How to support Social Pragmatic Communication Disorder (SPCD)

Social Pragmatic Communication Disorder(SPCD)?

What's the difference between a child who masks their autistic behaviour and a child with Social Pragmatic Communication Disorder(SPCD)?

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) Social (Pragmatic) Communication Disorder is meant to capture the social elements of communication dysfunction in children who do not meet autism spectrum disorder criteria. However, it is unclear whether Social (Pragmatic) Communication Disorder captures these elements without overlapping with Autism Spectrum Disorder.

These data suggest that social pragmatic communication disorder does not capture the profiles of children who have both social communication impairment and restricted interests and repetitive behaviour, but are in need of clinical services. (Social Pragmatic Communication Disorder: another name for the Broad Autism Phenotype?)

There are many disorders, such as Anxiety Disorder and OCD, and some of the Psychiatric disorders share similar traits, all on a spectrum. While I am not a clinician, I can see we are getting labels but not support. We have to wait so long to get a label; the damage of bullying or anxiety takes its toll.

Our experience of Social Pragmatic Communication Disorder

My son was given a diagnosis of (SPCD). The autistic assessment panel did not believe that my son had restrictive and repetitive behaviours at home because the school had not seen it for themselves and didn't back us up. My son talks about hiding his ways from year two because his peers would laugh at him.

At first, we didn't fully understand the diagnosis. Then we realised that we needed to go through the whole waiting list process again to be assessed for autism or pay for a private assessment before we could get any support. By this time, it was too late to support his education.

My take on Social Pragmatic Communication Disorder

Social Pragmatic Communication Disorder needs to be supported as if they are autistic because they have just missed the criteria. As autism is on the spectrum, they will have social communication issues, anxiety and stress of managing school life..... Or they are masking their behaviour to fit in.

Autism Spectrum Disorder (ASD) and Social (Pragmatic) Communication Disorder (SPCD)

These are related conditions that share some similarities regarding social communication difficulties, but they are separate diagnoses.

Autism Spectrum Disorder (ASD):

• ASD is a neurodevelopmental disorder characterised by a range of symptoms related to social communication and behaviour.

• Individuals with ASD may exhibit challenges in social interaction, repetitive behaviours, restricted interests, and difficulties with communication.

• Communication difficulties in ASD can involve challenges in nonverbal communication, understanding and using gestures, and developing and maintaining peer relationships.

Social Pragmatic Communication Disorder (SPCD):

• SPCD, on the other hand, is primarily characterised by difficulties in pragmatic communication without the presence of the broader range of symptoms associated with ASD.

• Individuals with SPCD typically struggle to use language for social purposes, understand and use conversational rules, and interpret social cues.

Relationship between ASD and SPCD:

• Some individuals with ASD may experience social communication difficulties similar to those seen in SPCD.

• The DSM-5 recognises that individuals with ASD may have additional symptoms related to social communication and repetitive behaviours that are not in the criteria for diagnosing SPCD.

There is an overlap in social communication challenges between ASD and SPCD; they are distinct conditions. Some individuals with ASD may also meet the criteria for SPCD, but not everyone with social communication difficulties will have ASD.

What happens when a child is masking his repetitive or restrictive behaviours

Many children learn to hide their autistic behaviour, such as stimming, jumping around, or individual ticks, which helps them manage their sense of overstimulation.

Supporting individuals with Social Pragmatic Communication Disorder (SPCD)

Here are some strategies that can be helpful:

Speech and Language Therapy:

• Enlist the help of a speech-language therapist who specialises in social communication disorders. They can work on specific communication skills, such as understanding nonverbal cues, initiating and maintaining conversations, and interpreting social contexts.

Social Skills Training:

• Provide structured social skills training focusing on social cues, perspective-taking, and appropriate social behaviours. Role-playing and real-life scenarios can be valuable tools.

Visual Supports:

• Use visual aids, social stories, and visual schedules to help individuals with SPCD understand and navigate social situations. Visual supports can provide a clear framework for expected behaviours and help reduce anxiety.

Explicit Instruction:

• Break down social skills into explicit steps and provide clear and direct instruction. Use concrete examples and practice situations to help individuals understand and apply social rules.

Peer Modelling and Interaction:

• Encourage positive peer interactions by facilitating opportunities for the individual to engage with peers. Peer modelling can be effective in demonstrating appropriate social behaviours.

Environmental Modifications:

• Create an environment that supports successful social interactions— minimising distractions, providing quiet spaces, or using visual cues to signal changes in activities.

Social Groups:

• Facilitate or encourage participation in social groups or clubs that align with the individual's interests. Opportunities for social interaction can develop insight and create a safe place to make friends.

Collaboration with School and Family:

• Collaborate with teachers, school staff, and family to ensure consistent support across different settings. S is information about effective strategies and interventions.

Self-Advocacy Skills:

• Help individuals with SPCD develop self-advocacy skills. Teach them to express their needs, ask for clarification, and communicate effectively about their challenges.

Use of Technology:

• Explore using technology to support communication. Apps and tools designed for social communication can provide additional resources and practice opportunities.

Social Thinking Programs:

• Consider programs like Social Thinking® that specifically address social communication challenges. These programs often provide a structured framework for understanding and navigating social situations.

  
  

Masking

How many Autistic children are being missed due to their need to protect themselves and hide?