There are many methods of language training, some of which can be done by parents, while others have to be done by a professional speech therapist.
1.Training for dysarthria
Dysarthria, also known as motor dysarthria, refers to the dysfunction of respiratory organs related to vocalization, such as the larynx, mouth, jaw, tongue, lips, etc. Therefore, the treatment of language disorders is first of all the training of motor dysarthria, the specific training methods are as follows.
(1) Breathing training
Because when children with motor retardation want to speak, they often have difficulty in pronunciation due to muscle tension, and children with tardive dyskinesia have the most obvious performance.
The correct control of air flow between breaths is the basis of articulation, and the control of breath can reduce the tension of throat muscles to facilitate vocalization. The correct vocalization and articulation must be powered by breathing, and only when a certain air flow pressure is formed can vocalization be made. The development of anti-gravity muscles plays an important role in respiratory function.
①Motor training of mouth, lips and jaw
Children with motor retardation have impaired jaw motor development and have difficulty opening and closing the mouth and lips normally, so they cannot make sounds.
For children with good intelligence, we can use language to instruct them to open their mouths, close their mouths, pout, show their teeth, grin, round their lips, puff their cheeks, suck their cheeks, smile, and repeat until they become proficient.
Stimulation with tongue depressor
When the child’s mouth does not close, the tongue depressor can be stretched into the child’s mouth with slight pressure, and when the tongue depressor is pulled outward, the child will have a lip-closing action to prevent the tongue depressor from being pulled out.
Ice cube stimulation method
Ice can be rubbed on or around the mouth and lips to promote the continuous action of closing and opening the lips with cold stimulation.
②Brush method
Using a soft bristle brush to quickly stimulate the local skin in and around the mouth and lips at a rate of 5 times per second can also have a lip closing effect.
③Patting the jaw method
Patting the skin near the jaw and jaw joint with the hand can promote lip closure. The trainer places one hand on the top of the child’s head and one hand on the child’s jaw to forcefully help the patient’s jaw action to promote the lower collar to lift up and promote lip closure action.
Sucking back with a straw, sucking with a pacifier, and putting food in the mouth can all promote the mouth-lip closing action. Using blowing bubbles, blowing feathers, and blowing bubble gum in front of a mirror in large affected children can achieve better results.
The training of both lips is very important for vocalization, and the coordinated movement of the lips and jaws lays the initial foundation for pronunciation.
(2)Tongue training
①Tongue movement training
Including the tongue forward and backward, tongue up against the palate, backward tongue roll, and tongue movement to both sides. The use of chewing movement, sucking action, so that the tongue and mouth and lip movement coordination, increase the tongue stirring action.
In the forward tongue extension stage, the child’s mouth is opened and food or a toy or a small spoon is placed in front of the lips of the mouth to make the child appear to extend the tongue to lick the object and to control it by himself.
During the forward, backward, left and right tongue movement phase, honey is applied around the mouth to encourage the child to extend the tongue and lick the candy.
Passive resistance training can also be done with a tongue depressor. For example, pressing the tip of the tongue with the tongue depressor and making the child lift the tip of the tongue with force can promote tongue movement.
②Improve oral sensation
Normal children often put objects in the mouth, through the oral cavity can feel the shape and characteristics of objects, while children with motor retardation due to oral sensory dysfunction, can not identify the shape of objects in the mouth, so to improve oral sensation, often used a variety of different shapes, different hardness of objects placed in the mouth for stimulation, so that the sensory experience. Therapists often use washed fingers to massage different parts of the child’s mouth, which is very beneficial to mobilize the movement of the lips, tongue and soft palate, and will also play a positive role in development.
③Training for accompanying involuntary movements
Use the antagonistic muscle resistance to regulate their mutual balance, such as regulating the up and down movement of the tongue, let the child stretch the tongue, use the tongue depressor to lift the tongue upward and downward, give the tongue muscle to alternate resistance, so that the tongue muscle active muscle and antagonistic muscle balance, so that the tongue movement is stable.
Light touch method: When the child is made to make random movements of pouting and grinning, the speech therapist can use fingers to lightly touch the lips of the mouth or lightly touch the two cheeks of the child with fingers, which can inhibit the involuntary movements, relieve the twitching of the lips and corners of the mouth, and gradually achieve the ability of self-control.
Pronunciation training
The dysarthria of children with motor retardation varies greatly from one child to another, so the training plan should be analyzed on a case-by-case basis and should have both immediate and long-term goals. The training should be done in accordance with the rules of language development and in close cooperation with visual, auditory and tactile functions, using the sounds that the child can produce, starting with the sounds that are easy to produce, such as labial b, p, m, etc., and then proceeding to the more difficult sounds, such as soft palate k, g, etc., dental and lingual-dental t, d, n, etc. You can also train to pronounce vowels, such as a, u, etc., then train to pronounce consonants, such as b, p, m, etc., and then combine the mastered consonants with vowels, such as ba, pa, ma, fa, etc. When training, let the child look at the trainer’s pronunciation with his eyes and imitate it repeatedly. After mastering it, then use the form of vowel + consonant + vowel, such as ama, apa, etc. to continue training, and finally transition to the practice of words and sentences. While training clear pronunciation, we should also pay attention to the control of volume, intonation and rhyme.
⑤ Vocalization training
When pronouncing the bilabial sounds p, b, m, the child can listen to the sound issued by the trainer through visual and auditory effects, look at the oral shape of the trainer’s pronunciation with his or her eyes and imitate it repeatedly, and keep encouraging the practice of opening and closing the lips during the training, which is required to reach more than 3-4 times per second. If the above requirements are not met, the language trainer can help the child to close the lips with his fingers to help pronunciation.
The child can be placed in a supine position with legs bent toward the chest, slightly backward or sitting on a chair with a backrest, head slightly backward and torso slightly backward, and the therapist can use fingers to lightly press the tongue root or tongue depressor to restrict the tongue tip from touching the palate or lightly press the lower jaw with fingers (equivalent to the tongue root), while encouraging the child to pronounce. When the finger or tongue depressor is removed from the root of the tongue, the k and g sounds are produced.
Finally, the training of alveolar and lingual-alveolar t, d, n. The posture of the child is very important during the training. The child can be placed in a supine position with the limbs extended and the therapist holding the child’s head up and slightly bending forward, or the child can be placed in a prone position with both elbows supported and the head bent forward or the head in a straight line with the trunk, or the child can be placed in a sitting position with both hands supporting the trunk and the head slightly bent forward. In any case, no matter which position is taken, the head must be flexed forward, and when the head is flexed forward, the lower jaw can be pressed from bottom to top, so that the lower jaw can be pushed up passively. Pronunciation training starts with bilabial sounds, such as p, b, m, then combined with vowels to form pa, ba, ma, and finally vowels, consonants, and vowels combined to form apa, ABA, ama, etc., gradually transitioning to words and sentences or short texts.
(6) Continuous pronunciation
Take a breath during the sound formation training, prolong the pronunciation time as much as possible, transition from a single vowel to 2-3 vowels, gradually increase, practice repeatedly and sustain the pronunciation. Ask the child to do cheek puffing, blowing, inhalation and exhalation during the training, which is very helpful for pronunciation.
(7) Do training to overcome nasalization
Children with motor retardation cannot close the pharyngeal palate during pronunciation due to the weakened movement of the soft palate, and pronounce non-nasal sounds as nasal sounds. This kind of nasalized sounds obviously affects the clarity of speech and makes it difficult to hear clearly, which affects the communication of language. Therefore, speech training for children with motor delays must be done to overcome nasalization. The method is to guide the airflow through the mouth, such as blowing a flute, blowing a candle, blowing a trumpet, or training the child to pronounce “ah” or “card” sounds, which can promote the contraction and lifting of the soft palate muscles, enhance the tension and motor function of the soft palate muscles, and promote the normal closure of the pharyngeal palate This will help the child to overcome nasal sounds.
H. Training the child to control the volume, pitch and rhythm
Due to motor dysarthria, children with motor retardation have low volume and low pitch, no accent change, and lack of intonation change. Therefore, children should be trained to control the volume, change the volume, such as from small to large, large to small, large to small alternately, expand the range of pitch, and train from low, medium and high three different tones. At the same time, sound-controlled toys, electronic organs, pianos, etc. can be used with the training to adjust the volume and tone. In order to develop a certain sense of rhythm, a metronome can be used to adjust the rhythm of pronunciation.
2.Training treatment for delayed language development
(1)Types of delayed language development
①Language symbol disorder
The main reason is that the child has not mastered the language symbols. The purpose of training is to make the child master the language symbols through various language symbols, gestures and children’s language to establish the foundation of interpersonal communication, and then do the training of understanding the symbols.
②Language expression disorder
The child cannot express his or her will in language. The purpose of training for this part of the child should be to express, and the training should be matched with the comprehension of language, with field training of sign language and language, so that the child can acquire the ability of language expression.
(3) Language level lags behind that of children of the same age
This group of children accounts for the majority of children with motor developmental delays, showing backward language level, symbol comprehension impairment and expression impairment, so training should be strengthened to enhance language comprehension and expression ability and promote language development.
④Understanding language symbols but not expressing them
The goal of training for this group of children is to improve the ability to express language on the basis of strengthening language comprehension, starting with sign language training, followed by expression training.
⑤ Attitude disorder of language communication
This part of the patient can understand the language symbols, have some ability to express, but there is a communication attitude disorder, aloof, afraid of people, can not communicate with others, training should focus on the communication attitude work.
Most of the children with delayed speech and language development are also lagging behind or have varying degrees of impairment in their motor functions, so it is important to do physiotherapy and occupational therapy training along with speech therapy to help children with delayed speech and language development.
(2) Training for language development delay
Training for children with motor developmental delays must be based on the specific rehabilitation plan and training methods according to the stage they are in. The training should pay attention to two-way development, i.e., horizontal expansion first, then vertical improvement. For example, learning to say the nouns “hat”, “glove”, “pants”, etc. (horizontal development), and further increasing the vocabulary “yellow hat “, “red gloves”, “blue pants” (vertical improvement).
①Play therapy
For younger children with motor delays, attention should be paid to learning language during the process of play. Different games should be added at different developmental stages so that the children can apply their learned vocabulary and phrases during play to promote the development of communication behavior.
② Training of gesture symbols
Gestural symbols are gestures that can be used to express one’s will and communicate with others non-verbally. Children with moderate or severe language delays or those who have not mastered language symbols and those who have difficulty expressing themselves can use gesture language as an introduction to expression training and gradually transition to the goal of expressing themselves in early childhood language and spoken language.
③Writing training
Word learning for normal children is based on a comprehensive mastery of language. However, for children with language delays who have difficulty learning speech, it is a very effective method of learning if written symbols are used as a medium for the formation of speech acts. In addition it can be used as a temporary substitute for speech. Word training is suitable for: children with delays in the development of both comprehension and expression; children who understand speech well but have difficulty expressing it; children who have both of these reasons and have dysarthria and low speech intelligibility. The sequence of word training is the identification of word shapes, the combination of word symbols and meanings, the combination of word symbols and sounds, and the combination of word symbols, meanings, and sound constructive correspondence.
④Communication Training
Communication training does not require special teaching materials, but mainly involves the selection of appropriate training programs according to the developmental level of the child. Communication training can be conducted not only in the training room, but also at home and in the community. The child should be helped to participate in family and social activities as much as possible, encouraged to play with other children, and encouraged to do the same activities as other children. Enhance his ability of social interaction. Be careful not to limit the means of expression to language only, but to make full use of gestures, expressions and other casual movements that may be utilized. As the ability to communicate in daily life improves, it will greatly promote the development of language and prepare the child to be able to enter society in the future.