From Big Medical Encyclopedia

ALALIA (a Greek negative prefix and - and lalia — the speech) — the absence or restriction of the speech at children caused by an underdevelopment of speech areas of big cerebral hemispheres or their defeat in the pre-natal or early post-natal period of development.

Etiology and pathogeny are various: inflammatory processes and brain injuries, alimentary and trophic, exchange disturbances in the pre-natal and early post-natal period of development of the child.

Clinical picture. Are observed And. various degree: from easy disturbances of the speech to heavy when the child does not speak up to 10 — 12 years or, despite long training, his speech is limited to a scanty lexicon, remaining at the level of the elementary agrammatichny speech. Distinguish motor And., developing at disturbance of functions of parietofrontal areas of bark of the left cerebral hemisphere (Brock's center), and touch And., arising at defeat of temporal area of the left hemisphere (Vernike's center). This division is conditional since at motor And. also touch, semantic disturbances are quite often observed. Can be total And., at a cut motor and touch components of the speech are broken. Children can have also semantic alalias when at safety of understanding of the everyday speech the understanding of value of more compound words is broken. Sometimes at children with And. neurotic reactions to the available defect of the speech are observed. Bystry fatigue, the lowered attention and working capacity, a secondary delay of mental development is noted.

The motor alalia is characterized by disturbance of the expressional speech at sufficient safety of her understanding.

Normal at the child the lepetny speech develops at clearly the expressed mimicry and gesticulation in the beginning. Lack of babble has to is aged more senior year to draw a close attention of parents and personnel of child care facilities. In the absence of the speech up to 2,5 — 3 years it is possible to assume that at the child A. Children with motor And. differ in a speech inaktivnost; even having certain speech potential, they refuse to speak, showing a peculiar speech negativism. Having seized an articulation of the speech, the child with And. experiences difficulties in pronouncing sound combinations, its movements of phonemes are observed, perseverations (repetition of one any sound or the word), simplifications. So, instead of «hey» it says «уа» or «уу», instead of «ауо» — «autonomous area». At the child with And. syllabic parafraziya are observed: «lomotok» instead of «hammer», etc.

From the beginning of the phrase speech agrammatisms which with accumulation of a lexicon increase contrary to their reduction at normally developing child come to light. Agrammatisms at children with And. are resistant and are expressed not only in the wrong declensional endings, the terminations on childbirth and numbers, not only in the use of verbs in an uncertain form and nouns in the Nominative case, but also in lack of pretexts, the unions, adverbs. Disturbances of motor function of the speech at the child affect also her understanding.

In the course of training of the child with And. in his speech gradually there are pretexts, the unions, there is available a formulation of separate short thoughts; however insufficient speech activity, the child remains with And. (in comparison with the healthy child of the same age) is at a loss in the verbal formulation seen and in retelling of read. The letter of the child reflects all way of its speech development: it agrammatichno, abounds with alphabetic, syllabic and verbal paraphasias.

Sometimes at children with motor And. in different terms of development of the speech, especially upon transition to the phrase speech, there is no smoothness of the speech, stutter develops. Mostly it is observed at pathological processes in the left premotorny area. Such children need to be trained in smoothness of the speech, melody, a variety of intonations.

The touch alalia is characterized by disturbance of understanding by the child of the speech at safety of elementary acoustical perceptions. At children with touch And. extreme lability of acoustical attention and disturbance of phonemic hearing is observed. Cases isolated touch And. are rare. Contrary to children with motor And., patients touch And. show considerable speech activity even in the period of the lepetny speech. Quite often their possibility of repetition of someone else's speech is developed without understanding of the repeated words that is predictively a favorable sign.

Diagnosis. Diagnostic mistakes at an otgranicheniya of children, patients are frequent And., from hard of hearing, deaf-and-dumb, mentally retarded, therefore at diagnosis And. it is necessary to exclude a hearing disorder, mechanical causes of infringement of an articulation, an anarthria (see. Dysarthtia ) and disturbances of intelligence.

From hard of hearing and deaf-and-dumb the child with touch And. differs in a ringing voice, safety of intonation, existence of reaction to sounds of small intensity; gesticulations at them are followed by the voice reactions which are emotionally modulated.

Forecast depends on weight of the basic pathological process, on extent of disturbance of the speech, on time of diagnosis And. and from statement of medical refurbishment work with the child.

At children with touch And. during well carried out logopedic work the speech quite often is recovered bystry, than at motor And.

Treatment. The special system of the logopedic occupations promoting development of the speech in children with a motor and touch form A is developed. (see. Logopedics ). Work on development of semantics of the speech is most complex, demands big logopedic and pedagogical work, with the help the cut is also possible to receive good results. Considerably efficiency of logopedic occupations with the children suffering from various forms A increases., if classes are given in combination with courses of treatment B12, B15 vitamins, Galantaminum, Gammalonum at constant dynamic observation of doctors (the neuropathologist and the pediatrician) of the child. See also Speech (frustration) .

Bibliography: Girshgorn I. Z., Holmyanskaya D. M. and Chistov Z. V. To a question of diagnosis of a touch alalia (slukhonemota) at children, Zhurn. ushn., nose. and throats, Bol., No. 2, page 41, 1965, bibliogr.; Danilova L. A. Features of logopedic work at different forms of a motor alalia and aphasia, Uchen, notes Leningr. ped. in-that, t. 256, page 297, 1963; Ippolitova A. G. About work of the logopedist at a touch alalia, in book: Vopr. patol. speeches, under the editorship of E. A. Babayan, etc., page 109, Kharkiv, 1959; Kovalyov V. V. and Kirichenko E. I. To a question of dynamics of speech and mental disturbances at children and teenagers with a syndrome of a motor alalia, Zhurn. neuropath, and psikhiat., t. 70, century 10, page 1561, 1970, bibliogr.; Levina R. E. Experience of studying of nonspeaking children (alalik), M., 1951; Mitrinovich-Modzheevsk A. Patofiziologiya of the speech, a voice and hearing, the lane with polsk., Warsaw, 1965, bibliogr.; Sketches on pathology of the speech and a voice, under the editorship of S. S. Lyapidevsky, century 1, page 24, M., 1960, century 3, page 47, etc., M., 1967; Pravdina O. V. Logopedics, M., 1969; Problems of abilities, under the editorship of V. N. Myasishchev, M., 1962; Rudenko Z. Ya. Clinical features of an alalia, Zhurn. neuropath, and psikhiat., t. 64, century 7, page 1065, 1964; Physiological mechanisms of disturbances of the speech, under the editorship of I. T. Kurtsin, L., 1967, bibliogr.; Fröschels E. Lehrbuch der Sprachheilkunde, Lpz., 1925; Gutzmann H. Sprachheilkunde, V., 1924.

M. B. Eidinova.