Social (Pragmatic) Communication Disorder and Its Relation to the Autism Spectrum: Dilemmas Arising From the DSM-5 Classification

J Autism Dev Disord. 2016 Aug;46(8):2821-2829. doi: 10.1007/s10803-016-2814-5.

Abstract

DSM-5 introduced two diagnoses describing neurodevelopmental deficits in social communication (SC); Autism Spectrum Disorder (ASD) and Social (Pragmatic) Communication Disorder (SPCD). These diagnoses are differentiated by Repetitive and Restricted Behaviors (RRB), required for an ASD diagnosis and absent in SPCD. We highlight the gaps between the research into SPCD and DSM-5's diagnostic criteria, and discuss the clinical implications of this diagnostic decision. We argue that DSM-5's demand for full manifestation of both SC and RRB axes when diagnosing ASD, prematurely forced a categorical view on the continual nature of the potentially dependent SC and RRB phenotypes. We conclude by highlighting the implications of this differential diagnostic decision on public health policies, designated therapy, and the need for further research regarding SPCD.

Keywords: Autism spectrum disorder; Differential diagnosis; Phenotype; Services; Social communication disorder; Treatment.

Publication types

  • Review

MeSH terms

  • Autism Spectrum Disorder / classification*
  • Autism Spectrum Disorder / diagnosis*
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Humans
  • Phenotype
  • Social Communication Disorder / classification*
  • Social Communication Disorder / diagnosis*