Social Communication Disorder: a new childhood diagnosis
Case
H. F. is an 11-year-old male with a history of major depressive disorder (MDD) and attention deficit disorder (ADHD) who presented to the inpatient child and adolescent mental health unit with suicidal ideation. During an interview with H. F. and family members, it became clear that there were behavior concerns during school, increased difficulties in interpersonal relationships with peers, and increasing use of the Internet and social media to form social relationships. His parents were also concerned about the inappropriate content of his conversations online.
During an interview with H. F. alone, he showed difficulty in conversation with tangents on an odd range of topics, for
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Overview and Diagnosis of SCD
SCD is a new psychiatric diagnosis first included in the 5th edition of the Diagnostic statistical manual of mental disorders (DSM) in the category of neurodevelopmental disorders. It is worthwhile noting that while the diagnosis is new in psychiatry a very similar diagnosis has existed in the field of language and communication disorders called pragmatic language impairment (PLI), which I will discuss later. Diagnostic criteria for SCD are as follows:
“Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: deficits in using communication for social purposes […] in a manner that is appropriate for the social context; impairment of the ability to change communication to match context or the needs of the listener […]; difficulties following rules for conversation and storytelling […]; and difficulties understanding what is not explicitly stated […] and nonliteral or ambiguous meanings of language […].” (American Psychiatric Association,
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The diagnosis of ASD was made simpler by moving towards a dyad model requiring both social communication deficits and repetitive and restrictive behaviors, and Aspberger’s Disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS) were eliminated (Swineford, et al, 2014). This aligns with goal of making the DSM an evidenced based document, as there was little consensus regarding the distinction between autism disorder, Aspberger’s disorder and PDD-NOS. This change and the addition of SCD as a diagnosis distinct from ASD emphasizes that these children have a pathology that is fundamentally different from, rather than a mild form of,
In the 1940’s two doctors in different countries observed children displaying similar behaviors and deficits. One of the doctors was Viennese pediatrician Dr. Hans Asperger and the other was a child psychiatrist named Leo Kanner. Dr. Kanner was the first of the two doctors to report his observations. What he described were behaviors similar to those seen in children with what we call Autistic disorder. The behaviors affected the children’s communication, social interaction and interests. Dr. Asperger later published an article discussing what he dubbed “Autistische Psychpathen im Kindesalter” which translates to “Autistic Psychopathy”. Although some behaviors overlapped, there were differences leading to the belief that these doctors were documenting two different disorders. The two most prevalent were the differences in motor and language abilities (Miller, Ozonoff). Another was Asperger’s belief that his patients were of normal or above average intelligence. It was not until 1994 that Asperger Syndrome was entered into the Diagnostics and Statistics Manual of Mental Disorders Fourth Edition (DSM IV), finally becoming an official diagnosis. At the time, Asperger Syndrome (AS) was labeled as a subcategory of autism along with autistic disorder, childhood disintegrative disorder and pervasive development disorder. Since then, the community of people with Asperger Syndrome has grown to love and better understand the disorder that they live with every day. Some of them have even affectionately named themselves “Aspies”.
There is an escalating problem that is becoming more prominent among adolescent society involving the use of anti-depressant medication and its increased risk of suicidal tendencies. Studies show that more Americans are turning to antidepressants and are not informed of the irreversible dangers that are associated with taking them. Antidepressants possess a variety of different side effects just like other medications, however, there is a growing concern regarding the increasing rate of suicides among adolescent teens. Especially in today’s society, there is an alarming increase in influences that the media places upon the younger generations living in America. Antidepressant use in this age group should include high monitoring of suicidal thoughts and tendencies, and should include an increased effort to raising awareness of this issue.
Approximately 24% of 12-17 year olds have considered suicide and up to 10% have attempted suicide.” (Suicide Intervention Training PG 3). Teens today are very likely to commit suicide for various reasons. In today’s society there are a lot of judging and bullying cases around the world. No matter how much we promote a bully free zone there will always be a couple of cliques, or individuals, who want to bring others down and who do not know the seriousness of bullying. Although bullying is a big cause of suicide, the leading cause is a mental illness that many people are familiar with called depression. “Psychiatric disorders can affect diverse aspects of an individual’s life.”( Dispelling Myth Surrounding Teen Suicide, PG 1). If you or someone you know seems down most of the time, the best thing to do is to go see someone about your despair. If you are diagnosed with depression, prescribed depression medicine can help and can be one way to prevent suicidal thoughts or actions. “There is a lot of evidence that suicide is preventable.”(Cont. Principles of Suicide Prevention, PG
A woman hates to stand in line in the grocery store because she's afraid that everyone is watching her. She knows that it's not really true, but she can't shake the feeling. While she is shopping, she is conscious of the fact that people might be staring at her from the big mirrors on the inside front of the ceiling. Now, she has to talk to the person who's checking out her groceries. She tries to smile, but her voice comes out weakly. She's sure she's making a fool of herself. Her self-consciousness and anxiety rise to the roof...(Richards 1) (1).
On the website autism speaks, “Autism is a general term used to describe a group of complex developmental brain disorders known as Pervasive Developmental Disorders (PDD). The other pervasive developmental disorders are PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified), Asperger's Syndrome, Rett Syndrome and Childhood Disintegrative Disorder. Many parents and professionals refer to this group as Autism Spectrum Disorders.” They also said that “Asperger’s syndrome is a developmental disorder that makes it very hard to interact with other people.” Your toddler may notice that it is a challenge to make acquaintances because he or she is socially gawky. Many citizens with Asperger’s Syndrome may possess some traits of autism. Asperger’s syndrome is an enduring condition, but symptoms do seem to get better over time. Asperger’s syndrome and autism both...
Asperger’s is one disorder of many in the Autism Spectrum. The Autism Spectrum includes early infantile autism, childhood autism, Kanner’s autism, high-functioning autism, atypical autism, pervasive developmental disorder, childhood disintegrative disorder, and Asperger’s (“American Psychiatric Association,” 2013). All disorders found in the spectrum are neurodevelopmental disorders. These types of disorders deal with impairments of development and growth of the brain and nervous system (Lord & Bishop, 2010). Each disorder found in the spectrum may have similarities, but are different from one another too. Asperger’s was not a part of the Autism Spectrum until the latest update of DSM-5 in 2013. It was classified as its own category, but now is an Autism Spectrum Disorder, or ASD (Macintosh & Dissanayake, 2004). The moving of Asperger’s Syndrome into the Autism Spectrum took place because of the various similarities to ASDs.
People constantly overlook the severity of depression, more importantly, major teen depression, which presents a legitimate obstacle in society. The intensity of teen depression results from society’s general lack of acknowledgement of the rising affair. In 2012, “28.5% of teens were depressed” and 15.8% of teens contemplated the option of suicide (Vidourek 1 par. 1), due to their major depression going unnoticed or untreated for. Even teenagers themselves often ignore their depression or remain in denial because neither them nor anyone else recognizes the signs. “A sudden change in behavior is a main sign of someone being depressed, which could lead to having suicidal thoughts,” stated Pam Farkas, a clinical social worker in California (Aguilar 1 par. 8). The warning signs and risk factors of teen depression include behavioral issues, social withdrawal, and inadequate interest in activities (Adolescents and Clinical Depression 2 par. 3), yet the unawareness of these signs does not allow professional medical attention to intercede. Deaths, illnesses, rejection, relationship issues, and disappointment present passages down the negative path of teen depression, but treatments, such as psychotherapy, intervention programs, and antidepressants express ways to subdue this major problem. Knowledge of the increasing dilemma needs to circulate, in order to promote stable teen lives in the present and future world. Understanding major teen depression, the events and incidents that lead to depression, and how to overcome the problem will lead to a decrease in major teen depression and its growing issue in society.
Autism or autism spectrum disorder (ASD) is behavioral and social communication impairment. It is a broad-based neurodevelopment or brain-based disorder that is the result of genetic events that occur prior to birth with widespread effects on cognitive and socio-emotional development (Geschwind, 2009).
Depression is the most common mental health problem in the United States. It affects people of all ages, races and economic backgrounds. In adolescents, as many as one in eight teens suffers with this condition. It can interfere with day-to-day functioning. Many times adolescents feel lost or hopeless and may not know who to turn to for help. This therapeutic environment uses specific objectives and goals to give adolescents the tools and skills they need to cope and function more successfully. This is a positive, caring environment so that each member will feel ready to share and cope with their problems. Currently, there is a lack of support and resources for adolescents with this mental illness and this group fulfills that need. This group is different from other groups of this nature, as members are carefully screened to make sure only those who can truly benefit from it are included.
In this paper I hope to illuminate you to the symptoms of Asperger’s syndrome. Asperger’s is part of the autism spectrum. It is at the top of the spectrum. People who have Asperger’s are very high functioning, but lack common social skills and they have average to above average vocabulary skills. The symptoms may not be identified until a child is two years of age, because of the natural (normal) development of a child. However, doctors prefer to test the child at six years of age. This topic is near and dear to my heart, because I have a ten year old son, Jayden, who has Asperger’s. Jayden was diagnosed when he was six years old. It was then that I was informed that Asperger’s is not a disease, instead, it is a learning disability. In fact, many times it has been mistaken for Attention Deficit Hyperactivity Disorder (ADHD). So, in this research I will enlighten you to the many and varied symptoms of Asperger’s which are as follows: limited or inappropriate social interactions; “robotic” or repetitive speech; challenges with non-verbal communication coupled with average to above average speech; tendency to discuss self rather than others; inability to understand social/emotional issues or non-literal phrases; lack of eye contact or reciprocal conversation; obsession with specific and often unusual topics; one-sided conversations and awkward movements or gestures.(retrieved on 11/7/13 from www.autismspeaks.org)
Social anxiety disorder is also known as social phobia. It is defined as the fear of social situations that involve interaction with other people. It is the fear and anxiety of being judged and evaluated negatively by other people or behaving in a way that might cause embarrassment or ridicule. This leads to feelings of inadequacy, self-consciousness, and depression. The person with social anxiety disorder may believe that all eyes are on him at all times. Social anxiety disorder is the third largest mental health case issue in the world, and it can effect 7% of the population (15 million Americans) at any given time.
These five developmental disorders are commonly known as Autism Spectrum Disorders. “The most common are Autism, Asperger's syndrome and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) (www.learningdisabilitiesinfo.com).” Severe Autism, Rett Syndrome, and CDD are usually recognized before a child reaches the age of three. However, high-functioning Autism and Asperger’s are often times not discovered until a child enters school. High-functioning Autism and Asperger’s are frequently compared, considering children with these disorders express the same traits and characteristics. Conversely, the main difference between the two disorders is pragmatics, or language skills. A child with Asperger’s Syndrome is capable of communicating, but due to their social and developmental impairments, they cannot appropriately communicate with their peers. On the other hand, a child with Autism lacks language skills and requires spec...
...of ABA, which has “demonstrated efficacy in…reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior” (Satcher, 1999, as cited in Brams, 2008, p. 6). Because all skill domains have the ability to be effectively addressed through the use of one multi-method ABA model, the process of confronting the many debilitating issues of ASD is simplified. There is still room for advancements within ABA and the Autism community, but the continual expansion of programs and dedication to ABA research is leading to more promises for the struggling ASD community. For the future of ASD, the hope is not only to keep individuals in their homes and out of institutions, but more importantly to provide them with the possibility of independence and the ability to thrive far beyond all of Autism’s previous restrictions (Blane, 2011, p. 6).
Teenage depression is a growing problem in today's society and is often a major contributing factor for a multitude of adolescent problems. The statistics about teenage runaways, alcoholism, drug problems, pregnancy, eating disorders, and suicide are alarming. Even more startling are the individual stories behind these statistics because the young people involved come from all communities, all economic levels, and all home situations-anyone's family. The common link is often depression. For the individuals experiencing this crisis, the statistics become relatively meaningless. The difficult passage into adolescence and early adulthood can leave lasting scars on the lives and psyches of an entire generation of young men and women. There is growing realization that teenage depression can be life- changing, even life threatening.
Whenever I had something to say, I could not bring myself to say it. I also made short pauses before I replied to someone’s question. If I did manage to say something, however, I would always stutter my lines in a way that would annoy the person I was talking to. Even making eye contact proved to be difficult. Because of this unpleasant activity, social anxiety sufferers make sure to never develop any sort of conversation with anyone. Severe cases of social anxiety can cause improper communication with even your closest friends and family. I became distant from my loved ones as a result. I kept quiet, despite my strong desire to express my thoughts. Having the inability to communicate with people will only prove to be difficult when attempting to live a normal, everyday