Delayed speech development in children 3 years of age treatment. Treatment of delayed speech development at home. "We have no problems, everything is fine with the child."

The development and formation of speech for each child occurs individually, depending on many factors. You should not compare one baby with another, but it is necessary to clearly understand the difference between the norm and pathology in development. If alarms appear in the delay in the child's speech, you may need the help of specialists if you cannot cope with the problem on your own.

What are the signs of delayed speech development in children under 3 years of age? And when is it worth sounding the alarm? This will be discussed in the article.

The norms of the development of speech in a child

Initially, every healthy baby is born unable to speak. All communication with his parents occurs through a different intonation of crying. And only with time and with proper care, the formation and development of speech occurs, which consists of a number of stages. Each of them is important, and without completing one, the child will not be able to master the next. The main task of parents is to recognize and help in time if the child has difficulties.

Normal speech development is considered if the child begins to walk at the age of 2 to 5 months. From three to five, learns to pronounce individual syllables, entering the babbling period. From 11 months, the first words appear. At the age of 2-3 years, the child is able to construct the first simple sentences. From the age of three, a child is able to build his thoughts into a coherent small text, memorize and retell short poems.

Formation of speech in the first year of life

The first year of life is very important for the correct process of the formation of a child's speech. During this period, his brain, hearing, and organs of speech are actively developing. The harmonious combination of these components allows us to talk about the health of the baby. Hearing someone else's speech, he first tries to copy the speaker's intonation, and then publish similar sounds and syllables.

The first months of life, the child utters sounds unconsciously, gradually training his. Then he begins to utter these sounds in a chant, passing into the humming stage. From three months, the baby responds, imitating an adult, in separate syllables, and by half a year clearly pronounces individual sound combinations. By the age of 9 months, the baby is babbling. During this period, he develops articulation, he tries to repeat certain words after adults. Speech hearing, perception of objects, understanding of how an adult speaks to him is improved.

By the end of the first year of life, the baby is already able to repeat individual words. His vocabulary is about 10 words, consisting of the same type of syllables. The circle of recognizable objects has expanded. He recognizes the names of loved ones, is able to distinguish who is depicted in the picture.

Development of speech from one to three years

From the age of one, the child begins to actively move in space, interact with a large number of objects. This cannot but affect the development of his speech. The first words appear, denoting actions, while in a generalized form. The passive vocabulary is becoming wider, gradually the words from it pass into the active one. The child, with the help of an adult, when interacting with various objects, learns to generalize them.

After a year and a half, the first simple sentences appear in the child's speech, often consisting of two or three words. Then the baby learns the plural, and by the age of two he uses the case forms. Delayed speech development in children 3 years old is diagnosed if the child does not know how. But is it worth it to immediately panic? To begin with, it is important to find out the reason.

Reasons for rejection

Why is there a delay in speech development in children? The reasons may vary. To effectively correct problems in a child's speech, it is necessary to clearly define the problem and contact the right specialist. Scientists identify the main reasons:

• Developmental problems during the prenatal period.
• Birth trauma.
• Head trauma at an early age.
• Psychological trauma, delayed neuropsychic development.
• Hearing problems.
• Limited adult-child communication.

It's not a secret for anyone that the health of a child is laid during a woman's pregnancy, when all organs are formed, the brain develops, which is responsible for the formation and development of speech in the future. Infectious diseases, trauma, antibiotic treatment, unhealthy lifestyle of the expectant mother can adversely affect not only the health of the baby, but the development of his psyche. Numerous studies also show the negative impact on the child's speech that occurs during birth trauma. It is then that there may be a delay in speech development in children 3 years of age and older.

Head trauma at an early age, concussion, severe infectious diseases with complications, stress, neurosis - all this can affect both the development of the child's body in general and speech in particular.

Hearing problems have a very detrimental effect on the development and formation of speech. In this case, there is a delay in speech development in children 3 years old. It is impossible to teach a child to reproduce sounds if he does not hear and understand them. Perhaps this is just a temporary phenomenon associated with an illness, ear inflammation or the presence of a sulfur plug. Or is it a serious ailment, such as hearing loss. Depending on the degree of the disease, the correct treatment is prescribed by an otolaryngologist.

It is known that the delay in speech development in children 3 years of age is eliminated by his constant contact with adults. Parents talk to their child long before he learns to answer them. These they stimulate the work of the brain, positive emotions, and therefore speech. It is noticed that those children who, for some reason, are deprived of the opportunity to communicate, begin to talk much later.

Development of speech in children 3-4 years old: norm and delay

Until the age of three, the diagnosis is very rare, in most cases with various concomitant diseases. If there are reasons for concern, then a timely appeal to a specialist can completely solve the problem. Particular attention should be paid if the baby does not seek to interact with other children. He is not accepted into the game because his speech is incomprehensible to those around him. The child is in too much of a hurry and swallows some of the words. He cannot answer simple questions. Does not recognize and cannot name simple objects. Your child needs help if these symptoms are present. It is likely that these problems can go away with simple exercise with the parents. If there is no result from classes after a short time, you should contact a specialist.

Delayed speech development in babies under five years old

After 4 years, there is a high probability of a transition from delayed speech development to This is due to the fact that speech underdevelopment inhibits the development of thinking, and vice versa, problems in mental development inhibit the normal formation of speech in a child. Success in the development of speech depends on the selected methods for the treatment and correction of ZPRD. However, it was noted that after the age of five, the chance of completely eradicating deficiencies in speech drops sharply. And after 6 years, it is only 0.2%.

Signs of a problem

How do you know if your child really has a speech delay? How to recognize deviations? Scientists and experts identify 10 main features:

1. Lack of "revitalization reaction" in an adult up to 4 months.
2. Lack of babbling for up to 9 months.
3. Problems with chewing and swallowing up to one and a half years.
4. Lack of simple words and misunderstanding of elementary commands up to one and a half years.
5. Vocabulary does not expand by two years.
6. Inability to form simple two-word sentences by 2.5 years.
7. Inaudible, hasty, or too slow speech by age 3.
8. Inability to compose your own sentences at 3 years old or the use of adult mirror phrases.
9. Failure to understand simple explanations of an adult after three years.
10. Constantly open mouth and profuse drooling, not associated with teething.

Delayed speech development - when to sound the alarm?

The development of speech has rather blurred boundaries. You should not constantly compare your child with other children. The process of formation of speech is purely individual. Scientists have also recorded that boys begin to speak a little later than girls. However, the percentage of delays in the development of speech in boys is higher.

If a child at the age of three understands an adult perfectly, fulfills his requests, and he has no delays in mental development, then you should not panic. If only speech suffers in the baby, then the reason lies in the individual readiness for the formation of speech. If the child does not speak at all or very little after three years, or his speech is incomprehensible, then this is a serious reason to consult a specialist.

Therapy and correction methods

Methods for the treatment of delayed speech development:

• Medication.
• Classes with specialists.

If during the examination by specialists, for example, a child is diagnosed with brain damage, then, as a rule, drug treatment is prescribed. It goes in parallel with classes with a speech therapist, massage therapist, child psychologist, if the situation requires it.

Specialists helping children with speech delays

Parents should not panic, as delayed speech and speech development in a child is treated. A number of specialists are engaged in this:

• Speech therapist.
• Defectologist.
• Neurologist.
• The audiologist.
• Psychologist.

Every parent should know when and why to see a particular doctor. Speech therapists help to put the correct sound pronunciation, massage the speech muscles, improve diction.

Defectologists often work in tandem with a speech therapist, the main task of these specialists is to eliminate developmental problems in children with mental and (or) physical disabilities.

A neurologist will diagnose and help identify or exclude brain damage. Psychologists help to develop memory, attention, small cope with psychological trauma that entailed delays in the development of speech.

An audiologist is a doctor who helps treat hearing problems.

Prophylaxis

A delay in speech development in a 3-5 year old child is extremely unpleasant for the whole family. The most effective work to prevent the described problem is constant communication with the mother, adults, creating good conditions for the development of the baby as a whole, constant communication with your child, reading books to him, memorizing poems. Hands play an important role in the development of speech - drawing, modeling from plasticine, finger and didactic games. All of these methods are available for implementation at home. Even if signs of delayed speech development in children under 3 years of age are completely absent, maximum communication is still needed to avoid problems in the future.

Speech development in children with delayed speech and psycho-speech development

By the nature of my activity, I have to meet with 2 opposites in the parental attitude towards the child. The first are overly anxious parents who sound the alarm when a child at 2 years old does not speak in broad phrases. And how! According to Aunt Masha's neighbor, her baby already reads all of Barto's poems by heart!
And the second group of parents are those who stubbornly do not notice the problems in the development of the child, and only when doctors unequivocally put a delay in development, they turn to specialists. Sometimes I come across such neglected cases that it is bitter to tell parents that help is too late, and now it is only possible to adapt the child a little to life in society. So what is delayed speech development and delayed psychoverbal development?

When should the child start talking?
At 1 year old, a child should pronounce about 10 lightweight words and know the names of 200 objects (cup, bed, bear, mother, walk, swim, etc. everyday objects and actions). The child must understand the speech addressed to him and respond to it. The words "where is the bear?" - turn your head to the bear, and at the request “give me your hand” - extend your hand.
At 2 years old, the child must build phrases and short sentences, use adjectives and pronouns, vocabulary at this age increases to 50 words (this is at the bottom of the norm), as a rule, experts want to hear at least 100 words from the child.
At 2 and a half years old, a child should build complex sentences, using about 200-300 words, correctly pronounce almost all letters, except for "l", "r" and hissing, ask questions "where?", "Where?" The child should know his name, distinguish between relatives, imitatively portray the voices of the main animals and birds. Adjectives appear in speech - big, tall, handsome, hot, etc.
At 3 years old, the child should speak in sentences combined in meaning, use all pronouns correctly, actively use adjectives and adverbs in speech (far, early, hot, etc.). From the point of view of a layman, it is easy to identify that a 3-year-old has speech problems as follows - have a stranger listen to your baby. If he understands 75% of what your little one says, and a simple conversational speech develops between an adult and a child, then everything is in order. The speech of a child at 3 years old should change by gender, number. That is, if the question "do you want candy?" the child answers “want” instead of “want” - this is already a developmental deviation.

Where is the line between individual developmental characteristics and lag?
Let's calm down the super-shy parents and grandmothers first. The framework that is taken into account by the development norms is flexible enough. If your baby speaks not 10 words a year, but 7, then you should not sound the alarm. Sideways fluctuations a little earlier or a little later are permissible within 2-3 months. Moreover, for boys, it is possible to lag behind girls by 4-5 months.
Commoners believe that there is a certain area, an area of ​​the brain, which is responsible for the development of speech. In reality, speech is formed only with the coordinated work of both hemispheres of the brain. For full and timely speech development, it is necessary that both the right hemisphere, which is responsible for the emotional-figurative sphere, spatial thinking and intuition, and the left hemisphere, which is responsible for rational-logical thinking, develop harmoniously. In boys, the bundle of nerve fibers connecting both hemispheres is thinner than in girls and develops more slowly. Therefore, it happens that the exchange of information between the hemispheres is difficult, which makes it more difficult for boys to clothe their thoughts in the form of a grammatically correct statement. If there are no cerebral and mental deviations in development, with an early slight lag in speech development, the boy, with the help of specialists, will overcome it. Moreover, it is men who have a more developed figurative speech, which is why there are an order of magnitude more male writers and poets than women.
At the same time, it is necessary to warn the parents of the boys that it is impossible to start the situation, and if the deviation from the norm is significant, be sure to sound the alarm. Due to the gender peculiarities of development, it is among boys that the percentage of deviations in speech and psycho-speech development is high. Here are some examples. Among children who stutter, there are twice as many boys as girls. Among those suffering from alalia (almost complete absence of speech with preserved hearing), there are three times more boys, and the same number of children with dysarthria (when a child experiences difficulties in pronouncing many sounds and his speech is almost incomprehensible to others).
What is considered speech? Until the age of 2.5 years, it is permissible if the child speaks "baby tongue". Words are considered not only full-fledged "mom" and "dad", but also "bb" instead of "car", "car-car" instead of "crow", and "kup-kup" instead of "go swimming". The child can come up with their own designations for objects. If a child persistently calls pasta "Kamani" - this is also a word. It is permissible that the same combination of sounds be used to designate different objects ("ki" - pussy, socks, toss).
But if a child of 2.5 years old does not try to speak with phrases of 3-4 words like "mom de kup-kup" (mom goes to swim), then you must definitely sound the alarm. In principle, attentive specialists can note a delay in speech development at a fairly early period.

We list the signs of a significant delay in speech development:
- If a child at 4 months does not emotionally react to adult gestures and does not smile, he does not become animated when his mother addresses him.
- If the child is already 8-9 months old, and there is still no babbling (repeating ba-ba-ba, pa-pa-ta, etc. combinations), and in a year it is an extremely quiet child who makes little sounds.
- If the child is already one and a half, but he does not speak simple words, for example "mom" or "give" and does not understand simple words - his name or the names of surrounding objects: he is not able to fulfill the simplest requests like "come here", "sit down."
- If the baby has difficulty sucking or chewing. For example, if a one and a half year old child does not know how to chew and chokes even on a piece of apple.
- If at two years old the child uses only a few separate words and does not try to repeat new words.
- If at 2.5 years of age the active vocabulary is less than 20 words and word imitations. Does not know the names of surrounding objects and body parts: upon request, he cannot point to a familiar object or bring anything that is out of sight. If at this age does not know how to make two-word phrases (for example, "give me some water")
- If a three-year-old baby speaks so incomprehensibly that even relatives hardly understand him. He does not speak simple sentences (subject, predicate, object), does not understand simple explanations or stories about events in the past or future.
- If a three-year-old child “rattles”, that is, speaks too quickly, swallowing the endings of words or, conversely, extremely slowly, stretching them, although there is no example of such speech at home.
- If at three years old a child speaks mainly with phrases from cartoons and books, but does not build his own sentences, this is a sign of a serious developmental deviation.
- If, in a mirror, he repeats what adults say in front of him, even if to the point - this is the reason for an urgent appeal to a specialist, and a psychiatrist!
- If a baby of any age constantly has a slightly open mouth or there is increased salivation for no apparent reason (not related to the growth of teeth)

What is the difference between Speech Delay (SPD) and Psycho-Speech Development Delay (SPD)?
Delayed speech development is when only speech suffers, and the child's mental and emotional development is normal. This is the case when the child understands everything and fulfills the requests, but speaks little or very poorly.
Delayed psycho-speech development implies that the child has a developmental and general intellectual lag.
If up to 4 years of age the diagnosis of RRD is rare and occurs only in the presence of serious diseases, then over 5 years, only 20% of children with speech problems remain diagnosed with RRD. If up to 4 years old a child mastered the world, little entering into communicative connections, then from this age he receives the bulk of information in communication with adults and peers. If speech is inaccessible to the child, inhibition of mental development begins, and by the age of 5 years from the delay in speech development (ZRD), unfortunately, a delay in PSYCHO speech development (ZPRR) is formed. Therefore, if the doctors have given your baby a ZRR, you should not, like an ostrich, hide your head in the sand and wait that "everything will go away by itself." ZRR is reflected in the formation of the entire psyche of the child. If communication with others is difficult, this interferes with the correct formation of cognitive processes and affects the emotional-volitional sphere. Waiting without treatment and training with a defectologist at the age of 5 often leads to a pronounced lag behind peers, in which case education will be possible only in a specialized school.
Sometimes delayed speech development is associated with delayed psychomotor development. The baby begins later than other children to hold his head, sit, walk. They are awkward, often fall, get injured, and bump into objects. A characteristic sign is long-term potty training, when at 4.5-5 years of age the child continues to have "opportunities".

What is the reason for the occurrence of RRR and RRR in a child?
It should be understood that ZRR and ZPRR are not independent diseases, but the consequences of certain deviations in the child's health, namely, disorders of the brain, central nervous system, genetic or mental disorders. Studying the anamnesis of children with delayed speech development, experts have established that various adverse effects during intrauterine development, premature, prolonged or rapid childbirth, a long anhydrous period, birth trauma, fetal asphyxia during labor, hydrocephalus can lead to disruption of the normal formation of speech in children. increased intracranial pressure, genetic predisposition, mental illness and even early transfer of the child to artificial feeding.
Severe childhood illnesses, especially in the first three years of life, craniocerebral trauma or simply neglected frequent falls, hearing impairment of varying degrees - all this can cause a lag in speech development. Under the influence of unfavorable biological (or social) factors, it is those areas of the brain that are most intensively developing at the moment that are most significantly damaged. Studies have shown that speech retardation often affects children whose mother or father has any mental disorder, often quarrels or abuse alcohol.
Delayed speech development is characteristic of children with cerebral palsy, Down's syndrome, children with early childhood autism, hyperactivity syndrome.
Regardless of the cause that led to the damage to the brain, the outcome is the same - different areas of the brain begin to work incorrectly or not actively enough. In children with delays in psycho-speech development, the zones that are responsible for speech and intellectual abilities "suffered" to a greater extent, and as a result, speech and mental development is delayed.
Negative social factors do not directly affect the child, but they do affect mental development. Therefore, RRP and RRP are often diagnosed in twins and twins, in children growing up in bilingual families or in a poor linguistic environment.
Of course, the hereditary factor plays a significant role. I would like to dwell on this point separately. Often mothers come with a five-year-old child who practically does not speak. I ask, what were you waiting for a year ago, a year and a half ago? After all, the earlier you start correction and treatment, the better the result! Mothers shrug their shoulders and say that, they say, the mother-in-law says that the child’s father spoke only at 4 years old and immediately in phrases, and the uncle spoke late. And nothing, both of the people got out.

Dear mothers! If, according to the stories of relatives, you, your husband or uncle-aunt and other close relative spoke late, then this signals that your child already has a genetic predisposition to RRP. From generation to generation, the ZRR takes on more and more severe forms. It is necessary to understand that active mastering of lexical and grammatical patterns begins in a child at 2-3 years old and ends by 7 years. If a child has NO speech AT ALL, even word imitation at 6 years old, the probability that he will speak is 0.2%. If the child is 8 years old, then he will have to master alternative methods of communication - gesture, card, written, but he will no longer have active speech in general understanding.
Therefore, waiting for everything to resolve itself is an extremely irresponsible position!

The help of which specialists and when may a child with speech delay need help?
Unfortunately, many parents believe that speech therapists "treat" developmental delays, but speech therapists are teachers, not doctors. They only teach the child to correctly speak various sounds, and this can be effectively dealt with only from 4-5 years old. But we already know that waiting up to 5 years in the case of a child with RRD is extremely dangerous.
So, first you need a fairly detailed diagnosis to identify the causes of the pathology of speech development.
The speech development of children is shown by the assessment of hearing (examination by an audiologist)
To assess development, age-appropriate tests are used: the Denver test of psychomotor development, the Early Language Milestone Scale, and the Bayley Scales of Infant Development.
From conversations with parents and observations, they find out how the child communicates his needs. In contrast to general developmental delay and autism, children are able to express their needs with hearing loss, motor apraxia of the facial muscles and primary neurogenic speech disorders.
It turns out if there is motor apraxia of the facial muscles, which is manifested in the form of difficulty in feeding and inability to repeat the movements of the tongue.
Comparison of comprehension and speech reproduction.
Information about the child's home environment and his communication helps to identify insufficient stimulation of speech development.
To find out the reasons for the delay in speech development, it is necessary to contact a neuropathologist, speech therapist, and in some cases to a psychiatrist and child psychologist. Specialized analyzes of brain function may be required - ECG, ECHO-EG, MRI and similar examinations.
Almost 100% of children with ZPRR and ZRD need drug treatment.

At what age does work on overcoming developmental delays begin?
The sooner the better.
Neuropathologists can prescribe treatment as early as 1 year if a neurological pathology is established early, which leads or may lead to a delay in speech development.
Defectologists begin to work with children from the age of 2, they help develop the child's attention, memory, thinking, motor skills. Specialists in the development of speech, pedagogues-correctologists also start working with children from 2-2.5 years old.
Speech therapists - help to "put" sounds, teach to build sentences correctly and write a competent story. Most speech therapists work with children from 4-5 years old.

What are the treatments for RRD and RRR?
Drug therapy - among the drugs that are used to treat ZPRD there are those that are "active nutrition" and "building material" for brain neurons (cortexin, actovegin, neuromultivitis, lecithin, etc.), and drugs that "whip up" activity speech zones (cogitum). All appointments are made ONLY by a neurologist or psychiatrist. Self-medication is dangerous, because the drug that helped your friend's child may be contraindicated for your child.
Electroreflexotherapy and magnetotherapy allow you to selectively restore the work of various centers of the brain responsible for diction, vocabulary, speech activity and intellectual abilities. The high efficiency of electroreflexotherapy is associated with an additional therapeutic effect on hydrocephalus. However, this effective method is prohibited for use in children with convulsive syndrome, epilepsy and mental disorders. There are no contraindications for magnetotherapy.
Alternative methods of treatment - hippotherapy (treatment with horses), dolphin therapy, etc. methods should also be selected individually.
However, only medical assistance to such children brings little result, if not supported by pedagogical influence. The main task of the teacher - defectologist is to increase the level of mental development of children: intellectual, emotional and social.
The teacher provides correction (correction and weakening) of negative development trends; prevents the appearance of secondary developmental disabilities and learning difficulties at the initial stage. In his work, a teacher-defectologist uses visual, practical, technical means of rehabilitation and conducts correctional lessons in a playful way according to an individual plan. There is no general methodology that helps absolutely everyone, an individual approach is needed.
It is very important that parents, having noticed signs of delayed speech development in the baby, not only rely on the help of specialists, but also actively work with the child themselves. The defectologist helps to choose the direction of the work that the child's relatives will have to carry out daily and hourly.

A little about the methods of correctional work.
In working with such children, they use art therapy, music therapy, methods of object-sensory therapy, special methods of developing large and fine (fine) motor skills, methods of expanding the conceptual apparatus of the child.
For example, finger games are actively used.
In the cerebral cortex, the departments responsible for the development of articulatory and fine manual motor skills are located close to each other and are closely interconnected. However, the hand develops earlier in the process of ontogenesis, and its development, as it were, "pulls" the development of speech. Therefore, by developing fine manual motor skills in a child, we stimulate the development of his speech. Therefore, if a child has the right hand as his dominant hand, he has a more developed left hemisphere; they have the most developed right, and not the left hemisphere, in which the speech and motor centers are located.
It is necessary that at home the parents provide the child with the opportunity to develop fine motor skills - constructor, puzzles, in-ear games, mosaics, lacing toys, cubes and balls of different sizes, pyramids and ring toss, simulators for fastening buttons and tying laces. It is necessary with the child to sculpt a lot from plasticine, draw with finger paints, string beads on a string, perform engravings and primitive embroidery.
The use of various massage and motor stimulation techniques is essential to develop perception and sensation from an early age.
In cases where the child has deviations in psychophysical development, the use of massage (in the system of correctional and developmental education) should be continued in preschool and primary school age.
It is recommended to use outdoor games (logo rhythm technique) that develop the ability to navigate in space, move rhythmically and dexterously, change the pace of movements, as well as games in which movements are accompanied by speech.
The musical development of the child is also important. Such games as “Guess what sounded?”, “Recognize by voice”, “What instrument is playing?” ), they do not know how to concentrate, are often distracted, do not hear the rhythm and poorly pick up the intonation coloration of the voices of others.
It is also necessary to develop visual attention by working with multi-colored stripes, sticks, cubes, geometric planar and volumetric figures and special cards.
Any classes should be carried out according to the system, therefore it is necessary to practice daily and under the supervision of a specialist. As a rule, it is enough for a 3-year-old child to visit a defectologist 1 time a week, if the parents are ready to do the full amount of what the specialist has set at home. A child 4.5-5 years of age and older needs to meet with a specialist at least 2 times a day, and in the case of a ZPRR, a combination of several specialists is better. For example, 2 times a week, a child works with a defectologist for general development, and 2 times a week - with a music therapist or art therapist.
from the age of 5, if the development of passive speech is sufficient and there is no delay in mental development, it is necessary to start classes with a speech therapist.
Children with a significant delay in speech development should not attend a general preschool institution, but a specialized neuropsychiatric or neurological nursery, then a speech therapy kindergarten. If the ZRR or ZPRR is not overcome by the age of 7, you should not insist that the child attend a regular school. Agree to a special correctional institution, where the child will be provided with enhanced attention of specialists and an adapted school curriculum.

In conclusion, I will emphasize once again that if you notice that the speech development of your baby does not correspond to the age norm, do not hesitate - urgently contact the specialists! If you start correcting speech disorders at an early age, then there is a high probability that already at the age of 6 your child will not be any different from his peers.

In the modern world, the number of babies who have certain deviations from the norm in the development of speech is rapidly increasing. According to statistics, after examinations of preschoolers and children of primary grades for the purpose of prevention, it was found that every second child has some kind of impairment associated with speaking skills. Almost every fifth child faces such a pathology as delayed speech development.

According to experts, many modern children suffer from speech abnormalities or do not know how to express their speech at all by the age of 2-3.

Conditions for the normal development of speech activity in a child

In order for the formation of the baby's speaking skills to occur naturally, without possible violations, first of all, you need:

• achievement of the required degree of maturity by various structures of the brain;
• correct and coordinated functioning of the vocal and respiratory systems;
• a sufficient level of formation of hearing, vision, motor skills and emotions;
• growing need for communication with others.

Stages of development of speech skills

During the first year of life, the child's speech progresses rapidly. Newborn babies are not yet able to make any sounds, but they are great at communicating their needs to others through crying. Crying is the very first and most natural way for a baby to communicate with parents and other people.

Child's age	Speech skills
2 months	The time of the appearance of the first sounds. The baby begins not only to vocalize, but also to react when they talk to him - for example, smile or rejoice at seeing his parents.
3-6 months	The beginning of humming, repetition of the same sounds, screeching and laughter. At this age, the baby closely monitors the movement of the lips and tries to copy.
6-9 months	Syllables and combinations of different sounds are added to the sounds that do not carry a semantic load, but such babbling plays an important role in pre-speech development.
9-10 months	The understanding of the speech of adults is formed, the first words appear. The babbling becomes melodic, with different intonations and pitch.
12-14 months	Meaningful pronunciation of at least 2 words, following simple verbal directions and recognizing familiar objects.
1.5-2 years	The understanding of the speech of others is rapidly developing, the vocabulary is growing, the first phrases appear. During this period, brain cells are ready to assimilate words and combine them into phrases.
3 years	Mastering the grammar of the native language. Slowing down the rate of speech formation.

Normally, a three-year-old child is excellent at expressing his thoughts to his parents, but for those around him, his speech can be a little slurred.

The age of appearance of the first words ranges from 9 months to a year and 3 months. In boys, this usually occurs later than in girls.

When a child turns one and a half years old, it is important that he is provided with a sufficient volume of speech that can be imitated - which is why parents should monitor how correctly and beautifully they speak with the baby. With a sufficient passive base, the baby will soon switch to an independent conversation.

Causes and types of delayed speech development

The launch of speaking skills does not always follow a natural scenario. Often the time to speak is already approaching, but the baby continues to be silent or his statements are so illegible that even parents can find it difficult to understand what he means. For children who have a delay in speech development, it is characteristic that there is a difference between how they understand what is said and how they verbally voice their own thoughts.

The behavior of different children with RRD during the examination period is fundamentally different. For example, some behave trustingly and affectionately, while others may cry or scream, run back and forth and not be able to concentrate, some are simply silent. For this reason, it is not possible to make an accurate diagnosis at one time. This situation requires monitoring the baby, consulting with specialists and taking anamnesis.

Tempo RRR

In the case of a temporal delay in speech development, the child begins to speak with a delay, although his intellect remains intact, auditory attention is not impaired, he understands people perfectly. Such a delay in the development of speech is most often caused by:

• disease;
• weakened body;
• wrong upbringing;
• limited communication.

For communication, an inquisitive child uses gestures, intonation, facial expressions and vocalizations. The launch of speech for children with delayed speech development can occur quite unexpectedly, after which it will develop normally (for more details in the article:). For some preschoolers with a speech tempo delay, a sharp jump from an insignificant vocabulary to a full-fledged conversation with phrases is characteristic. Linguists have given this phenomenon the name "linguistic explosion". Most often, such a transition occurs in the summer - it is in the summer that the child's body gets stronger, and he himself receives a lot of vivid emotions and impressions.

Very often, for children to overcome the delay in speech development, a certain stimulus is required to speak. Such an impetus can be classes with peers or with a speech therapist.

The abundance of emotions in the summer can be the impetus for the so-called "language explosion" - a sharp leap in the development of a child's speech (see also:)

Alalia

The name alalia received a complete or partial absence of speech. Its occurrence is preceded by damage to the areas of the brain that are responsible for speech. A child can receive them while in the womb, or in infancy. Such a delay in speech development is not a consequence of a decrease in intelligence or hearing.

In the case of alalia, children need special training and treatment from a neurologist. Without this, they will not be able to learn to speak before school, and sometimes longer. When communicating, they use babbling and some paralinguistic means: facial expressions, intonation and gestures.

If a child diagnosed with speech delay is not treated or corrected after 5 years, the baby may also lag behind in mental development. His knowledge of the world will be much inferior to the knowledge of those guys who are already talking. In addition, with alalia, all speech aspects are impaired:

• limited set of words;
• expressive speech and its systematic disorder;
• incorrect pronunciation of sounds;
• difficulties in mastering the grammatical rules of the native language.

RRD due to hearing loss or communication impairments

The most common and rather serious cause of delayed speech development is actually hearing loss. During the first year of life, the humming and babbling of a crumbs whose hearing is impaired practically does not differ from the pre-speech reactions of a well-hearing child. Nevertheless, by the age of one year, babbling gradually fades away and eventually completely disappears. If the degree of hearing loss is high, the child will be able to speak only after special classes with a deaf teacher. With an insignificant degree of hearing loss, speech appears a little later than among peers, plus this affects its quality, namely grammar, voice, prosody and pronunciation of sounds.

Symptoms of commutative disorders in a child, which cause delayed speech development, include:

• lack of a reciprocal smile or turning your head when addressing the baby;
• selective and short-term attention;
• unwillingness to contact with loved ones, including mom;
• motor awkwardness;
• monotonous games alone.

Such a child is quite capable of pronouncing sounds, sound combinations and words, but he does not use this in order to communicate. As a result of limited speech contact, the lexical and grammatical structure of speech is poorly developed, the voice is impaired and various phonetic disorders occur.

The development of speech in children with hearing impairments is more difficult than in their peers without disturbances in the functioning of the organs of perception

Delayed psychoverbal development

In this case, babies are characterized by insufficiently good formation of higher mental functions, including the functions of memory and voluntary attention. Such children can be divided into 2 groups: those with emotional-volitional deviations and children with a predominance of intellectual disability.

1. Classes with a child psychologist. They are necessary if the delay in the development of the child's speech is provoked by the suffered psychological trauma, the unfavorable situation in the family, the unwillingness of the child to communicate with other children (we recommend reading :).
2. Alternative methods. These are various therapies based on interaction with horses and dolphins, including music and painting. Also, all kinds of developmental exercises with parents are great - for example, collecting puzzles or outdoor games.
3. Osteopathy. Osteopaths, using manual influence on the active points of the child's body, try to balance the functioning of the nervous system, metabolism and the psyche of the little one.

The result is achieved exclusively through correct diagnosis and comprehensive treatment. From the video tutorials of Dr. Komarovsky, we can conclude that classes with a speech therapist and taking pills alone are not enough to overcome the delay in speech development.

Home therapy for speech delay

An integral part of the treatment of delayed speech development are speech therapy and developmental classes at home. The ability to speak directly depends on motor skills, so you should focus on her training - games with constructors, puzzles, mosaics and cubes are ideal for this. Also, a baby at 2-3 years old can already be taught to button up and handle laces.

As the child develops, he begins to make different sounds. As they grow, they become like syllables and eventually become words. The duration in the speech development of children is different. Someone begins to "gag" as early as six months, and someone until 2 years does not publish, except crying, not a sound. If a child has a lag in speech norms, this is a reason to start worrying, since there is a likelihood of a disease such as delayed speech development. The essence of this disease and the signs of its manifestation should be known to all mothers and fathers. The sooner it is detected, the more effective the treatment will be.

The lag in the development of speech is determined in children by the age of three. It is characterized by the absence of speech sounds by one year, fragmentary speech by two years and coherent speech by three years. The delay is detected on average in 3-10% of children. This disease can negatively affect the development of the psyche, memory, imagination, thinking, attention and the formation of interpersonal relationships of the baby. Therefore, parents whose children have it identified should seek advice from a pediatrician.

This disease usually does not appear on its own. The delay is facilitated, on the one hand, by reasons of a biological nature:

• complicated pregnancy;
• fetal pathology;
• intrauterine infections;
• childbirth injuries;
• prematurity or postmaturity;
• high intracranial pressure in a newborn;
• heredity;
• physical injury;
• delayed development of the brain;
• pathology of the hearing aid;
• poor development of facial muscles;
• slow development of the nervous system.

On the other hand, delayed speech can be associated with long-term mental disorders caused by the inability to meet the necessary needs - sleep, food, communication with the mother and father. Overprotection also has a negative effect: an environment in which the child's verbal communication is not in demand, since parents prevent all his desires without developing personal activity in him. It is very harmful for a baby to be in an overly informed environment, in which he is constantly faced with a large amount of information that does not correspond to his age. As a result, the baby stops listening to sounds and comprehends their meaning, tries to pronounce phrases and perform articulation exercises that are not related to the development of speech.

Typical symptoms

Special games can also help the child.

Parents can also determine the presence of a delay in speech development, since they are the ones who are constantly with the children and monitor what sounds they make. To do this, you need to familiarize yourself with the main age norms:

• 2 - 4 months. The child begins to make separate sounds, vowel sounds with a delay ("oo-oo-oo", "oo-oo", "ah-ah," sound in another, for example, "a-a-e-e-o-o", "a-a-u-u-e-e"). In this case, the child reacts to the appeal of adults - smiles, cries, gurgles;
• 5 - 8 months. During this period, the child has a sonorous hum, consonants begin to be added to the vowel sounds and certain syllables appear. The child improves free babbling, combines vowels and consonants, and also conducts a kind of dialogue with adults, while listening from time to time to their pronunciation. It is possible that during this period the child can purposefully pronounce syllables, for example, ask for something;
• 9 - 12 months. Closer to the year, the child tries to make combinations of sounds, for example, "ma-ma-ma", "nya-nya-nya", "pa-pa-pa";
• 1 - 1.5 years. At this stage, there is a reaction to one's own name and the names of loved ones, as well as words denoting surrounding objects;
• 1.5 - 2 years. The child can already pronounce simple phrases and sentences, requests ("I want to drink", "give me a toy");
• 2-3 years. At this age, you can hear small sentences, pronounced words clearly and without defects.

Knowing such norms, you can independently determine whether the baby is lagging behind in the development of speech or not. If there are certain deviations up to 3 years old, you need to contact your pediatrician. He will accurately determine whether to worry about speech delay and make the necessary recommendations.

By the way, the symptoms of hyperactivity in a child: abnormally increased physical activity, absent-mindedness, restlessness, impulsivity and poor memory, for more details - read the corresponding article.

Home remedies for child fright that have been proven effective - herbs, tinctures and fees. And of course psychological work with the child.

How to diagnose latency?

To diagnose delayed speech development, consultation with a neurologist, otolaryngologist, psychiatrist, speech therapist, psychologist and defectologist may be required. If you find possible signs of the disease, you must first contact your pediatrician. The doctor will analyze the somatic status, determine possible deviations in speech development and refer you to the necessary specialist.

The neurologist identifies microorganisms in the brain. In this case, ECHO-EG, EEN, scanning of the arteries of the brain are carried out. The otolaryngologist prescribes examinations to determine the presence of otitis media, hearing loss and adenoids.

The speech therapist makes an analysis of anamnestic information, the formation of the child's motor skills, speech and hearing aids, and the characteristics of communicative activity. In children under 12 months, vocal and preverbal activity is determined. After 1 year, the specialist finds out the time of the appearance of words, the volume of the vocabulary, the activity of speech, as well as fragmentary and coherent speech.

A complete analysis of the decrease in speech formation activity consists of the following examinations:

• determination of the motility of the facial muscles to identify the inability to make movements with the tongue;
• assessment of the child's hearing and identification of possible problems. The examination is carried out by an audiologist;
• testing. Tests are performed on the Griffiths scale, Bailey scale, on the early speech development scale and the Denver test;
• a conversation with parents according to Komarovsky's method of delay in order to determine what methods they use to communicate with the child;
• determination of the level of awareness and reproduction of sounds;
• definition of stimulation of speech formation. Analysis of information about home education and environment is carried out;
• examination of brain activity may be required. For this, ECG, MRI and ECHO-EG are performed.

Treatment of the disease

If a delay in speech development is detected in a baby in a timely manner, the disease is quickly and easily cured. Many moms and dads believe that if a defectologist conducts a course to normalize the pronunciation of sounds, this will be enough. This is totally wrong. Correcting the formation of speech involves complex treatment:

• drug therapy... The child can be prescribed medications ("Nootropil", "Neuromultivin", "Lekcitin", "Kogitum", "Cortexin", "Actovegin") to stimulate the blood circulation in the brain and improve its integrative function. Medicines are prescribed exclusively by a doctor. Self-medication delay is excluded;
• curative therapy... Areas of the brain that are responsible for the activity of pronunciation, mental capabilities, vocabulary and diction are exposed to a small current. This procedure allows you to activate their activities, stimulate speech development and cognitive processes;
• alternative therapy... In some cases, the doctor may prescribe dolphin therapy and hippotherapy;
• defectologist correction... With the use of visual, practical and technical means of rehabilitation, constant play exercises, the negative tendencies of speech maturation are corrected, minor deviations are prevented;
• speech therapy massage... A massage is performed on certain areas of the tongue, cheeks, lips, as well as hands and ears. In exceptional cases, massage is prescribed to Prikhodko, Krause, Novikova;
• homework... In addition to therapeutic measures, it is recommended to engage with the child at home, for example, various exercises to strengthen the tongue, facial muscles, and hearing aids. These can be various sound imitations, songs, fairy tales, exercises for the muscles of the face and hand motility, and others. Activities with your child should be regular.

What are the consequences?

Untimely treatment or its absence can lead to the following consequences:

• great lag in intellectual and mental development from peers;
• difficulties with attending educational institutions. Usually children with undeveloped speech are shown an auxiliary school.

Finally

If you notice that your child does not speak well, while his peers can already pronounce small sentences, you should seek help from specialists. It is very important to establish the reason for the delay. Otherwise, the provoking factor will not be eliminated, and the child's treatment will not give positive results. If signs of a delay in the formation of speech are found, it is necessary to undergo a comprehensive examination in order to determine an accurate diagnosis.

It is easier to prevent a disease than to treat it and use expensive medications. Therefore, parents need to communicate more often with their child. A child growing up in an atmosphere of loving parental attention rarely has difficulty developing speech.

- this is a later, in comparison with the age norm, the mastery of oral speech by children under 3 years of age. Delayed speech development is characterized by a qualitative and quantitative underdevelopment of the vocabulary, the lack of formation of expressive speech, the absence of phrasal speech in a child by the age of 2 years and coherent speech by the age of 3 years. Children with delayed speech development need advice from a pediatric neurologist, pediatric otolaryngologist, speech therapist, psychologist; if necessary, conduct a medical examination. Correctional work with delayed speech development should include psychological, pedagogical and medical assistance.

ICD-10

F80.1 Expressive speech disorder

General information

Delayed speech development (RAD) is a concept that reflects the slower pace of mastering the norms of the native language by children at the stage of early and middle speech ontogenesis. The speech therapy conclusion "delayed speech development" is valid for children under 3-4 years of age. The tempo lag concerns the formation of all components of speech: sounds of early ontogeny, vocabulary and grammar, phrasal and coherent speech. Delayed speech development occurs in 3-10% of children; in boys 4 times more often than in girls.

Delayed speech development negatively affects the development of mental processes, therefore, RRD and RRD are often observed in children in parallel and are referred to in the literature as delayed psycho-speech development (RRP). Delayed speech development is a medical and pedagogical problem affecting aspects of pediatrics, child neurology, speech therapy and child psychology.

Reasons for RRR

Organic causes

Delayed speech development can be caused by reasons of a biological and social nature. In about a third of cases, the reasons for delayed speech development remain unclear. Biological factors:

1. Minimal brain dysfunction... It is caused by perinatal brain damage (perinatal encephalopathy). In the anamnesis of children with delayed speech development, as a rule, intrauterine hypoxia and asphyxia during childbirth, birth trauma, intrauterine infections are traced; prematurity or prematurity.
2. Diseases of early age: TBI, malnutrition, neonatal meningitis and encephalitis, frequent or long-term illnesses that weaken the child, post-vaccination complications.
3. Hearing loss in a child. It is known that the formation and development of speech function occurs with the direct participation of the auditory analyzer, that is, based on the information heard by the child, therefore hearing impairment can also cause a delay in speech development.
4. Hereditary factors. Sometimes the slower rates of maturation of the nervous system are genetically determined: if one of the parents spoke late, it is likely that the child will also have a delay in speech development.

Social reasons

Socio-pedagogical prerequisites for delayed speech development most often lie in an unfavorable microsocial environment, leading to a deficit of speech contacts: lack of demand for speech (underdeveloped culture of communication in the family), “hospitalism syndrome” in frequently ill children; pedagogical neglect. Bilingualism, an unfavorable speech environment, and emotional stress can have a negative impact on the rate of development of a child's speech.

On the other hand, not only psychosocial deprivation, but also overprotection can have an inhibitory effect on the formation of a child's speech function: in these conditions, speech communication also remains unclaimed, since the surrounding adults warn all the child's desires without stimulating his independent speech activity.

It is extremely harmful for a young child to be in an overly informed environment, where he is faced with an excessive flow of information, which, moreover, does not correspond to the age of the baby. In this case, the child gets used not to listen to speech and not to comprehend the meaning of words; utters long, formulaic phrases that have nothing to do with the development of true speech.

Pathogenesis

In postnatal development, there are 3 critical periods (I - 1-2 years; II - 3 years; III - 6-7 years), characterized by the most intensive development of the speech system and at the same time - increased vulnerability of the nervous mechanisms of speech activity. During these periods, exposure to even insignificant harmful exogenous factors can lead to the occurrence of various speech disorders.

So, in the first critical period, when the intensive development of cortical speech zones occurs, under unfavorable conditions, prerequisites for delayed speech development and alalia can be created. In the second critical period - the time of intensive development of coherent speech, mutism and stuttering may occur. During the III critical period, a "breakdown" of nervous activity can cause stuttering, and organic lesions of the brain - childhood aphasia.

Speech development is normal

For a correct understanding of which signs indicate a delay in speech development, it is necessary to know the main stages and conditional norms of speech development in young children.

The birth of a child is marked by a cry, which is the first speech reaction of the infant. The child's cry is realized through the participation of the vocal, articulatory and respiratory sections of the speech apparatus. The time of the onset of the cry (normally in the first minute), its volume and sound can tell a neonatologist a lot about the condition of the newborn. The first year of life is a preparatory (pre-speech) period during which the child goes through the following stages:

• humming (from 1.5-2 months);
• babbling (from 4-5 months);
• babbling words (from 7-8.5 months);
• first words (at 9-10 months for girls, 11-12 months for boys).

Normally, at 1 year in the child's active vocabulary there are about 10 words consisting of repeated open syllables (ma-ma, pa-pa, ba-ba, dya-dya, etc.); in a passive dictionary - about 200 words (usually the names of everyday objects and actions). Until a certain time, the passive vocabulary (the number of words the child understands) far exceeds the active vocabulary (the number of spoken words).

At about 1.6 - 1.8 months. the so-called "lexical explosion" begins, when words from the child's passive vocabulary are abruptly merged into the active vocabulary. In some children, the period of passive speech can drag on for up to 2 years, but in general, their speech and mental development proceeds normally. The transition to active speech in such children often occurs suddenly and soon they not only catch up with their peers who spoke early, but also overtake them in speech development.

Researchers believe that the transition to phrasal speech is possible when the child's active vocabulary contains at least 40-60 words. Therefore, by the age of 2, simple two-word sentences appear in the child's speech, and the active vocabulary grows to 50-100 words. By the age of 2.5, the child begins to build detailed sentences of 3-4 words.

In the period from 3 to 4 years old, the child learns some grammatical forms, speaks in sentences combined in meaning (coherent speech is formed); actively uses pronouns, adjectives, adverbs; masters grammatical categories (changing words by numbers and gender). Vocabulary increases from 500-800 words in 3 years to 1000-1500 words in 4 years.

Experts admit a deviation of the normative framework in terms of speech development by 2-3 months in girls, and by 4-5 months in boys. Only a specialist (pediatrician, pediatric neurologist, speech therapist) who has the opportunity to observe the child in dynamics can correctly assess whether the delay in the timing of the appearance of active speech is a delay in speech development or an individual feature.

RRR symptoms

Signs of delayed speech development at different stages of speech ontogenesis can be:

• abnormal course of the pre-speech period (low activity of humming and babbling, soundlessness, vocalizations of the same type)
• lack of reaction to sound, speech in a child at the age of 1 year;
• inactive attempts to repeat other people's words (echolalia) in a child aged 1.5 years;
• the impossibility of performing a simple task (action, demonstration, etc.) by ear at 1.5-2 years of age;
• lack of independent words at the age of 2 years;
• inability to combine words into simple phrases at the age of 2.5-3 years;
• complete absence of his own speech at 3 years old (the child uses in speech only learned phrases from books, cartoons, etc.);
• the child's predominant use of non-verbal means of communication (facial expressions, gestures), etc.

Diagnostics

A child with delayed speech development should be consulted by a group of specialists, including a pediatrician, a pediatric neurologist, a pediatric otolaryngologist, a child psychiatrist, a speech therapist, and a child psychologist. The task of the pediatrician at the stage of examination is to assess the somatic status, preliminary determination of possible causes of delayed speech development and referral of the child to a specialist of the appropriate profile.

1. Medical block. Neurological diagnostics (EEG, EchoEG, duplex scanning of the child's head arteries) is required to detect microorganisms in the brain. A visit to a pediatric otolaryngologist is necessary to exclude chronic otitis media, adenoids, hearing loss in a child.
2. Speech therapy examination... It includes the study of anamnestic data and conclusions of medical specialists, motor development of children, the state of the speech apparatus, auditory and visual orienting reactions, the specifics of the child's communicative activity. In children under 1 year old, vocal and pre-speech activity is monitored in natural and provocative situations. In the presence of words, the time of their appearance, the volume of the active and passive vocabulary, the general speech activity of the child, the presence of phrasal and coherent speech, etc. are determined.
3. Psychological diagnostics. For diagnostic examination of speech and assessment of the general mental development of young children, speech therapists and child psychologists use the Denver test of psychomotor development, the Griffiths scale of psychomotor development, the early speech development scale, the Bailey scale, etc.

Delayed speech development must be distinguished from general developmental disorders (autism, elective mutism, oligophrenia), general speech underdevelopment of I-IV levels.

Correctional and developmental work with RR

The amount of corrective assistance to children with delayed speech development depends on the factors that caused the lag in the formation of speech skills. So, for reasons of a socio-pedagogical nature, first of all, it is necessary to organize a favorable speech environment, stimulate the child's speech development, correct selection of speech material, demonstrate samples of correct speech, “orechevate” (pronunciation) of all the child's actions.

If the basis for delayed speech development is brain dysfunction, correctional and pedagogical work should be accompanied by treatment prescribed by a pediatric neurologist: taking nootropic drugs, massage, transcranial micropolarization, magnetotherapy, electroreflexotherapy, etc.

In parallel with medical procedures and family education, children with speech retardation need classes with a speech therapist and a child psychologist on the development of speech and cognitive processes. In early childhood, special attention is paid to the development of fine motor skills, finger and outdoor games, productive activities (drawing, modeling, applications), didactic games (speech therapy loto, special speech games and exercises, etc.), the development of visual and auditory attention, passive vocabulary and active speech, coherent speech.

Forecast and prevention

The earlier the developmental activities with the child are started, the faster and more successful the result will be. Usually, with the elimination of predisposing causes and well-organized work, children with speech retardation catch up with their peers by the age of preschool age. The effectiveness of correction depends not only on the participation of doctors and teachers, but also on the efforts of parents, their observance of uniform speech requirements and recommendations of specialists.

Prevention of delayed speech development in children includes creating conditions for a favorable course of pregnancy, childbirth and the postnatal period; ensuring adequate microsocial conditions and speech environment surrounding the child. It is necessary that the toys that the child plays with are developmental, and the incoming information relates to the area of ​​the child's actual and proximal development. To assess the level of speech development at 2–2.5 years, it is advisable to visit a speech therapist.