Diagnosis and Management

  • David Crystal
Part of the Disorders of Human Communication book series (DISORDERS, volume 3)


It will be plain, from the very large number of “don’t knows” encountered in Chapters 2 to 5, that clinical linguistics is still at a primitive stage of development. There is a great deal of hard work that needs to be done before the generalizations envisaged in Chapter 1 can be achieved. Chapters 2 to 5 represent a first step in the direction of a theory and praxis of language disability, but the information they contain needs to be supplemented in two main ways. First, there are several important gaps that need to be filled by empirical research and theoretical model-building. Secondly, there needs to be a synthesis of the information obtained from each of the levels, so that an integrated view of a patient can emerge. It is always valuable to work with an analytical model, which allows us to examine in detail the parts of a phenomenon, in order to add to our understanding of the whole. But there has to be a corresponding synthesis, especially in a field like language disability, where patients often (perhaps even usually) present with symptoms which we can analyze on several linguistic levels at once. We can see this by looking at some of the commonly recognized conditions in linguistic pathology, and interpreting them in relation to the model of language used in this book.


Cleft Palate Voice Disorder Language Disability Normal Conversation Felicity Condition 
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  1. 1.
    See Laver (1968) (1980). Layer’s approach in fact makes use of several other variables: supralaryngeal settings, defined both longitudinally (e.g. raised and lowered larynx) and latitudinally (labial, lingual, faucal and mandibular settings), velopharyngeal settings (types ofnasalisation),and laryngeal (i.e. phonatory) settings.Google Scholar
  2. 2.
    There are, in addition, other factors of a more general methodological kind which would need to be incorporated into a voice profile chart, especially a more motivated way for indicating frequency of a problem than is often found. There are several possibilities (linear scales, e.g. estimating frequency in percentages, or impressionistic categories [e.g. intermittent, mild, severe]; numerical categories [e.g. utterance length marked in seconds, etc.], some of which maybe more efficient than others with reference to the categorization of a voice parameter.Google Scholar
  3. 3.
    See for example Fourcin and Abberton (1971).Google Scholar
  4. 4.
    See further Schlesinger and Namir (1978), Siple (1978).Google Scholar
  5. 5.
    Some textbooks on disability in fact use the term in this general sense, and thus constitute a different tradition from the classical “speech vs. language” one, e.g. Berry and Eisenson (1956), who include chapters on aphasia, language delay and hearing. This of course is one reason for the terminological dissatisfaction with the notion of “speech” clinician: see Crystal (1980: Ch 1).Google Scholar
  6. 6.
    It is called an “interlevel” by Halliday, McIntosh and Strevens (1964), for example.Google Scholar
  7. 7.
    This model is discussed further in Crystal (1980).Google Scholar
  8. 8.
    For a fuller discussion of deviance, see Crystal, Fletcher and Garman (1976: 28 ff.), Crystal (1979a: 27 ff.), in relation to grammar; see also Leonard (1972).Google Scholar
  9. 9.
    For an account of sociolinguistic theory, see Labov (1972), Hymes (1964), Trudgill (1974).Google Scholar
  10. 10.
    See Sacks, Schegloff and Jefferson (1974), Gumperz and Hymes (1972).Google Scholar
  11. 11.
    Felicity conditions“ refer to the criteria which must be satisfied if a speech act (see below) is to achieve its purpose, e.g. ”preparatory conditions“ relate to whether the person performing a speech act has the authority to do so (e.g. not everyone is qualified to say ”I baptise/arrest/marry…“). An utterance which does not satisfy these conditions cannot function as a valid instance of the type of speech act to which they apply, e.g. willyou drive?is inappropriate as a request, if the speaker knows that his hearer has not learned to drive. See Lyons (1977: Ch. 16).Google Scholar
  12. 12.
    See Austin (1962), Searle (1969), and the discussion in Lyons (1977: Ch. 16).Google Scholar
  13. 13.
    Some relevant child language studies are: Keenan (1974), Bruner (1975), Garvey (1975), Bates (1976), and the papers in Snow and Ferguson (1977) and Ochs and Schieffelin (1979).Google Scholar
  14. 14.
    For the minor vs. major distinction in grammar, see Crystal, Fletcher and Garman ( 1976: Ch. 3). Essentially, minor sentences are unproductive, i.e. they have a sentence structure which has no potential for development using the normal grammatical rules of the language.Google Scholar
  15. 15.
    For example, in Crystal, Fletcher and Garman (1976: Ch. 6), concerning the use of different question forms. See also Schachter, Fosha, Stemp, Brotman and Ganger (1976).Google Scholar
  16. 16.
    See further, Brown and Bellugi (1965), Nelson, Carskaddon and Bonvillian (1973), Bushnell and Aslin (1977).Google Scholar
  17. 17.
    See Schwartz (1974), Swisher and Pinsker (1971), Bloom and Lahey ( 1978: 295–296 ).Google Scholar
  18. 18.
    See Kanner-(1973). Other abnormal interaction patterns also exist, e.g. the various kinds of echolalia. For adults, see Rochester and Martin (1979), Shapiro (1979), whose title (“clinical psycho-linguistics”) refers to the interaction between linguistics and clinical psychology, and is thus a more restricted sense than the one used earlier in this book.Google Scholar
  19. 19.
    See further, Dato (1975), Allen and Cortazzo (1974), and on specific issues, Moore (1973), Corrigan (1978) and Tyler and.Marslen-Wilson (1978).Google Scholar

Copyright information

© Springer-Verlag Wien 1981

Authors and Affiliations

  • David Crystal
    • 1
  1. 1.Department of Linguistic ScienceUniversity of ReadingGreat Britain

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