Phonology

Clinical phonology emerged in the 1960s and 1970s at the time

when linguistic approaches were beginning to be applied to
communication impairments, so it is a relative latecomer. However, it
appeared to have great influence and force in clinical linguistics.

Phonological disorders are particularly common in young children.

These disorders may occur in the absence of other involvement such as
neurological impairment. Alternatively, they can be found as one of
several areas of language breakdown in children with a range of other
conditions including intellectual disability and hearing loss.

Phonological problems can also occur in adults with aphasia where

errors known as phonemic paraphasias may be produced.

Current clinical phonological approaches are drawn from a range

of theoretical perspectives including Optimality Theory, non-linear
approaches, gestural /phonology and cognitive/ usage-based phonology

phonological accounts off speech impairment have shown that they

are not necessarily the product of articulatory constraints but reflect
difficulties with the organisation and use of sound segments in words as
shown in the data in example 1 from a 4 years old child with
phonological difficulties we can see that although the child is clearly able
to articulate t d k and g he does not yet use them appropriately

‫المثال من الكتاب‬

Examples of phonological problems in children are shown below:

‘page’ /peiʤ/ → [peiʧ] ‘basket’ /bæskət/ → [ægə]

‘glove’ /glʌv/ → [glʌf]

The children with intellectual disability display some of these

phonological problems. For example, initial consonant and final
consonant deletion occur in ‘basket’. There is also consonant cluster
reduction of /sk/ to [g] in ‘basket’. Processes not seen in the other
children’s productions are voicing of /k/ to [g] in ‘basket’, and
postvocalic devoicing in /ʤ/ → [ʧ] of ‘page’ and /v/ → [f] of ‘glove’.

While such analyses have traditionally focused on single word

production, recent research has pointed to the value of examining the
phonetics and phonology of longer utterances,

Early phoneme and feature- based accounts of atypical sound

systems gave way in the 1980s to the application of natural phonological
process analysis to atypical speech production, particularly in
developmental speech difficulties.

Grammar

Syntax is a particularly important aspect of the clinical linguist’s

knowledge as grammatical impairments are commonly observed in
children and adults with language disorders.
Children with specific language impairment omit auxiliary verbs,
use object pronouns in the place of subject pronouns etc. Many of
immature grammatical features can also be seen in children with
intellectual disability often in the presence of a syndrome.
Adults with agrammatic aphasia display significant syntactic
impairment. Often, content words such as nouns, verbs and adjectives are
the only grammatical categories to be retained with function words such
as prepositions and articles omitted altogether. The resulting spoken
output has the appearance of a telegram.
Some of these syntactic deficits are shown below:
Children with expressive specific language impairment (SLI)
Example (1) ‘He eating’The child has omitted the auxiliary verb
‘is’.
Example (2) ‘Her’s painting a flower’
The child has succeeded in including an auxiliary verb. However, it
occurs alongside the object pronoun ‘her’ rather than the subject pronoun
‘she
 There is still a disagreement about the extent to which
grammatical impairment results from
1. a defect within a self- contained grammatical system, which is the
primary focus of linguistics,
2. or is a consequence of the way language is processed when it is
produced and understood and therefore linked with psychology and
cognitive processes such as memory and attention.
That's why such structural oddity like the omission of the obligatory
clause and phrase elements and problems with the agreement and
pronominal case marking in the following example spoken by a 51 years
old man with agrammatic aphasia are seen by some as the direct
consequence of damage to the language unit whereas others attempt to
explain them as a secondary consequence of processing limitation.
And then yeah . well . waste of time. Cos mother . here everyday
Semantics

Semantics is an important branch of linguistic study for the clinical

linguist because of its many concepts and theories.

Semantic deficits are a common feature of children and adults with

language disorders. Children with specific language impairment can
display naming errors with many errors related to the target word (e.g.,
the use of ‘shoe’ for foot).

The child with intellectual disability may have difficulty grouping

words according to semantic fields such as fruit and transport.

Many of the semantic paraphasias produced by adults with aphasia

can be characterized in terms of lexical relations such as hyponymy and
antonymy. Some of these semantic errors are demonstrated in the data
below:

‘It’s hot outside.’ JT: ‘It wasn’t cold for me.’

74-year-old woman (‘JT’) with Wernicke’s aphasia uses the antonym

‘cold’ in place of the target word ‘hot’.
Pragmatics and Discourse
In the clinical domain pragmatics and discourse analysis have
proved to be helpful in characterizing the communication difficulties that
result from autism, traumatic brain injury and the right hemisphere brain
damage.
Whose underlying causes are usually seen as being primarily
neurological and cognitive rather than linguistic. people with autism can
find it difficult to work out precisely what others mean by what they say
as in the following example>
Adult: can you turn the page over?
Child: with autism yes/ makes no move to turn the page.
The challenge for clinical linguists is to explain such behaviours in
ways which are both theoretically coherent and practically useful.
Pragmatic issues and theories such as speech act theory,
conventional implicature and relevance theory have been used to
characterize pragmatically anomalous communication, but although these
provide a useful set of descriptive information for assessment purposes.
That is to say how do we differentiate between symptoms and causes for
remedial purposes.
The search for the neurological basis of pragmatic impairment has
given rise to the relatively new subdiscipline of neuropragmatics this
discipline attempts to identify specific areas of the brain which are
responsible for pragmatically relevant cognitive activities. So, for
example, our awareness of others mental status has been linked to the
right frontal lobe social reasoning and MPC to the ventral medial frontal
lobe.

An alternative approach is to see pragmatic and discourse

impairment as being located in the social Space constituted by
communicating and groups rather than being attributed to an underlying
defect within an individual
one way of integrating this various different perspective is to see
pragmatics and discourse as an epiphenomenal consequence of all of
these