CEREBRAL PALSIED CHILDREN

Cerebral palsy is a general term which covers a variety of conditions caused by damage to certain areas in the brain. The most common forms are the spastic, the athetotic, and the ataxic. Speech is disturbed in about 70%of cases of cerebral palsy.

Their speech is labored, slow, the voice is often mono­tonous and relatively uncontrolled, and the articulation suf­fers because of the impaired muscular coordination. Cerebral palsied speech is a problem for the professional speech correctionist, but the classroom teacher plays a vital role in giving him opportunities of the training recommended by the speech correctionist and by other specialists. The treatment of cerebral palsy is a complex problem and the cooperation of a number of specialists is needed: the therapist, the neuro­logist, the pediatrician, the orthopedist, the speech correctionist and others. The majority of cerebral palsied children have several handicaps and therefore they need many kinds of help. They have the motor handicap by which their condition is defined and diagnosed, but they also have sensory difficulties and perceptual impairments. It is difficult for them to adjust to their handicaps and get through school and find a place in the life. Sometimes the child is emotionally unst­able; sometimes he is mentally retarded.

Cerebral palsied children attend a special school or a regular school. Sometimes they require permanent clinic care, some get education at home.

For many cerebral palsied children in overall programme would include the following.

1) Relaxation and voluntary control of the speech muscu­lature.

2) The establishment of breath control for vocalization and articulation.

Such children breathe too deeply or too shallowly for purposes of speech.

For most cerebral palsied children a normal length of phrase is not to be expected. Short, uninterrupted phrasing is a more modest and more possible achievement. For breath control blowing through a straw is helpful.

3) Control of the organs of articulation.

Considerable exercises are needed to establish directed and independent action of the tongue and to overcome the fre­quently present tendency of such a child to move his jaw аs he attempts to move his tongue and lift his tongue independently of his jaw.

Children enjoy such exercises as licking honey from their lips, or reaching for a bit of honey placed on the upper gum ridge.

The child should be shown what he does by observing himself in a mirror.

This muscle training may be carried out by incorporating it into functional work or it may be accomplished in isolation from any useful or meaningful activity.

The speech therapist emphasizes muscle training for ce­rebral palsied person.

4) Work on individual speech sounds.

The sounds most frequently defective are those that re­quire precise tip of the tongue action.

These include: t, d, n, 1, r, s, z. Sound play calling for repetition of the sounds the child can produce, may give the child a feeling of accomplishment. For many children nor­mal articulation may not be expected.

5) Incorporation of sounds in words and phrases.

Many cerebral palsied children have considerable diffi­culty in making the translation from the production individual sounds to connected speech.

Articulation must be coordinated with breathing and vocalization, then children speak better. The speech of the celebral palsied children may be normal when the muscles of the articulatory and respiratory organs are not affected but in general the speech is slow, jerky and laboured.

The rhythm is faulty with unnatural breaks. The consonants, particularly those which require precise articulation are apt to be inaccurate. Language development may be retard­ed.

T E R M S

cerebral palsy церебральный паралич

condition зд. состояние

Damage повреждение

brain мозг

the spastic спастический паралич

the athetotic атетоз /небольшие подёргивания/

the ataxic атаксия /нарушение координации/

impaired coordination нарушенная координация

speech correctionist логопед

neurologist невропатолог

pediatrician педиатр

orthopedist ортопед

sensory difficulties сенсорные нарушения

perceptual impairments нарушения восприятия

emotionally unstable эмоционально неустойчивые

relaxation расслабление, отдых

voluntary control произвольное управление

tongue язык

jaw челюсть

upper gum ridge верхний край десны

translation зд. переход

ТУРЕSOF SPEECH DEFECTS

A speech defect may be defined as any acoustic variation from an accepted speech standard.

Speech defects are the most prevalent of all the handi­caps of childhood. These defects are most numerous in the primary grades and decrease steadily in the senior grades. Boys have speech defects much more frequently than girls.

Speech defects include 1) functional articulatory de­fects; 2) stuttering; 3)voice defects; 4) cleft palate speech; 5) cerebral palsy speech; 6) retarded speech develop­ment and 7) speech defects due to impaired hearing.

Articulatory Defects include 1) the omission of sounds; 2) the substitution of one sound for another; 3) the distortion of sounds; 4) general indistinctness.

Articulatory defects present one of the most important problems of the speech correction programme, for most speech defects are of articulatory type. About three fourth of the speech defects are of articulatory type. About three fourth of the speech defects in a school population are articulatory. But many parents do not feel that articulatory defects are se­rious. Some parents have become so accustomed to their child­ren’s articulatory errors that they do not even hear them. Other parents think that their children will outgrow their articulatory difficulties.

Most children who make articulatory errors make more than one and usually are not consistent in their errors. Thеу maу make a sound correctly in one word and incorrectly in another. Or they may even substitute a sound that they do not ordinari­ly make correctly in one word for another sound. For example, they may say “thun” for “sun”.

This category includes many terms. Perhaps the one which parents use more frequently is “bаbу talk”. When the child omits substitutes or distorts his speech sounds as does a younger child, this term is applicable. In fact, some writers now include articulatory defects under the term “delayed speech” or “retarded speech development”. They indicate that the child reaches a certain level of development but does not progress beyond that certain point.

Other terms commonly included in this category are lisping and lalling. Lisping refers to аny defect of any or all of the four sibilant sounds: s, sh, z, zh. Lalling means difficulty with the “1” and “r” sounds.

T E R M S

speech defect речевой дефект

speech correction (rehabilitation, improvement, reeducation) логопедия

stuttering заикание

cleft palate расщелина твердого нёба

cerebral palsy церебральный паралич

articulatory errors артикуляторные ошибки

the substitution of one sound for another замена одного зву­ка другим

the omission of sounds пропуск звуков

the distortion of sounds искажение звуков

to become accustomed to привыкать к ….

Lisping сигматизм /шепелявость/

retarded speech development задержка речевого развития

delayed speech задержка речи

lalling ламбдацизм

sibilant sounds свистящие и шипящие звуки

general indistinctness общая нечёткость речи

STUTTERING

Stuttering is a disorder of childhood. The incidence of stuttering is highest from the age of six to ten; as the age of puberty is approached, the number of cases of stutter­ing decreases markedly.

More boys than girls stutter.

This fact is certainly significant. This is because boys learn speech more slowly and are more apt to have speech de­fects of all kinds than girls.

Stuttering has certain hereditary aspects. The persistant recurrence of this disorder in certain families is dif­ficult to explain merely on the basis of imitation. The fact that many of the stutterers in those families had little or no contact with stuttering relatives indicated the presence of some biological transmittable factor. Twinning, left-handedness and stuttering are often associated as hereditary factors.

The so-called speech organs of stutterers are structu­rally normal as in non-stutterers.

The stutterer’s articulatory muscles show some slowness. He cannot move his muscles as fast, as continuously, or as independently as a non-stutterer can.

During a stuttering block, a serious disorganization of the integrating centers of the central nervous system takes place. An asymmetrical action of paired muscles оn the two sides of the face appears. Lack of co-ordination of the limbs or eyes осcurs…

It is necessary for parents and teachers to cо-oреrаte with the specialist (speech therapist) in the treatment of stuttering. Irritating factors in the environment should be removed. We have a problem ofpreventing the development of fears and anxiety. The stuttering sраsms usually produce fear and anxiety; they, in turn, result in more serious and complex speech blocks, which ofthemselves create fеаrs. Тhe speech-therapist who examines the cases of stuttering will indicate, of course, the specific mеаsures for the treatment of each case. These specific mеаsures are different. There is no sudden cure, but there is every reason to hope for improvement.

But first of all the specialist should persuade the pa­tient that the first thing which he must understand is he must learn to live with the stuttering. Of course he does not want to stutter, he would prefer not to stutter. How­ever the more he tries to avoid stuttering the more he stutters. When he acquires the objective attitude to his stuttering, the second phase oftherapy maybe begun, name­ly, the process of eliminating the habit of substituting other words for words upon which the stutterer fears he will block. As the speech of the stutterer is rapid, stir­red, indistinct, it is desirable to give the stutterer the opportunity to participate in choral reading and singing. A very important aspect in speech training for the stutte­rer is the acquisition of slow speech of a normal rhythm.

The general principle for speech therapy is this:

a) seek to discover and remove all the possible irritating factors in the child’s environment, b) prevent the develop­ment of fear and anxiety about his speech, c) promote the growth of personality and social adjustment. Since stutter­ing is a disorder of childhood, it is more than probable that as the processes of normal maturation take рlace the symptoms of stuttering will gradually disappear, if a good therapy is applied in treatment of such stuttering children. There is not one simple procedure for treatment, they are many. The speech therapist must have some information about the child: 1) Does he stutter every time he talks or is it spasmodic? 2) Is it getting worse? 3) Does it appear in his speech when he is on the playground, as well as in the classroom? 4) Is there any relationship between appearance of the stuttering and his apparent physical condition, emo­tional state, persons with whom he talks, topics of conver­sation, time of day, attitude of the teacher?

This information is important to choose the most effective procedures for the treatment of stuttering …..

T E R M S

eliminate устранять

stirred возбужденная

stuttering заикание

puberty половая зрелость

hereditary наследственный

recurrence возвращение, повторение

twinning рождение близнецов

left handedness леворукость

stuttering block спазм заикания

integrating centers центры обобщения

paired muscles парные мышцы

cure, treatment лечение

irritating factors раздражающие факторы

to prolong vowels растягивать гласные

spasmodic судорожный

physical condition физическое состояние

emotional state эмоциональное состояние

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