Social Communication Disorder: Causes, Signs, Treatment

Social communication disorder (SCD) is when someone has trouble using words and body language to communicate with others in social situations. This condition can make it difficult for them to make friends, do well in school, and work with others. SCD can show up in different ways, like having trouble understanding jokes or knowing when to stop talking. It can be diagnosed on its own or with other conditions, but not with autism.

But first, let’s have a short video of a parent with a son who has SCD

How common is Social communication disorder?

Precise estimates of how common Social Communication Disorder (SCD) is have been difficult to determine due to inconsistent definitions and populations studied. However, in eighth-graders, SCD was estimated to be between 7% and 11%. Children with a history of DLD (developmental language disorder) were found to be three times more likely to have SCD than those without DLD. SCD was more common in males, with a male-to-female ratio of 2.5:1. SCD is often associated with other disorders, such as schizophrenia and delayed social competence in preterm infants. It is possible to obtain supplementary information regarding the occurrence and frequency of related conditions that share similar symptoms and features.

SCD, or social communication disorder, can affect a person’s ability to communicate in social situations. Symptoms can vary depending on the person’s age and the context of the communication but may include:

  • Difficulty with greetings.
  • Changing communication style based on the situation.
  • Telling and understanding stories.
  • Engaging in conversation.
  • Repairing breakdowns in communication.
  • Using appropriate verbal and nonverbal signals.
  • Understanding the figurative language.
  • Making inferences.
  • Forming and maintaining close relationships.

Deficits may be present in social interaction, social understanding, pragmatics, and language processing.

What are the causes?

Although the causes of SCD are unknown, it is typically identified in relation to associated conditions such as:

  • Aphasia
  • Dementia
  • Intellectual Disability
  • Pediatric Traumatic Brain Injury
  • Spoken Language Disorders
  • Traumatic Brain Injury in Adults
  • Written Language Disorders

How can a speech therapist help?

Speech-language pathologists (SLPs) are important in helping individuals with a social communication disorder (SCD). SLPs can screen, diagnose, and create a treatment plan for individuals with SCD. They can also educate other professionals, provide counseling to individuals and their families, and offer education to reduce the impact of SCD. SLPs collaborate with families, individuals, and other professionals to identify priorities and build a consensus on a functional intervention plan. They remain informed of the latest research on SCD and advocate for individuals with SCD at different levels.

How to assess patients?

When suspected cases of social communication disorder (SCD) arise, speech and language screening must be conducted to determine if the individual displays difficulties with social interaction, conversation, or interpreting nonliteral language. This screening should include hearing testing to rule out hearing loss as a contributing factor. 

Children with ADHD or a history of brain injury or neurological disorders should be considered for potential screening for SCD, as they are at greater risk for social interaction difficulties. A comprehensive speech and language assessment should be conducted if screening results indicate the need for further evaluation. 

This assessment must be culturally sensitive and functional and involve a collaborative effort between professionals and caregivers. Social communication norms that vary between individuals should not be considered as disorders, and diagnoses should take into account the individual’s capacity to adjust to the social standards of their surroundings or community.

Factors to Consider in Assessment

When assessing a patient with SCD, it is important to consider their age, cultural background, and expected stage of development. The assessment should include a combination of formal and informal assessments, as standardized assessments may lack ecological validity.

Differential diagnosis is important to rule out other disorders, such as ASD and developmental language disorder. 

Regardless of cognitive or language scores, children and adolescents with SCD are eligible for speech-language pathology services. When billing for services, SLPs cannot use DSM-5 codes related to SCD for payment purposes.

How to treat SCD?

When treating a patient with Social Communication Disorder (SCD), the focus is on improving their social communication skills and increasing their independence in natural communication settings. 

The treatment plan should involve the individual and their family, consider cultural norms, and focus on individual needs. Collaborating with different professionals can also be useful. One-on-one interventions are helpful for teaching new skills, while group interventions allow for practicing skills in functional communication settings. 

In school settings, environmental arrangements, teacher-mediated, and peer-mediated interventions can be used in treatment. Augmentative and alternative communication, computer-based instruction, and video-based instruction are all treatment modalities that can be used to improve language skills, social skills, and problem-solving.

Treatment Options

Several treatment options are available for individuals with SCD, including behavioral interventions/techniques, peer-mediated/peer-implemented interventions, and social communication treatments. 

Behavioral interventions/techniques use learning principles to modify or teach new behaviors. Peer-mediated/peer-implemented interventions typically develop peer-teaching strategies to facilitate play and social interactions with children with SCD. Social communication treatments specifically aim to improve social communication skills and include interventions such as comic strip conversations, SCORE skills strategy, social communication intervention, social scripts, social skills groups, and Social Stories™. 

These interventions can be used in one-on-one or group settings and can benefit both children and adults with SCD.

Factors to Consider in Treatment

Several factors must be considered for patients with Social Communication Disorder (SCD). Cultural and linguistic norms are essential to understand to determine communication patterns that reflect differences or disorders. Treatment should be conducted in the language used by the individual. As they grow older, adolescents with SCD should adapt and develop their social communication skills for different social settings. Support and interventions are also available for adults with SCD. Children who are deaf or have hearing dysfunction need special programs, starting with parent-child communication to develop social skills. Service providers should determine the optimal service delivery format, provider, dosage, and setting that may affect treatment outcomes.


Social Communication Disorder (SCD) is a condition where an individual has difficulty using words and body language to communicate with others in social situations. This condition can result in difficulties making friends, doing well in school, and working with others. SCD can manifest in various ways, and diagnosis is often associated with other disorders. Speech-language pathologists (SLPs) are essential in helping individuals with SCD, and assessment and treatment should consider cultural and developmental factors. Treatment options for SCD include behavioral, peer-mediated, and social communication treatments.

Written by: Dr. Jaafar Said

Edited and Reviewed by: Dr. Juhairah Magarang-Said