Anyone here heard of...?

iVillage Member
Registered: 04-02-2003
Anyone here heard of...?
7
Mon, 05-30-2005 - 10:35pm
WOndering if anyone on this board is familiar with Semantic Pragmatic Language Disorder? I have a dd who is a little over 2 1/2 with receptive/language issues. She is in speech therapy currently, her therapists do not think she is on the spectrum but I have a hard time figuring out what is going on with her. We are scheduled to start Psychology this month. I recently came across a wonderful article about SPLD which totally fit my daughter. It is the only thing I have ever read that clicked so much with her and her issues. However, I am not sure if it is even considered a dx. From my understanding it looks like it may be a subtype of Autism, or a high functioning autism. Perhaps, similar to how Asperger's is viewed. From what this article described it sounded like children with this form are the most social but have significant difficulty with learning language. Somewhat the opposite of Asperger's - where they have normal - exceptional language but, have awkward social interactions. Any info or insight is most welcome! Also, any suggestions for going through a psych eval and to diagnose/not diagnose (label) are valued. Thanks Again!
iVillage Member
Registered: 03-26-2003
Tue, 05-31-2005 - 12:02am

Yes I have and read tons on it. When my oldest was younger I thought for sure this was her exact challenge. I still think that she fits SPD to a T. However, that diagnosis won't get you a whole lot in the US and she is also Asperger's. So we go with asperger. You are right. When I first discovered it when cait was 3 or 4 it totally clicked with all her issues too. Including the progress they tend to make around kindie level.

Semantic-pragmatic disorder (SPD) is more a speech/language disorder. It is not an official diagnosis in the DSM so I doubt you would get much services via insurance or state agencies from that. Being a speech and language problem usually it is covered under special education depending on level of disability and the state regulations. It has alot of overlap with asperger's/high functioning autism. Some kids will be ASD and have an SPD. Some kids just ASD. Some kids are just straight SPD. There are some great sites if you do a search. I will find my favorite one. There is even a message board on yahoo for SPD (I think it is pragma group? something like that. I still get the emails but haven't written in in a while).

Cait had severe semantic troubles as a youngster. Her language was a bit late coming in but not horribly.(1 or 2 words at 18 months, 1 or 2 echolalic phrases at 2) When she did start putting together words on her own they were all mixed up if they weren't echolalia. I called it Yoda with word retrieval issues. "Blue lunch want I" meant "I want my lunch on a blue plate". That was at 3 or so.

Her language has tested as "age appropriate" since she was about 6 and she is 11. Some issues are harder to test and she still recieves speech. For instance, she has troubles relating narratives or telling stories or relating events. She may just ramble about the details and jump from one to another and it can be hard to follow her line of thought. There are times she still has to stop and think of how to word something or will word a sentence a little awkward, but it is barely noticable. She still has a hard time processing to much verbal info so it has to go slow for her and she is concrete. And being an aspie, has a hard time with pragmatics, figurative language, etc. But she is learning. She is even using idioms and figures of speech on her own.

Otherwise she is a great awesome kid. She is going to middle school and is mainstreamed for all academic classes.

Renee

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iVillage Member
Registered: 04-02-2003
Tue, 05-31-2005 - 3:03pm
Thanks so much for your reply. We start seeing the psychologist in a couple of weeks and I am hoping she will shed some light on all the diagnostic issues (Asp vs. HFA vs. the SPD). Right now she is dx as Developmental Delay and we are getting a lot of great services. She will start a special needs preschool in the fall. My insurance doesn't cover Speech no matter what (and I work for a Children's Rehab center and treat kids with special needs - isn't that ironic - my own kid can't have services!) BUt for now we have funding through our county, for now anyway... She has always had speech (about 50 words at 18 months) and some pretty intact social skills - but she has been inconsistent to say the least. She does a lot of echolalia and has pretty much memorized all language. I compare it to studying up for travel to a foreign country. She has learned all she needs to get through her routines, day, etc but throw in a question, change the routine, be in a very stimulating environment and it breaks down. Kind of like if you asked "Donde el bano?" in Spanish and someone answered back in Spanish - Which one, male, female, handicapped, do you need a changing area for the baby. You would be lost and unfortunately it seems that a lot of language is lost on her. Thanks so much. Any insight on what treatment has been helpful is welcome. Did your daughter do ABA? My daughter seems to be progressing well without, but sometimes I wonder if I should pursue it??
iVillage Member
Registered: 03-26-2003
Tue, 05-31-2005 - 5:20pm

I was an ABA therapist for early intervention when my DD was diagnosed so in a way she has always had it, but we only did discrete trial type stuff if there was something specfic we needed to teach her. We used and still use alot of ABA principals for behavior management and learning new skills. For instance, what are called activity schedules and task analysis. She went to an integrated preschool where she got OT, Speech and PT. It was pretty ABA based classroom and she had a sensory diet.

At that age I remember using lots of visuals and even PECS to communicate. Cait had a PECS board and I even used it to communicate with her even though she could talk. I also made lots of picture schedules, etc. She always understood visuals better. First/then boards too. That was more 3 and older since we were convinced by the powers that be that we were nuts before then so she didn't get any specific intervention until then.

Gotta go get the monkeys or I would write more.

Renee

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iVillage Member
Registered: 03-31-2003
Wed, 06-01-2005 - 6:33pm

My son is a HFA, but in reading about language disorders I have found that SPD seems to really summarize what is going on with him. I also suspect that SPD is closely related to or a sub-set of ASD.

Here is a good site for reading about it and it lists what to expect from children with SPD at different ages:
http://www.hyperlexia.org/sp1.html

HTH.

iVillage Member
Registered: 04-02-2003
Wed, 06-01-2005 - 8:14pm
Thanks to you both for your input. I actually read that article and realized that it fit my daughter so well. Nothing else that I had read about Autism, PDD, etc. fully fit her but that very article about SPD fits her to a T. Of course she is only 2 1/2 so it is hard to tell what the next few years hold. I know sometimes with the ASD dx these can evolve/change and a dx may be "fine-tuned". Any further parental insight is welcome. As a parent you try so hard to figure out what is best to help your kiddo. It is valuable to have other parents who have "been there done that". Best wishes to you both as you help your kiddos out!
iVillage Member
Registered: 01-19-2005
Thu, 06-02-2005 - 10:20am

This is a fascinating thread to me. I stumbled upon SPD awhile back and like you all thought it really described Eric's verbal habits better than anything else I had read, although he does definitely have some ASD characteristics too. But I also got the idea it was just a European/British label for PDD-NOS, maybe I am wrong.

Renee, I just had to say I was intrigued by your description of Cait's speech as a toddler. Eric is 3 and even before I read your post, DH and I have been commenting that he talks like Yoda! He has great vocab, a little echolalia--but uses it appropriately (and to us, humorously!) But he has started saying things like, "Daddy, where is?" "What that is?" "Cold am I." In some ways I am a little encouraged because I think he is finally starting to generate speech on his own. He had learned, though ST, to get his needs met, does fine saying "I want more juice, please." But to him I think it is a memorized "unit" that he has learned how to use. Other than the "I want" configuration that I think he has memorized, he has pronouns reversed and all mixed up. He seems to know this and will sometimes get addled and say things like "I,um you, um me, Eric like that."

Then some days, the sentences flow smoothly. I think I should start using PECS more, he does seem to respond to that. Maybe that would help him get word order right too? Hmmmm.

The other funny thing is that at our IEP the other day (yes we finally had it, went mostly ok, I'll post separately about that when I get a minute.) the team all noted that they wouldn't be surprised if Eric turned out to be Aspie later, but that it's too early to tell. I was kind of surprised to hear them say that since he initially had a big language delay, although he seems to have caught up.

One of the frustrating things to me is this. On all the ST tests that the school looks at, Eric tests at his age or higher, hence, he does not qualify for ST though the schools, although he does qualify for sped services via his "autism" exceptionality. Nobody seems to recognize his inappropriate use of words, semantic problems as terribly relevant. On the REEL test etc. he does great, but if a stranger asks him "what is your name" he'll probably respond with "your shirt is blue." He obviously still needs ST to address the pragmatics, but I guess the school system does not feel that is their responsibility. So we pay for ST on our own. But I digress.

Anyway, just wanted to say this whole SPD issue is really interesting to me too. I'd like to know more about it.

Katherine

iVillage Member
Registered: 03-26-2003
Thu, 06-02-2005 - 10:34am

Ya know, you can request that they use observations and annecdotal data as well. Cait was language delayed at 3 signficantly on the tests, but part of that was that she didn't have early intervention. The biggest problem was receptive. She could only follow a few well known 1 step directions. Once she did get speech she did catch up on testing by the time she was 5-6. She still had some problems that I could hear, but didn't "qualify" any longer.

I am very fortunate now in that our SLP gets it. Cait still doesn't test significantly low on language evals, but they use observations and annecdotal data as well. It is a well known fact that Aspies and HFA may be able to ace the testing but still cannot use speech/language skills adequately in every day life.

Perhaps he can continue to access language services through that means. Even Dave has speech on an consulting basis based on that. His scores are great too, it is conversationally. Dave did qualify for speech up until last year, but his was for articulation. It is so much easier to qualify for artic than language and language is definitely more severe a problem.

Renee

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