Social Communication Disorder

What Causes Social Communication Disorder?

The cause of SCD is unknown. Symptoms of the disorder are often associated with autism, but SCD may also exist on its own without the other symptoms of autism spectrum disorder. Sometimes, SCD emerges as a result of another brain-related condition, such as:

• Developmental disability
• Intellectual disability
• Attention-deficit/hyperactivity disorder
• Learning disability
• Language disorders
• Traumatic brain injury (TBI)
• Aphasia
• Dementia

Is Social Communication Disorder Hereditary?

Scientists don’t know yet what causes SCD, so it is not clear how much of a role genetics play in developing the disorder. However, the condition is more likely to occur in someone with a family history of autism, communication disorders, or specific learning disabilities, suggesting that genes are partially responsible for SCD risk.

Autism, a disorder commonly associated with social communication difficulties, arises from a complex interplay of genes and the environment. Genetics are significant in ASD, but scientists still don’t know precisely how risk for the disorder is inherited. Although environmental factors are almost certainly partly to blame for the development of autism, a recent study has suggested that as much as 80% of the risk for the disorder comes from genetics.

How Is Social Communication Disorder Detected?

In many cases, the first signs of SCD appear in early childhood, with developmental signs occurring as the child fails to achieve communication milestones.

Signs of SCD in childhood include:

• Delays in achieving language-related milestones
• Lack of interest in social interaction
• Failure to respond appropriately to social cues from parents, other adults, or peers
• Inability to initiate social interactions

How Is Social Communication Disorder Diagnosed?

Diagnosis of SCD begins with determining that the patient has a cluster of symptoms that meet the diagnostic criteria for the disorder. A doctor will start with a physical exam to rule out other problems that may be causing the symptoms. After these exams, if the doctor suspects that SCD is the cause of the symptoms, they may recommend a psychological or psychiatric assessment to solidify the diagnosis.

Diagnostic steps may include:

• A physical exam. This exam aims to rule out physical conditions that could be causing the symptoms. The doctor will likely administer a hearing exam to rule out hearing loss as a cause of the communication problems.
• Assessment by a speech-language pathologist. This assessment will attempt to understand the person’s ability to speak and understand language.
• Psychological assessments. If no physical or neurological causes can be found, the doctors may use these assessments to determine if the disorder has a psychological basis. The assessments may take the form of questionnaires or talk sessions with a mental health professional to assess the patient’s mood, mental state, and mental health history. Family members or caregivers may also be asked to participate in these assessments.

The results of the psychological assessments will be compared to the diagnostic criteria for SCD in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM criteria for SCD include:

• The person has problems using communication appropriately for social interaction (e.g., greetings).
• The person has problems changing communication styles to fit the situation.
• The person has problems following the rules of conversation or storytelling.
• The person has trouble understanding ambiguous language (e.g., metaphors, humor) or inferring things that are not explicitly stated.
• The symptoms significantly impair social relationships, school or work performance, or other aspects of social functioning.
• The symptoms begin in early childhood.
• The symptoms are not better explained by a neurological problem, a medical disorder, a sensory problem, or another mental health-related issue.

PLEASE CONSULT A PHYSICIAN FOR MORE INFORMATION.

How Is Social Communication Disorder Treated?

A wide range of behavioral therapies and psychotherapy approaches have proven effective at treating SCD. Commonly used treatments include:

• Social skills training
• Speech-language therapy
• Behavioral management therapy
• Cognitive-behavioral therapy

How Does Social Communication Disorder Progress?

Without treatment, people with SCD may struggle to create and maintain friendships and other meaningful relationships. Over time, their communication difficulties can lead to social isolation and the potentially serious complications that come along with it, including:

• Being bullied
• Problems with schoolwork
• Impairment of social relationships
• Anxiety or depression

How Is Social Communication Disorder Prevented?

There is no known way to prevent an SSD. However, recognizing the disorder early and intervening with treatment may help a child learn strategies to cope with the disorder’s challenges.

Social Communication Disorder Caregiver Tips

Some of the ways you can help your child cope with autism include:

• Educate yourself. The more you know, the better you’ll be able to help your child. That means you should learn as much as you can about SCD, but it also means you should know about your child’s individual experience with the disorder. You can best support your child when you’re an expert on their disorder.
• Be an advocate for your child. Only you know what’s best for your child, and it’s up to you to be sure that caregivers, teachers, family members, and everyone else knows how to best support your family.

The majority of people with SCD also suffer from other mental health and brain-related conditions, a condition called co-morbidity. Here are a few of the disorders commonly associated with SCD:

• Depression and anxiety are commonly comorbid with SCD.
• SCD and ADHD are frequently associated, and many children may be diagnosed with both disorders.

Social Communication Disorder Brain Science

Scientists don’t fully understand how differences in brain function impact social communication. However, some scientists believe people with social communication difficulties have trouble processing social cues quickly and effectively enough to respond appropriately. They theorize the problem lies in different brain networks, diverse parts of the brain that work together to process and react to external stimuli. In some people, these networks might not function properly, either internally within a network or in the connections between networks.

The brain networks that might be involved in social communication problems include:

• Salience network. This network includes the insula and the anterior cingulate cortex. One of its functions is thought to be the identification of other people’s mental states, an essential part of pragmatic language comprehension.
• Default mode network (DMN). This network is involved in deciphering social cues.

Studies have found that activity in these parts of the brain is atypical in people with social communication problems when they’re confronted with complex social situations.

Social Communication Disorder Research

Title: Promoting Transactional Supports to Optimize Social Communication Outcomes for Infants and Their Families

Stage: Recruiting

Principal Investigator: Nathan Call, PhD

Marcus Autism Center

Atlanta, GA  

This early treatment project is designed to address two significant public health challenges – the need for validated, manualized treatments for young children with Autism Spectrum Disorder (ASD) that are cost-efficient and feasible for community-based implementation, and the need to reduce the age of entry into early intervention to optimize outcomes. This study will use a 2-stage sequential multiple assignment randomized trial (SMART) design to develop an adaptive intervention by comparing individual and combined effects of preventative parent education and autism treatment starting in infancy. All parent-infant dyads from the pool of 250 high and low-risk siblings in the Emory Autism Center of Excellence (ACE) will be invited at six months of age and randomly assigned at Stage 1 to the Social Communication Growth Charts (SCGC) that use innovative web-based technology to teach parents early social communication milestones and how to support their child’s development very early or Usual Care (UC), to compare the efficacy on developmental trajectories from 9 to 30 months. Families of children who show early signs of ASD at 12 months of age, based on tailoring variables using parent reports and observational measures, will be re-randomized at Stage 2 to compare the efficacy of a parent-implemented (P-I) condition of a naturalistic developmental behavioral intervention (NDBI) based on the Early Social Interaction (ESI)1 model to a clinician-implemented (C-I) condition of NDBI based on a hybrid model from 12 to 21 months of age. The investigators anticipate that 80 children will show early signs of ASD and that 56 families (70%) will agree to participate in the Stage 2 treatment. Growth trajectories of parent contingent responsiveness and child social communication will be collected longitudinally with repeated measures at 9, 12, 16, 21, and 30 months. To measure differential treatment effects, outcome measures of autism symptoms, developmental level, and adaptive behavior will be examined at 21 and 30 months.

Title: Neural Basis of Social Cognition Deficits

Stage: Recruiting

Principal Investigator: Aarti Nair, PhD

Loma Linda University

Loma Linda, CA  

Difficulties in reciprocal social interaction are hallmark features of several neuropsychiatric disorders, most notably autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD). While recent studies have demonstrated substantial overlap in genetic etiology between ASD and SSD, little is known about common versus unique neural mechanisms that may underlie these downstream social deficits that cross diagnostic boundaries. Thus, a comprehensive imaging study examining social deficits in youth with ASD and adolescent-onset SSD at the neurochemical, connectivity, as well as functional activation level will be crucial in furthering our understanding of these underlying neural mechanisms. Specifically, the current project aims to examine how targeted social skills interventions may impact the organization of large-scale functional brain networks implicated in social cognition in these disorders, leading to improved outcomes. Thirty adolescents with ASD and 30 with SSD will undergo the Program for the Education and Enrichment of Relational Skills (PEERS), a 16-week parent-assisted social skills intervention that aims to improve friendship quality and social skills of teens with social difficulties. All participants will receive pre-and post-treatment MRI scans, including functional MRI and magnetic resonance spectroscopy, to quantify neural changes resulting from the intervention. All participants will also receive behavioral and social cognition assessments pre-and post-intervention to quantify real-world gains in social behaviors resulting from the intervention. Additionally, 30 typically developing adolescents will be recruited to serve as control participants and undergo two MRI and behavioral assessment sessions 16-weeks apart with no intervention in between. Specific aims include (1) examining inter-group disruptions in connectivity patterns, activation levels, and neurometabolite concentrations in key social brain regions pre-treatment in ASD and SSD groups, (2) examining inter-group changes in connectivity patterns, activation levels, and neurometabolite concentrations in key social brain regions in response to treatment in ASD and SSD groups, and, (3) dimensionally identifying intra-group differences in brain responses and how they relate to real-world treatment outcomes.

Title: Evaluating a Social and Communication Intervention for Preschoolers

Stage: Recruiting

Principal Investigator: Rebecca Landa, PhD, CCC-SLP

Kennedy Krieger Institute

Baltimore, MD  

This study aims to test the effectiveness of a school-based treatment aimed at increasing language and social skills in preschool-aged children with autism spectrum disorder (ASD). Through interactive development (continually seeking educator feedback for intervention improvement) and implementation of the intervention, the investigators hope to provide a feasible and practical means for educators to work with children with ASD in real-world, large-scale settings. ASD preschool educators, the children enrolled in their classes, between the ages of 3 and 6 years, and their families may join.