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Atypical pragmatic development

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There has been recognition in clinical and research contexts for many years that some children have pronounced difficulties using language in context or using language to communicate in socially purposeful ways. The diagnostic status of such children has been a matter of great debate, but recently, the most well-known diagnostic framework, the DSM-V, introduced Social (Pragmatic) Communication Disorder (SCD), a disorder characterised by persistent difficulties using verbal and non-verbal communication for social purposes, in the absence of restricted and repetitive interests and behaviours. There is currently much confusion about the precise diagnostic criteria for SCD and how this disorder relates to autism spectrum disorders (ASD), previous descriptions of pragmatic language impairment (PLI) and more specific language disorders (LD). In this chapter I will offer an overview of SCD and how pragmatic and social communication skills might be assessed. I argue that implementing the new diagnosis is currently challenged by a lack of well-validated and reliable assessment measures, and that SCD is probably best conceptualised a dimensional symptom profile that may be present across a range of neurodevelopmental disorders. In addition, social communication and aspects of pragmatic language may be dissociated, with the latter heavily influenced by structural language attainments.

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