This condition of severely disordered speech in conjunction with oro-muscular and possibly general "clumsiness" has since been called "verbal dyspraxia".

Through increased contact with infant teachers in the 1980s the connection between disordered speech (and possibly language) disorders and literacy difficulties started to become clear. Standard POPAT grew on from the virtually unchanged speech programme.

This first ‘making sounds obvious’ stage of POPAT, Listen and Choose, enables children with a cognitive age of 3 years or more to focus their listening attention on the phonemic structure of words, to identify consonant phonemes and to segment spoken words. It is essential that this stage is learnt thoroughly.

Each of 18 phonemes is linked with its own semi-representational pictorial symbol. The learners then use these ‘sound-pictures’ to show which phoneme they have heard in a group of three and then progressively in CV, VC, CVC and consonant cluster words.

This is done because the majority of very young children are not able to isolate individual speech sounds from the stream of speech or even from one syllable words and  therefore cannot understand them in isolation.

There are 23 consonant phonemes in English. The 18 used in POPAT are sufficient to make their similarities and differences clear to learners. Later on their ability to detect these differences makes them able to detect those of vowels.

A minority of children are not able to remember the sound sequences that are in spoken words, even though they recognize the meanings of these words. It would seem possible that the cause of this is that the trace in phonological working memory of a heard word (see Baddeley) fades very quickly or perhaps that it persists too long and causes perseveration.

In either case learners can develop inaccurate phonological representations in permanent memory and their production of words reflects these ‘fuzzy’ memory imprints. Many of these children are also unable to self-monitor because of their inefficient phonological working memory.

POPAT for Speech and Language Therapists steps aside from Standard POPAT at the stage of CV once the therapist is certain that the phonemes can be identified and segmented. At that point children are asked to begin to compare the way they produce words with the way their therapist does, to stimulate self monitoring and to provide practice in sequencing sounds correctly. 

All 18 consonant speech sounds are still covered, that is children are asked to produce and consider all of them. This is done to raise to consciousness how and when these sounds are used in speech; to give the necessary practice in forming the sounds the children have not been using correctly and to give the repetition needed for children to lay down accurate phonological representations in permanent memory, and to form correct neuro-muscular patterns.

As a result of  using POPAT it has been found that when children truly understand what speech sounds are and how they work in the everyday world they begin to fill in defective systems and replace incorrectly pronounced words spontaneously. A few children need traditional type practice of some sounds and words for which they may have laid down incorrect patterns of sequences of movements of the articulatory muscles, and practised them for a number of years.

One huge benefit of POPAT is that children enjoy doing it. Their mistakes do not have to be pointed out to them and in the earliest stage they don't even have to speak if they don't choose to.

It is mental processes that are targeted rather than a body of knowledge, so they become the property of the learner and therefore generalises more readily. It is highly structured so that the Therapist does not have to decide which sound or word to target next and it is easily carried out by carers to whom it gives insight into speech disorders.