11. Pragmatic disorders

Abstract

Pragmatic disorders have been an active area of clinical linguistic investigation for nearly forty years. During that time, the field has undergone considerable expansion and transformation, so much so in fact that it is doubtful if early investigators would even recognize the range of clinical populations and pragmatic phenomena that are now routinely investigated under its auspices. Notwithstanding the considerable research activity that has been directed towards the study of pragmatic disorders, there is much that has been problematic in the way investigators have examined these disorders. Clear theoretical frameworks and sound conceptual understanding have often been lacking from the investigations which have been undertaken. Studies have typically concentrated on particular clinical populations to the almost total exclusion of other populations. Certain pragmatic phenomena (e.g. speech acts and implicatures) have been extensively studied while other pragmatic behaviours (e.g. deictic and presuppositional phenomena) have been largely neglected. These various weaknesses in clinical pragmatic studies are not just academic points. For they have significant consequences in terms of how we assess and treat child and adult clients with pragmatic disorders (Cummings 2007a). There is thus an overriding clinical imperative to address these difficulties in a timely fashion. For our current purposes, we explore them in further detail with a view to delineating the content of the present chapter.For much of the relatively brief history of clinical pragmatics, the field has been characterized by a lack of theoretical direction and conceptual confusion concerning what constitutes a pragmatic disorder. Much of this conceptual disarray stems from a similar confusion within pragmatics itself about the scope of this discipline (Cummings 2007a). To the extent that workers in pragmatics have failed to circumscribe this field of study, it is unsurprising that clinical practitioners and researchers should display certain misunderstandings about the type of linguistic and non-linguistic impairments that can appropriately be called "pragmatic". Many studies of pragmatic disorders have also exhibited a grievous lack of theoretical direction. More often than not, studies have been undertaken simply because they can be done, rather than for their ability to address theoretically interesting questions. The reason so many clinical pragmatic studies have not been theoretically motivated is related in large part to the fact that the hitherto dominant philosophical approach to theorising in pragmatics is poorly equipped to characterize the cognitively oriented considerations that are at issue in pragmatic disorders (Cummings