Rhinolalia

The rhinolalia is the disturbance of an articulation caused by the wrong structure and functioning of organs of articulation (a nasopharynx, a nasal cavity, a hard and soft palate). Because of it the voice stream excessively or, on the contrary, resonates in a nasal cavity at a conversation insufficiently, and public and concordant get nasal sounding. The rhinolalia at children is characterized not only by the distorted pronouncing sounds, but also delays in development of the lexical and grammatical party of the speech because of secondary disturbances of the letter and phonemic processes.

Diagnosis of a rhinolalia consists in consultations of the otorhinolaryngologist, logopedist and maxillofacial surgeon for establishment of functional and anatomic defects of an articulation, and also extent of disturbance of an oral and written language.

Correction of a rhinolalia can include both logopedic and psychotherapeutic work, and physiotherapeutic, orthodontic and surgical treatment.

Classification and reasons of a rhinolalia

Depending on features of disturbance of interaction of a stomatopharynx and a nasopharynx distinguish the closed or open rhinolalia.

For closed like a disease the direction of a speech exhalation only through a mouth is characteristic. Because of the lowered physiological nasal resonance consonants are most strongly distorted: m, мь, N, нь. At a normal articulation air gets into a nasal cavity as the nasopharyngeal lock is open. At the absent resonance these sounds – completely oral: the m is said as, the N changes on. The conceptual framework of the speech strongly suffers because of it. Sounding of vowels is also greased as they are deprived of some tone characteristics.

According to the reasons of a rhinolalia of the closed type distinguish 2 of its forms:

• Organic. Is caused by anatomic deformations in a nasal cavity. Impassability is removed in the surgical way then defect of the speech vanishes, and breath becomes normal;
• Functional. Results from hyperfunction of a soft palate which at the expense of an elation directs an air stream through a mouth. It often occurs at neurotic frustration therefore the logopedist and the neurologist are engaged in treatment. After treatment the habit to mispronounce sounds sometimes remains.

The open rhinolalia is more widespread, than closed. Air passes at the same time through a nose and a mouth that is caused by constantly open message between an oral and nasal cavity. The nasal resonance which changes a timbre of all sounds results.

This speech disturbance can also be organic or functional. In the first case are the reasons of a rhinolalia as inborn defects (a crevice of an upper lip, a soft and hard palate), and acquired owing to injuries, hems, paresis, paralyzes or tumors. In the second case the functional rhinolalia is caused by a hypokinesis or the hypofunction of a soft palate which is expressed in its insufficient rise at phonation. Most often such rhinolalia occurs at children with a low muscle tone, with weak nervous impulses or after frequent diseases of a nasopharynx.

If the factors causing the closed and open rhinolalia are combined, then it is accepted to speak about the mixed disease type. Acoustic and articulation characteristics of the said sounds suffer because there is a leak of air through a nose at reduction of a nasal resonance.

Correction of a rhinolalia

Complex correction of a rhinolalia consists in holding the following events:

• Surgical correction of anatomic defects;
• Orthodontic elimination and prevention of repeated deformations of an upper jaw;
• Medical fortifying physical culture;
• Otorhinolaryngological sanitation for the purpose of prevention of a hearing disorder;
• Psychotherapeutic help.

Rhinolalia at children it is necessary to treat as soon as possible, it is the best of all to complete therapy before achievement of teenage age.

Main directions of the early logopedic help:

• Normalization of speech and physiological breath;
• Recovery of the correct palatopharyngeal smykaniye;
• Formation of a correct articulation;
• Correction of a sound pronunciation;
• Elimination of a nasal timbre of a voice;
• Fixing of skills of free speech communication;
• Reduction in norm of the prosodic party of the speech;
• Development of the sound analysis and phonemic perception;
• Prevention of a dysgraphia and dyslexia;
• Control over the general development of the speech.

In correctional work the sequence and systematicity of training have to be observed, and the offered material has to be evident and available. The logopedist has to watch the direction of an air stream, the provision of language and facial muscles constantly.

Efficiency of treatment of a rhinolalia depends on a number of external and internal factors:

• Expressivenesses of articulation defects;
• The accompanying disturbances and diseases;
• Terms of an initiation of treatment;
• Time and quality of the performed operations;
• Age of the patient;
• Degrees of its compensatory opportunities;
• Conditions of hearing;
• Features of the personality;
• Conditions of intelligence;
• Influences of the speech environment.

After correction of a rhinolalia the result is estimated on extent of normalization of the speech and lack of a nasalization.

By preparation for comprehensive school of the children having a rhinolalia it is necessary to provide to each child individual approach and to consider not only features of a disease, but also a microsocial environment.

The correct distribution of a medical and academic load is necessary in order that the child without overfatigue could carry out all tasks facing it. Under the influence of surgical interventions children are, as a rule, weakened somatic, at them working capacity, activity and endurance is reduced. Therefore treatment of a rhinolalia has to be accurately organized. Its productivity directly depends on collaboration of doctors, teachers and other specialists.