The optimal form of working with stuttering. These children

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Currently, there are a number of speech therapy techniques to eliminate stuttering. They can be considered depending on the age of stutterers: work with preschoolers, schoolchildren, teenagers and adults.

Children who stutter stay in specialized hospitals for 3-4 months. The preparatory period is about a month, the training period is 1.5-2 months, and the consolidation period is about a month.

A special feature of this system is that the course of treatment is divided into 3 cycles. Initially, children are treated for 2 months (first cycle), followed by a month-long break; after which again 1.5 months of treatment (second cycle) and 2.5 months - a break; finally, the last (third cycle) - 1 month of treatment and the final discharge of the child from the hospital.

The first cycle (2 months, 48 ​​lessons) is an active restructuring of speech. The optimal goal of the first cycle is to fully implement the tasks of the preparatory and training periods. In terms of implementation time, it schematically looks like this: 6 lessons - examination and acquaintance with children; 20 lessons - preparatory period; 22 lessons - training period.

From the first day of the child’s stay in the hospital until the start of the training period, a gentle regime is created for children.

On the days of the examination, children are on bed rest under the supervision of a teacher and a nurse, who organize quiet games, activities, read fairy tales, listen to records, etc. . Speech communication of children is sharply limited; permitted only in necessary cases and only in a whisper.

At the same time, primary tape recording is carried out children's speech. The speech therapist practices speech exercises with children and conducts calming and stimulating conversations. Groups of children are assembled for individual speech therapy work.

Actually, the preparatory period of speech therapy work begins with an examination of children’s speech and with the maximum limitation of their speech. The tasks and forms of the preparatory and training periods are outlined above.

Their features in the hospital will be expressed only in the following:

1) In a hospital setting, it is not possible to provide for the complication of speech situations outside of the training period.

2) Before the end of the first cycle of therapeutic and pedagogical work with children who stutter, only one comparative teaching tape session is conducted. It kind of sums up the achieved results of working on the child’s speech.

3) Speech therapy work in a hospital is closely connected with educational work. Our speech therapists correctional classes They build on the material recommended by the “Program” for the education of preschool children, and use forms of conducting classes and games for ordinary preschool institutions. In turn, teachers provide general education classes and educational activities correlate with speech therapy tasks. In their classes, teachers focus on the speech capabilities of each child; timely informed about the child’s successes in speech therapy classes, they consolidate the results of speech therapy work with him in educational classes and during general routine moments.

4) Working with parents is very unique. The discontinuity of the course of therapeutic and pedagogical work in a hospital requires a certain speech therapy awareness of parents, so that during the break between cycles of treatment for the child, the achieved results are not disrupted and they are consolidated. For this purpose, during the first cycle of the child’s stay in the hospital with his parents, a minimum speech therapy session is held once a week (on Saturday or Sunday).

First lesson. Lecture-conversation about stuttering in children, about the features of treatment in a hospital, about the role of parents in this process.

Second lesson. Lecture-conversation about the psychological characteristics of children who stutter, about the complex of therapeutic and pedagogical work with stutterers (with characteristics of behavior and treatment in given time every child. A neuropathologist takes part in the conversation).

Third lesson. A conversation about the direction of speech therapy classes, about speech therapy techniques. Open speech therapy session (parents attend classes with a group of children where their child is not present). Discussion of this lesson.

Fourth lesson. The presence of parents at an open speech therapy session with children (in the group where their child is). Discussion of this lesson.

Fifth lesson. A conversation about the results of eliminating stuttering in children during the first cycle of their hospital stay (a comparative tape recording is used), about the tasks facing parents during a month and a half break in the treatment of their child (separate recommendations are given to each parent).

Each session with parents ends with a meeting with the child. This stimulates both parties: parents to practice minimal speech therapy, children to speak and behave well in order to please their parents with their successes. Speech therapists need this kind of work, as it becomes possible to train a child’s speech in difficult conditions. All this requires a carefully thought-out system for conducting the entire parenting day, right down to questions and answers between parents and child.

The release of children from the hospital is decorated colorfully, joyfully, in the form of a cheerful matinee.

During the 1.5 month break in the child’s treatment, parents must create the necessary attitude for him at home from others, organize daily speech exercises and classes as directed by the speech therapist, and follow the doctor’s instructions.

The second cycle (1.5 months - 36 sessions) - reinforcing therapy. 8 sessions of this cycle are reserved for training correct speech child on healthy areas of speech (preparatory period) and 28 lessons - to consolidate the skills of correct speech and behavior in different situations, in the process of different activities, on speech material of varying complexity (training period).

Speech therapy classes in the preparatory period of this cycle begin with the restoration of elements of correct speech, with learning new speech exercises. Children are shown their speech recorded at the beginning of the first treatment cycle and before they are discharged from the hospital.

Attention is drawn to the progress they made during the first cycle of treatment. At the same time, the child is monitored: what he saved, what he acquired during his stay at home. Speech therapy classes begin on the first day.

During the training period of this cycle (approximately from the middle of it), it is planned to reduce the time of speech therapy classes to 1.5-1.40 (instead of 2-2.30). Special speech therapy classes are gradually being replaced by general education classes. Classes are conducted, as before, by a speech therapist, but the main goal of the classes is gradually changing - speech therapy tasks are replaced by general educational ones. The speech therapy session thus gradually turns into a speech therapy educational session.

Individual speech therapy work to eliminate concomitant speech deficiencies is carried out with children in parallel with general classes.

At the end of the training period, a comparative training tape session is conducted. The present speech is compared with the initial recording made when the child entered the first cycle of treatment. Discharge from the hospital is formalized in the form of a matinee concert. All children participate.

The intensity of classes with parents in the second cycle of treatment decreases slightly. Parents' days are held once every 2 weeks.

First lesson. Discussion of the results of the parents’ work with the child (statement from each parent). Open speech therapy session with discussion.

Second lesson. Discussion of the results of therapeutic and educational work with a child in a hospital (speeches by a speech therapist and a doctor). Open speech therapy session with discussion.

Third lesson. Listening to a comparative tape recording of children’s speech now and initially upon admission to the first cycle of treatment. Recommendations from a speech therapist or doctor for working with a child at home after his discharge.

The task of the parents is: during the 2.5 month break in treatment, to consolidate in the child at home the skills of correct speech and behavior acquired by him in the hospital. Daily speech exercises and classes, strict adherence to the recommendations of the speech therapist and doctor - this is the key successful work parents.

Third cycle (1 month - 24 lessons) - consolidation of correct speech skills. It consists of a preparatory period (3 lessons), a training period (5 lessons) and a consolidation period (16 lessons).

In the first lessons, the child is studied; tape recordings of children's speech are shown upon admission to the first cycle of treatment and before discharge after the second cycle; learning new speech exercises; elements of correct speech are practiced and restored in its healthy areas.

In the next 5 classes, speech exercises are intensively conducted of varying complexity and in different situations. After which, without changing the complexity of the exercises, speech therapy classes are gradually replaced by educational ones with their tasks and specifics. During the fixation period, a speech therapy hospital for preschoolers resembles an ordinary round-the-clock kindergarten, where two teachers work in a group: one in the morning, the other in the evening. Its distinctive feature is the small size of the group and mandatory speech therapy for all classes with children. Before the end of treatment, the last tape-recorded comparative training session is conducted. A festive concert is being prepared for the graduation of children, in which all children take part.

Working with parents in this cycle is no different from the previous one - classes follow the same pattern once every two weeks.

In conclusion, we note that the advantages of the above course of therapeutic and pedagogical work with children who stutter in a hospital setting are expressed in the following:

1) Without extending the length of stay of a stuttering child in a specialized hospital, the time of speech therapy work with him increases. The child is actually under observation for 9 months.

2) The child’s transition from the peculiar conditions of a specialized hospital to home is not carried out abruptly, but gradually.

3) In cases of successful correctional work with a child, it becomes possible to limit the length of his stay in the hospital, i.e. carry out only the first and third cycles of treatment, or the second and third for children who have previously worked with a speech therapist. Thus, the different focus of each cycle allows us to take into account individual characteristics children, vary the necessary forms of therapeutic and pedagogical work with them. This in turn allows you to increase and throughput specialized hospital.

4) The proposed system, on the one hand, promotes closer contact between the speech therapist and parents and, in particular, significantly activates the role of parents in correctional and educational work with the child.

5) On the other hand, the interaction between the speech therapist and the teacher is more closely intertwined. The speech therapist, consistently restructuring speech therapy sessions, includes general educational tasks, more deeply understands the general tasks of educational work with children. This is significantly reflected in his leadership of the work of a teacher in a hospital; the tasks of speech therapy and general education classes and routine moments are specified.

Stuttering is a violation of the communicative function of speech, accompanied by a violation of tempo, rhythm and smoothness, caused by convulsions articulatory apparatus. Stuttering is one of the most common childhood neuroses.

The delay in the pronunciation of sounds and syllables is associated with convulsions of the speech muscles: the muscles of the tongue, lips, and larynx. They are divided into tonic and clonic seizures.

Tonic convulsions are difficulty pronouncing consonant sounds.

Clonic seizures are when a child repeats sounds or syllables at the beginning of a word or pronounces extra vowels (i, a) before a word or phrase. Tonic-clonic stuttering also occurs.

The first symptoms of stuttering are possible of different nature– this may be repetitions of the first sounds, syllables and the inability to further pronounce words. The child seems to begin to sing the first syllable. For example - “Ta-ta-ta slippers.” Or the impossibility of starting a phrase - tonic convulsions.

Vocal spasms appear - prolongation of a vowel sound at the beginning or middle of a word. The first symptoms of stuttering occur during the development of phrase speech. This age ranges from 2 to 5 years. If you notice that a child has difficulty breathing during speech, voice difficulties, he cannot start a phrase, if he starts repeating the first syllables of words or prolonging vowel sounds, then these are alarming symptoms and you need to pay attention to them.

If you don't pay attention in time, then this speech behavior can develop into real stuttering, causing not only problems with speech, but also difficulties in social sphere. In adults, the process is dramatically disrupted and works large quantity facial muscles, neck muscles, upper shoulder girdle. The social picture is not pretty. But this speech defect is not an irreversible disorder and in most cases it can be cured. The efforts made to combat stuttering have made some people famous. These people: Demosthenes, Napoleon, Winston Churchill, Marilyn Monroe.

Fortunately, stuttering begins in a small percentage of children. According to statistics, only 2.5% of children have this defect. City children stutter more often than children from rural areas.

There are more boys than girls among children who stutter. This is associated with the structure of the hemispheres. The hemispheres in women are organized in such a way that left hemisphere works better than the right one. Thanks to this, girls usually begin to speak earlier, and they more easily overcome those speech difficulties that are usually expected at 2.5 - 4 years.

When a child begins to speak in phrases, he experiences difficulties in selecting words and coordinating them in number, gender and case. Sometimes we see that at this phase the child talks excitedly, with carelessness, he has difficulty finding words, he is in a hurry. And then we hear such specific hesitations in the child that qualify as a tendency to stutter.

In a 2-3 year old child, it is worth distinguishing stuttering from non-convulsive stuttering. When hesitating, there are no convulsions of the articulatory apparatus - neither vocal nor respiratory. Hesitations are always of an emotional nature. They happen because at the age of 2 - 5 years the child’s speech capabilities do not keep up with his thoughts, and the child seems to choke. This is called physiological iterations or hesitations. A child with a stutter, when asked to speak better, will worsen his speech, and a child with hesitation, on the contrary, will improve it.

Separate external and internal reasons occurrence of stuttering.

Internal reasons:

1. Unfavorable heredity. If parents have a stutter or even a fast rate of speech, a mobile, excitable psyche, then this type of weakened nervous system is transmitted, which then contributes to the occurrence of stuttering.
2. Pathology during pregnancy and childbirth. These are factors that can adversely affect the child’s brain structures responsible for speech and motor functions. In particular, any chronic pathology in parents, illness of the mother during pregnancy.
3. Organic lesions of the nervous system in traumatic brain injuries, neuroinfections.
4. Diseases of the speech organs (larynx, nose, pharynx).

External reasons:

1. Functional causes are much less common, and again there must be an organic predisposition, a certain type of nervous system that cannot withstand certain loads and stress. Fright, serious illnesses in the period from 2 to 5 years, which cause weakening of the body and reduce the stability of the body’s nervous system. It is also an unfavorable family environment. Stuttering in children also appears as a result of overly strict upbringing and increased demands on the child. Sometimes parents want to make geniuses out of their children, forcing them to learn long poems, speak and memorize difficult words and syllables. All this can lead to impaired speech development. Stuttering in children can increase or decrease. Stuttering becomes more severe if the child is overtired, catches a cold, violates the daily routine, and is often punished.
2. Dissonance between the hemispheres of the brain, for example, when a left-handed child is retrained to be right-handed. According to the World Health Organization, about 60-70% of retrained left-handers stutter.
3. Imitating a family member or another child who stutters.
4. Lack of parental attention during the formation of speech, and, as a consequence, fast speech and skipping syllables.

1. The very first and most important thing parents should do- This is to contact specialists who deal with stuttering problems. If you see the first signs of stuttering, then you need to contact speech therapists, psychiatrists, neurologists and psychologists in clinics. They will give the necessary recommendations, if necessary, they will appoint drug treatment and they will tell you what to do at first;

It is better to consult a neurologist first: receive treatment, complete a course and then, based on this, begin classes with a speech therapist. The pediatrician’s task is to cure concomitant pathologies, strengthen the body, and prevent colds, in particular, diseases of the ear and vocal cords. It is also important to cure chronic diseases and bring them into stable, long-term remission. Physiotherapeutic procedures are also important in treatment. These will be classes in the pool, massage, electrosleep.

The psychotherapist shows the child how to overcome his illness, helps him feel comfortable regardless of the situation, helps him overcome fear in communicating with people, makes it clear that he is full-fledged and no different from other children. Classes are carried out together with parents who help the child overcome the disease.

It is worth remembering that the sooner you take action, the better. The longer you have stuttered, the harder it is to get rid of it. You should try to overcome stuttering before enrolling your child in school, and to do this you need to contact a speech therapist as early as possible and follow all his instructions, since the training program includes speaking in public when answering questions from the teacher, which can serve big problem for your child.

The fight against stuttering will become more difficult with age due to the consolidation of incorrect speech skills and related disorders.

2. Switch to a slower pace of speech for the whole family. Usually the child easily picks up this pace and after 2 - 3 weeks begins to mirror it. It's good to play silent. You need to come up with any fairy tale story, explaining to the child why this needs to be done. It is unacceptable to talk to a child in short phrases and suggestions.

3. Limitation of communication. The child should not attend educational, preschool institutions, and stay at home for 2 months. You also need to stop all visits to guests.

4. Start drinking a sedative. For example, “Bay-bye.”

5. Analyze the situation in the family. It is necessary to pay attention to when a child begins to stutter, at what time of day, and to note all provoking factors. This is necessary so that when you go to a specialist, you already have an observation diary.

6. Calm the child: remove TV, loud music, emotional stress, extra classes. It is useful to turn on calm audio stories for your child. It is unacceptable to quarrel in the family in front of a child. It is important to avoid overtiredness and overstimulation of the child. Do not force your child to say difficult words over and over again. Make comments less often and praise your child more often.

7. Games to prevent stuttering. They create proper breathing by inhaling deeply and exhaling slowly. First of all, play calm games with your child. For example, draw, sculpt, design together. It is very useful to engage a child in leisurely reading aloud and measured declarations of poetry. Such activities will help him correct his speech. Learn poems with short lines and clear rhythm. Marching, clapping to music, dancing, and singing help a lot. Singing difficult moments and whispering helps to get rid of convulsive moments.

Examples of exercises for shaping correct breathing take a deep breath through the nose and slowly exhale through the mouth:

• "Glassblowers". For this you will need regular bubble. The baby’s task is to inflate them as much as possible;
• "Who is faster". For this you will need cotton balls. The baby’s task is to be the first to blow the ball off the table;
• For school-age children, a game with inflating balloons is suitable. It is useful to teach a child to play simple wind instruments (whistles, pipes);
• and while swimming, play “Regatta”. Move light toys by blowing;
• "Fountain". The game is that the child takes a straw and blows through it into the water.

If the children are older, then you can use Strelnikova’s breathing exercises. It is based on a short inhalation through the nose;

• "Home sandbox" First, you need to allow the child to play with sand silently. And on final stages ask to tell what the child built.

8. It is very useful to give him a relaxing massage when putting your child to bed. It is carried out by the mother, who sits at the head of the child’s bed. Soft massaging movements are performed that relax the articulation organs and the upper shoulder girdle.

9. Dubbing speech with the fingers of the leading hand. The speech and centers responsible for the leading hand have almost the same representation in the cerebral cortex. When the hand moves, the signal runs to the brain. That part of the cerebral cortex becomes excited and, since the speech centers are located here, the hand begins, as if in tow, to pull speech along with it. That is, we make a hand movement for each syllable. Young children can make movements with two fingers.

At speech therapy lessons, exercises are selected that relieve tension and make speech smooth and rhythmic. The child should repeat the exercises at home, achieving clarity of speech.

Lessons have a certain system, stages, and sequence. First, children learn the correct narrative presentation of the text. They read poetry and retell homework. The peculiarity of this story is that the child feels comfortable, he understands that he will not be graded and will not be ridiculed. During such exercises, children’s speech becomes measured and calm, and their intonation does not change. When achieving the absence of stuttering in a narrative story, the child introduces emotional coloring into speech: somewhere he will raise his voice, somewhere he will make an accent, and somewhere there will be a theatrical pause.

During the classes, various everyday situations in which the child finds himself are simulated. This teaches him to deal with stuttering outside the speech therapist's office.

Be sure to maintain a good emotional mood in your child. The child should be given a reward for his success. Even if it is just praise, the child should feel the importance of his achievements. The presence of examples of correct speech is mandatory in class. An example could be the speech of a speech therapist or other children who have already undergone treatment. Speech therapy rhythm is an important point in the treatment of stuttering. These are exercises for vocal and facial muscles, outdoor games, singing, and round dances.

Be sure to give your child homework so that treatment is not limited only to the speech therapist’s office.

Modern speech therapy methods help the child to quickly overcome the disease and lead a full life.

- one of the generally accepted methods of treatment. They develop the muscles of the speech apparatus and vocal cords, teach deep, free and rhythmic breathing. They also have a beneficial effect on the respiratory system as a whole and relax the child.

12. Computer programs- an effective method of treating stuttering. They synchronize the speech and hearing centers in the brain. The child is at home, sitting at the computer and speaking words into the microphone. There is a slight delay thanks to the program, which allows the child to hear his own speech, and he adapts to it. And, as a result, speech becomes smoother. The program allows the child to speak in circumstances with emotional overtones (joy, anger, etc.) and gives advice on how to overcome these factors and improve speech.

13. There is also a method of hypnosis for children over 11 years old. This method allows you to get rid of spasm of speech muscles and fear of speaking in public. Speech after 3-4 procedures becomes smooth and confident.

14. Acupressure method refers to alternative medicine. The specialist influences points on the face, back, legs, and chest. Thanks to this method, speech regulation by the nervous system improves. It is better to do massage regularly.

15. Treatment with medications is an auxiliary method of treating stuttering. This treatment is carried out by a neurologist. Anticonvulsant therapy and sedatives are used. Thanks to treatment, functions improve nerve centers. Sedatives also help well in treating stuttering: decoction and infusion of herbs (motherwort, valerian root, lemon balm). It is not possible to eliminate stuttering using medications alone.

16. General strengthening methods, such as daily routine, proper nutrition, hardening procedures, and eliminating stressful situations also bring benefits in the fight against stuttering. Long sleep (9 hours or more) is also important. For deep sleep You can wash in a warm shower in the evening or take a bath with relaxing additives (for example, pine needles).

The child should eat fortified foods, including more dairy and plant products. It is necessary to limit the child’s consumption of meat and spicy foods, and remove strong tea and chocolate.

1. Maintain a daily routine. A smooth, calm flow of life helps strengthen the nervous system.
2. Favorable atmosphere in the family. A friendly, calm atmosphere in which the child feels safe. A trusting relationship so that when a child has fears or anxiety, he can always turn to his parents.
3. Bring up emotional stability. There will always be stress and anxiety in a child’s life. Parents should teach their children how to get out of various stressful situations. Instill in your child the feeling that you can always find some way out.

Conclusion

The fight against stuttering is tedious, difficult, painstaking work. But there are historical examples, which show the heroism of people when they overcame stuttering and formed a fighting character.

The authors of the first domestic method of speech therapy work with stuttering children of preschool and preschool age N. A. Vlasova and E. F. Pay build an increase in complications speech exercises depending on the varying degrees of speech independence of children.

N. A. Vlasova distinguishes 7 types of speech, which, in order of gradualness, must be used in classes with preschool children: 1) conjugate speech, 2) reflected speech, 3) answers to questions about a familiar picture, 4) independent description of familiar pictures, 5 ) retelling what was heard a short story, 6) spontaneous speech(story based on unfamiliar pictures), 7) normal speech(conversation, requests, etc.).

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

At the first stage, exercises are offered in joint and reflected speech, in the pronunciation of memorized phrases and poems. Recitation is widely used. At the second stage, children practice verbally describing pictures based on questions, composing an independent story based on a series of pictures, or this topic, in a retelling of the content of a story or fairy tale that was read by a speech therapist. At the third and final stage, children are given the opportunity to consolidate their acquired fluent speech skills in everyday conversation with surrounding children and adults, during games, activities, conversations and at other moments in a child’s life.

The methods of N. A. Vlasova and E. F. Pay are based on varying degrees speech independence of children. The undoubted merit of these authors is that they were the first to propose and use a step-by-step sequence of speech exercises in working with young children, and developed instructions for individual stages of the speech correction system for stuttering preschoolers. For many years, the proposed technique was one of the most popular in practical work with children who stutter. Currently, speech therapists use many of its elements.

A unique system of correctional work with stuttering preschoolers in the process of manual activity was proposed by N. A. Cheveleva. The author proceeds from psychological concept that the development of a child’s coherent speech is carried out through a transition from situational speech (directly related to practical activities, with a visual situation) to contextual (generalized, associated with past events, with missing objects, with future actions), and then throughout preschool period contextual and situational forms of speech coexist (S. L. Rubinshtein, A. M. Leushina). Therefore, the sequence of speech exercises with children who stutter is seen in a gradual transition from visual, simplified forms of speech to abstract, contextual statements and includes following forms: accompanying, final, preceding.

The system of consistent complication of speech also provides for the gradual complication of the object of activity through an increase in the number of individual elements of work, into which the entire labor process in the manufacture of crafts is divided.

This system for overcoming stuttering in children includes 5 periods:

Propaedeutic. The main goal is to instill in children the skills of organized behavior, teach them to hear the laconic but logically clear speech of a speech therapist, its normal rhythm, and temporarily limit the speech of the children themselves.

Accompanying speech. During this period, children’s own speech is allowed regarding the actions they simultaneously perform. The greatest situationality of speech is provided by constant visual support. At the same time, it becomes more complicated due to the change in the nature of the speech therapist’s questions and the corresponding selection of crafts.

Closing speech - children describe the work already completed or part of it. By regulating (gradually increasing) the intervals between the child’s activity and his response to what he has done, varying complexity of the final speech is achieved. With a gradual decrease in visual support for the work performed, a consistent transition to contextual speech occurs.

Pre-talk - children talk about what they intend to do. They develop the ability to use speech without visual support, plan their work, name and explain in advance the action that they still have to do. Phrasal speech becomes more complex: children pronounce several phrases related in meaning, use phrases complex design, construct a story on their own. During this period, they are taught to think logically, express their thoughts consistently and grammatically correctly, and use words in their exact meaning.

Consolidating independent speech skills involves children telling stories about the entire process of making a particular craft, their questions and answers about their activities, statements about at will etc.

The method of N. A. Cheveleva implements the principle of successively complicating speech exercises in the process of manual activity based on one of the sections of the “Program for the upbringing and training of children in kindergarten.”

S. A. Mironova proposed a system for overcoming stuttering in preschoolers in the process of passing the program for the middle, senior and preparatory groups of kindergarten in the sections: “Introduction to surrounding nature", "Development of speech", "Development of elementary mathematical representations", "Drawing, modeling, appliqué, design."

When going through a mass kindergarten program with children who stutter, some of its changes are proposed, related to speech abilities children: use of previous material at the beginning of the school year age group, rearranging some class topics, extending the time frame for studying more difficult topics, etc.

The correctional tasks of the first quarter consist of teaching the skills of using the simplest situational speech in all classes. Occupies a significant place vocabulary work: expansion of vocabulary, clarification of word meanings, activation of passive vocabulary. The speech therapist himself is expected to be particularly demanding of the speech: specific questions, speech consists of short, precise phrases in different options, the story is accompanied by a show, the pace is leisurely.

The correctional tasks of the second quarter consist of consolidating the skills of using situational speech, a gradual transition to elementary contextual speech in teaching storytelling based on questions from a speech therapist and without questions. Great place It involves working on a phrase: a simple, common phrase, the construction of phrases, their grammatical design, the construction of complex sentences, the transition to composing a story. The sequence of studying program material is changing. If in the first quarter, in all classes, children are introduced to the same objects, then in the second quarter, the objects are not repeated, although objects are selected that are similar in terms of the general theme and purpose.

The correctional tasks of the third quarter consist of consolidating the skills of using previously learned forms of speech and mastering independent contextual speech. A significant place is devoted to work on composing stories: based on visual support, on questions from a speech therapist, and on an independent story. Children's practice in contextual speech increases. In the third quarter, the need for slow learning of the program, characteristic of the first stages of education, disappears, and classes approach the level of mass kindergarten.

The correctional tasks of the fourth quarter are aimed at strengthening the skills of using independent speech of varying complexity. Work on creative stories. Along with this, the accumulation of vocabulary and the improvement of phrases begun at the previous stages of training continue. In speech, children rely on the questions of the speech therapist, on their own ideas, express judgments, and draw conclusions. Visual material almost never used. The speech therapist's questions relate to the process upcoming work conceived by the children themselves. Corrective training is aimed at maintaining the logical sequence of the transmitted plot, at the ability to give additional explanations and clarifications.

The methods of N. A. Cheveleva and S. A. Mironova are based on teaching children who stutter to gradually master the skills of free speech: from its simplest situational form to contextual (the idea belongs to R. E. Levina). Only N.A. Cheveleva does this in the process of developing children’s manual activities, and S.A. Mironova does this when going through different sections of the kindergarten program. The very principle of the necessary combination of tasks of correctional and educational work with children who stutter should be considered correct and necessary in speech therapy practice.

V. I. Seliverstov’s methodology is primarily designed for working with children in medical institutions(in outpatient and inpatient conditions) and involves modification and simultaneous use of different (known and new) methods of speech therapy work with them. The author believes that the work of a speech therapist should always be creative and therefore in every specific case a different approach to children is needed in finding the most effective techniques overcoming stuttering.

In the scheme proposed by the author for successively complicated speech therapy classes with children, 3 periods are distinguished (preparatory, training, consolidative), during which speech exercises become more complicated depending, on the one hand, on the degree of independence of speech, its preparedness, volume and rhythm, structure, and on the other hand the other - from the varying complexity of speech situations: from the situation and social environment, from the types of activities of the child, during which his speech communication occurs.

Depending on the level (threshold) of free speech and the characteristics of the manifestation of stuttering in each specific case, the tasks and forms of speech exercises differ for each child in the conditions of speech therapy work with a group of children.

Required condition speech therapy classes is their connection with all sections of the “Program of education and training of children in kindergarten” and, above all, with play as the main activity of a preschool child.

The significance of differentiated psychological and pedagogical methods of education and training is revealed in the methodology of G. A. Volkova.

System comprehensive work with stuttering children aged 2-7 years old consists of the following sections: 1) methodology of gaming activity (system of games), 2) logorhythmic classes, 3) educational classes, 4) impact on the microsocial environment of children.

The game system, which constitutes the actual content of speech therapy classes, includes the following types games: didactic, games with singing, active, with rules, games-dramatization based on poetic and prose text, table tennis games, finger theater, creative games at the suggestion of the speech therapist and as planned by the children. In classes with children, the principle of play activity is primarily implemented.

Conventionally, the following stages are distinguished: examination, restriction of children’s speech, conjugate-reflected pronunciation, question-and-answer speech, independent communication of children in a variety of situations (various creative games, in the classroom, in the family, kindergarten program material (with a change in the sequence of topics) and is aimed at achieving corrective, developmental and educational goals.The lesson is structured in a single plot in such a way that all its parts reflect the program content.

The focus of the methodology under consideration in relation to stuttering children from 2 to 4 years old and children from 4 to 7 years old is different. In the first case, the tasks are not so much correctional as developmental education and upbringing of children. At this age, speech therapy work is preventive in nature. Working with children who stutter from 4 to 7 years old leading value acquires a corrective orientation of speech therapy influence, since formed in the process of individual development personal characteristics influence character speech activity stutterer and determine the structure of the defect.

The methodology of gaming activity is aimed at educating the individual and, on this basis, eliminating the defect.

In the practice of speech therapy work with children who stutter (methodology of I. G. Vygodskaya, E. L. Pellinger, L. P. Uspensky) games and gaming techniques used for relaxation exercises in accordance with the stages of speech therapy: relative silence; education of correct speech breathing; communicating in short phrases; activation of an expanded phrase (individual phrases, story, retelling); re-enactments; free speech communication.

Thus, the improvement of speech therapy work to eliminate stuttering in preschool children led to the 80s of the 20th century. development various techniques. The speech material of speech therapy classes is acquired by preschoolers in the conditions of step-by-step speech education: from conjugate pronunciation to independent statements when naming and describing familiar pictures, retelling a short story heard, reciting poems, answering questions about a familiar picture, independently telling about episodes from a child’s life, about a holiday etc.; in the conditions of gradual education of speech from the regime of silence to creative statements with the help of play activities, differentially used in working with children from 2 to 7 years old; in conditions of education of independent speech (situational and contextual) with the help of manual activities.

The speech therapist is obliged to creatively structure speech therapy classes, using known techniques in accordance with the population of children who stutter and their individual psychological characteristics. These methods of speech therapy intervention for stuttering preschoolers were developed in accordance with the “Program for the upbringing and training of children in kindergarten”, which is mandatory document both for mass kindergartens and for special speech kindergartens and speech groups at mass kindergartens. The methods are aimed at organizing speech therapy work within the framework of the “Program for raising children in kindergarten”, since ultimately, children who stutter, having mastered the skills of correct speech and knowledge defined by the program, are further trained and brought up in the conditions of normally speaking peers. Speech therapy intervention aimed at speech disorder itself and associated deviations in behavior, formation mental functions etc., helps a stuttering child to socially adapt among correctly speaking peers and adults.

The main directions of correctional work with children who stutter:

1. Respect for silence

2. Correct speech breathing.

3. Articulation gymnastics and articulation massage.

4. Normalization prosodic side speech.

5. Psychological method of treating stuttering.

6. Application of new computer programs.

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Main directions of correctional work with people who stutter

children

Stuttering is difficult speech disorder, to overcome which a complex of various correctional work is used, consisting of therapeutic and pedagogical measures. When eliminating stuttering, it is necessary to influence the entire body of the stutterer; work should be carried out aimed at normalizing all aspects of speech, motor skills, mental processes, and developing the personality of the stutterer. When organizing correctional work, one should rely on the results of a comprehensive examination of a person who stutters, which make it possible to take into account specific form disturbances in the rhythm and fluency of speech and, accordingly, determine the main directions of treatment. Corrective methods involve the joint work of a neurologist, speech therapist, and educational psychologist.

From the above, we can conclude that both examination and correction of stuttering should be based on an integrated approach.

The leading direction of speech therapy intervention for children who stutter is work on speech, which consists of several stages and begins, as a rule, with observing a regime of silence (the duration of the stage is from 3 to 10 days). Thanks to this regime, previous pathological conditioned reflexes, since the child no longer produces his convulsive speech. Also, during the period of silence, the stutterer calms down psychologically; he no longer has to worry about his defect. After the end of the silence regime, there is a transition to work directly on speech, which will now take place in conditions more favorable for relieving speech spasms.

Since play is the leading activity of preschoolers, in speech therapy practice most often work on speech development with children of this age is carried out in a relaxed playful form. This is what happens in the game comprehensive development child, not only speech is formed, but also thinking, voluntary memory, and independence. It is on the basis of this approach that the personal deviations of stuttering children are corrected and their speech is trained.

Correction of speech communication in school-age children is closely related to the leader at a given age educational activities. In the course of speech therapy work, schoolchildren receive enough skills and abilities necessary for the active use of acquired knowledge in order to adequately interact with other people in the process of performing various types activities in a variety of life situations.

It should be noted that in order to successfully overcome stuttering, it is necessary to organize speech therapy classes in such a way that stuttering is completely absent. To achieve this goal, speech therapists use forms of speech that help relieve speech spasms. These types include:

1. conjugate speech (speech together with a speech therapist);
2. reflected speech (repetition after speech therapist individual words, small phrases, while maintaining the given tempo and rhythm of speech);
3. rhythmic speech (beating a rhythm on each syllable or stressed syllable in a word);
4. whispered speech.

The transition to independent speech is carried out gradually, only at the final stages of speech therapy work does the child switch to emotional speech.

Researchers and practitioners have developed other specific techniques for correcting the speech of children who stutter. N.A. Cheveleva developed a method for eliminating stuttering in schoolchildren in the process of manual activity. Speech education using this method takes place in several stages: accompanying speech based on visual objects and actions, concluding speech about a completed action, preliminary speech without relying on a past action, consolidation of active speech or contextual speech. A.V. Yatrebova’s methodology is based on slightly different theoretical positions. She proposed a system of correctional education based on the use of a set of communicative exercises in working with children who stutter, aimed at developing their free communication skills.

Despite the fact that in speech therapy practice it is used a large number of various techniques and methods aimed at working on the speech of children with stuttering, many experts are still of the opinion that comprehensive treatment of this disorder is necessary.

The basis for correct speech is correct speech breathing. It has been established that the most correct and convenient for speech is diaphragmatic-costal breathing, when inhalation and exhalation are performed with the participation of the diaphragm and intercostal muscles. The lower, most capacious part of the lungs is active. Upper sections The chest and shoulders remain practically motionless.

In children who stutter, at the time of emotional arousal, the clarity of speech is usually impaired, and breathing becomes shallow and arrhythmic. Often children generally speak while inhaling or holding their breath. That's why the most important goal Speech therapy intervention in eliminating stuttering is the education of correct speech breathing.

To develop speech breathing skills, the following is most often used:

1. breathing exercises;
2. exercises to develop the skills of correct full inhalation;
3. exercises to train proper exhalation;
4. breathing exercises with movements.

IN speech therapy work breathing exercises by A. N. Strelnikova are widely used to control the speech breathing of people who stutter.

It is also known that when stuttering, the strength, speed, range of movements of the articulatory apparatus, and switchability from one articulatory structure to another are impaired, so it is very important for a child who stutters to learn to relax, control muscle tension, and remove clamps and spasms of the articulatory apparatus. The authors of the most common methods for eliminating stuttering use such correction techniques as articulatory gymnastics and articulatory massage.

Articulatory gymnastics helps to achieve clarity of pronunciation, relieve tension in the articulatory and facial muscles, and develops strength, accuracy, and coordination of movements. To achieve the above goals, the muscles of the lower jaw, lips, tongue, muscles of the pharynx and soft palate, facial muscles are trained, static and dynamic exercises. When performing gymnastics, it is important to form differentiation in the inclusion of various muscles, smoothness, symmetry and arbitrariness of articulatory movements.

Articulation massage has a great influence on the nervous system of a stuttering child. This is reflected in changes in general nervous excitability, lost or reduced reflexes are revived, and the overall state of the central nervous system changes. Also, when exposed to massage, tension in spastic muscles is relieved, and, conversely, the tone of weak and flaccid muscles of the articulatory muscles increases, the volume and amplitude of articulatory movements increases, and those groups of peripheral muscles are activated. speech apparatus who had insufficient contractile activity. The main massage techniques are stroking, rubbing, firm pressure, vibration and effleurage.

Since the speech of children who stutter is poor in intonation and monotonous, another main area of ​​stuttering correction is considered to be working on the expressiveness of speech.

Logical expressiveness – the most important condition any type of speech. This includes:

1. intonation;
2. logical stress;
3. logical pause.

Normalization of the prosodic aspect of speech includes the following tasks:

1. Development of the skill of intonation design of syntagmas and phrases in accordance with the four main types of intonations of the Russian language (interrogative, exclamatory, complete and incomplete).
2. Normalization of the process of speech pausing.
3. Formation of the skill of intonation division and highlighting the logical centers of syntagmas and phrases.

Work on intonation is carried out on the material of sounds, words, sentences, and small texts. The main elements of intonation exercises are the development of ascending and descending intonation, and work is also carried out on the rhythmic and intonation division of the speech flow. Children are recommended to observe the speech of the people around them, which allows them to compare and analyze intonation-colored and monotonous sound.

When stuttering, a variety of motor disorders are noted (instability of muscle tone, uncoordinated and chaotic movements, slow switching from one series of movements to another, tricks and auxiliary movements), as well as disturbances in the tempo and rhythm of speech. Experts believe that these disorders require a complex intervention for their correction, which must necessarily include speech therapy rhythms.

To overcome stuttering, speech therapy rhythms provide the following:

1. develops general motor skills, motor skills of the arms, hands, fingers;
2. normalizes the pace and rhythm of speech movements;
3. develops speech prosody;
4. helps overcome various kinds of unnecessary, including accompanying movements;
5. develops breathing, the correct ratio of inhalation and exhalation;
6. helps relieve speech convulsions;
7. develops auditory and visual perception, attention and memory.

The means of speech therapy rhythm is a system of gradually more complex rhythmic and musical-rhythmic exercises and tasks that underlie the motor, musical and speech activity of children.

Dedicated to the issue of the need for gradual and differentiated use of speech therapy rhythms in the correction of stuttering separate work G. A. Volkova. Another one effective technique, based on the rhythmization of speech, was proposed by L. Z. Harutyunyan. The peculiarity of this speech therapy technique is the synchronization of speech with the movements of the fingers of the leading hand, which determine the rhythmic-intonation pattern of the phrase.

Constant difficulties in speech traumatize the psyche of sick children, causing various neurotic disorders. That's why great importance used in the treatment of stuttering various forms psychotherapeutic influences: group psychotherapy, autogenic training, self-hypnosis, hypnosis, relaxation exercises. All these forms are used so that a stuttering child can learn to voluntarily relax his muscles, free himself from excess tension and fatigue, and feel calm and relaxed.

First psychological method treatment of stuttering was outlined in the work of G. D. Netkachev. Modern technique, which most fully takes into account the various aspects of the clinical and psychological picture of stuttering, was proposed by V. M. Shklovsky.

However, not all experts recognize the effectiveness of psychotherapy in the complex treatment of psychological disorders in children who stutter. Neurologists most often use medications (tincture of motherwort, phenibut, tranquilizers) to normalize the activity of the central and autonomic nervous system, eliminate seizures, normalize psychological condition sick. But, unfortunately, the question of which method is more productive remains open.

However, most experts agree that to treat the nervous system, it is not enough just to take appropriate medications or perform special procedures. We should start with provisions for people who stutter comfortable conditions life that would help strengthen the nervous system and the entire body as a whole. These conditions include:

1. correct daily routine;
2. proper nutrition with the exception of foods that have a stimulating effect on the nervous system ( spicy food, chocolate, strong coffee);
3. restful and sufficiently long sleep (daytime rest is especially important for children);
4. sufficient exposure to fresh air (walks);
5. do not overload the child with homework, since any physical and mental stress will result in an increase in stuttering;
6. full-fledged summer rest without overheating in the sun;
7. hardening;
8. practicing calm and least dangerous sports (such as swimming, cycling, skating and skiing);
9. avoiding watching psychologically traumatic and frightening television programs; after watching such programs, children are haunted by nightmares;
10. ensuring a calm environment in the family, avoiding stressful situations that force the stutterer to remain in a state of nervous tension;
11. a calm and friendly attitude of parents towards a stuttering child.

To fully stabilize the mental health of children who stutter, it is considered necessary to carry out consultative and methodological work with teachers, which is aimed at ensuring favorable conditions to influence the child, to create correct attitude to him in kindergarten, school.

Currently, new computer programs are widely used to treat stuttering -"Breathmaker" and "Zaikanie.net", with the help of which it was possible to createartificial connection between the auditory center and the center of speech pronunciation. The essence of these programs is that when a child speaks into a microphone, through headphones, his own speech is returned to him, but already corrected by a computer. It sounds smooth and without stuttering. The computer delays words for a fraction of a second and thereby slows down the overexcited speech production center. Therefore the child will not say next word until he hears the previous one. The processed speech that is fed into the headphones is also amplified. The brain is forced to choose a more powerful (correct) signal. Thus, the children’s speech stabilizes.By the end of training, a person who stutters loses the readiness of the muscles of the speech apparatus to spasm, causing stuttering. The child not only stops stuttering, but also acquires the ability to speak beautifully and expressively.