“Social communication difficulties” – What are they? How do we spot them? Is there anything that can be done to help? Speech and Language Therapists’ roles seem to grow all the time with new fields opening up and new treatments being explored. Social communication difficulties are very much in the Speech and Language Therapy remit, but I have to say from experience, the training I had at university or on placement was minimal.
Social communication difficulties are present in lots of different people, in a wide-range of ages and a wide-range of conditions. They might be diagnosed with “Social communication disorder” or with the less recently used term “Pragmatic language impairment”.
So, what is social communication? Social communication is our ability to use language in a social context. To not only understand verbal and non-verbal language, but also what is implied when we communicate. For example, if I say “I’m going to jump in the shower”, I’m not saying that I am literally going to get into the shower and jump up and down. Somebody who has difficulty with social communication might misinterpret that sentence literally. If you are at the other side of the room and I look at you and gesture “drink” or point to my cup and look at you questioningly by raising my eyebrows and widening my eyes, I’m not just showing you my drink or doing a funny face, I’m asking you if you would like a drink. Again, someone with social communication difficulties might not understand what I’m asking of them.
Signs of social communication difficulties:
- Difficulty taking turns in a conversation (not knowing when to speak, not knowing when to stop speaking)
- Difficulties in telling stories or using narratives (getting the beginning, middle and end mixed up, not giving key information, or giving too much detail)
- Difficulties with understanding non-literal or ambiguous language (e.g. butterflies in my stomach, it’s red hot outside)
- Difficulties understanding jokes
- Difficulties with using and/or understanding non-verbal communication (eye contact, facial expressions, gesture, tone of voice)
- Difficulties with changing language for the context (speaking more formally to a person in authority and less formally with friends)
Social communication disorder in children is known to put them at particularly high risk of social, emotional and behavioural difficulties. In adults, it can cause problems in developing or maintaining relationships and in the workplace. It can cause people to have trouble making friends and they can become socially isolated.
Is social communication disorder the same as autism? In a word, no. Whilst people with autism usually do have some social communication difficulties, people with social communication disorder generally do not have sensory processing difficulties or restricted and repetitive behaviours or interests as would be seen in autism.
So, how can we help with social communication difficulties? Here are some of my favourite strategies and tools:
- Comic strip conversations (perspective taking, problem solving, narratives)
- Social Thinking (https://www.socialthinking.com/ tonnes of free training online!)
- Getting the Picture book by David Nash (great for working on inferencing)
- Language for Thinking book
- Conversation Dos and Don’ts (for both the person with social communication difficulties and their conversation partners e.g. explain ambiguous language or avoid it)
- Role playing tricky scenarios
- General communication skills (speaking with confidence, using eye contact and turn-taking)
- Animal therapy
It’s also great to talk about the amazingly wide neurodiverse spectrum and seeing the positives in social communication disorder, such as saying exactly what you mean and being detail oriented when it comes to story telling. More research is needed around social communication disorder and much more input is needed from people who actually have social communication difficulties. I hope you enjoyed this week’s blog and if you have any questions or feedback, do let us know. If you are having difficulties with any of the things discussed in this week’s blog, please do get contact us here.
