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? Get started with an introductory call to learn more about speech therapy and how we can help with social pragmatic disorder.