Unclear speech and how to tell developmental verbal dyspraxia

Developmental Verbal Dyspraxia

Every time we produce a speech sound or string of speech sounds in a word, we rely on the cooperation and coordination of certain speech muscles and oral structures. To produce sound we coordinate our lips, tongue, teeth, palate, jaw, breathing etc. For more information on what speech involves see this article.

When these tools that we need to produce fluent speech struggle to coordinate, clear speech becomes very challenging. One way to describe what happens in the process of producing speech, may be to think of your brain as the messaging application on your phone. You know what you want to say, you start to type it in and then you click send.

Somewhere in between deciding on your message and clicking send, the predictive setting has another idea and it sends entirely the wrong word or a similar word but not the one you wanted! We have all been there! Your message was interrupted at the planning stage.

Children with developmental verbal dyspraxia have difficulties at the planning stage and struggle to coordinate the movement of the muscles needed to produce speech. You may have also heard the term Childhood Apraxia of Speech (CAS). This term is used to describe the same speech disorder but is more common in America.  Having verbal dyspraxia can make speech very hard to understand and of course, is very frustrating for the child, who often knows exactly what they want to say.

How do I know if my child has developmental verbal dyspraxia or something else?

In general, verbal dyspraxia has a low prevalence rate* (1-2 children per 1.000). There are many reasons why your child may have unclear speech but if verbal dyspraxia is suspected it is vital to rule this out. There are no universally agreed criteria for diagnosing dyspraxia, however your speech and language therapist will look for the presence of some of following characteristics.

In some cases, you may notice challenges with voluntary movements such as smiling or puckering the lips. If you suspect that your child has verbal dyspraxia, speaking to a speech and language therapist as soon as possible is recommended. Children with verbal dyspraxia commonly need intervention to improve and accessing support earlier is linked to better outcomes. Verbal dyspraxia impacts on each child’s speech differently.

For one child it may mean they have very limited verbal communication, struggling to produce many individual sounds and for another it may mean they only struggle to produce longer words e.g. ‘helicopter’.  In addition, as your child changes, so too does the influence of verbal dyspraxia on their speech. It is always best to seek out an initial assessment if you are in any doubt.

  • Early on in development there may be limited babbling e.g. ‘ba,ba’, ‘ga,ga’.
  • There may be a limited variation of babbling sounds e.g. only one consonant.
  • Saying the same syllable or word differently on each attempt e.g. ‘phone’ said by the same child may sound like ‘tone’, ‘none’, phod’ etc.
  • Speech may sound staccato.
  • As words get longer there may be difficulty putting the syllables together, syllables may change or go missing.
  • Vowel sounds may sound different and a little unusual compared to the vowel sounds you produce.
  • Words that were previously mastered, become hard to say.
  • May have a few consonant and vowel sounds
  • Speech is hard to understand.

How to help a child with verbal dyspraxia

Tailored, intensive therapy is often recommended. Support is needed to help children at the planning stage of speech. Helping them to teach their muscles to how to produce individual speech sounds and sequence them. This requires daily practice and lots and lots of repetition.  Collaboration between parents and the speech and language therapist is therefore key as children will benefit from practicing their goals at home and in all the environments in which they communicate. For some general tips on how to support your child’s speech look here speech strategies article.

Some more ideas are below: In the end, whether it is through speaking, drawing, pointing, acting it out or using signs; the goal is to help your child communicate. Do what works best for you and your child in order to have meaningful and successful communication exchanges.

  • Repetition of words and sounds is very important. Encouraging your child to have multiple attempts at the word or sound will increase their success. For ideas on games to play whilst doing drills with your child, have a look here 
  • Using repetitive books is a good way to practice the same targets over and over again. It may be that your child can only say the last word in the sentence, or part of the word. This is ok, go at your child’s pace. Use the book repeatedly, helping them to say what they can multiple times. Check out this related article.
  • Beat and rhythm can help. Try drumming or clapping out a word slowly, e.g. ‘car/pet’. Then see if you can bring the word back together ‘carpet’
  • Create fun images e.g. for the word ‘carpet’ draw a ‘car’ and a ‘pet’. Where you can do this with words, it will give your child another hook to remember the word and is also lots of fun.
  • Write down words in a notepad that are meaningful for your child, e.g. things they like, or names of friends. Practice these daily and keep going back to words that they mastered on previous days. Help them to feel successful

For more information and support https://www.apraxia-kids.org/

*Shriberg et al., 1997

Written by Carolyn Fox, Children's Speech and Language Therapist

Related articles:

How to help your child with speech sounds

I think my child has a stutter - how can I help them?