Anxiety is inherent in all people to one degree or another, and many of us sometimes perform rituals of varying degrees of irrationality, designed to insure us from trouble - banging our fist on the table or putting on a lucky T-shirt for 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 delusions, and what magical thinking has to do with it.

Endless Ritual

The hero of Jack Nicholson in the famous film "It doesn't get better" was distinguished not only by a complex character, but also by a whole set of oddities: he constantly washed his hands (and every time with new soap), ate only with his cutlery, avoided other people's touches and tried not to step on cracks on asphalt. All these "eccentricities" are typical signs of obsessive-compulsive disorder, a mental illness in which a person is obsessed with obsessive thoughts that make him repeat the same actions regularly. OCD is a real find 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: constant tension and fear are hidden behind innocent and even funny, at first glance, actions.

In the head of such a person, it’s as if a record is stuck: the same unpleasant thoughts regularly come to his mind, which have little rational basis. For example, he imagines that dangerous microbes are everywhere, he is constantly afraid of hurting someone, losing some thing, or leaving the gas on when leaving home. A leaky faucet or an asymmetrical arrangement of objects on a table can drive him crazy.

The flip side of this obsession, that is, obsession, is compulsion, the regular repetition of the same rituals, which should prevent impending danger. A person begins to believe that the day will go well only if, before leaving the house, he reads a children's rhyme three times, that he will protect himself from terrible diseases if he wash his hands several times in a row and use 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 to wash his hands every half hour and zip up his fly five times in the morning - but he simply cannot get rid of the obsession in another way. The level of anxiety is too high, and the rituals allow the patient to achieve temporary relief from the condition. But at the same time, in itself, the love of rituals, lists or putting things on the shelves, if it does not bring discomfort to a person, does not belong to the disorder. From this point of view, the aesthetes who diligently arrange carrot peels lengthwise in Things Organized Neatly are absolutely healthy.

Obsessions of an aggressive or sexual nature cause the most problems in OCD patients. Some become afraid that they will do something bad to other people, up to and including sexual violence and murder. Obsessive thoughts can take the form of individual words, phrases, or even lines of poetry - a good illustration can be an episode from the movie The Shining, where the protagonist, going crazy, starts typing the same phrase “all work and no play makes Jack a dull boy." A person with OCD experiences tremendous stress - he is simultaneously horrified by his thoughts and tormented by guilt for them, tries to resist them, and at the same time tries to make the rituals he performs go unnoticed by others. In all other respects, however, his consciousness functions perfectly normally.

There is an opinion that obsessions and compulsions are closely related to "magical thinking", which arose at the dawn of mankind - the belief in the ability to take control of the world with the help of the right mood 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, tuning in to a successful hunt, you will certainly be lucky. Apparently, this way of perceiving the world is born 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, do not relieve us of the need to look for a relationship 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 a stressful situation. Therefore, with an increased level of anxiety, many people begin to be afraid of their own thoughts, fearing that they can 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 obsessions were immediately sent to exorcists, and in the 17th century the concept was reversed - it was believed that such states 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 "compulsive disorder" is a thought disorder, but it does not affect other aspects of behavior. They used the German term Zwangsvorstellung, which, being variously translated in Britain and the United States (as obsession and compulsion respectively), became the modern name for the disease. And in 1905, the French psychiatrist and neurologist Pierre Maria Felix Janet singled out this neurosis from neurasthenia as a separate disease and called it psychasthenia.

Opinions differed about the cause of the disorder - for example, Freud believed that obsessive-compulsive behavior refers to unconscious conflicts that manifest themselves in the form of symptoms, and his German colleague Emil Kraepelin attributed it to "constitutional mental illness" caused by physical causes.

Famous people also suffered from obsessional disorder - for example, the inventor Nikola Tesla counted steps while walking and the volume of food portions - if he could not do this, the dinner was considered spoiled. And entrepreneur and American aviation pioneer Howard Hughes was terrified of dust and ordered employees to “wash themselves four times, each time using a large amount of lather from a new bar of soap,” before visiting him.

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. Supporters 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) - first of all, serotonin and dopamine, as well as norepinephrine and GABA. Some researchers have noted that many patients with OCD had birth trauma at birth, which also confirms the physiological causes of OCD.

Supporters of psychological theories believe that the disease is associated with personality traits, character traits, psychological trauma and an incorrect reaction to the negative impact of the environment. Sigmund Freud suggested that the occurrence of obsessive-compulsive symptoms is associated with the protective mechanisms of the psyche: isolation, elimination and reactive formation. Isolation protects a person from anxiety-causing affects and impulses, forcing them into the subconscious, liquidation is aimed at combating repressed impulses that pop up - on which, in fact, the compulsive act is based. And, finally, reactive formation is a 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, suffering from OCD since childhood

It started for me around 7 or 8 years old. The neurologist was the first to report the likelihood of OCD, even then there was a suspicion of obsessive neurosis. I was constantly silent, scrolling through various theories in my head like "mental chewing gum." When I saw something that caused me anxiety, obsessive thoughts about it began, although the reasons were very insignificant in appearance and, perhaps, would never have touched me.

At one time there was an obsessive thought that my mother might die. I turned over the same moment in my head, and it captured me so much that I could not sleep at night. And when I ride in a minibus or in a car, I constantly think about the fact that now we will have an accident, that someone will crash into us or we will fly away from the bridge. A couple of times the thought arose that the balcony under me would fall apart, or someone would throw me out of there, or I myself would slip in the winter and fall.

We never really talked to the doctor, I just took different medications. Now I'm moving from one obsession to another and follow some rituals. I constantly touch something, no matter where I am. I go from corner to corner throughout the room, adjusting the curtains, wallpaper. Maybe I am 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 more lucky. They are much better 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 an 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 thought. It is characterized by linking in the mind of a person a specific thought or a simple simple 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, say it out loud to himself, and so on. The classic manifestation of the perseveration of thinking is the constant return to the topic of conversation, which 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 the 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 brought into a separate subspecies 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 one 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 on the basis of physical damage to the cerebral hemispheres, which causes dysfunction in switching from one type of activity to another, a change in the train of thought, an algorithm of actions to perform some task, and so on, when the perseverative component dominates objective actions or thoughts.

The causes of perseveration against the background of neuropathology include:

craniocerebral trauma of the brain with predominant damage to the areas of the lateral orbitofrontal areas of the cortex or its prefrontal bulge,
(aphasia is a pathological condition in which deviations occur in a person’s speech, which has already been 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 of the frontal lobes of the cerebral cortex, similar to aphasia.

Perseveration in psychology and psychiatry reflects the course of a deviation against the background of psychological dysfunctions 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 undergone craniocerebral trauma and severe stress can serve as the first sign of the development of not only psychological, but mental abnormalities.

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

obsession and high selectivity of individual interests, which is most typical for people with an autistic spectrum of deviations,
a feeling of lack of attention against the background of hyperactivity can stimulate the manifestation of perseveration as a protective compensatory phenomenon aimed at drawing attention to oneself or one's kind of activity,
persistence in constant learning and the desire to learn new things can lead gifted individuals to fixate on a particular judgment or activity. The line between perseverance 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 with an idea that causes a person to perform certain physical actions (compulsions) because of intrusive thoughts (obsessions). A striking example of obsessive-compulsive disorder is the frequent washing of hands in fear of contracting a terrible infectious disease or taking various drugs in order to prevent possible diseases.

Regardless of the etiological factors, perseveration must be differentiated from obsessive-compulsive disorder, ordinary habits of a person, 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 peculiarities of child psychology, physiology and a rather active change in the child's life values at different stages of growing up. This creates certain difficulties in distinguishing perseverative symptoms from the intentional actions of the child, and also camouflages the manifestation of signs of more serious mental pathologies.

In order to early determine mental abnormalities 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 a place on the body, scratching, narrowly focused gaming activities, and so on,
drawing the same objects, writing the same word repeatedly,
recurring requests, the need for which is questionable in a particular situation.

Help with perseverative deviations

The basis of the treatment of perseverative deviations is always a complex psychological approach with alternating stages. It is more of 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. Of the drugs, groups of weak sedatives of central action are used, with the obligatory use of nootropics against the background of multivitaminization.

The main stages of psychological assistance for perseveration, which can either alternate or be applied sequentially:

waiting strategy. A fundamental factor in the psychotherapy of perseveration. It consists in the expectation of any changes in the nature of the deviations due to the use of any therapeutic measures. This strategy is explained by the persistence of the deviation symptoms to disappearance.
Preventive strategy. Often, perseveration of thinking gives rise to motor perseveration, and these two types begin to exist in combination, 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.
redirect 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 time of the next perseverative manifestation, changing the nature of actions.
Limiting strategy. This method allows you to consistently reduce perseverative attachment by limiting a person in his actions. The limit allows compulsive activity, but in strictly defined volumes. A classic example is access to a computer for a strictly allotted time.
Abrupt termination strategy. It is aimed at the active exclusion of perseverative attachments with the help of the patient's state of shock. An example is the unexpected, loud statements “That's it! This is not! It doesn't exist!" or visualization of harm from compulsive actions or thoughts.
Ignore strategy. An attempt to completely ignore perseverative manifestations. The method is very good when the etiological factor of the violation was the lack of attention. Not getting the desired effect, the patient simply does not see the point in his actions,
understanding strategy. An attempt to find out the true train of thought of the patient 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 respectively called: perseveration (stuck) and anticipation (anticipation, anticipation): a consonant, and less often - a vowel - replaces the displaced letter in a word.

Examples of perseverations in writing:

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

b) within the phrase: "at grandfather Modoz";

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

a) within the word: “on the devye”, “dod with a roof”, “with native places”.

b) within the phrase, sentence: "Beetle streams." “We have a house” - “At Nastya. ". “The kitten mewed plaintively” - plaintively. ".

Perseveration and anticipation of the syllable (and even the word) is possible: “stupali” - they walked, “descended” - descended; "small small fish" - a lot of small fish. The errors of these two types are based on the weakness of differential inhibition.

Glossary of speech therapy terms

Automation (sound) - the stage in the correction of incorrect sound pronunciation, following the setting of a new sound; aimed at the formation of the correct pronunciation of sound in connected speech; consists in the gradual, consistent introduction of the delivered 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. Distinguish between visual, tactile, auditory agnosia.

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

Adaptation is the adaptation of an organism to the conditions of existence.

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 areas of the cerebral cortex in the prenatal or early period of child development.

Alexia - the impossibility of the process of reading.

Amorphous words are grammatically invariable root words, "abnormal words" of children's speech - fragment words (in which only parts of the word are preserved), onomatopoeia words (syllable words with which the child denotes objects, actions, situations), contour words ( in which stress and the number of syllables are correctly reproduced).

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

Anamnesis - a set of information (about the conditions of a person's life, about the events that preceded the disease, etc.) obtained during the examination from the person being examined and (or) those who know him; used to establish the diagnosis, prognosis of the disease and the choice of corrective measures.

Ankyloglossia is a shortened hyoid ligament.

Anticipation - the ability to anticipate the manifestation of the results of an action, "anticipatory reflection", for example, premature recording of sounds included in final motor acts.

Apraxia is a violation of voluntary purposeful movements and actions that are not the result of paralysis and cuts, but related to disorders of the highest level of 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, words.

Articulatory apparatus - a set of organs that provide the formation of speech sounds (articulation), includes the vocal apparatus, muscles of the pharynx, larynx, tongue, soft palate, lips, cheeks and lower jaw, teeth, etc.

Ataxia - disorder / lack of coordination of movements.

Atrophy - 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.

An audiogram is a graphic representation of hearing data obtained using a device (audiometer).

Aphasia is a complete or partial loss of speech due to local lesions of the brain. See also the video tutorials "Forms of aphasia and methods of restoring speech."

The main forms of aphasia:

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

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

Aphonia - the absence of sonority of the voice with the preservation of whispered speech; the immediate cause of aphonia is the non-closure of the vocal folds, as a result of which air leaks 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.

Bradilalia is a pathologically slow rate of speech.

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

Wernicke Center - a region of the cerebral cortex in the posterior superior temporal gyrus of the dominant hemisphere that provides speech understanding (responsible for impressive speech).

Gammaism is a lack of pronunciation of sounds [Г], [Гг].

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 called fetal pathology that developed during pregnancy (chronic) or childbirth (acute) due to oxygen deficiency. The lack of oxygen supply to the fetus at the beginning of pregnancy can cause a delay or disturbance in the development of the fetus, and in the later stages affects the nervous system of the baby, which can significantly affect speech development.

The following factors can lead to the risk of developing hypoxia:

the presence of anemia, STDs, as well as serious diseases of the respiratory or cardiovascular system in the expectant mother;
disturbances in the blood supply to the fetus and in labor, preeclampsia, post-term pregnancy;
fetal pathology and Rh-conflict of mother and baby;
smoking and drinking alcohol by a pregnant woman.

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

If the doctor suspects hypoxia, he may decide that a caesarean section is necessary. A newborn with a severe degree of oxygen starvation is resuscitated, and with a mild degree, he receives oxygen and drugs.

Dysarthria is a violation of the pronunciation side of speech, due to 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 violation of the reading process, due to the immaturity (violation) of higher mental functions and manifested in repetitive errors of a persistent nature.

Dysgraphia is a partial specific violation of the writing process, due to the lack of formation (violation) of higher mental functions and manifested in repetitive errors of a persistent nature.

Speech development delay (SRR) is a lag in speech development from the age norm of speech development at the age of up to 3 years. From 3 years and older, the lack of formation of all components of speech qualifies as OHP (general underdevelopment of speech).

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

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

Impressive speech - perception, understanding of speech.

Innervation - providing organs and tissues with nerves and, therefore, communication with the central nervous system.

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

Cappacism is a lack of pronunciation of sounds [K], [K].

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

Compensation is a complex, multifaceted process of restructuring mental functions in case of violation or loss of any body functions.

Contamination is an erroneous reproduction of words, consisting in combining syllables related to different words into one word.

Lambdacism - incorrect pronunciation of sounds [L], [L].

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

Speech therapy massage is one of the speech therapy techniques that contributes to the normalization of the pronunciation side of speech and the emotional state of persons suffering from speech disorders. Speech therapy massage is included in the complex medical and pedagogical system of rehabilitation of children, adolescents and adults suffering from speech disorders.

Logorrhoea is an unrestrained, incoherent speech stream, often representing an empty collection of individual words, devoid of logical connection. Seen in sensory aphasia.

Logorhythm is a system of motor exercises in which various movements are combined with the pronunciation of special speech material. Logorhythmics is a form of active therapy, overcoming speech and related disorders 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 in their functions, working as a whole. Local - local, limited to a certain area, area.

Macroglossia - pathological enlargement of the tongue; observed with abnormal development and in the presence of a chronic pathological process in the tongue. At M. considerable disturbances of a pronunciation are observed.

Microglossia is a developmental anomaly, the 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 adopted in a given language environment, manifested in partial (partial) disorders (sound pronunciation, voice, tempo and rhythm, etc.) and due to disorders in the normal functioning of the psychophysiological mechanisms of speech activity.

Neuropsychology is the science of the brain organization of the higher mental functions of a person. N. studies the psychological structure and brain organization of non-speech HMFs and speech function. N. studies violations 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 corrective and restorative work.

General speech underdevelopment (OHP) 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 common name for activities for the development of 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 - violations of speech utterance, 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 statement (verbal paraphasia) in oral and written speech.

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

Perseveration - cyclic 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 skills and communication skills due to local brain damage.

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

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

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

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

Rhinolalia is a violation of the timbre of the voice and sound pronunciation, resulting from excessive or insufficient resonation in the nasal cavity during speech. Such a violation of resonance occurs from the wrong direction of the gloto-expiratory jet due to either organic defects in 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 - a disorder in the pronunciation of sounds [P], [Pb].

Sensory - sensitive, feeling, pertaining to sensations.

Sigmatism is a pronunciation disorder of whistling ([S], [Sb], [Z], [Zb], [Ts]) and hissing ([W], [W], [H], [Sch]) sounds.

A syndrome is a natural combination of signs (symptoms) that have a common pathogenesis and characterize a certain disease state.

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

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

Seizures are involuntary muscle contractions that occur with epilepsy, brain injuries, spasmophilia, and other diseases. Convulsions are characteristic of the state of excitation of subcortical formations, they can be caused reflexively.

Clonic convulsions are characterized by a rapid change in muscle contraction and relaxation. Tonic convulsions are characterized by prolonged muscle contraction, which causes a prolonged forced tense position.

Tahilalia is a violation of speech, expressed in the excessive speed of its pace (20-30 sounds per second), akin in nature to battarism. Unlike the latter, takhilalia is a deviation from normal speech only in relation to its tempo, while maintaining the 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 and phonemic underdevelopment is a violation of the formation of the pronunciation system of the native language in children with various speech disorders due to defects in the perception and pronunciation of phonemes.

Phonemic analysis and synthesis are mental actions to analyze or synthesize the sound structure of a word.

Phonemic hearing is a fine systematized hearing, which has the ability to carry out the operations of distinguishing and recognizing the phonemes that make up the sound shell of a word.

Phoniatrics is a branch of medicine that studies the problems of teeth and pathologies of the vocal cords and larynx, leading to voice disorders (dysphonia), methods of treatment and prevention of voice disorders, as well as ways to correct a normal voice in the desired direction. Violation of voice formation can also occur due to certain psychological disorders. The solution of some problems of phoniatry is closely related to the problems of speech therapy.

Cerebral - cerebral, belonging to the brain.

Expressive speech is an active oral and written statement.

Extirpation (larynx) - removal.

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

A speech embolus is one of the most frequent words, part of a word or a 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. The efferent articulatory praxis is fundamentally different from the afferent one in that it requires the ability to switch from one articulatory posture to another. These switches are complex in execution. They involve the mastery of intercalated fragments of articulatory actions - coarticulations, which are "ligaments" between individual articulatory poses. Without coarticulations, a word cannot be pronounced, even if every sound included in it is available for reproduction.

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

Where did you get the idea that with alalia, the intellect is primarily intact. Volkova, Kornev, Kovshikov just note the possibility of VR in children with alalia. And the definition of alalia does not in any way imply a primarily intact intellect. You are confusing with the definition of OHP.

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

Read the definitions carefully. With mental retardation, alalia can manifest itself, but alalia can also manifest itself with initially intact intelligence - due to organic damage to the speech zones of the cerebral cortex in the prenatal or early period of child development (this definition is published in the classic textbook "Speech therapy. Textbook for universities")

The speech therapist should clearly understand that alalia is not equated with mental retardation and conduct an accurate diagnosis of the child. This is extremely important for the construction of corrective work, it is necessary to distinguish between such diagnoses and be well aware of the difference between these concepts. Naturally, serious speech disorders in alalia can lead to a delay in some mental processes, but it is to ZPR, and not to mental retardation.

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

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

Perseveration is a psychological, mental and neuropathological phenomenon in which there is an obsessive and frequent repetition of actions, words, phrases and emotions. Moreover, repetitions are manifested both in oral and written form. Repeating the same words or thoughts, a person often does not control himself, leading a verbal way of communication. Perseveration can also manifest itself in non-verbal communication based on gestures and body movements.

Manifestations

Based on the nature of perseveration, the following types of its manifestation are distinguished:

Perseveration of thinking or intellectual manifestations. Differs in "settlement" in the human creation of certain thoughts or his ideas, manifested in the process of verbal communication. A perseverative phrase can often be used by a person when answering questions to which it has absolutely nothing to do with. Also, a person with perseveration can say such phrases out loud to himself. A characteristic manifestation of this type of perseveration is the constant attempts 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. It can be both the simplest movement and a whole complex of various body movements. At the same time, they are always repeated in the same way and clearly, as if according to a given algorithm.
Speech perseveration. It belongs to a separate subspecies of the motor-type perseveration described above. These motor perseverations are characterized by constant repetitions of the same words or entire phrases. Repetitions can be expressed orally and in writing. Such a 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 the defeat of the right hemisphere, and if he is right-handed, then, accordingly, the left hemisphere of the brain.

Causes of manifestation of perseveration

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

The repetition of the same phrase, caused by the development of perseveration, may occur against the background of neuropathological causes. These most often include:

Traumatic brain injury, in which the lateral region of the orbitofrontal region of the cerebral cortex is damaged. Or it is associated with physical types of damage to the frontal bulges.
With 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 case 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 in the case of aphasia.

Psychiatrists, as well as psychologists, call perseveration psychological type deviations 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 has signs of the formation of perseveration, but at the same time he did not endure 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, then there are several main ones:

Tendency to increased and obsessive selectivity of interests. Most often, this manifests itself in people characterized by autistic deviations.
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 can get hung up on certain judgments or their activities. Between perseveration and such a concept as perseverance, the existing line is extremely insignificant and blurred. Therefore, with an excessive desire to develop and improve oneself, serious problems can develop.
Feeling of lack of attention. It appears in hyperactive people. The development of their perseverative inclinations is explained by an attempt to attract increased attention to themselves or to 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 their hands clean and wash them regularly. A person explains this by the fact 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 washing of hands, or whether it is an obsessive-compulsive disorder. Also, it is not uncommon for the repetition 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 algorithm for the treatment of perseveration. Therapy is carried out on the basis of the use of a whole range of different approaches. One method, as the only method of treatment, should not be used. It is necessary to undertake new methods if the previous ones have not yielded results. Roughly speaking, treatment is based on constant trial and error, which ultimately allows you to find the best method of influencing a person suffering from perseveration.

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

Expectation. It is the basis in the psychotherapy of people suffering from perseveration. The bottom line is to wait for a change in the nature of the deviations that have arisen against the background of the use of various methods of influence. That is, the waiting strategy is used in conjunction with any other method, which we will discuss below. If there are no changes, switch to other psychological methods of influence, expect the result and act according to the 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, which a person most often talks about.
redirect. This is a psychological technique based on a sharp change in actions taken or current thoughts. That is, when communicating with a patient, you can drastically change the topic of conversation or move from one physical exercise, movement to another.
Limiting. The method is aimed at consistently reducing a person's attachment. This is achieved by limiting repetitive actions. A simple but understandable example is to limit the time within which a person is allowed to sit at a computer.
Abrupt termination. This is a method of actively getting rid of perseverative attachment. This method is based on the impact by introducing the patient into a state of shock. This can be achieved through harsh and loud phrases, or by visualizing how harmful the obsessive thoughts or movements, actions of the patient can be.
Ignoring. The method assumes a complete disregard for the manifestation of the disorder in humans. This approach works best if the disturbances were caused by an 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 by which the psychologist learns the patient's thought patterns in case of deviations or in the absence of them. Such an approach often allows a person to independently understand their thoughts and actions.

Perseveration is a fairly common disorder that can be caused by various reasons. With perseveration, it is important to choose a competent treatment strategy. Medicamentous influence in this case is not applied.

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

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Alalia motor - underdevelopment of expressive speech with a fairly intact understanding of speech;

Alalia sensory - underdevelopment of impressive speech, when there is a gap between the meaning and the sound shell of words; the child has impaired understanding of the speech of others, despite intact hearing and the ability to develop active speech;

Defectologist-speech therapist - a specialist with higher education in the field of studying, teaching, socializing people with speech disorders

Physiological iteration - 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 formation of speech in preschool childhood.

Nystagmus - involuntary rhythmic convulsive movements of the eyeballs.

Nootropics are drugs that improve the nutrition of nerve cells.

Passive vocabulary - a stock of understood words.

Tonic convulsions - 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, representation, or experience. This constancy sometimes turns into an annoying uncontrollable form, the person himself does not even notice this or is not aware of the phenomenon that is happening to him.

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

Perseveration most often occurs with a physical impact on the brain. At the same time, a person has difficulty 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 causes that are associated with physical damage to the brain or the influence of diseases on it, there are also psychological causes 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), a regular habit, subjective obsessions. With obsessive phenomena, patients realize that their behavior is a little strange, ridiculous, meaningless. With perseveration, there is no such awareness.

Symptoms

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

With motor perseveration, a person constantly repeats the same movement. Sometimes a patient can see a whole system of repetitive actions. Such actions have a certain algorithm that does not change for a long time. For example, if there is difficulty in opening a box, a person constantly hits it on the table, but this does not lead to anything. He understands the pointlessness of such behavior, but repeats these actions. Children can constantly call a new teacher by the name of the former 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 stuck-up of representations 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 a few 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 the behavior of their child, whether he has any even the most minor perseverations.

The Positives of Persistent Repetitions

It is believed that obsessive repetition of thoughts or actions characterize a person as sick or with deviations. But almost every one of us has experienced perseveration at least once in our lives. But in people without additional neurological or psychiatric dysfunctions, this condition is called careful analysis, experience, 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;
subdue 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 event.

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

Treatment

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

Medications for perseveration

As a symptom, perseveration is not treated, but due to drug therapy of the underlying disease, its intensity decreases. Often, neuroleptics are 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, the excessive experience of situations disappears, which can cause an annoying repetition of actions or thoughts. Psychomotor agitation decreases, aggressiveness decreases, the feeling of fear is suppressed. Some neuroleptics are used as sedatives, while others, on the contrary, are used when it is necessary to activate mental functions. Each drug is selected by the doctor individually.

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

Psychotherapeutic help

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 behavior and thoughts of the patient. After that, the need for medical assistance and direction in psychotherapeutic work with him is determined.

In psychotherapeutic work with a patient, it is important to teach him new thinking and motor skills, as well as to create rational attitudes and maintain the existing positive characteristics of a person in order to overcome constant repetition in actions, conversation and thoughts. To do this, the following methods and techniques can be used (their application can be done in sequence or alternately).

Persistent and annoying repetitions often interfere with a person's life. In this case, the help of a specialist is needed, who will determine the need for the use of medications, and also help to 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 to repeat the endings of words (the last syllables) several times during a conversation. for example: "the girl is going-tsya-tsya-tsya" or "potato-shka", his name was "whether". Now he is 5.5 and the situation has not changed. Sometimes this does not happen, I can not trace the pattern (it is not associated with either excitement or fatigue, it is just that this phenomenon is observed more often, and sometimes not). 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 perserverization, that is, it is connected with thinking, but she also does not know how to help the child. In general, he speaks well, there are slight defects in sound pronunciation ("r" either with his throat or with his tongue, sometimes he confuses "sh, w" and "s, z", does not always clearly pronounce "l" and there are agrammatisms). I have a question concerning. Are such repetitions stuttering or perserverization and what can be done to help the child?

Hello. It is a little difficult for me to answer you, because I do not work directly with and iterations (preservation). Then, again, like most mothers. you do not report anything about the anamnesis. Let's try to figure it out, but I immediately warn you, this is just an attempt, because there is no way to see the child, there is no information about development. It is also not clear, 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 P, if it doesn’t bother you, then it’s okay ... The main thing is that his child hears, distinguishes, correlates with the letter. Why aren't other sounds automated? I understand that there are violations of word formation and syllabic structure? Why? neurology? Then we are already talking about ZPRR? but at the same time, thinking, memory, attention, perception really suffer. .Uneven development of thinking and speech capabilities of the child. Speech stutters here are the result of age-related insufficiency in coordinating thinking and speech or age-related imperfections of the child's speech apparatus, his vocabulary, expressive means (physiological stutters). Delays in psychophysical development can occur as a result of past illnesses, injuries, unfavorable heredity. There is no information from you about this. Physiological iterations is the repetition by children of certain sounds or syllables, which is due to age-related imperfection in the activity of auditory and speech-motor analyzers. This imperfection usually manifests itself during the formation of speech, and scientists believe that iterations can manifest themselves not only at preschool age, but also much earlier - during the period when a child first words appear, and sometimes even earlier - during the “cooking” period. In the literature, you can also find another name for physiological iterations - perseveration, which literally translates as "jamming". The reason for perseverations lies in the peculiarities of fixing words, concepts and phenomena in memory. The fact is that at preschool age, the auditory and kinesthetic images of a number of words are not clear enough, so the child simply mistakenly can reproduce them, correct himself, repeat a more accurate version, and therefore rearrange or repeat sounds, syllables, etc. Such inaccuracies and repetitions are attributed by experts to age-related disorders of the tempo-rhythmic side of oral speech, when iterations are the most characteristic and striking shortcomings during the formation of a phrase, that is, after two years. When a child grows up, his perception is not limited to a minimum: there are so many interesting and new things around, the name of which the child simply does not yet know, but really wants to know, and therefore all the words spoken by adults correlate 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 is simply ahead of the speech capabilities of the talker, because of this, these very physiological hesitations and repetitions are made, as if correcting themselves. In addition, speech breathing is also imperfect (it has not yet been formalized), and the possibility of pronouncing 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 history, there is no neurologist’s conclusion, so each speech therapist is right in his own way, and they have more information about your child than I do. The advice that I can give is advisory in nature, but if it is strictly followed, then I hope it will help. 1. Do not show anxiety caused by the appearance of convulsive hesitation in a child, with him; do not discuss the problem with the child. 2. Normalize the sleep and nutrition of the child: prolonged sleep is desirable. As much as possible "ritualize" the regimen of the child's day during this period. 3. If the surrounding environment contributed to the appearance of hesitation, then try to change it to a more calm one. 4. Do not interrupt, do not stop the child if he began to speak. 5. Watch your speech: speak smoothly, making pauses. In no case do not shout at the child during this period! 6. Make a list of situations, environments, people around that increase or provoke hesitation in a child. Try to avoid what is on your list. 7. With an acute onset of stuttering, completely exclude watching TV (including other family members should not watch it with the child) and computer games. 8. Playing with water and sand (in winter - with snow) helps to relieve nervous tension. 9. Try not to make critical remarks (as far as possible), do not ask questions to the child during this period. 10. Strive to ensure that you do not part with your child for a long time, spend as much time with him as possible. 11. For some time, somatic overloads should also be avoided: 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 inaccuracies in speech, mocked or corrected irritably. 15. It is necessary to save the child from the fears that have arisen in him, not to let the child fixate on them: for example, in the form of some spots, you can depict what frightened the child on the tile in the bathroom, so that the child then washed off this image with a shower jet. 16. Harmonization of the child's condition by using paints of various colors. Drawing on wet paper, in light tones of colors, blurring the image soften the child's condition. Yellow color invigorates, activates the mental sphere, blue calms emotions. Black, gray, brown colors should not be used in joint drawing. 17. To overcome excessive timidity, it is useful to draw on large sheets of paper and with a wide brush, use thick paint, and draw with your hands. 18. For the prevention of stuttering, it is useful to stimulate the child's positive attitude to events taking place at home, for this purpose, parents can be recommended to jointly draw situations that are pleasant for the child from home life (birthday, joint walk, grandmother fries pancakes). 19. To organize the rhythm in the daily routine, as well as to overcome the possible lack of attention, it is useful to use the "visual organization of the day" in the form of a schedule for the child's activities. 20. It is useful to learn children's songs with children, to sing with a 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 the child, actively use pictures, pictograms, objects-symbols. However, if the child begins to speak, then it is impossible to forbid him, to strive only to translate his monologue form of speech into a dialogic one. 22. If the child resists any of your demands, you should switch his attention to another activity. 23. In the 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, long and complex in their grammatical structure; in case of an acute onset of stuttering, do not conduct classes for correcting sound pronunciation. 25. Stuttering is most likely when pronouncing low-frequency words, therefore, the child should be limited from the perception of such words in the acute onset of stuttering, so that he does not have a desire to “ask again”. 26. Perform daily breathing exercises: for the development of physiological and phonation breathing. The main task is to increase inspiratory volume and expiratory duration. 27. It is useful to read and memorize to children short, simple poems that are appropriate for the age of the child. 28. The choice of books to read to children should be limited and strictly age-appropriate. Don't aim for quantity. It is better to read one fairy tale to the child during the week, but in different books. 29. Conduct daily motor games with rhythmic movements. 30. Some children may experience a relapse of stuttering during school entry. Parents should alert teachers at the school to the problem. The child cannot be asked first, insist on an answer, if the child is silent, demand detailed oral answers from him. It is recommended at first to call a little schoolboy to answers in front of the class only with poetry reading. 31. To prevent recurrence of stuttering: when a child is weakened after somatic or infectious diseases, it is necessary to conduct a sparing general and speech regimen.

anonymously

Hello! Thanks for such a detailed answer. I'm updating the information. The child is engaged with a speech therapist in the kindergarten after passing the PMPK. Conclusion PMPK - OHP level 3. Classes are recommended with a speech therapist teacher (due to unsteady sounds and a psychologist teacher (due to signs of hyperactivity and attention deficit). A neurologist writes a REB with signs of motor disinhibition. EEG conclusion: M-echo displacement 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 of intracranial hypertension. He was sent to the commission due to problems with the sounds that I wrote above. BUT perserverization appeared later. In general, the child has a good memory for his age (both visual and auditory), inquisitive, 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 something (even a very simple one) with a pencil, for example, or paints is very difficult At the same time, when he expresses his thoughts, it is sometimes difficult to understand him (not by sounds, but by semantic content). He completed with ease, he only had to constantly draw attention to the task, as 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 pattern is that it has become more frequent over time. If at the very beginning (six months ago) 4-5 times a day could be heard, now much more often - in every sentence, almost every word. When all this first appeared, I took the path that you indicated - do not focus attention, reduce the load on the child, optimize the regimen, connect games to relieve stress, breathing. He knows a lot of poems, remembers them quickly (I just read to him every day what he asks for, and then he remembers 2-4 times). There are no repetitions of syllables in poems. But if he wants to tell me some story himself or his favorite fairy tale - then very much so. They have matinees in the kindergarten. When they are preparing for matinees, during this period he tells us in roles at home what which child says and what he does at the same time. At the matinee, he says the words that are entrusted to him, calmly, with an 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 said that it looks like stuttering, but she does not work with it. And the second speech therapist, who experienced stuttering, said that it was not stuttering, so she could not help. This is perserverization and the question is not for a speech therapist.

Hello. I became very curious as to what was going on. I repeat, I don’t work with stuttering, we don’t have such children at school. What I read and tried to understand. this is very similar to perserverization. And a speech therapist can only indirectly help here. I found an article, take a look, it might be useful? In general, you need an experienced neurologist who knows this problem. I know such people only in IKP RAO, but for sure, there are also in other places! Help with perseverative deviations The basis of the treatment of perseverative deviations is always a complex psychological approach with alternating stages. It is more of 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. Of the drugs, groups of weak sedatives of central action are used, with the obligatory use of nootropics against the background of multivitaminization. Manifestations of perseveration The main stages of psychological assistance in case of perseveration, which can either alternate or be applied sequentially: 1. Waiting strategy. A fundamental factor in the psychotherapy of perseveration. It consists in the expectation of any changes in the nature of the deviations due to the use of any therapeutic measures. This strategy is explained by the persistence of the deviation symptoms to disappearance. 2. Preventive strategy. Often, perseveration of thinking gives rise to motor perseveration, and these two types begin to exist in combination, 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. Redirect 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 time of the next perseverative manifestation, changing the nature of actions. 4. Limiting strategy. This method allows you to consistently reduce perseverative attachment by limiting a person in his actions. The limit allows compulsive activity, but in strictly defined volumes. A classic example is access to a computer for a strictly allotted time. 5. Abrupt termination strategy. It is aimed at the active exclusion of perseverative attachments with the help of the patient's state of shock. An example is the unexpected, loud statements “That's it! This is not! It doesn't exist!" or visualization of harm from compulsive actions or thoughts. 6.Strategy of ignoring. An attempt to completely ignore perseverative manifestations. The method is very good when the etiological factor of the violation was the lack of attention. Not getting the desired effect, the patient simply does not see the point in his actions.

Systemic perseverations are usually observed at. Perseveration in speech therapy. In pathological disorders, inertness can be expressed as perseveration