Social Pragmatic Communication Disorder Research Articles

SMILEY-assistive application to support social and emotional skills in SPCD individuals.

According to the available studies, mobile applications have provided significant support in improving the diverse skills of special individuals with social pragmatic communication disorder (SPCD). Over the last decade, SPCD has affected 8 to 11% of individuals, and therapy sessions cost between $50 and $150 per hour. This preliminary study aims to develop an interactive, user-friendly intervention to enhance social and emotional interaction skills in individuals with SPCD. The proposed intervention is an Android application that enhances social and emotional interaction skills. This pilot study involved 29 human subjects aged 7-13 years with pragmatic communication deficits. In a randomized controlled trial, the intervention was developed and implemented with consideration of caregiver and professional requirements. The improvement was analyzed using standard scales, including the Social Communication Questionnaire (SCQ) and the Social Communication Disorder Scale (SCDS). Moreover, the outcomes were examined through statistical parameters (mean, standard deviation) and tests (t-test). The intervention significantly improved the social and emotional skills of individuals with deficits. Before using the intervention, the identified statistical values for SCQ (mean = 6.48 and standard deviation = 3.37) and SCDS (mean = 8.17 and standard deviation = 4.79). However, after using the intervention, values for SCQ (mean = 8.24 and standard deviation = 3.95) and SCDS (mean = 9.48 and standard deviation = 4.72) were improved in comparison to the before-intervention outcome. The evaluation of the t-scores and p-values indicates that there has been significant improvement in the performance of individuals after the successful completion of the intervention. The proposed and applied intervention resulted in a significant impact in terms of improvement in social and emotional skills. The study concluded that it allows individuals to practice social and emotional interaction skills in a structured, controlled, and interactive environment. The proposed intervention has been found acceptable as per the reviews of caregivers and professionals, based on essential criteria including user experience, usability, interactive nature, reliability, and creditability.

Friendship interventions for children with neurodevelopmental needs: A systematic review and meta-analysis

Rationale Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. Objective To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. Method Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. Results Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). Conclusion Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.

Exploratory Factor Analysis of the Social Communication Disorder Screener.

Currently, there are no existing measures to screen for or diagnose Social (Pragmatic) Communication Disorder (SPCD). We conducted an exploratory factor analysis (EFA) of the Social Communication Disorder Screener (SCDS), a 14-item, parent-report measure based on the DSM-5 diagnostic criteria for SPCD. This EFA examined the internal consistency and factor structure of the SCDS for a sample of 500 parents of children, ages 5-18 years, representative of the U.S. census. Results yielded a correlated three-factor solution with good internal consistency reliability. Findings supported the presence of three subscale as well as the derivation of a total composite score reflecting overall verbal and non-verbal communication and limitations across contexts. Clinical and research implications are discussed.

Should social pragmatic communication disorder be included in DSM-5? On uncertainties, pragmatic considerations, and the psychiatric kind debate

Should social pragmatic communication disorder be included in DSM-5? On uncertainties, pragmatic considerations, and the psychiatric kind debate

Conduct disorder and hyperprolinemia type I: A case report

IntroductionHyperprolinemia is defined by high proline levels of blood and its primary type consists on a metabolic disorder that is the result of a number of different genetic defects affecting the degradation of proline. The complex relationship between this disease and different psychiatric phenotypes has been an important subject of study in recent years, suggesting a “common psychiatric phenotype” (Namavar et al. Am J Med Genet B Neuropsychiatr Genet 2021; 186(5), 289-317), though its exact characteristics are yet to be determined. A higher prevalence of psychotic disorders (Guo et al. Metab Brain dis 2018; 33 89-97) explained through altered glutamate metabolism, autism spectrum disorders, developmental delay and intellectual disability has been proposed.ObjectivesTo describe the case of a patient, recently diagnosed of hyperprolinemia type I, presenting a conduct disorder alongside with ADHD, oppositional defiant disorder and an unspecified pervasive developmental disorder.MethodsWe present the case of a 15-year-old male that has received follow-up care by our mental health services. The patient was born preterm (35+5 weeks) and required reanimation, oxygen therapy, antiretroviral therapy (biological mother was HIV positive) and pharmacological therapy with phenobarbital (in order to treat methadone withdrawal syndrome). It was adopted nationally when he was 18-month-old and experimented an adequate development during his first years, only highlighting slight psychomotor restlessness and distinctive facial features. During the next years, he receives diagnosis of ADHD (with little to no registered response to amphetamine derivatives), oppositional defiant disorder, social pragmatic communication disorder and fetal alcohol syndrome.ResultsDuring his first hospital admission, a neuropediatrician was contacted to study the patient and recommended for a metabolic screening to be done, where high blood levels of proline were detected (940.1μmol/L). After this, a procedure of massive exome sequencing of genes that were known to be related to alterations in the metabolism of proline was conducted, finding the mutation c.[1357C>T] in the gen PRODH. This translates to an amino acid replacement in the protein proline dehydrogenase (p.[Arg453Cys]; [Arg453Cys]), which has been studied (Bender et al. Am J Hum Genet 2005; 76 409–420) that it reduced its activity in a 70%, making it a very probable cause of the hyperprolinemia.ConclusionsThere is still scarce evidence of the psychiatric phenotypes presented in patients with hyperprolinemia. Further research is needed in order to accurately define the complex relationship between this metabolic disorder and its effect on the central nervous system.Disclosure of InterestNone Declared

Language and Communication Deficits in Chromosome 16p11.2 Deletion Syndrome.

Chromosome 16p11.2 deletion syndrome (OMIM #611913) is a rare genetic condition resulting from the partial deletion of approximately 35 genes located at Chromosome 16. Affected people exhibit a variable clinical profile, featuring mild dysmorphisms, motor problems, developmental delay, mild intellectual disability (ID), socialization deficits and/or autism spectrum disorder (ASD) traits, and problems with language. Specifically, a precise characterization of the speech, language, and communication (dis)abilities of people with this condition is still pending. We used standardized tests and samples of naturalistic speech to provide a longitudinal profile of the speech, language, and communication problems of a boy with Chromosome 16p11.2 deletion syndrome and without ID or ASD. The proband shows impaired expressive abilities as well as problems with receptive language, dysprosody, and ASD-like communication deficits, such as impaired interactive skills, perseverative verbal behavior, overabundance of tangential responses, and lack of metapragmatic awareness and communicative use of gaze, meeting the criteria for social pragmatic communication disorder. Our results support the view that language and communication impairment should be regarded as one core symptom of Chromosome 16p11.2 deletion syndrome, even without a diagnosis of ASD or ID. Clinical implications of our results, with a focus on therapeutic interventions for children with 16p11.2 deletion syndrome and no ASD or ID, are also discussed. https://doi.org/10.23641/asha.21561714.

Prevalence and functional impact of social (pragmatic) communication disorders.

The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample. We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2. Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes. A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.

Theophrastus's "Anaisthetos" ("The Obtuse Man"): the oldest "phenomenological" description of neurodevelopmental disorders in an adult.

Theophrastus (381-278 B.C.), was the first to adopt the term character for the description of distinct inner psychological and moral features of an individual. In his classic book 'Characters' in a simple style wording he analyses some of his contemporary individuals. The character "Αναίσθητος" (Anaisthetos) has been translated in English as "The Obtuse Man" and in Modern Greek both as "Αναίσθητος", meaning lack of appreciation and "Βραδύνους", meaning slowness of mind. Theophrastus' description of this particular character is compatible with the co-occurrence in an adult of two Neurodevelopmental Disorders: the Attention-Deficit Hyperactivity Disorder (ADHD) and the Social Pragmatic Communication Disorder (SPCD), according to the 5th Diagnostic and Statistical Manual of Mental Disorders. Ten out of the twelve statements support the possible occurrence of ADHD while five of them the occurrence of SPCD. The description does not justify a diagnosis of an intellectual disability; therefore, we consider that in the Modern Greek vocabulary the original term «Αναίσθητος» ("Anaisthetos"), meaning lack of appreciation, is more accurately corresponding to this particular Theophrastus's character than "Βραδύνους" ("Obtuse"), which indicates the presence of low intellectual capacities. Also the lack of repetitive and restrictive interests and behaviours excludes Autism Spectrum Disorder as a possible diagnosis. Minor psychiatric disorders and traits according to the Peripatic School were attributed to the lack of rational control over appetites and behavior. Accordingly, «Αναίσθητος» is a phenomenological description of a stigmatizing inappropriate social behavior and the only help that might give is in increasing self-awareness. In our contemporary clinical practice, though, the early recognition and appropriate treatment of Neurodevelopmental Disorders in affected individuals, leads to a better clinical care and may diminish stigmatization. The co-existence of these two disorders in a character in such a different historical context reinforces their validity as diagnostic constructs and provides an example of co-occurrence of Neurodevelopmental Disorders.

Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample

BackgroundControversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). MethodsThis study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. ResultsDSM-5 sensitivity ranged from .69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the “low-functioning” category. DSM-5 specificity ranged from .64 to .73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. ConclusionsFurther research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.

The comprehension of grammaticalized implicit meanings in SPCD and ASD children: A comparative study.

Autism spectrum disorder (ASD) and social pragmatic communication disorder (SPCD) are two neurodevelopmental disorders with many similarities in affected individuals' impairments in social-communicative and pragmatic development. A central question pertaining to their differentiation concerns whether the distinction is truly qualitative or, instead, quantitative in nature, and indeed, defining the boundary between SPCD and ASD with IQ in the normal range often presents differential-diagnostic difficulties. While deficits in the comprehension of certain linguistically systematic implicit verbal meanings have been targeted by experimental research in ASD, to date they have not been investigated in controlled experiments in SPCD. The empirical objectives of our study are twofold. First, it is explored whether the comprehension of a set of highly systematic, grammaticalized implicit meanings is impaired in ASD and SPCD children compared to their typically developing (TD) peers, and whether ASD and SPCD children differ from each other in accessing these verbal meanings. Second, it is investigated whether receptive grammatical competence and first-order ToM abilities are associated with children's performance in any way and whether there is a difference in this regard between the ASD and the SPCD group. Our main experiment, using a sentence-picture verification task, tested the comprehension of highly systematic implicit verbal meanings, including grammaticalized implicatures, presuppositions, and entailments. The experiment was complemented with a false-belief (ToM) task and a test of receptive grammar, among other measures. Seventy-one 4-to-9-year-old children participated in the study (ASD: n=19, SPCD: n=13, TD controls: n=39). While both children with SPCD and children with ASD performed significantly more poorly than the TD group, only the comprehension profile of the SPCD group differed significantly from that of the TD group. Importantly, while ASDs' performance exhibited an association with their ToM results, the performance of SPCDs showed a correlation with their receptive grammar skills. By contrast, the performance of TDs correlated with neither. These findings reveal potential divergences in the cognitive developmental mechanisms that underlie the semantic-pragmatic difficulties in the two clinical groups, suggesting that the communicative impairments in ASD and in SPCD differ qualitatively, rather than quantitatively. Specific implications for theories of pragmatic impairments in ASD and in SPCD are discussed. What is already known on the subject Linguistically systematic implicit meanings are understudied both in ASD and in SPCD. Within this domain of verbal meaning, the majority of relevant experimental work on ASD, concentrated on generalized (mostly: scalar) implicatures, has yielded somewhat divergent results, while the comprehension difficulties in SPCD have remained barely charted territory. Linguistically more highly conventionalized implicit verbal meanings have not been experimentally investigated in either neurodevelopmental disorder. What this study adds A primary finding of our study is that although both the SPCD and the ASD group show significant deficit in the comprehension of highly conventional, grammaticalized implicit meanings, SPCD children may diverge more in their comprehension profile from their TD peers than ASD children. Another key result is that the comprehension of grammaticalized implicit meanings is linked with different cognitive functions in ASD and in SPCD. While comprehension performance is associated with ToM in ASD but not in SPCD or in TD, it is correlated with receptive grammar skills in SPCD but not in ASD or in TD. Clinical implications of this study These findings provide potential support for the hypothesis that the difference between ASD and SPCD is qualitative rather than quantitative in nature, thereby casting doubt on the conception that pragmatic limitations in SPCD are to be approached as a less severe form of similar deficits in ASD. Uncovering differences in the underlying cognitive sources and in the comprehension deficits of children with ASD and SPCD are critical for the improvement of the accuracy of SPCD children's early diagnosis and timely therapeutic intervention.

Evaluation of a manualised speech and language therapy programme for children with social communication disorder: the SCIP feasibility study

BackgroundChildren with Social (Pragmatic) Communication Disorder (SPCD) have long-term needs in using and processing social language and have a high risk of later mental health difficulties. A manualised speech and language therapy programme, the Social Communication Intervention Programme (SCIP) provides therapy content for SPCD. A feasibility study is required to derive more precise estimates of key parameters for a future trial of SCIP.AimsTo assess the feasibility of conducting a substantive randomized controlled trial of SCIP for children with SPCD.MethodsA questionnaire was distributed to paediatric speech and language therapists in England. Survey questions addressed number of eligible children, routine intervention provision and trial recruitment factors. In the second phase, a single-arm intervention feasibility study was completed. Fifteen speech and language practitioners identified 24 children aged 5–11 years with SPCD. Practitioners received training/supervision to deliver 20 SCIP therapy sessions to each child. At time 1, parents of participating children provided three communication goals; expected steps in each goal were defined. After intervention, parents and practitioners independently rated each goal compared to baseline ability. Two research practitioners compared parent post-intervention commentaries with outcome scores to derive guidance about clinical significance. All practitioners recorded audio commentaries on therapy experiences. Post-intervention interviews were conducted with 6 practitioners and 6 parents. An expert panel completed a Delphi consultation on trial design.ResultsRoutine practice for SPCD varies widely. Children tend to be embedded in autism provision. Participation in a future trial was well supported provided resources are available to services. Outcomes analysis indicated all children except one made some progress on parent ratings; all children made progress on practitioner ratings. A power analysis for a future trial was carried out using current outcome measure as putative primary endpoint. Practitioners’ audio-diaries provided suggestions for training and adaption in a future trial. Outcomes and therapy methods were acceptable to practitioners and parents.ConclusionsThe feasibility study evaluated a novel outcome measure of social communication skills in SPCD. A power calculation indicated a feasible framework for a trial within a realistic period of time. Recommendations for recruitment methods, adaptation of manual and training were supported by practitioners and an expert panel.Trial registrationTitle: Speech-language therapy for child social communication disorderTrial ID: ISRCTN48030419. Date registered: January 1, 2017. Registered retrospectively.

Evaluation of a parent preference-based outcome measure after intensive communication intervention for children with social (pragmatic) communication disorder and high-functioning autism spectrum disorder

Background/objectivesChildren with Social (Pragmatic) Communication Disorder (SPCD) or High-Functioning Autism Spectrum Disorder (HFASD) have persistent deficits in language structure and language use (pragmatics). This feasibility study evaluated a novel parent preference-based outcome measure and secondary outcomes associated with the Social Communication Intervention Programme (SCIP). Methods15 UK speech and language practitioners identified 20 children aged 5–11 years with pragmatics/language needs. Practitioners received SCIP training and supervision. Children received 20 SCIP therapy sessions. Primary endpoint was a goal attainment scale (SCIP-GAS). Before intervention (T1), parents provided three prioritised communication goals, refined into a series of steps. After intervention (T2) parents and practitioners rated each goal compared to T1 and parents provided a narrative on outcomes. Secondary outcomes: Children’s Communication Checklist-2, Social Language Development Test (SLDT), and observational ratings of conversational interaction (TOPICC-2). ResultsAll children except one progressed on T2 SCIP-GAS parent outcomes. All children progressed on practitioner SCIP-GAS ratings. 82.5 % of parent comments supported their own SCIP-GAS ratings. Secondary outcomes measures: Only SLDT Making Inferences scores and TOPICC-2 ratings showed improvement at T2. ConclusionsA preference-based social communication measure showed feasibility as an outcome measure following social communication intervention for children who have HFASD or SPCD.

Applying Item Response Theory Modeling to Identify Social (Pragmatic) Communication Disorder.

Purpose No diagnostic tools exist for identifying social (pragmatic) communication disorder (SPCD), a new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition category for individuals with social communication deficits but not the repetitive, restricted behaviors and interests (RRBIs) that would qualify them for a diagnosis of autism spectrum disorder (ASD). We explored the value of items from a widely used screening measure of ASD for distinguishing SPCD from typical controls (TC; Aim 1) and from ASD (Aim 2). Method We applied item response theory (IRT) modeling to Social Communication Questionnaire-Lifetime (Rutter, Bailey, & Lord, 2003) records available in the National Database for Autism Research. We defined records from putative SPCD (n = 54), ASD (n = 278), and TC (n = 274) groups retrospectively, based on National Database for Autism Research classifications and Autism Diagnostic Interview-Revised responses. After assessing model assumptions, estimating model parameters, and measuring model fit, we identified items in the social communication and RRBI domains that were maximally informative in differentiating the groups. Results IRT modeling identified a set of seven social communication items that distinguished SPCD from TC with sensitivity and specificity > 80%. A set of five RRBI items was less successful in distinguishing SPCD from ASD (sensitivity and specificity < 70%). Conclusion The IRT modeling approach and the Social Communication Questionnaire-Lifetime item sets it identified may be useful in efforts to construct screening and diagnostic measures for SPCD.

Pragmatic Language and Social Communication Tests for Students Aged 8–18 Years: A Review of Test Accuracy

Purpose The accuracy of commercially available pragmatic language and social communication tests was reviewed. Method Online sources were searched to identify tests providing stand-alone pragmatic or social communication scores. Test manuals were examined to extract information about clinical and typically developing group comparisons, including sample size, inclusionary/exclusionary criteria, and mean group differences. Classification accuracy metrics, including sensitivity, specificity, optimal cut scores, and likelihood ratios, were reviewed. Results Six domain-specific pragmatic language and social communication tests and four omnibus language tests were identified. Test content varied and included video and audio recordings and question-and-answer formats to address hypothetical social vignettes, retell and comprehend narratives, interpret nonliteral language and multiple-meaning words, identify and display emotions, and infer another's perspective. Sample size and inclusionary/exclusionary criteria for comparisons of students with typical development (TD), developmental language disorder (DLD), autism spectrum disorder (ASD), and social (pragmatic) communication disorder (SPCD) varied widely. Mean group differences between TD and ASD or SPCD groups were generally larger (i.e., &gt; 0.5 SD to &gt; 2.0 SD s) than TD and DLD comparisons. Test authors interpreted these results as support for the accuracy of tests to identify deficits associated with ASD and SPCD and not DLD. Classification accuracy was reported for five domain-specific tests. Optimal cut scores ranged from 85 to 92, with adequate sensitivity and specificity (i.e., ≥ 80%); however, positive likelihood ratios and associated confidence intervals revealed limited confidence in reported levels. Conclusions Inadequate sample description for comparison and classification studies limit a clinician's ability to compare a student's profile with those in the samples. Although none of the tests meet all standards for test accuracy reviewed in this report, a checklist to guide test selection is provided to assist in identifying the best available test for a student's profile, if a test is needed.

SOCIAL (PRAGMATIC) COMMUNICATION DEFICITS IN PEDIATRIC PSYCHIATRY POPULATIONS: CLARIFYING ISSUES FOR CLINICAL PRACTICE

The goals of this presentation are as follows: 1) to describe social pragmatic communication (SPC) throughout childhood and when impaired in the development of other mental health disorders; 2) to present the issues in differentiating SPC disorder (SPCD) from ASD; and 3) to help clinicians become familiar with SPC deficits in youth engaged in aggressive behavior.

&lt;p&gt;Pragmatic abilities in children with neurodevelopmental disorders: development of Pragmatic Abilities Questionnaire based on the Rasch rating scale model&lt;/p&gt;

BackgroundPragmatic abilities includes a set of skills that could vary by culture and which are absolutely essential for social communication. These abilities can be impaired in many children with neurodevelopmental disorders and may lead to educational and psychological difficulties. Assessing pragmatic abilities requires valid and reliable instruments that should be developed with cultural differences in mind.PurposeThis paper reports on the development of a new instrument for measuring and evaluating pragmatic abilities in children with neurodevelopmental disorders.Methods and participantsThe questionnaire items were generated based on a literature review on the theoretical basis of pragmatic abilities, the available pragmatic assessment instruments, interviews with experts and the mothers of children with neurodevelopmental disorders and the observation of their interaction with children based on the pragmatic protocol. Item selection and reliability and validity assessment for the instrument were carried out based on the Rasch rating scale model analysis. The Pragmatic Abilities Questionnaire (PAQ) was completed by the mothers of 185 normally-developing children and the mothers of 120 children with neurodevelopmental disorders, including Autism Spectrum Disorder (ASD), Specific Language Impairment (SLI), Attention-Deficit/Hyperactivity Disorder (ADHD) and Social (Pragmatic) Communication Disorder (SPCD).ResultsThe initial pool of 119 items, reflecting the characteristics of pragmatic abilities, was first reduced to 80 after a review by ten experts, and then further reduced to 40 using the Rasch analysis for removing the misfitting items. The final PAQ had a person measure reliability of 0.97 with a separation of 6.03 and an item measure reliability of 0.99. The remaining items formed the questionnaire and measured a single construct, which explained 63.8% of the variance.ConclusionThe 40 items of the PAQ appear to construe a psychometrically-sound measure of pragmatic abilities.

الخصائص الاجتماعیة والسلوکیة لذوی اضطراب التواصل الاجتماعی النفعی واضطراب طیف الذاتویة فی ضوء المحکات التشخیصیة فی الدلیل التشخیصی والإحصائی الخامس Social and Behavioral Characteristics of Children with Social Pragmatic Communication Disorder and Autism Spectrum Disorder According to Diagnostic Criteria in the Fifth Diagnostic and Statistical Manual of Mental Disor

تستهدف الدراسة الحالية إلى التعرف على الخصائص التواصلية الاجتماعية والسلوکية للأطفال ذوي اضطراب التواصل الاجتماعي النفعي وأقرانهم الأطفال ذوي اضطراب طيف الذاتوية، وتألفت عينة الدراسة من (60) طفلا (30 طفلا لديهم اضطراب تواصل اجتماعي نفعي، 30 طفلا لديهم اضطراب طيف الذاتوية)، وقد تم استخدام مقياس اضطراب طيف التوحد للأطفال (إعداد/ جابر، 2018)، ومقياس اضطراب التواصل الاجتماعي النفعي للأطفال (إعداد/ جابر، 2018)، ومقياس التفاعل الاجتماعي (إعداد/ الباحث)، ومقياس المظاهر السلوکية (إعداد/ الباحث). وقد أشارت نتائج الدراسة إلى وجود فروق دالة إحصائيا عند مستوى دلالة (0.05) بين متوسطي درجات الأطفال ذوي اضطراب التواصل الاجتماعي النفعي والأطفال ذوي اضطراب طيف الذاتوية على مقياس التفاعل الاجتماعي لصالح الأطفال ذوي اضطراب التواصل الاجتماعي النفعي. کما أظهرت نتائج الدراسة وجود فروق ذات دلالة إحصائية عند مستوى دلالة (0.05) بين متوسطي درجات الأطفال ذوي اضطراب التواصل الاجتماعي النفعي والأطفال ذوي اضطراب طيف الذاتوية على مقياس المظاهر السلوکية غير المقبولة اجتماعيا لصالح الأطفال ذوي اضطراب طيف الذاتوية.

Social (Pragmatic) Communication Disorder: Another name for the Broad Autism Phenotype?

The Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Social (Pragmatic) Communication Disorder is meant to capture the social elements of communication dysfunction in children who do not meet autism spectrum disorder criteria. It is unclear whether Social (Pragmatic) Communication Disorder captures these elements without overlapping with Autism Spectrum Disorder or the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Language Disorder. Standardized behavioral assessments administered during a family genetics study were used to evaluate the social communication impairment and the restricted interests and repetitive behaviors in persons with autism spectrum disorder, language impairment, or neither. Social communication impairment and restricted interests and repetitive behavior were significantly correlated in all family members regardless of affection status. Rates of social communication impairment and restricted interests and repetitive behavior were highest in individuals with autism spectrum disorder. One-third of family members with language impairment presented with at least mild/moderate levels of social communication impairment (36.6%) and restricted interests and repetitive behavior (43.3%). A subset of unaffected members also presented with mild/moderate levels of social communication impairment (parents = 10.1%, siblings 11.6%) and restricted interests and repetitive behavior (parents = 14.0%, siblings = 22.1%). The majority of child family members with mild/moderate levels of social communication impairment had similar restricted interest and repetitive behavior levels reflecting criteria representing the Broad Autism Phenotype. These data suggest that social pragmatic communication disorder does not capture the profiles of children who have both social communication impairment and restricted interests and repetitive behavior but are in need of clinical services.

Assessing the heterogeneity of autism spectrum symptoms in a school population.

The results of the present study suggest that the distribution of autism spectrum symptoms are continuous and dimensional among school-aged children and thus support the need to establish clear cut-off points for detecting and diagnosing autism. In our sample, the prevalence of high-risk symptoms for autism spectrum disorders and social-pragmatic communication disorder was around 8%.

Measuring the Diagnostic Features of Social (Pragmatic) Communication Disorder: An Exploratory Study.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition introduced a new neurodevelopmental disorder, social (pragmatic) communication disorder (SPCD), that is characterized by deficits in 4 areas of communication. Although descriptions of these areas are provided, no assessment tools for SPCD are recommended. The purpose of this study was to examine the extent to which items from measurement tools commonly used in assessing pragmatic language impairment and related disorders might be useful in assessing the characteristics of social communication that define SPCD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Based on a literature search, 594 items from assessment tools commonly used to measure social communication abilities in people with pragmatic language impairment were identified. The first author judged whether each item reflected 1, more than 1, or none of the 4 SPCD diagnostic characteristics. After a brief training process, 5 second raters independently mapped subsets of items to the 6 categories. We calculated the percentage of agreement and Cohen's kappa for each pair of raters in assigning items to categories. Percentages of agreement ranged from 76% to 82%, and Cohen's kappa values ranged from .69 to .76, indicating substantial agreement. Sources and item numbers for the 206 items that both raters assigned to the same SPCD feature are provided. These items may provide guidance in assessing SPCD and in designing standardized screening and diagnostic measures for SPCD.