Social Communication Disorder In Children: What parents need to know

Key highlights:

  • Children with SCD don’t have language mechanics problems, like using grammar, but have difficulty communicating in socially appropriate ways.
  • Symptoms are present in early childhood, but the signs often become more noticeable when they are older.
  • There are a lot of activities parents can do at home to help children get better at social communication.

In 2013 a new disorder was defined called Social (Pragmatic) Communication Disorder (SCD).  According to Wikipedia, SCD is a disorder in understanding pragmatic aspects of language.  People with SCD have particular challenges with the semantic part of the language (the meaning of what is being said) and the pragmatics of language (using language appropriately in social situations).  Currently, as screen time for the very young has doubled in 20 years, social communication disorders are being diagnosed in children much more frequently than ever before.

Everyone struggles with social situations from time to time, but for a child with SCD, navigating social situations is a daily challenge.  Children with SCD have the disorder from early in their development.  They have trouble holding conversations and using spoken language in socially appropriate ways but are usually good with the mechanics of speaking, such as pronouncing words or constructing sentences; thus, parents might not notice the signs.

In this article, you’ll learn how social communication disorder affects children, how it is diagnosed, how it’s treated, and what parents can do to help children with SCD.

Social Communication Disorder: What Is It?

Social communication disorder (SCD) is characterized primarily by impairment in pragmatics – the linguistics area that has to do with how meaning is created and interpreted in verbal and nonverbal interactions.

Children with this disorder are not impaired in understanding word structure or grammar or in general cognitive abilities.  They tend to do fine with the mechanics of speaking—pronouncing words and constructing sentences.  What they struggle with is pragmatics.  These are the unspoken, subtle rules of spoken language that allow people to connect.  They primarily have difficulty using language in social situations, such as greetings, sharing information, changing speech to suit different social contexts, understanding things that are implied but not explicitly stated, and functioning in conversation and storytelling.

SCD affects all different types of verbal and nonverbal communication: spoken, written, gesture, and even sign language.  It’s not clear what causes these difficulties. But SCD often occurs with other conditions and challenges.  These include autism, ADHD, language disorders, and trouble with reading

What are the symptoms?

Children with SCD have trouble learning how to start a conversation, listen, phrasing a question, stay on topic, and know when the chat is over.  A child with SCD can struggle in developing reading and writing skills, including reading comprehension.  These children show an impaired ability to effectively communicate, participate socially, maintain social relationships, and perform academically or occupationally.

Children with social communication disorder have trouble with:

  • communicating appropriately for social purposes – for example, smiling and saying ‘hello,’ making eye contact while interacting with someone, or showing something interesting to another person, like pointing to a plane in the sky
  • adapting language to different listeners (for example, using formal manners with an adult versus casual language with a peer)
  • following social ‘rules’ – for example, holding out your hand to shake hands or taking turns during a conversation.  They may monopolize the conversation or interrupt often, or not respond at all.
  • understanding and using verbal and non-verbal cues – for example, knowing that if a person is looking around while you’re talking, the person might be bored
  • understanding facial expressions and gesturing
  • understanding riddles, sarcasm, and metaphors
  • getting too close to people when they speak

Symptoms are present in early childhood, but the signs often become apparent when a child is older and has to deal with complicated social situations and rules.

How Is Social Communication Disorder Diagnosed?

Many symptoms of SCD overlap with those of other conditions and learning disabilities, which often complicates diagnosis, according to a study completed in 2013.  Sometimes it is necessary to rule out other potential problems first.  For example, a doctor might recommend a comprehensive hearing assessment to rule out hearing loss early.  A speech and language pathologist with a thorough understanding of comorbid conditions and learning disabilities should complete the hearing and other evaluations, considering age, cultural norms, and expected stage of development.

According to ASHA, screening for SCD often includes interviews, observations, self-reported questionnaires, and information completed by parents, teachers, or significant others.  It should also take into consideration your family’s medical and educational history.  ASD symptoms are more likely if a family member has been diagnosed with ASD, communication disorders, or specific learning disorders, according to Child Mind Institute.

Following the assessment, the speech and language pathologist may provide a diagnosis, a description of the characteristics and severity of the condition, recommendations for interventions, and referrals to other specialists, as needed.

How Is Social Communication Disorder Treated?

SCD is a relatively new condition.  There is no specific treatment for SCD, but it is thought that speech and language therapy with an emphasis on pragmatics, along with social skills training, will help.

Treatment should be specific to the individual, focusing on functional improvements in communication skills, especially within social situations.  Treatment for SCD often includes parents and other family members. The therapist working with your child may also reach out to her teachers, special educators, psychologists to ensure that your child receives consistent practice and feedback in a variety of social situations, according to ASHA.

Strategies for parents

The good news is that SCD is treatable.  Clinical research suggests the primary treatment for social communication disorder is speech-language therapy.  It’s also critical for teachers and parents to reinforce these skills with opportunities to use them in school and at home.  The critical skills for children with SCD to learn are:

  • Facial expression: facial expressions beyond the basics of happy, sad, or angry can be difficult for children with SCD to read.  In many cases, communication is not just about words.  Our intended meaning is usually conveyed through a combination of facial expression, body language, ane of voice, and the words we use. Some strategies to develop facial expression reading skills are:
    – Use a mirror so that your child can see how her face looks when she experiences an emotion
    – Use “mood music” to experience different feelings
    – Take photos of facial expressions and the contexts. Match the pictures to different feelings and to possible reasons for feeling this way.
    – Use real contexts and video clips to explain body language’s meaning, linked to facial expression and voice tone.
    – Use a symbol book or chart to show who, where on their or another’s body and when it is appropriate to touch. Discuss who isn’t appropriate to say hello to, shake hands with, kiss, cuddle… and teach socially acceptable alternatives.
  • Speech pragmatics: Speech pragmatics training can help a child understand the meaning of idioms and teach them how and when to use appropriate greetings.
  • Conversation skills: Kids with SCD often struggle with back-and-forth exchanges, such as asking and answering questions during a conversation. 
  • Non-verbal communication: Learning how to use language is one component of the skill set necessary to communicate effectively. The other is interpreting and using non-verbal cues to assess someone’s mood, or knowing when someone is signaling discomfort or boredom, say, by looking at their watch.

Speech and language treatments are more successful with family engagement.  Parents can supplement speech-language therapies by facilitating “real-life” conversations and interactions between the child and their peers.  There are many other activities parents can do at home to encourage social communication skills.

  • Read and discuss.  Read a book with your child, asking and encouraging open-ended questions such as “what do you think about what he did?”
    >>> Learn how to make reading fun and educational here:
  • Talk about the feelings.  Books and stories provide an excellent opportunity to talk about feelings.  Suggest why you think a character in a story is behaving or feeling a particular way.  Try extending this to real-life situations, privately discussing what a friend or sibling might be feeling and why.
  • What’s next?  Have your child try to predict what will happen next in a story.  Help her locate the clues.  Once an event occurs, go back and figure out the clues leading up to the event.  For example, take a picture of spilled milk and food on the floor; ask what might have happened.
  • Use visual supports to aid in conversations.  Role-playing games and visuals can also assist children in learning strategies to manage social situations.

Children with SCD need professional intervention to develop their social interaction skills.  It’s not reasonable to expect them to simply “pick up” these skills by spending time with other children.  Placing a child with SCD into socially demanding environments without appropriate support can do more harm than good by leading to teasing and isolation.  We encourage parents to keep a close eye on your child as she grows and develops her language so that you can give the proper support when necessary.



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