RU2844402C1 - Method for eliminating stuttering by developing rhythmic component of speech - Google Patents

Abstract

FIELD: medical science.

SUBSTANCE: invention refers to medicine, particularly to psychoneurology, speech therapy, and may be used in treating the patients suffering stammering. Method consists in performing the exercises step-by-step. First stage involves the local exposure on muscles of respiratory, vocal and articulation departments. For this purpose, sitting on a chair, placing a palm in the abdomen, alternately protruding and retracting the abdomen counting one-two, performing 10 times. Sound A is pronounced with an open mouth softly – loudly – softly. Thereafter, the sound A is pronounced with an open mouth in a low voice, and then in a high voice. Further, the exercises are done counting to 10: the lips are stretched in a grin with tension. Then the lips are pulled forward with tension. Then forward lip pulling is alternated with lip stretching. Further, the mouth is slowly opened, the lips are tension-free, and the tension tongue is rested against the alveoli behind the upper incisors. Then tongue movements are alternated: up, down, to the right, to the left. At the second stage own nonverbal rhythm is formed. For this purpose, actions are performed successively and rhythmically with a count of up to 10-20: clapping hands, stamping feet, simultaneously clapping hands and stamping feet, playing drum, touch the right knee with the left elbow and vice versa, throw the ball and catch it from the floor, ball is knocked on the floor with two hands, only with the right hand, only with the left hand, thrown with the right hand, and caught with the left hand and vice versa. Jumps are made on two legs, on the right leg, on the left leg, on two legs “feet together, feet apart”, and marching. At the third stage, the sense of rhythm is developed by clapping hands, stamping feet, simultaneously clapping hands and feet stamping, beating the drum, marching, throwing and catching the ball with hands. Same actions are performed to the beat of a metronome and an audio recording. At the fourth stage, the rhythm of the verse speech is formed. That is ensured by reading the verses while swinging left-right. At the fifth stage, the prosaic speech rhythm is formed. Word is successively pronounced in syllables and a ball is thrown on the stressed syllable of the word. Words are pronounced in full with stress in each word. Then groups of words are pronounced on pictures to metronome sound, from 5 to 10 words. After the exercises of above 5 stages are mastered to automatism, the sixth and seventh stages are performed. At the sixth stage, narration and interrogative intonations are generated by answering questions and asking questions relating to the displayed words and images. Main word is singled out by voice. Seventh step involves automation of rhythmic processes in independent speech: making a descriptive account of a picture, answering the questions with common sentences, making sentences from parts, correcting errors in the sentences, reading and retelling the text with pauses and logical stresses observed.

EFFECT: invention is suitable for all age categories, does not require additional drug treatment.

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Description

The invention relates to medicine, psychoneurology, speech therapy, and can be used to treat stuttering.

Stuttering is a disorder of the rhythmic component of speech, which manifests itself in spasms of the muscles of the speech apparatus. Speech has a dynamic brain organization, specific zones responsible for the formation of different components are determined. And only due to the connection and joint work of these zones, speech is formed. Any speech is characterized by tempo, rhythm and logical stress. Tempo is the speed of speech, it depends on the individual characteristics of the person, on the state of health. The rhythm of speech is a sequence of stressed and unstressed syllables of words in sentences. Stress is the semantic center of the word. Incorrectly placed stress can distort the meaning and make the word inaccessible to perception. It is formed due to a longer pronunciation of the vowel sound, due to which the whole syllable sounds longer than the rest - unstressed. A spasmodic state of speech occurs only with insufficient formation of rhythmic components. Consequently, all work on eliminating stuttering should be based on the development and automation of the missing - rhythmic, link, on the formation of a connection with other speech components.

The formation of rhythm in ontogenesis occurs gradually and depends on external and internal factors. In the life of the organism, many processes are carried out rhythmically: heartbeat, breathing, locomotion (walking, crawling), sucking. In addition to internal processes, the formation of rhythm is also influenced by the external environment: dripping, the knocking of clock hands.

All these processes are basic in the formation of the feeling of iterative rhythm, which is manifested in the syllabic naming of words. Gradually, with the development of the motor sphere and thought processes, the semantic center of the word is formed - stress. Each word with all its characteristics (semantic, rhythmic, acoustic, articulatory), is fixed in the speech program of the brain in the form of a code. The loss of one or more characteristics leads to speech disorders. The lack of formation of the rhythmic component of the word leads to the development of stuttering - speech dysrhythmia, which manifests itself in the form of spasms of the speech apparatus.

A number of factors contribute to the development of stuttering: genetic predisposition to the formation of the central nervous system, the state of the central nervous system, and the features of the formation of functional asymmetry of the brain. Most often, stuttering manifests itself at the age of 2-7 years, during this period there is an intensive formation of mental processes, including speech, functional systems during the formation period are most susceptible to failures. According to research, in frequent cases (with a neurosis-like form), stutterers have organic brain damage of a diffuse nature, which most often manifests itself in a violation of the motor sphere - in chaos or inhibition, in the absence of precision and coordination of movements, in a violation of speech development. Violation of the motor sphere, in turn, leads to a delay in the formation of an active rhythm and a sense of rhythm.

There are two clinical forms of stuttering: neurotic (logoneurosis) and neurosis-like, in accordance with different pathogenetic mechanisms.

The neurotic form (logoneurosis) is a functional speech disorder that occurs as a result of exposure to stress factors, acute or chronic. Acute ones are understood as mental traumas that act sharply, suddenly, and often cause fright. Chronic ones imply long-term exposure to negative emotions.

Children with this form of stuttering do not show signs of intrauterine developmental disorders or birth injuries. Motor skills are developed in a timely manner. General movements are coordinated, easily switching from one movement to another. Fine motor skills of the hands are sufficiently developed. Facial expressions are "lively", emotionally charged. Speech development proceeds in accordance with the approximate norm. Convulsive hesitation occurs already in the presence of an expanded phrase. The rate of speech is often accelerated. Sound pronunciation is not impaired. Examination of stutterers indicates sufficient development of the rhythmic component of the motor sphere and speech.

The neurotic form of stuttering can proceed both regressively (favorably) and progressively. In the absence of correction, it often becomes chronic. Situational dependence in the manifestation of the severity of stuttering is observed already in childhood. During the period of awareness of the speech defect, logophobia appears - a fear of speech communication with an obsessive expectation of speech failures. An increase in the speech load in adolescence leads to the fact that speech becomes a source of constant mental trauma, which in turn causes increased exhaustion (mental and speech). Difficulty in expressing thoughts arises, since the stutterer tries to pronounce not what he thinks, but what is easier for him to pronounce.

A distinctive feature of stutterers with a neurotic form is that in a familiar environment or alone, speech is carried out without convulsive hesitation.

Neurosis-like form - a disorder of both organic and functional nature, in terms of symptoms this form is similar to logoneurosis, but occurs as a result of organic, vascular or other lesions of the nervous system. It begins gradually, without emotional causes. The anamnesis of such children often includes a severe course of pregnancy, hypoxia, asphyxia, birth injuries. In infancy, such children are often screaming, restless, sleep poorly. Motor development is within the low norm, or with a slight delay. Movements are insufficiently coordinated, motor awkwardness, disinhibition or inhibition of the motor sphere are characteristic. Exercises for switching poses are especially difficult, stutterers have difficulty remembering and reproducing the sequence of movements. They do not correct motor errors on their own. Speech development is delayed or within the norm. Convulsive stuttering appears at the stage of word formation (in severe cases), phrases and sentences. Pronunciation is characterized by disturbances. The rate of speech is accelerated or slow.

Examination of stutterers with this form indicates insufficient development of the rhythmic component of the speech system and motor sphere; they have difficulty perceiving and reproducing given rhythmic patterns, and have difficulty distinguishing stress in words.

At the initial stages, stuttering occurs in waves, then the situation worsens significantly and becomes stationary. The neurosis-like form of stuttering is characterized by stability of manifestations, independent of the external situation and emotional state, stuttering occurs in any environment, both alone and in society. Convulsions intensify with physical and mental fatigue, with deterioration of somatic health. In the absence of timely correction, this form tends to a progressive type of course. Most often, speech is characterized by the presence of tonoclonic seizures in all parts of the speech apparatus. In a severe form, speech tires stutterers physically and mentally, which further worsens the state of speech.

Regardless of the form of stuttering, the type of seizures, severity, course - speech correction must begin immediately. Early development of the missing rhythmic component of speech prevents the chronicity of the pathological process.

The development of new methods of stuttering treatment is a pressing issue, which is explained by the prevalence of the disease, on the one hand, and the insufficient effectiveness of existing treatment methods, on the other. Currently, drug therapy, breathing exercises, acupuncture, massage, and light and sound impulse therapy are used to treat stuttering. There are also known methods of stuttering treatment that include the use of psychocorrection and speech therapy methods (see patent RU 2180245 "Method for treating a tempo delay in neuropsychic development in children", RU 2120314 "Method for psychological rehabilitation of children with intellectual disabilities based on a computer synergistic system", RU 2128944) "Method for speech correction".

The main disadvantage of existing analogues is the low effectiveness of treatment, which is manifested in a slight and short-term improvement in the patient's condition. Regression of the disease most often occurs in stressful situations.

The closest to the claimed patent is RU 2449815 "Method of balance of force and accuracy", A61M 21/00, priority from 22.12.2009, published 10.05.2012, patent holder Surnin S.N. (RU). The method is implemented by rapidly increasing the strength of oral speech - the total phasic component of non-verbal movements of oral speech without direct relaxation of the articulatory muscles, for which purpose the development and consolidation of movements of oral speech with high phasic activity is carried out using a set of games, each of which contains a game image - a figurative representation of a physical phenomenon or a characteristic element of human behavior, reflecting the essence of the game, non-verbal components of the game - non-verbal movements of oral speech with high phasic activity, which are used before the beginning of the first phonetic unit and then at the boundaries of phonetic units of different levels, as well as verbal components of the game - pronunciation of words with a combined increase in the phasic activity of the muscles of phonation and articulation, while avoiding movements that cause an increase in the accuracy of oral speech - the total tonic component of the movements of the muscles performing articulation.

This method allows eliminating speech spasms. The disadvantage of this method is that when switching from slow equal-metric speech to normal heterometric speech, it is difficult to maintain the result obtained. In addition, the method does not allow completely eliminating drug treatment, while taking medications is fraught with side effects, allergic reactions, and addiction.

The objective of the invention is to create an effective method for eliminating stuttering that is suitable for all age groups, universal in relation to both forms of stuttering, does not cause relapse and does not require additional drug treatment.

To solve the problem, the method of eliminating stuttering is carried out by developing the rhythmic component of speech, for which a set of exercises is carried out in several stages: at the first stage, a local effect is produced on the muscles of the respiratory, vocal and articulatory departments through exercises aimed at relaxing and tensing these muscles, for this: sitting on a chair, placing your palm in the abdomen, alternately push out and pull in the stomach to the count of "one-two", and, when inhaling through the nose, the stomach is pushed out, when exhaling - pulled in, do 10 times; at the second stage, they develop their own non-speech rhythm by consistently and rhythmically counting the following actions: clap your hands, stamp your feet, clap your hands and stamp your feet at the same time, play the drum, touch your left elbow to your right knee and vice versa, throw the ball and catch it from the floor, bounce the ball on the floor with both hands, only with the right hand, only with the left hand, throw with the right hand and catch with the left and vice versa, jump on two feet, jump on the right foot, on the left foot, on two feet, do the "feet together - feet apart" exercise, march; at the third stage, they develop a sense of rhythm through the following exercises: translate a visual symbolic rhythmic series into a sounding one, reproduce the rhythm they heard; at the fourth stage, they form the rhythm of poetic speech by first reading simple, then more complex poems, swaying left and right to the beat; At the fifth stage, the rhythm of prose speech is formed, for this purpose, sequentially: first, words are pronounced syllable by syllable with a smooth transition from one syllable to another, then words are pronounced in full, emphasizing the stress in each word, simple phrases are read, simple sentences are read with stress in each word; at the sixth stage, narrative and interrogative intonation is formed using cards, for this purpose, questions are asked concerning the images on the cards; at the seventh stage, rhythmic processes in independent speech are automated, for this purpose, essays on a given topic are composed and told, while intonation is used, pauses are observed, and logical stress is emphasized.

The method of eliminating stuttering by developing the rhythmic component of speech is carried out as follows.

Stages of work:

Stage 1 - local impact on the muscles of the respiratory, vocal and articulatory sections, through exercises aimed at muscle relaxation and tension, switching and precision of movements.

Stage 2 – formation (development) of one’s own non-speech rhythm.

Stage 3 – development of a sense of rhythm.

Stage 4 - formation of the rhythm of poetic speech.

Stage 5 – formation of the rhythm of prose speech.

Stage 6 – formation of intonation.

Stage 7 - automation of rhythmic processes in independent speech. The attached drawings show:

Fig. 1-6 - examples of cards-guides for performing exercises of stage 1 for the muscles of the articulatory apparatus.

Fig. 7 and 8 are examples of cards-guides for completing exercises of stage 6 for developing intonation.

The following is a detailed description of how to complete each step.

Stage 1. Local impact on muscles

1.1. Exercise for respiratory muscles

Sitting on a chair, place your palm on your stomach, alternately push out and pull in your stomach to the count of "one-two", and when inhaling through your nose, push out your stomach; when exhaling, pull in. Do this 10 times.

1.2. Exercise for the vocal apparatus muscles

1.2.1 Pronounce the sound "A" with the mouth wide open quietly, then loudly, and again quietly, with a smooth transition from a quiet sound to a loud one and vice versa, while the muscles of the lips are not strained. During the exercise, the position of the lower jaw does not change.

1.2.2 Pronounce the sound A with a wide open mouth in a low voice, then in a high voice, with a smooth transition from low to high. Pronounce the sound A with a wide open mouth in a high voice, then in a low voice, with a smooth transition from high to low. The position of the lower jaw does not change during the exercise.

1.3. Exercises for the muscles of the articulatory apparatus

The exercises are performed without a mirror, relying on internal sensations.

1.3.1 Perform statically: stretch your lips into a smile, with strong, noticeable tension, hold in this position for a count of 10, then stretch your lips forward, with tension, hold for a count of 10.

1.3.2 Perform the following sequences dynamically and rhythmically, using cards (Fig. 1-3) as a guide, depicting sequences of dots and dashes, where a dot means “pull your lips forward” and a dash means “stretch your lips into a smile”:

- on the count of "one-two":

- on the count of "one-two-three":

- on the count of "one-two-three":

1.3.3 Perform statically: open the mouth, lips in a free position and without tension, rest the tense tongue against the alveoli behind the upper incisors and hold in this position for a count of 10.

1.3.4 Perform statically: open the mouth, lips in a free position and without tension, rest the tense tongue against the lower incisors and hold in this position while counting to 10.

1.3.5 Perform dynamically and rhythmically, using cards (Fig. 4-6) with sequences of arrows or vertical stripes as aids, where an up arrow means "move the tongue up", a down arrow means "move the tongue down", an arrow to the right means "move the tongue to the right", an arrow to the left means "move the tongue to the left", one vertical stripe means "narrow, tense tongue, extended forward", two vertical stripes mean "flat, relaxed tongue", the following sequences:

- on the count of "one-two":

- on the count of "one-two":

- on the count of "one-two":

Stage 2 - formation (development) of one's own non-speech rhythm

Exercises of stage 2

2.1 Clap your hands rhythmically, in sync with the count, up to 10-20 (the clap hits the percussion sound - one, two, three, four, etc.).

2.2 Rhythmically stomp your feet, in sync with the count, up to 10-20.

2.3 Rhythmically stomp your feet and clap your hands, synchronously, counting to 10-20.

2.4 Play the drum, counting to 10-20.

2.5 Touch the left elbow to the right knee and vice versa, rhythmically, counting to 10-20.

2.6 They throw the ball and catch it from the floor, counting to 10-20, while hitting the ball on the floor synchronously with the impact sound (so that the impact of the ball coincides with the impact sound) - one, two, three, four, etc.:

- with both hands;

- only with the right hand;

- only with the left hand;

- throw with the right hand, catch with the left;

- throw with the left hand, catch with the right.

2.7 Jump rhythmically:

- on two legs, counting to 10-20;

- on the right leg, counting to 10-20;

- on the left leg, counting to 10-20;

- on two legs "legs together, legs apart" counting to 10-20;

2.8 Marching, counting to 10-20.

Stage 3 - development of a sense of rhythm

Exercises of stage 3

3.1 Visual perception of rhythm

3.1.1 Looking at the symbolic visual series clap your hands rhythmically.

3.1.2 Looking at the symbolic visual series clap your hands rhythmically, pausing (two claps - pause - one clap - pause - two claps - pause, etc.).

3.1.3. Looking at the symbolic visual series clap your hands rhythmically, pausing and synchronously pronouncing the syllable "pa" (or "ba", "ma", "za", etc.).

3.1.4 Looking at the symbolic visual series sound out the rhythm with just a syllable, for example: ba-ba" (pause), "ba" (pause), "ba-ba" (pause), etc.

3.1.5 The following rows are performed in a similar manner:

3.2 Perception of rhythm by ear.

3.2.1 Perform actions to the rhythm of the metronome:

- clap their hands;

- stamp their feet;

- clap and stomp at the same time;

- beat the drum;

- throw and catch the ball from the floor (with two hands, right, left, alternately);

- jump on two legs, on the right, on the left;

- marching.

3.2.2 Clapping (stomping, knocking, etc.) repeat rhythmic sequences reproduced using an audio recording.

Stage 4 - formation of the rhythm of poetic speech.

Poetic rhythm is formed separately from the rhythm of prose speech and is not basic.

4.1 Exercise: read simple and more complex poems, starting with one such as A.L. Barto's poem "The Ball", intoning, rhythmically, swaying left and right, pausing between lines:

OUR TANYA CRYING LOUDLY: (pause)

SHE DROPTED A BALL INTO THE RIVER. (pause)

- QUIET, TANYA, DON'T CRY: (pause) THE BALL WON'T DROWN IN THE RIVER.

Stage 5 - formation of the rhythm of prose speech

Exercises of stage 5

5.1 They pronounce words syllable by syllable, using a ball, throwing the ball at each syllable of the word, and the syllables must be pronounced with a smooth transition from one syllable to another ("MA-SHI-NA, KA-SHA, MO-LO-KO"), etc.):

- using pictures;

- using printed words.

5.2 Pronounce words in full, highlighting stress, using a ball, throwing the ball onto the stressed syllable of the word ("aSHARK, pomidOR, krosSOVki"), pronouncing the stressed sound as a longer, exaggerated one):

- using pictures;

- using printed words.

5.3 Pronounce simple phrases, emphasizing the stress in each word, without mechanical assistance, without using the ball ("one cup, roses in a vase"), pausing briefly after each word and pronouncing the preposition along with the word related to it):

- using pictures;

- reading printed phrases.

5.4 Pronounce simple sentences, rhythmically and with stress pronouncing each word (The hippopotamus lives in the swamp. The fisherman catches fish):

- from pictures;

- read printed sentences.

5.5 They pronounce groups of words based on pictures to the sound of a metronome, 5 words each, then 10 words each, (“clock, cat, house, duck, dog”, “giraffe, crocodile, cup, globe, ruler, fireworks, balls, pencil, letter, books”), reproducing the percussion sound of the word synchronously with the beat of the metronome:

- for every knock, while the obligatory condition is to learn to hit every knock;

- every second knock.

Stage 6 - formation of intonation

Exercises of stage 6

6.1 To form a narrative intonation, answer the question asked using the displayed card (Fig. 7), highlighting the main word in terms of meaning with your voice (words in the cards can be replaced with pictures):

- Question: "WHAT is yellow?" Answer: "The BALL is yellow, the HAT is yellow, the DRESS is yellow, the FLOWERS are yellow."

- Question: WHICH? Answer: YELLOW ball, YELLOW hat, YELLOW dress, YELLOW flowers.

6.2 To form a questioning intonation, ask a question about the color of the object depicted on the card being shown (Fig. 8), emphasizing the main word in the meaning: "GREEN pencil? GREEN tree? GREEN apple? GREEN glasses?"

Stage 7 - automation of rhythmic processes in independent speech

When performing the exercises of stage 7, the following rule is observed: when a spasm occurs, it is necessary to stop speaking and start over more slowly, pronouncing each sound of the word, emphasizing the stress.

7.1 Compose a descriptive story based on the picture, telling it using intonation and observing pauses, highlighting logical stresses. Answer questions about the picture in a complete sentence.

7.2 Compose a story based on a series of plot pictures, answer questions about the text in a complete sentence:

- tell a fairy tale using pauses, logical stress, with expression (for example, the fairy tales "Turnip", "Ryaba the Hen", "Teremok");

- find the odd object out and explain their choice with a full answer (for example, a banana, cucumber, apple and plum are shown, the odd one out is the cucumber, because a cucumber is a vegetable, and a banana, apple and plum are fruits);

- they correlate objects, explain their choice with a complete answer, for example: “Yellow lemon - under the yellow blot”, “Red pencil - under the red blot”);

- make up sentences from parts, name sentences;

- make sentences from "scattered" words;

- correct mistakes in sentences, pronounce sentences;

- answer questions in complete sentences;

- read and retell the text, observing pauses and logical stress;

- read the proverb and explain the meaning;

- read and pronounce the tongue twister at a fast pace, clearly pronouncing the words.

The duration of work at each stage depends on individual characteristics; exercises must be performed until they are fully automated.

Experience working with various speech disorders has allowed us to identify distinctive features of stuttering, in addition to muscle spasms, and thus has allowed us to select a number of exercises aimed at developing the necessary components of speech.

Elimination of stuttering by the proposed method is applicable to both clinical forms of stuttering - neurotic and neurosis-like, does not require drug intervention, does not cause relapses, and is suitable for all age categories.

Below are examples of eliminating stuttering using the stated method.

Example 1. Child, 2 years 8 months

Stuttering: neurosis-like form, clonic spasms in all forms of speech, manifested both in the initial phase of the utterance and in other parts of the phrase, in any part of the word, the degree of stuttering is moderate-severe, the type of course is progressive.

Age of onset of stuttering: 2 years 6 months, phrasal speech is formed.

At the time of examination: speech rate is accelerated, motor disinhibition is characteristic. The child makes mistakes in tests for iterative rhythm, does not maintain or perceive simple rhythm, poetic rhythm is not formed, pronunciation of words by syllables is inaccessible. The state of speech does not depend on the situation, with fatigue, a deterioration in speech quality is observed. The child does not experience discomfort from the convulsive state.

We worked in the stated way for 8 months, without a protective mode and without a speech restriction mode, the change in speech quality had a wave-like character. By the end of the work, the speech had completely normalized, rare hesitations of a non-convulsive nature remained (like physiological iterations). During the entire period of work, the child's speech was not monitored, the process of development of the rhythmic component was natural.

Example 2.

Child, 3 years 6 months.

Stuttering: neurosis-like form, tonic spasms in all forms of speech, appear at the initial stage of utterance, mainly on vowel sounds, degree of stuttering is severe, type of course is progressive.

Age of onset of stuttering: 3 years, phrasal speech is formed.

At the time of examination: speech rate is slow, sound pronunciation is normal, voice is hoarse, weak, general motor skills are poorly developed, performs tests correctly, but slowly, switches movements with a delay. Perception and reproduction of simple non-speech rhythm is sufficiently developed. Poetic rhythm is insufficiently developed, pronunciation of words by syllables is inaccessible, complex (stress) rhythm of speech is not formed. The state of speech does not depend on the situation and the volume of speech utterance. Experiences discomfort from convulsions, becomes withdrawn, avoids speech.

We worked in the stated way for 6 months, without a protective regime, without a speech restriction regime, the improvement occurred at the stage of work on the formation of an iterative rhythm of words, the change in the quality of speech had a wave-like character. During the work, the child's speech was not controlled, the process of developing the rhythmic component of speech was natural. The state of speech normalized.

Example 3.

Child, 11 years old

Stuttering: neurotic form (logoneurosis), clonic convulsions in phrasal, coherent and independent forms of speech, mainly on consonant sounds, degree of stuttering - mild, type of progression - stationary.

Age of onset of stuttering: 6 years.

At the time of examination: speech rate is slightly accelerated, pronunciation is normal, voice is without peculiarities, general motor skills are sufficiently developed, performs switching tests quickly, with errors. Iterative rhythm is sufficiently developed, complex rhythm is perceived and reproduced correctly, poetic rhythm is developed, stress rhythm is insufficiently developed, during tests - search for stress in words. The state of speech depends on the volume of information transmitted, does not depend on the situation and emotional state.

We worked in the stated way for two months, convulsions disappeared from speech at the stage of stress formation. We introduced speech control using the rules: "keep the rhythm, highlight stress in words, speak expressively, use intonation." If the rules are followed, convulsions in speech do not occur.

Example 4.

Teenager, 14 years old

Stuttering: neurosis-like form, moderate severity, clonic-tonic spasms in all forms of speech, mainly in coherent and independent speech, more often in the initial phase of utterance, course type - progressive.

Age of onset of stuttering: 6 years.

At the time of examination: speech rate is normal, sound pronunciation is normal, motor sphere is developed without any peculiarities, iterative rhythm is developed sufficiently, perception and reproduction of complex rhythm is not developed enough, poetic rhythm is not developed, pronunciation of words by syllables causes difficulties, stress rhythm is not formed, search for stress in words is observed. The state of speech does not depend on the situation, emotional state and volume of transmitted information, stuttering always appears and intensifies with deterioration of somatic health.

We worked in the stated way for three months, the quality of speech improved at the stage of forming stresses in words. We introduced speech control using the rules: "keep the rhythm, highlight stresses in words, speak expressively, use intonation." The state of speech normalized.

Example 5.

Female, 32 years old

Stuttering: neurosis-like form, moderate severity, tonoclonic seizures in all forms of speech, appear more often in the initial phase of utterance, course type - stationary.

Age of onset of stuttering: in childhood, up to 10 years.

At the time of examination: speech rate is normal, pronunciation is normal, general motor awkwardness is characteristic, execution of tests is slow, with minor errors, iterative rhythm is insufficiently developed, perception and reproduction of simple and complex rhythm is impaired, poetic rhythm is not formed, there are difficulties when pronouncing words by syllables, the "stress" rhythm is not formed. The state of speech does not depend on the situation and emotional state.

We worked in the stated way for a month, the speech condition improved at the stage of syllabic pronunciation of words. Further work was carried out at home, in accordance with the recommendations received. The speech condition normalized.

Example 6.

Woman, 40 years old

Stuttering: neurosis-like form, moderate-severe degree, tonoclonic spasms in all forms of speech, manifested both in the initial phase and in the flow of speech, in different parts of words. The type of flow is stationary.

Age of onset of stuttering: in childhood, up to 10 years.

At the time of examination: speech rate is slow, monomorphic pronunciation disorder, general motor awkwardness is characteristic, execution of tests is slow, with errors. Iterative rhythm is insufficiently developed, perception and reproduction of complex rhythm is impaired, poetic rhythm is not formed, pronouncing words by syllables causes difficulties, "stress" rhythm is not formed. The state of speech does not depend on the situation and emotional state.

We worked in the stated way for four months, the quality of speech improved at the stage of forming stresses in words. Further work was carried out at home, in accordance with the recommendations received.

Example 7.

Child, 7 years old

Age of onset of stuttering: 5 years.

Stuttering: neurotic form (logoneurosis), moderate to severe, tonoclonic seizures, appear at the initial stage of utterance. Type of course - recurrent.

At the time of examination: speech rate is normal, speech is excessively emotionally colored, monomorphic pronunciation disorder, motor sphere is developed without peculiarities, iterative rhythm is developed sufficiently, perceives and reproduces complex non-speech rhythm, poetic rhythm is developed sufficiently, when highlighting stress in words, a search for the stressed syllable is observed. The state of speech depends on the situation and emotional state.

We worked in the stated way for a month, the quality of speech improved at the stage of automation of stresses in words. If the rule is observed ("exaggerate the pronunciation of the first sounds or syllables of "difficult" words, observing the stresses"), convulsions in speech do not appear.

Example 8.

Child, 6 years old

Age of onset of stuttering: 5 years.

Stuttering: neurosis-like form, severe degree, tonic spasms in all forms of speech, manifested both in the initial phase of utterance and in other parts of phrases. Type of course - stationary.

At the time of examination: speech rate is slow, polymorphic pronunciation disorder, coherent speech is insufficiently developed, general motor awkwardness is characteristic. Iterative rhythm is insufficiently developed, perception and reproduction of complex non-speech rhythm is impaired, poetic rhythm is not formed, pronunciation of words by syllables is impaired, "stress" rhythm is not formed. The state of speech does not depend on the situation and emotional state.

We worked at home, according to a drawn up plan, in accordance with the recommendations received. Over the course of a year, the state of speech has improved significantly, the degree of stuttering has become mild, manifested in the form of rare clonic seizures in independent speech.

Example 9.

Child, 10 years old

Age of onset of stuttering: 5 years.

Stuttering: mixed form, moderate to severe, tonoclonic seizures, manifested mainly in the initial phase of utterance, only at the beginning of phrases. Type of progression - stationary.

At the time of examination: accelerated speech rate, monomorphic pronunciation disorder, general motor awkwardness is characteristic, movements are fast, the child makes mistakes in tests, low level of self-control. The iterative rhythm is not sufficiently formed, the perception and reproduction of complex non-speech rhythm is impaired, the poetic rhythm is not sufficiently formed, pronunciation of words by syllables is accessible, the "stress" rhythm is not formed. The state of speech depends on the situation and emotional state.

We worked in the stated way for six months, the quality of speech improved at the stage of stress automation. If the rules are followed, cramps in speech do not appear.

Example 10.

Teenager, 15 years old

Age of onset of stuttering: 5 years.

Stuttering: mixed form, severe degree, tonoclonic spasms in all forms of speech, in different parts of words. Type of progression - stationary.

At the time of examination: speech rate is normal, sound pronunciation is normal, motor sphere is developed without any peculiarities. Iterative rhythm is underdeveloped, perception and reproduction of complex non-speech rhythm is impaired, pronunciation of words by syllables is underdeveloped, "stress" rhythm is not formed, poetic rhythm is not formed. The state of speech depends on the situation, emotional state and the volume of speech utterance.

We worked in the stated way for six months, the quality of speech began to improve at the stage of pronouncing words by syllables, a significant effect was achieved at the stage of forming stresses. If the rules are followed, convulsions in speech do not appear.

Claims (10)

1. A method for eliminating stuttering by developing the rhythmic component of speech, consisting of a step-by-step implementation of exercises, characterized in that: at the first stage, a local effect is produced on the muscles of the respiratory department, for this, sitting on a chair, placing a palm in the abdominal area, alternately protruding and pulling in the stomach to the count of one or two, and when inhaling through the nose, the stomach is protruded, when exhaling - pulled in, do 10 times; on the muscles of the vocal department - pronounce the sound A with an open mouth quietly, then - loudly and again - quietly, then pronounce the sound A with an open mouth in a low voice, then - in a high voice; on the muscles of the articulatory department - stretch the lips into a smile with tension, hold in this position for a count of 10, then stretch the lips forward with tension, hold for a count of 10, then alternate stretching the lips forward and stretching the lips into a smile, then slowly open the mouth, lips without tension, while the tense tongue is rested against the alveoli behind the upper incisors and held in this position for a count of 10, then open the mouth, lips without tension, rest the tense tongue against the lower incisors and hold in a fixed position for a count of 10; then alternate tongue movements: up, down, right, left; at the second stage, they form their own non-speech rhythm, for this they perform actions sequentially and rhythmically with a count of up to 10-20: clap their hands, stamp their feet, clap their hands and stamp their feet at the same time, play the drum, touch the left elbow to the right knee and vice versa, throw the ball and catch it from the floor, knock the ball on the floor with both hands, only with the right hand, only with the left hand, throw with the right hand and catch with the left and vice versa, jump on two legs, jump on the right leg, on the left leg, on two legs "feet together, feet apart", march; at the third stage, they develop a sense of rhythm: they clap their hands rhythmically, following various variations of the clap-pause sequence, then alternate pauses and pronounce syllables, after which they perform actions to the rhythm of a metronome and an audio recording: clap their hands, stamp their feet, clap and stamp at the same time, beat a drum, throw and catch a ball from the floor with two hands, right, left in turn, jump on two legs, on the right, on the left, march; at the fourth stage, the rhythm of poetic speech is formed, for this they read poems, swaying left and right; At the fifth stage, the rhythm of prose speech is formed, for this purpose they sequentially: pronounce words by syllables and throw the ball on each syllable of the word; pronounce words in full, highlighting the stress, and throw the ball on the stressed syllable of the word; pronounce phrases, highlighting the stress in each word; pronounce groups of words by pictures to the sound of a metronome, 5 words each, then 10 words each, reproducing the stressed sound of the word synchronously to each beat of the metronome; at the sixth stage, narrative and interrogative intonations are formed, for this they answer questions and ask questions concerning the words and images shown, highlighting the main word in meaning with their voice; At the seventh stage, the automation of rhythmic processes in independent speech is carried out, for this purpose they compose a descriptive story based on the picture, using intonation and observing pauses, highlighting logical stresses; answer questions about the picture with an extended sentence; find an extra object and explain their choice with a full answer; correlate objects, explain their choice with a full answer; compose sentences from parts; correct errors in sentences; answer questions; read and retell the text, observing pauses and logical stresses. 2. The method according to paragraph 1, characterized in that work is carried out from the first to the fifth stage until the exercises are mastered to the point of automatism, after which exercises of the sixth to seventh stages are carried out.