Question
What can be done to improve the cadence of a student with resolving dyspraxia... this student is a second grader with few remaining speech sound errors (distortion of /r/ and f/th substitution)...but his speech sounds very choppy and it really draws atten
Answer
Pannbacker (1988) published a review of the literature on programs designed for treating developmental dyspraxia. Her research suggests that most of the approaches have not been adequately tested for efficacy. These methods generally involve multimodality approaches such as tactile, kinesthetic, auditory, visual, and gestural cuing or prompting to assist the child. Others have used rhythm, intonation, melody, and stress drills paired with some rhythmic motor movement like finger or foot tapping. Still others have suggested reducing the speech rate to permit the articulators time to sequence the movements. Of course, one could also combine any of the above for instance, tactile-kinesthetic with rhythmic and melodic assists.
In any case, treatment should primarily emphasize working with syllables rather than with sounds in isolation. Think in terms of moving from syllable to syllable rather than sound to sound. Vary syllable shapes gradually increasing the complexity of the syllable shapes. Syllable sequencing drills may be helpful until some automaticity is achieved. Then, more traditional activities can be done to increase length and complexity such as establish a core vocabulary with these syllables, use carrier phrases with the core vocabulary, and finally progress on to more complex sentence structures.
Anecdotally, I have heard that some clinicians like a program called Moving Across Syllables by Kirkpatrick from Super Duper, which attempts to develop motor programming issues. There is an ASHA seminar program called Dynamic Remediation Strategies for Children with Developmental Verbal Dyspraxia by Velleman and Strand that has excellent ideas for working with motor programming problems. Strand and Skinder (1999), however, cautions us that no one technique will benefit all children and that there may be subgroups of developmental dyspraxia. Hope this helps. Good luck.
Sources:
Strand, E., & Skinder, A. (1999). Treatment of developmental apraxia of speech: Integral stimulation methods. In Anthony Caruso and Edythe Strand(Eds.).
Clinical Management of Motor Speech Disorders in Children. NY: Theime.
Pannbacker, M. (1988). Management strategies for developmental apraxia of
speech: A review of the literature. Journal of Communication Disorders, 21, 363-371.
Dr. Harmon is an Associate Professor on the graduate faculty at Mississippi University for Women. She currently teaches graduate courses in Fluency Disorders, Phonological and Articulatory Disorders, and Voice Disorders. Dr. Harmon has been an invited speaker in the area of stuttering therapy with state and regional associations and with Northern Speech Services across the country.