Alalia intervention

Many children of younger preschool age have speech defects. Some babies up to 2 years old are too lazy to talk and are silent, others babble incessantly swallowing the endings of words, others do not pronounce half of the alphabet. Most of these problems disappear over time, and many parents do not worry about this. However, not all children manage to learn to speak correctly, and speech defects only worsen with age. We are talking about alalia – an increasingly diagnosed speech abnormality that does not go away by itself. What is this diagnosis and what should parents do?

What is alalia? What forms of alalia are distinguished?

Alalia in children is a profound disruption of the brain, as a result of which the child’s speech is either absent, or there are serious defects in pronunciation and understanding. At the same time, no pathologies of intellectual development or damage to the speech and hearing apparatus are observed. That is why babies with alalia are potentially ready to master speech skills according to their age, but as a result of organic lesions of the speech areas of the brain, they cannot do this. 

Types of alalia:

• motor alalia;
• sensory alalia;
• mixed type – sensorimotor alalia.

Unfortunately, speech alalia is a disease, the causes of which are still not found. But doctors note factors that increase the risk of developing pathology of speech centers:

• birth trauma;
• fetal hypoxia;
• hypertonicity of the uterus during pregnancy;
• disruption of the endocrine system;
• the use of alcohol and drugs without a doctor’s prescription, tobacco smoking;
• severe stress on the mother during gestation;
• serious intrauterine infectious diseases;
• breech presentation of the fetus;
• entwining the umbilical cord around the baby’s neck;
• brain diseases in the pre-speech period;
• physical head injuries (blows, falls) in the first year of a child’s life.

Research confirms that the above factors were present in children with alalia. However, their presence does not at all guarantee the development of the disease but only indicates the likelihood. 

Alalia: signs and symptoms

In order not to miss alalia and not wasting time parents should use the standards of speech development of their beloved child and check age norms with the real picture. Signs of pathology:

• delayed speech development in a 1-year-old child – there was no stage of humming and babbling; 
• poor development of fine motor skills – it is difficult for a child to hold a pencil, to button, etc.;
• mood often changes – from excitement to apathy and inactivity, isolation, aggressiveness;
• increased fatigue, distraction, inability to concentrate;
• lack of response to addressed speech;
• a child under 2-3 years old does not communicate with phrases;
• unconscious reproduction of speech – text, fairy tales (echolalia);
• does not distinguish objects by name, does not respond to his name;
• there is no speech imitation;
• there is no positive dynamics – as he said two words at 2 years old, and continues at 4;
• adults cannot understand the meaning of the baby’s speech;
• mimic and gestural excessiveness.

Alalia, whose symptoms are at the age of 3, observed by parents is a reason to immediately consult a specialist. Not necessarily increased physical activity or inability to tie shoelaces – this is alalia. However, the above speech signs indicate a problem. 

Depending on the affected area of ​​the brain, 2 types of alalia are distinguished: motor (disorders in Broca’s center) and sensory (pathologies in Wernicke’s center). But, looking ahead, we note that “pure” variants are rare and a mixed type is more common – sensorimotor alalia, the signs of which combine the symptoms of motor and sensory. 

Features of motor alalia

In case of motor alalia, the part of the brain responsible for speech reproduction is affected in a child. That is, the kid understands everything, but is not able to adequately express himself. Motor alalia, signs:

• speech is completely absent – for communication, the child uses gestures, facial expressions, or shouting;
• if the child speaks, then he distorts words, does not build grammatically correct sentences, parts of speech are not consistent;
• complex audio components of speech are replaced by simple ones;
• poor vocabulary, the child uses several learned phrases of 2-3 words maximum;
• often uses nouns in the nominative case;
• passive vocabulary significantly exceeds active;
• does not repeat what adults have said;
• underdevelopment of large and fine motor skills in comparison with age norms;
• poor coordination, awkwardness, the baby often falls;
• decreased level of attention, concentration, memory, cognitive functions as a result of delayed speech development.

Features of sensory alalia

With sensory alalia, the baby suffers from pathologies of the center responsible for the understanding of speech – the inability to correlate sound and meaning. Such children do not understand addressed speech, do not distinguish between words and expressions in the stream, although they can perfectly speak themselves. That is, a baby with alalia can talk for hours without getting tired, but his speech is meaningless for him and those around him. 

Sensory alalia, signs: 

• speech is incoherent and not meaningful; 
• understanding the meaning of a phrase or story only in a familiar situation; outside of context, the child does not recognize the same sentence;
• there is no understanding of the addressed speech;
• distort words, sounds, echolalia are often noted;
• for communication, children mainly use gestures and facial expressions;
• they do not listen to the speech of others;
• hyperactivity or, conversely, physical inhibition;
• behavioral and speech impulsivity, uncritically;
• increased fatigue, soreness, exposure to stress;
• secondary decrease in the level of intellectual development due to speech defects.

In the International Classification of Diseases of the 10th revision (ICD-10), motor and sensory alalia is described as a disorder of expressive (F80.1) and receptive (F80.2) speech.

Any type of alalia not only causes everyday inconveniences but also seriously affects the future of the child. 

Alalia, whose symptoms at the age of 2, were ignored, will not allow studying normally at school, communicate with other people, assimilate new knowledge due to dyslexia or dysgraphia, and develop personally, which significantly impairs the quality of life. Therefore, parents should remember: if something confuses speech development or there are suspicions of pathology, you should immediately consult a doctor for advice. Better to refute the diagnosis than to miss precious time for treatment. 

At the same time, parents cannot make a diagnosis on their own based on “our baby talks a little”, and even more so to take up treatment – this approach can harm the child. Only a competent doctor, after diagnosis, can confirm or deny the disease. 

Diagnostics of alalia

To make a diagnosis in Ukraine, it is necessary to undergo consultations with several narrow specialists – a pediatrician, neurologist and psychologist, an otolaryngologist (to exclude hearing loss), and in some cases a psychiatrist to identify possible concomitant mental disorders.

Doctors analyze all information about the child – from pregnancy to the current level of development and social conditions of the child’s life. A complete history is necessary to clarify the diagnosis and determine prognosis, however, the final diagnosis is possible only after the detection of brain pathologies. For this, the child needs instrumental diagnostics: EEG, MRI, or echoencephalography. 

After consultations (tests for alalia, communication with parents, etc.), the doctor prescribes therapy, taking into account the child’s individual characteristics and concomitant pathologies.

Predictions directly depend on the severity of organic brain lesions and the patient’s age, because the earlier the treatment of even complex cases is started, the higher the likelihood of “catching up” with a child with alalia peers. With timeliness (early intervention), as a rule, the prognosis is favorable, and secondary intellectual impairments are not observed. However, according to statistics, speech with sensory alalia is restored faster than with motor alalia.

Alalia intervention 

It is impossible to cure alalia by taking one tablet for a month or several sessions with a speech therapist. Sensory alalia intervention, as well as treatment of sensorimotor alalia, or motor is a complex of corrective measures in which both defectologists, child psychologists, speech therapists, and the child’s parents, who cannot do without their help, participate. 

The main task with alalia is to activate the child’s speech function at all levels. That is, to teach the kid to recognize sounds, give the correct meaning to what he heard, correctly reproduce speech and use it for meaningful self-expression. 

Approaches to the alalia intervention

For high-quality intervention, and the consolidation of the results, teachers use several types of therapy, therefore, the treatment of alalia in children should be comprehensive:

• classes with a speech therapist according to an individual system of classes aimed at the gradual development of speech;
• speech therapy massage – a physical effect on the area of ​​the lower jaw to activate the speech muscles;  
• developing classes with a psychologist to activate cognitive functions, improve memory, attention, emotional-volitional structures, increase the level of emotional intelligence, self-control, stabilize mood, motor tone;
• physiotherapy (magnetotherapy, electrophoresis, etc.);
• logo rhythmics, music therapy, canistherapy, general massage;
• bioacoustic correction, Tomatis – a therapeutic effect on the brain with sounds, as a result of which cells are restored.

Medicines for alalia are rarely prescribed and mainly to eliminate the symptoms of concomitant pathologies – the effectiveness of pills for alalia has not been proven. 

Also, parents should strictly follow the instructions of doctors and teachers, training the acquired skills at home. You need to do this, as well as attend correctional classes, regularly. This will help to achieve and, most importantly, consolidate the result. 

The ‘Child with Future’ kindergarten for children with special needs provides its pupils with a full range of services for the alalia intervention. Professional educators with many years of experience working daily individually and in groups, gradually developing the child’s speech. And to achieve the best result and prevent speech defects, the kindergarten works with children from 1 year old!