Pragmatic disorders in forensic settings

Clients with pragmatic disorders are over-represented in the criminal justice system in comparison to the general population. Many of these disorders occur as part of conditions which are well recognised for their pragmatic impairments, including autism spectrum disorder, intellectual disability and schizophrenia. Others arise as a result of conditions which are somewhat less well known in clinical pragmatics, but in which there is increasing evidence of impairment in the areas of pragmatics and discourse (e.g. non-Alzheimer’s dementias). This chapter will examine the pragmatic disorders in these clinical populations. This examination will consider a number of factors that complicate the presentation, assessment and treatment of pragmatic impairments within forensic settings. These factors include the role of co-morbid conditions such as substance use disorders, the involvement of cognitive deficits such as theory of mind impairments in pragmatic disorders and societal prejudice against incarcerated individuals. These factors limit provision of, and reduce compliance with, pragmatic language assessments and interventions. The chapter will also address some of the implications of pragmatic disorders for the many verbally mediated interactions that defendants and inmates must comply with in the criminal justice system. These interactions include police arrest and interviews, legal examinations in courtrooms and prison rehabilitation programs which aim to reduce rates of re-offending behaviour. The specific pragmatic demands of these interactions will be considered, as will the ability of defendants and inmates with pragmatic disorders to meet these demands. Examples of the types of pragmatic skills which are integral to these interactions will be examined. The chapter concludes by arguing for an improved level of clinical language services with a focus on pragmatic language skills in prisons and other correctional facilities. It is contended that the substantial investment, which would be needed to achieve this improvement, would be offset by significant gains in the rehabilitation outcomes of incarcerated adults and young people.