Pragmatic disorders and theory of mind

Introduction For approximately 40 years, clinical investigators have actively pursued research into pragmatic disorders in children and adults (Cummings 2010). During that time, there has been considerably less concern on the part of researchers to explain pragmatic disorders than there has been on the attempt to characterize these disorders. The resulthas been a large and somewhat disjointed body of research findings, not all of which relate in a meaningful way to pragmatic disorders (Cummings 2005, 2007a, 2007b, 2008, 2009, 2011, 2012a, 2014a, 2014b). While many investigators haveappeared content with the task of characterizing pragmatic disorders, other investigators have pursued a deeper form of analysis by striving for cognitive explanations of these disorders. These investigators have appealed to cognitivefactors and frameworks such as inferential load (Bara 2010), relevance processing (Leinonen and Kerbel 1999) and weakcentral coherence (Norbury and Bishop 2002) to account for the pragmatic deficits that are seen to compromise communication in child and adult clients. However, one type of cognitive explanation has had more prominence than all others. This is the attempt to explain pragmatic deficits in terms of an impairment of the cognitive capacity to attribute mental states to the minds of others. This capacity, known as theory of mind, has had a powerful and transformative effect on research into pragmatic disorders in recent years. This chapter seeks to examine that effect and assess whatgains, if any, it has delivered in terms of our understanding of pragmatic disorders.