Sunday, October 7, 2012

What is Pragmatic Language?

What is Pragmatic Language?

Natural language; social communication; social discourse; social language; social skills
Pragmatics is broadly defined as the ability to understand and use language in social-communicative contexts.
Pragmatics is the area of communication function that involves the use of language in social contexts (knowing what to say, how to say it, when to say it, and where to say it).  It is the ability of natural language speakers to communicate more than that which is explicitly stated and to understand another speaker's intended meaning. Pragmatics includes both the verbal and nonverbal aspects of communication and may be thought of as a conversational code of conduct or a set of rules for communication. We learn this system of rules naturally and implicitly. If one has good pragmatic skills, he or she is able to communicate an appropriate message effectively in a real world social situation. Pragmatics involve the following social linguistic skills: (a) using language for different purposes (e.g., greeting and requesting); (b) changing language according to the needs of a listener or situation (e.g., talking differently to a peer than to an adult and speaking differently in a classroom than on a playground); (c) understanding non-literal language (e.g., metaphor, irony, figurative language, sarcasm); and (d) following rules for conversations (e.g., taking turns and staying on topic). The pragmatic aspect of language also includes appropriate eye contact, intonation, and the body movements and gestures that accompany communication.
Relevance to Autism
Children must be fluent and capable in the areas of pragmatic language in order to interact and participate successfully in school. When typical children engage in reciprocal conversation they are aware of the knowledge, interests and intentions of the other person, as well as the social rules which determine pragmatic competence. In contrast, children with poor pragmatic skills have significant problems using language socially in ways that are appropriate or characteristic of children their age. Many children with developmental disabilities have difficulties learning the complex rules of social interaction. For example, pragmatic language disorders are the most prominent communication deficit in children with autism spectrum disorders.  Because social communication deficits are among the core challenges of autism spectrum disorders, an evaluation of pragmatic competence is always a vital part of the assessment process. However, few standardized tests can effectively evaluate and quantify the complexity of pragmatic language. Valid norms for pragmatic development and objective criteria for performance are also limited. Indeed, formal testing may not identify the presence of a social pragmatic problem, thereby preventing the child from receiving the appropriate support. Assessment of pragmatic social skills requires more than a traditional standardized testing approach. Less formal naturalistic assessments are necessary, including observations of children’s pragmatic competency in everyday contexts. Given that pragmatic language is a critical part of everyday communication and social interaction, it is imperative that interventions for children with autism spectrum disorders focus on social linguistic skills. Programs designed to enhance social communicative competence include the SCERTS Model, a comprehensive developmental-pragmatic and research-based educational approach, and the Social Thinking Curriculum, a social cognitive approach to understanding social communication and reciprocity.
Prizant, B. M., Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2006). The SCERTS model: A comprehensive educational approach for children with autism spectrum disorders. Baltimore, MD: Paul Brookes Publishing Company.
Winner, M. G. (2005). Think social! A social thinking curriculum for school-age students. San Jose, CA: Think Social Publishing.
Wilkinson, L. A. (2011). Pragmatics in Encyclopedia of Child Behavior and Development, Part 16, 1138-1139, DOI: 10.1007/978-0-387-79061-9_2209
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor a text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools, and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. Dr. Wilkinson's most recent book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition).

Monday, October 1, 2012

Best Practice Review: Children’s Communication Checklist (CCC-2)

Best Practice Review: CCC-2

As a group, higher functioning students with autism spectrum disorders (ASD) tend to demonstrate strength in formal language, but a weakness is pragmatic and social skills. As a result, they often fail to qualify for speech-language services because they present strong verbal skills and large vocabularies, and score well on formal language assessments. Nevertheless, significant and severe deficits in the ability to communicate and interact with others can limit their participation in mainstream academic settings and community activities. Moreover, pragmatic deficits tend to become even more obvious and problematic as social and educational demands increase with age. Assessments to identify pragmatic language deficits are not as well developed as tests of language fundamentals. Although there are few standard measures available to assess these skills in higher functioning children with ASD, the Children’s Communication Checklist (CCC-2) is a promising third party checklist that can be used in screening and identification of pragmatic language problems.
The Children’s Communication Checklist (CCC-2) is a measure designed to assess the communication skills of children 4 to 16.11 years of age. The purposes of the CCC-2 are the identification of pragmatic language impairment, screening of receptive and expressive language skills, and assistance in screening for ASD. The CCC-2 has shown utility in identifying children who may require further assessment for an autism spectrum disorder (ASD). Initially developed in the United Kingdom, the CCC-2 has been adapted for use in the United States (Bishop, 2006). A Caregiver Response Form is completed by an adult who has regular contact with the child, usually a parent, teacher, therapist, or other professional. The CCC-2 consists of 70 items that are divided into 10 scales, each with 7 items. The first 4 scales focus on specific aspects of language and communications skills (content and form). The next 4 scales assess the pragmatic aspects of communication. The last 2 scales measure behaviors that are usually impaired in children with ASDs. The respondent rates the frequency of the communication behavior described in each item from 0 (less than once a week or never) to 3 (several times a day or always). Interpretation is based on a General Communication Composite (GCC) and the Social Interaction Difference Index (SIDI). A significantly depressed communicative competence score, coupled with a score of less than 11 on the SIDI, suggests a profile of ASD and the need for further evaluation. The CCC-2 reports a sensitivity value of .89 and a specificity value of .97 for identifying children with autistic symptomatology and pragmatic social impairment (Bishop, 2006). Previous versions of the CCC-2 have been strongly associated with the ADI-R total score and ICD-10 diagnostic criteria.

The CCC-2 appears to be a well-constructed instrument that has both face validity and reliability to achieve its stated purpose of assisting in identifying children with language and communication problems, especially in the area of pragmatic communication skills. In a recent study (Volden & Phillips, 2010), the CCC–2 was found to be a more sensitive tool than the Test of Pragmatic Language (TOPL) for identifying pragmatic language impairment in high-functioning speakers with ASD who have structural language and nonverbal cognitive scores within typical limits. The CCC-2 also has the advantage of sampling pragmatic skills in the child’s natural environment. In addition to other more comprehensive communication and language assessment tools, the CCC-2 should be a welcome and useful addition as either a screening tool to identify children who are at risk and need additional assessment, or a supplemental tool to other testing.
Bishop, D. V. M. (2006). Children’s Communication Checklist (2nd ed., U.S. ed.). San Antonio, TX: Psychological Corporation.
Volden, J. & Phillips, L. (2010). Measuring pragmatic language in speakers with autism spectrum disorders: Comparing the Children’s Communication Checklist—2 and the Test of Pragmatic Language. American Journal of Speech-Language Pathology, 19, 204–212.

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