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Wednesday, January 9, 2013

Clinical Grice

Speranza

Commentary on I. Adornetti,
"Why Philosophical Pragmatics Needs Clinical Pragmatics"

The study provides applications of Grice to clinical psychology, with extensive references.

Adoretti aims to show how clinical pragmatics (the study of pragmatic
deficits) can fruitfully inform the classical theoretical models proposed
by philosophical pragmatics.

In the first part of the essay Adornetti argues that
theories proposed in the domain of philosophical pragmatics, as those
elaborated by Herbert Paul Grice, are not plausible from a cognitive point
of view and that for this reason they cannot be useful to understand
pragmatic deficits.

In the second part, Adornetti shows that Relevance Theory
overcomes this limitation (being consistent with the data about actual
mind’s functioning), but I also argue that it offers a restricted view of
human communication which has to be integrated with a model of
language use that takes into account a central pragmatic property:
coherence of discourse.

Keywords: cognitive plausibility, discourse coherence, executive
functions, pragmatic impairments, relevance theory.



Pragmatics, since its dawn as a branch of the sciences of language, has been the
subject of numerous debates about the nature and definition of its object of
study.

While scholars of syntax and semantics agree, at least on a general level,
on what should be their field of study, among scholars of pragmatics there is no
general consensus on what constitutes the domain of study of their discipline.
The absence of such a consensus is evident, for example, in the various
definitions of pragmatics that it can be find among the authors who deal with it.

For example, some, assuming language centrality, define pragmatics in general terms as “the study of the use of language”, and more specifically as “the study of how contextual factors
interact with linguistic meaning in the interpretation of utterances”.

Other
authors, instead, focusing their attention on non-linguistic features (gaze,
gestures, postures, etc), describe pragmatic behavior as not dependent on the
use of language (Dronkers, Ludy, & Redfern, 1998).

In some others cases,
scholars distinguish, at least implicitly, between linguistic and non-linguistic
pragmatics by using terms such as ‘pragmatic language impairment’ (Bishop,
2000) or ‘pragmatic language disorders’ (Martin & MacDonald, 2003).


In recent decades, the definition of pragmatics has been strongly influenced
by the results from the field of clinical pragmatics: the study of clinical cases
has offered valuable new sources of data with respect to traditional issues in
philosophical and linguistic pragmatics (e.g. Cummings, 2009; Perkins,
2007).

At the basis of this kind of methodological approach there is the idea
that through the study of deficits it is possible to identify capacities and
processes that underlie pragmatic behavior: here the maximum is that we
become aware of the nature of a mechanism or process by examining what
happens when it goes wrong. From this perspective, therefore, it is possible to
propose a model of pragmatics that respects the cognitive plausibility (the
interpretive model should be compatible with the knowledge about the
functioning of our mind). In this paper I assume as working definition of
clinical pragmatics the following proposed by Cummings (2009, p. 6):


Clinical pragmatics is the study of the various ways in which an individual’s use
of language to achieve communicative purposes can be disrupted. The cerebral
injury, pathology or other anomaly that causes this disruption has its onset in
the developmental period or during adolescence or adulthood.

Developmental
and acquired pragmatic disorders have diverse aetiologies and may be the
consequence of, related to or perpetuated by a range of cognitive and linguistic
factors.

Adornetti's aim is to show that our understanding of pragmatics can be informed
and extended by the study of pragmatic impairments. In the next section I aim
to discuss the advantages of such an approach compared to some theories
proposed in the area of philosophical pragmatics.


Although classical pragmatic theory as those proposed by the Oxford philosopher such
Herbert Paul  Grice has had a remarkable impact on the study
of pragmatic impairments, understanding of communication deficits has not
always been particularly well served by these theories.

This is due to a large
extent to the fact that these theories provide a means of describing pragmatics
and pragmatic impairments that is rarely adequate for clinicians (for a
discussion, see Perkins, 2007).

Austin’s Speech Act Theory, for example,
although used to test communication in several clinical populations, including
adult with aphasia (Wilcox & Davis, 1977) and children with Asperger’s
syndrome (Ziatas, Durkin, & Pratt, 2003) and autism (Loveland et al., 1988),
shows some limitations (Allan, 1998) that can be problematic for clinicians. As
an example, consider the following transcript, spoken by a man with traumatic
brain injury (TBI).

I have got faults and. my biggest fault is.
I do enjoy sport .
It’s something that I’ve always done.
I’ve done it all my life.
I’ve nothing but respect for my mother and father and my sister. and basically sir.
I’ve only come to this conclusion this last two months. and as far as I’m concerned
my sister doesn’t exist.

From
Perkins, Body & Parker, 1995, p. 305).

As you can see, each single utterance is well formed and has the
illocutionary form of a statement.

 However, considered as a whole, this piece of
language appears inappropriate from a pragmatic point of view.

Indeed, it lacks
coherence: it is characterized by sudden and irrelevant topic shifts.

So,
according to Speech Act Theory, utterances produced by TBI subject are not
problematic, although they are ineffective from a more general communicative
perspective. Here the problem is that Speech Act Theory has tended to focus
on single isolated sentences independent from discourse context (Geiss,
1995), but (as I will discuss more specifically in the last paragraph) a central
property of pragmatics is coherence that pertains to the level of the discourse
rather than of the single sentence.

*********************************************

Herbert Paul Grice’s Theory has served as a
conceptual framework for understanding pragmatic impairment and has been
used for studying communicative problems of some clinical populations,
including adults with aphasia and right hemisphere damage

(Ahlsén, 1993;
Bloom et al, 1999; Stemmer, Giroux & Joannatte, 1994) or children with
autism (Surian et al., 1996).

********************

However, the application of theory of
Conversational Implicature proved problematic to study pragmatic deficits,
and its application is not always easy and straightforward.

The main problem of
this failure is that Gricean Theory (but the same is true, at a general level, for
philosophical pragmatics) doesn’t explain the underlying causes of pragmatic
behavior and pragmatic deficit.

However, the need to distinguish between such
levels, that of description and that of explanation, seems particularly
outstanding.

As an illustration of this, consider the following transcripts
discussed by Perkins (2007, p. 31).
a.

Prompt:
 the man who sits on the bench next to the oak tree is our mayor
Gary: amen

b.

Adult: can you think of anymore?

Matthew: a remote-controlled cactus

Transcripts (a) is the response of Gary, an 8 year old boy, to a task where the
subject is required to repeat the sentence heard.

Transcripts (b) shows a piece of
conversation between Matthew, aged 8, and an adult who has been asking
names for pets.

Gary’s and Matthew’s response may be apparently described in
a similar way.

They are examples of pragmatically anomalous behavior as they
appear to violate the Gricean maxim of relevance.

However, only Matthew’s response is a genuine case of pragmatic impairment.

Indeed, as Perkins (2007) shows, the underlying causes in each case are quite different.

Gary’s irrelevant
response is due to his problems with verbal memory and syntactic
comprehension.

The sentence

The man who sits on the bench next to the oak tree is our mayor.

is both too long and too syntactically complex for him.

On
the other hand, Matthew has normal syntax and verbal memory, but has a
diagnosis of autistic spectrum disorder.

His problems in social cognition are
responsible for his incapacity to take proper account of prior and surrounding
context during conversation.

Here the distinction is between primary and secondary pragmatic disorders.

Clinicians and theorists
use the term ‘secondary’ to describe an individual’s pragmatic disorder that is not related to any
impairment of pragmatic competence as such – the disorder is secondary to an impairment of
structural language. Instead, an individual with a primary pragmatic disorder has intact structural

The arguments discussed lead us to highlight an important issue.

The idea
that the development of a theoretical model about the nature of communication
cannot be separated from the reference to empirical data. In our case, the idea
is that the elaboration of a pragmatic theory should be constrained by clinical
data. The analysis of the deficits permits building theoretical models (founded
in human cognition) that can explain the actual communication processes
rather than describe them in the abstract.

Now, although the existence of a
deficit does not constitute in itself evidence to support that a certain
processing system is involved in a given function, in my opinion the study of
the deficit, and therefore the reference to the functioning of cognition, remains
an indispensable tool (while not sufficient alone) to test the empirical
plausibility of a theoretical model. The issue of pragmatic impairments opens
the way to question the relationship between pragmatic theory and the theory
of cognition. In the next section I discuss such a question using other frameworks.


There is  is a perspective on the nature of communication
strongly related to theories on the architecture of the mind.

Unlike Speech Act
theory and Conversational Implicature, this framework characterizes pragmatics referring
to cognitive processing rather than contextualized action or usage principle.


This framework, in fact, tries to give an account of the processing systems at the base of
human communication: the scholars who work within this perspective of
research explicitly seek to respect cognitive plausibility to explain
communication processes. In such a perspective assumptions about the nature
of communication are subject to confirmation or refutation and reformulation
in the light of experimental work concerning the nature of cognition. The methods adopted are, in fact, those of cognitive
psychology: in addition to purely philosophical or linguistic arguments, the
appeal of cognitive plausibility binds authors to construct models of
communication processes in line with the evidence produced by experimental
language skills, but may fail to understand the significance of context features for his choice of
linguistic utterance (Cummings, 2009).

studies on the deficit or with interpretations that come from evolutionary
psychology.

Following Herbert Paul Grice’s intuition, according to which an essential feature of most
human communication, both verbal and non-verbal, is the expression and
recognition of intentions (Grice, 1957), a framework sees
communication as an inferential pragmatic process in which the generation and
the detection of communicators' intentions is central.

More in detail, it is proposed an ostensive-inferential model of human communication
according to which the speaker provides just an evidence (e.g., an utterance) of
his intention to convey a certain meaning and the listener comprehends
speaker’s meaning by producing a series of inferences that are governed by
that evidence.

In this communicative process two intentions are involved:
1. the informative intention,

by which the speaker informs the listener of
something (the ostensive stimulus has to attract the attention of the
recipients);


2. the communicative intention
by which the speaker intends to inform the
listener of his own communicative intention (the ostensive stimulus has to
lead the attention of the recipients on the speaker’s intention).

Communication has a positive outcome when the recipient explicitly
recognizes the communicative intention of the speaker (therefore his
communicative behavior). To this end, the ostensive stimulus (behavior, verbal
utterance, etc.) must capture the attention of the recipient and direct the
attention on speaker’s intentions.

But, what does it make an ostensive stimulus
worth attending to? Some have argued that the answer to this
question is based on a theoretical notion of relevance. They wrote:
Relevance, as we see it, is a potential property of external stimuli (e.g.
utterances, actions) or internal representations (e.g. thoughts, memories)
which provide input to cognitive processes.

The relevance of an input for an
individual at a given time is a positive function of the cognitive benefits that he
would gain from processing it, and a negative function of the processing effort
needed to achieve these benefits.

2 The reference to evolutionary psychology is due to the fact that humans do have an automatic tendency to maximise relevance, not because we have a
choice in the matter […] but because of the way our cognitive systems have evolved, it is said.

Relevance is a guiding principle of communication. From this perspective,
the basic assumption of each conversational interaction is that speakers and
listeners have tried to make their contributions as relevant as possible and that
each one is interpreting the contributions of others taking relevance in mind.
However, the principle of relevance is also intended to apply to the domain of
cognition in general.

The idea is that relevance is a
feature of human cognition: human mind is geared toward the maximization of
relevance:

the human cognitive system has developed in such a way that our perceptual
mechanisms tend automatically to pick out potentially relevant stimuli, our
memory retrieval mechanisms tend automatically to activate potentially relevant
assumptions, and our inferential mechanisms tend spontaneously to process
them in the most productive way

Since we have said that this is a model of pragmatics that adheres to how the
mind works, it is important to analyze connections between this framework and theory of
human cognition.

At a general level, identification of the others’ intentions is
made possible by a specific cognitive system, Theory of Mind (ToM) module.


This term is used to describe the ability to attribute mental states such as
beliefs, intentions, and feelings to others and to explain and to predict the
actions that derive from them (Baron-Cohen, 1995). This framework sees
pragmatics as a specific component - a “relevance-based comprehension
module” – of the ToM module with its own proprietary concepts and
procedures distinct from general ToM module. From this point of view,
communication, and more specifically verbal comprehension, is a form of
mindreading.

Happé (1993) identifies different levels of mindreading capacity
that could be conceived as a continuum ranging from a basic capacity to
represent others’ mental state (i.e. representational ability) to the potentially
infinite representation of mental states about other mental states (i.e.
metarepresentational ability). According to Happé, representational ability
appears to be sufficient to understand metaphor, while metarepresentational
ability is needed to appreciate irony.

The condition most commonly associated with mindreading deficit is
autism (Baron-Cohen, 1995; 2001). Since this framework sees communication as an
exercise of mindreading, it has been a useful framework to analyze
communicative deficits of autistic people (e.g., Dennis, Lazenby & Lockyer
2001; Frith 1989; Happé 1995; Wearing, 2010). For example, a
mindreading deficit may be responsible for the incapacity of autistic subjects to
understand indirect requests. Consider the following transcripts:

T: can you turn the page over?

C: yes (non sign of continuing) (from Perkins, 2007, p. 67).



This is a piece of an interaction between C, a 4-year-old child with autistic
spectrum disorder, and T, a speech and language therapist. C seems unable to
infer that T’s utterance is intended as a request and is not just a question.


Another example of this kind of pragmatic impairment in autism is offered by
figure 1 that shows the response of a child with autism who was given a paper
with seven rectangles drawn on it and given the request to “write the days of
the week in these seven boxes” (Perkins & Firth, 1991).

It is evident that the
child’s response could be ascribed to a misreading of the speaker’s intention.
The Days of the Week


Fig. 1. The response of a child with autism to the request ‘write the days of the week in
these seven boxes’.


As we have seen so far, some characterize pragmatics
as “inferential comprehension” oriented to relevance detection.

This means
that the “relevance principle” characterizes, from a pragmatic point of view,
the essence of language. My opinion is that such a conception represents a too
limited view of human communication (a view that is heavily focused on the
aspects of language comprehension and therefore on the role of the hearer).


More specifically, I believe that it is opportune to put together with Relevance
Theory an interpretative model that takes into account another fundamental
pragmatic property, coherence, which has a key role in discourse processing
(clinical data show that it is a property that pertains, primarily, to the
dimension of language production). In next section I aim to show why
coherence is a central property of human communication and what kind of
devices make it possible.


Relevance is not the only principle that governs human communication.

As
highlighted, for example by Giora (1997, 1998), «speakers and hearers are
not constrained only by the search for relevance. In addition, coherence
considerations constrain communication and play a major role in discourse
structuring and understanding» (Giora, 1997, p. 31). As I have said in a
previous sections, my idea is that coherence pertains especially to the building
of discourse – to the production - and, for this reason, it is an effort principally
made by the speaker. To specify this point, I discuss briefly the case of TBI
subjects. This example allows us to emphasize the importance of production
dimension and the fundamental involvement of others cognitive systems,
specifically the executive functions of planning and monitoring, beyond ToM,
in pragmatic communication.

Before addressing this topic, I need to specify
more in detail the notion of coherence.

Coherence is a term that refers to conceptual organizational aspects of
discourse at the suprasentential level. The coherence of a text or discourse
depends, at least in part, on the speaker’s ability to maintain thematic unity
(Agar & Hobbs, 1982). When is a discourse coherent? The dominant idea,
especially among linguists, is that the coherence of discourse (spoken or
written) depends on the linear relations between adjacent sentences, that is to
say on cohesion between pairs of consecutive statements (Bellert, 1970;
Bublitz, 2011; Daneš, 1974; Halliday & Hasan, 1976; Tanskanen, 2006).


The most influential work from this perspective is Halliday and Hasan’s
Cohesion in English published in 1976.

Their concept of cohesion is semantic
one. Indeed, in their opinion cohesion refers «to relations of meaning that exist
within the text» (Halliday & Hasan, 1976, p. 4) and «enable one part of the
text to function as the context for another» (Halliday & Hasan, 1989, p. 489).
In a text, the relations of cohesion are realized through grammatical and lexical
devices. Grammatical cohesion includes elements such as reference,
substitution, ellipsis and conjunctions, while lexical cohesion is based on
reiteration (repetition, synonymy, etc.) and collocation (co-occurrence of
lexical item). Consider the following text:

After the forming of the sun and the solar system, our star began its long
existence as a so-called dwarf star. In the dwarf phase of its life, the energy that
the sun gives off is generated in its core through the fusion of hydrogen into
helium (from Berzlánovich 2008, p. 2).

As we can see, in this text the sentences are connected through lexical
cohesion: the lexical cohesive relations hold among the lexical items sun, solar
system, star, dwarf star and dwarf phase in the text.


What is important to note for the purposes of my argument is that in this
perspective cohesion is a necessary condition for discourse coherence (for a
discussion see Giora, in press). Now, although the cohesive relations
(grammatical and lexical) have an important role in the expression and
recognition of coherence relations, my idea is that cohesion between
consecutive sentences is not a necessary and sufficient condition for the
coherence of utterances in the flow of speech.


With reference to this a crucial
distinction is that between global and local coherence. Global coherence refers
to the relationship between the content of a verbalization with that of the
general topic of conversation; local coherence concerns the conceptual links
between individual sentences or propositions that maintain meaning in a text
or discourse (Glosser & Deser, 1990).


While local coherence is made possible
by cohesion relationships, my hypothesis is that global coherence is
independent from linguistic mechanisms (it is independent from cohesion).
Consider the following sentences:

I bought a Ford. The car in which President Wilson rode down the Champs
Élysées was black. Black English has been widely discussed. The discussions
between the presidents ended last week. A week has seven days. Every days I
feed my cat. Cats have four legs. The cat is on the mat. Mat has three letters


(Enqvist, 1978, pp. 110-111).

In this text the sentences are connected through the mechanism of
repetition.

However, the set of sentences, despite the abundance of cohesive
ties, is not perceived as a coherent whole. In this text the sentences do not
“hang together” in a reasonable way: the text lacks of global coherence.
The example and the arguments discussed so far show that global
coherence is a pragmatic property independent from linguistic devices.
Indeed, my hypothesis is that coherence relies on more general cognitive
processes such as the executive functions of action planning and monitoring.


The processes of planning and monitoring play (even intuitively) an important
role in building the flow of discourse. As speech is composed of linear
sequences of words and expressions, the speaker must constantly form a plan
of verbal expressions in order to decide what to say and how to organize what
he says, if he wants to express himself in a coherent manner. Moreover, during
the execution of a plan, that is, during the stage of discourse production, it is
necessary to continue estimation of the task in order to make sure that the
elements introduced accord with the general topic of conversation. Empirical
evidence confirms the effective role of these executive processes in processing
discourse coherence.


The most interesting data in this regard comes from studies of patients with
TBI with executive dysfunctions. These subjects have deficits in action
planning and monitoring: they are unable to complete a goal-oriented behavior
through a series of simple actions (e.g., Eslinger et al., 2011; Shallice 1982;
Zalla et al., 2001). Because of this, TBI patients cannot organize and maintain
global discourse coherence (while they have no problems at the level of local
coherence). As an illustration of this, consider the following transcript
discussed by Perkins (2007, p. 86) in which C, a man with TBI, is talking with
T, a speech and language therapist, about trade unions.

C: I admit this government we’ve got is not doing a good job but the unions are trying
to make them sound worse than what they are

T: mm

C: they . they . cos I’m a Tory actually but I I do vote . if there’s a . er . a communist
bloke there I will vote communist but . it all depends what his principles are but I don’t
agree . with the Chinese communism . and the Russian communism

T: right

C: but I believe every . should be equal but . I’m not knocking the royal family because
y . you need them
T: mm
C: and they they they bring people in to see take photos

Despite the local sequential links between trade unions–government,
government–Tory, Tory–communist, communism–Chinese/Russian
communism, communism– equality, equality–Royal Family, Royal Family–
tourist attraction, C shows a form of ‘topic drift’: he is unable to monitor what
has already been talked about or to relate each individual utterance to some
overall coherent plan or goal. In fact, neurolinguistic experimental data show
that TBI subjects connect sentences correctly by using cohesion ties
(grammatical devices), but they are unable to construct and maintain the global
coherence of their verbal productions (they cannot relate the individual
sentences to a plan or to a more general purpose) and often introduce material
that is irrelevant to the current context in their verbal productions (Biddle et
al., 1996; Glosser &Deser, 1990; Hough & Barrow, 2003; Marini et al.,
2011).

Because of their inability to formulate and to pursue a communicative
goal, their discourses appear pragmatically inappropriate.



In order to elaborate an interpretative model of the nature of language, the
analysis and the study of clinical data appear very important: they allow us to
propose a theoretical model that respects the constraint of cognitive
plausibility. I have showed that philosophical pragmatics does not respect this
constraint and, because of this, it is not at all adequate for the study of
pragmatic deficits. A cognitive plausible model of pragmatics is offered by
Relevance Theory. However, the clinical data discussed here have pointed out
the necessity to go beyond relevance: although pragmatic theory based on
relevance detection explains many aspects of human communication, such a
theory should be integrated with a theoretical model that takes into account
discourse coherence.

ACKNOWLEDGEMENTS
We  would like to thank Erica Cosentino and Francesco Ferretti for helpful
suggestions.

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