Dyspraxia is difficulty planning, sequencing and coordinating movements required for speech. It is not caused by a weakness of the speech muscles.
- Automatic movements for eating, yawning, coughing, etc. may be okay, but deliberate control for speech movements is affected.
- Dyspraxia normally occurs with aphasia, often after a brain injury or a stroke. Some words may be easy, especially social phrases such as ‘yes’, ‘no’, ‘hello’, ‘thank you’ or swear words.
- Deliberate speech is more difficult.
- Often the harder someone tries to talk, the worse it becomes, and increased frustration makes it more difficult.
- Dyspraxia can affect other actions except speech. Different types of dyspraxia may be dealt with by other health care professionals.
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What is it like?
- The person with dyspraxia knows what words they want to say.
- They have difficulty coordinating the muscle movements necessary to say those words.
- They may say something completely different. For example, a person may try to say “bus” but it may come out as “dush”.
- The person will recognise the error and try again, sometimes getting it right, but sometimes saying something else again.
- This can become quite frustrating for the person.
Symptoms may include:
- Struggling for the correct movements to produce speech sounds
- Speech is slow and deliberate because of difficulty sequencing the required mouth movements
- Saying words with the sounds in the wrong order
- Long words with many syllables may be especially difficult to say
- Difficulty getting a voice
How to help
- Allow the person time to speak.
- The person may find that watching someone else speak is a helpful way of relearning how to make a sound.
- Encourage them to remain calm and try to relax. Letting the person know you understand why he/she is having difficulties will be reassuring.
- Encourage any other type of communication, such as pointing, gesturing, facial expressions, nodding/shaking head, drawing.
- Offer picture charts or word lists to point to. Try using pictures or written words. They can show you what they want to say, by using a photo or pointing to written choices. If you ask ‘Do you want tea or coffee?’ and they are unable to answer, write down TEA / COFFEE and ask them to point to what they want.
- Ask only ‘yes’ or ‘no’ questions.
- If you can predict the word they need, offer the first sound or a beginning of the sentence:
- ‘It’s a ch …’
- ‘You sit on a …’
- Encourage practising automatic speech such as counting, saying the days of the week, the months of the year, singing.
- If they say a word clearly, do not ask for a repetition. Second attempt is often unsuccessful.
- Sometimes the harder a person tries to make the speech movements the more difficult it becomes. On these occasions, have a break and return to the topic later.
- Remember that speech and concentration can be tiring. Communication will be less successful when tired, upset or unwell.
Alternatives to Conversation
- It is important to maintain social contact when communication is difficult.
- Opportunities and motivation to interact can quickly reduce.
- Try turn-taking games that do not rely on language skills, e.g. Connect 4, Ludo, Draughts, Dominoes, simple card games, noughts and crosses.
- Find jigsaws with an adult theme but few pieces to complete together.
- Offer to read to them – a newspaper, a letter from a friend, a chapter in a book.
- Listen to the radio, music, audio books, or watch television and encourage comments and opinions.
- Look at pictures in books, magazines, photo albums, holiday brochures instead of reading.
- Find art activities such as painting-by-numbers or sketch books.
- Go outside or to the hospital cafe and discuss the people, places and things that you see
- Do not be afraid of simply spending time together (watching TV, holding hands or watching the world go by).
If you require any more information, go to the Stroke Association website: www.stroke.org.uk