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Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013). The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability (intellectual developmental disorder), global developmental delay, or another mental disorder. The onset of symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).ĭ.
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The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.Ĭ. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).ī. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.Ĥ. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language.ģ. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.Ģ. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:ġ. Social communication disorder can co-occur with other communication disorders in the DSM-5 (these include language disorder, speech sound disorder, childhood-onset fluency disorder, and unspecified communication disorder), but cannot be diagnosed in the presence of autism spectrum disorder (ASD). Sufficient language skills must be developed before these higher-order pragmatic deficits can be detected, so a diagnosis of SCD should not be made until children are 4–5 years of age. Individuals with SCD may be characterized by difficulty in using language for social purposes, appropriately matching communication to the social context, following rules of the communication context (e.g., back and forth of conversation), understanding nonliteral language (e.g., jokes, idioms, metaphors), and integrating language with nonverbal communicative behaviors. SCD is defined by a primary deficit in the social use of nonverbal and verbal communication (see Table 1 for the full list of criteria). Social (pragmatic) communication disorder (SCD) is a new diagnostic category included under Communication Disorders in the Neurodevelopmental Disorders section of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).