If your child’s speech is not clear, one explanation may be the condition called speech dyspraxia, also termed verbal dyspraxia, apraxia or developmental articulatory dyspraxia.
This article is based on the speech therapist’s speech therapy experience with dyspraxic children.
It aims to help parents and teachers understand what is dyspraxia, why children with dyspraxia may be unable to say certain sounds and have unclear speech or speech delay, what speech may sound like for a child with dyspraxia, how speech therapy can help, and offers teaching tips for parents and teachers.
What is speech dyspraxia?
As mentioned above, you may encounter similar terms for this condition such as verbal dyspraxia, apraxia or developmental articulatory dyspraxia.
Speech dyspraxia results in unclear speech or speech delay because there is impairment of the voluntary programming of speech muscle movements. These difficulties do not occur with involuntary movements. For example, the child may be able to lick food with his tongue, but is unable to move the tongue to say the ‘l’ sound in a word such as ‘lion’.
The problem occurs when the brain tries to programme the speech muscles for a particular movement or sequence of movements – somehow that message gets scrambled.
It’s like trying to watch cable television without the right decoder. There is nothing wrong with your television set. It’s just that your television set cannot read the signal that the station is sending out.
With dyspraxia, the impairment occurs with the programming of the speech muscles to be positioned at a particular position for a particular sound, be it ‘s’ or ‘p’ or ‘k’, as well as the programming of the sequence of movements in the right order (e.g. to produce sounds in a word such as ‘su-per-mar-ket’ in the correct sequence or order).
How dyspraxia may result in unclear speech, speech delay or the child not being able to say a particular sound:
- A child with dyspraxia or apraxia may be able to say a sound or word at one time and not be able to say it again, especially on demand (“Brian, say open”).
- A different sound may be substituted, sounds may get jumbled up or left out, (e.g. ‘police car’ may come out as ‘coopee ar’), or there may be no sound at all.
- A child may not be able to say a word when an adult is teaching it, yet say it later when he is playing alone.
- You may actually see the child struggling to get his lips and tongue in the right position. The process is effortful rather than subconscious.
- The child may seem to be screaming or shouting his words rather than saying them with appropriate loudness or pitch because of the effort required in ‘forcing’ the words out.
- The child may be able to say sounds correctly in short monosyllabic words, for example, when asked “What is this?” “Key”. However, speech becomes unintelligible in longer words or sentences, even if the same sound is involved (e.g. when trying to say a sentence “I saw a monkey at the zoo”).
These errors can be very frustrating for both the child and the parents. It is also often difficult for parents and teachers to understand because most children learn speech relatively uneventfully and speech becomes almost subconscious.
It is important to remember the errors are involuntary. The dyspraxic child is not being difficult, lazy or silly.
What can be done to help the child with unclear speech due to dyspraxia
A child who has speech apraxia or dyspraxia will not simply ‘grow out of it’. Without speech therapy, the child’s speech may improve with age, but may still be filled with errors and be difficult to understand.
Teachers or adults may underestimate the child’s ability because the child is not able to answer or speak immediately in response to a question.
For children who receive speech therapy, all but the most severely dyspraxic should eventually be able to communicate verbally. In severe cases, other forms of communication may be necessary to supplement speech (e.g. electronic communication aids).
How speech therapy helps a child with dyspraxia
A speech therapy programme for dyspraxia includes some or all of the following components:
- play / therapy activities where the child is encouraged and rewarded for speaking.
- learning activities for repetition of particular sounds or words so that the child will find it easier to say the sound (say the sound more subconsciously) and with increasingly less prompting.
- activities for improving accuracy and speed of speech movements so that the child will be able to say sounds in long words or sentences as easily as in short words, and express ideas in sentences that are clear and understandable to others.
Teaching tips for parents and teachers working with children who are dyspraxic or may have dyspraxia
Seek diagnosis from a qualified speech pathologist / therapist so that you can all work together to help the child.
It’s worth repeating: dyspraxia is a real speech problem. The speech errors are involuntary. The child is not being difficult, lazy or silly.
You could think of a dyspraxic child’s speech difficulties as similar to difficulties we may have learning other physical skills, for example, playing golf, or ballroom dancing. You know there’s nothing wrong with your hands and legs, but you may not know where to place them just by watching someone else play or dance!
Even after you learn a particular position, or step, it’s knowing how to do them all in the right sequence, and doing them fast enough, that is challenging.
For the child with dyspraxia, just as for us learning golf, dancing or driving, there is no substitute for practice. Practice, practice, practice, until it all becomes second nature – like …talking is, for the rest of us.
Fun speech activities that provide enjoyable opportunities for speech practice are among the most important things parents or teachers can do to help. These include:
- repetitive songs or rhymes (e.g. Old MacDonald with its “E-I-E-I-O’s”, Pat-a-Cake action rhymes).
- familiar favourite children’s stories with repeated lines (Gingerbread Man, the Three Little Pigs with its repeated “I’ll huff and I’ll puff” etc).
- daily routines (prayers, social greetings, bedtime rituals e.g. “Good night, sleep tight, don’t let the bed bugs bite!” etc).
Short note from the speech therapist
Children all around us use speech to express themselves everyday. Sometimes they enjoy the very process of saying certain words even if they don’t make any sense. In fact, the more nonsensical, the ‘weirder’, or possibly the ruder a word sounds, the more fun they have!
Children should be helped to learn, use and enjoy speech, and children who happen to have speech dyspraxia are no different. It is hoped that this article helps such children and their concerned parents and teachers.
The author, Ms Magan Chen brings with her more than 24 years of speech and language therapy experience in both private hospital and enrichment centre settings. This gives us exceptional understanding of our clients’ medical and/or school needs.
She has helped more than 1500 individuals to overcome their communication or learning difficulties.
Ms. Magan Chen trained in London, U.K. (M.Sc. Human Communication) and Sydney, Australia (B. App. Sc. in Speech Pathology).
Magan is a registered Certified Practising Speech Language Pathologist (CPSP) with the Speech Pathology Australia.
She is also the founding President and a registered member of Speech-Language and Hearing Association Singapore (SHAS, the professional body representing Speech Language Therapists in Singapore.
Magan has been interviewed and featured in various newspapers and magazines such as Young Parents Magazine, The Straits Times & The New Paper.
Together with Magan, our team of competent and caring speech language therapists and teachers help hundreds of individuals improve their ability to communicate and have more say in life.
If you would like to see a highly experienced speech language therapist / pathologist for an initial consultation, please call us at (65) 6223-7876.