Behavioral Health

Social Pragmatic Communication Disorder vs Autism: How Do They Differ?

Learn the key differences between Social Pragmatic Communication Disorder and Autism Spectrum Disorder, including symptoms, risk factors, and diagnosis.


If your child or loved one struggles to connect with others, it can be heartbreaking and confusing. 

As a parent or caregiver, understanding why these challenges occur is the first step in providing the right support. 

Social Pragmatic Communication Disorder (SPCD) and Autism Spectrum Disorder (ASD) are two conditions that often cause difficulties in social communication. 

Is Social Communication Pragmatic Disorder the Same as Autism?

Despite some similarities, they are not the same. 

In fact, knowing the differences and similarities between SPCD and ASD can make a world of difference in how you approach treatment and support. 

SCPD primarily involves difficulties with using language in social contexts, such as understanding idioms or following conversation rules. 

On the other hand, autism includes these social communication challenges but also involves restricted and repetitive behaviors. 

Let’s explore these two conditions to help you better understand their unique characteristics and how to best support your loved one.

What is Social Pragmatic Communication Disorder (SPCD)?

Social Pragmatic Communication Disorder is a condition characterized by significant challenges in the social use of both verbal and nonverbal communication. 

Those living with SPCD often struggle to use communication effectively for social purposes. This means they might have difficulty greeting others, sharing information, or engaging in conversations in a socially appropriate manner. 

For instance, they may not understand how to take turns in a conversation or adjust their communication style based on the listener or situation. 

These challenges can lead to misunderstandings and social awkwardness, making it hard to connect with peers and build meaningful relationships.

Common Symptoms of Social Pragmatic Communication Disorder

Social Pragmatic Communication Disorder manifests through various symptoms that impact a person's ability to communicate effectively in social settings. 

Here are some common symptoms:

  • Difficulty with greetings and sharing information - Individuals with SPCD often struggle with basic social interactions. This includes greeting others appropriately and sharing information in a way that is socially acceptable. The result may be awkward or uncomfortable social situations.
  • Problems adapting in communication style - People with SPCD may find it challenging to adjust their communication style to suit different contexts or listeners. For example, they might use the same tone and language when speaking to a peer as they would with a teacher or stranger. This can lead to misunderstandings.
  • Trouble following rules for conversation and storytelling - Following conversational norms can be particularly difficult. This includes taking turns speaking, staying on topic, and rephrasing statements when misunderstood. When telling stories, individuals with SPCD might struggle with organizing their thoughts and relaying events in a coherent, logical sequence.
  • Issues understanding implicit or figurative language - Nonliteral language (idioms, humor, metaphors, and sarcasm) often poses a significant challenge. Individuals with SPCD might interpret such expressions literally or miss the intended meaning. This can result in confusion or miscommunication.

SPCD Risk Factors

Understanding the risk factors associated with SPCD can aid in early identification and intervention. 

 Key risk factors to be aware of include:

  • Genetic predisposition - A family history of communication disorders can increase the likelihood of developing SPCD. Genetic factors play a significant role in the occurrence of these conditions.
  • Environmental factors - Early childhood experiences, such as neglect or a lack of exposure to social interactions, can contribute to the development of SPCD. Children who do not have sufficient opportunities to engage in social communication may be at higher risk.
  • Developmental history - Delays in speech and language development during early childhood are potential indicators of SPCD. Children who exhibit significant delays in reaching speech and language milestones may be more likely to develop social communication challenges.

Recognizing these risk factors can help caregivers take steps to monitor and support children who may be at risk for SPCD. This can lead to better outcomes through early intervention and targeted therapies.

Diagnosing SPCD

Diagnosing Social Pragmatic Communication Disorder involves a thorough approach to ensure an accurate identification of the condition. 

The key components of the diagnostic process include:

Comprehensive Evaluation by a Speech-Language Pathologist or Psychologist 

A detailed assessment by a qualified professional is essential. This evaluation includes observing the individual's communication skills and behaviors in various settings.

Use of Standardized Assessment Tools

Specific tools and tests designed to evaluate social communication skills are employed. These tools help to systematically assess the individual's ability to use language in social contexts, understand conversational rules, and interpret nonliteral language.

Rule Out Other Conditions

It is crucial to differentiate SPCD from other conditions, such as autism. Autism includes a broader range of symptoms, including restricted interests and repetitive behaviors. These are not present in SPCD. Accurate diagnosis involves ruling out these other conditions through comprehensive assessment.

Input from Parents, Teachers, and other Caregivers 

Gathering information from those who interact with the individual regularly provides valuable insights into how communication challenges manifest in different contexts. This multi-source input helps to create a complete picture of the individual's communication abilities and difficulties.

How SPCD is Treated

The best way to treat SPCD is with a personalized approach. No two people living with SPCD are the same. This means that every person will have slightly different treatment options.  

Here are some key treatment strategies:

  • Speech and language therapy - This therapy focuses on improving social communication skills. Speech-language pathologists work with individuals to enhance their ability to use language effectively in social situations, navigate conversations, and understand nonliteral language.
  • Social skills training - Teaching appropriate social interactions through role-playing and practice is crucial. Social skills training provides a safe environment for individuals to learn and rehearse social behaviors. This improves their confidence and ability to interact with others.
  • Collaboration with educators - Supporting communication in school settings is essential for the child's overall development. Educators can work closely with therapists and parents to implement strategies that facilitate better social communication in the classroom. This helps the child thrive academically and socially.
  • Parental involvement - Parents play a vital role in reinforcing social communication skills at home. Strategies for parents might include modeling appropriate social interactions, encouraging practice in everyday situations, and providing positive reinforcement for successful communication efforts.

Impact on Daily Living for Social Pragmatic Communication Disorder

SPCD significantly affects various aspects of daily life, from social to academic settings.

Here are some key impacts:

  • Difficulties in forming and maintaining friendships - Social communication challenges make it hard for individuals with SPCD to establish and sustain friendships. Misunderstanding social cues, struggling with conversation rules, and having difficulty sharing information appropriately can lead to feelings of isolation.
  • Struggles in academic settings - In school, individuals with SPCD may face particular challenges in group work or discussions. They might find it hard to participate in collaborative activities, follow class discussions, or understand the social dynamics of group interactions. This can impact their academic performance and social development.
  • Potential impact on self-esteem and mental health - Persistent social difficulties can affect self-esteem and lead to mental health issues. The frustration of not being understood or accepted by peers can result in feelings of inadequacy, anxiety, or depression. Support and understanding from family and educators are crucial in mitigating these effects.
  • Challenges in adapting to new social environments - Navigating new social settings can be particularly daunting for individuals with SPCD. They may struggle to understand and adapt to new social norms and cues. This can make transitions, such as starting a new school or joining a new group, especially challenging.

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects individuals in various ways. 

ASD is characterized by difficulties in social interaction, communication, and the presence of restricted, repetitive behaviors and interests. These challenges can manifest in a wide range of behaviors and abilities, impacting daily life and functioning.

There are many myths and misconceptions about ASD. One example is that all cases of ASD are the same.

The truth is that the symptoms and severity of ASD vary widely among individuals. Some people may have significant impairments and require substantial support. Others may have milder symptoms and need less assistance. 

The term "spectrum" reflects this variability. It acknowledges that each person with ASD has a unique set of strengths and challenges.

Common Symptoms of Autism Spectrum Disorder

Autism Spectrum Disorder presents a range of symptoms that can impact various aspects of an individual's life. Here are some common symptoms:

  • Social interaction challenges - Individuals with ASD often have difficulty understanding and responding to social cues. This can make forming and maintaining relationships challenging. They may struggle with making eye contact, interpreting body language, and understanding the perspectives of others.
  • Communication difficulties - Delayed speech development is common in individuals with ASD. They might also use limited gestures and have difficulty maintaining conversations. Luckily, there are many autism communication strategies to help those who have trouble with speaking.
  • Repetitive behaviors - Engaging in repetitive actions, following rigid routines, and having intense interests in specific topics are hallmark behaviors of ASD. These behaviors provide a sense of predictability and comfort but can interfere with daily functioning and flexibility.
  • Sensory sensitivities - Many individuals with ASD exhibit over- or under-reactivity to sensory stimuli. This can include heightened sensitivity to sounds, lights, textures, or other sensory inputs. Such sensitivity can lead to discomfort or distress in various environments.

ASD Risk Factors

Here are some of the key risk factors associated with ASD:

  • Genetic factors - There is a higher likelihood of ASD if there is a family history of autism or other genetic conditions
  • Prenatal and perinatal factors - Several factors during pregnancy and birth can contribute to the risk of ASD. These include advanced parental age at the time of conception, prenatal exposure to certain substances (such as medications or environmental toxins), and complications during birth that can affect brain development.
  • Environmental factors - While research is ongoing, there are potential links between ASD and exposure to pollutants or infections during pregnancy. Environmental factors combined with genetic predispositions may influence the development of ASD.

Diagnosing ASD

Diagnosing Autism Spectrum Disorder involves a thorough and collaborative approach to ensure an accurate identification of the condition. Here are the key steps involved in diagnosing ASD:

  • Comprehensive evaluation by a multidisciplinary team - A team of professionals, including psychologists, neurologists, and speech-language pathologists, conducts a detailed assessment. This multidisciplinary approach ensures that all aspects of the individual's development and behavior are considered.
  • Use of standardized diagnostic tools - Specific tools such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) are used to evaluate symptoms and behaviors associated with ASD. These standardized tools help provide a structured and reliable assessment.
  • Observation of behavior and developmental history assessment - Observing the individual's behavior in various settings and reviewing their developmental history are crucial components of the diagnosis. This includes noting social interactions, communication patterns, and repetitive behaviors.
  • Input from caregivers and educators - Gathering information from those who know the child well, such as parents, teachers, and other caregivers, provides valuable insights into the child's functioning across different contexts. This collaborative input helps to create a comprehensive picture of the child's abilities and challenges.

How ASD is Treated

Treating Autism Spectrum Disorder involves a comprehensive and individualized approach to support each person's unique needs. There isn’t a “cure” for ASD. Instead, strategies are used to give those living with it the best possible life.

Here are some key treatment strategies:

  • Early intervention programs - Early intervention is crucial for children with ASD. Programs such as Applied Behavior Analysis (ABA), speech therapy, and occupational therapy focus on improving communication, social skills, and daily living skills. These therapies are most effective when started early in a child's development.
  • Educational support - Children with ASD often benefit from Individualized Education Programs (IEPs) tailored to their specific needs. IEPs provide personalized learning strategies, accommodations, and goals to help the child succeed academically and socially in the school environment.
  • Behavioral therapies - Behavioral therapies address specific challenges related to social skills, communication, and behavioral issues. These therapies can include social skills training, cognitive-behavioral therapy (CBT), and other interventions designed to help individuals with ASD manage their behaviors and develop positive coping strategies.
  • Family support and training - Supporting families is an essential part of treating ASD. Providing parents and caregivers with training and resources helps them understand their child's condition and implement effective strategies at home. Family support can include counseling, support groups, and educational workshops to empower families in their journey.

Impact on Daily Living for Autism

ASD affects individuals in diverse ways and influences various aspects of daily life. Here are some key points regarding its impact:

  • Varies widely - The level of support required by individuals with ASD can vary significantly. Some may need considerable assistance with daily activities. Others may lead independent and fulfilling lives. The spectrum nature of autism means that each person's experience is unique.
  • Challenges in social interactions and communication - Difficulties in understanding and responding to social cues can impact relationships with family, friends, and colleagues. These challenges can also affect employment opportunities, as effective communication is often crucial in the workplace.
  • Need for routines and predictability - Many individuals with ASD thrive on routine and predictability. Sudden changes or disruptions to their routine can cause significant stress and anxiety. This makes flexibility in daily activities a challenge.
  • Sensory sensitivities - Over- or under-reactivity to sensory stimuli, such as sounds, lights, or textures, can influence participation in various environments and activities. Sensory sensitivities can affect a person's comfort and ability to engage in everyday settings, from school and work to social gatherings.

Social Pragmatic Communication Disorder vs Autism: Differences and Similarities

Both SPCD and ASD involve challenges with social communication and interaction. People with either condition might struggle with making eye contact, understanding social cues, and navigating conversations. These shared difficulties can make social interactions feel confusing and overwhelming.

On the other hand, Autism includes additional symptoms that are not present in SPCD. Individuals with autism may exhibit restricted, repetitive behaviors such as hand-flapping, strict adherence to routines, and intense interest in specific topics. 

They might also have sensory sensitivities, reacting strongly to certain sounds, lights, or textures. These behaviors and sensitivities are unique to autism and are not seen in SPCD.

Similarities and Differences in Treatment Approaches

Both SPCD and ASD can benefit from speech therapy, social skills training, and educational support. 

Speech therapy helps individuals improve their communication abilities. Social skills training teaches them how to interact more effectively with others. 

Educational support, such as Individualized Education Programs (IEPs), can be tailored to meet each child's unique learning needs and help them succeed academically.

Autism treatment often includes additional therapies not typically used for SPCD. For example, Applied Behavior Analysis (ABA) is a widely used behavioral therapy for autism that focuses on reinforcing positive behaviors and reducing negative ones. 

Sensory integration therapy helps individuals manage sensory sensitivities. This is also commonly used in autism treatment but is not typically part of SPCD interventions.

Shared and Unique Risk Factors

Both conditions share common risk factors, including genetic predisposition and environmental influences. 

For example, a family history of neurodevelopmental disorders can increase the likelihood of both SPCD and ASD. Early environmental factors, such as prenatal exposure to certain substances, can also contribute to this increased risk.

However, each condition has unique risk factors. For SPCD, the main signs are specific delays in speech and language development without the broader range of symptoms that are seen in autism.

In contrast, autism has additional unique risk factors. 

Certain genetic changes and things like infections during pregnancy or older parents have been linked to a higher risk of ASD. Some medical conditions, such as Fragile X syndrome, are also associated specifically with autism.

Help Your Loved Ones Living with Autism Thrive

Every child living with autism deserves a chance at a fulfilling life. 

Help the children in your life living with autism break through barriers to boost connection and communication.

Using skill-building therapies and other support systems, see how Sevita’s experts help children living with autism every step of the way.

Discover more about how you can support children living with autism today.

Learn About Autism Support Services

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