What is Social Communication Disorder?
Social communication disorder (SCD) makes it difficult to communicate with other people in social situations. The condition first appeared in the Diagnostic and Statistical Manual (DSM-V) in 2013; prior to that, people exhibiting its symptoms were commonly diagnosed on the autism spectrum, according to Autism Speaks.
“Social communication” encompasses more than the spoken word. It also includes social cognition, pragmatics, non-verbal communication, and language processing. Individuals with SCD may struggle to vary speech style; use different components of language like vocabulary, syntax and phonology; understand the rules of communication; and share perspectives, according to the American Speech-Language-hearing Association (ASHA.)
What Are the Symptoms of Social Communication Disorder?
Poor pragmatics — or changing speech and communication to fit the circumstances — is one of the hallmark characteristics of SCD. People with SCD have trouble modifying their communication — including tone of voice, pitch, and volume — based on the specific situation.
According to Autism Speaks, people with SCD may also struggle with:
- Responding to others
- Using gestures such as waving and pointing
- Taking turns when talking
- Talking about emotions and feelings
- Staying on topic
- Adjusting speech to fit different people and different circumstances
- Asking relevant questions
- Responding with related ideas
- Using words for different purposes, such as greeting people, asking questions, responding to questions, making comments
- Making and keeping friends
Early signs in young children, according to the Child Mind Institute, might include:
- A delay in reaching language milestones
- A low interest in social interactions
Young children with SCD may rarely initiate social interactions or respond minimally when social overtures are made, according to the Child Mind Institute.
How Is Social Communication Disorder Diagnosed?
Many symptoms of SCD overlap with those of other conditions and learning disabilities, which often complicates diagnosis, according to a study completed in 2013. Sometimes it is necessary to rule out other potential problems first. For example, a doctor might recommend a comprehensive hearing assessment to rule out hearing loss first. A speech and language pathologist with a thorough understanding of comorbid conditions and learning disabilities should complete the hearing and other assessments, taking into consideration age, cultural norms, and expected stage of development.
Screening for SCD often includes interviews, observations, self-reported questionnaires, and information completed by parents, teachers or significant others, according to ASHA. It should also take into consideration your family medical and educational history. ASD symptoms are more likely if a family member has been diagnosed with ASD, communication disorders, or specific learning disorders, according to Child Mind Institute.
Following the assessment, the speech and language pathologist may provide a diagnosis, a description of the characteristics and severity of the condition, recommendations for interventions, and referrals to other specialists, as needed.
How Is Social Communication Disorder Treated?
SCD is a relatively new condition. There is no specific treatment for SCD, according to the Child Mind Institute, but it is thought that speech and language therapy with emphasis on pragmatics, along with social skills training, will help.
Treatment should be specific to the individual with a focus on functional improvements in communication skills, especially within social situations. Other goals of treatment may include:
- Address weaknesses related to social communication
- Work to build strengths
- Facilitate activities involving social interactions to build new skills and strategies
- Look for and address barriers that may be making social communication more difficult
- Build independence in natural communication environments
Treatment for SCD often includes parents and other family members. The therapist working with your child may also reach out school personnel, including teachers, special educators, psychologists, and vocational counselors to ensure that your child receives consistent practice and feedback in a variety of social situations, according to ASHA.
Tools used during treatment might include:
- Augmentative and alternative communication (AAC), which includes supplementing speech with pictures, line drawings or objects, gestures, and finger spelling.
- Computer-based instruction for teaching language skills including vocabulary, social skills, social understanding, and social problem solving.
- Video-based instruction that uses video recording to provide a model of target behavior.
- Comic book conversations, which depict conversations between two or more people illustrated in comic-book style.
- Social skills groups that incorporate instruction, role playing, and feedback with two to eight peers and a facilitator, who may be a teacher or counselor.
In addition, the therapist might help your child develop scripted responses to help him or her get past the initial moments of a conversation.
How Is Social Communication Disorder Different Than Autism?
Social communication problems are a hallmark symptom of Autism Spectrum Disorder (ASD), however SCD can occur in individuals who do not meet the diagnostic criteria for ASD. People with both SCD and ASD have more than social communication difficulties; ASD also includes restricted or repetitive behaviors. Because it is considered part of an autism diagnosis, SCD cannot be diagnosed alongside ASD. However, it is important to rule out ASD before diagnosing SCD.
Prior to 2013, when SCD was added to the DSM-V as a stand-alone diagnosis, individuals with the symptoms above may have been diagnosed with ASD, most often pervasive developmental disorder not otherwise specified (PDD-NOS) or Asperger’s syndrome, both subtypes of ASD. After the introduction of SCD, one study found that 22 percent of those with SCD would previously have met the criteria for PDD-NOS and six percent would have met the criteria for Asperger’s syndrome.
How Can I Help My Child with SCD?
If your child has a diagnosis of SCD, Autism Speaks recommends taking this steps at home:
- Practice taking turns by rolling or throwing a ball back and forth. Take turns repeating words.
- Read a book with your child and ask open-ended questions to encourage discussion.
- Talk about what characters in books might be thinking and why. Take turns offering your ideas. Talk about how other people – siblings, friends, classmates – might feel during certain situations.
- Play “What’s next” when reading. Stop at a point and have your child predict what is going to happen next. Look for clues in the story that can help you guess.
- Plan structured play dates. Start small, with one friend. Have a planned, structured activity and a start and stop time.
- Use visual supports to aid in conversations.