Semantic pragmatic disorder (SPD) is a language comprehension and usage disorder that usually affects toddlers. Children with SPD have trouble understanding the meaning of words and phrases (semantics) and knowing the "right" (appropriate) thing to say to others (pragmatics). They can also have trouble interpreting the significance of an event and to distinguish what's important from what's not. Opinions vary over whether the condition is a subtype of autism or an entirely different condition, the National Autistic Society (NAS) explains.
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Children with SPD behave similarly in some respects to those with autism, the NAS reports. Symptoms include:
• difficulty making eye contact • desire for solitude • sensory difficulties • automatic repetition of what others say • temper tantrums • lack of imagination • immature behaviour • lack of empathy for others
SPD is usually diagnosed in children between eight months and two years of age. Children affected don't talk much and have trouble comprehending words and finding the words to communicate. Their unresponsiveness---even to their own names---can be mistaken for hearing problems. But they'll react to other sounds, such as the telephone or door bell ringing, BrightTots.com explains. They also have trouble understanding and following instructions associated with unfamiliar tasks and resist changes in normal routines.
Effect on the Senses
Children with SPD may be overly sensitive to noises or ignore loud noises, responding to more subtle ones instead. Some are sensitive to the taste of certain foods, others may not register hunger and have to be urged to eat. They may also be sensitive to touch, avoiding contact with anything sticky, wet or that feels unfamiliar. Others have a diminished sense of pain, and therefore, awareness of being injured.
Although many children with SPD remember words they hear, they have trouble learning what they mean or identifying important ones in phrases or sentences. When repeating what they hear, they often mimic that person's tone and inflection. This may cause some children to sound more mature than they are. They also tend to think very concretely and literally, rather than abstractly.
Children with SPD are often quite talkative but usually about issues that affect only them. As a result, they may not pick up on boredom or other social reactions from others. Because they tend to take what's said literally, they don't understand being teased, jokes, sarcasm and other relatively complex social interactions, NAS points out.
SPD is not an illness but a developmental disorder that improves with age, the Heathlands Language Unit reports. Children are likely to improve if they are given plenty of practice talking and are encouraged to participate in word games. They also "do well if they spend time with children who are equally or less socially sophisticated than themselves."
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