having NLD and SPD (semantic pragmatic disorder)

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I believe starygrrl was dx'd with both however it seems she got a dx in the 80's back when less was known about NLD.
anyway it would seem that these two diagnoses are not compatible.
I had a speech delay but my WAIS profile seems to indicate NLD.
not sure exactly what the nature of my speech delay was /exaclty what the problems where. perhaps it was just incomprehensible speech. I'll have to ask my father.
I keep on reading nld can't come with a speech delay but I actually read something on rourke's site that says there is an initial speech delay but then it develops rapidly.
I did grow up in a bilingual household.

from Rourke's site:

http://www.nld-bprourke.ca/BPRA5.html

Question # 5

Why is there so much emphasis on nonverbal in NLD?
Does this mean that persons with NLD have well-developed language?
In what sense is the language of persons with NLD deficient?
How can one characterize the relatively intact and defective linguistic characteristics of persons with NLD?

(4) The language of persons with NLD is usually delayed initially. Although all developmental milestones--including those related to language--tend to be delayed in youngsters with NLD, some language milestones tend to be delayed less than those in other areas (e.g., psychomotor coordination). This has the tendency for drawing parental and other caregivers' attention to the language of the youngster with NLD (unconsciously, perhaps, resolving their cognitive dissonance vis-a-vis the child), with the unfortunate by-product of a tendency to disregard other important dimensions of the child's development (e.g., motor/psychomotor; visual-spatial) that would bolster the notion that the child is significantly delayed or deficient in developmental skills.

I went to that website and HOLY CRAP!! !! that sounds just like my daughter. I read all over the website and it sounds so much like her. But I'd never heard of this before and she was diagnosed by evaluators with PDD-NOS which then got changed to HFA. According to this website, if it's HFA, it sure isn't NLD. And yet as I read through all the desriptions it described EVERYTHING, from stuff happening at home to stuff happening at school. It explained why she sight reads just fine but phonics is impossible for her. It explains why It explains why she doesn't get puns but can repeat back other people's conversations complete with accents. It explains why she can barely button her coat but scampers up and down the monkey bars without falling. It explains so much. But it's incompatible with HFA....

Now I'm confused. I have bookmarked the site and will read it through letter by letter trying to figure this out.

THANKS SO MUCH!

I googled it some more and found that yet another NLD thing my daughter does is constantly ask me to define words. She gets flummoxed by synonyms and homonyms. Once she learns a new word, she will work it into a sentence and then use it utterly out of context with some other kid. Other kid will look at her like she has 2 heads as she correctly uses the word but fails utterly to make a rational conversation point. She also has extremely intense eye contact. It's so intense that she could win a staring contest with a cat. (She has tried. The cat gave up and walked away before she broke eye contact.) This intense eye contact unnerves other kids and kept her from getting an autism spectrum diagnosis for quite a while. They finally decided that eye contact wasn't the be-all and end-all of diagnostic criteria and slapped her with HFA but reading all this I wonder...

She has had a neuropsych eval which is when she got the HFA label. I think the non-NLD thing that she does is stimming. Her verbal IQ was higher than her Performance IQ, which does fit, as well as the other linguistic features. But NLD kids aren't supposed to stim. Who knows??? It seems that researchers are driving themselves crazy trying to make ever-finer categories so that people fit within categories and not between them. And driving us crazy in the process. Thanks for the directions to NLD help. I'll go there and see if things fit. I'm really confused now.

edited to add WOW! I went to the NLD sticky and the way she plays also fits, except when it doesn't. Sometimes when she's stressed she just stims and stims instead of playing- very HFA. But then when she's feeling happy her dolls will talk to each other and have long-winded conversations and walk around the house and yard pretending to be in a jungle or similar. Which is very un-HFA. But if she undresses them she is incapable of putting their clothes back on and has me do it, all while having the dolls chit-chat, which is very NLD. Then something upsets her and she abandons the dolls and stims. I am so confused.

There is still dual diagnosis but it usually is caught under the PDD-NOS diagnosis. The usual thing is with this is there is a bunch going on here and elements of both, but not enough to call it pure autism or as.

What is known is the pragmatic language issues that can accompany NLD were not known back then. When those pragmatic language issues are present, PDD-NOS is the diagnosis, when they are not present, NLD is just well...LD-NOS. It is very context sensitive and based on an individual manifestation. Some people just manifest differently and exhibit multiple elements which seem like they don't go together logically, but do, that is why the PDD-NOS diagnosis exists, its atypical manifestations.

Also the status of SPD is entirely up for debate. Some say its high functioning autism, others say it falls and crosses over with HFA and AS but is more social, others think its something that intersects with every point in the spectrum in some way.


Also I have read recent case studies from neuropsychs where NLD and SPD were both present, or at least elements of both were present. These were RECENT case studies. They noted the existence of both and it confuses the hell out of diagnosticians, and the PDD-NOS is often the diagnostic result.

When I was a kid both were new diagnosis, so less was known. There has been literature though in the fact that NLD can have pragmatic language issues, and well, odd language. The PDD-NOS was later given to me by some psychiatrists and therapists. However, I have discussed this with neuropsychologists and psychiatrists in the field and they have said both can be co-morribund, even though you would think it is counter-intuitive and illogical. I could very well have AS, but this was how a neurologist looked at it in the eighties, and most psychs tend to like to stick with childhood neurologist diagnosis because they are often more definitive. The thing is I manifest traits of both...so I am not sure, I am one of those people who does fall into the atypical category though. It has been noted there have been manifestations that perplex diagnosticians, which is why they created the PDD-NOS category, the SPD/NLD combination is one of those. But NLD with pragmatic language issues is usually diagnosed as PDD-NOS. When there is both pragmatic and semantic issues...well its incredibly rare, but does happen.


While it would seem the diagnosis is not compatible, they can co-exist in some form, but it takes reading medical journals and case studies to realize this is the case.