Rinolaliya - a violation of articulation due to improper structure and functioning of the vocal apparatus (nasopharynx, nasal cavity, hard and soft palate). Because of this unnecessary voice stream or, alternatively, it is insufficient to resonate in the nasal cavity during a conversation, and vowels and consonants acquire nasal sound. Rinolaliya in children is characterized by not only the distorted pronunciation of sounds, but delays in the development of lexical and grammatical aspects of speech due to secondary disturbances letters and phonemic processes.
Diagnosis is rinolalii consultation otolaryngologist, speech therapist and maxillofacial surgeon to determine the functional and anatomical defects of articulation, as well as the degree of violation of oral and written speech.
Correction rinolalii may include both speech therapy and psychotherapeutic work and physical therapy, orthodontic and surgical treatment.
Classification and causes rinolalii
Depending on the specific violations of the interaction of the oropharynx and nasopharynx distinguish closed or open rinolaliyu.
For closed-type disease is characterized by the direction of the speech exhalation through the mouth only. Due to the low physiological nasal resonance most strongly distorted consonants: m, NIL, N, Hb. During normal articulation air enters the nasal cavity as nasopharyngeal shutter is open. In the absence of resonance, the sounds - completely oral: m pronounced as b, n is changed to on. The conceptual apparatus of speech because of that suffers greatly. The sound of the vowels and blurred, as they lack some of the tonal characteristics.
In accordance with the reasons rinolalii gated distinguish its two forms:
- Organic. Called anatomical deformities in the nasal cavity. Obstruction is removed surgically, followed by a speech impediment disappears and breathing becomes normal;
- Functionality. It arises as a result of hyperfunction soft palate, which is due to elation directs air flow through the mouth. This often happens in neurotic disorders, so treatment takes a speech therapist and a neurologist. After treatment, sometimes retained the habit mispronounce sounds.
Open rinolaliya more common than closed. The air passes through both nose and mouth, which is due to permanently open communication between the oral and nasal cavity. The result is a nasal resonance which changes the timbre of the sounds.
This speech disorders can also be organic or functional. In the first case, the reasons are rinolalii as congenital defects (cleft lip, soft and hard palate), and acquired as a result of injuries, scars, paresis, paralysis, or tumors. In the second case, the functional rinolaliya due to hypokinesia or hypofunction of the soft palate, which is expressed in the lack of it is being raised in the phonation. The most common such rinolaliya in children with low muscle tone, weak nerve impulses or after frequent diseases of the nasopharynx.
If the factors causing the closed and open rinolaliyu are combined, it is customary to speak of mixed type of the disease. Acoustic and articulatory characteristics of spoken sounds are affected because there is an air leak through the nose while reducing nasal resonance.
Complex correction rinolalii is to conduct the following activities:
- Surgical correction of anatomical defects;
- Orthodontic elimination and prevention of repetitive strain of the upper jaw;
- Medical restorative exercise;
- ENT rehabilitation in order to prevent hearing impairment;
- Psychotherapeutic aid.
Rinolaliyu children should be treated as early as possible, it is best to complete the therapy before reaching adolescence.
The main directions of the early speech therapy care:
- Normalization of speech and physiological breathing;
- Restoring proper velopharyngeal closure;
- Formation of correct articulation;
- Correction zvukoproiznoshenija;
- Remedy nasal tone of voice;
- Securing free speech communication skills;
- Reduction in the rate of prosodic aspects of speech;
- The development of sound analysis and phonemic perception;
- Warning dysgraphia and dyslexia;
- Control of the overall development of speech.
In correctional work must be observed and systematically learning and the proposed material should be visible and accessible. Speech should always follow the direction of air flow, the tongue and facial muscles.
Rinolalii effectiveness of treatment depends on a number of external and internal factors:
- Expressions articulation defects;
- Associated disorders and diseases;
- Timing of the start of treatment;
- Time and quality of the operations;
- The patient's age;
- The extent of its compensatory possibilities;
- Status hearing;
- Personality traits;
- The states of intelligence;
- Influences speech environment.
After correction rinolalii results were evaluated according to the degree of normalization of speech and lack of nasalization.
In preparation for secondary school children suffering rinolaliey necessary to give every child an individual approach and consider not only the features of the disease, but also microsocial environment.
Proper distribution of medical and academic load needed for a child without fatigue to fulfill all its tasks. Under the influence of surgery children are generally somatic weakened, they have reduced working capacity, activity and endurance. Therefore, treatment rinolalii should be clearly organized. Its efficiency depends on the joint work of doctors, educators and other professionals.