Social Pragmatic Communication Disorder versus Autism Spectrum Disorder

By Mark Hutten, M.A.
“What is Social Pragmatic Communication Disorder? And how does it differ from Autism Spectrum Disorder?”

Social Pragmatic Communication Disorder (SCD) is characterized by “a persistent difficulty with verbal and nonverbal communication that can’t be explained by low cognitive ability.” Symptoms include:
  • inappropriate responses in conversation
  • difficulties with academic achievement and occupational performance
  • limited effective communication
  • difficulties in the acquisition and use of spoken and written language
  • complications in social relationships



Also, these symptoms must be present in early childhood (even if they are not recognized until later when language, speech or communication demands exceed abilities).

The new diagnosis of SCD more correctly identifies children who have significant problems with verbal and nonverbal communication for social purposes. These problems lead to impairments in their ability to perform academically and occupationally, participate socially, maintain social relationships, and effectively communicate.

Previous editions of the Diagnostic and Statistical Manual of Mental Disorders didn’t provide an appropriate diagnosis for children with such symptoms. As a result, inconsistent treatment was initiated in various clinics and treatment centers, and a lot of children were lumped under the “not otherwise specified” category of Pervasive Development Disorder.

While previous editions of the Diagnostic and Statistical Manual of Mental Disorders included diagnoses with related symptoms, the SCD diagnosis is needed to address the special needs of SCD children (e.g., while Autism Spectrum Disorder does include communication problems, it also includes restricted, repetitive patterns of behavior, interests or activities, and gives equal weight to both communication difficulties and repetitive behaviors).

Research shows that communication disorders are very treatable. Thus, identifying distinct communication difficulties is a crucial first step in getting these children appropriate care. The SCD label helps them get the services and treatment they need.

As a side note, Autism Spectrum Disorder must be ruled out for SCD to be diagnosed.

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