Sosyal İletişim Bozukluğu: Dil ve Konuşma Terapistleri için Klinik Görünüm ve Müdahale Stratejileri

Year 2024, Volume: 7 Issue: 3, 353 - 390, 31.12.2024

Dilber Kaçar Kütükçü

https://doi.org/10.58563/dkyad-2024.73.5

Abstract

Amaç: Sosyal İletişim Bozukluğu (SİB), sosyal etkileşim, pragmatik dil kullanımı ve dil işleme gibi alanlarda inatçı zorluklarla karakterize edilen bir durumdur. Bu bozukluk, sosyal iletişim becerilerinin etkili bir şekilde kullanılmasını engelleyerek bireylerin sosyal ve akademik yaşamlarını olumsuz etkileyebilir. Bu çalışmanın amacı, SİB'i tanımlamak; SİB, otizm spektrum bozukluğu (OSB) ve gelişimsel dil bozukluğunun (GDB) klinik görünümleri arasında ayrım yapmanın zorluklarını tartışmak, DKT'ler için değerlendirme ve terapi yöntemlerine dair kapsamlı bilgiler sunmaktır. Bu bağlamda, DKT'lerin SİB ile ilgili bütüncül bir anlayış geliştirmelerine katkıda bulunmak hedeflenmiştir.

Yöntem: Bu çalışma geleneksel derleme yöntemi kullanılarak hazırlanmıştır. Alan yazın taraması “sosyal iletişim bozukluğu” “otizmde sosyal iletişim” “pragmatik dil bozukluğu” gibi terimlerin PubMed akademik veri tabanında ve Google Akademik arama motorunda taranmasıyla gerçekleştirilmiştir. Alan yazın taraması ve mevcut tanı kriterleri incelenerek SİB'in ayırt edici özellikleri, SİB’de değerlendirme ve müdahale yöntemleri, SİB’in yönetiminde DKT’lerin rolü gibi başlıklar oluşturulmuş; konu, ilgili başlıkların altında detaylı bir şekilde ele alınmıştır.

Bulgular: SİB, etkili tanı ve müdahale için kapsamlı bir yaklaşım gerektiren karmaşık bir bozukluktur. OSB’den özellikle kısıtlı/tekrarlayan davranışların yokluğu, sosyal iletişim sorunlarının daha belirgin olması ve dil gelişiminin genellikle daha az etkilenmesi gibi özelliklerle ayırt edilmektedir. Değerlendirme süreci, sosyal iletişim becerilerinin kapsamlı bir şekilde ele alınmasını gerektirir. Müdahale stratejileri, bireyselleştirilmiş planlar ve sosyal iletişim becerilerini geliştirmeye yönelik programları içermektedir. Sosyal İletişim Müdahale Projesi (SCIP) ve “Program for the Education and Enrichment of Relational Skills” (PEERS®) gibi programlar, SİB olan bireylerde iletişim becerilerinde anlamlı gelişmeler sağlama potansiyeline sahiptir.

Sonuç: DKT’ler, SİB'in değerlendirilmesi ve yönetiminde kritik bir rol oynamaktadır. Profesyoneller, aileler ve topluluklar arasında işbirliği, SİB'den etkilenen bireylerin sosyal ve akademik olarak gelişmelerine katkıda bulunabilir.

Keywords

Sosyal iletişim bozukluğu, ayırıcı tanı, otizm spektrum bozukluğu, gelişimsel dil bozukluğu

Ethical Statement

Bu çalışma etik kurul izni gerektirmemektedir.

Social Communication Disorder: Clinical Profile and Intervention Strategies for Speech and Language Therapists

Abstract

Purpose: Social Communication Disorder (SCD) is a neurodevelopmental condition characterized by persistent difficulties in the social use of verbal and nonverbal communication. These challenges often manifest in areas such as social interaction, pragmatic language use, and language processing. Individuals with SCD may struggle to adapt their communication to different social contexts, interpret nonverbal cues, or understand figurative language, which can significantly impact their social relationships, academic performance, and overall quality of life. The clinical presentation of SCD varies widely, with individuals exhibiting difficulties in areas such as initiating and maintaining conversations, interpreting nonverbal cues, and adapting communication to different social contexts. These challenges often lead to misunderstandings, social isolation, and reduced quality of life, underscoring the importance of early identification and intervention. The recognition of SCD as a distinct diagnostic category in the DSM-5 shows the need to address the unique challenges associated with this condition. The primary aim of this study is to provide a comprehensive overview of SCD, focusing on its definition, clinical presentation, and evidence-based strategies for the assessment and intervention of SCD. Additionally, the study seeks to support speech and language therapists (SLTs) in enhancing their knowledge and understanding of SCD, enabling them to effectively address the unique needs of individuals affected by this disorder.

Method: This study employs a narrative review methodology, synthesizing findings from a wide range of academic sources. A literature review was conducted using PubMed and Google Scholar with search terms including "social communication disorder," "social communication in autism," and "pragmatic language disorder." The review examines current diagnostic criteria, assessment tools, and intervention strategies, organizing the discussion under key thematic headings.

Results: SCD is primarily distinguished from ASD by the absence of restricted and repetitive behaviors, which are a hallmark of ASD. However, the overlap in social communication difficulties between these two conditions may pose significant challenges for differential diagnosis. Similarly, distinguishing SCD from DLD requires careful consideration of the individual's pragmatic language abilities, as SCD is primarily characterized by deficits in the social use of language, whereas DLD often involves structural language impairments. The assessment of SCD necessitates a comprehensive approach that integrates standardized tests, observational methods, and input from multiple sources, including parents, teachers, and other caregivers. Pragmatic language assessments, while essential, are often limited in their ability to capture the dynamic nature of social communication in real-world contexts. The lack of standardized tools for assessing SCD, particularly in Turkish, further complicates the diagnostic process. Many existing assessments are designed for structured testing environments and may not adequately capture the nuances of social communication in naturalistic settings. This highlights the need for the development of more ecologically valid assessment tools that can provide a comprehensive understanding of an individual's social communication abilities. Intervention strategies for SCD emphasize the development of individualized treatment plans that address the specific needs of each individual. Evidence-based programs such as the Social Communication Intervention Project (SCIP) and the Program for the Education and Enrichment of Relational Skills (PEERS) have demonstrated significant improvements in social communication skills among individuals with SCD. These programs incorporate techniques such as role-playing, social stories, and cognitive-behavioral strategies to enhance social understanding and interaction.

Conclusion: SLTs play a critical role in the evaluation and management of SCD. Intervention for SCD requires a multifaceted approach that addresses both the individual's communication skills and the environmental factors that influence their social interactions. Collaboration among professionals, families, and communities is essential to create supportive environments for individuals with SCD.

Keywords

Social communication disorder, differential diagnosis, autism spectrum disorder, developmental language disorder

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