Developmental verbal dyspraxia

Developmental verbal dyspraxia (verbal dyspraxia / apraxia of speech) is a neurological motor disorder that impacts upon the child’s ability to plan and execute the movement that is required to produce speech.

As developmental verbal dyspraxia affects the child's ability to articulate the correct sounds / words it can be very difficult for the child to be understood by others as it often affects the child's intelligibility.

Our speech and language therapists can help by increasing the intelligibility of the child's speech and provide other forms of communication if necessary such as Augmentative and Alternative Communication or sign language.

Developmental verbal dyspraxia occurs in a child when the brain has difficulty in coordinating the correct body parts and muscles (tongue, lips, jaw and velum) to produce the desired speech sounds. It is not the result of muscle weakness or paralysis of the muscles used in speech. There are two types of developmental verbal dyspraxia; developmental verbal dyspraxia and acquired verbal dyspraxia.

Acquired verbal dyspraxia is caused by damage to brain specific to the regions that involve the process of speaking. This can occur in a child after an infection, traumatic brain injury, brain tumour, stroke or an illness that can affect the functioning of the brain.

Developmental verbal dyspraxia is present in the child from when they are born. This can be co-occur with other conditions such a genetic disorders and syndromes such as autism spectrum disorder or Fragile X. The cause for developmental verbal dyspraxia alone is unknown, however some research suggests that certain genetic and environmental factors can affect motor development. Factors include, exposure to alcohol and drugs, prematurity and smoking.

There is minimal research into developmental verbal dyspraxia and its occurrence in children. Developmental verbal dyspraxia lacks a consistent definition between professionals. It is also a secondary disorder to other conditions and therefore isn’t always diagnosed. For that reason an agreed prevalence rate is not available. Some studies suggest that, 1-2 children in every 1,000 children have developmental verbal dyspraxia.

Developmental verbal dyspraxia is a complex disorder affecting the brain, the symptoms and their severity vary in children. Some children may demonstrate very mild forms of developmental verbal dyspraxia others have a more profound form. The severity of developmental verbal dyspraxia depends on the level functioning in the brain. Some common symptoms associated with developmental verbal dyspraxia in children are:

• Delayed speech development in children -
• Speech sounds may develop at a later age than typically expected.
• May not coo or babble as a child.
• Limited array of speech sounds -
• Children may only have a small variety of consonant and vowel sounds.
• Searching of speech sounds -
• Attempting purposeful movement to coordinate the lips, tongue and jaw to produce speech sounds. It appears as the child is searching for the correct coordination to produce the sound.
• Inconsistent speech sound errors -
• Inconsistent production of consonant and vowel sounds.
• Simplification of words by replacing speech sounds that they find difficult with easier ones.
• Deletion of sounds from within words to make them easier to say.
• Imitated and automatic speech better than spontaneous speech -
• Children may find it copying speech demonstrated by another person easier than spontaneous speech.
• Automatic speech such as singing the alphabet or counting numbers is also easier.
• Words with more syllables (long words) are more difficult -
• The more complex the words and the more sounds they have and therefore there are more chances for errors to occur.
• Difficulty with rate, rhythm, stress, intonation patterns and pitch (prosody) in speech -
• Children’s speech maybe monotonous they may find it difficult to vary tone of voice.
• Slow rate of speech.
• Difficulty stressing correct sounds in words.
• Nasal speech.
• Difficulty combining sounds within words and therefore may have long pauses between each sound.
• Others or unfamiliar listeners find speech difficult to understand -
• Inconsistent errors and production of speech sounds reduces their level of intelligibility to others.

Other difficulties that may arise alongside speech difficulties are:

• Difficulties with reading, writing and spelling.
• Hypersensitivity or hyposensitivity to touch inside their mouth.
• Delayed expressive language development- such as word order and word recall.
• Difficulties generally with coordination and fine motor skills.

Developmental verbal dyspraxia is a speech sound disorder and therefore has an effect on the child’s spoken language. This can make communicating with parents, siblings, peers and teachers problematic. Potential difficulties that a child with developmental verbal dyspraxia can experience on daily basis are:

• Difficulty being understood by others.
• Difficulty with reading, writing and spelling.
• Difficulty be able to express their thoughts through speech that is understood.

• Difficulty creating friendships.
• Difficulty expressing emotion by using volume and intonation in their voice.

Difficulties with speech and communication can build up frustration and anxiousness in children who have developmental verbal dyspraxia. Levels of frustration and difficulty experienced by the child can be reduced with help from our speech and language therapists. Our speech and language therapists can assess your child and provide an individualised treatment programme that can help increase your child’s intelligibility.

A comprehensive assessment of your child’s speech, language and communication skills will be provided by our speech and language therapists. As developmental verbal dyspraxia is a complex speech sound disorder, the assessment process would include a variety of formal and informal assessments. The assessment tools used to assess children would vary according to their abilities and needs. The following assessments would be carried out in either a formal or informal form:

• Oro-motor examination.
• Speech sound assessment.
• Spoken language assessment.
• Assessment of speech prosody.

Children with developmental verbal dyspraxia can find speech and language therapy of great benefit. It can increase their communication and help to make them more intelligible.

Our speech and language therapists will primarily work toward increasing your child’s speech, language and communication skills to their highest potential.

Some benefits of speech and language therapy for a child who has developmental verbal dyspraxia include:

• Children’s intelligibility levels increase.
• There is an increased level of communication between children and others.
• Reduced frustration within children.
• Increased level of confidence and self-esteem in children.

For a child who has developmental verbal dyspraxia, being understood by others can become a daily struggle. Our speech and language therapists can provide a course of speech sound intervention to work on specific sounds the child finds difficult, this will help to increase their intelligibility to others. As each child is different and their needs and abilities vary, our speech and language therapists will work in partnership with you and your child, the school and other professionals, to develop an individualised therapy programme that works on yours and your child’s main concerns.

Therapy approaches taken for developmental verbal dyspraxia include, motor-learning, linguistics, sensory cuing and prosodic therapy. Our speech and language therapists will combine the approaches according to child’s needs. It is suggested to improve intelligibility in children with developmental verbal dyspraxia frequent and intensive therapy is needed.

If the developmental verbal dyspraxia is severe in some children then our speech and language therapists may suggest Augmentative and Alternative Communication, for example, introducing sign language such as Makaton, visual aids or hi-tech devices.

Therapy options our speech and language therapists provide include:

• Speech sound intervention.
• Individual therapy.
• Group therapy.
• Speech group.
• Support, training and advice for parents and other professionals involved with the child.
• Adjusting the child’s environments to suit their needs.
• Alternative Augmentative communication.

Speech and language therapy aims to support a child who has developmental verbal dyspraxia to become more intelligible, to be able to communicate with peers and to participate in the same activities as their peers in daily life. To create a therapy programme that works on yours and your child’s goal our speech and language therapists can assess your child’s needs at school, home or in clinic.