Testing Pragmatic Language Disorders: A Culturally-sensitive Assessment

Recent years have seen a growing in interest in the application of pragmatic aspects of communication in the area of language disorders. This has led to the development of a range of different methods of screening to investigate the subject’s ability to understand and produce different types of communicative acts, to assess the disordered language of both children and adults. Yet Pragmatic language disorders (PLDs) remain difficult to diagnose in a cost-effective manner, and there are still few assessment tools that yield quantitative data, however in children PLD tests can quickly insure the identification of language problems that could severely interfere with learning and social interaction with peers. Pragmatic competence comprises a number of interrelated skills which manifest a range of adaptive behaviors driven by underlying cognitive processes. Tests are thus generally designed to assess six core subcomponents of pragmatic language: physical setting, audience, topic, purpose (speech acts), visual-gestural cues, and abstraction. Accordingly, assessment measures differ along a number of dimensions, mainly four evaluation scales: linguistic, extralinguistic, paralinguistic and social appropriateness. In this perspective, to ignore the impact of culture with respect to how the diagnosis of this language disorder is made would seem problematic. A culture is identified by its customs, beliefs, values, behaviors and attitudes that make it inherently different from another group of people or culture. Being that the major deficits in pragmatic communication refer to qualitative impairments in social interaction and communication, standardized measures may not be appropriate to the all racial and ethnic populations it is possible that the kinds of behaviors thought to be the very deficits that define the disorder may in fact vary from culture to culture. Applying the same criteria to every child is, in fact, not only culturally insensitive, but could result in serious misclassification of symptoms. The way in which a child does or does not respond in specific social situations may very well be mediated by cultural factors. Yet, the dearth of information on cultural differences in the diagnosis and the perception of these language disorders (whatever their etiology) does not allow easy the assessment of symptoms for children of different cultures. In this perspective, our study aims at investigating differences/analogies among a selection of different screening measures most widely used in Italy and English-speaking countries and at evaluating how cross-cultural differences may impact perceptions of language disorders in different countries.