We work with a range of people, many of whom have a hidden disability. Communication difficulties are not immediately visible, Frankie talks about one of these called Social (Pragmatic) Communication Disorder.
Communication difficulties come in many shapes and sizes, affecting anything from physical speech, storytelling skills, reading to attention. One such difficulty, which you may not be aware of is, Social (Pragmatic) Communication Disorder (S(P)CD). This disorder is particularly hidden as it often is confused with autism or people present as having a behavioural disorder. People with S(P)CD often use masking behaviours which hides this impairment further.
In this post, we’ll take a closer look at S(P)CD to reveal how this hidden disability may affect an individual in a court setting.
What is Social (Pragmatic) Communication Disorder?
Social (Pragmatic) Communication Disorder is recognised in the Diagnostic Statistical Manual 5 (2013) (DSM5) as a neurological developmental disorder. S(P)CD is characterised by difficulties in verbal and non-verbal communication in a social situation.
At this point it is easy to assume that S(P)CD is the same as autism spectrum conditions (ASC), however, people with S(P)CD do not meet the ASC diagnoses. For example, they do not present as having restricted interests, display repetitive behaviours or document sensory abnormalities.
Social communication is simply communication in social situations, which is a two-way interaction. Two key ingredients which go into social communication are semantics and pragmatics:
- Semantics are the actual message (transmitted through words and actions)
- Pragmatics are the context of the message (the unspoken rules we all use when communicating to add meaning)
Here is an example to explore the difference between semantics and pragmatics. The following scenarios use different pragmatics.
- Mrs Smith goes out for a meal, after she has paid, she leaves a tip of £1.10. Her server holds the restaurant door open, smiles, makes eye contact and said, “Thank you, see you soon”.
- Mrs Smith goes out for a meal, after she has paid, she leaves a tip of £1.10. Her server stays by the till, did not look at her and said, “Thanks, bye”.
Have a watch of this video to see this in action:
The message in these scenarios have broadly the same spoken message, however, the meaning of that message is altered due to the pragmatics: i.e eye contact, facial expression, body language and choice of words.
Fun Fact!: Minions are a brilliant example of communication using only pragmatics. They are able to communicate without using a human language… but we can all tell what they are saying without having to understand the semantics! AMAZING!
Pragmatics can be both verbal and non-verbal, the following lists highlight some pragmatic skills, separated into verbal and non-verbal skills.
Non-verbal pragmatics include:
- Understanding when and when NOT to talk
- Taking turns in conversation
- Sticking to or diverging from the topic appropriately
- Use of eye contact
- Understanding and using facial expressions
- Understanding and using body language
- Understanding and using gestures appropriately e.g., pointing, nodding or indicating for someone to wait.
Verbal pragmatics include:
- Adjusting formality of language to suit different situations
- Greeting and returning greetings
- Providing relevant information
- Providing the right amount of information
- The ability to make an inference from non-literal language or figurative language
- Identifying implied meaning (reading between the lines)
- Understanding how and when to ask a question and seek clarification
- Understanding how and when to request something
- Understanding how to refuse an offer
Here is a video from YouTube channel ‘Speech and Language Therapy’ which breaks social communication skills into slightly different areas, but presents the skills visually:
People with S(P)CD will have difficulties using and recognising pragmatics, leading to miscommunication or complete breakdown of communication in a social setting. S(P)CD does not affect IQ and people with this condition will be likely to understand and use a range of vocabulary in isolation.
“What is masking?” I hear you say…
Social masking is a term used within the ASC community; it refers to behaviours which a person displays to reduce how obvious their differences in social communication are. Masking behaviours are used for a variety of reasons, possibly to fit into a social environment, to make friends, to avoid bullying or even to be promoted at work.
Masking behaviours are not always intentional. They can become instinct when a person with a social impairment is in a social environment. Additionally, some people who use social masking report that performing these behaviours can be exhausting, requiring constant monitoring of the environment and considerable concentration. This phenomenon is discussed at length at the following website, https://www.spectrumnews.org/features/deep-dive/costs-camouflaging-autism/ , one poignant quote from this article is:
“All of these strategies call for considerable effort. Exhaustion was a near-universal response in the 2017 British survey: The adults interviewed described feeling utterly drained — mentally, physically and emotionally.”
Social masking is a normal behaviour most of us employ to some extent in social situations when we feel a little out of our comfort zone. Have you ever laughed along with a joke you don’t get? Engaged in a conversation about something you know little about and so agreed with what others have said? Gone to a wedding and danced when you haven’t wanted to? Or worse still, have you gone along with a hug because someone you have just met is, “very huggy”?
If you said yes to any of these you have socially masked, though you probably weren’t aware that that was what you were doing and it was not for any extended period of time.
With the examples I just gave you in mind, try to imagine how uncomfortable you felt in these situations, yet you still felt the need to do them so that you could ‘fit in’. For a person who is socially masking throughout all social interactions, they feel that discomfort continually which decreases their ability to engage and process interactions.
What do masking behaviours look like?
In truth, masking behaviours often look like “typical” social communication. The intention of these behaviours is to make social difference less noticeable, but they are behaviours a person with a social difficulty would not naturally do.
Some common masking behaviours include:
- Using complex vocabulary, this deflects away from not understanding what has been said in a conversation.
- Practicing behaviour before entering a situation.
- Forcing eye contact; find out more from this link https://autisticempath.com/6-ways-to-fake-eye-contact/ .
- Scripting conversations, e.g, thinking about responses to possible questions.
- Rehearsing and using a bank of phrases, e.g “I know exactly what you mean”.
- Minimising personal interests in order to ‘fit in’ with the crowd.
- Finding out about topics others might enjoy talking about and researching beforehand.
Social communication difficulties at court
The intermediary’s role
How do intermediaries identify a social communication difficulty, when these difficulties are often masked?
Intermediary reports often identify and describe a range of pragmatic and social communication difficulties.
For example, we assess an individual’s ability to understand common and uncommon figurative phrases such as “bear with me”. A person’s response will help us to identify if they have difficulty interpreting if there is a ‘deeper meaning’ to what has actually been said. The example “bear with me” could be interpreted literally or not understood at all. However, as it is a common phrase, the individual may have learned when it is used to demonstrate situational meaning or even be able to use it themselves as part of a learned behaviour.
None of these responses though, would indicate that the person has a true understanding of the meaning in context as they have not ‘read’ the pragmatics in combination with the semantics.
Another example of how intermediaries can comment on pragmatic skills regardless of masking behaviours is through informal discussion and observation. A person with social pragmatic impairment will likely not provide an appropriate level of relevant information independently, they may shift topics or interrupt when it is not their ‘turn’ in the conversation.
Other questions an intermediary may ask themselves is, “Does the person initiate an interaction?”, furthermore, “Can the person initiate an interaction?”. For example, requesting a break, indicate when they have not understood without being asked, or ask questions in return during a conversation.
How might someone present in court who has S(P)CD?
I will now take another look at the list from earlier and give an example of how a person with S(P)CD might present if they lack social pragmatic communication skills.
Non-verbal pragmatic breakdowns:
- Understanding when and when NOT to talk…
…The respondent or defendant may not respond to statement-style questions or may speak (seemingly inappropriately) out of turn during conferences, proceedings or when advocate’s ask questions during their evidence, possibly appearing rude for speaking out or defiant for not.
- Taking turns in conversation…
… The respondent or defendant might interrupt a speaker when giving evidence or perhaps not reply if a direct question has not been asked, they could appear reluctant to engage.
- Sticking to or diverging from the topic appropriately…
… Whilst giving evidence a person may fixate on a topic and find it difficult to answer a question. In conference this can make gaining instructions very difficult and conferences can become very lengthy.
- Use of eye contact…
… If an individual is not giving appropriate eye contact during legal proceedings, they may appear unwilling to engage.
- Understanding and using facial expressions…
… A respondent in a family matter may be watching a social worker give evidence, see the social worker smile at professionals out of courtesy. The respondent may misinterpret the meaning of the social worker’s expression.
- Understanding and using body language…
… An individual in court proceedings may stand with their head resting on their hand they may appear to be disinterested when in fact they do not understand how this action may be read by others seeing them.
Verbal pragmatic breakdowns:
- Adjusting formality of language to suit different situations…
… A defendant may say “Alright mate, will do” when responding to an instruction from a judge.
- Greeting and returning greetings…
… An individual may be greeted by the judge personally during a hearing and instead of returning the greeting they may wait for what the judge has to say, this may come across as defiance.
- Providing relevant information…
… Whilst giving evidence in court, a defendant or respondent may not provide relevant details even when being asked about a specific incident, because they do not understand what is and what is not relevant.
- The ability to make an inference from non-literal language or figurative language…
…A defendant may present as being evasive if they are asked “And so you saw red?” (Rather than, “Did that make you angry?”) and the defendant becomes confused, they may then get annoyed because they do not understand.
- Identifying implied meaning (reading between the lines)…
… A respondent may be asked how their child felt when they were late to school, in dirty clothes and asked to go home to get changed. The parent may answer with “I don’t know”, which could appear to demonstrate that a parent is uncaring and not prioritising their child’s emotional needs, when it could be that they do not understand the inferred meaning that the child was embarrassed and upset.
- Understanding how and when and to request something…
… A respondent or defendant may know that they need a break but be unsure how to request one resulting in them looking around the room or even leaving without permission.
What can be done to support people who have a pragmatic impairment
Supporting an impairment such as this can be difficult as everyone will have a different presentation. However, there are some techniques which are helpful to most people (regardless of their impairment).
Clearly introducing a new or change in topic can help people to understand that one area of discussion has come to an end and that a new area of discussion has begun, we call these topic headings. Topic headings cue the listener into the change of topic which bypasses their need to be able to independently identify a change.
Building on from topic headings, if a person has significant difficulty in topic management they will be benefitted by a break at the conclusion of a topic. The break may only need to be short, but it allows for the individual to process what has been said and time for them to shift their focus away from the concluded topic of discussion.
An individual with S(P)CD may have a difficulty understanding when they can and cannot talk and so remaining quiet in the courtroom may be difficult for them, especially if they have heightened emotions. To help support their understanding or when and when not to talk, they could be provided with a topic list so they know what is currently being discussed. They will have a chance to talk to their counsel about this topic in the coming break. The break then also allows time for the individual to ask any questions or voice any opinions which they may have been holding onto about the previous topic which would otherwise distract them from focusing on the new topic.
Let’s bring that together (click on the image to enlarge)…
Intermediaries continuously monitor a person’s presentation and appraise their communication skills within the court environment. We are reactive to what we observe; we update the court, provide additional recommendations, and create resources as necessary to support an individual.
Some strategies or adaptations may seem minor, but the correct strategy implemented in the correct way can avoid a person becoming confused, stressed or experiencing a communication breakdown.