What is Social (Pragmatic) Communication Disorder?

The American Psychiatric Association added a new diagnostic category to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) called Social Communications Disorder (SCD). SCD involves an impairment of communication in natural social settings. People with Social Communications Disorder have problems using verbal and nonverbal communication and cues. This has a detrimental effect on their social relationships.

Symptoms, Causes of Social Communication Disorder

The symptoms of Social Communication Disorder begin to show up in early childhood and can cause problems in social, academic, and occupational areas. Challenges in these areas cause anxiety and may result in isolation and exclusion from participation in social situations.

Symptoms of SCD include:

• Problems using communication (verbal and nonverbal) in social situations
• Challenges adapting communication style to fit the context or the style of people the person communicates with
• Problems following social rules like taking turns during conversation
• Difficulty understanding implied messages

To receive a diagnosis of SCD, the issues must not be better explained by autism spectrum disorder, a language disorder, or intellectual disability.

As with many mental health disorders, such as ADHD, autism, intellectual disability, and language disorders, experts aren't clear on the exact cause of SCD. People with SCD often have family members with communication disorders, autism, or specific learning disorders. This indicates that a genetic component may contribute to the development of SCD. Since it's a new diagnosis in the DSM-5, more research is necessary to discover possible causes of this disorder. (Does your child have difficulty with stuttering, a language disorder or a speech sound disorder? Read these articles.)

Treatment of Social Communication Disorder

Treatment for people with Social Communication Disorder will likely be similar to interventions used for Asperger's Syndrome (which is no longer a diagnosis included in the DSM-5). Effective treatment will use the child's natural interests as a foundation. Ideally, the mental health professional will develop a therapeutic strategy that meets the specific needs of the individual child. A typical program might include:

• Training in social skills that teaches the child skills they need to engage successfully with other children in social situations
• Cognitive behavioral therapy to help those with more anxiety and intense emotions manage their feelings better and cut back on repetitive behaviors and obsessive interests
• Medication for any co-existing conditions like anxiety or ADHD
• Occupational therapy for children with sensory integration issues
• Speech and language therapy for children with pragmatic speech problems (i.e. learning to take turns in conversations)
• Training and support for parents

There's no cure for Social Communication Disorder, but with effective treatment, children with SCD can learn to overcome many of their problems, but many may continue to find certain social situations challenging. They will need to practice using the skills and tools they learn in therapy to get them through the more difficult encounters.

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