Understanding Social (Pragmatic) Communication Disorder

Understanding Social (Pragmatic) Communication Disorder

Do you ever notice that you or your child has trouble managing normal conversations? Do they interrupt often or say things that seem inappropriate? Do you notice that they don’t seem to connect well with their peers or keep friends very well?

If this sounds familiar, your child may have social (pragmatic) communication disorder. This condition deals with nonverbal communication and cues. Read on to learn more about this condition and how it works.

What Is Social (Pragmatic) Communication Disorder?

Social communication disorder affects how people interpret communication. People with this disorder may have difficulty understanding implied or nonverbal communication. The disconnect comes when pragmatic language comes into play.

Pragmatic language is most of our non-verbal or implied communication. So, for instance, if you and a friend are talking with a third party who says something you disagree with and you and your friend share a look that says, “This person is wrong,” that would be a form of pragmatic language. A person with social communication disorder would not understand that look.

How Common Is It?

Social communication disorder has only just been added to the Diagnostic and Statistical Manual. This makes it hard to determine exactly how many people may have a social communication disorder. Until the condition was added, these people got lumped in with people who have autism spectrum disorders.

But since the condition has been recognized, several studies have been done to try to determine the prevalence. The American Speech and Hearing Association estimates that about 7.5 percent of children have some form of pragmatic language impairment.


If your child seems to have a strong grasp of language skills but poor social skills, they may have social communication disorder. You may notice that in conversation, they can’t adjust their communication style to match the conversation. They may interrupt the person they’re talking with or not use appropriate greetings.

Your child may notice that their social interactions don’t seem to go over well, so they may start avoiding them. They may respond in short answers or not at all when people try to engage with them socially. You may also notice that they don’t do well with making or keeping friends.


Currently, there is no definitive cause of social communication disorder. As is the case with many brain dysfunctions, we may never know quite why they happen. there are some working theories that are being investigated, however.

Some people think the disorder is the result of a “glitch” in the brain that makes it hard to process visual and verbal cues at the same time. Others think it’s the result of a dysfunction in your executive functioning skills. This is the part of your brain that keeps track of what all the other parts of your brain are doing – for instance, keeping an eye on the time while you make dinner so you can leave in time to get the kids to soccer practice.

Differences from Autism

For a long time, people with social cognitive disorder were lumped in with people on the autism spectrum. But in truth, this is a little more of an “all squares are rectangles, but not all rectangles are squares” situation.

For those on the autism spectrum, social communication disorders are common and, in fact, can be part of the diagnosis. But autism also involves repetitive behaviors that not everyone with this disorder experiences. So while most people on the autism spectrum will also have a social communication disorder, not everyone with social communication disorder will be on the autism spectrum.

How It’s Diagnosed

Diagnosing social communication disorder can be a long, complex process. Your doctor will want to rule out other causes of unusual social behavior first. For instance, they will probably run a hearing test to make sure your child’s communication challenges aren’t due to a hearing problem.

Once other issues have been ruled out, your doctor will want to observe your child, interview them, have them fill out questionnaires, and get information from you. They’ll likely ask about your family’s medical and educational history since there are some indications that social communication disorder may be genetically linked. All of this information will give your doctor what they need to diagnose your child appropriately.


So if your child is diagnosed with social communication disorder, what can you do to help them manage it? There currently isn’t a treatment for this condition, since it’s more along the lines of a communication abnormality than a medical disorder. But there are tools you can give them to cope with the condition.

Read books to your children and ask them open-ended questions about what’s happening in the story. Talk about how the book characters might be feeling in certain situations. You can also ask them to predict what will happen next in the story or take turns reading it out loud.

Find the Right Words

Social (pragmatic) communication disorder makes social connections challenging, but it’s not unmanageable. It takes some extra care, but your child can learn to handle social interactions well.

If you’d like to get help in managing your child’s social communication disorder, reach out to us at Great Speech by clicking the button below. We’re your online solution to speech therapy, providing therapy for clients age 5 to 85 on five different continents. Learn more about our services and start improving communication today.

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