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Communication Disorders Faculty Publications Communication Disorders

1982

Communication Development and Its Disorders: A Psycholinguistic Perspective

Rhea Paul Sacred Heart University

Donald J. Cohen

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Recommended Citation Paul, R., & Cohen, D. J. (1982). Communication development and its disorders: a psycholinguistic perspective. Schizophrenia Bulletin, 8(2), 279-293.

This Peer-Reviewed Article is brought to you for free and open access by the Communication Disorders at DigitalCommons@SHU. It has been accepted for inclusion in Communication Disorders Faculty Publications by an authorized administrator of DigitalCommons@SHU. For more information, please contact [email protected], [email protected]. VOL. 8, NO. 2, 1982 Communication Development and Its Disorders: A Psycholinguistic Perspective Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 by Rhea Paul and Abstract something "funny" about the Donald J. Cohen child. In both cases, it is very often There is a reciprocal relationship the child's lack of speech that between the study of language finally impels the parents to seek disorders and research in normal professional help. language development. Recent Psycholinguistic research into studies in normal acquisition have these failures in language acquisi- led to a model of language devel- tion has been of interest not only opment that includes not only lin- to those who deal with communi- guistic achievements, but the de- catively impaired youngsters, but velopment of social and cognitive also to theorists concerned with abilities that lay the basis for the the nature of language and the transition from prelinguistic com- normal course of its development munication to the use of conven- (Itard 1806; Jakobson 1968; Lane tional forms. This model has been 1976). Disorders of language learn- applied to the study of develop- ing have been seen as "natural ex- mental disorders of language periments" in which the usually learning. Such a model allows the integrated components of commu- more puzzling disorders of lan- nicative function—motoric, per- guage development, such as child- ceptual, intellectual, affective, in- hood aphasia and primary autism, teractional, and linguistic—can be to be placed in a framework that "teased" apart so that the effect of predicts language disruption disruption of one aspect of the when underlying perceptual, cog- system on the others can be seen. nitive, or social abilities are In this way, the examination of lacking. Assessment procedures language disorders has contrib- that can be drawn from the model uted to theoretical models of intact of language disorders are pre- linguistic processing and to the sented. It is argued that the study understanding of the complex re- of these disabilities is important lations among the biological, psy- in the building of theoretical chological, and social forces that models of intact language proc- result in the normal child's re- essing that specify more precisely markable and apparently effortless the contribution of underlying facility for picking up language. skills to overall functioning. At the same time, recent years Questions for future research that have seen a tremendous increase serve this reciprocal purpose are in interest in normal language de- discussed. velopment on the part of clinicians and investigators who work with One of the most frequent present- communicatively impaired chil- ing problems in children referred dren. One reason for this interest for developmental disorders of any is the current explosion in the lit- kind is a delay in the acquisition of erature on language acquisition, language. Failure to talk at the ap- which was sparked by Chomsky's propriate age may be the first sig- (1957) formulation of a transforma- nal that alerts parents to the fact tional grammar, a powerful theor- that their child is different from other children, or it may be the Reprint requests should be sent to culmination of a long period of Dr. R. Paul at the Child Study Center, vague suspicion that there is 333 Cedar St., New Haven, CT 06510. 280 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 etical model of the structure of hu- for psycholinguists to use in learning language with attentional man language. Transformational constructing theories of the ac- mechanisms that favor linguistic grammar influenced linguists' con- quisition of language and its role stimulation and auditory equip- ception of their subject in many in development, while new data ment capable of imposing struc- ways, but it also provided psy- and theoretical formulations on ture on it. This apparently innate chologists with testable the normal course of language organization is not limited to audi- hypotheses about, for example, learning give clinicians additional tory processing, however. As the relative complexity of syntactic categories for organizing their ob- Bornstein (1975) shows, infants di- structures. These hypotheses servations and rationales for de- vide the visual spectrum, as well, could be examined by looking at signing intervention strategies. into adult categories, i.e., blue, the order of acquisition of these For this reason, it is useful to re- green, yellow, and red. structures during the developmen- view what has been learned about Infants also exhibit well- tal period. Although transforma- the development of communica- organized social behavior in their tional notions were eventually tion and to follow the shifts in fo- first months. Looking, smiling, abandoned because they failed to cus that this research has taken. In and vocalizing are put to use by take into account either the se- this way, it will be possible to for- young infants in securing and mantic limitations or the nonverbal mulate the questions for future re- maintaining caregivers' attention communicative bases of early lan- search that will be of the greatest (Ainsworth, Bell, and Stayton guage, nonetheless they played an interest not only for the study of 1974). Infants also show early pref- important role in kindling an in- clinical populations, but also for erences for human faces over other tense interest in language acquisi- the understanding of the normal visual stimuli (Fantz 1961, 1963, tion among psychologists. These child's ability to learn to communi- 1966; Kagan and Lewis 1965). researchers have collected a wealth cate through language. These very early propensities for of information about the course of human interaction will certainly communication development and Communication Development help bond babies to caregivers to have made important changes in in Normal Children ensure the nurturance necessary the way it is understood. for survival, as Freedman (1974) The accumulation and dissemi- The Neonate's Equipment for suggests. But, in addition, they nation of this information has giv- Language Learning. How is the provide frames for increasingly en rise to a second reason for in- newborn biologically organized to complex communication routines terest in normal development on make use of the linguistic environ- which will eventually include con- the part of clinicians. Understand- ment that must eventually ventional grammatical communi- ing more about the nature of lan- be assimilated? Certain perceptual cation through language. guage learning has led to a abilities appear to be present from Thus, infants begin life with not growing conviction that the nor- the first weeks of life, including only attentional preferences for mal sequence provides the best special responsiveness to sounds human, linguistic stimulation, but curriculum guide for teaching lan- in the frequency range of the hu- also with social behaviors that can guage and communication skills to man voice (Hutt et al. 1968), a elicit this stimulation. In addition, children who have not, for one preference for speech over other they impose perceptual structure reason or another, managed to rhythmic sounds (Butterfield and upon the events they experience. learn them on their own (Lee 1974; Siperstein 1974), and a tendency to These abilities derive from a set of Miller and Yoder 1974; Tyack and synchronize movements with innate, "hard-wired" systems for Gotsleben 1974; Bloom and Lahey pauses in speech (Condon and processing sensory input. The ex- 1978; Naremore 1980; Miller 1981). Sander 1974). In addition, infants istence of built-in systems such as As a result of these mutual con- as young as 4 weeks of age have these provides enormous economy cerns, a reciprocal relationship has been shown to be able to make cat- to the task of learning language. been established between clini- egorical distinctions between Knowledge of their existence must cians and psycholinguists. Clini- phoneme pairs, such as Ibl and /p/ also lead to questions about their cians' skilled observations of chil- (Eimas et al. 1971). It seems, then, role in later development. To what dren with disorders provide data that the infant comes to the task of extent might these early VOL. 8, NO. 2, 1982 281 Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 attentional, perceptual, and social child participates in the routine vocalizations often contain intona- capacities be impaired in through attention, action, and vo- tion contours similar to those used language-disordered youngsters? calization, progress is made in the by the adults in the child's life How will their impairment impede ability to distinguish agent from (Menn 1978). later language learning? How can action and from recipient of Another achievement of this 9- detection of these early deficits im- action—distinctions that will pro- to 12-month period is the begin- prove treatment strategies? vide the basis for semantic catego- ning of the understanding of ries and grammatical order rela- words. A few words associated "Conversation" in the First Year tionships. Although it is not clear with routine games, such as "pat- of Life. Bruner (1974) has de- how much interaction of this kind a-cake" and naming rituals will be scribed the role of mother-infant is necessary for language learning recognized by children who have interaction in the "ontogenesis of (Snow 1981), early reciprocal rou- been playing these games more or speech acts." Proto-conversational tines do appear to provide mothers less as passive responders up to exchanges between caretakers and with an ideal opportunity for this point (Bruner 1975). Now babies occur in the context of embedding the child's actions in a merely saying the words ("Let's mutual gaze that is coordinated meaningful social context. From play pat-a-cake!" or "Show me with interactive vocalizations. In- this reliable data, the child can your nose!") in a familiar context fants and their caretakers look at form hypotheses about the con- will elicit a spontaneous action each other and take turns babbling nections between words and from the child (clapping, putting a sounds that the infant is capable of things that can be tested in subse- hand on the nose). Comprehen- producing (Jaffe, Stern, and Perry quent interactions. In this way, the sion is limited to these routines, 1973). These back-and-forth inter- child begins the transition from however. changes may establish the basis for prelinguistic to conventional the later development of turn- communication. First Words. Conventional use of taking in linguistic conversation. language begins around 12 months In addition to learning turn- Early Communicative Intents. Al- of age, when children usually say taking rules, children may be though children's first words do their first recognizable words. helped to make the transition from not generally appear until the be- Around this time, children also the attentional structures with ginning of their second year, in- show the first evidence of true lex- which they come equipped (e.g., fants show evidence of initiating ical comprehension, responding figure vs. ground) to the linguistic communication between 9 and 12 appropriately to words outside the structures that develop later by months of age. These nonverbal context of routine games early communicative experiences communications have been found (Huttenlocher 1974; Sachs and (Bruner 1974). Mothers focus in- in a variety of studies (Halliday Truswell 1976). During the 12- to fant attention on self or object in 1975; Bates 1976; Bates et al. 1979) 18-month period, there is a rapid joint attention routines. ("See the to express the same range of inten- increase in both receptive and ex- pretty ball!") Once joint attention tions. They are generally limited to pressive vocabulary and an in- is established, mothers act on or requesting objects or actions, re- crease in successive one-word ut- encourage the child to act on the jecting offered objects or activities, terances. The words children learn object, usually forming joint action and calling attention to objects or in this period both name rituals that are repeated over and commenting on their appearance. objects—usually those upon which over in play during the child's ear- These intents are expressed first the child acts (Mommy, cookie)— ly months. ("Here, you take the with nonconventional gestures, and encode relations among ob- ball. Good! Now give it back. Give such as reaching (for requests) and jects (all gone, more). Children Mama the ball. Good girl! Thank pushing away (for rejection). also learn social words to be used you!") As mothers remark on Somewhat later, vocalization in rituals such as greetings (hi, these ritual, predictable actions, accompanies the gesture or re- bye-bye) (Bloom and Lahey 1978). the basic topic/comment structure places it, although the range of in- These first words are used to ex- of human language is repeatedly tentions expressed remains similar press ideas such as appearance demonstrated for the child. As the until 16-18 months of age. These ("There!"), disappearance ("All 282 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 gone!")/ or recurrence ("More"), The period from 18 to 24 months be exceptions to them. which are related to the child's de- is also the time of important As the child's grammar becomes veloping notions of object perma- changes in conversational ability. more complex, average sentence nence (Bloom 1973). They general- Now children begin to recognize length increases (Loban 1976; Mill- ly serve communicative purposes the conversational obligation to re- er and Chapman 1981). Although similar to those achieved by the spond to speech with speech rates of increase vary quite widely, earlier gestures and vocalizations (Chapman 1981). Children relia- children tend to acquire the same (Halliday 1975). bly answer routine questions syntactic structures when their Toward the middle of the second ("Where's the 'X'? What's this? sentences are approximately the year, vocabulary size reaches 50 What does the 'X' say?") and ac- same length (Brown 1973). Mean words, and children begin knowledge their partner's com- length of utterance (MLU), then, combining words to form two- ment with their own remark. can be calculated from a sample of word "telegraphic" sentences Youngsters also begin to request spontaneous speech and used to (Brown 1973). These sentences information at this time, at first make a reliable prediction of the encode a limited range of mean- usually by asking for the names of syntactic rules the normal child ings, such as possession ("Daddy objects. This heuristic use of lan- will have mastered. As structures shoe"), location ("sit chair"), and guage marks the beginning of the in simple sentences approach the elaboration of earlier expressions child's capacity to use words to adult model, complex sentences of existence ("There doggy"), non- learn about the world (Halliday using embedded ("Whoever wins existence ("No milk"), disappear- 1975). can go first") and conjoined ance ("All gone cookie"), and re- ("Then it broke and we didn't currence ("More candy") (Bloom The Acquisition of Linguistic have it any more") clauses emerge 1970). Structures. The preschool period (Limber 1973; Paul, Chapman, and Linguistic comprehension in this (from 2 to 5 years) is the time in Wanska 1980). The abilities to period is not far ahead of express- which the child's language evolves encode ideas syntactically ("Dad- ive abilities (Bloom 1974). But chil- from primitive telegraphic utter- dy's shoe" vs. "Daddy shoe") and dren in their second year often ap- ances to fully grammatical forms. to relate ideas within one utter- pear to understand everything In addition to rapidly acquiring ance ("I'll fix it if you give me a their parents say. They achieve vocabulary—an average of 8 to 11 bite of your candy") free the this deception by employing a va- new words per day—the child also child's language from dependence riety of nonlinguistic strategies goes through a process of on the nonlinguistic context for in- that allow them to seem to be re- approximating more and more terpretation. While an adult had to sponding to what parents say, closely the syntax of the language use knowledge of the child and the when, in fact, they are responding spoken in the home. There is evi- situation to interpret "Daddy to what parents do or what they dence of the child's active role as a shoe" (The shoe that's Daddy's? know to be the way things usually syntactic hypothesis-generator in Daddy put on the shoe?), the syn- happen (Chapman 1978). These the frequent occurrence of tactically marked "Daddy's shoe" strategies include looking at what overgeneralized forms, such as is unambiguous and interpretable Mother looks at (resulting in the "goed," "corned," and "foots" by anyone. appearance of understanding ob- (Cazden 1968). In these overex- In addition to changing in syn- ject names, e.g., "See the ball?"), tensions of the inflectional rules tactic form, children between ages that the child has abstracted from doing what is usually done (re- 3 and 5 years also change the ideas the ambient language, forms are sulting in the appearance of un- that they express in their sen- expressed which the child could derstanding instructions, e.g., tences. While earlier utterances never have heard. It is clear that "Brush your hair"), and inter- generally described actions and children are not making these mis- preting sentences as requests for takes by imitating. They are objects that were immediately the child to act (resulting in the producing novel—albeit present, sentence content expands apparent understanding of com- wrong—forms by applying gener- during the preschool years to al- plex indirect requests: "Why don't ative rules to words that happen to low for reference to events remote you go close the door for me?"). in time and space (Bloom and VOL. 8, NO. 2, 1982 283 Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020

Lahey 1978). The uses to which and Wepman 1974) and for A final aspect of language that children put their language also condensing more information into undergoes important develop- become more diverse (Dore 1978; sentences by increasing the pro- ments in the school years is Tough 1977) to include imagina- portion of dependent clauses in metalinguistic awareness, the abil- tive, interpretive, and projective narratives (Loban 1976). Children ity to use language to talk about functions. In addition, a variety of also gradually learn to use and language and to examine language conversational skills emerge and comprehend the more complex, apart from the objects and events become refined. Children increase optional sentence types in their to which it refers. Children recog- their ability to maintain and add language, such as passives ("The nize the difference between words new information to their interlocu- boy was hit by the car") (Baldie and their referents around age 6 tor's topic (Bloom, Rocissano, and 1976; Lempert 1978), and sentence (Pease 1981). They use their Hood 1976), to clarify and request types that violate usual rules for metalinguistic skills to create clarification of misunderstood ut- assigning subjects to embedded words (Clark 1980) and to develop terances (Gallagher 1975), to make clauses ("John is easy to see" vs. codes and secret languages their requests politely and indi- "John is eager to see") (Chomsky (Ferguson and Macken 1980), rectly (James 1975; Bates 1976), 1969). In addition, they learn to probably in the service of and to choose the appropriate use syntactic cues not only to de- increasing social solidarity among speech style on the basis of the code semantic relations within peers during the preteen and teen- speaker's role (Sachs and Devin sentences but also to identify the age periods. Metalinguistic 1973) and the listener's status connections between sentence ele- awareness is also important in the (Shatz and Gelman 1973). ments and those given previously development of reading and writ- Increasing comprehension skill in the discourse (Paul 1981). ing abilities (Mattingly 1972). is reflected in the expanding num- Semantic and conversational ber of elements that can be proc- abilities also continue to develop Changes in the Focus of Child essed in a simple sentence (Chap- during the school years. Vocabu- Language Research man 1978). In addition, strategies lary size is still increasing and new for comprehending sentences words are now being learned from Since the early 1960s, the study of change from relying on knowledge reading, as well as from conversa- language acquisition has of the way things usually happen tion. Interestingly, the nature of undergone a series of shifts in di- (which could lead children to in- children's word associations rection. Chapman (in press) terpret "The dog is patted by the changes around age 7 from identifies five major shifts that mother" correctly) to reliance on syntagmatic (association to words have had important consequences linguistic rules, such as word or- similar in meaning .but not in for the study of language disor- der (which would lead them to grammatical class) to paradigmatic ders. The first involved a change misinterpret "The dog is patted by (association between words of the in theoretical models of the the mother" by assigning the first same class—a noun for a noun, an motivating force behind develop- noun to be the "doer" as it would adjective for an adjective) (Brown mental progression. While be in a simple active sentence, i.e., and Berko 1960; Ervin 1961). These transformational grammar implied "The dog pats the mother") (Bever shifts in association suggest that that syntactic acquisition proceeds 1970; Strohner and Nelson 1974; the school-aged child's "mental relatively autonomously as a result Maratsos 1974). dictionary" is being reorganized of the unfolding of innate according to linguistic rather than grammatical capacities, investiga- The Elaboration of Language. Al- episodic, or event-based, connec- tors in the early 1970s were forced though children have acquired tions (Nelson 1977; Petrey 1977). by their data to examine the se- most of the sentence structure of School-aged children also gradual- mantic limitations they discovered their language by age 5 (Menyuk ly acquire the ability to communi- in early speech in terms of devel- 1963; Tough 1977), syntactic devel- cate with precision and to take the oping cognitive abilities (Sinclair opment continues into the school listener's viewpoint into account 1970, 1971, 1973; Bloom 1971; years as children learn devices for in formulating an utterance (Asher Slobin 1973; Beilin 1975; Cromer elaborating their utterances (Hass 1978). 1976). In the latter half of the dec- 284 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 ade, it became clear that simple microdevelopment—the detailed ining the child's own rules, rather cognitive prerequisites for specific histories of the evolution of single than identifying mistakes, allows linguistic skills were not easy to rules (Bloom, Miller, and Hood investigators to compare children find (Miller et al. 1980). Attention 1975; Menn 1978; Bates et al. 1979). who suffer from developmental then shifted to the role of social- These studies have illuminated the disorders, not to adults, but to communicative skills as the early limitations of linguistic rules their normal peers and to decide guiding force behind language de- and underline the gradual, some- whether their language is delayed velopment (Bates 1976; Bates and times effortful process of (similar to that of a younger, nor- MacWhinney 1979; Greenfield increasing generalization and the mal child) or deviant (showing an 1979; Greenfield and Dent 1979). amount of active learning necessa- atypical system of intermediary As a result, interest in pragmatic ry to expand the contexts in which rules). A review of current concep- achievements such as the emer- rules can apply. tions of communication disorders gence of communicative intention, A final shift that is relevant to will reveal the extent to which turn-taking, topic maintenance, work in language disorders was they have benefited from the dia- and speech style adjustments to the change from accepting speech logue with research in normal particular social situations became (production or expressive lan- development. (and continue to be) a major focus guage) as the single index of lan- of research (for a review, see Rees guage development to the realiza- 1978). Current Views of Develop- tion of the importance of mental Disorders of A second shift involved a move investigating language compre- Communication away from comparing child lan- hension (Bloom 1974; Ingram guage to adult rules. In recent 1974; Chapman and Miller 1975, The model of language acquisition years, attempts have been made to 1980). This shift led to analyses of presented here implies that the de- examine primitive utterances not the relations between the two velopment of communicative com- as "mistakes," but as the output of modes of language and the recog- petence is not a strictly linguistic a set of rules that are different nition that the simple notion that achievement. Rather, it is the re- from those used by adults to gen- "comprehension precedes produc- sult of the complex coordination of erate sentences. The task has been tion" cannot account for many as- a set of interacting systems to describe these child-specific pects of the child's performance. including those involved in per- rules and to identify their contexts This discovery has resulted in the ceptual, cognitive, and social func- and scope of application. building of new and more complex tioning, to name but a few. The Although these child language theoretical models of linguistic model predicts that breakdown at rules appear to be used with re- processing in the language- any point in this finely tuned or- markable uniformity (Klima and learning child (Bloom and Lahey chestration will result in impaired Bellugi 1966; Brown 1973), there 1978). language ability. Certain of these are certainly individual differences These changes in thinking about impairments can be traced easily in language acquisition. These are language development have had to malfunctions in one of the sys- now becoming the object of exami- profound effects on the under- tems subserving language devel- nation (Nelson 1973, 1981; standing of childhood language opment. Communication problems Bowerman 1973). An attempt is disorders. For example, the shift in associated with congenital hearing being made to understand the di- emphasis from syntax, alone, to impairment constitute an example. versity of patterns and styles avail- the meaning (semantic) and con- Here, failure to talk and under- able for normal acquisition and the textual (pragmatic) aspects of lan- stand speech is simply a result of effects of cultural differences on guage has allowed clinicians to lack of access to the auditory sig- language learning (Blount 1970; identify and describe pervasive nals that contain linguistic infor- Mitchell-Kernan 1971). A related deficits in communicative compe- mation. Other failures to learn lan- change in the focus of this re- tence and to look at the conceptual guage are less easily traced to search is a shift from the study of and social abilities that may be ba- specific causes. Mentally retarded macrodevelopment—the broad sic to the failure to acquire lan- youngsters, for example, will usu- outlines of acquisition—to guage. As another example, exam- ally acquire language commensu- VOL. 8, NO. 2, 1982 285 Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 rate with their mental age. Yet, in do establish meaningful social re- possibility, developmental aphasia some cases, these children have lationships and have a consistent and primary autism do exist as dis- language deficits that exceed their history of doing so. In addition, tinct clinical entities that can be cognitive limitations. These defi- they generally can engage in pur- identified in their "pure" form in cits may encompass not only lin- poseful play with objects and some children and recognized as guistic structures but more basic show evidence of the ability to im- components of a disorder in failures of communicative inten- agine and pretend. others. The present model would tion. Other children without any On the other hand, those chil- postulate that each of these syn- apparent sensory or intellectual dren categorized as autistic not dromes arises from specific dysfunction nonetheless fail to only fail to talk during the pre- dysfunctions in one of the devel- learn to talk, or learn exceedingly school period, they also have a oping systems that contribute to slowly. In these youngsters, too, long history of poor or nonexistent intact language use, even though social-communicative deficits may social relationships—even with the precise nature of the dysfunc- accompany the linguistic disorder. their often devoted parents. They tion has not yet been identified. The severity of these disabilities show poor motor imitation skills, Such a model, derived from the in- can vary from total absence of both their play with objects is disorgan- teractive conception of language language and communicative func- ized, and personal gesture systems development that has arisen from tion to slight delays relative to the rarely serve any communicative recent research, allows the entire child's overall mental age. Idio- function. When autistic children spectrum of language disorders to syncratic or deviant structures may do develop language, it has pecul- be placed in an integrated also be present. iar characteristics, such as pro- framework. Two main categories can be noun reversals, protracted echola- In addition to providing an in- identified within this more lia, the use of words for highly clusive structure for viewing the puzzling class of language disor- personalized meanings, and a de- disorders of language learning, the ders: childhood aphasia and pri- liberate, stiff quality of speech shift in language acquisition stud- mary autism. Although the two with unusual intonation contours. ies away from syntax, alone, to- have similar features, there are Although aphasic children often ward broader aspects of communi- several characteristics that distin- develop distractibility, aggressive- cative competence makes guish between them (Cohen, ness, and social withdrawal that communication assessment possi- Caparulo, and Shaywitz 1976; Fay may make them appear autistic- ble even in children who are not and Schuler 1980). Children who like as they become older, their talking. Measures of nonverbal can be labeled "aphasic" generally language will generally sound like communicative function drawn seem perfectly normal, healthy, that of a younger, normal child from observations of preverbal and social during their first 2 years and will not display these communication in normal infants of life. Parents become anxious peculiarities. can now be applied to analyzing about them only when, by the end There may, of course, be mixed the interactions of children with- of the second or during the third syndromes of these disorders, and out overt language. In this way, year of life, they are not talking or children may experience multiple more precise diagnoses can be are talking very little. Many of handicaps, such as a coincidence made at an early point in the these children create their own of hearing impairment and devel- child's development. (See Appen- gestural system for augmenting opmental aphasia. In an interac- dix for a sample interview for as- their limited linguistic communi- tive model of language develop- sessing the history of development cation skills, and some benefit ment such as the one presented of prelinguistic communication from instruction in Total Commu- here, any component or compo- skills.) nication using American Sign Lan- nents of the system can malfunc- The current emphasis of re- guage. Although they may become tion, and these malfunctions will search on normal children is on frustrated and disturbed about result in language disorders that discovering the child's own rule their communication difficulties vary in their features depending system; that emphasis has also and may develop behavioral prob- upon the underlying capacities provided insights into disordered lems as they become older, they that are disturbed. Despite this children's behavior. One example 286 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020 is Fay's (1969, 1973; see, also, Fay tual generalization—provides hood aphasia and primary autism. and Schuler 1980) analysis of echo- models for teaching generative Older aphasics, for example, fail to lalia in autism. Instead of assum- rules to children who have not develop abstract thought and vo- ing that echolalia is a "mistake" in learned them on their own. cabulary (Caparulo and Cohen the use of language, Fay explores The shift in child language re- 1977), and there is a need to look the purpose it serves for the child. search from production to compre- more closely at the relations be- He concludes that echoing gives hension has especially great signif- tween language and thought in the linguistically incompetent icance for clinical work. Language these youngsters. What specific youngster something to say in or- disorders have traditionally been subskills in the sequence of cogni- der to continue a conversation. evaluated only in terms of produc- tive development might show def- Echolalia appears, then, to serve tive deficits; little attention has icits that would predict and con- an important phatic function for been paid to the relation between tribute to language disturbance? the autistic child—it keeps the expression and understanding. What effects do limited linguistic lines of communication open and But it may be the case that some skill have upon the development prolongs interaction. This analysis children who have been called of high-level cognitive organiza- has important implications for the "aphasic" suffer only from minor tion, which ordinarily relies so treatment of echolalia in the thera- lags in receptive ability. In that heavily on language as a mediating peutic setting. Understanding its case, aphasia, with its connotation device? Will children with severe function will make clinicians more of deficits in symbolic ability, may language disorders eventually de- wary of attempting to extinguish be a misnomer. For some of these velop deficits in problem-solving echolalia before more effective children, failure to speak may be a ability and disorders of thought as means of maintaining interaction result of more circumscribed a result of their inability to repre- have been substituted for it. neuromotor disabilities. This diag- sent and organize experience in Psycholinguistic interest in the nosis would, of course, have im- language? The answers to these range of individual differences portant implications for treatment. questions will contribute not only along the spectrum of normal de- An increasing awareness of the to diagnostic and prognostic ca- velopment has contributed to clin- importance of evaluating speech pacity, but also to the understand- ical ability to assess language dis- and understanding independently ing of the relations between lan- orders. Having a quantitative will help in making such distinc- guage and thinking in normal notion of the normal range allows tions in the future. individuals. the clinician to make more reliable Similarly, more careful analysis decisions about when a problem, Directions in the Study of of connections between social and in fact, exists. Miller and Chap- Language Disorders linguistic performance in children man's (1981) studies of normal with disorders will improve diag- variation in mean length of utter- Research in communication devel- nostic and prognostic power, as ance, for example, provide an in- opment has contributed in many well as shed light on the social dex of language delay that can be ways to the study of language dis- bases of normal language acquisi- of great value in deciding when orders. At the same time, informa- tion. The area of mother-child in- children are so far behind age- tion from investigations of lan- teraction is particularly fertile mates that intervention is re- guage disorders is valuable in ground for investigating this ques- quired. There is now a reliable way deepening the understanding of, tion, especially in light of the of deciding when too long a time not only the disorders themselves, wealth of information now availa- has elapsed for children to "grow but the nature of language and its ble on typical mother-child com- out of" their failure to use words. acquisition. What are the ques- munication. What very early mis- The orientation in acquisition re- tions about disordered language, matches that appear in the search toward microscopic analysis the answers to which would serve mother-infant dialogue will pre- of development also has clinical this dual purpose? One question is dict later language-learning prob- applications. Looking at the devel- the relationship between language lems? How do parents react to ab- opment of single rules—from their and cognitive development in lan- sent or disorganized social early, limited sphere to their even- guage disorders, such as child- behavior? Is there a response that VOL. 8, NO. 2, 1982 287 Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020

optimizes the child's chance for interest in building models of the ship be true? Could the inability to progress? (See Cohen, Caparulo, interweaving of skill components talk also impede progress toward and Wetstone, in press, for an ini- in language. For example, is the the ability to decode complex lin- tial approach to this question.) observation of Bates et al. (1979) guistic signals? This information would lead to a that language use correlates highly better understanding of the as- with performance on means-ends All of these questions center pects of mother-child interaction tasks (Uzgiris and Hunt 1975) true around one fundamental issue in that are necessary for language de- for this population? Might some the study of normal communica- velopment, in addition to provid- language disorders be the result tion and its disorders: How do the ing categories for early of, not a global, but a rather limit- components of the communication assessment. ed cognitive failure, perhaps a fail- system interact in development? The suggestion that disorders of ure to understand relations be- Which components are necessary, perceptual and attentional regula- tween means and ends? Could this sufficient, or simply associated tion are also present in aphasic failure, in turn, lead to a deficit in with the growth of which others? and autistic children represents social understanding, i.e., that Are the more puzzling disorders of another piece of the puzzle to be people can serve as a means to de- language learning actually the re- assembled in understanding these sired ends if the tools for sult, not of global, but of highly disorders (Caparulo and Cohen manipulating them (communica- specific, underlying failures of 1977). Although it is clear from the tion) are used? social-cognitive function? Or, on infant studies cited above that per- Finally, the relations between the other hand, do they, in some ception and attention are highly the modes of language in these cases, cause disorders of thinking organized even in newborns, the populations merit further investi- and relating because of the inabili- relations among perception, atten- gation. What is the typical rela- ty to use language to mediate tion, and communication are not tionship between speaking and thought and interaction? Not only yet clear. Simple prerequisite rela- understanding in children with will study of the language of tions will probably fail to explain language disorders? Can sub- communicatively impaired chil- clinical observations that identify groups within populations be iso- dren improve therapeutic inter- attentional deficits developed after lated on the basis of receptive/ vention, it will also contribute to the language-learning period in expressive distinctions? Certainly, understanding the complex in- aphasic youngsters (Cohen, children who fail to develop recep- tegration of abilities that results Caparulo, and Shaywitz 1976). tive abilities will be impaired in in the normal child's remarkable The relations between social and their expressive language as well. achievement in mastering a first cognitive development are also of But might the opposite relation- language.

Appendix. An outline for a communication development interview

Communication developmen- Age tal milestone Question for parents Reference

0-2 Responsiveness to sounds in Does the child turn head or look up at Huttet al. (1968) months the speech frequency range the sound of voices? Preference for speech over Can the child be soothed or made to Butterfield and other rhythmic sounds smile by the sound of voices? Does the Siperstein (1974) child seem to like listening to people talk? Tendency to synchronize Does the child seem aware of when you Condon and Sander movements to breaks in stopped talking? Does the child wait for (1974) speech a pause to reach or move? 288 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020

Appendix. An outline for a communication development interview—Continued

Communication develop- Age mental milestone Question for parents Reference

Categorical perception for Eimaset al. (1971) speech sounds Preference for human faces Does the child attend to your face? Fantz(1961, 1963, over other visual stimuli Does the child seem to look at you more 1966); Kagan and often than at other things when you are Lewis (1965) in the room? 2-8 Mother-child "dialogue" in Does the child "talk back" to you when Jaffe, Stern, and Perry months mutual gaze, joint action, you talk "baby talk"? Can you direct the (1973); Bruner (1974) babbling child's attention to objects? Does the child seem to enjoy playing with you using toys, playing games such as "pat- a-cake" or "So big"? 9-12 Expression of nonverbal corn- Does the child make wants and needs Halliday (1975); Bates months municative intents to request, known by gesturing and making (1976) reject, call attention to self and sounds? Does the child attempt to get object your attention this way? Does the child attempt to get you to play games or comment on his or her activities?

Understanding a few words in Does the child eventually recognize a Bruner (1975) routine contexts few words from games such as peek-a- boo and act spontaneously when he or she hears the word? 12-18 Use of first recognizable word Does the child use any words to ex- Bloom (1973) months press wants and needs? Understanding of words out- Does the child understand any words Huttenlocker (1974) side routine contexts without gesture or facial cues? For ex- ample, if you said, "Where's Daddy?" would the child turn and look for him? 18-24 Two words combined to form Does the child put words together in Bloom (1970); Brown months telegraphic sentences ex- two-word sentences? (1973) pressing a limited range of meanings Understanding of words for ab- If you ask for an object in another room, Miller et al. (1980) sent objects can the child fetch the correct item with- out gestural clues? Understanding of conversation- Does the child attempt to answer ques- Chapman (1981a) al obligation to respond to tions or respond to your comments in speech with speech some way, verbal or nonverbal? Use of language to request in- Does the child ever either verbally or Halliday (1975) formation nonverbally try to get you to say the names of objects? VOL. 8, NO. 2, 1982 289 Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020

Appendix. An outline for a communication development interview—Continued

Communication develop- Age mental milestone Question for parents Reference

2-5 years Average sentence length in- Does the child gradually add more Loban (1976); Miller creases from 2.0 to 4.5 words words to sentences? and Chapman (1981) or more Rules for forming plurals, past Does the child ever say words wrong, Cazden (1968) tense, etc., are overgen- such as corned, goed, or foots? eralized Mastery of morphological and Do the child's sentences eventually Klima and Bellugi syntactic rules for simple sen- sound more like an adult's? (1966); Brown (1973); tences; emergence of complex Limber (1973) sentences Use of linguistic rules for un- Does the child ever misunderstand Bever (1970); derstanding sentences things you say, especially when you use Maratosos (1974); long or complicated sentences? Strohner and Nelson (1974) Use of language to talk about Does the child tell you about things that Bloom and Lahey events remote in time and happened away from home? In the (1978) space past? Use of language for diverse Does the child talk about things that will Tough (1977) purposes, such as imagining, happen later? Could happen? Does the predicting, interpreting child talk about "make-believe" things? Increased conversational skills; Can the child stick to a subject in con- Bloom, Rocissano, topic maintenance versation, say something new about the and Hood (1976) subject? Clarification If the child doesn't understand you, Gallagher (1975) does he or she ask you to repeat? Can the child repeat or repair a sentence you misunderstand? Polite, indirect requests Can the child use language to "wheedle James (1975); Bates something out of you"? Can the child (1976) "say it nicer" in other ways than just adding please? Choice of the appropriate Does the child talk differently to younger Sachs and Devin speech style for the social situ- children? Is the child more polite to (1973); Shatzand ation grownups than peers? Gelman (1973) 5-12 years Use of devices to elaborate Can the child tell stories without Hass and Wepman and condense information in stringing sentences together only with (1974); Loban (1976) sentences and? Ability to use and understand Does the child sometimes use complex Chomsky (1969); unusual sentence types in the sentence forms in speaking? Writing? Baldie(1976); Lempert language, such as passives (1978) 290 SCHIZOPHRENIA BULLETIN Downloaded from https://academic.oup.com/schizophreniabulletin/article-abstract/8/2/279/1911884 by guest on 23 March 2020

Appendix. An outline for a communication development interview—Continued

Communication develop- Age mental milestone Question for parents Reference

Development of metalinguistic Does the child ever make up words, Mattingly (1972); awareness play games with words, make up puns? Pease (1981) Could the child tell you his or her favor- ite word?

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England Child Language Associa- Acknowledgments tion meeting, Providence, RI, pp. 121-129. March 1981. Sinclair, H. Language acquisition This research was supported in Petry, S. Word associations and and cognitive development. In: part by the MacArthur Founda- the developments of lexical memo- Moore, T., ed. Cognitive Develop- tion, the Eckman Foundation, and ry. Cognition, 5:57-71, 1977. ment and the Acquisition of Lan- The Solomon R. & Rebecca T. Bak- guage. New York: Academic Press, er Foundation, Inc., and by NIMH Rees, N. Pragmatics of language: 1973. pp. 9-26. Mental Health Clinical Research Applications to normal and disor- Center grant MH-30929, and the dered language development. In: Slobin, D.I. Cognitive prerequi- Children's Clinical Research Cen- Schiefelbusch, R., ed. Bases of Lan- sites for the development of gram- ter grant RR-00125. We are very guage Intervention. Baltimore, MD: mar. In: Ferguson, C.A., and appreciative of the collaboration of University Park Press, 1978. pp. Slobin, D.I., eds. Studies of Child Ms. Barbara Caparulo. 191-268. Language Development. New York: Sachs, J., and Devin, J. Young Holt, Rinehart and Winston, 1973. children's use of age appropriate pp. 175-208. speech styles in social interaction Snow, K. "The Role of Mother- and role-playing, journal of Child Child Interaction in Language De- The Authors Language, 5:17-24, 1973. velopment." Presented to the Sachs, J., and Truswell, L. "Com- Brown University Language Rhea Paul, Ph.D., is Associate in prehension of Two-Word Instruc- Awareness conference, Provi- Research, and Donald J. Cohen, tions by Children in the One-Word dence, RI, March 1981. M.D., is Professor of Pediatrics, Stage." Presented at the 8th annu- Strohner, H., and Nelson, K. The Psychiatry, and Psychology, Yale al Stanford Child Language Re- young child's development of sen- University School of Medicine and search Forum, Stanford Universi- tence comprehension: Influence of the Child Study Center, New Ha- ty, Stanford, CA, 1976. event probability, nonverbal con- ven, CT.