Has your child been diagnosed with autism spectrum disorder (ASD), or does he or she exhibit symptoms of autism? Before seeking autism-specific assistance, make sure the diagnosis is correct.
You may learn that your child has Social (Pragmatic) Communication Disorder (SCD). Recently added to the most current, fifth-edition of the DSM (Diagnosis and Statistical Manual of Mental Disorders), the signs and symptoms of ASD are very similar – and even overlap – with those of SCD, even though the two conditions are different.
If your child has yet to be diagnosed, or was diagnosed with ASD based on the 4th-edition of the DSM, it may be worthwhile to schedule a consultation with a licensed speech-language pathologist who is trained to identify the difference. Speech-language pathologists are available at most medical centers or your physician can refer you to a reputable center or clinic for accurate diagnosis.
Since the newest edition of the DSM-5, field tests show that some children who were diagnosed with ASD via the parameters of the older-edition of DSM-4 would now be diagnosed with ASD as a result of the new criteria.
What’s the Difference Between ASD and SCD?
One of the main differences – a red-flag for parents who suspect their child was misdiagnosed with ASD – is that children with autism have difficulties with social communication AND they exhibit repetitive and/or disruptive behaviors.
Repetitive or disruptive behaviors include things like:
- Repeated body movements such as rocking, flapping, jumping, twirling
- Obsessive fixation on routines and rituals
- Putting things in order and in order again, and/or a preoccupation with things being in a very specific order or placement
- Excessive repeating of sounds, syllables, words and/or phrases
- Intense and obsessive preoccupation with specific objects or subjects
- Extreme sensory sensitivity (particularly to sound and/or chaos)
Any disruption to routine, order, the schedule or an affront to their sensitivities can result in loud, sometimes violent, outbursts – with aggression being self-inflicted or inflicted upon others (or objects) in their immediate environment.
If your child was diagnosed with autism, but doesn’t tend to display the restrictive, repetitive or disruptive behaviors associated with autism spectrum disorder, he or she should be reassessed for an accurate diagnosis. You may find out the real issue is social communication disorder.
What is Social Communication Disorder (SCD)?
In order for a child to be diagnosed with SCD, the four key criteria must be present. These include:
- Persistent difficulties using verbal and nonverbal communication cues.
- Communication difficulties result in their inability to effectively communicate with family, friends and their community.
- The difficulties emerged in the early years, even if they weren’t diagnosed until later on.
- Their communication issues are not linked to another medical or specific language difficulty.
Children being screened for SCD will be evaluated for their ability to:
- Respond to others
- Talk about their feelings and emotions
- Take turns speaking and responding to others
- Stay on topic
- Use gestures and hand movements to express themselves (waving hello/goodbye, pointing, expressive gesturing, etc.)
- Adjust their speech according to the situation or environment (speaking quietly in a library or learning to speak differently to toddlers as opposed to adults)
- Ask questions or making comments that relate to the conversational topic
- Make and keeping friends
- Use words for a variety of purposes, from greetings and requests, to conversation or expressing emotions
If you have a young child, under 5-years of age, it is easy to think, “My child doesn’t do any of those things…” but do not automatically assume anything. Different children develop social communication skills at different stages, so you might just have a child who is less communicative right now.
That’s why professional assessment is so critical. You certainly don’t want to project anything onto your child that isn’t there, or spend precious time and resources treating something that doesn’t exist.
Accurate diagnosis is complicated further if a child also has a speech disorder, ADD/ADHD or other behavioral disorders.
Work With a Therapist Who Specializes in Your Child’s Condition
Regardless of whether or not your child has ASD or SCD, it’s important that he or she work with professionals who specialize in the specific condition.
For example, if your child does have SCD, a speech-language pathologist who specializes in SCD may be available via your child’s school. If not, speak with your healthcare provider or reach out to ASD resources who may be able to provide referrals.
Speech-language pathologists are trained to work with individuals who have non-verbal communications as well as social interactions. In addition to providing individuals and their families with practice and training, they also provide interactive visual tools – such as picture boards or tablets – which can help to bridge the gap as the individual makes progress through therapy.
Treatment for SCD typically includes:
- Professional therapy. Professional, one-on-one or small-group therapy with a licensed speech-language pathologist specializing in SCD works wonders.
- The whole family. Your family is your child’s microcosm of society. Since communication doesn’t happen in a vacuum, the therapist will be training the whole family in techniques, strategies, games, tools, etc., to help you communicate with your child. This practice will pay off in his/her other social groups and communities.
- Education/tools for teachers, coaches and other elders. Just as your family will need to practice, the child will be more fully supported if teachers, coaches and other close family/friend members have some information and tools with which to engage your child more fully.
- Practice, practice, practice. Finally, it takes lots of practice in real-life scenarios, via conversations and gentle reminders, using stories as a chance to discuss facial expression and ask/answer questions about characters’ interactions, talking about/asking about feelings and body language in particular situations, etc.
Parenting a child with SCD or ASD can be a challenge, and unanswered questions and concerns simply breed more unnecessary worry. Trust your instincts and seek the professional, qualified assistance needed to screen your child and obtain an accurate diagnosis.
The sooner you have a concrete diagnosis, the better able you and the experts will be at providing the essential tools and support your child needs to be successful. To learn more about either disorder, contact Sarah Dooley Center online or at 804-521-5571.