Anxiety is common to all people to one degree or another, and many of us sometimes perform rituals of varying degrees of irrationality designed to insure us against trouble - banging our fist on the table or wearing a lucky T-shirt to an important event. But sometimes this mechanism gets out of control, causing a serious mental disorder. “Theories and Practices” explains what tormented Howard Hughes, how an obsession differs from schizophrenic delusion, and what magical thinking has to do with it.

Endless Ritual

Jack Nicholson's character in the famous film “As Good As It Gets” was distinguished not only by his complex character, but also by a whole set of oddities: he constantly washed his hands (with new soap each time), ate only with his own cutlery, avoided the touch of others and tried not to step on cracks on the asphalt. All these “eccentricities” are typical signs of obsessive-compulsive disorder, mental illness, in which a person is obsessed with obsessive thoughts that force him to regularly repeat the same actions. OCD is a real boon for a screenwriter: this disease is more common in people with high intelligence, it gives the character originality, noticeably interferes with his communication with others, but at the same time is not associated with a threat to society, unlike many other mental disorders. But in reality, the life of a person with obsessive-compulsive disorder cannot be called easy: behind innocent and even funny, at first glance, actions hide constant tension and fear.

It’s as if a record is stuck in such a person’s head: the same unpleasant thoughts regularly come to mind, having little rational basis. For example, he imagines that there are dangerous microbes everywhere, he is constantly afraid of hurting someone, losing something, or leaving the gas on when leaving home. He may be driven crazy by a leaking faucet or an asymmetrical arrangement of objects on the table.

The flip side of this obsession, that is, obsession, is compulsion, the regular repetition of the same rituals that should prevent the impending danger. A person begins to believe that the day will go well only if he reads a nursery rhyme three times before leaving the house, that he will protect himself from terrible diseases if he washes his hands several times in a row and uses his own cutlery. After the patient performs the ritual, he experiences relief for a while. 75% of patients suffer from both obsessions and compulsions at the same time, but there are cases when people experience only obsessions without performing rituals.

At the same time, obsessive thoughts differ from schizophrenic delusions in that the patient himself perceives them as absurd and illogical. He is not at all happy about washing his hands every half hour and zipping his fly five times in the morning - but he simply cannot get rid of the obsession any other way. The level of anxiety is too high, and rituals allow the patient to achieve temporary relief. But at the same time, the love of rituals, lists, or putting things on shelves in itself, if it does not bring discomfort to a person, is not considered a disorder. From this point of view, aesthetes who diligently arrange carrot peelings lengthwise in Things Organized Neatly are absolutely healthy.

The biggest problems for OCD patients are obsessions of an aggressive or sexual nature. Some become afraid that they will do something bad to other people, including sexual assault and murder. Obsessive thoughts can take the form of individual words, phrases or even lines of poetry - a good illustration is the episode from the movie “The Shining”, where main character, going crazy, starts typing the same phrase “all work and no play makes Jack a dull boy” on a typewriter. A person with OCD experiences enormous stress - he is simultaneously horrified by his thoughts and tormented by a feeling of guilt for them, tries to resist them, and at the same time tries to ensure that the rituals he performs go unnoticed by others. In all other respects, his consciousness functions completely normally.

It is believed that obsessions and compulsions are closely related to “magical thinking” that arose at the dawn of humanity - the belief in the ability to take control of the world with the help of the right attitude and rituals. Magical thinking draws a direct parallel between a mental desire and a real consequence: if you draw a buffalo on the wall of a cave, setting yourself up for a successful hunt, you will certainly be lucky. Apparently, this way of perceiving the world originates in the deep mechanisms of human thinking: neither scientific and technological progress, nor logical arguments, nor sad personal experience proving the uselessness of magical passes free us from the need to look for relationships between random things. Some scientists believe that it is embedded in our neuropsychology - the automatic search for patterns that simplify the picture of the world helped our ancestors survive, and the most ancient parts of the brain still work according to this principle, especially in stressful situation. Therefore, when elevated level With anxiety, many people begin to fear their own thoughts, fearing that they may become reality, and at the same time believe that a set of some irrational actions will help prevent an undesirable event.

Story

In ancient times, this disorder was often associated with mystical causes: in the Middle Ages, people obsessed with obsessive ideas were immediately sent to exorcists, and in the 17th century, the concept was reversed - it was believed that such conditions arise due to excessive religious zeal.

In 1877, one of the founders of scientific psychiatry, Wilhelm Griesinger and his student Karl-Friedrich-Otto Westphal, found that the basis of “obsessive-compulsive disorder” is a disorder of thinking, but it does not affect other aspects of behavior. They used the German term Zwangsvorstellung, which, having been variously translated in Britain and the US (as obsession and compulsion respectively), became the modern name for the disease. And in 1905, the French psychiatrist and neurologist Pierre Marie Felix Janet isolated this neurosis from neurasthenia as a separate disease and called it psychasthenia.

Opinions varied about the cause of the disorder—for example, Freud believed that obsessive-compulsive behavior referred to unconscious conflicts that manifested themselves as symptoms, while his German colleague Emil Kraepelin classified it as “constitutional mental illnesses” caused by physical causes.

People who suffered from obsessive disorder included: famous people- for example, the inventor Nikola Tesla counted steps while walking and the volume of food portions - if he failed to do this, the lunch was considered spoiled. And entrepreneur and American aviation pioneer Howard Hughes was terrified of dust and ordered employees before visiting him to “wash themselves four times, each time using a large amount of foam from a new bar of soap.”

Defense mechanism

The exact causes of OCD are not clear even now, but all hypotheses can be divided into three categories: physiological, psychological and genetic. Proponents of the first concept associate the disease either with the functional and anatomical features of the brain, or with metabolic disorders (biologically active substances that transmit electrical impulses between neurons, or from neurons to muscle tissue) - primarily serotonin and dopamine, as well as norepinephrine and GABA. Some researchers have noted that many patients with obsessive-compulsive disorder had birth trauma at birth, which also confirms physiological reasons OCD.

Proponents of psychological theories believe that the disease is associated with personal characteristics, character, psychological trauma and incorrect reaction to negative impact environment. Sigmund Freud theorized that obsessive-compulsive symptoms are caused by defense mechanisms psyche: isolation, liquidation and reactive formation. Isolation protects a person from anxiety-causing affects and impulses, displacing them into the subconscious; elimination is aimed at combating the emerging repressed impulses - in fact, the compulsive act is based on it. And finally, reactive formation is the manifestation of patterns of behavior and consciously experienced attitudes that are opposite to emerging impulses.

There is also scientific evidence that genetic mutations contribute to OCD. They were found in unrelated families whose members suffered from OCD - in the serotonin transporter gene, hSERT. Studies of identical twins also confirm the existence of a hereditary factor. In addition, people with OCD are more likely to have close relatives with the same disorder than healthy people.

Maksim, 21 years old, suffers from OCD since childhood

It started for me at about 7-8 years old. The neurologist was the first to report the possibility of OCD; even then there was a suspicion of obsessive neurosis. I was constantly silent, spinning various theories in my head like “mental gum.” When I saw something that caused me anxiety, obsessive thoughts about it began, although the reasons seemed to be quite insignificant and, perhaps, would never have affected me.

At one time I had an obsessive thought that my mother might die. I replayed the same moment in my head, and it captured me so much that I could not sleep at night. And when I’m riding in a minibus or in a car, I constantly think that we’re going to get into an accident, that someone is going to crash into us, or that we’re going to fly off a bridge. A couple of times the thought arose that the balcony under me would fall apart, or that someone would throw me out of there, or that I myself would slip and fall in the winter.

We never really talked to the doctor, I just took different medications. Now I move from one obsession to another and follow some rituals. I am constantly touching something, no matter where I am. I walk from corner to corner throughout the room, straightening the curtains and wallpaper. Maybe I'm different from other people with this disorder, everyone has their own rituals. But it seems to me that those people who accept themselves as they are are luckier. They are much better off than those who want to get rid of it and are very worried about it.

Perseveration is a phenomenon of a psychological, mental or neuropathological nature, characterized by obsessive, frequent repetition of a physical action, word or whole phrase in written or oral speech, as well as certain emotions.

Depending on the nature of the manifestation, there are:

Perseveration of thinking. It is characterized by anchoring in a person’s mind a specific thought or a simple, uncomplicated idea, which often manifests itself in verbal communication. With a perseverative phrase or word, a person can answer questions that have absolutely nothing to do with it, speak it out loud to himself, and so on. A classic manifestation of perseveration of thinking is the constant return to a topic of conversation that has already been closed and is considered resolved,
Motor perseveration. The etiology of motor perseveration is associated with physical damage to the premotor nuclei of the cerebral cortex and motor subcortical layer. This type of perseveration is expressed in the repetition of one physical movement many times - elementary motor perseveration or a whole complex of movements with a clear algorithm - systemic motor perseveration.

Motor speech perseveration, when a person repeats the same word or writes it, can also be classified as a separate subtype of motor perseveration. This type of deviation is characterized by damage to the lower parts of the premotor nuclei of the cortex of the left hemisphere in right-handers and the right - in left-handers.

Fundamental factors and features of the genesis of perseverative deviations

The neurological etiology of perseveration is the most common, it is characterized by a wide range of atypical personality behavior due to physical damage to the cerebral hemispheres, which causes dysfunction in switching from one type of activity to another, changing the train of thought, the algorithm of actions for performing some task, and so on. when the perseverative component dominates objective actions or thoughts.

The causes of perseveration against the background of neuropathology include:

traumatic brain injury with predominant damage to areas of the lateral orbitofrontal cortex or its prefrontal convexity,
(aphasia - pathological condition, in which deviations occur in a person’s speech, which was already formed earlier. Occurs due to physical damage to the speech centers in the cerebral cortex as a result of traumatic brain injuries, tumors, encephalitis),
transferred localized pathologies in the area frontal lobes cerebral cortex, similar to aphasia.

Perseveration in psychology and psychiatry reflects the course of deviation against the background of psychological dysfunction in a person and, as a rule, is an additional sign of complex syndromes and phobias.

The occurrence of perseveration in a person who has not suffered traumatic brain injury and severe stress can serve as the first sign of the development of not only psychological, but mental disorders.

The main etiological factors of psychological and psychopathological directions in the development of perseverative manifestations may be:

obsessiveness and high selectivity of individual interests, which is most typical for persons with autism spectrum disorders,
a feeling of lack of attention against the background of hyperactivity can stimulate the manifestation of perseveration as a protective compensatory phenomenon aimed at attracting attention to oneself or one’s type of activity,
insistence on constant learning and the desire to learn new things can lead gifted individuals to become fixated on a specific judgment or type of activity. The line between persistence and perseveration is very blurred,
the complex of symptoms of obsessive-compulsive disorder often includes the development of perseverative deviations.

Obsessive-compulsive disorder is an obsession that causes a person to perform certain physical actions (compulsions) due to obsessive thoughts (obsessions). A striking example obsessive-compulsive disorder is frequent washing hands in fear of contracting a terrible infectious disease or taking various medications to prevent possible diseases.

Regardless of the etiological factors, perseveration must be differentiated from obsessive-compulsive disorder, normal human habits, and also from sclerotic memory disorders, when a person repeats the same words or actions due to forgetfulness.

Features of perseverative deviations in childhood

The manifestation of perseverations in childhood is a very common occurrence due to the characteristics of child psychology, physiology and a fairly active change life values child on different stages growing up. This creates certain difficulties in distinguishing perseverative symptoms from the child’s intentional actions, and also camouflages the manifestation of signs of more serious mental pathologies.

In order to early definition mental disorders in their child, parents should be more attentive to the manifestation of perseverative signs, the most common of which are:

regular repetition of the same phrases, regardless of the situation and the question posed,
the presence of certain actions that are repeated regularly: touching some place on the body, scratching, narrowly focused play activity, and so on,
drawing the same objects, writing the same word repeatedly,
regularly repeated requests, the need for fulfillment of which is questionable within a specific situation.

Help with perseverative deviations

The basis for the treatment of perseverative deviations is always a comprehensive psychological approach with alternating stages. Rather, it is a trial and error method than a standardized treatment algorithm. In the presence of neurological pathologies of the brain, treatment is combined with appropriate drug therapy. Among the drugs used are groups of weak sedatives central action, with the mandatory use of nootropics against the background of multivitaminization.

Main stages psychological assistance during perseveration, which can either alternate or be applied sequentially:

Waiting strategy. The fundamental factor in psychotherapy is perseveration. It consists of expecting any changes in the nature of the deviations due to the use of any therapeutic measures. This strategy is explained by the resistance of the symptoms of deviation to disappearance.
Prevention strategy. Often, perseveration of thinking gives rise to motor perseveration, and these two types begin to exist together, which makes it possible to prevent such a transition in a timely manner. The essence of the method is to protect a person from that physical activity, which he talks about most often.
Redirection strategy. A physical or emotional attempt by a specialist to distract the patient from obsessive thoughts or actions by abruptly changing the topic of conversation at the moment of the next perseverative manifestation, changing the nature of actions.
Limitation strategy. This method allows you to consistently reduce perseverative attachment by limiting a person in his actions. The limit allows obsessive activity, but in strictly defined volumes. A classic example is access to a computer for a strictly designated time.
Abrupt termination strategy. Aimed at actively eliminating perseverative attachments using the patient’s shock state. An example would be unexpected, loud statements “That's it! This is not the case! It doesn't exist! or visualization of harm from obsessive actions or thoughts.
Ignoring strategy. An attempt to completely ignore perseverative manifestations. The method is very good when etiological factor the violation was caused by a lack of attention. Without getting the desired effect, the patient simply does not see the point in his actions,
Understanding strategy. An attempt to find out the patient’s true train of thought at the time of deviations and in their absence. Often this helps the patient himself to put his actions and thoughts in order.

A peculiar distortion of the phonetic content of words occurs in oral and written speech according to the type of phenomena of progressive and regressive assimilation and is called, respectively: perseveration (stuckness) and anticipation (anticipation, anticipation): a consonant, and less often a vowel, replaces the repressed letter in a word.

Examples of perseverations in writing:

a) within the word: “shop”, “collective farm worker”, “behind the tire” (collective farmer, car);

b) within the phrase: “at Grandfather Modoz’s”;

c) within a sentence: “The girl fed the rooster and the chickens”: Examples of anticipation in a letter:

a) within the word: “on the maidens”, “on top of the roof”, “with birthplaces”.

b) within a phrase or sentence: “Streams are buzzing.” “We have it at home” - “We have it.” " “The kitten meowed pitifully” - pitifully. "

Perseveration and anticipation of a syllable (and even a word) is possible: “stepped” - stepped, “descended” - descended; "melgo small fish" - a lot of small fish. The basis of the errors of these two types is the weakness of differential inhibition.

Dictionary of speech therapy terms

Automation (of sound) is the stage of correcting incorrect sound pronunciation, which follows after setting a new sound; aimed at forming correct pronunciation sound in connected speech; consists in the gradual, consistent introduction of a given sound into syllables, words, sentences and into independent speech.

Automated speech sequences are speech actions implemented without the direct participation of consciousness.

Agnosia is a violation of various types of perception that occurs with certain brain lesions. There are visual, tactile, and auditory agnosias.

Agrammatism is a violation of the understanding and use of grammatical means of a language.

Adaptation is the adaptation of an organism to living conditions.

Acalculia is a violation of counting and counting operations as a result of damage to various areas of the cerebral cortex.

Alalia is the absence or underdevelopment of speech in children with normal hearing and initially intact intelligence due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of the child’s development.

Alexia is the impossibility of the reading process.

Amorphous words are grammatically unchangeable root words, “abnormal words” of children's speech - words-fragments (in which only parts of the word are preserved), words-onomatopoeia (words-syllables that the child uses to designate objects, actions, situations), contour words ( in which stress and number of syllables are correctly reproduced).

Amnesia is a memory disorder in which it is impossible to reproduce ideas and concepts formed in the past.

Anamnesis is a set of information (about a person’s living conditions, events preceding the disease, etc.) obtained during the examination from the person being examined and (or) persons who know him; used to establish a diagnosis, prognosis of the disease and select corrective measures.

Ankyloglossia is a shortened hypoglossal ligament.

Anticipation – the ability to foresee the manifestation of the results of an action, “anticipatory reflection”, for example, premature recording of sounds included in the final motor acts.

Apraxia is a violation of voluntary purposeful movements and actions that are not a consequence of paralysis and cuts, but related to disorders top level organization of motor acts.

Articulation is the activity of the speech organs associated with the pronunciation of speech sounds and their various components that make up syllables and words.

The articulatory apparatus is a set of organs that ensure the formation of speech sounds (articulation), including the vocal apparatus, muscles of the pharynx, larynx, tongue, soft palate, lips, cheeks and lower jaw, teeth, etc.

Ataxia is a disorder/lack of coordination of movements.

Atrophy is pathological structural changes in tissues associated with inhibition of metabolism (due to a disorder in their nutrition).

Asphyxia - suffocation of the fetus and newborn - cessation of breathing with continued cardiac activity due to a decrease or loss of excitability of the respiratory center.

Audiogram – graphic image data from a hearing test using a device (audiometer).

Aphasia is a complete or partial loss of speech caused by local lesions of the brain. See also video lessons “Forms of aphasia and methods of speech restoration.”

Main forms of aphasia:

acoustic-gnostic (sensory) – violation of phonemic perception;
acoustic-mnestic – impairment of auditory-verbal memory;
semantic – impaired understanding of logical and grammatical structures;
afferent motor – kinesthetic and articulatory apraxia;
efferent motor – violation of the kinetic basis of series of speech movements;
dynamic – violation of the sequential organization of utterances, planning of utterances.

Afferent kinesthetic praxis is the ability to reproduce isolated speech sounds, their articulatory patterns (postures), which are often also called speech kinesthesia or articulomes.

Aphonia – lack of sonority of the voice while maintaining whispered speech; The immediate cause of aphonia is the failure of the vocal folds to close, resulting in air leakage during phonation. Aphonia occurs as a result of organic or functional disorders in the larynx, with a disorder of the nervous regulation of speech activity.

Bradylalia is a pathologically slow rate of speech.

Broca's Center is a section of the cerebral cortex located in the posterior third of the inferior frontal gyrus of the left hemisphere (in right-handed people), providing motor organization of speech (responsible for expressive speech).

Wernicke Center is an area of the cerebral cortex in the posterior part of the superior temporal gyrus of the dominant hemisphere, providing speech understanding (responsible for impressive speech).

Gammacism is a lack of pronunciation of the sounds [Г], [Гь].

Hemiplegia is paralysis of the muscles of one half of the body.

Hyperkinesis - automatic violent movements due to involuntary muscle contractions.

Hypoxia is oxygen starvation of the body. Hypoxia in newborns is a fetal pathology that develops during pregnancy (chronic) or childbirth (acute) due to oxygen deficiency. Lack of oxygen supply to the fetus at the beginning of pregnancy can cause delays or disturbances in fetal development, and later affects the baby’s nervous system, which can significantly affect speech development.

The following factors may put you at risk for developing hypoxia:

presence of anemia, STDs, as well as serious illnesses respiratory or cardiac vascular system from the expectant mother;
disturbances in the blood supply to the fetus and labor activity, gestosis, post-term pregnancy;
pathologies of the fetus and Rh conflict between mother and baby;
smoking and drinking alcohol by a pregnant woman.

Also, the green color of amniotic fluid indicates oxygen deficiency.

If the doctor suspects hypoxia, he may decide whether a cesarean section is necessary. Newborn with severe oxygen starvation is reanimated, and with mild degree receives oxygen and medications.

Dysarthria is a violation of the pronunciation side of speech, caused by insufficient innervation of the speech apparatus.

Dyslalia is a violation of sound pronunciation with normal hearing and intact innervation of the speech apparatus.

Dyslexia is a partial specific disorder of the reading process, caused by the immaturity (impairment) of higher mental functions and manifested in repeated persistent errors.

Dysgraphia is a partial specific disorder of the writing process, caused by the immaturity (impairment) of higher mental functions and manifested in repeated errors of a persistent nature.

Speech development delay (SSD) is a lag in speech development from age norm speech development up to 3 years of age. From 3 years of age and older, the immaturity of all components of speech is classified as GSD (general speech underdevelopment).

Stuttering is a violation of the tempo-rhythmic organization of speech, caused by the convulsive state of the muscles of the speech apparatus.

Onomatopoeia is a conditional reproduction of natural sounds and sounds that accompany certain processes (laughter, whistling, noise, etc.), as well as animal cries.

Impressive speech – perception, understanding of speech.

Innervation is the provision of organs and tissues with nerves and, therefore, communication with the central nervous system.

Stroke – caused by a pathological process acute disorder cerebrovascular accident (CVA) with the development of persistent symptoms of damage to the central nervous system. Hemorrhagic stroke is caused by hemorrhage in the brain or its membranes, ischemic stroke is caused by the cessation or significant reduction of blood supply to a part of the brain, thrombotic stroke is caused by blockage of a cerebral vessel with a thrombus, embolic stroke is caused by blockage of a cerebral vessel by an embolus.

Kappacism is a lack of pronunciation of the sounds [К], [Кь].

Kinesthetic sensations are sensations of the position and movement of organs.

Compensation is a complex, multidimensional process of restructuring mental functions in the event of disruption or loss of any body functions.

Contamination is the erroneous reproduction of words, which consists of combining syllables belonging to different words into one word.

Lambdacism is the incorrect pronunciation of the sounds [L], [L].

Speech therapy is the science of speech disorders, methods of their prevention, identification and elimination by means of special training and education.

Speech therapy massage is one of the speech therapy techniques that helps normalize the pronunciation side of speech and emotional state persons suffering from speech disorders. Speech therapy massage is part of a comprehensive medical and pedagogical system of rehabilitation for children, adolescents and adults suffering from speech disorders.

Logorrhea is an uncontrolled, incoherent flow of speech, often representing an empty collection of individual words, devoid of logical connection. Observed in sensory aphasia.

Logorhythmics is a system of motor exercises in which various movements combined with the pronunciation of special speech material. Logorhythmics is a form of active therapy, overcoming speech and associated violations through the development and correction of non-speech and speech mental functions.

Localization of functions - according to the theory of systemic dynamic localization of higher mental functions, the brain is considered as a substrate consisting of departments differentiated by their functions, working as a single whole. Local – local, limited to a certain area, area.

Macroglossia – pathological enlargement of the tongue; observed with abnormal development and in the presence of chronic language pathological process. With M., significant pronunciation disturbances are observed.

Microglossia is a developmental anomaly, small size of the tongue.

Mutism is the cessation of verbal communication with others due to mental trauma.

Speech disorders are deviations in the speaker’s speech from the language norm accepted in a given language environment, manifested in partial (sound pronunciation, voice, tempo and rhythm, etc.) disorders and caused by disorders normal functioning psychophysiological mechanisms of speech activity.

Neuropsychology is the science of the brain organization of higher mental functions of a person. N. studies psychological structure, brain organization of non-speech HMFs and speech function. N. studies disorders of speech and other HMF depending on the nature of brain damage (local, diffuse, interzonal connections), as well as the diagnosis of these disorders and methods of correctional and rehabilitation work.

General speech underdevelopment (GSD) is a variety of complex speech disorders in which children have impaired formation of all components of the speech system related to its sound and semantic side, with normal hearing and intelligence.

Reflected speech is speech repeated after someone.

Finger games are a generally accepted name for activities to develop fine motor skills in children. Finger games develop fine motor skills, and its development stimulates the development of certain areas of the brain, in particular speech centers.

Paraphasia is a violation of speech utterances, manifested in omissions, erroneous replacement or rearrangement of sounds and syllables in words (literal paraphasia, for example, mokolo instead of milk, cheekbones instead of chair) or in the replacement of necessary words with others that are not related to the meaning of the utterance (verbal paraphasia) in oral and written speech.

Pathogenesis is the mechanism of development of a specific disease, pathological process or condition.

Perseverations are cyclical repetition or persistent reproduction, often contrary to the conscious intention of any actions, thoughts or experiences.

Prenatal period – pertaining to the period before birth.

Speech decay is the loss of existing speech and communication skills due to local lesions brain

Reflex - in physiology - a natural response of the body to a stimulus mediated by the nervous system.

Disinhibition is the cessation of the state of internal inhibition in the cerebral cortex under the influence of extraneous stimuli.

Disinhibition of speech in children - activation of speech development in children with delayed speech development.

Disinhibition of speech in adults – restoration of speech function in speechless patients.

Rhinolalia is a violation of voice timbre and sound pronunciation, resulting from excessive or insufficient resonance in the nasal cavity during speech. Such a violation of resonance occurs from the incorrect direction of the voice-exhalatory stream due to either organic defects of the nasopharynx, nasal cavity, soft and hard palate, or disorders of the function of the soft palate. There are open, closed and mixed rhinolalia.

Rotacism is a disorder in the pronunciation of the sounds [P], [Rb].

Sensory – sensitive, feeling, relating to sensations.

Sigmatism is a disorder in the pronunciation of whistling ([С], [Сь], [З], [Зь], [Ц]) and hissing ([Ш], [Х], [Ч], [Ш]) sounds.

Syndrome is a natural combination of signs (symptoms) that have general pathogenesis and characterizing a certain painful condition.

Somatic is a term used to designate various kinds of phenomena in the body associated with the body, as opposed to the psyche.

Conjugate speech is the joint simultaneous repetition by two or more persons of words or phrases spoken by someone.

Cramps – involuntary contractions muscles that occur with epilepsy, brain injuries, spasmophilia and other diseases. Convulsions are characteristic of a state of excitation of subcortical formations and can be caused reflexively.

Clonic seizures are characterized by rapid alternations between muscle contraction and relaxation. Tonic cramps are characterized by prolonged muscle contraction, which causes a prolonged forced tense position.

Tahilalia is a speech disorder, expressed in excessive speed of its tempo (20-30 sounds per second), related in nature to battarism. In contrast to the latter, tachylalia is a deviation from normal speech only in relation to its tempo, with full preservation of phonetic design, as well as vocabulary and grammatical structure.

Tremor – rhythmic oscillatory movements of the limbs, head, tongue, etc. with damage to the nervous system.

Phonetic-phonemic underdevelopment - a violation of the process of formation of the pronunciation system native language in children with various speech disorders due to defects in the perception and pronunciation of phonemes.

Phonemic analysis and synthesis are mental activities of analyzing or synthesizing the sound structure of a word.

Phonemic hearing is a subtle, systematized hearing that has the ability to carry out operations of discrimination and recognition of phonemes that make up the sound shell of a word.

Phoniatrics is a branch of medicine that studies dental problems and pathology. vocal cords and larynx, leading to voice disorders (dysphonia), methods of treatment and prevention of voice disorders, as well as methods for correcting a normal voice in the desired direction. Voice disturbances can also occur as a result of certain psychological disorders. The solution to some problems in phoniatrics is closely related to the problems of speech therapy.

Cerebral – cerebral, belonging to the brain.

Expressive speech is active oral and written expression.

Extirpation (of the larynx) – removal.

An embolus is a substrate circulating in the blood that is not found under normal conditions and can cause blockage of a blood vessel.

Speech embolus is one of the most common words, part of a word or short phrase before the disease, repeated many times by the patient when trying to speak. It is one of the speech symptoms of motor aphasia.

Etiology is the cause of a disease or pathological condition.

Efferent kinetic praxis is the ability to produce a series of speech sounds. Efferent articulatory praxis is fundamentally different from afferent one in that it requires the ability to switch from one articulatory posture to another. These switches are complex in the way they are executed. They involve mastering inserted fragments of articulatory actions - coarticulations, which are “connections” between individual articulatory poses. Without coarticulation, a word cannot be pronounced, even if every sound included in it is available for reproduction.

Echolalia is the involuntary repetition of heard sounds, words or phrases.

Where did you get the idea that with alalia, intellect is primarily preserved. Volkova, Kornev, Kovshikov just note the possibility of UO in children with alalia. And from the definition of alalia, it in no way follows that the intellect is primarily preserved. You are confusing with the definition of OHP.

This definition was accepted in speech therapy and was published in the “Conceptual and Termenological Dictionary of Speech Therapist” edited by V. I. Seliverstov (Reviewers: academician of the Russian Academy of Education, doctor psychological sciences, Professor V.I. Lubovsky, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Education, Doctor of Psychological Sciences, Professor V.A. Slastenin, Honored Scientist of the Russian Federation, Academician of the Academy of Sciences, Doctor of Pedagogical Sciences, Professor L.S. Volkova, Doctor medical sciences, Professor E.M. Mastyukova). You can argue with these respected experts.

Read the definitions more carefully. With mental retardation, alalia can appear, but alalia can also appear with initially intact intelligence - due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of the child’s development ( this definition published in the classic textbook “Speech Therapy. Textbook for Universities")

The speech therapist should clearly understand that alalia does not equate to mental retardation and carry out an accurate diagnosis of the child. This is extremely important for constructing correctional work; it is necessary to distinguish between such diagnoses and be well aware of the difference between these concepts. Naturally, serious violations speech during alalia can lead to a delay in some mental processes, but specifically to mental retardation, and not to mental retardation.

Alalia is an independent diagnosis that can be diagnosed both in cases of mental retardation and in children with primarily intact intelligence.

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What is perseveration? The concept of perseveration in speech therapy and psychology

Perseveration refers to psychological, mental and neuropathological phenomena in which there is an obsessive and frequent repetition of actions, words, phrases and emotions. Moreover, repetitions appear both in oral and written form. Repeating the same words or thoughts, a person often does not control himself when communicating verbally. Perseveration can also manifest itself in nonverbal communication based on gestures and body movements.

Manifestations

Based on the nature of perseveration, they distinguish the following types its manifestations:

Perseveration of thinking or intellectual manifestations. It is distinguished by the “settling” in the human creation of certain thoughts or its ideas, which manifest themselves in the process verbal communication. A perseverative phrase can often be used by a person when answering questions to which it has absolutely nothing to do. Also, a person with perseveration can pronounce such phrases out loud to himself. Characteristic manifestation This type of perseveration is a constant attempt to return to the topic of conversation, which has long been stopped talking about or the issue in it has been resolved.
Motor type of perseveration. Such a manifestation as motor perseveration is directly related to a physical disorder in the premotor nucleus of the brain or subcortical motor layers. This is a type of perseveration that manifests itself in the form of repeating physical actions repeatedly. This can be either the simplest movement or a whole complex of different body movements. Moreover, they are always repeated equally and clearly, as if according to a given algorithm.
Speech perseveration. It is classified as a separate subtype of the motor type perseveration described above. These motor perseverations are characterized by constant repetition of the same words or entire phrases. Repetition can manifest itself in oral and written form. This deviation is associated with lesions of the lower part of the premotor nucleus of the human cortex in the left or right hemisphere. Moreover, if a person is left-handed, then we are talking about damage to the right hemisphere, and if a person is right-handed, then, accordingly, to the left hemisphere of the brain.

Reasons for the manifestation of perseveration

There are neuropathological, psychopathological and psychological reasons development of perseveration.

Repetition of the same phrase, caused by the development of perseveration, can occur against the background of neuropathological reasons. These most often include:

Traumatic brain injuries that damage the lateral region of the orbitofrontal cortex. Or is it related to physical types damage to the frontal convexities.
For aphasia. Perseveration often develops against the background of aphasia. It is a condition characterized by pathological deviations of previously formed human speech. Similar changes occur in the event of physical damage to the centers in the cerebral cortex responsible for speech. They can be caused by trauma, tumors or other types of influences.
Transferred local pathologies in the frontal lobe of the brain. These may be similar pathologies, as is the case with aphasia.

Psychiatrists, as well as psychologists, call perseveration deviations of a psychological type that occur against the background of dysfunctions occurring in the human body. Often, perseveration acts as an additional disorder and is an obvious sign of the formation of a complex phobia or other syndrome in a person.

If a person shows signs of developing perseveration, but has not suffered severe forms of stress or traumatic brain injury, this may indicate the development of both psychological and mental forms of deviation.

If we talk about the psychopathological and psychological reasons for the development of perseveration, there are several main ones:

Tendency to increased and obsessive selectivity of interests. Most often this manifests itself in people characterized by autistic disorders.
The desire to constantly learn and learn, to learn something new. It occurs mainly in gifted people. But the main problem is that that person may become fixated on certain judgments or his activities. The existing line between perseveration and such a concept as perseverance is extremely insignificant and blurred. Therefore, with an excessive desire to develop and improve oneself, serious problems can develop.
Feeling of lack of attention. Occurs in hyperactive people. The development of perseverative inclinations in them is explained by an attempt to attract increased attention to themselves or their activities.
Obsession with ideas. Against the background of obsession, a person can constantly repeat the same physical actions caused by obsession, that is, obsession with thoughts. The simplest, but very understandable example of obsession is the desire of a person to constantly keep his hands clean and wash them regularly. A person explains this by saying that he is afraid of contracting terrible infections, but such a habit can develop into a pathological obsession, which is called perseveration.

It is important to be able to distinguish when one person simply has strange habits in the form of the same constant hand washing, or it is obsessive-compulsive disorder. It is also not uncommon for repetitions of the same actions or phrases to be caused by a memory disorder, and not by perseveration.

Features of treatment

There is no universally recommended treatment algorithm for perseveration. Therapy is carried out based on the use of a whole complex different approaches. One method should not be used as the only method of treatment. It is necessary to take new methods if the previous ones did not produce results. Roughly speaking, treatment is based on constant trial and error, which ultimately allows you to find optimal method impact on a person suffering from perseveration.

The presented methods of psychological influence can be applied alternately or sequentially:

Expectation. It is the basis in psychotherapy for people suffering from perseveration. The point is to wait for a change in the nature of the deviations that arise during application various methods impact. That is, the waiting strategy is used in conjunction with any other method, which we will discuss below. If there are no changes, move on to others psychological methods impact, expect results and act according to circumstances.
Prevention. It is not uncommon for two types of perseveration (motor and intellectual) to occur together. This makes it possible to prevent such changes in time. The essence of the technique is based on the exclusion of physical manifestations that people most often talk about.
Redirection. This is a psychological technique based on a sharp change in ongoing actions or current thoughts. That is, when communicating with a patient, you can suddenly change the topic of conversation or move from one physical exercise or movement to another.
Limitation. The method is aimed at consistently reducing a person’s attachment. This is achieved by limiting repetitive actions. A simple but clear example is to limit the amount of time a person is allowed to sit at a computer.
Abrupt cessation. This is a method of actively getting rid of perseverative attachment. This method is based on the effect of introducing the patient into a state of shock. This can be achieved through harsh and loud phrases, or by visualizing how harmful the patient’s obsessive thoughts or movements or actions can be.
Ignoring. The method involves completely ignoring the manifestations of the disorder in a person. This approach manifests itself the best way, if the violations were caused by attention deficit. If a person does not see the point in what he is doing, since there is no effect, he will soon stop repeating obsessive actions or phrases.
Understanding. Another relevant strategy with which the psychologist recognizes the patient’s train of thought in case of deviations or in the absence of them. This approach often allows a person to independently understand his thoughts and actions.

Perseveration is a fairly common disorder that can be caused by various reasons. When perseveration occurs, it is important to choose a competent treatment strategy. Medication is not used in this case.

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Terms that are used in speech therapy, defectology, psychology, neurology.

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Motor alalia - underdevelopment of expressive speech with fairly intact speech understanding;

Sensory alalia - underdevelopment of impressive speech, when there is a gap between the meaning and the sound envelope of words; the child’s understanding of the speech of others is impaired, despite intact hearing and the ability to develop active speech;

A speech pathologist-speech therapist is a specialist with higher education in the field of study, training, and socialization of people with speech disorders

Physiological iteration is the repetition by children of certain sounds and (or) syllables, due to age-related imperfections in the activity of the auditory and speech motor analyzers during the period of speech formation in preschool childhood.

Nystagmus is involuntary rhythmic convulsive movements of the eyeballs.

Nootropics are medications that improve the nutrition of nerve cells.

A passive dictionary is a stock of understandable words.

Tonic cramps are prolonged muscle contractions due to a single impulse.

Perseveration is a phenomenon that is characterized by a psychological, mental or neuropathological disorder of human behavior and speech. Perseveration manifests itself through the constant repetition of an action, phrase, idea, idea or experience. This constancy sometimes turns into an annoying, uncontrollable form; the person himself does not even notice it or is not aware of the phenomenon happening to him.

Such behavior in actions or speech is possible not only with mental or neurological abnormalities. There are often cases when perseveration was noted in a person due to overwork or distraction.

Perseveration most often occurs due to physical impact on the brain. In this case, a person experiences difficulties in switching attention from one object to another or from one action to another. The main neurological causes of perseveration are:

What psychological problems lead to perseveration?

In addition to neurological reasons that are associated with physical damage to the brain or the influence of diseases on it, there are also psychological reasons for the occurrence of perseveration.

Perseveration should be distinguished from other diseases or stereotypical human actions. Repetitive actions or words can be a manifestation of sclerosis, OCD (obsessive-compulsive disorder), regular habit, subjective obsessive phenomena. With obsessive phenomena, patients realize that their behavior is a little strange, ridiculous, and senseless. With perseveration there is no such awareness.

Symptoms

Depending on how perseveration manifests itself, experts distinguish motor and mental (intellectual) forms.

With motor perseveration, a person constantly repeats the same movement. Sometimes you can see a whole system of repetitive actions in a patient. Such actions have a certain algorithm that does not change for a long time. For example, when having difficulty opening a box, a person constantly hits it on the table, but this leads to nothing. He understands the pointlessness of such behavior, but repeats these actions. Children may constantly call a new teacher by the name of the previous one, or look for a toy where it was stored before, but its storage location has long been changed.

Intellectual perseveration is characterized as an abnormal stuckness of ideas and judgments. It is expressed through the constant repetition of phrases or words. This form of the disease is easily diagnosed when the specialist asks several questions, and the patient answers everything with the very first answer. In a mild form, perseveration can be observed when a person constantly returns to the discussion of a long-resolved issue, the topic of conversation.

Doctors draw the attention of parents to the need to monitor their child’s behavior to see if he has any even the most minor perseverations.

The Positive Side of Persistent Repetition

It is believed that obsessive repetitions of thoughts or actions characterize a person as sick or abnormal. But almost every one of us has been subject to perseveration at least once in our lives. But in people without additional neurological or psychiatric dysfunctions, this state is called careful analysis, worry, perseverance.

Sometimes repetition of thoughts or actions helps people adapt to a particular situation. Perseveration is useful or at least not pathological when:

a person needs to understand something in detail;
pacify strong emotions and overcome psychological trauma;
a person tries to remember something for a long time;
you need to see something new in an already known fact;
take into account all the probabilities of the phenomenon.

Persistent repetition is useful during learning when it does not interfere with achieving goals. In other cases, this phenomenon requires correction or treatment.

Treatment

It is a known fact that perseverations accompany some mental or neurological diseases, such as Alzheimer's disease, arteriosclerosis, genuine epilepsy, organic dementias, Down syndrome, OCD, autism. If you have a history of such diseases, then you first need to treat the root cause of frequent recurrences with medication.

Medicines for perseveration

As a symptom, perseveration cannot be treated, but thanks to drug therapy of the underlying disease, its intensity is reduced. Neuroleptics are often used for the above diseases. This is a group of drugs that have a calming effect.

With their constant use, a person does not react to external stimuli in the same way, that is, excessive experience of situations goes away, which can cause annoying repetition of actions or thoughts. Decreasing psychomotor agitation, aggressiveness is weakened, the feeling of fear is suppressed. Some antipsychotics are used as sedatives, while others, on the contrary, are used when it is necessary to activate mental functions. Each drug is selected individually by the doctor.

Along with the use of drugs, it is important to provide psychotherapeutic support to the person, especially if perseverations are caused by stress and other psychological factors.

Psychotherapeutic assistance

Before conversations and the use of psychotherapy, psychological tools are used to diagnose the patient’s condition. This is a technique that includes 7 subtests that help assess the degree of pathological manifestations in the patient’s behavior and thoughts. After this, the need for medication assistance and direction in psychotherapeutic work with him are determined.

When working psychotherapeutically with a patient, it is important to teach him new mental and motor skills, as well as create rational attitudes and support existing ones. positive characteristics person to overcome constant repetitions in actions, conversation and thoughts. For this, the following methods and techniques can be used (their use can be done in sequence or alternated).

Persistent and annoying repetitions often interfere with a person’s life. In this case, you need the help of a specialist who will determine the need to use medications and also help you get rid of such a phenomenon as perseveration with the help of psychotherapeutic methods.

Timely and qualified assistance with persistent repetition of actions, ideas, thoughts and phrases will help a person better adapt to the reality around him.

anonymous, Male, 5 years old

Hello! My child, at about 4.5 years old, began repeating the endings of words (last syllables) several times during a conversation. for example: “the girl is getting ready” or “potato”, his “name”. Now he is 5.5 and the situation has not changed. Sometimes this doesn’t happen, I can’t trace the pattern (it’s not associated with anxiety or fatigue, it’s just that this phenomenon is observed more often, and sometimes not). The opinions of speech therapists were divided. One said that this is a form of stuttering, but it does not work with such a problem, the other said that this is not stuttering, but perservation, that is, it is associated with thinking, but also does not know how to help the child. In general, he speaks well, there are slight defects in sound pronunciation ("r" sometimes speaks in his throat, sometimes with his tongue, sometimes he confuses "sh, zh" and "s, z", he does not always clearly pronounce "l" and there are agrammatisms). I have a question. due to this. Are such repetitions stuttering or persistence, and how can you help your child?

Hello. It’s a little difficult for me to answer you, because I don’t work directly with iterations (preservation). Then, again, like most mothers. You don't report anything about your medical history. Let's try to figure it out, but I warn you right away, this is just an attempt, since there is no way to see the child, nor is there any information about the development. It’s also unclear, but have you been? I understood with speech therapists, but here I need a consultation with a psychologist and a neurologist. You can’t do without a full-fledged PMPK. Now a little about sound pronunciation. The throat sound R, if it doesn’t bother you, then fine... The main thing is that the child hears it, identifies it, and relates it to the letter. Why aren't the other sounds automated? I understand that there are violations of word formation and syllable structure? Why? neurology? Then are we already talking about ZPRR? but at the same time, thinking, memory, attention, and perception really suffer. .Uneven development of the child’s thinking and speech abilities. Speech hesitations here are the result of age-related insufficiency in coordinating thinking and speech or age-related imperfections in the child’s speech apparatus, his vocabulary, expressive means(physiological hesitation). Delays psychophysical development may arise as a result of previous illnesses, injuries, or unfavorable heredity. There is no information from you about this. Physiological iterations are the repetition by children of certain sounds or syllables, which is caused by age-related imperfections in the activity of the auditory and speech motor analyzers. This imperfection usually manifests itself during the period of speech formation, and scientists believe that iterations can appear not only in preschool age, but also much earlier - during the period of the child’s first words, and sometimes even earlier - during the “cooing” period. In the literature you can find another name for physiological iterations - perseveration, which literally translates as “stuckness”. The reason for perseverations lies in the peculiarities of consolidating words, concepts and phenomena in memory. The fact is that in preschool age, the auditory and kinesthetic images of a number of words are not clear enough, so the child can simply reproduce them by mistake, correct himself, repeat a more accurate version, and therefore rearrange or repeat sounds, syllables, etc. Experts attribute such inaccuracies and repetitions to age-related disorders of the tempo-rhythmic side of oral speech, when iterations are the most characteristic and striking shortcomings during the period of phrase formation, that is, after two years. When a child grows, his perception is not limited to the minimum: there are so many interesting and new things around, the names of which the child simply does not yet know, but really wants to know, and therefore all the words spoken by adults are correlated with the objects denoted by these words and are assimilated (remembered). precisely in sound and object correlation). But the speech apparatus is not yet fully formed, and therefore thinking simply outstrips the speech capabilities of the talker, because of this, these very physiological hesitations and repetitions occur, as if correcting itself. In addition, speech breathing is also imperfect (it has not yet been formalized), and the ability to pronounce long phrases is psychologically difficult due to the fact that the motor implementation of speech lags behind the mental side of speech activity. Conclusion? I don’t know the medical history, there is no neurologist’s report, so each speech therapist is right in his own way, and they have more information about your child than I do. The advice I can give is advisory in nature, but if you follow it strictly, then, I hope, it will help. 1. Do not show concern caused by the appearance of convulsive stuttering in a child; Do not discuss the problem that has arisen in front of your child. 2. Normalize the child’s sleep and diet: prolonged sleep is desirable. “Ritualize” your child’s daily routine during this period as much as possible. 3. If the environment contributed to the appearance of hesitations, then try to change it to a calmer one. 4. Do not interrupt or stop the child if he starts talking. 5. Watch your speech: speak smoothly, taking pauses. Do not yell at your child during this period under any circumstances! 6. Make a list of situations, environments, people around you that increase or provoke hesitation in your child. Try to avoid what is on your list. 7. In case of acute onset of stuttering, completely eliminate watching TV (including other family members should not watch it in front of the child) and computer games. 8. Withdrawal nervous tension Playing with water and sand (in winter - with snow) is encouraged. 9. Try not to make critical comments (as much as possible) or ask questions of the child during this period. 10. Strive not to be separated from your child for a long time and spend as much time with him as possible. 11. For some time, you should also avoid somatic overload: do not attend sports sections for some time. 12. Coordinated uniform educational influences in the family are especially important. 13. Children should not be “trained” to be brave. Do not provoke the consolidation and strengthening of fears in the child. 14. A child should not be punished for errors in speech, imitated or corrected irritably. 15. You should rid the child of the fears that have arisen in him, and not allow the child to fixate on them: for example, in the form of some stains, you can depict what scared the child on the tiles in the bathroom, so that the child can then wash off this image with a stream of shower. 16. Harmonization of the child’s condition by using paints of different colors. Drawing on wet paper, using light tones of paint, and blurring the image soften the child’s condition. Yellow color invigorates, activates the mental sphere, blue calms emotions. Black, gray, and brown colors should not be used in joint drawing. 17. To overcome excessive timidity, it is useful to draw on large sheets of paper with a wide brush, use thick paint, and draw with your hands. 18. To prevent stuttering, it is useful to stimulate a child’s positive attitude towards events occurring at home; for this purpose, parents can be recommended to jointly draw situations that are pleasant for the child. home life (birthday, walk together, grandma frying pancakes). 19. To organize the rhythm of the day, as well as overcome possible attention deficits, it is useful to use “visual organization of the day” in the form of a child’s activity schedule. 20. It is useful to learn children's songs with children and sing with the child. 21. It is advisable to avoid verbal contact with the child (silence mode), replacing it with non-verbal (at least for two weeks). To communicate with your child, actively use pictures, pictograms, and symbolic objects. However, if a child begins to speak, then one cannot forbid him, one should only strive to transform his monologue form of speech into a dialogic one. 22. If a child resists fulfilling any of your demands, you should switch his attention to another activity. 23. In case of acute onset of stuttering, any emotionally significant situations for the child should be avoided: for example, a trip to the grandmother, whom the child has not seen for a long time; PMPK; first trip to kindergarten. 24. Do not require the child to pronounce “difficult” words, sentences that are long and complex in their grammatical structure; In case of acute onset of stuttering, do not conduct classes to correct sound pronunciation. 25. Stuttering is most likely when pronouncing low-frequency words, so you should limit the child from perceiving such words during the acute onset of stuttering, so that he does not have the desire to “ask again.” 26. Carry out breathing exercises daily: to develop physiological and phonation breathing. The main task: increasing the volume of inhalation and the duration of exhalation. 27. It is useful to read and memorize short, simple poems that are age-appropriate for children. 28. The choice of books to read to children should be limited and strictly age appropriate. Don't strive for quantity. It is better to read one fairy tale to your child during the week, but in different books. 29. Practice motor games with rhythmic movements every day. 30. When entering school, some children may experience a relapse of stuttering. Parents should alert teachers at school about the problem. You should not ask the child first, insist on an answer if the child is silent, or demand detailed oral answers from him. At first, it is recommended to challenge the little schoolchild to give answers in front of the class only by reading poetry. 31. To prevent relapses of stuttering: when a child is weakened after somatic or infectious diseases, it is necessary to carry out a gentle general and speech regimen.

anonymously

Hello! Thank you for such a detailed answer. I'm updating the information. The child works with a speech therapist in kindergarten after completing the PMPK. Conclusion PMPK - ONR level 3. Classes with a speech therapist (due to unsteady sounds) and a teacher-psychologist (due to signs of hyperactivity and attention deficit) are recommended. The neurologist writes an REP with signs of motor disinhibition. EEG conclusion: Displacement M-echo D-S = 0.25 mm (between d and s arrow towards s, I just don’t know where this icon is on the computer) Indirect signs intracranial hypertension. I was sent to the commission due to problems with sounds, which I wrote above. BUT perservations appeared later. In general, the child has a good memory for his age (both visual and auditory), is inquisitive, and knows enough for his age. Fine motor skills are worse (he is the only one in the group who knows how to tie shoelaces, but drawing anything (even a very simple one) with a pencil, for example, or with paints is very difficult). Moreover, when he expresses his thoughts, it is sometimes difficult to understand him (not by sounds, but by semantic content). He completed the intelligence tests (which were offered to him at the PMPC) with ease; he only had to constantly draw attention to the task, since he was very distracted. Situations of repetition of the last syllables in a word are not associated with excitement and not with new or difficult words. The only regularity is that over time this has become more frequent. If at the very beginning (six months ago) you could hear it 4-5 times a day, now it’s much more common - in every sentence, almost every word. When all this first appeared, I followed the path that you indicated - not to focus attention, reduce the load on the child, optimize the regime, use games to relieve tension, breathing. He knows a lot of poems, memorizes them quickly (I just read to him every day what he asks for, and then he remembers it 2-4 times later). There are no repetitions of syllables in the poems. But if he wants to tell me some story himself or his favorite fairy tale, then very much so. They have morning performances in the kindergarten. When they are preparing for matinees, during this period he tells us in roles at home what each child says and what he does. At the matinee he speaks the words assigned to him calmly, with expression (and without repeating syllables). It turns out that repetitions of the last syllables appear in ordinary everyday spontaneous speech. When I first asked a speech therapist about this, she replied that it was similar to stuttering, but she didn’t work with it. And the second speech therapist, who had experienced stuttering, said that it was not stuttering, so she could not help. This is a perservation and the question is not for the speech therapist.

Hello. I began to wonder what was happening. I repeat, I don’t work with stuttering; we don’t have kids like that at school. What I read and tried to understand. this is very similar to perservation. And a speech therapist can only indirectly help here. I found an article, take a look, maybe it will be useful? In general, we need an experienced neurologist who knows this problem. I know such people only at IKP RAO, but for sure there are others in other places! Help with perseverative deviations The basis for the treatment of perseverative deviations is always a comprehensive psychological approach with alternating stages. Rather, it is a trial and error method than a standardized treatment algorithm. In the presence of neurological pathologies of the brain, treatment is combined with appropriate drug therapy. Among the drugs used are groups of weak centrally acting sedatives, with the mandatory use of nootropics along with multivitaminization. Manifestations of perseveration The main stages of psychological assistance with perseveration, which can either alternate or be applied sequentially: 1. Waiting strategy. The fundamental factor in psychotherapy is perseveration. It consists of expecting any changes in the nature of the deviations due to the use of any therapeutic measures. This strategy is explained by the resistance of the symptoms of deviation to disappearance. 2.Preventive strategy. Often, perseveration of thinking gives rise to motor perseveration, and these two types begin to exist together, which makes it possible to prevent such a transition in a timely manner. The essence of the method is to protect a person from the physical activity that he talks about most often. 3.Redirection strategy. A physical or emotional attempt by a specialist to distract the patient from obsessive thoughts or actions by abruptly changing the topic of conversation at the moment of the next perseverative manifestation, changing the nature of actions. 4.Limitation strategy. This method allows you to consistently reduce perseverative attachment by limiting a person in his actions. The limit allows obsessive activity, but in strictly defined volumes. A classic example is access to a computer for a strictly designated time. 5. Abrupt termination strategy. Aimed at actively eliminating perseverative attachments using the patient’s shock state. An example would be unexpected, loud statements “That's it! This is not the case! It doesn't exist! or visualizing harm from obsessive actions or thoughts. 6. Ignoring strategy. An attempt to completely ignore perseverative manifestations. The method is very good when the etiological factor of the disorder is lack of attention. Without getting the desired effect, the patient simply does not see the point in his actions.

Systemic perseverations are usually observed when. Perseverations in speech therapy. In pathological disorders, inertia can be expressed in the form of perseveration