What is social communication disorder? (Before called “pragmatic language impairment” or “semantic pragmatic disorder”)

Kelli Johnson
Understood (@UnderstoodOrg)

«What is social communication disorder?

»SCD is a lifelong condition that makes conversation difficult. It’s been an official diagnosis since 2013. (Before that it was called pragmatic language impairment or semantic pragmatic disorder.)

»People with SCD tend to do fine with the mechanics of speaking—pronouncing words and constructing sentences. What they struggle with is pragmatics. These are the unspoken, subtle rules of spoken language that allow people to connect.

»For example, people with SCD may monopolize conversations and interrupt a lot. Some say things that are off-topic. Others hesitate to talk at all.

»It’s not clear what causes these difficulties. But SCD often occurs with other conditions and challenges. These include autism, ADHD, language disorders, and trouble with reading.

»Social communication disorder (SCD) is a condition that makes it hard to talk with other people. It’s not a problem with speech or with the mechanics of language, like using grammar. But it does impact other areas of language.

»People with SCD have trouble communicating in ways that are socially appropriate. They may not follow the rules of spoken communication. They don’t always understand the give-and-take of conversation. And they often don’t “get” sarcasm or language that isn’t literal.

»These challenges make it hard to connect with people, whether it’s at school, on the job, or in social settings.

»SCD isn’t related to intelligence. People who have it are as smart as anyone else. But it can impact learning and create challenges at work.

»How is social communication disorder diagnosed?

»Signs of SCD show up in early childhood. (In fact, having early symptoms is a criteria for diagnosis.) Very young kids may have delays in social communication milestones like using sounds or gestures to greet people. They may also have little interest in interacting socially. But families and teachers may not recognize the signs until later on. People can also be diagnosed as adults.

»Speech-language therapists use a variety of tests to diagnose SCD. These tests look at verbal and nonverbal communication skills in different settings. Therapists might also observe kids in the classroom and at home.

»Here are some signs of SCD at any age:

»_ Doesn’t get sarcasm; is overly literal

»_ Doesn’t give background information when talking to unfamiliar people

»_ Has trouble understanding things that are implied but not stated

»_ Has trouble picking up on social cues like facial expressions

»_ Doesn’t use appropriate greetings

»How is social communication disorder treated?

»The main treatment for SCD is speech-language therapy. Speech-language therapists can work with kids on conversation skills either one-on-one or in small groups. They might use role-playing games or visuals like comic books. Social skills groups can also help kids with SCD improve their communication skills.

»Young adults and adults may be able to find groups or workshops that focus on building social skills or life skills. These programs may be run by speech-language therapists, social workers, psychologists, vocational counselors, and college counselors.

»Families can also work on conversation skills and reading facial expressions at home.»

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