NDP3 is based on a motor skills learning approach, with a particular emphasis on motor programming skills.

The main focus is on speech output, but input and representational levels of speech processing are also recognised.

It can be described as a “bottom up” approach, in that the aim is to “build” accurate speech from core units of single speech sounds (phonemes) and simple syllables.

New motor programs for single phonemes and words of different levels of phonotactic structures are created and perfected using cues and feedback. They are established as stored representations by associating them with pictorial images and through frequent practice and repetitive sequencing exercises.

As speech is not only a motor skill, but also a linguistic medium, phonological skills are incorporated into the treatment approach through the use of worksheets organised as minimal pairs of words.

Speech skills are conceptualised as a “brick wall”, with pre-speech oro-motor skills and single consonant and vowel sounds seen as the foundations, and word level skills built up in layers of bricks on top of the foundations.

The brick wall: NDP3 focuses on establishing (as fully as possible) a set of motor programs at each level of the wall, as well as supporting the development of a full range of psycholinguistic processing skills.

Simple CV and VC syllables are the first layer, moving up in layers through CVCV, CVC, CVCVC and multi-syllabic words, clusters, word combinations of phrases and sentences and finally reaching the top layer of connected speech.

The approach provides a multi-layered, multi-target treatment approach involving working on several layers at the same time (eg oro-motor skills, single sounds and CV word level), but with different targets at each level.

The approach works from the child's strengths: what he can already do and builds skills in small achievable steps from this point.

It is a cumulative approach in that practice exercises from the early stages continue to be included in the therapy programme as the child moves up the layers.