationships; consolidation of achieved results; medical examination and prevention; Spa treatment.

The preparatory (diagnostic) stage lasts 10-15 days. At this time, the patient is studied by a neuropathologist, defectologist and psychotherapist; Anamnestic and clinical data are studied, psychotherapeutic and speech therapy measures are planned, and drug treatment is prescribed.

Considering the complex impact on people who stutter as a combination of speech therapy and psychotherapeutic work, V.M. Shklovsky at this stage divides speech therapy work into two parts: preparatory and active training of smooth and continuous speech. The first part includes:

1) correction of breathing, register and timbre of voice;

2) developing the correct rhythm and tempo of speech;

3) mastery of “standards”, “formulas” of speech;

4) identifying the potential speech abilities of people who stutter. Normalization of the patient's speech breathing and voice, rate of speech, mastery of “standards” - all this is the basis for subsequent suggestive and rational psychotherapy.

In total, at least 3-4 hours should be devoted to speech classes during the day (each lesson is 10-15 minutes of speech training).

Speech exercises in systems of logopsychotherapeutic sessions with people who stutter are based on those generally accepted in children's speech therapy, but taking into account the age characteristics of patients.

In addition, and with some features: L.Z. Andronova builds speech exercises based on syllable speech (full form of speech); V.M. Shklovsky and others - for varying degrees of independent speech; Yu.B. Nekrasova attaches particular importance to the development of elements of stage speech, etc.

2.4 Methodology N.A. Vlasova and E.F. Rau

1) reflected speech;

2) memorized phrases;

3) retelling based on the picture;

4) answers to questions;

5) spontaneous speech.

At the same time, the authors recommend mandatory rhythmic and musical classes with children and conducting explanatory work with parents.

ON THE. Vlasova distinguishes 7 “types of speech”, which, in order of gradualness, must be used in classes with preschool children:

1) conjugate speech;

2) reflected speech;

3) answers to questions based on a familiar picture;

4) independent description of familiar pictures;

2) the birth of the idea of an utterance in inner speech;