Clinical linguistics is a sub-discipline of

applied linguistics Applied linguistics is an interdisciplinary field which identifies, investigates, and offers solutions to language-related real-life problems. Some of the academic fields related to applied linguistics are education, psychology, communication rese ...

involved in the description, analysis, and treatment of language disabilities, especially the application of

linguistic theory Theoretical linguistics is a term in linguistics which, like the related term general linguistics, can be understood in different ways. Both can be taken as a reference to theory of language, or the branch of linguistics which inquires into the n ...

to the field of Speech-Language Pathology. The study of the linguistic aspect of

communication disorder A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. The delays and disorders can range from simple sound substitution to t ...

s is of relevance to a broader understanding of language and

linguistic Linguistics is the scientific study of human language. It is called a scientific study because it entails a comprehensive, systematic, objective, and precise analysis of all aspects of language, particularly its nature and structure. Linguis ...

theory. The

International Clinical Phonetics and Linguistics Association The International Clinical Phonetics and Linguistics Association (ICPLA) is an international scholarly association dedicated to the study of speech disorders and language disorders. It was founded in 1991. The Association sponsors a biennial con ...

is the unofficial organization of the field and was formed in 1991. The Journal of Clinical Linguistics and Phonetics is the major research journal of the field and was founded by

Martin J. Ball Martin J. Ball is Honorary Professor in Linguistics at Bangor University in Wales. Until August 2017 he was Professor of Speech-Language Pathology (Clinical Linguistics and Phonetics) at Linköping University in Sweden. He holds dual UK-US citiz ...

. Practitioners of clinical linguistics typically work in Speech-Language Pathology departments or linguistics departments. They conduct research with the aims of improving the assessment, treatment, and analysis of disordered speech and language, and offering insights to formal linguistic theories. While the majority of clinical linguistics journals still focus only on English linguistics, there is an emerging movement toward comparative clinical linguistics across multiple languages.

History

The study of

s has a history that can be traced all the way back to the

ancient Greeks Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of classical antiquity ( AD 600), that comprised a loose collection of cultu ...

. Modern clinical linguistics, however, largely has its roots in the twentieth century, with the term ‘clinical linguistics’ gaining wider currency in the 1970s, with it being used as the title of a book by prominent linguist

David Crystal David Crystal, (born 6 July 1941) is a British linguist, academic, and prolific author best known for his works on linguistics and the English language. Family Crystal was born in Lisburn, Northern Ireland, on 6 July 1941 after his mother had ...

in 1981. Widely credited as the ‘father of clinical linguistics’, Crystal's book ''Clinical Linguistics'' went on to become one of the most influential books of the field, as this new discipline was mapped out in great detail. The application of linguistic science to the analysis of speech and language disorders has always been necessary but understudied.

Roman Jakobson Roman Osipovich Jakobson (russian: Рома́н О́сипович Якобсо́н; October 11, 1896Kucera, Henry. 1983. "Roman Jakobson." ''Language: Journal of the Linguistic Society of America'' 59(4): 871–883. – July 18,Speech-Language Pathology. Published in 1941, his book ''Kindersprache, Aphasie und allgemeine Lautgesetze'' recorded the results of his analysis of language use in child language acquisition and in adults with acquired

aphasia Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in t ...

. Although Jakobson's book only gained influence in the Anglophone world following the publication of the translated version ''Child language, Aphasia and Phonological Universals'' in 1968 its impact was felt in the United States and the United Kingdom, among others, where changes of approach were adopted for phonological, grammar, semantic and other areas of language impairment. His observation that deviant sound patterns obeyed similar rules to those of regular language systems remains a guiding principle in clinical linguistics even today. Most notably, the same approach was also adopted by Crystal and his colleagues in their development of a set of language ‘profiling’ procedures.

Disciplines

These are the main disciplines of clinical linguistics:

Clinical phonetics

Phonetics Phonetics is a branch of linguistics that studies how humans produce and perceive sounds, or in the case of sign languages, the equivalent aspects of sign. Linguists who specialize in studying the physical properties of speech are phoneticians. ...

is a branch of linguistics that studies the sounds of human speech. Clinical phonetics involve applications of phonetics to describe speech differences and disorders, including information about speech sounds and the perceptual skills used in clinical settings.

Clinical phonology

Phonology Phonology is the branch of linguistics that studies how languages or dialects systematically organize their sounds or, for sign languages, their constituent parts of signs. The term can also refer specifically to the sound or sign system of a ...

is one of the branches of linguistics that is concerned with the systematic organization of sounds in spoken languages and signs in sign languages. Unlike clinical phonetics, clinical phonology focuses on the application of phonology on interpretations of speech sounds in a particular language and how it deals with

phoneme In phonology and linguistics, a phoneme () is a unit of sound that can distinguish one word from another in a particular language. For example, in most dialects of English, with the notable exception of the West Midlands and the north-west o ...

Clinical prosody

In linguistics, prosody is concerned with elements of speech that are not individual phonetic segments (vowels and consonants) but are properties of syllables and larger units of speech. Prosody is essential in communicative functions such as expressing emotions or affective states.

Clinical morphology

Morphology Morphology, from the Greek and meaning "study of shape", may refer to: Disciplines * Morphology (archaeology), study of the shapes or forms of artifacts * Morphology (astronomy), study of the shape of astronomical objects such as nebulae, galaxies ...

is the study of words, how they are formed, and their relationship to other words in the same language. It analyses the structure of words and part of words, such as stems, root words, prefixes, and suffixes.

Clinical syntax

Syntax In linguistics, syntax () is the study of how words and morphemes combine to form larger units such as phrases and sentences. Central concerns of syntax include word order, grammatical relations, hierarchical sentence structure ( constituency) ...

is the set of rules, principles and processes that govern the structure of sentences in a given language, usually including word order. Every language has a different set of syntactic rules, but all languages have some form of syntax.

Clinical semantics

Semantics Semantics (from grc, σημαντικός ''sēmantikós'', "significant") is the study of reference, meaning, or truth. The term can be used to refer to subfields of several distinct disciplines, including philosophy Philosophy (f ...

is the study of the interpretation of signs or symbols used in agents or communities within particular circumstances and contexts .

Clinical pragmatics

Pragmatics In linguistics and related fields, pragmatics is the study of how context contributes to meaning. The field of study evaluates how human language is utilized in social interactions, as well as the relationship between the interpreter and the int ...

is a subfield of linguistics and

semiotics Semiotics (also called semiotic studies) is the systematic study of sign processes ( semiosis) and meaning making. Semiosis is any activity, conduct, or process that involves signs, where a sign is defined as anything that communicates something ...

that studies the ways in which context contributes to meaning. It refers to the description and classification of pragmatic impairments, their elucidation in terms of various pragmatic, linguistics, cognitive and neurological theories, and their assessment and treatment.

Clinical discourse

corpus linguistics Corpus linguistics is the study of language, study of a language as that language is expressed in its text corpus (plural ''corpora''), its body of "real world" text. Corpus linguistics proposes that a reliable analysis of a language is more feas ...

, discourse refers to the study of language expressed in corpora (samples) of “real world” text, the codified language of a field of enquiry, or a statement that determines the connections among language and structure and agency.

Applications

Linguistic concepts and theories are applied to assess, diagnose and administer language disorders. These theories and concepts commonly involve psycholinguistics and sociolinguistics. Clinical linguists adopt the understanding of language and the linguistic disciplines, as mentioned above, to explain language disorders and find approaches to treat them. Crystal pointed out that applications of linguistics to clinical ends are highly relational. In his book ‘Clinical Linguistics’, Crystal references many commonly known disorders with linguistic knowledge. Some examples from his book are as follows: # Voice orders - involves sub- and supra- laryngeal settings involved in

dysphonia A hoarse voice, also known as dysphonia or hoarseness, is when the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch. A hoarse voice, can be associated with a feeling of unease or scratchiness in the ...

; syllabic vs polysyllabic distinction to account for volume and timbre dimensions in voice; synchronic vs diachronic distinction should be used for more recognisable voice quality; interaction between non-segmental phonetic and phonological variables (p. 192-193). # Cleft palate syndrome - phonological variable and statement must be interpreted in perceptual and production terms; distribution of segments in an utterance (p. 193). # Fluency - segmental phonetic level (taking into consideration prolongations, abnormalities in muscle tension) can affect the production of speech phonologically; transition smoothness at the prosodic level (tempo, pause etc.); semantic factors including avoidance of particular lexical terms, coupled with grammatical structure between and adult vs child (p. 194). #

Aphasia Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in t ...

- speech comprehension and production requires non-segmental organization of language involving; Notions of segment, feature and process would aid in the analysis of phonological problems (p. 194). # Dyspraxia - requires multiple analysis in terms of segments, features and processes for phonological realization; more serious cases would require the analysis of disturbances in non-segmental phonology (p. 195). # Deafness - systematic analysis of segmental and non-segmental phonological organizations, and phonetic abilities; semantic, the grammatical structure as well as sociolinguistic interaction studies are vital dimensions that cannot be neglected for the oral production and comprehension for the deaf (p. 195). Some broad linguistics methods that are commonly used in the treatment of patients mentioned by Cummings (2017) include: * Use of

standardized Standardization or standardisation is the process of implementing and developing technical standards based on the consensus of different parties that include firms, users, interest groups, standards organizations and governments. Standardization ...

and

norm-referenced test A norm-referenced test (NRT) is a type of test, assessment, or evaluation which yields an estimate of the position of the tested individual in a predefined population, with respect to the trait being measured. Assigning scores on such tests may b ...

s *

Conversation analysis Conversation analysis (CA) is an approach to the study of social interaction, embracing both verbal and non-verbal conduct, in situations of everyday life. CA originated as a sociological method, but has since spread to other fields. CA began with ...

Discourse analysis Discourse analysis (DA), or discourse studies, is an approach to the analysis of written, vocal, or sign language use, or any significant semiotic event. The objects of discourse Analysis ( discourse, writing, conversation, communicative event ...

Linguistics sets the foundation of many speech and language diagnostic tests. More specifically, some speech and languages assessments include the test of articulation, which assesses phonetic articulation based on the pronunciation of certain phonemes such as Malayalam articulation test and the Kannada articulation test etc. The language age of a minor is determined by looking at linguistic aspects (i.e. case markers, synonyms etc.). The Early Reading Skills Test examines the Phoneme-Grapheme correspondence for diagnosing learning disability, whereas tests like Test of Emergent Expressive Morphology (TEEM) evaluates one's understanding of morphemes. Other examples of speech-language pathology (SLP) testing instruments like the Bracken Basic Concept Scale (BBCS) and Clinical Evaluation of Language Fundamentals (CELF) evaluate a broad range of language skills which include children's acquisition of basic concepts of colours, letters, numbers, formulation of words and sentences, among other language and cognitive skills. Tests such as Peabody Picture Vocabulary Test (PPVT) assesses instead the receptive vocabulary of children, and even adults.

The future of clinical linguistics

The past works of linguists such as Crystal were applicable to a wide range of communication disorders at every linguistic level. However, with the influx of new insights from disciplines such as

genetics Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...

, cognitive

neuroscience Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, development ...

and neurobiology (among others), it is no longer sufficient to just focus on the linguistic characteristics of a particular speech impairment. In today's context, one of the challenges in clinical linguistics includes identifying methods to bridge the knowledge of different fields to build a more holistic understanding. The translation of general research that has been done into effective tools for clinical practice is another aspect that requires future work.

Notes

References

* Crystal, D. (1981). Clinical linguistics. In Arnold, G.E., Winckel, F. & Wyke, B. D. (Eds.), Disorders of Human Communications 3. New York, NY: Springer-Verlag Wien. * Crystal, D. (2013). Clinical linguistics: Conversational reflections. Clinical Linguistics & Disorders 27:4, 236–243. * Crystal, D. (1984). Linguistic encounters with language handicap. Oxford, UK: B.Blackwell * Crystal, D. (1982). Profiling linguistic disability. London: Arnold. * Crystal, D., Fletcher, P., & Garman, M. (1976). Grammatical analysis of language disability. London: Arnold. * Cummings, L. (2017). Clinical linguistics. Oxford University Press. Retrieved from http://oxfordre.com/linguistics/view/10.1093/acrefore/9780199384655.001.0001/acrefore-9780199384655-e-337 * Grunwell, P. (1982). Clinical phonology. London: Croom Helm. * Ingram, D. (1976). Phonological disability in children (1st ed.). New York, NY: Elsevier. * Jakobson, R. (1941). Kindersprache, aphasie und allgemeine lautgesetze. Uppsala, Sweden: Almqvist and Wiksell. * Jakobson, R. (1968). Child language, aphasia and phonological universals. The Hague: Mouton. * Müller, N. (2000). (Eds). Pragmatics in Speech and Language Pathology: Studies in clinical applications. Amsterdam: John Benjamins Publishing. Retrieved from https://books.google.com/books?hl=en&lr=&id=TXE9AAAAQBAJ&oi=fnd&pg=PP1&dq=clinical+linguistics&ots=hCKFMFzqE_&sig=SY2XHEuwMYmvzGECjfjqB_OH0W8#v=onepage&q=clinical%20linguistics&f=false * Neurath, O., Carnap. R. & Morris, C. F. W. (Editors) (1955). International Encyclopedia of Unified Science. Chicago, IL: University of Chicago Press. * Perkins, M. R. (2011). Clinical linguistics: Its past, present and future. Clinical Linguistics & Phonetics, 25(11-12):922-7. Retrieved from: https://www.researchgate.net/publication/51519279_Clinical_linguistics_Its_past_present_and_future/stats * Perkins, M. R. (2007). Pragmatic Impairment. Cambridge: Cambridge University Press. * Ravi, S. K. (n.d.). The scope of clinical linguistics and applications of clinical linguistics. Academia. Retrieved from https://www.academia.edu/1759317/The_Scope_of_Clinical_Linguistics_and_Applications_of_Clinical_Linguistics * SLP Resource Guide: Standardized Assessment Resource List. (n.d). Retrieved from https://www.iidc.indiana.edu/pages/speech-pathology-assessments

External Readings

* Journal of Clinical Linguistics and Phonetics
The European Master's in Clinical Linguistics
{{Authority control Applied linguistics Neurolinguistics Comparative linguistics Language disorders