May 26, 2022

Online Speech Therapy for Social Communication Disorder

by Team Stamurai

A conversation may be a talk between two or more people that involves the exchange of pleasantries, news, or ideas. Most people find it effortless to start and hold conversations with others, even strangers. However, there are a few among us who find it challenging to follow the common social “norms” of a conversation, such as taking turns to speak, staying on topic, or avoiding unpleasant topics.

Have you ever considered that these individuals are not “acting strangely” on purpose? They may have social communication disorder. They may lack the resources and pragmatic language skills necessary to hold a conversation.

Social communication disorder or SCD does not appear in a day! Those with this disorder begin showing signs as a young child. A child with SCD may have trouble using and understanding verbal and non-verbal language. It not only affects their conversation skills, but also takes a toll on their personal life, social bonds, and relationships.

The signs of social communication disorder become more apparent as a child grows older and begins interacting with their peers. Want to know more about SCD? Here in this post, we will shed light on this disorder; we will discuss the most common symptoms of social communication disorder in toddlers & older children and its diagnosis & treatment.

If you think your child is having a hard time initiating social conversations, forming social bonds or holding a regular conversation, you should not wait! It is not a phase that passes on its own. Your child may need the attention and help of a trained speech therapist or speech-language pathologist (SLP).

What Is Social Communication Disorder?
Social Communication Disorder vs. Autism Spectrum Disorder
Is Social Communication Disorder Common?
What Are The Social Communication Milestones Children Should Achieve While Growing Up?
What Are the Symptoms of Social Communication Disorder (SCD)?
What are the leading causes of Social Communication Disorder?
How Is Social Communication Disorder (SCD) Diagnosed?
What Is the Treatment for Social Communication Disorder (SCD)?
How Can Parents Help A Child With Social Communication Disorder?
How can Stamurai help with the evaluation and treatment of social communication disorder (SCD)?

1. What Is Social Communication Disorder?

To define social communication disorder (SCD), we need to start with what SCD doesn't include. Those who have social communication disorder –

Do not have speech problems. They don’t have problems pronouncing words or forming sentences.
Don’t have any difficulty understanding language.
Have a normal functioning vocabulary.
Are not less intelligent than other people.

Children and adults with SCD struggle with communication in social situations. Some refer to it as pragmatic language impairment since it involves difficulty using pragmatic language. Those with social (pragmatic) communication disorder have difficulty interpreting meaning during interactions (verbal and non-verbal).

That can make it challenging for the person to follow social norms of a conversation, such as taking turns to speak. A person with SCD may not greet another person when they meet and directly jump into a speech. They may appear to be monologuing, or they may interrupt a speaker repeatedly. A person with pragmatic language impairment may also fail to match the tone or style of their speech with varying social contexts.

It is easy to confuse the signs and symptoms of social communication disorder with that of autism spectrum disorder (ASD). Both these disorders have shared traits. However, there are some crucial differences.

SCD and ASD involve difficulty with social communication. Nonetheless, people with ASD have a plethora of other symptoms, such as limited interests and/or compulsive behaviors that impact their social interactions.

Individuals with ASD often become disturbed and irritated when their daily routines are disrupted. They may be hyper-focused on a topic while showing little to no interest in other topics. They may also be hypersensitive to certain sounds and textures.

Social communication disorder is a part of ASD. As a result, autism spectrum disorder and social communication disorder are rarely co-diagnosed. However, those with SCD may or may not have other symptoms of ASD. Children or adults diagnosed with SCD only have challenges concerning their social skills.

Little is known about the prevalence of social communication disorder since its official addition to the DSM-5 in 2013. Before 2013, it was known as pragmatic language impairment and did not have properly defined diagnostic criteria.

A study conducted in 2019 found that almost 7-8% of 1335 kindergarteners observed showed signs of pragmatic language impairment. The same study also showed that boys are more likely than girls to be diagnosed with pragmatic language impairment.

Children learn the cues of social communication gradually and progressively. However, there are a few social communication milestones children should exhibit depending on their age. A child's exposure to language, interactions, and culture profoundly impacts these milestones.

0 To 12-Months

A child between 0 and 12-months old should exhibit the following social communication skills –

They should look at human faces. They can make eye contact and follow the direction of your gaze. They may even listen when you speak, especially if you are a parent or caregiver.
They should be able to tell the difference between the tones of voices. For example, happy, angry, or sad.
They attempt to take turns in vocalizations when interacting with adults.
They can demonstrate joint attention. The child should share your gaze and try to focus on the person or object you are looking at.
A child closer to their first birthday should be able to use simple gestures to communicate. For example - tugging at your fingers for food.
They should also be able to participate in simple games of peek-a-boo.

12 To 18-Months Old

A child older than 1-year should gradually acquire and exhibit more social communication skills. For example –

They can make requests by gesturing or vocalizing.
They learn and say "hi" and "bye."
They begin to replace gestures with vocalizations and spoken language.
A child older than 12-months can make eye contact in response to spoken language.
They can demonstrate emotions such as empathy and sympathy.
As a child grows older, they can change the pitch, volume, and tone of their voice to express happiness, sadness, surprise, and fear.

18 To 24-Months

A child between the ages of 18-months and 2-years should already be acquiring spoken language rapidly. You can refer to this speech checklist to see if your child is advancing at par with their peers.

Your child should be using single words and short phrases to make requests, gain attention, and express their needs.
The child should also be able to use different pronouns such as I, me, you, and my.
A child closer to 24-months should be able to show signs that they can stay on topic while communicating.
They can also take turns while talking.

24 To 36-Months

When a child is close to 3-years (360-months), around 75% of their speech should be understood by strangers. Therefore, you can expect them to acquire social conversation skills rapidly.

A toddler should be able to engage in short conversations and stay on topic.
They can introduce and change the subject of discussion during a conversation.
They can ask for meanings and clarifications if they don’t understand a part of the conversation.
A toddler can take turns to communicate and interrupt minimally.
They can relate a conversation or dialog to their own experience and add to the conversation.

3 To 5 –Years

Preschoolers should have a rich and rapidly expanding vocabulary that they use during conversations.

They should be able to start, hold and stop a conversation.
They learn to use filler words such as "okay" and "yeah" to acknowledge other speakers.
A preschooler should be able to use language to describe a dream, fantasy, or tell a joke.
They can tell a simple story or narrate an experience.

School-Age

School-aged children often exhibit competitive social conversation skills. By 6-years of age, your child should be able to correctly pronounce almost all common words. Strangers should understand 100% of their speech. They should be able to use newly learned words during conversations.

By the time a child is 6-years-old, they can read body language and expressions; they can also predict how the speaker is feeling.
They have the power to empathize and understand another person’s perspective.
A school-aged child demonstrates strong social conversation skills such as holding eye contact, staying on topic and taking turns during a discussion.
They should be able to ask questions and make observations during a conversation.
The school-aged child can use complex language to persuade the listener and express and support their opinion.

Social communication skills will vary according to the child's age and environment. However, there are a few telltale signs that do not waver irrespective of the language, interactions, culture, and environment of a child.

They may face persistent trouble with verbal and non-verbal communication without any signs of low cognitive ability or developmental delay.
Difficulty in the acquisition of spoken and written language to express themselves is a defining symptom of social communication disorder in toddlers.
They have difficulties understanding whatever is not explicitly stated during a conversation (references and inferences).
They may put forth inappropriate responses during a conversation.
Children with SCD have difficulty understanding idioms, metaphors, humor, and meanings that depend on context.

These deficits take a toll on effective communication and social participation. These symptoms should be present from the early developmental period, but they may not be observable until social communication becomes more demanding.

Most importantly, the symptoms should not be better explainable by other medical conditions, developmental delays, autism spectrum disorder, or intellectual disability.

There is no established cause of social communication disorder. There is limited research on the condition. However, studies show that children with a family history of autism spectrum disorder (ASD), learning disabilities, and global developmental delay are at a higher risk of SCD.

Social communication disorders are often present with other disorders such as ADHD, delayed speech, and intellectual development disorder.

The initial symptoms of social communication disorder (SCD) are evident during the early stages of development. Some children may begin showing the signs during their infancy. For example, some toddlers with social communication disorder may not use gestures, vocalizations, or eye contact.

For a formal diagnosis of social communication disorder, children should be using spoken language. Therefore, children often receive their first SCD diagnosis at around 4 to 5-years of age.

The evaluation and assessment of the child's speech and underlying symptoms should be conducted by a certified speech-language pathologist (SLP). They will use multiple diagnostic tools and social communication disorder tests to determine the validity of the diagnosis. During an assessment, you can expect the SLP to –

Ask about your family history of speech and language disorders, ADHD, ASD, and developmental disorders.
Ask for a thorough medical history of your child and enquire about other disorders they may have.
Interact with your child directly and observe them in several situations.
Run a wide array of diagnostic tests to measure their language and communication skills.
Use multiple questionnaires that can measure the aspects of language proficiency in children.

During these appointments, the speech therapist will try to rule out other possible diagnoses that may better explain your child’s symptoms.

Speech-language therapy remains the main treatment for social communication disorder in adults and children. However, since each individual is different, the SLP crafts a custom therapy plan according to the needs of each client. The SLP will weigh your child’s strengths and weaknesses in social communication before including specific activities and exercises in speech-language therapy for social communication disorder.

Therapy for SCD typically –

Recognizes the need for involving the individual and their family.
Considers the variations in the societal and cultural values and norms of the client.
Focuses on both short-term and long-term functional outcomes.
Tailors the goal according to the individual’s unique needs in their current environment.

The SLP will use a combination of therapy methods that can improve your child’s functional communication skills. Some of the more common examples include –

Augmentative and Alternative Communication

Augmentative and alternative communication (AAC) methods supplements and compensates for the impairments in social communication skills if the symptoms are particularly severe. The SLP teaches the individual to use assistive technology such as tablets, iPads, smartphones, picture boards, gestures, and sign languages to communicate.

Video Modeling

The SLP uses video recordings of target or model behavior to teach individuals how to act or react during particular social situations. It is ideal for older children, adolescents, and adults.

Role-Playing

The SLP can assume the role of a teacher, friend, ice-cream vendor, or cafeteria worker to prompt different conversations. It can help the child with SCD learn different ways to communicate with various people in life.

Peer-Mediated Interventions

The SLP will speak with the parents and/or friends of the individual with SCD; the SLP will teach them techniques/strategies to facilitate social interactions with children with social communication disorder.

Scripted Responses

The SLP can create scripts for the children to practice and re-enact during social conversations.

The speech and language therapy for SCD primarily focuses on social pragmatics, conversational skills, and non-verbal communications.

Parents and caregivers play a crucial role in the development and reinforcement of a child’s communication skills. Since a child spends most of their waking hours around and with parents/caregivers, you are the best person to help improve their social communication skills.

Your SLP should help you learn new strategies, activities, and exercises that you can continue at home to boost your child's social communication. Here are some suggestions from our SLPs which may help your child in the long run –

Greetings

Always say "hi," "good morning," "good night," and "bye" at appropriate times to your child. Greet others in front of your child. Accompany these greetings with gestures like waving while talking to your child.

Read to them

Set aside a fixed time to read to your child. While reading, ask open-ended questions such as “Why do you think X is angry?” or “What do you think the prince looks like?”

Take Turns While Talking

Use a prop like a ball or a cushion as a talking pass. Whoever has the cushion or ball gets the chance to talk. If the other person wants to talk, they have to wait for the cushion or ball.

Role-Play

During game-time, pretend to play the role of a postman, teacher, ice cream truck driver, or friend. Hold conversations with your child while playing these roles. Use different voices and makeup to make things fun for both of you!

Tell Stories

Narrate simple stories that your child knows, or talk about a sportsman or a cartoon character both of you like. However, leave out small details and see if your child can recognize the story or character. Encourage your child to tell a story and ask questions about the characters and/or places they mention.

Use Non-Verbal Cues

Offer non-verbal cues like a gesture, expression or sign, and ask your child what they mean. Make sure your child is already familiar with those.

Stamurai offers online speech therapy for social communication disorder (SCD). The team will match your needs with a certified speech and language therapist.

The SLP will evaluate and assess the symptoms of SCD in your child before working out a plan to treat the symptoms. They will ask you and your child quite a few questions and observe your child as they talk to you and the therapist.

The course of therapy will depend upon your child's age and their ability to interact with the SLP via video chat.

Ages 0 To 3-Years

The SLP will work with the parents of very young children directly. You can learn new techniques and activities that you can continue at home with your child to improve their social communication skills. You will report to the SLP directly.

Ages 3 To 6-Years

Parents should attend the video sessions alongside their children to learn different strategies and exercises the SLPs use for enhancing the child's social communication. Reinforce these exercises for social communication disorder in children outside the session to promote at-home skill-building.

Ages 7 Years And Above

Older children can attend online speech therapy sessions for social communication disorder on their own. However, parents can speak to the SLP, get detailed progress reports, and offer feedback.

Adults

Adults typically attend the video sessions with their SLP alone. However, you can always bring your family or loved ones to sit in during the sessions with you.