Have you ever met a person who finds it difficult to talk to others? Maybe they find grasping the rules of spoken communication particularly challenging.

You may have met someone who keeps interrupting a conversation or veers off topic.

These are potential signs that the person has social communication disorder (SCD). This condition makes it difficult for individuals to understand and follow the general rules of communication.

It is NOT a speech and language disorder. These individuals can pronounce words and use the correct grammar.

Typical social communication skills include the ability of a person to vary how they speak in different situations. They can also consider others' perspectives and correctly use language syntax, vocabulary, and phonology.

Social communication is necessary for comprehension and expression in both spoken and written forms of language.

What Are the Symptoms of Social Communication Disorder (SCD)?

Individuals with SCD have trouble communicating in everyday social situations. The signs and symptoms of social communication disorder may vary between two individuals.

Here are some of the common signs of social communication disorder –

• They don't understand sarcasm and maybe overly literal.
• Individuals with SCD may not provide background information to unfamiliar people when talking.
• They may have trouble understanding meanings that are not stated but implied in a conversation.
• People with SCD may have difficulty following facial expressions and social cues.
• They may fail to use proper greetings.
• Individuals with SCD may face difficulty in understanding and narrating stories.
• They may not be able to use verbal and non-verbal gestures.
• Often, individuals with SCD have problems maintaining close friendships.

These signs of social communication disorder may occur irrespective of the age of the individual in question.

However, young children may have some delays in achieving social communication milestones, such as using gestures and sounds to greet their peers. They may even show reluctance in pursuing social interaction.

Typically, the signs of social communication disorder typically show up early, but teachers and parents may have trouble recognizing them. The diagnosis of this condition is often delayed due to the lack of understanding of these behaviors as potential signs of a communication disorder.

What Causes Social Communication Disorder (SCD)?

The causes of social communication disorder are not clear. Researchers have not yet identified the factors that cause social communication disorder. However, several studies show that it occurs with other developmental disorders and conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), developmental disabilities, traumatic brain injury, aphasia, spoken and written language disorders, and learning disorders.

Social communication problems are a defining feature of autism spectrum disorder (ASD). Along with SCD, an individual with ASD may also exhibit restricted-repetitive behaviors.

You must remember that social communication disorder has no relation with the intelligence of a person. Most people who have SCD may face challenges at school and work, but, generally they are as intelligent and capable as those without the disorder.

How Is Social Communication Disorder Diagnosed?

Diagnosis of social communication disorder depends on several rounds of screening for speech and language problems, auditory challenges, comorbidities, and physiological conditions.

1. Speech and Language

Screening of SCD is a part of speech and language evaluation for any individual at risk of communication disorders.

The screening process typically depends upon competency-based tools such as personal interviews, observations, and self-report questionnaires.

The speech-language pathologist should also consult the parents, teachers, and other caregivers.

2. Hearing

The parents of a child with a possible social communication disorder (SCD) should consult an ENT (ear-nose-throat doctor) to rule out auditory problems. Loss of hearing can be a potential cause of social communication deficits in children.

If the individual wears hearing aids an audiologist must inspect them, and ensure that the hearing aids are working.

Loss of hearing or malfunctioning of one’s hearing aid can create symptoms that may mimic a communication disorder.

3. Comprehensive Assessment

The speech-language pathologist (SLP) may refer the individual for a thorough speech and language assessment if they have reason to believe that a person has social communication disorder after their preliminary screening.

In case the individual has a coexisting condition, then the SLP is responsible for determining the overlapping signs and symptoms. It is also the responsibility of the SLP to conduct the assessment of the individual in question in a culturally sensitive manner.

The assessment should involve the individual's parents, teachers, and psychologists. The SLP should consult other professionals, such as special educators and audiologists when necessary.

The comprehensive assessment should also include the following –

• Family history of speech and language pathologies.
• Impairments of body structure and functions, including anomalies of the person’s articulators.
• Notes on contextual factors that may serve as hindrances to the proper development of social communication skills.
• The effect of the communication impairments on the person’s quality of life.
• Existence of co-morbidities and co-existing conditions.

More specifically, an SLP assesses the person’s –

• Ability to engage in successful verbal and non-verbal communication.
• Comprehensive and interpretive abilities.
• Ability to begin and sustain a conversation.
• The capability of manipulating and navigating topics of conversations.
• Skills of understanding verbal and nonverbal cues in social, academic, and community settings.
• Aptitude for catching and following figurative or ambiguous language in conversations.
• Ability to form friendships and relationships based on their communication skills.

An SLP may use traditional and informal tools to assess the person's social skills. They may give the person tasks appropriate for their age to understand how the child may react in real-world situations.

The assessment is necessary for –

• The diagnosis of social communication disorder
• Understanding the severity of the disorder
• Describing the characteristics of SCD
• Depicting how social communication disorder affects the person’s social and personal wellbeing
• Outlining the possible treatment and interventions that improve the prognosis

What Is the Treatment for Social Communication Disorder (SCD)?

Early diagnosis and treatment improve the prognosis of social communication disorder. Speech-language therapy plays a significant role in the treatment of kids with SCD.

Intervention for social communication disorder should –

• Emphasize the strengths and address the weaknesses concerning the disorder.
• Improve the person's social skills that allow them to participate in social interactions and form social relationships.
• Address and change the factors that act as hindrances to successful communication and participation.

While chalking out the treatment plan, the SLP should involve the family members, consider the preference and need of the client, focus on the functional outcomes, and tailor the goals according to the individual's potentials.

The SLP may implement one or more treatment strategies depending on the individual’s needs. Here are some available treatment options for those diagnosed with SCD –

1. Behavioral Interventions

Behavior modification techniques can change existing behavior as well as teach new behavior to children and adults. Behavioral interventions depend upon the principles of learning including social skills (desired behavior) through operant conditioning.

Behavioral approaches are particularly effective in teaching desired social skills in one-on-one or naturalistic settings. Sessions may include just the client, their friends, or family members depending upon the context.

2. Peer-Mediated Interventions

Peer-mediated interventions are typically efficient if the client is a little older and the peers are of age to take responsibility.

In peer-mediated interventions, the SLP teaches different strategies to modify the social skills of the person.

In a manner similar to the Lidcombe Program, peer-mediated interventions may also involve parents and other immediate care providers. The SLP instructs them to facilitate play therapy and social interactions with children diagnosed with social communication disorder.

Various Modalities for the Treatment of Social Communication Disorder

SLPs may choose one of the multiple treatment modalities for social communication disorder. Currently, the most popular treatment modalities include –

1. Augmentative and Alternative Communication (AAC)

Children with SCD may utilize augmentative and alternative communication (AAC) methods for replacing or supplementing natural speech with various symbols. These may be in the form of picture cards, manual signs, gestures, and line drawings.

2. Computer-Based Methods

Individuals with SCD may utilize computer technology like iPads and specialized software programs to communicate. The SLP may use the same technology to teach the children the necessary language and social skills. Children can develop social skills, social understanding, and social problem solving using computer-based methods.

3. Video-Based Instructions

The SLP may choose video modeling to provide a “model behavior” that children can emulate. This form of teaching uses video recordings of desired behaviors.

Older children may respond to self-modeling techniques similar to the ones used in stuttering treatment.

Children may receive therapy for SCD in multiple possible settings. You may choose a one-on-one clinical setup for your child to interact with their SLP.  Your child may also receive treatment from school/district-employed speech-language pathologists (SLPs).

It is not necessary for all kids with SCD to participate in special education programs. However, those with autism and/or ADHD may benefit from the attention of a special educator.

What more should you know about SCD?

It isn’t possible for children to overcome social communication disorder without professional help and guidance.

If you suspect that your child has trouble communicating or using language in social contexts, then you should reach out to a SLP as soon as possible.