Social Pragmatic Communication Disorder
Social pragmatic communication disorder (SPCD) is a disorder that is characterized by difficulties using verbal and non-verbal communication skills appropriately. SPCD is usually recognized in early childhood, after language skills have been somewhat developed, but can be seen into adolescence. SPCD was introduced in 2013 after some heated debate as to its origins and its effects. Many researchers have argued that SPCD is an offshoot of autism spectrum disorder (ASD), while others insist that it should be its own diagnosis. SPCD has been classified as a disorder that affects communication but does not share some of the symptoms of ASD such as repetitive behaviors or other learning delays. Symptoms of SPCD are sometimes difficult to diagnose. Cultural difference in communication styles, and ruling out other possible reasons for communication issues can be challenging. However, a mental health professional or a speech and language pathologist will be able to assess a child’s communication abilities and make the appropriate diagnosis. Research in the field of communication disorders has become more prevalent in recent years, but currently, there is no known cause for SPCD. Most professionals do agree that it is the result of a neurodevelopmental disorder.
Difficulty greeting others.
Difficulty sharing information in the appropriate social context.
Difficulty understanding or following basic rules of conversation such as taking turns or active listening (uh-huh, ok, wow, then what?)
Expressing nonverbal communication such as looking at the speaker.
Difficulty understanding humor, sarcasm, metaphors.
Difficulty changing communication style based on the environment, such as no concept of indoor voice, no understanding that communication at the dinner table is different than communication with friends at school, speaking to unfamiliar adults, vs. speaking to relatives.
Difficulty interpreting or inferring statements.
Only understanding the literal meaning of words.
No understanding of social or environmental context when speaking at home, at a restaurant, on the playground, adults vs. peers.
Access to treatment early on yields the best results. Treatment of SPCD is often done through behavioral therapy, speech therapy, and parental support. Behavioral therapy models and reinforces skills such as greeting someone, using manners, nonverbally engaging with the speaker, talking about relevant information, reciprocating ideas with another, active listening. Behavioral therapy relies on rewarding positive behavior until it becomes second nature. So, if a child says “hi, how are you today” to a friend and waits for a response, they would be rewarded with praise (or a treat), thus encouraging the child to continue the behavior. Correcting behaviors over and over again can help a child learn how to speak to others in an appropriate social and environmental context. A speech therapist would be able to work with a child one-on-one to develop the skills necessary to understand the context of words. Learning the meaning of humor, inferences, and metaphors can be addressed through role-playing and games. Helping parents fully understand SPCD and how to support behavioral intervention is valuable. Consistency at home will be key in making sure the appropriate learned behaviors are reinforced. Keeping a progress / token economy chart on the fridge, praising every appropriate interaction and correcting inappropriate communications will help keep your child on track.
Diagnosis of SPCD can often be a long and difficult task. Prepare and be patient.
Most schools will be able to provide a speech therapist. Talk to your child’s school about classroom support.