Memory, speech, attention and their disorders (cognitive impairment). Memory impairment

Speech diction

Diction is the clear pronunciation of sounds and words with their correct articulation. The speech apparatus produces sounds, and its violations and defects are the reason that a person’s diction is of low quality.

Speech diction consists of:

• From distinct articulation;
• Correct articulation;
• Manner of pronunciation: tempo and intonation.

Clear articulation - correct and clear pronunciation of sounds. It is thanks to clear articulation that the speaker’s speech is legible and his interlocutors easily understand what he wants to convey. Violation of this indicator of diction may occur due to the physiological characteristics of a person. You can improve the clarity of pronunciation of sounds by training your tongue and lip muscles.

Correct articulation is the coordinated movement of the muscles of the articulatory apparatus. Malocclusions and frenulums have a negative effect on articulation. With such physiological deviations, burr and nasal sound may appear.

Timbre. Often, the manner of pronunciation is influenced by a person’s temperament. The speaker may tend to monotony or speed up his speech. Often it is haste that occurs in people with poor diction. But, as practice shows, almost anyone can “defeat” this problem.

Intonation. As for intonation, it is formed primarily from the ability to clearly pronounce vowel sounds and stress.
You can set intonation with the help of some breathing exercises and reading aloud. Improving intonation is very difficult and painstaking work.

general characteristics

Retardation is a slowness of mental and physiological processes.
In the scientific community, the terms “bradypsychism” and “bradypsychia” are used to denote it. The most typical external signs are slow reactions, protracted speech, inability to engage in joint activities or communication that proceed at a normal pace. Inhibited people often remain alone, seem unsociable, withdrawn for no reason. The most severe variants of the disorder are observed with apathy and stupor, when patients do not respond to anything. There are three types of inhibition: ideational, motor and complex. The symptom is called ideatorial when slowness is most pronounced in speech and thinking. People show moderate or slightly weakened motor activity, but when trying to carry on a conversation, inhibition occurs - they do not have time to follow the progress of the conversation, track the change in topic, or answer the questions posed. Others get the impression that the thought process and speaking take a lot of energy from a person.

Motor retardation is manifested to a greater extent by slowing down movements. It is characterized by physical weakness, relaxed posture, and incoordination. People constantly feel the desire to lean on something stable, sit down or lie down. The decrease in speech rate is mild; communication difficulties arise only when conducting an intellectually complex or emotional conversation. With complex retardation, the mental and motor spheres suffer: patients speak quietly, with long pauses, move slowly or remain practically motionless.

Working on diction and pronunciation

Oratorical talent is extremely rare. Almost all famous people intensively prepare for every public appearance. It is known that Cicero could not utter a single word without preparation. And he is still held up as an example as a great rhetorician.

There are many exercises with which your speech can become clear and beautiful. Among them are both universal exercises and those that are designed to help correct a specific problem. For example, a whistling “S”, an indistinct “L” or a violation in the pronunciation of the sound “R”. In order to solve these problems you will have to work.

Treatment

The methods of primary therapy depend on the cause that provoked the inhibition. As part of the treatment program, various methods are used: drug correction, psychotherapy, targeted stimulation of intellectual functions and motor activity. All activities are aimed at restoring physiological brain processes responsible for the dynamics of psychomotor activity, as well as training mental and physical skills.

Taking medications

Drug therapy is prescribed to most patients and is aimed at improving the metabolism of nerve cells and tissues, protecting them from damaging factors, and slowing down death. Restoring active blood supply improves the functioning of various parts of the brain. As a result, mental activity is activated and symptoms of inhibition are reduced. Patients are advised to take neuroprotectors and nootropics.

Psychotherapy and psychocorrection

Psychocorrectional classes are aimed at increasing the speed of cognitive functions. They include exercises such as selection of associations, generalization of concepts, analysis of logical sequences, and solving intellectual problems. The correctness of the results and the speed of completing tasks are taken into account. During psychotherapeutic sessions, methods of social adaptation of a person with inhibition are mastered. The specialist gives recommendations on choosing a professional field, helps to master behavioral and speech skills that compensate for slowness.

Exercises for diction and voice

When speaking in public or during normal conversation, we use the muscles of the tongue and throat. It is logical that in order to speak beautifully, you need to “pump up” these muscles.

Exercises that will help prepare the necessary muscles:

• You can pump up the muscles involved in producing sounds by regularly pronouncing “A-E-O”. At the same time, it is important to try not to open your mouth too much. The effect can be achieved by pronouncing sounds as deep as possible in the oral cavity.
• A very good effect can be achieved in diction and by training your lips. To do this, you need to say: “GL”, “VL”, “VN” - for the upper lip and “KS”, “GZ”, “VZ”, “BZ” - for the lower lip.
• You can also shape your tongue into a shovel shape and say “I” and “E” several times. Now let’s give the tongue a hook shape and simultaneously pronounce “O” and “U”.
• We continue to “pump up” the muscles of the tongue. We close our mouth and, using internal movements of the palate, cheeks and lips, make the sound “M”.

Diagnostics

Lethargy, fatigue, and weakness are common reasons for people turning to a neurologist. Less often, the initial examination is carried out by a therapist or psychiatrist. First, a clinical interview of the patient, observation and examination is carried out. In order to objectively confirm the presence of inhibition, a pathopsychological examination and psychophysiological tests are performed to determine the reaction rate. To clarify the diagnosis, instrumental studies of the brain and its vessels and blood tests for hormone levels may be prescribed. The standard diagnostic complex includes:

• Clinical conversation.
  When interviewed, patients complain of slowness, memory impairment, and decreased intellectual abilities. They say that they have become worse able to cope with professional responsibilities and everyday affairs, and are unable to carry on a conversation. Possible additional symptoms are drowsiness, headaches, confusion. Children show moodiness, tearfulness for no particular reason, and lack of interest in games.
• Observation.
  When answering a doctor, patients often pause and drawl out their words. The voice is quiet, they speak unintelligibly, the question is answered after silence, so it may seem that auditory perception is impaired or it is difficult to understand the meaning of what was said. They are slow and passive in behavior. The movements are awkward and forced.
• Study of thinking.
  Pathopsychological tests are carried out to assess the speed of the thought process: an associative experiment, selection of antonym words, and others. The results indicate a slowdown in the pace of cognitive functions, a decrease in the number of ideas, and “getting stuck” on one thought. Intellectual activity is characterized by inertia and inactivity.
• Determination of reaction rate.
  When diagnosing retardation, psychophysiological methods are used that measure the reaction time to a stimulus (sound, light) and parallel changes in the bioelectrical activity of the brain, heart rate, and respiratory rate. With inhibition, a significant increase in the time of simple visual-motor and auditory-motor reactions, depression of the alpha rhythm on the EEG, and slowing of breathing are detected.

Exercises for diction and articulation

Since the tip of the tongue is actively involved in clear pronunciation, we use exercises that develop its flexibility:

• Imagine that your tongue is a hammer and hit your teeth with its tip. During such blows, “pronounce” yes-yes-yes-yes. Then try to clearly pronounce the letters “T-D”.
• To clearly pronounce the letters “K” and “G” you need to “pump up” your larynx. To do this, inhale through your nose and completely empty your lungs through your mouth. The release of air through the mouth should occur sharply and resemble the sound “Fu”. Do this exercise several times.
• If you notice that you have a problem pronouncing the letters “P” and “B,” then train your labial muscles. To do this, you need to puff out your cheeks and release the air from your mouth with a vigorous clap.
• It is also very important to learn how to control the amount of air. To do this, you need to use breathing exercises and practice in front of a mirror. Try reading a short text at normal volume. As a rule, you can easily control your voice. Now, do the same, but increasing the volume. There must be problems.

Lethargy

Iron deficiency

Diabetes

Atherosclerosis

Stroke

11439 04 May

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Lethargy: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.

Definition

The functioning of the nervous system is based on the reflex arc - the path along which irritation (signal) from the receptor passes to the effector organ. A reflex arc is a set of neural circuits consisting of sensory, intercalary and motor neurons that provide perception of a signal from the outside, conduct it to special centers of the brain, where the received information is analyzed and a response impulse is generated.

Thus, a high speed of impulse conduction and information processing is one of the necessary conditions for adequate speed of functioning of the nervous system.

Due to the fact that the structure of the nervous system is very complex, consisting of many cells connected to each other by nerve processes (nerve fibers), this system is subject to significant influence from the environment. Thus, changes in the composition of the fluid that washes the nerve cells, changes in temperature and other factors can significantly slow down its coordinated work.

Types of retardation

Retardation is manifested by a slowdown in the speed of certain nervous functions. In this case, both isolated changes can be observed (for example, a slowdown in motor activity, inhibition of perception), and complex ones - when all the main functions of the nervous system, including higher mental activity, slow down.

Retardation can develop acutely or gradually.
The more sudden it appears, the more attention must be paid to finding the reasons for its development. Possible reasons for the development of lethargy
There are many reasons for the slowdown of nervous processes, and one of them is
nervous exhaustion
. This term refers to the insufficiency of nerve tissue reserves to perform its functions, which develops during prolonged hard work of the nervous system.

The next condition associated with lethargy is oxygen starvation

central nervous system.
Lack of oxygen may be due to its insufficient supply from the outside (for example, staying in a poorly ventilated room), impaired gas exchange in the lungs due to various bronchopulmonary diseases
, impaired blood supply as a result of damage to the vessels supplying the central nervous system, or as a result of
heart failure
associated with poor blood supply to all organs and tissues.
Also, impaired oxygen delivery develops with anemia
- a decrease in the concentration of hemoglobin in the blood. Hemoglobin is a protein found in red blood cells that binds and carries oxygen from the lungs to every cell of our body.

Due to the fact that the nervous system's oxygen needs are high, oxygen deficiency quickly leads to disruption of its functioning.

Another cause of lethargy is a state of
hypoglycemia
- a decrease in blood glucose levels. It is observed when there is insufficient intake of glucose from food, during significant physical exertion (when glucose is predominantly spent by intensively working muscles), and when patients with diabetes mellitus overdose on insulin.

Lethargy also occurs due to toxic damage to the nervous system as a result of cerebral edema.

Diseases that cause lethargy

Among diseases of the cardiovascular system that may be associated with insufficient blood supply to the brain,
atherosclerotic vascular damage
, including against the background
of arterial hypertension, diabetes mellitus, heart failure
due to
myocardial infarction, myocarditis
and other diseases.

Bronchopulmonary diseases leading to insufficient oxygen saturation of the blood include pneumonia, chronic obstructive pulmonary disease, bronchial asthma

(especially at the time of an attack), etc.

Anemia

may develop due to a disorder of hematopoiesis (for example, iron deficiency anemia), destruction of red blood cells (hemolytic anemia), acute or chronic blood loss.

Hypoglycemia

observed not only in diabetes mellitus, but also in endocrine diseases, such as adrenal insufficiency, insulinoma, long-term severe liver diseases, etc.

Toxic damage to the central nervous system can be caused by the intake of certain toxic substances

from the outside, and by intoxication due to the development
of liver failure
(for example, with cirrhosis of the liver) or
renal failure
.
Intoxication syndrome accompanies most infectious diseases
, as well as many
malignant processes
.

Separately, it is worth noting life-threatening conditions that lead to cerebral edema and are manifested, among other things, by lethargy - these include stroke

, compression of the brain
by an intracranial tumor
,
traumatic brain injury
.

Which doctors should I contact if I feel lethargic?

Due to the fact that the cause of the development of lethargy can be diseases of a variety of organs and systems, if this symptom appears, you should consult a general practitioner, or. These specialists, after establishing the probable cause, can refer the patient to a nephrologist or hepatologist.

Diagnostics and examinations for lethargy

Diagnosis of diseases accompanied by lethargy begins with a survey and examination of the patient. Often this is enough to make a preliminary diagnosis. However, to confirm it, some additional research is necessary:

• a clinical blood test with a leukocyte count, which is necessary primarily to exclude anemia;

Features of correcting slurred speech in children and adults

The cause of slurred speech may be a pathology in the structure of the articulatory apparatus (interdental gaps, malocclusion, short lingual frenulum), neurological pathology, or the habit of incorrect pronunciation. Another explanation for why a person’s speech has become slurred lies in the field of psychology. When a person is worried, his usual clear speech turns into a barely audible muttering, incomprehensible to listeners.

The work of a speech therapist to correct slurred speech is based on several principles:

• Personal orientation – orientation towards the psycho-emotional characteristics of an adult or child.
• Creating an emotionally comfortable environment in classes, support and emotional resonance.
• Interaction with parents (if we are talking about slurred speech in a teenager or child).
• Positive motivation for learning is a game form of classes.

Speech therapy classes include work on the mobility of the articulatory apparatus, sounds and the development of phonemic hearing and the lexico-grammatical structure of speech.

A speech pathologist-defectologist conducts classes in a playful way, using speech games and a computer (for older children and adults). Combined classes flexibly switch attention from one type of activity to another, preventing loss of interest and loss of attention.

WHOM TO CONTACT?

Correction of speech defects is carried out by two specialists - a defectologist and a speech therapist.

A speech therapist is a specialist who restores the speech of patients who do not have any deviations in physical and mental health, as well as disorders of the central nervous system.

A defectologist is a doctor who not only teaches how to speak and pronounce sounds correctly, but also deals with the correction of developmental disorders. The task of this specialist includes several tasks - eliminating defects of the speech apparatus, teaching a person to communicate, overcoming barriers and life difficulties.

Tips for parents

It is important for the child to create a positive speech environment.

Repeatedly talk through ordinary, daily activities:

dressing, washing, eating, bathing, walking, getting ready for bed, going to bed, cleaning the room and toys, cooking. All these processes must necessarily be accompanied by the speech of adults.

Say nursery rhymes, tongue twisters, proverbs, proverbs, sing songs

.

Talk to your child as often as possible

, listen carefully to his answers to questions. This will not only improve your baby’s speech, but will also establish a trusting relationship between you.

Read together

, discuss what you read, illustrate the plot together, discuss the drawings.

BASIC PRINCIPLES OF OPERATION OF THE CENTER IN KURSK

The center practices an individual approach to each patient, personal selection of diagnostic and correction methods. The specialists treat everyone who comes to the clinic with care and very patience, and always provide feedback to the parents of young patients. Parents are also consulted and useful recommendations are selected. After each lesson, a positive result is noticeable.

The network employs real professionals in their field. They have knowledge, skills and experience, therefore, they can provide quality assistance in each specific case.

It is important to understand that effective elimination of speech disorders is very important for every person. After all, it is speech that allows you to find your place in society and achieve certain heights. Every person should have this opportunity. Don’t delay your visit, call, make an appointment for your child and give him a future.

Types of dysarthria

The type of disorder, as well as its symptoms, depend on the location of the affected center in the brain:

1. The bulbar form develops due to damage to the nuclei of the cranial nerves located in the medulla oblongata. Accompanied by pronounced degradation of speech activity. It becomes extremely indistinct, sounds are difficult to separate from each other. The voice is quiet, the person speaks “in the nose.” The acts of chewing, swallowing, and sucking are impaired, and profuse salivation is observed. There is no facial expression.
2. The pseudobulbar form is characterized by damage to the corticobulbar pathways. Along them, the impulse passes from the cortical centers to the articulatory components of the speech-motor apparatus. When this connection is disrupted, the bulbar nerve nuclei become overactive. This causes hypertonicity of the speech muscles. The vocal cords, being in a tense state, cease to vibrate correctly when trying to reproduce sounds, which affects the character of speech. It becomes slow, incomprehensible, and difficulties appear in switching from one speech posture to another. There are difficulties in the act of swallowing, ptyalism.
3. Subcortical or hyperkinetic dysarthria manifests itself against the background of damage to the subcortical nuclei of the brain, which is accompanied by hyperkinesis. They are expressed by involuntary contractions of facial and “speaking” muscles. As a result, the patient’s speech is saturated with a sudden change in its usual rhythm. It can slow down, becoming monotonous and incomprehensible, or, conversely, speed up. Then speech becomes super fast, a person can swallow endings, rearrange syllables, and stumble verbally. Often this form is accompanied by stuttering.
4. The cortical form develops with focal brain damage. It is accompanied by difficulty in voluntary speech activity.
5. The cerebellar form manifests itself in pathologies of the cerebellum. It is characterized by a violation of the organization of the speech flow. It is associated with a break in the fluency of speech. There is a jerky, intermittent tone, chanting, and involuntary shouts.

Degrees of disorder

Dysarthric disorder is not limited to speech defects. This includes all disorders that are in one way or another associated with pathological innervation or with inadequate functioning of improperly innervated organs. Thus, due to hypotonia or hypertonicity of the tongue, as well as paresis of the soft palate, difficulties appear in the act of swallowing and chewing. Ptyalism is observed - increased salivation. Facial expressions suffer due to a disorder of the innervation of the facial muscles. The inability to move the eyebrows, smile, puff out the cheeks, the face takes on the appearance of a mask.

However, it cannot be said that one patient has all the pathological characteristics. The disease manifests itself depending on the degree of development of the disorder.

A mild degree of dysarthria is accompanied by a reduction in the activity of the articulatory side of speech due to slow movements of the tongue and lips. The speech of such patients is slowed down and lacks forceful expression. Sounds are blurred during pronunciation. It is difficult to pronounce hissing words, voiced consonants do not sound loud enough. The sound of soft consonants is disrupted, as this requires the active participation of the back of the tongue and the soft palate. Swallowing is practically unimpaired.

With an average degree, a significant modification of speech is already observed. She becomes inarticulate and very quiet. Even defects in the pronunciation of consonants appear. Voiced consonants are replaced by voiceless ones. The endings are swallowed. The voice becomes nasal and there is increased nasal exhalation. Characterized by chewing and swallowing disorders. Facial expressions suffer.

Severe severity is characterized by deep lesions of the speech-motor system. As a result, the tongue and lips of such patients are almost completely immobilized, and the face acquires mask-like features. The mouth is always half open due to drooping of the lower jaw. All this makes speech production very difficult, resulting in anarthria - the inability to speak. A person can only make individual sounds. Chewing and swallowing are inaccessible to him.

Psychological and pedagogical classification

The psychological and pedagogical classification takes into account the structural components of the speech system (sound aspect, grammatical structure, vocabulary), functional aspects of speech, and the relationship between oral and written speech.

Speech disorders in the psychological and pedagogical classification are divided into two groups.

Disruption of means of communication

PHONETIC-PHONEMATIC UNDERDEVELOPMENT
(FFN)
FND is a violation of the formation of the pronunciation of sounds of the native language in children with various speech disorders. It arises due to defects in the perception and pronunciation of phonemes.

The main manifestations of FFN:

Undifferentiated pronunciation of pairs or groups of sounds

- “tyumka”, “tyaska”, “chopper” instead of “bag”, “cup”, “hat”.

Replacing some sounds with others

- when a child pronounces a sound that is easier for him to reproduce. For example, “L” instead of “R”, “F” - instead of “W”.

Mixing sounds

- when a child can pronounce the sounds “R”, “L” or “S” separately, but makes mistakes in speech statements. For example, “a carpenter is planing a board” instead of “a carpenter is planing a board.”

GENERAL SPEECH UNDERDEVELOPMENT (GND)

OSD are various complex speech disorders in which the formation of all components of the speech system is disrupted: the sound side (phonetics) and the semantic side (vocabulary, grammar).

ONR can be observed in complex forms of childhood speech pathology: alalia, aphasia (always), as well as rhinolalia, dysarthria.

There are four levels of ONR:

OHP level 1

- the child completely lacks coherent speech - “speechless children”. The child tries to convey his thoughts to others using gestures or extremely unclear, simplified speech.

OHP level 2

— initial speech is developed, but the vocabulary is extremely poor. The child pronounces most words incorrectly. Making mistakes, he can compose and pronounce the simplest sentence of several words.

OHP level 3

— is quite good at composing sentences, but pronounces words with errors, and the meaning of the sentences may not be clear to others.

OHP level 4

— speaks well, knows how to make sentences. The speech of a child with ODD at this stage is practically no different from his peers. Problems arise only when composing long phrases.

Violations in the use of means of communication

Stuttering

- a disorder of the tempo-rhythmic aspect of speech, caused by repeated convulsions in the articulatory, vocal or respiratory parts of the speech apparatus. A combined defect is also possible, in which stuttering is combined with OHP.

Non-convulsive disturbances in the tempo and rhythm of speech

- stumbling, tachylalia, bradilalia.