Experience of speech dyspraxia/phonologic al disorders?

(24 Posts)
LadyMargolotta Thu 24-Jan-13 08:14:13

My four year old ds already has intensive speech therapy, and they have finally said that he has speech dyspraxia and a phonological speech disorder. Apparently it is quite unusual to have the two?

His understanding and vocabularly are normal.

He is awaiting further tests for motor skills. I am assuming that he probably has generalised dyspraxia as well as speech dyspraxia.

If your child has/had similar problems, how did they progress? What help did they receive in school?

Thanks!

LadyMargolotta Thu 24-Jan-13 08:17:56

And how did they get on emotionally with their problems? DS is becoming more and more clingy, refusing to sleep alone, and not wanting to go to school. I think it's because he realizes more and more that the other children and teachers don't understand him sad

LadyMargolotta Thu 24-Jan-13 16:48:53

Bumpsmile

Ineedmorepatience Thu 24-Jan-13 19:10:55

Hi lady you might be better posting this on the special needs:children board.

There are lots of helpful, knowledgable people over there.

Good lucksmile

Journey Thu 24-Jan-13 23:15:53

My ds has speech apraxia but not the phonological speech disorder. To be honest though I find it difficult to understand what the difference is between the two. The more I read I wonder if many speech therapists really know themselves since it all seems to be a bit of a blur.

My ds is doing very well at school (which in turn means the same can apply for your ds). Speech apraxia has no impact on intelligence. He has friends and has had no issues with his classmates or teachers not understanding him. I'm quite surprised by this but I think they have just accepted my ds's voice so haven't thought twice about it.

He has had speech therapy for about six years now, and has had support for sentence structure at school and past/present tenses of words.

A lot can change in a year for a dc with speech apraxia. He is young to be going to school at 4 years old. If you can delay him at all I would.

A little observation I have noticed is boys with speech disorders tend to get on with the girls in their class (especially during their first year at school). I wonder if it is because the girl likes to do all the talking! I'm not saying for one moment he can't make friends with boys but I wouldn't dismiss a playdate with a girl because it might be beneficial for him.

The future is good for speech apraxia so try not to worry too much.

Journey Thu 24-Jan-13 23:18:37

Op - speech apraxia and speech dyspraxia are the same thing. I just realised I used speech apraxia which may of confused you.

LadyMargolotta Fri 25-Jan-13 08:19:56

Thank you very muchsmile

Journey - you are right - he does play with the girls - and they do most of the talking! Telling him what to do, helping him. He is a very gentle boy anyway, and really isn't into the rough and tough playing that most other boys do.

It's typical for children in Belgium to go to school from 2 and a half, but formal learning won't start until the year he is 6. So there is no pressure on him to start learning to read and right. School for him at the moment is structured play, crafts, singing, dancing.

Funnily enough, he loves to sing, and he comes home singing songs I recognise - even though he can't sing the words, he can sing the tune very well.

I am trying to understand the difference between the two disorders. I think that speech dypraxia is a muscle co-ordination probem (neurological in cause); and the phonological is that he cannot hear the difference between the sounds, even though his hearing is normal. I think I may have a phonological problem, although not as bad.

Will hunt out the special needs forum.

LadyMargolotta Fri 25-Jan-13 12:40:23

Journey - did they do any other tests on your ds? The doctor has suggested that they may want to do neurological tests on ds.

HormonalHousewife Fri 25-Jan-13 12:48:53

I would second exactly what Journey has said. In fact its an excellent post and mirrors my experience almost exactly.

My son is quiet but has never had problems with making friendships and his peers have always managed to understand him or interprate for him. This was one of my biggest worries that he would shrink away and loose any confidence. Far from it !

At six we are making leaps and bounds now. In fact his speech therapist has said he doesnt need anymore help at the moment as he is catching up with the 'normal' age appropriate sounds.

It just takes time and you have to be patient.

LadyMargolotta Fri 25-Jan-13 13:29:34

Thank you HormonalHousewife. I can understand ds a lot of the time, probably about 70% of the time, but his teacher and his aunties and grandparents don't understand him very much at all.

His vocabularly has improved a lot over the past couple of months, and he pronounced 't' for the first time in a word the other day, so there is definite progress.

Journey Fri 25-Jan-13 15:53:05

HormonalHousewife That's great to hear about your ds doing so well.

LadyMargolotta if you look at the apraxia-kids website there is a chart with the difference between apraxia and phonological disorder (and also dysarthria). I've tried copying the link but I don't think I've been successful!

http://www.apraxia-kids.org/site/apps/nl/content3.asp?c=chKMI0PIIsE&b=788447&ct=464135

Verbal apraxia is a neurological motor speech impairment that involves a breakdown in the transmission of messages from the brain to the muscles in the jaw, cheeks, lips, tongue and palate that facilitate speech.

I think they say it is a bit like us trying to watch tv without it properly tuned in but having to make sense of it. The way I sometimes view it is my DS's library of words in his head is stored in a different way from the norm so his recall is done in a "chaotic" manner when he wants to say something, while someone without speech apraxia has a well organised, sructured storage of words and so can find the words automatically.

This definition may also help you:
Verbal apraxia (VA) is a motor speech disorder that interferes with an individuals’ ability to correctly pronounce sounds, syllables, and words. It is a neurologically-based motor planning disorder of unknown cause. It affects the programming of the articulators and rapid sequences of muscle movements for speech sounds. Verbal apraxia may occur as part of many neurological conditions or may occur in isolation.

I think motor apraxia is when there is a problem with the muscles when trying to speak.

The fact your ds wants to sing is wonderful. It is meant to be good for speech apraxia.

Being able to pronounce "t" is great. When my ds was doing his speech therapy he made the best progress when we just focused on small steps. So for instance one week we would just do "sh" words. The fact your ds is progressing and you are noticing a difference is very encouraging.

Tell the teacher and your relatives how to respond to your ds when they don't understand him. For instance, I would usually tell them to say "could you say that a bit louder please because my hearing isnt the best/ there is too much noise in the background/etc so your ds doesn't feel self conscious when he speaks.

In the apraxia-kids website there is a link to "My child has apraxia - letter to the teacher" which you may like.

To diagnose my ds he had a verbal test with the head speech therapist in our area when he was about 7 years old. He hasn't had any neurological tests. It does sound a bit scary, however, if my ds was offered them I would accept. I think it might help to pinpoint things better because as I said in my earlier post I think there is a bit of a blur with speech disorders like apraxia.

The initial stages of speech apraxia can be daunting but things will workout okay. Just remember when you go through these tests how wonderful your ds is. I wish you and your ds all the very best.

LadyMargolotta Fri 25-Jan-13 16:26:32

Thank you journeysmile

He is such a wonderful little boy, and we will encourage him to sing. I think his speech problems are inherited, mainly from my father, who is also a musician, so who knows, maybe he's inherited his musical ability as wellsmile

I will look at the website. It looks very interesting, thank you.

blueberryupsidedown Sat 26-Jan-13 10:18:14

In the UK I think it's generally refered to as developmental verbal dyspraxia, or DVD. The Nuffield hospital has developed a world renouned therapy www.ndp3.org for DVD. Basically, the therapist isolates a number of vowel sounds and has various games for the child to try and repeat the sounds correctly. It can take months for a child to achieve this (it did for my DS) and then they do consonate vowel words, then CVC words, then longer words. I think it works on the principle that by repeating the sounds correctly over and over again, the brain will form new pathways to enable the child to use the correct sound in normal speech.

DS was diagnosed at the Nuffield hospital in London, and received therapy locally as well as at the Nuffield. He has been receiving therapy from the age of 3 to the age of 5 and has now been discharged from the Nuffield but still gets speech therapy and support at school, 4 days a week.

This is very helpful: en.wikipedia.org/wiki/Developmental_dyspraxia
and this: www.dyspraxiafoundation.org.uk/downloads/Developmental_Verbal_Dyspraxia.pdf

LadyMargolotta Sat 26-Jan-13 10:26:47

Thank you very much blueberryupsidedown.

So he was diagnosed when he was three? What extra help does he have in school - just speech therapy or one to one help?

blueberryupsidedown Sat 26-Jan-13 10:37:01

He was diagnosed at 3 and a half. But at three he went to a nursery which had a special speech and language unit, he was refered there by his local speech therapist. He started babbling at 2.5, and his first words were at 3 years old.

We always had concerns about him as he didn't make sounds, didn't attempt to make sounds, except laughing, grunting and crying. He didn't look at people in the eyes, and didn't respond to his name. Our GP refered him for earing tests and speech therapy when he was 20 months old, but he saw the SALT when he was just over two years old. She saw him every month to monitor him and give us tips.

He is now in year 1, and he spends 30 minutes to one hour, four days a week, with a specialist (and excellent) teacher assistant, sometimes one to one, sometimes in small groups with other children in his class, sometimes with other children from the school that have speech difficulty. They do various games, and follow on the Nuffield program. He still sees a qualified speech therapist in therapy blocks of six weeks in a row, once a week.

His reading and spelling are excellent, and he is brilliant at maths (I really mean it!). He has an exceptional understanding of numbers and maths concepts, and he is good at learning the piano (he loves best 'composing' little melodies).

Have you tried using Makaton signs with your DS?

LadyMargolotta Sat 26-Jan-13 10:42:21

blueberryupsidedown - does he have other problems apart from the speech dyspraxia?

All of my children were slow speaking, so I didn't really start to get worried until ds was 2.5. It took a year to find a speech therapist who was prepared to listen, as they all fobbed us off, saying that his bilingual upbringing was the problem.

Speech therapy didn't start until 3.5, and his speech therpist thinks that he may have dyspraxia and a 'working memory' problem, which is inhibiting his progress. She also suggesetd that he has autistic traits, but I don't think this is significan - his eye contact with me is good, he is empathetic and playful. He is probably just shy due to his speech problem.

blueberryupsidedown Sat 26-Jan-13 11:28:00

Has he seen a peadiatrician? If there are concerns over autism traits a SALT is not qualified to diagnose.

DS doesn't have other problems other than some mild physical dyspraxia. He 'grew out' of his problems with eye contact. The other issue he had is glue ear, which was mild and he never needed grommets.

He also have hypotonia (general) and hypermobility. Both are quite mild.

LadyMargolotta Sat 26-Jan-13 14:43:35

His school have referred him to a specialist clinic. I am not in any hurry for him to be tested, especially as I don't think that he has autism. In fact I am hoping that by the time the appointment comes through, he won't need it.

It's his speech and fine motor skills that are the worry at the moment.

blueberryupsidedown Sat 26-Jan-13 14:59:47

could he have more generalised dyspraxia - it does affect motor skills, both gross and fine. Can he ride a bike? Pedal? does he have general coordination problems? there is a checklist here. For us it was a peadiatricial that tested DS for dyspraxia. www.dyspraxiafoundation.org.uk/services/dys_dyspraxia.php

LadyMargolotta Sat 26-Jan-13 15:03:10

He will be tested shortly for motor skills. I think he has fine motor problems, to me, his gross motor skills seem ok.

lorisparkle Sun 27-Jan-13 09:26:06

My ds1 was diagnosed with a speech disorder at 4 after being fobbed off with 'it is just a delay'. He started school at 4 with most people unable to understand him. With salt guidance I worked with him literally relearning all the speech he had sound by sound first in isolation then with another sound then in a word then in two words then in structured sentences and eventually in everyday speech. It was lots of work and felt very slow but by year 1 most people could understand him. He is now in year 2 and his grammar is unusual and his sounds not perfect but he has been signed off.

From my understanding dyspraxia, dyslexia, adhd, autism, are thought by some to be part of same family and ds1 certainly has characteristics of them although not severe enough for a diagnosis.

LadyMargolotta Sun 27-Jan-13 09:48:58

Thank you lorisparkle. I try my best with ds, and he has made huge progress in that he is speaking so much more and attempting very complicated sentances.

The main problem with me helping him is that my pronunciation/articulation isn't that great, not a problem in english, but a big problem in flemish, and all of his speech tharepy is in flemish.

I find it hard to practise the homework with him.

It is interesting that all of these problems are interlinked. I am just hoping that ds's problems are 'just' speech dyspraxia and general dyspraxia, and nothing else.

lorisparkle Sun 27-Jan-13 22:40:10

That sounds really hard LadyMargolotta. Could someone at school do more with him or could the SALT give more guidance on the pronounciation. Although not the same I have never been able to say the sound 'r' however after working with DS1 and DS2 on their speech sounds I have now learnt how to make the sound (I never realised but I was putting my tongue in the wrong place) and can say 'r' appropriately!

LadyMargolotta Mon 28-Jan-13 09:25:23

Well done at saying 'r'! We deliberatley choose my dc's names to avoid 'r'. It's not much of a problem of english, but it's a real problem for me in flemish.

People regularly don't understand me because of my lack of that one consonant. I also find the vowel pronunciations in flemish difficult.

Unfortunately my own name, dh's surname, our road name and our house number all contain the letter 'r' and that does make life difficult sometimes.

I once took part in a presentation, just a couple of minutes talk, and afterwards the assessor stood up and said that she had not understood a word I had said and that obviously I had a serious speech impediment. That was very hard to hear, and it makes me very sad for ds, who has a far more serious problem then I ever did.

At some point ds will get more help at school, but for now, they think that SALT is enough.

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