ABSTRACT
For many years now there have been reports of children and adults with difculties with how to use language in communication. The utterances produced are generally grammatically and semantically well-formed but do not always seem to t the conversational context. Often the listener is unable to infer what the given utterance means in a particular conversational context because of the unusual and disconnected nature of the utterance. They can be described as not always having the necessary degree of relevance with regard to the ongoing topic. Speech and language therapists have been providing therapy for individuals whose difculties seem to lie with the understanding and/or production of connected discourse rather than linguistic structures but it was not until the 1980s that researchers (McTear & Conti-Ramsden, 1992; Rapin & Allen, 1983) began to investigate such difculties. First referred to as “semantic-pragmatic disorders” (Bishop & Rosenbloom, 1987; Rapin & Allen, 1998; Vance & Wells, 1994), they came to be known as “pragmatic language impairments,” or “pragmatic impairment” (Bishop, 2000) to reect the primary difculties of using language in context. It is now recognized that pragmatic impairments are a likely reection of some underlying cognitive and social impairments (Bishop, 2000; Brook & Bowler, 1992; Hays, Niven, Godfrey, & Linscott, 2004; Linscott, 2005) and exist across a range of diagnostic boundaries such as autistic spectrum disorder (ASD) and pervasive developmental disorder not otherwise specied (PPDNOS). The relationship of such impairments experienced by children and adults on the autistic continuum has been subject to much debate (Bishop, 2000; Botting & Conti-Ramsden, 1999; Brook & Bowler, 1992; Gagnon, Mottron, & Joanette, 1997) with the outcome that the term “pragmatic impairment” is best considered a descriptive tool rather than a diagnostic entity. However, there is general agreement that, especially in children, the identication of pragmatic language impairment is important in the consideration of appropriate therapeutic and educational needs (Bishop, 2002). The remediation of children with pragmatic language impairment (PLI) continues to form a signicant part of the caseload of speech and language therapists (Adams, Lloyd, Aldred, & Baxendale, 2006).
