A 7-year-old girl has marked difficulty holding back-and-forth conversation, understanding nonliteral language such as idioms, and adjusting her speech to the listener. She has no restricted interests, no stereotyped movements, and no insistence on sameness. Her eye contact and use of gestures are normal. Which is the most likely diagnosis?

• A Social (pragmatic) communication disorder ✓
• B Autism spectrum disorder
• C Specific learning disorder with impairment in reading
• D Language disorder

Explanation

DSM-5 created social (pragmatic) communication disorder precisely for children with persistent pragmatic communication deficits who lack the restricted, repetitive behaviours required for autism spectrum disorder. Normal eye contact, gesture use, and absence of any insistence on sameness exclude ASD here. Language disorder involves deficits in vocabulary and sentence structure rather than the social use of language.

Reference: Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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