Social Pragmatic Disorder vs Autism: What's the Difference?

Social Pragmatic Disorder vs Autism: What’s the Difference?

Despite similarities, Autism Spectrum Disorder (ASD) is not Social Pragmatic Communication Disorder (SCD). SCD first appeared in the Diagnostic and Statistical Manual in 2013. SCD is a newer discovery and the symptoms of ASD and SCD are similar, even overlapping, yet different.

A person struggling with SCD may have trouble with tones or sharing their thoughts. Speech-language therapy is a main part of treatment. Speech, nonverbal communication, and social cues are the most common problems for individuals.

People with SCD will have trouble understanding the meaning of their interactions. Individuals with autism will experience symptoms common of SCD and have other symptoms.

If you suspect someone you love has SCD, keep reading. This article will outline the signs and treatments of SCD. To learn more about it, let’s start with how it gets misdiagnosed.

Diagnosing SCD vs. ASD

There are many ways to separate Social Pragmatic Communication Disorder from autism. Visits to doctors and speech pathologists will be necessary. Hearing tests and other screenings ensure the person is not misdiagnosed.

People with autism repeat certain behaviors and have disruptive behaviors. Individuals with SCD will not display these behaviors. People with SCD struggle to adjust their communication based on the specific situation.

Collecting information from parents, teachers or significant others is an ongoing process. Interviews, questionnaires and personal observations are examples of the type of information needed. A look at family medical history will provide insight in making an assessment.

ASD Specific Behavioral Signs

There are some consistent signs shared among those along the autism spectrum. Here are the most common:

  • Twirling, jumping, rocking, flipping the hands, headbanging, and other repetitive behavior.
  • Obsession with putting things in order or items having a certain placement.
  • Extreme fixation on rituals and routines.
  • Repeating of sounds, syllables, words and/or phrases in excess.
  • Very preoccupied with specific objects or subjects.
  • Odd responses to sensory stimulation, especially sound, and visual chaos.
  • Doesn’t take part in pretend or make-believe activity.

SCD Behavioral Signs

In comparison, there are some Social Pragmatic Communication Disorder-specific signs. They differ slightly from ASD, but here are some important distinctions:

  • Not responding to people in a way that is understandable.
  • Interrupting others during conversation.
  • May not use gestures such as waving and pointing.
  • Difficulty expressing feelings and emotions.
  • Changing the topic or losing track of what is being discussed.
  • Difficulty using words as needed to make conversation.
  • Trouble making friends and maintaining friendships.
  • Delays in speech or language development which can even include disinterest in talking.

Treatment of SCD and ASD

There are many different types of treatment available. Speech and language therapy is very helpful in the treatment of people with either SCD or ASD. Early diagnosis is also great because it gives the person a headstart.

Social Pragmatic Communication Disorder Treatments

Bear in mind many of the treatments for SCD are also helpful in the treatment of ASD. Treatment should focus on improvements in functional communication skills specific to social situations. A focus on the individual’s needs will also need to take precedent.

Develop tools that will be most beneficial in the person’s daily engagements. In some cases, scripts help the person handle common conversations. These can help identify weaknesses and practice overcoming social roadblocks.

Social interactions need encouragement within and outside of observable settings. A therapist can train family members on a variety of strategies to help with engagement.

Involvement of school staff is likely the best route for children. This will ensure practice and feedback in a variety of social situations is taking place. It’s also important to prevent any bullying situations.

Autism Spectrum Disorder Treatments

Trial and error, a great team of people and patience will be necessary to properly treat ASD. There are four categories of treatment when dealing with autism.

Treatment of Behavior and Communication

Approaches that help involve structure, organization, direction, and family participation. Below are some specific treatments.

  • Applied Behavior Analysis (ABA) is popular. ABA comes in several forms but generally speaking, involves tracking and measuring behaviors. Promotion of good behavior and discouragement of bad behavior is the general goal.
  • Developmental, Individual Differences, Relationship-Based Approach (DIR) or floortime is another form of treatment. DIR focuses on the development of feelings and relationships. It works for peers, caregivers or family. How the child deals with sensory stimulation like smells and sounds is also addressed.
  • Occupational Therapy teaches everyday skills. Independence is the goal here. Focus can be on getting better at eating, bathing and understanding others
  • Sensory Integration Therapy helps the person handle things like sights, sounds, and smells. This form of therapy is good for people that struggle with touch or noisy environments.
  • Speech Therapy helps to improve a person’s communication skills. This therapy will help the person develop the style of communication best suited for them. Some people may be better at using pictures to communicate or gestures rather than words.

Dietary Approaches

Consult a doctor before trying a dietary approach. Methods used include removing foods that contain gluten, milk, soy and/or sugar from the diet. Vitamin supplements fill in any nutritional gaps and can increase cognitive performance.

There isn’t much scientific support for this method, unfortunately.

Medication

There are medicines that can help with some of the symptoms of ASD. Medication that helps with an inability to focus or even high energy levels may be quite helpful.  Medicines treating seizures and depression have also been effective.

Complementary and Alternative Medicine

Several treatments falling under this category also fall under dietary approaches. Consult a doctor before beginning any form of alternative medicine or complementary treatment.

Epsom baths, gluten-free diets, and use of natural home products are good practices. These practices have come under controversy because they lack scientific support.

The More You Know

We know this can be a lot to take in. Hopefully, this article has helped with understanding Social Pragmatic Communication Disorder. You may have more questions about SPCD and we’re here to help.

You may even be ready to begin treatment for your child or even a person you provide care. Take a moment to look over our online speech therapy services.

You can always find updated information available on our website. Contact us if you can’t find what the answers on our page. The more we know about SPCD, the better the quality of life we can provide.

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Social Pragmatic Disorder: What you Need to Know About It

If you suspect that your child might have a social pragmatic disorder (or social communication disorder), you probably have a lot of questions.

Social pragmatic communication disorder is a diagnosis, and it’s gone by many different names in the past.

This disorder is characterized by the difficulty with the use of spoken language in socially appropriate ways. Children with SCD may be able to pronounce words and construct sentences, but they will struggle to hold conversations. This can make it difficult to make friends and perform well in school.

Let’s break down SCD as a disorder–and how you can find help.

What Is Social Pragmatic Disorder?

So why is it called social pragmatic disorder? Children with SCD have trouble with pragmatics, which are the underlying and unspoken rules of spoken language. The pragmatics of language include changing the way you speak in different situations, altering the tone or loudness of your voice, and understanding social cues in speech.

Clients with SCD might not understand how to hold a conversation. Some of them might talk too much and interrupt frequently, while others might not talk at all.

People with social pragmatic disorder will often have difficulty mastering these verbal and non-verbal communication skills:

  • Responding to others
  • Reaching language milestones
  • Using gestures (waving, pointing, shaking head)
  • Staying on the same topic
  • Discussing emotions
  • Adjusting speech to fit different people or situations
  • Taking turns when speaking with others
  • Understanding sarcasm
  • Comprehending implicit references
  • Asking relevant questions
  • Making Friends

This has nothing to do with the way the children were raised or how they were taught manners by their parents. For reasons that still aren’t clear, people with social pragmatic disorder struggle to learn how to use language in a socially appropriate way.

How Is It Different from Autism?

In many ways, this difficulty to communicate can overlap with signs of autism. Many medical professionals might diagnose children with SCD with autism. However, new research has shown that some children with SCD don’t show any signs of autism–and therefore, they’re not getting the right treatment.

Social pragmatic disorder was only recognized as an official diagnosis in 2013. The American Psychiatric Association (APA) added it to the Diagnostic and Statistic Manual of Mental Disorders (DSM) in an effort to bring light to the condition. For years it was considered a symptom of language impairment, a sign of autism spectrum disorder, or a different developmental disorder.

Autism also involves difficulty with social communication, but it also involves restricted and/or repetitive behaviors. Before a diagnosis of SCD is reached, an evaluation must rule out autism.

Making this distinction can be difficult because many behaviors overlap between autism and SCD. In fact, SCD can occur alongside other disorders including learning disabilities, speech sound disorder, and ADHD. You should always consult a professional for an official diagnosis.

What Causes Social Pragmatic Disorder?

It’s not clear exactly what causes social pragmatic communication disorder. These kinds of disorders occur in about 5 to 15 children per 10,000 births–but it’s unclear how many of these include SCD as a diagnosis. Because it overlaps with so many other disorders, the cause and prevalence of SCD are unknown.

It’s thought to be a neurodevelopmental disorder that affects the brain’s right hemisphere. This may make it more difficult for individuals to process both verbal and visual information at the same time. It may also be related to challenges with executive functioning.

What Are the Next Steps If Your Child Is Diagnosed?

Symptoms are most often present in early childhood, but they may not be recognized until years later. If you think your child exhibits signs of SCD, take them to a physician or a psychologist for an official diagnosis.

You can also seek out a speech-language psychologist, or a speech therapist. They will do the following:

  • Observe your child at home or in the classroom
  • Interview the parents and teacher of the child
  • Perform one-on-one testing to assess communication and language skills

The goal of this testing is to analyze your child’s verbal and non-verbal communication in different settings. This will help identify whether these skills are underdeveloped or affecting your child’s ability to learn and form relationships with others.

Once you’ve gotten an official diagnosis, you can start thinking about treatment for social communication disorders.

Treatment plans can include a speech therapist to work one-on-one with your child to teach them strategies and reinforce their skills. You can also work with your child’s school to develop an Individualized Education Program (IEP), which can include speech therapy, skills training, and in-class support or accommodations.

Activities You Can Do at Home

While getting professional help is the best step to move forward, there’s more that you can do at home to encourage social communication skills. Just make sure that you’re discussing goals with your child’s therapist and guiding your activities to meet those goals. Here are a few examples:

Taking Turns

Play some games that help your child practice taking turns. This could be as simple as tossing a ball back and forth or repeating words or sounds. Start with just you and your child before you move on to other people.

Reading

Read books and stories aloud to your child. Encourage them to engage with the material by asking open-ended questions like: “What do you think about what this character did?” Focus on emotions or feelings, such as what a character in a story might be feeling and why they feel this way.

Play Dates

Plan some structured play dates for your child. You can begin with just one friend at a time and set a time limit. Later on, you can introduce more friends or increase the length.

Use Visual Support

Children with SCD may have trouble understanding your verbal or non-verbal cues. Try using visual aids to help set expectations or rules.

What You Need to Know About Social Pragmatic Disorder

If your child has social pragmatic disorder, there’s a lot you can do to help them develop their communication disorders. It’s important that you know what to expect–and get your child to a professional for a proper diagnosis and treatment plan.

Looking for more resources to get your child on track? Contact us to learn more about speech therapy.