Social Communication Disorder: Clinical Profile and Intervention Strategies for Speech and Language Therapists

Dilber Kaçar Kütükçü
Abstract

Purpose: Social Communication Disorder (SCD) is a neurodevelopmental condition characterized by persistent difficulties in the social use of verbal and nonverbal communication. These challenges often manifest in areas such as social interaction, pragmatic language use, and language processing. Individuals with SCD may struggle to adapt their communication to different social contexts, interpret nonverbal cues, or understand figurative language, which can significantly impact their social relationships, academic performance, and overall quality of life. The clinical presentation of SCD varies widely, with individuals exhibiting difficulties in areas such as initiating and maintaining conversations, interpreting nonverbal cues, and adapting communication to different social contexts. These challenges often lead to misunderstandings, social isolation, and reduced quality of life, underscoring the importance of early identification and intervention. The recognition of SCD as a distinct diagnostic category in the DSM-5 shows the need to address the unique challenges associated with this condition. The primary aim of this study is to provide a comprehensive overview of SCD, focusing on its definition, clinical presentation, and evidence-based strategies for the assessment and intervention of SCD. Additionally, the study seeks to support speech and language therapists (SLTs) in enhancing their knowledge and understanding of SCD, enabling them to effectively address the unique needs of individuals affected by this disorder.

Method: This study employs a narrative review methodology, synthesizing findings from a wide range of academic sources. A literature review was conducted using PubMed and Google Scholar with search terms including "social communication disorder," "social communication in autism," and "pragmatic language disorder." The review examines current diagnostic criteria, assessment tools, and intervention strategies, organizing the discussion under key thematic headings.

Results: SCD is primarily distinguished from ASD by the absence of restricted and repetitive behaviors, which are a hallmark of ASD. However, the overlap in social communication difficulties between these two conditions may pose significant challenges for differential diagnosis. Similarly, distinguishing SCD from DLD requires careful consideration of the individual's pragmatic language abilities, as SCD is primarily characterized by deficits in the social use of language, whereas DLD often involves structural language impairments. The assessment of SCD necessitates a comprehensive approach that integrates standardized tests, observational methods, and input from multiple sources, including parents, teachers, and other caregivers. Pragmatic language assessments, while essential, are often limited in their ability to capture the dynamic nature of social communication in real-world contexts. The lack of standardized tools for assessing SCD, particularly in Turkish, further complicates the diagnostic process. Many existing assessments are designed for structured testing environments and may not adequately capture the nuances of social communication in naturalistic settings. This highlights the need for the development of more ecologically valid assessment tools that can provide a comprehensive understanding of an individual's social communication abilities. Intervention strategies for SCD emphasize the development of individualized treatment plans that address the specific needs of each individual. Evidence-based programs such as the Social Communication Intervention Project (SCIP) and the Program for the Education and Enrichment of Relational Skills (PEERS) have demonstrated significant improvements in social communication skills among individuals with SCD. These programs incorporate techniques such as role-playing, social stories, and cognitive-behavioral strategies to enhance social understanding and interaction.

Conclusion: SLTs play a critical role in the evaluation and management of SCD. Intervention for SCD requires a multifaceted approach that addresses both the individual's communication skills and the environmental factors that influence their social interactions. Collaboration among professionals, families, and communities is essential to create supportive environments for individuals with SCD.


Keywords

social communication disorder, differential diagnosis, autism spectrum disorder, developmental language disorder


References

Acevedo, B., Aron, E., Pospos, S., & Jessen, D. (2018). The functional highly sensitive brain: A review of the brain circuits underlying sensory processing sensitivity and seemingly related disorders. Philosophical Transactions of the Royal Society B: Biological Sciences, 373(20170161). https://doi.org/10.1098/rstb.2017.0161

Adams, C. (2005). Social communication intervention for school-age children: Rationale and description. Seminars in Speech and Language, 26(3), 181–188. https://doi.org/10.1055/s-2005-917123

Adams, C., Lockton, E., Freed, J., Gaile, J., Earl, G., McBean, K., Nash, M., Green, J., Vail, A., & Law, J. (2012). The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. International journal of language & communication disorders, 47(3), 233–244. https://doi.org/10.1111/j.1460-6984.2011.00146.x

Adams, C., Lockton, E., & Collins, A. (2018). Metapragmatic explicitation and social attribution in social communication disorder and developmental language disorder: A comparative study. Journal of Speech, Language, and Hearing Research, 61(3), 604–618. https://doi.org/10.1044/2017_JSLHR-L-17-0026

Adams, C., Gaile, J., Roddam, H., Baxendale, J., Clitheroe, L., & Emsley, R. (2020). Evaluation of a manualised speech and language therapy programme for children with social communication disorder: the SCIP feasibility study. Pilot and Feasibility Studies, 6(137). https://doi.org/10.1186/s40814-020-00658-2

Adams, C., & Gaile, J. (2020). Evaluation of a parent preference-based outcome measure after intensive communication intervention for children with social (pragmatic) communication disorder and high-functioning autism spectrum disorder. Research in Developmental Disabilities, 105, 103752. https://doi.org/10.1016/j.ridd.2020.103752

Ahmed-Husain, S., & Dunsmuir, S. (2014). An evaluation of the effectiveness of Comic Strip Conversations in promoting the inclusion of young people with autism spectrum disorder in secondary schools. International Journal of Developmental Disabilities, 60(2), 89-108. https://doi.org/10.1179/2047387713Y.0000000025

Aldughaysh, K. S. (2017). The efficacy of digital comic strip conversations to teach empathetic responding to children with autism (Master's thesis, Missouri State University). MSU Graduate Theses, 3107. https://bearworks.missouristate.edu/theses/3107

Alev, G. (2011). Pragmatik Dil Becerileri Envanteri’nin Türkçe Standardizasyon Çalışması (Yüksek Lisans Tezi). Anadolu Üniversitesi, Sağlık Bilimleri Enstitüsü, Eskişehir.

Alkinj, I., Pereira, A., & Santos, P. (2022). The effects of an educational program based on modeling and social stories on improvements in the social skills of students with autism. Heliyon, 8(5), e09289. https://doi.org/10.1016/j.heliyon.2022.e09289