RU2486925C1 - Method for recovering and developing human speech functions - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurology and speech therapy, and may be used for the rehabilitation of patients with speech disturbance, as well as for the development of speech forms and functions of a healthy human speech. The speech disturbances are assessed for a degree of deviation from an age norm using 7-rate scale of speech maturity and/or complicating a human response to the environmental factors. The 3-point degree of speech deviations requires giving lessons including massage of chest, throat, hands, facial and articulatory muscles, and using a moderate and noxious stimulus on an upper and lower respiratory system to elicit audible responses and vocalisms. The 4-point degree provides giving lessons including massage of chest, massage of throat, massage of hands, massage of facial and articulatory muscles with passive articulation exercises accompanied by elements of maximum tension and limited chest excursion. The 5-point degree giving lessons including the passive articulation exercises with elements of maximum tension with the active articulation exercises with the facial exercises, and the exposure to various analysers and limited chest excursion. The 6-point degree ensures giving lessons that include the active articulation exercises with the facial exercises, as well as name-calling with set expressions and singing. The 7-point degree is giving lessons, including mechanical noise, any physical exercises that can be performed by a patient in the dynamic or static mode, as well as external mechanical disturbances: kicks, vibration, percussions, tickling. The 8-point degree is giving lessons that include singing in various octaves, pantomime, using the rhetorical exercises and involving acoustic noise. The 9-point degree is giving lessons that include optical interference: various eye movements during a conversation in the static and dynamic mode, viewing the various images - magazines, illustrations. The 10-point degree provides the exercises involving vestibular load, or mixed load: use a combination of different 2-3 interference. using combinations of 2-3 various interferences.

EFFECT: method enables improving the effectiveness of the solution of speech, psychological and social problems of a patient or a healthy person while recovering and developing the speech functions.

Description

The invention relates to medicine, namely to neurology and speech therapy, and can be used for the rehabilitation of patients with speech disorders, as well as for the development of speech forms and speech functions of a healthy person.

The formation of various forms and functions of a healthy person’s speech in ontogenesis begins with the formation of proprioceptive and vibrational sensitivity, then the appearance of the first sounds (screaming, babbling, humming), then mastering normative and profanity (cliche or persistent phrases, phraseological units).

The full verbal maturity of a person is normally determined by his ability to meaningfully decorated public speaking.

A person with speech developmental disorders goes through all the same stages of ontogenetic development as a healthy one, but only in him this process proceeds non-uniformly (nonlinearly) and slowly.

Accordingly, for the restoration and development of human speech functions (cognitive, regulatory, communicative), regardless of the state of his health and at each stage of his physical development, but taking into account the specifics of neurological and speech therapy problems, the general principles of therapeutic and pedagogical phased measures to form or restoration of full-fledged speech communication skills.

The generally accepted rehabilitation complex includes psychological, pedagogical, phonopedic and speech therapy methods that are built and applied taking into account and based on an assessment of the severity of a speech defect and levels of speech maturity (reflex, instinctive, conscious and personal) and differ in the duration of each stage.

The basis of speech rehabilitation is always the use of speech exercises - trainings (step by step - pronunciation of words, phrases, reading and retelling of texts, conducting free conversation, etc.).

But, despite the fact that speech exercises are absolutely necessary for the restoration and development of human speech functions, it is proved that without activation of other functional systems of the human body responsible for providing the functions of the speech apparatus, they are insufficient.

More effective at the present stage of development of neurology and speech therapy in terms of restoration and development of speech functions are methods that include various methods of influencing the patient’s condition at the corporate level or at the level of other functional systems and aimed at activating human adaptive systems through the use of (increasing during training) non-specific auditory-speech, physical and psycho-emotional stress.

For example, there is a method of speech rehabilitation (patent RU 229491 C2), in which training sessions are conducted with pronouncing words and / or related phrases while maintaining patient equilibrium in a vertical position on a stable platform of a computerized stabilizer during a computer game using visual biological feedback.

The methodical method used in the known method, on the one hand, aims to reduce the concentration of attention on speech loads to reduce the patient's psycho-emotional stress during the training period, but on the other hand, it does not allow to activate speech function and does not contribute to the intensification of the rehabilitation process.

For the prototype of the proposed method, a method for the restoration and development of human speech functions was selected, including a course of speech rehabilitation using increasing auditory-speech, physical and psycho-emotional stress (patent RU 2306153 C2).

This method is used to treat stuttering, however, according to general approaches to the rehabilitation and development of human speech functions (activation of the speech function and intensification of the rehabilitation process by increasing the load on specific and non-specific adaptation systems), this method is, from the point of view of the authors, the closest analogue of the proposed way.

The prototype method provides for the comprehensive rehabilitation of the patient, taking into account specific speech disorders and the degree of their deviations from the norm, and correction of existing disorders through social-speech, adaptive-physical, psychological and pedagogical rehabilitation.

In contrast to similar methods, in social and speech rehabilitation classes, the authors of the method achieve a deep disinhibition of speech through a dosed, increasing from class to class load on auditory perception, pronunciation and psychoemotional sphere. For this, the brain is first activated by stimulation of the auditory and speech zones.

In adaptive-physical rehabilitation classes, deep muscle stretching is performed, for which the main part of the session includes performing the gymnastics exercise “bending over” in a static isometric mode. When performing exercises on the patient’s back, they provide an additional external load in the form of either pressure on the trainer’s hands or a load on the back.

In classes on psychological and pedagogical rehabilitation, stress resistance is developed by repeated repetition of stress loads increasing from class to class and their psycho-correction.

According to the authors, this method allows you to provide a persistent effect of cure in the complete absence of disease regression (stuttering), provided that drug therapy is excluded from the course of treatment.

The results of the application of this tactic for correcting speech impairment indicate the correctness and legitimacy of the approach to rehabilitation by using various “aggravating” loads.

Those. To increase the effectiveness of rehabilitation and development of speech functions, it is necessary to combine auditory-vocal, physical and psycho-emotional “aggravating” loads to simultaneously activate the systems involved and adaptive capabilities (stress resistance) of a person.

However, as you know, the use of “aggravating” loads, in particular, an increase in the auditory-vocal load, above threshold values of the adaptive capabilities of one system can lead to the development of functional diseases at the corporate level (autonomic dystonia syndrome, irritable bowel syndrome, etc.). Those. To determine an adequate rehabilitation tactics and reduce the risk of developing functional diseases, an objective rehabilitation diagnosis is primarily required.

The objective of the invention is to increase the efficiency of rehabilitation and development of speech functions of a sick or healthy person due to the maximum possible activation of auditory-vocal, physical and psycho-emotional capabilities of a person while reducing the risk of developing functional diseases.

The problem is solved in that in the method of restoration and development of human speech functions, which includes assessing the degree of speech deviations from the age norm and a course of rehabilitation exercises using speech exercises against the background of increasing auditory-speech, physical and psychoemotional loads,

the degree of speech deviations from the age norm is assessed using a 10-point scale of speech maturity and / or complication of a person’s reaction when interacting with the environment, where

- the absence of reaction reactions and interactions with the environment is estimated at 1 point,

- the presence of signs of a reaction to the external environment is assessed at 2 points,

- the presence of interaction with the external environment through vocalization and communication at the sound level is rated 3 points,

- interaction with the environment through communication using a syllable is estimated at 4 points,

- interaction with the environment through egocentric speech and communication at the word level is estimated at 5 points,

- interaction with the environment through egocentric speech and communication at the level of stable expressions is estimated at 6 points,

- interaction with the external environment through dialogue and communication at the level of a simple sentence is estimated at 7 points,

- interaction with the external environment through dialogue and communication at the level of complex sentences is estimated at 8 points,

- interaction with the external environment through polylogue and communication at the level of a simple text is estimated at 9 points,

- interaction with the external environment through polylogue and communication at the level of a complex text is estimated at 10 points;

the complex of speech exercises includes linguistic lessons with vocals;

auditory-speech loads increase in amplitude and frequency to the level of short-term stunning;

physical activity is increased to the level of vocalisms;

psycho-emotional stress build up to the level of simultaneous use of speech exercises and mixed mechanical, acoustic, optical and vestibular interference;

with a degree of speech deviations from the age norm of 1 and 2 points, classes are carried out that include physical exercises in the form of massage of the chest, larynx, hands, facial and articulating muscles against a background of a moderate irritant to the upper and lower respiratory system;

with a degree of speech deviations from the age norm of 3 points, classes are conducted aimed at activating vocalisms and including massage of the chest, larynx, hands, facial and articulating muscles using a pain stimulus on the upper and lower respiratory system;

with a degree of speech deviations from the age norm of 4 points, classes are conducted, including chest massage, larynx massage, brush massage, facial and articulation muscle massage, passive articulation gymnastics with elements of the maximum allowable tension and limitation of the chest excursion;

with a degree of speech deviations from the age norm of 5 points, classes are conducted aimed at the development of gestural speech and include passive articulation gymnastics with elements of the maximum allowable tension, active articulation and facial gymnastics with effects on various analyzers while restricting chest excursion;

with a degree of speech deviations from the age norm of 6 points, classes are conducted on the development of monologic speech with dialogue elements and including active articulation gymnastics, facial gymnastics, singing, as well as speech loads in the form of stable expressions of jargon speech;

with a degree of speech deviations from the age norm of 7 points, they conduct classes aimed at developing dialogue skills and including dramatic techniques in characters, conducted against the background of mechanical disturbances in the form of gymnastic exercises that the patient can perform in dynamic or static mode;

with a degree of speech deviations from the age norm of 8 points, they conduct classes aimed at developing dialogue skills and based on real events using beliefs, evidence and argumentation, as well as including singing in different octaves, pantomimics, rhetorical exercises conducted against the background of acoustic noise;

with a degree of speech deviations from the age norm of 9 points, classes are conducted aimed at developing rhetoric skills, conducted against the background of optical interference;

with a degree of speech deviations from the age norm of 10 points, classes are conducted aimed at developing rhetoric skills on relevant topics conducted against the background of vestibular loads.

The technical result of the invention is to increase the efficiency of solving logopedic, psychological and social problems of a sick or healthy person during the restoration and development of his speech functions.

The method of restoration and development of human speech functions is as follows.

1. Establish a rehabilitation diagnosis.

Using tests to understand the patient’s speech of others, the possibilities of expressing their own desires, thoughts, communicating with others, they assess the state of speech development and compare with the scale of speech maturity and / or the complexity of response reactions when interacting with the environment (Myshlyaeva S.Yu. Scale).

Next, the results are compared with the scale and the degree of deviation of the results is evaluated in points.

Speech underdevelopment (lack of response reactions and interactions with the environment) - 1 point.

Speech underdevelopment (the presence of signs of a reaction to the external environment) - 2 points.

Speech underdevelopment (vocalization, communication at the sound level) - 3 points.

Speech underdevelopment (vocalization, communication using the syllable) - 4 points.

Delayed speech development (egocentric speech, communication at the word level) - 5 points.

Delayed speech development (egocentric speech, communication at the level of stable expressions) - 6 points.

Normal speech development (dialogue, communication at the level of a simple sentence) - 7 points.

Normal speech development (dialogue, communication at the level of a complex sentence) - 8 points.

Accelerated speech development (polylogue, communication at the level of a simple text) - 9 points.

Accelerated speech development (polylogue, communication at the level of a complex text) - 10 points.

2. At the stage of restoration of the patient's speech functions, individual or group classes are conducted.

- With a rehabilitation diagnosis of "Speech maldevelopment" 1 and 2 points

conduct classes, including physical exercises in the form of massage of the chest, larynx, hands, facial and articulatory muscles against the background of a moderate stimulus to the upper and lower respiratory system.

- With the rehabilitation diagnosis "Speech maldevelopment" 3 points are carried out

classes, including massage of the chest, larynx, hands, facial and articulatory muscles using a moderate and painful stimulus to the upper and lower respiratory system before evoking sound responses and vocalisms.

The main action is the activation of vocalisms.

- With a rehabilitation diagnosis of "Speech maldevelopment" 4 points are carried out

classes, including chest massage, larynx massage, brush massage, facial and articulation muscle massage + passive articulation gymnastics with elements of maximum allowable tension + chest excursion restriction.

The main action is the activation of vocalisms.

- With a rehabilitation diagnosis of “Delayed speech development” of 5 points, classes are conducted that include passive articulation gymnastics with elements of maximum allowable tension + active articulation gymnastics + facial gymnastics + effects on various analyzers + limitation of chest excursion.

The main action is sign language.

- With a rehabilitation diagnosis of “Delayed Speech Development” of 6 points, classes are carried out, including active articulatory gymnastics + facial gymnastics + name-calling using stable expressions + singing.

The main action is a monologue with dialogue elements with loads using slang speech.

3. At the stage of development of the patient's speech functions, individual or group exercises are conducted against the background of interference and loads.

- With a speech development of 7 points, classes are carried out, including mechanical disturbances, any gymnastic exercises that the patient can perform in dynamic or static mode (standing on one leg, standing on a chair, squats, jumping, push-ups, twine, using certain gestures, etc. e.) + external mechanical interference (shocks, vibration, patting, tickling, etc.).

The main action is a dialogue using drama in the characters.

- With a speech development of 8 points, classes are held, including singing in different octaves, pantomime, the use of rhetorical exercises + acoustic noise (loud noises and sounds: knocking, popping, whistling, screaming, playing musical instruments, melodies, parallel conversation, singing).

The main action is a dialogue based on real events using beliefs, evidence and argumentation (a family dispute, a production conflict, a diploma defense, etc.).

- With a speech development of 9 points, classes include optical interference (various eye movements during a conversation in static and dynamic mode, turns, rotation of the eyeballs, closing and blinking eyes, viewing images of various contents - magazines, illustrations, coloring pictures, folding puzzles , mosaics, bright light in the eyes, flickering of various objects in front of the eyes).

The main action is rhetoric.

With a speech development of 10 points, classes are carried out, including vestibular loads (handstand, rotation around its axis, rotation of the head + mixed loads (use combinations of various 2-3 interferences).

The main action is rhetoric on current topics.

The use and increase of “aggravating” loads is carried out gradually or stepwise with the regulated combination of load and rest under constant control of breathing, heartbeat and other vegetative parameters.

The interval between classes is kept within the limits guaranteeing the restoration and increase of communicativeness at each stage of classes, as well as the prevention of possible voice and auditory complications.

The novelty of the method is due to the fact that according to available scientific and practical information to solve the problem, the proposed solution in rehabilitationology, in particular in the restoration and development of human speech functions, was not used.

The scientific and technical level of the invention is due to new scientific information obtained as a result of studies related to the study of the mechanisms of medical rehabilitation of patients with disorders of the nervous system, i.e. in people with motor, mental and speech disorders, as well as in the course of work on the discovery “The Phenomenon of Restoring the Structural and Functional Maturity of the Human Brain in Ontogenesis”.

The scientific and technical level of the proposed method is also due to the fact that it is based on the ontogenetically consistent stimulation of speech development (logogenesis), taking into account the specific quality disorders typical for different clinical forms of the disease, as well as the provision that:

- with the help of ontogenetically oriented phonopedics, deep disinhibition of speech (retraining) is carried out, which affects sociability (through social process),

- the sound load dosed in amplitude and frequency leads to the specialization of the middle and inner ear and stem structures of the brain, which causes the development of phonetic hearing (sound attention),

- the development of phonemic hearing (voice attention) is associated with the maturation of the median structures of the brain (midbrain),

- air pressure, vibration in various cavities (chest, pharynx, cavity of the facial skeleton) causes the formation of proprioceptive and vibrational sensitivity,

- maturation of nerve fibers (myelination), differentiation of nerve cells of the subcortex (basal nuclei) and cerebral cortex are the basis for understanding sounding speech (sensory side of speech),

- the motor side of speech depends on the degree of conscious control of the respiratory system and articulation apparatus,

- when the afferent link of the reflex arc (the peripheral end of the cranial nerves) is exposed, excitation occurs in the nuclei of the cranial nerves of the caudal group, and new connections are created between the pyramidal tract and cranial nerves involved in the act of reproducing voice and speech.

A significant difference between the proposed method and the known ones is that it most fully complies with the principles of a systematic approach to the restoration and development of human speech functions, is based on the standards of natural speech development (S. Myshlyaev scale) and consistently provides the solution to the following tasks:

- The formation of proprioceptive and vibrational sensitivity.

- The development of phonetic and phonemic hearing.

- The formation of respiratory movements.

- The formation of articulation structures.

- The formation of the pronunciation skills of individual sounds.

- Formation of singing skills.

- Synthesizing sounds into sound complexes (syllable, word).

- Formation of a statement (a complex sentence, including: retelling, monologue, dialogue) based on semantic, meaningful and grammatical analysis and synthesis of words and constructions.

- Training in the use of non-verbal means of communication (pose, gesture, facial expressions, pantomimics) to reinforce the content side of the statement.

- The formation of culturological stereotypes of communication (greeting, farewell, appeal, polite words, obscene language).

- Formation of public speaking skills.

A significant difference between the proposed method and the known ones is that the transition from non-verbal methods of communication (to the possibility of using speech exercises) to verbal is carried out through activation of the respiratory centers and simultaneous control of the articulation apparatus.

To do this, use techniques to physically limit chest excursions and speech therapy massage.

A significant difference of the proposed method is also that speech exercises are used in a complex of linguistic lessons with vocals (improving the voice or speech stereotype).

This is due to the fact that, from a structurally functional point of view, the peripheral end of the auditory analyzer is the ears, and the temporal lobes of the brain are the end, so a combination of linguistic lessons with vocals is necessary for the formation of new (missing) neuro-vocal connections.

It is necessary to have a long and constantly increasing voice pressure in speech classes, as a specific means by which a directed effect on the patient’s logogenesis or speech is achieved.

A significant difference of the proposed method is that speech exercises are used in a complex of linguistic lessons with vocals, while the auditory-speech loads are increased in amplitude and frequency to the level of short-term stunning, physical exercises are increased to the level of vocalisms, psycho-emotional loads are increased to the level of simultaneous the use of speech exercises and mixed mechanical, acoustic, optical and vestibular interference.

It is practically proved that the use of special linguistic lessons with vocals allows you to 100% correct existing speech disorders and prevent the formation of pathological speech stereotypes.

In the aggregate of all the claimed essential features of the invention, the proposed method for the restoration and development of human speech functions when used provides acceleration and more complete restoration and development of the speech functions of a sick or healthy person at any stage of its ontogenetic development.

Claims (1)

A method for the restoration and development of human speech functions, including an assessment of the degree of speech deviations from the age norm and a course of rehabilitation classes against the background of increasing auditory, physical and psychoemotional stresses, characterized in that the degree of speech deviations from the age norm is assessed using a 7 point maturity scale and / or complications of human reaction reactions in interaction with the external environment: the presence of interaction with the external environment through vocalization and communication at the sound level evaluated as 3 points; interaction with the environment through communication using a syllable - 4 points; interaction with the environment through egocentric speech and communication at the word level - 5 points; interaction with the environment through egocentric speech and communication at the level of stable expressions - 6 points; interaction with the external environment through dialogue and communication at the level of a simple sentence - 7 points; interaction with the external environment through dialogue and communication at the level of complex sentences - 8 points; interaction with the environment through polylogue and communication at the level of a simple text - 9 points; interaction with the external environment through polylogue and communication at the level of a complex text - 10 points, and with a degree of speech deviations of 3 points, classes include massage of the chest, larynx, hands, facial and articulating muscles and the use of moderate and painful stimuli on the upper and lower part of the respiratory system before evoking response sound reactions and vocalisms; 4 points - conduct classes including chest massage, larynx massage, brush massage, facial and articulation muscle massage with passive articulation gymnastics with elements of maximum allowable tension and chest excursion restrictions; 5 points - conduct classes, including passive articulation gymnastics with elements of maximum allowable tension with active articulation gymnastics with mimic gymnastics, as well as the impact on various analyzers and limiting chest excursions; 6 points - conduct classes, including active articulatory gymnastics with facial gymnastics, as well as name-calling using stable expressions and singing; 7 points - conduct classes that include mechanical interference, any gymnastic exercises that the patient can perform in dynamic or static mode: standing on one leg, standing on a chair, squats, jumping, push-ups, twine, the use of certain gestures, as well as external mechanical interference : tremors, vibration, patting, tickling; 8 points - conduct classes that include singing in different octaves, pantomime, using rhetorical exercises and including acoustic noise: loud noises and sounds: knocking, crackling, whistling, screaming, playing musical instruments, melodies, parallel conversation, singing; 9 points - conduct classes including optical interference: various eye movements during a conversation in static and dynamic mode, turns, rotation of the eyeballs, closing and blinking eyes, viewing images of various contents - magazines, illustrations, coloring pictures, folding puzzles, mosaics, bright light in the eyes, flickering of various objects in front of the eyes; 10 points - carry out exercises including vestibular loads: a handstand, rotation around its axis, rotation of the head, and also mixed loads: use combinations of various 2-3 interferences, while the auditory-speech loads increase in amplitude and frequency to the level of short-term stunning, psycho-emotional stress is increased to the level of simultaneous use of speech exercises and mixed mechanical, acoustic, optical and vestibular interference, physical activity is increased to the level of vocalisms.