Social Communication Disorder: This Is Our Baby, SLPs! Puzzled by how to treat students with social communication disorder? Use these five concepts to figure it out. School Matters
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School Matters  |   April 01, 2018
Social Communication Disorder: This Is Our Baby, SLPs!
Author Notes
  • Bonnie Brinton, PhD, CCC-SLP, is a professor in the Department of Communication Disorders at Brigham Young University. She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education. bonnie_brinton@byu.edu
    Bonnie Brinton, PhD, CCC-SLP, is a professor in the Department of Communication Disorders at Brigham Young University. She is an affiliate of ASHA Special Interest Group 1, Language Learning and Education. bonnie_brinton@byu.edu×
  • Martin Fujiki, PhD, CCC-SLP, is a professor and chair of the Department of Communication Disorders at Brigham Young University. martin_fujiki@byu.edu
    Martin Fujiki, PhD, CCC-SLP, is a professor and chair of the Department of Communication Disorders at Brigham Young University. martin_fujiki@byu.edu×
Article Information
Language Disorders / Social Communication & Pragmatics Disorders / School Matters
School Matters   |   April 01, 2018
Social Communication Disorder: This Is Our Baby, SLPs!
The ASHA Leader, April 2018, Vol. 23, 38-39. doi:10.1044/leader.SCM.23042018.38
The ASHA Leader, April 2018, Vol. 23, 38-39. doi:10.1044/leader.SCM.23042018.38
Social communication disorder (SCD) is a relatively new diagnostic designation. Given this newness and its similarities with autism spectrum disorder indicators, speech-language pathologists might find diagnosing SCD puzzling.
The Diagnostic and Statistical Manual of the American Psychiatric Assocation (DSM-5) says diagnosis of SCD depends on identifying social-interactional deficits that can’t be totally attributed to poor language structure. With this in mind, SLPs might wonder what role they can play in treating this disorder.
But this is our baby, fellow SLPs! Let’s think about it. We specialize in expressive and receptive language, understand pragmatic language use, and appreciate the social and emotional knowledge making communication possible. Not only do our skills and training in expressive, receptive and pragmatic language prepare us to provide treatment for children with SCD, we are also well-suited to lead an intervention team.
Think about these five concepts, school-based SLPs—or any SLP treating a child diagnosed with SCD—when coordinating and providing treatment for children with this disorder.
Conceptualize social communication. Social communication (SC) is frequently considered synonymous with pragmatics. We prefer Catherine Adams’ view of SC as a more encompassing entity allowing us to share our thoughts, experiences and emotions with others. SC involves three intertwining components: language processing (vocabulary and syntax), pragmatics (conversational management, for example), and social and emotional learning.
Considering SC from this broader perspective keeps us from losing sight of one aspect of communication while we focus on another. A broader perspective provides a better view of a child’s functioning within their social world.

Focusing on the child—rather than the diagnostic category—allows us to pinpoint each child’s strengths and needs in specific areas.

Concentrate on the child, not the label. Even if clear on paper, diagnostic categories often become blurred in practice. Children don’t usually fit neatly within a single category, and astounding variability also exists within each category.
For example, children with SCD commonly demonstrate associated language disorders. Children with autism spectrum disorders might also experience issues with all three components of social communication (language processing, pragmatics, and social and emotional learning), as well as a history of restricted interests or repetitive behaviors. Children with a primary diagnosis of developmental language disorder frequently demonstrate difficulties with pragmatics and with social and emotional learning, such as poor emotional understanding, poor emotional regulation, poor emotional inferencing, and nonresponsiveness.
To complicate matters, we find some behaviors difficult to interpret. A child with SCD or a language impairment might exhibit immature play preferences, which might appear repetitive or restricted in some contexts. Other behaviors can obscure underlying deficits, such as talkativeness that masks problems with comprehension. Focusing on the child—rather than the diagnostic category—allows us to pinpoint each child’s strengths and needs in specific areas. This approach also makes it possible to evaluate how these behaviors intertwine within the broader whole of a child’s social communication.
Aim for authenticity. Children with social communication disorder struggle with the dynamic landscape of social interactions. It’s extremely difficult to “teach” social rules when they vary from context to context and minute to minute. Our best chance at helping children with SCD improve their social communication involves targeting intervention goals that facilitate communication in authentic contexts. Practicing a skill in an authentic context helps a child appreciate what makes certain behaviors appropriate in some instances but not in others.
Determining what is “authentic” for a given child demands some thought, however. We ask the following four questions to gauge the authenticity of treatment procedures:
  1. Is there a real connection formed between the child and another participant? Look for signs of engagement, such as eye contact, reciprocal action, cooperation and shared emotion.

  2. Are the students sharing real information? When participants exchange or discover a perspective they did not know previously, it means they’re sharing real information. This steers us away from rhetorical or meaningless questions and probes.

  3. Could this activity occur in the course of a child’s day? In other words, would this scenario ever actually happen? A wide range of activities to try—for children of different ages—includes conversations, games, book sharing and pretending.

  4. Does the activity require a synergistic use of the social communication components? Set up activities to facilitate the real-life integration of language processing, pragmatics, and social and emotional learning in interaction.

Authentic treatment contexts encourage a child to adjust to accommodate different conversational partners in different situations.

Facilitate flexibility. Children with SCD have difficulty adjusting their contributions in an interaction to meet the needs of others. Authentic treatment contexts encourage a child to adjust to accommodate different conversational partners in different situations. Changing the child’s roles and responsibilities in response to various activities and partners can lessen rigidity and encourage flexibility. For example, if acting out a sociodramatic script, a child can play a different part each time. If participating in a group project, the child can assume a different responsibility each day. If playing group games, the child might take a different role each time.
Stay the course. Children with this disorder probably need repeated exposure and practice with new concepts over an extended period of time. Meaningful change may not come easily. As we find with most students we treat, SLPs have to stay the course in order to facilitate real growth.
Effective social communication demands a complex interation of language processing, pragmatics, and social and emotional knowledge. As SLPs, we know how to address a child’s needs within each of these areas. Even more important, we can guide children with SCD as they learn new abilities to help them succeed academically, establish relationships and become full participants in their communities.
Keep at it SLPs, we are uniquely prepared to help these children!
Learn More About SCD at Schools Connect in July

To find out more about diagnosing and treating social communication disorder, look for Martin Fujiki’s presentation at ASHA Schools Connect, July 20–22, at the Baltimore Convention Center in Baltimore, Maryland. For information and registration, visit www.asha.org/Events/Connect.

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April 2018
Volume 23, Issue 4