Clinical pragmatics

Clinical pragmatics. By Louise Cummings. Cambridge: Cambridge University Press, 2009. Pp. xii, 305. ISBN 9780521888455. $ 118 (Hb).

Reviewed by Kanavillil Rajagopalan, State University at Campinas, Brazil

In her introduction, Louise Cummings claims her task is ‘in part a critical one—a critical examination of our current state of knowledge in clinical pragmatics as well as of the application of this knowledge to the assessment and treatment of pragmatic disorders in children and adults’ (1). The field itself is relatively new, as C concedes, but she claims it is ‘a field of study in its own right’ (1).

The volume is made up of seven chapters: ‘Clinical pragmatics: Theory and practice’ (1–39), ‘A survey of developmental pragmatic disorders’ (40–87), ‘A survey of acquired pragmatic disorders’ (88–117), ‘The contribution of pragmatics to cognitive theories of autism’ (118–38), ‘The cognitive substrates of acquired pragmatic disorders’ (139–76), ‘The assessment and treatment of pragmatic disorders’ (177–215), and ‘A critical evaluation of pragmatic assessment and treatment techniques’ (216–55). This is followed by an up-to-date and fairly comprehensive forty-two page bibliography as well as an index of key terms and topics.

As is clear from the chapter headings, C considers it important to maintain the distinction between developmental and acquired pragmatic disorders. Symptoms can be confusing. Confusions arise from ‘describing as pragmatic, behaviors that are not pragmatic in any reasonable interpretation of [the] term’ just as much as ‘a failure to capture the essential pragmatic character of behaviors that are genuinely pragmatic in nature’ (218). Also, C readily dismisses the idea of ‘linking developmental and acquired pragmatic disorders to specific chronological periods’ (8) because the whole issue is yet to be further investigated.

But C also credits a good deal of the confusion in clinical pragmatics to the existence of multifarious approaches to the very question of what pragmatics is all about. Unlike their fellow researchers in syntax and semantics, ‘theorists in pragmatics lack even [the] the most basic consensus on what constitutes their domain of study’ (216).

C, however, does take a firm stand on certain crucial issues. Against what she sees as a pervasive trend of equating pragmatics with communication, effectively leaving nothing as off-limits for it, C invokes the authority of John Searle in order to ‘reverse the tendency set in motion by Chomsky’s famous competence/performance distinction by arguing for the integration of pragmatics within our linguistic competence’ (7).

The book presents the reader with a wide, panoramic view of the very young field of clinical pragmatics. For instance, the opening chapter presents ten items under the subsection title ‘Concepts and theories in pragmatics’. In the subsequent chapters, various mental disorders, both developmental and acquired, are discussed alongside useful insights into how knowledge gathered in the field of pragmatics might help understand what is going on and how best to address the problem clinically.

This book should attend to the needs of a newcomer to the field, but also has the potential to prod other researchers to divert their thoughts in directions hitherto not contemplated.