Prevalence and functional impact of social (pragmatic) communication disorders

J Child Psychol Psychiatry. 2023 Mar;64(3):376-387. doi: 10.1111/jcpp.13705. Epub 2022 Sep 16.

Abstract

Background: The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample.

Methods: We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2.

Results: Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes.

Conclusions: A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.

Keywords: Social-communication disorder; language; pragmatics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autistic Disorder* / diagnosis
  • Child
  • Child, Preschool
  • Communication
  • Communication Disorders* / epidemiology
  • Humans
  • Language
  • Language Development Disorders* / diagnosis
  • Language Development Disorders* / epidemiology
  • Prevalence