Motor speech disorder is the term used to describe impairment in one or more of the motor processes that underlie speech. Children with a motor speech impairment have difficulty programming speech movements, thought to take place at a motor planning level i.e before a speech sound is articulated. Common terms used for motor speech disorders include Dyspraxia or Childhood Apraxia of Speech.
Following a motor speech hierarchy, therapy helps children to plan the movement required to produce words, and therefore communicate more effectively. The Motor Hierarchy program aims to develop the child’s ability to coordinate speech movements through gradually increasing the complexity of oro-motor sequences (movements of the tongue, lips, jaw and plate that are required for speech). It is beneficial for children who:
- Require lots of repetition to be able to produce sounds.
- Require small steps to help them to produce sounds in a wide variety of words.
- May be able to produce sounds in isolation but have difficulty combining sounds into words.
- Have difficultly producing vowel sounds (eg ee, oo, ar) as well as consonants (eg p, b, s, f).
The program consists of a selected vocabulary of words, which the child practices to build up their ability to say in words. These sounds and words are divided into stages and levels that aim to increase in complexity. Each stage has several sounds that the child may be working on at one time. As the child progresses through the stages new sounds are added to the ones they can already say. At each stage the child’s ability to produce the target sounds in different positions of a word is focused on.
AAC may also be used in conjunction with this therapeutic approach.