What is a VED analysis

gms | German Medical Science

text

background

Verbal developmental dyspraxia (VED, buccofaciale or glossolabial apraxia, English childhood apraxia of speech, CAS) is a developmental disorder of children's speech of unclear genesis with deficient pronunciation and impaired speech movement planning and programming, resulting in the inability to use the organs of articulation arbitrarily and for a planned utterance to be used in a controlled manner.

The barely understandable language is characteristic [1]. The variability of the phonetic formation errors is great, a systematic phonetic malformation profile is not discernible. The sequential arrangement of sounds and the required speed of movement are particularly problematic. This state is inconsistent, so correct movements are possible. Symptomatic of the verbal developmental dyspraxia are, among other things, noticeably poorly pronounced babbling phases, a lack of verbal imitation and a noticeably late start of speech, possibly with "loss" of already mastered words. Phonological awareness usually shows deficits. So-called motor milestones are only reached with a delay, and there are often gross and fine motor restrictions. Seeking articulation movements as well as deficits in oral perception occur more frequently. The sound formation is particularly noticeable, consonants are hardly formed. An increasing error frequency with increasing length and sound complexity can often be observed.

The VED affects the entire developing language system, especially with regard to vocabulary and grammatical competence with undisturbed language understanding [3].

material and methods

A detailed pediatric audiological diagnosis by means of a hearing test (tone audiogram, Göttingen children's language comprehension test 2, language discrimination from the background noise, dichotic listening test (Feldmann), tympanogram), language diagnostics using PLAKKS (psycholinguistic analysis of children's speech disorders), AWST-R (active vocabulary test for 3- Children up to 5 years of age - revision), HSET (Heidelberg language development test) and a review of general development with the CFT 20 R (Culture Flair Intelligence for 8-18 year olds).

Results

With inconspicuous peripheral hearing and age-appropriate cognitive development, there were clear abnormalities in the area of ​​articulation with severe phonetic-phonological disorders and expressive speech findings with almost age-appropriate speech understanding.

Phonematic discrimination was limited (tested with Werscherberger test and rhymes). The auditory memory span / auditory sequencing, phoneme identification, phoneme differentiation (tested with the Mottier test) were also significantly reduced.

Demonstration of a VED based on the case study of a 10; 11 year old boy.

discussion

The VED represents a great challenge in terms of diagnosis and therapy. A comprehensive anamnesis and diagnosis, which takes into account all linguistic, motor and psychological levels, forms the basis. In addition, interdisciplinary cooperation is necessary to rule out other causes.

The suspicion of a VED often arises only due to insufficient or minimal progress despite long speech therapy. So far, there are neither precise inclusion criteria for diagnosing VED nor for therapy effectiveness.

According to a Cochrane analysis (2008), the study situation has not yet confirmed any form of therapy to be sufficiently effective [2]. Oral motor exercises do not seem to be effective. The treatment of the VED must be geared towards the special concerns of a speech-dyspractical disorder.

literature

1.
Dannenbauer FM. Verbal developmental dyspraxia (VED) - a still little understood developmental disorder of children's speech. Available from: http://web.archive.org/web/20050905002536/http://www.zbl.ch/pdf/Dannenbauer_Referat.pdf
2.
Morgan AT, Vogel AP. Intervention for childhood apraxia of speech. Cochrane Database Syst Rev. 2008; (3): CD006278. DOI: 10.1002 / 14651858.CD006278.pub2
3.
Schulte-Mäter A. Verbal developmental dyspraxia. In: Grohnfeldt M, ed. Textbook of speech therapy and speech therapy. Volume 2, manifestations and disorders. Stuttgart: Kohlhammer; 2001. pp. 254-61.