Question
I have just begun seeing a child with a multitude of difficulties including verbal dyspraxia. He exhibits the typical characteristics of this diagnosis but he also appears to ''stutter''. Is this separate from the dyspraxia or is it part of the original
Answer
There are critical pieces of information missing in the body of your question---to name a few: child's age, what ''multitude of difficulties'', test(s) used and results (including severity!), abnormal developmental milestones?, age of suspicion of stuttering, etc.
If the original diagnosis of dyspraxia is accurate (be certain!), then stuttering would not be 'part' of that diagnosis but a separate one with differing observations. Severity, however, is critical to know in order to provide you with a quality answer. However, let me at least offer some thoughts.
Dyspraxics are highly variable in errors, inconsistent from trial to trial with no impairment of a specific muscle group. Stutterers are also highly variable but not in articulation errors, per se. Both demonstrate an alteration in prosody. Unlike stutterers, imitation of words is harder than spontaneous speech production in dyspraxia, in general (again, severity is an issue).
Parents and the child (age dependent) can offer differential information regarding situation or person(s) avoidances, fluctuations in fluency as long as months in ease or difficulty with speaking fluently and fears of sounds or words. Evaluate age of onset, progression (usually with dysfluency there IS a progression) of severity, fears and avoidances.
The dyspraxic is not certain of where articulators 'are' or how to make them perform....they present 'off-target' articulation. Also, the type of speech errors is different. For example, a dyspraxic would say:
''ob-obs-er-ob-serve'' for observe (which is very atypical for stutterers)
''kear-sear-skill-fully'' for skillfully (note 'off-target' in 2nd production)
''s-o-sss-sp-sp-snow'' for snow
(examples taken from Darley & Spriestersbach)
Similar to stuttering would be:
''sssswiflty'' for swiftly
''th-thinks'' for thinks
''pro-uh-profound'' for profound
Note if you record struggle behaviors (as opposed to off-target), same sound , whole word, or phrase repetitions, difficulty in onset of a sound/word (no sound), prolongations of sounds to help you differentiate. Note areas of tension!
Each treatment session in difficult cases should always also be considered to be a differential diagnostic session!! Parents are generally excellent and reliable sources of critical information.
BIO:
Janet Skotko, M.Ed., has been a Speech/Language Pathologist for approximately 30 years and was distinguished by being one of the first named to be among the Board Recognized Fluency Specialists. She maintains a private practice in Tampa, Florida but sees clients world-wide. For further information , please visit: www.thevoiceinstitute.com.
