Social Pragmatic Communication Disorder
Social Pragmatic Communication Disorder (SPCD) is a new addition to the latest version of the Diagnosis and Statistical Manual of Mental Disorders 5th edition, which was released in 2013. It does not have a known cause, but is suspected to be a neurodevelopmental disorder.
SPCD is characterized by impairments in pragmatic language; which consist of verbal and nonverbal language skills used in daily interactions, and are important for communicating one’s ideas, thoughts, and feelings. It is theorized that SPCD may be possibly due to malfunctioning of a person’s right brain hemisphere, making it difficult to process verbal and visual information simultaneously.
For someone to be diagnosed with SPCD, symptoms must be present in early childhood. Symptoms of SPCD may not even be evident until a child start school, but some may exhibit a delay in language development, and display little to no interest in social situations. Unfortunately, it is quite possible that parents and doctors may not realize the symptoms until many years later.
Individuals diagnosed with this disorder are not hindered in grammar, word structure, or cognitive abilities, but experience difficulties with applying language in social situations and grasping reciprocal communication. It is hard for them to grasp social concepts, such as turn taking in conversations. Consequently, they may “monopolize” or engage in a one-sided conversation. Others may hesitate or struggle to communicate their needs due to a lack of understanding.
Individuals with SPCD struggle to adapt their language to different people or situations, and they may say inappropriate, interruptive, and unrelated things during conversations. In other words, they may speak the same way to an adult as they do to a friend, or they may speak like they do outside on the playground as they do in a classroom. They lack an ability to make inferences, understand sarcasm or riddles, or have trouble with nonverbal gestures, such as facial expressions or hand gestures. Additionally, persons with SPCD may have difficulty with storytelling, as well as knowing how or when to use verbal and nonverbal signs when signaling communication.
Other disorders that can possibly be associated with social pragmatic communication disorder include autism, ADHD, or even reading problems. Previously, many medical professionals would diagnose children with SPCD with autism because weak social communication skills are one of the main signs of autism. However, new studies have shown that some children with SPCD symptoms do not have other symptoms of autism. According to the American Psychiatric Association, children who fall into this category should be diagnosed with SPCD, not autism. Ultimately, an evaluation of autism must be ruled out before a child can be diagnosed with SPCD. The diagnosis of SPCD can be difficult because of how the symptoms overlap with autism, or other developmental issues.
While a specific cure for SPCD is not known, there are various evidence based treatments for it. Many medical centers have speech language pathologists who can work with parents and teachers to help children’s social communication skills improve. Children with SPCD need professional help in learning proper pragmatic language skills because such social skills do not occur for them automatically. Putting a child with SPCD into demanding social situations can lead to the child to encounter bullying, like teasing. This not only does nothing to help the child, and causes them emotional distress.
A thorough plan can be devised to help children suffering from SPCD. For example, children can go through social skills training to teach them needed skills they can use to interact with other people in social situations. They can also go through cognitive behavioral therapy to help minimize any anxiety and uncomfortable emotions they may have. Additionally, there are support and training classes for parents with children who have SPCD. Not only should children with SPCD have professional help, but they also should have help at home. When reading books at home parents can ask their children questions about the stories they are reading. By forcing the child to reflect on what they have read they can learn to make inferences and improve their comprehension skills. It is also important for parents to make eye contact with a child affected by SPCD.
Parents can discuss the correct way to ask for something, or why asking for something politely is more effective than being rude. It is also recommended by professionals that the child is praised for their successes to promote positive changes.
SPCD can cause social, emotional, and learning problems. A child’s everyday life can be affected if nothing is done to help them. It is crucial that these children get the professional help they need in developing their social interaction skills. Knowing a child’s problem is the first step in getting the help they may need. It is important for parents to talk to their child’s doctor if they have any concerns or assumptions. Finally, it is important for parents with children who have social pragmatic communication disorder realize they are not alone. There are many online communities with other parents dealing with the same challenges.