Looking for social pragmatic communication disorder in the complex world of Italian special needs: an exploratory study

Social Pragmatic Communication Disorder (SPCD) is characterised by a number of pragmatic difficulties and may lead to obstacles in school readiness. These difficulties also apply to children with Special Needs. Several authors pointed out the difficulty to detect SPCD, also considering the lack of sensitive assessment tools. The aim of this study is to investigate the pragmatic ability of children with BES not otherwise specified (BES-NOS), compared to a control group of children with Typical Development (TD) using the Assessment Battery for Communication (ABaCo). Our expectation is that BES-NOS perform worse than children with TD. Furthermore, for exploratory purposes, we investigate whether it is possible to identify a subgroup of children with undiagnosed SPCD within the BES-NOS group, by performing a cluster analysis. Our results show that children with BES have a significantly lower pragmatic performance than the TD group and suggest the sensitivity of ABaCo in identifying individuals with undiagnosed SPCD among children and adolescents with BES-NOS.

Clinical Considerations From Researcher-Created Morphological Awareness Assessments

PURPOSE

Morphological awareness develops throughout formal schooling and is positively related to later reading abilities. However, there are limited standardized measures available for speech-language pathologists (SLPs) to use when assessing morphological awareness in clinical practice. The purpose of this tutorial is to guide clinicians in choosing between researcher-created measures of morphological awareness to use with their school-aged students.

METHOD

We first summarize previous morphological awareness assessment research and outline important clinical considerations when choosing a morphological awareness assessment for students in early elementary grades and beyond. Second, we highlight item characteristics regarding morpheme type, frequency, shift transparency, and imageability for students in early elementary versus later grades. Third, we discuss the type of tasks (i.e., production, decomposition, and judgment) and administration modes (i.e., oral or written and static or dynamic) available to clinicians assessing the morphological awareness skills of school-aged students. Throughout the tutorial, we reference a hypothetical case study to illustrate how SLPs might apply these suggestions and link morphological awareness assessment to treatment recommendations.

CONCLUSIONS

This tutorial highlights the importance of including morphological awareness assessments in clinical practice to support oral and written language development. We provide practical guidelines to help SLPs evaluate and choose appropriate morphological awareness assessments for their school-aged students as part of their comprehensive language evaluations and to support intervention planning.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24545470.

Exploring the contributions of expert review and cognitive interviewing to evaluating the content validity of items for anew measure of adolescent social communication, the Transition Pragmatics Interview

Interventions to facilitate improvement in adolescent social communication are more effective when they are tailored to adolescents' individual profiles of ability. Current social communication assessments for adolescents are not designed to identify their profiles of ability for settings beyond compulsory education. To address this gap, we developed the Transition Pragmatics Interview (TPI). The purpose of these studies was to evaluate the content validity of items developed for the TPI using expert review and cognitive interviewing. Cognitive interviewing is recommended in health-related measurement standards but is not widely reported for assessments of developmental language disorders. Six speech-language pathologists participated in the expert review, rating how well TPI items represented facets of social communication ability. All questions were rated as representative of their intended construct. Eight adolescents (age 14-21) of varied social communication abilities participated in the cognitive interview study to explore whether items were understood as intended by the developers. Participants responded to each item while aresearcher observed their response process and asked questions to identify the respondents' thinking about the items. Transcribed responses were classified based on whether they indicated aconstruct-irrelevant difficulty with the item. Nine of 52 items were identified with recall difficulties, ambiguous wording or potential sources of bias. Cognitive interviewing complemented expert review by identifying issues with content validity not identified by expert review. Items with construct-irrelevant barriers to response will be modified and re-evaluated prior to field testing.

The fuzzy boundaries of the social (pragmatic) communication disorder (SPCD): Why the picture is still so confusing?

Introduction

Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder.

Methods

The search strategy was defined by combining the following keywords: "social pragmatic communication disorder," "DSM-5," "differential diagnosis," and "child." The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review.

Results

After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases.

Conclusions

SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies.

Prevalence and functional impact of social (pragmatic) communication disorders

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.

Psychometrics of the Pragmatic Rating Scale for School-Age Children With a Range of Linguistic and Social Communication Skills

Purpose Social communication or pragmatic skills are continuously distributed in the general population. Impairment in these skills is associated with two clinical disorders, autism spectrum disorder (ASD) and social (pragmatic) communication disorder. Such impairment can impact a child's peer acceptance, school performance, and current and later mental health. Valid, reliable, examiner-rated observational measures of social communication from a semistructured language sample are needed to detect social communication impairment. We evaluated the psychometrics of an examiner-rated measure of social (pragmatic) communication, the Pragmatic Rating Scale-School Age (PRS-SA). Method The analytic sample consisted of 130 children, ages 7-12 years, from five mutually exclusive groups: ASD (n = 25), language concern (LC; n = 5), ASD + LC (n = 10), social communication impairment only (n = 22), and typically developing (TD; n = 68). All children received language and autism assessments. The PRS-SA was rated separately using video-recorded communication samples from the Autism Diagnostic Observation Schedule. Assessment data were employed to evaluate the psychometrics of the PRS-SA. Analysis of covariance models were used to assess whether the PRS-SA would detect differences in social communication functioning across the five groups. Results The PRS-SA demonstrated strong internal reliability, concurrent validity, and interrater reliability. PRS-SA scores were significantly higher in all groups compared to the TD group and differed significantly in most pairwise comparisons; the ASD + LC group had the highest (more atypical) scores. Conclusions The PRS-SA shows promise as a measure of social communication skills in school-age verbally fluent children with a range of social and language abilities. More research is needed with a larger sample, including a wider age range and geographical diversity, to replicate findings. Supplemental Material https://doi.org/10.23641/asha.15138240.