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Cited by 70Autism Spectrum Disorder ResearchLanguage Development and DisordersChild and Adolescent Psychosocial and Emotional Development

Evaluating social (pragmatic) communication disorder

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Mandy, William, Wang, Adele, Lee, Irene, Skuse, David·2017·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.12785
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Abstract

BACKGROUND: Social (pragmatic) communication disorder (SPCD) is a new diagnosis introduced by DSM-5, characterised by problems with verbal and nonverbal social communication. It is currently unclear whether SPCD is a valid diagnostic category, because little is known about the characteristics of those who meet its criteria. We sought to identify and describe cases of SPCD, to contribute to debates about its validity. We investigated whether the symptoms of SPCD cluster together to form a coherent syndrome that is distinct from autism spectrum disorder (ASD) in terms of its core and associated features. METHODS: Participants were young people (N = 1,081, age range = 4-18 years) who had attended a specialist social communication disorders clinic for children with fluent language and normal-range intelligence. Standardised parent-report data were collected using the Developmental, Dimensional and Diagnostic Interview (3Di), Child Communication Checklist (CCC) and Strengths and Difficulties Questionnaire (SDQ). An algorithm was designed using 3Di and CCC items to implement DSM-5 SPCD criteria. RESULTS: Eighty-eight young people met our criteria for SPCD, with 801 meeting DSM-5 ASD criteria and the remaining 192 having neither SPCD nor ASD ('clinical comparison group'). The core symptoms of SPCD co-occurred to a moderate degree (average interitem correlation = .22). SPCD cases had autistic social difficulties that were intermediate between ASD and the clinical comparison group. SPCD was associated with high rates of nonautistic psychopathology, with 63.5% scoring in the abnormal range of the SDQ's Total Problems scale. CONCLUSIONS: We did not find evidence that SPCD is qualitatively distinct from ASD. Rather, it appears to lie on the borderlands of the autism spectrum, describing those with autistic traits that fall just below the threshold for an ASD diagnosis. SPCD may have clinical utility for identifying people with autistic traits that are insufficiently severe for ASD diagnosis, but who nevertheless require support.

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  • Developers of ICD-11 criteria were not convinced that a specific disorder of this nature could be differentiated clearly from atypical social communication associated with ASD, nor from varieties of Specific Language Impairment.

    “The developers of ICD-11 criteria were not convinced that a specific disorder of this nature could be differentiated clearly from atypical social communication that is associated with ASD, nor from varieties of Specific Language Impairment (Mandy et al., 2017).”

    From Innovations of the ICD-11 in the Field of Autism Spectrum Disorder: A Psychological Approach (2022) · cites this paper as Mandy et al., 2017

    The introduction (p. 5) says it remains unclear whether SPCD can be distinguished from ASD, and the Limitations (p. 20) acknowledge that some identified cases might instead have specific language impairment. The paper does not attribute these concerns to ICD-11 criteria developers or establish their view of whether SPCD could be distinguished from varieties of SLI. (LLM, conf=0.83)

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Research works printed but not linked: 2

  1. American Psychiatric Association (2000). The Diagnostic and Statistical Manual, Fourth Edition Text Revision ( DSM-IV-TR) . Washington DC: APA Press
  2. American Psychiatric Association (2013). The Diagnostic and Statistical Manual, Fifth Edition ( DSM-5) . Washington DC: APA Press

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Authors
Mandy, W., Wang, A., Lee, I., & Skuse, D.
Affiliations
  • University College London (GB)
  • Great Ormond Street Hospital (GB)
Corresponding author
Mandy, William
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2017-07-25
Volume
58
Issue
10
Pages
1166-1175
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.12785
OpenAlex
W2738260389
Cited by
70
References
34
Citations by year
2026: 4 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 12 · 2021: 14 · 2020: 10 · 2019: 10 · 2018: 5 · 2017: 2
FWCI
4.24
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Explore Bristol Research (submittedVersion, other-oa)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
social (pragmatic) communication disorder, autism spectrum disorder, diagnostic validity, DSM-5, autistic traits, social communication deficits, symptom clustering, children and adolescents, Strengths and Difficulties Questionnaire
MeSH terms
Social Communication Disorder, Autism Spectrum Disorder, Adolescent, Child, Child, Preschool, Female, Humans, Male, Diagnostic and Statistical Manual of Mental Disorders

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