This blog is in follow-up to my blog post a few months ago, where I have gone through the process to be formally diagnosed, which took almost a year from start to finish!
Yesterday I received my formal diagnosis, which I had never heard of— social pragmatic communication disorder (SPCD). SPCD refers to marked challenges with both nonverbal and verbal communication skills used in social settings. I received a secondary diagnosis of Sensory Processing Disorder (SPD)—which I did suspect after my ADOS assessment.
What is SPCD?
“Newly added to the DSM-5’s Communication Disorders section, SPCD refers to a “primary deficit” in both verbal and nonverbal communication used in social situations.
Such difficulties may include:
inappropriate communication in certain social contexts
difficulties with using language to socialize
not knowing how to use and understand both verbal and nonverbal cues
a lack of understanding regarding nonliteral language”[1]
The symptoms are listed below:
“difficulties with adapting communication skills to different social contexts, such as greetings and initiating conversation
inability to switch between formal and informal language
problems with taking turns during conversations
difficulties with using nonverbal communication techniques during social interactions, such as eye contact and hand gestures
difficulty understanding nonliteral language, such as inferences, sarcasm, metaphors, and idioms made during conversation
making and/or keeping friends”
Ironically I texted a close friend with the SPCD diagnosis and after they read about it they said “you don’t have SPCD, but I do”. Funny. I think what is important to understand is I am almost 54 years old and I am being diagnosed for the first time. These are disorders that affected my childhood and growing up experiences deeply and I had to learn on my own how to compensate. They are also my super hero power. My SPD make me an excellent therapist as I can track empathically at warp speed. The flip side is I can get overwhelmed in groups and public settings with too much input. I have designed a life where I minimize larger group interactions. The irony is I still teach and longer days of teaching can be challenging, which I learned during the pandemic and the mask wearing, which heightened my SPD in a very challenging way.
The effects of mask wearing on people with communication disorders is real. I feel a lot of compassion for younger children who have to endure the mask wearing during development and critical time. I cannot even imagine the long-term impact this will have on them. I have learned in my practice that craniosacral therapy (CST) is really helpful for children and adults with managing their vagal tone. The vagus nerve is an important regulator of sympathetic (fight or flight) and parasympathetic (rest and digest) response to situations. I think it is easier for those of us with SPD to get locked into a sympathetic response pattern. I personally have found CST to be a powerful tool to allow for high tone in my vagus system, which means I can be more fluid between sympathetic and parasympathetic response patterns.
Fortunately for myself, the SPCD already put me in a category of avoiding groups, so I was able to mostly avoid trying to figure out accommodations, which is my next processing piece. What do I need for support in the classroom so that I don’t get the meltdowns that are associated with my SPCD and SPD. I don’t have answers yet and will be working on it.
Meanwhile, I am grateful I went through the process to be diagnosed. I found myself saying out loud “it is good to know I am not crazy and my experience was real”.