Pragmatics and language pathology

Pragmatic concepts are often poorly understood and characterized by the clinicians and researchers who use them. To be clear from the outset on the nature and extent of pragmatic behaviours, this chapter examines a range of pragmatic and discourse concepts which will be addressed throughout the book: speech act, implicature, presupposition, deixis, non-literal language, context, cohesion, and coherence. Numerous examples, including those taken from clinical subjects, will be used to demonstrate these concepts. The chapter also examines the ‘pragmatic turn’ in the study of language disorders. This turn has served to reshape every aspect of the clinical management of language disordered clients, and not just those with pragmatic disorders. The implications of this turn for how these disorders are diagnosed, assessed and treated are considered. In an era of budgetary constraints and evidence-based health care, clinicians who treat clients with communication disorders are increasingly being required to demonstrate the effectiveness of speech and language therapy (SLT). Many of the functional communication measures which are used for this purpose have their origins in pragmatics. The chapter concludes with a discussion of how pragmatics has shaped the measures that are now used to demonstrate the effectiveness of SLT interventions.