As a separate speech pathology, functional tongue-tied language was first identified by professor-phoniatrist M. Siman in 1955. In speech therapy, functional disorders of sound pronunciation are contrasted with mechanical dyslalia caused by organic disorders of the structure of the peripheral organs of speech, and dysarthria associated with disorders of their innervation. With the functional form of dyslalia, anatomical defects and innervation insufficiency are absent, the inaccuracy of the pronunciation of phonemes is associated with incomplete maturation of the central speech apparatus or with gaps in upbringing. Timely uncorrected defects of articulation and phonemic hearing later serve as the basis for the formation of writing and reading disorders.

In children with the speech problem under consideration, the structure of the peripheral speech apparatus is normal, the innervation of the articulatory muscles is not impaired, and physical hearing is preserved. The detected pronunciation defects are due to a violation of the course of neurodynamic processes in the cerebral cortex. Functional dyslalia can be caused by both biological and social (pedagogical) factors:

• Biological prerequisites . They include delayed psycho-speech development , somatic weakening of the child due to frequent infectious diseases, chronic pathologies, hypovitaminosis , eating disorders (dystrophies). Violation of general physical development predetermines neurodynamic deficit, which is expressed in the weakening of fine differentiations in the speech-auditory or speech-motor analyzer. Articulation movements are imprecise, speech kinesthesia is indistinct, phonemic hearing is underdeveloped.
• Social prerequisites . These include cases of improper upbringing of children’s speech: imitation of parents to babbling pronunciation of a preschooler, a child’s assimilation of defective speech patterns of adults (burr, blurred sound, dialect features). The development of children’s speech is negatively affected by being in a bilingual environment – in this case, the features of sound pronunciation, normative for one language, can be transferred to another, where they are not the norm. Finally, the cause of dyslalia may be a late appeal to a speech therapist or pedagogical neglect , when adults do not pay attention to defective pronunciation and do not participate in the development of the child’s speech.

The mechanism of the onset of functional dyslalia is associated with an imbalance and weakness in the dynamics of nervous processes in the brain. The cortical sections of the speech-auditory and speech-motor systems are without pathology, but the balance of excitation and inhibition in them is disturbed, uncoordinated. The nature of the leading defect is determined by the localization of disturbances in cortical neurodynamics. If this phenomenon affects the center of motor realization of speech (Broca‘s zone), mainly motor failure arises: the reproduction of phonemes primarily suffers, and secondarily – speech hearing. With the localization of neurodynamic disorders in the sensory speech zone (Wernicke center), the primary defect is the lack of sound perception and sound recognition; against this background, confusion and replacement of phonemes appear in expressive speech .

On the basis of the pathogenetic approach, which takes into account the predominance of speech and auditory or speech motor impairment, three forms of functional dyslalia are distinguished: motor, sensory and mixed. This classification considers the psychophysiological mechanisms of speech that are impaired in a child and require speech therapy correction in the first place:

• Motor dyslalia . It is caused by the insufficient readiness of the organs of articulation to perform complex speech-motor acts: to hold the tongue and lips in the desired position, to switch from one articulum to another. As a result of motor awkwardness and undifferentiated movements of the organs of speech, instead of the correct sound pronunciation, the defective is fixed.
• Sensory dyslalia . Caused by the underdevelopment of speech hearing, leading to difficulty in recognizing and distinguishing between opposition sounds. With this form of inarticulateness, the phonemic system of the language has not been formed.
• Sensomotor (mixed) dyslalia . Motor and sensory acts are closely interconnected, therefore, combined disorders may underlie defective pronunciation. So, with sensory insufficiency, the formation of sound kinesthesias suffers, and inaccuracy of pronunciation, in turn, negatively affects the development of auditory differentiations.

In addition to the nature of functional shifts in the central link of speech production, the classification takes into account the leading defect – phonetic or phonemic. In accordance with this criterion, dyslalia is divided into several types:

• Acoustic-phonemic . It is based on the child’s inability to distinguish acoustically similar phonemes by ear. Sound pronunciation defects are represented either by the absence of sounds, or by their mixing or substitutions. All sounds are pronounced normatively, not distorted.
• Articulatory-phonemic . The normative articulatory base has not been formed, therefore, instead of the correct ones, the child uses simpler or more similar articulatory sounds. Based on the similarity of phonemes in place or mode of formation, their replacements or confusion arise.
• Articulatory-phonetic . Violations affect the phonetic level of speech with complete preservation of phonemic processes. It is manifested by sound distortions – the use of incorrect versions of a particular sound in speech. The complete absence of sound is rare.

Various forms of tongue-tied language have common manifestations, however, each of them is characterized by its own special set of features. The lack of formation of speech skills is expressed in the replacement of sounds with similar articulation or acoustic properties, mixing (unstable use), distortion (abnormal pronunciation) or absence. Only consonants suffer, pronunciation and vowel discrimination remain correct. The disorder can affect individual sounds within the same phonetic group or different groups of sounds (sonorant, whistling and hissing). Soft and hard sounds are disturbed equally.

In the case of the acoustical-phonemic variant, sounds are recognized incorrectly, which is accompanied by an incorrect perception of the word (instead of “barrel” – “kidney”, instead of “mountain” – “bark”). The child mixes and replaces phonemes that are similar in acoustic characteristics (voiced and deaf, hard and soft, sonors (rl), hiss and sibilants). Rarely is the complete absence of one or another phoneme due to the fact that the child does not distinguish it by ear either in the speech of others or in his speech.

The articulatory-phonemic form of dyslalia can proceed in two ways. In the first case, due to the lack of formation of articulatory structures, the child uses sounds that are simpler in articulation. In the other variant, despite the assimilation of all articulatory positions, the child confuses the position of the tongue and lips, pronouncing the words either correctly or incorrectly. Substitutions and mixing relate to sounds that are similar in the method or place of formation: hissing and whistling (roof – “rat”), occlusive-explosive anterior and posterior lingual (“Tolya” – “Kolya”), hard and soft pairs of sounds (“small “-” crumpled “), sonors (” hand “-” bow “), affricate (” heron “-” chapla “).

Pronouncing defects in the articulatory-phonetic form are represented by various types of rotacism , sigmatism , lambdacism, inaccurate pronunciation of palatal sounds ( kappacism , gammacism, chitism, iotacism). The wrong version of the sound (allophone) is close in sound to the normalized one, therefore it is easily recognized by others (for example, the burst “p”). Distorted articulation is firmly fixed in the child’s phonetic memory and does not disappear on its own, but does not affect writing in any way.

Defective pronunciation, first of all, is reflected in the communicative function: peers hardly understand the speech of a disliked child, ridicule and mimic him. This can adversely affect mental health, causing isolation, neurotic disorders , deviant behavior in children. Functional dyslalia, namely its acoustic-phonemic and articulatory-phonemic forms, causes difficulties in sound analysis and synthesis, which in school years is manifested by errors in writing ( dysgraphia ) and reading ( dyslexia).). The child makes mistakes both when writing under dictation and when writing creative works – composition, presentation. The consequence of this is the lack of academic performance in humanitarian subjects, which further exacerbates social rejection and withdrawal.

Determination of the form of dyslalia (mechanical, functional) and the type of the latter is carried out within the framework of a speech therapist consultation. The data obtained in the course of speech therapy diagnostics are of key importance for planning the tactics of correctional and pedagogical influence. During the diagnosis, material and tasks are used that correspond to the age of the subject.

• Collecting anamnesis . It is carried out during a conversation with adults – parents or other representatives of the child. The main questions of interest concern the course of the antenatal period, the pre-speech and speech development of the child, the diseases suffered in early childhood, the presence of pronunciation defects and bilingualism in the family . A speech therapist may ask for the conclusions of a neurologist , otolaryngologist , pediatrician about the child’s health.
• Assessment of speech motility . To examine the articulatory praxis, the child is asked to perform a series of special exercises: open and close the mouth, stretch the lips into a tube and stretch in a smile, stick out a wide and narrow tongue, etc. The volume, accuracy, activity, pace of movement, muscle tone are assessed.
• Sound pronunciation survey . The child is asked to name the objects shown in the pictures. Didactic material is selected in such a way that the presented sound is in different positions: at the beginning, middle and end of words. At the same time, the nature of the defective sound pronunciation is revealed: replacement, skipping, mixing, distortion of sounds.
• Phonemic hearing test . At this stage, special attention is paid to checking the differentiation of phonemes that are similar in sound or articulation. The child is asked to repeat the syllables (sa-sha, da-ta) after the speech therapist, and are presented with pictures depicting objects denoted by words with opposition consonants.

Differential diagnosis of functional dyslalia and erased dysarthria can be of practical difficulty – with the latter, there is also fuzzy and blurred articulation, however, pareticism or dystonia of muscles, impaired speech breathing and prosodic will also be noted. Within the functional inarticulateness, the greatest difficulty is the differentiation of the articulatory-phonemic and acoustic-phonemic forms of dyslalia.

When choosing a priority direction, they are guided by the structure of the speech defect. So, with acoustical-phonemic dyslalia, the main vector will be the development of phonemics, with articulatory-phonetic dyslalia – speech motor skills, with articulatory-phonemic dyslalia – both processes equally:

• Development of articulatory praxis . It is achieved by training the muscles involved in the pronunciation of “difficult sounds”, and by specifying articulation poses. For this purpose, it is recommended to perform a special complex of articulatory gymnastics, exercises for the development of a directed air stream, speech therapy massage . Only after this do they move on to sound production, consolidation and differentiation of the evoked sounds.
• Development of phonemic processes . Conducted in parallel with work on articulation. Includes the formation of auditory attention, memory, phoneme discrimination. The child is explained the differences in the articulatory structure and characteristics of the mixed phonemes. Games for onomatopoeia, recognition of non-speech sounds, exercises for sound analysis and synthesis are used.

In addition to training skills during speech therapy classes, it is necessary to practice them multiple times in a kindergarten group and at home (repetition of articulatory and respiratory gymnastics exercises, doing homework in a workbook, memorizing phrases and verses). Only after consolidating the formed speech skills in situations of free communication, speech therapy work can be considered complete.