Social Communication Disorder (SCD)

Reviewed by:
Hannah Andreasen

December 19, 2022

Social communication disorder (SCD) refers to children who have trouble using language to interact with others. Individuals with SCD understand language and can use it in some contexts, but have trouble communicating in social situations. Between 7% and 11% of children are estimated to have SCD.

Difficulty with social communication is one of the defining features of autism spectrum disorder (ASD). However, children with SCD do not have restricted, repetitive patterns of behavior like children with ASD.

What Is Social Communication?

To better understand SCD, we should learn more about social communication. 

Social communication refers to how language is used in social situations. It enables individuals to share experiences, thoughts, and emotions. Children need skills in social communication to be able to express themselves and to understand others. 

The components of social communication include social interaction, social understanding, pragmatics, and language processing. 

Social Interaction

Social interaction refers to communication between two or more people. The rules that govern social interactions may vary across different cultures and communities. 

Social interaction includes:

  • Attachment to a caregiver 
  • Understanding and regulation of emotions 
  • Social tasks 
  • Speech style 
  • Code-switching (changing language and communication style based on the setting and partner)
  • Social reasoning
  • Conflict resolution

Social Understanding

Social understanding helps guide our response to social interactions. Social understanding is also referred to as social cognition. 

Social understanding is based on your ability to understand the emotions and mental state of those around you. It requires you to be able to put yourself in another’s shoes and see things from their perspective. 


Pragmatics refers to the set of rules around using language in conversation and social settings. It includes verbal and nonverbal communication. 

Verbal communication involves using speech to communicate thoughts and feelings. 

Nonverbal communication involves all ways you communicate using your body, including:

  • Posture
  • Body language
  • Facial expression
  • Eye contact
  • Pointing or gesturing
  • Waving

Language Processing

Language processing involves transferring internal thoughts and feelings into expressive communication through speaking, reading, or writing. The components of language processing include:

  • Understanding spoken and written language 
  • Order of words (syntax)
  • Vocabulary used (semantics)
  • Word form (morphology)
  • Speech sounds (phonology) 

Language processing involves both expressive and receptive language.

Expressive language is the internal generation of language. 

Receptive language is the understanding and interpretation of language. 

What Are the Symptoms of SCD?

Children with SCD have difficulty using verbal and nonverbal communication in a social setting. Most children with SCD will start showing symptoms when they are very young. 

The symptoms of SCD include experiencing difficulty with the following:

  • Using an appropriate greeting
  • Code-switching
  • Telling a story
  • Understanding figurative language 
  • Understanding information that is not explicitly stated
  • Understanding tone and context 
  • Forming and maintaining close friendships
  • Using words or gestures appropriately 
  • Talking with others
  • Learning language
  • Sharing attention
  • Turn-taking in play and conversation
  • Maintaining a topic of conversation
  • Understanding nonverbal cues 
  • Interrupting others 

How Is SCD Diagnosed?

Children should be screened for SCD if they have not been diagnosed with any other disorders but have difficulties with social interaction, conversation, or understanding of nonliteral language. 

It is important to take into account cultural differences in social behavior when screening and evaluating children for SCD. The wide variety of cultural norms can make assessing SCD challenging. 

Speech-language pathologists and psychologists will help evaluate the child for SCD. The evaluation may be done along with an assessment of expressive and receptive language skills. 

During the evaluation, the speech-language pathologist might assess:

  • Turn-taking
  • Eye contact
  • Ability and willingness to maintain a topic of conversation
  • Ability to switch conversation topics
  • Understanding of verbal and nonverbal cues
  • Ability to communicate using speech, gestures, pictures, and writing 

Autism can look a lot like SCD. In addition to difficulties communicating, children with autism will also have repetitive behaviors and narrow interests. Because of this, it is important that children also receive screening for autism. It may also be appropriate to screen them for other communication disorders and attention deficit hyperactivity disorder (ADHD). 

How Is SCD Treated?

Currently, there are no specific treatments for SCD. However, children with SCD have similar difficulties with communication as children with autism, so many of the treatments for autism can work for SCD. 

SCD treatment aims to increase the child’s engagement and independence in the environment in which they naturally communicate. Treatment focuses on verbal and nonverbal communication, play skills, and social skills training. It usually involves collaboration between several different professionals, including speech-language pathologists, classroom teachers, psychologists, and caregivers. 

There are several treatment options available:

  • Behavioral approaches—Applied behavior analysis (ABA) interventions such as discrete trial teaching (DTT), natural environment teaching (NET), and positive behavior support (PBS) can help teach new behaviors or modify existing behaviors. 
  • Peer-mediated interventions—In this intervention, typically developing peers learn strategies to facilitate communication and play with children who have SCD. 
  • Social communication treatments—These treatments can improve social communication skills using examples of social interactions such as comic strips, videos, scripts, and role play. 


Children with SCD have difficulty communicating and interacting with others. Social communication is complex and varies widely across cultures. Children with SCD may behave similarly to children with autism in social situations. Because of this, many autism treatments can be helpful for children with SCD. 

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