Semantic-Pragmatic Language Evaluation

Whether pursuing speech and language evaluation, therapy, or altering current speech and language goals and objectives based on a child’s performance, a thorough assessment of an individual’s language ability is essential to securing a therapist (and services) who will address your child’s specific communication needs. More importantly, a speech and language assessment should be individualized with regard to the types of standardized test batteries selected based on parent/educator’s concerns, previous testing (in both cognitive and speech and language domains), and the cognitive and linguistic profiles of any given subtype of autism, such as Asperger Syndrome (AS), High-Functioning Autism (HFA) PDD-NOS and Autistic Disorder (also known as classic autism) and other developmental disabilities.

A semantic-pragmatic language evaluation, administered by a qualified speech and language pathologist with expertise in the field of autism (and the ability to accurately interpret normative data in terms of relative strengths and weaknesses and how they affect one’s ability to engage in social communication), can identify strengths and weaknesses in the areas of language known as content and use and provide differential diagnosis of a secondary (to autism) language disorder known as semantic-pragmatic language disorder. This disorder:
Selectively affects the language areas of content (particularly meaning and intent) and use (otherwise known as pragmatic language) despite the presence of average to superior form (grammar, speech) or expressiveness
More common in children with AS and HFA (and may not be as apparent or even detected if the proper assessment tools are not used)
Can be present in children without an autism spectrum disorder (Rapin & Allen, 1983; Bishop & Rosenbloom, 1987).

Rapin and Allen described a “semantic-pragmatic syndrome…in which there is fluent and syntactically complex expressive language, but the child has problems in understanding discourse.” Children with deficits in semantics and pragmatics can have impairments in one or more of the following higher-order language skills: figurative language, rules of social language (conflict resolution, generating multiple solutions, debating/disagreeing, accepting consequences, offering compromises) conversational skills (personal introductions, topic initiation, topic maintenance, turn taking, conversational repairs, self-monitoring skills, etc.), and presupposition or perspective taking (incorporating the thoughts and ideas of the listener into conversations, taking their feelings and emotions into account). In the context of academics, children with the aforementioned deficits will have difficulty with assignments that require descriptions of: social characteristics, similarities and differences, overall themes, social nuisances, cause and affect vs. correlation, as well as, comprehension and use of: idioms, figurative language, and overall problem solving abilities including sequencing and predicting.
Many people with a HFA or AS have not been able to qualify for speech and language services in the school or have been discharged from these services due to average to superior performance on the assessments utilized. A majority of tests used in schools districts assess basic area of language including form and speech production or intelligibility. However, many of these students require speech and language therapy to focus on areas of higher-order language, areas that are often not evaluation in a school-based assessment. It should be noted that speech-language pathologists working in school environments are only allotted a small amount of time for testing by their school districts. Therefore they do not have the time that is often needed to conduct comprehensive assessments of all areas of language. A center-based semantic-pragmatic language evaluation allows for a more in-depth evaluation of the language areas affected in HFA and AS.

Gina-Marie Muscillo, speech language pathologist and Stacey Kanin, clinical fellow-speech language pathologist at the Center for Autism, are pleased to offer center-based independent semantic-pragmatic language evaluations for children, adolescents, and adults with HFA, AS, or symptoms of this disorder. Potential candidates for this assessment include people with basic conversational skills (using basic language to talk with others). This type of evaluation typically involves 3-4 hours of standardized testing in the areas of content and use. Specific tests are chosen based on several factors including the patient’s age, primary diagnosis, parental concerns, academic functioning/educator’s concerns, and a review of previous evaluations and IEP’s (1-2 years prior). The tests concentrate on figurative language, inference, ambiguity, contextualized meaning, social judgment, and problem-solving using open-ended questioning and at times visual stimuli. Informal observations are also made regarding a client’s understanding and use of supralinguistics including sarcasm, irony, and humor. The presence of a semantic-pragmatic language disorder is determined after an in-depth review of: previous evaluations across disciplines (speech and language, social work, psychiatry, psychology), current IEP, and results from the semantic-pragmatic language evaluation. Tests Recommendations as to academic modifications, speech and language therapy, specific language goals and objectives, therapy materials and programs, and social skills groups are provided in the final report. Information obtained from this evaluation may warrant a recommendation for further diagnostic testing.

For people over the age of 21 interested in a semantic-pragmatic language evaluation:
At this time standardized testing of higher-order language, is not currently available for people over the age of 21. A semantic-pragmatic language disorder can still be diagnosed by a speech-language pathologist. The testing used for people under the age of 21 is implemented and assessed subjectively by the speech-language pathologist. Informal observations and age-equivalents are also utilized to determine the presence of the disorder.

For more information or to schedule an appointment please contact Gina-Marie Muscillo-Moravcik or Stacey Kanin at the Fay J. Lindner Center for Autism 516-802-8600