Prevalence and functional impact of social (pragmatic) communication disorders

BackgroundTo 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.MethodWe 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.ResultsRegardless 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. ConclusionsA considerable proportion of children in the early years of primary school have 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 under-identification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.