Social Communication Disorder


During a conversation, there are a number of “social rules” people follow: wait your turn to talk, maintaining eye contact, keeping on topic, responding when a question is asked, and using nonverbal communication such as pointing and gestures, among other things.


Using verbal and nonverbal language for social interactions might be difficult for children with a social communication disorder. This can make it difficult for them to have a conversation and impair how they build social ties and maintain good social interactions.


As a child grows older and engages in more varied social contexts, such as playing with classmates on a playground or at school, signs of social communication disorder become more obvious. This might give parents anxiety and cause them to wonder if their child is merely going through a “phase” or has a more severe problem that requires treatment.


To answer parents’ questions about social communication disorder, the speech therapists at Therapy Works Together have put together this guide including the following:


  • What is a Social Communication Disorder?
  • Is Social Communication Disorder Different From Autism Spectrum Disorder?
  • Are Social Communication Disorders Common?
  • What Are Social Communication Milestones?
  • Symptoms of a Social Communication Disorder.
  • What Causes Social Communication Disorder?
  • How Can Speech Therapists Diagnose Social Communication Disorder?
  • Can Speech Therapy Help Social Communication Disorder?
  • What Can Parents Do At Home?



What is a Social Communication Disorder?


Children and adults with a social communication disorder find it difficult to communicate effectively in social situations. It’s characterized by a problem with pragmatic language (another word for social communication), which refers to how meaning is interpreted in verbal and non-verbal interactions. 


This makes it difficult to follow social rules of conversation like greeting people when they enter the house, taking turns correctly during conversation, monopolizing conversations, interrupting speakers, not using formal/casual language appropriately and more. 


People who have social communication difficulties do not necessarily have any issues with speech (sounds in words) or language (comprehension or words, ability to put together sentences, grammar etc), and they have no differences in intelligence in comparison to others. 


Is Social Communication Disorder Different From Autism Spectrum Disorder?


Social communication disorders may be a part of the diagnosis for those with  autism spectrum disorder (ASD), but there are notable differences:

  • Autism Characteristics: Difficulties with social communication. Limited interests and/or repetitive or compulsive behaviors. Examples include, being very focused on a specific topic with no interest in others, repetitive behaviors like lining toys up or tapping. Very sensitive to certain conditions like sounds and textures. Rigidity and difficulty transitioning to new tasks. 
  • Social Communication Disorder Characteristics: Difficulties with social communication.


Are Social Communication Disorders Common?


Social communication disorder became an official diagnosis in 2013 with specific definitions and diagnostic criteria. Prior to 2013, it was called pragmatic language impairment. Therefore, it is difficult to get accurate data as to its prevalence. 


A population study from 2009 suggested that pragmatic language impairment occurred in 7-8% of children. Boys were also more likely than girls to be diagnosed.


What Are Social Communication Milestones? 


The American Speech-Language-Hearing Association (ASHA) reports some common social communication milestones for children by age. There are many factors that impact these including cultural differences. 


0-12 Months 

  • Preference for human faces, makes eye contact, follows caregiver’s gaze, listens to caregiver’s voice
  • Can discern between tones of voice (i.e. happy, angry)
  • Takes turns vocalizing
  • Focuses their attention on the same person or object as caregiver (joint attention)
  • Uses simple gestures to requests (e.g., to be picked up)
  • Engages in simple games like peek-a-boo


12-18 Months

  • Requests by pointing or vocalizing
  • Says words like “hi” and “bye”
  • Starts to replace gestures with verbal language
  • Makes eye contact to respond to speech
  • Shows emotions like sympathy or empathy
  • Changes the pitch, volume, or tone of their voice depending on the situation


18-24 Months

  • Makes a request, indicate possession, express a problem, or gain attention using short phrases
  • Begins to use different pronouns (I, me, you, my)
  • Stays on topic when communicating
  • Takes turns when speaking


24-36 Months

  • Engages in short conversations
  • Introduces topics and shifts topics
  • Adds their own experience to a topic of conversation
  • Requests clarification when they don’t understand


3-4 Years

  • Can have a longer conversation and stop a conversation
  • Uses words like “yeah” or “okay” to acknowledge a speaker
  • Uses imaginative language like talking about a fantasy, telling something funny, teasing
  • Tells a simple story from beginning to end
  • Uses simple language to talk to a younger person


4-5 Years

  • Uses words like: this, that, here, there
  • Talks about their emotions and feelings
  • Tells stories that have a sequence of events (may not be a theme or have a central character)
  • Can shift topics of conversation



  • Can read body language, facial expressions to predict someone’s feelings or behaviors
  • Shows empathy with another person’s perspective and changes their language appropriately (e.g., like comforting a sad person)
  • Conversational skills improve like staying on topic or increasing the number of back-and-forths during an exchange
  • Uses more complex language (persuasion, telling their opinions)


Symptoms of a Social Communication Disorder


Social communication skills differ by age and developmental stage. Yet there are some overarching aspects of social communication that are shared. When these are missing, there may be an issue with social communication:

  • Using Social Language: Using greetings (“hi,” “bye”), smiling at others, maintaining appropriate eye contact (not too long/short), pointing to draw someone’s attention to something, initiating a conversation, responding to a question
  • Changing Communication Styles Depending on Setting/Situation: Speaking differently to children and adults, understanding the conventions of formal vs. casual situations, such as a classroom or a birthday party
  • Adhering to Social Rules: Not interrupting, staying on a topic of conversation, engaging in normal back-and-forth of a conversation
  • Understanding Verbal and Non-verbal Cues: Understanding non-verbal cues such as when a person’s eyes wander they may be bored
  • Understanding Figurative Language: Can understand the meaning of a message when it is not explicitly stated (making inferences); picking up on sarcasm, understanding jokes


What Causes Social Communication Disorder?


While there is no specific cause of social communication disorder there are studies that have shown that a family history of autism spectrum disorder, learning disabilities and other disorders increase the risk of this diagnosis. 


Some researchers also think that there may be a genetic component. So it might run in families with a history of social or pragmatic language difficulties.


Lastly, social communication disorder may coexist with other disorders like ADHD. Importantly, social communication disorder is not caused by ASD, ADHD, or any other neurological condition.


How Can Speech Therapists Diagnose Social Communication Disorder?


Diagnosis of social communication can only occur around age 4 or 5 when a child is talking and communicating with others. The speech therapist might use the following combination of diagnostic tools to determine if there are any deficiencies in social communication:

  • Interviews (with client, parent, caregivers)
  • Questionnaires about medical, behavioral history
  • Observations of the child/client in various situations
  • Standardized evaluations to measure language skills 


It is important for the speech therapist to rule out medical or neurological conditions like ASD or intellectual disorders so an evaluation might be more comprehensive than only testing social communication.


Can Speech Therapy Help Social Communication Disorder?


Yes. Treatment for social communication disorder is speech-language therapy. Since each child is unique, a speech therapist will create a customized treatment plan based on their strengths and deficits in social communication. To increase effective communication in a number of social situations, the SLP will utilize a variety of therapy strategies such as: 

  • Videos: Watching other people talking can be used to model proper social behaviors
  • Role Playing: Engaging in role playing activities that focus on different topics, conversational partners, and social settings allows the child to practice
  • Practice Scripts: Using and practicing with responses that are scripted can help children practice conversation norms
  • Explicit Instruction: The SLP can provide explicit explanations around figurative language to help the child understand how to interpret this type of language when it comes their way


What Can Parents Do at Home?


Parents are very important in helping their children work on their social skills. They spend more time with their child than the speech therapist ever could. During speech therapy sessions, the SLP should provide ideas and can coach parents as to how to teach their child how to improve their social communication skills. 


The speech therapists at Therapy Works Together have listed some ideas for what parents can do at home to help their child increase appropriate social communication: 

  • Work on Saying Hi: Practice greetings like saying “hello” and “goodbye,” waving, and extending your hand for a handshake. Prompt the child to watch you as you say “hello” to someone.
  • Call Attention to Non-Verbal Communication in Books: If there is a character that looks sad, happy or bored, call attention to how you know. What in the character’s facial expressions or body language tell you this? Talk about this explicitly. 
  • Taking Turns While Playing: Engage in turn taking play activities like rolling a ball back and forth, stacking blocks or playing a board game. Explicitly talk about the fact that you are taking turns just like you would in conversation. 
  • Pretend Play with Dolls: Discuss what is appropriate to say and not say by using a doll. Talk out loud about what the doll might be feeling if your child says something not appropriate. 


How Can Therapy Works Together Evaluate and Treat All Ages Online?


Therapy Works  Together helps families connect online with a licensed and certified speech therapist that is a trained expert in diagnosing and treating a variety of speech, language and communication issues. Speech therapy is delivered online at home with video conferencing applications.


The age of our clients as well as their diagnosis and goals is important in determining how speech therapy online will be delivered. 


Speech therapy for babies and toddlers: For kids aged 0-3, we usually work on early communication skills like joint attention, social communication, or increasing language skills in late talking toddlers.  


Parents work with their assigned speech language pathologist, usually in a parent coaching model, to learn tips and strategies that speech therapists use so they can be adept at practicing teaching their child after the session is over and at home. You can read more here about how important it is for parents to be involved in their child’s speech therapy at home.


Speech therapy for preschoolers: For kids age 3-6, speech therapists target age appropriate articulation, language delays, reading readiness and more. Parents join in for online video sessions with the child so that both learn the speech strategies and skills from the speech therapist. Learning how to use these skills after the session helps kids improve. 


Speech therapy for school age kids: for children age 7 and up, speech therapists might work on academic skills, increasing vocabulary, social skills for kids with autism, stuttering and more. Children this age can come to online video sessions on their own. Our speech therapists keep parents informed by sharing tips and homework. 


Speech therapy for adults: Adults attend speech therapy sessions online after becoming stroke patients, for stuttering, for accent modification and more. They come to sessions on their own from the comfort of their home or office. Often, they bring a caregiver or family members to learn strategies if they will need help communicating with others.


Read More

A team of certified speech therapists online who are experts in your needs.

Our licensed and certified speech therapists can help with speech or language issues for kids and adults, stuttering, social skills, articulation issues and more. With Therapy Works Together, you get the same high quality and expertise in online speech therapy as with face to face therapy, but with the convenience and affordability you want.

How it Works

Complete the Online Intake Form

We need some basic information for your speech therapist.

Book Your Session

Pick a convenient time for sessions with your speech therapist.

Connect at Home

Use your computer / tablet / smartphone to start speech therapy at home.

The Benefits of Therapy Works Together

Therapy Works TogetherTraditional & Other Online Services
More Affordable


As high as $250/Session

Licensed expert speech therapists



Convenient to attend

Online sessions from home, office, school

Usually 9-5, commute required

Scheduling is easy & flexible

Easy, flexible scheduling online

Rescheduling may require a fee

Communicate Easily Online with Your Therapist Online

Text and communicate online with your therapist securely online

Not usually available

Hassle Free & Honest Billing

We bill for sessions only after completed

Memberships and subscriptions; You may be charged for sessions not attended

Traditional & Other Online Services
More Affordable $59/Session Up to $250/Session up to
Licensed experts speech therapists
Convenient to attend
Scheduling is easy & flelxible
Communicate Easily Online with Yout Therapist Online
Hassle Free & Honest Billing

“Ellenore was the perfect fit for my son. She helped him achieve his goals, which in turn helped him with his confidence.”

– K.S., August 2021

Ellenore M.A., CCC-SLP

“We learned strategies from Tricia and pretty quickly my son was talking just like any other three year old”

– L.M., July 2021

Tricia M.S., CCC-SLP

“My child has been working with Jessica and she is amazing and so patient.”

– J.F., September 2021

Jessica M.A., CCC-SLP

“She is patient and genuinely cares about my son. She has been a wonderful support for my son and our family”

– M.A., June 2021

therapist-online2 (1)
Natalie M.S., CCC-SLP