I first heard about Pragmatic Communication Disorder, or PCD for short, from a Tweet just a few weeks prior to writing this article.
The Tweet said:
Been using “autism lite” ever since I explained pragmatic communication disorder to an
autistic friend and he said the phrase. And also no one knows what PCD is and it’s a mouthful to say.
After reading it, I became intrigued and researched PCD for a bit. Here are the results of my efforts, if you're interested in this lesser-known neurodevelopmental disorder that’s apparently similar to autism.
Definition
According to the DSM-V, Pragmatic Communication Disorder is characterized by a persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability.
Let’s break that down.
The ‘pragmatic’ in Pragmatic Communication Disorder refers to the use of language in its proper context, like text organization, taking turns in a conversation, and understanding things not explicitly stated.
So people with PCD struggle with understanding and communicating such pragmatics, hence the suffixed ‘-Communication Disorder’.
Additionally, the DSM-V states:
Symptoms include difficulty in the acquisition and use of spoken and written language as well as problems with inappropriate responses in conversation. The disorder limits effective communication, social relationships, academic achievement, or occupational performance. Symptoms must be present in early childhood even if they are not recognized until later when speech, language, or communication demands exceed abilities.
Difficulty in spoken/written language, poor communication skills, hindered social relationships, symptoms present in early childhood, and so on. Sounds pretty similar to Autism right?
Pragmatic Communication Disorder vs Autism Spectrum Disorder
PCD and Autism have a lot of overlapping symptoms, like mentioned above.
But the main difference is that while PCD also affects an individual’s ability to communicate effectively, it doesn’t include the same restrictive or repetitive behaviours (hyperfixations, routines, etc.) seen in ASD.
Symptoms seen in ASD but not PCD:
General aversion to social interaction
Sensory sensitivities
Repetitive behaviours and restricted interests
More pronounced non-verbal communication issues
Broader range of developmental delays beyond communication
Symptoms seen in PCD but not ASD:
Trouble with pragmatic language use
May desire social interaction but hindered by poor communication skills
So although you could say PCD is kind of like Autism-Lite, PCD also includes some symptoms not seen in Autism and thus differentiate it from Autism.
Lastly, here are some common ways to deal with PCD.
Managing PCD
The main problem individuals with PCD struggle with is communication and social interaction. So naturally, treatment plans focus on improving communication and speech skills, and providing accommodations that make it easier to function.
Some treatment plans include assistive communication devices, communication training and support, and behavioural interventions (rewarding desired behaviour like making eye contact).
If you identify with several symptoms of Pragmatic Communication Disorder and/or believe you may have it, I strongly recommend seeking a consultation with a speech-language pathologist or psychiatrist.
Thank you for reading.
Also, I should note that while I used the term "Autism-Lite" for explanatory purposes, it’s generally inappropriate to simplify a serious condition like PCD with such labels without explicit consent from those directly affected.
Works Cited
American Psychiatric Association. (2013). Social (pragmatic) communication disorder. In Diagnostic
and statistical manual of mental disorders (5th ed.).
Korta, Kepa and John Perry, "Pragmatics", The Stanford Encyclopedia of Philosophy (Summer 2024
Edition), Edward N. Zalta & Uri Nodelman (eds.).
Villines, Z. (2022, May 30). “What to know about social communication disorder.” Medical News
SDCAadmin. (2018, June 5). “The difference between autism & social communication disorder
(SCD).” Sarah Dooley Center for Autism.
er-scd/
Amoretti, M. C., Lalumera, E., & Serpico, D. (2021). “The DSM-5 introduction of the Social
(Pragmatic) Communication Disorder as a new mental disorder: A philosophical review.” Hist Philos
Life Sci, 43(4), 108. https://doi.org/10.1007/s40656-021-00460-0
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