Showing posts with label pragmatics. Show all posts
Showing posts with label pragmatics. Show all posts

Monday, 23 September 2013

The confusing terminology used by speech and language therapists, hopefully will become clear.....


I am always conscious of the terminology we, as speech and language therapists use when talking to other professionals and parents, and those terms that we use in our reports. To us, after 3-4 years of training these terms become second nature; and sometimes we can forget that the words we use can seem a little confusing to say the least. So I thought I would define some commonly used words and terms used by speech and language therapists. But first, maybe it would be useful to know what speech and language therapy is, what we do, where we work, with whom we work etc.

Speech and Language Therapy is used to help people that have speech, language, and communication difficulties; it can also be used to help people who have difficulties swallowing, eating and drinking.

The role of a Speech and Language Therapist, or commonly used term SLT, or even SALT within a hospital environment, is to assess and treat speech, language and communication problems in adults and children. With the desired outcome that individuals will communicate to the best of their ability. They may also work with people who have eating and swallowing difficulties.

What type of difficulties will a SLT come across?
       difficulty in producing and using speech
       difficulty understanding language
       difficulty using language
       difficulty with feeding, chewing or swallowing
       a stammer
       a voice problem

Where do SLT’s work?
       Schools (mainstream & special schools)
       Hospitals (inpatients & outpatients)
       Clinics/community health centers
       Clients homes
       Hospices
       Sheltered accommodation
       Prisons, young offenders institutes
       Courts, as a intermediary
       Mental healthcare settings
       Private/independent practice
       Assessment units & day centers

What type of work does an SLT do?
       work directly with children & adults e.g. using games and interactive learning; carrying out exercises e.g. speech exercises, breathing exercises etc.
       provide clients with work to carry out at home
       work with children & adults with similar difficulties in a small group
       provide clients with relevant resources & information
       provide clients with relevant contacts and support with other professionals, co-workers, support groups etc.
       an SLT will also endeavor to provide clients and their parents or carers with emotional support and appropriate skills to help them on a daily basis.
       a large part of a SLT’s role involves working closely with others e.g. teachers, physiotherapists, occupational therapists, doctors, nurses, GP’s, psychologists, health visitors, social workers , orthodontists/dentists, dieticians,  audiologists, politicians/government, other SLT’s i.e. team work.

Ok, so what about some of those terms we use, what do they mean?
Attention and Listening is the foundation to all learning. Children must practice, and learn to ‘listen’ and ‘look’ appropriately to control their own focus of attention. The ability to listen and concentrate is an important part of all children’s speech, language and communication development. It is so important to encourage and develop ‘good’ attention and listening skills for all children; especially those that have difficulties in speech and/or language development.
Communication is the exchange of information between two or more people; using verbal and non-verbal means.
Language takes the form of two parts; receptive language is the ability to understand what someone communicates, either through sound (auditory), or visually (reading and interpretation of sign). Expressive language is the ability to formulate a message into words and sentences; which can be spoken, written or signed.
Non-verbal communication (NVC) is the process of communication through sending and receiving wordless messages. For example, your facial expressions, gestures, tone of voice etc. can all convey meaning to our listeners i.e. about how we are feeling; without actually using words. NVC, is influenced by culture and society, and is shaped by experience, observation and practice.
Phonology is the sound system of a language, and the rules for combining these sounds to produce meaningful units of speech.
Play, why do SLT’s look at this? Symbolic play skills are important for language development. It is a lovely way for children to learn about communication, language and other people. A child’s play skills can help to aid a diagnosis, and is the best way to implement therapy as it is fun and interactive!
Pragmatics/social skills refer to the ‘rules’ of language in social situations. It includes the speaker-listener relationship, the context, and the intentions of the communication. Therefore, speech and language are not the only components important for effective communication.
Social interaction skills include:
·         appropriate eye contact,
·         ability to listen,
·          ability to express ourselves,
·          ability to take turns,
·         ability to process what others are saying,
·         ability to initiate a conversation,
·         ability to maintain a conversation
·         ability to close a conversation appropriately,
·         awareness of a listeners feelings,
·         an awareness of the impact of what you are saying on others
·         the use of appropriate gesture, and the ability to understand it
·         the use of appropriate facial expressions, and the ability to understand them
·         ability to understand the intent of the communication, not just the literal interpretation
·         ability to be flexible in using and adapting language in a particular context
Phew, amazing isn’t it? All these things we do all day everyday; and we quite often take it for granted! So how do we do it? Well, all these social interaction skills are culturally determined, and learned through observation, trial and error, and life experience!!
Semantics is the meaning behind the language that is transmitted by words, phrases and sentences.
Speech is the physical production of sounds e.g. p, t k, d etc.

There may be more terms that you have probably heard used by professionals but I hope this clarifies some things for you. My advice would be, if you’re with a professional i.e. doctor, dentist, teacher, SLT etc; and they are using words you find confusing don’t be afraid to stop and ask them what they mean. Sometimes we can forget how ambiguous we can be!

Georgina White




Tuesday, 6 December 2011

What does 'pragmatics'mean?

By Vanessa King, Smart Talkers, Surrey



Baby Sale – lots of bargains! 

What is meant by this sign? We know without asking that it means items related to baby care are for sale, not that the shop is not literally selling babies. We know this because we have a context for the sign, a society in which we don’t sell babies in shops.

Pragmatics is a branch of linguistics concerned with the ways context contributes to meaning. It studies how meaning doesn’t just depend on understanding grammar and vocabulary, but also the situation of the speaker and the listener. It explains how language users are able to overcome apparent ambiguity in meaning, because meaning is transmitted by more than just the words the person is saying. The ability to understand another person’s intended meaning is called pragmatic competence and is regarded as one of the most challenging aspects of language learning because it comes only through experience.

We can divide pragmatics into three main sections:

  • Using language for different purposes
  • Modifying language according to the needs of the listener or the situation
  • Following rules for conversation and storytelling
To understand the importance of pragmatics, you might find it helpful to think about conversations you may have had with people from other cultures. If you have ever felt offended, confused or misunderstood, it’s probably due to a difference in pragmatics.

Using Language
We use language for many different purposes. Consider a typical conversation between me and my children regarding dinner in one evening.
“I’m hungry.” “I will make dinner in a minute.” “Get me an apple!” “I want doesn’t get!” “Mummy, will you make my dinner please?” “I’m making dinner now.”

All of that makes me sound like a really bad parent, but each of those phrases represents a different purpose to language. Language is used for informing, promising, demanding, instructing, requesting and many more. Eventually my children are fed so the language fulfils its purpose in each instance and my children are learning to communicate meaningfully.

Modifying Language
We frequently modify our language according to the needs of a listener or a situation. Even though we both speak English, my partner and I sometimes have difficulty understanding each other. He will say something and even though I understand the words I have to hesitate before replying. This is because in my mind I’m thinking ‘he can’t possibly mean what I think he means, so what does he actually mean?’ An example of this that happened recently – the computer was switched on and my Facebook account was displayed on the screen. My partner said ‘are you on the computer?’ I thought he was asking if I’m logged into the computer, which clearly I was so he must have meant something else. I didn’t know what he meant so he had to modify his question to ‘Can I use the computer?’ For me these are quite different questions but for him they mean the same thing. A similar thing occurred less than ten minutes later when I picked up a sample of my son’s artwork and he said ‘Oh have you seen that?’ Well, of course I’ve just seen it, it’s in my hand so what does he mean?!

Rules of conversation and storytelling
The ability to abide by rules of conversation and storytelling is of particular importance and crucial to success at school. Such rules are often learned through example and having an explicit understanding of just some of these rules will help you become a better communicator. Examples of the rules I’m talking about might include:
Taking turns. A conversation is at its most rewarding when it occurs between two or more people. If you listen to others as they speak, you’re taking the opportunity to think about their contribution which in turn enriches your own. If you dominate a conversation then you might as well be talking to yourself.

Introducing a new topic of conversation can be tricky too. I’ve been so tempted to interrupt someone (not taking turns!) with something that may or may not be related to what they’ve been saying because what they’ve said has triggered a memory or a thought I’m just desperate to share. I’m sure you’ve met people who do this habitually and they can be quite tiresome because they’re not following those unspoken rules of conversation.

Staying on topic is related to the above example. How can you be sure that what you want to say contributes to the conversation? There are verbal and non-verbal signals that we need to learn to recognise and some adults find them difficult to identify, how much harder it must be for young children who are quite ego-centric in their view of the world.

Apart from the words we use, being able to recognise the meaning of and using non-verbal signals is very important to communication. I know someone who frequently misses the shuffling feet, moving eyes and fiddling hands of the person they’re talking to, so they don’t recognise that the person has lost interest in what they’re saying. This is related to the use of facial expression and eye contact. Put simply, eye contact indicates interest while wandering eyes might indicate boredom, disinterest or lack of understanding.

Personal space

In conclusion, pragmatics is the study of the complex ways in which we use language and how context creates meaning. Pragmatics is learned by example by most people, but sometimes, for whatever reason, some people miss some of the lessons and they find it difficult to communicate and are frustrated when they can’t identify why. An understanding of pragmatics can help to diagnose communication issues and provide a framework for addressing those needs.


Frequently, in may areas NHS therapists cannot provide input for this type of difficulty but fortunately, Small Talk can help www.private-speech-therapy.co.uk

Saturday, 23 April 2011

Is my child being rude? .... may be not!


Picture the scene.... your 10 year old points to a rather large lady in the supermarket and says, 'She's got an enormous bottom!' You're shocked and highly embarrassed that your child could be so rude. But it may not be rudeness, it might be that he doesn't know how to use language appropriately in social situations and was just being honest. Many of the children I work with have such problems and I have to quite thick skinned on occasion!

A child may be able to use long complicated sentences with excellent vocabulary, no speech sound difficulties but still have a communication problem - it may be that has not mastered the rules for social language, also called pragmatic use of language or pragmatics 

Pragmatics involve three major communication skills:

  • Using language for different purposes, such as
    • greeting (e.g. hello, goodbye)
    • informing (e.g. I'm going home)
    • demanding (e.g. Take me home)
    • promising (e.g. I'm going to take you home)
    • requesting (e.g. I would like to go home, please)
  • Modifying language according to the needs of a listener or situation, such as
    • giving background information to an unfamiliar listener
    • speaking differently in a classroom than on a playground
  • Following rules for conversations and storytelling, such as
    • taking turns in conversation
    • introducing topics of conversation 
    • staying on topic
    • starting conversations appropriately
    • finishing conversations e.g. not walking away mid-sentence
    • how to use and read verbal and nonverbal signals
    • how close to stand to someone when speaking
    • how to use facial expressions and eye contact
These rules vary across cultures and within cultures. It is important to understand the rules of your communication partner. In a previous job, I employed Eastern European staff and was un-prepared for the differences especially in inter-personal space.

An individual with pragmatic problems may:

  • say inappropriate or unrelated things during conversations
  • tell stories in a disorganised way
  • have 'boring language' with little variety in language use
Younger children will have difficulties with this, we all have examples of our 3 year olds where they've have hugely embarrassed us by telling a complete stranger on the phone that 'Mummy's having  a poo!'  or such-like. However, if problems in social language use occur often and seem inappropriate considering the child's age, a pragmatic disorder may exist. 


Children with autism will have difficulty with social use of language but it does not mean that someone with social language problems necessarily has ASD. Pragmatic disorders will often appear alongside other language problems such as word-finding difficulties. These problems can lead to isolation and avoidance by others. 
Speech and language therapists can assess to see if there is a problem, decide the extent of the difficulty, look at any additional factors and draw up an action plan to help. 


I really like the work of British Therapist Alex Kelly, who has some excellent resources http://www.alexkelly.biz/ see links below.


If you are concerned about your child's social communication or any other aspect of their speech, language or communication www.private-speech-therapy.co.uk or check the yellow pages for the nearest NHS clinic.










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Saturday, 24 July 2010

Is it always autism?

NO!!! We're too quick to jump to conclusions when a child doesn't tick all the boxes for 'normal'! (Can you tell this is another of my personal bug bears?!)
Everyone has heard of autism but few know anything about receptive language difficulties or other language disorders which can mean that the child has trouble making sense of the world, fitting in with his peers and communicating his needs and thoughts. These are all symptoms of autism but do not necessarily mean the child has ASD. My own clinical case-load has several children who have been referred for ASD assessments by their school but actually have language based disorders. As they've already been referred when I pick them up it's too late to stop the parent needlessly worrying.
This is why  proper assessment for a differential diagnosis of ASD needs to be very thorough and requires Paediatrician, highly specialist speech & language therapist and expert Clinical Psychologist. At Small Talk our assesments follow the NAS guidelines. A one-off assessment in clinic is not sufficient to label a child for a life-time.
We used to have a term called semantic-pragmatic disorder: Semantic refers to the meanings of words and phrases while Pragmatic refers to the use of language in a social context (knowing what to say and when and how to say it to other people). We now try to separate the two so that we can work on the exact needs of the child. 
The Charity AFASIC have lots more information and they describe it in a way I can't improve upon. The following is from their website www.afasic.org.uk © Afasic 
"Children with semantic difficulties:
  • Struggle to understand the meaning of sentences or words. 
  • Words which refer to abstract concepts such as feelings (sad, puzzled, jealous) or status (important, official) can be especially hard for these children to understand. 
  • They misinterpret and take literally phrases such as "Cut it out!", "Stop it" or "He's a push-over". 
  • Often it can be difficult for children with a semantic disorder to work out the topic or key information in a sentence. 
Children with pragmatic difficulties struggle:
  • To use language socially. 
  • They do not understand how we take turns when we talk. 
  • They interrupt more than is acceptable. 
  • Their conversation often seems inappropriate or irrelevant. 
  • They can seem to be unaware of what their conversational partner needs to know - and can therefore say too much or too little about a subject. 
Some children have both semantic and pragmatic difficulties" other children might have significant receptive language impairment which lead to problems understanding spoken language. I met a 15 year old earlier this year with severe behaviour problems... he had an auditory memory of just 2 items, no wonder he punched first, he knows what outcome is expected from that type of interchange! Imagine how frightening it would be to live in a world when you 'just don't get it' all the time (to use his words).
One of the only benefits of the long wait for ASD diagnosis in Staffordshire (up to 90 weeks for some) has been that it's now clearer when the child's problems are more language based than autistic spectrum based. The difference lies mainly in the rigidity of thinking.
I can highly recommend the AFASIC web site for any parent or professional who wants to know more.
We know more about autism as society now so its time to spread the word about other disorders and problems that affect our chidren's ability to communicate. Problems of any kind, however mild, will certainly lead to isolation, frustration and an inability to fully integrate into society. Children will have a harder time making friends and fitting into nursery or school.