What Is Social Communication Disorder?

Medically Reviewed by Poonam Sachdev on October 08, 2022

Social communication disorder (SCD) is a condition that makes it difficult to communicate verbally and nonverbally. Individuals with this disorder can use speech but struggle to understand the social aspects of conversations. For instance, a person with SCD may have issues interpreting metaphorical language or waiting their turn to speak during conversations. 

This condition can impair a person’s ability to develop healthy relationships and have regular social interactions. But several effective treatments for social communication disorder can help affected individuals navigate social situations more effectively. 

Learn about the causes, symptoms, and treatments of social communication disorder.

What Is Social Communication Disorder? 

Social communication disorder impairs your ability to interpret and use verbal and nonverbal communication in social settings. Contrary to popular belief, people with social communication disorder don’t have cognitive impairments. They also understand the technical mechanics of language like grammar but struggle to find the right words to use in social situations.

The condition affects several aspects of social communication, including: 

  • Language processing: The ability to express yourself through language and interpret the gestures and speech of others.
  • Pragmatics: The appropriate use of language in social contexts to accomplish goals.
  • Social interaction: The use of verbal and nonverbal language to communicate with at least one other person.

In 2013, the American Psychiatric Association added this condition to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as Social (Pragmatic) Communication Disorder. Some health care providers and researchers use other terms to refer to this condition, including pragmatic disability, pragmatic language impairment, and semantic-pragmatic syndrome.

Because social communication disorder is a relatively new diagnosis, researchers have not yet determined how many people this condition affects. One study found that 7.5% of sampled children have pragmatic language impairment, and the ratio of affected boys to girls is 2.6 to 1. But more research is needed to fully understand the prevalence of social communication disorder.

What Are the Causes of Social Communication Disorder? 

Experts don’t fully understand the causes of social communication disorder. In adults, this condition has been linked to medical problems like: 

People diagnosed with this condition often have other communication disorders, like:

  • Childhood-onset fluency disorder. Also known as stuttering, this condition begins in childhood and causes disfluencies and interruptions in the flow of speech. 
  • Language disorder. This condition makes it difficult to form sentences and pronounce words. 
  • Speech sound disorder. Individuals with this disorder have problems pronouncing particular letters, sounds, and words after 8 years of age. 

Individuals with autism spectrum disorder can’t be diagnosed with social communication disorder because both communication issues and repetitive behaviors characterize autism. As a result, health care providers must rule out autism before diagnosing a patient with social communication disorder.

What Are the Symptoms of Social Communication Disorder? 

Social communication disorder symptoms include issues with language processing, nonverbal communication, and social interaction. Individuals with this condition may struggle to appropriately:  

  • Adapt language and tone for different social situations 
  • Convey information and stories 
  • Develop language at the same pace as peers 
  • Grasp implied meanings and sarcasm
  • Greet others
  • Respond when approached by others

Additionally, people with social communication disorder typically have problems interpreting nonverbal communication, such as facial expressions and gestures. 

The condition typically appears at an early age, with many children receiving a diagnosis at 4 or 5 years of age. If you have a young child, you should remain vigilant for signs of social communication disorder during this stage of development and consult with a speech language pathologist if you notice symptoms.

How Can Social Communication Disorder Affect Your Health? 

Social communication disorder doesn’t impact your physical health but can seriously affect your social life. The condition may hinder your ability to: 

  • Engage in social situations 
  • Form close friendships and romantic relationships
  • Perform expected job functions
  • Succeed in academic settings

This disorder can also harm your self-esteem.

How Is Social Communication Disorder Diagnosed?

Before you have your child or yourself assessed for social communication disorder, you should have a health care provider conduct a hearing screening. People with hearing disorders may experience difficulties expressing and understanding language, which can resemble or contribute to social communication disorder. 

If your health care provider rules out hearing problems, they may order an evaluation for social communication disorder. Common assessment tools include: 

  • Comprehensive Assessment of Spoken Language. This tool evaluates how individuals use expressive language. The assessment consists of four subtests that analyze the patient’s ability to interpret and employ idiomatic language, inferencing, nonliteral language, and pragmatic judgment. People aged 3 to 21 years old can take this assessment. 
  • Pragmatic Protocol. During this assessment, the health care provider observes the patient during an unscripted, spontaneous conversation. They evaluate the patient based on 30 criteria, which include paralinguistic, nonverbal, and verbal elements of pragmatic language. 
  • Test of Pragmatic Language. This exam assesses individuals based on six areas of pragmatic language: abstraction, audience, physical setting, purpose, topic, and visual-gestural cues. Health care providers can use this test to assess children and teenagers between 6 and 18 years old.

How Is Social Communication Disorder Treated? 

Social communication disorder therapy can help patients successfully communicate and participate in social interactions. Treatment can take place during individual sessions with clinicians, in group interventions, or in school settings.  

Methods used in social communication disorder treatment include: 

  • Augmented communication. Assistive technologies can help patients express themselves and interpret the communication of others more effectively. 
  • Comic strip conversations. Individuals with social communication disorder can practice social skills like conflict resolution by creating comic strips that show characters talking. 
  • Computer-based instruction. Patients can learn language skills through computer programs. 
  • Social Communication Intervention Project. This initiative provides speech and language therapy for schoolchildren. Patients learn how to interpret emotional cues, tell stories, and other social skills. 
  • Social scripts. Children can learn prompts that teach them how to use appropriate language while speaking with others. 
  • Social skills groups. A group of social communication disorder patients works with a teacher to practice social interactions with peers.

With timely diagnosis and effective treatment, individuals with social communication disorder can learn strategies that will help them overcome challenges and succeed in social environments.

Show Sources

American Psychiatric Association: “Social (Pragmatic) Communication Disorder.”
American Speech-Language-Hearing Association: “Fluency Disorders," “Social Communication Disorder.”
Child Mind Institute: “Quick Guide to Social Communication Disorder.”
Churchill Center & School: “What is Social Communication Disorder?”
History and Philosophy of the Life Sciences: “The DSM-5 introduction of the Social (Pragmatic) Communication Disorder as a new mental disorder: a philosophical review.”
Journal of Neurodevelopmental Disorders: “Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category.”
Neuropsychiatric Disease and Treatment: “Social communication disorder: a narrative review on current insights.”
Research in Developmental Disabilities: “Screening for pragmatic language impairment: The potential of the children’s communication checklist.”
Stanford Medicine Children’s Health: “Speech Sound Disorders in Children.”
Understood for All: “What is social communication disorder?”

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