Social Pragmatic Communication Disorder: Understanding the Basics

By NeuroSpark Health

Note: At NeuroSpark Health, we prefer to use neuroaffirming and nonpathologizing language. However, this article is meant to welcome and educate those who are using search engines to look up “social pragmatic communication disorder.” 

Social Pragmatic Communication Disorder (SCD) is a relatively new diagnosis introduced in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) in 2013. It describes challenges in social communication, particularly in understanding and using language in social contexts. SCD may not be a widely known form of neurodivergence, which is why it is important to explore the definition of SCD, how it differs from autism, whether it is considered a form of autism, and how it manifests in adults.
 

What is Social Pragmatic Communication Disorder?

Social Pragmatic Communication Disorder is a form of neurodivergence that primarily impacts an individual’s ability to use verbal language in social interactions. People with SCD might struggle to interpret nonverbal cues, adjust their language to fit different social contexts, or follow conversational rules like turn-taking or staying on topic. Some individuals with Social Pragmatic Communication Disorder may be considered “functionally nonverbal,” in that they struggle significantly with traditional verbal and nonverbal communication and may rely on alternative forms of communication such as AAC (alternative and augmentative communication), visual communication cards, written word, etc. Learning about Social Pragmatic  Communication Disorder is important for everyone, but especially those in neurodiversity spaces, because understanding and accommodating all neurotypes is crucial in building a neuroinclusive world. 
 

Key Features of SCD

Understanding the nuanced challenges faced by individuals with Social Pragmatic Communication Disorder (SCD) requires a closer look at its key features. These characteristics often overlap with other forms of neurodivergence but are distinct in their focus on social and pragmatic language use. 
 

1. Difficulty with Verbal and Nonverbal Communication

Effective communication often relies on an interplay between spoken words and nonverbal cues, such as gestures, facial expressions, and tone of voice. Individuals with SCD may struggle to integrate these elements cohesively.
 

• Interpreting Nonverbal Cues
  People with SCD may find it difficult to decode body language, such as crossed arms signaling discomfort or a smile indicating friendliness. This can lead to frequent misunderstandings in both casual and formal interactions. For example, a coworker’s subtle annoyance might go unnoticed, or a friend’s sarcasm may be taken literally.
   

• Expressing Themselves Nonverbally
  Similarly, individuals with SCD may find it challenging to use gestures or facial expressions effectively. They might come across as “flat” or disengaged during conversations, even if they are actively participating.
   

• Impact on Relationships
  Miscommunications stemming from these challenges can affect personal and professional relationships, leading to frustration for both the individual with SCD and those around them.
   

2. Challenges in Adjusting Speech to Social Contexts

The ability to modify language based on context is a cornerstone of effective communication. For individuals with Social Pragmatic Communication Disorder, this adaptability may be limited.
 

• Formal vs. Informal Language
  Adjusting language to fit a formal workplace setting versus a casual gathering can be difficult. Someone with SCD might use overly formal language in relaxed environments, creating a sense of distance, or speak too casually in professional settings, leading to misunderstandings about their competence or intent.
   

• Audience Awareness
  Awareness of who is listening and adjusting speech accordingly can also be a struggle. For example, explaining a technical concept to a non-expert might result in confusion if the explanation is too detailed or overly simplistic.
   

• Cultural Nuances
  Cultural expectations around communication styles can add another layer of complexity. For instance, certain cultures value indirect communication, which can be especially challenging for someone with SCD to navigate.
   

3. Problems Following Conversational Rules

Social conversations often follow unspoken rules, such as taking turns, staying on topic, and recognizing when someone wants to speak or change the subject. For individuals with Social Pragmatic Communication Disorder, these rules may be difficult to grasp.
 

• Turn-Taking Difficulties
  Conversations can feel overwhelming or unpredictable for someone with SCD, leading them to interrupt frequently or dominate discussions. This behavior may be misinterpreted as rude or self-centered when, in reality, it stems from a difficulty understanding conversational dynamics.
   

• Staying on Topic
  Shifting topics smoothly is another area where challenges may arise. Someone with SCD might fixate on a single topic, ignoring cues that others want to move on, or abruptly change the subject in a way that feels jarring to others. 
   

• Understanding Social Flow
  Navigating group conversations can be especially difficult. The fast-paced back-and-forth and the presence of multiple speakers may create sensory or cognitive overload, leading the individual to withdraw or misstep socially.
   

4. Issues Understanding Nonliteral Language

Figurative language adds depth and richness to communication, but for individuals with SCD, interpreting nonliteral speech can be a significant challenge.
 

• Struggles with Sarcasm
  Sarcasm relies heavily on tone and context, which can be difficult for someone with SCD to decode. For example, a sarcastic remark like “Oh, great job!” might be taken at face value, leading to confusion.
   

• Idioms and Metaphors
  Phrases like “It’s raining cats and dogs” or “breaking the ice” can be perplexing when interpreted literally. This can make casual conversations or storytelling feel inaccessible.
   

• Impact on Humor
  Humor often relies on wordplay, timing, and shared cultural references, all of which may be difficult for someone with SCD to navigate. As a result, they may feel left out during social gatherings or hesitant to participate.
   

• Literal Thinking as a Strength
  While challenges with nonliteral language can create barriers, literal thinking can also be a strength. Many individuals with SCD excel in fields that require precise, straightforward communication, such as science, engineering, or data analysis.
   

By understanding these key features of Social Pragmatic Communication Disorder in greater depth, we can better appreciate the unique challenges and strengths of individuals with SCD. These insights also highlight the importance of creating inclusive environments that accommodate diverse communication styles.
 

What is the Difference Between Autism and Social Pragmatic Communication Disorder?

One of the most common questions about SCD is how it differs from autism, as the two neurotypes share some overlapping characteristics. However, there are distinct differences.
 

Shared Features

Both SCD and autism can involve:

• Challenges in social communication.

• Difficulty interpreting nonverbal cues.

• Struggles with pragmatic language (language used in social contexts).
   

Key Differences

1. Presence of Repetitive Behaviors

   • Autistic people engage in repetitive behaviors (stimming) and special interests. SCD does not include these traits.
      

2. Sensory Sensitivities

   • Many autistic individuals experience sensory processing sensitivities (e.g., hypersensitivity to sounds or textures), while this is not a feature of SCD.
      

3. Social Motivation

   • Autistic people may have differences in social motivation, sometimes preferring solitude or finding social interactions overwhelming.

   • People with SCD typically want to engage socially but struggle with the mechanics of social communication.
      

4. Developmental Delays

   • Autism may include developmental delays in various areas, such as language or motor skills. SCD is more narrowly focused on communication challenges.
      

Is SCD a Form of Autism?

No, Social Pragmatic Communication Disorder is not considered a form of autism. While the two share overlapping features, SCD is a separate diagnosis. The DSM-5 intentionally distinguishes SCD from autism to better account for individuals who experience social communication challenges without meeting the broader diagnostic criteria for autism. However, some experts argue that SCD exists on a broader continuum of neurodivergence and that it may overlap with autism in ways we do not yet fully understand.
 

What Does Social Pragmatic Communication Disorder Look Like in Adults?

While SCD is often diagnosed in children, many adults also have SCD—some without realizing it. In adults, SCD may manifest in a variety of ways.
 

1. Difficulty Navigating Social Settings

Adults with SCD may struggle with workplace interactions, group conversations, or casual social encounters. They might come across as "awkward" or "inappropriate," even though their intentions are good.
 

2. Challenges in Professional Communication

People with Social Pragmatic Communication Disorder may have difficulty adapting to the tone of a professional email versus a casual text. They may also misinterpret feedback or indirect instructions from colleagues.
 

3. Struggles with Nonverbal Communication

Those with SCD may misread body language, facial expressions, or tone of voice, and also find it challenging to gauge when someone is joking versus being serious.
 

4. Relationship Difficulties

Because of these communication challenges, they may struggle to maintain friendships or romantic relationships due to misunderstandings, especially if the other person does not understand SCD or how to accommodate them. People with SCD may also inadvertently come across as blunt or insensitive due to difficulties with tact or subtlety.
 

5. Trouble Understanding Contextual Language

Those with SCD often interpret things literally, including figurative language or sarcasm. This can make them feel confused and uncomfortable during conversations that rely on subtle humor or cultural references.
 

Supporting Adults with SCD

For adults with SCD, targeted interventions and accommodations can make a significant difference. 
 

Therapy and Support

1. Speech-Language Therapy

   • Focuses on improving pragmatic language skills.

   • Teaches strategies for interpreting nonverbal cues and adapting communication to different contexts.

   • Neuroaffirming speech-language therapy will ensure that the individual is learning to communicate in ways that do not feel dysregulating or uncomfortable.
      

2. Social Skills Training

   • Role-playing exercises to practice conversations and interactions.

   • Strategies for conflict resolution and emotional regulation.

   • Ensuring that this intervention is neuroaffirming is crucial to make sure that those with SCD are harnessing their strengths and using an accommodating and holistic approach.
      

3. Neurodiversity Affirming Therapy

   • Helps manage anxiety or frustration related to social challenges.

   • Builds self-confidence in social settings.
      

Self-Help Strategies

1. Seeking Neurodivergent Communities

   • Online or in-person support groups provide a safe space to share experiences and tips.
      

2. Using Visual Supports

   • Visual aids, such as flowcharts or conversation maps, can help navigate complex social situations.
      

3. Practicing Mindfulness

   • Techniques like deep breathing or meditation can reduce stress in overwhelming social situations.
      

4. Advocating for Accommodations

   • Requesting clear, direct communication in workplaces or other environments.
      

How Society Can Adapt

Instead of focusing solely on "fixing" individuals with SCD, society can also adapt to accommodate their needs. Ensuring that Social Pragmatic Communication Disorder is included in neurodiversity awareness and education is a great first step. Many people, even in neurodiversity spaces, may not be aware of SCD or how it impacts people. Cultivating open conversations about neurodiversity can help raise awareness of the neurotype as well as teach people how to accommodate it by encouraging direct communication and valuing diverse communication styles. 
 

Conclusion

Social Pragmatic Communication Disorder is a nuanced diagnosis that sheds light on the challenges some individuals face with social communication. While it shares some similarities with autism, it is a distinct neurodevelopmental difference and neurotype. Adults with SCD can face unique challenges in social and professional contexts, but with the right support and accommodations, they can succeed. Understanding and embracing neurodiversity, whether in the form of SCD, autism, or other differences, makes our world richer and more inclusive. Recognizing the strengths and needs of individuals with SCD helps break down stigma, making space for everyone to express themselves authentically.