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Neurodevelopmental

Social communication disorder (pragmatic)

Difficulties with social language use: adapting speech to context, respecting turns, understanding the implicit or jokes, without the restricted interests of autism.

Common signs

Takes sentences literallyFinds it hard to keep a back-and-forth conversation goingDoesn't adapt how they speak to each person

Tips

For you

  1. Explain social rules explicitly
  2. Practise conversations and turn-taking through games
  3. Assessment by a speech therapist or psychologist

For family and friends

  1. Explain clearly what is expected in each situation
  2. Practise conversations together with turn-taking games

When to ask for help

  1. If they become isolated or are teased
  2. If they also have very narrow interests (assess for autism)

Test for families

For parents or relatives: answer thinking about the child or person you are worried about, over the last few weeks. There are 8 questions and you get your result straight away. Your answers are not saved or sent.

0 of 8
1. Takes what is said to them literally
2. Doesn't really understand jokes or irony
3. Speaks to an adult the same way as to a child
4. Finds it hard to take turns in conversation
5. Changes topic out of the blue
6. Finds it hard to tell a story in order
7. Doesn't notice when the other person is bored
8. Has trouble making friends because of how they communicate
Also take the full autistic traits test →

Free resources

Downloadable PDF sheetSigns, tips and resources to print or saveFree guide: Childhood and youthFree resource from Clínica Vivaldi

Related disorders

Intellectual disabilityNeurodevelopmentalGlobal developmental delayNeurodevelopmentalLanguage disorderNeurodevelopmentalSpeech sound disorderNeurodevelopmental

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Reviewed by María Teresa Fernández Vicente, health psychologist and neuropsychologist (registration no. CV17304), in November 2026. Educational information prepared by the Clínica Vivaldi team based on the DSM-5-TR classification. It does not replace a professional assessment and cannot be used to diagnose.