Stuttering is not a disease, but a manifestation of the disease, one of its symptoms. Accordingly, in order to talk about treatment tactics for stuttering, it is necessary to establish exactly what disorder it is a manifestation of...

Developed a large number of methods for getting rid of stuttering. It is difficult to say which technique is suitable in each specific case. Today we bring to your attention the technique described in V.M. Lykov’s book “Stuttering in Preschool Children” (M., 1978).

The essence of stuttering

Stuttering is a fairly common phenomenon. However, everyday observations show that adults do not have a clear idea of ​​stuttering, a clear understanding of the psychology of people who stutter, or knowledge of evidence-based ways of prevention and treatment.

Stuttering is not only a complex speech disorder, but also a disease of the entire body. And therefore, along with pedagogical measures, children who stutter need special restorative treatment.

Surveys of parents have shown that for the most part they understand stuttering as a kind of “mechanical breakdown” of sound pronunciation and do not associate it with complex mental processes. Hence the purely formal approach to the education and training of people who stutter.

How modern science interprets this phenomenon? Based on the teachings of I.P. Pavlov, stuttering is considered as private view neurosis - logoneurosis (speech neurosis), resulting from a functional disorder of higher nervous activity.

It is known that two interrelated and interdependent processes continuously occur in the cerebral cortex - excitation and inhibition. Normally, balancing each other, they create peace and well-being for the entire body, the so-called state of comfort. But when the mutual balance of these processes is disrupted, a phenomenon arises that I. P. Pavlov figuratively called a “collision.”

The diseased focus formed as a result of such a “collision” changes the interaction between the cortex and subcortex. Having escaped the control of the cortex, subcortical formations begin to send random impulses to the cortex, including the speech production zone, causing the appearance of convulsions in various parts of the speech apparatus (larynx, pharynx, tongue, lips). As a result, some of its components fire earlier, others later. The pace and smoothness of speech movements is disrupted - the vocal cords tightly close or open, the voice suddenly disappears, words are pronounced in a whisper and prolongated (elongated) - pp-field, bbb-be-birch, which is why the thought is expressed vaguely, is not brought to the end, becomes incomprehensible to those around you.

In this regard, the question arises: “What factors negatively affect the normal course of excitation and inhibition?”

There are several reasons. But the main one is weakness nervous system, most often due to infectious diseases(complications after measles, encephalitis), sluggish chronic pathology - rheumatism, pneumonia, etc.

Sometimes children are born with a weakened nervous system, which is the result of an unfavorable pregnancy.

We have named a group of causes of a pathogenic nature, but there is also another group - defects in education. Abnormal household environment, quarrels between parents in the presence of the child, uneven attitude towards him (shouts, intimidation, punishment), and finally, different requirements in the family, they hurt the child’s psyche and lead to a speech disorder.

Many other factors are known to science and practice, for example, left-handedness, imitation, hesitations in speech, impaired sound pronunciation, speech underdevelopment, etc. By the way, it is undesirable to both lag and excessively rapid development of speech, encouraging children to master difficult words and suggestions. It also happens that a child, imitating the sloppy speech of those around him, tries to quickly express his thoughts, gets confused, gets confused in sounds and begins to stutter.

However, the listed factors are not enough for stuttering to occur. A kind of impetus, a trigger for stuttering, are such irritants as fear, conflict situations, severe emotional experiences. From here it becomes clear why children more often begin to stutter after illnesses: a weakened nervous system reacts sharply to strong stimuli, to a rude shout, etc.

Stuttering in most cases is associated with fear (animal attacks, car collisions, fires, drowning, rooster crowing, punishment, emotional stress). Indeed, about 70 percent of stuttering cases are associated with mental trauma.

They may object: “Many children get scared, but not all of them stutter.” What is true is true. To be or not to stutter depends entirely, as we have noticed, on a number of incidental circumstances - the state of the nervous system at the time of mental trauma, the strength of the traumatic stimulus, etc.

Stuttering usually develops in children between two and five years of age, i.e., during the most rapid period of speech development. In the system of others mental processes speech is the most fragile and vulnerable due to its “youth”, and therefore loads on the nervous system directly or indirectly affect speech activity. Young children lack strong inhibitory reactions. Babies are easily excited, and excitement can lead to convulsions, including convulsions of the speech apparatus - stuttering. Stuttering occurs three times more often in boys than in girls. Scientists explain this phenomenon by the fact that boys, due to their more active lifestyle, are exposed to more frequent traumatic opportunities. Rural schoolchildren exhibit stuttering less frequently than urban students. IN rural areas there are fewer traumatic factors, there is a calmer and more measured rhythm of life.

Symptoms of stuttering

Stuttering occurs in different ways, but identifying the disease is not difficult. It manifests itself either in the obsessive repetition of sounds and syllables, or in involuntary stops and delays, often accompanied by convulsions of the speech organs. The spasms affect the vocal cords, muscles of the pharynx, tongue, and lips. The presence of spasms in the speech stream is the main phenomenon of stuttering. They vary in frequency, location and duration. The severity of stuttering depends on the nature of the seizures. The tension in the organs of pronunciation does not allow a person who stutters to conduct a conversation accurately, clearly, and rhythmically. The voice also becomes upset - in people who stutter, it is uncertain, hoarse, and weak.

There is an opinion that the basis of stuttering is blocking (turning off) voice production. Indeed, a number of experiments confirm this idea. When a child stutters, he spends a lot of physical energy. When speaking, his face becomes covered with red spots and sticky cold sweat, and after speaking he often feels tired.

Individual sounds, syllables, words become so difficult that children avoid using them, as a result of which speech becomes impoverished, simplified, becomes inaccurate, and incomprehensible. Particularly great difficulties arise when reproducing coherent stories. And to make their situation easier, kids begin to use sounds, words or even whole phrases that have nothing to do with the subject of the statement. These "alien" sounds and words are called gimmicks. “A”, “e”, “here”, “well”, “and” are used as speech tricks.

In addition to speech, children who stutter also develop motor tricks: children clench their fists, step from foot to foot, wave their arms, shrug their shoulders, sniffle, etc. These auxiliary movements make it easier for the child to speak, and later, when they become established, they become an integral part of the speech. speech act. Extra movements disrupt coordinated motor skills and load the psyche with additional work.

Some preschoolers develop a fear of speaking. Even before starting a conversation, the child begins to worry that he will stutter, that he will not be understood, that he will be judged poorly. Uncertainty in speech, wariness, and suspiciousness appear.

Children are painfully aware of the difference between themselves and their peers. If, in addition, their comrades laugh at them, imitate them, and adults scold them for speaking incorrectly, stuttering children withdraw into themselves, become irritable, fearful, and they develop a feeling of inferiority, which further depresses the psyche and aggravates stuttering.

Psychological layers can be so pronounced that first of all one has to direct efforts to streamline behavior, and only then to fight stuttering.

People who stutter have poor coordination in their movements. Some have motor restlessness and disinhibition, others have angularity and stiffness. This is why people who stutter usually avoid crafts that require fine finger movements. But the signs of stuttering do not end there. People who stutter develop undesirable character traits - irritability, tearfulness, resentment, isolation, distrust, negativism, stubbornness and even aggressiveness.

Preschoolers who stutter are more susceptible to colds than ordinary children; their sleep and appetite are more often disturbed. If we talk about the dynamics of stuttering, it strikes next to characteristic features- instability of the clinical picture, adaptability and variability. Often more complex shape speech is pronounced more freely than facilitated.

In the spring-summer period, stuttering smoothes out, in the autumn-winter period it intensifies. In an unfamiliar environment it manifests itself more strongly than in a familiar one. The severity of stuttering is also influenced by the situation in which the child finds himself. In kindergarten it gets worse; when surrounded by friends and family, the child feels freer. In labor classes, speech is much more confident than in native language classes.

Stuttering gets worse as fatigue increases. At the beginning of the day the defect appears less grossly than at the end. Hence the conclusion that classes with stutterers should be conducted in the morning.

When a child is alone, he does not stutter. Children do not stutter when singing, reading poetry, or reciting memorized stories. From the foregoing, we can conclude that in order to correct the defect, it is necessary to influence not only the speech of the stutterer, but also the personality as a whole.

Overcoming stuttering

Before moving on to specific recommendations for overcoming stuttering, it would be useful to recall some general provisions. The first thing parents should do is consult with a psychoneurologist and speech therapist, together with them, based on the child’s personality characteristics, outline and implement a program of medical and pedagogical influence.

Currently, a comprehensive method of overcoming stuttering has become widespread, in which parents play a prominent role. What is its essence?

Structurally, it consists of two interconnected parts - therapeutic and health-improving and correctional and educational. Each of them, complementing each other, pursues its own goals and objectives: therapeutic and health-improving is aimed at normalizing neuropsychic processes, at improving the nervous system; correctional and educational - to develop and consolidate correct speech skills.

To improve the child’s health, various activities are carried out, sedatives, calcium supplements, and various vitamins are prescribed. Drug therapy is combined with physiotherapy and climatotherapy, sleep, etc.

It is extremely important for parents to create a favorable, calm environment for the baby, instill cheerfulness in him, and distract him from unpleasant thoughts. The speech of adults should be friendly, leisurely, and simple. Jerking, shouting, and punishment are not allowed.

Since the body of a stuttering child is weakened in most cases, he really needs a correct and solid daily routine, a rational alternation of work and rest. A measured rhythm of life helps to normalize the functioning of the body and, in particular, higher nervous activity. In this case, sleep plays an important role. Children who stutter should sleep 10-12 hours at night and 2-3 hours during the day.

The daily routine includes time for games and walks. Moreover, it is important to choose calm games for active children, and fun, active ones for inert ones.

Parents should pay close attention to the child’s nutrition - make it varied, sufficiently high in calories, well fortified with vitamins. People who stutter are recommended to eat four meals a day with regular meal times.

Hardening procedures—rubbing, dousing, bathing—have an exceptionally beneficial effect on a child’s health. Walking, sledding and skiing are required. We should not forget about morning exercises and physical exercises that contribute to the development of coordination of movements, improve the functioning of the cardiovascular and respiratory systems. The daily routine should also include elements of child labor: the child can bring dishes, remove spoons and pieces of bread from the table, tidy up the children's corner, and prepare items for play. The child is entrusted with caring for plants, etc.

Medical and health activities create a physiological foundation for conducting special speech classes. Corrective and educational measures are aimed at normalizing the tempo, smoothness and rhythm of speech, developing the ability to work purposefully, enhancing speech communication, as well as eliminating defects in sound pronunciation.

The program of correctional and educational activities is implemented in the process of the child’s daily activities, and is as close as possible to his needs, interests, hobbies, in a word, speech correction should take place in natural conditions. Under no circumstances should you force a child to complete certain tasks. He must do everything without much coercion.

Speech classes

Speech classes are built in the form of conversations, viewing didactic materials, filmstrips, and working on crafts. During classes you should use books, toys, and board games. At the same time, parents should monitor their children’s speech, help them express their thoughts correctly, without focusing on the speech defect.

Speech classes should be conducted regularly and in accordance with the principle from simple to complex, from familiar to unfamiliar. From the simplest situational forms to a detailed statement - this is the way to overcome stuttering. This is a very difficult task, and success here accompanies those parents who are not stopped by the first failures.

Typically, overcoming stuttering in preschoolers at home takes 3-4 months. All this time you need to be close to the child and “live” with him all the stages of speech re-education. Never give up hope of improving your stuttering. Remember: stuttering is a removable disease.

The course of overcoming stuttering is conventionally divided into three periods: preparatory, training, consolidative.

Preparation period

This period includes medical, recreational and protective measures: visiting a doctor, speech therapist, organizing a work and rest regime. At this time, it is necessary to limit the speech communication of a stuttering child with other children. Family members should carefully ensure that their own speech is clear, expressive and unhurried. It is necessary to draw up a plan for working with your child every day and make notes on its implementation. They have casual conversations with the child about how together (with mom and dad) he will learn to speak correctly and beautifully, and tell interesting fairy tales or stories. At the same time, play a children's record for your child or let him listen to a tape recording of the fairy tales “Teremok”, “Kolobok”, “Three Bears” and others. Games, drawing, and modeling help to prepare him for the upcoming speech work. Engage in education correct speech while walking and playing outdoors.

During the preparatory period, simple speech classes are organized - three to four times a day, lasting 10-15 minutes each. It is better to start classes with speech exercises. The child is asked to count to five, to ten, and then, following his parents, say short phrases: "I'm learning to speak slowly." "I'm learning to speak loudly."

Excerpts from children's poems can serve as material for speech exercises. The purpose of speech exercises is to prepare the child for the upcoming lesson, to make him feel that he can speak correctly. It is important that during a conversation the child does not tense up, does not raise his shoulders, and breathes silently and calmly.

After exercise, speech classes begin, which consist of special exercises that normalize speech. Speech exercises are built in a certain sequence - from simple forms of speech to complex ones.

Conjugate speech is the easiest for children who stutter. The child and his parents simultaneously name the objects shown in the pictures, the letters of the alphabet, speak short phrases (based on the pictures), and recite poetry. The training method is quite simple. While looking at the picture, at the same time as your child, smoothly and leisurely say: “This is Mishka. Teddy Bear is bathing. Mishka has big paws.”

You can take any toy and tell what parts it consists of: “This is a Lena doll. Lena has eyes, a mouth, a nose. Lena has a new dress and white shoes.” Seeing objects in front of him, the child expresses his thoughts easier and more confidently.

The lesson can end with playing lotto with pictures or reading a poem. As soon as the child is fluent in conjugate speech, move on to the next form of speech.

Reflected speech is a more complex form that allows storytelling based on objects, pictures, toys. The parents say the phrase, the child repeats: “I have a pencil.” "I'm drawing". “Once upon a time there was a goat, and she had seven kids.” With children it is advisable to recite “Teremok”, “Kolobok”, M. Prishvin’s story “The Brave Hedgehog”, A. Barto’s poems “Bunny”, “Bear”. With older preschoolers you need to learn the alphabet, and you should also teach them to read and write using the ABCs.

During this period, exercises for coordinating words with movement are introduced. March in a circle with your child: “We learned to count: one, two, three, four, five.” And so three times. Or another exercise. Give your child a ball and count each time the ball is thrown on the floor. The lesson ends with a speech board game. For example, you can prepare any subject lotto. Show your child the picture and calmly say: “I have a squirrel.” Then you just show the picture and the child names it.

This is a schematic lesson plan for the education of the reflected form of speech, based on which you can create subsequent lessons yourself.

During this period, learn N. Naydenova’s poem “Spring” with your child. Use days of the week, months, seasons of the year as speech exercises. If your child reads, choose for him folk tales, interesting poems.

After two or three lessons, the child himself begins to be active and confidently repeats the text, willingly plays, throws the ball up, hits the floor or wall. The movement is accompanied by words. Counting rhymes, jokes, and riddles are especially convenient for such exercises (they can be found in the magazines “Funny Pictures” and “Murzilka”).

This concludes the preparatory period. Its duration may vary depending on the success of mastering the conjugate-reflective form of speech. Fluency in them provides the basis for the transition to the next period - training. There are often cases when, already at the initial stage, certain forms of stuttering (especially mild ones) are successfully overcome. For preventive purposes, classes should be continued. However, the daily routine and gentle regime should remain the same. After a month, the child can be taken to a regular kindergarten.

Training period

The training period is the main period in working to eliminate stuttering. Its goal is to master the most complex forms of speech based on the skills acquired in the preparatory period. The child felt that he could speak freely and confidently, and therefore subsequent classes would not seem overly difficult to him.

The training period begins with mastering the question-and-answer form of speech. Classes are structured in the form of conversation, games, labor activity. Pictures, toys, etc. serve as didactic material. The main thing for parents is to be able to pose the question correctly. In contrast to exercises with reflected speech, the child independently pronounces one word when answering a question. In the future, the answers become more complicated, and the child speaks 3-4 words independently.

Here is an example lesson for one day. Based on this composition, you can build similar activities for the following days.

In the morning

Speech exercises for coordinating words with movement. Stand opposite the child two meters away with the ball.

- Zhenya, what do I have in my hands?
- Ball.
- Catch! (Zhenya catches it).
- Zhenya, what did you do?
— I caught the ball.
- Throw it to me (Throws it).
- What did you do?
— I threw the ball.
- What ball is this?
— Rubber ball (round, small). (At the word “rubber” the child throws the ball). The next exercise is squatting and straightening with emphasis on your toes.
- What will you do?
- I will rise on my toes and squat down.
The exercise is performed as follows: On the count of times - squat.
- Zhenya, what did you do?
— I squatted down. On the count of two - straightening.
- Zhenya, what did you do?
— I stood on my tiptoes.
Answers to questions based on familiar pictures. Prepare a set of subject and plot pictures. Show them to your child one by one:
- Who is this?
- It's a girl.
- What is the girl doing?
— A girl plays with a doll. Next picture:
- Who is this?
- Boy.
-What is the boy holding in his hands?
— The boy has a fishing rod in his hands.
- What is the boy doing?
— The boy is fishing.
In this vein, go through a few more pictures with your child. Do not rush your child, make sure that he answers smoothly, without mistakes. If you have any difficulties, let him repeat after you.
From subject pictures, move on to working with subject pictures cut out from children's magazines. Children willingly study based on the painting by K. Uspenskaya “They didn’t take me fishing.”
First, the child carefully examines the picture, and then answers the questions:
— Zhenya, what is shown in the picture?
- In the picture there is a boy, a chicken, an uncle and another boy.
-Where does the boy live? In the city or in the village?
— The boy lives in the village.
“Where do you think your father and older brother went?”
— They went fishing.
-What do they have in their hands?
— There are fishing rods in my hands.
- Who else wanted to fish?
- This Boy.
- Did they take him or not?
“They didn’t take it, and he’s crying.”
- What is your sister doing?
- Smiles.
As the picture is analyzed, the questions become more complex.
For children 4-5 years of age, select pictures depicting animals and heroes of your favorite fairy tales. Finish the lesson by cutting out the letter “a”. Draw the letter “a” on a piece of paper and have your child cut it out. During the operation, ask:
- Zhenya, what are you doing?
— I cut out the letter "a."
Say “ah-ah-ah” out loud together.

V. M. Lykov

Article provided by the website Kindergarten.Ru

Comment on the article "Stuttering in Children. Part 1"

Stuttering in children. Part 2. Girls, if anyone has a textbook for 5th grade literature by Korovin, part 1 (my child only brought the second part from the library.) Please give me a print screen or hard copy of the fairy tale by A.T. Arsiria “The Parts of Speech Dispute.”

Discussion

Our children in the class all have a test. There are no failures, the class writes a sample again tomorrow - they practice.

Now I looked at the grades in my daughter’s class - 4 twos, 3 threes, 10 fours, 3 fives. But these are grades in the diary, and they were assessed pass/fail according to all criteria. It turns out that out of 20 people, 4 did not write - it looks like what you have. Mine is sitting, getting ready on her own, there is no hope for school.

Stuttering is a complex speech disorder associated with psychophysiology, in which the integrity and fluency of a person’s speech is disrupted. This manifests itself in the form of repetition or prolongation of sounds, syllables, or words. It can manifest itself in the form of frequent stops or hesitation in speech, as a result of which its rhythmic flow is disrupted. Causes: increased tone and periodically occurring convulsive readiness of the motor endings of the speech centers of the brain; consequences of acute and chronic stress...

Stuttering in children. Part 2. A child plays with a ball and reads S. Marshak’s poem “My cheerful ringing ball.” Having become the first word of our year... Russian language - terminology. The common part of related words is called ROOT.

Discussion

Pine, pine and to pine are the same word) And so on.

Different case forms are not related words. For example, pine and pine are just different cases.
1. Pine, pine, pine, pine
2. Window, small window, small window, window sill.
I think so.

If your baby has just started to stutter, there is no “maybe it will pass”!

Stuttering in children. Speech therapy. Pediatric medicine. Child health, illnesses and treatment, clinic, hospital, doctor, vaccinations. Stutters on the first syllables. I would also be grateful for your thoughts on where to go first - speech therapist? neurologist?

"What to do, what to do? Dry the crackers!" - film “Beware of the car” My child is a thief. Many adults go to extremes when realizing such a thought. They drink valerian in liters, discuss the problem with friends, grab their belts, and run to a consultation with a psychologist. It's scary to be the parents of a thief. However, instead of solving the problem, new difficulties appear. The child continues to steal, becomes uncontrollable and secretive. Why are the old “grandfather’s” methods, along with the advice of educational psychologists...

Discussion

Every mother wishes the best for her child and wants him to grow up to be a decent person. But the trouble is that we look at our children through the prism of our own worldview, completely not understanding that the child may be completely different from us. What stimulates us and is beneficial for us can be disastrous for a child. And the opportunity to understand the root causes of a child’s behavior is worth a lot - it allows you to eliminate possible pedagogical errors.

01/28/2012 21:09:26, YanaSobol

Gee-gee. I finished reading to “With the child of criminals - repeat offenders, everything is immediately clear - an innate attraction to crime”

There is no innate desire for violations. Tell this to the geneticists, they will laugh at you. There is no theft gene and no criminal gene. Conclusion: this does not apply to “innate”.

Stuttering or what? Speech. Child from 1 to 3. Raising a child from one to three years: hardening and development, nutrition and illness, daily routine and development of household skills. Sonya stuttered so much at my first >.

Discussion

Sonya stuttered so much on the first syllables - I really wanted to say a lot at once! It's probably been a couple of months. Neurologists offer a standard option - remove external stimuli, like TV, calm games to the maximum, and when speaking, ask not to rush and speak calmly...

Does the task ask questions about adjectives or definitions? [link-1]

I have trilingual children. The eldest (7 years old) seems to be right-handed, but somehow unconvincing, perhaps ambidextrous. She never stuttered, although at one time she spoke 4 languages ​​(her study of a fourth language was interrupted 3 years ago, and now she has forgotten everything). The youngest (4 years old) did not stutter, although at 2-3 years old, when he began to speak, he seemed to shut up on one word, repeated it many times and could not find the next one, sometimes in frustration he reported that he could not speak. We always listened to him very patiently, did not rush him, never interrupted or prompted him, gradually everything went away. Now he cheerfully speaks all three languages. I know many bi- and trilingual children, some of them left-handed - not a single one with a stutter. I have my doubts about 80%. IMHO in Russia there is generally a wary attitude towards multilingualism.

I think it's probably just individual feature Your child. Perhaps bilingualism had a negative impact in your situation, but now the child is already bilingual, so IMHO you need to continue to study. The progress may be small and not very noticeable to you. Have you asked the specialist where she notices progress? Unfortunately, I can’t give any advice on methods, but I believe in the power of systematic training.

1) switched to a whisper (with hugs and kisses),
2) sang,
3) they maintained speech calm (I also have chatter) - she explained why it was necessary to remain silent, that “the mouth is tired,” “you see, the tongue can’t handle it anymore.” It worked.

What helped us EXCEPT medical consultations (according to my personal observations).

1) adherence to the regime (sleep during the day mandatory, even if it seems that he will never sleep). I went to bed with him however I wanted, but I had to sleep during the day.
2) I removed all the exciting moments (they wrote it correctly for you below) - no circuses, attractions, TV was removed AT ALL, all visits to relatives and friends in doses, only the “essentials” - grandmothers who will be offended if the child is not taken for half a year.
3) Increased communication with water. Swimming for a long time, splashing, transfusion, etc., etc.
4) I did massage and physical contact (but I generally like to cuddle, sometimes I’m ready to howl).
5) We arrange an emotional release, for example, jumping on a gymnastic mat and squealing, or somersaulting, obviously a release after that :)))

We have been living in this mode for six months now, and progress is obvious. For me personally, this is VERY difficult - EVERYTHING is tailored to the child - the daily routine, all weekends, I have practically no personal time, I’m very tired, but I don’t see any other way out.....

stuttering. My son began to stutter at the age of 3. I would like to talk to parents who have gone through this and recovered, or vice versa. Don't be afraid that there will be an environment with children who stutter. Additional classes with specialists do wonders.

Discussion

Just in case, I would also have him examined by a neurologist: my younger brother’s stuttering was directly related to cerebral circulation disorders. First he was treated for his stuttering, then he was treated by a speech therapist. Ours cured stuttering in 2-3 months. I don’t remember the technique, it involves “singing” sounds, then words, sentences. Setting up "lower" breathing.

The main thing is to find a good speech therapist.
It is quite possible that you still have a “temporary” stutter.
I would advise you to try to get into a speech therapy kindergarten, in the appropriate group. Organizing such classes even with a visiting speech therapist is very expensive and difficult. And in the kindergarten, in addition to the speech therapist, there will be another adjusted program (there should be).
Don't be afraid that there will be an environment with children who stutter. Additional classes with specialists do wonders.
Another piece of advice is to learn to sing (develop proper breathing).
We have already lived through all this (my son is 16 years old). The defect is noticeable only to a knowledgeable specialist and after prolonged communication. Although this was achieved with great difficulty and the main work, it was at the age of 4-7 years

Hysteria, stuttering - what to do? Lately some kind of nightmare has been happening to us - I just don’t recognize my child. When a child cannot imagine himself without his mother, it is as if she is part of him. When I first left him for seven hours, I left, and he was with his grandmother, cat...

Discussion

A very similar situation. Our Toshka was also absolutely normal, and then very suddenly a progressive stuttering began... Plus, the child is very reactive, active, and easily excitable. In short, at one time the sky seemed like a sheepskin. We went through many specialists. As a result, the problem was solved in the following way. Firstly, they transferred the child to a speech therapy kindergarten, where, in addition to playing, a speech therapist worked with him every day. He taught me not only how to speak correctly, but also how to overcome stuttering itself. It turned out that there are a lot of effective methods. Secondly, we began to introduce a system of rituals in the evenings aimed at gradually calming the child and preparing him for sleep. All active games ended 2 hours before bedtime. Then there was dinner. Behind him are mandatory water procedures. Including soothing baths with herbal extracts. Then - the indispensable cocoa. (My son really loved Nesquik... :)) Then - the ritual of putting on pajamas and putting soft toys to bed. And then - a bedtime story. At first it was a little difficult, but after about three months my son got used to this ritual and the process, as they say, began. :)))

I, too (like Svetlana) noticed that my daughter has a time when she easily falls asleep and if she does, then it’s hard for her to fall asleep. I'm the same way, so I understand it. Well, making sure that it doesn’t go overboard is, of course, my concern. We had a difficult period after my birth - I left to give birth at night and returned 2.5 days later, and apparently my daughter still had a fear that her mother might disappear at night. She had a very difficult time falling asleep and waking up at night. It helped her that I sat and reclined next to her. It is very important to be patient and not scold or run away ahead of time. Improvement is not going so quickly, and every mother’s breakdown pushes her back again. It took us, it seems, about 2 months to return to a normal bedtime routine. We don't have rituals. You can really consider washing and brushing your teeth as a ritual. And I also kiss and hug her when she is already lying in bed, and she me.
I would give her the pacifier back. I heard that important changes for a child should be made no more than once every three months. She's already going through a stressful period. Well, you can pick up the pacifier a couple of months later.
Hysterics.. I wouldn’t stop her from doing what she wants. Well, if he wants to jump, let him jump. There are worse vices... :)). And at the same time she would explain that if she talks about it instead of shouting, it will be more pleasant for everyone. I would definitely explain all refusals in detail. Maybe you can take sick leave for a week? Good luck!

Already in antiquity, Hippocrates, Aristotle and others tried to eliminate stuttering using therapeutic methods. From the 1st century AD Until the 19th century, surgical methods were used to treat stuttering (Fabricius, Diefenbach). In the 19th century, didactic methods of teaching correct speech began to develop, as well as psychological methods(Bertrand, Schultes, H. Lagusen, G.D. Netkachev).

The greatest merit in correctional work belongs to I.A. Sikorsky, who in 1889 first characterized stuttering as a neurosis. Various options and combinations of the complex method were developed by N.A. Vlasova, S. Ya Lyapidevsky, V.I. Seliverstov, N.E. Khvattsev and others.

The first domestic traditional method of overcoming stuttering in preschoolers was proposed by N.A. Vlasova, E.F. Rau. This technique is still used today. This methodology includes the following sections:

• · a system of gradually more complex exercises and speech situations;
• · system of development and correction of speech in general;
• · system of development of speech and general motor skills;
• · psychotherapeutic and educational influence.

According to this methodology, work is carried out taking into account the sequence of formation of forms of mechanical speech of different accessibility. So N.A. Vlasova identified 7 levels of speech difficulty: 1) conjugate speech, 2) reflected speech, 3) answers to questions about a familiar picture, 4) independent description of familiar pictures, 5) retelling of a short text heard, 6) spontaneous speech (story based on an unfamiliar picture), 7) normal emotional speech: conversations with a speech therapist, other children, strangers.

The work also proposes a system for overcoming stuttering during the game by G.A. Volkova. Game is the leading activity of preschool children.

Gaming activities can also be used as a means of educating children who stutter, to correct their speech and, at the same time, personal deviations. When using a game system when working with children who stutter, the teacher must keep in mind: the psychophysical characteristics of the children; manifestations of stuttering (form and type of convulsions, degree of their severity); type of speech being brought up (conjugate, reflected question-and-answer, independent); microsocial environment; peculiarities play activity well-spoken children; didactic principles; children's age.

All games are played with subsequent complication of plots, speech material and methodology.

For the development of all types of speech of stuttering children aged 3-5 years, games with singing (round dances with dance movements) are of paramount importance. They are held in almost every lesson. Further consolidation of the active behavior and speech of stuttering children takes place in the process of outdoor games , which are in second place in terms of importance. Outdoor games in pedagogy are divided into games of large, medium and low mobility. When working with children who stutter, games of the last two types are used mainly, since games of great mobility disrupt the breathing rate, which is not normal in children who stutter.

In outdoor games, children move with pleasure and speak in rhythm with their movements. However, we must remember that playing with a ball is difficult for children aged 3-5 years, so it is better to use ribbons and flags. Outdoor games help prepare children to master independent speech. Changing the presenters, the speech pathologist (educator) pronounces the words with everyone. With reflected speech, the child, having begun to speak after an adult, finishes the phrase independently.

Outdoor games normalize the motor skills of children who stutter: during the game they have to respond to some signals and refrain from moving during others, combining movements with the rhythm of speech.

Didactic games are especially useful for children with general underdevelopment speech. Usually, before eliminating stuttering, a speech pathologist teacher works to correct sound pronunciation, since sometimes with the correction of incorrect pronunciation, stuttering also disappears. But if stuttering has already affected the child’s behavior, tongue-tiedness and stuttering are corrected in parallel. Games on onomatopoeia, with collapsible toys, lotto, dominoes, and on a certain sound normalize pronunciation, and a calm manner of conducting them has a positive effect on children’s behavior. Clear and certain rules in didactic games, children's speech stereotypes to accurately express their thoughts clear their speech of unnecessary words.

After educational games dramatization games follow in order of importance poems, prose, tabletop theater games and creative games (first at the suggestion of an adult, then at the idea of ​​the children themselves).

In working with stuttering children aged 5-6 years, the leading place is occupied by games-dramatization of a poetic text. Dramatization games prepare children for detailed, coherent and consistent presentation of thoughts, develop the speech of stuttering children, teach them intonation expressiveness, develop movements, cultivate moral qualities, creative initiative, sociability, organizational skills, and instill in children the ability to be in a group of peers. The verbal material children learn contributes to freedom of communication.

Singing games are no less important for this age group. During the period of children learning conjugate speech, children sing and play together with the speech pathologist (educator), when reflected, the adult begins the song, and the children repeat the chorus and perform the actions; during question-and-answer speech, the child leader sings, and the rest answer him in chorus or one at a time.

Corrective work on the game system is carried out in several stages.

At the first stage The teacher-defectologist examines the state of children’s speech during activities, studies their behavior in games and when performing routine tasks, identifies the personal characteristics of each, carries out correction of breathing, voice, development of the dynamics of the speech apparatus, draws up an individual and joint work plan with the teacher.

Second phase -- stage of maximum speech restriction. Its goal is to slow down pathological reflexes in children to incorrect speech, accompanying movements and actions, use unnecessary words. This stage includes a period of silence (3-6 days) and a period of whispered speech (10-12 days). During this time, children who stutter develop attention, perseverance, imitation, and general and manual motor skills.

At the third stage (lighter forms of speech), children develop a soft voice, unified pronunciation, expressiveness of speech, and duration of exhalation. At the same time, work is underway to instill voluntary behavior in children who stutter. At this stage, elements of creative games are introduced into classes at the suggestion of the speech pathologist teacher. Homework materials include board games, didactic games, outdoor games, and conjugate-reflective recitation of nursery rhymes, poems, excerpts from fairy tales, etc. by children together with their parents.

At the fourth stage The speech pathologist continues to work on correcting the behavior and speech of children who stutter. The selection of games can be very different: games with singing, didactic, active games with rules, dramatization games, creative ones. Required condition is the observance of dialogic speech in question-and-answer form in all games.

The purpose of the fifth stage - education of independent speech. A teacher-defectologist creates big number game situations in which retellings of a previously prepared text are organically included.

In the speech therapy sector of the Research Institute of Defectology of the Academy of Pedagogical Sciences of the USSR, a representative of the psychological school, R. Levina, developed the following technique for overcoming stuttering. The authors proposed using mechanical methods in the traditional method, i.e. unproductive forms of speech. However, it was later proven that, under certain conditions, independent speech is available to a child who stutters from the first days of correctional intervention, provided that the material must be accessible. Then comes gradual complication material. This technique includes the following stages:

• 1. Propaedeutic, which is designed for 4 lessons (an organizational stage with the aim of instilling behavioral skills in children: a speech therapist speaks during 2-3 lessons, and a regime of limited speech, but not silence, is introduced for children).
• 2. Accompanying speech: 16 lessons in which children perform various actions(manual labor, drawing and answering questions from a speech therapist).
• 3. Closing Speech Stage: 12 sessions in which children have to describe the work they have completed or part of the work. Along with accompanying speech, accompanying speech continues to be used.
• 4. Pre-speech stage: 8 lessons. This is a more complex form of speech, because the child speaks not about what he has done, but about what he will do. In this situation there is no reliance on the visual image. This type should be switched to when children already freely use accompanying and final speech.
• 5. Final stage: consolidation of independent speech skills.

A comprehensive method of rehabilitation for people who stutter is recognized by domestic experts as the most effective. It can be divided into three main areas: speech therapy, psychotherapeutic and clinical. The idea of ​​a comprehensive rehabilitation method was first put forward a century ago by N.A. Sikorsky. This position is later developed by V.A. Gilyarovsky and his colleagues (N.A. Vlasova, E.F. Pay, E. Griner, etc.).

A comprehensive method of rehabilitation for people who stutter involves carrying out correctional work in the above three directions. This means that in addition to the general improvement of the body (regime, physical exercise, drug and physiotherapeutic treatment), targeted development of motor skills (coordination and rhythmization of movements, development of fine articulatory motor skills, etc.), speech breathing, self-regulation skills of muscle tone and emotional state(psychotherapy and, in particular, autogenic

training), great importance is given to the education of the individual and the development of social relationships.

Within the framework of a comprehensive rehabilitation method, there are different systems of correctional work. In each of the systems, one of the areas of the complex method (speech therapy, psychotherapeutic or clinical) is dominant.

3.4.1. Comprehensive systems for stuttering rehabilitation in preschool children

One of the first comprehensive systems of correctional work with stuttering preschoolers in domestic speech therapy is the system proposed ON THE. Vlasova and E.F. Pay(1933, 1959, 1983), which has not lost its relevance to this day. The authors are the first to substantiate a number of principles of a comprehensive method of rehabilitation for people who stutter: 1) before starting correctional work, it is necessary to conduct a thorough medical, psychological and pedagogical examination; 2) corrective influences should be directed not only at the development of fluent speech skills, but at the entire body and personality of the stutterer as a whole; 3) speech therapy work on developing fluent speech skills should be preceded by a “protective speech regime”; 4) the development of fluent speech skills includes a gradual complication of the “degree of independence of speech”: conjugate, reflected, short answers to questions on a familiar picture, independent description of a familiar picture, retelling of what was heard a short story, a story based on a familiar picture and speech in a conversation (spontaneous).

The organization of the “protective speech regime” is presented in detail in paragraph 3.2.1.

Sequence of use various types speech corresponds to the main stages of correctional work.

Particular attention in this comprehensive rehabilitation system is paid to the development of memory, attention, mental operations. It is recommended to place special emphasis on these types of activities when working with children suffering from a neurosis-like form of stuttering.

In addition, the rehabilitation system includes the following sections: work on the development of general and fine motor skills, which is carried out in logarithmic classes, in manual labor and visual activities of children, work on correcting sound pronunciation, work on the development of children’s speech, its lexical content and grammatical design.

The main provisions of this system are still widely used by speech therapists in practical work with stutterers of different age groups. (More detailed description techniques, see: Stuttering. Ed. ON THE. Vlasova, K.P. Becker, 1983.)

An integrated approach to the rehabilitation of people who stutter mainly in outpatient and inpatient settings of medical institutions has been developed IN AND. Seliverstov (1968, 1994).

IN AND. Seliverstov especially emphasizes the need to individualize corrective action when developing tasks and timing of corrective action. His system places great importance on the active and conscious participation of children in the process of working on their speech and behavior.

This system of speech therapy classes provides for the regular and mandatory use of a tape recorder at all stages of working with children who stutter. This allows children to intensify their attention to “speech mistakes”, both their own and other children, to more correctly assess their achievements and shortcomings, etc. Parents become active assistants to the speech therapist in solving correctional and educational problems.

Speech therapy classes for people who stutter are structured depending on the speech capabilities of the individual, i.e. based on the level of intact, stutter-free speech. Speech exercises are offered in accordance with the degree of independence of speech, its preparedness, structural complexity, volume, and also taking into account speech situations.

The author divides the construction of a comprehensive rehabilitation effect into three stages:

1. Preparatory stage. Along with recreational activities and a gentle speech regime, during this period they begin work on developing motor skills and expanding vocabulary. Speech therapy work is carried out only with the use of those types of speech in which speech spasms in a stutterer do not appear, i.e. A purely individual approach is taken.

2. Training stage. Along with motor skills, the targeted development of active attention, memory and other mental functions is carried out. Speech therapy classes include further formation of the lexical and grammatical aspects of speech. The process of speech therapy training gradually includes those types of speech in which the child previously had hesitations, i.e., “an attack on the sore areas of speech” is carried out. 3. Final stage. The complex psychological and pedagogical impact on the personality of the stutterer as a whole continues. At this stage, free speech skills are consolidated in everyday activities.

The system of speech therapy classes also provides for a gradual increase in the complexity of speech situations. In this system speech therapy classes include methodological material that strictly takes into account the age characteristics of children and the objectives of the kindergarten education program.

The course of outpatient classes is designed for 3-4 months (32-36 classes). Preparation period takes about 7-8 lessons. At this time, at home, parents provide a gentle regime, which includes a calm environment, a firm daily routine and, if possible, limiting verbal communication with others. During speech therapy classes during this period, several problems are solved: the speech therapist stimulates the child to actively work on his speech and convinces him of the positive outcome of special classes.

In addition, children memorize special psychotherapeutic texts for morning and evening (before bed) speaking, which are compiled by a speech therapist in accordance with the child’s age. During classes, the child’s attention is fixed on the concepts of “beautiful and correct speech.” These concepts include sonority, expressiveness, leisurely tempo and smoothness. Attention is drawn to the child’s calm, relaxed and free behavior when communicating.

Speech tasks include speech “exercises”, i.e. pronouncing vowel sounds and their combinations with consonants; poetic texts combined with movements; pronouncing automated series (counting, days of the week, months, etc.); exercises on conjugate-reflective speech, answers to specific questions, silent articulation, whispered and rhythmic speech.

Children's speech training is carried out taking into account different conditions: at different positions of the child (sitting, standing, in motion, etc.), in the process different types classes (modeling, drawing, etc.), in various educational games.

Training period(20-22 lessons). During this period, children practice those types of speech and situations that are difficult for them. This involves a gradual transition from answering questions to spontaneous speech, from quiet to loud speech, from quiet activities to emotional ones, etc. Accordingly, at this stage, outdoor games, role-playing and creative games are introduced. Consolidation of acquired speech skills is transferred from office conditions to real-life situations (shop, museum, walk). Consolidation of acquired skills is carried out thanks to the active assistance of parents.

During the consolidation period of speech (6-9 lessons), the child’s smooth speech is consolidated in more difficult conditions. In speech therapy classes, forms of speech such as conversations, stories, etc. are used. Role-playing and creative games are actively used. The speech therapy course ends with a concert in which all children participate.

At all stages of the correctional work proposed by V.I. Seliverstov, attaches great importance to the work of a speech therapist with parents. Thus, during the preparatory period, the speech therapist conducts conversations with parents about the essence of stuttering, the meaning and goals of speech therapy classes and determines the role of parents in the treatment and pedagogical process, so that parents become active assistants to the speech therapist from the very first day. Such conversations are conducted both collectively and individually. Parents regularly attend open speech therapy classes at all stages of correctional work.

One of the areas of correctional pedagogical work with children who stutter is associated with the psychological school R.E. Levina. A galaxy of scientists educated by this school is developing a holistic system of influence on stuttering preschoolers and schoolchildren (N.A. Cheveyaeva, A.V. Yastrebova, S.A. Mironova, O.S. Bot, L.F. Spirova). These researchers proceed from the idea that

Children who stutter, as a rule, have a sufficient vocabulary, sometimes exceeding the age norm, at the same time, they do not adequately use the vocabulary, formulate thoughts vaguely, and do not sufficiently maintain the logical sequence of speech.

In accordance with this, for normal speech communication, children suffering from stuttering need to correct not only speech hesitations, but also mental activity (attention, memory, thinking), as well as develop the planning function of speech.

The systems of rehabilitation influence developed by these authors combine training and education, the content of which corresponds to the programs of preschool and school institutions, with speech therapy work on the development of coherent speech in people who stutter and re-education of the characteristics of mental processes. To correct speech in people who stutter, the laws of speech ontogenesis are used, i.e. development of speech from situational to contextual.

ON THE. Cheveleva (1976), when working with stuttering preschoolers, includes 5 periods of development of coherent speech.

1st period - propaedeutic;

2nd period - accompanying or establishing speech;

3rd period - final or speech following visual representations;

4th period - planning speech or speech without visual support;

Period 5 - consolidation of coherent speech skills.

During the propaedeutic period, children are taught the skills of organized behavior. A regime for restricting children's speech is being introduced.

During the period of accompanying speech, children’s own speech is allowed only in the situation of actions they perform in speech therapy classes.

During the final speech Children use speech that accompanies their actions and descriptive speech in relation to the action performed.

In the next pre-speech period Along with the forms of speech that were used earlier, the child develops the ability to plan out loud the upcoming work.

At the final stage of speech development, the previously acquired skills of independent, detailed, specific speech are consolidated.

Based on the “Program of education and training in kindergarten” for middle, high and preparatory groupsS.A. Mironova(1975, 1979) proposed a system of education and training, where both programmatic and correctional tasks are set. For correctional purposes, rearrangement of the types of program tasks is used and the time for children to master more difficult speech program material is increased. Moreover, at the beginning school year children repeat speech material from the previous age group.

In correctional tasks first quarter includes expanding the vocabulary, clarifying the meaning of words, and activating passive vocabulary. All these tasks are implemented using the simplest types situational speech in all classes conducted by both speech therapist and educators.

In the second quarter, children who stutter are taught how to construct a simple and common phrase, the grammatical design of a phrase, the construction of complex constructions, and the ability to compose a coherent story. This quarter reinforces the skills of using situational speech. There is a transition to elementary contextual speech.

In the third quarter, the tasks of developing the speech of people who stutter become identical to the tasks of mass speech kindergarten. People who stutter learn to compose stories By

visual support, speech therapist questions, retelling and independent storytelling.

In the final fourth quarter work continues to enrich the lexico-grammatical structure of speech. Corrective tasks are aimed at the ability to build logical sequence of the transmitted plot.

For stuttering children of preschool age, 2-4 years old, the system of correctional and pedagogical influences has its own specifics. Features of speech therapy work in children of this age are presented L.M. Krapivina (1992).

Speech therapy classes for children aged 2-4 years are carried out in conditions nursery group kindergarten. The number of children in speech therapy classes should be no more than 3-5 people. The rehabilitation effect is complex and includes speech therapy classes, logorhythmic, music, physical education classes and teaching children the elements of muscle relaxation.

The main objectives of correctional intervention are: development of general, fine and articulatory motor skills, phonation breathing, intonation side of speech, development and clarification of vocabulary and grammatical structures, development of dialogic speech. Corrective pedagogical influence on children is carried out differentiated, depending on the clinical form of stuttering.

Thus, in children with a neurosis-like form of stuttering (they, as a rule, are 3.5-4 years old), a lot of time is devoted to normalizing the sound-pronunciation side of speech and developing vocabulary. In the case of a neurotic form of stuttering in children, attention is paid to the normalization of the parents’ relationship with the child, the general improvement of the child’s body (especially his nervous system), special importance is given to psychotherapeutic influence as part of speech therapy work.

Classes for people who stutter.

Stage 1

Lesson No. 1, 2, 3. Relaxation of arm muscles.

Goal: To teach relaxation of the hands, focusing on a pleasant state of relaxation.

1. Sit on a chair, lean on the back. Hands on knees, relax.

We have a game like this -

Very easy, simple:

Movement slows down

Tension disappears...

And it becomes clear:

Relaxation is nice!

1. Exercise "Fists"

Clench your fingers tightly into a fist. To make the bones turn white.

This is how tense the arms are. It's unpleasant for us to sit like this. My hands are tired. Straighten your arms. So the arms relaxed. It became easy and pleasant. (perform the exercise 3 times).

Calm inhale - exhale, inhale - exhale.

Press the thumb firmly against the rest:

We squeeze our fingers harder, release, unclench.

Raise and drop the child's relaxed hand.

Resting fingers.

1. Exercise "Deer".

Let's imagine that we are deer. (raise your crossed arms above your head, fingers spread wide)These are the antlers of a deer! Straighten your arms! His hands became as hard as the antlers of a deer. It's hard to hold your hands. Tension is unpleasant. Quickly lower your hands, drop them on your knees. Hands relaxed. They are resting.

Inhale - exhale, inhale - exhale.

Look: we are deer, the wind is rushing to meet us!

The wind has died down, let's straighten our shoulders,

Hands on your knees again, And now - a little laziness...

Hands are not tense and relaxed...

The adult, with a slight movement of his fingers, runs along the child’s hand from the shoulder to the fingertips.

Breathing exercise"Blow out the candle"

Calmly inhale through your nose and just as calmly exhale through (through your mouth) onto the candle, saying in a whisper F - F - F.

Repeat the exercise 3 times 4 times a day.

Lessons 7, 8, 9. Relaxation of the muscles of the arms, legs and body

Speech therapist . Children, let's start the game. Place your hands on your knees, calm down. (Children take a resting pose.) Listen and do as I do. (The formula for general rest is given. All exercises from previous lessons are repeated.)

Exercise "Barbell"(Fig. 7, 8). Speech therapist. Let's play sports. Get up! Let's imagine that we are lifting a heavy barbell. Bend over, take it. Clench your fists. Slowly raise our hands. They are tense. Hard! We held the barbell... Our arms got tired and we dropped the barbell. (The arms drop sharply and hang freely along the body, rice. 9.) Hands are relaxed, not tense, resting. Easy to breathe! Listen and do as I do. Calmly inhale - exhale!..

We're getting ready for a record

Let's play sports. (Lean forward.)

Rice. 6.

We lift the barbell from the floor... ( Straighten up.)

We hold it tight...

The speech therapist touches the muscles of the shoulder and forearm of the children, draws their attention to tension and subsequent relaxation.

- And we quit! ( The exercise is repeated three times.)

Our muscles are not tired -

And they became even more obedient!

It becomes clear to us:

Relaxation is nice.

Exercise "Boat"(Fig. 10, 11). Speech therapist . Imagine that we are on a ship. Rocks. To avoid falling, spread your legs wider and press them to the floor. Clasp your hands behind your back. The deck shook - we pressed our right foot to the floor. (The right leg is tense. Left - relaxed, slightly bent at the knee, toe touching the floor.) Straightened up! Relaxed! It swung in the other direction - we pressed our left leg. (The left leg is tense. Right leg relaxed.) Straightened up. Listen and do as I do. Inhale - exhale!

Breathe alternately

IP: standing (sitting on a chair). 1 - inhale and exhale through the nose; 2 - inhale through the nose, exhale through the mouth; 3 - inhale through the mouth, exhale through the nose; 4 - inhale and exhale through the left half of the nose, then through the right (alternately); 5 inhale through one half of the nose, exhale through the other (alternately); 6 - inhale through the nose, extended exhalation through the nose with intensification at the end; 7 - inhale through the nose, exhale through loosely compressed lips; 8 - inhale through the nose, exhale through the nose in jerks (diaphragmatic).

Fish

Equipment: 2-3 bright paper fish.

* * *

At the level of the child’s mouth, hang multi-colored fish on strings. Children stand in front of the fish.

Speech therapist . Let's make our fish start playing happily. Look, I blow on them and they float. Try it too.

The speech therapist shows how to blow on the fish, and the children repeat.

An article about an integrated approach to the correction of stuttering in adults and adolescents, used in the Center for Neurological Neurosurgery in the Department of Logoneurosis.

The article includes a general work plan. In the future, I intend to send material that will tell more specifically about developments in this area.

Speech therapy work to correct stuttering in adults and adolescents

Stuttering is not always eliminated in childhood. Every adult who stutters and decides to get rid of a speech disorder will have to face more established pathological stereotypes of the speech act and more pronounced psychological problems.

A neurodefectologist-speech therapist, working with adults who stutter, needs to help the patient coordinate breathing, vocal and articulatory processes, “feel” this coordination and bring it to automaticity. There are a number of benefits to speech therapy work for adult patients. They study meaningfully and consciously. They can use the will to achieve their goals. At the same time, everyone understands that stuttering is a very complex speech disorder that requires systematic, consistent work.

Speech therapy work is considered as a system of correctional and pedagogical measures aimed at the harmonious formation of the speech of people who stutter, taking into account the need to overcome or compensate for the defect.

Speech therapy influence in the Center for Logoneurosis in the Department of Logoneurosis is carried out in two directions: direct and indirect.
Direct speech therapy intervention is implemented during group and individual sessions with people who stutter. These classes provide for the development of general and speech motor skills, normalization of the tempo and rhythm of breathing and speech, and activation of verbal communication.

In classes, psychological deviations in behavior are eliminated for people who stutter, and the correct attitude towards the defect is developed. Individual lessons are conducted if additional exercises are needed to develop correct speech skills.

Indirect speech therapy is a system of speech therapy for all routine moments for patients. The speech mode of adolescents and adults involves their choice of the necessary speech exercises, their understanding of the requirements of correct speech, systematic training of correct speech skills in different conditions.

The speech aspect of speech therapy classes includes the regulation and coordination of respiratory, vocal and articulatory functions, and the education of correct speech.

Based on the position that “stuttering is a discordinative convulsive speech disorder that occurs in the process of communication through the mechanism of systemic speech-motor neurosis, and is clinically represented by primary, actual speech, and secondary disorders, which often become dominant in adults. As with other neurotic disorders, psychological, socio-psychological and biological factors take part in the mechanisms of this speech motor neurosis. In many cases of stuttering, the so-called organic “soil” is noted in the form of cerebral deficiency of various origins.” At the Center for Stuttering, a comprehensive treatment system was developed, which combines speech therapy classes and active psychotherapy, combining various variants of the suggestive method with the work of restructuring disturbed personal relationships, including through the use of modern group psychotherapy. All work is carried out in close contact with a speech therapist, psychologist, psychotherapist, psychiatrist, neurologist, specialists in physical therapy, massage and other methods.” book V.M. Shklovsky “Stuttering”. M. 1994. p. 8., p. 176.

Speech therapy work in a day hospital consists of: a diagnostic period and a period of restructuring pathological skills in the system of a comprehensive method of treating stuttering.

Diagnostic period

In order to establish a final diagnosis and outline a treatment plan, it is necessary to conduct a thorough examination of the patients by all specialists in the department (psychiatrist, psychotherapist, neurologist and speech therapist).

The examination of speech function in people who stutter is carried out according to methods generally accepted in speech therapy (L.I. Belyakova, E.A. Dyakova, E.V. Oganesyan, I.A. Povarova). The scheme of speech therapy examination includes the study of the state of the structure and mobility of the articulatory apparatus, speech breathing, voice, speech rate. When studying speech and motor disorders, the localization and form of speech spasms, the duration and frequency of their manifestation, the presence of accompanying movements, verbal, motor and psychological tricks, the attitude of the subject to stuttering, and the degree of fixation on it are considered. Anamnestic and clinical data are studied that determine the possible causes of stuttering, and the group to which the patient can be classified according to V.M. Shklovsky’s classification is determined:

Group 1 - patients who did not have persistent neurotic disorders. The speech defect (it can be very pronounced) of these stutterers did not significantly affect the development of their personal and social status.

Group 2 - patients with persistent neurotic disorders. The speech defect (it can be very pronounced) of these stutterers influenced the development of their personal and social status.

Group 3 - patients who have even more pronounced neurotic disorders, combined with anxious suspiciousness and an insurmountable fear of speech.

The period of restructuring of pathological speech skills consists of three stages:

- preparatory stage

At this time, speech therapy classes are conducted to develop speech techniques according to the plan:

1. Removing muscle tension. Establishment of diaphragmatic breathing. Practicing long, uniform speech exhalation on sounds, a standard, automated series, in a phrase.

2. Work on a soft attack of sound, on unity, smoothness of voice, flight, height, strength of voice, prolonged pronunciation of vowel sounds, expanding the range of voice modulations, intonation of speech.

3. Normalization of speech rate.

4. Rhythmic speech with the support of the leading hand, gradual collapse of the external support, transition to the internal rhythm.

5. Pausing speech.

6. Work with articulation.

7. Use of facial expressions and gestures in verbal communication.

- the stage of consolidating rhythmic speech techniques on simple speech material.

1. Reading poetic texts with a short and a longer line.

2. Reading the roles of fables.

3. Reading aloud prepared and unprepared texts of varying complexity.

4. Retelling the texts read.

5. Dialogues based on the material read.

The stage of automation of rhythmic and prosodically colored speech techniques on complicated speech material.

1. Automation of speech technique skills with their introduction to all types speech activity and various situations.

2. The transition from prepared forms of speech to independent improvisations.

3. Formation of readiness for verbal communication in different life situations.

4. Developing resistance to speech and psychological difficulties that arise in life situations after completing the course of treatment.

Three months of systematic training is the minimum that will allow a stuttering teenager or adult to understand, feel and consolidate the acquired techniques in speech. Further automation of continuous and fluent speech will require at least another year of supervision by a specialist.