Phonetic speech impairment with reasons diagnostic Treatment

Phonetic speech impairment ( Deficiencies in the pronunciation of individual sounds (NPOZ) , FNR )

Phonetic speech disorder is a group of speech disorders in which only the pronunciation side is disturbed with sufficient formation of phonemic hearing, vocabulary, and grammar. Phonetic defects include distortion of sounds and syllable structure of words, prosodic violations. Pronouncing deficiencies are revealed during speech therapy diagnostics. Correction of phonetic speech disorders includes the formation of correct articulation positions, the development of speech breathing, the setting and automation of defectively pronounced sounds. Phonetic speech impairment with reasons

General information

Phonetic speech disorders (FNR), or deficiencies in the pronunciation of individual sounds (NPOZ), are spoken in cases where there is inaccurate phonation or articulation that does not correspond to linguistic norms with preserved physical hearing, intellectual status. FNR belongs to the categories of psychological and pedagogical classification, along with FFN , LHNR and OHR . The speech therapy conclusion of the FNR / NPOZ allows to single out the category of children with the same type of speech defects, to form a group of speech pathologists who need equivalent speech therapy assistance .

The reasons

Phonetic disorders are typical for a number of speech therapy nosologies: dyslalia , rhinolalia, erased dysarthria , voice disorders. They are distinguished by the presence of sound and phonation defects. The immediate causes of phonetic deficiencies can be:

  • Anomalies of the structure of the languageMost consonants are pronounced with the participation of the tongue, so any deviations in its anatomy are reflected in the correct articulation. The most common cause of phonetic defects is the short sublingual ligament (ankyloglossia). Less common are such anomalies as megaloglossia , microglossia, splitting of the tip of the tongue.
  • Dentofacial defects . A common condition that distorts the pronunciation of children is a defective bite: open anterior and lateral, mesial , distal . The Gothic sky , crevices of the upper palate and the face, which grossly distort not only sound pronunciation, but also prosody, belong to the same category of FFN etiofactors . Phonetic speech impairment with reasons
  • Changes in the tone of the speech muscles. Spasticity or pareticism of the articulatory muscles is characteristic of dysarthric syndrome . This leads to inaccurate movements of the tongue, lips, insufficient activity of the palate, vocal cords, weak and absent-minded exhalation.
  • Laryngeal pathology . Various diseases of the larynx (malformations, laryngitis, papillomatosis ), as well as functional overstrain of the vocal apparatus, cause dysprosodia phenomena, which are also referred to as phonetic disorders. In these cases, intonation and melody suffer, articulation does not change.
  • Bilingualism . Bilingual children often introduce phonetic features of the sound pronunciation of their native language into Russian speech, for which such a variant is not normative (for example, uvular [P], interdental [C], two-lipped [B]).
  • The influence of the microsociium. Sometimes phonetic defects are the result of inattention of others (parents, teachers, nannies) to the child’s speech development. The socio-pedagogical factors in the formation of FFN should include the copying of incorrect examples of adult speech (lisp, lisp, softened), the reproduction of dialectisms, the lisping manner of communication, etc.

Phonetic underdevelopment can also act as part of more complex speech disorders, but then they speak of phonetic-phonemic or general (systemic) speech underdevelopment.

Development mechanisms

The phonetic side of speech includes sound (sounds, syllables, sound chains) and melodic-intonation (tempo, rhythm, tone, stress) design of the statement. Each sound has certain articulatory and acoustic characteristics, which are taken as the norm in the language. With phonetic disorders, the mechanisms of speech production change, which leads to a distorted sound of the speech stream.

Poor mobility of the tongue with structural anomalies or disturbed innervation makes its movements insufficiently active, undifferentiated, does not allow taking accurate articulatory postures, which is why the acoustic effects of pronounced sounds differ from the norm. With clefts of the soft and hard palate , an air flow leaks through the nasal passages, as a result of which the voice becomes hypernasal, monotonous, unmodulated. The pathology of the vocal cords leads to their non-closure and non-participation in phonation – hoarseness , hoarseness , and deafness of the voice appear .

FNR symptoms

Phonetic deficiencies include defects in the pronunciation of sounds, a violation of the sound-syllable rhythm of a word, and dysprosody . Distortions of articulation can relate to individual sounds, a whole group (for example, sigmatism of sibilants ) or several groups of sounds (sibilant and hiss sigmatism + rotacism ). Distorted sound pronunciation, as a rule, is not reflected in the writing, therefore, does not interfere with the mastery of literacy.

Violations of the sound-syllabic structure of a word can be represented by omissions of consonants / vowels or whole syllables, insertion of “extra” syllables, rearrangements of sounds and syllables, perseverations, etc. In the younger preschool age, such errors in long, unfamiliar words are normal. By older preschool age, almost all children master the sound-syllable structure of polysyllabic words (with the exception of foreign-language, low-frequency words, highly specific terms). Errors in the form of omissions of consonants in their confluence, reduction in the number of syllables mainly indicate a violation of articulatory motor skills.

Disprosody leads to a change in the rhythmic pattern, a decrease in the emotional coloring of the statement. Speech breathing, which is usually impaired in children with rhinolalia, dysarthria, has a significant impact on the melodic-intonational context. Therefore, their voice sounds weak, and their speech is not expressive enough. Phonetic speech impairment with reasons


The design of the pronunciation side of speech basically ends by the age of 5-6, that is, in preschool childhood. If age-related inarticulateness does not disappear on its own, undesirable consequences may arise. It is known that sounds that are simple in articulation create the basis for the appearance of more articulatory phonemes. If the first ones are pronounced incorrectly, distorted, then the basis for the appearance of subsequent sounds in ontogeny turns out to be unformed.

Errors in the sound-syllable composition negatively affect the development of the lexical-grammatical and phonemic aspects of speech, are reflected in the writing in the form of dysgraphia . In general, phonetic difficulties “inhibit” the child’s mental development, hinder the knowledge of the surrounding world, and impede communication with peers and adults.


Speech therapy diagnostics always begins with finding out the general and speech anamnesis. From the words of the parents, the speech therapist-defectologist receives information about the course of pregnancy and childbirth, the early postnatal development of the child, and childhood illnesses. The speech environment, the time of appearance and the activity of preverbal reactions are assessed. When studying the medical card, the state of hearing, neuropsychic development is specified. Special methods for diagnosing phonetic disorders include:

  1. Assessment of the structure and function of the speech apparatusA careful examination of the peripheral organs of speech is performed, during which anatomical anomalies of the tongue, jaws, and dentition can be detected. When conducting static and dynamic tests, signs of innervation insufficiency (tremor, deviation of the tongue to the side, synkinesis) are revealed.
  2. Study of sound pronunciation. According to the traditional scheme, vowels and consonants of early, middle and late ontogenesis are examined. Sounds are examined in different positions in the word: at the beginning, middle, end, intervocal position. The repetition of words of complex syllable structure is checked. For a phonetic disorder, a distortion of the sound and syllabic image of the word is typical.
  3. Study of vocal and prosodic function. At this stage, the speech therapist evaluates the tempo, rhythm, intonation, pause of speech. Draws attention to the characteristics of the voice – pitch, clarity, loudness, modulation. Pays attention to speech exhalation – duration, smoothness, purposefulness.
  4. Study of phonemic and LH processes. Phonemic and lexical-grammatical development proceeds without deviations. Children with FNR differentiate speech sounds well, correctly perform tasks for phonemic analysis and synthesis, have a well-formed vocabulary, word formation and inflection skills, and developed coherent speech. Phonetic speech impairment with reasons

Advanced diagnostics of phonetic disorders, if necessary, also includes a medical unit. The list of studies is determined by a specialist doctor (pediatric neurologist, orthodontist, maxillofacial surgeon):

  • MRI of cerebral structures ;
  • EEG ;
  • laryngoscopy ;
  • CT of the facial skeleton ;
  • TRG with cephalometric analysis.

FFN correction


Medical assistance is required in cases where the correct pronunciation cannot be achieved with speech therapy alone. The child may be assigned:

  • pharmacotherapy: nootropics, B vitamins;
  • physical rehabilitation: exercise therapy , massage SHVZ , Vojta therapy , electrical neurostimulation ;
  • dental treatment: bite correction ( functional devices , aligners , braces ), frenuloplasty ;
  • closure of chloe clefts: cheilorinoplasty , uranoplasty ;
  • treatment of pathology of ENT organs: removal of papillomas of the larynx .

Speech therapy correction

Organized children with phonetic disorders should be enrolled in the speech center of an educational institution to conduct systematic lessons to improve sound pronunciation. The main tasks of correctional training are reduced to the clarification of acoustic and articulatory signs of sounds, their formulation and consolidation, the development of speech exhalation, intonational expressiveness.

  • Development of basic articulation patterns . This corrective task is solved with the help of articulatory gymnastics exercises , phonetic rhythmics, speech therapy massage . Along with the development of speech praxis, much attention is paid to the development of fine motor skills as a method of stimulating the speech-motor analyzer.
  • Development of prosodic components. Includes work on the voice, speech breathing, tempo, rhythmic, intonational side of speech. It is realized with the help of breathing exercises , logo-rhythmic exercises , role-playing games, theatrical activities, playing musical instruments, vocal exercises.
  • Sound production and automationSound production is started after working out the basic patterns and developing an air flow. They use techniques of imitation, from reference sounds, with the help of probes and probe substitutes. The sequence of staging repeats the order of appearance of sounds in ontogeny. Automation means working out sounds in an isolated position, syllables, words of various syllable structures, pure phrases, phrases, and coherent speech.

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