A speech therapist helping a child with dyspraxia
Dyspraxia in children (also called apraxia, oral dyspraxia, verbal dyspraxia, or Childhood Apraxia of Speech CAS) is not a disorder that is well known in the community. As a Speech Pathologist, many parents tell me that they have never heard of dyspraxia (or apraxia) before their child was diagnosed. They also find that relatives, day care workers and teachers are not aware of dyspraxia or the other possible related issues, and not sure about what helps and what doesn’t.
As dyspraxia is a disorder of motor planning (planning and carrying out actions), it has serious repercussions for actions that the face and mouth need to do. Some children have difficulty eating and swallowing, and then learning to talk. Other children just have difficulty making speech sounds and joining them together. Babies with possible dyspraxia will usually have difficulty initially latching on for breastfeeding. Some may even have trouble adjusting to different bottle teats, or swallowing safely.
Early babbling sounds will also be limited, and many babies with dyspraxia are later described to be as “a quiet baby”. Some babies drool constantly and parents find they are often changing bibs and changing damp clothes.
When the time comes to move onto solids, swallowing may still be an issue. Most children with dyspraxia resist lumps and often refuse many types of solid foods. They seem to be finicky or fussy eaters. Sometimes they attempt to chew food and spit it out or simply resist eating.Their sounds at this stage are usually limited. Instead of joining up all different consonant and vowels sounds in a variety of sequences, children with dyspraxia mainly use just a few consonant sounds (like m or d or b) joined up to a limited range of vowels (like u or ah).
When they start to talk they are usually behind their peers with their speech development. By one year old children with dyspraxia may have a few words, but they are not very clear, and quite often they use the same ‘word’ to represent a few different things (like ‘duh’). Sometimes they even develop ‘their own little language’. Mums and dads may be able to understand some of what is being said but other people probably won’t.
Children with dyspraxia (or apraxia) can become reluctant to talk, especially when they have a high level of awareness of their difficulties, which can often be the case with bright little toddlers. They may have excellent comprehension skills. Parents often tell me their child understands everything they hear, and they can follow instructions and be interested in the world.Often by this time toddlers are becoming increasingly frustrated with their inability to make themselves understood. Behaviour can become quite difficult to manage. Some children become very adept at using other strategies to make themselves understood, to get what they need or want or to refuse what they don’t want.
By the time children are about two years, the difference in their talking between themselves and their peers can be quite dramatic. When they can say words they usually then have difficulty joining up syllables. The next step would be to join words. Very often, children can make a particular sound or say a particular word, but when they put it with another syllable they revert to making it inaccurately. This is because they are trying to plan a larger segment of speech and finding it too difficult. Older children with dyspraxia or apraxia can still have difficulty with some food textures. The most obvious differences between them and their peers are going to be in their speech, where they have difficulty with sentence structure and telling stories (oral narrative). They may also not always be clear with their speech. By this stage, if untreated, they may well have significant difficulties with auditory memory (remembering what they hear) so have more trouble following instructions, paying attention in class or learning to read and spell.
It is important to get help as early as possible. Early treatment can minimise the other possible later difficulties as well as making children happier with good social skills. However, at whatever point a parent realises that their child is having more difficulty than they should, with their talking, a Speech Pathologist can help to remedy the situation. All children need to be able to communicate easily and efficiently.
