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Delayed Speech and Developmental Aphasia

Br Med J 1955; 2 doi: https://doi.org/10.1136/bmj.2.4937.463 (Published 20 August 1955) Cite this as: Br Med J 1955;2:463

Re: Delayed Speech and Developmental Aphasia

Dear Editors,

A wide open mouth leads to rhinolalies, unintelligible speech, splutter, stagnation in learning. The faces of these children are lifeless, without mime, expression or vitality, "face-masks".

Their speech is unintelligible, incomprehensible, and not energetic, their diaphragm is completely inelastic. These children are unable to withstand physical or mental stress, indulge in learning; they are growing only physically, not spiritually. Later on, they will present personality disorders.

Therapeutically, we must first activate the whole body of the child by specific exercises, then activate diaphragmatic breathing, then help them close their mouth with special massages and suggestions, then proceed to special speech therapy, and finally move on to learning.

This method, developed and perfected by Maria Summer in Rankweil, Austria, is for quick and effective treatment of disorders of speech, voice, breathing and learning, in approximately 60 sessions.

Myokinetic exercises to revitalize the body.

1) Alternating taps right hand-left knee at a right angle, left hand-right knee at a right angle, from the upright position, with many repetitions.

2) Rhythmic rolling on a wooden floor.
A big break, of 2-3 minutes, follows, on the floor, on a hard surface, no cushion, chin to chest, cheek leaning down, arms close to the trunk aside of the body, palms facing upward, feet very open, relaxed.

At this posture of complete relaxation-peace, we observe the child's breathing.
All this is done on the ground, on a hard orthopedic mattress, in a well-ventilated room, with the child wearing overalls and not clothes that restrict his/her movements.

All exercises for proper breathing function should not be conscious for the child, at whom we never mention the word "breathing".

3) Riding without a horse: the child without shoes, on a wooden floor, with open legs, is pretending to ride a horse, making rhythmic jumps, while singing a song, or saying "hop hop", for 5-10 minutes.

4) Vibrations of the spine: therapist and child without shoes, on a wooden floor, grabbing each other’s hands, while facing each other, perform exercises. First the therapist starts by hitting hard his/her heel on the floor. After a short break, the child imitates with the opposite leg. The same goes with the other leg. Afterwards, they move to two blows of their heel on the right side, one on the left side, crossing over the fixed leg. Afterwards, they move to 3 blows of their heel on the right side, 2 on the left side, crossing over the fixed leg. They change heels and perform many repetitions.

At each hit of the heel, therapist and child repeat, in turns: "tsummmm-bummmm".

During breaks at the posture of complete relaxation-peace, we observe the activity of the diaphragm during inhalation.

In the early sessions, children's diaphragm will appear inactive, rusty.

5) In a large space, the child rhythmically rides on a wooden horse.

6) Perioral massage: in advanced sessions and after noticing improvement, the child lies down on its back, on the floor, and with a spatula, the therapist engages in circular massaging points around the lips, starting from the center to the right side, just below the nose, moving from the center to the left side, just below the nose, finishing with similar cyclical movements in the respective lower parts of the lips.

Each circular motion of the spatula is accompanied by sound hums of the therapist, in various tones.

mmmmmmmmmmmmmm…
mmmmmmmmmooooooo…
etc

The child, after a short break, repeats the hum, mimicking his therapist.

7) Similar pressure massage is applied to adjacent points of the cheeks, always supported verbally by encouraging periodically the child to close its mouth.

8) Finally, with clean fingers, the child is encouraged to make funny sounds vibrating its lips.

9) The therapist places four fingers on pressure points above the upper lip, while also pressing the thumb under the bottom lip of the child.
With his fingers, remaining perfectly calm, the therapist applies vibrations, while whispering a hum (summen), in various tones.

mmmmmmmmmmmmmm…
mmmmmmmmmooooooo…
etc

The child, after a short break, repeats the hum, mimicking his therapist.

10) After several repetitions, and when improvement is noted, the therapist proceeds to activation by vibration of the nasal cavity, with the following hums:

mmmmmmmmmmmmmm…
mmmmmmmmmooooooo…
nnnnnnnnnnooooooooooo…

In advanced sessions, these exercises for lips and nose can be made with the child seated, with legs at right angles and keeping the spine straight.

11) Children are encouraged to deliver small syllables just when they bend a knee, leaning forward from the upright standing posture.

We begin with these phonemes:
kkkhhhhhhhhhhhhhh…
fffffffffooooooooooo…
pammmmmmmmmm…

Later on, they proceed to the pronunciation of words with the same kinesthetic process.

During sessions, we keep constantly correcting the child's posture, or urge to close the mouth, since old stereotypes are a very strong habit.

12) With both hands clasped, resting on top of the head, the child is encouraged to express the following hums:

ommmmmmmmmm…
ammmmmmmmmm…

13) At cobra posture, the child, from the ground face down slowly lifts his head, keeping the chin attached to the chest, and focuses his gaze, for a few seconds, at a distant point.

When tired, the child returns to the posture of complete relaxation-peace on the ground.

Proper execution of these exercises is more important than quantity. Proper implementation is difficult to describe and must be experienced by each therapist in practical training sessions.

Competing interests: Chasapis Athanasios studied, for many years, at the speech therapist Center and Institute of breathing run by Mrs. Maria Summer, and participated in many seminars for Advanced Speech Therapy abroad. He then transferred and extensively used these practices of the holistic method (speech-voice-breathing-attention-learning disorders-etc.) in his speech therapy Practice in Greece, from 1982 until now. He is the author of a forthcoming book in German, which describes extensively the pioneering holistic method of Mrs. Maria Summer, who died in 2007, without leaving a textbook behind.

05 March 2014
Athanasios G. Chasapis
Psychologist-Specialist speech therapist using the holistic method
Stavros Saripanidis, Consultant in Obstetrics and Gynaecology
retired
Thessaloniki, Greece