Has anyone got experience of Verbal Dyspraxia?

[mymumdom]

First of all, hello. I hope it's okay to begin my life as a MN'er on this board?
My son is 3.5 years old and has what we've been told is 'most probably' verbal dyspraxia. He never babbled as a baby, and was late to wave and point. When he was 2, he only had a couple of vowel sounds, no words. We started weekly speech therapy last September and the SALT is pleased with his progress. He now has most of the vowel sounds, as well as a few consonants and uses about 10 words including, no, yes, mummy, daddy. We are waiting for an appointment from the CDC for him to be assessed. We are hoping for a diagnosis, and on the back of that a statement.
It's only his expressive language that is affected, his receptive (understanding) is good and he seems to have good co-ordination by our family's standards. He's a happy, healthy 3 year old who just can't talk- he gets most things over to us by signing and with sounds that we understand. Strangers can't understand him- but his nursery staff do now he's been there around a year
He is at nursery 3 days a week atm, and they do his speech exercises with him on the days he is there. I try to do things when he is at home, but he's not hugely co operative. We do usually manage to slip a couple of exercises under the radar before he realises though.
Our problem is that we are needing to sort out schools for him in 2012. Our borough has a school with a language unit a couple of miles up the road that he could go to. It's a good school, in an okay area. He will only be in the unit when he needs ST ( 2x a week) but he will be supported in the mainstream school. This would be fine if he was an only child, but he's not.
We have three older DD's who go to a school 4 mins down the road, over the Borough's border. It's an excellent school and we moved to the area especially for the school. This school will take him if we want to send him there but he will find it hard if he can't get the support he will need in mainstream school. The ST's who deal with the borough the school is in, won't help our son as he's from a different borough; the NHS ST's from our borough will not visit the school. We will have to pull DS out of and take him to his sessions during school hours if he goes to our present school.
I just don't know how we will manage the school run if he goes to the school with the language unit, transport has been mentioned but I don't want to stick my 4 year old on a bus :(
Also he thinks he is going to the same school the girls do, and is used to it. He will be upset if he can't.
I guess I'm hoping his speech will improve enough within the next year that he can go to our present school, even if he doesn't get a statement. Has anyone's child with Verbal dyspraxia improved that much with a year of SALT?
Or has anyone else got any other advice for us? We want to do the best we can for DS, of course, but not at the cost of the rest of the family unless it's absolutely necessary.

What is different about Nuffield therapy? My daughter is diagnosed as "severe VD" and has weekly therapy at the clinic, but it is mostly what I would guess is standard therapy? Lots of picture lotto with words begining with the target letter and some 'big mouth' pictures which show how the sound is made. Are we missing out by not doing Nuffield? (by the way I totally respect our SALT, I'm just aware that they can't be expert in eveything).

Nuffield is multilevel, multitarget with a heavy emphasis on production work.

That means your child might be working on lots of different sounds but in different sound patterns/syllable shapes. The decision about what sound they would do at any level would depend on analysis of what they were already doing and what was the easiest next step.

/l/ at single sound consonant
/a/ at vowel level
m at cv level moo, ma, mee, my etc
n at vc level e.g. an, in, on, un etc
b at cvcv level e.g. beebee, booboo, baba (you might have a few cvcv targets with some sounds staying the same across the word like beebee, some changing like teddy or money or digger)
cvc words - (maybe different targets for words at the beginning and ends e.g. you might be working on k at the end of a word like back but b at the beginning as in bat)

s in ccvc words e.g. spin, spot, spat
s in cvcc words
Other sounds in more complex words.

Not all children might be working on all of these - some children might start with just work on single sounds (vowel and consonant) and trying to put these into cv/vc combinations, or they might have single sounds and cvcv combinations like mama and baba and dada as these are the easiest next step.

Therapy is very fast paced - lots of drill work. Not so much listening work (if any...).

The above examples are just examples by the way - not an example of how therapy would really look like.

Picture lotto would be fine if it is very fast-paced and they are doing lots of repetition of the target e.g. if saying dad they are saying this again and again really quickly.

Cued articulation (Jane Passy) is often a helpful cue for children with VD too.

Thanks for the explanation working9while5. I can see from your description that it is more specific but also why our therapist isn't choosing to use it just now. We are not at the stage of being able to do 'fast-paced' anything - and a lot of it is to do with confidence. I can see us nearly being able to do it though - so will look into it. Thanks.
Our SALT suggested cued articulation too. She doesn't use it really in therapy (a shame) but I use it loads at home and it really is brilliant. For others interested, I learned it from the DVD here which is a bit pricey for a 5 minute DVD, but well worth it for the results.
Thanks again.

The other practical I can suggestion I can make if you are at the early stages of therapy and your child has limited attention etc is to ask for suggestions of more play based drills e.g. we used to use a collapsible tent and a big sheet of colourful material with young children to establish the motivation for repeated trials of in/on/boo and then we would throw in animals/toys and toss them about e.g. baba or moo or moomoo or baabaa or a doll (baba). Lots of rough and tumble, hiding the animal in a bag or under a blanket and running in and out of the tent.

Sounds targeted would need to be appropriate to your child's level following assessment.. just giving an idea of how you can make drills more workable. We would do it really fast.. Lots of boo! Boo! boo! We also used this to teach him how to use a communication aid as he would ask for people to join him in the tent.

If you haven't already, do consider augmentative and alternative communication early on, if you can. It's important for the development of spoken language (sentences etc) that they are learning how words work in sentences and using language in a variety of contexts, not just waiting until speech comes on to do that.

I have seen some specialist SALTs wait on this but it's not a good idea IMO. I say this as someone who works in secondary language units and who has had to introduce AAC really too late in the game for those few students with very severe VD who have gone as far as they can with speech. I often think that if they had AAC when they were younger and used language more that perhaps there would have been a better motivation for them to use and practice their sounds more so actually they may have needed AAC less? Just a hypothesis, no evidence for it.. but I feel passionately that kids need to have a proper voice and not become trapped into learned helplessness needing an adult or older child to interpret for them.

Hi again. Funny you should mention a collapsible tent. That's one place that my DD is happy to practise in. I think that it feels 'safe'.
Just a quick query about AAC that you refer to. Signing is the alternative communication that we (and I guess a lot of young children with speech delays of any sort) are using. Do you mean signing here, or do you mean picture board, electronic aids? Thanks.

Hi Boboma - any type is fine as long as it's sufficient to keep pace with what she needs to say e.g. she doesn't have motor difficulties that make it hard for her to say what she wants to say through signing.

I'm finding this all very helpful. My ds (2 and a few months) has just had a diagnosis of 'probable' verbal dyspraxia so we're about to start the journey... I'm thinking about doing a makaton course or trying to find a makaton tutor in north ldn. Anyone got any experience / recommendations?

I am the OP and have just found this thread again so thought I'd update.
DS is now 7 and did eventually get a diagnosis of VD.
We sent him to the mainstream school his sisters attended as I felt we could go on with his ST privately if we needed to. Thank goodness we did, as a term after he would have started in the unit, it closed down! I would have been gutted if I'd sent him there.
He had 15 hours of 121 a week in his reception year and had weekly ST out of school and we were lucky in that he responded very well to it.
These days his speech is about 95% telligible to a total stranger and people often find it incredible that he had a problem at all. He talks all the time, and I do have to tell him to be quiet sometimes!
As he's grown, it's become quite obvious that he as other SNs though, most likely physical dyspraxia, as well as poor muscle tone, lack of co ordination and hypermobility, so we are dealing with these things atm.

Hi FiveHoursSleep. Nice of you to come back with an update and some positive changes for your son. My DS is just 4 with a diagnosis of VD. He receives weekly SALT and daily individual TA sessions in school, all of which we have to pay for. We've opted to do this in a small independent, Montessori school as our other option was a 20 mile trip to a language unit in a not great school. He finds school hard as he's young for the year but we can see he is making progress with his speech and he has the confidence to form relationships and contribute in class.

We went to the PT/OT a couple of weeks ago and it seems that we may have the same issues with physical hypermobility and dyspraxia. Have just had some exercises through and will start to have a go with these. I'm dropping my work hours so we can have a bit more time to focus on DS's needs. Onwards and upwards, one step at a time and all that.

Thanks again for posting. I am so pleased to hear that your sons speech is intelligible to a stranger. I'd give anything for that outcome from where we are now.

Thanks for your reply Boogle. Has your son been diagnosed recently?
We were lucky that we got an early diagnosis. I blogged about his progress here
mymumdom.com/a-proud-mummy-post/
If you click on that, you will see links to videos of his progress over time if you are interested.
I am sure an early diagnosis helped us tremendously but it was hard work getting it and I think it's harder now :(