Understanding Social Communication Disorder: How it Differs from Autism

Erin Vollmer MS, CCC-SLP

Erin Vollmer is a speech language pathologist and co-founder of TherapyWorks, she has been practicing in pediatrics for over 20 years.

October 26, 2023

Social communication plays an essential role in our daily lives. It allows us to communicate and socially interact with others. We’re able to share thoughts and emotions, form relationships with others, and have the ability to improve our overall well-being.

By definition, social communication is how and why we use language to interact with other people. This includes both verbal and nonverbal language.

There are several ways we use social communication, like saying “hello” to someone when we see them, communicating differently when speaking to a child versus an adult, and taking turns with talking and listening during a conversation.

Some children have trouble understanding and using social communication behaviors like these, which can lead to a diagnosis of Social Communication Disorder (SCD).

Social Communication Disorder can appear very similar to Autism Spectrum Disorder, however it is a separate diagnosis and one that cannot be given to a child who has Autism.

Let’s explore more about what Social Communication Disorder is, and how this unique diagnosis differs from Autism. We’ll also delve into how SCD is diagnosed, and the recommended intervention and support that can help improve a child’s skills.

What is Social Communication Disorder?

According to the American Speech Language Hearing Association (ASHA), Social Communication Disorder (SCD) is characterized by:

“Persistent difficulties with the use of verbal and nonverbal language for social purposes.”

A child with Social Communication Disorder might have difficulties with social understanding, social interacting, pragmatics, and/or processing language. He or she might have communication difficulties with the following skills:

Nonverbal Language

Understanding nonverbal cues from others (like body language and facial expressions)
Using nonverbal cues appropriately

Verbal Language

Engaging in conversation appropriately (taking turns listening/speaking, staying on topic)
Understanding and using different tones of voice to convey certain emotions
Understanding and telling stories
Adjusting communication style according to different social contexts (i.e., who they’re speaking with or the environment)
Understanding and using figurative language
Making inferences/drawing conclusions from something that isn’t explicitly said

Social Communication Disorder is associated with certain medical diagnoses, like Traumatic Brain Injury or Intellectual Disability. Without the presence of another medical diagnosis, the cause of Social Communication Disorder is unknown.

How common is Social Communication Disorder? More research is needed. One study estimated that between 7-11% of eighth graders had SCD.

When interacting with a child with SCD, you might notice that he or she does things like: gives too much information about a certain topic, has trouble staying on topic, or stands too close to someone when talking.

Differentiating SCD from Autism

If the signs of SCD seem a lot like those of Autism to you, you’re right. Children with Autism also have difficulties with social communication.

However, SCD and Autism are distinct, mutually exclusive disorders. An individual that has a diagnosis of one of these disorders cannot also have a diagnosis of the other.

Autism is a complex neurodevelopmental disorder that is characterized by two core defining features: restrictive and repetitive behaviors (RRBs) and persistent difficulties in social communication and interaction.

The presence of RRBs is an important factor that differentiates Autism from Social Communication Disorder. Another difference is that Autism is often diagnosed in early childhood. In SCD, difficulties that lead to a diagnosis are often noticed later in childhood or even into adolescent years.

The Diagnosis Process

If a child is suspected to have Social Communication Disorder, he or she should be evaluated by a speech language pathologist (SLP). SLPs are trained in assessing a child’s communication skills, including their understanding and use of social communication skills.

Speech therapists can assess a child’s pragmatic skills by making observations during interactions and by administering standardized assessments. These assessments allow the SLP to examine the child’s ability to comprehend nonliteral language (like sarcasm, words with multiple meanings, or idioms).

Depending on the results of the evaluation, the therapist may give the child a diagnosis of Social Communication Disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the criteria for diagnosing SCD includes:

Persistent difficulties in social communication & interaction across multiple contexts.
Significant functional limitations in social, academic, or occupational areas.

The speech therapy evaluation should be part of a comprehensive evaluation by a multidisciplinary team, which often includes a psychologist.

Intervention & Support

With the appropriate treatment and support, children with SCD can improve their social communication skills.

Speech therapy can help children with SCD. During individual therapy sessions, the SLP will teach the child strategies for improving their understanding and use of specific social communication skills that he or she may struggle with.

The child can practice using these strategies during social interactions in various environments, like home and school.

Parents are encouraged to participate in therapy sessions and continue helping their child use the tools they learned in speech therapy to communicate more appropriately and functionally during social interactions.

Group therapy like social skills training programs can also help a child practice using appropriate social skills during interactions with peers. These groups are often led by a speech-language pathologist, and teach children with SCD to generalize skills by engaging in group activities and role-playing different social scenarios.

Additional Resources

Children with social communication disorder (SCD) struggle with using and understanding verbal and nonverbal communication while interacting with others. They have difficulty with things like joining a conversation, saying “please” to ask to borrow something instead of making a demand, staying on topic, or understanding idioms like “I’m all ears.”

Although both SCD and Autism are characterized by difficulties with the social use of language, they are distinct disorders. Children with Autism, unlike those with SCD, have restrictive, repetitive behaviors (RRBs) and are often diagnosed earlier in childhood.

Speech therapy can help a child with Social Communication Disorder improve their skills so they can thrive in life.

The speech-language pathologists at TherapyWorks are experienced in working with children with Social Communication Disorder. TherapyWorks offers speech therapy, occupational and physical therapy both in person (in Illinois, Michigan, and Ohio) and through teletherapy (nationwide). If you would like to learn more, or discuss your child’s specific needs, please don’t hesitate to reach out to TherapyWorks!

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