Social Language Disorders/ASD

Social Communication

Social communication is the use of language in social contexts. It encompasses social interaction, social cognition, pragmatics, and language processing.

Social communication skills include the ability to vary speech style, take the perspective of others, understand and appropriately use the rules for verbal and nonverbal communication, and use the structural aspects of language (e.g., vocabulary, syntax, and phonology) to accomplish these goals.

Social communication, spoken language, and written language have an intricate relationship (see figure below). Social communication skills are needed for language expression and comprehension in both spoken and written modalities. Spoken and written language skills allow for effective communication in a variety of social contexts and for a variety of purposes.

Social communication behaviors such as eye contact, facial expressions, and body language are influenced by sociocultural and individual factors (Curenton & Justice, 2004; Inglebret, Jones, & Pavel, 2008). There is a wide range of acceptable norms within and across individuals, families, and cultures.

Social Communication Disorder

Social communication disorder is characterized by difficulties with the use of verbal and nonverbal language for social purposes. Primary difficulties are in social interaction, social cognition, and pragmatics. Specific deficits are evident in the individual’s ability to

  • communicate for social purposes in ways that are appropriate for the particular social context;
  • change communication to match the context or needs of the listener;
  • follow rules for conversation and storytelling;
  • understand nonliterate or ambiguous language; and
  • understand what is not explicitly stated.

This definition is consistent with the diagnostic criteria for Social (Pragmatic) Communication Disorder detailed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association [APA], 2013).

Social communication disorder can result in far-reaching problems, including difficulty participating in social settings, developing peer relationships, achieving academic success, and performing successfully on the job.

Social communication disorder may be a distinct diagnosis or may co-occur with other conditions, such as

  • intellectual disability;
  • developmental disabilities;
  • learning disabilities;
  • spoken language disorders;
  • written language disorders;
  • attention-deficit/hyperactivity disorder (ADHD);
  • traumatic brain injury (pediatric and adult);
  • aphasia;
  • dementia; and
  • right-hemisphere damage.

In the case of autism spectrum disorder (ASD), social communication problems are a defining feature, along with restricted, repetitive patterns of behavior. Therefore, social communication disorder cannot be diagnosed in conjunction with ASD.

Autism Spectrum Disorders (ASD)

About Autism

Autism is also known as Autism Spectrum Disorder (ASD). People with autism have challenges with communication and social skills. They also have repetitive behaviors or restricted interests. Speech-language pathologists, or SLPs, can help.

People with autism have challenges with communication and social skills. They often find it hard to have conversations and may not pick up on social cues. Some people with autism may not talk at all, and others may talk very well. But all will have some challenges making friends and communicating socially.

People with autism also have some type of restricted interest or repetitive behaviors. They may focus on one topic, like cars or a television show, or they may be attached to a certain object or activity. A person with autism may not like changes in their schedule or changes in the way they do something.

Autism can range on a spectrum from mild to severe, depending on how much these challenges affect everyday life.

Signs and Symptoms of Autism

You can often observe signs and symptoms of autism in very young children. But sometimes they are not very noticeable, and they might not be recognized until school age or even adulthood. Signs and symptoms my change as the person gets older, but there will always be challenges with communication, social skills, and behaviors.

Communication

Communication includes understanding, talking, reading, and writing. A person with autism may have challenges

  • understanding and using gestures like pointing or waving;
  • understanding and using words;
  • following directions;
  • learning to read or write—some children with autism read early but do not understand what they read (called hyperlexia); and
  • having conversations.

A person with autism may

  • lose early words;
  • be hard to understand;
  • repeat words or phrases they just heard or that they heard days or weeks earlier (echolalia);
  • use a robotic or singsong speaking voice;
  • talk very little or not at all; and
  • use challenging behaviors instead of words or gestures to communicate what they want.

Social Skills

A person with autism may have challenges relating to others. It might seem like they are not interested in others or in making friends.

It may be hard for a person with autism to

  • share attention with someone else and focus on the same object or event;
  • join in play with others and share toys;
  • respond when others invite them to play or talk;
  • understand how others feel;
  • take turns in play or in conversation; and
  • make and keep friends.

Behaviors

A person with autism may

  • repeat certain behaviors including hand or body movements;
  • cry, laugh, or become angry for unknown reasons;
  • have trouble changing from one activity to the next;
  • get upset by certain sounds, smells, or textures;
  • like only a few foods;
  • choose foods based on look or texture; and
  • be interested in only a few objects or topics.

Causes of Autism

Autism is present throughout the person’s lifetime, and you may not know what caused it. Sometimes, autism runs in families. Some possible causes include

  • genetic differences;
  • differences in brain development or in brain function; and
  • exposure to harmful materials or chemicals in the environment.

Seeing a Professional

Testing for Autism

Testing is usually done by a team of individuals who know about autism. The team may include a medical doctor, a neurologist, a developmental psychologist, and an SLP. The individual and their family members are always part of the team. An audiologist also tests the person’s hearing to make sure they do not have a hearing loss.

SLPs test the person’s communication and social skills. They may talk with others to learn about the person’s communication in settings like home, school, or work.

Some people with autism are hard to understand, talk very little, or don’t talk at all. SLPs test the person’s ability to use augmentative and alternative communication (AAC) to help them communicate. AAC can include sign language, gestures, pictures, computer tablets, and other electronic devices.

All people with autism have social communication challenges. But not all people with social communication challenges have autism. SLPs can help figure out if a person has autism or a social (pragmatic) communication disorder. Knowing the diagnosis will help the SLP find the best treatment.

Treatments for People With Autism

There is no known cure for autism. For young children with autism, it is best to get help early. Ask about local early intervention and preschool programs. Adolescents and adults with autism also benefit from treatment to help them communicate better in school, at work, and in the community.

A variety of specialists might work with a person with autism throughout their lifetime. These can include SLPs, audiologists, psychologists, special educators, vocational counselors, and job coaches.

SLPs play an important role in autism treatment. They can help the person with autism build communication and social skills in various settings like home, school, and work. SLPs can also help the person learn to use AAC if they need help communicating. SLPs may work with the person alone or in small groups. Groups can help the person practice their skills with others.

Depending on the person’s needs, SLPs may work on some of the following skills:

  • Getting along with others in a variety of settings
  • Using appropriate communication behaviors
  • Taking turns in conversation
  • Transitioning from one task or setting to another
  • Accepting change and expanding interests, including trying new foods
  • Improving reading and writing skills

For people with autism who are transitioning to work, SLPs can also

  • help them write cover letters;
  • practice interview skills; and
  • learn strategies to communicate better at work.