10/31/01
With two boys at home and the shortage of pharmacists necessitating overtime it's been hard to find time to update the website lately. Zach recently had his I.E.P. (Individual Education Plan) with his school and the the teachers and therapists there. He also has continued to see his speech therapist, Mindy, at St. Luke's rehab here in Spokane. The consensus seems to be that Zach has DVD (Developmental Verbal Dyspraxia) also known as Speech Apraxia -- difficulty in coordinating the muscles used in speech. Zach continues his therapy and school and one of our goals is for him to have a 50 sign sign language vocabulary by the end of the year.

Here's some information I was able to find about it on the internet. See related sites for links to the individual web sites.

Developmental Verbal Dyspraxia: General Information for Parents (David Hammer)
Developmental verbal dyspraxia (DVD), also known as developmental apraxia of speech and as oral motor planning disorder, is a disorder that is more easily defined by what it is not.

It is not a muscle disorder and it is not a cognitive disorder

The problem occurs when the brain tries to tell the muscles what to do -- somehow that message gets scrambled. It's like trying to watch cable TV stations without the right descrambler. There is nothing wrong with the TV station, and nothing wrong with your set. It's just that your set can't read the signal that the station is sending out. The child's language-learning task is to figure out how to somehow unscramble the mixed message her/his brain is sending to her/his muscles.

The visible results (symptoms) of DVD are:

little or no babbling in infancy; few consonants, understanding of language much better than production of language, slow, effortful, or halting speech; sometimes seems to struggle very hard to understand and may make slow progress in therapy.

DVD has MUCH more effect on volitional (voluntary, creative) speech than on automatic speech. This means that THE MORE YOUR CHILD WANTS TO COMMUNICATE A PARTICULAR MESSAGE, THE HARDER IT WILL BE! So, if you happen to hear her/him say something once when there is no pressure, and you say, "Say it again!", you are guaranteeing that she/he won't be able to. IT IS VITAL TO PUT A MINIMUM OF COMMUNICATION PRESSURE ON THE CHILD.
NOTE: Your child's speech-language pathologist will need to put communication pressure on the child. Low-pressure verbal activities are the most important thing a parent can do to help. These include:

songs -- especially repetitive songs, like Old MacDonald and finger-plays
poems
verbal routines (pat-a-cake, Willowby Walloby Woo, etc.)
repetitive books
daily routines (prayers, social greetings, salute to the flat, etc.)

You can make other activities into verbal routines; make up little sayings or poems that you say every time you do the same thing, label instead of counting objects in counting books ("Three dogs: dog, dog, dog"), verbalize repetitive activities (e.g., setting the table: "Plate, plate, plage, plage; fork, fork, fork, fork."), and so on.
Don't make a big fuss about whether or not your child is talking or singing along; just provide a supportive environment for her/him to do so: Don't EVER say "You can't have it unless you say it first" -- that's sheer torture for a child with DVD.

If your child is unable to communicate effectively right now, the use of a sign language or a communication board to SUPPLEMENT speech temporarily not only decreases the frustration but also even seems to HELP WITH SPEECH DEVELOPMENT. Don't be afraid to try it!

Dyspraxia may affect other motor functions (e.g. fine motor control, gross motor planning), AND other language functions (e.g. learning grammatical function words like "the," "is," "or," etc; learning more complex grammatical forms like passive; spelling; putting words together into a sentence or sentences together into a paragraph, etc.).

Occupational therapy, physical therapy, and learning disabilities assistance are often helpful for children who have these difficulties. DVD can be a very frustrating disorder at times. It is common for children to make progress in "fits and starts" -- good progress for a little while, then none, then more, etc. Don't get discouraged! The therapy IS helping, even if you don't see the effects immediately.

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Developmental Verbal Dyspraxia -- by Megan M. Guenther, MA, CCC-SLP
Developmental verbal dyspraxia, also known as childhood apraxia, is a serious communication disorder in which a child's ability to carry out voluntary speech movements (pharynx, palate, tongue, lips) are impaired in the absence of any paralysis. In addition, children with DVD have difficulty with expressive syntax (grammar).
Children with DVD are unable to sequence speech and speech movements. Their problem is in articulation, syntax (grammar) and phonology and doesn't hinder other mouth functions such as eating. Their problem is extremely resistant to traditional treatment. Children with DVD understand much more than they can express. They may also show subtle neurological problems.

Children with DVD exhibit multiple speech sound production errors, involving both consonants and vowels. They may be unable to achieve the proper mouth position needed for an individual sound, or may be unable to maintain the proper position as the sound is produced.

Children with DVD are unable to sequence speech sounds. They may omit sounds in sequences of 2 or 3 or more. They may mix the order of sounds in a given sequence. They may distort sounds in a given sequence.

Because of these sequencing and memory weaknesses, errors increase as word length increases and single words are clearer than conversation. Errors vary with the complexity of the speech sounds involved. Errors are inconsistent.

Children with DVD are not necessarily mentally retarded, although performance on formal verbal testing may reflect "retardation" in speech and language. Children with DVD are not typically deaf nor even moderately hearing impaired. Their inability to produce speech sounds results from coordination problems, not hearing or listening problems. Children with DVD are not typically emotionally disturbed, although behavioral outbursts are common reactions to the frustration the child feels being unable to effectively communicate.

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