Wednesday, 12 December 2012

Communication and Pragmatic Disorders

In two recent articles, Louise Cummings explores issues about communication and pragmatic disorders.

In 'Pragmatic Disorders', she argues that, while pragmatic disorders present a considerable barrier to effective communication, their study has tended to be overshadowed by investigations of impairment in rule-based aspects of language. Moreover, such studies of pragmatic disorders as have been undertaken have typically not been theoretically motivated. The result has been a collection of clinical findings that are often poorly interrelated and provide a weak basis for intervention. In this recent article, she considers the current state of our knowledge of pragmatic disorders by examining the features of these disorders in child and adult clients. Specifically, she considers how breakdown in the pragmatics of language adversely affects the comprehension and expression of speech acts, the processing of implicatures, the use and understanding of deictic expressions and presuppositional phenomena, the utilisation of context during utterance interpretation, and the processing of nonliteral language. Impairments in pragmatic aspects of nonverbal communication are also considered. These features are discussed in the context of experimental studies as well as studies of conversation and discourse.  

In a second article, she explores the role of clinical pragmatics in establishing diagnostic criteria. The study of pragmatic disorders is of interest to speech-language pathologists who have a professional responsibility to assess and treat communication impairments. However, these disorders, she argues, have a significance beyond the clinical management of clients with communication impairments. Specifically, pragmatic disorders can now make a contribution to the diagnosis of a range of clinical conditions in which communication is adversely affected. These conditions include attention deficit hyperactivity disorder (ADHD), the autistic spectrum disorders, schizophrenia and the dementias. Pragmatic disorders are already among the criteria used to diagnose some of these conditions (e.g. ADHD), although they are not described in these terms. In other conditions (e.g. the dementias), pragmatic disorders have potential diagnostic value in the absence of reliable biomarkers markers of these conditions and similar initial presenting symptoms. Using clinical data, and the findings of empirical studies, the case is made for the inclusion and/or greater integration of pragmatic disorders in the formal classificatory systems that are used to diagnose a range of disorders. A previously unrecognised role for pragmatic impairments in the nosology and diagnosis of clinical disorders is thereby established

Cummings, L. (2012) ‘Pragmatic disorders’, in H.-J. Schmid (ed.) Cognitive Pragmatics [Handbook of Pragmatics, Vol. 4], Berlin: De Gruyter, 291-316.

Cummings, L. (2012) ‘Establishing diagnostic criteria: The role of clinical pragmatics’, Lodz Papers in Pragmatics, 8 (1): 61-84.

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