The scope of this page is limited to social communication disorders in school-age children (5-21 years old); social communication resources for preschool and early adult populations will be developed at a later date. While the four domains of social communication function in an integrated way, this document focuses on disorders of social interaction, social cognition, and pragmatics, because these are unique to social communication. Disorders of receptive and expressive language will be addressed in a separate Practice Portal page.
Social communication can be defined as "the synergistic emergence of social interaction, social cognition, pragmatics (verbal and nonverbal), and receptive and expressive language processing" (Adams, 2005, p. 182). See components of social communication [PDF] and social communication benchmarks [PDF] across the age span.
Social communication disorders may include problems with social interaction, social cognition, and pragmatics. A social communication disorder may be a distinct diagnosis or may occur within the context of other conditions, such as autism spectrum disorder (ASD), specific language impairment (SLI), learning disabilities (LD), language learning disabilities (LLD), intellectual disabilities (ID), developmental disabilities (DD), attention deficit hyperactivity disorder (ADHD), and traumatic brain injury (TBI). Other conditions (e.g., psychological/emotional disorders and hearing loss) may also impact social communication skills. In the case of ASD, social communication problems are a defining feature along with restricted, repetitive patterns of behavior.
Social communication includes interactions with a variety of communication partners, including family, caregivers, child care providers, educators, and peers. 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), and there is a wide range of acceptable norms within and across individuals, families, and cultures. For example, preferences for maintaining or averting eye contact, expectations for adult-child interactions, or norms for personal space may vary. The rules of interaction are highly dependent on the situation and condition in which the child is involved (Kayser, 1989; Wolfram, 1986). Clinically and culturally appropriate assessment must examine variations in norms and distinguish these variations from a disorder(s).
Coding for social communication disorders can be complicated. For guidance, refer to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association, 2013), ASHA's Billing and Reimbursement, and ASHA's Speech-Language Pathology Billing Codes.