Verbal dyspraxia is defined as a speech impairment, manifested by a weakened faculty, in the absence of manifest motor or sensory paralysis, to effect deliberate movements of the joint organs (Ferry, C., Hall, M ,. & Hicks L. 1975). It would affect one to two children in miles and would be two to three times more common among boys than girls. The etiology of verbal dyspraxia is multiple and the causes and factors are generally poorly understood.
Brain lesions as explanatory factors are discarded, it is neither a problem of reflexes, nor of paralysis or muscular weakness. However, there is a possibility of hereditary factors, environmental, so it is a neurological disorder, genetic since the child born with this disorder (Charron, L., & MacLeod, A.A.N., 2010). It is often mistakenly thought, whether for motor dyspraxia for verbal, that the child is lacking stimulation.
Verbal dyspraxia mainly affects the verbal sphere, each verbal dyspraxia is particular to the affected child, it will be necessary to judge the diagnosis according to the level of difficulty, the disorders associated with it, the intervention put in place for the child and its improvements. Other factors can be taken into account such as the personality or temperament of the child and many others.
As such, even if, at a certain point, it differentiates itself and presents a diagnostic particular to its manifestations, we can say that verbal dyspraxia may present comorbidity such as dysphasia, attention-deficit hyperactivity disorder, or learning (oral and written language) dysarthria, phonological disorders and many others (Edwards, M. (1973), Belton, E. et al, (2003), Ferry, C., Hall, M, & Hicks L. (1975), Pal, DK et al, (2010), Murdoch, E. et al, (1995), Stackhouse, J., (1992) & Bussy, G. et al, (2010)).
Etiology remains vague, but many alterations are nevertheless known and are observed in these patients in particular at the cognitive (deficits in the discrimination of words and not words, phonological problems which prevent them from using phoneme-grapheme correspondence rules, sequencing deficiencies), clinical (deficits in the discrimination of words and not words, phonological problems which prevent them from using phoneme-grapheme correspondence rules, sequencing deficiencies), phonetic (speech delay, resistance to rehabilitation and intelligibility) and linguistic (altered syntactic phonological factors) level (Stackhouse, J., 1992), the causes of verbal dyspraxia are multiple and can as well of genetic nature, (with the implication of locus 11p13, gene FOXP2 and ELP4) (Belton, E. et al, (2003) & Pal, DK et al, (2010)) that neurological, indeed abnormalities affecting the organs of the two hemispheres (caudate nucleus, angular gyrus …) have been demonstrated as well as the presence of neuromotor mechanisms (deficit of articulatory processes) related to the productive aspect of language, deficient in these subjects (Belton, E. et al, (2003), Normand, MT et al, (2000) & Le Normand, MT et al, 2000).
There is no known treatment to date to treat verbal dyspraxia, indeed it is subject to divergence with respect to its etiology by the difference in degree of impairment, with people who will present certain signs that others will not manifest, some authors have taken time to arrive at a diagnosis specific to this disorder (with associated comorbidities) while others still associates with these disorders. The only treatment interventions that led to improvements were Dynamic Tempor (al and Tactile Cuneing, Rapid Syllabus Transition Treatment), Integrated Phonological Awareness Intervention (ALP) or Alternate Communication (Better Communication for Children) (Murray). E., McCabe, P., & Kirrie, J., 2014).
The technique of integral simulation corresponds to a motor intervention, thanks to clues the child must observe the articulatory movements of the person who speaks to then imitate these gestures, the choice of indices and targets to imitate as well as a lot of practice are essential the successful completion of this intervention (Charron, L., & MacLeod, AAN, 2010). Another motor technique, the generalized motor programs (PMG) which detail the movements made during the speech and the elements that can relate them to the context, aiming at a training with the programming of the motions movements and their planning, to be done, the plan of treatment must be done according to three principles “think in terms of syllabic structure”, “vary the combinations of phonemes and syllables” and “aim for a high level of change” (Charron, L., & MacLeod, AAN, 2010).
Clinical trial over a period of several months are first considered, if it does not work, other therapies are recommended as a complete communication ie with the gestures, table, sign language, electronic communication, drawings , intonations, sounds, (Ferry, C., Hall, M., & Hicks L. 1975).
Practical investments and further theoretical research to enable advanced knowledge of the subject and its precise neurological origin should make it possible to implement treatments.
In practical terms, environmental stimulation (parental and speech therapist) seems to be very important. The child must be encouraged and must persevere when he communicates, moreover, to go at his own pace and not to force him is essential. Use the same means of communication as him (words, sounds and gestures), do activities and support him during these interactions or help him practice while making it lucrative and fun for him (http://www.sosdyspraxie.com/linked/brochure_dyspraxie_verbale__2010_irdp.pdf).
Help him to articulate well so that he records the movements make him do activities he likes to encourage him to speak, accentuate the mimicry(http://www.cshc.qc.ca/upload/home/deficience_intellectuelle.pdf). Regular follow-up of speech-language pathology is therefore part of the means of intervention aimed at helping the child to improve himself and help him to reach a correct level of language (to carry out himself the movements to produce a speech) via exercises of A game that appeals to the child and is of his age, moreover, it helps him to learn for himself gestures and words (short) that will allow him to be understood (Edwards, M. 1973).
Despite an understanding and a verbal level preserved, this verbal deficit is reflected in the plan of later academic difficulties such as learning or concerning skills such as reading and writing (Snowling, J., & Stackhouse J., 1983 and has multiple emotional consequences, such as lower self-esteem, mental health problems (depression, anxiety), feelings of insecurity and low tolerance for frustration in these children. For example, at school, because of a poor communication relationship with peers, the child has low self-esteem and can isolate himself.
Verbal Dyspraxia can always be present in adulthood in the form of pronunciation difficulty for some whereas for others the difficulties are no longer so. It is therefore essential to pay close attention to the treatments and implications for the practice in order to offer these children possibilities of adaptation and to be able to live better with this disorder.
Keywords : Verbal Dyspraxia ; motor ; verbal sphere ; langage ; pronunciation