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Reply to "Social pragmatic communication disorder"
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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I think its the new catch-all, which used to be PDD-NOS.[/quote] No it's not. If you don't have a kid with this diagnosis, best not to give ignorant opinions.[/quote] Actually, I think this is true. The removal of PDD-NOS from the DSM and the creation of social-communication disorder suggests that borderline ASD diagnoses will now be SCD instead of PDD-NOS. The problem with SCD is that it's not clear how it exists outside of the DSM -- eg there is not a big body of research on diagnostic tests and therapies. That's why it's probably better to look to ASD therapies on social skills for guidance. My kid sounds a lot like OPs and that is what we are doing. [/quote] Social skill therapies are all based on some group or another, but it the rigor under which they were designed that makes Unstuck and On Target, The Kazdin Method, or Superflex generalizable to other kids with LDs or even NT kids. However, Social Communication Pragmatics disorder is a stand alone diagnosis unto itself. There is a lot of similarity between ASD, so at 4 it's possible the OP's kid will actually receive an ASD diagnosis down the line. You "opinion" doesn't make something true and quite frankly is patronizing to parents who have been given this diagnosis since it was created with and who never received an autism diagnosis even with the ADOS. It's not just autism-lite. [/quote] It's a diagnosis that was created on paper, not out of research. It's not a new disorder that suddenly came into being because the DSM drafters discovered it as a new disease. The DSM is to a certain extent a line-drawing exercise, and kids who are on the ASD line will fall into SCD now. Not sure why you find that insulting? I have a kid who likely (not sure yet) will be give an SCD diagnosis and I have no problem with this. "Some children who previously would have received a diagnosis of PDD-NOS may now receive a diagnosis of Social Communication Disorder." https://www.autismspeaks.org/dsm-5/faq ":The inclusion of SCD was partially driven by the transition from DSM-IV PDD to DSM-5 ASD and the subsequent loss of DSM-IV PDD-NOS. PDD-NOS was a broad diagnostic category that included all conditions in which “there is severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behaviors, interests, and activities" https://jneurodevdisorders.biomedcentral.com/articles/10.1186/1866-1955-6-41 [/quote] Dearie, the DSM [b]is[/b] based on research. Nothing is really new. They eliminated PDD-NOS b/c it was way to broad and non-specific. Social Communication Pragmatics Disorder has a set of very specific characteristics. And yes, there will definitely be overlap in how you would treat autism, just not in the reimbursement from the insurance company. So keep your unhelpful comments to yourself, since it's obvious that you don't have a child with either diagnosis and are just trolling here to provoke an argument and address the OP's original question.[/quote] Read the second article I linked. There is still a TON of research to do to tease out the research-based differences between SCD and ASD. The "characteristics" of SCD listed in the DSM are diagnostic (ie in large part theoretical line-drawing), and not entirely clinical/research based. I'm not sure why you think this is offensive, unless you have some kind of investment in saying that your SCD kid is so very different from kids with ASD? There's still a whole lot unknown about SCD, but what is known is that the social communication deficits overlap with those in ASD, and that some kids who would have gotten a PDD-NOS diagnosis will now get SCD. "In the DSM-5, ASD is a new diagnostic category in the Neurodevelopmental Disorders section, characterized by impairments in social communication and social reciprocity and by the presence of restricted interests and repetitive behaviors. DSM-5 ASD replaces the disorders that comprised the DSM-IV pervasive developmental disorders (PDD) category, including autistic disorder, Asperger’s disorder, and pervasive developmental disorder, not otherwise specified (PDD-NOS). The inclusion of SCD was partially driven by the transition from DSM-IV PDD to DSM-5 ASD and the subsequent loss of DSM-IV PDD-NOS. PDD-NOS was a broad diagnostic category that included all conditions in which “there is severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behaviors, interests, and activities” [6]. Because DSM-5 ASD criteria require the presence of repetitive behaviors, some have raised the concern that some individuals who met the DSM-IV PDD-NOS criteria no longer have a diagnostic home and will therefore be ineligible for the treatment services appropriate for their impairments. Thus, SCD and ASD are common in the requirement of deficits in social communication skills, but individuals with SCD cannot evidence restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. It is essential to rule out a diagnosis of ASD by verifying the lack of these additional symptoms, currently or by history, before assigning a diagnosis of SCD. Thus, the criteria for SCD are qualitatively different from ASD and are not equivalent to “mild ASD.” However, whether children display the specific pattern of the SCD diagnostic criteria is still an empirical question, as the criteria have just been added to the DSM and children with severe social communication difficulties and without significant repetitive behaviors are often overlooked in the literature [7]. Although SCD may serve as a diagnostic home for individuals who would have previously met the criteria for DSM-IV PDD-NOS, the goal of new DSM diagnostic categories is not to prevent the loss of previously diagnosed disorders, but instead to represent natural phenomena as accurately as possible. Therefore, the rationale for the addition of SCD to DSM-5 communication disorders was rooted in literature suggesting that the impairment in pragmatics that is observed in individuals with significant social communication deficits can be differentiated from the structural and formulation difficulties that characterize language disorder. However, a long-standing debate exists regarding the nature of the overlap between social communication/pragmatic impairments and other communication and neurodevelopmental disorders. The introduction of the SCD diagnosis does not settle this debate, but instead gives researchers a tool with which to develop empirical evidence to answer the question. Thus, in addition to the question of the overlap between SCD and other language disorders, important questions exist surrounding the practice of ruling out DSM-5 ASD when SCD is diagnosed [8]. Since the publication of the DSM-5, there has been a focus on how these particular issues may affect clinical practice [8]. While such discussions are important, the current review focuses on previous research relating to the new DSM-5 category and outlines research to be conducted to investigate the validity of the new diagnostic category. As described below, SCD aligns conceptually and practically with pragmatic language impairment, although SCD was purposefully expanded to incorporate difficulties with nonverbal communication. From the existing literature, we summarize what is known about differential diagnosis, familial aggregation, developmental course, and prognosis. We also discuss the possible impact of changes in the DSM-5 ASD criteria. We emphasize here and throughout that given the variable definitions used for pragmatic language impairment in the past and the broader definition of SCD in the DSM-5, it is not yet known if and how the extant literature on pragmatic language impairment will relate to findings for SCD."[/quote]
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