Semantic Pragmatic Disorder Support Group

Who can Help

The best person to help a child with communication difficulties is a Speech & Language Therapist. All Speech and Language Therapists must complete a recognised three - or four- year degree course and register with the Health Professions Council before being able to practise.

Speech & Language Therapists (SLTs) work closely with parents and carers and other professionals, such as Teachers, Nurses, Occupational Therapists and Doctors. There are around 10,000 practising SLTs in the UK. Therapists may work in the NHS or for Education Services or in private practice.

SLTs work with:

Babies with:

  • feeding and swallowing difficulties

Children with:

  • mild, moderate or severe learning difficulties
  • autism / social interaction & communication difficulties
  • stammering
  • difficulties in producing sounds
  • language delay
  • cleft lip and palate
  • hearing problems
  • specific language impairment
  • dyslexia
  • voice problems

Adults with:

  • communication & swallowing difficulties after a stroke
  • degenerative conditions ( such as Parkinson’s disease)
  • voice problems
  • hearing loss
  • learning difficulties
  • stammering
  • cancer of the head & neck


Most NHS Speech & Language Therapy departments operate an open referral system, which means that as a parent you are able to make a referral yourself. If you prefer you may ask your GP / Health Visitor or School Nurse to make the referral for you. In the first instance you will probably attend for an initial assessment. The therapist will start by taking a detailed case history, asking questions about your child's medical and developmental history and your concerns about speech & language development. The therapist will then begin by assessing your child's speech, language and communication skills (including listening & attention, play skills and social use of language). The therapist will assess your child through a combination of observation, play and informal and formal tests / checklists and profiles such as:-

  • Test for Reception of Grammar (TROG) Bishop, D. V. M. (1983).
  • Preschool Language Scales 3( PLS) Zimmerman, I, Steiner, V and Pond, R (1991).
  • Reynell Developmental Language Scales 3 (University of Reading edition) Edwards. S, Fletcher. P, Garman. M, Hughes. A, Letts. C and Sinkra, I (1997). NFER-NELSON
  • CELF-Preschool UK Clinical Evaluation of Language Fundamentals - Preschool UK Edition Elisabeth H Wiig, Wayne Secord and Eleanor Semel, 2000
  • Clinical Evaluation of Language Fundamentals® - Third Edition UK (CELF-3 UK) Eleanor Semel, Elisabeth H Wiig and Wayne Secord, 2000
  • Test of Word Knowledge (TOWK) Elisabeth H Wiig and Wayne Secord, 1992
  • Renfrew Bus Story Catherine E. Renfrew
  • Renfrew Word Finding Test Catherine E. Renfrew
  • Renfrew Action Picture Test Catherine E. Renfrew
  • Pragmatics Profile of Communication Skills in Children Dewart, H and Summers, S (1995). NFER-NELSON
  • Derbyshire Language Scheme (DLS) Knowles, W and Masidlover, M (1979/1982). Derbyshire County Council
  • Language Assessment Remediation and Screening Procedure (LARSP)
  • STASS materials- South Tyneside Assessment of Syntactic Structures
  • Test of Word Finding - Second Edition (TWF-2) Diane J German, 2000
  • Living Language Locke, Ann (1985). NFER-NELSON
  • Teaching Talking Locke, Ann and Beech, M (1991) (NFER-Nelson)
  • Assessment of Comprehension and Expression 6-11 ACE (NFER)
  • Boehm Test of Basic Concepts 3rd Edition (Boehm-3) Ann E Boehm, 2000
  • Children's Communication Checklist (CCC-2)Second Edition Dorothy Bishop, 2003

It may be helpful to make a list of things that you have noticed about your child’s communication skills (eg; doesn’t always give eye contact, often misinterprets what has been said, prefers to play with certain toys in a particular way, can’t say certain sounds …). At the end of the session the therapist will feedback to you and will discuss your options, which may be to recommend regular weekly 'blocks' of therapy, review appointments only, out of clinic programmes (school / nursery), referral to another agency or discharge. At this stage she may be able to give you a name for your child’s communication difficulty (eg; expressive language delay or dysfluency) or further assessment sessions may be required for more complex difficulties (semantic pragmatic disorder). The therapist should always provide opportunity for questions. Speech & Language Therapy for children with Social Communication Difficulties aims to address the following areas:

  • social understanding and particularly the child’s understanding of ways in which they can affect their environment
  • social skills / pragmatics
  • motivation to communicate
  • development of play skills
  • attention & listening skills
  • understanding language (receptive language)
  • use of expressive communication (verbal / written / symbols and signs)

Therapy approaches may include the following:

  • Structured language programmes
  • Picture Exchange Communication System (PECS)
  • Introduction to visual cues to support understanding and expression
  • Work within the TEACCH structure (Treatment & Education of Autistic and related Communication handicapped Children)
  • Social Stories
  • Intensive Interaction
  • Non – directive communication Therapy

Skilled therapists will treat you as an important treatment facilitator. They will encourage you to observe sessions, use speech development strategies at home, listen carefully to your concerns and address them in treatment, and involve you and other key individuals (e.g day care providers, teachers, grandparents, siblings) in the therapy process. Get involved! You have many more observations and insights to offer a treatment programme than any therapist does. Never apologise for making suggestions or asking tough questions. If you are unhappy with any part of your child's Speech and Language Therapy, try to talk to your child's named therapist. If you are still unhappy speak to the Head of Service who should try to resolve the problem.


Lisa Houghton BSc(Hons) MRCSLT HPC ASLTIP
Speech & Language Therapist