Study Guide for Social Pragmatic Communication Disorder
Background
Social (pragmatic) communication disorder, according to the DSM-5, is a mental disorder characterized by individuals having marked challenges with understanding the pragmatic aspects of communication, both in nonverbal and verbal communication. This study guide will aim to equip the learners with the knowledge of the disorder from symptoms, diagnosis, comorbidities, management and treatment, and ethical and education considerations. The study guide for the social (pragmatic) communication disorder is divided into 5 modules. Module 1 will focus on disorder symptoms, signs, prognosis, and development course. Module 2 will focus on diagnostics and differential diagnoses. 
Module 1: Social (pragmatic) communication disorder symptoms, signs, prognosis, and development course.
Signs and Symptoms
- Showing difficulties with communication within social settings or socialization (Flax et al., 2019),
- Inability to suit or adjust communication with context,
- Difficulties in overall use of verbal and nonverbal communication (Swineford et al., 2014),
- Inability to sustain a conversation,
- Difficulties in understanding nonverbal communication or nonliteral meanings in language, including humor, sarcasm, and metaphors (Flax et al., 2019).
- Difficulties comprehending the course of a conversation,
- Difficulties with understanding or maintaining sentence grammar and lexical semantics.
Other signs and symptoms may include:
- Avoiding social interactions,
- Avoiding eye contact,
- Difficulties adhering to instructions,
- Delayed speech development,
- Inability to understand emotions.
Prognosis and Development of Social (Pragmatic) Communication Disorder
- A child may develop normally with sufficient language and communication skills,
- Semantic pragmatic issues can be identified between the ages of 4 and 5 years (Topal et al., 2018).
- Social communication disorder cannot be diagnosed before the age of 4,
- SCD can first be diagnosed as autism spectrum disorder (ASD) however, its development into adult age differs from ASD as it is only characterized by the ability to keep close relationships (Swineford et al., 2014).
Module 2: Social (Pragmatic) Communication Disorder Diagnostics and Differential Diagnoses
Diagnostics and Lab
SCD can be diagnosed through the use of interdisciplinary teams, including:
- Speech-language pathologist (SLP)
- Parents and caregivers,
- Teachers, pediatricians, and psychologists.
Diagnostics focus on the evaluation of communication for social purposes generally and through specialized evaluations.
The link between social communication disorder and other developmental disorders such as autism and Asperger’s syndrome.
Differential Diagnoses
SCD can be confused with autism spectrum disorder (ASD) and other developmental disorders during the diagnosis process as the disorder occurs with other disorders (Hilt & Nussbaum, 2016). The DSM-5 advises differential diagnoses for SCD to focus on the following signs and symptoms in the absence of other developmental delays (Swineford et al., 2014):
- Functional limitations in effective communication,
- Social participation and nature of participation,
- Social relationships,
- Engagement in academic activities in and out of the classroom.
Module 3: Social communication disorder incidences, comorbidities, and considerations related to culture, gender, and age, among other incidence factors.
Incidence
As a newly diagnosed category of mental disorder, the prevalence rate of social communication disorder cannot be readily developed, however:
- Based on the DSM-5 diagnostic guidelines, 7.5% of children globally are prone to pragmatic impairments
- 4 in every 5 children between the ages of 4 and 5 can be diagnosed with SCD,
- The disorder incidents are rare in children aged below 4 years,
- Men have a higher probability of developing social communication disorders as compared to women,
- Some incidences are mild and may not be identified until later during adolescence as social interactions become complex.
Comorbidities
Social communication disorders has been diagnosed alongside other developmental and language disorders including:
- Attention-deficit/hyperactivity disorder (ADHD) (Topal et al., 2018),
- Autism spectrum disorder (ASD),
- Language and speech disorders (Topal et al., 2018),
- Age-specific learning and communication disorders,
- Behavioral disorders and related behavioral difficulties.
Considerations related to culture, gender, and age
- Social communication disorders are common in children aged between 4 and 5 years,
- Lack of therapy can lead to the symptoms manifesting through adolescence to adulthood,
- SCD in adulthood may impact the overall quality of life of the individual,
- Boys are more likely to have communication challenges than girls and, therefore, more likely to seek speech therapy,
- Age is a factor that should also be considered during diagnosis and development interventions,
- Cultural influences and views on the development of speech and communication skills may also influence the perception of social communication disorder and how it is managed,
- Social communication disorder can be related to genetic traits within a family with a history of neurocognitive deficits, intellectual disability, ASD, and other psychiatric and developmental disorders (Swineford et al., 2014).
Module 4: Treatment and management of the social communication disorder: Pharmacological and non-pharmacological treatments and the associated side effects
The intervention and treatment for SCD depend on the specific needs of the patient. It is a new category of mental disorder. Therefore, most treatment approaches and interventions are non-pharmacological.
Pharmacological Treatments
- SCD is a new diagnostic category based on the DSM-5 on mental disorders.
- There lacks specific pharmacological interventions designed for SCD,
- The side effects of the existing pharmacological interventions are not yet established.
Non-pharmacological interventions and treatments
- Psychosocial education and the development of an Individualized Education Plan (IEP) based on the specific communication challenges of the child,
- Specialized speech and language therapies (Gaile & Adams, 2018).
- Family involvement in supporting the patient and creating an environment to promote social communication,
- Making small adjustments in all of the patient’s social settings to encourage social interactions and communication, and practice in real life,
Module 5: Legal, ethical, and pertinent patient education considerations related to social (pragmatic) communication disorder.
Legal and ethical considerations
- All legal and ethical considerations must be made when managing patients with mental and behavioral disorders,
- Specialist, teachers, parents, and caregivers are required to consider the rights of the patients as any other human,
- The selected form of intervention must be able to meet the needs of the child or patient,
- If a child is to undergo any form of therapy, the health professional and others involved must include the consent of the child’s parent,
- All interventions selected for the treatment of a patient or child must be backed with sufficient evidence on efficiency and effectiveness,
- SCD patients have a right to available treatment and intervention options.
Pertinent patient education considerations
- Psychosocial education and Individualized Education Plan (IEP) must be designed on the basis of the child’s communication challenges and needs,
- Social education is required to create awareness of the social communication disorder.
References
Flax, J., Gwin, C., Wilson, S., Fradkin, Y., Buyske, S., & Brzustowicz, L. (2019). Social (pragmatic) communication disorder: Another name for the broad autism phenotype?. Autism, 23(8), 1982-1992.
Gaile, J., & Adams, C. (2018). Metacognition in speech and language therapy for children with social (pragmatic) communication disorders: implications for a theory of therapy. International journal of language & communication disorders, 53(1), 55-69.
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.
Swineford, L. B., Thurm, A., Baird, G., Wetherby, A. M., & Swedo, S. (2014). Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category. Journal of neurodevelopmental disorders, 6(1), 1-8.
Topal, Z., Samurcu, N. D., Taskiran, S., Tufan, A. E., & Semerci, B. (2018). Social communication disorder: A narrative review on current insights. Neuropsychiatric disease and treatment, 14, 2039.
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Question 
Study Guide for Social Pragmatic Communication Disorder
Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.
Areas of importance you should address, but are not limited to, are:
- Signs and symptoms according to the DSM-5
- Differential diagnoses
- Incidence
- Development and course
- Prognosis
- Considerations related to culture, gender, age
- Pharmacological treatments, including any side effects
- Nonpharmacological treatments
- Diagnostics and labs
- Comorbidities
- Legal and ethical considerations
- Pertinent patient education considerations