NDP3

Question 1

This program was developed by Pam Williams & Hillary Stephen

Answer 1

Nuffield Dyspraxia ProgrAM (NDP3)

Question 2

In UK, dyspraxia therapy or apraxia therapy focuses on:

Answer 2

● Teach the child sounds they cannot make
● Teach the child to join sounds together in words, phrases, and sentences
● Improve overall tone, voice, intonation, rhythm
● Improve speech intelligibility

Question 3

Strongest evidence exists for 4 treatment approaches (2018):

Answer 3

1) Dynamic Tactile and Temporal Cueing (DTTC): Strand et. al., 2006
2) Integrated Phonological Awareness Approach (IPA): McNeill et al., 2009
3) Nu eld Center Dyspraxia Program (NDP3): Williams & Stephens 2004
4) Rapid Syllable Transition Treatment (ReST): Ballard et al., 2010 (developed in Australia)

Question 4

Nu eld Dyspraxia Program (NDP3) is a comprehensive, flexible assessment and treatment that provides:

Answer 4

○ An assessment procedure
○ A set of therapy procedures and techniques, to plan treatment for children with DVD/CAS
○ A large resource of pictures/materials to use in therapy

Question 5

Principles of NDP3

Answer 5

● Based on motor learning skills approach
● Uses psycholinguistic principles (Stackhouse & Wells, 1997)
● Building accurate speech from the bottom up
● Multi-level, multi-target layered approach

Question 6

The motor learning of the child is really considered as it starts with the very simple ones to the more complex

Answer 6

Working on speech (sounds and words) through a motor programming approach

Question 7

NDP3: Motor Learning Skills Approach

Answer 7

● Working on speech (sounds and words) through a motor programming approach
● Small graded achievable steps
● Based on repetition and practice
● Utilizes cues and feedback
● Works from child’s strengths

Question 8

T or F: Based on their research, patients should be given lots of practice to acquire the motor program for a particular speech sound. In this program, the patients are given approximately 100 opportunities to produce certain speech sounds or word targets over the 45-60 minute session.

Answer 8

True

Question 9

Used to acquire skills by giving cues and feedback on technique

Answer 9

pre-practice phase

Question 10

Used to develop generalization and retention by giving feedback on outcome (right/wrong) but not on performance and cues are reduced

Answer 10

Practice phase

Question 11

T or F: In the Psycholinguistic approach, they assumed that there must be a story of information or a representation which serves as a basis for recognizing speech as well as generating speech output.

Answer 11

True

Question 12

T or F: The representation would often include details of words, meaning which is the semantic representation, its sound structure, which is the phonological representation, and instructions for articulation which is the motor program.

Answer 12

True

Question 13

are part of lexical representations, “Blueprint” of how to say a sound/word

Answer 13

Motor Programs

Question 14

online process of creating change NB transitions/blending
tasks

Answer 14

Motor Programming

Question 15

T or F: we start from bottom up so simple to complex words. If you have a faulty motor programming, what this program does is to erase all of those and start froom the bottom and it builds your speech skills from the simple ones to complex.

Answer 15

True

Question 16

Role of Repetition/Drilling

Answer 16

● Child learns how to articulate new sound or word
● Accuracy is inconsistent/trial and error
● Repetition and sequencing allows child to develop consistent/stable production
● Contrastive sequencing allows child to maintain accurate production “under pressure”
● SLT can control this - distant -> closer contrasts

Question 17

Contrastive sequencing-graded

Answer 17

ask the patient to produce this speech sound a lot of instances and then if that is stable enough, you’re going to teach the child that, okay we have to di erentiate this from the other speech sounds. You do that so that he would have a stable production and would learn how di erent this target is from the other sounds

Question 18

It has to be maximally di erent.

Answer 18

Very distant contrast

Question 19

Both of them are stops but /b/ is voiced

Answer 19

Least Distant

Question 20

Both of them are stops and are voiceless

Answer 20

Least distant

Question 21

Both of them are stops, voiceless, and this is the sound that the child uses to substitute for /k/.

Answer 21

Close Contrast

Question 22

Eg. Child who used to say “tea” for sea, but has recently learnt to produce “ sea”

Answer 22

Start with the contrast first, vowels: Repetitions: sea, sea, sea, sea
Vowel contest: sea-saw, sea-saw
Distant consonant contrast: sea-bee, sea-bee
Close consonant contrast: sea-tea

Question 23

NDP3: A Bottom Up Approach goals

Answer 23

Improve motor planning and programming “from bottom up, starting for the isolated speech sound to more complex syllable shape, then to sentences and more connected speech

Question 24

NDP3 is Bottom up because:

Answer 24

● (1) Start from what the child can produce (based on the result of the NDP3 Assessment)
● (2) Work in target sounds and/ or words that child cannot produce
● (3) Incorporate newly learned sounds or words into framework of current sets of sounds of words

Question 25

NDP3: A Multi-level, Multi-target Approach

Answer 25

Work in 2 or more levels at the same time, but with different targets for each level

Question 26

Nueld Dyspraxia Program: AIM

Answer 26

To support children with CAS and other motor speech disorders in building accurate motor programs for individual speech sound, syllables, and words of varying phonotactic complexity, through a fine-tuned therapy hierarchy and frequent repetition.

Question 27

Nueld Dyspraxia Program: GOAL

Answer 27

● To produce functional speech ● To use motor programs within a contrastive phonological system

Question 28

NDP Approach (Building SKills from:)

Answer 28

Building speech skills from: ○ Single consonant and vowel sounds ○ To words of increasing length and complexity ○ To sentences and connected speech

Question 29

NDP CRITERIA

Answer 29

Designed for 3-7 years old children ● The child should be able to : ○ Sit and attend ○ Attempt speech tasks and take feedback ○ Recognize pictures ○ Develop some “meta” skills regarding sounds, blending, and segmenting - In the manual, some journals, and references, you can adjust for older or younger but you need to adjust your programs and activities. ● the child uses /t/ to substitute for /k/.

Question 30

Treatment Planning (stages)

Answer 30

○ Stage 1 - Early consonants, vowels, and CV words ○ Stage 2 - 1 and 2 syllable words (CVCV, CVC) ○ Stage 3 - later developing sounds, 2 AND 3 syllable words, clusters and some phrases ○ Stage 4 - later developing sounds, any word gaps, sentences and conversations

Question 31

how are you going to implement it?

Answer 31

1) start with selecting appropriate targets at dierent levels of the wall 2) select your targets based on the results of your assessment, 3) Identify your specific goals for the patient. 4) Identify the cues that would support the child in achieving your target. 5) Identify specific pictures/worksheets from the packet that you are going to use to facilitate your target goal 6) Choose games and tasks to encourage repetition and practice

Question 32

Represents consonants, vowels, and diphthongs

Answer 32

Sound Cue Pictures

Question 33

T or F: sound cue pictures - It is necessary early in therapy to teach the child to associate the sound-cue picture with sounds they represent

Answer 33

True

Question 34

Early Sound Making Sheets

Answer 34

● Explore sound production /m/, /b/, /ee/, /ah/, /oo/ ● Placement for sound production /p/, /b/, /m/, /t/, /d/, /n/ ● Voice worksheets and long vowels - Help the child turn on the voice ● Replaced oromotor advice sheets

Question 35

Single Sounds and CV Words

Answer 35

● Begin by introducing 4-6 sound-cue pictures of consonants and vowels that the child can already produce spontaneously, or imitate. ● The selected sounds should be from dierent sound classes to facilitate retrieval of separate motor programs

Question 36

Can you find and post the card that say “oo”? You can put in a flag when you say the sound

Answer 36

Play games to reinforce production and recognition

Question 37

Gradually introduce symbols for consonants and vowel sounds the child can already say

Answer 37

While continuing to reinforce previously introduced symbols at the beginning Provide cues and feedback to ensure articulatory accuracy

Question 38

CV words

Answer 38

Introduce the pictures of any CV or VC words the child can already produce (functional aspect) ● Reinforce with games/activities

Question 39

Teaching New Sounds

Answer 39

Once the child is familiar with the number of consonant and vowels sound cue pictures and is able to produce them accurately and consistently, you have to teach one or more sounds that the child cannot produce spontaneously or imitate

Question 40

SLP should consider the following factors in teaching new sounds

Answer 40

- Stimulability - Developmental approach vs Complexity approach

Question 41

If imitation is not possible in teaching new sounds

Answer 41

use various strategies to facilitate the production of the new sounds (phonetic placement techniques, visual, verbal, tactile, and kinesthetic cues, facilitative contexts)

Question 42

● Teach through elicitation ideas and support with oromotor and discrimination activities ● Accept “approximations” at the start then gradually refine and correct the productions ● Reinforce new sounds through games and incorporate into set of sounds the child can already say

Answer 42

Teaching new sounds

Question 43

Introducing Sequnceing

Answer 43

Introduce contrastive sequencing (e.g., b s b s b s b s): when ○ New motor programs have been established ○ The child has produced at least 8 repetitions of the same sound during tasks

Question 44

How to Introduce Contrastive Sequencing with the Patient

Answer 44

1. Ask the child to produce the target in a reduced rate 2. Contrasts should be maximally dierent at first gradually move to fine contrast 3. Gradually increase the rate of production, ad incorporate the rhythm and stress patterning (can be incorporated)

Question 45

If the child is unable to imitate the clinician’s model, facilitate the development of new CV words:

Answer 45

○ Combine 2 established motor programs (C+V = CV) ○ Use the transition worksheets. Present the sequence of a consonant and vowel, followed by the CV word created as they join