Semantic-Pragmatic Language Disorder

Hmmmm... it can't be auditory processing disorder. I mean, I think many kids might fit both.. but, that doesn't cover all the listening/applying problems that my dd seems to have. It does for SOME, but she has problems hearing things literally and not knowing something applies to something else.

For example.. I told her we were going to the playground the other day. When we didn't cross the street but continued to go up the street, she had a melt down. She didn't understanding that there was another playground because I told her playground, and we USUALLY do go to the one across the street. It took her a long time to calm down enough for me to talk to her and explain that there was another playground we were going to.

Another.. she said the bath water was too hot, she wanted it cold. I told her, "It will cool down soon." she melted down. I repeated it, and it didn't help she kept saying she wanted it cold. I said, "It will be cold soon." and she understood that.

If she isn't putting her shoes on, and I tell her, "If you don't put your shoes on we aren't going to the playground today." she melts down crying, "No no no no I wan go!" and it doesn't motivate her to get ready at all because she thinks that I told her we aren't going.

I asked her what did go to the library for.. she starts talking about a lollipop that she ate there. Yes,.. she did. BUT, what do we go to get at the library? ...more random talking.. because she has no idea.

Same thing with food. Where do we get food from? When daddy buys food, where does it come from? She talks about spongebob eating some fruit or something. I repeat it. She says, "What you say." and then talks about random things again. She doesn't seem to know what I'm asking.

Very recently she learned to respond to "What is your name?" with "I'm Ivy." and "How old are you?" with "I'm 4" but she is still spotty on her answering those. Some days are good, some days she has a blank look on her face.. says 3.. or 5... or looks like she needs a prompt to answer correctly.

Some of those things can fit with auditory processing, like her inability to follow a three step command.. but some of it, like her comprehension doesn't seem to fit that one, or her out of context speech and rambling.

It's not the same as apd. It's a different diagnosis that's used in UK, but not here. There are some different criteria. I'm unable to find my favorite web page on it. I can look when I have more time.

Nature, the stuff your dd is doing could still be related to apd, ime, and if indeed that is what is affecting my dd. Keep in mind that she is 4, and the beginnings of these disorders are different than they ultimately end up. APD can't be diagnosed until 7 for this kind of reason. With my dd, we had to practically drill to work out how to answer yes and no questions, answer her name and her age. She got all those skills within the last 6 months, near to 5. She still messes up pronouns, mixes up words, and has all kinds of language idosyncracies. She talks a lot like my dd did last year, except it sounds like she has a bit more vocabulary and grammar than my dd did then. It's like there is a connection that won't let what's in the mind out and what's outside in.

From our evaluations, it seems that apd does ultimately cover this kind of speech pattern. The US diagnosises seem to be much broader with what they cover than some of the things used for diagnosis in the UK.

So an auditory processing disorder is different from a language processing disorder...

Yet when I search for information on a language processing disorder I only find things about APD. :

Wow this is confusing.

And if you add any autistic like behaviors, they are more likely to dx it as a spectrum disorder..

Welcome to my world, Nature! I'm glad to have the company, but I'm sorry it had to include you.

Language processing disorder is (as far as I can tell so far) an umbrella term to cover lots of individual disorders or if they can't find anything else specific to call it. However, it does seem to be used more diagnositically in the UK. Or at least, most of the resources I found using the term "language processing disorder" are from the UK. For right now, my dd is diagnosed with language processing disorder, but from what I understand that just means she has problems with using and understanding language. it won't be a diagnosis we'll keep once one is required for her.

As far as adding autistic behaviors, I think it depends. My dd can act quite autistic, but she is (as of now) not diagnosed. IMO, certain autistic traits might be associated with not having good communication skills and language abilities. Anecdotally, for example, I've heard of a lot of late talking kids who stim but are never diagnosed with autism and in fact sometimes become more or less typical later. The stimming, though, begins to disappear as the language comes in, as it did for my dd. Or there are correlations with late language acquisition and sensory issues because they're finding that sensory processing disorders affect other aspects of learning, so a lot of symptoms in common with autism can stem from there, too. The autism diagnosis seems to be something somewhat at the discretion of who is doing the evaluation and whether or not they feel that the autism is causing the language problems or whether the language problem is causing the autistic traits. Or, then again, the experiences I've had with my dd might just be unusual.

My DD also has these sorts of issues too, and I had asked our SLP about semantic-pragmatic language disorder and she had never heard of it. I do not think it is an accepted diagnosis in the US. But DD's language is very impaired and idiosyncratic similar to the descriptions I've read for semantic pragmatic disorder. She has a lot of trouble matching words to ideas and it is difficult to discuss anything abstract. It took a great deal of effort to teach her how to answer yes/no questions and also questions about "Do you like ___?"

She was originally diagnosed as autistic at 3 but we're doing a neuropsych eval now and the psych says no way to the autism label. I haven't felt the autism diagnosis to be accurate for a long while (she's now 4.5) and the autism label did not give us access to anything she needed through schools (she needs intensive language supports/therapy and they wanted to offer behavior management programs and sensory integration stuff). Her behavior can look a little autistic at times, but most of it is due to communication issues. Every new language use really has to be demonstrated visually multiple times before it snaps into place. Her expressive language is very impaired also. The neuropsych says her new diagnosis will probably be childhood/developmental aphasia (we're awaiting the consult about results but that was what the psych told me in passing after a recent appointment). The issues are more severe than most of what I read about auditory processing disorder but there's a definite component of that. We plan to have her evaluated for APD when she turns 6 or 7, since that seems to be the cutoff age for audiologists to reliably test for it.

The whole quest for a label has been extremely frustrating. It seems like a lot of labels out there overlap or do not fully account for everything and a lot are up to the opinion of the person doing the evaluation. And there's a definite trend to call everything autism spectrum these days even when that label doesn't really fit.

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I'm so interested in where this discussion is going. Don't mind me - please keep discussing!

Oh no! I'm not in a rush to throw a label at her. I'm just the type of person that has to research to keep my own mind occupied. And its easier to research when I know what I'm looking for.

I originally asked about semantic pragmatic disorder because that does seem to fit dd quite a bit and I'm confused as to why it doesn't fit in here in the US. I mean, there are a few dx's that kind of cover some of it but not completely.

I actually used a few of the things I found that are said to help children with semantic pragmatic disorder with dd today, and really was able to look at her with a new set of eyes you could say. I can clearly see now that much of her issue hasn't been just a normal sensitive moody 4 yo. She really doesn't understand what I say when I say things. And explaining the meaning of words changes that. It is hard to keep her focused enough for me to even get through a simple explanation. "Ivy, when Mama says the bath water will "cool off." It means that the water will get colder, just how you like it." The next time I used the phrase "cool off." She immediately said, "Dat means get cold!" Whether the new information sticks, I'm not sure.. but we'll see.

So really, finding where she fits isn't to stick a label on her.. but more to help me. If that makes any sense.

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That makes perfect sense. That's why labels are important to me, so that I can find the information I need and succinctly share with other knowledgable people the information that they need.

I'm going to look this up. I wonder if my DD is having similar problems. A lot of what you describe is so very familiar.

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Let me know if you get further than I have! I seem to be Googling in circles.

That goes along with what this page says. And the description in here sounds just like dd.. except my dd has a lot more sensory issues, is very clumsy, and does have vocal stims especially when she is engaged in something like "playing" (which I use loosely since she doesn't actually act out anything, she more of less makes noises and fiddles with the toys)

At her playgroup today it was interesting to watch the teacher working with her. All the other kids were out sick, so it was just my daughter there. It gave her time to have some one on one with her and really see the issues I was talking about. Right away during the instruction for arts and crafts, my dd was reaching for the supplies and totally not listening. She repeated herself, and told dd she could start. My dd has no idea what to do and kinda just started coloring everywhere. The teacher redirected her to what she was supposed to do, and several times had to say, "Ivy. Look at me. Watch what I'm doing. Ivy. Ivy. Look at my fingers Ivy." and my dd was sorta spacing off and yet.. still trying to do the craft but not really connecting with it. She was adamante about doing it herself and would not let anyone "help her" by showing her with her craft.. she watched, but its almost as if she didn't really SEE or HEAR what she was supposed to do.

It was nice to see someone else say, Yes.. there is an issue here. Yanno? As silly as that sounds. Its at least one other person saying I'm not neurotic.

She said if she was going to be starting school next year that she'd need a lot of redirection and effort to stay on task and she really hopes something comes from the ped appointment on Monday.

Ack! I'm sorry about that post. I started to formulate a post and then changed my mind and decided my input wasn't important here and then somehow posted only a part of it. : And it sounded dismissive and rude. I'm sorry...it was a mistake I promise.

Since I've already jumped in (badly) I think I'll re-try to formulate what I wanted to express.
It is relevant to me because my son, like kiddos described here, doesn't on initial glance quite fit either but I don't see it the same I don't think. Again, I'm sorry for that post..it wasn't intentional. After I get my boys to bed I'll try to express what I was going to say.

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No worries! I didn't take offense to it!