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Pragmatic Disorders in the Twenty-First Century

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Handbook of Pragmatic Language Disorders

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Abstract

In 40 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 40 years of clinical pragmatics will have prepared the ground for many more years of fruitful intellectual and clinical inquiry in pragmatics.

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Notes

  1. 1.

    The Epilepsy Foundation of America (2020) reports that the prevalence of epilepsy in the US population is between 5–8.4/1000 persons per year or approximately 1% of the population. The point prevalence of developmental stuttering is also 1% (Bloodstein & Bernstein Ratner, 2008).

  2. 2.

    Pragmatic language skills may be impaired on account of deficits in structural language (syntax and semantics) or as a result of cognitive deficits. Clients who have impaired pragmatic language skills in the presence of language and/or cognitive deficits have a secondary pragmatic disorder. However, in a primary pragmatic disorder, the pragmatic impairment does not arise on account of any structural language impairment or cognitive deficit.

  3. 3.

    Negative symptoms in schizophrenia are the absence of normal behaviours. They include alogia, avolition (lack of motivation) and a lack of affect. Positive symptoms in schizophrenia are the presence of abnormal behaviours. They include delusions (false and bizarre beliefs), hallucinations (the perception of things which do not exist), and disorganised speech. A diagnosis of schizophrenia is based on the presence of both types of symptom.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

    Book  Google Scholar 

  • Arria, A. M., Caldeira, K. M., Allen, H. K., Bugbee, B. A., Vincent, K. B., & O’Grady, K. E. (2017). Prevalence and incidence of drug use among college students: An 8-year longitudinal analysis. American Journal of Drug and Alcohol Abuse, 12, 1–8.

    Google Scholar 

  • Ash, S., McMillan, C., Gross, R. G., Cook, P., Morgan, B., Boller, A., Dreyfuss, M., Siderowf, A., & Grossman, M. (2011). The organization of narrative discourse in Lewy body spectrum disorder. Brain and Language, 119(1), 30–41.

    Article  Google Scholar 

  • Bambini, V., Arcara, G., Bechi, M., Buonocore, M., Cavallaro, R., & Bosia, M. (2016a). The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Comprehensive Psychiatry, 71, 106–120.

    Article  Google Scholar 

  • Bambini, V., Arcara, G., Martinelli, I., Bernini, S., Alvisi, E., Moro, A., Cappa, S. F., & Ceroni, M. (2016b). Communication and pragmatic breakdowns in amyotrophic lateral sclerosis patients. Brain and Language, 153–154, 1–12.

    Article  Google Scholar 

  • Bearden, C. E., Wu, K. N., Caplan, R., & Cannon, T. D. (2011). Thought disorder and communication deviance as predictors of outcome in youth at clinical high risk for psychosis. Journal of the American Academy of Child and Adolescent Psychiatry, 50(7), 669–680.

    Article  Google Scholar 

  • Bishop, D. V. M. (2003). Children’s communication checklist–revised (2nd ed.). Psychological Corporation.

    Google Scholar 

  • Bloodstein, O., & Bernstein Ratner, N. (2008). A handbook on stuttering (6th ed.). Thomson Delmar.

    Google Scholar 

  • Bosco, F. M., Tirassa, M., & Gabbatore, I. (2018). Why pragmatics and theory of mind do not (completely) overlap. Frontiers in Psychology, 9, 1453. https://doi.org/10.3389/fpsyg.2018.01453

    Article  Google Scholar 

  • Bowie, C. R., Tsapelas, I., Friedman, J., Parrella, M., White, L., & Harvey, P. D. (2005). The longitudinal course of thought disorder in geriatric patients with chronic schizophrenia. American Journal of Psychiatry, 162(4), 793–795.

    Article  Google Scholar 

  • Broeders, M., Geurts, H., & Jennekens-Schinkel, A. (2010). Pragmatic communication deficits in children with epilepsy. International Journal of Language & Communication Disorders, 45(5), 608–616.

    Article  Google Scholar 

  • Christo, C. (2014). Developmental dyslexia. In L. Cummings (Ed.), Cambridge handbook of communication disorders (pp. 88–108). Cambridge University Press.

    Google Scholar 

  • Clark, A., & Fitzsimons, D. (2016). Unidentified and unmet. Bulletin, 769, 16–17.

    Google Scholar 

  • Clark, A., Barrow, E., & Hartley, K. (2012). Unmet need in Scotland’s criminal justice system. Bulletin, 718, 20–21.

    Google Scholar 

  • Coelho, C. A., & Flewellyn, L. (2003). Longitudinal assessment of coherence in an adult with fluent aphasia. Aphasiology, 17(2), 173–182.

    Article  Google Scholar 

  • Cummings, L. (2007). Clinical pragmatics: A field in search of phenomena? Language & Communication, 27(4), 396–432.

    Article  Google Scholar 

  • Cummings, L. (2009). Clinical pragmatics. Cambridge University Press.

    Book  Google Scholar 

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

    Article  Google Scholar 

  • Cummings, L. (2013). Clinical pragmatics and theory of mind. In A. Capone, F. Lo Piparo, & M. Carapezza (Eds.), Perspectives on linguistic pragmatics (Perspectives in pragmatics, philosophy & psychology) (Vol. 2, pp. 23–56). Springer.

    Chapter  Google Scholar 

  • Cummings, L. (2014a). Pragmatic disorders. Springer.

    Book  Google Scholar 

  • Cummings, L. (2014b). Pragmatic disorders and theory of mind. In L. Cummings (Ed.), Cambridge handbook of communication disorders (pp. 559–577). Cambridge University Press.

    Chapter  Google Scholar 

  • Cummings, L. (2015). Theory of mind in utterance interpretation: The case from clinical pragmatics. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2015.01286

  • Cummings, L. (2017a). Cognitive aspects of pragmatic disorders. In L. Cummings (Ed.), Research in clinical pragmatics (Perspectives in pragmatics, philosophy & psychology) (Vol. 11, pp. 587–616). Springer International Publishing AG.

    Chapter  Google Scholar 

  • Cummings, L. (2017b). Pragmatic disorders in forensic settings. In F. Poggi & A. Capone (Eds.), Pragmatics and law (Perspectives in pragmatics, philosophy & psychology) (Vol. 10, pp. 349–377). Springer International Publishing AG.

    Chapter  Google Scholar 

  • Cummings, L. (2019a). On making a sandwich: Procedural discourse in adults with right-hemisphere damage. In A. Capone, M. Carapezza, & F. Lo Piparo (Eds.), Further advances in pragmatics and philosophy. Part 2: Theories and applications (pp. 331–355). Springer International Publishing AG.

    Chapter  Google Scholar 

  • Cummings, L. (2019b). Describing the Cookie Theft picture: Sources of breakdown in Alzheimer’s dementia. Pragmatics & Society, 10(2), 151–174.

    Article  Google Scholar 

  • Cummings, L. (2019c). Narrating the Cinderella story in adults with primary progressive aphasia. In A. Capone (Ed.), Further advances in pragmatics. New paradigms (Vol. 2, pp. 301–329). Springer International Publishing AG.

    Google Scholar 

  • Cummings, L. (2021). Language in dementia. Cambridge University Press.

    Google Scholar 

  • Debiais, S., Tuller, L., Barthez, M.-A., Monjauze, C., Khomsi, A., Praline, J., de Toffol, B., Autret, A., Barthelemy, C., & Hommet, C. (2007). Epilepsy and language development: The continuous spike-waves during slow sleep syndrome. Epilepsia, 48(6), 1104–1110.

    Article  Google Scholar 

  • Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168.

    Article  Google Scholar 

  • Douglas, J. M. (2010). Relation of executive functioning to pragmatic outcome following severe traumatic brain injury. Journal of Speech, Language, and Hearing Research, 53(2), 365–382.

    Article  Google Scholar 

  • Eddy, C. M., Mitchell, I. J., Beck, S. R., Cavanna, A. E., & Rickards, H. E. (2010). Impaired comprehension of nonliteral language in Tourette syndrome. Cognitive and Behavioral Neurology, 23(3), 178–184.

    Article  Google Scholar 

  • Ellis Weismer, S. (2014). Specific language impairment. In L. Cummings (Ed.), Cambridge handbook of communication disorders (pp. 73–87). Cambridge University Press.

    Google Scholar 

  • Ellis, C., Crosson, B., Gonzalez Rothi, L. J., Okun, M. S., & Rosenbek, J. C. (2015). Narrative discourse cohesion in early stage Parkinson’s disease. Journal of Parkinson’s Disease, 5(2), 403–411.

    Article  Google Scholar 

  • Epilepsy Foundation of America. (2020). Epilepsy statistics. Retrieved 11 August 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/epilepsy-statistics.

  • Fazel, S., Yoon, I. A., & Hayes, A. J. (2017). Substance use disorders in prisoners: An updated systematic review and meta-regression analysis in recently incarcerated men and women. Addiction, 112(10), 1725–1739.

    Article  Google Scholar 

  • Feyereisen, P., Berrewaerts, J., & Hupet, M. (2007). Pragmatic skills in the early stages of Alzheimer’s disease: An analysis by means of a referential communication task. International Journal of Language & Communication Disorders, 42(1), 1–17.

    Article  Google Scholar 

  • Fukuhara, K., Ogawa, Y., Tanaka, H., Nagata, Y., Nishida, S., Haga, D., & Nishikawa, T. (2017). Impaired interpretation of others’ behavior is associated with difficulties in recognizing pragmatic language in patients with schizophrenia. Journal of Psycholinguistic Research, 46(5), 1309–1318.

    Article  Google Scholar 

  • Gerenser, J. (2009). Language disorders in children with autism. In R. G. Schwartz (Ed.), Handbook of child language disorders (pp. 67–89). Psychology Press.

    Google Scholar 

  • Hirst, W., LeDoux, J., & Stein, S. (1984). Constraints on the processing of indirect speech acts: Evidence from aphasiology. Brain and Language, 23(1), 26–33.

    Article  Google Scholar 

  • Honan, C. A., McDonald, S., Gowland, A., Fisher, A., & Randall, R. K. (2015). Deficits in comprehension of speech acts after TBI: The role of theory of mind and executive function. Brain and Language, 150, 69–79.

    Article  Google Scholar 

  • Katsos, N., Roqueta, C. A., Estevan, R. A. C., & Cummins, C. (2011). Are children with specific language impairment competent with the pragmatics and logic of quantification? Cognition, 119(1), 43–57.

    Article  Google Scholar 

  • Keating, D., Syrmis, M., Hamilton, L., & McMahon, S. (1998). Paediatricians: Referral rates and speech pathology waiting lists. Journal of Paediatrics and Child Health, 34(5), 451–455.

    Article  Google Scholar 

  • Kim, Y. T., Kwon, D. H., & Chang, Y. (2011). Impairments of facial emotion recognition and theory of mind in methamphetamine abusers. Psychiatry Research, 186(1), 80–84.

    Article  Google Scholar 

  • Krill, P. R., Johnson, R., & Albert, L. (2016). The prevalence of substance use and other mental health concerns among American attorneys. Journal of Addiction Medicine, 10(1), 46–52.

    Article  Google Scholar 

  • Losh, M., Martin, G. E., Klusek, J., Hogan-Brown, A. L., & Sideris, J. (2012). Social communication and theory of mind in boys with autism and fragile X syndrome. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2012.00266

  • Maki, Y., Yamaguchi, T., Koeda, T., & Yamaguchi, H. (2013). Communicative competence in Alzheimer’s disease: Metaphor and sarcasm comprehension. American Journal of Alzheimer’s Disease and Other Dementias, 28(1), 69–74.

    Article  Google Scholar 

  • McCann, C., Tunnicliffe, K., & Anderson, R. (2013). Public awareness of aphasia in New Zealand. Aphasiology, 27(5), 568–580.

    Article  Google Scholar 

  • McDonald, S. (2000). Exploring the cognitive basis of right-hemisphere pragmatic language disorders. Brain and Language, 75(1), 82–107.

    Article  Google Scholar 

  • Najam, N., Tarter, R. E., & Kirisci, L. (1997). Language deficits in children at high risk for drug abuse. Journal of Child & Adolescent Substance Abuse, 6(2), 69–80.

    Article  Google Scholar 

  • Nesbitt, R., & Thompson, R. (1995). Exploring interdisciplinary management of Parkinson’s disease. International Journal of Language & Communication Disorders, 30(S1), 414.

    Article  Google Scholar 

  • Novak, J. M., & Kapolnek, K. M. (2001). Speech-language pathologists serving clients with mental illness: A collaborative treatment approach. Contemporary Issues in Communication Science and Disorders, 28, 111–122.

    Article  Google Scholar 

  • Onuoha, R. C., Quintana, D. S., Lyvers, M., & Guastella, A. J. (2016). A meta-analysis of theory of mind in alcohol use disorders. Alcohol and Alcoholism, 51(4), 410–415.

    Article  Google Scholar 

  • Palepu, A., Gadermann, A., Hubley, A. M., Farrell, S., Gogosis, E., Aubry, T., & Hwang, S. W. (2013). Substance use and access to health care and addiction treatment among homeless and vulnerably housed persons in three Canadian cities. PLoS One. https://doi.org/10.1371/journal.pone.0075133

  • Pawełczyk, A., Łojek, E., Żurner, N., Gawłowska-Sawosz, M., & Pawełczyk, T. (2018). Higher-order language dysfunctions as a possible neurolinguistic endophenotype for schizophrenia: Evidence from patients and their unaffected first-degree relatives. Psychiatry Research, 267, 63–72.

    Article  Google Scholar 

  • Petranovich, C. L., Walz, N. C., Staat, M. A., Chiu, C. P., & Wade, S. L. (2016). Structural language, pragmatic communication, behaviour, and social competence in children adopted internationally: A pilot study. Applied Neuropsychology. Child, 23, 1–12.

    Google Scholar 

  • Premack, D., & Woodruff, G. (1978). Does the chimpanzee have theory of mind? Behavioral and Brain Sciences, 1(4), 515–526.

    Article  Google Scholar 

  • Prinz, P. M. (1982). An investigation of the comprehension and production of requests in normal and language-disordered children. Journal of Communication Disorders, 15(2), 75–93.

    Article  Google Scholar 

  • Prinz, P. M., & Ferrier, L. J. (1983). “Can you give me that one?”: The comprehension, production and judgment of directives in language-impaired children. Journal of Speech and Hearing Research, 48(1), 44–54.

    Google Scholar 

  • Rakhlin, N., Hein, S., Doyle, N., Hart, L., Macomber, D., Ruchkin, V., Tan, M., & Grigorenko, E. L. (2015). Language development of internationally adopted children: Adverse early experiences outweigh the age of acquisition effect. Journal of Communication Disorders, 57, 66–80.

    Article  Google Scholar 

  • Reilly, J., Rodriguez, A. D., Lamy, M., & Neils-Strunjas, J. (2010). Cognition, language and clinical pathological features of non-Alzheimer’s dementias: An overview. Journal of Communication Disorders, 43(5), 438–452.

    Article  Google Scholar 

  • Rom, A., & Bliss, L. S. (1983). The use of nonverbal pragmatic behaviors by language-impaired and normal-speaking children. Journal of Communication Disorders, 16(4), 251–256.

    Article  Google Scholar 

  • Saavedra, J. (2010). Quantitative criteria of narrative coherence and complexity in persons with paranoid schizophrenia. Journal of Nervous and Mental Disease, 198(5), 349–355.

    Article  Google Scholar 

  • Saldert, C., & Ahlsén, E. (2007). Inference in right hemisphere damaged individuals’ comprehension: The role of sustained attention. Clinical Linguistics & Phonetics, 21(8), 637–655.

    Article  Google Scholar 

  • Snow, P., & Douglas, J. (2017). Psychosocial aspects of pragmatic disorders. In L. Cummings (Ed.), Research in clinical pragmatics (Perspectives in pragmatics, philosophy & psychology) (Vol. 11, pp. 617–649). Springer International Publishing AG.

    Chapter  Google Scholar 

  • Spinelli, E. G., Mandelli, M. L., Miller, Z. A., Santos-Santos, M. A., Wilson, S. M., Agosta, F., Grinberg, L. T., Huang, E. J., Trojanowski, J. Q., Meyer, M., Henry, M. L., Comi, G., Rabinovici, G., Rosen, H. J., Filippi, M., Miller, B. L., Seeley, W. W., & Gorno-Tempini, M. L. (2017). Typical and atypical pathology in primary progressive aphasia variants. Annals of Neurology, 81(3), 430–443.

    Article  Google Scholar 

  • Stemmer, B. (2017). Neural aspects of pragmatic disorders. In L. Cummings (Ed.), Research in clinical pragmatics, volume 11, Perspectives in pragmatics, philosophy & psychology (pp. 561–585). Springer International Publishing AG.

    Google Scholar 

  • Surian, L. (1996). Are children with autism deaf to Gricean maxims? Cognitive Neuropsychiatry, 1(1), 55–72.

    Article  Google Scholar 

  • Whyte, E. M., & Nelson, K. E. (2015). Trajectories of pragmatic and nonliteral language development in children with autism spectrum disorders. Journal of Communication Disorders, 54, 2–14.

    Article  Google Scholar 

  • Wiig, E. H., & Secord, W. (1989). Test of language competence-expanded edition. The Psychological Corporation.

    Google Scholar 

  • Wilcox, M. J., & Davis, G. A. (1977). Speech act analysis of aphasic communication in individual and group settings. In Proceedings of the clinical aphasiology conference (pp. 166–174). BRK Publishers.

    Google Scholar 

  • Winner, E., & Leekam, S. (1991). Distinguishing irony from deception: Understanding the speaker’s second-order intention. British Journal of Developmental Psychology, 9(2), 257–270.

    Article  Google Scholar 

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  1. Department of English ​and Communication, The Hong Kong Polytechnic University, Kowloon, Hong Kong

    Louise Cummings

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    Louise Cummings

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Cummings, L. (2021). Pragmatic Disorders in the Twenty-First Century. In: Cummings, L. (eds) Handbook of Pragmatic Language Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-74985-9_1

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