CLINICAL LINGUISTICS
Combined approach
In 1999, the journal Language Testing published a special issue devoted to ‘assessment in speech-language pathology. The editors introduced the issue by noting that speech-language pathology is a ‘field in which the assessment of linguistics and communicative abilities is a regular and integral activity but one which to date has not figured highly in the pages of this journal’ (Baker and Chenery 1999: 243). Their purpose in assembling the papers for this issue was to link the fields of speech-language pathology and language testing. Such an attempt is reminiscent of the bridging model which, I suggested, informed the development of the ETAL Series. Making such linkage is at the heart of applied linguistics; it informs and illuminates both specialisms and helps clarify what it means to be doing applied linguistics.
It is no surprise, then, that those who have produced the necessary instrumentation for diagnostic assessment are not in the main linguists but applied linguists (including speech therapists who have been trained in applied linguistics), phoneticians, medics and engineers. Thus Anthony et al. (who produced the Edinburgh Articulation Test 1971) included an engineer, a medical doctor specializing in neuro pediatrics and two speech therapists. Laver et al. (1981) who produced a normative Vocal Profiles Analysis scheme included a phonetician and two speech therapists. Wirz writes that current practice tends to favor approaches more from cognitive psychology (Byng and Coltheart 1986) than from medicine, which in the past was heavily dominated by the anatomical (and therefore localization) view of impairment. She characterizes the development in the twentieth century from individual diagnostic to comparative group assessment with a return to a greater (and better informed) study of the whole communicative person. In all of this linguistics plays a part, but a small part. We see in the training of clinical linguists such as speech therapists both a parallel with the development of applied linguistics in their need to draw on a wide variety of informing disciplines and in part an insight into the role of applied linguistics within speech therapy itself, since for many (but not all) practitioners, speech therapy is a branch of applied linguistics.
Wirz (1993) writes of ‘the richness of variety that offers the speech and language therapist the challenge in any assessment undertaken’ (Wirz 1993: 14). That richness of variety is also necessarily seen in the training the therapist receives. Crystal (1995: 434) writes of a ‘broad-based course of study, including medical, psychological, social, educational and linguistic components, as well as the fostering of personal clinical and teaching skills’.
Courses can be broad-based in two ways: either by ranging widely across many subject areas (medicine, psychology, sociology, education and (applied) linguistics) or by taking for granted a wider than normal frame of reference to any one subject. Thus the applied linguistic approach to clinical linguistics is likely to consider impairment as an aspect of loss, itself the negative inverse of positive language retention in the individual. The parallel type of loss in society is represented as language decay or language death (when a whole language dies through abandonment by its speakers, most commonly through death), while the parallel social retention is referred to as spread. All parameters may be regarded as aspects of language shift. Now placing shift as the superordinate means that applied linguistics has admitted its own interest in language change. But we should make two comments here. The first is that applied linguistics comes to this theoretical construct not from above but through the need to explain and understand different types of loss; and the second is that the applied linguist remains not fundamentally interested in shift in itself: what he/she is doing is attempting to understand it better in order to stabilize it, however momentarily, and so orient and remedy the impaired to that stable moment.