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Semantic Pragmatic Disorder explain please

20 replies

asdx2 · 06/08/2009 12:52

Can somebody give me the idiots guide to this please? Can it be co morbid to ASD or is it a feature of ASD? One or two examples would be great? And what input to expect/request from SALT? Thanks

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bubblagirl · 06/08/2009 13:06

not sure if this will help

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bubblagirl · 06/08/2009 13:08

my ds is HFA and this was mentioned for him also i always thought it was part of being autistic until i read this and realised its viewed outside as separate disorder yet most you read about it sounds like ASD i found it all confusing

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asdx2 · 06/08/2009 13:19

Yes dd has autism (moderate to severe at diagnosis at two but functions HF at 6 after intensive early intervention)but just feel that there is something more to her language difficulties than the autism.
Appears to use a lot of delayed echolalia even when she knows the appropriate vocabulary. Accquires language seemingly easily but the more she accquires the less accurate her use of it is as though she is more and more confused by the possibilities.
Not got very good SALT input and because her articulation is perfect and she speaks fluently she doesn't meet the criteria for SALT with autism specialist interest.
Trying to consider all possibilities really.

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pickyvic · 06/08/2009 16:57

my sons dx mentions that semantic pragmatic language disorder is the language of autism.
try this
www.mugsy.org/spd.htm

(hope the link works!)

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BONKERZ · 06/08/2009 17:07

ds has a dx of atypical autism and odd and when he was diagnosed it was suggested he be assessed for SPD.
that was a year ago now, ds has had a full cognitive assessment which showed he has a huge problem with language skills, he has also had SALT assessment which showed a huge difference with how DS processed spoken language and visual. he has also just had a full sensory assessment which shows he needs alot of visual aids as he has problems with audio senses.
SPD has not been mentioned though and whilst all the issues that have been highlighted definately point to SPD the pead and OT eel DS will get more help with the ASD and dont think SPD would be a worthwhile DX.

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tclanger · 06/08/2009 18:34

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tclanger · 06/08/2009 18:39

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Shells · 06/08/2009 21:24

Hi everyone,
This is interesting for me too. DS2 has recently been diagnosed with AS but I'm a little sceptical as all of his issues have been around language. The more I read about SPD the more it seems to fit.

As tclanger says, its actually more beneficial to have an ASD diagnosis as you'll get more help. You know all this, I'm sure ASDx2.

Thanks for all the links everyone. I'm going to do some more reading.

(Nice to see you back on MN tclanger - have missed your expertise!)

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tclanger · 06/08/2009 22:04

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mysonben · 06/08/2009 22:08

I have read in a book "the handbook of austism" by Maureen Aarons (SALT), that a semantic/pragmatic disorder dx can be given when ASD issues and behaviours are very mild, with the language delay/disorder being the main problem with minor autistic traits.
In this case it is viewed as a separate disorder.
But semantic/prag. language disorder is also wrapped up in an asd dx. Like Pickiwic said 'it is the language of autism'.

So the cutoff line between the 2 is very fine indeed, both conditions sort of overlap, or also co-happen with each other, iykwim? ...it's a bit hard to explain.

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Shells · 06/08/2009 23:04

Its a hard one isn't it - because there are so many diff sets of criteria that diff professionals are using.

Part of me thinks - does it really matter? But I do think that it matters in terms of SALT.

I'm being told that I need to work on DS's social issues now and the language will just come right. I'm not so sure and feel that the language will be the key to him sorting out his social stuff.

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tclanger · 06/08/2009 23:18

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asdx2 · 07/08/2009 12:38

I had expected the social communication to improve gradually as the language has
That was my expectation too but if anything the more language she accquires the more muddles and inappropriate she gets as she now has far more options.
Fully agree with the autism diagnosis but just question whether there is something more.

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tclanger · 07/08/2009 15:33

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Shells · 08/08/2009 21:09

We've been told that DS2 won't benefit from much more SALT input which I'm struggling to accept. Even though he has had a language explosion, his speech is full of echolalia, gabble, wrong tenses, pronouns etc. and really quite hard to understand sometimes.

He also really struggles with more abstract concepts like 'what are you going to do tomorrow' or 'what did you dream about' or 'whats your biggest wish'. The Paed thinks this is part of the ASD tendency for literal thinking but it seems to me that its really just that his speech (receptive and expressive) is just not developed enough.

Whats your plan for DD, asdx2?

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asdx2 · 09/08/2009 17:16

I am stumped tbh SALT would like to dump Lucy but it's written into her statement so she remains for now although expect her to be removed at next AR.
Not really sure that her input is necessary even now tbh the resources she provides don't have any impact on her difficulties anyway and Lucy is almost proficient in ths repeated assessments.
Lucy's difficulties are subtle in that her speech is grammatically correct always her vocabulary is vast and she appears to be able to speak like a highly intelligent child two or three years older than her age.
BUT whilst her answers to your questions are right in their phrasing and appropriate to the question quite often they bare no relation to what has happened or what Lucy is supposed to be telling you.
For example at school Lucy had a nosebleed, her LSA wrote in the communication book that she had been bumped on the nose when a child stepped back.Asking Lucy what happened she reports "C punched me on the nose"
When prompted to show me what happened she shows me just what the LSA had written. Lucy knows the word bumped and banged and can use them appropriately but because punch on the nose is in her learned stock of phrases that is what she used.
Even when I phrased it for her afterwards "C bumped you on the nose" she agrees "Yes C punched me on the nose"
This isn't a rare occurrence it happens numerous times each day and the more speech she learns the less accurate her ability to communicate through speech becomes.
Practising situations doesn't really help because she just adds to her stock of phrases.
It's not even that she doesn't understand the question because her answer does fit the question so she does understand what?, where?, why? who? It's more that her echolalia overrides the language she has got.
No idea where to go from here, thought that the understanding would come as the language did but it hasn't if anything the gap gets wider and wider in fact she was more able to communicate when she only used three word sentences as she had far fewer options to choose from.

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tclanger · 09/08/2009 22:10

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PipinJo · 09/08/2009 22:19

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tclanger · 10/08/2009 08:37

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tclanger · 10/08/2009 08:39

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