Social Communication Disorder: Information & Treatments

今天的“有问题？”言语病理学家黛安·保罗（Diane Paul）和唐娜·默里（Donna Murray）的反应。Paul博士是美国语音语言听力协会语言病理学临床问题的主任。默里博士担任高级主任新利luck娱乐在线自闭症会说自闭症治疗网络（ATN）。

谢谢你的问题。您并不孤单地对此诊断感到困惑。社会（务实）传播障碍（SCD）is, indeed, a new addition to the Diagnosis and Statistical Manual of Mental Disorders 5th edition (DSM-5). The American Psychiatric Association published this new edition of its diagnostic manual in May 2013. It provides healthcare providers with new guidelines for diagnosing mental and behavioral conditions.

SCD涵盖了社会互动，社会理解和语用学的问题。语用学是指在适当上下文中使用语言。例如，对于孩子来说，在玩年轻的孩子和老师时，以不同方式使用语言的能力很重要。

在DSM-5中添加SCD伴随着手册的自闭症谱系障碍诊断标准（ASD）的重大改进。

Field tests of the new criteria indicated that some children who would have received a diagnosis of autism under DSM-IV (the previous edition) would instead receive the new diagnosis of SCD.

但是，尽管SCD是DSM手册的新手，但对于语音语言病理学家来说并不是新手。我们有培训和经验来提供帮助。

How is Social (Pragmatic) Communication Disorder diagnosed?

SCD is diagnosed based on difficulties with both verbal and non-verbal social communication skills. These skills include:

• 回应他人

• Using gestures (like waving or pointing)

• 说话或玩耍时轮流

• 谈论情绪和感受

• Staying on topic

• Adjusting speech to fit different people or situations – for instance, talking differently to a young child versus an adult or lowering one’s voice in a library.

• Asking relevant questions or responding with related ideas during conversation

• 使用单词出于各种目的，例如向人们致意，发表评论，提出问题，做出诺言等。

• Making and keeping friends

Like SCD, autism involves difficulty with social communication skills. But autism has the additional defining characteristic of restricted and/or repetitive behaviors. So an evaluation must rule out autism before reaching a diagnosis of SCD.

This differential diagnosis can be difficult because many symptoms and behaviors overlap between ASD and SCD. In addition, SCD can occur alongside other developmental issues such as language impairment, learning disabilities, speech sound disorder and attention-deficit/hyperactivity disorder.

好消息是，大多数医疗中心都有语言病理学家 - 受过培训的专业人士，可以评估和提供有关社会通讯问题的治疗方法。言语病理学家与老师和父母合作，以帮助在课堂和家里发展儿童的社交沟通技巧。

我们建议您与孩子的医生或学校一起寻找具有评估和治疗SCD经验的语言病理学家。

Speech-language pathologists also work with individuals who have problems with the non-verbal aspects of communication and social interaction. For example, some children don’t use gestures like waving to say “goodbye” or extending arms to be picked up. Or, they may shake their head “no” when they mean “yes.”

Additionally we can develop visual supports and other forms of augmentative and alternative communication for individuals who are non-verbal or minimally verbal. This can be as simple as pointing to pictures on a picture board or as high-tech as a speech-generating computer or electronic tablet.

Your child can receive therapy for SCD in a variety of settings. Schools and school districts employ speech-language pathologists to provide such services as part of early intervention and special education programs. Many clinics and children’s hospitals likewise offer social communication services. These include all the centers in theAutism Speaks Autism Treatment Network。

The therapist will work directly with your child and provide you with strategies for improving your child's social communication skills at home and in other settings.

治疗需要什么？

Speech and language treatments are more successful with family engagement. This is especially important for a disorder that affects the social communication. It will be important for you to provide lots opportunities for your child to practice skills in real-life situations.

We likewise recommend that you involve additional “communications partners” such as your child’s teachers, counselors and other special educators such as occupational or physical therapists.

治疗通常从与治疗师的一对一发展，以支持促进与其他儿童使用新技能的小组。

家庭策略

您可以在家中进行许多活动，以鼓励社交沟通技巧符合您与孩子的治疗师的目标相符。例如：

• 轮流。Participate in simple turn-taking activities that mirror the flow of social interaction. Examples including rolling or throwing a ball back and forth. Or you can repeat words and other sounds that your child makes. Start simple with just a few turns between you and your child or your child and another person.

• Read and discuss.Read a book with your child, asking and encouraging open-ended questions such as “what do you think about what he did?”

• Talk about the feelings.书籍和故事为谈论感受提供了一个很好的机会。暗示为什么您认为故事中的角色表现或感觉特定方式。尝试将其扩展到现实生活中，私下讨论朋友或兄弟姐妹的感觉以及原因。

• What’s next?Have your child try to predict what will happen next in a story. Help him locate the clues. Or work backward. Once an event happens, go back and figure out the clues leading up to the event. Take, for example, a picture of spilled milk and food on the floor; ask what might have happened.

• 

  线索进入流行文化。Introduce your child to popular, developmentally appropriate shows and public figures so he can join related conversations with friends and classmates.

• 计划结构化的游戏日期。一次只从一个朋友开始，并进行计划的活动，并有时间限制 - 例如，开始60至90分钟。

• Use visual supports.许多患有SCD的儿童（像许多受自闭症影响的孩子一样）在视觉上处理信息。视觉支持在帮助您的孩子了解期望和时间表方面特别有用。

下载免费的副本Autism Speaks Visual Supports Tool Kit。

例如，您可以使用视觉支撑，例如孩子说话的照片或张开的嘴巴来提示您的孩子说话。（请参阅右图。）这可以帮助他学会减少不适当的中断，并学习何时希望做出回应或评论。

Professional help is crucial

正如我们提到的，患有SCD的孩子需要专业干预来发展其社交互动技能。期望他们通过与其他孩子共度时光来简单地“掌握”这些技能是不合理的。实际上，将患有SCD的孩子放在社会苛刻的环境中，没有适当的支持，弊大于利，而造成挑逗和隔离。

At the same time, participating in social activities with proper support can be a wonderful learning experience. A therapist trained in social communication intervention can provide your child – and you – with the strategies needed to make these experiences rewarding and beneficial. We encourage you to work closely with your child’s speech-language pathologists to reinforce the new skills he’s learning in therapy.

更多资源要探索：

Social Communication Disorders in School-Age Children- 美国语音听力协会专业人士的信息

Social Communication Disorders in Children: Speech-Language Pathologists Can HelpA guidebook for families.

Got more questions?将它们发送到gotquestions@autismspeaks.org。