This is bran new in the DSM as of last year. Any thoughts about the differences between this and ASD ? Especially HFA. Or any great links you can share with more added info on it? Anyone here have this but, not ASD? I'm not an expert on this. But, want to learn more. Any thoughts?
New to the DSM: Social (Pragmatic) Communication Disorder
Another link:
Autism in DSM-5
The last two paragraphs are pertinent (first, about the criterion that separates ASD from SCD, repetitive and restricted behaviors/interests, and second, about SCD specifically):
"A DSM-5 diagnosis of ASD also requires that the specific fixated interests and repetitive behaviors criterion be met. Although these symptoms have been required for the diagnosis of autism from DSM-III onward, there have been few in-depth studies of these behaviors. When they have been studied, it is often assumed that they represent a common factor, but this may not be true. Studies have shown that fixated interests and repetitive behaviors are frequently present in people with autism and Asperger's disorder. But three factor analysis studies (
4–
6) suggest that there may be two categories of fixated interests and repetitive behaviors: one associated with “insistence on sameness” and the other with repetitive sensorimotor behaviors. If someone has social communication deficits and poor mentalizing ability, then he or she might be expected to wish that social and environmental factors remain predictable. Sensorimotor repetitive behaviors tend to be correlated with less-developed intellectual skills, specific language deficits, and younger age.
To demand that sensorimotor fixated interests and repetitive behaviors be present for the diagnosis of ASD could exclude many people who do have significant social communication symptoms but lack the sensorimotor symptoms. However, there needs to be confirmation of this two-factor model or identification of a better model.
"There is a final, and rather unexpected, feature of DSM-5 on which I must comment. There are two diagnoses in DSM-5 that appear quite similar: autism spectrum disorder and social communication disorder. The latter is listed in the new diagnostic category of language impairment. Persons with social communication disorder have an “impairment of pragmatics” and impairment in the “social uses of verbal and nonverbal communication.” The presence of fixated interests and repetitive behaviors is required for ASD, but it is an exclusionary factor for social communication disorder. In the past 20 years, social communication disorder has been studied extensively by speech and language specialists.
My review of this literature convinces me that ASD and social communication disorder are the same disorder, except for the required DSM-5 presence of fixated interests and repetitive behaviors in ASD. I wonder if social communication disorder was included as an attempt to better define mild autism. However, to introduce a fairly similar category to autism spectrum disorder, more than 60 years after Kanner's and Asperger's landmark publications, could be clinically disruptive. The diagnosis of autism (i.e., pervasive developmental disorder in the past three versions of DSM) has long been incorporated into a network of official research, public health, school, and reimbursement systems. How will these systems deal with ASD and social communication disorder? There is no discussion of this in DSM-5, but perhaps the field trials will illuminate any conflicts."
