semantic pragmatic disorder

[jmb1964]

Our 5 yo son (no 2 of 4) has been having behavioural problems since starting school last August. Looking back he has always been 'a bit wild', but being in a class of 30 and having to do as he's told for hours every day is proving beyond him, and it seems that this is more than just naughtiness. He has huge temper tantrums if things don't go his way, and can occasionally be very aggressive, as well as just completely unco-operative at school. Yesterday he was sent home before lunchtime because of this, and the fact they had no spare teachers/classromm assistants to be with him. The school has applied for an auxiliary for him for next year, but he does not yet have an official 'label' so they are not very optimistic about this. At a developmental assessment by a community paediatrician the possibility of semantic pragamtic disorder was raised, and he is due a further more detailed assessment, but this is not until June.
For the moment, he lurches from one disaster to the next, but in between is compliant, loving, and utterly adorable. We just don't know how best to handle his outbursts, and it is making socialising as a family almost impossible. We all feel as if we are walking on eggshells, and he is just beginning to say he doesn't want to go to school, which is a worrying new development.
Does anyone out there have any ideas?

School can be a very difficult place for children with semantic pragmatic disorder. A proper diagnosis and proper support is essential. I do know of many families with children with these tyoe of problems who home educate. Would that be a possibility- even whilst they sorted out proper support? Alternatively would the school let him go part time whilst something was sorted out.

I would highly recommend talking to IPSEA (they can be found via google- sorry don't have their address). They are invaluable, and will help you get the support he needs in school. If you want to explore the home-ed option further let me know and I'll dig out a good SEN home-ed website.

My ds had similar problems when he first started school. He was assessed by the school paediatrician and she thought that he may have semantic pragmatic disorder. I looked it up on a search engine and I personally didn't think that he had this. One of the major signs is your child taking everything as literal ie.'you're full of beans today' the child would literally think that they were full of beans. Also SMP children are very placid and are not prone to outbursts like you have described.
After further assessments with a number of health professionals my ds was finally diagnosed as having ADD.
If you would like further information try looking up ADDNET on a search engine for a more detailed description.

Hello Thanks for these messages - I think as a new girl to this I'd better pick up the lingo and start talking about ds1. He was back at school yesterday and aparently all went well, but then as they were all playing around in the playground at home-time he got knocked off a borrowed bike, and was trying to strangle the boy who did it. He was furious because Aidan had pushed him off 'WHEN I WASN'T EVEN WEARING A HELMET' - he wouldn't have minded otherwise. He never cries, even when he's quite badly hurt, just rages.
I don't think I could cope with home ed, though I take my hat off to those who do it. I work three and a half days a week and love my job, even though I am sometimes consumed with guilt. But maybe accepting that full-time school without extra support is too much for ds1 would be a temporary answer. The teacher always has difficulties with him in the afternoons, because the classroom assistant is only there for the mornings, so she's on her own with 30 kids. Crazy, isn't it?
I had a phone call from the hospital yesterday to tell me there has been a cancellation, so he now has his communications clinic appt next week. (At least I think that was what she said - the older children were both out with a friend, and when the woman said she was phoning from the Sick Childrens I immediately assumed that at least one of them must have been run over; this catastrophic thinking can be quite disabling sometimes..)
Anyway, I have my doubts about the semantic pragmatic diagnosis too, though reading some of the Aspergers threads has made me wonder about it all again. ds1 did use our fingers to point at things when he was little, and he is inclined to talk non-stop whether or not people appear to be interested. And he does eat loads and loads of bread. I started him on omega-3 fish oil and EPO about 6 months ago, and it did seem to help. His fine motor control took off very suddenly after that, and he learnt to write his name in the space of a couple of weeks, having completely refused even to scribble before that. But he DOES play imaginatively, and doesn't have a problem with metaphor. Yesterday I was boiling some carrots rather too hard, and he said 'oh look, the pan-lid's dancing'. He uses complex words, sometimes getting the pronunciation wrong, but he ususally gets the meaning right, and rarely lets a word pass if he doesn't understand it. One day at school he told the teacher he couldn't multitask!
As all these problems have grown over the last few months, and I've started reading up about it all, I wonder more and more if dh has some Asperger traits - he's an academic, which suits him fine, but in some areas of our lives he just flounders hopelessly.
Anyway, time to do tea for them all. I feel like a kid with a new toy having found this website!

Oh no forget the guilt- having a child who has some sort of problem is hard enough without adding in the guilt. Home-ed is hard anyway I think. School can provide a much needed respite. I always mention it just because not everyone realises its legal!

Eating loads of bread does sound a bit suspicious I've posted more about this on the worried/asperegers thread. you could always ssee if enzymes make a difference if the thought of removing the bread is a bit daunting.

It's great that you have a appointement next week- let us know how you get on.

The school sound like they need extra help. Fi schools go about it the right way they should be able to get it. I know of one little boy who needed full time help but was only funded part time. The school observed him in a few lessons without help- write down all the reasons why he wasn't coping- submitted it to the lea- and the funds were made available.

The other option is to think about statementing- you can request that yourself- although it would definitely be worth talking to IPSEA first. Statements are getting harder to obtain because of school action plus (school are meant to have the funds to provide for most SEN- your school doesn't seem to).

Glad the fish oils worked. I've found they've really helped ds1. 6 months ago he couldn't walk and carry something (not even a little pecs card)- now he's great. And very pleased to hear about the writing. DS1 has refused to hold a pen until this week- suddenly he's drawing on everything- yeah. Hopefully he'll try writing soon as well.

Don't worry too much about the diagnosis. All these things are related. My son has a diagnosis of autism- but his dyspraxia (especially verbal dyspraxia) is to my mind far more of a problem- or barrier to learning- as the ed psych put it. He also does lots of things he's isn't "meant" to- he recognises faces in photos really easily, has a sense of humour- has imaginary play (basic- but its there). What one peadiatrician would call PDD, another would call autistic tendencies, another would call atypical autism, another would call Aspergers and yet another would call semantic pragmatic disorder. And an American dr would call them something else again.

Best of luck- and let us know how you get on.

Thanks Jimjams for the moral support - we're meeting with P's school to 'touch base' tomorrow, then the Communication clinic on Friday. I'm not sure about 'statementing'- I think the eqivalent here in Scotland is a Record of Needs, and apparently there's legislation in the pipeline which will make it harder to get the help needed - we'll cross that bridge when we get to it I suppose. Meanwhile I think I will investigate the Sunderland thing. What's all this about hot red ears? P has them too, and he had several ear inections in his first year, and an anaphylactic reaction to egg, and a febrile fit... And then there were the other casualty visits for 'ordinary' accidents. Son no 2 is 13 months and has just been called for his MMR - a dilemma, but I'm sure it's all been well covered here before.

oh yes read the MMR thread under health if you dare... I have put lots of links in there- hopefully balanced ones (akthouth probably biased) ! A bit of a hobby horse of mine

The record of needs has been given a bit of a reprieve as the proposed changes were against human rights legislation! The system is different though- I think IPSEA cover it as well.

Sunderland is definitely worth considering. The urine test is great as it does give an indication of whether something biological is going on- and if there is there's a lot you can do. It's 50 quid for the test- or free for those on a low income. They send you a kit- you just collect a urine sample, freeze for 24 hours then send off. They quote up to 6 weeks for the results, but ours came back within a week. I'm glad I had it done as it's given me a starting point. FWIW the little things you've said anaphylactic shock, red ears, ear infections suggest it would be worth looking into further. Another good website/organisation is Allergy induced autism- their website is www.autismmedical.com Don't be put off by all the "autisms"; children can have the underlying biological problems, but not be affected badly enough to qualify for a diagnosis of autism iyswim.

I rave a bit about the diet- but, for my son - it has made a hige difference. That isn't the case for everyone but I always think it's worth looking into- just because the potential benefits can be so great.