Beyond Words: Understanding Social Pragmatic Communication Difficulties

What is Social Pragmatic Communication Disorder

Social pragmatic communication disorder (also known as SPCD) is defined by difficulties in using verbal and nonverbal language appropriately in social situations. 

The most common areas of difficulty relate to:

• social interaction (trouble initiating or maintaining conversations)
• language processing
• understanding others (especially jokes and sarcasm)
• non-verbal communication (facial expressions and body language)

Someone who is struggling with SPCD may have difficulty understanding and using certain tones of voice, interpreting the communication of others, or effectively sharing their own thoughts and ideas. For individuals with social pragmatic communication disorder, speech, nonverbal communication, and social cues are the most common areas of difficulty. 

Social (Pragmatic) Communication Disorder (SPCD) was formally defined and introduced as a new diagnostic category in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. 

Examples of Social Pragmatic Communication Disorder

Some typical examples of social pragmatic communication disorder include:

• The person may speak in the same formal tone to a child that they do to someone of authority. 
• During conversation, they may fall into a long monologue on a topic that interests them but not notice that others are disinterested or bored.
• Misunderstanding sayings, jokes, and sarcasm. For example, if someone says “break the ice”, they may take it literally as in physically breaking the ice and not its conversational meaning of starting a conversation. 
• They may dominate the conversations by not allowing for turn-taking. 
• Difficulty reading body language and nonverbal cues. 

Causes of Social Pragmatic Communication Disorder

Because social pragmatic communication disorder is a relatively recent label, the cause is still being investigated. 

Some of the potential causes currently being investigated are:

• Genetic - There is evidence that supports a link between SPCD and family history of communication disorders. 
• Brain Differences - It is suspected that a “glitch” in the brain that makes it difficult to process visual and verbal cues at the same time may be the culprit. Others believe that it is a result of a dysfunction in the executive functioning skills and the part of the brain that keeps track of what all the other parts of the brain are doing. For example, keeping an eye on the time while you make breakfast so you can leave on time to get the kids to school. 
• Environmental Factors - Some believe that it may be related to a lack of early language exposure as well as early social opportunities.
• Overlap with Neurodevelopmental Disorders - Some signs overlap with disorders such as Autism Spectrum Disorder and ADHD, as well as learning disabilities. Because of this, there may be a link between them. With some of these signs overlapping, the cause and prevalence are difficult to determine.  

Since research is still ongoing, practitioners must remain cautious with claiming a single cause. 

Is Social Pragmatic Communication Disorder the same as Autism

There are similarities between social pragmatic communication disorder and autism; however, they are not the same. 

Similarities between SPCD and ADS

Both conditions involve challenges with understanding and using social communication. 

These challenges can include:

• Difficulty with turn-taking, staying on topics, and asking and answering questions appropriately.
• Misunderstanding humor and sarcasm.
• Trouble adjusting communication style to fit the audience. For example, speaking differently to a child vs an adult. 
• Difficulty understanding non-verbal cues such as gestures, facial expressions, and body language. 
• Struggling with developing and maintaining relationships.

Differences between SPCD and ASD

• ASD can come with repetitive and sometimes disruptive behaviors, whereas SPCD does not
• Individuals with SPCD typically only show early delays with social communication, whereas those with ASD may show early developmental differences in multiple areas such as play, interaction, and motor skills. 

Because SPCD is relatively new, many caregivers, educators, and even doctors may mistake it for Autism Spectrum Disorder (ASD). It is necessary to note the importance of an accurate diagnosis when it comes to determining the appropriate treatment plan, as it will vary depending on the diagnosis and severity. 

You can read more on this topic in our blog titled - Social Pragmatic Disorder vs Autism: What's the Difference?

Does speech therapy help SPCD?

SPCD is fundamentally about difficulties in using language socially. This makes speech therapy a great choice for anyone with this disorder. 

Each treatment plan starts with a thorough evaluation to determine the individual’s specific goals and needs. From there, an individualized treatment plan will be created. 

Therapy can target:

• Turn-taking in conversations
• Understanding nonverbal cues
• Interpreting humor and sarcasm
• Role-playing for day-to-day interactions

…and more!

Speech therapy is a great tool to help improve both verbal and non-verbal communication abilities, leading to a happier, more fulfilled life. If you or someone you love is struggling with social pragmatic communication disorder, schedule your free introductory call today - it’s FREE!