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by Keri Spielvogle, M.C.D., CCC-SLP
A child receives the diagnosis of childhood apraxia of speech (CAS). A
child with similar characteristics of speech has a diagnosis of
developmental verbal dyspraxia (DVD). What is the difference between the
diagnoses and what is the best way to treat the child?
Childhood Apraxia of Speech (CAS) vs. Developmental Verbal Dyspraxia (DVD)
Often, a distinction between the two is not clear to the parent. This
causes confusion when speaking to a person who uses these terms
synonymously. The two are both derivatives of the root word, praxis
(praxia), meaning execution of voluntary motor movements. The "a" and the
"dys" are prefixes, changing the meaning of the root word. In medical
terminology, "a" usually stands for an absence of something. "Dys" means
partial ability or partial loss. Therefore, the difference between apraxia
and dyspraxia is unintelligible speech vs. partial intelligibility. But,
keep in mind that SLPs use these terms interchangeably!
Diagnosing Childhood Developmental Apraxia of Speech (CAS) and
Developmental Verbal Dyspraxia (DVD)
A Speech-Language Pathologist familiar with diagnosing CAS/DVD should
conduct a full speech and language evaluation. This should include many of
the following areas: articulation and phonology (including phonological
processes); voice (including factors such as prosody, rate, intensity, and
pitch); an inventory of what sounds (vowels and consonants) the child is
able to spontaneously produce; a full oral-motor exam (assessing movement
of lips, tongue, palate, and muscle tone, checking for concurrent oral
apraxia); and language (assessing both receptive and expressive language
skills). The Speech-Language Pathologist working with your child will
determine what battery of tests are appropriate for your child and discuss
all findings with you.
Treatment of CAS and DVD
A child has a diagnosis of CAS or DVD. What should happen now? It is
important to keep in mind that each child is different and will respond
differently to therapy techniques. Working closely with the child's
Speech-Language Pathologist will benefit your child greatly, especially if
you plan to work with the child at home. Focusing on the same goals and
using similar techniques used in therapy at home helps the child retain
new information and reinforces learned behaviors. This also keeps
communication open between you and your child's speech therapist, building
trust and respect.
Here are some general suggestions to help you help your child communicate
better.
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When asking your child questions, provide options to help the child
answer the question. For example, "Do you want juice or toast?" (Put
desired response in the last position.) Accept any response the child
makes. If this is too difficult for the child, use objects and allow the
child to point to the desired object.
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Be a good speaking model. Pronounce your words correctly and speak
slowly. When working with the child, be sure to repeat the target words
in short phrases and at an appropriate volume.
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Read to your child, allowing him/her to make comments about the story.
Books that have rhyming words work well for phonemic awareness. Do not
attempt to correct your child's speech if unintelligible.
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It is important to let your child express his/her wants and needs. If
he/she is so unintelligible that you or other adults he/she comes into
contact with cannot understand, a communication book may be appropriate.
Speak with your child's speech therapist about content.
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Singing songs with your child or using slow music with words sometimes
helps with prosody and intelligibility.
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Combine vowels with early developing consonants in different positions,
making a silly song (bay, bee, bye, bow, boo).
Using the terms dyspraxia vs. apraxia interchangeably can be confusing.
The best way to clear up any misconceptions and best treat your child is
to maintain a close relationship with your child's speech therapist.
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