Dyspraxia

Developmental verbal dyspraxia (DVD) is a speech disorder. The affected person has difficulty voluntarily making speech sounds and stringing these sounds together in the correct order to make words.

There is usually nothing wrong with the muscles used for speech. The difficulty seems to occur because of a breakdown in the motor program sent from the brain to the muscles used for speech. This does not mean that a person with DVD has an intellectual impairment. DVD is a speech disorder that can continue into adult life.

Other names for DVD
Some people call the disorder developmental apraxia of speech, or childhood apraxia of speech.

The numbers of people with DVD are not clear
It is difficult to estimate how many people have DVD because not all researchers and professionals can agree on the features that make up DVD. Therefore, at this stage, there is no data available to tell us how many people have a diagnosis of DVD.

Features of DVD
A person diagnosed with DVD may:

• · Pronounce the same word differently each time they say it.
• · Have general oral–motor difficulties. e.g. trouble chewing, sucking, blowing, and/or making certain speech sounds.
• · Look like they are searching or groping for the right sound.
• · Have difficulty imitating sounds and words.
• · Use a limited number of consonant sounds when speaking.
• · Mix up the order of sounds in words.
• · Have more difficulty saying longer words and sentences.

• Signs shown by small children
  Some very young children show signs that they may be having difficulty planning movements with their tongue, lips and jaw. Signs that may indicate a child will be at risk of future speech difficulties include:

• · Babies who don’t play with sounds and babble.
• · Babies and young children who have difficulties sucking, swallowing and chewing.
• · Young children who are not starting to speak like other children their age.
• · Young children who only use noises, gestures and vowel sounds to communicate.

• The cause is unknown
  There is no known cause of DVD. Some people think that a particular area of the brain is damaged in some way or has not developed normally. There is no evidence for this at the moment. Some people think there may be a genetic factor that causes a person to have DVD. There is no evidence to support this either. Further research is ongoing to see if a cause can be found.
  
  Some people may have other difficulties
  People who have a diagnosis of DVD may experience the following difficulties:

• · Feelings of frustration because they can’t get their message across.
• · Oral language difficulties, eg. the ability to put sounds into meaning.
• · Academic difficulties, such as reading and spelling.
• · Difficulties with other motor skills (for example using scissors, writing, riding a bike).
• · Sucking, chewing and swallowing difficulties.
• · Difficulty performing actions with their tongue and lips when asked to do so.
• · Clumsiness.

• A clear diagnosis is important
  It is important for a speech pathologist to make a clear diagnosis of DVD. They will then work to improve the person’s ability to store and find motor plans and motor programs for speech. They may also work on developing the person’s language abilities.
  
  Planning a support program
  There are lots of things to consider when planning a support program for a person with DVD. Some factors to consider include:

• · The severity of the speech disorder.
• · The person’s ability to concentrate on the program.
• · The person’s ability to understand what is expected.
• · The commitment of the person or their family to support the program.
• · The need to create a supportive environment.

• Benefits of support programs may take some time
  People with a diagnosis of DVD may not make improvements quickly. People with DVD will need to participate in an intensive therapy program for a number of years. Frequent sessions with a speech pathologist are beneficial.
  
  Speech pathology strategies
  A speech pathologist working with a person with DVD may:

• · Ask the person to imitate sounds, syllables and words.
• · Teach the person about sounds and explain the rules about when to use certain sounds in words.
• · Use gestures, pictures or touch specific points on the face or neck, to help the person make the right sound or sequence of sounds.
• · Introduce other ways to communicate; for example communication boards, key word signing or voice output devices. This will also help to reduce some of the frustration that naturally occurs if a person has difficulty getting their message across.

• A team of professionals may be involved
  A number of people may make up the team of professionals who support the person with DVD. Speech pathologists will assess, diagnose and support people with DVD. Other team members may include:

• · Teachers
• · Psychologists
• · Occupational therapists.

• The person with a diagnosis of DVD (and their parents or carers, in the case of children) are important members of the team and should be encouraged to contribute to goal setting and reviews of the program.
  
  Suggestions for parents, carers and family members
  Remember that the person will need to work through an intensive therapy program for a long time.
  
  Try to be supportive and allow the person to have time to communicate. Placing pressure on a person with DVD makes speaking more difficult. Remember, that a person with DVD has a lot to say – they are not intellectually impaired and they do understand what you are saying.
  
  Where to get help

• · Your local school or Education department may have a speech pathologist.
• · Your local hospital or community health centre
• Your doctor
• · Child psychologist
• · Child psychiatrist
• · Pediatrician

• Things to remember

• · DVD is a difficulty in voluntarily making speech sounds and stringing these sounds together in the correct order to make words.
• · A person with DVD is not intellectually impaired.
• · Speech pathologists can assess, diagnose and support people with DVD.