How does the NDP3 treatment
differ from other approaches?

Articulation therapy
NDP3 has been described by some as a very structured articulation therapy approach. However, although it is true that the focus is on speech output and developing motor programming and planning skills, there are a number of features which make it different to conventional articulation therapy:

In the NDP3 approach, a number of single sounds are worked on at a time, whereas in articulation therapy, the focus is on working on one sound at a time.

The NDP3 approach starts from a child's strengths, utilising whatever speech skills the child already has, whereas articulation therapy works on a child's weaknesses ie sounds s/he cannot currently produce.

In articulation therapy, once a sound is acquired, therapy focuses on establishing the sound in initial, medial and final positions in words. However, in NDP3, the emphasis is on developing a complete inventory of speech sounds, learning to use sounds at different levels of phonotactic complexity and on developing a contrastive system at each of these levels.

In articulation therapy, the focus is mainly on consonant sounds, whereas NDP3 involves vowel and consonant sounds and also works on suprasegmental aspects of speech.

In the UK, NDP3 is the only published resource, which provides an approach and materials for working with children presenting with dyspraxic difficulties.

Cueing systems
NDP3 uses picture symbols, but it can be used in conjunction with other cueing systems eg: cued articulation, orthographic cues and diagrammatic cues.

Auditory discrimination
It is the belief of the authors of NDP3 that children with DVD have a primary difficulty with motor programming and need a therapy approach that focuses on speech output. However, it is acknowledged that some children need to also work on input skills and it is recommended that output and input skills should be worked on “back to back”. This is different to traditional dyspraxia therapy approaches where it was believed that auditory discrimination was not an area of difficulty for children with DVD.

Phonological awareness
Although NDP3 is not specifically designed to focus on phonological awareness skills, the materials make it very suitable for PA tasks and activities are included at appropriate levels within the therapy approach eg sound and syllable blending, syllable segmentation at CVCV and multi-syllabic word levels and onset-rime segmentation at CVC level. Activities, tasks and games involving phonological awareness are included in Appendix 6 of the manual.

Meaningful minimal pair contrasts
NDP3 is not specifically designed as a meaningful minimal pair approach, but since the aim of therapy is to build a contrastive speech system at each level of word complexity, minimal pairs are inevitably involved. The picture cards and worksheets provide many minimal pair contrasts.

Oro-motor programmes
NDP3 includes oro-motor exercises for lips, tongue, palate and voice. In the manual, it is recognised that this is an area of controversy in the literature, but as clinicians working with children with complex speech disorders, we continue to view oro-motor skills as valuable pre-speech skills which support the development of accurate speech sounds. Although oro-motor skills may be introduced in isolation, they are very soon linked to speech sound production and therefore NDP3 is different to oro-motor approaches which are purely designed to develop oro-motor skills.