Speech stutters are unintentional stops in speech that are non-convulsive or spasmodic in nature. They can have a physiological origin, be a sign of speech, neurological, mental disorders. Manifested by stumbling, repetition of sounds, syllables and sound combinations, interrupting the statement. They are diagnosed according to neurological, speech therapy, psychological examination. Therapy includes the creation of calm conditions in the family and the team, the observance of the speech regimen. In speech pathology, speech therapy classes and medical measures (massage, psychotherapy, physical therapy, drug correction) are carried out.
Depending on the pathogenetic basis, stuttering in speech can have a convulsive and non-convulsive mechanism of occurrence:
Repetitions of sound complexes and words are observed in a significant number of children aged 3-5 years. This is a period of active development of a coherent statement, improvement of lexical and grammatical categories.
Vocabulary is accumulating at a rapid pace, a large flow of sensory information falls upon the child. At the same time, the speech capabilities of the child are still sufficiently limited, mental functions are in the process of formation, and the work of the articulatory apparatus is imperfect. Against this background, physiological hesitation (iteration) develops.
"Stuck" on individual sounds more often appear in children who are somatically weakened, diagnosed with "ADHD", heredity burdened by stuttering. Hesitation in speech in a child can be provoked by a strong emotional shock: quarrels of parents, transfer to another kindergarten, change of residence. More often they occur in the off-season, can persist for several weeks or months, disappear and reappear.
Hesitations are non-convulsive in nature, they occur anywhere in a word and phrase (more often in words with a complex syllabic structure, a confluence of consonants, complex sentences). Children repeatedly repeat sounds and their combinations, rearrange syllables, stumble when pronouncing a phrase. They often speak while inhaling, because of which the speech statement is interrupted. The children themselves do not notice their speech defect, they treat it calmly.
Usually, physiological hesitation disappears without additional intervention as speech skills improve and HMF develops. It is enough to provide the child with a comfortable emotional environment, the right speech environment. However, with persistent fixation of the wrong speech stereotype, non-convulsive stuttering can develop into convulsive stuttering.
Speech stutters are observed in adults due to strong excitement. Such stumbling is regarded as a manifestation of anxiety, a neurotic personality. Hesitation occurs in different situations: in an exam, during a public speech, when meeting new people. The more a person tries to keep the situation under control, to speak clearly and confidently, the more he begins to stumble.
Short-term hesitation appears with fright, in such cases it is said that the person "began to stutter with fear." However, in all these cases, speech iterations are short-lived and transient. Speech normalizes as soon as the stress factor disappears.
Speech convulsions are the leading symptom of logoneurosis and neurosis-like stuttering. In this case, there is an obsessive involuntary repetition of syllables (“ma-ma-shop”) and / or getting stuck on a single sound (“p-p-rooster”). Hesitation often occurs on certain “difficult” sounds ([k], [p], [t]) or sound combinations with a confluence of consonants ([cr], [st] [tr]), on stressed and pre-stressed syllables, on the first syllable in word.
Sometimes convulsions are manifested by silence, because due to a spasm of the speech muscles, a person cannot start a phrase. A stutterer may feel a speech spasm as an obstruction in the larynx, compression of the chest, tension in the facial muscles and abdominal muscles. The frequency of hesitation, their duration increases in unfamiliar conditions, with strangers.
With stuttering, the pace and rhythm of speech, the fusion and fluency of utterance suffer. Secondary neurotic reactions are superimposed on speech symptoms: speech tricks, accompanying movements, vegetative manifestations. Logophobia is the fear of spoken language. On their own, without special therapy, convulsive hesitation does not disappear from speech.
Speech excitedly is characterized by an excessively accelerated pace, dysrhythmic character with sudden stops and subsequent breakthroughs. There are hesitations, unintentional repetitions, swallowing of syllables and words. The intelligibility and intelligibility of oral speech is lost. If a patient with tachilalia is pointed out to his speech errors, then hesitations and perseverations temporarily disappear, but the pace of speech still remains fast.
Especially brightly all speech defects are shown at excitement, at the moments of dispute and emotional excitement. In the non-speech sphere, motor restlessness, tics, attention deficit, irascibility, vasomotor reactions are noted. In some cases, speech stutters with tachilalia turn into a late form of stuttering.
Poltern, or cluttering, as a special case of takhilalia, is characterized by a non-convulsive interruption of speech against the background of its accelerated pace. For this speech disorder, stumbling, repetitions of sounds and syllables, their omissions, rearrangements are typical. Hesitations are manifested by chaotic silent movements of the tongue and lips, unreasonable pauses in phrases. Because of the haste in speech, the endings of words are often “swallowed”, sometimes whole phrases and phrases “fall out”.
When cluttering, other aspects of speech activity also suffer: the smoothness and melodiousness of speech is disturbed, there are no logical stops and stresses, a nasal tone of voice appears, and errors in writing appear. The speech flow is accompanied by restless behavior, grimaces, absent-mindedness. Due to illegible speech, verbal communication is difficult, the defect is not recognized.
Convulsive stutters in speech may appear "at the exit" of patients from motor alalia, aphasia, dysarthria. The reason for this phenomenon lies in the intensive correctional and speech therapy impact, when the volume and pace of the introduction of new speech material does not correspond to the functional capabilities of the brain. Usually there are repetitions of the last syllables, while the patient can not move to a new word.
Discoordinated spasms of the articulatory muscles, as a rule, do not transform into pathological stuttering. With the organization of competent correctional and pedagogical assistance, such hesitation is successfully compensated without relapses.
The occurrence of stuttering in speech may be associated with an unfavorable speech environment: the fast pace of speech of parents, imitation of stuttering friends or relatives. In some cases, hesitation occurs a second time, against the background of various disorders:
The appearance of speech stutters is an occasion to immediately seek the advice of a speech therapist. The sooner their cause and nature is established, the more effective the treatment and correction will be. Diagnostics consists of three blocks:
If the hesitations in the child's speech are of a physiological nature, it is necessary to organize an optimal general and speech regimen: ensure sufficient daytime and nighttime sleep, increase the time spent walking in the fresh air. It is important to temporarily limit the flow of new information, to minimize watching TV, playing computer games, and attending mass events. In speech communication, the following recommendations should be observed:
It is indicated for patients with emotional hesitations in speech, stuttering, tachilalia, poltern. This direction of correctional work helps to reduce fixation on a speech defect, eliminate logophobia, master new mechanisms of self-regulation, and expand communication opportunities. The main methods of psycho-corrective work are sessions of psychotherapy and hypnosis, communication trainings, autogenic trainings.
Taking into account the reasons underlying speech stutters, classes are held to develop speech, correct stuttering, overcome tachilalia, etc. Logotherapy is aimed at developing a new speech stereotype, its consolidation in all communicative situations. The following methods and techniques are used in the work:
They are organized on the basis of a polyclinic or a neurological day hospital. The goal is to normalize the regulatory function of the central nervous system, increase adaptive mechanisms. Patients with pathological stutters in speech are prescribed: