Social communication disorder and behavioural addiction: Case report and clinical implications

BackgroundSocial communication disorder (SCD) is a neurodevelopmental disorder that includes communication difficulties. Literature linking SCD and addictions is scarce, and there are only a few case reports regarding the co-occurrence of addiction and autism disorder spectrum, and only one of them addressed behavioural addictions.Case presentationWe report MC’s case, who displayed an SCD and sexual addiction (SA). Clinical and neuropsychological evaluations suggested an alteration of social cognition, especially of affective theory of mind. This article also presents the adaptation made of the usual treatment.DiscussionThis case report illustrates the importance of social cognition abilities in the development and maintenance of behavioural addictions, and specifically SA. It also highlights the possible comorbidity of these two disorders and the possibility to work on social cognition as an alternate therapy in the treatment of behavioural addictions.ConclusionsThe co-occurrence of SCD and a behavioural addiction triggered clinical adaptations and implications that may affect a patient’s treatment presenting one of these disorders.

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

Background Children 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. Aims To assess the feasibility of conducting a substantive randomized controlled trial of SCIP for children with SPCD. Methods A 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. Results Routine 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. Conclusions The 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 registration Title: Speech-language therapy for child social communication disorder Trial ID: ISRCTN48030419. Date registered: January 1, 2017. Registered retrospectively.

Diagnosing and Teaching Students with Social Communication Disorder in Included Classrooms

Autism Spectrum Disorder (ASD) was for many years considered to be one of five pervasive developmental disorders (PDD) as defined in the 4th edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV-TR) published by the American Psychiatric Association (APA, 2000). These disorders included Autism, Rett Syndrome, Childhood Disintegrative Disorder, PDD-NOS (not otherwise specified), and Asperger’s syndrome. The 2013, fifth revision of the manual (DSM-5) presented a modification in the diagnosis for Autism Spectrum Disorder. It is now being diagnosed as an inclusive disorder of a range of symptoms or autism related symptoms from mild to severe (APA, 2013). It has dropped four of the previous diagnoses and is now only one encompassing disability called Autism Spectrum Disorder. Using the new DSM-5 diagnostic criteria some students who were previously diagnosed as having Asperger’s Syndrome do not fit the new Autism Spectrum Disorder criteria. These students might now be diagnosed with Social Communication Disorder (SCD). This diagnosis meets the symptoms presented by these individuals more appropriately. SCD describes the social difficulties and pragmatic language differences that impact comprehension, production, and awareness in conversation that are not caused by delayed cognition or other language delays.