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Social pragmatic communication disorder - SPCD

social pragmatic communication disorder

Social (pragmatic) communication disorder (SPCD) is a newly added diagnosis in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The condition is characterized by difficulty in communication both verbal and non-verbal. Research has confirmed that the symptoms of this disorder can be very similar to those of ASD and ADHD.

This blog is focused on getting an insight into SPCD or social skills deficit and a few differentiating features between SPCD and, ASD and ADHD.

What is Social pragmatic communication disorder?

SPCD is characterized by difficulty in pragmatic communication, that is, the person faces difficulty in the day-to-day use of verbal and non-verbal skills that are important for communicating our thoughts, feelings, and ideas. It is a mental disorder, and it is theorized that it can be due to malfunctioning of a person's right brain hemisphere, affecting a person's ability to process verbal and visual information. The person may face difficulty in-

  • Using and understanding verbal and visual cues.

  • Inappropriate communication in social settings.

  • Difficulty in using language skills to communicate.

  • Lack of understanding of nonverbal language.

The symptoms of SPCD can not be attributed to other medical or neurological conditions, and cannot be explained by autism spectrum disorder.

Approximately 7.5% of children experience difficulties with social pragmatic communication, with higher rates of difficulties in males than females. 

Symptoms of social pragmatic communication disorder.

The symptoms of SPCD can vary in intensity and presentation from person to person. Sometimes the symptoms can even be similar to those of ASD and ADHD. The symptoms of SPCD may not be evident until the child starts going to school. However, a child may present with a speech delay, and little or no interest in social situations. It can often be difficult to detect the symptoms for parents thereby leading to delayed diagnosis and treatment. Here are few indicators a child with SPCD can present with:

  • They may have difficulty using language in social situations.

  • Faces difficulty in reciprocal communication.

  • The concept of taking turns can be difficult for them to grasp, and they often end up engaging in one-way communication.

  • End up saying inappropriate, interruptive, and totally unrelated things during a conversation. For instance, they may speak in the classroom just like they speak in the playground.

  • They lack the judgment to understand sarcasm, riddles, jokes, and references.

  • They have trouble using nonverbal gestures, such as facial expressions, and hand gestures like pointing, eye contact, etc.

  • Difficulty in understanding nonliteral or ambiguous meanings of literature such as idioms, metaphors, humor, etc.

The mere presence of these symptoms doesn't mean the person has SPCD, in order to be diagnosed with SPCD, DSM-5 has specified that the symptoms must have an impact on-

  • Work,

  • Education,

  • Social life,

  • Personal relationships.

SPCD has been categorized as a different disorder as per the new DSM-5 criteria, as it is often confused with an autism spectrum disorder or ADHD.

Social Pragmatic Communication Disorder and Autism Spectrum Disorder

A major differentiating feature is that SPCD is not caused by any underlying developmental disorder or medical condition.

Even though the two conditions have been categorized differently by the DSM-5 criteria, few symptoms of SPCS tend to coincide with those of ASD-

  1. Lack of interest in social communication

  2. Difficulty in following basic etiquettes of a conversation like turn-taking.

  3. Difficulty in taking part in two-way communication.

In contrast to ASD the child with SPCD doesn't show any issues in two classical domains that are behavioral or sensory development.

Social Pragmatic Communication Disorder and ADHD

These two conditions can often overlap, and research shows that a child with SPCD is more likely to have ADHD. However, the cause and impact of both the conditions aren't the same.

Communication difficulties a child with ADHD faces are-

  1. Difficulty in waiting for their turn to talk

  2. Seems like they aren't focused when someone is talking to them.

  3. Excessive talking

  4. Cutting or interfering with others while they are talking.

Why does SPCD occur?

The exact underlying cause of SPCD is still unclear, the role of genetics as a causative factor has been implicated by several researches. The signs of SPCD can overlap with neurodevelopmental conditions like ASD and ADHD. Hence it was classified as a different category by DSM-5, as it is often misdiagnosed as some neurodevelopmental disorder and those affected by it may not receive appropriate therapy on time.

Few conditions that can be risk factors for SPCD-

  • ADHD

  • Intellectual disability

  • Hearing loss

  • Learning disability

  • Traumatic injury to the brain

  • Dementia

Treatment of SPCD-

Out of various evidence-based treatments, speech therapy continues to be a mainstay treatment. A speech therapist/ speech language pathologist first screens and accesses the child. It can be performed by various means such as questionnaires, interviews (with the child and the parents), hearing tests, and if required obtaining reports from teachers or caregivers.

As SPCD can vary in intensity and presentation, a special tailor-made plan is formulated for the child, that is implemented over various therapy sessions. The therapy can be one-on-one or group. Group therapy can be quite helpful in developing social communication skills.

Additionally, there are support and training classes for the parents of the child as well. As it is very important that a child with SPCD receives appropriate help at home along with speech therapy.

Sounderic provides online speech therapy sessions for children with various communication disorders. We would love to help you. Get in touch with us on WhatsApp at or schedule a consultation with us at

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