About 80% of children with cerebral palsy have different degrees of language disorders, among which the incidence is higher in children with cerebral palsy with tetraplegia, often preceded by difficulty in sucking, swallowing and chewing, manifested as slurred pronunciation, dysarthria, language expression disorder, and even aphasia.
There are three main causes of language disorders in children with cerebral palsy, as follows.
1. Vocalization disorder: In children with cerebral palsy, there are more symptoms of not being able to control breathing at will, and breathing disorders often occur. In addition, some children will not control their breathing and will have vocal difficulties due to many changes in head position.
2. Dysarthria of the diction organs (jaw, mouth, lips, tongue, etc.): limb paralysis in children with cerebral palsy can also cause disorders in breathing, vocalization and diction muscles. The reason for dysarthria in children with cerebral palsy is not only the inflexibility of organs such as the lower jaw, mouth, lips and tongue, but also the poor coordination ability due to the damage of the central nervous system, which can also contribute to dysarthria.
3. Delayed language development: Delayed language development is more common in children with cerebral palsy. They start to speak late, increase words late, abstract words are not easily understood, and it is difficult to express in complete sentences. This is related to the fact that most children with cerebral palsy live in an environment that is neglected by people, especially children with cerebral palsy due to the limitations of the language environment and the surrounding environment.
In fact, a more scientific approach is to train the whole body state of children with cerebral palsy before training the organ of speech, because the movement of the organ of speech is influenced by the whole body state. Only when the whole body condition is normal, the child with cerebral palsy can pronounce normally, and the jaw, mouth and tongue can move normally. Therefore, language training for children with cerebral palsy should be carried out according to the following steps.
I. Control the abnormal movements of the whole body
Children with cerebral palsy have difficulty controlling their body movements and postures because of abnormal muscle tone. For example, when they start to practice pronunciation, they often have abnormal facial expressions or even twitch their whole body, which affects their breathing and pronunciation and makes their voice short and blurred. Children with low muscle tone cerebral palsy tend to keep their heads low and bend their backs, so that their mouths cannot be fully opened and their chests are in a state of compression, which makes it difficult to talk about articulation skills. Therefore, effective control of the whole body of children with cerebral palsy is the prerequisite and foundation of language training.
In order to effectively control the abnormal posture, we must start training from the large motor muscles such as head, neck and shoulder, and gradually move to the fine motor muscles such as jaw, day lip and tongue. Before training, it is necessary to eliminate the psychological uneasiness of children with cerebral palsy, especially children with strong dystonic cerebral palsy, otherwise the effect is not obvious.
II. Constructive organ training
Due to the abnormal oral muscle tone and abnormal movements of the whole body, children with cerebral palsy cannot control the phonological organs (jaw, mouth, lips, tongue, etc.) flexibly, which seriously affects the vocalization. The training of oral movements should start from the feeding function, using eating to train the correct sucking, chewing and swallowing skills of children with cerebral palsy, thus increasing the control of the jaw, mouth, lips and tongue. The specific methods are as follows.
1. Breathing training: blowing feathers, blowing windmills, blowing toy horns, blowing whistles, blowing balloons, etc. The apparatus to practice from small to large, from light to heavy.
2, tongue training: the use of children like to eat lollipops, ice cream, etc., let them eat with the tongue add, which can train the tongue flexible stretching, increase the facial muscles and tongue motor function. At the same time, teachers can also make up some tongue gymnastics as a way to train students.
3, sucking training: first use a short thick tube to suck in the cup and is the student’s favorite drink, the students can easily suck; then use a long thin tube to suck in the bottle of drinks, so that the training gradually increase the difficulty. Using this method can quickly make the students’ breathing ability to strengthen.
4, chewing training: chewing action requires the participation of all the sound-forming organs in the mouth, which is the most primitive and effective way to train the sound-forming organs. You can give students difficult food to chew, such as sweet potato fries, etc.
III. Pronunciation training
The traditional method of practicing vowels and rhymes before practicing words and sentences should be abandoned when training occurs.
It is important to have correct posture and provide normal muscle tone while breathing deeply and slowly during training. Practice with games or singing first so that the child with cerebral palsy can relax his nerves and adjust his muscle tone to an optimal state. It is best to start with onomatopoeia because it is fun and easy to pronounce. Choose the sounds most often heard in the surrounding environment to practice, such as the sound of a car or a barking dog, and then gradually practice words, phrases and sentences. When practicing sentences, it is best to choose children’s songs with simple lyrics so that they can sing and practice in a joyful atmosphere.
Fourth, language communication training
The ultimate purpose of language learning is to communicate. Improving the ability of children with cerebral palsy to use language to communicate is the most important and complicated part of language training. It requires a lot of preparation work and joint efforts of school and family. The important role of family in language training for children with cerebral palsy should be given full play. Because the family is the environment where children with cerebral palsy live, it is the best training place for language practice. All members of the family can participate in this training process. Not only can individualized teaching be done one-on-one, but it is not limited by time and space. However, the school should give the parents the necessary guidance.