Belton, E; (2004) Evaluation of the effectiveness of the Nuffield Dyspraxia Programme as a treatment approach for children with severe speech disorders. Doctoral thesis , UCL (University College London).

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Abstract

The aim of this study was to evaluate the effectiveness of the Nuffield Dyspraxia Programme (NDP) in the treatment of severe developmental speech disorders. A single subject design was used with four children aged 4-6 years. All scored below the 1st percentile on Percentage Consonants Correct (PCC), had difficulties at a number of speech output levels and were unimpaired on auditory discrimination tasks. Two children met Dodd's criteria for consistent phonological disorder plus articulation disorder, one for inconsistent disorder plus articulation disorder and one for developmental verbal dyspraxia (Dodd 2005). Each child received 20 hours of 1:1 therapy (one hour per week). Assessments were carried out before and after each block of 10 sessions. Micro speech assessments addressed the production of single sounds, words at the CV, CVCV, CVC, multisyllabic and cluster level, and sentences. 'Macro' assessments measured global changes to overall PCC, inconsistency, intelligibility, and oromotor function. Expressive language assessments were used as control measures. Micro assessment revealed that all children showed change at the single word and sentence levels, ranging from highly significant change at all levels of complexity to small changes in phonetic closeness to target phonemes. In all cases phonetic inventories increased, and number/frequency of phonological processes were reduced. At the macro level, three children showed significant improvement in PCC, and all had increased intelligibility ratings after therapy. This study shows that the NDP is effective in bringing about micro and macro changes in speech production in the treatment of severe speech disorders. It also reveals that variation in response to therapy may be in part related to the nature of the speech disorder but can also be affected by additional factors such as engagement with the therapy process and emotional and behavioural difficulties.

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