Dyspraxia

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.

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

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.

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