Social Communication Disorder

Social communication disorder (SCD) is characterized primarily by impairment in what is called pragmatics—the area of linguistics that has to do with how meaning is created and interpreted in verbal and nonverbal interactions. Children with this disorder have difficulty 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. SCD is a newly defined disorder. Children who had these symptoms were diagnosed with pervasive developmental disorder not otherwise specified (PDD-NOS), a type of autism spectrum disorder, leading to inconsistent treatment and services.

A child who has difficulty applying communication and linguistic skills in certain situations, despite having mastered them, may have SCD. Other signs include low interest in social interactions and a delay meeting language milestones. SCD can impair a child’s ability to understand—and display that understanding of—concepts such as narratives, conversations, and to respond appropriately to different social situations. The problems associated with SCD are distinct from more general deficits associated with disturbances in cognitive ability. SCD affects spoken and unspoken language, including written, gesture, even sign language.

Symptoms of the SCD must be present in early childhood for a child to be diagnosed—though they may not fully manifest until speech, language, and communication demands start to exceed practical skills. Autism spectrum disorder must also be ruled out. Because SCD symptoms were not defined in previous editions of the DSM, individuals with such symptoms may have been included in the not otherwise specified category of pervasive development disorder.

There is no known treatment for SCD. Speech and language therapy designed to improve language pragmatics and social skills training can help these children.

A child is at higher risk for social communication disorder if there is a family history of autism spectrum disorder, communication disorders, or specific learning disorder. Social communication disorder can coexist with other disorders, such as speech disorder, specific learning disorder ADHD, and intellectual development disorder.