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Reply To: Developmental Verbal Dyspraxia – request for information on clinical practice

Rosemary Nicholson

Hi Lucy,

This does sound interesting. I use the PROMPT approach in my clinic.

We observe how the mouth, lips and jaw move during formal and informal speech samples. We address muscle tone, structures and phonatory control.

 Speech sounds are the direct result of how well someone is able to move their jaw lips and tongue as well as coordinate breath control for speech. So targeting this physical movement is far more effective than treating each and every speech sound. The assessment uses a motor speech hierarchy made up of motor speech sub-systems. 

We observe and identify the motor patterns that are not efficient for speech to then target motor patterns rather than treat individual sounds. 

This process is much more effective as it results in more expedient recovery for speech and generalisation as well for sequenced movements in phrases and conversations. Individuals also begin to access higher motor speech sub-systems when errors lower down are corrected. Resulting more stability and access to increased language. 

Dyspraxia as a diagnosis is not necessarily something we specify unless it is required as the treatment is the same. 

It is easy to see if a child is having particular difficulty learning specific movements and coordinate between planes of movement as well ad sequencing and transitioning between these movements for precise timing, grading, and stability. Also if a child requires extra time to learn movements (unrelated to cognitive – linguistic or social-emotional function) then that would also be a strong indication. 

Typical children to correct ‘basic speech sound errors’ might only require a handful of PROMPT sessions. 

The research and evidence for PROMPT is very strong in treating motor speech disorders and dyspraxia. Also my experience using this approach has been amazing to say the least! 

I don’t have to struggle now targeting individual sounds or vowels. I am able to use specific sounds in order to treating identified speech sub-systems and put these sounds into functional word and phrases used in a variety of different activities. They can even be used to support improved social interaction as well as expressive and receptive language development. 

I would definitely recommend anyone working with motor speech to at least attend a level one PROMPT training.