Conflict of interest statement: No conflicts declared.
Practitioner Review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications
Article first published online: 9 OCT 2013
© 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of Child Psychology and Psychiatry
Volume 55, Issue 3, pages 204–216, March 2014
How to Cite
Norbury, C. F. (2014), Practitioner Review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. Journal of Child Psychology and Psychiatry, 55: 204–216. doi: 10.1111/jcpp.12154
- Issue published online: 19 FEB 2014
- Article first published online: 9 OCT 2013
- Manuscript Accepted: 16 JUL 2013
- autism spectrum disorders;
- language disorder;
- social communication
DSM-5 sees the introduction of Social (Pragmatic) Communication Disorder (SPCD), characterized by persistent difficulties using verbal and nonverbal communication for social purposes, in the absence of restricted and repetitive interests and behaviours. There is currently much confusion about the precise diagnostic criteria for SPCD and how this disorder relates to autism spectrum disorders (ASD), previous descriptions of pragmatic language impairment (PLI) and more specific language disorders (LD).
Proposed criteria for SPCD are outlined. A selective review of the evidence considers whether these criteria form a cohesive and distinct diagnostic entity. Approaches to assessment and intervention are discussed.
Implementing the new diagnosis is currently challenged by a lack of well-validated and reliable assessment measures, and observed continuities between SPCD and other neurodevelopmental disorders. High rates of comorbidity between SPCD and other seemingly disparate disorders (including conduct disorder, ADHD and disorders of known genetic origin) raise questions about the utility of this diagnostic category.
SPCD is probably best conceptualized as a dimensional symptom profile that may be present across a range of neurodevelopmental disorders, although there is an urgent need to investigate the latent structure of SPCD using consistent diagnostic criteria. In addition, social communication and aspects of pragmatic language may be dissociated, with the latter heavily influenced by structural language attainments. Finally, there is a dearth of reliable and culturally valid assessment measures with which to make a differential diagnosis, and few rigorously tested intervention programmes. The implications for research and clinical practice are outlined.