The Cambridge Handbook of Communication Disorders examines the full range of developmental and acquired communication disorders and provides the most up-to-date and comprehensive guide to the epidemiology, aetiology and clinical features of these disorders.
EDITOR: Ball, Martin J. TITLE: Clinical Sociolinguistics SERIES: Language in Society PUBLISHER: Blackwell YEAR: 2005
Michael P. Dean, Regional Neurological Rehabilitation Unit, Homerton University Hospital NHS Trust, London, UK
This volume, edited by Martin Ball, contains 21 contributions, organised into two sections. Part One contains chapters that review primary trends within sociolinguistics, and Part Two the application of these paradigms to clinical situations. Each chapter has a list of recommended further reading. The volume as a whole contains references, and author and subject indices. The aim of the book is to promote, from both sides, the further development of a clinical sociolinguistics.
In Chapter 1, Britain and Matsumoto discuss the different kinds of relationships between people that have been used to characterise communities, namely common evaluation of norms, social networks, and shared enterprise. The relative merits of these concepts are examined with reference to studies of New York accents and of Italian migrants in Germany, and other examples. The authors consider the role of group and individual identity in linguistic variation.
In Chapter 2, Maclagan describes how topographic region and social variables (class, gender, ethnic background, education, and the context of the communication) can influence variation in phonology, morphology, syntax and lexis. She uses examples to illustrate a complex pattern, with some aspects of language use being affected by some variables more than others.
Guendouzi expands on language and gender, considering how behaviours such as interruption, turn-taking, topic management, cooperativity, self-disclosure, and advice giving may reflect sex differences or power dominance. Understanding the development of these differences, whether innate or through socialisation, is important to clinical practice as larger numbers of male children are diagnosed with a range of communication disorders. Differences in diagnoses could themselves reflect gender stereotyping. Guendouzi also discusses gender differences and expert vs. cooperative styles that may apply in therapeutic situations.
In Chapter 4, Edwards introduces bi- and multilingualism, dealing with definitions of competence, additive and subtractive bilingualism, primary and secondary bilingualism, and transitional vs. stable collective bilingualism. He introduces behaviours such as transference, borrowing, interference and code-switching that can occur at different levels of linguistic analysis, and the use of which interact with social attitudes towards the speaker. He discusses response to the communication difficulties posed by multilingualism, such as the expansion of individual repertoires, the acceptance of shared link languages and translation, and resistance to change due to language use's role in establishing group identity and maintaining relative status.
Chapter 5 is 'Code-switching and diglossia' by Muller and Ball. They discuss the terminology for a family of related behaviours. There are systematic patterns to code-switching; it can be analysed in terms of the text - the points where switches occur, the kinds of element that are switched, and the linguistic relationships between the two languages at those points -, and in terms of speaker and listener characteristics, the situation, and transactional motivation. Diglossia is often defined as the situation pertaining with a High standard form and a related Low vernacular form. This definition, however, can be extended to include unrelated languages, to overlap with definitions of bilingualism. The High and Low distinction breaks down in some cases, as the status of forms may differ between different groups of users, and there may be shifts in status over time.
Damico, Simmons-Mackie and Hawley discuss the relationship between language and power in Chapter 6. Power in interaction is socially constructed, with operational characteristics of complexity, multidimensionality, and its differing manifestations between cultures, settings and particular interactants. It is collaboratively constructed, emerging as the interaction proceeds. Example manifestations are discussed, including forms of address, control of speaking turn, topic selection and maintenance, asking questions (their form and purpose), and the use of evaluative statements. In clinical contexts, asymmetries of power exist and may be deemed necessary to achieve the goals of the interaction. If recognised and controlled, this adds to the arsenal of the clinician.
Taylor and Mendoza-Denton discuss language and culture in Chapter 7. They introduce the concept of linguistic co-construction of meaning. The interaction between verbal and nonverbal communication and the social and physical environment is illustrated by instances in very different cultural contexts of the use of gesture and speech to refer to place. The authors then discuss the use of discourse markers or 'filler words' to modulate disagreement and take stance within discussion, and to indicate group membership.
In Chapter 8, Wolfram describes accounts of the origins and early development of African American English (AAE), and the establishment of a social grouping with language norms that support a distinct cultural identity. He details phonological, grammatical and unique lexical features AAE. There are implications for the use of clinical assessments that have been standardised on other, or non-inclusive, populations, with the potential to impact on, e.g., educational provision. Assessments can be developed, not only to recognise 'alternative correct' responses, but to focus on levels of language organisation shared across varieties. Wolfram notes that speech-language pathologists are uniquely placed to educate students and colleagues on the orderly nature of sociolinguistic diversity.
Watt and Smith introduce concepts and methodologies in the study of language change over time. Changes can be substantial and rapid and are often most evident in children's language, where innovations may be regarded by adults as evidence of individual laziness or wider spread language decay. Difficulties arise clinically when innovative changes are in the direction of features associated with delayed or disordered speech and language. An example is given of recent changes in the vowels patterns of West Yorkshire English; in that they deviate from standard forms, these have been described as disordered in at least one study. A second example relates the language use of children in a region of Scotland, with inflectional and lexical syntactic features that are also associated with specific language impairment.
Language planning refers to the strategies that societies use to change (or stop change) in their use of language and is discussed by Tonkin in Chapter 10. Planning occurs, for example, through the action of governments, companies, education systems, and within families, and can affect content (corpus planning) or pattern of use within society (status planning). Planned actions can be minor adjustments, or can be wholesale adoptions or the instigation of language death. Plans necessarily favour one group of speakers over another. Tonkin gives many examples where language planning has been a telling component in a nation's political history.
Preston and Robinson describe how the stereotyping of characteristics of groups extends to their use of speech and language. These attitudes can pervade education and clinical practice. Speakers of a standard form tend to be judged high in competence, whereas non-standard forms invite high ratings of integrity and attractiveness. Attitudes can be based on identifying that the speaker belongs to a particular social group, or be reactions to particular linguistic features themselves. Investigating such factors can cast light on folk theories of language. The authors detail their studies of university students' maps of speech regions and ratings of evaluative characteristics. Rather than simply rating their own region most positively, speakers have different investment in 'correctness' or 'pleasantness'.
Roberts describes the acquisition of sociolinguistic variation, noting that this variation is orderly, and that acquiring it is integral to competence within a speech community. This includes considerations of the language acquisition environment, different socialization processes, and dialect related features of child directed speech. The few studies that there have been of dialect production in children reveal that they acquire patterns of variation early.
Bi- and multilingual language acquisition is reviewed by Zhu Hua and Li Wei in Chapter 13. People become bilingual in different ways, for example, whether planned or unplanned, whether languages are acquired simultaneously or successively, and in different contexts (e.g. at home or in formal education). Parents may have different language use to each other, they may apply specific strategies (e.g. one parent speaks one language to the child, the other the other), and the wider community exercises a pattern of language use. The authors cite studies and evidence for various standpoints in the debates surrounding the plurality of language processing systems in bilingual speakers, whether bi- and monolingual acquisition occur via the same or different processes, and whether there are specific considerations associated with multi- vs. bilingual acquisition.
Chapter 14, by Oetting, concerns the assessment of language in children who speak a non-mainstream variety of English, stressing the need to distinguish between language differences and weaknesses. She provides information on tools that are of direct use in clinical practice, noting that further work on including non-mainstream speech communities is needed. The few measures that have been designed for non-mainstream varieties adopt different approaches, e.g. standardised tests normed on appropriate populations, tests that assess skills other than existing knowledge of forms (e.g. learning new forms, the non-word repetition task), and analyses of language samples (with the relatively good performance of MLU–mean length of utterance; DSS–developmental sentence score' and IPSyn–index of productive syntax, across varieties in identifying language impairment).
In Chapter 15, Li Wei, Miller, Dodd and Zhu Hua expand on the features of language development in bilingual children that differ from monolinguals. Bilingual children may produce error forms that would be considered delayed or disordered in normally developing monolingual children, they may demonstrate error forms in one language and not the other, and they may demonstrate different interaction skills, such as use of silence and signaling of turns. The authors list possible evidence for communication disorders in bilingual children. Clinicians need to recognise that an assessment session is one particular social context, and which can be enriched with natural elicitation procedures, by considering community definitions of pathology, and from community corroboration of test and natural data.
Speech perception, hearing impairment and linguistic variation are reviewed by Clopper and Pisoni in Chapter 16. The speech signal carries 'indexical' information about the talker such as gender, age, identity, dialect and emotional state. In the normal hearing population, these are readily perceived under degraded conditions and are readily learned. In deafened adults with cochlear implants, talker discrimination is a more difficult task. A single case of dialect identification within the normal range is described. Pre-linguistically deaf cochlear implant users have reduced talker identification (correlating with lexical identification skills) but good gender discrimination skills. The authors conclude that those with hearing impairment are able to process indexical information and use it in normal processes of attitude formation.
Gitterman discusses aphasia in multilingual populations, including hypotheses that there are different anatomical bases for languages acquired through explicit strategies and implicitly, and a greater role for the right hemisphere in processing a second language due to a greater role for pragmatic processing, or reflecting processing of visuo-spatial information in sign languages, pitch in tone language, or of characters in ideographic systems of writing. In terms of assessments, an overview of the Bilingual Aphasia Test is given - a battery of tasks given in both languages, plus translation tasks. Gitterman cites evidence that treatment in one language improves skills in the other, with structural similarity between languages a factor in the extent to which this generalization occurs.
Chapter 18 is 'Designing assessments for multilingual children', by Patterson and Rodriguez. As social context is a significant factor in language use and hence learning experience, Patterson and Rodriguez believe it should be an organising element in assessment. A case history should include the family's language-related history, and assessment should include their concerns. Assessment should be in all languages spoken, and not assume that a 'dominant' language will encompass all skills of a 'weaker' one. Assessment should occur in contexts congruent with experience, and can proceed through observation, sampling, standardised instruments, and dynamic means (e.g. how does the child respond to the scaffolding provided by others in acquiring new skills?). Analyses should include explanation in terms of language use and inter-language influence, as well as disorder.
In 'Literacy as a sociolinguistic process for clinical purposes' (Chapter 19), Damico, Nelson and Bryan discuss a view that stresses dynamic and functional qualities of literacy skills. Examples include that literacy is often acquired in a social context of modeled and joint reading with a parent, and that definitions of (il-) literacy have changed over time. Literacy skills are used with purpose within specific contexts - essentially, what are the texts about? - and so literacy work has the potential to motivate and empower students. Individuals and communities make many adaptations to meet the literacy demands of society (e.g. making use of skilled others, using substitute technologies) and so the relationship between an individual's literacy skills and the ability to participate in literacy activities is not straightforward.
Lucas, Bayley and Kelly consider the sociolinguistics of sign languages in Chapter 20. They provide a historical review and discuss major themes in the relationship between the spoken language of the wider community and the signed language of the Deaf community, and whether frameworks developed in the investigation of spoken languages necessarily apply. They discuss the unique historical social contexts of sign language learning. Sociolinguistic variation in sign languages is considered, with an illustrative study of systematic variation in the sign DEAF, determined by discourse factors and signer characteristics. A second example is of Tactile American Sign Language used by Deaf-Blind people, with deviation from the visual form determined in part by the physical contact between signer and receiver.
The final chapter is 'Managing linguistic diversity in the clinic: interpreters in speech-language pathology' by Isaac. Interpreters can play a role in language translation and also the interpretation of a speaker's intent, given their specific cultural background. It is therefore important to consider whether they are 'bicultural' as well as bilingual. There are many barriers to effective interpreter-mediated interaction; Isaac summarises these under interacting categories of: inadequate preparation, inadequate communication; issues of independence, and assumptions, with examples from post-session reflection by speech-language pathologists and interpreters. She offers specific suggestions for maximising success, including collaborative partnership and increased awareness of the interpreter's skills and role.
This volume achieves its aim of introducing the concerns, accounts and lessons of sociolinguistic research to clinical practice with people with communication disorders. It hence contributes to the development of a clinical sociolinguistics. The individual contributions, while differing in scope, provide excellent overviews of their topic areas, are clearly written without exception, and contain reference to a further literature where this exists.
The collecting together of individual contributions means that commonly occurring themes become evident, as do omissions. The latter are expected in what must be considered a fledging discipline. The most fully developed themes are of multilingualism, dialect variation and, clinically, the assessment of children's speech and language skills in the context of these factors (chapters 4, 5, 8, 9, 12, 13, 14, 15 and 18). This emphasis reflects the agenda of academics in addressing the social exclusion of many minority ethnic and other marginalised groups, through access to education. Of course, as the authors here often reiterate, multilingualism and use of non-standard forms are in fact the norm for the majority of the world's communicators. To assess them appropriately, it is not a matter of 'translating' materials developed for a monolingual population of standard form speakers, but rather of recognising that they possess different and additional skills (skills perhaps not possessed by the majority of the world's healthcare commissioners and curriculum setters).
While the major theme emerging concerns the clinician's ability to distinguish between difference and disorder, there is less research to date and less here on the IMPACT of speech and language impairments as understood within a sociolinguistic framework. For example, how about the impact of pragmatic disorders on social networks, code-switching in bilinguals as a skill to address in therapy, the ability to shift dialect when using alternative communication technologies, listener attitudes to speakers with dysarthria, or the different disabling effects of a literacy impairment depending upon a community's normal practice. This is not an error of omission, but rather reflects the developing nature of the discipline. This book therefore succeeds in provoking the reader into thinking about how sociolinguistic frameworks can be applied elsewhere (and it is exciting to be provoked so).
Not all of the authors in Part One of the book explicitly consider clinical application. I think this is an opportunity missed, as it is not transparent how all aspects of the sociolinguistics presented here have relevance. The most frequently made link to clinical application is that clinicians need to understand the language use of the communities they serve, and therefore need an understanding of sociolinguistics. This is a simple statement, though undeniably true; the point is not, in every case, fleshed out. The chapters by Guendouzi, and Damico, Simmons-Mackie and Hawley are examples where the authors do more fully develop their ideas with the book's remit in mind. Overall, this volume makes a valuable contribution, in giving an introduction to research that is underway and setting some foundation stones, indicating space for neighbours.
ABOUT THE REVIEWER:
ABOUT THE REVIEWER
Michael Dean, Ph.D. is a speech and language therapist working with brain
injured adults, in a post-acute neurological rehabilitation unit within the
National Health Service. The unit is located in a culturally and
linguistically diverse part of London. He has research interests in
aphasia and cognitive neuropsychology.