Social (Pragmatic) Communication Disorder

In addition to the changes related to individuals with Aspergers and HFA, the DSM-V introduced a new condition in the diagnostic category of communication disorders: Social (Pragmatic) Communication Disorder (SCD).

SCD is marked by difficulties with pragmatics—aka practical everyday use—or the social use of language and communication. Therefore, SCD is concerned with an individual’s use of verbal and nonverbal social communication in everyday life.

The condition is of particular interest to individuals with Aspergers or HFA because, in the DSM-V, it specifically states that individuals who have marked deficits in social communication but whose symptoms do not otherwise meet the criteria for autism spectrum disorder (ASD) should be evaluated for social (pragmatic) communication disorder.

SCD is expressed as deficits in understanding and following social rules of verbal and nonverbal communication in real life, changing language according to the needs of the listener or situation, following rules for conversations and storytelling, and understanding what is not specifically and explicitly stated.

Some illustrative examples that individuals with SCD may struggle with:

  • Greeting and/or sharing information that is appropriate for the social context
  • Speaking differently in a classroom than the playground
  • Talking differently to children and adults
  • Taking turns in conversations
  • Knowing how to use verbal and nonverbal signal to guide interaction
  • Recognizing nonliteral or ambiguous meaning of language (e.g. idioms, humor, metaphors, etc)

Other requirements for a diagnosis of SCD include that these deficits result in limitations of effective communication, social participation, academic achievement, and/or occupational performance. Also, the symptoms must be related to the early developmental period of a child’s life and not related to other medical/neurological conditions or abilities.

Social (pragmatic) communication is based on the development of basic speech and language skills, therefore, SCD is rarely seen in children younger than four years due to lack of development of speech and language abilities needed to diagnose it. Milder forms of this disorder, however, may not be seen until early adolescence when language and social interactions grow in complexity.

ASD and SCD differ by the presence of restricted, repetitive patterns of behavior, interests, or activities in autism and their absence in SCD. For parents seeking answers for their child’s development, it is important to keep in mind that only if a developmental history fails to provide evidence of these past patterns, should a diagnosis of social (pragmatic) communication disorder be considered.

What do you think about this new diagnosis?

By ACN Executive Director Loree Primeau, PhD, OTR, FAOTA

Source:

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), (pp. 47-49), American Psychiatric Association, 2013.

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Jennifer Allen

After an extensive career broadcast marketing, Jennifer and her husband searched for answers when their oldest son hit the kinder years with great difficultly. After finally learning that their oldest son had Aspergers Syndrome, she left her career in television and became a full time mother to both of her sons. Jennifer elicited the participation of her sons and together they produced several independent programs including a children’s animated series titled Ameriquest Kids (now distributed by Landmark Media) as well as her documentary and book titled, Coping to Excelling: Solutions for school-age children diagnosed with High-Functioning Autism or Aspergers Syndrome. The need for more information encouraged Jennifer to elicit a team of autism experts to provide weekly, original content to a website free to anyone seeking to live their best under the diagnosis of High-Functioning Autism/Aspergers Syndrome… appropriately titled: Aspergers101.com.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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9 thoughts on “Social (Pragmatic) Communication Disorder

  1. There is a GREY area now. “ASD and SCD differ by the presence of restricted, repetitive patterns of behavior, interests, or activities in autism and their absence in SCD”
    So if a child doesn’t meet an ASD diagnosis, they look for SCD. But if there are routines and rituals, they don’t meet SCD either.
    There is this chasm of grey that a lot of children fall into because they have tightened the ASD criteria so much.

  2. Our 9-year old daughter was just diagnosed with SCD today (FINALLY, we have title that fits!), and we were instructed to find tutoring from a CALT certified/instructed therapist. We Live in North Texas (Dallas/Ft. Worth), and are looking for more resources, please so we can take advantage of these precious summer months.

    • How is your daughter doing with therapy? I just read this and wonder if this fits my son. His therapist thinks it’s Asperger’s and the psychiatrist says it’s not. I read this article based on the suggestion of a friend and this really fits my son, who is always sticking his foot in his mouth, so to speak and he’s 10.

  3. Interesting article although my 4-ye-old son has both the social/communication difficulties and repetitive behavior and was not diagnosed on the spectrum. GARS indicated autism but A-DOS did not so the scored GARS as ” false positive”. He is very ” surface socable”- loves adults more than kids, touches and climbs on people but more difficulty maintaining friendships and back/ forth conversation. He talks ” at people” and constantly. He was given these diagnosis: social communication disorder, dyspraxia, sensory processing disorder, ADHD, and OCD.

    • This sounds a bit like my son. My son is now 10 and was just diagnosed with severe childhood bipolar disorder. We thought it was ADHD, SPD and possible Asperger’s, then when his BP disorder got bad he developed gross motor tics. It just spiraled out of control, until he got stabilized on antipsychotics. Now we are left with severe anxiety and social problems. We are chiseling away but at least we have the hyperactivity and depression taken care of for now.

  4. My son, now 30yrs old has had difficulties since childhood and we know he has Aspergers. During his teens he was extremely angry and sad but he came through this period. Today he lives independently, has his own home and car but for the past year he has not spoken at all to anyone. His life is restricted to his job which is in jeopardy because of his refusal to speak to his co-workers. He was visiting me on Sunday but now that has ended. He literally speaks less than a Yes or No to anyone. We have been to social service, Doctors, Clinicians, speech therapists, Psychologists and he refuses to see any of them. Everything I read on line is about children. Any advice???????

    • Hello Doug,

      Thank you for your comment and sharing your experiences. Ken Kellam, one of our contributing writers with Aspergers, has written a response to your question that will be in the form of a Q&A blog post at the end of this week. This post will publish on Friday, October 28 2016 in the morning. We hope this provides helpful insight for you.

  5. The mind of a child teen or adult wihh social communic disorder – falling short of aspergers diagnosis lacking repetitive mivements, had same mental make-up and brain processes / needs. Are we depricing scd diagnosed people the benefits of decades of research, tretmdnt pathways, etc, by pulling scd out of the ‘autistic’ spectrum diagnostically. Our child diagnosed with scd is of the thought that communications need some tuning while if she had a repetitive action or unusual collection that was peculiar would be diagnosed as aspergers and the aspergers way the mind thinks would be a major part of the therapeutic process. Seems scd is the mind of apergers without movement disorder but is otherwise the same. Scd is not however being treated by psychologists with benefit of the larger understanding of aspergers