RU2759869C1 - Method for the treatment of children with delayed speech development - Google Patents

Abstract

FIELD: medicine; pediatrics; neurology; psychiatry; physiotherapy.

SUBSTANCE: invention relates to medicine, namely pediatrics, neurology, psychiatry, physiotherapy; it can be used for the treatment of children with delayed speech development. Physiotherapeutic effect is carried out against the background of drug therapy, including drugs selected from a group: sedative, nootropic, metabolic drugs. As a physiotherapeutic effect, photochromotherapy is carried out by exposure to red narrow-band optical LED radiation with a wavelength of 650 nm on parotid-masticatory areas and on the submandibular area with closed jaws at a radiation power of 50 MW, radiation power density of 10 MW/cm², total radiation dose of 18 J, in continuous mode, lasting 6 minutes, 2 minutes per field, the total area of skin irradiation is 54 cm², according to a contact stable technique. The course of treatment consists of 10-12 procedures carried out by 1 procedure daily on a Spectrum LC device. Speech therapy correction includes general developmental and speech therapy exercises. Repeated courses are carried out in 3-4 months until the speech corresponds to the age level.

EFFECT: method provides an improvement in the mobility of organs of the articulatory apparatus, an increase in the volume of movements, the development of child's speech abilities, the exclusion of fixation of the child during the procedure due to joint photochromotherapy, general developmental and speech therapy exercises against the background of drug therapy.

1 cl, 6 tbl, 3 ex

Description

The invention relates to the field of medicine, namely pediatrics, neurology, psychiatry, physiotherapy, and can be used in the complex therapy of children with various manifestations of delayed speech development (RAD).

Under the wording, delayed speech development most often means a lag in the formation of speech from the age standards in children under 3-4 years of age.

One of the indicators of the vital competence of a preschool child is his speech activity in various spheres of life, associated with the ability to establish speech interaction with people around him, use communication to satisfy his own needs, and competently build and express his thoughts. In recent years, there has been an increase in the number of children with speech disorders. According to domestic sources, speech development disorders occur up to 25% among school-age children [1]. In foreign literature sources, this indicator varies - from 3.8 to 15.6% [2].

Delayed speech development in the absence of timely comprehensive care in most children causes pathocharacterological development of the personality (aggressiveness, lack of attention, memory, performance), which leads to social maladjustment and a decrease in the quality of life of patients [3].

For this reason, the introduction of new, effective and safe techniques, especially at an early stage of the disease, is an urgent task.

The main directions of correction for violations of speech formation in children today are: speech therapy, psychological and pedagogical, psychotherapeutic assistance to a child and his family, as well as drug treatment, in the form of repeated courses of drugs, mainly of a nootropic series.

The main goal of therapy for the disease is to achieve stable clinical remission and prevent the development of delayed consequences of speech underdevelopment. Treatment of children with delayed speech development is complex, including pathogenetic and symptomatic therapy and is aimed at normalizing the child's speech function.

In order to correct defects of the speech apparatus, two main strategies are currently being actively used at the outpatient stage: drug therapy and physiotherapeutic methods of treatment.

Despite the wide variety of groups of drugs used to correct speech disorders, the effectiveness of none of the drugs used is sufficient, since there are no drugs intended for treatment directly, RRR, therefore, symptomatic drugs are prescribed, which are most often used in combination ... In addition, a long course of taking these drugs is required to develop a visible effect, and the presence of side effects in some cases limits their use.

The second direction of correction of speech disorders is physiotherapy methods of treatment. For this purpose, children are used: medicinal electrophoresis of vascular drugs, sinusoidally modulated currents, inductothermy [3].

However, the use of these techniques also has its drawbacks, especially given their use in preschool children. So, when using medicinal electrophoresis, there are the following contraindications: individual intolerance to galvanic current, disorders of skin sensitivity, violation of the integrity of the skin in the places where electrodes are applied, acute purulent inflammatory processes, eczema, neoplasms or suspicions of them, systemic blood diseases, pronounced atherosclerosis, decompensation cardiac activity, fever, cachexia. There is a possibility of allergic reactions to the medicinal substances used during the procedure. Also, excessive or prolonged exposure to electric current on the patient's body can cause redness and irritation of the skin at the site of application of the napkin. The procedure is carried out in a strictly recumbent position, which also causes certain technical difficulties, given the preschool age of the patients.

When using sinusoidally modulated currents (SMT), the duration of the procedure is 15-20 minutes, the patient must lie strictly in a fixed position, given the procedure in pediatric patients, this additionally causes technical difficulties. During the procedure, the patient experiences a sensation of rhythmic muscle contraction due to the stimulation of muscle fibers in the area of exposure to CMT. Therefore, during the procedure and after it, it is necessary to constantly contact the child and learn from him about the experienced sensations and discomfort in order to prevent the development of side effects. CMT therapy has a rather long list of contraindications.

When using inductothermy, the active factor of which is a high-frequency alternating electromagnetic field, the field energy penetrates to a depth of 6-8 cm. In this case, the energy of the high-frequency magnetic field is absorbed mainly in muscles or tissues (blood, lymph). As a result, interstitial heat is formed, which leads to an increase in the temperature of the skin by 1-6 ° С, and deep tissues - by 2-4 ° С. When exposed to large volumes of tissues with an extensive vascular network, general reactions of the body are also possible. It is very important to carefully dose this physical factor, since at its high intensity, a collaptoid reaction may develop. This method also has a number of contraindications: purulent processes, a tendency to bleeding, violation of thermal sensitivity.

As a prototype for the closest technical essence, we have chosen a method of treating children with ZRR by physiotherapeutic action, which consists in low-intensity laser radiation (LILI) on the device "UZOR-A-2K". Irradiation was carried out in a sitting position of the patient in the scalp zone (motor, inhibition of chorea and tremor, psychomotor, speech), and after 2 hours on acupuncture points (general effects used for speech disorders, impaired innervation and contractures of the muscles of the articulatory apparatus, hypersalivation). For this, a wavelength of 0.89 μm was used, the output radiation power was 2.7 W, the pulse repetition rate was 5-1500 Hz, the exposure time to the zone was 1.5 minutes, and the acupuncture point was 5-30 seconds. A contact-mirror method of exposure with a pulse repetition rate of 80 Hz was applied to the zones. After the procedure, speech therapy correction is carried out according to the generally accepted technique, including general developmental and speech therapy exercises. The course of procedures consisted of 10 procedures performed daily [4].

• The disadvantages of the method we have chosen as a prototype include:

• Insufficient effectiveness of treatment, characterized by:

- insufficiently high quality sound pronunciation, and

- insufficient expressiveness of speech;

- insufficient increase in the performance of tests characterizing the mobility of the organs of the articulatory apparatus (4 out of 9 tests had an increase);

• the need for strict fixation of the child during the procedure, since the technique is point-like, which complicates the implementation of the method;

• duration of application of the method, which is more than 2 hours;

• the use of high doses of radiation causes the development of complications: exacerbation of the disease, the appearance of dizziness, headache, drowsiness, psychological discomfort, a decrease in blood pressure, which is associated with the depletion of the antioxidant defense of the body;

• contraindications to the use of the method, which are:

- cardiovascular diseases in the decompensation phase;

- violation of cerebral circulation of the II degree;

- pulmonary and pulmonary heart failure in the phase of decompensation;

- malignant neoplasms;

- benign formations with a tendency to progress;

- diseases of the nervous system with sharply increased excitability;

- fever of unexplained etiology;

- diseases of the hematopoietic system;

- hepatic and renal failure in the stage of decompensation;

- diabetes mellitus in the stage of decompensation;

- hyperthyroidism;

- pregnancy at all stages;

- mental illness in the acute stage;

- hypersensitivity to laser radiation (photodermatitis and photodermatosis, porphyrin disease, discoid and systemic lupus erythematosus).

The technical result of the invention is:

• increasing the effectiveness of treatment by:

- improving the mobility of the organs of the articulatory apparatus, increasing the range of motion, thereby eliminating blocks for the development of speech;

- improving the development of the child's speech abilities, assessed by the quality of sound pronunciation, as well as by the expressiveness of speech;

• reducing the time of the procedure;

• exclusion of the development of complications inherent in the prototype method;

• expansion of the patient population at the expense of patients with contraindications to the prototype method;

• exclusion of strict fixation of the child during the procedure, which will greatly simplify the implementation of the method.

The technical result of the invention is achieved by the fact that the method of treating children with delayed speech development consists in a physiotherapeutic effect, carried out against the background of drug therapy, including sedative, nootropic, metabolic drugs. As a physiotherapeutic effect, photochromotherapy is carried out by exposure to red narrow-band optical LED radiation with a wavelength of 650 nm on the parotid-masticatory regions and on the submandibular region with closed jaws, at a radiation power of 50 mW, a radiation power density of 10 mW / cm ² , a total radiation dose -18 J, in continuous mode, lasting 6 minutes, per field for 2 minutes. The total area of skin irradiation is 54 cm ² , according to a stable contact technique. The course of treatment consists of 10-12 procedures, 1 procedure daily using the Spectrum LC apparatus. Speech therapy includes general developmental and speech therapy exercises. Repeated courses are carried out in 3-4 months until the speech corresponds to the age level.

The method is carried out as follows: The patient can receive the procedure while sitting on a chair or standing. Affect by a physical factor against the background of drug therapy, including sedative, nootropic, metabolic drugs. As a physical factor, photochromotherapy is carried out by exposure to narrow-band optical LED radiation with a wavelength of 650 nm on the parotid-chewing areas and on the submandibular region with closed jaws, with a radiation power of 50 mW, a radiation power density of 10 mW / cm ² , a total radiation dose - 18 J for one procedure, in continuous mode, lasting 6 minutes, for one field for 2 minutes, the total area of skin irradiation in one procedure is 54 cm ² . If the area of one field is 18 cm ² , then one field is 0.33 J / cm ² , according to the contact stable technique, 10-12 procedures, carried out one procedure daily on the Spectrum LC apparatus. After the physiotherapy procedure, speech therapy correction is performed, including general developmental and speech therapy exercises. Repeated courses are carried out in 3-4 months until the speech corresponds to the age level.

Drug therapy, including sedative, nootropic, vascular, metabolic drugs, is usually required for children with delayed speech development, due to the presence of a large number of concomitant neurological and behavioral features [5].

Exposure to red narrow-band optical radiation with a wavelength of 650 nm is used in the treatment of various pathological processes:

- with injuries of peripheral nerves (6);

- in the rehabilitation of cancer patients (7);

- with dystrophic degenerative diseases of the spine (8) with acute respiratory diseases (9);

- in the treatment of infected wounds, trophic ulcers, osteomyelitis (10).

Until now, in the complex therapy of children with delayed speech development, the effect on the parotid-masticatory regions and on the submandibular region with closed jaws, narrow-band optical radiation with a wavelength of 650 nm was not known.

The red color penetrates into biological tissues to a depth of 25 mm, being absorbed in the epidermis and the skin itself (dermis). About 25% of the falling energy reaches the subcutaneous fatty tissue. Red color (620-760 nm) is absorbed mainly by enzymes (catalase, ceruloplasmin), as well as chromatoform groups of protein molecules and, in part, oxygen [6]. With a local effect on the skin surface, the red color changes the local temperature in the irradiated tissues, causes vasodilation, an increase in the blood flow rate, which is manifested by mild hyperemia. Red radiation improves the functional state of the muscles. It has a trophic-stimulating effect by increasing blood circulation and accelerating blood flow, improving metabolic processes in pathological foci. It increases the tone of striated and smooth muscles, stimulates the maturation of collagen structures. There is a marked stimulation of the immune system and erythropoiesis. Red color actively affects the psycho-emotional status of a person, namely, it stimulates cortical activity.

In addition, the red color activates the functions of ventilation of the lungs, this is manifested in deeper and faster breathing. It also activates the reparative regeneration of damaged tissues, which leads to accelerated healing of wounds and ulcers of the skin and mucous membranes.

The impact is carried out on the peripheral speech apparatus, namely, on the areas of muscles involved in speech production, namely, on the parotid-chewing areas and on the submandibular region.

Radiation power, radiation power density, total radiation dose, continuous mode, duration of exposure to one field, total area of skin irradiation in one procedure, type of technique (contact stable), as well as the total number of procedures selected during the study.

A repeated course is carried out after 3-4 months, which is explained by the aftereffect time of this physical factor. Due to the fact that not all sounds, syllables and words immediately appear in the child's speech, a second course of treatment is required until the speech is maximally matched to the age level.

The set of distinctive essential features of the proposed method of treating children with IAD is new and allows you to achieve the technical result of the invention.

Here are examples from clinical practice:

Example 1. Patient G., 4 years old.

He was admitted for outpatient treatment on March 3, 2020 with a diagnosis of Delayed development of expressive speech. Attention disorder risk group.

Complaints about a delay in speech development in speech about 5 words, syllables, in December 2018 he underwent a course of treatment with Pantogam, more words appeared in the speech, but incomprehensible ones.

Objectively: On the part of the lororgan, hearing is normal. There were no injuries, convulsions, fainting. Heredity is not burdened. Cranial nerves: symmetrical, tongue: in the midline, muscle tone: physiological, proprioceptive reflexes: D = S, negative meningeal symptoms.

Up to a year was observed by a neurologist with a diagnosis of Perinatal encephalopathy of the central nervous system. Over the past 4 months, there is no dynamics in speech.

Received drug treatment in accordance with clinical guidelines:

03.03.2020 g pantocalcin 0.25 mg 1 tablet 3 times a day for 3 months, fish oil in an age dose for 1 month. 05/29/2020 g Cerebrolysin 1.4 ml IM No. 10 every other day the first injection is 0.5 ml, the second 1 ml IM with 3 injections 1.4 ml (body weight 14 kg), tenoten for children 1 ton 2 times a day for 1 month.

The effectiveness of the therapy on clinical grounds before the appointment of treatment and after the course of treatment was carried out using:

• research of dynamic coordination of articulatory movements;

• assessment of sound pronunciation, that is, the pronunciation of vowels and consonants. The assessment of sound pronunciation before the course of treatment was 3 points;

• assessing the expressiveness of speech;

The dynamic coordination of articulatory movements was assessed using the following tests:

№1 - "Smile-tube" (alternation of movements); No. 2 - "Delicious Jam" (put the tip on the upper lip, move it inside the mouth for the upper incisors); No. 3 - "Broom brush" (movements of the tongue to the right, left); No. 4 - "Wheel" (circular movements of the tongue along the upper and lower lip); № 5 - "Swing" (movement of the tongue up and down); No. 6 - "Horse" (tongue clatter); No. 7 - "Painter" (movement with the wide tip of the tongue across the sky); №8 - "Snake" (movements with a narrow tongue forward and backward); No. 9 - "Imitation of a cough". The worse the child performed on the test, the higher the grade point. This test allows you to assess:

- the sequence of the movements;

- the ability to switch from one movement to another;

- inertia of movement, perseveration;

- the pace of movements;

- range of motion (range of motion is sufficient, limited);

- Accuracy of execution of movements (exact execution, approximate, search for articulation, replacement of one movement with another);

- the presence of synkinesis, hyperkinesis, salivation.

The study of the dynamic coordination of articulatory movements before the start of treatment showed difficulties in performing these tests.

Also, the assessment of sound pronunciation, that is, the pronunciation of vowels and consonants, was carried out. The assessment of sound pronunciation before the course of treatment was 3 points.

Evaluation of expressive speech was carried out by observing how the child communicates while completing tasks. The assessment of expressive speech before the course of treatment was equal to 2 points.

Against the background of drug therapy, with nootropic, neuroprotective, antioxidant and tissue-specific action - Cortexin 5 mg IM No. 10, the first injection of 1 mg followed by 5 mg; then with neurometabolic, neuroprotective and neurotrophic effects - pantocalcin 0.25 mg 1 tablet 2 times a day for 2 months and speech therapy correction according to the generally accepted technique, including general developmental and speech therapy exercises, acted as a physical factor according to the claimed method. We performed 10 procedures, one procedure daily. Speech therapy correction according to the generally accepted method, including general developmental and speech therapy exercises, was carried out after each physiotherapy procedure, 10 sessions.

After the course of treatment, according to the results of the dynamic coordination of articulation movements, the performed tests improved markedly (Table 1).

The effectiveness of the therapy on clinical grounds in patient D, 4 years after the first course of treatment:

• indicators of dynamic coordination of articulatory movements when performing tests №№ 1, 4, 5, 6, 8, 9 decreased by 1 point, which indicates a positive trend.

• assessment of expressive speech - 2 points,

• the score for sound pronunciation decreased and amounted to 2 points.

Thus, the child's articulatory motor skills, and, accordingly, his speech abilities (sound pronunciation, expressive speech) improved during the period of complex therapy, but speech correspondence to the age level was not achieved, and therefore a second course of treatment was required after 4 months.

The effectiveness of the therapy on clinical grounds in patient D, 4 years after a second course of treatment after 4 months:

• indicators of dynamic coordination of articulation movements decreased according to tests No. 1, 8, 9 to 1 point, that is, the tasks were performed correctly, and according to tests No. 2, 3 there was a decrease by 1 point after the first course of treatment, the results of tests No. 2, 3 were previously 2 points;

• the assessment of sound pronunciation is equal to 1 point, and after the first course it was equal to 2 points:

• the assessment of expressive speech is 1 point, and after the first course it was equal to 2 points:

In patient G., 4 years old, after 4 months of a second course of treatment, speech correspondence to the age level was achieved.

Example 2. Patient A., 5 years old.

He was admitted for outpatient treatment on 25.12.2018 with a diagnosis of delayed speech development.

Objectively: in March 2020, they finished taking encephabol, speech is still fuzzy, there are many simplified words, simple sentences in speech, questions have appeared, difficulties in retelling. On the part of the lororgan, hearing is normal. There were no injuries, convulsions, no fainting. Heredity is not burdened. Cranial nerves: symmetrical, tongue: in the midline, muscle tone: physiological, proprioceptive reflexes: D = S, negative meningeal symptoms.

Drug treatment: Pantocalcin 0.25 mg 1 tablet 2 times a day for 2 months.

A study was carried out on the dynamic coordination of articulatory movements.

The assessment of sound pronunciation before the course of treatment was 3 points.

The assessment of expressive speech before the course of treatment was 3 points.

Received medical treatment in accordance with clinical guidelines.

In complex therapy against the background of drug therapy, with neurometabolic, neuroprotective and neurotrophic effects - pantocalcin 0.25 mg 1 tablet 2 times a day for 2 months, as well as speech therapy correction according to the generally accepted method, including general developmental and speech therapy exercises, therapy with red narrow-band optical radiation was used according to the claimed method of treatment. We performed 11 procedures, one procedure daily. Speech therapy correction according to the generally accepted method, including general developmental and speech therapy exercises, was carried out after each physiotherapy procedure, 11 sessions.

The effectiveness of the therapy on clinical grounds in patient A., 5 years after the course of treatment:

• according to the results of dynamic coordination of articulatory movements, the indicators improved (Table 2) according to the results of the performed tests No. 1, 2, 5, 6, 7, 8, 9 there was a decrease by 1 point.

• the assessment of sound pronunciation decreased and amounted to 2 points,

• the assessment of the expressive speech of the treatment became equal to 2 points, Thus, the child's articulatory motor skills, and, accordingly, his speech abilities (sound pronunciation, expressive speech) improved during the period of complex therapy, but speech correspondence to the age level was not achieved, and therefore a repeated course was required treatment.

The effectiveness of the therapy according to clinical signs in patient A., 5 years old after a second course of treatment after 3.5 months:

• indicators of dynamic coordination of articulatory movements have improved (Table 2). According to the results of the performed tests No. 3, 4, 6, 8, 9, there was a decrease in indicators by 1 point. As a result, 4 tests were performed correctly (No. 1, 6, 8, 9).

• the assessment of sound pronunciation is equal to 1 point, and after the first course it was equal to 2 points:

• the assessment of expressive speech is equal to 2 points and after the first course it was equal to 2 points, that is, it remained unchanged;

After 3 months of a second course of treatment in 5-year-old patient A., speech correspondence to the age level was achieved.

Example 3. Patient D., 4 years old. Was admitted for outpatient treatment on 03/27/2020 with a diagnosis of delayed speech development. Risk group for ADHD.

Objectively: No phrasal speech, self-care skills by age.

on 18.02.2019, he took a course of pantocalcin without a positive effect.

The family is bilingual.

On the part of the lororgan, hearing is normal. There were no injuries, convulsions, no fainting. Heredity: a cousin under 5 years old was diagnosed with motor alalia. Cranial nerves: symmetrical, tongue: midline, dystonic, muscle tone: physiological, proprioceptive reflexes: D = S, negative meningeal symptoms. A study was carried out on the dynamic coordination of articulatory movements.

The assessment of sound pronunciation before the course of treatment was 4 points.

The assessment of expressive speech before the course of treatment was 3 points.

Received medical treatment in accordance with clinical guidelines.

In complex therapy against the background of drug therapy, with neurometabolic, neuroprotective and neurotrophic effects - pantocalcin 0.25 mg, 1 tablet 3 times a day for 2 months, as well as speech therapy correction according to the generally accepted method, including general developmental and speech therapy exercises, therapy with a red narrow-band optical radiation. We performed 12 procedures, one procedure daily. Speech therapy correction according to the generally accepted method, including general developmental and speech therapy exercises, was carried out after each physiotherapy procedure, 12 sessions.

The effectiveness of the therapy on clinical grounds in patient D., 4 years after the course of treatment:

• indicators of dynamic coordination of articulatory movements have improved (Table 3)

After the first course of treatment, according to the results of the performed tests No. 3,4,5,7,9, there was a decrease by 1 point.

• the assessment of sound pronunciation decreased and amounted to 3 points,

• the assessment of expressive speech became equal to 2 points,

When assessing the effectiveness of complex therapy, positive dynamics was noted, in the form of an improvement in the mobility of the organs of the articulatory apparatus, and an increase in the range of movements, thereby eliminating blocks for the development of speech, according to the indicators of dynamic coordination of articulatory movements (Table 3). Also, the child's sound pronunciation and expressive speech improved, but speech correspondence to the age level was not achieved, and therefore a second course of treatment was required.

The effectiveness of the therapy on clinical grounds in patient D., 4 years old after a second course of treatment after 3 months:

• indicators of dynamic coordination of articulatory movements improved, according to the results of tests No. 1, 2, 3, 6, 8, there was a decrease in indicators by 1 point. As a result, given the initial difficulties in completing most of the tasks, 2 tests were performed correctly for the final testing (No. 1, 3).

• the assessment of sound pronunciation is 3 points, and after the first course it was equal to 2 points:

• the assessment of expressive speech is equal to 2 points and after the first course it was equal to 2 points, that is, it remained unchanged;

After a repeated course of treatment after 3 months, positive dynamics was noted, expressed in an improvement in the mobility of the articulatory apparatus, sound pronunciation and expressive speech in patient A., at 4 years old, speech correspondence to the age level was not achieved, therefore, after 3 months, a second repeated course was carried out. after which the speech correspondence to the age level was achieved. In order to prove the higher efficiency of the effect of red narrow-band optical LED radiation in the treatment of patients with delayed speech development, we present the results of treatment according to the claimed method, as well as according to the prototype method.

We compared the proposed method (16 patients - experimental group) and the prototype method (20 patients - control group).

A total of 36 children of 4-5 years of age were examined.

In order to assess the capabilities of the organs of the articulatory apparatus before and after the course of treatment, tests were carried out:

№1 - "Smile-tube" (alternation of movements); No. 2 - "Delicious Jam" (put the tip on the upper lip, move it inside the mouth for the upper incisors); No. 3 - "Broom brush" (movements of the tongue to the right, left); No. 4 - "Wheel" (circular movements of the tongue along the upper and lower lip); № 5 - "Swing" (movement of the tongue up and down); No. 6 - "Horse" (tongue clatter); No. 7 - "Painter" (movement with the wide tip of the tongue across the sky); No. 8 - "Snake" (movements with a narrow tongue back and forth); No. 9 - "Imitation of a cough". Tests were evaluated on a point system.

All patients were under the supervision of a speech therapist.

According to the results of the calculations, it was found that both methods provided by the end of the course a significant improvement in the state of articulatory motor skills according to all evaluated tests (p <0.05).

The next stage of the study was to compare the effectiveness of the proposed method and the prototype method with each other. The comparison results are shown in Table 4.

From table 4 it follows that in the experimental group, an increase is noted in tests No. 1, 5, 6, 8, 9 (29% of the initial level), while in the control group, an increase is noted in tests No. 2, 3, 4, 7. In the experimental group showed a greater increase in the performance of test No. 9 - 35, 56% of the initial level, and in the control group the increase was only 22.73% of the initial level. All these differences had a significant level of significance of differences (p <0.05).

According to the assessments of sound pronunciation and expressive speech, there is a greater increase in the group of the proposed method (assessment of sound pronunciation 31.25%, and assessment of expressive speech 38%) in comparison with the prototype (assessment of sound pronunciation 33.1%, and assessment of expressive speech 34%).

Thus, the proposed method, in comparison with the prototype method, significantly improved the performance:

• mobility of the organs of the articulatory apparatus, thereby eliminating blocks for the development of speech;

• speech function (improvement of sound pronunciation, expressive speech (assessment by speech therapy conclusions).

Thus, the proposed method allows, in comparison with the prototype:

• to increase the effectiveness of treatment by improving the mobility of the organs of the articulatory apparatus, thereby, eliminating blocks for the development of speech, to improve sound pronunciation, expressive speech;

• reduce the duration of the procedure (prototype method - more than 2 hours, the proposed method - 6 minutes);

• exclude the development of possible complications inherent in the prototype method;

• to expand the contingent of patients at the expense of patients who have contraindications to the prototype method;

• to exclude the strict fixation of the child during the procedure, which greatly simplifies the implementation of the method.

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Claims (1)

A method of treating children with delayed speech development, which consists in physiotherapeutic effects and speech therapy correction, characterized in that the physiotherapeutic effects are carried out against the background of drug therapy, including drugs selected from the group: sedative, nootropic, metabolic drugs; as a physiotherapeutic effect, photochromotherapy is carried out by exposure to red narrow-band optical LED radiation with a wavelength of 650 nm on the parotid-masticatory areas and on the submandibular region with closed jaws at a radiation power of 50 mW, radiation power density - 10 mW / cm ² , total radiation dose - 18 J, in continuous mode, lasting 6 minutes, 2 minutes per field, total skin irradiation area - 54 cm ² , according to a stable contact technique, the course of treatment consists of 10-12 procedures, 1 procedure daily using the Spectrum LC apparatus ; speech therapy correction includes general developmental and speech therapy exercises; repeated courses are carried out in 3-4 months until the speech corresponds to the age level.