Fine motor skills in children with motor alalia. Alalia. Possible complications and consequences
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With alalia, speech in children is either not formed at all, or there are significant impairments in it despite healthy intellect and hearing. This condition is accompanied by underdevelopment of all speech functions - phonetic, grammatical, lexical.
The insidiousness of this condition is that it is often diagnosed quite late. But the later a violation is detected, the more difficult it is to correct.
The cause of alalia is associated with damage to the areas of the brain responsible for speech. Depending on which center of the brain is disturbed, alalia can be motor or sensory. Sometimes a mixed form is possible, in which symptoms of both disorders are found.
Motor alalia
In this case, the part of the child’s brain responsible for speech production is damaged. If the articulatory apparatus is intact, children cannot speak correctly.
This type is characterized by the following symptoms:
- Complete lack of speech. The child expresses himself using babble, gestures and facial expressions. Occurs with severe disruption of brain structures.
- If speech is present, it is characterized by incorrect sound pronunciation, agrammaticity, mixing and replacement of complex sounds, and a poor vocabulary.
- The child speaks using individual words or simple sentences of two or three words. In this case, nouns prevail and, as a rule, are used in the nominative case. The volume of the passive dictionary is much larger.
- Neurologically, there is poor development of fine and gross motor skills, poor coordination, and clumsiness.
- Higher mental activity also suffers - memory, attention, and the emotional-volitional sphere are reduced.
- A decrease in intelligence is only a consequence of a lag in speech development and, with proper correction, is restored.
Sensory alalia
This form of alalia is distinguished by underdevelopment of speech perception with excellent hearing. The child is not able to understand speech addressed to him; his own speech activity may even be increased.
Signs of sensory alalia:
- In severe forms, the spoken speech remains completely incomprehensible to the child. He himself can reproduce various sounds and a meaningless set of words.
- If the violation is not very pronounced, alaliks can understand the meaning of what was said in a certain context. However, outside of him, the meaning of what was said again eludes him.
- Children in this state are not critical of their own speech; they often use gestures or facial expressions to communicate.
- Alalia is characterized by impulsiveness, increased fatigue in children, and attention disorders.
In its pure form, the sensory form of alalia occurs infrequently, in most cases it is combined with some manifestations of the motor one.
Causes of alalia in children
The occurrence of these disorders of the speech centers of the brain is associated with problems in intrauterine development or the first years of a child’s life:
- Severe pregnancy, leading to fetal hypoxia and intrauterine infection.
- Difficult childbirth - application of forceps, long anhydrous period, asphyxia, etc.
- Infectious diseases of a child in the first years - head injuries, diseases affecting the brain (encephalitis, meningitis).
Experts also attribute a hereditary factor to the reasons for the development of alalia. If there have been cases of speech disorders in the family, you should pay attention to this.
Diagnostics
It is extremely important to determine the child’s condition as early as possible. In order to diagnose alalia, a consultation will be required.
- a neurologist (with accompanying studies necessary to assess the state of the brain);
- otorhinolaryngologist (to exclude hearing problems);
- speech therapist-defectologist;
- psychologist.
How to help a child with alalia
Despite the fact that speech impairment in this case is associated with damage to certain areas of the brain, corrective measures may well improve the situation. The most important thing is not to wait for the weather “by the sea”, hoping that the situation will form itself.
The fact is that with alalia a rather extensive disorder occurs, in which the brain is not able to compensate for it itself.
Correction of alalia should be comprehensive with a combination of medication and psychological and pedagogical measures.
If necessary, the neurologist prescribes medications that help stimulate the maturation of brain functions. In addition, physiotherapeutic procedures are indicated for alalik children.
Speech pathologists and speech pathologists undoubtedly take on the main role in working to correct this condition. They are the ones who have the most difficult task - teaching a child to speak.
Classes with a defectologist are structured with mandatory consideration of the child’s individual condition and the level of speech underdevelopment. During the correction, work is carried out on:
- Formation of a conceptual apparatus.
- Expansion of active and passive vocabulary.
- Improving sound pronunciation.
- Development of general and fine motor skills.
- Correct word formation and the formation of coherent speech.
- Development of auditory attention and phonemic speech. Read more about.
- Cultivating sustainable attention, developing memory and thinking.
Features of speech therapy work in the correction of alalia
Due to the fact that alalia is a systemic disorder of speech formation, speech therapy corrective measures affect almost all areas. It cannot be said that the result is achievable in a short time. However, with proper and systematic training, it is quite possible to help an alalik learn to communicate.
- All lessons are conducted in a playful way. Children in classes should feel comfortable, not overtired or overloaded. The speech therapist carefully assesses the child’s condition and makes sure that tasks progress from simple to complex.
- The classes use logorhythmics, didactic games, speech therapy massage, and outdoor games.
- A child's positive attitude is extremely important. When monitoring the correct completion of tasks, be sure to praise the student, demonstrating his success.
- The key to a positive result is the early start of corrective actions, as well as consistency. Speech therapists do not advise parents of children with alalia to quit classes at the first improvement, since complications may appear over time - possible stuttering, dysgraphia and dyslexia.
Creating the right speech environment at home is also of great importance. Parents can get advice from a speech therapist on how to properly communicate with their child and how to help him study. Alalia requires significant efforts for correction, but timely measures will allow the child to adapt to society.
– severe underdevelopment or complete absence of speech caused by organic lesions of the cortical speech centers of the brain that occurred in utero or in the first 3 years of a child’s life. With alalia, there is a late appearance of speech reactions, a poor vocabulary, agrammatism, a violation of the syllabic structure, sound pronunciation and phonemic processes. A child with alalia needs a neurological and speech therapy examination. Psychological, medical and pedagogical effects for alalia include drug therapy, the development of mental functions, lexico-grammatical and phonetic-phonemic processes, and coherent speech.
General information
Alalia is a profound immaturity of speech function, caused by organic damage to the speech areas of the cerebral cortex. With alalia, speech underdevelopment is systemic in nature, that is, there is a violation of all its components - phonetic-phonemic and lexical-grammatical. Unlike aphasia, in which there is a loss of previously present speech, alalia is characterized by an initial absence or sharp limitation of expressive or impressive speech. Thus, alalia is spoken of if organic damage to the speech centers occurred in the prenatal, intranatal or early (up to 3 years) period of the child’s development.
Alalia is diagnosed in approximately 1% of preschool children and 0.6-0.2% of school-age children; Moreover, this speech disorder occurs 2 times more often in boys. Alalia is a clinical diagnosis, which in speech therapy corresponds to the speech conclusion ONR (general speech underdevelopment).
Causes of alalia
The factors leading to alalia are diverse and can act during different periods of early ontogenesis. Thus, in the antenatal period, organic damage to the speech centers of the cerebral cortex can be caused by fetal hypoxia, intrauterine infection (TORCH syndrome), the threat of spontaneous abortion, toxicosis, falls of a pregnant woman with injury to the fetus, chronic somatic diseases of the expectant mother (arterial hypotension or hypertension, heart or pulmonary failure).
The natural outcome of a complicated pregnancy is complications of childbirth and perinatal pathology. Alalia may be a consequence of newborn asphyxia, prematurity, intracranial birth trauma during premature, rapid or prolonged labor, or the use of instrumental obstetric aids.
Among the etiopathogenetic factors of alalia that affect the first years of a child’s life, one should highlight encephalitis, meningitis, head injury, and somatic diseases leading to depletion of the central nervous system (hypotrophy). Some researchers point to a hereditary, family predisposition to alalia. Frequent and prolonged illnesses of children in the first years of life (ARI, pneumonia, endocrinopathies, rickets, etc.), operations under general anesthesia, unfavorable social conditions (pedagogical neglect, hospitalism syndrome, lack of speech contacts) aggravate the leading causes of alalia.
As a rule, the history of children with alalia reveals the participation of not one, but a whole complex of factors leading to minimal brain dysfunction - MMD.
Organic damage to the brain causes a slowdown in the maturation of nerve cells, which remain at the stage of young immature neuroblasts. This is accompanied by a decrease in the excitability of neurons, inertia of the main nervous processes, and functional exhaustion of brain cells. Damages to the cerebral cortex in alalia are mild, but multiple and bilateral, which limits the independent compensatory capabilities of speech development.
Alalia classification
Over many years of studying the problem, many classifications of alalia have been proposed depending on the mechanisms, manifestations and severity of speech underdevelopment. Currently, speech therapy uses the classification of alalia according to V.A. Kovshikov, according to which they distinguish:
- expressive(motor) alalia
- impressive(sensory) alalia
- mixed(sensorimotor or motosensory alalia with a predominance of impaired development of impressive or expressive speech)
The occurrence of the motor form of alalia is based on early organic damage to the cortical part of the speech motor analyzer. In this case, the child does not develop his own speech, but his understanding of someone else’s speech remains intact. Depending on the damaged area, afferent motor and efferent motor alalia are distinguished. With afferent motor alalia, there is damage to the postcentral gyrus (lower parietal parts of the left hemisphere), which is accompanied by kinesthetic articulatory apraxia. Efferent motor alalia occurs with damage to the premotor cortex (Broca's center, the posterior third of the inferior frontal gyrus) and is expressed in kinetic articulatory apraxia.
With sensory alalia, the tasks are to master the distinction between non-speech and speech sounds, the differentiation of words, their correlation with specific objects and actions, the understanding of phrases and speech instructions, and the grammatical structure of speech. As the vocabulary accumulates, subtle acoustic differentiations and phonemic perception are formed, the development of the child’s own speech becomes possible.
Forecast and prevention of alalia
The key to the success of correctional work for alalia is its early (from 3-4 years of age) onset, its complex nature, systemic impact on all components of speech, the formation of speech processes in unity with the development of mental functions. With motor alalia, speech prognosis is more favorable; for sensory and sensorimotor alalia – indeterminate. The prognosis is largely influenced by the degree of organic brain damage. During schooling, children with alalia may develop written speech disorders (dysgraphia and dyslexia).
Prevention of alalia in children includes ensuring conditions for a favorable course of pregnancy and childbirth, and early physical development of the child. Corrective work to overcome alalia helps prevent the occurrence of secondary intellectual disability.
With motor (expressive) alalia, the lack of speech in children is not directly related to motor disorders such as paralysis or pronounced paresis. They have sufficient mobility of the speech organs for speech, but it is often difficult to master motor skills and abilities, including those necessary for articulating sounds. For example, a child who easily licks jam from his upper lip with the tip of his tongue turns out to be unable to lift his tongue up at the request of an adult - it is as if he cannot “find” this movement. He “doesn’t know how” to stick his tongue out of his mouth or even just blow according to instructions.
The main difficulty preventing the mastery of speech is that the child does not develop linguistic operations for generating speech utterances. This is expressed in his “inability” to select the necessary sounds and words to express his thoughts and then correctly (in accordance with the laws of language) combine them into sentences and coherent statements. Understanding the speech of others relatively well, the child turns out to be powerless before mastering the laws of his native language to construct his own speech utterances. At the same time, mentally he behaves quite normally and does not lag behind his peers - the lag concerns only his speech development. However, with a long-term absence of speech, children with alalia subsequently develop a secondary mental retardation caused by their speech inferiority (the inability to ask about something, find out something incomprehensible, etc.), which gradually smoothes out as they master speech.
A very characteristic and slowly disappearing symptom of motor alalia is a violation of the ability to repeat sound speech. In severe cases, the child may not be able to repeat even one vowel sound after an adult, much less a combination of two or three vowels (such as AU or AUI). Moreover, the more complex the structure of a syllable, the later its repetition becomes possible (in particular, this applies to syllables with a combination of consonants). It is very difficult to repeat even well-known words that are already used in a child’s independent speech, and even more so to repeat phrases.
Children with motor alalia not only suffer from speech problems, but also have non-speech disorders - neurological and mental. Let's consider all these types of violations.
- Neurological symptoms manifest themselves in general motor clumsiness, clumsiness in children, lack of coordination of their movements, decreased motor activity, and especially poor development of fine motor skills of the fingers. For a long time, children cannot learn to fasten buttons, lace shoes, cannot master self-care skills, etc. They do not like to participate in outdoor games because they do not know how, for example, to jump on one leg, catch a ball, jump rope, overcome small obstacles, maintain balance, run quickly, etc. Many children are also characterized by awkwardness and some inhibition of the movements of the tongue and lips, and an “inability” to find their desired position. With motor alalia, increased motor activity may also be observed, which is associated with a certain localization of brain damage. In these cases, children are too disinhibited, hyperexcitable, and fussy. Most children with motor alalia are characterized by rapid fatigue and decreased performance.
- Mental symptoms are expressed in disturbances of attention, memory, slowness of thought processes, visual-spatial disorders, and disorders of the emotional-volitional sphere. Thus, children with motor alalia find it difficult to concentrate on a specific activity, they are quickly distracted, constantly move from one type of activity to another, and it is difficult to interest them in anything for a long time. Even when speech has begun to form, they, unlike normally developing peers, cannot remember the simplest poems, the names of the days of the week and months, or learn ordinal counting.
It is also difficult to assimilate ideas about the shape and size of objects and their location in space in relation to each other. The child noticeably lags behind his peers when assembling pyramids (he cannot take into account the size of the rings), composite nesting dolls (one or even several of them often turn out to be “superfluous”), when performing tasks on selecting geometric figures of the same size or shape, etc. Such a lag can be easily noticed even by the parents themselves.
Disorders of the emotional-volitional sphere most often manifest themselves in increased irritability and touchiness of the child, in his tendency to violent reactions and tears, in isolation and reluctance to contact others. This is largely a consequence of speech insufficiency, which does not allow the child to establish normal verbal communication with people and fully adapt to living conditions in a “speech” environment. - Speech symptoms are expressed in a violation of all aspects of speech, as noted above. At the same time, the inferiority of sound pronunciation, vocabulary and grammatical structure of speech with motor alalia has characteristic features.
Thus, despite the full possibility of performing articulatory movements (unlike, for example, dysarthria), sound pronunciation with motor alalia turns out to be grossly impaired. And even after mastering the correct articulations of sounds, the child finds it difficult to use them appropriately in speech - he constantly mixes the already acquired sounds with each other, allowing for their unstable replacements (for example, the word GUSI is pronounced as KUSI, then as TUSI, then as PUTI, etc. .). This extreme instability in the use of even correctly pronounced sounds does not indicate articulatory difficulties, but disorders of a higher level, in particular language difficulties. True, with motor alalia there may also be a dysarthric component in the disturbance of sound pronunciation, associated with paresis of some muscles of the tongue, but this is not the leading one here. Much more difficult to master the correct sound pronunciation is the difficulty of “finding” articulations that are quite accessible to the child and the lack of understanding of where exactly one or another already mastered sound should be used.
The grammatical structure of speech is acquired with great delay and with deviations from the norm. The child does not have the opportunity to formalize his thought grammatically correctly - instead, he ends up with a simple set of almost unrelated words. For example, he says GIRL BROOM instead of a girl sweeping the floor with a broom, NIGA TEL instead of a book lying on the table. As can be seen from these examples, verbs are most often omitted, and significant words are used without any endings, not coherent with each other. Prepositions are omitted or incorrectly used (SOUP PLATES instead of soup in a plate), verbal prefixes (for example, the child does not see the semantic difference between the words WENT, GONE and CAME, and therefore does not choose the most appropriate one when constructing a sentence). All this causes the speech of children with motor alalia to be ungrammatical, that is, it is constructed without taking into account the laws of grammar, which they seem to “not feel.”
It is especially important to note that even after mastering phrasal speech, the agrammatisms of children with alalia differ from the age-related agrammatisms of children with normal speech development. In particular, the case endings of nouns are distorted in an unusual way. For example, if a normally developing child in the early stages of language acquisition replaces endings within one case (says UNDER THE BEDS instead of under the bed, similar to “UNDER THE CLOUD”), then a child with motor alalia mixes endings of different cases (UNDER THE BED instead of under the bed - replacement of the ending instrumental case ending in genitive or dative). All the difficulties noted here are related to the construction of individual sentences. It is quite natural that an even greater difficulty for a child with alalia is combining several sentences into a coherent statement.
Experiencing great difficulties in communicating through speech, children from a very early age begin to widely use gesture to express their requests and desires, and verbal speech can be closely intertwined with gestural speech. For example, when wanting to ask for a comb, a child says the word ABA (head) and at the same time makes the gesture of combing his hair. Of particular importance is the pointing gesture, in which the child points with his index finger at a particular object, thereby wanting to attract the attention of others to it. This indicates his desire to say something, that is, the emerging need for communication. This is a very good sign, since even in normally developing children, the pointing gesture usually precedes the appearance of speech.
The degree of speech difficulties with alalia can vary. It is customary to distinguish 3 levels of speech underdevelopment in children - from the most severe to the easiest:
Level 1 - absence of commonly used speech.
Level 2 - the beginnings of common speech. The child has a certain vocabulary and constructs small sentences from them, but the vocabulary of these words is still small, their sound-syllable structure is distorted and the phrase is agrammatic. Many speech sounds are also pronounced incorrectly.
Level 3 - extensive speech with elements of underdevelopment in the entire speech system. The vocabulary is already quite large, the child speaks not only phrasal, but also connected speech, but words that are complex in structure are pronounced distortedly, there are agrammatisms in speech, and defects in the pronunciation of individual sounds often remain.
The mentioned levels of speech underdevelopment do not have a direct correlation with the age of the child - and at 5-6 years old he may be at the first level of speech underdevelopment.
All violations present in children’s oral speech are subsequently inevitably reflected in reading and especially in writing (letter substitutions corresponding to the sounds being replaced; distortions of the sound-syllable structure of words; agrammatisms). In addition, due to impaired visual-spatial concepts, children have difficulty remembering letter signs and often mix them up, which also makes it difficult to master written language.
Particular attention should be paid to the issue of speech understanding by children with motor alalia. The most superficial look at things leaves the impression that the child “understands everything.” By the way, parents almost always say this. But is this really so?
A child, as a rule, understands only everyday speech and statements that are quite unambiguous and do not require precise knowledge and consideration of the grammatical patterns of the language. Thus, he will understand the request addressed to him to close the door, turn on the light, pour water into a glass, etc., while focusing on the general situation and the semantic meaning of the words. For example, if the door in a room is closed, and for some reason it is suddenly mentioned in a speech, then the child can only open it (there is too little likelihood that he may be asked to wash or paint this door, remove it from its hinges, etc.). For this reason, knowledge of just the word DOOR, which adults in such a situation also often point to with a gesture or glance, completely ensures the child’s understanding of “speech.”
However, if you put two pictures in front of such a child, one of which shows a key, and the other shows keys, then he will not notice any difference in their names and, in response to a request to show the KEY, he can quite calmly show the KEYS. This is explained by the fact that he is able to grasp only the semantic meaning of the word KEY, but that at the same time he is unable to understand its grammatical form (in this case, the role of the ending meaning the plural). The same thing will happen when showing pictures like TABLE - TABLE - the presence of the suffix -IK in the second word will not tell the child anything, and he will not understand the diminutive meaning inherent in this suffix. This is the case with understanding the meanings of grammatical forms even of individual words. The same goes for understanding many phrases. If you ask a child to hand over a book or glasses, he will immediately understand this request and can easily fulfill it. But you just have to offer him to put the glasses ON THE BOOK, UNDER THE BOOK or IN THE BOOK, and complete bewilderment will immediately appear on his face. This means that he does not understand at all the meanings of prepositions, and, consequently, the relationships between objects expressed with their help (the so-called prepositional constructions).
Thus, we can only talk about the relative preservation of speech understanding during motor alalia, since a gross violation of the formation of language systems cannot but affect all aspects of speech, including its understanding.
A number of children with ODD experience a delay in the development of the motor sphere. This manifests itself in the form of poor coordination of complex movements, their lack of accuracy and dexterity, and in the form of pronounced difficulties when performing exercises according to verbal instructions.
Characteristic are some stiffness, lack of ease and grace when performing exercises.
The features of fine motor skills of the fingers also attract attention. Observing how a child fastens and unbuttons buttons, ties and unties ribbons, and shoelaces reveals a lack of finger coordination. In special tests, pronounced slowness, getting stuck in one position, missing individual elements, and other features are clearly revealed.
The named deviations in the motor sphere are most clearly manifested in children with dysarthria (This refers to children in whom dysarthric syndrome is pronounced in the structure of general speech underdevelopment).
A correct assessment of deficiency in the area of motor activity is necessary to identify patterns of abnormal development of children with general speech underdevelopment and to build a system of corrective influences.
It is recommended to include a series of preparatory exercises in correctional work that ensure the formation of hand-eye coordination, as well as the development of fine motor skills of the fingers. At the same time, the child develops the ability to accurately and deftly perform certain movements.
The main tasks of correctional work:
1. Teach children to walk in a certain direction (in a straight line, in a circle) to a given rhythm.
2. Teach children to climb 2-3-4 steps, first with the help of adults, and then on their own.
3. Teach children to walk down the stairs and then with small jumps.
4. Teach children to stand alternately on their right - (left) leg.
5. Teach children to jump on two legs, then on the right and left legs.
6. Teach children to alternately stand up and squat while counting.
7. Teach children to raise their arms up, forward, to the sides, to the waist; stretch your arms forward; put your foot to the side; lower your head down; bending forward to the side, backward; left hand to the shoulder, right hand to the head; put your right foot forward, on your heel, on your toe... Teach children to catch the ball with both hands, with one hand.
9. Teach children to catch the ball after hitting the floor or wall.
10. Teach children to catch the ball after several hits on the floor (hitting the floor with the left and right hands, alternating).
11. Teach children to roll the ball along the valley and hit a given target (goal).
12. Teach children to roll (throw) the ball from one hand to the other.
13. Teach children to pass balls from a short distance in ranks.
14. Teach children to unbutton and fasten buttons on a coat, dress, blouse, panties (then move on to doll clothes).
15. Using ribbons and then a rope, teach children to tie and untie a knot or bow.
16. Teach children to clench and unclench their fists.
17. Teach children to tightly squeeze one hand with the other, shake father’s and mother’s hands.
18. Teach children to alternately bend and straighten the fingers of their right and left hands, and make a lattice of fingers.
19. Teach children to alternately connect the thumb and index, middle, ring, and little fingers.
20. Teach children to rhythmically perform the “palm-fist-palm” movements.
Task 1. (Work with balls.) Several balls are placed on the table in front of the child. A box is placed at some distance from them. The speech therapist shows and explains how to roll the ball so that it hits the box. First, the adult helps the child in completing this task, then gradually limits the help and ensures that the child completes the task independently.
Task 2 (Working with rings.) There is a wooden rod on the table and several rings of the same size. The child is asked to put these rings on the rod one by one. First, the adult explains and shows how to perform these actions.
Task 3. (Working with cubes.) Several cubes of the same size are placed in front of the child. After an explanation and demonstration from a speech therapist, the child must independently place the cubes one on top of the other to form a tower, then a train, a chair, and a house.
Task 4. (Working with wooden toys.) Folding wooden nesting dolls, pyramids, and boxes are laid out on the table. The speech therapist together with the child carefully examines these objects. Then the child is shown how the toy opens, how it can be disassembled, assembled and closed. After explanation and demonstration, the speech therapist invites the child to perform the following actions independently:
a) assemble a pyramid of 5 rings
b) collect 4-5 cubes into one large cube;
c) collect one nesting doll out of 4-5.
Exercise 5. An empty milk bottle is placed on the table, and several balls are placed on both sides of it. The speech therapist takes one ball, which is on the right side of the child, and throws it into the bottle, and then invites the child to do the same. In this case, it is necessary to determine how much control the child has with one and the other hand, how he grasps the ball (equally with the right and left or not), whether he puts all the balls in, whether he scatters a lot, whether there is a pronounced awkwardness of movements.
Motor alalia is a systemic underdevelopment of expressive speech (active oral utterance) of a central organic nature, caused by damage to the speech zones of the cerebral cortex in the prenatal or early period of speech development. This violation is due to the immaturity of linguistic operations in the process of generating speech utterances with the relative preservation of semantic and sensorimotor operations.
Causes of motor alalia:
Birth injuries and asphyxia.
Intrauterine encephalitis and meningitis.
Unfavorable development conditions.
Fetal intoxication.
Congenital burden.
Intrauterine or early lifetime brain injuries.
Diseases of early childhood with burden on the brain.
Motor alalia is not just a temporary delay in speech development. The entire process of speech formation in this disorder takes place under conditions of a pathological state of the central nervous system. Individual manifestations of motor alalia appear outwardly similar to the normal development of a child at an earlier stage.
Motor alalia is a complex syndrome, a complex of speech and non-speech symptoms, the relationships between which are ambiguous. In the structure of speech defects in motor alalia, the leading ones are language disorders.
Symptoms of motor alalia:
Speech:
Children suffering from this form of alalia have sufficient pronunciation capabilities, but they are not able to use them. The disorders are phonemic in nature; the operation of selecting a sound to form a speech utterance is impaired. In the speech of motor alalitics, literal paraphasia (replacement of a sound in a word with another), perseveration (obsessive reproduction of sounds or words), and elision (loss of sounds) abound.
There are also violations of the semantic aspect of speech. These children have significantly more words in their passive vocabulary than they use in active speech. There is a predominance of subject vocabulary, while the verb vocabulary is sharply limited, both the understanding of verbs and the use in speech.
Children replace some words with others that are close in meaning and included in the same associative field with them, for example, instead of the word table they say chair, etc. Contamination can be observed in speech when a child in speech combines syllables belonging to different words into one for example, the word “trashet” means the tractor is plowing.
Violation of the grammatical structure of speech is manifested in incorrect agreement of words in number, gender, case, and tense. Children omit prepositions in their speech. Most motor speakers understand spoken speech at the nominative level (they mostly know the names of objects).
Non-speech:
Severe neurological disorders are observed:
· Oral apraxia (motor disorders of purposeful movements and actions of the facial muscles with a disorder of complex movements of the lips and tongue).
· General motor clumsiness; children with motor alalia have impaired balance.
· Impaired fine motor skills.
· Signs of minimal brain dysfunction.
· pronounced vegetative-vascular changes.
Psychopathological symptoms:
· Speech negativism (reluctance to speak) is very characteristic.
· The mental development of children lags behind the norm to varying degrees.
· Higher mental functions (memory, attention, thinking, etc.) are formed unevenly.
· Local lesions of the cerebral cortex also affect nearby speech areas.
· It is difficult to program one’s actions, and there is a decrease in the arbitrariness of actions.
· Children can be inhibited, but more often they are disinhibited and impulsive.
· Poorly adapt to the conditions that surround them.
· There is a pronounced lack of formation of game actions.
· Children are touchy, withdrawn and often aggressive.
Recently, speech therapists and neurologists have diagnosed motor alalia much more often than it should be. Motor alalia is something like a common diagnosis of acute respiratory viral infections and acute respiratory infections; all non-speaking children are automatically registered as motor alalia, although they are not always such.