Preferences of Speech Language Pathologists Regarding Diagnoses and Treatment of Social Communication Disorder

Abstract

Background: Social Communication Disorder (SCD) presents unique diagnostic and therapeutic challenges, especially in low-resource contexts where culturally appropriate tools are lacking and clinical practice patterns remain underexplored. In Pakistan, speech-language pathology (SLP) is an emerging discipline, and the preferences, barriers, and practices of clinicians managing SCD are not well documented. Objective: To systematically examine the diagnostic and intervention preferences of Pakistani SLPs regarding SCD, quantify the use of formal and informal assessment tools, and identify perceived barriers to best-practice implementation. Methods: A cross-sectional observational survey was conducted from December 2024 to May 2025 among 91 registered SLPs across clinical and educational settings in Pakistan. Participants completed a validated, structured questionnaire addressing demographics, frequency of assessment tool and intervention use, and perceived challenges. Descriptive and inferential statistics were applied to compare patterns across experience levels and to identify significant inter-variable associations. Results: Formal standardized tools such as the CCC-2 and TOPL-2 were most frequently used for SCD assessment, yet 59.3% of respondents cited limited access to these tools as a barrier. Early-career SLPs reported greater reliance on informal or combined assessment methods and experienced more implementation challenges than experienced clinicians (p<0.05). Intervention strategies such as Functional Communication Training and Social Skills Training were widely adopted, while perceived barriers, especially low parent engagement and lack of training, remained prevalent. Conclusion: Pakistani SLPs demonstrate strong endorsement of evidence-based SCD assessment and intervention approaches, but widespread access and training gaps hinder optimal implementation, particularly among less experienced clinicians. Strategic investment in locally adapted tools, ongoing professional development, and family-centered models is essential for advancing SCD management in Pakistan.