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Social (Pragmatic) Communication Disorder

Kathryn Patricelli, MA

What is Social (Pragmatic) Communication Disorder?

sad girl outsideSocial (Pragmatic) Communication Disorder is a Communication Disorder. Speech problems are often caused by problems with the body's nervous system. The problems between the brain and the nervous system affect the use of language, speech or communication.

Symptoms of this disorder include:

  • ongoing problems in the using verbal and nonverbal communication (words and actions) in social ways with others including:
    • problems in greeting others (not knowing to wave to them to say hello or goodbye, pointing to others, etc.)
    • having trouble adjusting how you talk to different people. For example, knowing that you should talk in a more formal way in a classroom to your teacher compared to outside on the playground with a friend.
    • having problems following accepted rules for conversations like taking turns when talking or asking questions if you don't know what someone is trying to say.
    • problems drawing conclusions from what someone said (understanding things that they don't actually say)
    • not understanding with more descriptive phrases. For example, not knowing that someone saying "he is the apple of my eye" really means "he is special to me." or your friend saying "a penny for your thoughts" means she is asking what you are thinking.
  • these issues cause problems in school, in talking with others, or both.
  • the symptoms first showed up when the child was 2 to 4 years-old, but the problems may not become noticeable until later on when talking to others requires more advanced speaking skills.
  • the problems are not happening because of another condition such as autism spectrum disorder, intellectual disabilities, global developmental delay, or any other medical or brain condition.

How common is Social (Pragmatic) Communication Disorder?

Because this is a new disorder, prevalence rates are not yet known.

By the time a child is 4 or 5 years old, they should be able to have conversations with other people. If they are having problems at this time, then they may be diagnosed with Social (Pragmatic) Communication Disorder.

Some children with the condition are able to improve their communication skills, but others may continue to have issues as an adult. Those that do improve may still have some issues in relationships with others or with learning related skills, such as writing down their thoughts.

What are the risk factors for Social (Pragmatic) Communication Disorder?

Those who have a family member with autism spectrum disorder, specific learning disorder, or other communication disorders are more likely to be at risk for this disorder as well.

What other disorders or conditions often occur with Social (Pragmatic) Communication Disorder?

Children with this disorder often also have autism spectrum disorder, specific learning disorder, and other communication disorders.

How is Social (Pragmatic) Communication Disorder treated?

If a parent is worried about how a child's talks, they should start with the child's doctor first. The doctor may suggest that the family talk to a person who is trained to test and treat people with speech or language disorders (a speech-language pathologist). That person will talk about the child's skills and will use special tests. A hearing test is often done because hearing problems can affect learning how to talk.

After the tests are done, they may suggest the parents do things at home to help the child practice and improve in talking and writing, or that the child do individual or group therapy with a counselor to work on their skills.

They may suggest more tests and a check-up by a person trained to identify and measure hearing loss (an audiologist), or a psychologist who is an expert in how children grow and develop.

Psychotherapy, including cognitive behavioral therapy, may also be used to help the child deal with their feelings about the problems that they may be having because of their trouble talking with or understanding other people.