Social Communication Disorder
The Long and Short of it
I was diagnosed with SCD October 2nd, 2019.
This post isn't any kind of plea. I'm not looking for any kind of special treatment going forward or even forgiveness for my past behavior (though I probably do owe an apology or two). My hope is that it serves as a convenient place to point people in the future. It would also be nice if someone else new to SCD stumbles across this and it makes them feel better knowing they're not alone.
What is Social Communication Disorder?
It's also sometimes referred to as Social (Pragmatic) Communication Disorder and Pragmatic language impairment. It's coded as DSM-5 315.39 (F80.89).
You can find different explanations all over, but I like the way it's stated in its Wikipedia entry (at least at the time of this writing):
Individuals with social communication disorder have particular trouble understanding the meaning of what others are saying, and they are challenged in using language appropriately to get their needs met and interact with others.
Interacting with others is indeed a challenge. My daughters frequently remind me that I have trouble peopling. While many share this challenge for various reasons, I am apparently physically wired for it... SCD is a neurodevelopmental disorder (my brain wired itself a little off kilter very early in life).
Why was I tested?
Six months prior to the diagnosis (April), I saw a therapist for the purpose of a kind of checkup. I wanted to ensure I was doing a decent job raising my younger daughter (the older having already grown and moved out). Just asking friends and family wouldn't have been enough (or trusted - bias!), I wanted a professional's opinion. Toward the end of the very first session, the therapist asked me if I had Asperger's Syndrome.
Asperger's Syndrome? I said I assume not since I have never heard of it. She thought it a strong possibility so sent me home with a link to an online test: Aspie-Quiz. That test showed what she called "interesting results", but nothing ultimately came of it. Our time together was rather short - she assured me she thought I was doing great by my daughter and didn't know how else she could help. With Asperger's and Autism not being her thing, all she could do was wish me luck and shuffle me along.
After noodling this new idea for a while, I took a more extensive online test: The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R). That link is specifically to my test result. It shows scores well above the thresholds for being suspected as having ASD. Well that was it for me, now I had to know.
Where was I tested?
At first I couldn't find anyone local who could do adult ASD evaluations. As luck would have it, a friend at my daughter's karate dojo works in the field and knew someone who might be able to help. She pointed me to The Center for Professional Psychology down in Fort Smith. I hadn't even considered broadening my search there. Dr. Jackson is the psychologist there who helped me and I couldn't be more pleased. She is extremely easy to talk with and really seemed to understand not only me, but everything to do with Autism and Asperger's. I truly felt I was in good hands.
The evaluation happened over three visits. First was a one hour screening that allowed her to hear my story and determine whether or not Asperger's/Autism was even a possibility. I liked the idea that she wasn't going to waste either of our time if it wasn't. The second visit was the full 4 hour evaluation (IQ test and 4 different psych tests). The final visit was three weeks later when I got the results.
The evaluation showed that I am not neurotypical, but also that I do not exhibit severe enough symptoms to support a diagnosis of Autism.
Back when Asperger's was still a diagnosis, I would have landed there, but now Asperger's has been split such that the patient is either severe enough to just be called autistic, or the patient is diagnosed with the less severe condition of Social Communication Disorder.
TMI - more detail from the psychological evaluation
Here are a few notes pulled from the clinical summary.
This condition involves poor social skills, including problems initiating and maintaining relationships appropriate to his achieved chronological age. It also includes difficulty understanding the perspective of others.
All of these issues have led and will likely continue to lead to functional impairment in his primary relationships. Social Communication Disorder is a developmental disorder that affects the patient on a chronic and lifelong basis...
He processes life from an almost exclusively logical framework and struggles with perspective taking of others who tend to be more emotionally driven.
Finally, personality testing and interview information identified an overall level of low emotionality with no clinical emotional symptoms. Thus, he has a higher threshold for experiencing emotion than most others and a general tendency towards anhedonia or a lack of enjoyment in activities as others might enjoy. While this limits discomfort, it can also limit positive emotional expression and it may routinely be misunderstood by others.
All of these issues have led and will likely continue to lead to functional impairment in communication in maintaining interpersonal relationships.
This was pulled from the section detailing specific test results (MMPI-II-RF in this case).
He tends to have less positive experiences than is typical as well as tends to be pessimistic, self-critical, and prone to guilt. Moreover, regarding interpersonal functioning, his response profile indicates that he is likely to avoid social situations, be introverted, have difficulty forming close relationships, and be emotionally restricted. He is likely to be uncomfortable and socially inhibited.
Where do I go from here?
That's a great question.
On one hand, I have survived this long. There's a reasonable expectation that I'll plod along just fine the rest of the way too even if I change nothing.
However, Dr. Jackson did leave me with some great recommendations. Things like continued therapy (including a reference), supplements, volunteering, and something called adult based pragmatic speech therapy. I like the idea of all of these. They might make for some great adventures and stories too.
I think I'll sit on it for a minute. Spontaneous is not generally a word used to describe my actions. I'll keep you posted.