Semantics
Semantics is the aspect of language function that relates to understanding the meanings of words, phrases and sentences, and using words appropriately when we speak. Children with semantic difficulties have a very hard time understanding the meaning of words and sentences.

This is sometimes apparent from their unusual responses when they are told to do something, and sometimes it is revealed by the questions they ask, and the things they say about words. There is an example here of 12 year old Nerida's interpretation of the word "acquire". In the example, she was unable to detect from the context that she was being asked what "acquire", rather than "a choir" meant.

People with semantic processing difficulties have particular trouble with abstract words like 'curious' or 'vague', words that relate to feelings and emotions such as 'embarrassed' and 'anxious', and words that refer to status (for instance 'expert' or 'authority') or degree (for example, 'essential' or 'approximate').

They have difficulty with idioms, sayings and slang expressions, often taking them literally or interpreting them oddly. For example, when asked if he enjoyed spending time with his friends, a 14 year old with semantic processing problems replied, "I don't see how you can spend time, and I certainly don't see how you could enjoy it because spending time is not something you can do. You can only actually spend money".

Another difficulty children with semantic problems experience is that they may not be able to identify the key point or topic in a sentence, and because of this may suddenly change the subject, very obscurely, apparently thinking they are on the same subject. Here is another real example from a girl aged eleven. Question: "Could you get the book off the shelf and give it to me?" Reply: "The Gulf Stream warms the coast-line"

NOTE: CLOSE QUESTIONING REVEALED THAT THE OBSCURE CONNECTION HERE WAS THE CONTINENTAL SHELF, AND THE GULF STREAM. HER RESPONSE WAS RELATED TO HER DEEP  INTEREST IN MARINE BIOLOGY AND OCEAN CURRENTS.  

Children with pragmatic difficulties have great trouble using language socially in ways that are appropriate or typical of children of their age. They often do not understand that we take turns to talk, and they will "talk over the top of you" at times, or, at other times respond to what you say with inappropriate silences, or in a voice that is too quiet. They may interrupt excessively and talk irrelevantly or about things the listener shows no interest in. Their communicative behaviour often appears rude and inconsiderate.

They often do not assume prior knowledge. So for example, one boy explained to me in minute detail how to wash a car, wrongly assuming that I needed (and wanted) the information and that I had never washed a car.

On the other hand, they may assume prior knowledge that the listener could not possibly have, and launch into a long disquisition without describing in sufficient detail the participants, location and general background of their story.

They can go on far too long telling stories, and include so much detail that the listener becomes disinterested.  

Semantic-Pragmatic Language Disorder
Children with SPLD (called semantic-pragmatic disorder (SPD) in some literature) have a language disorder that affects both semantic processing and the pragmatics of language use. Some authorities see SPLD as part of the autism spectrum of disorders while others see it purely as a language disorder.

I once said to a twelve year old with semantic and pragmatic difficulties "Tell me all about yourself." He responded, perfectly seriously, with "It will take a very long time", and made an immediate start!

Although isolated examples like the ones here can appear quite amusing and even endearing, these difficulties with word comprehension and social aptitude can be extremely embarrassing, upsetting, confusing and frustrating for the child with SPLD, and can give rise to teasing and criticism of the child.

Family, peers, teachers and other adults need to apply great sensitivity to guiding the young person with SPLD. Understanding the nature of the disorder is helpful in this regard.

Assessment
Speech-Language Pathology treatment is planned on the basis of a formal language assessment, interviews with the client and their caregivers and clinical observations.

It is always necessary to determine whether the client has:

1. isolated semantic processing difficulties OR

2. isolated difficulties with the pragmatics of language use OR

3. a combination of the two OR

4. semantic pragmatic language disorder (SPLD) OR

5. SPLD in combination with another communication disorder that is NOT in the autism spectrum, for example, developmental apraxia of speech OR

6. SPLD in combination with another disorder in the autism spectrum, for example, Asperger's Syndrome OR

7. SPLD in combination with another disorder that is NOT in  the autism spectrum, e.g., Attention Deficit Hyperactivity Disorder (ADHD).

The diagnosis of isolated semantic difficulties, isolated pragmatic difficulties and combinations of the two is "routine" for  many paediatric SLPs. The diagnosis of SPLD can be difficult, lengthy and indeterminate, often involving several professionals in addition to the speech-language pathologist (family physician, paediatrician, audiologist, clinical psychologist, occupational therapist, etc). There are many children with semantic and pragmatic difficulties who don't quite "fit" into a definite diagnostic category.

Links
Auditory Processing Disorders
Article by Caroline Bowen

Auditory Processing Disorders (a-p-d) Listserv
Professional discussion

Autism, Asperger's syndrome and semantic-pragmatic disorder: Where are the boundaries? 
Article by D.V.M. Bishop. British Journal of Disorders of Communication 24, 107-121 (1989) © The College of Speech Therapists, London 

Belonging: Creating Community in the Classroom 
Mona Halaby's highly acclaimed (by teachers) book!

Conversational characteristics of children with semantic-pragmatic disorder 2: What features lead to a judgement of inappropriacy? 
Article by D.V.M. Bishop & C. Adams. British Journal of Disorders of Communication, 24, 241-263 (1989) © The College of Speech Therapists, London

Information sheet 
by Dr Jane Shields, The National Autistic Society 

Jeers and Tears: Teasing and Communication Disorders 
Judith Maginnis Kuster

Pragmatics, Socially Speaking on the ASHA web site

Questioning the validity of the semantic pragmatic syndrome diagnosis 
ABSTRACT "The classification of developmental language disorders has recently witnessed the birth of a subsyndrome, semantic-pragmatic syndrome, used to describe the case of children with specific language and communication impairments. However, there are striking similarities between children with semantic-pragmatic syndrome and those with high-functioning autism on a communicative, behavioural and cognitive level. This article questions the validity of semantic-pragmatic syndrome as a diagnostic concept distinct from high-functioning autism and, consequently, its use as a clinical entity."

Sematic Pragmatic Disorder Forum (on Denise Vignola's site)
"Welcome to the Semantic-Pragmatic Disorder Forum. Share your thoughts, experiences and questions on SPD. A special welcome to SPD adults who wish to share their experience with us!"

Semantic-Pragmatic Disorder Web Page 
Denise Vignola's useful collection of links and articles has been constructed from the perspective of a parent of a young child with APD, and also from that of an adult with the same issues. 

Social Thinking
"Michelle Garcia Winner, MA CCC is a speech and language pathologist who addresses the educational and life-planning needs of people who live on the autism spectrum. She specializes in social thinking and perspective-taking therapy and education for professionals, educators, and children, adults, and their families with high-end autism spectrum disorders..."

Tele-collaboration - Social Communication
The Social Communication Web site from the University of Washington, Department of Speech and Hearing Sciences is designed to provide caregivers and professionals with a deeper understanding of social communication problems exhibited by school age children, and ways to assess these problems. 

What is semantic pragmatic disorder? by Julia Muggleton 
Published by the Surrey Branch of National Autistic Society in the UK. 

Young people with communication disorders
Article by Caroline Bowen: "For students with communication disorders, high school and university can feel like an interminable ordeal. But when supplied with appropriate information, insight, resources and time, and input from parents when necessary,  teachers can provide structure, support, encouragement and an exciting learning environment for them..." 

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