Many with Autism Have Pragmatic Language Impairment, But What Is It Exactly?

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Pragmatic language impairment, also known as social communication disorder, is one of the more widely known and recognized symptoms of autism, but most people don’t know it by this formal name. It’s a common occurrence in people on the spectrum and can lead to social anxiety and trouble forming and maintaining quality relationships.

Want to know more about pragmatic language impairment, its diagnosis, and its treatment? Read on to have all your questions answered.

What is pragmatic language impairment?

Pragmatic language refers to the way people use and change their language for different types of social settings. Most of us intuitively choose different words and different intonations for similar messages based on whether we’re demanding, inquiring, informing, requesting, greeting, or performing some other social

Pragmatic language impairment refers to the inability to grasp what types of language are appropriate in which types of situations. It may include problems with knowing what to say, when to say it, how to say it, and how to act around others in social situations. Similarly, it may cause a person to misunderstand the underlying meaning when someone else says something.

How is pragmatic language impairment related to autism?

Roughly 7.5 percent of children struggle with pragmatic language impairment, and they are most often those who have autism and/or other language disorders.

People with autism and pragmatic language impairment may have a fantastic grasp of language in terms of grammar, spelling, and syntax, and they may have an extensive vocabulary, but they struggle with knowing how to use language in particular social settings. The problem is highly likely to cause social anxiety or exacerbate preexisting social anxiety. It also contributes to learning disabilities and other struggles people with autism may face in their lives.

What are the characteristics of pragmatic language impairment?

Pragmatic language impairment may present itself in several different ways in people with autism, including the ways they use language and the ways they understand other people’s language. In young people, it often starts with a late development of language, but the symptoms range far beyond that.

If you know someone with pragmatic language impairment, you may have noticed them asking “inappropriate” questions, initiating off-topic conversations, misinterpreting jokes or sarcasm, and taking non-literal language as literal. They may have trouble with the concept of taking turns in a conversation, be unable to rephrase a statement when misunderstood, or making inferences when information is implied rather than explicitly stated. These types of behaviors often lead to social awkwardness and a difficulty in forming new friendships and other types of relationships.

Some people with this impairment may also have issues with improper word order, pronoun reversal, verb tenses, and even stuttering. They might have trouble organizing information, picking out the main point of a story, or understanding and making decisions. At this point, pragmatic language impairment may cause more than just social problems; it may also impact the person’s school or work performance, making it more difficult to pass classes or find and keep a job.


Click “next” below to learn how pragmatic language impairment is diagnosed and treated.

Elizabeth Nelson is a wordsmith, an alumna of Aquinas College in Grand Rapids, a four-leaf-clover finder, and a grammar connoisseur. She has lived in west Michigan since age four but loves to travel to new (and old) places. In her free time, she. . . wait, what’s free time?
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