Chapter 6: Pragmatic Disorders in Complex and Underserved Populations (original) (raw)
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Chapter 3: The Psychosocial and Other Impact of Pragmatic Disorders
Pragmatic Disorders, 2014
Keywords: delinquency; educational attainment; mental health; psychosocial impact; social exclusion 3.1 Introduction Pragmatic disorders can have serious, adverse consequences for the children and adults who experience them. Pragmatic impairment in children can lead to educational underachievement, failure to establish social relationships with others, and a range of psychological difficulties. As these children progress into adolescence and adulthood, their problems are frequently compounded by additional difficulties including a lack of vocational opportunity, difficulty forming personal relationships, participation in criminal activity and the development of substance use disorders. Notwithstanding the significant impact of pragmatic disorders on the lives of affected individuals, these various outcomes are seldom the focus of clinicians and researchers who work with this client group. Yet, there are clear reasons why they must be given greater prominence. Firstly, healthcare providers are increasingly being required to demonstrate the effectiveness of the clinical interventions they offer clients. Speech pathology services are no exception in this regard. Clinicians must be able to demonstrate measurable gains in the quality of life of their clients as a result of pragmatic language interventions, and indicators such as improved social and psychological adjustment are often the clearest means of achieving this. Secondly, the considerable cost to individuals, society and the economy of criminal behaviour has prompted discussion of how earlier identification and treatment of those at risk of this behaviour may best be achieved. The increased prevalence of language
Chapter 1: Pragmatic disorders in the 21 st century
Handbook of Pragmatic Language Disorders: Complex and Underserved Populations, 2021
In forty years, pragmatics has moved from a position of relative obscurity in the study of language disorder to become an area of central interest to clinicians and researchers in speech-language pathology. Several factors have contributed to the growing prominence of pragmatics in a clinical context. They include the recognition of pragmatics as a branch of linguistics on an equal footing to disciplines like syntax and semantics, the realisation that many clients have intact structural language skills but still communicate inadequately, and the development of better techniques for the assessment and treatment of individuals with pragmatic language impairments. The emergence of clinical pragmatics has resulted in many achievements, not least for the management of children and adults with pragmatic disorders. But we would do well not to assume that these achievements will simply continue in the years to come. For the substantial present-day gains of clinical pragmatics to be extended into the future, new directions for research need to be explored. In this chapter, I reflect on the form that these directions might take, and consider the clinical populations and issues that might concern speech-language pathologists in the years ahead. In thinking about new priorities in clinical pragmatics, the chapter considers how disciplines such as neuropsychology and psychiatry will have an increased role to play in our understanding of pragmatic disorders. The chapter will also address a growing diagnostic role for pragmatic language impairments in the management of clients with psychiatric disorders and conditions such as dementia. If these new directions prove to be correct, the first forty years of clinical pragmatics will have prepared the ground for many more years of fruitful intellectual and clinical inquiry in pragmatics.
Psychosocial Aspects of Pragmatic Disorders
2017
This chapter considers the everyday psychological and social costs attached to having pragmatic language difficulties. We briefly review key terminology concerning pragmatic language functions, before summarizing features of pragmatic language difficulties that occur in both the developmental period (e.g. associated with language impairment, autism spectrum disorder, hearing impairment, traumatic brain injury, intellectual disability) and in adulthood (e.g. in fronto-temporal dementia, aphasia, and Alzheimer’s disease). We present a schematic model as a means of conceptualizing the elements of pragmatic language competence and its inverse, pragmatic language difficulties, within the broader psycho-social context. We argue that psychological factors such as coping style and self-efficacy for communication need to be considered alongside social factors (such as cultural mores and everyday communication contexts) if the true impact of pragmatic language difficulties is to be both docum...
The SAGE Encyclopedia of Human Communication Sciences and Disorders, 2019
Pragmatic impairment (also known as social (pragmatic) communication disorder) can be defined as any breakdown in the use of language across a range of communicative contexts. Deficits in the pragmatics of language pose a significant barrier to effective communication and can compromise social, academic and occupational functioning. To mitigate these adverse consequences, individuals with pragmatic impairment must be assessed and treated by speech-language pathologists. This entry will examine the different aetiologies that can cause pragmatic disorders and significant distinctions in the classification of these disorders. It will also consider the contribution of cognitive deficits to these disorders and will address how clinicians assess and treat pragmatic disorders.
The assessment and treatment of pragmatic disorders
Clinical Pragmatics, 2009
At its most general level, the clinical management of clients with pragmatic disorders involves two main types of activity. In order to establish which pragmatic skills are impaired, clinicians must first engage in a process of assessment. Assessment is usually conducted over several sessions and can involve an extensive range of techniques. The results of assessment provide a basis for the planning of intervention as well as a baseline measurement of the client's pragmatic skills. We will see subsequently that this baseline measurement is vital in establishing a client's progress in therapy and in determining the efficacy of a particular programme of intervention. An equally eclectic group of techniques is used in the intervention or treatment of pragmatic disorders. These techniques often reflect the particular experience of a clinician and the availability of resources. Certainly, few of these techniques have been the subject of efficacy studies. There is a very important sense, therefore, in which most interventions of pragmatics lack the type of clinical validation that we have come to expect of interventions in areas such as phonology and syntax. In this section, we examine the full range of methods that are available to the clinician who is charged with the assessment and treatment of pragmatic disorders in children and adults. In doing so, we will make a distinction between formal and informal assessment methods. We will consider the types of clients that may be assessed and treated using these methods. We will also discuss the question of efficacy studies in the area of disordered pragmatics. Before engaging with these issues, however,
Chapter 2: Pragmatic Disorders across the Life Span
Pragmatic Disorders, 2014
Pragmatic disorders display no preference for the individuals they afflict. People of different ethnicities, socioeconomic classes, and ages can develop pragmatic disorders. Men and women appear to be equally predisposed to pragmatic disorders. 1 Pragmatic disorders are not confined to people living in certain geographical regions, and are no more commonly found in urban over rural dwellers (or vice versa). No lifestyle, culture or type of education places an individual at an increased risk of developing a pragmatic disorder. In view of this lack of discrimination, pragmatic disorders are best examined within a life span perspective. This perspective adopts a chronological approach in which pragmatic disorders are examined in their order of occurrence throughout the life span. The chapter begins by examining pragmatic disorders which have their onset in the developmental period. These disorders are found in children and adults with autism spectrum disorders and a range of genetic syndromes, amongst other conditions. Beyond the developmental period, older children and adolescents can sustain injuries and develop illnesses that compromise their pragmatic language skills. This age group is challenging for clinicians in that while many pragmatic skills have been acquired, these children do not have adult-like pragmatic competence. In adulthood, events such as cerebrovascular accidents (strokes) and head injuries can disrupt previously intact pragmatic skills. In later life, neurodegenerative diseases such as the dementias can cause significant, progressive loss of
Pragmatic disorders and their social impact
2011
Pragmatic disorders in children and adults have been the focus of clinical investigations for approximately 40 years. In that time, clinicians and researchers have established a diverse range of pragmatic phenomena that are disrupted in these disorders. Pragmatic deficits include problems with the use and understanding of speech acts, the processing of non-literal language, failure to adhere to Gricean maxims in conversation and discourse deficits. These deficits are found in several clinical populations including individuals with autistic spectrum disorders, schizophrenia, traumatic brain injury and right-hemisphere damage. However, what is less often investigated is the social impact of pragmatic disorders on the children and adults who are affected by them. In this paper, I examine what is known about pragmatic disorders in these clinical groups. I then consider the wider social consequences of these disorders, where consequences are broadly construed to include factors that act as indicators of social adjustment.
A CLINICAL APPRAISAL OF THE PRAGMATIC LANGUAGE ASPECTS OF
A descriptive taxonomy, the pragmatic protocol, was developed for this study. The protocol consists of 30 pragmatic parameters of language. The purpose of the study was to test the utility of the tool to evaluate a range of pragmatic aspects of language in a sample of conversational speech fiom subjects in six groups. Among the disordered subjects, four distinct profiles emerged that separated the diagnostic groups. Individual differences in the way pragmatic deficits were distributed within a diagnostic category were also identified. The authors stress that the assessment of pragmatics should encompass a range of parameters that includes aspects of linguistic structure as well as those aspects of communication that have to do with principles governing language use. We offer our data as an early look at the way in which pragmatic deficits stratify across disordered populations.
Disability and rehabilitation, 2016
The purpose of this study is to provide a review of pragmatic communication ability and its disorders, as a resource for rehabilitation team members. This review is a product of the Joint Committee on Interprofessional Relations Between the American Speech-Language-Hearing Association and Division 40: Society for Clinical Neuropsychology of the American Psychological Association. Review of the literature and expert opinion. We summarize key theoretical frameworks that guide assessment of pragmatic communication ability, describe the developmental progression of pragmatic skills and expectations for children and adults, provide an overview of pragmatic communication disorders, and discuss current assessment approaches. An understanding of pragmatic communication disorders may assist all rehabilitation team members, as impairments in this domain may have significant effects on rehabilitation progress and outcomes. Implications for Rehabilitation Pragmatic communication ability is the ...