A Language Disorder first introduced by Rapin and Allen in 1983, which describes a group of children who present mild Autistic features and specific semantic pragmatic language and communication impairments. SPD is separated into two groups: receptive and expressive language. Mainly characterized by poor conversational skills with inappropriate use of language. Receptive language becomes difficult because comprehension of words is unclear.
Validity of semantic-pragmatic as a developmental language disorder or as a distinct from of high- functioning autism has been questioned since its introduction. Given the similarities between semantic- pragmatic syndrome and autism. For example, three major characteristics are, a cognitive deficit, poor social skills and utilization of non-verbal communication. They also share the same specific characteristics within the autism spectrum.
Definition of Semantic Pragmatic
Semantic - Memory for the meaning of words, interpretation behind a word.
Pragmatic - Concerned with the facts, or actual occurrence.
Many of these children babble or use jargon speech much longer than children of the same age. Their first words are late and learning language is difficult. Problems are usually first identified between 18 months and 2 years when the child has little speech and trouble with communication. At times one wonders if perhaps the child is deaf because they do not appear to respond to his or her name. These children ignore their names in the early years yet react to the ring of telephone or the door bell. Early on in their lives, Semantic-Pragmatic Disordered children are found to have problems following instructions, and they “shut down” when taken out of the normal routine.
Children who find it difficult to extract any kind of meaning will find it even more difficult to generalize and grasp the meaning of new situations. They will insist on to keeping situations predictable. Maintaining sameness, by following routines, will eat certain foods or wearing particular clothing and develop obsessional interests are characteristics of children with SPD.
These children have difficulty extracting meaning both orally and visually, the more stimulating the environment it becomes difficult processing information. Children with SPD can often respond to instructions without difficulty. They are better at visible cues that are occurring at the time. The objects are in sight and they have very little difficulty understanding visible concepts like size, shape and color.
Early Signs of Ages 0-4
• Quiet baby, content most of the time.
• Likes playing alone repetitively.
• Difficult toddler with no sense of danger.
• Does not respond to name, at times appears deaf.
• Late talker, does not babble.
• Speaks out of context, memorizing phrases of favorite t.v shows.
• Inconsistent eye contact.
• Late pointer, unable to express wants.
• Fussy eater, refuse to eat certain textures.
• A loner, prefers to play alone then with peers of the same age.
• Late in recognizing self in pictures or mirror.
• Unable to initiate play with other children but will interact with in rough tumble play.
• Difficulty sharing, tantrums persist.
• Good with jigsaw puzzles, numbers, letters, shapes & colors.
• Prefers helping in real activities like washing up, or operating a computer.
• Repeats like a parrot.
• Obsessional interests.
• Very independent, does not ask for help.
• Inappropriate response to sensory stimuli like touch, pain, sound.
• Difficulty in following rules.
SPD children are skilled at the following:
• Using long sentences
• Speaking clearly
• Learning new vocabulary, in specific interests areas
• Using familiar phrases and terms
• Love music and have a good memory for tunes.
• Good rote skills in math and computers.
• High IQ’s
Today research shows that children with Semantic-Pragmatic Disorder have difficulty in speaking and understanding speech. It’s believed that the issue with SPD kids may be the way their brain processes the information, they are not able to understand the meaning instead focus details. For example if your are speaking to an SPD toddler, they will hear without understanding.
• Some children have a heightened awareness of loud noise. Others ignore loud noise and focus on peripheral sound.
• Many have a heightened awareness of smell or taste and may refuse certain foods. Others have a diminished awareness of hunger and may only eat if told.
• Some avoid touching certain materials particularly sticky or wet substances.
• Some children seem to have a diminished awareness of pain. After a serious fall they’ll brush it off and only display distress after observing blood.
Comprehension problems usually improve with speech therapy. They learn to express their wants and dislikes so that by the age of four years, many of the children appear to be function very well. By the age of 5 communication becomes more natural. Although these children continue to have problems with certain aspects of communication. Examples of difficulties is language which require more than listening to the words. One needs to comprehend what the speaker is thinking and implying. They need to understand non literal expression, jokes, and sarcasm. These children take in the details of speech and often this type of communication makes them feel uncomfortable.
Children who are diagnosed as having semantic pragmatic disorder are more accurately described as high-functioning autistic. Clinicians tend to give all autistic children who have good intelligence the label Asperger syndrome, even if a child actually has very limited speech. Children with Aspergers’ are able to talk in sentences by the age of three, whereas Semantic Pragmatic children develop their speech late. However, a child with semantic pragmatic difficulties in language eventually becomes a fluent talker. Lastly, children with SPD tend to have better socialization skills than those with Aspergers’. Many children improve dramatically and diagnostic labels can change.
Until about 10 years ago, only the most handicapped children were diagnosed with Autism. Children were either Autistic or they were not. This meant that many high functioning children on the spectrum with mild and specific learning difficulties were excluded from receiving therapy. Many were dismissed as language disorders or as having behavior problems, leaving parents with much unresolved worries. Today they have extended the boundaries to include those children with mild social difficulties, some of whom may be able to extend their special interest and abilities to out perform their peers. Parents of children with Semantic Pragmatic Disorder should feel optimistic.