Pragmatic Disorders in Complex and Underserved Populations

Abstract

Not all pragmatic disorders have received the level of clinical study of the populations examined in  Chap. 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, clinical 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, it is clear 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. These factors include the growing health burden of diseases such as dementia and the considerable economic and social costs of criminal behaviour. The search for effective ways to address these problems means that an examination of the pragmatic impairments of clients in these various populations is particularly timely.