Social Communication Problems

When someone has Social Communication Disorder (SCD), this means they have much more difficulty than other people their age using language for social purposes.

Depending on the person, their age, and the nature of their challenges, this can mean:

• trouble using language to connect with others

• difficulty using the expected language within a particular social context

• difficulty following typical patterns and rules of conversation

• trouble understanding nonliteral language (language that does not mean exactly what it says, such as jokes, exaggeration, sarcasm, idioms, and metaphors)

• difficulty using spoken (or signed) language along with nonverbal communication such as gestures and facial expressions

• trouble adjusting what a person is saying to the needs or interests of the listener

• difficulty making logical inferences when someone hints at something in their language

In order to have a diagnosis of SCD, a person must also:

• have symptoms that appear in early childhood

• have symptoms that interfere in their daily life

• not have autism spectrum disorder (ASD), intellectual disability (ID), or a broader language disorder that explains their SCD

When someone with a heart defect struggles with social communication, these struggles can often negatively affect multiple aspects of their lives. For example, they might;

• have trouble making and keeping friends

• get into arguments and fights

• have poor reading comprehension

• not easily follow along in conversations

• feel anxious in social situations

• be vulnerable to bullying

• have trouble connecting with other people

Luckily, interventions can help people with social communication challenges to learn skills and feel more successful. Depending on the person and their needs and goals, services could include:

• Speech and Language Therapy (from school or a clinic)

• Occupational Therapy (OT) (from school or a clinic)

• Social Skills Training (from school or a clinic, often with a psychologist, social worker, or mental health counselor)

• Psychotherapy (from school or a clinic, with a psychologist, social worker, or mental health counselor)

• Applied Behavior Analysis (ABA) (from school or an agency, with a board-certified behavior analyst [BCBA] or ABA technician)

If families are concerned about social communication, they should reach out to their school team, medical team, and a speech and language pathologist to find appropriate services in their area.

With intervention, people with social communication problems can learn how to connect with other people more effectively. They can get better at sharing their ideas and expressing their needs in a way other people can appreciate, and can get better at understanding what others say. These skills can help people to meet their own goals for social connections and relationships.

This content was reviewed by a speech and language pathologist at Boston Children's Hospital.

Families local to Boston can seek help for a social communication problem from the Speech-Language Pathology Program or the Cardiac Neurodevelopmental Program.