SOCIAL COMMUNICATION DISORDER IS NOT AUTISM AND GAVE ME GREAT LEARNING! By Cathy Cooper
This year I worked with a high school student with a diagnosis of Social Communication Disorder (SCD). I had no idea what this meant for the student, which meant the student unwittingly provided a great learning opportunity for me.
For example, I learned that SCD is characterised primarily by an impairment in pragmatics—the area of linguistics about how meaning is created and interpreted in verbal and nonverbal interactions. Therefore, the student I was working with was not impaired in understanding word structure or grammar, or in general cognitive abilities. They principally had difficulty using language in social situations, such as in greetings and sharing information, as well as in changing speech to fit different social contexts, understanding meaning that is inferred but not plainly stated, and functioning in conversation and storytelling.
I also learned that SCD is a newly defined disorder and has only been listed in the most recent edition of the American Psychiatric Association's (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Previously, anyone with these symptoms was diagnosed with pervasive developmental disorder not otherwise specified, a type of autism spectrum disorder. Unfortunately, inaccurately receiving this diagnosis led to inconsistent treatment and services. People with autism spectrum disorder may have pragmatic communication problems, but they also have other symptoms directly related to gaps in social interactions and behaviour that people with SCD do not.
Thanks to the student I was working with, I learned that someone with a diagnosis of SCD may have a firm grasp of many communication and linguistic skills, but can experience difficulties applying them in the context of certain social situations. People with SCD may respond minimally or abnormally when social overtures are made toward them. They may have difficulty in their ability to comprehend and display comprehension of conversations, discussion and speeches. They may have difficulty in responding appropriately to different social situations.
I realised that due to their SCD symptomology, the student tended to have problems with
- Understanding social context cues
- Understanding emotion cues
- Increasing flexibility through strategies
- Understanding thoughts and intentions of others
- Understanding friendships
The problems associated with SCD affect all types of verbal and nonverbal communication: spoken, written, gesture, and even sign language. I felt saddened to read that there is not yet specific treatment for SCD however felt gladdened that studies undertaken have shown social skills training greatly assists young people navigating adolescence with SCD. With this directly in mind, I suggested this student’s school support the student by:
a. Being aware that social communication problems may cause the student to have a lack of motivation to please teachers. This may cause an “I don’t care” attitude and response.
b. Being aware that the student’s responses to noise and bright light can cause the student to unintentionally react in ways that others can find distracting and annoying.
c. Working with the student’s classmates to help them make sense of the student’s difficulties and in turn promote their tolerance and understanding.
d. Providing peers to role model / tutor social skills.
e. Providing buddies from other classes to increase peer relationships and decrease classmate fatigue.
f. Providing an adult / young adult for the student to talk to in a mentoring role.
I felt happy to find out that the school did take on board my suggestions and happier still that the student (and their parent) reported they were having a more enjoyable time at school! I am very grateful to this student for extending my knowledge in what can be implemented to help create an even playing field in educational attainment for high school students with extra support needs.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Child Matters Institute (2020). Social Communication Disorder Basics. https://childmind.org/guide/social-communication-disorder/
Mandy, W., Wang, R., Lee, I. & Skuse, D. (2017). Evaluating social (pragmatic) communication disorder. Journal of Child Psychology and Psychiatry. 58. 10.1111/jcpp.12785. https://www.researchgate.net/publication/318676827_Evaluating_social_pragmatic_communication_disorder
Timler, G.R. (2018, April 1). Similar … But Very Different. AshaWIRE. https://leader.pubs.asha.org/doi/10.1044/leader.FTR2.23042018.56