While many of us may have experience of seeing or interacting with people who suffer from pragmatic impairments, that is those whose ‘use’ of language is disrupted to a greater or lesser degree, it is interesting to note that clinical pragmatics, as a field of inquiry, is still relatively new. This is most surprising given the fact that, as noted by Perkins (Reference Perkins2005), almost all communicative disorders exhibit various degrees of pragmatic impairment. In this respect, it would not be an exaggeration to argue that if one wishes research in such an important area of inquiry as ‘language disorders’ to continue to contribute to our understanding of the mechanisms that are involved in, or cause, such disorders, more attention needs to be directed towards uncovering the ‘wide range of cognitive and linguistic factors responsible for pragmatic deficits’ (Parvaresh Reference Parvaresh2016: 309). Of course, in the past few years, clinical pragmatics has received attention from a variety of scholars and is bound to transform into a fully-fledged field of inquiry (see e.g. Cummings Reference Cummings2014). However, as Cummings notes in the Preface to this edited volume, Research in Clinical Pragmatics, the field is ‘still a relative newcomer to the study of language and communication disorders’ and that it is only ‘a recent offshoot of linguistic pragmatics’ (v). The volume, as Cummings notes, serves two general purposes: (i) to provide the reader with an assessment of the state of the field; and (ii) to help future researchers become familiar with what lies ahead and the directions open to investigation in this thriving field of inquiry.

The book is divided into five sections (parts), totalling 23 chapters, which cover a wide range of topics and address many important research questions. Part I, entitled ‘Developmental pragmatic disorders’, includes seven chapters which examine, as the name suggests, pragmatic disorders that have their onset in the developmental period. Besides the depth of studies reported in this section of the book, I particularly like the first chapter, entitled ‘Pragmatic development’, written by Gabriella Airenti, which explains how children develop pragmatic ability. Elaborating on and explaining ‘how children acquire pragmatic language ability’ (5), the chapter offers a better understanding of how children learn to use language appropriately in context, before the thorny issue of pragmatic deficits is tackled throughout the book. One such developmental disorder, discussed in the third chapter of this section, is Autism Spectrum Disorder (ASD). As author Joanne Volden reports, its prevalence ‘is currently estimated at one in 68 children, making it one of the most common developmental disorders’ (59). As the chapter reveals, nowadays, communicative impairment in ASD is thought to lie ‘in the area of social, rather than structural communication’ (59). This has moved ASD closer towards the area we all recognise as pragmatics. While, as the chapter reveals, the true nature of the difficulties that people with ASD experience is not yet fully established, one of the characterising deficits of ASD is pragmatic impairment. Volden concludes that ‘although several theories of the potential cognitive deficits that underpin pragmatic performance have been advanced, there is still no widespread consensus on the source of pragmatic dysfunction’ (77).

Part II, entitled ‘Acquired pragmatic disorders’, includes eight chapters that address a wide range of issues from aphasia and schizophrenia to dementia. As Caroline Jagoe illustrates in the first chapter of this section, ‘Disruption of pragmatics in adulthood’, pragmatic disruption in adults is indeed a complex and vast field of inquiry to the extent that ‘nuances and variability are the norm’ (202). Consequently, fragmented research findings abound in the literature. The chapters in this section not only integrate ‘existing issues in the field’ and identify ‘new developments’ but also ‘present the current state of research in relation to specific clinical populations’ (202). For example, in the chapter ‘Right-hemisphere pragmatic disorders’, Margaret Lehman Blake reveals how the literature and research on pragmatic deficits caused by damage to the right cerebral hemisphere is replete with ‘contradictions, equivocal findings, and overgeneralisations’ (244). In this respect, the chapter calls for the development of more sensitive measures ‘to assess specific pragmatic processes in a variety of tasks with different levels of familiarity and processing demands in order to identify the true underlying impairments that diminish the quality of communication’ (260) in adults who suffer from damage to the right cerebral hemisphere. Another noteworthy chapter in this section is entitled ‘Alzheimer’s dementia’, by Jacqueline Guendouzi & Meghan Savage. Reviewing the results of research spanning the past decade, the authors shed light on the ways in which the ‘communication characteristics’ of people suffering from Alzheimer’s dementia ‘affect their ability to manage their conversations’ (324). For these patients, the ‘initial stage of pragmatic processing’, which is normally heavily dependent on ‘rapid recognition of the speech event and participant roles’ (343), causes the most difficulty.

The third part of the volume, ‘Pragmatic disorders in other populations’, comprises three chapters that address pragmatic disorders in – to borrow a phrase from the editor’s Preface – ‘clients who have not traditionally been in receipt of clinical language services for the remediation of pragmatics’ (vi). The category ‘other populations’ thus includes both adults and children ‘who have sensory deficits such as hearing loss and visual impairment’ (vi). For example, the first chapter of this section, ‘Hearing loss and cochlear implantation’, by Louise Paatsch, Dianne Toe & Amelia Church, is concerned with those children who have cochlear implants due to hearing loss. The authors elaborate on a model of intervention which they have been developing for ‘clinicians, classroom teachers and specialist teachers of the deaf’ (413) to investigate and support these children’s pragmatic development. Children with hearing loss ‘have difficulty with developing some of the more complex and subtle pragmatic skills required for social interaction’ (434). The model illustrated in the chapter is termed CONVERSATION and is based on the authors’ recent research involving a conversation-analytic methodology emphasizing, among other things, ‘the collaborative nature of talk-in-interaction’ (413). ‘Stuttering and cluttering’, by Kathleen Scaler Scott, is another noteworthy chapter, in which pragmatic difficulties associated with two important fluency disorders, namely stuttering and cluttering, are placed under scrutiny. In contrast to stuttering, in which the speaker ‘knows the words they want to say, but has difficulty moving forward with the production of the speech sounds’ (472), in the case of cluttering, ‘[t]he speaker’s rate sounds fast to the listener’ (473), thus leading to less intelligible speech. Having discussed the strategies which clinicians can use to both identify and treat communication problems in people suffering from fluency disorders, the author recommends that:

Although the fourth part of the volume, ‘Management of pragmatic disorders’, consists of only two chapters, it provides a wealth of insight into two important issues: the techniques or approaches available for measuring pragmatic language skills and the management of intervention in both adults and children. In the chapte ‘Pragmatic assessment and intervention in adults’, for example, Charlotta Saldert elaborates on ‘current clinical practice’ in the management of adults suffering from ‘dementia, traumatic brain injury, right-hemisphere damage and left hemisphere-damage’, conditions which ‘adversely affect pragmatic aspects of communication’ (527). In this respect, the author introduces the reader to a wide variety of methods and instruments available to speech-language pathologists, ranging from ‘high-level language tasks and comprehension test batteries’ (532) to ‘communication checklists and rating scales’ (537). Saldert concludes that ‘there is some evidence of positive outcomes from interventions that focus on the pragmatic abilities of people with cognitive communication disorders or aphasia and their communication partners’ (551).

The last part of the volume, ‘Recent developments in pragmatic disorders’, includes three chapters which throw light on neural aspects, cognitive aspects, and psychosocial aspects of pragmatic disorders, respectively. Despite their relevance to recent research in the field, these aspects, as editor Cummings notes, ‘do not often appear centre stage’ (vi). The potential contributions these chapters make, both to the book as a whole and to ongoing research, are therefore undeniable. For example, Pamela Snow & Jacinta Douglas’s chapter, ‘Psychosocial aspects of pragmatic disorders’, examines some of ‘the more serious and pervasive psychosocial consequences’ (618) associated with pragmatic impairment. The focus of the chapter is on ‘specific groups of speakers, at different points in the lifespan’ (618). This lifespan perspective is important because recent research has documented that the development of pragmatic disorders is not dependent upon one’s culture, lifestyle or education (Cummings Reference Cummings2014). As a corollary of this observation, it would therefore be worthwhile to examine, for instance, the impact ‘acquired communication impairments’ exert on ‘intimate spousal/partner relationships’ (637). In this respect, Snow & Douglas’s conclusion is revealing:

All in all, Louise Cummings’s edited volume, Research in Clinical Pragmatics, is without doubt a timely and welcome contribution to the field. Besides being a very informative volume, it will also appeal to a wide readership. Although the book will appeal primarily to clinicians, the manner in which the contributors have explained and simplified specialised technical items has resulted in this volume being accessible to readers from different fields of inquiry and background knowledge.