What Is Social Communication Disorder?

Social communication disorder (SCD) is a neurodevelopmental condition that leads to difficulty speaking in social settings. SCD typically appears during early child development.

It is often confused with autism spectrum disorder (ASD) because of similar traits, making diagnoses tricky. To get an accurate diagnosis, doctors must eliminate the possibility of ASD and vice versa.

SCD is a relatively new discovery. Previously considered part of ASD, SCD was finally added to the Diagnostic and Statistical Manual (DSM-5-TR) in 2013 as a standalone diagnosis.

Symptoms of Social Communication Disorder

Social communication disorder causes individuals to struggle with changing their communication style to fit different scenarios. They may develop a vocabulary, understand grammar and individual words but aren’t aware of pragmatic language.

SCD can impact speaking, writing, gestures and sign language. Signs of SCD include:

• Difficulty recognizing when and how to change tone or communication styles. For example, speaking differently on the playground versus the classroom.
• Trouble sharing information, initiating conversations, greeting people and engaging in conversation.
• Constantly interrupting and struggling to adhere to conversation etiquette such as providing more details or interpreting verbal and nonverbal cues.
• Issues understanding implied communication such as humor, sarcasm or metaphors.
• Poor eye contact
• Difficult expressing and understanding the feelings of others

The implications of SCD can have long-term consequences impacting a person's daily life and their ability to keep, maintain and participate in personal and professional relationships.

Diagnosis of Social Communication Disorder   

Experts recommend that parents wait until their child is 4 or 5 years old before seeking a diagnosis. A speech-language pathologist takes a medical and behavioral history, collaborates with parents and teachers, and performs several diagnostic tests. 

Screening for SCD includes interviews and observations, hearing tests, and questionnaires to determine an accurate diagnosis. Doctors rule out other neurological disorders and medical conditions that may impact speech, such as intellectual development disorder, global development delay, or another mental disorder.

Causes of Social Communication Disorder 

Although the cause of social communication disorder is currently unknown, the risk is higher if there is a family history of autism, other communication disorders, or specific learning disabilities. SCD can occur alone or along with conditions including:

• Language disorders
• Speech sound disorders
• Childhood-onset fluency disorders (stuttering)
• Unspecified communication disorders

Social Communication Disorder vs. Autism Spectrum Disorder

People with social communication disorder and autism have difficulty communicating, but those with ASD also show restricted interests and repetitive behavior.

Since SCD is considered part of an autism diagnosis; it can’t be diagnosed alongside ASD. Before SCD was added to the DSM-5, people may have been diagnosed with ASD or pervasive developmental disorder not otherwise specified.

A 2018 study found that 22% of the children previously diagnosed with pervasive developmental disorder, not otherwise specified (PDD-NOS) would now receive a diagnosis of SCD. 6% of those previously diagnosed with Asperger's syndrome would now receive a diagnosis of SCD.

Treatment for Social Communication Disorder  

There are a variety of treatments that parents, teachers, and doctors can do, but speech-language therapy is the primary treatment. Experts use various methods that work on conversation skills through one-on-one or small group activities.

Here are treatment methods for SCD:

• Organize structured playdates: Invite a friend over and monitor the interaction while your child does a structured activity. As the skills in this area grow, you can try new locations.
• Read books: While reading, hypothesize what the characters may be thinking and why, and ask open-ended questions about the book.
• Play games: Playing teaches boundaries and how to wait your turn. During the game, ask open-ended questions and promote conversation.
• Speech pragmatic training: This practice teaches the meaning of idioms and the appropriate use of greetings.
• Create social scripts: These scripted prompts show people how to use language during certain social situations.
• Stories: Media like books and anecdotal stories can play a key role in explaining social situations, promoting problem-solving and teaching responses that fit social situations
• Have visual aids: At times when they may not be able to verbalize how they feel, those with SCD may be able to communicate using pictures, toys or props.

Coping With Social Communication Disorder  

Social communication can impact the whole household. By working with a speech-language therapist, individuals can learn strategies to reduce the impact of SCD on their social life.

More research is needed to determine the effectiveness of therapy over time, but the sooner you find out the better. With the help of a doctor, people with SCD can learn how to navigate social situations.