Social pragmatic language deficits may be secondary to another diagnoses such as autism, ADHD, Non verbal learning disability, anxiety or language disorders. A child with social pragmatic language deficits may have difficulty following the social rules of language and behavior. They often have a significant deficit in “Theory of Mind” which in a simple statement means, “I know that you know that you know that I know”. It’s the ability to get into the mind of another person and take their perspective. Social language understanding and use is an innate ability that begins to develop at birth as newborns begin to respond to the voices of their caregivers. Newborns are hard wired to be attracted to faces before objects and thus begin to, from a very early age to understand the meaning of facial expressions and tone of voice. However, this hard wiring may not be present in some children and as they grow their social differences become more and more obvious.
Children with social pragmatic language deficits may have difficulty sharing space with children their own age and others in general. They may not be able to engage with their peers to participate in pretend play in preschool because they have difficulty taking perspective and imagining their role in play such as being the “father” in the example of “playing house”. Those with social pragmatic deficits may appear to lack the motivation to interact with others or tantrum at the drop of a hat if an interaction doesn’t go their way. Initiating with peers or others to interact, have a conversation, or keep an interaction going can be extremely challenging. Without these abilities success in school and later life will likely be extremely challenging. Explicit teaching of “social thinking” would be necessary to improve a child’s understanding of not only what to do but “why” we do it.
Successful treatment of social pragmatic language deficits should include an individualized program developed for a child based on their strengths and weaknesses.