What To Know About Verbal Dyspraxia
Feb 7, 2024, 9 min read
If you or a loved one has experienced the symptoms of a speech disorder, you may be researching to find out more about what this could be. Dyspraxia is a relatively well-known condition, but you may not have come across verbal dyspraxia before, and it could be useful to understand more about this condition to find out if this could be the cause of you or your loved one’s speech issues.
Here, we are taking a closer look at verbal dyspraxia, including the symptoms and signs in children and adults, what causes it and what can aggravate existing symptoms, how to get a diagnosis, how treatment works, how it relates to autism, and more. At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about verbal dyspraxia, we’re here to help.
What is verbal dyspraxia?
Dyspraxia is a developmental coordination disorder that affects a person’s physical coordination, with signs in adults such as issues with posture, balance and movement. There are 3 different types of dyspraxia which cause a variation of symptoms; motor dyspraxia, which causes issues with coordination, oral dyspraxia, which causes issues with the movement of the mouth and tongue, and verbal dyspraxia, which causes issues with speech. Verbal dyspraxia can occur alongside other types of dyspraxia or in isolation, but if they are both present they may not appear in equal measure of severity.
In this article we will focus on verbal dyspraxia, which is known by a few different names. Developmental verbal dyspraxia (DVD) is often used in the UK, whereas in the US the same condition may be referred to as developmental apraxia of speech (DAS), childhood apraxia of speech (CAS), or simply apraxia of speech, depending on the age of the person.
In children, verbal dyspraxia is a very rare motor speech sound disorder thought to have a prevalence of 1-2 children out of 1,000 in the general population. When someone has verbal dyspraxia, they can have perfectly healthy muscles with no damage, but issues affecting the muscle coordination. They may have trouble organising and coordinating the correct movements in order to control the muscles needed for clear speech, such as the lips, tongue, soft palate and face. Verbal dyspraxia can also impact the voice and breathing patterns needed for making accurate speech sounds, and all of these symptoms combined can make it difficult for someone with this condition to be understood.
What is the difference between the names ‘dyspraxia’ and ‘apraxia’?
Although apraxia and dyspraxia are both brain-based conditions, they are different; people can be born with dyspraxia, or dyspraxia that is acquired later in life is known as apraxia. Apraxia may develop as either a result of something like a brain injury, dementia, brain tumour or a stroke, or it can develop as a result of possible genetic components, neurological disorders, metabolic disorders, or something else. This means it can be both a longer-term condition, or – if it develops after something like a stroke – it could potentially go away on its own in several weeks.
For clarity, we will refer to both verbal dyspraxia and apraxia of speech throughout this guide.
What causes verbal dyspraxia/apraxia of speech?
Acquired Apraxia of Speech
This type of verbal dyspraxia can affect anyone of any age, but it tends to occur in adults as a result of damage to the areas of the brain involved in speech. As mentioned, this can happen as a result of something like a stroke, a head injury, or an illness affecting the brain.
Childhood Apraxia of Speech
This type of verbal dyspraxia is specific to children, and will be present from birth. It is often confused with developmental delays in speech, where a child may take longer than expected to develop their speech abilities. The causes of childhood verbal dyspraxia are not fully known, as this does not occur from damage to the brain or differences in structure. Some theories surrounding childhood verbal dyspraxia include genetic factors such as family members with a history of communication disorders or learning disabilities.
What are the symptoms of verbal dyspraxia/apraxia of speech?
The symptoms of verbal dyspraxia often differ depending on the individual, but they can also differ between children and adults.
In adults, the symptoms of verbal dyspraxia include:
- Knowing what you want to say, but finding it difficult to say it
- Producing the wrong sounds for what you are trying to say
- Producing no sound when you intend to
- Being able to speak clearly on some occasions, but unable to on others
- Being unable to speak or gesture
- Only being able to clearly say learned things such as counting or common phrases
- Making movements with your mouth and tongue when trying to search for a word
- Regularly getting stuck when trying to sound out a word
- Producing words and phrases that seem muddled up
- Having many pauses and hesitations when speaking
- Putting in a lot of effort to create words and phrases
Although many symptoms will overlap between children and adults, in children studies have specifically identified symptoms of verbal dyspraxia to include:
- Inconsistent phonetic errors when trying to pronounce words
- Lengthened or disrupted transitions between sounds and syllables (this could sound like staccato speech)
- Inappropriate patterns of stress and intonation (this could cause speech to sound all the same tone and loudness)
- Co-occurring issues with non-speech motor behaviours, speech perception, syntax, morphology, reading and writing
It can be difficult to identify verbal dyspraxia symptoms in yourself or in your child, so if you believe you struggle with any of the above you may wish to speak to a specialist who can help you determine if you may have verbal dyspraxia, how severe the symptoms are, and what coping strategies may be able to help. Our free 15 minute consultation can guide you to a verbal dyspraxia specialist.
What can aggravate symptoms of verbal dyspraxia/apraxia of speech?
In some cases, a person with verbal dyspraxia may notice their symptoms and speech difficulties can feel more pronounced at certain times. It is thought that symptoms may be exacerbated when the person feels tired, stressed, or under pressure to speak.
If you believe you have verbal dyspraxia, being patient with yourself and never feeling rushed to complete sentences or find the right words can help keep your stress levels low and manage your symptoms. Similarly, if a loved one has verbal dyspraxia, avoid forcing or rushing them to communicate, and focus on ensuring they have ample time to find the right words themselves without feeling panicked or stressed.
How can I be diagnosed with verbal dyspraxia or apraxia of speech?
If you believe you or a loved one has verbal dyspraxia, receiving a formal diagnosis can be incredibly helpful in order to access the appropriate treatments. The process of diagnosing verbal dyspraxia often begins with a referral to a speech-language pathologist, who will be the best person to diagnose and suggest treatment for verbal dyspraxia. They may use the Apraxia of Speech Rating Scale (ASRS) as a way to assess and diagnose childhood verbal dyspraxia, however there is no one test to detect its presence.
A speech-language pathologist will typically look at the symptoms in order to rule out other conditions that may cause muscle weakness or issues producing language, and have the person perform certain elements of their speech abilities such as repeating a specific word, or reading out a list of words that increase in length. Depending on the nature of the verbal dyspraxia, they may also examine the person’s skills in conversation, reading, writing and non-speech movements. In childhood verbal dyspraxia these checks may need to be done over several sessions to see the full range of abilities and deficits.
Studies suggest that diagnosis of verbal dyspraxia can be difficult, and even official diagnoses may be considered either confident, probable, possible or something else. There may also be recognition of a neurological communication disorder that cannot otherwise be specified without being able to confidently diagnose verbal dyspraxia. While this may be frustrating, it is always worth seeing a professional about any symptoms you have so that they can offer treatment options that may help.
Misdiagnosis is common with speech disorders, especially if symptoms are mild. Conditions such as aphasia, developmental language disorders, dysarthria and others may be explored or even diagnosed, so it is important to understand that before a confident diagnosis can be made other options will likely be looked into.
In addition, dyspraxia is linked to a number of other conditions which can co-occur alongside it, with autism being one. Autism is often associated with childhood verbal dyspraxia due to a common genetic background and overlapping clinical features. It is thought the prevalence of childhood verbal dyspraxia is higher in non-verbal or minimally verbal autistic children, which is thought to be around 25-30% of the autistic population without useful speech by the age of 5.
If you suspect you may have dyspraxia, or that your child may have the condition, you can speak to your GP about a possible diagnosis or take our free 15 minute consultation to be put in touch with a specialist who can answer more questions for you.
How is verbal dyspraxia/apraxia of speech treated?
Treatment for verbal dyspraxia depends on the cause; if the condition has been present since childhood the focus may be on improving and managing symptoms rather than curing the condition. If, however, verbal dyspraxia is caused by a brain injury or specific condition, it may improve over time to the point where symptoms are minimal or non-existent.
There are a number of therapies that may be explored to help manage the issues and improve speech, such as speech and language therapy. This is when a specialist assesses speech and advises a treatment plan to help improve communication. Studies have found that typical treatment approaches for childhood verbal dyspraxia rely on motor learning. This could mean things like:
- Frequent speech drills to learn specific sounds
- Oral-motor and oral-sensory exercises such as using light touch
- Use of visual cues, like gestural cueing and mirror work
Studies in the areas of speech motor control have advanced the medical understanding of childhood verbal dyspraxia, however other studies have found that children showing limited progress with traditional speech therapy may benefit from alternative interventions – your therapist can suggest the best options to help.
What support can I give to someone living with verbal dyspraxia or apraxia of speech?
Living with verbal dyspraxia can be challenging. If you are living with someone who has this condition, some practical suggestions recommended by the NHS include:
- Leave time in conversations to allow the person to finish speaking, even if it takes them longer
- Sit or stand close together, and face the person so you both have a clear view of each other’s face
- Make the environment quiet if possible, or choose a place with low noise levels so the person can be better heard and understood
- Ask questions that require only short responses to make speech easier for them
- Do not interrupt the person, but ask questions to help identify what they are trying to say, for example, “Are you telling me about…?”
- Let them know if you are struggling to understand what they are trying to say, rather than brushing it off – try to find alternative ways to reach an understanding
- Remember the person’s intelligence is not affected, only their speech, so treating them with respect and dignity is important
If you are caring for a child that you believe may have verbal dyspraxia, there are resources and support options available. According to Speech and Language UK, 1.9 million children are struggling with talking and understanding words. While the organisation does not focus solely on verbal dyspraxia, they do explore this condition and offer various resources to help.
You may also find useful information on The Dyspraxia Foundation website, who offer support groups for those with dyspraxia conditions.
Improving symptoms with the help of a specialist can increase your speech abilities and confidence, and your GP may be able to point you in the direction of a therapist who can assist with exactly what you need to address any underlying issues and feel more empowered when speaking.
If you have a question about mental health, like the signs of dyspraxia in adults, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.
Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private dyspraxia assessment or review, to broader private mental health care.