Social (Pragmatic) Communication Disorder: A Quick Guide

Effective communication is a vital skill that allows us to express ourselves, build relationships, and succeed in our personal and professional lives. But for some, communicating appropriately in social contexts can be a significant challenge. SPCD is a complex and under-recognized condition that affects a person’s ability to use language effectively.

In this comprehensive guide, we will take a look at...

  • the symptoms, causes, and diagnosis of SPCD,
  • interventions and treatment options, and
  • coping strategies for people with SPCD.
Let’s dive in.
Social (Pragmatic) Communication Disorder_ A Quick Guide

The Basics Of SPCD

Social (pragmatic) communication disorder (SPCD) is a neurodevelopmental disorder that basically affects a person’s ability to use verbal and non-verbal communication for social purposes. It can manifest in pragmatic deficits, such as: difficulty initiating and maintaining conversations, using inappropriate tone of voice, or struggling to understand jokes, sarcasm, irony, and figurative language.


The prevalence of SPCD in the general population is not well established. However, studies have suggested that it may affect up to 7.5% of school-age children.

SPCD is more common in males than females, with a male-to-female ratio of approximately 3:1. It is also more prevalent in individuals with other neurodevelopmental disorders, such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD).

SPCD and Autism

SPCD and Autism Spectrum Disorder (ASD) share similarities in social communication difficulties. However, they are two distinct conditions. SPCD is a standalone diagnosis that specifies the absence of the repetitive patterns of behavior and intense fixations that are characteristic of ASD. SPCD symptoms are typically less severe than those experienced by children with Autism Spectrum Disorder, who may have more pronounced difficulties in social communication and other areas of development. While children with SPCD may be at an increased risk of developing other developmental disorders, understanding these differences can help ensure accurate diagnosis and appropriate interventions.


Research suggests that up to 50% of individuals with ADHD may also have communication difficulties similar to those seen in SPCD. However, in ADHD, these difficulties are often related to impulsivity, hyperactivity, and distractibility rather than a specific impairment in social communication. Children with SPCD can struggle to understand the nuances of language while those with ADHD may be more likely to make careless mistakes due to a lack of focus. Although SPCD and ADHD can co-occur in some individuals, they are two separate diagnoses with different diagnostic criteria and treatment approaches.

Causes & Risk Factors

The causes of SPCD are not fully understood, but a number of factors may contribute to its development. These include genetic predisposition, neurological differences, and environmental influences. Developmental delays or other social communication disorders can also increase a person’s risk for developing SPCD. Traumatic events such as abuse or neglect can lead to difficulties in social communication.

Typical Characteristics of SPCD

The symptoms of SPCD can be divided into four main categories.

1) Problems with using appropriate language:

    • Using words that are too formal, too informal, or not appropriate for the situation

2) Problems with nonverbal communication:

    • Struggling with the use and interpretation of body language, facial expressions, and tone of voice
    • Difficulty interpreting implied meanings, sarcasm, or humor
    • Difficulty making eye contact

3) Problems with their conversational skills:

    • Challenges with initiating and maintaining conversations, or ending them appropriately
    • Difficulty understanding when it is their turn to talk or when to ask questions

4) Problems with social rules and conventions

    • Struggling to understand the social context of a situation
    • Difficulty understanding social hierarchies, such as who has authority in a given situation

Long-Term Effects of Persistent Pragmatic Language Difficulties

Persistent difficulties in pragmatic language development can have long-term effects on a person’s ability to navigate social relationships. They could struggle to make friends, form meaningful bonds, or maintain relationships over time. This could lead to feelings of isolation and frustration. If not addressed in a timely manner, these issues can continue into adulthood, having a negative impact on both professional and personal relationships.

Early intervention is key when it comes to improving long-term outcomes for those with pragmatic language impairments.

Diagnosis & Assessment

Diagnosing SPCD requires a thorough evaluation by a qualified healthcare professional, such as a Speech-Language Pathologist (SLP) or a psychologist. The evaluation typically includes a review of the child’s developmental and medical history, as well as a thorough assessment of their language and social skills. It is also important to rule out other potential causes of social communication deficits, such as hearing loss or intellectual disability.

The DSM-5 diagnostic criteria for SPCD include the following:

    • Persistent difficulties in the social use of verbal and nonverbal communication in social contexts
    • Deficits that interfere with communication, academic achievement, or occupational performance
    • Onset of symptoms in the early developmental period
    • Symptoms not better explained by another neurodevelopmental disorder, such as ASD or ADHD

Once diagnosed, the SLP can develop an appropriate treatment plan to address any identified deficits in order to target the child’s individual needs.

Interventions and Treatment Options for SPCD

Interventions and Treatment Options for SPCD

Treatment for SPCD typically involves a multidisciplinary approach and can vary based on the child’s needs and their specific communication difficulties. Some common interventions include:

Speech-language therapy
Speech therapy is an effective way to improve social communication skills for those with SPCD. It can help the child better understand and use language in social settings using a variety of approaches, such as exercises, role-playing, and video modeling. Speech therapists also focus on improving the child’s understanding of nonverbal communication, such as facial expressions and tone of voice. The goal is to help them develop strategies for initiating conversations, staying on topic, and using appropriate language in various social settings.
Social skills training
Social skills training is an effective intervention to help the child learn how to interact appropriately with peers and adults in various settings. This type of training uses role-playing activities and other techniques to help children understand the expectations of different social situations. Social coaching helps by providing feedback and strategies for real-life situations.
Cognitive Behavioral Therapy (CBT)
CBT is a form of psychotherapy that can help the child identify and modify negative thoughts and behaviors affecting their social communication. It involves identifying triggers for certain behaviors and modifying them to create positive outcomes in social interactions. It may involve practicing real-life social situations in a safe environment to improve the child’s confidence.
Occupational therapy
Occupational therapists can help children develop strategies for managing sensory processing issues that can interfere with successful communication in social situations. They may also provide guidance on how to use assistive technology devices or other tools that can make communication easier for those with SPCD.

Collaboration with family members, teachers, and peers can help support children with SPCD. Family members and teachers can help practice their skills in everyday situations, while peers can provide social support and opportunities for social interaction.

Benefits of Early Intervention on Pragmatic Language Development

Early intervention programs are essential for improving long-term outcomes. When children receive early intervention, they have a greater chance of improving their social communication skills, which can lead to better outcomes in academic and social settings.

Here are additional benefits in the long run:

    • Prevention of negative behaviors and outcomes resulting from poor social communication skills,
    • Development of stronger relationships with peers and family members,
    • Prevention of social isolation and loneliness,
    • Improved quality of life,
    • Increased confidence and self-esteem in social settings, and
    • Greater success in future employment opportunities.

With the right support system in place, children affected by SPCD can learn the necessary pragmatic language skills for successful communication in everyday life and reach their full potential.

Strategies for Improving Pragmatic Skills at Home

Strategies for Improving Pragmatic Skills at Home

Living with SPCD can be challenging, but there are several coping strategies that parents and caregivers can use to help improve pragmatic skills at home.

Here are some examples:

    1. Encourage social interactions: Encourage your child to interact with others as much as possible, and provide opportunities for them to do so. This could include playdates with friends, joining clubs or activities, or participating in community events.
    2. Practice social communication: Use everyday situations to practice social communication skills with your child. For example, ask them to greet a new person, make eye contact, or ask and answer questions in conversations.
    3. Use visual aids: Use pictures or videos to help your child understand and recognize different emotions, facial expressions, and body language. This can help them understand and respond appropriately in social situations.
    4. Provide feedback: Provide constructive feedback to your child about their social communication skills. This can help them understand what they are doing well and what they need to work on.
    5. Model appropriate behavior: Model appropriate social communication behavior for your child. For example, use polite language, make eye contact, and use appropriate tone of voice when speaking with others.
    6. Use social stories: Create social stories that teach your child how to respond appropriately in social situations. Social stories are short, illustrated narratives that teach specific social skills or behaviors.
    7. Play games: Play games that encourage social interaction, such as board games or role-playing games. This can help your child learn how to take turns, share, and communicate effectively with others.

Overall, these strategies can be effective in improving the child’s pragmatic abilities in the comfort of their own homes. By practicing regularly, providing constructive feedback, and developing a solid support system at home, parents and caregivers can help boost the child’s confidence and improve their pragmatic language skills.

If you think that your child is displaying early signs of SPCD, apply for a consultation with one of our licensed Speech-Language Pathologists. Early detection and intervention are important to help your child navigate social situations effectively and lead a fulfilling life.

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Lauren Templeton - Apheleia Speech Therapy
Lauren Templeton

Owner & Speech-Language Pathologist

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