Zrr in 3 years of treatment. Treatment of delayed speech development at home. Why you need to see a doctor

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Delayed speech and psychoverbal development - what is it and how to deal with it?

Rudova A.S., teacher-defectologist, psychologist,

Director of the Center for Developing Innovative

methods in the field of education and culture

and children's studio of innovative development "Harlekin".

By occupation, I have to meet with 2 opposites in the parental attitude towards the child. The first are super-concerned parents who, when a child at 2 years old does not speak in extended phrases, sound the alarm. But how! According to Aunt Masha's neighbor, her baby already reads all Barto's poems by heart!

And the second group of parents are those who stubbornly do not notice problems in the development of the child, and only when doctors unequivocally put a developmental delay do they turn to specialists. Sometimes I come across cases so neglected that it is bitter to tell parents that help is too late, and now you can only slightly adapt the child to life in society.

So what exactly is Speech Development Delay and Psycho-Speech Development Delay?

When should a child start talking?

At 1 year old, a child should pronounce about 10 facilitated 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. To the words "where is the bear?" - turn your head towards the bear, and at the request "give me a hand" - stretch out your hand.

At 2 years old, the child must build phrases and short sentences, use adjectives and pronouns, the 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, pronounce almost all letters correctly, except for “l”, “r” and hissing, ask questions “where?”, “Where?”. The child must know his name, distinguish between relatives, imitate the voices of the main animals and birds. Adjectives appear in speech - big, tall, beautiful, hot, etc.

At 3 years old, the child should speak in sentences that are united in meaning, use all pronouns correctly, actively use adjectives and adverbs in speech (far, early, hot, etc.). From the point of view of a non-specialist, it is easy to identify that a three-year-old has speech problems as follows - let a stranger listen to your baby. If he understands 75% of what your baby 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 birth, 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 boundary between individual characteristics of development and lagging behind?

Let's calm down the super-shy parents and grandmothers first. The framework that is taken into account by development standards is quite flexible. If your baby speaks not 10 words a year, but 7, then you should not sound the alarm. Fluctuations to the side a little earlier or a little later are acceptable within 2-3 months. And for boys, it is possible to lag behind girls by 4-5 months.

The inhabitants believe that there is a certain zone, an area of ​​the brain 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, 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, because of which it is more difficult for boys to dress their thoughts in the form of a grammatically correct statement. If there are no brain and mental deviations in development, with an early slight lag in speech development, the boy will overcome it with the help of specialists. 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 worth warning the boys' parents that the situation should not be started, and if the deviation from the norm is significant, be sure to sound the alarm. In connection with the gender characteristics of development, it is among boys that the percentage of deviations in speech and psycho-speech development is high. Let's take a few examples. Among children who stutter, there are twice as many boys as girls. Among those suffering from alalia (almost complete lack of speech with intact hearing) there are three times more boys, and the same number of children with dysarthria (when a child has difficulty pronouncing so many sounds and his speech is almost incomprehensible to others).

What counts as speech? Until the age of 2.5 years, it is acceptable if the child speaks "baby language". Words are considered not only full-fledged "mom" and "dad", but also "bee-bee" instead of "car", "car-car" instead of "crow", and "kup-kup" instead of "let's go swimming." The child can come up with their own designations for objects. If a child stubbornly calls pasta "kamani" - this is also a word. It is acceptable that the same combination of sounds be used to denote different objects (“ki” - pussy, socks, throw).

But if a child at 2.5 years old does not try to speak in phrases of 3-4 words like “mom de cup-cup” (mom is going to swim), then you need to 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 the gestures of adults and does not smile, does not perk up when mommy addresses him.

• If the child is already 8-9 months old, and still there is no babbling (repeated ba-ba-ba, pa-pa-ta, etc. combinations), and in a year it is an extremely quiet child, making 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 simple requests like “come here”, “sit down”.

• If the child has difficulty sucking or chewing. For example, if a one and a half year old child does not know how to chew and chokes on even a piece of an apple.

• If at two years the child uses only a few separate words and does not try to repeat new words.

• If at 2.5 years the active vocabulary is less than 20 words and word imitations. Does not know the names of surrounding objects and body parts: cannot, upon request, point to a familiar object or bring something that is out of sight. If at this age he does not know how to make two-word phrases (for example, “give me water”)

• If a three-year-old baby speaks so incomprehensibly that even relatives can 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 "rumbles", that is, he speaks too quickly, swallowing the endings of words, or, conversely, extremely slowly, stretching them out, although there is no example of such speech at home.

• If at three years old a child speaks mainly in phrases from cartoons and books, but does not build his own sentences, this is a sign of a serious developmental deviation ... If at three years old a child mirrors what adults say in front of him, even if out of place, this is the reason an urgent appeal to a specialist, and a psychiatrist!

• If a baby of any age has a constantly open mouth or increased salivation for no apparent reason (not associated with tooth growth)

Severe childhood illnesses, especially in the first three years of life, traumatic brain injuries or simply neglected frequent falls, hearing loss of varying degrees - all this can cause a lag in speech development. Under the influence of unfavorable biological (or social) factors, it is precisely those areas of the brain that are most intensively developing at the moment that are most significantly damaged. Studies have shown that children whose mother or father have any mental disorders, often quarrel or abuse alcohol often suffer from delayed speech development.
Of course, the hereditary factor also plays a significant role. I would like to stop separately at this point. Often mothers come with a five-year-old child who practically does not speak. I ask you, what did you expect a year ago, a year and a half ago? After all, the sooner you start correction and treatment, the higher the result! Moms shrug their shoulders and say that, they say, the mother-in-law says that the father of the child spoke only at the age of 4 and immediately with phrases, and the uncle spoke late. And nothing, both people got out.
Therefore, waiting for everything to resolve itself is an extremely irresponsible position!

The help of what specialists and when may a child with a speech delay need help?
Hearing assessment for children with speech delay (examination by an audiologist)

• To assess development, age-appropriate tests are used: the Denver psychomotor development test, the Early Language Milestone Scale, the Bailey Scales of Infant Development.

• From conversations with parents and observations, find out how the child communicates his needs. In contrast to general developmental delay and autism, children with hearing loss, motor apraxia of the facial muscles, and primary neurogenic speech disorders are able to express their needs.

• It turns out that there is no motor apraxia of the muscles of the face, which is revealed in the form of difficulties in feeding and the inability to repeat movements of the tongue.

• Compare understanding and speech reproduction.

• Information about the child's home environment and his communication helps to identify insufficient stimulation of speech development.

What is the difference between Speech Delay (SPD) and Psycho-Speech Development Delay (PSP)?

A delay in speech development is when only speech suffers, and the mental and emotional development of the child is normal. This is the case when the child understands everything and fulfills requests, but speaks little or very poorly.

A delay in psycho-speech development implies that the child has a developmental lag of a general intellectual nature.

If before the age of 4, the diagnosis of ZPRD is quite rare and happens only in the presence of serious diseases, then over 5 years, only 20% of children with speech problems remain diagnosed with ZPRD. If before the age of 4 the child mastered the world, entering into little communication, then from this age he receives the bulk of the information precisely in communication with adults and peers. If speech is inaccessible to a child, mental development begins to slow down, and by the age of 5, due to a delay in speech development (SRR), unfortunately, a delay in PSYCHO-speech development (SPR) is formed. Therefore, if doctors have given your baby a ZRR, you should not, like an ostrich, hide your head in the sand and wait that “everything will pass by itself”. ZRR is reflected in the formation of the entire psyche of the child. If communication with others is difficult, this prevents the correct formation of cognitive processes and affects the emotional-volitional sphere. Waiting without treatment and classes with a 5-year-old defectologist often leads to a pronounced lag behind peers, in which case training will be possible only in a specialized school.

Sometimes a delay in speech development is associated with a delay in psychomotor development. The baby begins later than other children to hold his head, sit, walk. They are awkward, often fall, get injured, fly into objects. A characteristic sign is a long potty training, when at the age of 4.5-5 years the child continues to have “opportunities”.

What is the reason for the occurrence of ZRR and ZPRR in a child?

It should be understood that ZRR and ZPRR are not independent diseases, but the consequences of certain deviations in the health of the child, namely, disorders of the brain, central nervous system, genetic or mental disorders. Studying the anamnesis of children with delayed speech development, experts found that various adverse effects during fetal development, premature, prolonged or rapid labor, a long anhydrous period, birth injuries, fetal asphyxia during childbirth, hydrocephalus and increased intracranial pressure, genetic predisposition, mental illness, and even early transfer of the child to artificial feeding.

Delayed speech development is characteristic of children with cerebral palsy, Down syndrome, children with early childhood autism, hyperactivity syndrome.

Regardless of the cause that led to brain damage, 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 are more “affected”, and as a result, speech and mental development is delayed.

Negative social factors do not have a direct pathological effect on the child, but they affect mental development. Therefore, RDD and RDD are often diagnosed in twins and twins, in children growing up in bilingual families or a poor language environment.

Dear mothers! If, according to the stories of relatives, you, your husband or uncle-aunt and another close relative spoke late, then this signals that your child already has a genetic predisposition to RDD. From generation to generation, ZRR wears more and more severe forms. . It must be understood that the active mastery of lexical and grammatical patterns begins in a child at 2-3 years old and ends by the age of 7. If a child has NO speech AT ALL, not 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 - gestural, card, written, but he will no longer have active speech in the general sense.

Unfortunately, many parents believe that speech therapists "treat" developmental delay, but speech therapists are educators, not doctors. They only teach the child to speak various sounds correctly, and this can only be done effectively from the age of 4-5. But you and I already know that waiting up to 5 years in the case of a child with ADHD is extremely dangerous.

So, first you need a fairly detailed diagnosis to identify the causes of the pathology of speech development.

To find out the reasons for the delay in speech development, it is necessary to contact a neurologist, a speech therapist, and in some cases a psychiatrist and a child psychologist. Specialized brain tests may be required - ECG, ECHO-EG, MRI and similar examinations.

Almost 100% of children with STDs and STDs require medical treatment.

At what age does work to overcome developmental delays begin?

The sooner the better.

Neurologists can prescribe treatment from the age of 1 year if a neurological pathology is detected early, which leads or may lead to a delay in speech development.

Defectologists start working with children from the age of 2, they help develop a child's attention, memory, thinking, and motor skills. Speech development specialists, corrective teachers also start working with children from 2-2.5 years old.

Speech therapists help to “put” sounds, teach how to build sentences correctly and compose a competent story. Most speech therapists work with children from 4-5 years old.

What are the methods of treatment of RRR and RRR?

Drug therapy - among the drugs that are used to treat STDs, there are those that are "active nutrition" and "building material" for brain neurons (cortexin, actovegin, neuromultivit, lecithin, etc.), and drugs that "spur" activity speech zones (cogitum). All appointments are made ONLY by a neurologist or psychiatrist. It is dangerous to self-medicate, 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 must also be selected individually.

However, only drug assistance to such children brings little result if it is not backed up by pedagogical influence. The main task of the work of a defectologist teacher 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 deviations in development and difficulties in learning at the initial stage. In his work, the teacher-defectologist uses visual, practical, technical means of rehabilitation and conducts remedial classes in a playful way according to an individual plan. There is no general technique that helps absolutely everyone, an individual approach is needed.

It is very important that parents, noticing signs of a delay in speech development in a child, not only rely on the help of specialists, but also actively engage with the child themselves. The defectologist helps to choose the direction of the work that the relatives of the child will have to do daily and hourly.

A little about the methods of corrective work.

In working with such children, art therapy, music therapy, object-sensory therapy methods, special methods for developing large and small (fine) motor skills, methods for expanding the child's conceptual apparatus are used.

For example, finger games are actively used.

It is necessary that at home parents provide the child with the opportunity to develop fine motor skills - a designer, puzzles, insert games, mosaics, lacing toys, cubes and balls of different sizes, pyramids and ring throws, simulators for fastening buttons and tying shoelaces. It is necessary with the child to sculpt a lot from plasticine, draw with finger paints, string beads on a cord, perform engravings and primitive embroideries.

Of great importance is the use of various massage techniques and motor stimulation for the development of perception and sensations from an early age.

It is recommended to use outdoor games (logo-rhythmic technique) that develop the ability to navigate in space, move rhythmically and deftly, change the pace of movements, as well as games in which movements are accompanied by speech.

Any classes should be carried out according to the system, so you need 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 once a week, if the parents are ready to do the work assigned by the specialist at home in full. A child 4.5-5 years old and older needs to meet with a specialist at least 2 times a day, and in the case of 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.

In conclusion, I emphasize once again that if you notice that the speech development of your baby does not correspond to the age norm, do not hesitate - contact a specialist immediately! If the correction of speech disorders is started at an early age, then it is likely that at the age of 6 your child will not be any different from his peers.

Usually parents are very sensitive to the way their child speaks. After all, correct speech is one of the most obvious signs of the normal intellectual development of a baby. If the baby begins to speak early, clearly and clearly - the parents are happy and proud. But a child with a speech delay causes concern and anxiety for moms and dads. And this is absolutely correct - after all, speech disorders are effectively treated only at the age of 2.5 to 7 years. Then it might just be too late.

Normal development of speech in children

How should a child's speech develop? What is considered the norm?

• V year the baby should be able to speak about ten words. Naturally, these are still “childish” words, understandable only to him and you - “ma”, “ba”, “ki” (pussy). At the same time, the child must know the names of objects and actions familiar to him and respond to them: “give me a cube”, “let's go for a walk”, “bed”, “spoon”, “window”.
• V two years the baby begins to speak in short sentences and use simple adjectives and pronouns (“I went”, “white pussy”). The vocabulary of a child, as a rule, consists of 50-100 words.
• V 2.5 years the baby should pronounce more or less correctly about 200-300 words, and also know his name and speak, uses adjectives. At this age, the child begins to ask questions, tries to imitate the voices of animals - “meow”, “woof-woof”, etc.
• TO three years children should be able to coherently compose a story from several sentences. In speech, pronouns, adverbs, adjectives must be used correctly. The kid should be understood by an outsider.

Naturally, the above norms are very relative - after all, all children have a different character, temperament, heredity, and the environment in which they grow up is different. In addition, as a rule, boys begin to speak later than girls by 4-5 months.

However, these guidelines will help attentive parents assess whether the baby's speech is appropriate for his age. If the lag is significant, then it may be time to contact a specialist.

Signs of a clear delay in the development of speech in children

Parents should start to worry if a child:

• V 4 months does not respond to the appeal of the mother, does not smile at her.
• V 9 months does not babble.
• V 1.5 years: does not pronounce simple words; does not know the names of the surrounding objects and his own name; unable to follow a simple command such as "give me your hand" or "come to me."
• V 2.5 years: knows few words; does not remember the names of objects; cannot speak in sentences, at least two words.
• V 3 years: speaks incomprehensibly even to you; cannot make a sentence of three words, but speaks in phrases from fairy tales, rhymes and "cartoons" or repeats the phrases of adults uttered in front of him; does not understand your explanations; speaks very slowly or, conversely, too quickly, swallowing the endings; the baby has difficulty chewing and may choke on even a small piece; walks with a constantly half-open mouth; He has increased salivation for no apparent reason.

If you notice any of these signs in your baby, you should immediately contact your pediatrician. The doctor will prescribe an examination and refer you to the appropriate specialist. The earlier the treatment of delayed speech development in a child is started, the more likely it is that by school he will not be any different from his peers.

What are speech delays in children?

Language Development Delay (SPD)- this is when the baby does not speak the way it should be at his age.

Distinguish:

• Speech articulation disorder- the child speaks very indistinctly, even relatives cannot understand him, but at the same time he understands everything, does not have any mental disorders and is otherwise completely healthy.
• Expressive speech delay- the baby's speech is significantly behind his age norm / the child speaks very little or is silent at all.
• Receptive speech disorder- the child does not understand well what is said to him, although his hearing is all right.
• Combinations previous disorders.

Causes of speech delay in children

Experts divide the causes of speech disorders into social and physiological, that is, those that are related to health.

TO social factors usually attributed to improper upbringing, depriving children of the desire to speak.

• This may be insufficient attention to the child - he simply has no one to talk to. Or parents speak so fast that the baby does not have time to isolate individual words and, in the end, stops trying to understand the adult.
• Sometimes the environment that is not suitable for the baby can lead to problems with speech - the child grows up in an environment where speech loses its value. For example, the TV is constantly on, adults are talking loudly to each other, there are a lot of extraneous sounds. The kid gets used not to listen to the speech and begins to speak with quotes from the "cartoons", not attaching importance to the words.
• Oddly enough, overprotection can also lead to a delay in the development of speech - in families with over-attentive parents, children can also lose their motivation to develop speech - after all, they are already understood!
• Very often there are difficulties with speech in children in bilingual families.
• And, of course, excessive demands on the child can “beat off” any desire to speak. Parents force the baby to repeat the same words and phrases, causing him to have a negative attitude towards speech.

Speech tempo delay associated with a lack of motivation to communicate is the easiest to correct. Of course, with timely treatment to the doctor. The best results are obtained by treatment started before 3–4 years of age. If you start to study with the child on time, then by the age of six he can catch up with his peers and even overtake them.

However, speech correction can be started even later, even at 5 or 7 years old. The main thing is not to ignore the problem.

TO physiological factors Speech developmental delays include:

• hearing impairment;
• underdevelopment of the organs of articulation: lips, tongue, facial muscles, soft palate;
• visual impairment;
• brain damage, neurological diseases (intrauterine trauma, hypoxia, difficult or premature birth, trauma in the first year of life, severe illness at an early age);
• psychological trauma (fear, parental quarrels);
• alcoholism of parents;
• heredity (if parents in the family started talking late, then this is a reason for close monitoring of the baby and early contact with a specialist);
• congenital diseases: cerebral palsy, Down syndrome, autism, hyperactivity syndrome.

The delay in the development of speech in children associated with the listed reasons is treated much more difficult and longer. In these cases, the help of a doctor is required, and sometimes the joint efforts of different specialists.

Which specialists deal with speech disorders

Many parents believe that speech therapists are involved in the treatment of speech disorders. In fact, speech therapists only "set" the correct pronunciation of sounds. They start working with children from the age of four or five. Very few speech therapists work with younger children. But to wait so long, if the child clearly does not speak the way it should be at his age, it is impossible in any case.

Speech delay in a child requires, first of all, finding out the reasons. Only after this, the necessary specialist will be able to correct the development of the baby - a defectologist, psychologist, neuropathologist, speech therapist or even a psychiatrist.

A neuropathologist can start treating a one-year-old child if he has been diagnosed with any neurological disease. Defectologists and corrective teachers work with 2-year-old children, they are engaged in improving memory, thinking, attention, and motor skills. At the age of 4–5, speech therapists are involved, who teach children to speak clearly and competently, to build a story.

How is RRR treated?

Speech delay in children is treatable - the main thing is to start it on time, be patient and show some perseverance.
Treatment of speech disorders usually consists of the following components.

• Drug therapy

The attending physician will prescribe you medications, as a rule, these are means for “feeding” the neurons of the brain and for stimulating the speech zones.

• Magnetotherapy, electroreflexotherapy, dolphin therapy and hippotherapy

These methods of therapy allow you to influence the areas of the brain responsible for diction, memory, and intelligence. Magnetic therapy has no contraindications, but electroreflexotherapy cannot be used to treat children with epilepsy, convulsive syndrome and mental illness.

Dolphin therapy, hippotherapy and similar alternative methods are practiced by some specialists. These treatments are selected individually.

• Work with the proofreading teacher

No drug therapy, if it is not accompanied by the work of a corrective teacher, psychologist or defectologist, is not able to eliminate the tempo delay of speech. The task of teachers is the mental development of children, their social adaptation, the correction of past mistakes in education, the improvement of intellectual abilities, memory and attention. Every child is unique, so every child is treated individually.

• Daily work with parents

And, of course, parents should not hope that doctors will do all the work. The successful outcome of treatment largely depends on the perseverance, consistency and patience of mothers and fathers. It is very important that parents engage with the baby in a playful environment, without causing negative emotions in him.

What Methods Do Teachers Use?

The main methods for correcting speech delays are:

• Music and art therapy. Music therapy improves memory and attention. Art therapy improves visual memory.
• Object-sensory therapy, development of large and fine motor skills of hands, massage. For example, all finger games are very useful - modeling from plasticine, drawing with fingers, picking up puzzles, designers, pyramids, playing with cubes, fastening buttons, stringing beads on a thread. This is understandable - in the brain, speech centers are located next to the centers of fine motor skills of the hands, therefore, by developing the motor centers, the child automatically improves his speech.
• Outdoor games. Teachers can advise outdoor games that form the ability to orientate in space, the ability to move rhythmically or special games with speech accompaniment.

In general, it is quite possible to cope with the problem of speech delay in a child if you approach it seriously and responsibly. Just don't let it take its course, hoping that over time everything will go away on its own. From how well and correctly the baby speaks by the age of six, his future psychological development, his ability to communicate with peers and adults, his ability to study at school largely depend. The main thing is not to miss the moment - the sooner you start treatment for speech delay, the more likely it will be successful.

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Delayed speech development is a pathology that requires timely diagnosis and correction by specialists. Neglecting the problem can lead to serious complications, for example, a delay in psychoverbal development in preschoolers.

How to launch active reproduction of the first words at 1 year and 2 months? Why does a 2-3 year old baby not talk? What treatment will be effective for RDD in children? How can you help your child at home? What medications does a child up to 3-4 years old need if he does not speak well?

Norms for the development of a child's speech by age

The development of a child's speech is one of the highest priorities for parents. This is facilitated by joint activities with my mother, reading books, talking at home and on a walk. If parents do not pay due attention to their baby, then by the age of three he is unlikely to learn to talk.

The first year of life is a pre-speech period. At this stage, the baby learns the world, studies various phenomena, and also remembers and reproduces the first sounds and words. After the child is 1 year old, parents should monitor his speech. Babies develop differently - some later, and some earlier - therefore, the norms of speech, according to age, are conditional.

Doctors distinguish the following stages of normal speech development:

• 1 year. At this age, the baby knows about 10 words from repeating syllables - “ma-ma”, “pa-pa”, “ba-ba”. At the same time, the child fulfills requests, can independently ask for and bring objects familiar to him. A toddler's passive vocabulary is approximately 200 words.

At the age of 2, the so-called explosion occurs. At the same time, the child begins to actively turn passive speech into active speech. This jump occurs suddenly, so the conversation of two-year-old children is very different from toddlers at one and a half years.

• 2nd year. At the age of two, babies begin to speak in phrases. Children can only learn this when their active vocabulary consists of 50-100 words. At this age, some kids know how to ask questions.
• 3rd year. A child's active vocabulary should have approximately 300 words by the age of 3. The kid at the same time knows how to call his name, the names of parents and relatives. At this age, children begin to build detailed sentences. By the age of three, babies are understood not only by parents, but also by strangers.
• 4th year. A 4-year-old can speak over 1,000 words. Children can pronounce all sounds, ask and answer questions, and change intonations correctly.

Possible causes of delayed speech development in children

All of the above norms are conditional, however, significant deviations should encourage parents to consult with a specialist. To eliminate the pathology, it is necessary to eliminate its cause. Speech delay in babies occurs against the background of physiological or biological factors associated with health, as well as social prerequisites caused by the unfavorable environment of the baby.

Biological reasons include:

• minimal pathology of the brain against the background of perinatal encephalopathy;
• hypoxia and asphyxia in labor;
• intrauterine infection;
• premature or late birth;
• complications after vaccination;
• traumatic brain injury;
• hearing loss;
• genetic predisposition;
• congenital diseases - cerebral palsy, autism, Down syndrome;
• meningitis or encephalitis.

If the cause is physiological, then the treatment will take a very long time. In this case, the child needs complex therapy. If the baby cannot speak for one of the social reasons, then fixing it is much easier and easier.

Social preconditions include:

Varieties and symptoms of pathology

Speech delay is a diagnosis that is made to children with a discrepancy in speech development for age. There are several main manifestations of this pathology, among which:

1. Tempo delay. Many parents are familiar with the following problem - the child understands everything perfectly, brings the items that the mother asks for, but his speech is slurred and it is very difficult for others to understand it. In this case, doctors talk about the tempo delay in speech development.
2. Disorders of expressive speech. The active vocabulary of the baby is significantly different from the speech of peers. The child is very silent.
3. Lag in receptive speech activity. Children with this diagnosis understand adults very poorly, and they have no hearing problems.

If parents neglect all of the above manifestations, then by the age of 5 there may be a transition to a delay in psychoverbal development (ZPRR) (we recommend reading:). The sooner the treatment of pathology begins, the higher the child's chances of recovery. If parents do not pay attention to the problem in a timely manner, the baby will lag behind in mental and speech development in kindergarten and school. Symptoms of ZPRR are the inability to build logical chains, formulate sentences, think abstractly and concentrate on tasks.

Diagnostic methods

If the baby has significant deviations in the development of speech, parents should not neglect this problem. Many mothers are sure that each child is individual and all children master certain skills at different ages. This point of view cannot be considered wrong, but it cannot be called true either. If the baby really does not have any problems, and the delay in speech activity is just an individual feature, any specialist can confirm this after carrying out the necessary diagnostic measures.

First of all, the mother should contact the pediatrician, who can additionally refer the baby to other pediatric specialists. Doctors to contact for speech delays include:

1. Neurologist. Diagnosis of a pathology of a neurological nature associated with a lag in the development of speech allows the doctor to prescribe special treatment, starting from 12 months. If during the examination, the neurologist does not find any problems, he may refer the baby for an additional examination of the brain (EEG and computed tomography) to identify the cause of the developmental delay.
2. Defectologist. This specialist deals with children after two years. Visits to a defectologist are very effective for the development of speech, thinking, attention and logic.
3. Speech therapist. This doctor is engaged in the development of children's speech activity. Diagnostic methods of speech therapists include a test and scale of psychomotor development, a scale of early speech development. These specialists study the behavior of children with speech delay in natural and artificially created environments.
4. Otolaryngologist. Consultation of this specialist is necessary to exclude hearing loss - one of the main reasons for the lag in the development of speech.
5. Psychologist. If the child did not have any of the causes of a biological order, then the problem lies in pedagogical neglect or the wrong approach of parents to the development of speech.

Features of the treatment of RRR

The treatment of this pathology requires complexity, especially when it comes to the occurrence of a problem against the background of social prerequisites. The main components of therapy are massage, drug treatment, physiotherapy, corrective classes with a defectologist and a speech therapist.

Parents in this case should be patient, since a positive result can not be achieved immediately. Moms need to remember that the effectiveness of all these treatments directly depends on their joint efforts with the baby. Positive emotions, a friendly atmosphere in the family are the main components of successful speech acquisition.

Medications

All drugs should be taken by the child strictly as prescribed by the doctor. Self-medication can only harm the baby. As a rule, in this case, pediatric neurologists prescribe drugs for babies that stimulate the speech zones of the brain - Gliatilin, Pantogam, Cinnarizine, Magne B6 and many others. The doctor prescribes medications in accordance with the age of the baby and the degree of delay in his speech development.

Physiotherapy

Physiotherapy for children should include magnetotherapy, electroreflexotherapy, dolphin therapy and hippotherapy. With the help of these methods, an impact is made on the areas of the brain that are responsible for the development of speech activity, diction, and intelligence. Their use is prohibited up to 2 years.

Electroreflexotherapy, unlike other methods of physiotherapy, has several contraindications, including:

• epilepsy;
• mental disorders;
• convulsions.

Spending time with dolphins and horses is an innovative method with a high success rate. The effectiveness of dolphin therapy and hippotherapy depends on how often the child communicates with dolphins and horses. Only regular classes allow you to achieve success in the shortest possible time.

Massage

Massage is very effective for overcoming RDD. A visible result appears even after the first course. Massage requires qualified training, so it is better for parents to invite a massage therapist home. The areas that need to be given maximum attention are the muscles of the face, neck, shoulder blade, arms, and abdomen. Impact on the points of the face - ears, lips, cheeks - also contributes to the launch of active speech.

Correctional classes

Correctional assistance is needed for all children who have been diagnosed with a delay in the development of speech. If it is associated with social prerequisites, then the child will need to consult a defectologist, psychologist and speech therapist. These specialists in their classes create natural and unusual communicative situations in which the child must somehow show himself.

Further treatment strategy will depend on how correctly the child selects speech patterns. The most common methods of working with such children are finger games, exercises for the development of hand motor skills, productive activities (sculpting, drawing), as well as gymnastics and outdoor games. Many defectologists prefer music therapy, which improves memory and concentration.

Preventive measures

Preventing speech delay is not so difficult. Firstly, you need to deal with your baby every day, starting from the first days of life - read poetry, fairy tales, sing lullabies, show objects and talk about them. By the age of one, children should already be able to pronounce a few basic words. In order for a one-year-old child to learn to speak his first 10 words, he needs to create favorable conditions - exclude quarrels and swearing, introduce him to educational toys appropriate for his age, arrange role-playing games and comment on cartoon episodes.

If the mother has the slightest suspicion of problems with the reproduction of active words in the baby, she should immediately contact the pediatrician. At the age of 2.5-3 years, it is advisable for parents to show the baby to a speech therapist for preventive purposes.

The opinion of Dr. Komarovsky

Dr. Komarovsky devoted the 39th issue of his program entitled “Why the child does not speak?” to this problem. (see video). He highlights the only reason that a baby at this age fulfills all requests, but does not talk. This is a lack of communication in the family. Many parents leave the child alone with cartoons or toys, while they themselves go about their business for days on end. Despite the fact that they are in the same room all day and the mother is always there, the baby does not benefit from this in terms of speech development.

Children need stimulation to talk. For example, games with toys are much more useful than all gadgets. During the game, the child becomes interested in learning how to play with the object, what can and cannot be done with it. At this stage, it becomes necessary to understand adults. Thus, a passive vocabulary is formed, which, with a competent approach, is transformed into an active vocabulary.

Komarovsky believes that it is necessary to start sounding the alarm if a child at the age of two cannot fulfill a two-phrase request. Its implementation indicates that the first stage was successfully completed, since the baby understands what they want from him. Otherwise, the child needs to be examined by a neurologist, speech therapist and child psychologist.

Delayed speech development in children (SRR) is a complex disease in which the development of speech lags far behind the accepted age norms. Despite the fact that each baby is individual, by the age of 3-4 he should speak clearly and coherently. ZRR is noted in the case when the intellectual development of the child corresponds to his age, and speech lags far behind. This disease is effectively treated in children under 7 years of age. How to recognize it in time?

Norms of development of children's speech

Each child has his own temperament, his own heredity. Many factors influence its development. The above norms are relative: if the development of the baby's speech deviates for several months, you should not worry. You also need to consider that boys usually start talking 5 months later than girls. You need to be guided by the given data in order to find out whether the speech of the crumbs corresponds to his age.

The child must be able to:

• by the year, pronounce at least 10 words that are understandable to himself and close people (at the same time, the child must know the name of simple objects and actions known to him);
• by the age of 2, speak in short sentences (of 2-3 words), his vocabulary increases to 100 words;
• at 2.5 years old, it is correct (or almost correct) to pronounce about 300 words, know and say your name, use adjectives, ask simple questions;
• by the age of 3, compose a short story of several sentences, use all parts of speech correctly (the child’s words must be understood by strangers), his vocabulary increases to 1000 words;
• at the age of 4, build sentences of more than 4 words, pronounce almost all sounds correctly, change intonation, answer questions.

A specialist should be contacted if by the age of 3-4 years the child pronounces words incomprehensibly even for parents, does not understand adult speech, speaks too quickly or slowly, often uses phrases from cartoons, is not able to make a sentence of 3 words. If, along with these signs, there is increased salivation, difficulty chewing and swallowing, you should immediately visit a doctor. Timely treatment of ZRR gives the baby every chance to be no different from his peers by the beginning of school.

Causes of the problem

All the reasons for the delay in the speech development of a child are divided by experts into 2 groups. Physiological factors include those related to the health of the baby. Treatment of RDD caused by such problems is always more difficult and requires the help of different specialists. Social causes include those reasons that depend on the environment of the baby, the characteristics of his upbringing.

Physiological causes of RRR:

• hearing impairment;
• vision problems;
• poor development of the organs of articulation: tongue, lips, soft palate;
• brain damage;
• trauma or serious illness in the neonatal period;
• diseases caused by intrauterine trauma;
• problems during the mother's pregnancy, her alcohol use;
• premature or difficult childbirth;
• some congenital diseases: Down syndrome, cerebral palsy, hyperactivity, autism;
• heredity.

Social factors:

• insufficient attention paid to the child when he has no one to talk to;
• slurred speech of parents and surrounding people;
• overprotective parenting leading to deprivation of motivation to speak;
• frequent emotional stress;
• the constant operation of the TV, the presence of extraneous sounds surrounding the child;
• family communication in several languages.

Why should you see a doctor?

If the necessary treatment for speech delay is not started at the latest at the age of 7, the child will noticeably lag behind peers at school age. Such a baby will have to attend only a specialized school. Parents will need to always monitor the condition of the child. An increase in mental or physical stress, diseases (even mild ones), vaccinations can lead to a deterioration in his well-being and cause sleep disturbance, headache, nosebleeds, hysteria, memory loss, aggression.

Treatment of disorders in speech development is carried out not only by a speech therapist. This specialist deals only with the production of sounds in children 4-5 years old. What to do if a younger child speaks with obvious speech disorders? Under no circumstances should diagnosis and treatment be delayed.

After finding out the reasons for the delay in speech development, a specialist can deal with the problem. Defectologists, psychologists, neuropathologists, psychiatrists, proofreaders work with 3-year-old children. If a child has a congenital neurological disease, a neuropathologist can begin treatment at the age of one. Speech therapists teach children 4-5 years old to speak clearly and competently.

Treatment Methods

Parents are always interested - at what age should a baby be treated? According to doctors, treatment should begin as soon as the first suspicions of a pathology appear. All specialists involved in the development of speech can already work with children 3-4 years old. There are several treatments for RDD.

The drug method consists in taking certain medications by the child. All drugs are prescribed by a pediatric neurologist after a thorough examination. Such drugs activate the activity of speech zones and "feed" the neurons of the brain. In no case should you give the child these or other drugs on your own, they should be prescribed only by a doctor.

Physiotherapy includes magnetotherapy and electroreflexotherapy. These procedures allow you to restore the functioning of certain areas of the brain that are responsible for vocabulary, mental abilities, and diction. They can be used from 2 years. Contraindications are epilepsy, convulsive syndrome, mental disorders.

Drug therapy and physiotherapy must be accompanied by the work of a corrective teacher, otherwise they will be ineffective. Specialists work with children from 3 years of age and help correct developmental defects, prevent the possible occurrence of speech inhibition, and teach them to cope with difficulties in the treatment process. For each child, an individual plan of treatment sessions is developed in the form of a game.

How to help doctors?

Treatment will be more successful if parents help specialists. The child spends most of the time with them, so regular classes with mom and dad will have a huge positive effect. To determine what kind of work parents need to do daily with the child, you should consult with a specialist.

The following exercises bring good results.

1. . The development of manual motor skills improves the functioning of the articulatory apparatus. From 2-3 years old, it is useful for a child to collect puzzles, a designer, play with cubes, mosaics, lacing, liners, sculpt from plasticine, draw with finger paints, string beads on a fishing line.
2. Outdoor games. For the development of speech, games aimed at the ability to navigate in space, deftly move, change the speed and direction of movement are useful. It is good if all the actions of the child are accompanied by words.
3. Music games. They perfectly develop attention, teach you to concentrate, catch a change in timbre, rhythm. You can guess the voices of animals, various musical instruments, with older children - the names of melodies.
4. The development of visual attention. To improve speech, games with colorful objects, geometric shapes, and special cards are indispensable.
5. Massage. It is necessary if the ZRR is caused by deviations in the psychophysical development of the child. It is better to entrust professional massage to a specialist, and parents can also do general strengthening movements.

Any occupation requires a systematic approach, so it needs to be paid attention daily. In the process of treatment, the supervision of a specialist is required. A 3-year-old child must be shown to a defectologist once a week. A 4-year-old child will need to meet with specialists twice a week. To enhance the effect of treatment, when communicating with a child, follow simple rules:

• do not talk with the baby about his problem, do not be shy about his speech;
• make the crumbs want to imitate an adult in speech, emotions;
• voice all the actions that you or the child perform, do not be afraid to repeat the same words;
• use simple sentences (of 3-4 words) when communicating with the baby;
• read fairy tales, poems accessible to his understanding;
• limit or completely exclude TV viewing;
• sing songs with your baby every day for at least 5 minutes;
• develop the baby's respiratory system: teach him to play the pipe, harmonica, blow soap bubbles;
• do not force the baby to study, do it in the form of a game;
• massage children's hands and fingers with a special massager, for this you can use spruce or pine cones;
• if the child is tired, postpone classes for a more favorable time for him;
• always encourage the improvement of the child's speech development.

The most "advanced" methods of treatment may be ineffective if the child develops in an unfavorable environment. To stimulate his speech development, additional methods are needed, such as dolphin therapy, hippotherapy. Even the communication of a child with a pet can enhance the effect of treatment. The main thing is to remember: the sooner speech correction is started, the faster and easier the result will be achieved.

The delay in speech development in children of 3 years is manifested by the late ability of children younger than this age to independent oral speech compared to the norm for this age. The delay in the development of speech covers the concepts of the quality of the expressive speech of the child and the quantitative underdevelopment of the vocabulary. As a result of the delay, the child did not develop phrasal speech by the age of 2 and the ability to link words into syllables by the age of 3. Treatment of this condition has three main areas: medical, pedagogical and psychological assistance.

Why there is a delay in speech development in children

Delayed speech development can occur for three reasons:

• First, otolaryngological diseases that prevent the child from speaking normally and learning to verbally express their thoughts and desires.
• Also, other serious diseases can become the cause of delayed speech development (SRR) in a 3-year-old child. These may be organic lesions of the central nervous system. These diseases can often be accompanied by a general lag in the development of the baby. Organic causes of delayed speech development are associated with brain dysfunction, namely:
  • Perinatal brain damage.
  • Intrauterine hypoxia and asphyxia in childbirth.
  • Birth trauma.
  • intrauterine infections.
  • Prematurity or postmaturity.
  • Traumatic brain injury (TBI).
  • Hypotrophy.
  • neonatal meningitis and encephalitis.
  • Frequent or prolonged illnesses of early age.
  • The lag in speech development may be associated with hearing loss in a child.
• The third reason for the delay in passive speech development (ZPRR) may be insufficient attention to the upbringing of the child. You need to constantly work with the child.

If the cause of the problem is in education, it is necessary to correct mistakes, purposefully work with the child at home and attract the necessary qualified help. The more the baby lags behind in the development of speech, the more difficult it will be to catch up. The development of speech is directly related to the quality of thinking, that is, a child with a well-developed speech perceives the world not only with the help of sight, hearing and touch, but also with the method of verbal description in his head. Properly developed speech helps to form the personality of the child, to think, to perceive the world around him.

Important! If the cause of speech delay in a child is a disease, it is necessary to consult a doctor in order to start treatment as soon as possible.

How delayed speech development manifests itself in children 3-4 years old

To understand correctly, you need to know the basic norms for the development of speech in young children.

Stages of the pre-speech period:

• Cooing (from 1.5-2 months).
• Baptism (from four months).
• Babble words (from 7-8.5 months).
• The first words in children (at 9-10 months in girls, 11-12 in boys).
• At 1 year old, there are about 10 words in the child's vocabulary, consisting of warehouses.
• At about 1.6-1.8 months, vocabulary becomes active. In some children, the period of passive speech can be delayed up to 2 years, but in general, development proceeds normally.
• Until the age of two, phrasal speech is formed in the child's speech.
• Up to 2.5 years, the child begins to build sentences of 3-4 words.
• In the period from 3 to 4 years of age, a child develops a coherent language. Vocabulary grows from 400-700 words in 3 years to 900-1200 words in 4 years.

Signs of delayed speech development at different stages of language ontogenesis:

• Low activity of cooing and babbling, soundlessness.
• No response to sound at 1 year of age.
• The impossibility of repeating other people's words in a child with a delay in speech development of 2 years.
• At 1.5-2 years old, by ear, follow the actions and instructions of the parents.
• Inability to combine words into simple phrases at age two.
• By the age of three, the complete absence of his own speech.
• Predominant use of facial expressions or gestures by the child.

Options for diagnosing delayed speech development

To diagnose a delay in speech development in a child of 3 years old, you need to consult with a commission of specialists. The conclusion is provided by a pediatric neurologist, a pediatric otolaryngologist, a child psychiatrist and,.

• The pediatrician evaluates the somatic status, preliminarily determines the possible causes of speech development delay and refers the child to a specialist of the appropriate profile.
• Neurological examination (EEG, EchoEG, duplex scanning of the arteries of the head) is necessary to detect organic brain lesions.
• A visit to a pediatric otolaryngologist is carried out to exclude chronic otitis media, adenoids, and hearing loss in a child.
• Speech therapy study of a child with delayed speech development includes the study of anamnestic data and the conclusion of medical specialists, the motor development of children.
• For a diagnostic examination of speech and an assessment of general mental development (speech delay must be distinguished from autism, mutism, oligophrenia), the following are used:
  • Denver test of psychomotor development;
  • Griffith scale (psychomotor development);
  • scale of early speech development;
  • Bailey scale.

Help with speech delay in a child

The speech development of the child must be formed without relying on the data embedded in it. If there is a delay in the development of speech in children 3-4 years old, special treatment is prescribed. For this, special exercises should be carried out. They are associated with the development of fine motor skills, proper breathing and speech production. Exercises with the baby should be carried out regularly, unobtrusively, in a playful way. If the basis of the delay in speech development in children 2-3 years old is brain dysfunction, it is prescribed by a pediatric neurologist:

• Taking nootropics.
• Massage.
• transcranial micropolarization.
• Magnetotherapy.
• Electroreflexotherapy.

In parallel with medical procedures and family education of children with delayed speech development, classes with a speech therapist and a child psychologist are necessary. These classes with speech delay in a child of 3 years old can be carried out as a treatment at home. Particular attention in early childhood is paid to the development of fine motor skills, finger and outdoor games, productive activities (drawing, modeling, applications), didactic games (speech therapy loto, special language games and exercises). Follow your doctor's recommendations.

Doctor's advice! Treatment for speech delay in a child from two to five years old should be systematic and carried out under the supervision of a doctor.

Prevention of speech delay in children

Important! Seek immediate medical attention if you are unsure what to do if you develop new symptoms that your child has not experienced before.