Speech therapy work for stuttering preschoolers. Speech therapy work to correct stuttering in adults and adolescents

An article about an integrated approach to the correction of stuttering in adults and adolescents, used in the Center for Neurological Neurosurgery in the Department of Logoneurosis.

Article includes overall plan work. In the future, I intend to send material that will tell more specifically about developments in this area.

Speech therapy work to correct stuttering in adults and adolescents

Stuttering is not always eliminated childhood. Every adult who stutters and decides to get rid of a speech disorder will have to face more established pathological stereotypes of the speech act and more pronounced psychological problems.

A neurodefectologist-speech therapist, working with adults who stutter, needs to help the patient coordinate breathing, vocal and articulatory processes, “feel” this coordination and bring it to automaticity. There are a number of benefits to speech therapy work for adult patients. They study meaningfully and consciously. They can use the will to achieve their goals. At the same time, everyone understands that stuttering is a very complex speech disorder that requires systematic, consistent work.

Speech therapy work is considered as a system of correctional and pedagogical measures aimed at the harmonious formation of the speech of people who stutter, taking into account the need to overcome or compensate for the defect.

Speech therapy influence in the Center for Logoneurosis in the Department of Logoneurosis is carried out in two directions: direct and indirect.
Direct speech therapy intervention is implemented during group and individual sessions with people who stutter. These classes provide for the development of general and speech motor skills, normalization of the tempo and rhythm of breathing and speech, and activation of verbal communication.

In classes, psychological deviations in behavior are eliminated for people who stutter, and the correct attitude towards the defect is developed. Individual lessons are conducted in case of necessary additional exercises to develop skills correct speech.

Indirect speech therapy is a system of speech therapy for all routine moments for patients. The speech regime of adolescents and adults involves their selection of the necessary speech exercises, their understanding of the requirements of correct speech, and the systematic training of correct speech skills in different conditions.

The speech aspect of speech therapy classes includes the regulation and coordination of respiratory, vocal and articulatory functions, and the education of correct speech.

Based on the position that “stuttering is a discordinative convulsive speech disorder that occurs in the process of communication through the mechanism of systemic speech motor neurosis, and is clinically represented by primary, actual speech, and secondary disorders, which often become dominant in adults. As with other neurotic disorders, psychological, socio-psychological and biological factors take part in the mechanisms of this speech motor neurosis. In many cases of stuttering, the so-called organic “soil” is noted in the form of cerebral deficiency of various origins.” At the Center for Stuttering, a comprehensive treatment system was developed, which combines speech therapy classes and active psychotherapy, combining various options The suggestive method with the work of restructuring disrupted personal relationships, including through the use of modern group psychotherapy. All work is carried out in close contact with a speech therapist, psychologist, psychotherapist, psychiatrist, neurologist, specialists in physical therapy, massage and other methods.” book V.M. Shklovsky “Stuttering”. M. 1994. p. 8., p. 176.

Speech therapy work in a day hospital consists of: a diagnostic period and a period of restructuring pathological skills in the system of a comprehensive method of treating stuttering.

Diagnostic period

In order to establish a final diagnosis and outline a treatment plan, it is necessary to conduct a thorough examination of the patients by all specialists in the department (psychiatrist, psychotherapist, neurologist and speech therapist).

The examination of speech function in people who stutter is carried out according to methods generally accepted in speech therapy (L.I. Belyakova, E.A. Dyakova, E.V. Oganesyan, I.A. Povarova). The scheme of speech therapy examination includes the study of the state of the structure and mobility of the articulatory apparatus, speech breathing, voice, speech rate. When studying speech and motor disorders, the localization and form of speech spasms, the duration and frequency of their manifestation, the presence of accompanying movements, verbal, motor and psychological tricks, the attitude of the subject to stuttering, and the degree of fixation on it are considered. Anamnestic and clinical data determining possible reasons appearance of stuttering, the group to which the patient can be classified according to V.M. Shklovsky’s classification is determined:

Group 1 - patients who did not have persistent neurotic disorders. The speech defect (it can be very pronounced) of these stutterers did not significantly affect the development of their personal and social status.

Group 2 - patients with persistent neurotic disorders. The speech defect (it can be very pronounced) of these stutterers influenced the development of their personal and social status.

Group 3 - patients who have even more pronounced neurotic disorders, combined with anxious suspiciousness and an insurmountable fear of speech.

The period of restructuring of pathological speech skills consists of three stages:

- preparatory stage

At this time, speech therapy classes are conducted to develop speech techniques according to the plan:

1. Removing muscle tension. Establishment of diaphragmatic breathing. Practicing long, uniform speech exhalation on sounds, a standard, automated series, in a phrase.

2. Work on a soft attack of sound, on unity, smoothness of voice, flight, height, strength of voice, prolonged pronunciation of vowel sounds, expanding the range of voice modulations, intonation of speech.

3. Normalization of speech rate.

4. Rhythmic speech with the support of the leading hand, gradual collapse of the external support, transition to the internal rhythm.

5. Pausing speech.

6. Work with articulation.

7. Use of facial expressions and gestures in verbal communication.

- the stage of consolidating rhythmic speech techniques in simple speech material.

1. Reading poetic texts with a short and a longer line.

2. Reading the roles of fables.

3. Reading aloud prepared and unprepared texts of varying complexity.

4. Retelling the texts read.

5. Dialogues based on the material read.

The stage of automation of rhythmic and prosodically colored speech techniques on complicated speech material.

1. Automation of speech technique skills with their introduction to all types speech activity and various situations.

2. The transition from prepared forms of speech to independent improvisations.

3. Formation of readiness for verbal communication in various life situations.

4. Developing resistance to speech and psychological difficulties that arise in life situations after completing the course of treatment.

Three months of systematic training is the minimum that will allow a stuttering teenager or adult to understand, feel and consolidate the acquired techniques in speech. Further automation of continuous and fluent speech will require at least another year of supervision by a specialist.

Stuttering is a widespread speech disorder. It often occurs in children aged 3-5 years, when their speech is most actively developing. At the same time, personality development occurs. The problem is a serious obstacle to the development of the child’s personality, as well as to his socialization.

This disorder and personality development are closely related, so this problem should be considered in conjunction with individual personality characteristics. Stuttering correction should be approached comprehensively.

Despite the fact that doctors have devoted more than a dozen years to the problem, the mechanisms of the disorder are still not studied today. Can contribute to the appearance of a defect various factors, the mechanism will vary.

The defect can be interpreted as difficult case a neurotic disorder that arose as a result of disruption of processes in the nervous system, in the cortical structures of the brain. The interaction between the cortex and subcortex is disrupted, auto-regulated speech movements (breathing, voice, pronunciation) are disrupted.

In other cases, the defect is considered as a neurotic disorder that resulted from memorizing an incorrect speech pattern that arose due to speech difficulties.

Sometimes the disorder is interpreted as extensive, which arose due to disharmony in speech development and incorrect individual speech development.

Doctors also explain the phenomenon of stuttering by damage to parts of the central nervous system.

As the defect was studied, each doctor proposed his own treatment method, based on his own ideas about the disorder. There are many treatment methods. This is due to the fact that the pathology has very complex structural manifestations, and it has not been sufficiently studied.

Scientific experiments and studies have proven that each case requires an individual approach. The characteristics of each patient should be taken into account and special stuttering correction techniques should be used.

Types of correction

As the problem was studied, speech therapists around the world suggested different schemes treatment. At the moment, several areas of treatment are known:

Drug treatment.
Physiotherapy.
The use of speech correction devices.
Creative development.

When treating, it is advisable to combine different types of therapy, this way the most pronounced effect can be achieved.

Correction methods

To treat stuttering, doctors have invented many correction methods. But this pathology is serious, and it is difficult to overcome it even today, since there is little information about it. Popular methods include:

treatment with;
speech therapy exercises, tongue twisters;
mechanical devices;
surgical intervention;
psychotherapy, etc.

Experts use technical means during speech correction for stuttering. At the moment, there are 4 types of speech changes that can be made using various devices. Devices can affect muting, amplification of speech, rhythm development, and “delayed” speech. The devices make convulsive manifestations of stuttering less pronounced.

Recently, speech therapists have begun to use neurodynamic rhythmoplasty as a means of stuttering correction. This complex consists of physical therapy and choreography.

It is recommended to use different techniques, this is the only way the effect will be most pronounced. Work to correct stuttering should be carried out under the supervision of a psychotherapist or psychologist. The supervision of a speech therapist is also necessary.

Modern comprehensive methods for stuttering correction

Treatment of stuttering using methods from different specialists can differ significantly.

These specialists were involved in the correction of stuttering in junior schoolchildren. They assumed that for effective elimination pathologies need to give the child exercises different levels difficulties. The goal of this technique is to relieve the child of stress, make his speech free, eliminate incorrect pronunciation and reinforce correct articulation.

According to this technique, there are 3 stages of stuttering correction. At the first stage, the child must memorize phrases. The speech therapist teaches him correct recitation.

The second stage is characterized by an exercise in which the child must verbally describe the pictures and compose his own stories from a series of images or on their theme. Sometimes a person who stutters is asked to retell a text read by a speech therapist.

The third stage is the final one. The child consolidates the acquired skills in conversation with others.

Mironova's scheme

The speech therapist proposed using a scheme in which children with disabilities, as they progress through preparatory groups in kindergarten, will attend additional classes, dedicated to familiarization with the surrounding world, elementary mathematical concepts, drawing, modeling, appliqué, etc.

Mironova’s stuttering correction method includes 4 stages. For mass kindergartens specialized for children who stutter, it is proposed to introduce a modified program that is based on the speech abilities of children.

The correctional methodology assumes that as a result, children should be able to freely master speech of any complexity.

Cheveleva proposed a unique system for correcting stuttering in preschoolers. She believed that first of all, it was necessary to develop fine motor skills of the hands. According to Cheveleva, for treatment the child must engage in making crafts. The more complex the speech, the more work the baby will have to do.

Her judgment assumes that speech consists of two levels - situational (simpler) and contextual (complicated). First, children use situational, then contextual speech. As we grow older, the two types of speech become mixed.

The system of corrective measures for stuttering included 5 periods. Complication occurs from one level of speech to another.

Seliverstov's scheme

The program is more designed for children in medical institutions. It includes the simultaneous use of different types speech therapy exercises. According to the author, a speech therapist should be a person with creative approach, since each child requires an individual approach.

The technique is three-stage. Corrective work for stuttering begins with the preparatory stage, at which the child practices the rhythm and independence of speech. Then comes the training, more difficult stage. Final stage– reinforcing, in which the baby solves complex speech therapy problems (for example, contextual description).

Correction stages

Different methods require different numbers of steps. But, as a rule, all stages can be combined into three main ones - preparatory, training and consolidation. In all treatment regimens, the child first engages more simple tasks and then more complex.

Depending on which treatment regimen was chosen, the baby can engage in either creative development, or develop fine motor skills of the hands, or perform exercises to normalize articulatory muscles.

If a child has a stutter, parental support is very important to overcome it. There should be a calm and understanding atmosphere at home. If there is family disharmony, the work of a speech therapist will be useless.

enter a daily routine for the child;
adjust your sleep, it should be at least 8 hours;
you should speak to the child in a calm and quiet voice;
Avoid raising intonation and aggressive tone;
do not interrupt the baby when he speaks;
refrain from frequent criticism;
Praise your child for his successes.

The child must understand that he will find support and support in the family. An aggressive environment can have an extremely negative impact on him.

Conclusion

The problem needs A complex approach, it is advisable to resort to different types treatment. Harmony in the family is very important factor. Therefore, you should pay attention to the well-being of the environment in which the child grows up. You cannot treat a child for stuttering on your own; you should always consult with speech therapists, psychologists and neurologists.

The authors of the first domestic method of speech therapy work with stuttering children of preschool and preschool age N. A. Vlasova and E. F. Pay build an increase in the complexity of speech exercises depending on the varying degrees of speech independence of children.

N. A. Vlasova distinguishes 7 types of speech, which, in order of gradualness, must be used in classes with preschool children: 1) conjugate speech, 2) reflected speech, 3) answers to questions about a familiar picture, 4) independent description of familiar pictures, 5 ) retelling what was heard a short story, 6) spontaneous speech (story based on unfamiliar pictures), 7) normal speech (conversation, requests, etc.).

E.F. Pay sees the task of speech therapy work as “to, through systematic planned lessons, free the speech of stuttering children from tension, make it free, rhythmic, smooth and expressive, as well as eliminate incorrect pronunciation and cultivate clear, correct articulation.” All classes on speech re-education for stuttering children are divided into 3 stages according to the degree of increasing complexity.

At the first stage, exercises are offered in joint and reflected speech, in the pronunciation of memorized phrases and poems. Recitation is widely used. At the second stage, children practice verbally describing pictures based on questions, composing an independent story based on a series of pictures or on a given topic, and retelling the content of a story or fairy tale read by a speech therapist. At the third and final stage, children are given the opportunity to consolidate their acquired fluent speech skills in everyday conversation with surrounding children and adults, during games, activities, conversations and at other moments in a child’s life.

The methods of N.A. Vlasova and E.F. Pay are based on different degrees of speech independence of children. The undoubted merit of these authors is that they were the first to propose and use a step-by-step sequence of speech exercises in working with young children, and developed instructions for individual stages of the speech correction system for stuttering preschoolers. For many years, the proposed technique was one of the most popular in practical work with children who stutter. Currently, speech therapists use many of its elements.

A peculiar system correctional work with stuttering preschoolers in the process of manual activity was proposed by N. A. Cheveleva. The author proceeds from the psychological concept that the development of a child’s coherent speech is carried out through a transition from situational speech (directly related to practical activities, with a visual situation) to contextual (generalized, associated with past events, with missing objects, with future actions), and then throughout the preschool period, contextual and situational forms of speech coexist (S. L. Rubinshtein, A. M. Leushina). Therefore, the sequence of speech exercises with children who stutter is seen in a gradual transition from visual, facilitated forms of speech to abstract, contextual statements and includes the following forms: accompanying, final, preparatory.

The system of sequential complication of speech also provides for the gradual complication of the object of activity through an increase in the number individual elements work into which the entire labor process when making crafts.

This system for overcoming stuttering in children includes 5 periods:

Propaedeutic. The main goal is to instill in children the skills of organized behavior, teach them to hear the laconic but logically clear speech of a speech therapist, its normal rhythm, and temporarily limit the speech of the children themselves.

Accompanying speech. During this period, children’s own speech is allowed regarding the actions they simultaneously perform. The greatest situationality of speech is provided by constant visual support. At the same time, it becomes more complicated due to the change in the nature of the speech therapist’s questions and the corresponding selection of crafts.

Closing speech - children describe the work already completed or part of it. By regulating (gradually increasing) the intervals between the child’s activity and his response to what he has done, varying complexity of the final speech is achieved. With a gradual decrease in visual support for the work performed, a consistent transition to contextual speech occurs.

Pre-talk - children talk about what they intend to do. They develop the ability to use speech without visual support, plan their work, name and explain in advance the action that they still have to do. Phrasal speech becomes more complex: children pronounce several phrases related in meaning, use phrases complex design, construct a story on their own. During this period, they are taught to think logically, express their thoughts consistently and grammatically correctly, and use words in their exact meaning.

Consolidation of skills independent speech provides children's stories about the entire process of making a particular craft, their questions and answers about their activities, statements on at will etc.

The method of N. A. Cheveleva implements the principle of successively complicating speech exercises in the process of manual activity based on one of the sections of the “Program for the upbringing and training of children in kindergarten.”

S. A. Mironova proposed a system for overcoming stuttering in preschoolers during the process of completing the middle, high and preparatory groups kindergarten in sections: “Acquaintance with the surrounding nature”, “Development of speech”, “Development of elementary mathematical representations", "Drawing, modeling, appliqué, design."

When going through a mass kindergarten program with children who stutter, some of its changes are proposed related to the speech capabilities of children: use at the beginning school year material from the previous age group, rearranging some lesson topics, extending the time frame for studying more difficult topics, etc.

The correctional tasks of the first quarter consist of teaching the skills of using the simplest situational speech in all classes. Vocabulary work occupies a significant place: expanding the vocabulary, clarifying the meanings of words, activating passive vocabulary. The speech therapist himself is expected to be particularly demanding of the speech: specific questions, speech consists of short, precise phrases in different options, the story is accompanied by a show, the pace is leisurely.

The correctional tasks of the second quarter consist of consolidating the skills of using situational speech, a gradual transition to elementary contextual speech in teaching storytelling based on questions from a speech therapist and without questions. A large place is occupied by work on the phrase: a simple, common phrase, the construction of phrases, their grammatical design, construction of complex sentences, transition to composing a story. The sequence of studying program material is changing. If in the first quarter, in all classes, children are introduced to the same objects, then in the second quarter, the objects are not repeated, although objects are selected that are similar in terms of the general theme and purpose.

The correctional tasks of the third quarter consist of consolidating the skills of using previously learned forms of speech and mastering independent contextual speech. A significant place is devoted to work on composing stories: using visual support, questions from a speech therapist, and independent storytelling. Children's practice in contextual speech increases. In the third quarter, the need for slow learning of the program, characteristic of the first stages of education, disappears, and classes approach the level of mass kindergarten.

The correctional tasks of the fourth quarter are aimed at strengthening the skills of using independent speech of varying complexity. Working on creative stories plays a big role. Along with this, the accumulation of vocabulary and the improvement of phrases begun at the previous stages of training continue. In speech, children rely on the questions of the speech therapist, on their own ideas, express judgments, and draw conclusions. Visual material is almost never used. The speech therapist’s questions relate to the process of the upcoming work, conceived by the children themselves. Corrective training is aimed at maintaining the logical sequence of the transmitted plot, at the ability to give additional explanations and clarifications.

The methods of N. A. Cheveleva and S. A. Mironova are based on teaching children who stutter to gradually master the skills of free speech: from its simplest situational form to contextual (the idea belongs to R. E. Levina). Only N.A. Cheveleva does this in the process of developing children’s manual activities, and S.A. Mironova does this when going through different sections of the kindergarten program. The very principle of the necessary combination of tasks of correctional and educational work with children who stutter should be considered correct and necessary in speech therapy practice.

V.I. Seliverstov’s technique is primarily designed for working with children in medical institutions (in outpatient and inpatient settings) and involves the modification and simultaneous use of various (known and new) techniques of speech therapy work with them. The author believes that the work of a speech therapist should always be creative and therefore in each specific case it is necessary different approach to children in search of the most effective techniques overcoming stuttering.

In the scheme proposed by the author for successively complicated speech therapy classes with children, 3 periods are distinguished (preparatory, training, consolidative), during which speech exercises become more complicated depending, on the one hand, on the degree of independence of speech, its preparedness, volume and rhythm, structure, and on the other hand the other - from different complexity speech situations: from the situation and social environment, from the types of activities of the child, during which his verbal communication occurs.

Depending on the level (threshold) of free speech and the characteristics of the manifestation of stuttering in each specific case, the tasks and forms of speech exercises differ for each child in the conditions of speech therapy work with a group of children.

Required condition speech therapy classes is their connection with all sections of the “Program of education and training of children in kindergarten” and, above all, with play as the main activity of a preschool child.

The significance of differentiated psychological and pedagogical methods of education and training is revealed in the methodology of G. A. Volkova.

The system of comprehensive work with children aged 2-7 years who stutter consists of the following sections: 1) methodology of play activities (system of games), 2) logorhythmic classes, 3) educational classes, 4) impact on the microsocial environment of children.

The system of games, which constitutes the actual content of speech therapy classes, includes the following types of games: didactic, games with singing, movement, with rules, dramatization games based on poetic and prose text, table tennis games, finger theater, creative games at the suggestion of the speech therapist and according to children's plans. In classes with children, the principle of play activity is primarily implemented.

The following stages are conventionally distinguished: examination, restriction of children’s speech, conjugate-reflected pronunciation, question-answer speech, independent communication of children in a variety of ways. different situations(various creative games, in the classroom, in the family, kindergarten program material (with a change in the sequence of topics) and is aimed at achieving corrective, developmental and educational goals. The lesson is structured within a single plot in such a way that all its parts reflect the program content.

The focus of the methodology under consideration in relation to stuttering children from 2 to 4 years old and children from 4 to 7 years old is different. In the first case, the tasks are not so much correctional as developmental education and upbringing of children. At this age, speech therapy work is preventive in nature. In working with stuttering children from 4 to 7 years old, the corrective orientation of speech therapy influence takes on leading importance, since the personal characteristics influence the nature of the speech activity of a stutterer and determine the structure of the defect.

The methodology of gaming activity is aimed at educating the individual and, on this basis, eliminating the defect.

In the practice of speech therapy work with children who stutter (methodology by I. G. Vygodskaya, E. L. Pellinger, L. P. Uspensky), games and play techniques are used to conduct relaxation exercises in accordance with the stages of speech therapy: a regime of relative silence; education of correct speech breathing; communicating in short phrases; activation of an expanded phrase (individual phrases, story, retelling); re-enactments; free speech communication.

Thus, the improvement of speech therapy work to eliminate stuttering in preschool children led to the 80s of the 20th century. development of various techniques. The speech material of speech therapy classes is acquired by preschoolers in the conditions of step-by-step speech education: from conjugate pronunciation to independent statements when naming and describing familiar pictures, retelling a short story heard, reciting poems, answering questions about a familiar picture, independently telling about episodes from a child’s life, about a holiday etc.; in the conditions of gradual education of speech from the regime of silence to creative statements with the help of play activities, differentially used in working with children from 2 to 7 years old; in conditions of education of independent speech (situational and contextual) with the help of manual activities.

The speech therapist is obliged to creatively structure speech therapy classes, using known techniques in accordance with the population of children who stutter and their individual psychological characteristics. These methods of speech therapy intervention for stuttering preschoolers were developed in accordance with the “Program for the upbringing and training of children in kindergarten”, which is mandatory document both for mass kindergartens and for special speech kindergartens and speech groups at mass kindergartens. The methods are aimed at organizing speech therapy work within the framework of the “Program for raising children in kindergarten”, since ultimately, children who stutter, having mastered the skills of correct speech and knowledge defined by the program, are further trained and brought up in the conditions of normally speaking peers. Speech therapy, aimed at the speech disorder itself and associated deviations in behavior, the formation of mental functions, etc., helps a stuttering child to socially adapt among correctly speaking peers and adults.

Currently, there are a number of speech therapy techniques to eliminate stuttering. They can be considered depending on the age of stutterers: work with preschoolers, schoolchildren, teenagers and adults.

Children who stutter stay in specialized hospitals for 3-4 months. The preparatory period is about a month, the training period is 1.5-2 months, and the consolidation period is about a month.

A special feature of this system is that the course of treatment is divided into 3 cycles. Initially, children are treated for 2 months (first cycle), followed by a month-long break; after which again 1.5 months of treatment (second cycle) and 2.5 months - a break; finally, the last (third cycle) - 1 month of treatment and the final discharge of the child from the hospital.

The first cycle (2 months, 48 lessons) is an active restructuring of speech. The optimal goal of the first cycle is to fully implement the tasks of the preparatory and training periods. In terms of implementation time, it schematically looks like this: 6 lessons - examination and acquaintance with children; 20 lessons - preparatory period; 22 lessons - training period.

From the first day of the child’s stay in the hospital until the start of the training period, a gentle regime is created for children.

On the days of the examination, children are on bed rest under the supervision of a teacher and a nurse, who organize quiet games, classes, read fairy tales, listen to records, etc. . Speech communication children are sharply limited; allowed only in necessary cases and only in a whisper.

At the same time, primary tape recording is carried out children's speech. The speech therapist practices speech exercises with children and conducts calming and stimulating conversations. Groups of children are assembled for individual speech therapy work.

Actually, the preparatory period of speech therapy work begins with an examination of children’s speech and with the maximum limitation of their speech. The tasks and forms of the preparatory and training periods are outlined above.

Their features in the hospital will be expressed only in the following:

1) In a hospital setting, it is not possible to provide for the complication of speech situations outside of the training period.

2) Before the end of the first cycle of therapeutic and pedagogical work with children who stutter, only one comparative teaching tape session is conducted. It kind of sums up the achieved results of working on the child’s speech.

3) Speech therapy work in a hospital is closely connected with educational work. Our speech therapists correctional classes They build on the material recommended by the “Program” for the education of preschool children, and use forms of conducting classes and games for ordinary preschool institutions. In turn, educators correlate general education classes and educational activities with speech therapy tasks. In their classes, teachers focus on the speech capabilities of each child; timely informed about the child’s successes in speech therapy classes, they consolidate the results of speech therapy work with him in educational classes and during general routine moments.

4) Working with parents is very unique. The discontinuity of the course of therapeutic and pedagogical work in a hospital requires a certain speech therapy awareness of parents, so that during the break between cycles of treatment for the child, the achieved results are not disrupted and they are consolidated. For this purpose, during the first cycle of the child’s stay in the hospital with his parents, a minimum speech therapy session is held once a week (on Saturday or Sunday).

First lesson. Lecture-conversation about stuttering in children, about the features of treatment in a hospital, about the role of parents in this process.

Second lesson. Lecture-conversation about psychological characteristics children who stutter, about the complex of therapeutic and pedagogical work with stutterers (with characteristics of behavior and treatment in given time every child. A neuropathologist takes part in the conversation).

Third lesson. A conversation about the direction of speech therapy classes, about speech therapy techniques. Open speech therapy session (parents attend classes with a group of children where their child is not present). Discussion of this lesson.

Fourth lesson. The presence of parents at an open speech therapy session with children (in the group where their child is). Discussion of this lesson.

Fifth lesson. A conversation about the results of eliminating stuttering in children during the first cycle of their hospital stay (a comparative tape recording is used), about the tasks facing parents during a month and a half break in the treatment of their child (separate recommendations are given to each parent).

Each session with parents ends with a meeting with the child. This stimulates both parties: parents to practice minimal speech therapy, children to speak and behave well in order to please their parents with their successes. Speech therapists need this kind of work, as it becomes possible to train a child’s speech in difficult conditions. All this requires a carefully thought-out system for conducting the entire parenting day, right down to questions and answers between parents and child.

The release of children from the hospital is decorated colorfully, joyfully, in the form of a cheerful matinee.

During the 1.5 month break in the child’s treatment, parents must create the necessary attitude for him at home from others, organize daily speech exercises and classes as directed by the speech therapist, and follow the doctor’s instructions.

The second cycle (1.5 months - 36 sessions) - reinforcing therapy. 8 lessons of this cycle are allocated for training the child’s correct speech in healthy areas of speech (preparatory period) and 28 lessons for consolidating the skills of correct speech and behavior in different situations, in the process of different activities, on speech material of varying complexity (training period).

Speech therapy classes in the preparatory period of this cycle begin with the restoration of elements of correct speech, with learning new speech exercises. Children are shown their speech recorded at the beginning of the first treatment cycle and before they are discharged from the hospital.

Attention is drawn to the progress they made during the first cycle of treatment. At the same time, the child is monitored: what he saved, what he acquired during his stay at home. Speech therapy classes begin on the first day.

During the training period of this cycle (approximately from the middle of it), it is planned to reduce the time of speech therapy classes to 1.5-1.40 (instead of 2-2.30). Special speech therapy classes are gradually being replaced by general education ones. Classes are conducted, as before, by a speech therapist, but the main goal of the classes is gradually changing - speech therapy tasks are replaced by general educational ones. The speech therapy session thus gradually turns into a speech therapy educational session.

Individual speech therapy work to eliminate concomitant speech deficiencies is carried out with children in parallel with general classes.

At the end of the training period, a comparative training tape session is conducted. The present speech is compared with the initial recording made when the child entered the first cycle of treatment. Discharge from the hospital is formalized in the form of a matinee concert. All children participate.

The intensity of classes with parents in the second cycle of treatment decreases somewhat. Parents' days are held once every 2 weeks.

First lesson. Discussion of the results of the parents’ work with the child (statement from each parent). Open speech therapy session with discussion.

Second lesson. Discussion of the results of therapeutic and educational work with a child in a hospital (speeches by a speech therapist and a doctor). Open speech therapy session with discussion.

Third lesson. Listening to a comparative tape recording of children’s speech now and initially upon admission to the first cycle of treatment. Recommendations from a speech therapist or doctor for working with a child at home after his discharge.

The task of the parents is: during the 2.5 month break in treatment, to consolidate in the child at home the skills of correct speech and behavior acquired by him in the hospital. Daily speech exercises and classes, strict adherence to the recommendations of the speech therapist and doctor - this is the key successful work parents.

Third cycle (1 month - 24 lessons) - consolidation of correct speech skills. It consists of a preparatory period (3 lessons), a training period (5 lessons) and a consolidation period (16 lessons).

In the first lessons, the child is studied; tape recordings of children's speech are shown upon admission to the first cycle of treatment and before discharge after the second cycle; learning new speech exercises; elements of correct speech are practiced and restored in its healthy areas.

In the next 5 classes, speech exercises of varying complexity and in different situations are intensively conducted. After which, without changing the complexity of the exercises, speech therapy classes are gradually replaced by educational ones with their tasks and specifics. During the placement period, the speech therapy hospital for preschoolers resembles a regular round-the-clock kindergarten, where there are two teachers working in a group: one in the morning, the other in the evening. Its distinctive feature is the small size of the group and mandatory speech therapy for all classes with children. Before the end of treatment, the last tape-recorded comparative training session is conducted. A festive concert is being prepared for the graduation of children, in which all children take part.

Working with parents in this cycle is no different from the previous one - classes follow the same pattern once every two weeks.

In conclusion, we note that the advantages of the above course of therapeutic and pedagogical work with children who stutter in a hospital setting are expressed in the following:

1) Without extending the length of stay of a stuttering child in a specialized hospital, the time of speech therapy work with him increases. The child is actually under observation for 9 months.

2) The child’s transition from the peculiar conditions of a specialized hospital to home is not carried out abruptly, but gradually.

3) In cases of successful correctional work with a child, it becomes possible to limit the length of his stay in the hospital, i.e. carry out only the first and third cycles of treatment, or the second and third for children who have previously worked with a speech therapist. Thus, the different focus of each cycle allows us to take into account the individual characteristics of children and vary necessary forms therapeutic and pedagogical work with them. This, in turn, allows increasing the capacity of a specialized hospital.

4) The proposed system, on the one hand, promotes closer contact between the speech therapist and parents and, in particular, significantly activates the role of parents in correctional and educational work with the child.

5) On the other hand, the interaction between the speech therapist and the teacher is more closely intertwined. The speech therapist, consistently rearranging speech therapy classes, includes general educational tasks, understands more deeply general tasks educational work with children. This is significantly reflected in his leadership of the work of a teacher in a hospital; the tasks of speech therapy and general education classes and routine moments are specified.