The Nuffield Dyspraxia Programme (NDP3) and the Evidence Base

The treatment approach of the Nuffield Dyspraxia Programme (NDP3) has been evaluated in a randomised controlled trial (RCT) and in a number of single case studies.

It is included as an intervention on The Communication Trust’s What Works database and currently has a rating of moderate evidence, in line with other published speech interventions. Within the evidence, successful outcomes have been reported for NDP3 both in the RCT and in case studies.

Communication Trust

Randomised Controlled Trial (Murray, McCabe & Ballard, 2015)

Twenty-six children, aged 4 to 12 years, diagnosed with mild to severe Childhood Apraxia of Speech (CAS) were randomly assigned to receive treatment either with the NDP3 or with Rapid Syllable Transition (ReST) treatment.  Treatment was delivered intensively in one hour sessions, four days a week over a three week period by student speech and language pathologists attending the University of Sydney, who were trained and supervised closely by the authors. The results showed large treatment effects and significant generalisation to untreated stimuli for both interventions. Therefore, both NDP3 and ReST treatment were found to have support for clinical use.

For further details, see:

Murray, E. McCabe, P., & Ballard, K (2015) A randomized controlled trial for children with childhood apraxia of speech comparing Rapid syllable transition treatment and the Nuffield Dyspraxia Programme (3rd edition). Journal of Speech, Language & Hearing Research, vol 58 (3), 669-686.

Murray,E, McCabe,P & Ballard, K.J (2012) A comparison of two treatments for childhood apraxia of speech: methods and treatment protocol for a parallel group randomised control trial. BMC Paediatrics, 2012, 12:112.

A second RCT investigating the use of NDP3 treatment in tablet form is currently taking place at the University of Sydney.

Case studies

  1. Six descriptive case studies are included in Chapter 7 of the Therapy manual of NDP3 (Williams and Stephens, 2004). These case studies demonstrate treatment planning and the NDP3 therapy approach in specific children, aged 4-12 years. The children all achieved intelligible speech following intervention but the duration and quantity of therapy varied and the treatment was delivered by different speech and language therapists.
  1. Saunders (2006) reported a single case study of a 3 year old child called Caelen, who had a dual diagnosis of autism spectrum disorder and developmental verbal dyspraxia (DVD). Saunders (2006) followed the principles of the NDP3 treatment approach and utilized the NDP3 picture resources and delivered the treatment in once weekly therapy sessions, supported by practice at home and at nursery. Caelen was reported to have made excellent progress with his speech and expressive language development, following intervention.

For further details, see:

Saunders, H. (2006) How I (2): Phonology never too soon to start. Speech and Language Therapy in Practice, Summer 2006 27-28. www.speechmag.com

  1. Teal (2005) reported a single case study of Ruth, aged 6 ;11 years, who had persisting speech difficulties. NDP3 and Core vocabulary (Dodd, 2005) were utilized during a course of intensive therapy and both were found to be effective in bringing about change, but in different aspects of Ruth’s speech processing system. Furthermore NDP3 also produced significant generalization to untreated words.

For further information, see:

Teal, J (2005) An investigation into classification approaches and therapy outcomes for a child with a severe persisting speech difficulty. Unpublished MMedSci.  Dissertation. Department of Human Communication Sciences, University of Sheffield.

Williams, P & Stephens, H (2010) The Nuffield Centre Dyspraxia Programme, (chapter 7, p.159-177), in Williams, L, McLeod, S & McCauley R (eds.) (2010) Interventions for Speech Sound Disorders in Children. Baltimore, Maryland. Brookes Publishing Co.

  1. Belton (2006) investigated the effectiveness of NDP3 treatment for four boys with severe speech sound disorders aged 4-6 years. The children received 20 hours of individual therapy, delivered one hour per week by two experienced speech and language therapists in a real-life clinical setting. The treatment followed the principles of the NDP3 treatment approach and utilized the NDP3 pictorial resources. Assessments were carried out before and after each block of ten therapy sessions and detailed quantitative and qualitative analyses were carried out by the author. The results showed that all four children increased their phonetic inventories, reduced the number of and frequency of their phonological simplification processes and increased their intelligibility ratings following intervention. They also increased their accuracy at both single word and phrase/sentence level but there was considerable individual variation. This ranged from highly significant changes at all levels of complexity to small changes in phonetic similarity to target phonemes. The study highlighted the variability in response to intervention and the complexity of factors involved in treating children with severe speech sound disorders.

Pagnamenta (nee Belton) & Williams (2009) compared the results of intervention for two of the children included in the study by Belton (2006) in a paper presented at RCSLT Conference in London UK.

For further details, please see:

Belton, E (2006) Evaluation of the Effectiveness of the Nuffield Dyspraxia Programme as a treatment approach for children with severe speech disorders. Unpublished M Sc Dissertation. Department of Human Communication Science, University College London.

Pagnamenta , E and Williams, P (2009) Evaluation of the effectiveness of the Nuffield Dyspraxia Programme in treating two children with severe speech disorders. Paper presented at the Royal College of Speech and Language Therapists Conference in London, UK.

Williams, P & Stephens, H (2010) The Nuffield Centre Dyspraxia Programme, (chapter 7, p.159-177), in Williams, L, McLeod, S & McCauley R (eds.) (2010) Interventions for Speech Sound Disorders in Children. Baltimore, Maryland. Brookes Publishing Co.

  1. Flinders (2009) evaluated the effectiveness of NDP3 treatment for two children with severe speech sound disorders aged 4-6 years (NB different children to those included in the Belton (2006) study). Both children received 10 once weekly therapy sessions, each of one hour’s duration and treatment followed the principles of the NDP3 treatment approach and utilized the NDP3 pictorial resources. The therapy was delivered by two experienced speech and language therapists and home practice was encouraged. The children’s progress was assessed using repeated measures. The results showed that both children made some improvements in their speech production but to differing degrees. One child made statistically significant gains in all areas targeted in intervention, whilst the other made slight but non-statistically significant progress. Given that both children received the same number of treatment sessions, delivered by two speech and language therapists experienced in using NDP3, and carried out similar amounts of practice at home, it seemed likely that child-specific factors were responsible for the differences in the results obtained.

For further details, see:

Flinders, H (2009) An evaluation of therapy using the Nuffield Centre Dyspraxia Progamme with children with severe speech disorders: two single case studies. Unpublished M Sc Dissertation. Department of Human Communication Science, University College London.

  1. Williams, P, Stephens, H & Flinders, H (2010) Preliminary case study evidence for The Nuffield Centre Dyspraxia Programme. Poster presented at ASHA Convention, Philadelphia, Pennsylvania, USA.
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