Navigating the “Hidden” Divide: Social Communication Disorders

By Alexis Molineaux Gibbons, M.A., CCC-SLP

Even for the most skilled of us, navigating the social world can be difficult. As adults, we sometimes find ourselves “putting a foot in our mouth” or making a social “faux pas” or misstep.

Social interaction requires that we not only understand what someone has said, but that we consider nonverbal cues, the context or situation, conversational conventions, and the feelings and thoughts of our listener. With split second efficiency, we then make decisions about our responses to others. Although learning to be a skilled communicator can take a lifetime, children begin to use and understand the “hidden” rules of social communication in their preschool years.

For children with Social Communication Disorder (SCD) these skills can be overwhelming and seemingly impossible to obtain, creating anxiety, frustration and loneliness. Children with Attention Deficit Hyperactivity Disorder, Traumatic Brain Injury, Speech and Language Disorders, Autism Spectrum Disorders, and Disruptive Behavior Disorders can be especially susceptible to communication difficulties. SCD is a cluster of symptoms impacting a child’s ability to form and maintain close relationships.

So, what are the signs of a Social Communication Disorder?

Not modifying tone of voice/ word choice based on the listener: Speaking to a teacher, infant or peers in the same way.

Difficulty following conversational conventions: Entering a conversation appropriately, staying on topic, and conversational turn taking. Difficulty participating in back-and-forth conversation.

Trouble repairing/ identifying communication breakdowns: Observing when someone doesn’t understand what’s been said, and rephrasing or clarifying.

Challenges understanding/responding to nonverbal language: This includes gestures, tone of voice and facial expressions.

Difficulty understanding ambiguous and figurative language: This includes figures of speech, words with multiple meanings, and sarcasm.

Trouble making inferences: Understanding what is implied but not specifically stated.

Challenges taking another’s perspective: Understanding how a situation might make another person feel or think.

Difficulty looking at the context or situation: Understanding that our behavior has to be modified based on where we are and who we are with.

Most of us develop social expertise on our own. But children with SCD may require explicit teaching to master and understand these “hidden” rules. Social communication disorders are diagnosed and treated by Speech-Language Pathologists, who provide targeted individual or group therapy to support communication skills. Treatment typically takes a holistic approach, with collaboration with teachers, parents and other professionals to support carryover and practice of skills to school and home.

You can support your child’s social communication development by talking to them about the “hidden” rules of social communication:

Point out body language/ facial expressions and explore what they mean. For example, “Johnny is frowning, and is crossing his arms. I bet he feels mad.”

Talk about what other people might be thinking or feeling. “Johnny didn’t get a turn on the swing. I bet he feels sad and thinks it’s not fair”.

Talk to your child about social contexts. For example, when at the movie theater, “See how everyone is staying in their seat, and quietly watching the movie? We need to sit and quietly watch.”

Help your child make inferences. For example, when picking your child up from school, “Look! I brought your swimsuit and a towel! Where do you think we’re going? To swimming lessons!”

Explain ambiguous figurative language. “Your coach said to give it a shot. What does that mean? It means to try.”

Point out that we talk to different people differently. “It’s okay to say, ‘what’s up’ to friends, but you should say ‘hello’ to your teacher.”

Talk about or model how to have a conversation. Saying hi, taking turns, acknowledging what the other person has said, staying on topic, and ending a conversation.

Help your child understand/ fix breakdowns. For example, “I don’t understand. Can you tell me again? Or say it in another way?”

If you have concerns about your child’s social communication, speak to their pediatrician about a referral to a Speech-Language Pathologist. Research consistently demonstrates that early intervention for communication disorders (including SCD) leads to better long-term outcomes for children. Although SCD is not something that children typically “grow out of”, children can learn strategies and skills that significantly improve their social interactions and quality of life.