Agrammatism is the inability to construct or perceive grammatical constructions. Agrammatism occurs in oral speech and in writing. They are characteristic of the early period of speech development, as well as people with general speech underdevelopment, bilingualism, aphasia, hearing impairment, dysgraphy. It is diagnosed during speech therapy examination of oral and written speech, neuropsychological testing. Correctional and restorative training to overcome agrammatism is aimed at improving the grammatical categories of the language.
Classification
Depending on the nature of the violation (internal or external speech), two types of agrammatism are distinguished in speech therapy practice:
- impressive – the understanding of the meaning of grammatical turns is violated;
- expressive – the ability to correctly use case forms, prepositions, and word coordination in independent utterance is not formed or disintegrates.
According to the level of formation of grammatical processes, there are three degrees of agrammatism (from heavier to lighter):
- Non-articulate (one-word) sentences are used in speech. Composing and repeating detailed phrases causes difficulties.
- Sentences are short, syntactic connections between structural components are broken. Repeated speech suffers.
- Errors of declension of sentence members are noted, otherwise the independent phrase is framed correctly. There are no errors when repeating a given phrase.
Causes of agrammatism
Preschool age
The assimilation of the basic grammatical forms of the native language occurs in the first 3-5 years of life. Children accumulate a significant vocabulary, master the skills of inflection and word formation, correctly understand and use prepositions, use simple and complex sentences.
In the speech of preschoolers and younger schoolchildren, individual agrammatism may occur. As a rule, they are associated with the use of low-frequency words, complex grammatical turns, exceptions to the rules of the Russian language. However, with normal speech development, grammatical errors gradually disappear from the child’s speech routine.
General underdevelopment of speech (GUS)
Agrammatism is a characteristic phenomenon for children with general speech underdevelopment of various levels. GUS is a collective concept, which may hide various speech disorders: alalia, dysarthria, open rhinolalia.
- Level 1 GUS. The grammar is not formed. There are immutable root words in the vocabulary.
- GUS 2 levels. The initial level of grammar formation. There are numerous agrammatisms: incorrect change of words by persons and numbers, confusion of cases, coordination errors, incorrect use of prepositions.
- GUS 3 levels. Simple grammatical forms are used without errors. Agrammatism occurs when matching words, using prepositions and case endings, placing accents.
- GUS 4 levels. Residual errors remain in word formation with the help of suffixes, declension of plural nouns, and the use of complex prepositions.
Bilingualism
In a situation of bilingualism, agrammatism can be detected both when communicating in their native language and in Russian. Based on the criterion of lexical and grammatical correctness of speech, 3 levels of speech development of bilingual children are distinguished:
- low – there are regular and numerous morphological and syntactic errors, difficulties in using the correct grammatical forms of parts of speech. There is no self-correction.
- medium – agrammatism does not interfere with speech communication. The most common mistakes are in coordination and management. Self-correction is possible only within the framework of the studied material.
- high – the skill of self-correction is formed: the child independently corrects grammatical errors. The correct use of prepositional and case forms, coordination of parts of speech, inflection, intonation of the utterance is available.
Aphasia
Agrammatism is observed in patients with various types of aphasic disorders. Grammatical difficulties are usually characteristic of moderate to mild speech disorders (with severe aphasia, active speech or its understanding may be completely absent).
- Motor aphasia. Expressive agrammatism is characteristic. With afferent aphasia, there are errors in coordination, the use of prepositions, and simplification of phrases. For Brock’s aphasia, the telegraphic style is typical (absence of prepositions), the use of verbs in the infinitive, incorrect coordination.
- Dynamic aphasia. Agrammatism can be expressed in two ways. In the first case, there is a violation of the programming of a speech utterance (lack of a verbal dictionary, monosyllabic phrases, speech stamps), in the second – difficulties of grammatical structuring (telegraphic style, problems with word coordination).
- Acoustic-gnostic aphasia. It is difficult to understand the reversed speech, the phenomenon of alienation of the meaning of the word is noted, instructions are not available to patients. With spontaneous utterance, logorrhea and agrammatism of coordination are revealed.
- Acoustic-mnestic aphasia. Gross agrammatism is not characteristic. Difficulties arise when using syntactically complex sentences.
- Semantic aphasia. The main defect is impressive agrammatism. Patients lose the ability to understand complex (temporal, spatial) logical-grammatical relations.
Tachylalia
The pathologically accelerated pace of speech with tachylalia negatively affects the grammatical and syntactic design of the utterance. First of all, the sentence structure suffers: the correct word order in the phrase is violated. The endings of the words are “swallowed” or replaced with incorrect ones. In spontaneous speech, logical cause-and-effect relationships are distorted, which entails a violation of the meaning of what is said.
Violations of written speech
Agrammatism in writing is the essence of agrammatic dysgraphy. In written works, incorrect construction of sentences is found, violation of the presentation of a coherent text. In words there are errors of declension and agreement in gender and number, incorrect spelling of prefixes and suffixes.
Grammatical errors in reading are characteristic of agrammatic dyslexia. In the process of reading, case endings, the form and tenses of verbs are incorrectly used, nouns are consistent with adjectives and pronouns. Comparisons and metaphors are difficult to perceive. As a result, the meaning of what is read is lost, the understanding of the text suffers.
With dysorphography, along with spelling errors, students have difficulties with morphological analysis of words, case declension, word matching in a sentence, punctuation. Written agrammatism is usually found in children with GUS.
Intellectual disabilities
Lexical and grammatical underdevelopment is typical for children suffering from autism, MR, mental retardation. In their speech, agrammatism occurs at the level of a word, phrase and coherent text. The severity of grammatical underdevelopment depends on the degree of decline in intelligence.
The most violated are the operations of inflection. Prepositions are omitted or used incorrectly, case endings are distorted. Mistakes are made in the formation of adjectives from nouns, diminutives. Children use primitive prepositional constructions. If there is a detailed phrase, there is often a semantic discrepancy in it. Coherent speech is inconsistent, fragmentary.
Hearing disorders
The speech of hard-of-hearing children develops with significant grammatical disorders. The inaccuracy of auditory perception causes the erroneous use of prepositions, case endings, difficulties in constructing complex sentences. The listed shortcomings of oral speech are reflected in the letter. Agrammatism with hearing loss is persistent, it is difficult to eradicate.
Diagnostics
The detection of agrammatism in writing and in oral utterance is carried out by a speech pathologist during a pedagogical examination. To assess the condition of VPF, a neuropsychologist’s consultation is required. The general diagnostic plan consists of the following stages:
- Diagnostics of oral speech. Primary attention is paid to the examination of vocabulary and grammar. Vocabulary, word formation skills using prefixes and suffixes, word changes by numbers, genders, cases are studied. Tasks are given for retelling the text, composing a story based on a plot picture and a series of pictures. A comprehensive examination reveals morphological agrammatism.
- Diagnostics of written speech. Students study written works. Students are invited to make suggestions based on pictures and with reference words, write an exposition. When performing written tasks, as a rule, syntactic and semantic agrammatisms are detected.
- Examination for aphasia. In patients with aphasic disorders, the understanding of speech (questions, instructions) and the ability to utter (automated, repeated, spontaneous speech, naming objects, composing stories) are investigated. The ability to write and read is analyzed. The examination may reveal expressive or impressive agrammatism.
- Neuropsychological diagnostics. Within the framework of the neuropsychological approach, the individual’s ability to program, regulate and control the speech act, the peculiarities of processing auditory-speech, visual-spatial information is evaluated. In the presence of agrammatism, neurodynamic disorders involved in the organization of speech activity are revealed.
Correction
Speech therapy classes should be started in parallel with medical events or immediately after them. So, assistance to hearing-impaired children, first of all, should include rational hearing prosthetics, classes with a surdologist. With CVA, which entailed aphasia, complex medical, neuropsychological, physical and speech rehabilitation is required. With tachylalia, a favorable background for speech therapy correction is achieved with the help of physiotherapy, hydrotherapy, and a course of massage. The tactics of speech therapy are determined taking into account the leading syndrome.
Improving the grammatical system
To form the grammatical structure of the language, it is necessary to communicate a lot with the child from early childhood, read high-quality children’s literature, surround him with worthy speech examples to follow. It is not necessary to repeat the child’s agrammatism, it is necessary to immediately correct the mistakes made by pronouncing the correct sample. Grammatical games are useful for speech development, helping to automate normative variants of word formation.
GUS correction
Correctional education of children with GUS is carried out in specialized speech therapy groups of preschool institutions, starting from the age of 4. Agrammatism should be overcome by the beginning of school. In the classroom, the speech therapist clarifies and expands the vocabulary of children, develops understanding of speech, forms the skills of inflection, word formation, the use of simple common and complex sentences. With the improvement of lexical and grammatical means, coherent speech develops, the ability to compose a story is formed, to retell what is heard.
In parallel, phonetic gaps, phonemic underdevelopment, and violation of syllabic structure are eliminated. The preparatory group is working on the formation of elementary reading and writing skills. In the course of classes, physical exercises, articulatory gymnastics, phonetic rhythmics, exercises for the development of fine motor skills are used, according to indications – speech therapy massage.
Correction of dysgraphy
Since written agrammatism is a consequence of general speech underdevelopment, their correction is carried out in the same main directions. Additional attention is paid to the study of the morphological composition of the word and the syntactic structure of the sentence. The consolidation of grammatical norms and rules is carried out not only in oral, but also in written exercises.
Rehabilitation work for aphasia
Different types of aphasic disorders require a differentiated approach to speech rehabilitation. To eliminate impressive agrammatism in semantic aphasia, work is underway to overcome violations of spatial perception, restore understanding of logical and grammatical constructions. With sensory aphasia, the patient is taught to understand situational speech, differentiate phonemes, and formulate a phrase grammatically correctly.
After disinhibition of oral speech in patients with motor aphasia, they proceed to the development of correct articulatory poses and switches, overcoming grammatical distortions (making detailed sentences, correct use of prepositions and conjunctions, etc.), restoring reading and writing.
The main task in dynamic aphasia is to stimulate speech activity, training in inflection, constructing phrases of various syntactic models. In order to overcome agrammatism in patients with acoustic-mnestic aphasia, work is being done to expand auditory-speech memory, to compose complex sentences.
