What is Social (Pragmatic) Communication Disorder (SCD)?

March 28, 2016

Many of us take for granted the social and communication skills needed to mingle with other people and take part in small talk or chit chat. For many children, teens and adults on the spectrum, conversing does not come naturally.  The latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) explains the new diagnosis of social (pragmatic) communication disorder (SCD) which may be what your child/teen/young adult is struggling with.  Let’s look at this new designation and what it means for treatment of social and communication disorders.

What is SCD?

SCD encompasses problems with social interaction, social understanding and pragmatics. Pragmatics refers to using language in proper context. Pragmatics also refers to the unspoken, subtle rules of spoken language that allow people to connect. For example children that exhibit signs of SCD have difficulties using language in social situations, such as greetings, sharing information, changing speech to suit different social contexts, understanding things that are implied but not explicitly stated, and functioning in conversation and storytelling.

Symptoms of SCD

Speech-language pathologists have the training and experience to identify common criteria that would lead to an SCD diagnosis. Both verbal and non-verbal skills are taken into account when looking at the common symptoms of this disorder. They include:

  •  not responding to others
  • inappropriate gesturing or facial expressions
  • monopolizing a conversation
  • not talking about emotions and feelings
  • inability to stay on topic
  • inability to adjust speech to fit different people or situations – for instance, talking differently to a young child versus an adult or lowering one’s voice in a library.
  • not understanding how to use words for a variety of purposes such as greeting people, making comments, asking questions, making promises, etc.
  • difficulty making inferences and understanding things that are implied, but not stated explicitly
  • tendency to be overly literal and not understand riddles and sarcasm
  • an inability to make and keep friends (Source: Autism Speaks)

Diagnosis and Treatment

The American Speech-Language-Hearing Association (ASHA) recommends evaluating children in many different settings such as: observation in school and home settings, interviews/questionnaires for teachers and caretakers, and formal one-on-one testing to assess your child’s language and communication skills. While there is no specific treatment for SCD  as of yet, it is presumed that speech and language therapy designed to improve language pragmatics will greatly assist these children, along with social skills training.