Quick Description of Semantic Pragmatic Difficulties

© Jane Stanton and Lynne Thomas Cumbria Gov

Semantic Pragmatic Disorder

The term semantic pragmatic disorder (SPD) is sometimes used for a group of children who show possible autistic spectrum tendencies and specific language difficulties that cause complex communication problems. The following features are common to children with SPD: -

• Inappropriate eye contact/facial expression
• Speech is fluent but lacks content and direction
• Explanations and answers to questions are not specific
• Comprehension is poor, particularly of abstract concepts and understanding can be literal
• Interactive and imaginative play is poorly developed and there is difficulty in recognising and expressing emotion
• There is difficulty following the "unwritten" rules of conversation such as turn-taking, appropriateness and non-verbal language
• Weak temporal concepts cause confusion over school routine and chronological events
• Auditory memory is poor but rote learning is often a strength
• There are poor attention skills, erratic motivation and distractibility
• They rarely ask for help or seek clarification
• Behaviour can be described as naive or eccentric
• Mechanical reading skills are good but there is limited understanding
• Self esteem is low (this is not a criteria for SPD but is often an unfortunate consequence)
• Can appear rude, arrogant, gauche

A significant contributing factor to the majority of these features is poor auditory-processing skills; the ability to select, assimilate, memorise and systematically store information has enormous impact on language skills of both comprehension and expression. Children with SPD are unable to use language with the same understanding and flexibility as other children.

• Lack of attention
• Easily distracted
• Lack of understanding of text and/or vocabulary
• Word retrieval - find it hard to store information about word meaning and need prompts to recall words
• Inability to follow quick verbal interchange
• Slow to respond or inappropriate responses - not applicable/too much
• Inability to follow changes of topic in discussion
• Misuse of tenses through weak concepts of time
• Inability to understand implied meaning

Strategies for Whole Class Activities

• Cue in with use of name, key words or other signal
• Use visual cues such as pictures or written word and refer to it frequently
• Encourage attention towards and active processing of key words/phrases by highlighting, underlining and focus on physical aspects of the word.
• List key vocabulary and explain at the beginning of a session. Repeat, recap and refer to this frequently
• Use an individual word box for use with LSA to practice and learn new vocabulary
• Revise relevant words before a session and introduce new words practically if possible
• Repeat key information and link to written language and/or vocabulary
• Interrupt inappropriate responses, explaining why you have done this. Make links with what has been offered if possible
• Allow time for thinking
• Use differentiated questioning - closed questions that can be answered or offer multiple choices
• Make clear breaks between changes in topic, point these out if necessary
• Use spatial timeline to aid understanding of past, present and future tenses
• Use an LSA to support and maintain focus on key teaching points
• Explain exactly what you mean or expect the child to do. Make the implicit explicit Use visual maps to link ideas for planning, writing or showing sequential story development General Strategies
• Child is likely to be a visual "hands-on" learner so give lots of opportunity to take part in practical tasks
• Child likes routine so use a picture diary which signals what is happening now and later
• Give short, individual, explicit instructions. For example, "Put the cars in the box", not "tidy up"
• Give clear explicit rules including rules for "good talking" and "good waiting"
• Explain through the use of role-play, why we need a particular rule
• Praise him constantly when he observes the rule. For example, "Good listening Ben"
• Give him practice at giving instructions to other children
• Give him practice at small group conversation skills. These can include a social use of language programme
• Pre-tutoring. Tell parents in advance what topics you are going to do or what stories you are going to read in literacy hour
• Develop a positive behaviour programme which ignores unwanted behaviour and praises the child when he is right. This avoids dependency on prompts
• Use visual support to teach abstract words, for example; time, quantity and feelings
• Most children with SPD have a limited use of language to explain how they feel. Build up their repertoire by commenting as events occur, for example "Ben is sad". If they understand the labels we use to describe their own feelings then they will make a connection with ours
• Try to find some skill with which the child can compete on equal terms with his peers and use it to build his own self-esteem
• Provide a distraction reduced environment to help reduce inappropriate behaviours like flapping, biting and spitting
• Remember that parents may describe very different behaviours at home. Try putting aside a regular time to meet up with them and discuss
• An achievement book may be useful. The rules are described in the back and the front records the child's progress - for example, going to bed on time, dressing or completing work
• Joint focus between home and school can help children to overcome their resistance to try out new activities