Home > Practice Portal > Clinical Topics

Social Communication Disorders in School-Age Children

Overview

Incidence and Prevalence

Signs and Symptoms

Causes

Roles and Responsibilities

Assessment

See the Assessment section of the social communication evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspective.

Screening

Screening of social communication skills is conducted whenever a social communication disorder is suspected or as part of a comprehensive speech and language evaluation for any child with communication concerns.

Screening typically includes

  • norm-referenced parent and teacher report measures,
  • competency-based tools such as interviews and observations,
  • hearing screening to rule out hearing loss as a possible contributing factor to social communication difficulties.

Comprehensive Assessment

Individuals suspected of having a social communication disorder based on screening results are referred to an SLP, and other professionals as needed, for a comprehensive assessment. Assessment of social communication should be culturally sensitive and functional and involve the collaborative efforts of families, caregivers, classroom teachers, SLPs, special educators, and psychologists as needed. Assessment is sensitive to the wide range of acceptable social norms that exist within and across communities.

Typically, SLPs assess a child's

  • initiation of spontaneous communication and reciprocal turn-taking in functional activities across communication partners and settings;
  • willingness to initiate and maintain conversation;
  • ability to manipulate conversational topics and repair communication breakdowns;
  • comprehension of verbal and nonverbal discourse in social, academic, and community settings;
  • communication for a range of social functions that are reciprocal and promote the development of friendships and social networks, including differentiation of one's own feeling from the feelings of others (Theory of Mind [ToM]);
  • verbal and nonverbal means of communication, including natural gestures, speech, signs, pictures, and written words, as well as other AAC systems;
  • ability to access literacy and academic instruction, as well as curricular, extracurricular, and vocational activities.

See social communication benchmarks [PDF] for age-specific social communication skills. SLPs consider cultural diversity of social communication when they examine eye gaze, orienting to one's name, pointing to or showing objects of interest, pretend play, imitation, nonverbal communication, and language development.

Comprehensive assessment of communication skills typically includes

Standardized Assessment—an empirically developed evaluation tool with established reliability and validity. Coexisting disorders/diagnoses are considered when selecting standardized assessment tools as deficits vary from population to population (e.g., ADHD, TBI, ASD). Formal testing may be useful for assessing the structure and form of language but may not provide an accurate assessment of an individual's use of language (i.e., pragmatics).

Parent/Teacher Child Report Measures—rating scales, checklists, and/or inventories completed by the family member(s)/caregiver(s), teacher(s), and/or child. Findings from multiple sources (e.g., family member, teacher, self-report) may be compared to obtain a comprehensive profile of social communication skills.

Ethnographic Interviewing—an interview technique using open-ended questions, restatement, summarizing for clarification, and avoidance of leading questions and "why" questions in order to develop an understanding of the client's and the family's perceptions, views, desires, and expectations.

Analog Task(s)—observation of the child in simulated social situations that mimic real world events, including peer group activities.

Naturalistic Observation—observation of the child in everyday social settings with other individuals.

Assessment may result in

  • diagnosis of social communication disorder,
  • description of the characteristics and severity of the disorder,
  • recommendations for intervention and support,
  • referral to other professionals as needed.

As mandated by the Individuals with Disabilities Education Improvement Act (IDEA; 2004), SLPs should avoid applying a priori criteria (e.g., discrepancies between cognitive abilities and communication functioning, chronological age, or diagnosis) in making decisions on eligibility for services. In the schools, children and adolescents with social communication disorders are eligible for speech-language pathology services, due to the pervasive nature of the social communication impairment, regardless of cognitive abilities or performance on standardized testing of formal language skills.

Treatment

Resources

References

Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.