How to help child with verbal apraxia/dyspraxia?

[Biscuitless]

DS is 4 and although we don't have a formal diagnosis of what is wrong with his speech, he ticks all the boxes I have read about for verbal dyspraxia of speech, which I believe is called apraxia in the US.

Has has good (age appropriate) understanding, as confirmed by our private speech therapist, but zero spoken words. He can't even say mummy. He has just (in the last 6 months) started to copy some consonants but cannot get vowels - if I try to get him to copy a vowel it comes out differently each of the 5 times in a row we try it. He cannot blend sounds together at all. He can recognise much of the alphabet and we are trying to use letters to teach him to speak.

It is not an understanding or auditory problem (he reacts instantly to even complex/indirect spoken sentences) but seems to be a motor planning issue between brain and mouth. He has also been assessed for ASD and there are some traits (language and social communication delay) but not the other aspects of the triad. I feel the ASD is not the cause of his current lack of language. He spends a lot of time playing interactive games with his sibling. The private SALT said there is a specific language disorder going on as well as the ASD as she would expect him to have some words at his stage.

He has received very little therapy to date other than what we have paid for privately. NHS SALT kept assessing him and asking us to come back in 3 months but offered no actual therapy. Private SALT has got him to the stage he's at now but isn't allowed to see him any more now he is school age (as she works in schools). He's just started in a language unit attached to a mainstream school but I am not sure yet what to expect.

The only treatment information I have been able to find is US-based and involves highly intensive and specialised therapy. So, my questions are: if you have experienced this

1. what therapies did you find helpful
2. what was the outcome

Many thanks!

Good morning

My son has verbal dyspraxia and asd.

In answer to your questions,

1. his private and nhs speech therapists delivered the Nuffield programme or address his difficulty with speech sounds. He also had other programmes to address his expressive language problems. He attended a speech and language unit attached to his school for 18 months from when he started school shortly after his 4th birthday.

2. he is now aged 8 in mainstream, getting suppprt via his EHCP. He is happy and making ok progress. His speech is understood 95% of the time I would say.

I am so sorry you are getting so little help from the nhs. The sad thing is they are stupidly under resources and it’s a postcode lottery.

Best option will probably be to fight for help via education system - have you applied for EHCP?

Go to ipsea or afasic websites for more information, both these charities also have helplines. There are also some great verbal dyspraxia Facebook groups. Search verbal dyspraxia UK - dvd

Happy to help with any other questions

Thank you so much Ahhcanthink - it is so good to hear from someone who has experienced this (I sometimes feel I have made up this condition as I've never met anyone who seems to know anything about it). It is also good to hear that the treatment has really helped in your case. Your DS must have worked so hard!!

We do have an EHCP, which got him into the language unit, but it contains nothing specific to what I think his actual problem is. All the assessments we have ever had done focus on the ASD aspect but that's not what's holding his expressive language back. I am fighting to get them to believe me and for treatment which actually helps. The NHS SALTS we saw assumed he doesn't understand language and that I am a deluded mother. In our last session they ignored him for 30 minutes while they spoke to me then they asked him to point to an object on the table. By that time he was completely fed up (he didn't like me talking about him) and he went and fetched both our coats and insisted we leave! So he wouldn't co-operate with any of their tests.

I hadn't thought of looking for information on Facebook but have now applied to join the group you mentioned. Will look up websites and also the Nuffield programme.

My DD was diagnosed with profound verbal dyspraxia aged 2. We had to go private as well, but once we did and had their reports, the NHS started offering us therapy. We had this alongside private therapy. You can do the therapy yourself once you know how.

As the pp said, look up the Nuffield programme. They have a CD you can buy where you can make your own sound worksheets and symbols. We also got an appointment at the Nuffield Centre in London. They were very thorough, but as DD was about to start school in a speech unit, they said they couldn't offer any more help than she would get there.

DD spent 3 years there and now, aged 8, has been in mainstream for a year. Although she still has an EHCP and a little help at school with practising sounds, everyone can understand her now. To think we wondered if she'd ever be able to speak, it's truly amazing. It is a really tough thing to go through, but your DS will get there. Just practise (making it fun!) all the time.

DD2 has "normal" dyspraxia, plus a lot of problems articulating sounds which I strongly believe is verbal dyspraxia (but our NHS speech therapist was useless and never actually put her finger on exactly what was "wrong" with her speech at all), and also some organisational/grammatical issues with her speech characteristic of dyspraxic speech in general (from the much much more useful private speech therapist).

The only real help we've had is school - who've put together their own programmes of intervention while we were fighting through the NHS speech therapy referral lists... unfortunately they put so much intervention in place in terms of helping her articulate speech sounds that it put her right on the cusp of the revised NHS criteria around here (changed the week before her assessment appointment came through - you couldn't make up the shitty luck we've had with this) and it was touch and go if they'd see her at all... waited our time out (year on the list) and then got this dire therapist who just whined about having to do the clinic across the far side of town and had a right attitude on her. Our NHS criteria around here now seems to be that if you can put teddy in the blue cup you can fuck off home - we can put teddy in the blue cup till the cows come home - the understanding has always been there.

So bank of Gran and Grandad is paying for a private therapist to work with her going into school (school are begging for some guidance for intervention work for her - so it would be rude not to take advantage of this!).

From starting nursery with pretty much zero intelligible speech (the understanding, content and vocabulary were there - they're fantastic), school where I could probably only understand her 50% of the time (so anyone not tuned into it much less) she finished Reception year pretty much intelligible to people (apart from when she's having a good whinge when it just drops to a stream of pissed off woe). We still have a lot of issues with unnatural intonation, and she slows her speech going through words as she gets to a sound she knows she needs to think harder about to articulate, and you can hear the wheels turning when she's processing how to respond to a statement - so her speech still sounds quite forced - but she can make herself understood (and she's a right bloody chatterbox doing so).

No ASD in our case - possibly an element of inattentive ADHD (but we're right under the threshold with scoring for that) and lots of sensory processing difficulties.

The other issue we've had is that as her speech has developed - we're now about 3 years behind the curve emotionally as her ability to argue the toss and protest about everything has materialised - so we're back with the terrible twos/threenager strops at the moment.

Thanks to everyone for the helpful replies. So glad to hear your children are making progress with the right treatment (although I note the battles along the way).

I understand it can be frustrating but your lang unit place is like stardust. They will see there what he responds to and doesn’t and it’ll be easier to review his ehcp and action interventions than. It sounds like your DS has more DLD and stammer than ASD. A similar thing happened to our DD, they thought she had ASD at that age as she just did not speak at all. They didn’t give her much therapy because they only offer it to kids who they believe it would work on so we did lots of confidence building with her. By about year 1 she’d say short sentences but they were grammatically iffy and not longer than 3 words. She’s 10 now and has a diagnosis of DLD. Her speech is here and there but she manages. Never had therapy. Starting reading helped but early years were very very frustrating.

@Biscuitless how is your child doing now ? I’m in a similar situation with my 4 year old . Thank you.