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Semantic-Pragmatc disorder?

My son just turned 3. At 15 months he was described as a "model" toddler by the pediatrician. At 17 months he appeared to regress, stopped using the 10 or so words he knew, pointing, making eye contact. By 18 months he improved, started talking again, making eye contact and regained his sense of humor. However, he has consistently showed SOME signs of developmental problems. He has never brought us toys just to show us them. He HAS consistently brought us his magna-doodle to draw with and stories to read to him, and has always engaged us (mom and dad) in tag type games, peek a boo, songs, ring around the rosie. When he stopped pointing he used words to indicate his interest in something. He often would not respond to his name and often seemed to be deliberately ignoring at a young age, but does fine now. He does NOT have a security object, and engages little (but definitely some) pretend play with stuffed animals and dolls. He pretends objects (computer mouse) is a phone, candy bars are whistles, and makes faces out of food and objects. We emphasized teaching him letters, numbers, songs from age 12 months, all of which he knows well and he can count up to 15 items. At age 28 months he finally started calling us Mommmy and Daddy- and everyone else by name, and he resumed pointing. He is very good at andswering "what is this" questions, very articulate and very smart. He is very good at telling his wants, don't wants and telling us what he sees. He meets all of his fine and gross motor milestones and can draw letters and faces. He tantrums but never carries on for more than a minute or so. His eye contact is very good and will ask you a question and attempt to look you in the eye until YOU make eye contact with him and answer. His favorite questions are "Where is" and "What are you doing" but if you ask him the same he ignores you. We recently taught him to answer "yes" with some success, however he has immediated and delayed echolalia, will repeat our questions and answer them, and has pronoun reversal when asking for something (Do you want milk?) but NOT when saying "I dont want" or "I see". He memorizes movie dialog from childrens movies and books and recites. He has a large vocabulary that everyone is impressed with. He does NOT stick to routines lavishly, has NO self stimulating behaviors and greets EVERYONE with a Hi, unprompted. He has never shyed away from a social situation and separates well from us. He has no sensory sensitivity. He is preoccupied with books, letters and numbers, but can go hours without counting etc. But he does not talk like other kids. There is an absence of telling us his thoughts or feelings or actions, although he knows the difference between happy and sad and knows from my body language if I am sad and will comfort me with actions and words. He seems to have symptoms of SPD, but not with the autistic behaviors. We are in the process of trying to get a referral. Are there any other disorders with similar features?
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Avatar universal
Thank you. We (my husband and I) agree that so many things don't seem to fit the autistic spectrum and that this could just be his way of developing. My sister's daughter (now age 10 and very normal) had an almost exact pattern of development. We are hoping that he proceeds as she did and hope that the evaluation will confirm this. Thank you for your comments.
Helpful - 1
242606 tn?1243782648
MEDICAL PROFESSIONAL
To be frank, while the diagnosis of Sematic Pragmatic Disorder might eventually prove to be appropriate, I tend to think that your son more accurately at this point displays symptoms of developmental delay in the communication domain. In other words, I'd tend now to focus on the process of communication and try to idetify areas in which he is 'up to par' and areas where he may be slightly behind. One of the problems when we think of Semantic Pragmatic Disorder is that it is often viewed as indicating that a child displays a condition somewhere along the Pervasive Developmental Disorder spectrum (I think it is unfortuante that this association is often made), and that really does not appear to apply to your son. Children do not progress at the same rate in all the various developmental spheres. Ineviatble, any one child will proceed at one pace in one area, at another pace in another area, etc. Your son is not terribly in arrears re: development of communication, and you may ultimately find that he is fine and that his development of communication skills will proceed well. Remember, he's only three - don't expect too much. If you look at each area of development with a fine tooth comb, it'll only drive you to distraction.
Helpful - 0

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