Social communication disorder refers to an individual’s difficulties with properly using verbal and nonverbal language skills. Autism also encompasses challenges with social communication, as well as a history of restrictive and repetitive patterns of behavior.
Knowing the difference between the two conditions is essential for getting your child the correct therapies and services.
What Is Social Communication Disorder?
Social communication refers to how people effectively use language in social contexts and includes social interaction and cognition, pragmatics, and language processing. Social communication disorder, therefore, is marked by challenges with using verbal and nonverbal language in social situations.
Individuals with social communication disorder struggle with social interactions and how they think about them. People with social communication disorder often struggle with the following:
- Communicating appropriately in various social settings
- Adjusting their communication style to fit the context or listener
- Adhering to social rules of conversation and storytelling
- Understanding ambiguous and nonliteral language
- Understanding nonexplicitly stated pieces of a conversation
Children and adults with social communication disorder can experience a range of problems that impacts many areas of their lives. Such problems include challenges in the following areas:
- Participating in social settings
- Developing relationships with peers
- Performing well in school
- Doing well at work
Researchers have not yet identified a specific cause of social communication disorder. It is often attributed, however, to additional conditions that it is associated with, such as an intellectual disability, spoken or written language disorder, traumatic brain injury, or dementia.
Prevalence of Social Communication Disorder
The exact prevalence of social communication disorder is difficult to estimate as it frequently co-occurs with other disorders with varying symptoms and characteristics. Likewise, studies conducted on social communication disorder vary significantly on the populations observed and definitions used to identify the disorder.
Studies reviewed by the American Speech-Language-Hearing Association (ASHA) have found, however, a pragmatic language impairment prevalence of about 7.5% among kindergarteners. Boys were also more than twice as likely to be affected by the language impairment than girls.
In another study, among individuals with language disorders, as much as one-third of people also exhibited problems with social communication.
Social Communication Disorder vs. Autism
The American Psychological Association (APA) released the updated version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A significant update made in the DSM-5 was establishing criteria for autism spectrum disorder (ASD) and separate, though related, criteria for social communication disorder.
Prior to this change, individuals who exhibited symptoms of social communication disorder were frequently diagnosed with ASD. They are now recognized as distinctly separate conditions, however, as one may exhibit social communication challenges but not the rest of the symptoms needed to qualify for an ASD diagnosis.
To receive a diagnosis of ASD, the following criteria must be met:
- Persistent deficits in social communication and social interactions in various contexts
- Restricted and repetitive patterns of behaviors, interests, and/or activities
- Symptoms present in early childhood development, although they may not become more prevalent until later in life when certain challenges are present
- Symptoms that cause clinically significant problems in social, occupational, and other important areas of functioning
- Symptoms that cannot be better explained by intellectual disability or global developmental delay
Unlike ASD, the diagnostic criteria for social communication disorder focus solely on the challenges caused by a lack of social communication skills. The diagnostic criteria for social communication disorder are:
- Persistent challenges with the social use of verbal and nonverbal communication.
- Functional limitations of effective communication, social participation and relationships, and academic and occupational achievement as a result of deficits in social communication skills.
- Symptoms that presented in early childhood development.
- Symptoms that cannot be better explained by a different medical or neurological condition, intellectual disability, global developmental delay, mental disorder, or autism spectrum disorder.
Upon first glance, ASD and social communication disorder appear to be closely related. But they are distinct conditions that require proper diagnosis and appropriate interventions to be managed and treated successfully.
Social Communication Disorder Comorbidity With Autism
Social communication disorder can co-occur alongside other developmental and learning disabilities. When it comes to ASD, however, the two conditions cannot be considered comorbid.
ASHA explains that because social communication problems are a primary feature of autism, social communication disorder is not given as a secondary or comorbid diagnosis. Someone with ASD already has social communication deficits, along with restricted and repetitive patterns of behavior.
How to Get a Proper Diagnosis
Before getting a diagnosis of social communication disorder, autism must be fully ruled out. Arriving at such a differential diagnosis helps clinicians pull apart the overlapping symptoms of ASD and social communication disorder.
Likewise, other potentially co-occurring disorders or developmental issues must also be identified to determine if there is more going on (or not) than just social communication problems.
A speech-language pathologist (SLP) is the professional to see to get a proper diagnosis of social communication disorder. SLPs are trained to assess, diagnose, and treat social communication problems.
SLPs do the following to help children and adults with communication issues:
- Perform comprehensive language assessments
- Collaborate with teachers and parents
- Address verbal and nonverbal aspects of communication
- Create individualized treatment plans
- Develop visual supports to enhance communication
- Provide forms of augmentative and alternative communication
Speaking with your child’s doctor or school is a great place to start your search for a qualified SLP. SLPs work in a variety of settings including in schools, hospitals, community clinics, and private practice. After making a proper diagnosis, the SLP works with you and your child to help them get the most out of their speech and language skills.
Resources for People With Social Communication Disorder
Fortunately, there are many resources available today for people of all ages living with social communication disorder. For children and adults with social communication disorder, as well as their families, the following resources may be helpful:
- Autism Speaks Visual Supports Tool Kit
- Social Communication Disorders in Children: Speech-Language Pathologists Can Help guidebook
- Assessment Tools, Techniques, and Data Sources for assessing language ability
- Information about Social Communication provided by ASHA
- Information about taking a Family-Centered Practice and Person- and Family Centered Care approach to treatment
- Social Communication Benchmarks for individuals from birth through adulthood
- Information on supporting Transitioning Youth with special needs from high school into further education or employment
A selection of organizations dedicated to supporting individuals with social and communication disorders across the lifespan include:
- The Association for Positive Behavior Support
- The American Speech-Language-Hearing Association
- Autism Speaks
- Autism Speaks’ Autism Treatment Network (ATN)
- Autism Navigator
- Brigham Young University: Building Social Skills with Books
- The Early Childhood Technical Assistance Center
- Center for Autism and Related Disorders (CARD)
- Operation Autism (for military families)
- Starbridge for support in education, employment, and healthy living
If you have concerns about your child’s social communication development, don’t hesitate to consult your child’s pediatrician or an SLP. If your child is struggling with social communication skills, the sooner they receive a proper diagnosis and start appropriate treatment, the better they will be able to achieve their communication potential and live a full and rewarding life. Children and adults respond well to speech and language interventions, and it is never too late to start developing effective language skills.
Autism Diagnosis Criteria: DSM-5. Autism Speaks.
Social Communication Disorder. American Speech-Language-Hearing Association.
Social Communication Disorder: Information & Treatments. (April 2015). Autism Speaks.