The impact of pragmatic disorders

Pragmatic disorders can have serious, adverse consequences for the children and adults who experience them. Pragmatic impairment in children can lead to educational underachievement, failure to establish social relationships with others, and a range of psychological difficulties. As children with pragmatic disorders progress into adolescence and adulthood, their problems are frequently compounded by additional difficulties including a lack of vocational opportunity, difficulty forming personal relationships, participation in criminal activity and the development of substance use disorders. Notwithstanding the significant impact of pragmatic disorders on the lives of affected individuals, these various outcomes are seldom the focus of clinicians and researchers who work with this client group. This chapter addresses this important, but neglected area by examining the impact of pragmatic disorders along a number of parameters. These parameters are (1) psychological impact, which ranges from minor problems such as low self-esteem through to severe psychiatric disturbances; (2) social impact, which includes problems relating to social adjustment and integration; (3) academic impact, which includes performance on a range of indicators of academic achievement; (4) occupational and vocational impact; (5) behavioural impact, which includes externalizing problems such as conduct disorder; and (6) forensic impact, which includes engagement in juvenile delinquency, the use of illicit substances and other forms of criminal behaviour.