Jackson, age 10, is in fifth grade and fits the social communication disorder (SCD) profile. He has difficulty making friends. In an effort to be part of a conversation, he sometimes interrupts or changes the topic abruptly. Jackson doesn’t pick up on nonverbal cues and often misinterprets his classmates’ intentions or feelings. In the classroom, he has difficulty expressing his ideas in an organized way, and he struggles to understand nonliteral language, make inferences and draw conclusions when he reads curriculum materials. His classmates sometimes tease him
If you are a speech-language pathologist working in the schools, you’re involved in the identification and treatment of children like Jackson. SCD is a relatively new diagnostic category from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition)—and although it shares some features with autism spectrum disorder (ASD), it is a distinct disorder. And SCD can’t be diagnosed in conjunction with ASD.
In diagnosing and treating children with SCD and ASD, it’s important to understand the distinction. Both SCD and ASD are marked by difficulties using language for social purposes. These social communication difficulties are a defining feature of ASD, but ASD also includes restricted, repetitive behaviors. In practice, the distinction isn’t always apparent, given the variability within each disorder and the possible presence of other conditions like language disorders. In addition, repetitive behaviors can become subtle over time, making them harder to identify.
Try these key considerations from James Madison University SLP Geralyn Timler when determining if a child has social communication disorder versus autism spectrum disorder.
SLPs are uniquely suited to teasing out the differences, identifying the characteristics that point to SCD or ASD, and developing effective, functional treatment programs.
Why are SLPs suited for the task? Think of social communication as the interaction of language comprehension and production, pragmatics, social interaction and social cognition (including emotional expression and understanding). Children with poor social interaction and social cognition skills might experience issues with expressing themselves and interpreting what they hear or read. They often find it challenging to make friends, interact in social settings and succeed academically. And language comprehension and production problems can make it difficult for them to interact in social settings. SLPs understand language processing and pragmatics, and we know how social and emotional skills interact with language to facilitate communication.
One of the most effective ways to help children with SCD learn to navigate social interactions involves focusing on communication within authentic contexts. For practical tips on using this approach for treating school-age children with SCD, check out the recent article by Brigham Young University SLPs Bonnie Brinton and Martin Fujiki: “Social communication disorder: This is our baby, SLPs!”
Also, peruse ASHA’s updated social communication disorder portal page with expanded information on how this disorder affects individuals across the lifespan.
Phyllis Bonelli, MA, CCC-SLP, is ASHA’s SLP practices resource manager. email@example.com