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What Is Pragmatic Language Impairment?

Marjorie McAtee
Marjorie McAtee

Pragmatic language impairment, also known as semantic-pragmatic disorder (SPD), may be a type of autism, although some psychologists think this is a language disorder. Children with this disorder typically learn to speak later than their non-disordered peers, or even their peers with high-functioning forms of autism. It is believed that pragmatic language impairment results from a brain dysfunction related to speech and understanding speech, so that these children have problems both with understanding what is said to them and with forming speech of their own. They are generally only able to understand direct speech, and usually have problems comprehending nuanced speech, such as joking. They cannot typically make the connection between the speaker's words and the speaker's thoughts, and they usually have problems intuiting any shared understanding between themselves and others they are speaking with.

In very early childhood, people with pragmatic language impairment generally have problems learning language and usually don't appear to understand what is said to them. They may pay more attention to insignificant sounds on the periphery, for instance, than to the speech of a parent or caregiver. These children may often fail to recognize their own names, and may sometimes fail to respond to sound or speech altogether in the manner that a deaf child would.


While children with SPD generally learn to talk later than their peers, they can eventually become quite talkative. The problem generally is with the way these children talk. They are considered very prone to repeat things they hear in conversation, television programs or films. They may say things that are entirely inappropriate to the conversation at hand. Children with pragmatic language impairment usually don't use language in a way that expresses their thoughts or emotions, the way children without this disorder learn to do.

When those with SPD do engage in conversation, they often speak only about things that pertain to their own interests. They are usually unable to pick up on their conversational partner's verbal and nonverbal cues and may leave others confused or disinterested. Though they are typically able to understand instructions and other types of direct speech, they have problems understanding many of the thought processes behind others' speech, and will generally fail to intuit the speaker's emotional state. Often, children with this language disorder have problems learning to spell, read, and write, especially creatively.

Children who suffer from pragmatic language impairment often have symptoms similar to those of many disorders on the autism spectrum. This is why experts remain unsure as to whether SPD is a a type of autism or a specific language impairment. These children often have problems interpreting input from their senses, and may be disturbed by extreme sensory input such as loud noises. They are generally quite happy to do things on their own, and may display little creativity. They often have problems relating to others, and may display behavioral difficulties.

Discussion Comments


@MrsPramm - It's definitely not a conscious choice. Babies and toddlers can't just decide not to pick up language. Language acquisition is one of the more fantastic things about being human. It's an essentially involuntary, but immense and extraordinary feat of memory and understanding and it's one of the things that completely sets us apart from other animals. It's a physical aspect of the human brain and people can't just decide to not become conversant in their local language.

There is little wonder that occasionally the brain is different and behaves in ways that aren't like the average. Many people who identify as Autistic will state that they have advantages as well as disadvantages compared with "normal" people and that might be true of folk who have SPD as well.


@clintflint - I'm not sure how you would teach them explicitly. We don't expect people to analyze every facial expression consciously, and that would take a long time, stunting conversation anyway.

Besides, it sounds like the people suffering from this kind of disorder tend to only want to talk about and learn about subjects that interest them. I wonder if that might not be the problem. If they have such an intense focus on particular subjects, they might just not want to change that focus for any reason, even to learn basic communication skills.


When you consider how complex language is, it's not surprising that there are people who aren't able to learn it as quickly as others, or who are unable to grasp some of the subtleties of meaning inherent in language.

They say that something like 90% of meaning is actually conveyed non-verbally in conversation, through tone and context and facial expressions and these are things that we all just pick up without being explicitly taught them. I wonder if it would be possible to explicitly teach them and if that would help at all.

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