Qualitative studies have produced new but fragmentary observations of the discourse of clinical lessons. This paper surveys these findings and integrates them around the principles of conversational discourse and discourse analysis. The picture which emerges is that training lessons are patterned within and across levels of conversational discourse. Social, verbal, and nonverbal components of clinician—child interaction are organized hierarchically for the purposes of eliciting correct linguistic responses. Clinical discourse research is discussed with reference to questions of clinical validity and practicality. Five learning hypotheses are also suggested.
There has been a small accumulation of studies of clinician-child discourse. Early work has demonstrated the value of careful description of real lessons as they are carried out by clinicians working with speech and language-disordered children. In this descriptive report the role of non verbal communication is emphasized, particularly with reference to pointing as a clinical teaching device. Transcriptions of three clinician-led lessons were analysed. The results verified the systematic nature of pointing as an augmentation to remedial control. The need for full descriptions of nonverbal communication as it facilitates lesson applications is discussed.
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