A child may be able to say words accurately and be able to use long, complex sentences and still have a communication disorder. A social communication disorder, or a disorder of pragmatic language, is evident when a child has difficulty using language socially.

Children with social communication disorder exhibit persistent difficulties in the social use of verbal and nonverbal communication. The social challenges of these children results in functional limitations in effective communication, social participation, and relationships. The onset of social communication disorder happens in the early developmental period but may not be manifest until the demands of the social environment exceed the child’s social capacity.

Language is used socially for different functions such as requesting, greeting, commenting, and demanding. We also use language flexibly, whether for different audiences (speaking to a baby vs. an adult), in different contexts (giving more information to an unfamiliar listener than a friend), and in different locations (using different language in the classroom and on the playground). Additionally, there are different rules for language use that are socially acceptable within a culture and setting, such as turn taking, introducing a topic, entering a conversation that is already ongoing, changing the topic of a conversation, understanding verbal and non-verbal cues, and how close to stand to a conversation partner.

Characteristics of social communication disorder include:

• Difficulties using communication for social purposes, such as greeting and sharing information, in a socially appropriate manner.
• Impairment of the ability to adapt communication to match context or the needs of the listener. Examples include speaking differently in a classroom than on the playground, talking differently to a child than to an adult, and avoiding using overly formal language.
• Difficulties following rules for conversation and storytelling. Examples include taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.
• Difficulties understanding what is not explicitly stated (e.g., making inferences) and non-literal or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation) (American Psychiatric Association, 2013).

How do I know if my child has a social communication disorder?

All children have difficulty with some isolated aspects of the social use of language as they learn they learn the social norms of their family, their culture, and their social structure. However, if a child has frequent difficulty with the social use of language and if the types of errors seem inappropriate for the child’s age, it is possible that the child has a social communication, or pragmatic language, disorder.

An assessment conducted by a speech therapist can determine whether or not your child’s social communication ability is on par with same age peers. The assessment process will look at all aspects of social communication including non-verbal and non-literal language, to help determine if treatment services are warranted to best meet the needs of your child.

How can social communication therapy help?

To assist children with social communication disorders, clinicians often use a combination of teaching specific rules of social engagement along with practicing those rules in real-life situations. Therapy can happen in individual sessions, group sessions, or a combination of both individual and group sessions.  Addressing these skills typically requires peers, and social communication groups are a great way to teach and practice these skills. Strong social interaction skills mean: more meaningful relationships, greater happiness and self-esteem, greater social acceptance, greater desire to participate in social situations, and less anxiety (Cardon & Wilcox, 2011).

What can I do to help my child?

Attend therapy sessions with your child to become familiar with the concepts being developed and the verbal and visual cues the clinician is using to help support your child’s social language development. As you partner with the clinician, as a team you can determine what will be most helpful for your child and how to best support your child across all social contexts.

Resources

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Publishing.

Cardon, T. & Wilcox, M.J. (2011). Promoting imitation in young children with autism: A comparison of reciprocal imitation training and video modeling. Journal of Autism and Developmental Disabilities, 41, 5, 654-677.