General underdevelopment of speech
General speech underdevelopment (ONR) is a symptom complex characterized by the presence of complex speech disorders of a functional nature, in which speech disorders of varying intensity and frequency are observed. It is noteworthy that this pathological condition is characterized by simultaneous disorders of all components of the speech system without exception. Violations concern both the lexical and phonetic, as well as the grammatical side of the patient’s speech. As a rule, the condition is not associated with any disorders of intelligence or hearing aid functions.
The content of the article:
Classification of ONR in patients of different ages
Etiology and pathogenesis of ONR
Characteristics of the features of the development of pathology
Diagnosis of ONR (speech therapy examination)
Correction and prevention of ONRktics and prognosis of ONR
Prevention and prognosis of ONR
General underdevelopment of speech
The pathological condition is characterized by the presence of certain manifestations that are characteristic of ONR and do not depend on the cause that provoked it. Such manifestations include:
late start of speech activity;
phonetic and grammatical unformed speech;
incomprehensible speech of the child;
lagging expressive speech from intensive, etc.
The child understands the words addressed to him, but is unable to respond and react to the appeal.
Classification of ONR in patients of different ages
All clinical manifestations of this pathological condition are heterogeneous and have different intensity. On this basis , it is customary to distinguish the following forms of pathology:
uncomplicated by various dysfunctions of brain activity, motor skills, muscle regulation or disorders of the emotional and volitional sphere;
complicated forms with the development of neuropsychiatric disorders;
deep pathological ONR, when the patient has lesions of the speech parts of the brain.
Depending on the severity of certain lesions of speech activity , it is customary to distinguish 4 levels of speech development in children with ONR:
the first level or “speechless children”. The child uses onomatopoeia and “babble”, and also accompanies speech with gestures and facial expressions;
the second level. In this case, in addition to “babble”, the child has a very limited “set” of generally accepted words that he actively uses. Words can be distorted, typically reducing the number of syllables or rearranging them in places, speech capabilities lag behind the norm corresponding to the age of the child;
the third level of ONR. Free communication is difficult, but the child has the skills of detailed speech, uses phrases. There is a violation of the lexical, grammatical and phonetic structural structure of speech. Such children speak freely only in the presence of a person who could explain their speech (parents, teachers and educators, acquaintances, etc.);
the fourth level of ONR. Sound reproduction is not impaired, but the child confuses some sounds in speech, he lacks distinct articulation and diction. Often children replace some words that are difficult to pronounce with others that are close in meaning. There are lexical and phonetic errors in speech. They mainly concern declension, conjugation and matching of words in a sentence.
Etiology and pathogenesis of ONR
ONR is considered to be a polyethological pathology, which some researchers associate with disorders of prenatal fetal development. So the cause of ONR can be:
hypoxic lesions of the central nervous system;
rhesus conflict of mother and fetus;
fetal asphyxia;
birth injuries of the fetus, etc.
Due to the above-mentioned reasons, a child may have disorders in the development and maturation of organs and tissues of the central nervous system at the intrauterine level, which leads to various functional disorders, including various speech disorders of the child.
In addition, this condition can develop in children who suffer from various severe infectious diseases, have chronic ailments or have suffered severe traumatic brain injuries. Also, the development of speech in a child is affected by the lack of emotional contact or attention from parents.
Characteristics of the features of the development of pathology
All children with speech underdevelopment begin to speak quite late, not earlier than at 3-4 years old. Speech is incomprehensible, incorrectly framed — both from the point of view of vocabulary, phonetics and grammar. Due to the fact that the verbal activity of the child is disrupted, he may have memory disorders, mental activity, as well as lack of cognitive interest and attention.
Children with level 1 ONR are characterized by a rather simplified speech. Often they use “babble” instead of words or individual words that are not clear outside the situation. Such children strongly gesticulate, try to convey the meaning of their statements through the language of facial expressions and gestures. The vocabulary of a child with this level of ONR is very poor and consists of individual sounds or combinations of them, babble and a limited number of everyday words that can be severely distorted. Children are unable to understand the meaning of many words and grammatical phrases. Many sounds are not available for pronunciation, phonemic hearing is impaired, that is, the child does not distinguish between sounds. The articulation is fuzzy, and the pronunciation of sounds is very unstable.
With speech disorders of level 2, in addition to babbling and gestures, children are able to reproduce fairly simple sentences consisting of a maximum of three short words. The statements are situational, of the same type and rather poor in their content. The vocabulary of such a child lags far behind the vocabulary of his peers and the age norm, children do not know and do not understand the meaning of many words. Moreover, the grammatical structure of speech is also significantly disrupted. The child does not understand the difference between singular and plural, does not know how to change words by numbers and cases, incorrectly uses prepositions, etc. Such children are absolutely not ready for sound analysis.
Children with diagnosed level 3 of general speech underdevelopment have phrasal speech. This means that they can reasonably construct a small coherent sentence consisting of 2-3 short words, but they find it difficult to compose longer and more complex sentences. Such children use verbs and nouns well, but it is difficult to assimilate adverbs and adjectives, often confuse the names of objects or replace some verbs with others. They often confuse endings and incorrectly or inappropriately use prepositions. Another characteristic feature is the complexity of constructing causal relationships, as well as temporal and spatial relationships. The phonetic structure of speech in children with this form of disorders is also impaired, but to a somewhat lesser extent than with violations of levels 1 and 2.
Children with level 4 ONR vocabulary is quite rich and diverse, they are able to reproduce not only large and complex sentences in structure, but also retell small stories. However, at the same time they often lose the essence and the main idea of the presentation and “get hung up” on minor details. In some clinical cases, children with this level of ONR confuse individual sounds or experience certain difficulties in word formation, and also have a fairly low level of phonetic perception.
Although all levels of general speech underdevelopment have their own characteristics, each of these conditions requires timely diagnosis and, to one degree or another, can be corrected.
Diagnosis of ONR (speech therapy examination)
The initial stage of speech therapy examination includes the collection of anamnesis, during which the doctor examines the medical documentation of the child, starting from early childhood. It is good if there is data on how the mother’s pregnancy and childbirth proceeded, since it is in the prenatal and neonatal period of fetal development that the causes of this pathological condition often lie.
After that, oral speech is diagnosed, during which it is revealed:
the child’s ability to make coherent sentences, picture stories, or retell what he has heard;
the ability to correctly change words, incline them and link them together (grammatical component of speech);
the child’s vocabulary is relative to the age norm.
Further examination involves the study of the anatomical structure of the organs of the speech apparatus, as well as the sound (phonetic) side of the child’s speech, the ability to analyze and synthesize the sounds that the child hears.
As a result of the examination, the doctor makes a conclusion about how strongly the general underdevelopment of the child’s speech is expressed.
Correction and prevention of ONRktics and prognosis of ONR
First of all, it is worth noting that if you communicate more with the child, then ONR can, if not avoided, then significantly improve the baby’s speech. Speech therapy work with a child is very individual and should take into account not only speech, but also other features of the patient.
At each of the levels of ONR, a different correction of the general underdevelopment of speech is required:
at level 1, activities are carried out aimed at developing the skills of understanding oral speech and independent speaking, as well as activating non-verbal processes in the child (memory, perception, attention, etc.);
at level 2, ONR is actively working on the pronunciation of sounds difficult for the child, on understanding oral speech and activating speaking skills. Also, for children with this level of ONR, classes on the development of lexical and grammatical skills are necessary;
the purpose of correction at the 3rd level of ONR is to consolidate existing skills and acquire new ones: pronunciation, phonemic skills, vocabulary expansion, the ability to describe pictures and compose small coherent texts;
at the 4th degree of ONR, the main task of speech therapy correction is to “tighten” the child’s speech to the age norm and consolidate the existing skills.
Prevention and prognosis of ONR
Correction of general speech underdevelopment is a persistent joint work of the baby, his parents and a speech therapist. Sometimes the treatment is delayed for many months, but the results are pleasantly pleasing to both parents and teachers. It is better to start correction at the age of 3-4 years, when the child is actively developing speech skills. Today, there are many methods that allow us to assess the prognosis for ONR as favorable.
Prevention consists in the prevention of conditions that are the etiological cause of the development of pathology. The more you talk to your child, the more it stimulates his speech activity.
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