Speech impairment in an adult male. Speech disorder in adults

Panina Valentina Viktorovna

Actress, Honored Artist of the RSFSR

Open review scan

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I found out about you on the Internet - I urgently need an MRI.

And here I am after the performance. I really liked your employees. Thank you for your attention, kindness and accuracy.

May everything be as good in your soul as I am now, despite all the problems ...

Be!!! We are happy! Your Panina V.V.

[~PREVIEW_TEXT] =>

I found out about you on the Internet - I urgently need an MRI.

And here I am after the performance. I really liked your employees. Thank you for your attention, kindness and accuracy.

May everything be as good in your soul as I am now, despite all the problems ...

Be!!! We are happy! Your Panina V.V.

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I found out about you on the Internet - I urgently need an MRI.

And here I am after the performance. I really liked your employees. Thank you for your attention, kindness and accuracy.

May everything be as good in your soul as I am now, despite all the problems ...

Be!!! We are happy! Your Panina V.V.

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Sergei Shnurov

Russian rock musician, film actor, TV presenter and artist.

Ts. M. R. T. "Petrogradsky" thank you!

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Thank you so much for such a good, professional service in your clinic. Nice, comfortable! Great people, great environment.

Open review scan

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Rusanova

Open review scan

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Everything is very competent, very friendly service. I will recommend this clinic to my friends. Good luck!!!

Open review scan

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Kuznetsov V.A.

Open review scan

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Khrabrova V.E.

Open review scan

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Thank you very much for the consultation and examination ... Very polite, accessible and explained in detail the course and result.

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There are several types of stuttering:

• Tonic appearance - frequent stops in speech and stretching of words.
• Clonic view - repetition of syllables and sounds.

Stuttering can be triggered and aggravated by stress, emotional situations, and shocks, such as speaking in front of a large number of people.

Stuttering, or logoneurosis, is one of the most common disorders. This disorder is expressed in the periodic repetition of individual syllables or sounds during a conversation. In addition, convulsive pauses may occur in a person’s speech.

Logoneurosis occurs in adults and children. It can be caused by neurological and genetic factors. With timely diagnosis and treatment, it is possible to completely get rid of this problem. There are many methods of treatment - both medical (physiotherapy, speech therapy, medication, psychotherapy), and methods of traditional medicine.

It develops in adults after a strong fright or intolerable stress against the background of congenital insufficiency of the speech apparatus. The reasons may be outwardly harmless, but affect important concepts for a person - love, affection, family feelings, career aspirations.

The basis is a neurotic disorder. Often, logoneurosis intensifies in situations of tension - at crucial moments, when speaking in public, at an exam, during a conflict. Several unsuccessful attempts or tactless behavior of others can lead to a fear of speech, when a person literally “freezes” and cannot utter a word.

Logoneurosis is manifested by long pauses in speech, repetition of sounds, syllables or whole words, as well as spasms of the lips and tongue. Trying to "skip" a difficult place sharply increases stuttering. At the same time, there are no specific words or sounds on which a person stumbles; speech can stop at any word.

Stuttering is always accompanied by respiratory neurosis when respiratory convulsions occur. Almost always, along with the fear of speech, a person is worried about anxiety, low self-esteem, internal tension, sweating, and sleep disorders. Additional movements in the form of ticks of the facial muscles, movements of the arms and shoulder girdle are not uncommon. Successful treatment of stuttering is possible at any stage, it is important to consult a doctor in time.

Speech disorders in adults

There are many internal and external factors that provoke deviations in speech pronunciation. Moreover, depending on the cause of speech impairment, the process of development of deviations can be both hasty and gradual. The most common causes of dysfunction are:

Speech problems are not limited to children who are just learning to speak. For various reasons, adults who have been able to speak perfectly normally for decades may begin to lose their speech - in our clinic, we just deal with solving such problems.

Since adults have been talking for years, most often their problems are associated with injuries or diseases that affect the brain, and with age, the risk of acquiring such problems only increases. We treat aphasia and dysarthria - frequent speech disorders that occur just because of such situations.

Slurred speech in adults can appear suddenly or develop gradually. It can also appear in children. Specialists first find out why this happened, and only then begin treatment. Slurred speech can occur due to several factors. The reasons are as follows:

• Brain disorders.
• Brain injury resulting from a stroke or thrombosis.
• Head injury.
• Tumors of the brain.

• degenerative diseases.
• Excessive alcohol consumption.
• Weakness of the muscles of the face.
• Weak or tight fastening of dentures.

A disorder of the speaking function in an adult can occur suddenly as a manifestation of a serious illness, develop gradually, or be present in a patient from childhood due to the pathology of the articulation apparatus left unattended.

Speech disorders in adults, the causes and types of anomalies are very diverse. These can be disorders of both impressive (perception of sounds, reading) and expressive speech (written or oral speech).

Speech is the highest human function. It is connected, in the main degree, with a person's ability to think, his memory, feelings. The correct pronunciation of sounds directly depends on the work of the brain, the respiratory system and the organs of the articulatory apparatus (tongue, larynx, oropharynx, teeth, lips).

In general, the physiological mechanisms of speech formation are divided into two forms.

A detailed description of the forms of speech can be found in the table below.

• The ability of a person to perceive heard speech, as well as understand written (reading).
• Analyze all the sound components of speech (letters, sounds).
• The mechanism of speech disorders according to the impressive type is associated with disorders in the work of the brain, auditory and visual apparatus. Patients with this pathology do not catch the general semantic component of phrases, do not recognize the words addressed to them, which is often the reason for the substitution of sounds in syllabic reproduction. Sometimes a person's speech becomes unrecognizable to others

• Active speech.
• Ability to write independently.
• Ability to form words, sentences, pronounce sounds correctly.
• The disorder of expressive speech is manifested by a limited vocabulary, immature pronunciation of sounds. Violations are associated with abnormal functioning of the brain, organs of the articulatory apparatus, psychological problems

Speech disorders are characterized by the following features:

• Stuttering. Violation of the pace and rhythm of speech. Spasms in the organs of the speech apparatus.
• Nasal. Changing the voice tone. The main cause of this anomaly is a pathological process in the area of ​​the nasal septum.
• Slowness, retardation of speech.
• Distorted pronunciation of sounds.
• Misunderstanding the general meaning of speech.
• Hoarseness, hoarseness of voice.
• Inability to express one's thoughts.
• Salivation.
• Indistinct diction.
• Rapid pace of speech. It is characterized by the swallowing of individual sounds.
• Small vocabulary.
• Complete silence of the patient (mutism).

All manifestations of speech disorders in adults are a significant obstacle to the full communication of patients and require treatment. It is almost impossible to overcome these symptoms on your own.

Important! It is impossible to ignore any dysfunction of the articulatory apparatus. Often, speech difficulties can indicate the development of a serious illness (stroke, tumor process in the brain area)

Speech disorders in adults are divided into two types due to the reasons that provoke it.

For example, such as organic speech disorder (OHP). The cause of this type of speech disorder is traumatic brain injury (TBI), other painful conditions characterized by damage to the organs of the articulatory apparatus (tongue, lips, nasopharynx, teeth), individual parts of the nervous system associated with the conversational function, as well as diseases of the hearing aid.

Symptoms of OHP may appear after such past illnesses as:

• Acute viral infections.
• Tumors of the brain.
• Stroke.
• Thrombosis.
• Birth trauma.
• Alzheimer's disease, Parkinson's. The elderly suffer. In addition to speech disorders, patients have psycho-emotional disorders and memory problems.
• Taking some antibiotics can have an ototoxic effect, lead to hearing loss, and as a result, speech disorders.
• Neuroinfections (meningitis, encephalitis, Lyme disease).
• Botulism. A severe infectious disease that affects the human nervous system.
• Spasm of cerebral vessels.
• pre-stroke state.
• Alcoholism.
• Infantile cerebral palsy (ICP).
• Epilepsy.

Functional speech disorder (FNR). This pathology can occur due to the effect on the human body of the following adverse factors:

• Strong stress.
• General underdevelopment of speech of the 3rd, 2nd, 1st levels revealed in childhood, left without proper treatment.
• Mental retardation.
• neuroses.
• Severe depression.
• Strong fright.
• Hysteria.
• Long-term use of antidepressants, tranquilizers.
• Mental illness.
• genetic predisposition.

However, it should be noted that the distinction between speech disorders, starting from provocative factors, is relative. Often, in patients with FND, subsequently, a detailed examination reveals organic abnormalities.

All of the above symptoms are associated not only with difficulties in pronunciation, but also with the perception of speech, insufficient ability to independently form words, sentences, and the exact formulation of thoughts. That is, they can be a manifestation of inferiority, both impressive and expressive speech.

Speech disorders in adults that occur suddenly or develop gradually can be a symptom of various diseases. It is necessary to consult a doctor (general practitioner, neurologist, otorhinolaryngologist) as soon as possible for a complete examination.

Diagnosis of speech disorders includes the following activities:

• Analysis of the patient's conversational function, his complaints.
• Collection of anamnesis. It is necessary to find out when the disorders first appeared, with what factors the first manifestations of speech dysfunction were associated.
• An otorhinolaryngologist examines the organs of the articulatory apparatus. Order an x-ray.
• The neurologist will check the reflexes, identify possible psychological disorders. If necessary, he will prescribe computed tomography (CT), magnetic resonance imaging (MRI) of the brain. He will send you for tests (common blood, urine) to identify the infectious process.

Treatment

dysarthria

This is also a speech disorder, but with it, first of all, pronunciation is violated - the articulation of sounds is disturbed. It often manifests itself in childhood, but in adults it can appear due to a stroke, traumatic brain injury, brain tumor and a number of disorders of the nervous system: multiple sclerosis, cerebral atherosclerosis, oligophrenia, neurosyphilis, Parkinson's disease.

A disease that is characterized by slurred speech and problems with the articulation of sounds. Appears due to disorders in the central nervous system.

One of the characteristic features of this disease can be called reduced mobility of the speech apparatus - lips, tongue, soft palate, which complicates articulation and occurs due to insufficient innervation of the speech apparatus (the presence of nerve endings in tissues and organs, which provides communication with the central nervous system).

• Erased dysarthria is not a very pronounced disease. The person has no problems with hearing and speech apparatus, but has difficulty in sound pronunciation.
• Severe dysarthria is characterized by incomprehensible, slurred speech, disturbances in intonation, breathing, and voice.
• Anarthria is a form of a disease in which a person is unable to speak clearly.

This violation requires complex treatment: speech therapy correction, drug intervention, physiotherapy exercises.

Change of pace

The normal rate of speech is 10 or 14 words per minute. The most common reason for a change in pace is emotions or mental disorders. Stressful exposure - unfamiliar surroundings, communication with an authoritarian person, an argument - can cause both an acceleration and a slowdown in the pace. Prolonged acceleration of speech is observed in affective psychoses (the old name is manic-depressive), and other states when thinking is accelerated. Speech is also accelerated in Parkinson's disease, accompanied by trembling paralysis. The rhythm and fluency of pronunciation suffers.

Slow speech with a small vocabulary is typical for people with mental retardation or dementia, which has developed as a result of various diseases of the nervous system. Words and sounds are drawn out, pronunciation is unclear, wording is primitive or incorrect.

Nasalness can be the result of both a displacement of the nasal septum and paralysis of the muscles of the palate. Transient nasality is familiar to everyone, it happens with a severe cold. If there is no respiratory infection, then nasality is a reason for urgent medical attention.

Dyslalia

Tongue-to-tongue is a disease in which a person pronounces some sounds incorrectly, skips them or replaces them with others. This disorder, as a rule, occurs in people with normal hearing and innervation of the articulatory apparatus. As a rule, treatment is carried out by speech therapy intervention.

This is one of the most common disorders of the speech apparatus, which is found in about 25% of preschool children. With timely diagnosis, the violation is quite successfully amenable to correction. Preschool children perceive correction much easier than schoolchildren.

Oligophasia

A disease that often occurs in people who have had an epileptic seizure. It is characterized by an impoverishment of the vocabulary or a simplified construction of sentences.

Oligophasia can be:

• Temporary - acute oligophasia caused by an epileptic seizure;
• Progressive - interictal oligophasia, which occurs with the development of epileptic dementia.

Also, the disease can occur with disorders in the frontal lobe of the brain and some mental disorders.

Oligophasia

Aphasia

A speech disorder in which a person cannot understand someone else's speech and express their own thoughts using words and phrases. The disorder occurs when the centers responsible for speech are affected in the cerebral cortex, namely, in the dominant hemisphere.

The cause of the disease can be:

• hemorrhage in the brain;
• abscess;
• traumatic brain injury;
• cerebral thrombosis.

There are several categories of this violation:

• Motor aphasia - a person is not able to pronounce words, but can make sounds, understand someone else's speech.

Since aphasia is not a mental disorder, it is necessary to eliminate the cause of the disease in order to treat it.

A speech disorder in which a person confuses individual letters or words and replaces them with incorrect ones.

There are two types of violation:

• Verbal - replacing words that are similar in meaning.
• Literal - caused by sensory or motor speech problems.

This is a violation of the structure of speech or understanding of its meaning.

Motor aphasia is a sign of damage to Broca's area or the lower parts of the frontal lobe. The person understands the addressed speech, but cannot pronounce anything. Sometimes individual words or sounds break through, often obscene. Such a speech disorder is almost always accompanied by motor disorders in the form of paralysis of the right limbs. The reason is blockage of the upper branch of the middle cerebral artery.

Sensory aphasia - the inability to understand the meaning of speech, develops when the temporal gyrus of the hemispheres or Wernicke's area is damaged. A person does not understand the addressed speech, but fluently pronounces a set of words devoid of any meaning. The handwriting remains the same, but the essence of what is written is missing. Often combined with visual impairment, a person is not aware of his defect.

The reason is blockage of the lower branch of the middle cerebral artery by an embolus or thrombus. Conductive or conductive aphasia - a person understands speech, but cannot repeat or write anything from dictation. Speech consists of many mistakes that a person persistently tries to correct, but cannot. The white matter of the brain of the supramarginal gyrus is affected.

Acoustic-mnestic - a person cannot pronounce long complex phrases, making do with a minimal primitive set of words. It is extremely difficult to find a word. It develops with damage to the left temporal region, characteristic of Alzheimer's disease.

Optical-mnestic - a person recognizes objects, but cannot name and describe them. The loss of simple concepts from everyday life impoverishes both speech and thinking. It develops with toxic and dyscirculatory encephalopathies, as well as brain tumors.

Total aphasia - there is no way to understand speech, or to say or write anything. It is characteristic of cerebral infarctions in the basin of the middle cerebral artery, often accompanied by paralysis, visual impairment and sensitivity. With the restoration of blood flow in the middle cerebral artery, speech can be partially restored.

• Motor aphasia - a person is not able to pronounce words, but can make sounds, understand someone else's speech.
• Sensory aphasia - a person can speak, but cannot understand someone else's speech.
• Semantic aphasia - a person's speech is not impaired and he is able to hear, but cannot understand the semantic relationships between words.
• Amnestic aphasia is a disease in which a person forgets the name of an object, but is able to describe its function and purpose.
• Total aphasia - a person is not able to speak, write, read and understand the speech of another.

This is a violation or even lack of speech, which a person has already formed. There are six to eight types of aphasia, but the causes are the same: damage to the areas of the cerebral cortex that are responsible for speech. Often this happens because of strokes, but traumatic brain injuries, brain tumors, progressive diseases of the nervous system and inflammation of the brain can also lead to speech disorders.

Causes of speech disorders in children

It is difficult and long to select words so that something coherent comes out, but this often still does not work out, but individual words or structures may have new meanings.

Some sounds and words are constantly replaced by others, rearranged and repeated. It begins, it would seem, with a harmless replacement of “b” with “p”, and ends with still incomprehensible combinations of words and sentences almost backwards. In some cases, such problems occur with written speech.

It's hard to understand what other people are saying. In addition, a person does not seem to understand his own speech and pours out a stream of consciousness, and in the first two months after an illness or injury, this can be a stream of random sounds or words.

The rhythm and melody of speech is disturbed, it sounds unnatural: the pauses are too long, the voice is quiet, a whisper.

Difficulty remembering information heard or read. Problems can arise already with four related words in a row. In such a situation, long sentences are difficult to understand, so they lose their meaning.

It is difficult to name objects and use speech turns, popular expressions, proverbs. It is also difficult to understand them. How to treat and what will happen if you do not treat

Aphasia can only be corrected in a clinic. During the correction, a person learns to speak correctly again, as in childhood. With a speech therapist, he learns to perceive oral and written speech, correctly use the speech apparatus (respiratory organs, tongue, lips), and pronounce sounds.

Treatment may vary depending on the type of disorder, but in any case, it is important to start it as early as possible. This is because a person gets used to his manner of speaking, and speech defects are fixed. The patient may perceive some sounds instead of others, constantly repeat frequently used words and incorrectly build sentences. If you delay with the correction of aphasia, it will be even longer and more difficult to eliminate entrenched violations.

Speech therapists distinguish four degrees of dysarthria, but even with the mildest of them, doctors cannot be ignored:

1. pronunciation disorders can only be detected by a speech therapist, in everyday speech they are hardly noticeable;
2. violations are noticeable to people around, but the speech is still understandable;
3. speech is understood only by people who are well acquainted with the patient, and by strangers who simply accidentally understand some phrases;
4. even close people do not understand what a person is saying, if the sounds he makes can be called speech at all - this is severe dysarthria, or anartria.

Speech is slurred, incomprehensible, slow. There is a feeling of “blurring” of everything that a person says, as if he has porridge in his mouth, he is trying to say something, but does not yet understand that it is almost useless.

Some sounds drop out, some people pronounce through the nose (nasalization occurs, compare “n” and “b”), speech is basically simplified and it may seem that the patient is trying to pronounce a polysyllabic word in one syllable. Sounds are distorted and replaced by others, as in aphasia.

• Depending on the type of dysarthria, the tongue, lips, muscles of the face and neck may work in different ways. In some cases they are constantly tense, in others they are too relaxed so that the mouth is ajar. In addition, during a conversation, such too relaxed muscles can sharply tighten.

A developmental disorder in children in which there are shortcomings in the use of expressive means of speech. At the same time, children are able to express their thoughts and understand the meaning of someone else's speech.

Symptoms of this disorder also include:

• small vocabulary;
• grammatical errors - incorrect use of declensions and cases;
• low speech activity.

This disorder can be transmitted at the genetic level, and is more common in men. It is diagnosed during examination by a speech therapist, psychologist or neurologist. For treatment, mainly psychotherapeutic methods are used, in some situations, medication is prescribed.

Among the causes of speech disorders, there are biological and social risk factors. The biological causes of the development of speech disorders are pathogenic factors that affect mainly during fetal development and childbirth (fetal hypoxia, birth trauma, etc.), as well as in the first months of life after birth (brain infections, injuries, etc.). )

A special role in the development of speech disorders is played by such factors as family history of speech disorders, left-handedness and right-handedness. Socio-psychological risk factors are mainly associated with mental deprivation of children. Of particular importance is the lack of emotional and verbal communication of the child with adults.

A negative impact on speech development can also be exerted by the need for a child of primary preschool age to learn two language systems at the same time, excessive stimulation of the child’s speech development, inadequate type of upbringing of the child, pedagogical neglect, i.e. lack of due attention to the development of the child’s speech, speech defects of others.

As a result of these causes, the child may experience developmental disorders of various aspects of speech. Speech disorders are considered in speech therapy within the framework of clinical-pedagogical and psychological-pedagogical approaches. The mechanisms and symptoms of speech pathology are considered from the standpoint of the clinical and pedagogical approach.

Adentia is a disease that consists in a defect in dental units, which is expressed in their partial or complete absence. The disease can be diagnosed in both adults and children. Since such a deviation is primary and secondary, it is natural that the reasons in each case will be different. There are quite a few predisposing factors, ranging from the death of the rudiments of teeth to a wide range of dental pathologies.

Alcohol intoxication is a complex of behavioral disorders, physiological and psychological reactions that usually begin to progress after drinking alcohol in large doses. The main reason is the negative impact on the organs and systems of ethanol and its decay products, which cannot leave the body for a long time.

Angioma (red mole) is a benign tumor that consists of lymphatic and blood vessels. Most often, the formation is formed on the face, skin of the trunk and limbs, on the internal organs. Sometimes its appearance and development may be accompanied by bleeding. In most clinical situations, this pathology is congenital and is diagnosed in newborns in the first few days of their life.

A cerebral aneurysm (also called an intracranial aneurysm) appears as a small abnormal formation in the vessels of the brain. This seal can actively increase due to filling with blood. Before its rupture, such a bulge does not carry danger or harm. It only exerts slight pressure on the tissues of the organ.

What is arterial hypertension? This is a disease that is characterized by blood pressure indicators above 140 mm Hg. Art. in this case, the patient is visited by headaches, dizziness and a feeling of nausea. Eliminate all the symptoms that have arisen can only be specially selected therapy.

Atypical autism (syn. autism spectrum disorder, infantile autism) is a neuropsychiatric disease that causes a violation of perception and understanding of the surrounding reality. The disease can lead to permanent mental retardation, or STD. The development of such a pathological process is due to a violation of the structures of the brain, which in most cases is irreversible.

Alzheimer's disease is a degenerative brain disease that manifests itself in the form of a progressive decline in intelligence. Alzheimer's disease, whose symptoms were first identified by Alois Alzheimer, a German psychiatrist, is one of the most common forms of dementia (acquired dementia).

Niemann-Pick disease is an inherited disorder in which fat accumulates in various organs, most commonly in the liver, spleen, brain, and lymph nodes. This disease has several clinical forms, each of which has its own prognosis. There is no specific treatment, high risk of death. Niemann-Pick disease affects both males and females equally.

Pick's disease is an irreversible pathological process that leads to complete atrophy of the cerebral cortex, most often in the frontal and temporal lobes. This eventually leads to dementia. The disease is usually diagnosed after the age of 50, however, cases of younger or older people are also affected. Treatment, in most cases, is palliative in nature and is aimed at improving the quality of life of the patient.

Fabry disease (syn. hereditary dystonic lipidosis, ceramide trihexosidosis, diffuse universal angiokeratoma, Andersen's disease) is a hereditary disease that causes metabolic problems when glycosphingolipids accumulate in the tissues of the human body. It occurs equally in men and women.

Botulism is a rather severe disease of a toxic-infectious nature, the course of which leads to damage to the nervous system, spinal cord and medulla oblongata. Botulism, the symptoms of which are manifested when botulinum toxin-containing products, aerosols and water enter the body, as a result of a complex of processes, also leads to the development of acute and progressive respiratory failure. As a result of the lack of proper treatment of botulism, the onset of death is not ruled out.

• Rhythm and tempo disturbances:
  • Stuttering (a deviation known since time immemorial. According to historians, the ancient Greek orator Demosthenes once suffered from a stutter, but stubbornly trained in making speeches, stuffing his mouth with small pebbles. Learning to speak clearly with stones in his mouth, he developed excellent articulation and self-confidence , thereby getting rid of the disease. Speech therapists still practice this method of correcting speech disorders).
  • Dyslalia (in oral speech, the child incorrectly pronounces or distorts individual sounds).
  • Dysarthria (organs of articulation (lips, tongue) have critical limitations of mobility).
  • Rhinolalia (reduced resonance in the nasal cavity).
  • Other disorders of articulation: poltern, takhilalia, bradilalia.
• Voice disorders:
  • Aphonia (loss of a sonorous voice, the person speaks in a whisper. Problem with the vocal cords).
  • Dysphonia (hoarseness or nasality, due to laryngitis and other inflammations of the larynx, or due to functional abnormalities.
  • Rhinophonia or palatolalia (twang due to problems with the soft palate, its muscle weakness or size).
• Oral speech disorders:
  • Structural and semantic disorders: alalia (occurs during childbirth when the speech areas in the brain are damaged. At the same time, the child is all right with intelligence and hearing), aphasia (a similar problem. Organic lesions of the areas of the cerebral cortex that are responsible for controlling speech , and the adjacent "subcortex". It differs from alalia in that it is not a congenital phenomenon, but acquired - in people who already know how to speak. Usually occurs as a result of a stroke in adults).
  • Disorders of phonation design.
• Writing disorders:
  • Dyslexia (complex perception of written text, mixing sounds and words when reading, inability to put letters into ready-made words).
  • Dysgraphia (deviations in writing, can be combined with dyslexia, be its consequence).

Logoclonia

A disease that is expressed in the periodic repetition of syllables or individual words.

This disorder is provoked by problems with the contraction of the muscles that are involved in the speech process. Muscle spasms are repeated one after another due to deviations in the rhythm of contractions. This disease can accompany Alzheimer's disease, progressive paralysis, encephalitis.

Most speech disorders can be corrected and treated if detected early. Be attentive to your health and contact a specialist if you notice deviations.

Varieties of violations

Slurred speech of phonation (external) design appears separately, and together with other disorders. In speech therapy, there are the following types of violations:

• Aphonia and dysophonia. There is a disorder or lack of phonation due to pathologies of the vocal apparatus. Usually there is a violation of the height, strength, timbre of the voice.
• Bradilalia. Speech slows down. The peculiarity is the slow implementation of the articular speech program.
• Tahilalia is an increase in the rate of speech. Accelerated articulatory speech program.
• Stuttering. The organization of speech is disturbed when the muscles of the speech apparatus undergo convulsions. Usually seen in children.

• Dyslalia. This pathology is presented in the form of a disorder in the pronunciation of sounds, when hearing and innervation of the speech apparatus in humans are normal. There is a distorted sound design of words. This is slurred speech. The sound may be mispronounced, replaced, or mixed up.
• Rhinolalia. The pronunciation of sounds and the timbre of the voice is disturbed, which is associated with disorders of the speech apparatus. Changes in the timbre of the voice are manifested when the vocal stream of air passes into the nasal cavity during exhalation and pronunciation. This causes resonance.
• Dysarthria. Pronunciation is disturbed, which is associated with insufficient innervation of the speech apparatus. This disease appears due to cerebral palsy, which are detected at an early age.

Structural and semantic design of speech

On this basis, disorders are divided into 2 types: alalia and aphasia. Each type of disease has its own symptoms. Alalia manifests itself in the form of the absence or incomplete development of speech. This occurs due to damage to the areas of the brain that are responsible for it. The disorder may appear during fetal development or at an early age.

With alalia, slurred speech appears. This defect is considered one of the most difficult, since speech activity is not fully formed. Aphasia is called the loss of the ability to speak, which appeared due to local damage to the brain. Why does slurred speech appear with this disorder? This is associated with traumatic brain injuries, neuroinfections and brain tumors.

Features of diagnostics

It is necessary to analyze the complaints that the patient expresses. The history of the disease is also taken into account. Specialists usually ask when slurred speech appeared and whether there are relatives suffering from such an ailment. Be sure to visit a neurologist, to undergo an examination. The doctor will check the mandibular and pharyngeal reflexes, examine the pharynx, make sure there is atrophy of the muscles of the tongue.

The reflexes of the lower and upper extremities are checked. You should be examined by a speech therapist. The doctor evaluates the performance of speech, reveals violations of the pace, complexity. An examination by an otorhinolaryngologist is necessary, which will protect against such processes in the mouth as ulcers and tumors, which can cause disorders.

Computed tomography and magnetic resonance imaging of the head are performed, with the help of which it will be revealed why slurred speech appeared. Causes in adults and children are also determined in consultation with a neurosurgeon. Only after a complete diagnosis, treatment methods are prescribed.

Treatment of speech disorders

Speech disorders (in adults) are a symptom of a number of diseases in which the so-called "speech" areas of the brain are involved in the pathological process. This can be either a steadily progressing pathology (multiple sclerosis, Alzheimer's disease, a number of degenerative diseases), or the consequences of focal brain damage as a result of a stroke, traumatic brain injury, radically operated tumors, etc.

The decision on the expediency and complexity of the impact is made after carrying out diagnostic measures, including examination and testing in order to assess the nature of the violations and the severity of the lost functions. Rehabilitation of patients with speech pathology consists of a complex impact.

including drug treatment, transcranial magneto-electro stimulation (TMES) and speech therapy correctional sessions with the patient. Drug treatment is selected individually, taking into account the existing disease, the degree of violation of lost functions, the state of the body as a whole. The goal of drug therapy is to improve the integrative ability of the brain (speech, memory, attention, learning ability) by activating the processes of neuroplasticity.

Speech disorders (in adults) are a symptom of a number of diseases in which the so-called "speech" areas of the brain are involved in the pathological process.

This can be either a steadily progressing pathology (multiple sclerosis, Alzheimer's disease, a number of degenerative diseases), or the consequences of focal brain damage as a result of a stroke, traumatic brain injury, radically operated tumors, etc.

If in the first case, the therapeutic effect is ineffective, then in the situation of a “faded” brain catastrophe, early rehabilitation gives a good clinical result.

The decision on the expediency and complexity of the impact is made after carrying out diagnostic measures, including examination and testing in order to assess the nature of the violations and the severity of the lost functions.

Rehabilitation of patients with speech pathology consists of a complex effect including:

• drug treatment;
• transcranial magneto-electro stimulation (TMES);
• speech therapy correctional classes with the patient.

Drug treatment is selected individually, taking into account the existing disease, the degree of violation of lost functions, the state of the body as a whole. The goal of drug therapy is to improve the integrative ability of the brain (speech, memory, attention, learning ability) by activating the processes of neuroplasticity.

The dysfunction of the speech apparatus has a direct impact on the life of any person, and therefore, it is very important to diagnose the pathology in a timely manner at the slightest deviation in order to avoid serious complications in the future.

Speech impairment is a violation of speech function, which can be provoked by completely different reasons. This term includes various types of deviations in human speech development, which can lead to both complete and partial loss of the reproduction of words and sounds.

Conventionally, speech disorders in medical practice are divided into two main groups:

• Organic reason for the development of deviations. The causes of dysfunctions of the speech function in this case are internal anatomical pathologies affecting the structure of the speech apparatus. For example, birth or mechanical damage to the areas of the brain responsible for speech functions, the abnormal structure of the speech apparatus, hereditary disposition, etc.;
• Functional reason for the development of deviations. In this case, the normal operation of the speech apparatus is disrupted due to certain external factors. For example, prolonged stress, deviations in the functioning of the nervous system, infectious diseases, head injuries, mental disorders, etc.

Deviations can manifest themselves in the form of expressive speech, inhibition of pronunciation, nasality or stuttering. To identify the causes of violations, a consultation with a neurologist, speech therapist and diagnostics is required.

As soon as the cause of the pathology is identified and a diagnosis is made, the doctor will prescribe the appropriate treatment, the basic principle of which is to eliminate the causes that caused speech dysfunction.

As for children, a speech therapist can help correct speech defects at an early age. But only if the deviations are not associated with mental disorders and mechanical damage to the head. It is important to understand here that the older the patient and the more complex the cause of deviations in speech, the longer the process of treatment and correction of speech deviations will be.

Treatment methods are as follows:

1. Conservative treatment. It implies classes with a speech therapist, the use of special exercises to restore speech and articulatory gymnastics, as well as physiotherapy procedures.
2. Medical treatment. It comes down to improving cerebral blood flow, normalizing pressure and enhancing metabolic processes in the central nervous system. Also, drugs are used that affect the process of improving the memory, attention and perception of the patient.
3. The last resort is surgery. Which involves the removal of tumors and abscesses in the cranial cavity, resection of hematomas and the elimination of other growths that provoked the occurrence of deviations of the speech apparatus as a result of dangerous diseases. Surgery is used only when all other methods of treatment have not had the expected result.

The choice of a specific method of treatment, medications and the appropriateness of the operation is determined by the doctor, depending on the form of the pathology and the stage of concomitant diseases.

There is a separate branch of psychology that deals with the study of people suffering from deviations in speech functions - logopsychology. The psychology of persons with speech disorders requires a systematic and thorough study of the symptoms, signs and mechanisms of development of this deviation. Due to this, it is possible to achieve positive results through the development of special methods of psychological assistance and suitable treatment regimens in each case.

It should be understood that any defects and speech disorders, as well as damage to parts of the speech apparatus, with untimely or incorrect treatment, can lead to underdevelopment of speech, reduced communication and attentiveness, as well as to limiting the patient's logical and mental conclusions.

If slurred speech is detected, what to do? It is necessary to treat the main disease due to which the violation occurred:

• Tumors are removed surgically.
• Resection of the hematoma, if it is on the surface.
• Surgical removal of abscesses in the skull, followed by the appointment of antibacterial agents.
• Normalization of pressure.
• The use of funds to restore metabolism and cerebral blood flow.

People with various disorders need to visit a speech therapist so that the deficiency can be corrected with the help of special exercises. Regular practice is required.

Rules for the formation of speech

Speech impairment appears not only due to the pathology of the articulatory apparatus, neurological pathology and the habit of incorrect pronunciation. Another factor is the psychological reason. With excitement, a person’s speech becomes barely audible and almost incomprehensible.

The activities of a speech therapist to restore speech are based on the following principles:

• Personal orientation.
• Creating an emotionally favorable environment.
• Interaction with parents.
• Positive motivation.

Speech therapy classes involve improving the mobility of the articulatory apparatus. There is also work on sounds and the restoration of phonemic hearing. Specialists work with children in a playful way, using speech games, a computer. Combined activities are carried out, involving switching attention from one activity to another.

Classes with a specialist in children allow you to form competent speech, phonetically clear. But such activities will not be enough. The speech therapist helps only to put the sound. Everything else depends on the child and parents.

In order for speech to be successfully formed, the following rules must be observed:

• You should not scold the child for slurred speech, you just need to carefully correct it.
• Simple exercises should be shown.
• No need to focus on mistakes, stumbles.
• It is necessary to positively tune in to classes with a speech therapist.
• Parents need to watch their speech.

Experts recommend regularly being examined in order to identify the backlog, if any, as early as possible. One child is from among those who "slowly harness, but quickly rushes." He will start talking later, but in a month he will catch up and overtake his peers. Then consider yourself lucky. But for another kid, such gloomy diagnoses as autism spectrum disorder, alalia and others may be hidden behind a prolonged silence. And it is very important not to miss them and start the correction on time.

If you have any doubts about whether the pace of development of your child fits into the norms, it is better to visit specialists. Does he suddenly have a general speech disorder (general underdevelopment of speech - OHP) or speech development delay (ZRR)?

It is often difficult for a child with severe speech impairment to perceive the world around him positively. He grows up as a gloomy beech, touchy and aggressive, feels insecure, and with age begins to feel his inferiority. You can read more about the symptoms and degrees of speech underdevelopment here.Consult a specialist! Both small and more significant speech deviations are usually detected in the first few years of life as a result of a comprehensive diagnosis.

The spheres and areas of responsibility of the specialists of the Amber Center for speech problems are distributed as follows:

• Speech therapist:
  Consults from 1.5 years old, conducts classes from 2 years old. At the consultation, he makes a final diagnosis, if it is a disease, sends him to a neurologist if he suspects violations of a corresponding nature;
• Defectologist teacher:
  works with non-speaking children; with delays in psychoverbal development and pre-speech diseases (alalia, autism spectrum disorders) it helps to “start” speech and develop other cognitive functions to the level of the age norm.

First of all, we are talking about small children. There are also speech disorders in adults - due to a brain injury or a stroke. Their correction is carried out by speech therapists-aphasiologists. Sometimes a speech disorder in schoolchildren and adults remains from neglected/undertreated pronunciation defects in childhood.

Phonetic-phonemic underdevelopment of speech lies in the fact that a person experiences difficulties with the expression of thoughts. The initial manifestations of deviation occur in childhood.

The lack of treatment and corrective measures leads to problems in communicating with others. In comparison with children's dysfunctions of the articulatory apparatus, speech disorders in adults are more severe.

Causes and risk factors

The classification of a pathological condition implies a division into organic and functional. The disorder may be a consequence of dysfunctions of the central nervous system, hearing impairment. Also, its occurrence is caused by injuries and bruises of the head, damage to the organs of speech. It can be a neoplasm of the brain, stroke, thrombosis. In older people, there is a connection with Alzheimer's disease, Parkinson's. In this case, pathological memory disorders and mental disorders occur in parallel. Less often, epilepsy, alcohol abuse, cerebral palsy, infectious diseases of the brain contribute to dysfunction.

Functional causes of speech disorder are external factors, such as stress, fear, hysteria, untreated pathology since childhood. Under the influence of taking certain medications (antidepressants, tranquilizers), auditory perception may decrease, which aggravates speech disorders. An important role is given to the hereditary factor. If there is a predisposition, it is necessary to observe the state of a person in dynamics.

Perhaps the simultaneous influence of external and internal causes, in which case the pattern of disorders becomes multi-layered and manifests itself in a large number of symptoms.

Communicative functions in a person also suffer from improper installation of dentures. Deep stress and overstrain can lead to spastic dysphonia. At the same time, the intensity of the voice or its disappearance is noted.

Classification of disorders in adults

Similarly to children's dysfunctions, pathology is divided into types according to its manifestations and symptoms. Specialists distinguish the following disorders of expressive speech:

• aphasia;
• alalia;
• bradilalia;
• dysarthria;
• dysorphography, dysgraphia;
• dyslexia, dyslalia;
• stuttering;
• delayed speech development, or SRR.

The characteristic of aphasia is the same as in childhood. Speech impairment is caused by damage to various parts of the brain. Depending on the localization of the pathological process, various symptoms come to the fore. Each of the varieties of aphasia has common and individual features. In varying degrees, there are always violations of writing and reading. If pathological changes are associated with age-related changes, already formed speech skills disappear.

Forms of speech impairment

Establishing diagnosis

Diagnosis of speech disorders in adults is carried out using MRI of the brain and blood vessels, examination by a speech therapist and defectologist, neurologist, ENT doctor. An integrated approach allows for precise differentiation and a therapy plan.

In a child, pronunciation defects are often laid in the perinatal period, in an adult - after a stroke, uncontrolled medication or irreversible degenerative processes in the brain. Therefore, when complaining of a sudden violation of the speech of a person, they are always sent for a thorough examination.

In case of improper bite formation in children and violation of the growth of teeth, an orthodontist consultation is required. Speech correction begins with the elimination of the cause of the deviation.

Symptoms and signs

Violation of speech consists in any manifestations of deviations from the norm. This is the wrong pace, a change in sound type, insufficient vocabulary, etc. They can be chronic or occur suddenly. A characteristic difference between childhood disorders and adults is that the cause of the latter is often an organic disease. Common accompanying symptoms: increased salivation, stuttering, lack of facial expressions, fuzzy phrases, etc.

When several signs of the disease appear, speech becomes difficult for others to perceive. With sudden speech disorders, it is necessary, first of all, to exclude the development of a stroke.

Treatment Methods

The choice of therapy regimen determines the underlying disease, as well as the age of the patient. If speech disorders are caused by an acute condition, such as a stroke, the patient needs emergency ambulance. The sooner rehabilitation is started, the higher his chances for a full life in the future. Treatment consists of speech therapy tasks, physiotherapy, massage and medication. Plastic surgery of the maxillofacial region and special gymnastics, psychotherapy sessions may be required. With spastic dysphonia, spasm is removed with Botox injections directly into the vocal cords.

Throughout the course of treatment, external stimuli should be avoided, if possible, do not leave a sick person alone in unfamiliar places. In case of problems with the vocal cords, a gentle mode is recommended so as not to strain them. Also, some medications and foods can cause them to spasm, such as coffee.

Each type of communication disorder requires a special approach in accordance with its manifestations. So, with dysarthria, it is better to communicate with a person in writing and with the help of gestures. Oral speech should be as simple and slow as possible.

At home, you can continue corrective work to eliminate speech defects with the help of exercises prescribed by your doctor. It is necessary to give preference to communication with interlocutors, rather than watching TV.

Prevention

It is impossible to say with 100% certainty that there are certain ways to prevent pronunciation problems. In the presence of risk factors, it is necessary to undergo regular examinations in a medical institution. The specificity of defects in the articulatory apparatus does not make it possible to make a forecast for the future. With problems of a vascular nature, it is necessary to control the level of pressure and lead a healthy lifestyle. Remember that sitting at a computer monitor, you will not get rid of the problem. You need to communicate more with friends and family, take walks in the fresh air.

Speech impairment in adults is not a sentence; a large role is assigned to its early diagnosis and an integrated approach to therapy. Treatment should not be symptomatic, but aimed at eliminating or suppressing the cause. Of course, some age-related changes are irreversible. So, with senile dementia, the dynamics will only worsen over time. However, through drug treatment, doctors manage to slow down the development of the disease and the transition to the terminal stage. Do not forget that great importance is given to the state of the patient's psyche. A positive attitude will help and give self-confidence not only to him, but also to relatives.

Speech therapists, as well as neurophysiologists, neurologists, otolaryngologists and other specialists study and treat speech difficulties in adults and children.

Symptoms and manifestations

This pathology can be expressed either in the complete absence of speech, or in violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

• there is fuzziness and slowness of speech, it is illegible;
• the patient finds it difficult to choose words and correctly name things;
• fast and without hesitation speech is possible, but completely meaningless;
• there is haste and incoherence of thinking;
• a person strongly separates syllables and puts stress on each of them.

Causes in adults

Sudden or gradual development of speech disorders is possible. There are such main reasons that can lead to this pathological process:

• improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movement of the muscles of the body and for speech);
• brain injury caused by stroke or thrombosis;
• head injury;
• the presence of tumors in the brain;
• the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
• Lyme disease;
• excessive consumption of alcoholic beverages;
• weakness of the muscles of the face, for example, Bell's palsy;
• too weak or tight fastening of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

1. Phonation (external) design of the utterance - this includes speech pronunciation disorders;
2. Structural-semantic (internal) design of the utterance is a systemic or polymorphic speech disorder.

Violations of the process of speech of the phonation of the utterance can be both separate and combined. Based on this, the following types of violations are distinguished in speech therapy:

1. Aphonia and dysafonia - is a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, height and timbre of the voice or the complete absence of phonation. Aphonia and dysafonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of a child's development.
2. Bradilalia is a pathological slowing of the speech rate. A characteristic feature is the slow implementation of the articular speech program.
3. Tahilalia is a pathological acceleration of the speech rate. The accelerated implementation of the articulatory speech program is characteristic.
4. Stuttering is a violation of the organization of speech, in which the muscles of the speech apparatus are in a convulsive state. Pathology is centrally conditioned and appears, as a rule, in the process of speech development of the child.
5. Dyslalia - pathology is a disorder of the pronunciation of sounds, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifested in the form of a distorted sound design of speech, while there is an incorrect pronunciation of sounds or their replacement and mixing.
6. Rhinolalia is a violation of the pronunciation of sounds and the timbre of the voice, due to anatomical and physiological disorders of the speech apparatus. A pathological change in the timbre of the voice is characteristic, accompanied by the passage of a vocal air stream on exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of a resonance in the latter.
7. Dysarthria is a violation of pronunciation, a distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy, which appeared at an early age of the child.

Difficulties in speech of structural and semantic design are divided into two varieties: alalia and aphasia.

• Alalia - is the absence or insufficient development of speech, provoked by damage to the areas responsible for speech, located in the cerebral cortex in the process of intrauterine development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the operation of selection and analysis at all stages of birth, as well as the reception of speech utterance, as a result of which the child's speech activity is not fully formed.

• Aphasia is a complete or partial loss of speech, which is caused by local lesions of the brain. The ability to speak normally can be lost due to traumatic brain injury, neuroinfection or brain tumors, after the formation of speech.

Diagnostics

First of all, it is necessary to analyze the complaints made by the patient, as well as the history of the disease. It is important to take into account how long ago there were complaints of quiet, slow speech and difficulty in pronouncing words and phrases, as well as whether the patient's next of kin have similar manifestations.

Then it is necessary to undergo an examination by a neurologist, which consists in checking the mandibular and pharyngeal reflexes, examining the pharynx, and the presence of thinning (atrophy) of the muscles of the tongue. In addition, it is important to check the reflexes of the lower and upper extremities.

You need to be examined by a speech therapist, the doctor will be able to assess speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronouncing specific sounds.

An examination by an otolaryngologist helps to exclude various volumetric processes (abscesses and tumors) in the nasal cavity, since they can also affect the voice.

With the help of computed tomography and magnetic resonance imaging of the head, it is possible to conduct a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these can be tumors, foci of impaired blood circulation, abscesses, foci of myelin decay, the main protein of the nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy of speech disorders consists in the treatment of the main disease, which provoked dysarthria:

• the tumor must be removed surgically;
• resection of a hematoma (hemorrhage) is possible if it is located on the surface;
• abscesses are surgically removed from the cranial cavity, and then antibacterial drugs are prescribed to stop the infectious process as soon as possible;
• normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any kind of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

A single point of appointment to the doctor by phone.

Speech disorder: classification of pathology, symptoms and methods of treatment

For each person, speech is an integral part of normal interaction with others, and any deviation in the speech function can lead to psychological problems associated with the impossibility of self-realization of the individual.

The dysfunction of the speech apparatus has a direct impact on the life of any person, and therefore, it is very important to diagnose the pathology in a timely manner at the slightest deviation in order to avoid serious complications in the future.

Speech impairment is a violation of speech function, which can be provoked by completely different reasons. This term includes various types of deviations in human speech development, which can lead to both complete and partial loss of the reproduction of words and sounds.

Conventionally, speech disorders in medical practice are divided into two main groups:

• Organic reason for the development of deviations. The causes of dysfunctions of the speech function in this case are internal anatomical pathologies affecting the structure of the speech apparatus. For example, birth or mechanical damage to the areas of the brain responsible for speech functions, the abnormal structure of the speech apparatus, hereditary disposition, etc.;
• Functional reason for the development of deviations. In this case, the normal operation of the speech apparatus is disrupted due to certain external factors. For example, prolonged stress, deviations in the functioning of the nervous system, infectious diseases, head injuries, mental disorders, etc.

Deviations can manifest themselves in the form of expressive speech, inhibition of pronunciation, nasality or stuttering. To identify the causes of violations, a consultation with a neurologist, speech therapist and diagnostics is required.

Classification of speech deviations

There are several main forms of speech disorders in adults encountered in medical practice. Depending on the type of speech defect, specific work is always required to eliminate deviations, since the lack of competent treatment at any time can lead to a complete loss of speech function or psychological deviations.

The main classification of speech disorders includes several forms of deviations in the development of speech:

One of the main types of deviations in speech is stuttering. The reasons for the development of this pathology are factors such as stress, fear, neurological abnormalities, genetic disposition, severe emotional shock.

Speech dysfunction is characterized by such signs as constant disruptions in the rhythm of speech caused by spasms or convulsions of some parts of the speech apparatus. When a person stutters, there are difficulties in pronouncing words and sounds, as a result of which he is forced to constantly make long pauses and repeat the same sound or syllable several times.

In order to identify the form of the disease, it is necessary to understand what reasons serve as an impetus for the development of deviations in speech.

Reasons for the development of deviations in adults

There are many internal and external factors that provoke deviations in speech pronunciation. Moreover, depending on the cause of speech impairment, the process of development of deviations can be both hasty and gradual. The most common causes of dysfunction are:

• severe pathologies affecting the brain: with high intracranial pressure, a stroke may occur, the main consequence of which may be a violation of speech functions;
• in the course of impaired coordination of movements caused by damage to the cerebellum of the brain (for example, infarction or ischemia of the brain), an organism reaction such as complete or partial loss of speech may occur;
• mechanical damage and trauma to the head and face, in particular, in children during childbirth;
• brain pathologies caused by thrombosis;
• dysfunction of the parts of the brain responsible for speech and movement;
• various types of degenerative pathologies of the nervous system and brain (Alzheimer, dementia, tumors, etc.);
• genetic disposition;
• malfunctions of the central nervous system;
• birth trauma, during which speech functions are damaged;
• alcoholism can cause speech failures;
• facial paralysis;
• atherosclerosis;
• pathology of the muscular articulatory and motor speech apparatus (low mobility of the lips, tongue, facial muscles);
• improper fastening of the denture;
• decreased tone of the soft palate;
• stress, fear, prolonged depression;
• some infectious diseases;
• developmental delay, dementia;
• disruption of the blood circulation;
• cerebral palsy;
• oligophrenia;
• deafness;
• frequent neuroses;
• Down syndrome;
• Lyme disease;
• long-term use of certain medications (antidepressants, antibiotics).

It should be remembered that the causes of speech disorders can be both physiological and social and psychological in nature.

Signs of deviations

It should be noted that more severe cases of speech disorders that occur with dementia and some psychological abnormalities in the body, regardless of the age of the patient, can provoke dumbness. Therefore, it is very important to recognize the primary signs in a timely manner in order not to allow the disease to progress.

1. Inconsistency of the language norm with the age of the speaking person.
2. Spastic dystrophy is manifested by involuntary vibrations of the patient's vocal cords. In this case, speech deviations may be accompanied by initial signs such as hoarseness, a choked voice, or breathy speech.
3. With aphasia, a person is completely unable to competently and quickly express his thoughts. The patient has problems with the perception of the speech of other people. A person suffering from deviations in speech formulates his thoughts for a very long time and expresses them in words. The words and sounds that he pronounces are wrong and slurred.
4. Too fast pace of speech, or, conversely, too slow, may be evidence of dysfunction in the patient's speech apparatus. This may be the result of a complex mental illness; THR caused by brain pathologies; infectious diseases or degenerative conditions.
5. Another disease syndrome is a violation of the timbre of the voice. Any change in the function or form of the vocal cords can provoke a change in the articulation and pronunciation of individual sounds, as well as lead to ease of speech during pronunciation.
6. Due to the weakness of the speech apparatus and vocal muscles, signs such as inhibition of speech and "swallowing" of sounds appear.
7. Problems can manifest themselves in the form of expressive speech - rapid and frequent repetition of the same words, increased speech activity, unusual for a normal person, violation of the syntactic structure of phrases and fluency of pronunciation.
8. Nasal, stuttering, inability to pronounce a word or phrase, repeated pronunciation of sounds are the main signs of deviations in speech.

It should be noted that the intellectual-mnestic functions, which are various forms of mental disorder, are of a degrading nature. Often, with this form of disorder, brain cells are affected, which negatively affects the patient's speech function. As a result of such complex pathologies as a heart attack or stroke of the brain, an adult patient, over time, may develop a severe impairment of speech functions, up to complete numbness. Therefore, it is so important at the slightest manifestation of symptoms to consult a specialist in a timely manner.

Treatment

As soon as the cause of the pathology is identified and a diagnosis is made, the doctor will prescribe the appropriate treatment, the basic principle of which is to eliminate the causes that caused speech dysfunction.

As for children, a speech therapist can help correct speech defects at an early age. But only if the deviations are not associated with mental disorders and mechanical damage to the head. It is important to understand here that the older the patient and the more complex the cause of deviations in speech, the longer the process of treatment and correction of speech deviations will be.

Treatment methods are as follows:

1. Conservative treatment. It implies classes with a speech therapist, the use of special exercises to restore speech and articulatory gymnastics, as well as physiotherapy procedures.
2. Medical treatment. It comes down to improving cerebral blood flow, normalizing pressure and enhancing metabolic processes in the central nervous system. Also, drugs are used that affect the process of improving the memory, attention and perception of the patient.
3. The last resort is surgery. Which involves the removal of tumors and abscesses in the cranial cavity, resection of hematomas and the elimination of other growths that provoked the occurrence of deviations of the speech apparatus as a result of dangerous diseases. Surgery is used only when all other methods of treatment have not had the expected result.

The choice of a specific method of treatment, medications and the appropriateness of the operation is determined by the doctor, depending on the form of the pathology and the stage of concomitant diseases.

There is a separate branch of psychology that deals with the study of people suffering from deviations in speech functions - logopsychology. The psychology of persons with speech disorders requires a systematic and thorough study of the symptoms, signs and mechanisms of development of this deviation. Due to this, it is possible to achieve positive results through the development of special methods of psychological assistance and suitable treatment regimens in each case.

It should be understood that any defects and speech disorders, as well as damage to parts of the speech apparatus, with untimely or incorrect treatment, can lead to underdevelopment of speech, reduced communication and attentiveness, as well as to limiting the patient's logical and mental conclusions.

Incoherent speech in an adult causes

THE ARTICLE WILL HELP YOU UNDERSTAND THE CAUSES OF SPEECH LOSS, BECAUSE WHO CORRECTLY DIAGNOSES - THAT CORRECTLY TREATS. Sudden loss of speech can be caused by the following reasons. One by one, checking and rejecting one by one reasons not related to your case, only your case will remain. The prognosis of health and life largely depends on timely recognition.

FIRST MANDATORY STEP - DETECTING THE LOCATION OF THE BRAIN FOCUS IN SUDDEN LOSS OF SPEECH, IF THERE IS A FOCUS

If the post-central sections of the dominant hemisphere, which receive information from receptors that transmit information from the speech-motor apparatus and ensure the coordinated work of the speech-motor apparatus, are damaged, loss of speech occurs - afferent motor aphasia. When this part of the brain is damaged, there is a violation of the coordination of the muscles involved in the formation of speech, and errors appear when pronouncing individual speech sounds, more pronounced if there is a similar phonetic pronunciation (for example, front-lingual "t", "d", "n"; fricative "sh", "u", "z", "x"; lip "p", "b", "m").

Because of this, spontaneous speech turns out to be illegible, numerous replacements of sounds appear in it, which makes it incomprehensible to others, while the patient himself is not able to control it due to a kind of sensitive ataxia in the structures that ensure the emergence of speech. Afferent motor aphasia is usually combined with oral (buccal-lingual) apraxia (inability to reproduce movements of the tongue and lips on assignment, requiring considerable accuracy - to place the tongue between the upper lip and teeth, etc.) and is characterized by a violation of all types of speech production (speech spontaneous , automated, repeated, naming).

If the posterior sections of the inferior frontal gyrus (Broca's area) are damaged, there is an efferent motor aphasia. At the same time, the articulation of individual sounds is possible, but it is difficult to switch from one speech unit to another. The patient's speech is slow, he is laconic, there is poor articulation, which requires considerable effort from him, speech is replete with numerous literal and verbal perseverations (repetitions), which is manifested, for example, by a disorder in the ability to alternate individual syllables (ma-pa-ma-pa). Due to the omission of auxiliary words and case endings, the patient's speech sometimes becomes "telegraphic". With pronounced manifestations of this form of aphasia, the formation of "speech emboli" in patients is possible - the repetition of certain words (often swear words) that the patient pronounces "out of place", while conveying his attitude to the situation with intonation. Sometimes the patient succeeds in repeating individual words after the examiner, but he cannot repeat a phrase, especially an unusual one, devoid of meaning. The nominative function of speech (naming objects), active reading and writing are impaired. At the same time, the understanding of oral and written speech is relatively preserved. It is possible to preserve fragmentary automated speech, singing (the patient can sing a melody).

Patients, as a rule, are aware of the presence of a speech disorder and sometimes experience the presence of this defect hard, showing a tendency to depression. With Broca's efferent motor aphasia, there is usually hemiparesis on the side opposite to the dominant hemisphere, while the severity of paresis is more significant in the arm and on the face (according to the brachiofacial type).

Dynamic motor aphasia occurs when the prefrontal area is damaged anterior to Broca's areas, characterized by a decrease in speech activity, initiative. At the same time, reproductive (repetition after examining words, phrases) and automated speech suffer much less. The patient is able to articulate all sounds, pronounce words, but his motivation for speech is reduced. This is especially evident in spontaneous narrative speech. Patients seem to be reluctant to enter into verbal contact, their speech is simplified, reduced, depleted due to the difficulty of maintaining a sufficient level of mental activity in the process of verbal communication. Speech activation in such cases is possible through a stimulating effect on the patient, in particular, by talking on a topic that has a high degree of personal significance for the patient. This form of speech loss can be explained as a result of a decrease in the influence on cortical structures from the activating systems of the reticular formation of the oral parts of the brain stem.

Sensory aphasia, or acoustic-gnostic aphasia, occurs when Wernicke's area, located in the posterior part of the superior temporal gyrus, is damaged. At the heart of sensory aphasia is a speech recognition disorder in the general sound stream due to a violation of phonemic hearing (phonemes are units of the language with which to distinguish and equate its components; in Russian speech, they include voiced and deaf, stressed and unstressed). In this case, there is a violation of the sound-letter analysis and alienation of the meaning of words.

With sensory aphasia, the ability to repeat words is also lost. A patient with a sudden loss of speech in the form of sensory aphasia cannot correctly name familiar objects. Along with the violation of the oral speech of the patient, the ability to understand written speech and to read is also impaired. In connection with the disorder of phonemic hearing, a patient with sensory aphasia makes mistakes in writing, especially when writing from dictation. In this case, first of all, the replacement of letters reflecting shock and unstressed, hard and soft sounds is characteristic. As a result, the patient's own written speech, like oral speech, seems meaningless, but the handwriting may be unchanged.

In typical, isolated sensory aphasia, manifestations of hemiparesis on the side opposite the dominant hemisphere may be absent or mild. However, upper quadrant hemianopsia is possible due to involvement in the pathological process passing through the temporal lobe of the brain, the lower part of the visual radiation.

Semantic aphasia occurs when the lower parietal lobule is damaged. It is manifested by difficulties in understanding any phrases that are somewhat complex in construction, comparisons, reflexive and attributive logical-grammatical phrases expressing spatial relationships. The patient is not oriented in the semantic meaning of prepositions, adverbs: under, above, before, behind, above, below, lighter, darker, etc. It is difficult for him to understand how the phrases differ: “The sun is illuminated by the Earth” and “The Earth is illuminated by the Sun”, “Father’s brother” and “Brother’s father”, give the correct answer to the question: “If Vanya follows Petya, then who goes ahead?”, draw a triangle in a circle, a cross over a square, etc.

Amnestic (anomic) aphasia is observed when the posterior parts of the parietal and temporal lobes of the left hemisphere, mainly the angular gyrus, are damaged, and is manifested by the inability to name objects; at the same time, the patient can correctly speak about their purpose (for example, when the examiner asks to name the demonstrated pencil, the patient declares: “Well, this is what they write with” and usually tries to show how this is done). The hint helps him remember the right word for the name of the object, while he can repeat this word. In the speech of a patient with amnestic aphasia, there are few nouns and many verbs. At the same time, active speech is fluent, understanding of both oral and written speech is preserved. Concomitant hemiparesis on the side of the subdominant hemisphere is uncharacteristic.

Total aphasia is a combination of motor and sensory aphasia: the patient does not understand the speech addressed to him and at the same time is unable to actively pronounce words and phrases. It develops more often with extensive cerebral infarctions in the basin of the left middle cerebral artery and is usually combined with severe hemiparesis on the side of the hemisphere opposite to the dominant one.

It was proposed to take into account the manifestations of minimal dysphasia, or preaphasia, which are often encountered in the clinic, in which the speech defect manifests itself so easily that during a normal conversation it can go unnoticed by both the speaker and his interlocutor. Preaphasia is possible both with increasing brain pathology (atherosclerotic encephalopathy, brain tumor, etc.), and in the process of restoring impaired functions after a stroke, brain injury, etc. (residual dysphasia). Its identification requires especially careful research. It can manifest itself in the form of speech inertia, spontaneousness, impulsivity, a decrease in the ability to quickly and easily select the right words, the use of predominantly words that are found in the patient's dictionary with great frequency. At the same time, rarer words are remembered with difficulty and with delay, and the patient often replaces them with words that are more common, although less suitable in this context. In the speech of patients, “hackneyed” words and phrases, speech “stamps”, habitual speech turns become abundant. Not finding the exact words and phrases in a timely manner, the patient tends to substitute words (“well, this thing is like her”) and thus compensate for the lack of quality of his speech with an excessive amount of speech production, in connection with which excessive verbosity is manifested. If the patient performs individual tasks correctly, then the implementation of a serial task (for example, touch the bridge of the nose with the index finger of the right hand, take oneself by the right ear with the left hand and close the left eye) is difficult. Verbally presented material to patients is unsuccessfully interpreted and inaccurately repeated, difficulties arise in explaining the meaning of such generally accepted expressions and proverbs as “golden hands”, “taking the bull by the horns”, “devils live in still waters”, etc. Difficulties are possible when listing objects belonging to a certain class (animals, flowers, etc.). Speech disorders are often detected when a patient composes an oral or written story based on a picture or on a given topic. In addition to other difficulties, in the process of communicating with the patient, uncertainty in the perception of a verbal task and the resulting slowness of reactions to it can be noted.

THE SECOND MANDATORY STEP - FINDING OUT THE MAIN CAUSE OF SUDDEN SPEECH LOSS:

2. Stroke in the left half of the brain

3. Condition after a seizure

4. Migraine with aura in the form of speech impairment

5. Herpes simplex encephalitis

6. Thrombosis of the intracerebral sagittal sinus

7 Psychotic Mutism

8. Psychological problems

Diagnostic studies conducted to diagnose the causes of sudden loss of speech:

Complete blood count and erythrocyte sedimentation rate (ESR); blood chemistry; computed tomography CT or magnetic resonance imaging (MRI); ophthalmologist

fundus, visual fields; examination of cerebrospinal fluid (CSF);

Doppler ultrasound (USDG) of the main arteries of the head; neuropsychologist consultation.

1 Cause of sudden loss of speech - Tumor or abscess of the brain.

Sudden loss of speech can occur: due to rupture of the vessel supplying the tumor with blood, which is accompanied by hemorrhage into the tumor;

due to the rapid increase in edema;

or - in the case of a left hemispheric localization of the tumor or abscess - due to a partial or widespread seizure of epilepsy.

Computed tomography for both tumor and abscess diagnoses a volumetric process inside the brain in the form of a low-density focus with or without contrast absorption. With abscesses, there is more often a more pronounced perifocal edema i.e. located or occurring near the site of tissue damage. Cause of sudden loss of speech - Migraine with aura.

2 The reason for the sudden loss of speech is a stroke in the left hemisphere of the brain.

In a speech disorder in an elderly patient, the most likely diagnosis is a stroke. In most cases, speech disorders in stroke patients have

lack of strength or muscle weakness in the right arm and / or leg, impaired sensation in the right arm and / or leg, sometimes - a violation in the right visual field.

Computed tomography and magnetic resonance imaging are the only ones that most reliably distinguish intracerebral hemorrhage from ischemic stroke.

Loss of speech almost always occurs with a left hemispheric stroke. It can also be observed with a right-hemisphere stroke (i.e., with damage to the hemisphere opposite to the dominant one), but in these cases speech is restored much faster.

3 The reason for the sudden loss of speech is the condition after a convulsive seizure.

At any age, acute sudden loss of speech can be caused by a post-seizure condition.

In these cases, speech is quickly restored.

The epileptic seizure itself may go unnoticed, and biting of the tongue or lips may be absent;

The EEG helps to diagnose the condition after a seizure as the cause of the loss: generalized or local slow- and sharp-wave activity is recorded.

An increase in the level of blood creatine phosphokinase as a diagnosis of an epileptic seizure is unreliable.

4 In young patients, sudden loss of speech may be due to migraine with aura.

In 60% of cases, during the collection of the medical history, the patient's relatives also have migraine headaches.

In these cases, acute or subacute loss of speech occurs simultaneously with the headache.

On ELECTROENCEPHALOGRAPHY - EEG, there may be a focus of slow-wave activity in the left temporo-parietal region, which can persist for 3 weeks, while

magnetic resonance imaging and computed tomography do not find any causes. Pronounced focal changes on the EEG in the absence of deviations according to the results of neuroimaging

studies on the 2nd day of the disease, in principle, make it possible to make a correct diagnosis, with the exception of cases of herpetic encephalitis described below.

Transcranial Doppler ultrasound should be performed whenever possible. In a patient suffering from migraine and related to

to the age group from 40 to 50 years, there may be an asymptomatic stenosing vascular lesion, but the typical nature of the headache, rapid reverse

the development of symptoms and the absence of structural changes in the brain according to the results of neuroimaging research methods in combination with the changes described above in

EEG allows you to make the correct diagnosis.

The patient should be free of cardiac murmurs, which may indicate the possibility of a cardiogenic embolism, which can occur at any age.

A possible source of embolism is identified (or ruled out) by echocardiography. Listening to vascular noises over the vessels of the neck is less reliable compared to

5 The cause of sudden loss of speech is encephalitis caused by the herpes simplex virus.

Because in herpetic encephalitis caused by the herpes simplex virus

The temporal lobe is predominantly affected; aphasia (or paraphasia) is often the first

With computed and magnetic resonance imaging, a low-density zone is determined, which soon acquires the characteristics of a volumetric process and spreads from the deep parts of the temporal lobe to the frontal lobe, and then contralaterally, primarily involving the zones related to the limbic system. in the cerebrospinal fluid

there are changes in the inflammatory process.

The EEG reveals focal slow-wave activity, which, upon repeated recording of the EEG, changes into periodically occurring three-phase complexes. Over time, these complexes also capture the frontal and leads on the opposite side. Clarification of the herpes simplex virus by direct visualization of viral particles or by immunofluorescence analysis is carried out with a significant time

delay, while antiviral therapy should begin immediately at the first suspicion of viral encephalitis (taking into account the fact that lethality in encephalitis caused by the herpes simplex virus

6 Cause of sudden loss of speech - Thrombosis of the intracerebral sagittal sinus.

A triad of symptoms that may indicate intracerebral sinus thrombosis: general or partial epileptic seizures, hemispheric focal symptoms, decreased wakefulness.

With magnetic resonance imaging and computed tomography, sinus thrombosis is evidenced by hemispheric edema (mainly in the parasagittal region) with diapedetic hemorrhages,

hyperintensity of the signal in the region of the sinus(s) and a deltoid-shaped zone that does not accumulate the injected contrast and corresponds to the affected sinus.

On the EEG, generalized low-amplitude slow-wave activity is recorded over the entire hemisphere, which also extends to the opposite hemisphere.

7 Cause of Sudden Loss of Speech - Psychotic Mutism

negativism in schizophrenia.

8 The reason for the sudden loss of speech is psychogenic mutism.

Psychogenic mutism is manifested by the absence of reciprocal and spontaneous speech, with the ability to speak and understand the speech addressed to the patient intact. This syndrome may

observed in the picture of conversion disorders. Another form of neurotic mutism in children is selective, which occurs when communicating with only one

Difficulty speaking

(speech disorder, speech disorder, speech problems)

Difficulty in speech can be expressed both in the complete absence of speech, and in the partial violation of the pronunciation of words and phrases. Speech impairment is expressed in the fact that a person:

• speaks slowly and indistinctly, unintelligibly;
• with difficulty selects words and names things;
• speaks without hesitation and quickly, but meaninglessly;
• speaks hastily and incoherently;
• separates syllables too much and emphasizes each of them.

If it becomes difficult for a person to speak and understand someone else's speech, most likely he is sick or his speech center of the brain is damaged. Gradual difficulty in speech can occur due to Alzheimer's disease and some other diseases of the nervous system. The causes of a sudden articulation disorder can be a stroke, alcohol or drug intoxication, head trauma, poisoning.

Causes and types of speech disorders in adults

A disorder of the speaking function in an adult can occur suddenly as a manifestation of a serious illness, develop gradually, or be present in a patient from childhood due to the pathology of the articulation apparatus left unattended.

Speech disorders in adults, the causes and types of anomalies are very diverse. These can be disorders of both impressive (perception of sounds, reading) and expressive speech (written or oral speech).

General characteristics of speech disorders in adults

Speech is the highest human function. It is connected, in the main degree, with a person's ability to think, his memory, feelings. The correct pronunciation of sounds directly depends on the work of the brain, the respiratory system and the organs of the articulatory apparatus (tongue, larynx, oropharynx, teeth, lips).

In general, the physiological mechanisms of speech formation are divided into two forms.

A detailed description of the forms of speech can be found in the table below.

• The ability of a person to perceive heard speech, as well as understand written (reading).
• Analyze all the sound components of speech (letters, sounds).
• The mechanism of speech disorders according to the impressive type is associated with disorders in the work of the brain, auditory and visual apparatus. Patients with this pathology do not catch the general semantic component of phrases, do not recognize the words addressed to them, which is often the reason for the substitution of sounds in syllabic reproduction. Sometimes a person's speech becomes unrecognizable to others

• Active speech.
• Ability to write independently.
• Ability to form words, sentences, pronounce sounds correctly.
• The disorder of expressive speech is manifested by a limited vocabulary, immature pronunciation of sounds. Violations are associated with abnormal functioning of the brain, organs of the articulatory apparatus, psychological problems

The main symptoms of disruption of the articulatory apparatus in adults

Speech disorders are characterized by the following features:

• Stuttering. Violation of the pace and rhythm of speech. Spasms in the organs of the speech apparatus.
• Nasal. Changing the voice tone. The main cause of this anomaly is a pathological process in the area of ​​the nasal septum.
• Slowness, retardation of speech.
• Distorted pronunciation of sounds.
• Misunderstanding the general meaning of speech.
• Hoarseness, hoarseness of voice.
• Inability to express one's thoughts.
• Salivation.
• Indistinct diction.
• Rapid pace of speech. It is characterized by the swallowing of individual sounds.
• Small vocabulary.
• Complete silence of the patient (mutism).

All manifestations of speech disorders in adults are a significant obstacle to the full communication of patients and require treatment. It is almost impossible to overcome these symptoms on your own.

Important! It is impossible to ignore any dysfunction of the articulatory apparatus. Often, speech difficulties can indicate the development of a serious illness (stroke, tumor process in the brain area)

Causes of speech impairment in adults

Speech disorders in adults are divided into two types due to the reasons that provoke it.

For example, such as organic speech disorder (OHP). The cause of this type of speech disorder is traumatic brain injury (TBI), other painful conditions characterized by damage to the organs of the articulatory apparatus (tongue, lips, nasopharynx, teeth), individual parts of the nervous system associated with the conversational function, as well as diseases of the hearing aid.

Symptoms of OHP may appear after such past illnesses as:

• Acute viral infections.
• Tumors of the brain.
• Stroke.
• Thrombosis.
• Birth trauma.
• Alzheimer's disease, Parkinson's. The elderly suffer. In addition to speech disorders, patients have psycho-emotional disorders and memory problems.
• Taking some antibiotics can have an ototoxic effect, lead to hearing loss, and as a result, speech disorders.
• Neuroinfections (meningitis, encephalitis, Lyme disease).
• Botulism. A severe infectious disease that affects the human nervous system.
• Spasm of cerebral vessels.
• pre-stroke state.
• Alcoholism.
• Infantile cerebral palsy (ICP).
• Epilepsy.

Functional speech disorder (FNR). This pathology can occur due to the effect on the human body of the following adverse factors:

• Strong stress.
• General underdevelopment of speech of the 3rd, 2nd, 1st levels revealed in childhood, left without proper treatment.
• Mental retardation.
• neuroses.
• Severe depression.
• Strong fright.
• Hysteria.
• Long-term use of antidepressants, tranquilizers.
• Mental illness.
• genetic predisposition.

However, it should be noted that the distinction between speech disorders, starting from provocative factors, is relative. Often, in patients with FND, subsequently, a detailed examination reveals organic abnormalities.

Types of speech dysfunction

Speech disorders in adults, depending on the manifestations of the disease, are divided into such types as:

• Tahilalia. Too fast pace of speech with hesitations and swallowing of sounds. May be a sign of epilepsy, oligophrenia.
• Aphonia. People, for various reasons (pathology of the larynx, stress) can only speak in a whisper due to the loss of sonority of the voice.
• Dyslalia. Violation in the pronunciation of sounds in patients with normal intelligence, hearing, articulatory apparatus.
• Bradilalia. Slow motor skills of speech due to difficult thinking. May be present in encephalitis, severe depression, TBI.
• Rhinolalia. It is observed in people with an abnormal structure of the organs of the speech apparatus (“cleft palate”, “cleft lip”, palate injuries), manifested by various defects in the pronunciation of sounds.
• Stuttering. Violation of the pace and rhythm of speech. It can occur due to genetic predisposition, severe stress, fear.
• Such a speech disorder as dysarthria is characterized by disorders in the pronunciation of sounds, speech motor skills due to brain damage, as well as insufficient innervation of the articulatory apparatus. Occurs with cerebral palsy, stroke, multiple sclerosis, myasthenia gravis.
• Alalia. The complete absence of speech or a deep underdevelopment of the speech function is most often the result of damage to the areas of the brain responsible for speech. It is observed in diseases such as TBI, stroke, autism.

All of the above symptoms are associated not only with difficulties in pronunciation, but also with the perception of speech, insufficient ability to independently form words, sentences, and the exact formulation of thoughts. That is, they can be a manifestation of inferiority, both impressive and expressive speech.

Diagnosis of the disease

Speech disorders in adults that occur suddenly or develop gradually can be a symptom of various diseases. It is necessary to consult a doctor (general practitioner, neurologist, otorhinolaryngologist) as soon as possible for a complete examination.

Diagnosis of speech disorders includes the following activities:

• Analysis of the patient's conversational function, his complaints.
• Collection of anamnesis. It is necessary to find out when the disorders first appeared, with what factors the first manifestations of speech dysfunction were associated.
• An otorhinolaryngologist examines the organs of the articulatory apparatus. Order an x-ray.
• The neurologist will check the reflexes, identify possible psychological disorders. If necessary, he will prescribe computed tomography (CT), magnetic resonance imaging (MRI) of the brain. He will send you for tests (common blood, urine) to identify the infectious process.

Treatment

First of all, the treatment of speech disorders in adults lies in the correct diagnosis.

To restore both impressive and expressive speech after excluding brain pathologies, mental illness, organic damage to the organs of the articulatory apparatus, it is necessary to consult a speech therapist.

Various exercises for speech correction will be effective, taking into account the individual characteristics of a person.

For example, special breathing exercises, singing will help get rid of stuttering. Also, physiotherapy procedures will bring maximum benefit.

For example, such as:

• transcranial micropolarization. A new method based on the impact of a minimum power current, close to the physiological processes of the body, on the human brain. Reduces nervous excitability, improves conversational function, memory. Helps restore vision and hearing.
• Reflexology (acupuncture). Improves the functioning of all organs and systems in the human body.
• Logopedic massage.

Also, to completely get rid of speech dysfunction, you may need the participation of a psychotherapist, a psychologist.

Various psychotherapeutic techniques will help to find possible hidden causes that provoked speech disorders, and will normalize the emotional state of a person.

Patients suffering from speech disorders of varying severity need the help of not only qualified specialists, but also the participation of relatives, normal living conditions, understanding of loved ones, good nutrition, which will maximize the restoration of neuropsychic health and the speech apparatus.

In case of speech disorders, it is necessary to contact such specialists.

Speech rate is one of the expressive means of oral speech, it depends both on the speed of pronouncing successive speech sounds, and on the frequency and duration of pauses between words and sentences.

A normally speaking person pronounces 9-14 sounds in one second, with an acceleration of the rate of speech, it is possible to pronounce 15-20 sounds per second, but the pronunciation does not lose its clarity and intelligibility.

Speech tempo disorder

Violation of the tempo of speech is an excessive slowing down of speech and the same speeding up of it. Most preschool children speak quickly; this can be explained by the fact that their inhibitory processes and control over their speech are still weak.

If fast, hasty speech prevails in the family, then the fast pace of speech becomes habitual; in adolescence, it tends to increase even more; in neuropathic children, a fast pace of speech leads to stuttering. The reasons speech tempo disorders

intrauterine (perinatal) pathology;

damage during childbirth (natal pathology);

exposure to harmful factors after birth (postnatal pathology).

Intrauterine disorders are caused by maternal diseases during pregnancy, Rhesus or immunological conflict, drug use, medications, alcohol, smoking, exposure to ionizing radiation, as well as a number of production factors (vibration, microwave). Natal pathology occurs with prolonged or rapid childbirth, tight entanglement of the umbilical cord, caesarean section, and malposition of the fetus.

In the process of speech development, a fast pace interferes with the formation of speech differentiations and can lead to the consolidation of children's incorrect sound pronunciation and general slovenliness in speech.

Fast paced speech

tahilalia this is a pathologically accelerated rate of speech, in which instead of 10-12 sounds per second, 20-30 are pronounced. Speech is characterized by uncontrollable speed. With haste, disorders of speech attention, stuttering, repetition, swallowing, rearrangement of syllables, words, ambiguity in the pronunciation of phrases may appear ... However, when attention is drawn to speech, stutters disappear.

Depending on the situation of verbal communication, the severity of symptoms changes. The greatest difficulties are experienced in vital situations, communicating with authoritarian people, in an unfamiliar environment, in moments of excitement, a dispute.

Tahilalia is often accompanied by disorders of general motor skills, mental processes, emotional-volitional sphere, autonomic nervous system. Therefore, overcoming tachilalia should begin with the normalization of general movements: slowing down their pace, training coordination, the formation of rhythm, smoothness.

The causes and mechanisms of tachilalia have been extensively investigated, as this disorder may have been the cause of stuttering. Accelerated speech may be organically caused by a violation of the central speech mechanism. He assigns a significant role in this to heredity and also points to the genetic connection of accelerated speech with stuttering. Accelerated speech occurs when the extrapyramidal system malfunctions.

The cause of takhilalia can be congenital speech motor insufficiency of the speech apparatus, as well as sloppy, uneven speech of others, lack of attention and timely correction of the child's fast speech.

Symptoms of tachilalia

Speech symptoms of takhilalia are characterized by the following features:

Abnormally fast pace (instead of 10-12 sounds per second, 20-30 sounds are pronounced) of speech without sharp distortions of phonetics and syntax.

Speech is characterized by uncontrollable speed.

With haste, disorders of speech attention, hesitation, repetition, swallowing, rearrangement of syllables, words, distortion of sentences, ambiguity of pronunciation of phrases may appear.

When attention is drawn to speech in those suffering from takhilalia, a quick restoration of balance between internal and external speech occurs, although its pace remains fast compared to the speech of others, the hesitation disappears.

In the symptoms of tachilalia, interverbal acceleration is noted (acceleration of the rate of speech), which manifests itself in polysyllabic words, long phrases and long connected texts. A long word or phrase, a name of several words is pronounced so rapidly that some syllables fall out of the verbal heap, sounds are distorted due to inaccurate and fast articulatory movements.

Interverbal acceleration can be explained by the fact that during the construction of speech, the regulatory influence of the cerebral cortex on the course of speech is temporarily turned off.

Inner speech disorder

Along with the violation of external speech, similar disorders of internal speech, reading and writing are observed. It is the required word that appears in the memory of a person, but it is immediately, even before pronunciation, replaced by another. In writing and in reading, substitutions, rearrangements of letters, sounds, syllables are observed. Whole words are replaced by others that are related in sound or spelling.

In a person with tachilalia, the pace of general movements is disturbed: movements are fast and impetuous (fast walking, quick start and stop, hyperactivity, tics). Motor restlessness is noted even during sleep (children toss and turn in bed). Attention is unstable, switching from object to object is increased, insufficient visual, auditory and motor memory.

The flow of thoughts is faster than the ability of her articulation. Children with takhilalia are quick-tempered, easily excitable. During arousal, vasomotor reactions appear:

redness of the face, ears;

sweat on the face;

coldness and sweating of the hands.

Children become emotionally labile and undisciplined. Rapid speech produces an unfavorable impression on strangers, which is reflected in the child's later life, the formation of his personality.

Bradilalia is an unnaturally slow pace of speech, reading and writing, monotony of voice, long pauses between words, drawn out pronunciation of speech sounds.

Bradilalia can be an independent violation of the rate of speech, and can also be observed in the clinic of some forms of mental illness: with oligophrenia, in a neurological clinic in patients with the consequences of meningoencephalitis, with dystrophic, organic diseases of the central nervous system, injuries, brain tumors, etc. In these cases, it is combined with the following violations:

bradykinesia (slowness of all movements);

general lethargy;

• weakness.

As an independent disorder, bradilalia occurs most often in phlegmatic, slow, lethargic people. Features of speech similar to bradilalia are observed in the inhabitants of the northern countries, where they are the usual form of speech.

The speech characteristics (symptoms) of bradilalia are diverse: slowness of the tempo of external (expressive) and internal speech, slowness of the processes of reading and writing, monotony of the voice, inter- and intraverbal slowdown (lengthening of pauses between words or slow, stretched pronunciation of speech sounds and lengthening of pauses between the sounds of a word ).

Sounds and words succeed each other less quickly than under normal conditions, although they are formed correctly. If syllables are separated by short pauses, then the speech becomes scanned. The articulation of sounds may be disturbed, but the coordination of syllables or words is not upset.

With bradylalia, the voice is monotonous, loses modulation, constantly maintains the same pitch, sometimes a nasal tone appears. The musical accent also changes when pronouncing individual syllables, the pitch of the voice fluctuates up or down.

Bradilalia in children

Children with bradilalia pronounce a phrase with pauses between words, stretching syllables on vowel sounds, blurring articulation. Such speech is unaesthetic and interferes with communication with others, as it causes them tension and exhaustion of attention, discomfort and fatigue.

The above symptoms are observed in various forms of independent speech: in dialogue, retelling from a picture and a series of pictures, retelling of a text, a story on a given topic, reading. Visual perception of the text does not contribute to the normalization of the rate of speech when reading. Children pronounce words correctly, but slowly. They also write down words and even more so phrases slowly.

Non-speech symptoms in bradilalia are expressed in the following symptomatology:

General motor disorders;

violation of fine motor skills of hands, fingers, mimic muscles of the face;

slow movements;

motor awkwardness;

amiable face.

Movements are slow, sluggish, insufficiently coordinated, incomplete in volume, motor awkwardness is observed. Amicable face. There are also features of mental activity: slowness and disorders of perception, attention, memory, thinking.

Having focused on one subject, children hardly switch to another. Perceiving the instruction, they do not execute it immediately, but after several repetitions. There is a tendency to stereotypy, perseveration, orientation disorders. With mild bradilalia, these speech and non-speech symptoms are not noticed by the children themselves.

In more severe cases, there is an awareness of speech impairment and associated psychological experiences. Stuttering(logoneurosis), a violation of the rhythm, pace and smoothness of speech due to convulsive contraction of various muscle groups that form the sound design of speech (expressive speech) is one of the most common disorders in childhood and adolescence (in 70-90% of patients it begins at 2-4 - summer age, i.e. at the time of the formation of speech).

Symptoms

Pathology can be expressed in the absence of speech or in violation of pronunciation. This may present with the following symptoms:

• Fuzziness and slowness of speech, its illegibility.
• A person is difficult to select words and incorrectly names things.
• Fast speech, but meaningless.
• Haste of thought.
• Separation of syllables and setting the stress on each of them.

Why does it appear in adults?

Slurred speech in adults can appear suddenly or develop gradually. It can also appear in children. Specialists first find out why this happened, and only then begin treatment. Slurred speech can occur due to several factors. The reasons are as follows:

• Brain disorders.
• Brain injury resulting from a stroke or thrombosis.
• Head injury.
• Tumors of the brain.

• degenerative diseases.
• Excessive alcohol consumption.
• Weakness of the muscles of the face.
• Weak or tight fastening of dentures.

Types of disorders in children

Slurred speech in a child is associated with various ailments. The main ones include:

• The external design of the utterance is a pronunciation disorder.
• Internal design - a systemic speech disorder.

Varieties of violations

Slurred speech of phonation (external) design appears separately, and together with other disorders. In speech therapy, there are the following types of violations:

• Aphonia and dysophonia. There is a disorder or lack of phonation due to pathologies of the vocal apparatus. Usually there is a violation of the height, strength, timbre of the voice.
• Bradilalia. Speech slows down. The peculiarity is the slow implementation of the articular speech program.
• Tahilalia - speeding up the pace of speech. Accelerated articulatory speech program.
• Stuttering. The organization of speech is disturbed when the muscles of the speech apparatus undergo convulsions. Usually seen in children.

• Dyslalia. This pathology is presented in the form of a disorder in the pronunciation of sounds, when hearing and innervation of the speech apparatus in humans are normal. There is a distorted sound design of words. This is slurred speech. The sound may be mispronounced, replaced, or mixed up.
• Rhinolalia. The pronunciation of sounds and the timbre of the voice is disturbed, which is associated with disorders of the speech apparatus. Changes in the timbre of the voice are manifested when the vocal stream of air passes into the nasal cavity during exhalation and pronunciation. This causes resonance.
• Dysarthria. Pronunciation is disturbed, which is associated with insufficient innervation of the speech apparatus. This disease appears due to cerebral palsy, which are detected at an early age.

Structural and semantic design of speech

On this basis, disorders are divided into 2 types: alalia and aphasia. Each type of disease has its own symptoms. Alalia manifests itself in the form of the absence or incomplete development of speech. This occurs due to damage to the areas of the brain that are responsible for it. The disorder may appear during fetal development or at an early age.

With alalia, slurred speech appears. This defect is considered one of the most difficult, since speech activity is not fully formed. Aphasia is called the loss of the ability to speak, which appeared due to local damage to the brain. Why does slurred speech appear with this disorder? This is associated with traumatic brain injuries, neuroinfections and brain tumors.

Features of diagnostics

It is necessary to analyze the complaints that the patient expresses. The history of the disease is also taken into account. Specialists usually ask when slurred speech appeared and whether there are relatives suffering from such an ailment. Be sure to visit a neurologist, to undergo an examination. The doctor will check the mandibular and pharyngeal reflexes, examine the pharynx, make sure there is atrophy of the muscles of the tongue.

The reflexes of the lower and upper extremities are checked. You should be examined by a speech therapist. The doctor evaluates the performance of speech, reveals violations of the pace, complexity. An examination by an otorhinolaryngologist is necessary, which will protect against such processes in the mouth as ulcers and tumors, which can cause disorders.

Computed tomography and magnetic resonance imaging of the head are performed, with the help of which it will be revealed why slurred speech appeared. Causes in adults and children are also determined in consultation with a neurosurgeon. Only after a complete diagnosis, treatment methods are prescribed.

Principles of treatment

If slurred speech is detected, what to do? It is necessary to treat the main disease due to which the violation occurred:

• Tumors are removed surgically.
• Resection of the hematoma, if it is on the surface.
• Surgical removal of abscesses in the skull, followed by the appointment of antibacterial agents.
• Normalization of pressure.
• The use of funds to restore metabolism and cerebral blood flow.

People with various disorders need to visit a speech therapist so that the deficiency can be corrected with the help of special exercises. Regular practice is required.

Speech Correction Rules

Speech impairment appears not only due to the pathology of the articulatory apparatus, neurological pathology and the habit of incorrect pronunciation. Another factor is the psychological reason. With excitement, a person’s speech becomes barely audible and almost incomprehensible.

The activities of a speech therapist to restore speech are based on the following principles:

• Personal orientation.
• Creating an emotionally favorable environment.
• Interaction with parents.
• Positive motivation.

Speech therapy classes involve improving the mobility of the articulatory apparatus. There is also work on sounds and the restoration of phonemic hearing. Specialists work with children in a playful way, using speech games, a computer. Combined activities are carried out, involving switching attention from one activity to another.

Rules for the formation of speech

Classes with a specialist in children allow you to form competent speech, phonetically clear. But such activities will not be enough. The speech therapist helps only to put the sound. Everything else depends on the child and parents.

In order for speech to be successfully formed, the following rules must be observed:

• You should not scold the child for slurred speech, you just need to carefully correct it.
• Simple exercises should be shown.
• No need to focus on mistakes, stumbles.
• It is necessary to positively tune in to classes with a speech therapist.
• Parents need to watch their speech.

Forecast and prevention

Speech disorders can be corrected if this work is started at an early age or at an early stage. An important role in improving the condition is influenced by the surrounding people and the efforts of the person himself. If the violation is detected in a timely manner, as well as treatment is started, it is possible to achieve normalization of speech. Such children continue to study in ordinary schools and get along well with the guys.

With complex forms of the disease, it is not easy to achieve improvement in speech. You can only correct the speech function. In such situations, the complex of measures is wider, and the patient needs to visit a specialized institution. It is necessary to observe the continuity of speech therapy organizations: go to special kindergartens, correctional schools. It is also important to be treated in neuropsychiatric hospitals, if this was prescribed by a doctor.

Prevention involves the implementation of effective measures from birth. The child must be protected from neutroinfection, injuries of the skull and brain. It should not be affected by toxic factors.

It must be taken into account that success comes with a systematic approach and complex organization of events. Along with traditional treatment, non-traditional methods should not be forgotten. It is important to carry out activities for physical activity. Using a variety of methods allows you to get excellent results if used correctly.

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- Speech disorders in mental illness -
Speech disorders are caused by various reasons and are quite common. From the point of view of a psychiatrist, the most important are those that are directly related to mental disorders themselves - changes in thinking and affect, hallucinations, delusions, dementia, etc. R.'s changes relate to its speed, diction, grammatical structure, and content. Usually they are combined with each other in various proportions in certain forms of speech disorders.

Speech speed disorders manifest itself in its acceleration or deceleration. With a slight degree of acceleration, R. remains quite smooth and consistent. At the same time, the number of words increases significantly - the so-called logorrhea. At the same time, words are often interspersed with consonances of the last syllables (rhymes), sayings, excerpts from poems, aphorisms. Further acceleration of R. leads to the appearance of unfinished phrases, the ease of transition from one topic to another, and as a result, a violation of the sequence of statements. The thinking of such patients is defined as a leap of ideas. R. becomes sketchy, may be interrupted by laughter, whistling, singing, questions that are not related to this situation, to which patients do not expect an answer. At extreme degrees of R.'s acceleration, the so-called verbal okroshka occurs. Most often, accelerated R. occurs in hypomanic, manic, and catatonic states.

When R. slows down, the number of spontaneous utterances decreases until it completely disappears. Patients begin to answer only questions. The active vocabulary becomes poorer, the grammatical structure of phrases is simplified. Often patients answer only in monosyllables (“yes”, “no”) and at the same time complain about the absence of thoughts or that one thought haunts them - monoideism. Slow R. can be replaced by complete silence (mutism). Depending on the background on which mutism develops, it is defined as depressive, hysterical, catatonic, reactive, organic. In cases where the slowdown of R. and other mental processes (thinking, quick wits, etc.) occurs against the background of organic brain lesions - epidemic encephalitis, Parkinson's disease, damage to the frontal lobes of the brain (traumatic brain injury, tumors, Pick's disease, etc.) .d.) - they talk about bradyphrenia (bradypsychism).

Violations of diction varied. In some cases, the sound strength increases - R. is capacious with expressive or monotonous intonations (hypomanic and manic states) or, on the contrary, weakens - R. is quiet, whispering, at times barely audible, devoid of modulations (depressive, delusional states, dementia states), when R. is accompanied by a pronounced effective component theatrical, reciting, stilted, pathetic (catatonic, hysterical, psychopathic states, states of speech excitation in progressive paralysis, etc.) or, on the contrary, moaning, with crying and lamentations (anxiety-depressive state) .
Changes in diction can be associated with an emphasis on individual words or phrases, chanting, the appearance of childish intonations (hebephrenic state, puerilism, pseudodementia, dementia). R. herself can become slow, viscous, depleted of words (various organic lesions of the brain). In some patients, intonations sound interest, surprise, curiosity, often interspersed with anxiety and fear, tension and anger (hallucinatory states, states of obscuration of knowledge); in others, intonations of confidence and peremptoryness (paranoid, psychopathic states), evasiveness, omissions and suspicion (delusional states), sweetness, tenderness and humiliation (epilepsy, psychopathy) can dominate.

Grammar violations in their extreme degrees, they are represented by a set of separate, unrelated words. In other cases, unfinished phrases or their fragments are used, phrases devoid of verbs, or, conversely, phrases in which verbs are used in an indefinite mood.
Replace the personal pronoun "I" with others - in the singular and plural ("he", "we", "they"). They can talk about themselves in a different way. There is a use of periphrases - instead of designating an object, its description is carried out. This form of R.'s disorder testifies either to the severity of mental disorders, or to the fact that there are deep personality changes caused by some kind of chronic mental illness.

Broken speech accompanied by various degrees of violations of the grammatical structure and the meaning of the expression, or, if the grammatical structure is preserved, its meaning is lost (a state of clouding of consciousness, dementia, schizophrenia).

Violations of the semantic content of speech in the most distinct form are manifested in neologisms - new, created by the sick words themselves. Neologisms are words that make sense and are a means of active verbal communication with others. They are created by the patient as if to more accurately express their experiences. For example, an organization of persons allegedly persecuting a patient is called by him svarnops (“I am being pursued by svarnops”). They occur both in consistent, grammatically correct R., and in R. with a sharply disturbed grammatical structure. Neologisms, which are habitual speech turns, indicate the presence of a chronic mental illness with pronounced personality changes.

passing words (mimorech) is expressed in the fact that the answers of patients are out of any connection with the questions asked: sometimes, quite inopportunely, the answers include individual words of the question (with reactive psychoses, catatonic syndrome, etc.)

Monologue - this is continuous R., although addressed to the interlocutor, but due, first of all, to the internal state of the patient, and not to the need for verbal communication. At the same time, the patient does not pay attention to the questions asked, but continues to speak his own. If the monologue is the usual form of R., this is a reliable sign of a chronic mental illness accompanied by personality changes (for example, in schizophrenia).

Speech pressure expressed in increased speech activity with accelerated R., verbosity. It is difficult for the patient to stop or switch his statements to another topic, to answer the questions asked. Speech pressure occurs in patients with manic-depressive psychosis, schizophrenia, epilepsy, organic brain diseases, psychopathy.

mirror speech - this is the pronunciation of words (read, audible, arising spontaneously) from the end; observed in schizophrenia.

puerile speech observed in an adult using words and speech patterns characteristic of children: the use of diminutive words, lisping, burr, simplified or distorted grammatical structure of phrases, mentioning oneself in the third person, etc. (reactive psychoses, schizophrenia, senile dementia).

Reasoning speech built with a predominance of lengthy, abstract, usually of little content reasoning; patients are prone to superficial analogies, sophisms. Such R. is usually not based on specific facts and is unproven (schizophrenia, psychopathy).

sugary speech expressed in the use of diminutive and laudatory words, pronounced with exaggerated respect, insinuatingly, obsequiously, or with emotion and delight (epilepsy, psychopathy, organic diseases of the brain).

Slip speech manifests itself in statements, the main content of which is suddenly interrupted by side ones that have nothing to do with the main ones, which makes it difficult to understand them (schizophrenia).

stereotypical speech (verbigeration) consists of the same individual phrases, words, cries repeated many times in a monotonous voice (catatonic syndrome, a state of dementia).

echolalic speech (echolalia) It is expressed in the automatic involuntary, single or multiple repetition by the patient of individual words, phrases or phrases (echophrasia) heard by him from others (schizophrenia, Alzheimer's disease, organic diseases of the brain).

Verbal okroshka (verbal salad) - this form of broken speech, in which statements consist of separate words, devoid of grammatical structure and not interconnected in meaning (schizophrenia, a state of clouding of consciousness, an organic disease of the brain).

Anxious verbigeration - monotonous repetition of individual phrases, words, cries against the background of anxiety-depressive affect: reflects existing affective disorders (manic-depressive psychosis, involutional melancholy, schizophrenia, senile dementia).

schizophasia - a form of torn R., in which the expressed phrases, with a preserved grammatical structure, are devoid of any meaning, and the content of the R. reflects delusional disorders (schizophrenia).

Usually, one or another form of speech impairment is combined with other neurological symptoms, with specific facial expressions, movements, and behavior. Based on the totality of these disorders, especially speech disorders, in many cases it is possible not only to correctly qualify the mental status of the patient, but also to make a clinical and topical diagnosis.