Here some suggested organisations that offer expert advice on SN.

Can anyone tell me about SPD?

(45 Posts)
itfriesthebrain Sat 16-Feb-13 23:47:21

good evening. I have been lurking on here for some time and have found many posts very informative. Please could anyone tell me of any experiences of semantic pragmatic disorder?

zzzzz Sun 17-Feb-13 00:06:36

I think it's a very old fashioned diagnosis and would probably be either, language disorder or ASD now. In my mind it seems a good descriptor for the social communication problems faced by many with Aspergers.

My son is severely language disordered with normal to high IQ. SPD was muted by one EdPsych a few years ago but I think that probably underplays his issues quite significantly.

Sweetdelight Sun 17-Feb-13 00:16:43

Zzzz, A child can have semantic pragmatic language disorder a specific language impairment, a disorder language development, a receptive impairment language, or an expressive language impairment, an auditory language impairment, a phonological language impairment and so on. Yawn, for the record all children on the autistic continuum have a semantic pragmatic language disorder ie a communication disorder, regardless of cognitive ability.

zzzzz Sun 17-Feb-13 00:27:31

I'm not sure what your point is sweet? What I was trying to say is that I don't think SPD is dx'ed often now, certainly in my experience. I think an ASD dx or a language disorder, is much more common, so worth reading up on.

SPD is more likely to be used to describe a 'symptom' of a Dx, rather than be a Dx in itself.

Sweetdelight Sun 17-Feb-13 00:32:48

A language disorder is different from a language impairment and different again from a social communication disorder and one has to look at a child's cognitive ability. Your son can not be language disordered if it underplays his issues significantly, he must have an SLI. I suggest you get his language reassessed by SALT.

'A language disorder is different from a language impairment and different again from a social communication disorder'

Who says?

zzzzz Sun 17-Feb-13 00:40:57

Sweet I'm not sure I understand. What, as you understand it, is the difference between SLI and a language disorder?

My understanding is that a language disorder is an uneven profile, while an SLI is a specific deficit. I am not sure how the severity of the first would imply the second.

Ineedmorepatience Sun 17-Feb-13 10:17:10

Who are you sweetdelight have you name changed?

I am not familiar with you but am interested in why it makes such a difference?

If all dc's with Asd have spd then so does my Dd3 but it is one small part of her dx and some of her other issues overshadow the spd some of the time.

Ineedmorepatience Sun 17-Feb-13 10:21:02

Sorry OP, I meant to say that I think it is more common for children to be given an Asd diagnosis now.

Spd plainly plays a role in Asd but when Dd3 was assessed by SALT they set out her issues individually rather that calling it Spd, IYSWIM.

Good lucksmile

moondog Sun 17-Feb-13 10:26:13

Don't waste your time and energy worrying about whatever label is currently in vogue/used by the HPC/LEA bod you are seeing. It is all highly inaccurate in any case and will be supereceded in months. They are all used interchangeably and there is no standard way of describing issues which are idiosyncratic to each child in any case.

I would never use any label apart from talking very generally about a delay versus a disorder.
It's way more helpful to
a.) Get a clear jargon free description of what your child finds difficult (with copious examples)

b.) Have the person who is charged with helping you tell you in clear jargon free language what they are gonig to do about it and how they are going to measure if what they are doing is having an effect or not.

My own view is that bandying about clever sounding labels deflects attention from the fact that a.) and b.) are often sadly neglected.

zzzzz Sun 17-Feb-13 10:34:34

moondog thank you for that. I will mutter it to myself when they finish assessing ds (again).

Ineedmorepatience Sun 17-Feb-13 10:38:58

Thanks moon we got (a) but havent ever managed to get (b) hmm

Hey ho, at least we know what the issues are!

moondog Sun 17-Feb-13 10:42:58

Don;t allow your energy (or anynoe else's) to be deflected/sidetracked by discussing what you call it.
I could call my tip of a kitchen all sorts of things.
'overused food preparation station'
'vibrant heart of the home'
'gathering place for semi feral youth'

Doesn't change the fact that it's pretty dirty and needs a good clean.

That old chestnut
When in doubt, assess and then assess again.
Three months later, assess, review and monitor.
Assess again
Repeat ad infinitum.,
It means yuo never have any time left to remediate. hmm

zzzzz Sun 17-Feb-13 10:52:13

That old chestnut
When in doubt, assess and then assess again.
Three months later, assess, review and monitor.
Assess again
Repeat ad infinitum.,
It means yuo never have any time left to remediate^

moondog I am crying. That is our life. How do I get out of this loop. We never get to doing anything. I do everything and I DON'T KNOW WHAT THE FUCK I'M DOING.

Ds is nearly 8, home educated and massively language disordered, he's ASDish as well but that is SO minor compared to his language.

PolterGoose Sun 17-Feb-13 11:00:18


Take a deep breath, you do know what you are doing and you are making a significant difference thanks

moondog Sun 17-Feb-13 11:04:04

I'm sorry if I am sounding like the voice of doom and gloom Zzzz. I am utterly disillusioned with the ''all talk zero action'' SEN industry, full of people rustling papers, attending meetings and spouting jargon but doing little of substance.

Assessment is vital but a good assessment should then flow seamlessly into a coherent measurable paln of action.
Maths assessment leads to definable measurable curriculum
Language assessment leads to definable measurable curriculum

And so on.
It's not that difficult to do, that's the ultimate irony.
I've managed it for my own child and I truly believe that the vast number of my colleagues in the LEA and myself have manged it for most of the kdis we work with.
But it sure as hell isn't that way in most places.

zzzzz Sun 17-Feb-13 11:08:09

Thank you polt.

moondog it's not that you are the voice of doom, it's that you crystallise my own thoughts and I am cross and tired and a teeny bit desperate. OK is not good enough for my boy. He's starting off with a disadvantage, he NEEDS excellent focused intervention.

moondog Sun 17-Feb-13 11:10:39

It is an enormous challenge to try and do it yourself (and I speak as someone who was home schooled by necessity due to geography but not disadvantaged by language problems)

What outside help do you have?


This is how I see it.

Focused quality intervention is an entitlement but also an illusion. Fight to the death for it and you'll still probably not get it for him whilst those involved convince themselves he IS getting it with any failings being down to his in capability and/or parental interference.

That means that even if you make mistakes, get things wrong or aren't efficient, you are still his best interventionslist because you actually get on and DO it.

zzzzz Sun 17-Feb-13 11:27:49

No outside help. Have requested and am in the process of doing assessment of where he is now. Half way through CELF. SALT says definitely severe language disorder but need to see profile of that disorder.

Thank you star , yes an illusion. It's like running towards a mirage in the desert eh?

Must go as have promised the beach to ds for all his hard work at SALT this week and he is going to explode with frustration.

Beach in February hmm . One wonders who's in charge here.

PolterGoose Sun 17-Feb-13 11:34:14

Have fun grin

moondog Sun 17-Feb-13 11:38:17

Are you doing CELF yourself?!
I assume not but you do need some more input from outside I think.

Don't knock the beach in February.
You tend to get it all to yourself.
We've spent the last three days on the beach, building and digging and making fires.
Excellent fun. grin

inappropriatelyemployed Sun 17-Feb-13 11:41:05

Love the beach in February. Wish I was there.

Moondog, what you say about assessments is so true. Like meetings which are, of course, the antidote to everything!

moondog Sun 17-Feb-13 11:46:46

I have a friend who used to work for one of the big supermarkets. She told me all meetings took place standing and on the shop floor. That kept them focussed and brief. I would love to see some of that attitude in the NHS and LEA. I am aware of plenty of folk who believe that going to meetings is their job.


moondog Sun 17-Feb-13 11:47:15

So annoying to cock up an emoticon.grin

inappropriatelyemployed Sun 17-Feb-13 11:51:11

Meetings about meetings are the best of all.....!

I once had a job that involved going to meetings about meetings.

My favourite set was when we were organising a pre-pre-feasibility committee to turn a section of a library into a community space. The whole project cost millions and it was nearly all spent on tea before being disbanded.

moondog Sun 17-Feb-13 12:18:07

One has to laugh or one would weep.
If any consolation, I think endemic in other areas too.
My dh works in international development.
There are striking parallels with the SEN industry ,not least the fact that the illusion of activity is far more important than measurable activity and outcomes themselves.

Let's not start on reports about reports (all of which start with 'X is a delightful little boy/girl')

Ineedmorepatience Sun 17-Feb-13 12:21:10

I am stuck in a loop of meetings at work at the moment. I hate meetings, I have the concentration span of goldfish and start doodling or looking at the patterns on the carpet within about 3 minutes.

Oh and dreaming of campfires on the beach grin

But I was junior then, and those experiences were 'training' my expectation and work ethic should I have progressed to a more senior position.

I moved from that into a job that required me to account for every hour and assign it to a budget that required signing off by the budget holder. There were of course problems with that system too, but boy was I productive, and with significantly increased job satisfaction.

inappropriatelyemployed Sun 17-Feb-13 12:22:45

Meetings, aaaah, how different my life would be without them.....

I might actually get time to have a camp fire on the beach. grin

Ineedmorepatience Sun 17-Feb-13 13:21:54

IA, feel free to join me daydreaming about themgrin

inappropriatelyemployed Sun 17-Feb-13 13:23:39

Or dreaming of who we could put on them?? grin

itfriesthebrain Sun 17-Feb-13 19:59:13

ok thank you so SPD is no longer diagnosed but can be a part of an asd diagnosis? hope I have read that right its just I have been having a look on the web and it appears that the symptoms of SPD are similar to the symptoms my son displays which are being described as autistic tendencies

Ineedmorepatience Sun 17-Feb-13 20:24:20

Spd describes the communication difficulties that children with Asd can have but there is much more to Asd for example, sensory issues, rigidity around rules and routines, lack of empathy, difficulties with social skills, repetetive behaviours and probably loads of other things that I have missed.

Is your Ds being assessed for Asd?

itfriesthebrain Sun 17-Feb-13 20:38:52

yes Ineedmorepatience he is due the ados next week. I can't seem to stop myself from looking on the web. I really wish I wouldn't but I really can't help myself.

zzzzz Sun 17-Feb-13 20:47:45

Look at RALLI on utube, and watch some Temple Grandin videos too.

Despite all the anxiety up thread, ds is lovely and we have a good life.

Ineedmorepatience Sun 17-Feb-13 22:34:03

I agree with zzzzz Dd3 has Asd and is an absolute treasure. She can make me laugh and cry at the same time. She is very loving and sweet as well as being a toad at times.

She is mostly happy, especially when working to her own agenda. And I wouldnt change her even if I could. We do work on helping her to devlop the skills that will help her through life but I see that as part of her education, not a way of changing her personality.

Having a diagnosis has really helped me and Dd3 to get our heads around some of her difficulties and work out ways of getting round them or through them.

Good luck with the Adossmile

itfriesthebrain Sun 17-Feb-13 22:53:04

zzzzz I will take a look at the videos you suggested thank you. Ineedmorepatience your Dd sounds very similar to my Ds. He is wonderful, I love him to pieces there is never a dull day, and believe it or not I find him so much easier to care for than my daughter but then he is very much like me. I think I have learnt a lot about myself during my searches on the web. Now my daughter, she is definately the opposite to my Ds, she really is a handful but I'm not sure if thats because she is a girl or if theres a little more to it.

MerryCouthyMows Mon 18-Feb-13 09:31:06

The sum total of DS3's Speech Therapy currently? An assessment and me being given a wodge of worksheets with Makaton signs on. A second appointment that took place in a waiting room, more Makaton worksheets, and being told to 'use PECS then for the signs he isn't picking up'.

Nowhere does it say WHY his speech is over a year behind (at just 2yo, that's a fairly significant delay).

No ACTUAL therapy provided.

Just me, working on things like I did with DD and DS2, blindly, hoping for the best, assuming I can get him to talk, if not perfectly (DS2 still has some syntax issues at 9yo), but talking, simply because I eventually managed it with DD and DS2.

DS1 you could have a full conversation with at 18mo, so I know it's not ME. Yet they accuse me of alternately not talking enough, or talking too much. Often in the same report.

Why don't speech therapists actually DO therapy?!

moondog Mon 18-Feb-13 10:04:42

MCM, that is because unfortunately they have caseloads of about 100 ++ each.
Children with less severe communication issues are often seen in clinics for blocks of therapy.
Those with pervasive communication issues, if in special schools and units, often have an s/lt who visits regularly.

I think kids with long standing issues in mainstream schools often miss out.

Handywoman Mon 18-Feb-13 10:23:42

I really think that if a caseload is so big that S&LTs spend all their time assessing and very little time remediating, there has got to be something very wrong with that service. And surely that service will be demonstrating very little efficacy? Nowadays it's all about the paper trail in the NHS, everyone has to justify their existence.

Moondog, do S&LT service managers audit the actual number of hours spent giving therapy? Do the results of the service get audited? Or is it audited by how many get discharged as opposed to how children have improved? Do S&LT get demoralised? Just wondering.

zzzzz Mon 18-Feb-13 10:54:04

Me too handy! Surely someone somewhere points out it isn't working?

I'm almost beginning to think that all improvements are developmental anyway, so what's the therapy doing?

moondog Mon 18-Feb-13 11:15:30

HW I agree.
There is something very worng with the service!
I often wonder what the point is myself.
It's what first brought me to MN as I have a child with communication issues and what was on offer was not good enough for me, hence my foray into other areas such as ABA. That is another story however....

I'm not a manager but a clinician but as in all departments in the NHS, huge pressure to ensure clinicians are as active as possible. From my perspective, there is focus on bums on seats rather than measurable outcomes but there is increasing pressure on s/lts to prove that what they do is effective (ie measurable outcomes).

If we can't prove that this is the case, doubtless we will be amongst the first to get the chop.

Do they get demoralised?
Had I not gone into using s/lt with a different focus (ie measurable outcomes and based on evidence) I doubt I woudl have remained in the profession.

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