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Social Communication Disorder (SCD) is a psychiatric condition characterized by deficits in the use of pragmatic language. These pragmatic language deficits primarily affect the way that children relate to peers or communicate needs to adults, and adversely affect the quality of interpersonal interactions. SCD is typically diagnosed in childhood or adolescence. Youths who are diagnosed with SCD show impaired ability to attend to and understand verbal and nonverbal social cues (e.g., figures of speech, puns, intonation, gestures). However, they do not tend to show a semantic, morphological, or grammatical impairment of language.[1]

Areas of Deficit
Children who are diagnosed with SCD show deficits in four areas of spoken and unspoken communication: (1) social, (2) contextual, (3) conversational, and (4) implicit. A child with social communication deficits may communicate using passages of a book, quotes from a movie, song lyrics, or jargon to communicate. The child may have one-sided conversations about the interests of the individual, which may not be interesting to the person to whom he or she is talking. A child with impaired contextual communication would display situational deficits of language. For example, a child might speak to a teacher in the same way he or she would speak to peers, instead of adjusting language in a manner appropriate to the social context. The child may have trouble distinguishing offensive remarks. Conversational communication deficits include difficulty taking turns in conversation, or adjusting language when the child is not understood (conversational repair). Implicit deficits refer to difficulties comprehending symbolic language such as similes, metaphors, and figures of speech.

DSM-5 Criteria
SCD is classified as a communication disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To be diagnosed with SCD, children must meet four criteria surrounding deficits in spoken and unspoken language and communication. For example, children may exhibit the following deficits: Furthermore, the communication deficits shown by children with SCD have the following features:
 * Socially in appropriate greetings, sharing information in a way that is relevant to the situation.
 * Inability to adjust communication to fit the particular group being communicated with, such as children or adults and authority figures.
 * Difficulty following unspoken social rules of communication in storytelling or back and forth conversation (i.e. taking turns).
 * Trouble comprehending implied language such as metaphors and figures of speech.
 * They interfere with the child’s ability to form relationships and communicate to others effectively.
 * They do not meet the diagnostic criteria for Intellectual Disability, Global Developmental Delay, or Autism Spectrum Disorders.
 * They appear early in childhood, but may not become fully evident until the child exhibits difficulty abiding by social expectation.

DSM-IV to DSM-5 Changes
Social Communication Disorder is a new addition to the DSM-5. This diagnosis was added to the newest edition of the DSM to give a diagnostic “home” to children who present with severe social impairment but do not meet other diagnostic criteria for Autism Spectrum Disorder (ASD). Previously, children with social and pragmatic communication deficits were placed in the category of Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS), and received treatment that was inconsistent and sometimes ineffective. Furthermore, a diagnosis of SCD enables children who may not have been eligible for treatment and support to receive the help they need to thrive in social contexts. In ASD, the child may present with social and pragmatic communication deficits, but they exist within the broader context of the autism diagnosis. This larger context includes restricted and repetitive behaviors as well as communication and language deficits. To summarize, this new diagnosis was created to meet the specific needs of individuals with only social and pragmatic communication impairment.

Treatment
Since this is a new disorder, research and empirically supported treatments are still limited. However, a few treatments have been developed to better a child’s interactions with peers, parents, and teachers. Treatment of Social Communication Disorder does not focus on teaching specific behaviors, but rather training children to develop their own strategies to navigate a wide variety of social situations more easily.
 * Play - The Denver Model is a play-based treatment that teaches social communication skills in the context of one-on-one therapy, school interactions with peers, and interactions with parents and teachers.
 * Peer involvement - Therapists will sometimes involve peers to help mediate the development of social skills in a safe space (i.e. the speech-language pathologist’s office). Typically developing peers are taught strategies to involve and include children with social communication deficits.
 * Social Scripts - Children with SCD are given certain scripts to follow for different situations in which social communication is needed.
 * Social Stories (TM) - Use of stories and pictures to illustrate and explain various social situations that a child may encounter on a daily basis. The skills needed to navigate the illustrated social situations are taught through the stories and pictures.