Intervención logopédica en un caso de dispraxia verbal y trastorno por déficit de atención con hiperactividad

Abstract

This article describes the assessment and intervention process carried out in a case of verbal dyspraxia associated with attention deficit-hyperactivity disorder (ADHD), combined subtype. In ADHD, deficits occur in behavioral inhibitory control, affecting the control, flow and syntax of the performance of complex motor sequences, such as speech articulation. During language development, the characteristics of ADHD probably hamper articulatory control, sometimes contributing to aggravating a core symptom of verbal dyspraxia. Verbal dyspraxia involves difficulty in automatically and unconsciously creating motor programs for phonemes, syllables and words during first language acquisition. The present article discusses strategies for assessing dyspraxia, as well as diagnosis of this order based on the criteria included in the specialized literature. The intervention was based on three key elements: careful selection and sequencing of linguistic objectives, enhancement of feedback mechanisms and introduction of an augmentative system (gestures to support the phoneme) to achieve slow and progressive automation of motor programs or verbal automatisms. In addition, to achieve treatment goals, the instruction and methodology were adapted to the child's ADHD status. As the child's speech became fluent, language difficulties were manifested in morphology and syntax, predictable in these cases, pointing to a broader symptomatology of the disorder, not limited to the praxis component.