Social communication disorder

The language in the human being has a direct relationship with his thought, being considered fundamental for the human species, (Williams, 1992), the author argues that human language can be considered the expression of an additional contribution of the nervous system to the formation of images mental, analogous to the contribution of the sensory and associative systems of the brain, refers that this supposes a mind capable of separating image and object, word and thing, reference and referred object and it is not enough that there has to be the possibility of referring to something that is not present, nonexistent. The above indicates that verbal as well as non-verbal language is part of the world of communication.

Likewise Vygotsky tells us that «language, the different ways of counting and calculating mnemonic exercises, algebraic symbols, works of art, writing, sketches, diagrams, maps, blueprints, etc.», by means of These means and especially through language, man can organize his own behavior, not on the basis of direct stimulus, but through a field of internal signs that reflects environmental influences in a more or less generalized way, we see that communication plays an important role in the life of every human being. Professionals in the area of ​​health in the world from the desire to contribute to the proper management of people investigate every day in order to improve the quality of life of people, and the American Psychiatric Association is no stranger to these purposes , not in order to categorize or label, but in order to be a help and a support to many families and people in the world.

(Martínez Alonso, 2015) have the following definition: social communication disorder (pragmatic) is a diagnostic entity included in the DSM-5. Differentiating themselves from autism spectrum disorder by the absence of restricted interest and / or stereotyped activities, they also tell us that within the changes in the criteria for generalized developmental disorders (PDD), separating this autism spectrum disorder (ASD), being able to thus making differential diagnoses, this disorder must begin in the early stages of development, and they continue to say that although it cannot manifest itself until social demands exceed capacities. Similarly, (Mónica González Blanco, 2015) state that these deficits are expressed as functional limitations in communicative effectiveness, social participation, the development of social relationships, academic achievements or work results. The social communication disorder (pragmatic) according to the DSM-5 (APA. 2013), also indicates that it is described under the heading of communication disorders, and these in turn are part of neurodevelopmental disorders.

According to DSM-5, the following disorders are established with their respective criteria to be considered:

Language disorder:

  1. Persistent difficulties in the acquisition and use of language in all its modalities (i.e., spoken, written, sign language or other) due to comprehension or production deficiencies including the following:
  2. Reduced vocabulary, knowledge and use of words).
  3. Limited grammatical structure (ability to put words and word endings together to form sentences based on grammatical and morphological rules).
  4. Speech impairment (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).
  5. Language skills are notably and from a quantifiable point of view below what is expected for the age, which produces functional limitations in effective communication, social participation, academic achievement or job performance, individually or in any way. combination.
  6. The onset of symptoms occurs early in the development period.
  7. Difficulties cannot be attributed to hearing or other sensory impairment, motor dysfunction, or other medical or neurological condition and are not better explained by intellectual disability (intellectual development disorder) or global developmental delay.

Phonological disorder:

  1. Persistent difficulty in phonological production that interferes with speech intelligibility or prevents verbal communication of messages.
  2. The disturbance causes limitations in effective communication that interferes with social participation, academic achievement, or job performance, individually or in any combination.
  3. The onset of symptoms occurs early in the development period.
  4. The difficulties cannot be attributed to congenital or acquired conditions, such as cerebral palsy, cleft palate, hearing loss, brain trauma, or other medical or neurological conditions.

Childhood Onset Fluency Disorder (Stuttering):

  1. Disorders of normal fluency and temporal organization of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by the frequent and noticeable appearance of one (or more) of the following factors:
  2. Repetition of sounds and syllables.
  3. Prolongation of consonant and vowel sound.
  4. Fragmented words (eg, pauses in the middle of a word).
  5. Audible or silent blocking (pauses in speech, full or empty).
  6. Circumloquios (word substitution to avoid problem words.
  7. Words produced with an excess of physical tension.
  8. Repeating whole monosyllabic words (eg, «I-I-I-I see it.»
  9. The disturbance causes anxiety when speaking or limitations in effective communication, social participation, academic or work performance individually or in any combination.
  10. The onset of symptoms occurs early in the development period.
  11. The disturbance cannot be attributed to a motor or sensory speech deficit, dysfluence associated with neurological damage (eg, stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder.

Social communication disorder (pragmatic):

  1. Persistent difficulties in the social use of verbal and non-verbal communication manifested by all of the following factors:
  2. Deficiencies in the use of communication for social purposes, such as greeting and sharing information, in a way that is appropriate in the social context.
  3. Impaired ability to change communication in a way that suits the context or needs of the listener, such as speaking differently in the classroom or in a park, talking differently with a child or adult, and avoiding use of overly formal language.
  4. Difficulties following the rules of conversation and narration, such as respecting the conversation turn, expressing oneself differently when not well understood, and knowing when to use verbal and non-verbal signs to regulate the interaction.
  5. Difficulties understanding what is not explicitly said (eg, making inferences) and non-literal or ambiguous meanings of language (eg, idioms, humor, metaphors, multiple meanings that depend on context for interpretation).
  6. Impairments cause functional limitations in effective communication, social participation, social relationships, academic achievement, or job performance, either individually or in combination.
  7. Symptoms begin early in the developmental period (but impairments may not fully manifest until the need for social communication outweighs limited capabilities).
  8. The symptoms cannot be attributed to another medical or neurological condition or to low ability in the morphology and grammar domains, and are not better explained by an autism spectrum disorder, intellectual disability (intellectual development disorder), global developmental delay. development or other mental disorder.

Unspecified communication disorder

This category applies to presentations in which the characteristic symptoms of communication disorder predominate, causing clinically significant distress or impairment in social, occupational, or other important areas of functioning but do not meet all criteria for communication or communication disorder. none of the disorders in the diagnostic category of neurodevelopmental disorders. The Communication Disorder Unspecified category is used in situations where the clinician chooses not to specify the reason for failure to meet the criteria for Communication Disorder or a Specific Neurodevelopmental Disorder, and includes presentations where no there is enough information to make a more specific diagnosis.

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