Sensory alalia in children. Signs and treatment, what it is, the prognosis for recovery

Sensory alalia in children represents a violation of the functionality of the speech apparatus with preserved hearing and intelligence. Pathology is provoked by organic brain damage up to 3 years. The main symptom of a systemic disease is a violation of the phonetics and lexical and grammatical structure of the language.

Non-speech symptoms can be detected: sensory, consisting in impaired sensitivity and perception, as well as psychopathological. Diagnosis and treatment of alalia are difficult and require the exclusion of hearing loss and mental disorders.

The activities take several months and require close supervision of the child. In the sensory form, there is a distortion in the analysis of sounds and audible speech. The connection between the sound image and the object is broken. The child hears the words, but does not understand their meaning.

Main and additional reasons

The main cause of the pathology is organic damage to brain cells, which provokes a violation of the functionality of the auditory and speech analyzer in the upper region of the temporal lobe (Heschl loop), as well as in the Wernicke zone, where primary processing is carried out sounds.

The main provocateurs include:

• oxygen starvation of the fetus;
• toxicosis in a pregnant woman;
• the use of alcoholic beverages and drugs;
• brain injury in a child;
• meningitis;
• encephalitis;
• rickets;
• brain tumors.

  

Additional factors include:

• infectious and somatic pathologies of a pregnant woman;
• anemia of a pregnant woman;
• entanglement of the fetus with the umbilical cord;
• narrow pelvis of a woman;
• the presence of Rh-conflict in a pregnant woman and a fetus;
• endocrine diseases of the mother.

Children's hearing does not suffer, but the speech of another person is not perceived. Excitation in brain cells does not spread to other analyzers due to a failure of their functionality.

Speech ontogenesis

Scientific research has revealed that with sensory alalia, a specific disorder of the auditory analyzer is formed, based on the weakness of arousal and inhibition and mild generalization (inconstancy of sound perception).

The main feature of hearing in sensory alalia is the rapid formation of the inhibition process due to increased functional exhaustion. In pathology, brain cells are underdeveloped. The termination of their functionality is observed at the level of neuroblasts. Such a violation can be congenital or acquired in nature, formed in the pre-speech phase.

Impaired functionality of the temporal region of the brain

Sensory alalia in children (signs and treatment are described in the article) suggests an underdevelopment of brain structures. Morphological violation of the temple area causes a lack of analysis and synthesis of sound stimuli. For this reason, there is a lack of formation of a connection between the sound and the object.

In some cases, there is a clear localization of the pathological process in Wernicke's area, located in the left hemisphere. Sometimes a certain area of ​​the lesion is absent, since, in addition to Wernicke's zone, the functionality of other areas is impaired.

There is research confirming that many children did not have organic brain damage. The data were obtained during electroencephalography. Most modern scientists consider it incorrect to identify the localization of the zone that causes the loss of speech in an adult with a defect in children.

Bilateral brain damage

The formation of speech centers, according to neurophysiologists, takes place in ontogenesis. Scientists argue that sensory alalia may result from bilateral damage to brain structures.

This view is supported by the fact that unilateral impairment due to the plasticity of the child's brain and its extensive compensatory capabilities is not able to cause persistent speech impairment. Alalia is caused by more extensive organic damage than aphasia.

Clinical manifestations

Speech is incoherent and illegible. A child hears words spoken by another person, repeats sounds, knows elementary words, but is not able to understand their essence.

The main signs of the disease include:

• immunity to sounds;
• extensive use of gestures;
• the presence of active facial expressions;
• the ability to combine two words into one;
• setting the wrong ending;
• skipping letters;
• lack of memorization of words;
• a sharp change in mood and physical activity;
• late formation of speech;
• poor vocabulary;
• violation of phonetic norms.

A patient with sensory alalia needs a deep neurological, psychological and speech therapy examination. About 1.5% of preschool children and 0.5% of school children suffer from pathology.

The importance and complexity of diagnosis

Sensory alalia in children (signs and treatment can be established by a specialist) involves the consultation of a neuropsychiatrist, otolaryngologist, psychologist and speech therapist.

Neurological examination includes:

• Monitoring the electrical activity of the brain. It is carried out by placing electrodes in certain areas on the surface of the head.
• Electroencephalography. The electrical activity of the brain is examined by placing electrodes in specific areas on the head.
• Sleep deprivation electroencephalography. It is assumed that sleep is stopped up to 24 hours for an accurate diagnosis of pathologies in the brain.
• Photo and phonostimulation are used.
• Echoencephalography. Ultrasonic waves are used.
• X-ray of the skull and craniovertebral zone. The study of the internal structure of the brain is carried out by x-ray transmission. The results are recorded on a special tape.
• Magnetic resonance imaging of the brain. To obtain images of internal organs and tissues, nuclear magnetic resonance is used.
• Doppler ultrasound of the vessels of the head and neck. The measurement of ultrasonic waves reflected in the moving erythrocytes is carried out. A series of pulses allows you to see a graph on the screen showing the speed of blood movement at a specific depth.

The task of the otolaryngologist is to distinguish between sensory alalia and hearing loss. Audiometry and otoscopy are used. A neuropsychologist diagnoses auditory and speech memory.

After the conclusion of medical workers, the diagnosis is carried out by a speech therapist. The specialist establishes a perinatal and postnatal history. The conclusion is based on the distinctive features of the child's speech and sensory development.

Sensory alalia in children (signs and treatment are described in many scientific papers) involves monitoring speech. The connection between an object and a word, as well as a word and an action is investigated. Diagnosis is based on observation. Attention is drawn to the correctness of the construction of grammatical structures and the consistency of statements. It is important to limit the disease from hearing loss, autism and mental retardation.

Diagnosis of sensory alalia requires repeated communication with the child and monitoring him, since in the same situations, children can manifest themselves in different ways, demonstrating a good understanding of what is said or a complete refusal communications.

Taking into account complex behavioral features, mood inconsistency, irritability, the correction of speech impairment differs in duration. The child is very unpredictable, sometimes hysterical and chaotic in actions.

Sensory alalia is difficult to diagnose, since the pathology is similar to other hearing and speech disorders, as well as systemic types of dysontogenesis.

The cost of consulting a neuropsychologist in Moscow will range from 3000 to 5500 rubles. In Samara, such a service will cost from 2500 to 4000 rubles.

Correction and clinical guidelines

Correction of alalia depends on the form of pathology and is carried out on an individual basis. The therapy involves the help of a speech therapist and related specialists. The treatment regimen is drawn up depending on the health condition and age of the child.

Speech therapy courses

Speech therapy work should be started as early as possible.

Therapy is based on the development of correct pronunciation and phrase building skills, as well as expansion of vocabulary.

Classes are built on the game, gestures, facial expressions, rhythmic movements. Includes drawing, imitating animal voices. In the process of mastering non-speech material, the speech therapist begins to develop the pronunciation of voice sounds similar to simple words, with the subsequent complication of the phonemic and syllable composition.

The child takes an interest in the process. The game form of conducting promotes the development of memory, attention and understanding of the essence of objects and their functions.

The table shows the main stages of a speech therapist's work:

Stage	Receptions
First	Establishing contact with the child, awakening interest in the sounds of everyday life, music, rhythms.
Second	Distinguishing non-speech sounds. Musical toys and objects with a contrasting sound are used.
The third	Consolidation of the relationship between object and sound. The target of correction is vocabulary (passive and active) and enrichment of speech with verbal constructions. The method is based on the preservation of visual perception. Grapheme is gradually connected. A graphic representation of letters or words is complemented by toys or pictures. Expansion of vocabulary also occurs when working with text. After reading a short passage, questions are asked to help make sense of it. Over time, the words that the child is able to read are included by the specialist in the situational text, which involves the use of short sentences and phrases from the dialogue.
Fourth	Working with a phonemic language system. The initial stages involve the discrimination of vowel sounds and their subsequent inclusion in words. With these words, phrases are composed, which are then pronounced and recorded. Further, consonants are isolated. The method is based on the differentiation of sounds.

Speech therapy classes are based on the safety of higher mental functions, visual perception and kinesthetic development. Classes are held 2-3 times a week. The duration of the corrective work is 2-3 years, followed by observation of the patient. Therapy should be continuous, intense and consistent.

Speech therapy massage

The number of procedures is determined by a speech therapist-defectologist. It is carried out after a thorough examination of the articulation apparatus. With the correct implementation of the massage, there is an improvement in the functionality of the child's nervous and muscular system.

The therapeutic method is capable of:

• optimize the mobility of the speech apparatus;
• normalize the tone of the muscular system;
• increase the volume and amplitude of articulatory movements;
• develop muscle memory coordination for the pronunciation of complex sounds.

The massage helps to strengthen the pharyngeal reflex and develop the facial muscles. The effect of a mechanical nature on the nerve endings has a beneficial effect on the work of the speech centers of the brain.

Physiotherapy procedures

Physiotherapy plays a special role. In the course of manipulations, electric impulses are applied. The procedures are safe and painless.

Of the main methods, it should be noted:

• Inductothermy. The method is based on exposure to a high-frequency alternating magnetic field, which contributes to the formation of eddy currents. Their energy is transformed into heat, which improves blood circulation, dilates blood vessels.
• Magnetotherapy. The effect of variable low frequency magnetic waves is carried out. Computer monitoring assumes constant control and makes it possible to draw up an individual therapeutic program. The procedure helps to normalize vascular tone, improve microcirculation and lymph flow, optimize the functionality of the autonomic nervous system.
• Electrical stimulation. The method is based on the use of various impulse currents to stabilize the functionality of nerve and muscle fibers. Electrical stimulation helps to maintain the contractility of muscle tissue, creates a stream of nerve impulses that enter the central nervous system.

Psychotherapeutic assistance to the family

It involves the submission of information about the therapy being carried out, motivating parents to joint long-term pursuits. There is a distribution of responsibility between the speech therapist and the family. Experts prohibit the use of gadgets by a child and advise its inclusion in motivating speech activity.

Medicines

Drug therapy involves the use of nootropics and vitamins.

Nootropics help to improve cerebral circulation. From the drugs of this series, "Glycine", "Vinpocetin", "Piracetam", "Cinnarizin" are used.

The drug "Glycine" is prescribed for functional and organic disorders of the brain. Children under 3 years of age are prescribed 25 mg of the drug 2-3 times / day.

Patients over 3 years old are prescribed 1 tablet 2-3 times / day. The course of treatment is 7-10 days. Depending on the indications, therapy can be increased up to 30 days. If necessary, the course is repeated in a month. The cost of the drug 100 mg is 36 rubles. The package contains 50 tablets.

In violation of cerebral blood flow "Cinnarizin" children are prescribed 25 mg 3 times a day. The duration of therapy is from several weeks to months. The cost of the drug 25 mg is 55 rubles. The package contains 50 tablets.

Of the vitamins, it should be noted "Alphabet is our baby", "Pikovit", "Kinder Biovital", "Vitrum Baby".

"Alphabet is our baby" is assigned to children aged 1.5 to 3 years, 1 sachet with meals. The contents of a 3 g bag are dissolved in 30 ml of warm boiled water with vigorous stirring for 3 minutes. Preparation of the solution is carried out before use. The treatment lasts 30 days. The cost of the drug is 460 rubles. The package contains 45 bags.

The vitamin complex "Vitrum Baby" is prescribed at the age of 3 to 5 years. Take 1 tablet a day after meals. The tablet should be chewed. The duration of treatment is 2-3 months. On the recommendation of a specialist, a second course can be carried out. The cost of the drug is 455 rubles. The package contains 30 tablets.

Recovery prognosis

Sensory alalia in children, the signs and treatment of which are determined only with an integrated approach of specialists, is a systemic speech disorder.

Diagnostics carried out in the early stages of the disease, therapy and rehabilitation courses allow you to correct the pathology and integrate the child into society for a general education. Correction should be carried out from the age of 3-4 years. The formation of speech processes should take place in parallel with the development of mental functions.

The prognosis for sensory alalia is uncertain. The outcome of treatment is influenced by the degree of organic brain disorder.

Complications and consequences

Sensory alalia in children is a dangerous pathology that can provoke mental retardation. In some cases, neurotization of the personality may appear.

These children have:

• isolation;
• uncertainty;
• irritability;
• tendency to cry.

Later, speech disorders have a negative impact on the educational process. Without correction, the development of the child's psyche acquires the features of intellectual backwardness. With a mild degree of pathology, difficulties in mastering speech skills are traced. Lack of understanding of the addressed speech is an alarming signal.

Sensory alalia in children can be accompanied by signs such as impaired writing (dysgraphia) and reading disorder (dyslexia). A comprehensive examination and treatment of a neurologist is required. Defects are caused by a malfunction of mental processes.

Prevention of sensory alalia in children includes providing conditions for a favorable course of pregnancy and childbirth, early physical development of the child. Timely treatment of pathology allows you to prevent the occurrence of secondary signs of intellectual disability.

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