Apologies this is a bit long but I thought rather than retyping a load of stuff I would just copy and paste the document I gave to my educational psychologist who is very interested in this area.
Examples of Ds?s Semantic Pragmatic Language Disorder (age 4.5)
Ds had language skills from an early age which was appropriate to age, but he soon fell behind. His receptive language skills were fairly good when understanding concrete objects around him. However it became apparent at age 3 that he hadn?t moved on in terms of talking in more than one or two words together. He also made no attempt to talk about things around him. Even when questioned he didn?t attempt to answer and I was usually just met with a blank look. One day when he was about 3.5 I asked him what he had done at Playgroup and he finally said ?painting?. He was also engaging in quite a bit of echolalia at this time and I also began to notice idiosyncrasies in his speech and understand of language. On another occasion I asked him what he?d done at Playgroup ? I had only got to ?what did you ....?? when he interrupted me and said ?painting?. He hadn?t done painting at all that day ? his response was just a one word answer to the trigger question and bore no relation to reality.
His speech improved around age 4 but he still tended to repeat a lot of phrases over and over and would repeatedly ask for things till he got them.
Ds used to make up his own words eg ?bruined? when something wasn?t working or spoiled. I think this was a combination of ?broken? and ?ruined?.
A couple of months ago he was confusing me by asking for ?cold bread?. I spread some peanut butter on some bread but he didn?t want it. I started making some toast for dd and he said I want hot bread. He was actually asking for toast but decided instead that it was hot bread but had exchanged hot and cold.
He once most confusingly asked me when I handed him a piece of toast, ?I want some toast on it? - how can you put something on itself? I realised that he actually wanted margarine on it but because toast and margarine go together he had linked the two words. He was actually asking for margarine on the toast.
Ds often confuses opposites, eg in/out (?let the cat out? when the cat is already outside), upstairs/downstairs, on/off. He may say ?take my coat on?, rather than ?put my coat on? (confusing ?taking off? and ?putting on? ). Most conjunctions present a problem including ?or?. He finds a choice quite confusing and it is easier just to ask if he wants one thing, than wait for an answer before offering another. In general he finds relational words difficult, eg ?middle?. He finds words such as ?faster?, ?quicker? and ?louder? confusing and may mix them up and ask me to do something louder when he actually means faster.
Another example is using words that sound alike eg ?I want some bread soup? - Ds was definitely saying bread, and I finally worked out he meant ?red? soup which is actually tomato soup... so quite a leap from bread soup to tomato soup but this is the kind of linking I have to do. He thinks because bread and red sound the same then he can use either word.
He also calls ?crisps?, ?Christmas?.
Ds may also miss out part of a word. He had pasta at Nursery one day. I asked him and he said ?asta? ? I said you mean ?pasta? but he insisted it was called ?asta? enunciating it quite clearly without the p.
On the other hand he may add unnecessary words. Before he knew the phrase ?turn round? he would come out with phrases such as ?Mummy turn your head on your neck? if he wanted me to face him.
Ds finds the word ?not? difficult at times. He may say ?it?s working? when he means ?it?s not working?. He may also ignore words such as ?don?t? at the beginning of a sentence. So will ignore instructions to ?not do X? because he hasn?t acknowledged the not/don?t word. This can have important implications for commands such as ?don?t run into the road? which should be phrased in a different way. It is better to tell him to do something rather than to not do something as Ds finds it hard to visualise not doing something.
For some time he would use one core word to cover many different aspects or functions eg ?teeth?. This was referring to the objects itself but also extended to the toothbrush.
At the moment he is using the word ?funnel? to mean a funnel on a train but also a chimney and exhaust pipe from a car. He is concentrating on the action of the smoke coming out of the pipe rather than what it is attached to.
Ds is still having some problems with talking about himself and using ?I?. He is trying but gets mixed up. At the moment if he wants help putting on clothes he will say ?you do it for myself? which is partly an echoed phrase of me asking if he wants to something himself,
His speech can be a bit incoherent, at times not forming words properly, and he may start a sentence a few times over in a stammering manner as if searching for the right words. He may say ?oh I can?t think of it? and sort of bang his head in frustration.
Ds sometimes says ?please? and ?thank you? but isn?t consistent. He seems to think they are ?empty? words as he doesn?t understand the concept of politeness.
Ds uses few facial expressions and his voice can appear flat and monotonous at times. (However he can sing quite well and in tune!) He can also speak at an unnecessarily high volume. He may also ?bark? out commands, ?Mummy come this way? and expect me to come immediately. He is just starting to understand ?wait? but saying it doesn?t always mean that he will stop requesting whatever he wants over and over till he gets it. He is now also starting to understand ?later? which is very useful as it means he will now stop a task/activity and understand he can return to it.
Ds finds very abstract terms such as ?sister? very difficult. Things either are one thing or the other, and he is quite resistant to the idea that dd is both called dd and his sister. However he now understands that she is a girl and he is a boy. He also finds questions such as ?why did you do that?? impossible to answer. I don?t think he understands what ?why? means and also finds it difficult to connect a sequence of events.
February 2004