Wednesday, April 17, 2013

Spoken Language/Motor Disorder-Dyspraxia

Learning Disability: Any one of heterogenous set of learning problems that affect the acquisition and use of listening , speaking, writing, reading, mathematical and reasoning skills.

A learning disability can impair areas of spoken language such as, listening and speaking. A spoken language learning disability can present itself in a Dyspraxic client.

Dyspraxia: A disorder that affects motor skill development. If often presents itself through the lack of ability to plan and complete fine motor tasks. The severity and symptoms of a Dyspraxic individual are highly variable.

Statistics of Dyspraxia:
-70% of those affected are male
-About 6% of children show signs of Dyspraxia
-Dyspraxia affects around 2% of the population  

  Diagram of Motor Plan:

Dyspraxia and other Learning Disabilities:
-Dyspraxia often exists among other LD
-Common amongst individuals with:
    - Dyslexia
    - Dyscalculia
    - ADHD

Causes of Dyspraxia:
-Often caused by brain damage
-Not due to muscle paralysis or weakness
-Children with Childhood Apraxia of Speech(CAS) is known as a neurological problem. It is often comorbid with another disorder, such as Fragile X syndrome, Cerebral Palsy or Rett Syndrome.
-CAS origin can also be idiopathic ( unknown)

Four Main Categories of Dyspraxia:
   1. Ideomotor Dyspraxia: May cause trouble with completing single step motor tasks
   2. Ideational Dyspraxia: May cause trouble with multi-steps tasks
   3. Oromotor Dyspraxia: May cause trouble coordinating the muscle movements needed to pronounce        words for speech
   4. Constructional Dsypraxia: May cause trouble with recognizing spatial relationships, and accuracy

The National Center for Learning Disabilities(NCLD) Suggested Warning Signs of Dyspraxia by Age:

  •   Recognize if Young Child exhibits trouble with:
    • Learning to walk, hop, skip or throw a ball
    • Pronounce words and being understood
    • Establishing the difference between Right and Left
    • Bumping into things
    • Move their eyes, instead of whole head
    • Are sensitive touch, by clothes, hair brush, or tooth brush
  • Recognize if School- Aged Child exhibits trouble with:
    • Trouble gripping pencil, and has poor letter formation and slow handwriting
    • Doing activities that require fine motor skills, like cutting with scissors
    • Playing sports, riding a bike, or coordination issues
    • Sense of direction
    • Speaking at normal rate, or in a way that is easily understood
    • Making social connections due to speech trouble
    • Phobias or excessive behavior
  • Recognize if Teen or Adult exhibits trouble with:
    • Speech control such as, volume, pitch and articulation
    • Writing and typing
    •  Sensitivity to smells, tastes and lights
    • Personal grooming or self help activities
    • Cooking or household chores
    • Driving
    • Clumsiness

Assessment of child with Dyspraxia:
-Professional involved in assessment process include:
    -Speech-Language Pathologist
    -Occupational Therapist
-Detailed interview with parent/caregivers
-Directly test child's ability to execute functions
-Standardized testing and screening tools
-May consult classroom Teacher for input
-Clinical diagnosis by physician after excluding neurological and physiological causes

Impact of Dyspraxia and learning on children:
-Listening to and remembering instructions are very difficult
-Children require a high level of verbal feedback to help with retaining information
-Can impact language and speech development, since manipulation of the articulators requires fine motor movements
-As child ages, the impact of Dyspraxia on language skills becomes more apparent.
-Language delays or disorders will affect academic, social, and emotional well being of child
-May affect motor abilities

Video Clip: Dyspraxia in Children

Actor Daniel Radcliffe struggles with Dyspraxia

“I was having a hard time at school, in terms of being crap at everything, with no discernible talent.” Radcliffe also suffers from dyspraxia, a developmental disorder affecting motor skills, and he still has trouble tying his shoes. “I sometimes think, why, oh why, has Velcro not taken off?” Radcliffe says.

Read Daniel Radcliffe's story on Dyspraxia Foundation USA

How Speech Language Pathologists can help patients with Motor Speech Disorders:
-Identify the components of speech which are effected
-Identify the impact of the deficits on overall communication
-Identify the impact of the communication deficits on an individuals quality of life
-Develop a treatment plan that improves communication for the purpose of improving quality of life
-Work on communication partners to facilitate adequate daily living function
-Work with related professionals to ensure that speech treatment is coordinated with other services to meet the patient's needs (Neurologists, Teachers, Physical Therapists, Occupational Therapists)
-Continually assess functional outcomes and modify treatment accordingly
-Identify alternative or augmentative communication techniques if necessary
-Use step by step activities
-Early Intervention is key

Neuro-Developmental Therapy and Dyspraxia:
-Effective functioning cannot exist without normal development.
-The brain is a focal point of intervention

Tips for Teachers:Students with Dyspraxia may benefit from the following assistance in school:
-Individual attention
-Extra help in problem solving subjects
-Allowing type written work, instead of hand written
-Provide simple, step by step directions for games and activities
-Allow for extra time for homework or tests
-Provide student with plenty of encouragement and confidence building

Tips for Parents:                           
-Be a strong advocate for your child
-Provide intervention activities frequently and in short duration  
-Be patient, available, and listen to your child
-Model correct speech and language
-Be willing to play with your child, and provide your child with many different experiences

Bernthal, J. E., Bankson, N. W., & Flipsen, J. (2012).Articulation and phonological disorders: Speech sound disorders in children. (7th ed.). Boston: Pearson.
Webb, W., & Adler, R. K. (2007). Neurologoy for the speech language pathologist. (5 ed.). Philidelphia, PA: Mosby.
Vinson, B. P. (2012). Language disorders across the lifespan. (3rd ed.). Clifton Park, NY: Delmar Pub.

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