Communication Disorder


Pragmatic Disorders

  • What are they?
    • Pragmatics is the study of individuals use of language in social interactions and the effects of its use 
    • Language use = how to use language in society 
    • People with a pragmatic disorder are poor communicators in spite of all the appearances of having a relatively intact linguistic system 
    • Problems with deciding how to use language 
  • Who are they?
    • Everybody some of the time 
    • Adults have pragmatic competence 
    • Varying pragmatic performance 
    • Children with a pragmatic or semantic pragmatic disorder 
    • People with fluent (Wernicke's) aphasia 
    • People with right hemisphere damage 
    • People with certain psychopathalogical conditions such as schizophrenia 
    • Those on autistic spectrum 
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Typical problems

  • Limited verbal behaviour (may ask too many questions) 
    • People judge: young - naughty, old - antisocial 
  • Poor turn taking and timing of responses
    • No/limited responses/no waiting for response
  • Poor self/group awareness 
    • May confuse given or new information 
    • May not realise that we communicate to pass information 
  • Topics are inappropriate 
  • Some children are labelled with behavioural problems 
    • Can be too easy to assume that those who use language inappropriately are displaying a peverse attitude especially if they have excellent command of language structure 
    • There are some children/adults whose behaviour is not under concious control and who are generally hampered by an inability to understand and control the way in which language is used in everyday interaction 
  • Pragmatic disorders are on a continuum 
    • Not one pragmatic profile 
    • Mute: have ability but dont speak, talk when spoken to, engage in conversation with own rules, typical interactions most of the time 
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  • Inferential Ability 
    • People with a pragmatic disorder will often miss the point and/or draw the wrong conclusion 
    • They may fail to understand direct requests, irony, punchline of jokes 
    • Struggle to correctly infer
    • Relevant information has to be shown visually 
  • Social Cognition and Theory of Mind 
    • Social cognition is the ability to make social inferences about the actions, beliefs and intentions of other persons in order to understand the behaviour of others and to be able to adapt messages to their needs 
      • Appreciating perspective of others 
      • A Theory of Mind is the ability to explain and predict the actions, both of oneself and of others
  • Executive Function
    • Organisation
    • People with a pragmatic disorder may have problems organising their conversations and maintaining topics appropriately 
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Weaknesses 2

  • Memory
    • They may have a poor memory
    • They often do better on recognition than they do on recall 
    • Excessive repetitiveness and topic bias may conceal the fact that the person has forgotten what has been said, they may opt for a default topic or give a general statement of opinion 
  • Affect (information)
    • May be defined as one's ability to express emotion through prosody 
    • Their speech may be too high or too low, noises may intrude, they may use a flat tone, their articulation may be unclear and erratic 
    • Speech pattern may not be typical 
    • Experience emotions but cant show them 
  • World Knowledge 
    • Such people may have limited interest and/or restricted knowledge owing to obsessive routines 
    • Factual areas of interest, not relations
    • Restricted ability to interact with others due to niche topics 
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Weaknesses 3

  • Innapropriate Behaviour 
    • Fail to consider status of listener 
    • Poor attention span 
    • Cannot grasp purpose and conversation 
    • Unpredictable - doesnt consider effect of language
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  • Rarely observed before before seven years of age, onset is most common in adolescence
  • No known underlying physical abnormality 
  • Positive symptoms: thought disorder, unexpected reactions to typical situations, delusions, hallucinations 
  • Negative symptoms: apathy and social withdrawel 
  • Lack of willingness to communicate (affective flattening and alogia), chaotic output with constant shifts in topic, incoherence between sentences, perseverations and innapropriate emotional expression 
  • Cause
    • Genetic basis 
    • Abnormal cerebral structure
  • Communication 
    • Schizophrenic speech is disturbed but their language competence appears intact: good language, poor interaction 
    • Primary deficit on the level of discourse and pragmatics, difficulties with implicatures, non-literal language, humour, illocutionary force of speech acts 
    • Violate Grice's Maxims 
    • Non verbal behaviour: innapropriate gestures, staring, facial grimaces 
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Language Structure: Schizophrenia

  • Main issue = pragmatics 
  • Phonology and morphology generally typical 
  • Syntax = speech is syntactically complex, generally well formed 
  • Semantics 
    • Incorrect use of words
    • Neologisms 
    • Different responses in word association 
    • Dont know how they should communicate as reality is unknown = different system
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Conversational Abilities and Challenged of People

  • Autism is the opposite of Williams Sydrome 
    • Autism is best known as a communication disorder 
    • Involves abnormalities of language and communication 
    • Inability to form relationships 
      • Touching is difficult, fear of contact
    • Lack of spontaneous and imaginative play
      • Preference for physical things 
    • Obsesive insistence on specific routines and/or interests 
    • Concentrate on categorising the world 
      • Make sense of reality
  • Autistic behaviour 
    • Persistent and excessive rocking 
    • Jumping 
    • Ritualistic hand over mouth sound production 
    • Throaty growls 
    • Finger play
    • Abscence of delusions, hallucinations associated with schizophrenia 
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What is Autism?

  • Cant be acquired, developmental 
  • Lifelong developmental disability that affects the way a person communicates and relates to people around them 
  • Autistic subjects are unable to impute beliefs to others and are thus at a grave disadvantage when having to predict the behaviour of other people 
  • Deficit in Theory of Mind
    • Cant appreciate another perspective 
    • Struggle to realise your knowledge is different from others 
  • Affects 1 in 100 in the UK
  • Brain stem abnormality 
    • Unknown causes, genetic predisposition, environmental trigger, combined factors likely 
  • Communication 
    • Researchers agree that communication dysfunction is one of the prime symptoms of the syndrome of childhood autism 
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Language Characteristics of Autism

  • Cognitive difficulties - low IQ 
  • Mutism 
    • 50% do not develop functional speech 
    • Can speak but dont 
  • Delayed acquisition 
    • Many children have a pervasive and marked delay in language development even when matched with a cognitive age control on a non verbal task 
  • Phonetics and Phonology 
    • Delayed 
    • Poor babbling and speech development - problems with prosody 
    • Display a variety of motor deficits including lack of gross motor control, motor imitation and can show bizarre motor gestures 
    • Can experience problems with auditory discrimination but do better with visual intergration 
    • No accomodation - wont pick up dialect of those around them in order to identify 
  • Syntax
    • Echolalia: repeating what they've heard in the environment
    • Fragmented speech
    • Problems acquiring function words, tense and agreement + pronouns 
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Language Characteristics of Autism 2

  • Lexicon and Semantics 
    • Neologisms (make up words) - dont conventionally connect to society so dont need to use proper names 
    • Difficulty with abstract language 
    • Difficulty generalising word meanings to situations other than those in which they were learned 
      • Wont overgeneralise 
    • Confusion of words with similar connotations 
    • Few attention words 
      • Dont want to interact 
  • Pragmatics: Language use is the main area of deficit 
    • Dont care about feedback 
    • Social withdrawel 
    • Difficulty in intiating and maintaining topics 
    • Desire for sameness 
    • Tendency to engage in extensive conversation about a particular topic in the abscence of ongoing appraisal 
    • Idiomatic and metaphorical expressions are not understood: literal language preferred
    • Language is interpreted literally
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Adults with Autism

  • Since the Autism Act 2009, most local authorities have schemes for adults 
  • 70% feel they are not getting the help they need 
  • 53% want to find work 
    • 10% get the support to do so
  • Intervention 
    • Little success with operant conditioning therapy but alternative systems can be helpful
    • Trying an alternative system can sometimes get an improvement with speech 
      • Much stronger visually than orally 
  • Augmentative and Alternative Communication 
    • Aided and un aided 
    • People with Autism may be capable of using language when given the appropriate tool 
      • Able to talk through writing - control of situation
    • Psychological interventions: talking therapies, creative therapies, cognitive and behavioural therapies 
    • Behavioural interventions: applied behaviour analysis, discrete trial training, verbal behaviour approach
    • Motor sensory intervention
    • Medication
      • Helps with symptoms, wont cure autism 
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