In a building, construction has to happen in a particular order.  Scaffolding is used to be able to complete the job.

All children need some support to learn to talk well, and we can do this by acknowledging what they say, and modelling a more correct version, and showing them how to extend what their words or sentences.

Children with dyspraxia need a lot more scaffolding than most children learning to talk.  There are some strategies that work particularly well for children with dyspraxia.  Do praise all their efforts.  You can never give enough praise, and your child will be more successful if they feel that their efforts are worth it. Lots of praise, teamed with accurate feedback, will work well.  Your child needs to know when their attempts are more successful.

If your child is not talking very clearly, you can try some of these strategies:

• Model very clearly how a word or phrase should be said
• Repeat these models a number of times
• Exaggerate your speech, stretching out the long sounds, exaggerating the stressed syllables or key words
• Speak more slowly than you usually would
• Use the tune in your voice, speaking naturally but with more exaggeration – children with dyspraxia can use the tune to support their speech
• Sing and say songs and rhymes, exaggerating the rhythm
• Use actions or signs – they will stimulate the words to come
• Some children will respond to showing them how to pace their words or syllables (using a steady rhythm)
• When trying to build up longer words, use backward chaining – practise the last syllable first, then add the previous syllable, adding earlier syllables one at a time.  This can also be used to get all the words in sounds
• To help your child make sounds, show him with your mouth how to do it
• Follow your Speech Pathologist’s guidelines on how to stimulate specific sounds or if this is not possible see Dyspraxia e-book soon on this site

Aim to making talking and learning to talk fun.  Children with dyspraxia often need to drill sounds and words.  Elsewhere on this site are ideas for making drill fun.  Please remember that your child is trying to do something that is actually very difficult for them, and you may need to persevere for quite some time.

You can use different strategies at different times.  Some will work better than others at different stages of your child’s speech development, so be guided by your Speech Pathologist.

The strategies on this page will help you help your child over-all to produce better speech.

If you have ideas for scaffolding that have worked for you, let us know.  Leave a comment!

Your Speech Pathologist will most likely continue to work with you for some time to come.  We know that children with dyspraxia are at high risk for poor listening and remembering, following instructions and, later, literacy difficulties.  Children who are late talkers run a risk that other language skills are not developing when they should.

So it is really important at this stage that several other areas are tackled, to ensure that the language journey continues.

My top two areas to work on at this stage are:

• Auditory memory – remembering what you hear, and
• The foundation for oral narrative

Encourage remembering exact words of songs and stories

AUDITORY MEMORY means that when you hear acoustic (sound) information you remember it.  For children with dyspraxia this particularly needs to be memory for the sounds and words of speech.  Because they haven’t been able to practise saying what they have heard, they have not had the opportunity to develop the brain pathways for remembering words and sentences.

It is absolutely crucial for children to remember information, and to be able to develop more complex language skills.  They also need good functioning auditory memory so that they can follow instructions.

This skill can be developed even before your child can say long sentences.  You can, for example, use stories with repetetive refrains where, by the time they have heard it a few times, your child can start to fill in some of the words.  Or you can use stories with interesing vocabulary.  Pick a few favourites and read them lots of times.  Then start leaving off the last word in a sentence, or the most exciting words, waiting expectantly for your child to say the missing word.  This is called cloze.

Songs and rhymes are wonderful for developing auditory memory.  Do them enthusiastically one-on-one with your child, slowly and emphasising the rhythm, with actions wherever possible.  Start leaving off the last word of a line for your child to fill in.

Help your child start to tell stories

ORAL NARRATIVE simply means telling a story of some kind, like retelling something that has happened to us, retelling a story we have heard or read or making one up.  This needs to happen before we can make explanations or write stories, or generally make ourselves understood.

Even before your child can say long sentences or put lots of sentences together you can start on telling stories.  Pick some favourite stories with lots of pictures, using mostly short sentences.  Tell the stories many times.  Children tend to often choose the same stories over and over again.  This is because they are learning mastery of new skills on familiar ground.

Giving lots of support, help your child to start telling the well-known stories using the pictures as prompts.  If necessary, start the sentence for them.  Point to the parts of the pictures that need to be talked about.  Any attempts to mention the main points in the story deserve heaps of praise.

From time to time, pick new stories, say, from the library.  If the book has short sentences you can use the text as it is, or you can tell it in your own words using short sentences.  Make sure the plot is quite simple and straightforward.  Then go back over the story, pointing to the parts of the picture that you mentioned and help your child to retell the essential parts.

Build up your child’s confidence that they can do this retell by making it achievable and providing the scaffolding (support) that he or she needs to be successful.

If you have other ideas for helping your child remember or tell stories, let us know…

Certainly in the clinic we see lots of children who have had help with talking because of dyspraxia, who look for a Speech Pathologist when they are older because they are having trouble with literacy.

Why?

Reading is essentially a high level language skill.  It is based on the ability to hear and understand sounds.  It is particularly important to be able to hear sounds joining up to make words.  This is called Phonological Awareness.

Children also need to be able to manipulate sounds quickly and easily, out loud, and be able to do tasks like blending words into sounds (“What word am I saying?  p-l-u-m), and separating words into separate sounds (“What are all the sounds you can hear when I say plum?”).  Higher level phonological awareness tasks include being able to delete sounds (“Say plum but don’t say the p.”  “lum”), and substitute sounds (“Say hut, but instead of the u put an o”).

Good reading needs these skills to be fast and automatic, because the brain needs to be able to do other processes at the same time, like decoding, being able to match letters to sounds, and understand the words, sentences and ideas.

Children with dyspraxia have not had a good start in life as far as understanding sounds.  Because they can have so much difficulty in producing sounds and words, their brain has not had the same opportunity to remember exactly what sounds are like.  Even with excellent therapy, they run the risk of having some language skills that are below what are expected for their age.  They are likely to less well developed auditory processing skills – the ability to process sounds.  I find, especially, that children with dyspraxia have poor auditory memories.

Auditory memory is the ability to remember sounds and sequences of sounds, including words and sentences.  In children with dyspraxia this should not be overlooked.  Extra care needs to be given in therapy to make sure that children are given the practise at remembering, including remembering new words (vocabulary), sentence structure, rhymes and songs and instructions.

Another skill that is hard for children with dyspraxia is being able to plan actions and carry them out in a sequence.

As children get older and approach school age therapy needs to continue to make sure that the pre-literacy skills are working well.  Children need to be able to hear rhyming words and make up their own, and to hear syllables in words (like el-e-phant, three syllables).

If your child is in this age group, have fun with some of these phonological awareness skills.  Pick long words and clap out the syllables.  There are lots of animals and food that have multisyllables (like rhinocerus and watermelon).  Make up silly rhymes and real rhymes.  And find a Speech Pathologist who will help you with these skills, particularly planning and sequencing as well as phonological awareness.

They are not just careless children.  They are clumsy.  They are children who are having treatment for dyspraxia, usually a combination of Speech Pathology and Occupational Therapy.

Not all children with speech difficulties due to dyspraxia also have a motor dypsraxia.  However, many children do have an element of motor dyspraxia that affects their overall ability to plan actions and carry them out.  If they have an ideation dyspraxia then they find it hard even to conceptualise how to start an action or series of actions.  These children usually are within normal range for IQ and generally understand well.

Sometimes this disorder is even called Clumsy Child Syndrome or Developmental Coordination Disorder.

Many of these children don’t enjoy constructions toys as they can’t plan out what it will look like in 3-D.  They often don’t ride bikes as they can’t get their balance.  Even 2-D jigsaw puzzles can be hard.  Multitasking is very hard.  When they eat their meals some of it always ends up on the table or the floor.

Children with these difficulties are often ‘floppy’ with low muscle tone, and this is usually noticeable from babyhood when babies have ‘floppy’ heads.  By the time children are toddlers or in their early school years they would rather sit and watch TV or play on the computer than be active.  As a result they can be overweight and look as though they are lazy.

Treatment needs to make sure these children learn normal movement patterns that other children learnt to do as babies.  Physiotherapists or Occupational Therapists work on these areas.  In our practise we have Occupational Therapists who tackle these physical body movements as well as working on such skills as hand-writing and eye-tracking.  Where children find these skills difficult, in the classroom they will focus poorly and their attention will be easily distracted.

And then their academic succes is likely to be compromised, as their reading is likely to be poor.  Early talking difficulties make it harder to learn the pre-literacy skills like phonological awareness.   Reading also requires multi-tasking.

Poor motor control has been shown in reasearch to be correlated with poor performance at school.  Both sides of the brain need to be working in a coordinated way for thinking skills to be developed.

If your child fits this picture, find a practise where Speech Pathology and Occupational Therapy can work together to ensure that your child can easily make all the movements they need to get the information transfering betweent the two sides of the brain.  If the dypraxia is well managed, your child will have an easier time of academic performance and a happier school life.

By drill, I simply mean lots of repetition.  You absolutely need to practise whatever your speech pathologist has suggested.

There are a few tricks to drilling when children have dyspraxia.

Firstly, when children are really struggling with dyspraxia, you CAN attempt to say something too many times.  Dyspraxia is variable by nature, but repeated practise can result in a higher error rate.  So when your child starts finding it harder, rather than easier, leave it and try something else.  Better to come back to it in a few minutes or a few hours and take a fresh approach.

Secondly, drill needs to be very supportive.  When children have dyspraxia, you can’t just say, “Say it!”  They usually need the support of being shown how to do it, or picture prompts to make a word in steps, or they may need starting off.  Whatever strategies your speech pathologist has found works for your child – always implement them in your practise.

Incentives make drill fun

The last applies to drilling anything with children (or adults, for that matter).  Make it fun!  Children who are enjoying themselves actually learn faster.  They are also more likely to be willing, of course, if they are happy with what they are doing.  Ideas for fun drill are as limitless as your imagination.

If you are running out of ideas, try some of these:

• Post anything.  Most children will do something over and over if they can they ‘post’ an item, in a fancy post-box or a cardboard box with a clown face stuck with a hole where the mouth belongs.  You can post tokens or pictures of the words being practised (target words).
• Put your target words or sounds on cards and have your child shine a random torch on them to select which one to practise next.
• Pull target words out of a ‘feely’ back, glittery on the outside, soft and furry on the inside.
• Throw a bean bag onto target words turned upside down.
• Hide the target words under cups or containers.
• Offer a reward or token every time a word is said or a number of targets are reached.  This can include new pieces of lego, stamps, stickers or anything else that is motivating for your child.
• Have a ‘colour by number’ page handy and colour in a section every time a goal is reached or a word is practised x many times.
• Have your child pick a number.  Say, “Pick a number between 4 and 7″.  That is the number of times each item is practised.
• M&Ms are the best therapy tool I have.  Not much kids won’t do for a chocolate!

Rewards are usually of short-term benefit, but they do help to get kids over some difficult humps.  As your child finds they are having success, this becomes motivating in itself.

If your child has a smile on their face, then they will be making progress!

Babbling is an important part of speech development

Recent research has analysed baby’s babble and found that the quality of the babble is related to how easily a child learns to talk and the size of their vocabulary, as well as how clearly they can make sounds.

It doesn’t seem to matter what language a child is talking – their babbling is very similar!

At about 3 – 6 months, babbling sounds need to include sounds made in different parts of the mouth, including the lips (like b and p), and using nasal properties (like m and n and ng) and using the tongue (like d), as well as a range of different vowel sounds.  They need to be able to join some sounds together and repeat them (like dada, baba).

Your baby, in making these sounds, is learning to plan out the patterns needed to make these sounds.

In parts of Australia there is a screening program, designed by Speech Pathologists, that is used by Child Health Nurses to try to identify children who are at risk for speech difficulties.  Some of the questions relate to the kind of babbling babies are doing, as well as questions about their feeding and eating and socializing. If queries are raised about any of the answers to the questions in this program then the family is able to have several visits by Speech Pathologists.

When I see children who look as if they have dyspraxia, parents often tell me they have been quiet babies.  This sometimes becomes really obvious when a little brother or sister is born who is much noisier with their vocalising.  Vocalising simply means making sounds that are not speech.

So babbling has been found to be an important precursor to talking successfully and it is a good indicator of possible potential difficulties. Not always, but often.

Dyspraxia is not the only reason a baby is quiet.  The other most common cause is hearing loss or at least intermittent hearing loss.

An important part of babbling to think about is whether your child is using a range of different sounds and moving from one sound to another sound.

If you do have a quiet baby or your baby does not seem to meet this criteria then early Speech Pathology intervention can help to ensure that they get a good start to speech development. They can tell you how best to interact with your baby and encourage as much babbling as possible, as well as encouraging a good range of sounds.

Talk to your baby constantly, so that they develop a good memory for the sounds of speech.  Exaggerate how you say words and phrases, using lots of tune in your voice.  And have fun with making lots of sounds and noises together.

Everyone knows that children develop skills at different rates, and this includes talking. However, as a general rule of thumb, Speech Pathologists suggest that children should be using at least 50 words and starting to join them together by the time they are two years old.

Parents can be told to “wait and see” if their child is not talking at this rate, even sometimes by family doctors. If, though, you are at all concerned about speech development it is ALWAYS worth investigating.

A Speech Pathologist can look at how a child is trying to communicate, for example. We use communication for a wide range of reasons (communicative intentions) and it is most important that children learn early to do this. We use speech and other communication skills to do things such as ask and answer questions and use polite language.

We need to also see how hard a child is trying to talk and how successful these attempts are.

There can be all sorts of reasons why a child is not talking as well as their peers. Issues such as hearing loss or autism spectrum disorders can be a cause, or dyspraxia. Most of the time the explanation will be a fairly simple one. It is always better to know.

All the research shows the value of early intervention. There are potential impacts on learning, thinking skills, social skills and later literacy development.

Do seek a Speech Pathology assessment if you are at all concerned. In my experience, mothers are usually right when they are uneasy about a child’s development. You may be given reassurance, or else easy strategies that you can add to what you are already doing to enhance your child’s development.

If you have had either early intervention or have been told to wait, leave a comment to let us know about your experience…

This is a subject that is fraught with anxiety for many families!

When I see a family for the first time with a small child who is not talking well, parents are often surprised when I ask questions about feeding and eating. I ask about early feeding (Was the baby breastfed? Were their any difficulties latching on? How easy was it to transition to solids? What about eating lumps?)

Some children are fussy because they don’t like certain flavours, or just “like what they like”. Some children are allowed to develop fussy tendencies. But most of the children I see that eat a limited range of foods do so because it is actually hard for them to manage various textures. It can be particularly hard to manage meat and food that has mixed textures.

Children with dyspraxia have difficulty planning how to use the muscles of their mouth, lips, tongue and palate. The other muscles needed for swallowing can also be involved, including around the pharynx (at the back of the mouth, above the entry to the osophagus).

Fussy eating can be a symptom.

Not all children with dyspraxia are affected orally like this, but many are. A Speech Pathologist, as well as helping with speech, can help you to introduce and modify other textures.

Sometimes this can be done by taking a flavour your child particularly likes and presenting it with gradually modified texture over time. For example, if a child will only eat apple when it is pureed, but enjoys the flavour, puree it less and less over a few weeks.

If you have experience of a fussy eater, please leave a comment. Let us know if you have found strategies that work!

When I was growing up, it was thought that if brain damage occurred (because brain cells called neurons died) then the damage was permanent because the brain could not heal. However, since at least the mid-20th century therapists have been working to help people with rehabilitation after some kind of brain trauma or damage. So, in effect, they were finding they could ‘repair’ some of the damage.

Can the brain heal itself?

When technology eventually allowed scientists to look at living brains (instead of during post-mortems) neurological research went ahead quickly until by the mid-1990s it was accepted that the brain was ‘dynamic’ instead of fixed, and it was shown that new neurons could actually grow in the brain.

Simply put, information is passed through the brain by means of pathways of connecting neurons. When some sort of damage occurs it causes an interuption to these pathways. This means that the person can no longer do something they previously could do, and this could involve actions, speech, memory or other cognitive (thinking) function. Rehabilitation by skilled therapist can help to re-establish some of these pathways or develop new ones.

And learning always involves developing new pathways through the brain or reinforcing existing ones. As pathways are used more often they become ‘well worn’ and so tasks become easier and more automatic.

Learning in children is the same process.

So, for children with dyspraxia, some of the pathways that should have developed have not done so.

Speech therapists or occupational therapists are usually needed to help these children develop their speech. They generally establish what the child can do and show them how to make the next step, and then to practise the skills until they are automatic.

At times, people who have brain damage seem to regain some skills without therapy. Often in the early stages there is swelling or inflammation in the brain, and when this subsides then some skills are able to recover. Also, people are sometimes doing tasks or practising skills that help in the process, in the same way that a therapist might set tasks to do for particular skills. Sometimes people have been known to work really hard at accomplishing a skill they wish to remaster. Sometimes other parts of the brain have been found to have then ‘taken over’ the skills previously controlled in the damaged part of the brain.

In the same way, parents of small children are often able to encourage speech and language skills in a way similary to the way some therapy tasks might be given by a therapist.

So, yes, sometimes improvements can be made without therapy.

But, what a good therapist can do is identify for clients exactly where the breakdown is occurring in skills, whether in children who are learning something for the first time or in people whose brains need rehabilitation. They can then design therapy tasks that will directly work on the skills needed. They also know lots of tricks to help the practise along so that the talking becomes easy and automatic.

So, if at all possible, enlist the help of a Speech Pathologist to help children with dyspraxia. It is too important to just hope for the best.

So how do these terms all relate to each other?  He doesn’t have different types of dyspraxia piled on top of one another!

It helps if you think of dyspraxia as a disruption to the motor program. A motor program is the plan our brain makes in order to carry out any action.   When we are going to do anything, we first think of the concept, then plan how to do it, then tell our body how to carry it out and make adjustments as we go, if we need to.

A motor program plans and executes an action.

Ideation dyspraxia happens when the disruption happens at the conceptual planning stage.  The brain just can’t plan how to do a task.  This might be talking or building or riding a bike.  It is then highly likely that someone with this dyspraxia will also have trouble getting speech out, so this effect of the dyspraxia is called verbal dyspraxia.   A disruption at this early planning stage will often also affect the way the mouth and facial muscles are moved, and this is often called oral dyspraxia.

So the label that is given can be dependent on the point at which the disruption occurs, and also can be related to which processes are affected.  As well, dyspraxia has levels of severity, so that someone may have a widespread type of dyspraxia stemming from the conceptual part of the process, but have minimal symptoms.  Or they may have disruption starting at a later part of the process but have significant symptoms.

One of the main reasons for this website is to offer accessible information to people with dyspraxia, parents, teachers and others.

Feel free to leave a comment or question and I will answer it for you or point you in the right direction!