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THEORETICAL FOUNDATION OF THERAPEUTIC SPEECH MASSAGE (AN INTERNATIONAL PERSPECTIVE)By Elena A. Dyakova, PhD, SLP from Moscow, Russia
INTRODUCTION BY DIANE BAHR, MS, CCC-SLP
This blog is an excerpt from an article written by Dr. Elena Dyakova, the author of the book Therapeutic Speech Massage (2013). Dr. Dyakova has developed massage techniques that can be systematically applied (when needed) in conjunction with traditional speech treatment. Thank you, Dr. Dyakova, for sharing this wonderful and enlightening information with us. You may read Dr. Dyakova’s entire article (in English) by clicking on the link at the end of this blog.
ARTICLE BY ELENA DYAKOVA, PHD, SLP
As one method of treatment for a number of severe speech disorders, massage of speech muscles has been in use for some time. The theoretical underpinnings for its use were provided in the works of the following Russian speech-language pathologists: M. B. Yeydinova, O. V. Pravdina, K. A. Semenova, and S. A. Bortfeld in the 1970s. Nonetheless, the techniques of applying differentiated massage in various cases of speech pathology have only been developed fairly recently and have yet to be more widely incorporated into the practice of speech therapy. However, among specialists in the field, there is no doubt as to the practicality of using massage in speech therapy, especially when treating severe speech disorders such as dysarthria, apraxia, rhinolalia, and stuttering.
Nearly ten years have passed since the first book, Therapeutic Speech Massage, was written (Dyakova, 2003, 2005, & 2012 by the Academy in Russian; 2013 by Xlibris in English). During this period, Therapeutic Speech Massage (TSM) gained wide popularity among practicing speech language pathologists in different countries. Since the first edition of this book, many training workshops on Therapeutic Speech Massage have been conducted. In the past decade, it has been gratifying to observe the interest speech therapists have had in mastering the practice of speech massage.
It is well known that many speech-language pathologists (SLPs) working in medical and academic settings use the techniques of Therapeutic Speech Massage in their work and endeavor to obtain expertise in this area. Until recently, however, there has been no focused or systematic university curriculum which teaches the use of massage techniques to appropriately treat the specific causes and development of speech disorders. Presently, a class in Therapeutic Speech Massage is included in the speech therapist training program of many Russian universities and is also offered as a special seminar in the continuing education program using a carefully developed curriculum.
The purpose of this article is to describe the methods of Therapeutic Speech Massage and to offer suggestions for its use in the treatment of speech disorders. We have endeavored to systematize and more fully present therapeutic speech massage techniques in order to provide a physiological foundation for the desirability of using massage in the practice of speech therapy.
Therapeutic Speech Massage (TSM) is an active method of mechanical intervention that alters the condition of the muscles, nerves, blood vessels, and tissues of the entire speech apparatus. Therapeutic Speech Massage is a technique that normalizes all the components of speech: breath support, vocalization, resonance and articulation, as well as the emotional state of people suffering from speech disorders.
TSM is focused on the muscles of the peripheral speech apparatus. Muscles of the articulation apparatus (i.e., tongue, neck, lips, and the mimic muscles of the face), the muscles connected with the function of the vocal chords, and the muscles of the respiratory apparatus all combine to constitute a unified muscle system, which produces speech. TSM covers all the areas mentioned above even when muscle anomalies are diagnosed for a seemingly unconnected local area.
Therapeutic Speech Massage is part of a comprehensive intervention speech pathology program for the rehabilitation of children, adolescents,and adults with speech disorders. Massage is used in speech therapy practice with people who have been diagnosed with speech disorders such as dysarthria, apraxia, rhinolalia, dysphasia, voice disorders, and stuttering. TSM also can be used for prevention of speech disturbances among children in the prespeech period of life who have different kinds of movement disturbances. In general, TSM may be used in all cases in which there are anomalies of muscle tone.
Therapeutic Speech Massage can be performed at all stages of speech therapy intervention, but its use is especially crucial at the initial stage of treatment. Massage is often a necessary condition of effective speech therapy intervention. Many years of practical experience working with patients with different speech disorders has demonstrated that application of TSM will considerably reduce the time needed for speech therapy. This is particularly true when working with people with oral-motor disorders. The use of TSM, which leads to a gradual normalization of muscle tone, often results in the spontaneous improvement in production of previously distorted sounds. In situations when a patient has marked severe neurological symptoms, using TSM especially at the initial stage of therapy may offer a better chance for positive results. For purposes of prophylaxis of speech disturbances, massage is used at the earliest stages of treatment with young children having neurological symptoms, especially children suffering from cerebral palsy.
Massage can be integrated with traditional speech therapy techniques. In working to overcome articulation disorders, massage is performed along with different kinds of oral-motor exercises. TSM is also important to use with relaxation exercises in training the voice and vocal respiration and improving a patient’s emotional state, especially in cases of stuttering.
Therapeutic Speech Massage can be performed by speech-language pathologists, disability specialists, medical providers, and physical therapists who have mastered the techniques of TSM (i.e., those who have undergone special training and know the anatomy and physiology of the muscles that support speech, as well as the pathogenesis of speech disorders). Elements of massage may also be performed by parents who have been instructed and trained by a speech language pathologist….
Thank you again, Dr. Dyakova, for sharing this wonderful article with us. Here is Dr. Dyakova’s contact information if you have questions or comments for her:
Elena A. Dyakova, PhD, SLP
Professor of Department of Social-Humanitarian and Natural Science Disciplines,
Institute of Economics and Business, Moscow
President of International Institute of Speech Pathology, USA
Dyakova, E. A. (2013). Therapeutic speech massage: A manual for practitioners and students. Moscow: Academia Press (2003, 2005, & 2010 in Russian), USA: Xlibris, 2013 in English.
This is an excerpt from the article entitled Theoretical Foundation of Therapeutic Speech Massage by Dr. Elena Dyakova. Dr. Dyakova granted Ages and Stages®, LLC permission for republication.