The influence of scale structure and sex on parental reports of children’s social (pragmatic) communication symptoms

Abstract

The addition of social (pragmatic) communication disorder [S(P)CD] to the DSM-5 taxonomy has left clinicians and researchers searching for appropriate diagnostic measures. Factor analysis procedures examined the extent to which S(P)CD symptoms presented within the Children’s Communication Checklist-Second Edition (CCC-2) represented a unique construct and whether these factors were influenced by children’s sex. Parents of 208 children (males = 125 and females = 83) from a community-based sample completed the CCC-2. Two pragmatic scores from the CCC-2 were analysed as follows: the social interaction difference index (SIDI) and a pragmatic composite from the original CCC (PC-5). Factor analysis failed to find a unique factor structure for either pragmatic composite. Analyses uncovered different factor structures for the CCC-2 SIDI and PC-5 composites and for boys and girls. S(P)CD represents a complex combination of symptoms that are poorly differentiated from other language and socioemotional behavioural difficulties.

Social (Pragmatic) Communication Disorder: Another name for the Broad Autism Phenotype?

“…If individuals had difficulties expressing their needs and ideas at the structural language level, it followed that social communication issues could become impacted. Like Ash et al (2017), we were not able to disambiguate the differences in characteristics associated with structural LI and those characteristics associated with SPCD to create an isolated diagnosis such as required with SPCD. When combined with the lack of independence of social impairment and RRBs, the utility and complexities of the diagnosis of SPCD became questionable.…”

“…Social behavior, LIs, and RRBs are all included in its definition and there are assessments specifically designed to pick up irregularities and differences in these behaviors for all ages. Studies such as Ash et al (2017), Mandy et al (2017), and Visser and Tops (2017) have reported difficulty in separating the symptoms of SPCD from other communication and social emotional disorders, describing SPCD as lying on the "borderlands" of ASD but not meeting any of the expected thresholds. The BAP could be a reasonable alternative that would help these children receive the services that they need, either for communication or behavior issues.…”

“…Unaffected siblings were significantly different on only the CASL measures. Given that our sample was relatively small and the male-female ratio was large, we may have not been able to capture the types of sex differences reported by Ash et al (2017) or Klusek, Losh, & Martin (2014).…”

“…This type of clinical environment can be hampered by the fact that it is often difficult for a clinician to create an appropriate communication setting to assess social skills during an office visit (Norbury, 2014). Other critics suggest that the category of SPCD was released before any empirical evidence of separable constructs had been developed to support the diagnostic category (Ash, Redmond, Timler, & Kean, 2017) and before consideration such as sex differences could be explored (Halladay et al, 2015).…”

The profile of pragmatic language impairments in children with ADHD: A systematic review

“…pragmatic and structural language skills, see Ash, Redmond, Timler, & Kean, 2017 for a discussion of this composite score). Several studies have compared pragmatic language skills in children with ADHD and those with autism (Geurts et al, 2004;Geurts & Embrechts, 2008;Kuijper et al, 2017).…”