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Verbal Dyspraxia
ICD (784.69)

Article by:
Sarah Morales, BS
Children's Speech Care Center

Verbal Dyspraxia is a motor speech disorder. It is also referred to as apraxia, verbal apraxia, and developmental verbal dyspraxia. The person with verbal dyspraxia has difficulty programming his/her speech muscles for movement. A child with verbal dyspraxia has difficulty producing sounds, syllables and words because they cannot consistently find the correct placement for the structures of speech (e.g., lips, tongue, jaw). This affects their ability to say certain sounds/sound combinations and sequence the sounds into words and sentences. This difficulty is neurologically based (meaning within the brain). Unlike dysarthria, there is nothing wrong with the muscles themselves.

The disorder can be present from birth (hence, the term developmental verbal dyspraxia) or it can be acquired due to brain damage (e.g., traumatic head injury, stroke) in which case the term apraxia (“loss of” movement) may be used. In children with verbal dyspraxia, speech may be absent altogether, because they may be unable to initiate speech. This is often the problem that prompts parents’ concerns. If a child does speak, they may only use vowels in a restricted and repetitive way. We may also observe children who distorted vowels, exhibit searching behaviors, and/or produce inconsistent errors on words.

When persons with verbal dyspraxia attempt to speak, their speech is often not understandable (unintelligible) or they have difficulty producing the intended word. For example, in trying to say “cat” the speech output may include “tat…uh, mat…tack,” etc. However, correct speech may be produced “by accident.” For example, in attempting to say “California,” the dyspraxic patient may try several times before giving up, whereupon he/she could say “I can’t do it” perfectly. This is due to the fact that verbal dyspraxia is a disorder of volitional or voluntary control, e.g., automatic speech comes more easily and naturally than speech produced with conscious effort. Furthermore, stutter-like movements and postures as well as groping (the searching behaviors mentioned above) may also be present as the individual struggles to find the correct placement and sequencing for speech.

This disorder does not respond easily to treatment, and requires an intensive schedule of intervention. Therapy may be somewhat lengthy in duration (i.e., several years). Other means of communication (e.g. sign language, gestures, computerized speech, picture boards) may become necessary to assist in or supplement communication. Our primary goal should be to provide children with verbal dyspraxia a means to communicate. Many children that use alternative methods of communication begin to speak in conjunction with their use.

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