May 24, 2018

Categories: ASD

Is Social Communication Disorder a Form of Autism?

By: Sabrina Riera & Suzi Naguib, Psy.D.

The classification of mental health disorders is ever changing. In the most recent update to The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V) in 2015, the neurodevelopmental disorders were consolidated, and added to, in a pretty dramatic way. With big changes like this, it can be confusing and challenging to understand new or unfamiliar disorders that your child may be diagnosed with.

Autism is a very well known neurodevelopmental disorder impacting children. Another lesser known, but related disorder, is social communication disorder (SCD). New to the DSM-V, this disorder encompasses an experience that is quite similar to autism, but slightly different in its presentation. “It is currently unclear whether SCD is a valid diagnostic category, because little is known about the characteristics of those who meet its criteria” (7). In this blog, we will look at what Social Communication Disorder is and discuss the controversy of this new diagnostic category.

What is social communication disorder?

Social communication disorder is a neurodevelopmental disorder that was newly categorized in the DSM-V. This disorder is characterized by “difficulties in the social use of verbal and nonverbal communication” (1). Sometimes referred to as Social Pragmatic Communication Disorder, SCD is defined by difficulty using language in social situations. Children with SCD often have difficulties understanding the nuances of language and communicating in social settings (5). Some symptoms you may notice in a child with SCD include (4):

  • Delays in language milestones
  • A lack of interest in social interactions
  • Difficulty focusing and getting off-topic in a conversation
  • Difficulties adapting language to various social situations

The social communication impairments present in SCD are highly similar to the social communication impairments present in an autism diagnosis. SCD was classified as a unique disorder in the updated DSM-V in order to define the unique experience of children facing social communication problems, but lacking the behavior patterns of an autism diagnosis (6). For years, it was debated whether it was connected to language disorders or autism, but it has since been decided that it is its own unique disorder, and children with this disorder may benefit from speech-language services to help improve their social communication skills (3,2).

How is this different from Autism?

The main difference between ASD and SCD is that there are no restricted and repetitive behaviors (for example, hand flapping, playing repetitively with toys) present in a child diagnosed with SCD (1). As a result, a child who does not present with any restricted and repetitive behaviors, or who only presents with one restricted behavior, rather than two, will not meet the benchmarks to receive an autism diagnosis (3). A diagnosis of SCD allows children to receive treatment to help them improve their social communication skills.

Is SCD a unique disorder?

Though SCD has been defined as its own unique disorder in the DSM-V, and the social communication challenges these children face are very real, researchers and professionals in the field still wonder if this disorder warrants its own diagnosis. Are the symptoms of SCD truly independent from other neurodevelopmental disorders, such as ASD? It seems that the symptoms of this disorder may actually be comorbid features of other neurodevelopmental disorders. In fact, the research that has been conducted on the topic shows very little evidence that SCD is its own unique disorder (3, 7). When clinicians thoroughly evaluated the developmental history of children facing social pragmatic communication concerns, they always uncovered that the children also met diagnostic criteria for other neurodevelopmental disorders, like ASD and Speech Language Impairment. Other studies show that those who would have been diagnosed with PDD-NOS, a catchall diagnosis that was removed from the latest version of the DSM, would now be diagnosed with this new disorder (7). This limited data on SCD means that as clinicians, we need to be sure we are conducting a thorough evaluation of every child that we see so that we can provide the best fit diagnosis for a child. When an accurate diagnosis is provided, the doors are opened to more specific evidenced-based treatments for children facing social communication challenges.

If your child is having difficulty making and keeping friends and struggles in social situations it is important to seek help. Having your child evaluated will be the first step to understanding what is going on and to identifying an appropriate course of treatment.

To schedule an appointment at Sunfield Center, please call us at (734) 222-9277.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

2. Paul, D., and Murray, D. (2017). What is Social Communication Disorder? How is it Treated?. Autism Speaks. Retrieved from https://www.autismspeaks.org/blog/2015/04/03/what-social-communication-disorder-how-it-treated

3. Tager-Flusberg, H. (2013). Evidence weak for social communication disorder. Spectrum News. Retrieved from https://spectrumnews.org/opinion/viewpoint/evidence-weak-for-social-communication-disorder/

4. Tagiliareri, L. (2017). Understanding Social Communication Disorder. Understood: For learning and attention issues. Retrieved from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder

5. Taylor, L. J., & Whitehouse, A. J. (2016). Autism Spectrum Disorder, Language Disorder, and Social (Pragmatic) Communication Disorder: Overlaps, Distinguishing Features, and Clinical Implications. Australian Psychologist, 51(4), 287-295.

6. (2017). Social Communication Disorder: What is it?. Child Mind Guides. Retrieved from https://childmind.org/guide/social-communication-disorder/what-is-it/

7. Mandy, W., Wang, A., Lee, I., & Skuse, D. (2017). Evaluating social (pragmatic) communication disorder. Journal of Child Psychology and Psychiatry, 58(10), 1166-1175.