Sunday, February 14, 2010

Is SPLD autism, or not? *

Many children with AD/HD, Asperger's, Autism Spectrum Disorders, Non-Verbal LD, Bipolar, etc. have co-occurring Semantic/Pragmatic Language Disorders.

Some authorities see SPLD as part of the autism spectrum of disorders while others see it purely as a language disorder. 


First, we found that though many children with PLI did show some autistic features on the ADI, very few of them met diagnostic criteria for autism on both ADI and ADOS. Furthermore, many children with SLI, who had not been regarded as showing any signs of autism, did score in the autism range on ADI. This further supported the idea that there are no clear boundaries between these different developmental disorders: they shade into one another, and the diagnostic categories are something of an artificial abstraction (though necessary to ensure children get access to appropriate services).

Let's see...hmmm...

It is always necessary to determine whether the client has:

isolated semantic processing difficulties OR
isolated difficulties with the pragmatics of language use OR
a combination of the two OR
semantic pragmatic language disorder (SPLD) OR
SPLD in combination with another communication disorder that is NOT in the autism spectrum, for example, developmental apraxia of speech OR
SPLD in combination with another disorder in the autism spectrum, for example, Asperger's Syndrome OR
SPLD in combination with another disorder that is NOT in the autism spectrum, e.g., Attention Deficit Hyperactivity Disorder (ADHD).

WTF??????  Is it just me, or.......


The author said...

What it really means is that Autism is only one class within a greater class that contains neuro diversity in general, I have long thought that the category of autism is not sufficiently rigourous to stand entirely on it's own as it has been currently envisaged.It has also long been a criticism of mine that autism research has a very inward looking tendency to exclude research about other neurological conditions as if the boundaries are watertight between nosologies.

I am a fan of Dorothy Bishop and Courtney Norbury's research. I have met both of them, and heard them present.

r.b. said...

You never cease to amaze me. I'd never even heard of them before today.

I think you are quite right to include many diagnosis under the umbrella of neurodiversity. As a teacher, I can see that it is often the system that fails the kid, and not the other way around.

VAB said...

SPLD is a subclass of autism, just like AS. The thing in that diagram labeled "autism" referred (when the diagram was made) to Kanner autism. The Brits, who were the only people who used SPLD as a separate diagnosis, rolled it into ASD a long time ago.

I agree that neurodiversity covers a lot more than just the autism spectrum, but SPLD is not outside the autism spectrum.

r.b. said...

Sorry, VAB, I remembered it was you who brought up the S-P diagnosis, and it took me back 13 years.

Ben has had many labels...ADHD among them. Learning differences do seem to be very fluid that way. What it amounted to was he received Special Ed services for years, and at the end was placed in an Emotionally Disturbed classroom 1 period a day. (ED, that's another one...)We homeschool now, because of dyscalculia, and dysgraphia, the two labels I gave him, and the only ones he will accept.

VAB said...

The who diagnosis thing is weird, isn't it? I do like that diagram, and I do think that the positioning of the SPLD circle is useful in describing the sorts of challenges our guy has, but in the end, for practical purposes, it's just too much information. I tried to explain that very diagram at an IEP meeting last week, because they had all kinds of stuff on him IEP that he didn't need and not enough of the stuff he did need. In the end, I think it just confused them.

Then, in a separate meeting last week, a teacher asked me, "Your sin suffers from autism, doesn't he?" I really should have set the man straight -- nobody's suffering around here. But I though more good would be done by not putting him on the defensive, so I just said, "Well, autism is his thing." Could you imagine if I had trotted with SPLD thing with that guy?

In the end, we are all people with strengths and weaknesses, coming up with one term that describes all the strengths and weakness that one person has (let alone that many people have) is impossible. We should not even try.

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