Semantic pragmatic disorder is a communication disorder, which crosses the boundaries of both specific language impairment and autistic spectrum disorder.

It may be diagnosed as one or other of these conditions or it may be identified specifically.

Children with semantic pragmatic disorder are unable to process complex information in social situations. They have difficulties with social relationships and any situation involving communication. They are very inward-looking and are usually unable to empathise or to demonstrate any perceptive responses.

They often develop obsessive interests, which they love talking about, but find it difficult to understand that you do not share their enthusiasms. They have the triad of impairments that usually indicate the child is on the autistic spectrum – socialising, language and imagination – and semantic pragmatic disorder is often described as the outer spectrum of autism. Children with this disorder may also have attention deficit disorder or dyslexia.

Key characteristics

A child with semantic pragmatic disorder may:

  • speak in a grown-up way
  • not be able to make eye-contact
  • find facial expressions, gestures and body language confusing
  • think and speak very literally and in concrete terms
  • have difficulty with abstract concepts concerning time (eg. next week) or motivation
  • read early or late, but without comprehension
  • be either very active or very passive
  • be logical and inflexible in following rules and expects everyone else to be the same
  • be either a loner or appear over-friendly
  • be poor at taking turns or taking part in team games or group activities
  • have a dislike of crowds
  • have food fads
  • find social events challenging, being unsure how to take part or react
  • have minor motor-skills problems
  • demonstrate over-sensitivity to some everyday noises
  • be easily distracted
  • suffer from specific language impairment or dyslexia.

Support strategies

You may need to:

  • give the child practical, hands-on tasks
  • provide a quiet, orderly environment
  • use visual clues whenever possible
  • break instructions into short sentences
  • keep to classroom routines as much as possible and help them to cope when change is unavoidable
  • avoid abstract concepts whenever possible (the child probably won’t understand ‘guess’ or ‘pretend’ and will find time words, such as ‘long ago’, problematical)
  • give literal instructions eg. ‘put the puzzles in the cupboard’ rather than ‘tidy away’
  • help them to learn strategies for socialising• provide them with a visual written or pictorial timetable • explain metaphors, sarcasm and jokes when they are used • build on their special interests • follow any given programmes such as from the speech and language therapist

    • give constant encouragement and praise.

Support agencies

Association for all Speech Impaired Children (AFASIC)
Communications Forum
National Autistic Society