Social Communication Disorder is marked by difficulties with pragmatics—aka practical everyday use—or the social use of language and communication. Therefore, SCD is concerned with an individual’s use of verbal and nonverbal social communication in everyday life.

The condition is of particular interest to individuals with Aspergers or HFA.

In the DSM-V, it specifically states that individuals who have marked deficits in social communication but whose symptoms do not otherwise meet the criteria for autism spectrum disorder (ASD) should be evaluated for social (pragmatic) communication disorder.

SCD is expressed as deficits in understanding and following social rules of verbal and nonverbal communication in real life, changing language according to the needs of the listener or situation, following rules for conversations and storytelling, and understanding what is not specifically and explicitly stated.

Some illustrative examples that individuals with SCD may struggle with:

  • Greeting and/or sharing information that is appropriate for the social context
  • Speaking differently in a classroom than the playground
  • Talking differently to children and adults
  • Taking turns in conversations
  • Knowing how to use verbal and nonverbal signal to guide interaction
  • Recognizing nonliteral or ambiguous meaning of language (e.g. idioms, humor, metaphors, etc)

Other requirements for a diagnosis of SCD include that these deficits result in limitations of effective communication, social participation, academic achievement, and/or occupational performance. Also, the symptoms must be related to the early developmental period of a child’s life and not related to other medical/neurological conditions or abilities.

Social (pragmatic) communication is based on the development of basic speech and language skills.

Therefore, SCD is rarely seen in children younger than four years due to lack of development of speech and language abilities needed to diagnose it. Milder forms of this disorder, however, may not be seen until early adolescence when language and social interactions grow in complexity.

ASD and SCD differ by the presence of restricted, repetitive patterns of behavior, interests, or activities in autism and their absence in SCD.

For parents seeking answers for their child’s development, it is important to keep in mind that only if a developmental history fails to provide evidence of these past patterns, should a diagnosis of social (pragmatic) communication disorder be considered.

What do you think about this diagnosis?

by ACN Executive Director Loree Primeau, PhD, OTR, FAOTA


Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), (pp. 47-49), American Psychiatric Association, 2013.

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  1. You say that the emerging symptoms are found in early grade school, and that the topics of the conversations of individuals with SCD are repetitive or maybe cyclical. What happens to people that are finally diagnosed later in life, say at the age of fifty. Do you think that the symptoms are masked by other mental health issues relegating ASD to a background or underlying pathology? Do you think behavior is modified with the background pathology, do you agree with the terms I employ? Are there parallels with other MH conditions that refer to the repetitive nature of socialized behaviors, say for example disthymal disorder?

  2. I am also trying to understand. So is Social Communication Disorder a new name for what used to be classified as Aspergers? My teen daughter was diagnosed with SCD and ADD almost 2 years ago.

    1. It depends on who you ask. Some professionals say it is while others say it isn’t. I’m waiting for my evaluation results, but my evaluator thinks I have SPCD and told me that I would have been diagnosed with Aspergers if I was evaluated years ago.

  3. So what about young children (especially girls) who don’t meet ASD because of normal cognitive functioning and lack of repetitive behaviors who struggle with social communication (waving, pointing, asking for things, saying hello and goodbye, putting words together, prefering to play alone, limited imaginitive play but extreme interest in books and letters and normal or even advanced vocabulary) before the age of 4? Do we just ignore them????

  4. My son, Sonny, did have a diagnosis of ADHD and low spectrum autism with adjustment disorder. Now the low spectrum autism has been changed to social communication disorder and also he is having some sensory issues. He is 7 years old and in life kindergarten. It seems like he is angry a lot. He’s been put on a non stimulant medication for the adhd. I feel that it is making him irritable. There is no help in the town that I live in. Although there is a promise of a center for autism in the next year. I hope he can get help there also for his scd. This really is confusing!!

  5. My daughter who has had intense interests and trouble socially since kindergarten was just diagnosed with SPCD. She has a very high IQ. Psychiatrist says she basically has Aspergers but is diagnosing her with SPCD due to the fact that she doesn’t have rigid interests or routines. We are very confused.

    1. Dear Sara, My sister just shared with me her almost 12 year old grandson was diagnosed with SPCD this past year. I am hoping to find more information on educational/financial assistance as his parents are seeking the best for their child. My niece and husband have good insurance, but SPCD does not fall within the states guidelines as a form of autism. The needed services for my nephew are not covered. Could you share with me possible contacts for SPCD. I am a 40 year educator who has worked for a District with wonderful student services. My niece feels so helpless after living one year in Idaho. She feels defeated by the school and local state services. Thank you for any information regarding how parents can begin meeting their child’s needs so that the child has the opportunity to live a happy and productive life. Sincerely, Mary

  6. My husband and I have been together for 30 years. He has been diagnosed with ADD but that never really explains the “whole picture.” When I heard there was a new diagnosis named Pragmatic Social Communication Disorder. I went online, looked it up, and read the symptoms. I was floored – this diagnosis describes my husband perfectly. It was so validating to know that his issues are actually categorized and explained.

  7. I have 5 children. My two oldest (boys 26 & 22) from my first marriage and my oldest (boy 12) from my second marriage were all diagnosed with Asperger’s. I also have 8 year old boy girl twins. My youngest son clearly has symptoms less severe than others but enough where I wanted him to be evaluated. My daughter has the least amount (a little immature socially, slight muscle tone issues and ADD) but still wanted her to be evaluated as well. I was very surprised when the doctor said he felt they both had SCD, ADD and also low muscle tone not autism (aka Aspergers). He is either wrong or I have to rethink all my children’s diagnoses. And to give myself even more frustration I just read about dyspraxia which fits my eight year old son perfectly. I have a couple nephews also diagnosed w/ Autism and sisters with ADD. I wish there was someone who would look at the entire family. Multiple diagnoses for multiple family members is confusing. There has to be some common thread.

    1. Have you considered interacting with a genetic physician? If these markers run both within your children and other family members, the signs/symptoms may align with a specific syndrome. The genetic specialist could evaluate every family member and make a determination of appropriate description for entire group.

  8. Hello, my son was diagnosed with Social (pragmatic) Communication Disorder last year.
    Our psychologist said, my son Ethan met criteria for an Autism Spectrum Diagnosis but his diagnosis at this time will be SCD. I am a little confused. Should I have him re-evaluated?

    1. We have the same issue with out son. He is diagnosed SCD but he really does have the repetitive behaviors and limited interests, though they are not as apparent during the ados testing as they are after a few minutes of play in a clinical setting. We wouldn’t care to dwell on this except for the face that the treatment for SCD should require ABA Therapy, too, which it can be challenging to get without the Autism diagnoses. This shades of grey between Autism and SCD reminds me of how difficult it used to be to get school support and proper treatment for ADHD over a decade ago. It is very frustrating especially with dual diagnosis.

  9. The mind of a child teen or adult wihh social communic disorder – falling short of aspergers diagnosis lacking repetitive mivements, had same mental make-up and brain processes / needs. Are we depricing scd diagnosed people the benefits of decades of research, tretmdnt pathways, etc, by pulling scd out of the ‘autistic’ spectrum diagnostically. Our child diagnosed with scd is of the thought that communications need some tuning while if she had a repetitive action or unusual collection that was peculiar would be diagnosed as aspergers and the aspergers way the mind thinks would be a major part of the therapeutic process. Seems scd is the mind of apergers without movement disorder but is otherwise the same. Scd is not however being treated by psychologists with benefit of the larger understanding of aspergers

    1. I agree 100%. The “experts” must have been under some pressure to reduce treatment costs for the autism epidemic. The selection of repetitive movements as an essential diagnostic criteria is arbitrary, and they are deliberately ignoring the literalistic thought pattern. A person’s thoughts make them who they are, not the motions they make.

  10. My son, now 30yrs old has had difficulties since childhood and we know he has Aspergers. During his teens he was extremely angry and sad but he came through this period. Today he lives independently, has his own home and car but for the past year he has not spoken at all to anyone. His life is restricted to his job which is in jeopardy because of his refusal to speak to his co-workers. He was visiting me on Sunday but now that has ended. He literally speaks less than a Yes or No to anyone. We have been to social service, Doctors, Clinicians, speech therapists, Psychologists and he refuses to see any of them. Everything I read on line is about children. Any advice???????

    1. Hello Doug,

      Thank you for your comment and sharing your experiences. Ken Kellam, one of our contributing writers with Aspergers, has written a response to your question that will be in the form of a Q&A blog post at the end of this week. This post will publish on Friday, October 28 2016 in the morning. We hope this provides helpful insight for you.

    2. Does he communicate in other ways such as writing (or texting) anyone? At least you can gauge any possible reasons for the shutdown (some unidentifiable trauma?).

  11. Interesting article although my 4-ye-old son has both the social/communication difficulties and repetitive behavior and was not diagnosed on the spectrum. GARS indicated autism but A-DOS did not so the scored GARS as ” false positive”. He is very ” surface socable”- loves adults more than kids, touches and climbs on people but more difficulty maintaining friendships and back/ forth conversation. He talks ” at people” and constantly. He was given these diagnosis: social communication disorder, dyspraxia, sensory processing disorder, ADHD, and OCD.

    1. This sounds a bit like my son. My son is now 10 and was just diagnosed with severe childhood bipolar disorder. We thought it was ADHD, SPD and possible Asperger’s, then when his BP disorder got bad he developed gross motor tics. It just spiraled out of control, until he got stabilized on antipsychotics. Now we are left with severe anxiety and social problems. We are chiseling away but at least we have the hyperactivity and depression taken care of for now.

      1. I am a psychologist who has been training in Havening Techniques. This is a form of somatosensory therapy that is non invasive and might be helpful for your child’s extreme anxiety. I would urge you to do some reading. I’ve seen some wonderful results in my practice using it

    2. I have social communication disorder and ADHD symptoms. They ruled out an ADHD diagnosis because apparently those symptoms are common with SCD. Please make sure they don’t overmedicate your child. In particular, ritalin will not help.

  12. Our 9-year old daughter was just diagnosed with SCD today (FINALLY, we have title that fits!), and we were instructed to find tutoring from a CALT certified/instructed therapist. We Live in North Texas (Dallas/Ft. Worth), and are looking for more resources, please so we can take advantage of these precious summer months.

    1. How is your daughter doing with therapy? I just read this and wonder if this fits my son. His therapist thinks it’s Asperger’s and the psychiatrist says it’s not. I read this article based on the suggestion of a friend and this really fits my son, who is always sticking his foot in his mouth, so to speak and he’s 10.

  13. There is a GREY area now. “ASD and SCD differ by the presence of restricted, repetitive patterns of behavior, interests, or activities in autism and their absence in SCD”
    So if a child doesn’t meet an ASD diagnosis, they look for SCD. But if there are routines and rituals, they don’t meet SCD either.
    There is this chasm of grey that a lot of children fall into because they have tightened the ASD criteria so much.

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