RU2497555C1 - Method for stammering correction - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly defectology. The patient is contacted and prepared for overcoming a speech disorder by dropping off the patient into total silence; diaphragm and costal respiration and verbal voice are trained. The physiotherapeutic measures are taken: A.N.Strelnikova's respiratory exercises, speech muscle massage, and autotraining with getting into a normally speaking character. Phrasal speech and reading aloud are trained. That is followed by social adaptation. That involves G.N.Sytin's autotraining, physical exercises for attention and will concentration; and normal speech formation attitudes are repeated silently. Before and between the respiratory and physical exercises, 8 drops of raw warm water with added 3 drops of 62% liquid stevia extract in 200 ml of water and 0.05-0.10 g of dietary salt on the tongue. Tobacco smoking and alcohol consumption are prevented and withdrawn. A diary is kept. The verbal voice is trained. The phrasal speech is developed with using an auditory-speed wave guide.

EFFECT: method extends the range of products for stammering correction.

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Description

FIELD OF TECHNOLOGY.

The invention relates to the field of meeting the vital needs of a person, medicine, human hygiene as a system of maintaining health, namely, accelerated rehabilitation of patients with speech disorders with stuttering and stuttering disorders of neurotic origin, suffering from speech breathing disorders, with hearing pathology and in mastering rhetoric skills to improve speech culture among public professions.

RELEVANCE AND LEVEL OF TECHNOLOGY.

The most important means of transmitting information in human communication is speaking and writing - the language that shapes society and the person himself, his thinking, understanding of reality and himself in it. A verbal language based on letters, words, and speech distinguishes a person from other living beings. Human language is addressed primarily to hearing and is designed for multi-stage comprehension. In the language there are three main levels: sound, verbal and sentence level. Language provides a person with the most important functions: a means of communication, modeling of reality by naming it, describing and cognizing the external world, addressing the person’s inner world, creativity aimed at instilling an interlocutor with an incentive role, poetic, as it is reported, for addressing, describing oneself. A man through language joins culture, his family, people, homeland, masters the outside world in words and turns into a repository of knowledge and cultural values, the history of language is the history of the people [1. Series "Scrabble". Language and folklore. - M .: LLC TD Publishing House World of Books, 2007. - 192 p., P.6-9]. Language is a necessary condition for the formation of higher mental functions of man. Any deviations, violations in the development of the child affect his interaction with the outside world, the formation of language and speech, his socialization. Speech occupies a key place in the system of higher mental functions and is the main mechanism of thinking, conscious activity. Out of speech, the formation of personality is impossible [2. Kalyagin V.A., Ovchinnikova T.S. Logopsychology: textbook. allowance for students. higher textbook. institutions. - M.: Publ. Center "Academy", 2007. - 320 p., p. 18].

In psychology, distinguish between external and internal forms of speech. External speech includes oral (dialogic and monological) and written forms. Written speech is a graphically designed speech, organized on the basis of letter-image signs, based on in-depth skills in sound-letter analysis and the ability to logically and grammatically correctly convey your thoughts, analyze written and improve the form of expression. The full mastery of writing and written speech is determined by the level of development of oral speech, with speech underdevelopment, as a rule, there are violations of writing of varying severity. Internal speech (speech "to oneself") is soundless speech, occurs when a person thinks about something and makes plans, is formed in the child on the basis of external and is the main mechanism of thinking. In the development of speech, the child masters three aspects of the gradual mastery of the language: the development of phonemic hearing and the formation of pronunciation skills of phonemes of the native language, the mastery of the vocabulary and syntax rules, the mastery of the semantic side of speech. In the mental development of a child, speech is of tremendous importance and performs three main functions: communicative, generalizing, and regulating. Deviations in the development of speech are reflected in the formation of the entire mental life of a person. Speech is one of the complex higher mental functions of man and is carried out by a complex system of organs with the main, leading activity of the brain, the most perfect form of communication inherent only to man is carried out through language. Language is a system of phonetic, lexical and grammatical means of communication. The speaker is motivated, selects words to express thoughts, connects them according to the rules of the grammar of the language, and pronounces them by articulating the speech organs as a result of the coordinated action of the mechanism for making a speech using the speech apparatus. The speech apparatus provides speech production and consists of a central (regulatory) and peripheral (executive) parts. Speech, stuttering, like other manifestations of higher nervous activity, develops on the basis of reflexes and speech reflexes are associated with the activity of various parts of the brain. The cerebral cortex is connected with peripheral organs of speech by conducting nerve pathways. All organs of the peripheral vocal apparatus are innervated (provided by nerve fibers) by the main cranial nerves: the trigeminal, facial, glossopharyngeal and vagus nerves, the additional nerve for the muscles of the neck, the hyoid nerve to supply the muscles of the tongue with motor nerves and inform him of the possibility of various movements. The peripheral speech apparatus consists of the respiratory, voice, articulatory (sound producing) departments. The respiratory section includes the chest with lungs, bronchi and trachea, the diaphragm, intercostal muscles, supplies air and is closely related to the pronunciation of speech in the exhalation phase, performs the main function of the gas exchange of the body. The voice section consists of the larynx with the vocal folds located in it and serves to form the voice. The operation of the mechanism of voice formation: under the pressure of a jet of exhaled air when the vocal folds are closed and opened, their vibrations occur, causing vibrations of air particles above the vocal folds, sound waves propagating in the environment and perceived as sounds of a voice that differs in strength, pitch and timbre. The articulation department includes the main organs: tongue, lips, upper and lower jaws, hard and soft palate, alveoli in the palate, small tongue, oral cavity and nasal cavity. The main organ of articulation is the language involved in the formation of all vowels and almost all consonants except labial. Articulation is the work of the organs of speech in the pronunciation of sounds and consists in the formation by the listed organs of a resonator, a gap or a bow when the tongue approaches or touches the sky, alveoli, teeth, when lips are compressed or pressed to the teeth, movements of the soft palate and small tongue. The loudness, coloring and distinctiveness of the characteristic sounds of speech is created by the active organs of the articulation apparatus by the resonator of the extension tube, including the organs located above the larynx: pharynx, oral cavity or nasal cavity. The extension tube due to its structure can vary in volume and shape, causing changes in the resonant frequency and specific speech timbre of sounds. Sound is formed in the larynx and in the resonators (pharyngeal, oral, nasal). The oral cavity and pharynx are involved in the pronunciation of all sounds of the Russian language. In a person with the correct pronunciation, the nasal resonator is involved only in the pronunciation of the sounds "m" and "n" and their soft variants. When pronouncing the remaining sounds, the palatine curtain formed by the soft palate and small tongue closes the entrance to the nasal cavity. For proper speech production, the body implements control through feedback from sensors of sensation of position, movement, pressure in the speech organs and sound, a person notices an error and corrects, corrects articulation. A feedback system forms a second signaling system and provides automatic regulation of the functioning of the organs of speech. Speech is correctly formed when the developing second signaling system is supported by impulses of the first signaling system, which reflects real reality through the senses. For the development and production of speech, hearing is important, which acquires a special property in the development process to accurately distinguish the sounds of human speech. Vision allows the sighted person to observe the movements of the tongue and lips of the speakers and repeat them, well imitate the articulation movements of the lips and hands [3. Filicheva T.B., Cheveleva N.A., Chirkina G.V. The basics of speech therapy: Textbook. allowance for students. ped in-to special "Pedagogy and Psychology (preschool.)." - M .: Education, 1989. - 223 p., S. 4-22]. Man is a complex system and its work depends on the weakest link, including speech production. All bodies involved in the formation of speech sounds should work correctly and in concert. Painful conditions of certain organs of the speech apparatus can cause speech disorders. It is necessary to treat a person, not a disease.

Stuttering (logoneurosis) is a disease, the most severe and common defect in the absence of healthy speech skills, and is manifested as a violation of the tempo-rhythmic organization of speech caused by the convulsive state of the muscles of the speech organs. In many cases, the mechanism of stuttering is interpreted as complex neurotic (the most frequent, develops according to the mechanisms of speech neurosis), neurosis-like (associated with organic brain damage) and functional communication disorder, a bad habit acquired as a result of a violation of the interaction of speech organs and the rate of speech movements recorded the reflex of incorrect speech, which initially arose as a result of speech difficulties of various origins, or the disharmonious development of personality [4. Speech Therapy: Textbook for students. defectol. Fak. ped Universities / Ed. Volkova L.S., Shakhovskoy S.N. - M .: Humanity. ed. VLADOS Center, 1998. - 680 p., p. 252-330; 5. Shevtsova E.E. Psychological and pedagogical diagnosis and correction of stuttering. - M.: Publisher: V.Sekachev, Trading house of the Institute of Fine Arts, 2009. - 272 p., P.21]. Stuttering is the result of a spasm in one or more speech organs, while there are no pathological changes in the central and peripheral parts of the speech apparatus, however, the speech control system does not work in coordination with the executive organs. There are many causes, forms and degrees of stuttering. A significant part of the population suffers from stuttering: stuttering often occurs at a young age, when speech automatisms are not fully developed (up to 4%), more common in boys and left-handed people, can disappear with age, but some children remain for life, about 1% adults stutter. Stuttering causes suffering for stuttering children with their parents, adults, relatives and others.

Often stuttering is a link in the chain of bad habits tobacco - alcohol - drugs that contribute to stuttering and return after treatment. In the forms of stuttering: nervous, respiratory, constitutional, determined by temperament, stuttering is distinguished, the psychic basis of which is informational and physiological dependence due to habit. After the start of stuttering, if you do not take measures to get rid of it, addiction occurs, stuttering becomes automatism, manifests itself as a conditioned reflex and disease. Only a small part - one of the hundreds of thousands who want to completely stop stuttering on their own. Sikorsky I.A. it was possible to cure stuttering in only 60% of patients and to achieve improvement in 20%, statistics from several researchers give stutter non-cure in 20% [5. S.20-21]. A significant number of methods (and techniques) for treating stuttering are known in the world, about 40 of them are used in practice. However, none of them is universal. The stuttering problem is acute. Stuttering therapy is a necessary part of a healthy society.

It is known that stuttering treatment methods have a huge effect, which are based on the rhythm externally set by the device during chanting, reading and retelling of the read text, metric pronunciation of words and chanting, speech synchronization using the movement of the fingers of the leading hand in the process of speaking. Rigid hardware visual, auditory feedback does not take into account possible violations of the generation and reproduction of speech temporhythms that insufficiently restore speech, and the externally set rhythm is fixed as intrusive at the psychological level.

A known method of recovery in speech disorders of various origins [6. Patent RU 2242954, cl. 7 A61F 5/58, publ. 12/27/2004], which consists in influencing the patient’s own speech with individually selected light and sound pulses and synchronizing it through these pulses. At the same time, sound pulses are additionally supplied with the possibility of their tactile perception, moreover, the rhythm of light and sound pulses is set within 40-200 bits per minute and visually controlled by a floating and / or running line of the pendulum light signal, the duration of each pulse is selected in the interval 0, 2-1 s, the sound volume is in the range from 0 to 60 dB, the range of the sound pulse is 438-445 Hz. This method provides a comprehensive effect on several analyzers, the possibility of independent studies and dynamic self-monitoring of their results, however, additional operations using complex equipment are required, which in the absence of physiotherapeutic recreational measures can increase the duration of treatment and reduce its effectiveness.

A known method of eliminating the neurotic form of stuttering [7. Patent RU 2336911, cl. A61M 21/00, publ. October 27, 2008], including conducting speech training, during which pronounce command phrases by repeating them repeatedly. At the same time, command phrases are pronounced on a scream for 2-20 minutes at the maximum possible volume, clearly and measuredly, while the sound comes from the diaphragm, command phrases are pronounced until the vocal apparatus is physically unable to play phrases also loudly, clearly and distinctly, after which the pronunciation of command phrases on the scream is stopped and they begin to pronounce the same phrases in a voice with normal volume, after 2-3 minutes they again begin to pronounce the command phrases on the scream with maximum volume, clearly, distinctly measuredly and further alternate the utterance of command phrases on screaming and with a voice with normal volume, speech training is performed from 30 minutes to 1.5 hours for one speech training daily or every other day for several months until the stutter can utter the command phrases in shouting at the maximum possible volume, clearly, distinctly and measuredly for 15-20 minutes in a row, while the voice should sound clear and loud, and the total number of speech training individually. This method is simple to implement, does not require hardware. The disadvantage of this method is the lack of self-control, flexible feedback, the significant duration and complexity of the treatment, which in the absence of physiotherapeutic wellness measures can increase the duration of treatment and reduce its effectiveness.

Closest to the claimed is a method of exemption from stuttering [8. Patent RU 2199352, cl. 7 A61M 21/00, A61H 1/00, A61H 7/00, publ. 02/27/2003], adopted as a prototype and including group and individual treatment sessions using suggestive exposure and speech therapy training methods. Conduct 11-12 group sessions daily for 3-5 hours, with individual work with the patient being carried out before and after 1.5-2.0 hours; at the first session, contact is made and tuned to overcome the disorder, entered into a trance state and immersed in complete silence for four days, during which, using speech therapy methods, they teach diaphragmatic-rib breathing and speech voice, physiotherapeutic measures are carried out: respiratory gymnastics according to Strelnikova A.N, massage of the muscles involved in the process of speech production, carry out a psychotherapeutic effect in the form of auto-training, with which the patient is accustomed to the image normally man used to say; at the 5-6 session, the patient continues to remain silent, excluding group classes, during which training in articulation and phrasal speech is added to speech therapy methods; at the end of the seventh session, the patient is taken out of silence and during the next 7-12 sessions they consolidate the acquired skills, develop phrasal speech and reading aloud, and carry out social adaptation.

The disadvantage of the prototype is the use of suggestive effects, the complexity of the treatment process and its reproducibility, the dependence of the result on the individual qualities of the host, the exclusion of the patient’s conscious participation from the treatment process, the lack of self-healing measures, which can reduce the frequency and reliability of relieving stuttering.

SUMMARY OF THE INVENTION

The objectives of the invention are to alleviate the severity of stuttering and complete release from it, strengthen the speech apparatus, significantly improve speech and rehabilitation of persons suffering from neurotic stuttering, without the use of suggestive effects.

To solve these problems, the proposed "Method for correcting stuttering."

The present invention allows to obtain the following technical result: reducing the amount of harm to the body during correction of stuttering, increasing the frequency and reliability of complete weaning from stuttering as a bad habit, rapid self-healing, restoration of personal internal hygiene, getting rid of functional disorders associated with stuttering.

This result is achieved in that the stuttering correction method provides for a course of 10-11 two-hour group sessions daily, before and after each session for 1.0-1.5 hours, individual work with the patient is carried out, and from the second to fifth session the patient is transferred to the full mode silence, auto-training is carried out according to the method of Sytin G.N., they additionally perform physical exercises to concentrate attention and will, while simultaneously pronouncing “silently” attitudes to the formation of normal speech skills, before and in between flax-motor exercises take 8 sips of raw warm water with the addition of 3 drops of 62% liquid Stevia extract in 200 ml of water and 0.05-0.10 g of salt in the tongue, while conducting psychological and physiotherapeutic measures to prevent and get rid of smoking and alcohol consumption, write an evening diary of stutter correction; achieve deep concentration of the patient and clarification in the consciousness of the problem of the formation of normal speech; in silent mode, they work out a voice voice on exhalation without articulation, they teach the use of a speech-auditory waveguide with a ratio of output to ear to input from the mouth of the diameters equal to 1.618, from the sixth session, the patient is taken out of silence and practiced and strengthened with working with the oral and nasal resonators with training the soft palate and small tongue, develop phrasal speech and reading aloud using a speech-auditory waveguide; carry out social adaptation; for up to three months, they carry out remote monitoring and emergency care for the patient.

The applicant does not know how to correct stuttering with the specified set of essential features and the claimed set of essential features does not follow explicitly from the current level of technology, which confirms the compliance of the claimed invention with the criteria of "novelty" and "inventive step".

DESCRIPTION OF DRAWINGS.

The invention is illustrated in the drawing, which shows a speech-auditory waveguide - a device for endore speech stuttering therapy (PERTZ), a side view in the plane of the bend.

DETAILED DESCRIPTION OF THE INVENTION

The method is implemented by conducting a course on getting rid of stuttering. From those who want to get rid of stuttering, a group of up to 10 patients is formed with their relatives and one two-hour group lesson is held with them daily for 10-11 days, while individual work is carried out with them before and after 1.0-1.5 hours every patient. To solve this problem, you only need to take a course of classes once. Group work is a priority and contributes to the positive mutual influence of the achievements of each student on other members of the group, creating an atmosphere of cooperation and social adaptation. Collaboration with relatives ensures individual repetition and development of group work material, consolidation of positive dynamics in getting rid of stuttering and the basis for a new life without stuttering. Stuttering as a disease is a way of life in which harmony between the internal state and external factors is violated, while self-discipline, self-regulation and self-medication fail [9. Neumyvakin I.P., Neumyvakina L.S. Endoecology of health. SPb .: Publ. "Dilya", 2003. - 544 p., Pp. 11-23]. At the heart of any form of stuttering is a violation of metabolic processes in the nervous system, these disorders are of an electrical nature and, as a result, a biochemical nature, leading to dehydration and suffocation of cells, organs and systems of the body, and it is necessary to treat a person, not a disease. We are building a new comprehensive method for eliminating stuttering on the basis of: understanding the physical principles and electromagnetic nature of breathing and speech production, eliminating choking, dehydration, and metabolic disorders in the nervous system and speech production organs and systems using speech therapy methods, a speech-auditory waveguide, and herbal medicine respiratory and physical exercises, massage and psychotherapeutic attitudes at the same time, deep concentration of the patient and clarification in the consciousness of the problem of the formation of normal oh speech. Water, air, stevia and salt, exercises, massage, a mental attitude, a speech-auditory waveguide - there is a complex to get rid of stuttering of various shapes. The course of getting rid of stuttering is based on the principles: a voluntary desire to give up stuttering as a bad habit, concentrating one's own volitional efforts to get rid of stuttering and developing conditioned reflex skills in healthy speech, self-organization and self-control, an individual approach, an integrated systematic approach taking into account a multi-factor model interactions of the patient with the external environment and individual organs and systems inside his body, without medication and suggestive effects. The whole process of stutter correction is divided into three stages: the first - preparatory (1-4 days), accelerated elimination of vicious speech disorder-habits, training and recovery; the second (5-10 days) is the main stage in the formation of normal speech skills without stuttering when exposed to factors that cause relapse; the third - social adaptation to new conditions of a healthy lifestyle without stuttering and remote tracking.

The stuttering lesson course is conducted in the form of seminar group classes and mandatory individual independent work of patients, using the latest scientific discoveries in the field of biomechanics of the body’s transport systems, hydrodynamics and gas exchange in the human body. Each lesson consists of four parts: group theoretical and practical, individual independent work, planning and checking homework and evening diaries of each patient.

The proposed method for correcting stuttering does not replace medical care, is based on self-regulation and therefore has no age (the lower age limit of 6-7 years when correcting stuttering in this way is determined by the time 1-3 years of stable stuttering after speaking) and gender restrictions, takes into account different degree of stuttering, different ages, heterosexuality, individual characteristics of the patient’s body, possible nicotination, alcoholization, excess weight, different rates of patients' progress. If the patient or his relatives have several addictions (alcohol, tobacco, food), it is recommended first to release from tobacco and alcohol addictions.

FIRST STEP. First day: in a group lesson, they introduce each other, diagnose the state and severity of stuttering in various speech forms of the patient, state the objectives of the course and briefly how to achieve them in comparison with other known methods, introduce them to the psychological and physiological methods of acquiring healthy speech skills, and give positive examples complete cessation of stuttering on the basis of diaries of patients previously freed from stuttering or their speeches, positive statistics on getting rid of stuttering according to the proposed c person, show practical methods of preparing for the complete cessation of stuttering, teach respiratory and physical exercises, practical methods of self-hypnosis to get rid of stuttering, give each patient a personal diary of stutter correction with questions, a speech memo and a task for individual independent work, set up to overcome speech disorder and immersed in complete silence for four days.

Diagnosis of the patient’s condition is carried out first at an individual interview with the patient and parents (they fill out the patient’s questionnaire with their signatures, the questionnaire is handed over to the presenter on the first day of classes), and then in the presence of the whole group the patient demonstrates independent speech, reading aloud; examine the severity of stuttering, classify the patient’s condition and classify his speech seizures to a specific type, form and degree, identify the entire set of symptoms (the presence of concomitant movements, motor, speech, psychological tricks); determine the overall level of speech development (sound pronunciation, vocabulary, grammatical structure); find out the measures taken earlier to overcome stuttering and their results (experience of communication with speech therapists, neuropathologists, a thorough diagnosis). The purpose of the classes is to find a beautiful, calm and smooth, normal speech, to achieve which during the diagnosis all additional directions of work are determined. The initial state of the patient is fixed in order to compare with the achieved result at the end of classes. The main goal of the initial acquaintance and diagnosis is to establish contact with the patient and parents, and set them up for serious work. Acquaintance and diagnosis is the immediate beginning of work to get rid of stuttering. In the classroom, patients are considered as strong and strong-willed individuals who have all the opportunities to cope with this functional disorder on their own. They inform about psychology, physiology and metabolic processes, about stuttering, which is understood as a functional disorder of the speech mechanism, impaired speech skills - “speech scrapping”, which you need to get rid of and learn to speak correctly and beautifully. The operation to get rid of the “speech scrape” is performed on the first day: they carry out a psychotherapeutic attitude - patient auto-training according to the method of G. N. Sytin the acquisition of calm and smooth speech skills, the normalization of metabolic processes in the body [10. Sytin G.N. Life-giving power. Help yourself. - M .: Energoatomizdat, 1991. - 416 p., Pp. 187-194], through which the patient is relieved of stuttering through medical suggestion, during the mood of each patient they are immersed in silence, which is a “speech plaster” imposed on articulatory -voice apparatus for speech production. They fix the information received and the rejection of verbal communication in any form.

Patients are given the task to gain a foothold in a new state with the help of individual work carried out for 1.0-1.5 hours before and after classes daily, and auto-training, get used to the image of a normally speaking and healthy person, develop their own speech mechanism and accelerate self-healing with respiratory gymnastics Strelnikova A.N. in the evening [11. Semenova N.A. Man is the salt of the Earth. - St. Petersburg: "Dily Publishing", 2007. - 448 p., Pp. 102-106], self-massage of the muscles involved in the process of speech production (smoothing, rubbing, vibration movements), hands and fingers, feet and toes, perform morning exercise [9. S.473-495; 11. S.145-179] on the concentration of attention, the will to suppress fears and to harmonize the work of the nervous, circulatory, respiratory and musculoskeletal systems with the simultaneous pronunciation of "silently" internal speech settings for the formation of healthy speech skills.

At the same time, before and in between breathing-motor exercises for accelerated recovery in the process of getting rid of stuttering, patients are advised to take 8 sips of raw warm water [12. Batmanghelidzh F. Water for health. - Mn .: "Potpourri", 2006, p.497-514] with the addition of three drops of 62% liquid Stevia extract in 200 ml of water and with the intake of grains 0.05-0.10 g of sea food salt per tongue. The leaves of the herb of the Stevia family of the Asteraceae family contain components that provide its unique therapeutic and prophylactic properties: stevioside (300 times sweeter than sugar and free of calories), essential oils, zinc and chromium, vitamins B1, B2, C, β-carotene (provitamin A) , P, PP, amino acids. Stevia is a natural powerful antiseptic and antibacterial, prophylactic agent that rejuvenates the entire body and prolongs human life. The addition of stevia helps to treat nervous diseases, liver, diabetes, kidneys, stimulates the gastrointestinal tract, cardiovascular system, microcirculation and blood pressure, the functioning of the genital organs, increases the body's defenses and sexual abilities [13. Korodetsky A.V. Stevia is a step into immortality. - St. Petersburg: Peter, 2005. - 96 p., P. 38-92]. Stevia is used as a means of self-healing, which has a very positive effect on the treatment of acquired functional disorders: digestive and cardiovascular systems, musculoskeletal system, cough, bronchitis, and as a substitute for sugar for weight loss, enhancing immunity, and the fight against diabetes and parasites. Reception of sea salt contributes to the restoration of water-salt metabolism and trace elements in the body. Performing exercises and taking water with stevia and salt enhances metabolic processes at the cellular level, in the brain and in the organs of speech production, the removal of toxins and toxins from the body, is introduced into the patients' task for individual independent work as an effective means of self-healing of the body with accelerated elimination of stuttering.

Also, the patient is given the task, in a personal diary of stuttering correction with questions, give written answers on separate sheets before going to bed with an analysis of the entire current speech situation over the past day. The diary written last evening is delivered the next day by the patient for verification. Autotraining text obtained at the seminars, information and homework for independent work are recorded in the patient's workbook. The speech memo outlines the rules for pronouncing syllables, words and sentences, performing breathing gymnastics exercises, training speech breathing and voice, speech production, patients are given the task to study its sections that correspond to the topics of current classes.

Parents are given the task to periodically “interrogate” their child patients, while the child must keep the answer with an internal speech “to himself” in his head and be silent for a long time. Communication is possible only in writing, to exclude gesticulation and the making of inarticulate sounds (lowing) to avoid acquiring new negative habits.

Second day. The lesson adjusts the speech mechanism, “restores” the tongue, smooths, relaxes the muscles, removes muscle clamps, studies in breathing physics, psychology, physiology and metabolic processes.

The basic material of the first day is repeated, an analysis of individual homework is performed. Inspect the state of the articulatory organs, check the respiratory and vocal apparatus of each patient in the presence of the group and with the participation of the parents. They begin with an examination of the language, it can be in an unnatural - “dislocated” state (in 60%), and requires putting it in place, “setting up”. Patients are prepared for this, this condition is explained as a muscle clamp, which appears due to overstrain as a result of severe stress. During a speech act, the entire speech mechanism should be in a “lazy" state, through conviction a relaxed state of the lower jaw is achieved, through an additional set of exercises the undeveloped mandibular joint, speaking with an almost closed mouth, tense lips, clamps of the muscles of the neck, shoulder girdle are eliminated. They give recommendations on the correction of speech production organs, which must be strictly followed in the process of further group and individual lessons. They inform about the need to use the so-called large speech path, when the abdomen, chest, throat, vocal cords, tongue, oral and nasal resonators, controlled by the speech centers of the cerebral cortex, participate in the formation of words and sentences. They explain the mechanisms and physics of the work of the respiratory organs associated with the electrification and water exchange in the body, teach methods to achieve a state of deep concentration and clarify in the mind the problems of forming healthy speech by mastering knowledge of psychology, physiology and metabolic processes and writing evening diaries of stuttering correction. Only during normal operation of all organs will speech be clear, beautiful, voluminous. In the process of informing patients, a feeling of calm and self-confidence is evoked, which is fixed in the process of auto-training according to the method of Sytin G.N., patients are tuned for speech breathing, calm and smooth speech, normalization of metabolic processes in the body.

In the course of classes, when analyzing diaries, they control and adjust homework, the strength of silence and breakdowns in it, changes in the number of breaks in silence per day, the degree of concentration and clarification in the mind of the problem of metabolic processes in speech production systems, on an independent decision to completely stop stuttering and the desire to make willpower, performing auto-training to acquire the skills of calm and smooth speech and self-healing activities.

Also, in the second and subsequent classes for patients who abuse tobacco and alcohol, parents, relatives, psychological and physiotherapeutic measures are taken to prevent and eliminate smoking and alcohol consumption that violate speech production [14. Patent RU 2360708 "Method of exemption from tobacco abuse", publ. 07/10/2009. Bull. No. 19], [15. Patent RU 2469749 "Method of exemption from alcohol abuse", publ. 12/20/2012. Bull. No. 35].

The task for independent work includes: breathing exercises and physical exercises with pronunciation “to oneself” of attitudes to the formation of normal speech skills, massage, taking water with stevia and salt, writing an evening diary of stutter correction, and maintaining silence.

The third day. The lesson conducts the development of speech breathing, voice training.

Summarize the first two days. They inform about the device of the respiratory, voice-forming apparatus and familiarize themselves with the mechanisms of diaphragmatic-rib breathing, voice production with recording in personal notebooks of patients. Individually with each patient, in the presence of the entire group and parents, speech breathing (diaphragmatic-costal) is developed. Often, patients have the so-called clavicular breathing, in which inhalation is performed in the upper parts of the lungs, the clavicles rise, and an obstruction of the free air flow is created, and speech formation is possible only on exhalation in the presence of a strong jet of exhaled air. To correct such breathing, practical breathing techniques are shown and practiced. In breaks, the organs of speech breathing are trained on their own. In the process of auto-training, the formation of this skill is continued, patients are tuned for speech breathing, calm and smooth speech, normalization of metabolic processes in the body.

They write down a task for independent work: warming up the speech mechanism through respiratory gymnastics and physical exercises with pronunciation “to oneself” of attitudes to the formation of normal speech skills, massage, water intake with stevia and salt, training of speech breathing, answers to parents' questions only with speech breathing (think , imagine the answer in your head, speak it to yourself, then through the open mouth and nose, take a short deep breath into the lower part of the lungs and prolonged exhalation), write the evening diary Kania, maintaining silence.

Fourth day. The lesson conducts the development of a speech voice, teaching the device and operation of the voice and articulation apparatus, its use for speech production and getting rid of stuttering.

The voice of speech is the basis of clear, distinct, stereo speech. In the classroom, along with speech therapy methods for stuttering correction, they teach stage speech techniques according to Stanislavsky KS system to produce beautiful speech. Often, parents and relatives of patients also need to set up a voice voice so that they do not provoke their children in the future with an unclear confused speech. Repeat the information received, warm up the speech apparatus using gymnastics, self-massage, intensive speech breathing, informing the device of the voice and articulation, sound-producing apparatus, the main positions are fixed by patients in their notebooks, the presenter demonstrates the possibilities of the vocal cords and articulatory organs: the primary sound of the voice, vibration only vocal cords, weak and unpleasant by ear; voice reinforced separately by nasal, oral, and thoracic resonators, monotonous sound, ugly; speech voice, when the entire vocal apparatus sounds and the primary sound of the voice is amplified by all resonators and acquires strength, pitch, individual coloring - timbre, intonation, sounds higher-lower, free and beautiful.

Members of the group are introduced to the views of the great theatrical figure Stanislavsky K. on the meaning of the speech voice for beautiful speech. Then, during the training, everyone tries their own voice voice - takes a deep speech breath, makes them vocal cords sound when exhaling, amplifying this sound with the help of the oral, nasal and chest cavities. During the break, patients are required to remain silent. After the rest, they begin to master their speech voice in full, the work is carried out individually with each patient, if necessary, with the parent, in the presence of the whole group. They start with speech breathing, then adjust the speech voice, rediscover its capabilities, achieve a beautiful and free sound. When this is achieved, the patient repeats the same, standing in front of the group, listens to his voice and feels how freely it flows and sounds beautifully. With individual patients, additional work is carried out on resuscitation of the vocal apparatus in the presence of the so-called “nasal voice”, when the entire stream of exhaled air is routinely passed through the nose; or if there is a creaky sound of the voice only vocal cords. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice without stuttering, and normalization of metabolic processes in the body.

They write down a task for independent work: to perform a warm-up of the speech mechanism, train speech breathing, voice voice, answer the questions of parents, respiratory gymnastics and physical exercises with pronunciation with different intonation with pronunciation “silently” of attitudes to the formation of normal speech skills, massage, water intake from stevia and salt, writing an evening diary of stutter correction, maintaining silence.

SECOND PHASE. Fifth day. In the lesson, they prepare and withdraw from silence, first try a voice without and then connect an articulation apparatus, try a new, beautiful speech, learn how to use a speech-auditory waveguide to accelerate the elimination of stuttering.

Practice practical techniques for the formation of new speech skills. Patients begin to speak, at first very slow and simple words, and then - everything is more complicated. At the beginning of the lesson, continuation of information about the structure and operation of the articulation apparatus is given for recording, due to which speech sounds are formed, giving it articulation. The patient, under the control of the facilitator, demonstrates speech breathing, makes a speech voice of various strengths, composes words and sentences from the voice, makes a new speech, says the dear word “Mom!”, Two or three more phrases, the facilitator asks simple questions and allows the patient to hear his new speech. After a break, patients in the process of auto-training are fixed in a new speech, leaving the opportunity to use only a voice voice. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and speech without stuttering, normalization of metabolic processes in the body.

Show practical methods of achieving accelerated elimination of stuttering by applying the proposed speech-auditory waveguide. In [16. Bagaev S.N., Zakharov V.N., Orlov V.A. Physical mechanisms of transport systems of a living organism. - Novosibirsk, SB RAS, Institute of Laser Physics, 1999. - 52 p .; 17. Zakharov V.N., Orlov V.A. Scientific discoveries in physiology and medicine. Annotation. Swirling flow of biological media in the transport systems of a living organism. - Novosibirsk, SB RAS, Institute of Laser Physics, 2006, - 50 p., Pp. 1-11] when studying the biomechanics of the circulatory, respiratory, digestive and urinary systems, the general physical mechanism of rotational-translational movement of biological media in transport channels and the property of swirling flow to create traction in funnel-shaped channels, as a result of self-organization and self-sufficiency of living systems, which, thanks to a long evolution, made it possible to create transport systems based on general laws in force in Nature manifested in optimal functioning. This is the basis of the inventive method for implementing the patient’s auditory biological feedback — the proposed auditory-waveguide, performed with a ratio of output to ear to input from the mouth of diameters equal to 1.618, which provides transmission, amplification, cutting of low frequencies and delayed sounds of your speech, recommend it to be used by the patient as a device for endore speech stuttering therapy during practical exercises and individual independent work. The design of the auditory waveguide is illustrated in the drawing, a side view in section in the plane of the bend. The numbers in the drawing indicate: 1 - an inlet with a diameter of d1, into which sound is directed from the mouth and nose; 2 - waveguide (expandable, rotatable, rigid, body of revolution in cross section), 3 - outlet with a diameter of d2, from which sound is directed to the ear. The design implements the ratio d2 / d1 = 1.618. In the process of training, at the beginning the presenter pronounces syllables, words and phrases with the patient, while the patient does not stutter, after which they are repeated with the other presenter (assistant, parents), this ensures normal speech production without stumbling in a random environment. Further, the presenter does not participate in the training of speech production, it is replaced by a speech-auditory waveguide at the patient’s head, which is applied like a telephone tube, with an inlet to the mouth and the output to the ear, fixed to the head if necessary. When speaking aloud while exhaling into the waveguide, the mental function is monitored - speech production, speech-auditory feedback flow provides timely correction of errors in speech [18. Home speech therapist. Complete reference. - M .: 2007. 496 p., P.245}, the voice and speech of the patient changes in timbre, sound power and replaces the presenter, the patient has confidence, decisiveness, courage in speech production without hesitation. At the same time, as a result of the harmonious interaction of the centers of speech and hearing, the patient forms a stable, increasing positive reflex of healthy speech production, which provides preparation for independent, more accelerated, reliable and stable complete weaning from stuttering compared to other methods. The patient himself tries, regulates the process of speaking without fears, worries, indecision, causing stuttering, works out a smooth healthy flow of speech and is fixed in normal speech. A speech-auditory waveguide is recommended for use in correcting stuttering, in case of hearing pathology and in mastering rhetoric skills to improve speech culture in public professions, it plays the role of a speech crutch, the need for which disappears after several (2-5) days of its use, and the patient speaks in a normal voice without hesitation.

They write down the task: breathing gymnastics and physical exercises with pronunciation “to oneself” of attitudes to the formation of normal speech skills, massage, water intake with stevia and salt, training of speech breathing, voices, only voice your biography, talk about home, school, work, continue to independently develop normal speech skills using a speech-auditory waveguide, writing an evening diary of stutter correction.

Sixth day. The lesson conducts training of speech breathing, speech voice, speech.

They develop and consolidate skills in working with the oral and nasal resonators with training of the soft palate and small tongue, which determine normal speech production, and develop phrasal speech. Patients are instilled with a sense of responsibility for each of their actions, including for their speech. Each one speaks with a parent, leader, another patient, while slowly controlling himself. Carry out auto-training to master the skills of calm and smooth speech. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and speech without stuttering, normalization of metabolic processes in the body.

Homework: to study the pronunciation technique of words and sentences in the speech memo, do breathing exercises and pronunciation with the pronunciation “to oneself” of attitudes to build normal speech skills, massage, train speech breathing, the voice of voice, take water with stevia and salt, continue on your own develop speech skills using a speech-auditory waveguide, writing an evening diary of stutter correction.

Seventh day. The lesson conducts the development of voice and speech.

Patients are relieved of stuttering, armed with knowledge of the pronunciation technique of words and sentences, received permission to speak and are full of desire to talk. Mandatory work with parents is carried out: they are obliged to take care of their children, taking their first steps in a new speech; parents are required to ask their children only simple questions, speak slowly, make words and sentences out of voices. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice, and normalization of metabolic processes in the body. Each patient produces speech breathing, speech voice, answers a simple question, from the voice produces words and sentences and goes to the leader, the parent is nearby. The host shows how to train the soft palate and small language, make words and sentences, “closes” the patient by establishing eye contact, hand contact, and the patient repeats simple phrases following the host, answers the host’s simple questions at a slow pace, connects the parent and patient answer his questions and ask them himself. The patient develops phrasal speech, with each phrase he feels more confident and joyful. If you make a mistake, you need to stop, find out the cause of the error, and re-enter your entire vocabulary without stuttering, make an effort and say in a new voice the difficult and beautiful parts of the word that you received earlier without a voice and repeat them five times to consolidate, praising yourself for the result. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and healthy speech, and normalization of metabolic processes in the body. After the lesson, they work with patients who need additional help in case of errors in complicated speech structures: additional warm-up of the speech mechanism, development of speech breathing, joining of voice voice and phrasal speech until the desired result is obtained, the patient speaks only with additional control of the respiratory movements with his hands, one hand in the area of the diaphragm and the other in the upper part of the chest, instructions are given to the patient and the parent on developing the correct speech skills without errors.

Homework: talking a lot, telling your biography, about school, about home, about friends, etc., talking slowly, watching your speech, doing breathing exercises and physical exercises with pronunciation "to yourself" of attitudes to form normal speech skills, massage, train speech breathing, speech voice, take water with stevia and salt, continue to independently develop normal speech skills using a speech-auditory waveguide, writing an evening diary of stutter correction.

The eighth day. In the lesson, mastering reading aloud, training new speech in full force.

They check everyone’s speech by speaking with parents and with each other, and make sure that the whole group is ready for a new speech. They teach reading aloud, showing maximum patience and caution, as in many children it is completely undeveloped. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and healthy speech, and normalization of metabolic processes in the body. They develop reading skills aloud. They take patients to nature, try and develop voice and speech in full force.

Assignment for independent work: in addition to the previous one, reading aloud with an individual purpose of its duration and volume is added.

Ninth day. In the lesson, they consolidate in new speech and reading.

An emotional instruction is given about the patient’s life attitude: about the need to live in thoughts, and in actions, and in affairs based on the principle of caring for the welfare of other people, not to poison their hearing with disturbed speech, to feel confident in speech and in life, patients are trained ways of effective behavior and solving life problems, to find their internal resources, as they realized when getting rid of stuttering, rely only on their own strengths. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and healthy speech, the implementation of new life settings, the normalization of metabolic processes in the body. They conduct training of independent speech, reading aloud, getting used to the role of a normally speaking person.

They carry out additional work with patients who need the correct setting of speech sounds. By this time, speech has been relieved of stuttering, the entire speech apparatus is in good condition, speech breathing, speech voice are tuned. They show the correct formulation of the articulation organs and fix this position when performing special exercises described in the speech therapy literature [5, pp. 96-136].

The task for independent work: to do breathing exercises and physical exercises with pronunciation “to oneself” of attitudes towards the formation of normal speech skills, massage, train speech breathing, the voice of voice, take water with stevia and salt, speak and read aloud, be sure to start from the workout of the speech apparatus, describe everything around by pronouncing words, read aloud and retell aloud records in notebooks, develop normal speech skills using a speech-auditory waveguide, writing an evening diary and stutter correction.

The tenth day. The lesson conducts communication, development and improvement of speech, studying the basic rules of the grammar of the Russian language (or the rules of speech movement by analogy with the rules of the road and driving a car) and the culture of speech.

Parse the rules for constructing phrases [19. Sheshko N.B. Rhetoric. - Minsk: Sovrem, school., 2007. - 272 p., Pp. 36-241], give the necessary information about the development of your vocabulary, about observing the rules of exemplary literary pronunciation, hone the art of speaking beautifully. They give methods of social adaptation. In the process of auto-training, patients are tuned for speech breathing, a calm and smooth speech voice and communication without stuttering, social adaptation, normalization of metabolic processes in the body. A new daily routine is given for recording: to keep your speech apparatus in good shape, you need to do a general strengthening and speech workout in the morning, train speech breathing, voice voice, speak and read aloud; during the day to control your speech and yourself, in the evening to take stock in the diary, praise yourself when passing the day without errors; if something did not work out, scold yourself and correct the mistake made, voice this word and repeat it again in the morning. The speech memo as an instruction for making words, sentences and speech production should always be at hand. Parents and children talk with each other, patients communicate with each other, talk about themselves, read aloud.

The task for independent work: to do breathing exercises and physical exercises with pronunciation “to oneself” of attitudes towards the formation of normal speech skills, massage, train speech breathing, the voice of speech, take water with stevia and salt, speak and read aloud, be sure to start from the workout of the speech apparatus, describe everything around by pronouncing words, read aloud and retell aloud records in a notebook, from the time of classes live on a new daily routine, perform the necessary exercises, observe the regimen, a lot of vorit and read aloud, writing diary evening stuttering correction.

THIRD STAGE. Eleventh day. The lesson conducts the development of speech, the development of skills in the culture of speech, summarizes the lessons, announces the end of classes and the beginning of a new healthy life path without stuttering.

They analyze speech etiquette, styles of speech and communication, the culture of business speech [19. S.36-241], inform about the development of their vocabulary, about the implementation of pronunciation rules, form oratory. The information received is fixed in practice when reading aloud and communicating. The skills of life without stuttering are fixed, additional practical methods of social adaptation are shown, resistance to relapse of stuttering and behavior in various conditions, self-healing, the formation of a healthy lifestyle in new conditions without stuttering.

Each patient passes an exam, the final diagnosis of the state of patients ’speech is done by reading aloud, pronouncing an independent oral narrative, conversational speech, imitating various life situations: answering at the blackboard, talking on the phone, in the store, on transport, describing the environment [2. S.201-234; 3. S.143-157; 4. S.252-328; 5. S. 58-86; 17. S.163-265].

Further, patients and parents themselves regulate their workload, their daily routine, adaptation and getting used to the new conditions of a healthy lifestyle without stuttering. The facilitator conducts remote monitoring of the patient for up to three months and provides first aid, if necessary, by means of correspondence and monitoring by telephone, the Internet, checking diaries, and correction in case of speech disturbance during severe stress.

EXAMPLE 1. Observed KS, 14 years old, student of grade 8, stuttering while reading and speaking, mixed type, respiratory-articulatory form, expressed to a high degree, could not start reading, involuntary twitching of lips, shoulders, everything is spasmodic, the whole body is enslaved. I took a course in this way: at the beginning of classes it was like a pillar, after 2 days movements started, I worked hard, began to change radically, at the end of classes my cramps were almost invisible, my lips stopped, my shoulders didn’t twitch, breathing was restored, speech with significant improvements in classes literature first went to the blackboard and got 5, reads out loud in class, perked up, minor residual phenomena of stuttering, works hard.

EXAMPLE 2. Observed KI, 17 years old, a student of grade 10, sings baritone at competitions, stuttering in conjugated speech, clonic type, voice articulation form, moderate, speech tricks, auxiliary movements, general speech underdevelopment, abuse tobacco. He completed a course of speech correction in this way. “... Your methods are unique in that for a short period of time Ilya not only began to speak without stuttering and quit smoking, he perked up, recharged with positive, his self-confidence grew, his eyes glow with happiness,” he writes in a letter of thanks Director of the Orphanage No. 4 K.N.G. Biysk city. The patient is delighted with the course, “... Now I am entering a new life without two bad habits - without stuttering and smoking. The method is simple and very effective. To achieve the desired results, you need hard and serious work on yourself. " Speech is free, practically healthy, and singing has become much better than before.

EXAMPLE 3. Observed ZK, 22 years old, laboratory assistant at the university, stuttering of the clonotonic type, voice-articulatory form, expressed to a high degree, problems of pronunciation of sounds. He completed a course of speech correction in this way. The lip spasm disappeared, speech smoothness appeared, speech with significant improvements, slight residual stuttering phenomena, the initial letters m-p remained stumbling with strong excitement, further development of the speech path is required.

EXAMPLE 4. Observed K.E., 24 years old, stuttering in dialogical speech, tonoclonic type, respiratory-voice articulation form, moderate, general speech underdevelopment. “... He is a translator of Chinese, recently demobilized from the ranks of the RA. To get a job in a specialty he was prevented by a problem with speech, which was aggravated after serving in the army. The son suffered from stuttering from early childhood. From preschool age speech therapists, pediatric neurologists have been involved with him a lot. He was treated with acupuncture in psychics. At the age of 15, he took him to the famous Ivankin A.A. in the city of Liski, Voronezh region. But he did not have effective improvement from any method. I took a two-week course on speech correction using this method: a very convincing system of healing based on fundamental knowledge of biophysics and human physiology. My son and I cannot fully believe in the real result, the son spoke without hesitation and stops, smoothly and freely, positive results in a state of health! ”Writes mother K.V.I., a doctor from Yakutsk. Freed from stuttering, speech is almost healthy, leads a healthy lifestyle, normalized family life and work.

Thus, we can state the elimination of stuttering and alleviation of the severity of stuttering, the strengthening of the speech apparatus and the improvement of speech in all those observed at the end of the course for up to three months. The observed persons showed resistance to factors that induce relapse, internal hygiene and health are restored, the quality of life is improved, and the joy of life without stuttering has appeared. Work on getting rid of stuttering in this way has been going on for 4 years 4-8 times a year, as a result of which up to 30 people a year get rid of stuttering with high reliability and stability, and are also freed from concomitant functional disorders and abuse of tobacco, alcohol.

Compared with the known, the proposed method has the following advantages. 1. The method is based on the use of own reserves of the body, brain, self-regulation of organs of speech production, the organized use of a speech-auditory waveguide, the intake of water with stevia and salt and self-healing measures, with the effectiveness of getting rid of stuttering from 80% to 100%, drug and suggestive are completely eliminated impact. 2. For complete release from stuttering and reliable fixing in this state, 10-11 days of intensive work are necessary. 3. There are practically no relapses when observed for up to three months, in patients with residual stuttering, the degree of stuttering with an initial high and moderate decreases by one or two steps. 4. The method eliminates concomitant functional disorders - diseases of the nervous and cardiovascular systems, gastrointestinal tract, respiratory, visual, hearing, memory and intelligence disorders, metabolic processes, tobacco and alcohol abuse, and it is recommended to master rhetoric skills, instead of a bad habit stuttering forms new programs and behavioral stereotypes aimed at creating a healthy lifestyle and leading to active longevity.

The present invention, in its practical implementation, allows you to expand the existing range of reliable ways to get rid of stuttering and can contribute to the domestic program to create a healthy lifestyle and improve the quality of life.

Claims (1)

A method for correcting stuttering, including speech therapy methods of training, group and individual therapeutic classes, during which they establish contact with the patient and configure him to overcome speech disorder, immerse the patient in complete silence for four days, during which they teach diaphragmatic-rib breathing and speech voice, conduct physiotherapy: breathing exercises according to A. Strelnikova, massage the muscles involved in the process of speech production, conduct auto-training from live by means of a patient into the image of a normally speaking person, they develop phrasal speech and read aloud, conduct social adaptation, characterized in that the course is 10-11 two-hour group lessons daily, before and after each lesson, 1.0-1.5 hours are held individually work with the patient, and from the second to the fifth session, the patient is transferred to complete silence mode, auto-training is carried out according to the method of Sytin G.N., additionally, physical exercises are performed to concentrate attention and will with simultaneous pronunciation “To oneself” attitudes to the formation of normal speech skills, before and in between breathing exercises, take 8 sips of raw warm water with the addition of 3 drops of 62% liquid stevia extract in 200 ml of water and 0.05-0.10 g of food salt to the tongue, while conducting psychological and physiotherapeutic measures to prevent and get rid of tobacco smoking and alcohol consumption, write an evening diary of stutter correction; achieve deep concentration of the patient and clarification in the consciousness of the problem of the formation of normal speech; in silent mode, they work out a voice voice on exhalation without connecting articulation, they teach the use of a speech-auditory waveguide with a ratio of output to ear to input diameter of the mouth from the mouth equal to 1.618, from the sixth session, the patient is taken out of silence and practiced and strengthened with working with the oral and nasal resonators with training of the soft palate and small tongue, they develop phrasal speech and reading aloud with the use of a speech-auditory waveguide; for up to three months, they conduct remote monitoring and assistance to the patient.

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