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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.
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,
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.
Archives de Pédiatrie, 2019
Pragmatics is a complex subject encompassing linguistics, psychology, sociology, and philosophy disciplines, and has many definitions depending on these different fields of research. In accordance with Rondal et al., language is not just a question of mastering the structural aspects (lexical, syntactical, etc.), but also 21 implies an appropriate use in a situation requiring communication 22 [1]. A pragmatic disorder therefore implies a mismatch between 23 language and context [2]. 24 Pragmatic disorders are mentioned as a new diagnostic 25 category in the 5th edition of the Diagnostic and Statistical Manual 26 of Mental Disorders (DSM) [3]; it is called social (pragmatic) 27 communication disorder (SCD), which is similar to the semantic-28 pragmatic deficit syndrome in the last DSM edition [4]. SCD 29 appears to be a contributing factor in the diagnosis of autism 30 spectrum disorder (ASD) when disorders include ''restricted, 31 repetitive patterns of behavior, interests or activities.'' It may also Archives de Pé diatrie xxx (2018) xxx-xxx
International Encyclopedia of Rehabilitation, 2013
For most people, the ability to use language to communicate with others is a skill which is taken for granted. We can tell when someone is making a suggestion, offering an opinion on a topic or passing a comment. We also know how utterances can be used to extend and decline invitations, to dissuade those around us from an ill-advised course of action, and to forge friendships and other interrelationships. These activities are not a challenge to the majority of us because we have intact pragmatic language skills. However, for a significant number of children and adults, these everyday uses of language are very far from being effortless accomplishments. For these individuals, breakdown in the pragmatics of language compromises a range of daily communicative activities and also has implications for functioning in other domains.(1) This article examines some of these children and adults and considers the types of pragmatic disorders they exhibit. The discussion begins with an account of pragmatics for readers who do not have a background in linguistics.
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.
Chapter 5: Theoretical Models and Pragmatic Disorders
Pragmatic Disorders, 2014
For approximately forty years, investigators have attempted to characterize impairments of pragmatics in children and adults. During this time, certain trends have been evident in how investigators have pursued this work. One of the most noteworthy trends has been the relentless drive to demonstrate skills and behaviours which are disrupted in children and adults with pragmatic disorders. The result has been an abundance of empirical findings, many of which have considerable interest for clinical researchers and practitioners. For example, it is a fact worth knowing if children and adults with an autism spectrum disorder cannot recover the sarcastic intent of certain utterances, or if the schizophrenic adult fails to observe the relation maxim in his contribution of turns to a conversation. However, at the same time as there has been a proliferation of empirical findings, many of these findings can appear poorly interconnected and of limited significance. They can also often lack proper explanatory value. It is important to interrogate why this is the case. As I will argue in this chapter, the answer lies in the lack of theoretical models in clinical pragmatic research. In the absence of these models, clinical pragmatic studies have produced copious findings. However, only some of these findings have the type of theoretical significance that can advance our understanding of pragmatic disorders.
Clinical pragmatics: a field in search of phenomena?
2007
Since its inception as a branch of linguistic enquiry, pragmatics has been the focus of numerous debates about its scope of study. While such debates have brought about necessary refinement of core concepts, they have also resulted in uncertainty about exactly which linguistic phenomena are pragmatic in nature. This uncertainty has come to characterise the related discipline of clinical pragmatics, with many investigators labelling as ‘pragmatic’ behaviours that are not pragmatic on any reasonable interpretation of this term. In this paper, I examine a number of clinical studies in which behaviours have been incorrectly characterised as pragmatic. These studies will be classified according to several categories of error. The implications of these erroneous characterisations for the assessment and treatment of pragmatic language disorders will be discussed. Finally, a number of criteria are advanced which, it is expected, will constrain the tendency of clinicians and theorists alike to incorrectly identify behaviours as pragmatic.
Chapter 6: Pragmatic Disorders in Complex and Underserved Populations
Pragmatic Disorders, 2014
Keywords: Attention deficit hyperactivity disorder; emotional and behavioural disorders; frontotemporal dementia; non-Alzheimer's dementias; prison population 6.1 Introduction Not all pragmatic disorders have received the level of clinical study of the populations examined in chapter 2. While the pragmatic impairments of clients with right-hemisphere damage or traumatic brain injury are well characterized, relatively little is known about the pragmatic language skills of children with emotional and behavioural disorders or adults with non-Alzheimer's dementias. These children and adults belong to 'complex' populations by virtue of the fact that their pragmatic disturbance occurs in the presence of significant psychiatric and cognitive disorders. Similarly, certain groups of clients with pragmatic impairments are beyond the reach of, or are overlooked by, language services. These groups include adolescents in juvenile detention facilities and adults in prison. These clients belong to an 'underserved' population to the extent that their language needs are inadequately assessed and treated. Although these different clients have not been the focus of extensive academic research or clinical services to date, what is clear is that an array of factors means complex and underserved populations are likely to become an increasingly important part of the caseload of speech and language therapists in years to come. With this consideration in mind, an examination of the pragmatic impairments of these clients now seems timely. 6.2 Emotional and behavioural disorders
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...