When it comes to social and communication challenges, most people assume a person has autism. However in 2013, when the DSM-V was released, the writers created a new diagnosis called Social Pragmatic Communication Disorder (SPCD). Many assessors became confused because it was so similar to the social challenges that autistic people face, but diagnosticians insisted that people with SPCD did not have autism spectrum disorder (ASD).

Though they may seem similar at first glance, these two conditions are distinct, with differences in how they impact individuals’ social communication skills, behavior, and overall functioning. In this blog, we’ll dive into the key distinctions between SPCD and ASD, shedding light on each condition’s unique features.

What is Social Pragmatic Communication Disorder?

Social Pragmatic Communication Disorder (SPCD) is a condition that primarily affects an individual’s ability to use language appropriately in social contexts. The hallmark of SPCD is difficulty in understanding and using verbal and non-verbal communication to engage with others in everyday social situations.

Key features of SPCD include:

• Difficulty with social interaction: People with SPCD may struggle to understand the social rules of conversation, such as taking turns, maintaining appropriate eye contact, or knowing when to start or end a conversation.

• Trouble with context-specific communication: Individuals with SPCD may have difficulty understanding how to adjust their language based on the setting, audience, or purpose. For example, they might have trouble knowing how to speak to a peer versus a teacher.

• Challenges with non-verbal communication: There can be difficulty understanding and using gestures, facial expressions, and body language to communicate effectively.

However, individuals with SPCD do not exhibit the repetitive behaviors, restricted interests, or sensory sensitivities that are characteristic of Autism Spectrum Disorder. Their challenges tend to be more focused on the social use of language, rather than on sensory processing or restricted behavioral patterns.

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is a broad neurodevelopmental condition characterized by persistent difficulties in social communication and interaction, restricted and repetitive behaviors or interests, as well as sensory challenges. It’s a spectrum disorder, meaning the symptoms can range from mild to severe and vary greatly from person to person.

Key features of ASD include:

• Social communication and interaction challenges: Similar to SPCD, people with ASD often face difficulties with verbal and non-verbal communication. However, the nature of these challenges is usually more pronounced in ASD. For instance, individuals with ASD may struggle with interpreting and using both spoken language and social cues, such as tone of voice, facial expressions, or body language.

• Restricted and repetitive behaviors: Unlike SPCD, people with ASD often engage in repetitive behaviors, such as stimming, rocking, or an intense focus on specific topics or activities. These behaviors can be a form of self-regulation or simply a result of a strong interest.

• Sensory processing differences: Many individuals with ASD experience sensory sensitivities, such as heightened or diminished responses to sound, light, touch, or smell. They often struggle with transitions and have emotional dysregulation challenges when shifting from one activity to another without warning.

People with ASD can also have varying levels of intellectual functioning, from highly gifted to having an intellectual disability, which further distinguishes it from SPCD.

Key Differences Between SPCD and ASD

While both conditions involve challenges with social communication, there are a few distinct differences:

1. Presence of Repetitive Behaviors:

   • SPCD: Individuals with SPCD typically do not engage in the repetitive behaviors or restricted interests that are common in autism.

   • ASD: Repetitive behaviors, such as hand-flapping, lining up objects, or rigid routines, are a core feature of autism.

2. Social and Emotional Engagement:

   • SPCD: While individuals with SPCD have trouble using language in social contexts, they typically desire social interaction and will engage with others when they can. The key issue is the pragmatics of communication, or the “how” of conversation.

   • ASD: Social challenges in autism can be more complex, ranging from difficulties in understanding social cues to a decreased desire for social interaction altogether. Some individuals with autism may actively avoid social situations due to sensory overload or a preference for solitude.

3. Sensory Sensitivities:

   • SPCD: Sensory issues are not typically a part of SPCD. The main difficulty lies in language and communication skills.

   • ASD: Sensory sensitivities are common in autism, with individuals experiencing either heightened or diminished sensitivity to various stimuli, such as sounds, textures, or lights.

4. Language Development:

   • SPCD: Language development may appear normal in children with SPCD, but they will have trouble using language appropriately in social contexts. This means they may speak well but struggle with conversation, context, or adjusting their speech to suit the audience.

   • ASD: In autism, language development can vary widely. Some children may have delayed speech, while others may develop language early but struggle with the social use of language, making it difficult for them to understand or engage in reciprocal conversations.

5. Diagnosis and Criteria:

   • SPCD: Social Pragmatic Communication Disorder is diagnosed based on difficulties with the practical use of language and social interaction, without the presence of repetitive behaviors or restricted interests. It is often considered in the differential diagnosis when autism is suspected, but it does not fully explain the behavior.

   • ASD: The diagnostic criteria for Autism Spectrum Disorder include both social communication challenges and restricted/repetitive behaviors. It is a more comprehensive diagnosis that encompasses a wider range of difficulties.

Why the Distinction Matters

Understanding the distinction between SPCD and ASD is crucial for several reasons, particularly for proper diagnosis and intervention. While the two conditions may overlap in some ways, the treatment strategies may differ significantly.

• Intervention for SPCD: Therapy for SPCD typically focuses on improving pragmatic language skills, including conversation skills, understanding social cues, and using language effectively in different social settings. Speech and language therapy can be beneficial.

• Intervention for ASD: In addition to speech therapy for communication challenges, individuals with autism may benefit from interventions that address sensory sensitivities, repetitive behaviors, and social skills development. Therapists who specialize in autism can help the individual work through some of the emotional challenges of social difficulties while also helping work through some of the relationship challenges that come with the diagnosis.

Conclusion

While Social Pragmatic Communication Disorder and Autism Spectrum Disorder both impact social communication, they are distinct conditions with different characteristics and treatment needs. SPCD is primarily focused on challenges with the social use of language, while ASD involves a broader range of developmental differences, including restricted behaviors and sensory sensitivities.

Ultimately, understanding these differences ensures that individuals receive the most appropriate support tailored to their unique needs, helping them thrive in social and communicative contexts. If you or someone you know is experiencing difficulties in social communication, seeking a professional evaluation can provide clarity and open the door to the right interventions.=