Is a clinical sociolinguistics possible?

CLINICAL LINGUISTICS &

PHONETICS, 1992, VOL. 6, NOS. 1 & 2, 155-160

Is a clinical sociolinguistics possible? M A R T I N J. BALL University of Ulster, Jordanstown, Co. Antrim, N. Ireland

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Abstract This paper considers the idea of developing a clinical sociolinguistics. Various areas of the field are examined, and the importance of the ‘core’ area of the correlation of non-linguistic variables with linguistic variables stressed. Issues concerning language and class, region, sex, age and context of utterance are investigated, together with the implications for clinical linguistics. Finally, the difficulty of integrating such issues into clinical assessment is explored, and a tentative step forward suggested along the lines of a ‘clinical sociolinguistic checklist’. Keywords: Sociolinguistics, clinical linguistics, language variation, assessment.

Introduction In his seminal work on clinical linguistics, Crystal (198 1) discusses the possibility of the creation of a ‘clinical sociolinguistics’ to complement the advances in other areas of clinical linguistics (a point he returns to in Crystal, 1984). In this discussion, Crystal gives the example of a clinical linguistic interaction between a clinician and a patient that illustrates the difference between discourse in clinical settings, and ‘natural’ conversation. Crystal acknowledges that this area of study might well come to be termed ‘clinical pragmatics’ or ‘clinical discourse analysis’ rather than ‘clinical sociolinguistics’. Indeed, we have seen in recent times the development of an interest in pragmatic aspects of language disorder: see, for instance, Gallaher and Prutting (1983), Grunwell and James (1989), and McTear and Conti-Ramsden (1989), as well as in numerous papers published in collections (for example Smith, 1988) and in the speech pathology journals (see McTear and Conti-Ramsden for accounts of some of these); and it would appear from most of this work that ‘clinical pragmatics’ has indeed been adopted as the term to cover this area of clinical linguistic enquiry. (See also the papers by Penn and Beecham, and by Milroy and Perkins in this volume.) This paper, therefore, will exclude pragmatic and discourse-related issues from the narrower definition of sociolinguistics. A further area of study that has been included under the label of sociolinguistics in some publications (see, for example, Trudgill, 1974b; Fasold, 1984; Wardhaugh, 1986) is multilingualism and the related areas of code-switching, language planning, and language and disadvantage. This general area has also had some treatment within clinical linguistics (see, for example, the papers in Miller, 1984), and again we will exclude it from consideration here. This does not mean that these eyr‘Aded areas are not worthy of consideration for clinical linguists, or that thert IS not still plenty of work to be done in them; rather 0269-9206192 $3.00

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that in this account we wish to concentrate on ‘core’ areas of sociolinguistics, and see how they may be integrated into clinical linguistics. By ’core areas’ of sociolinguistics in this account is meant the relation between language variation on the one hand, and non-linguistic features on the other. For the purposes of this discussion the following non-linguistic features will be considered: social class, geographic region, sex, and age as aspects of speaker variability, and style as an aspect of environmental variability. These features will be examined in turn.

Speaker variability Social class and region Social class membership and regional origin are linked sociolinguistically in many societies. For example, in Britain the higher up the social scale you are situated the fewer regional features of speech will be used. The non-regional RP pronunciation, and the non-regional Standard English dialect will be found with members of the upper middle classes, while localized accent (see Wells, 1982) and dialect features will be encountered with members of the lower working class. In between in terms of class membership are found speakers whose accent and dialect will reflect some regional features, these decreasing with higher social class. All of this is, of course. well known from the work of Labov (e.g. 1966, 1972), Trudgill (1974a. 1986) and others. It is also known that it is not a universal characteristic of speech communities that the link between class and region operates in this manner. Work referred to in Trudgill (1974b) shows that in India (for Kannada) the higher the class (i.e. caste) the speaker is, the more likely he or she is to use regional forms, and the retention of standard. cross-regional forms is found with low-caste speakers. Indeed, it has to be remembered that in bilingual situations there may not be an equal spread of language users among all the social classes. As noted, for example. in Ball (1988). in parts of Wales the Welsh speakers are restricted to lower-class groups (for example in rural areas), or to professional middle-class groups (in the metropolitan areas). and in this case a class analysis of speakers’ language use is unhelpful. We must now consider how important is the class/region feature of language variation in terms of the speechilanguage clinician. Considering only phonological disorders, it is comparatively easy to envisage a situation where aspects of class/ regional variation in language can complicate an analysis. Assuming a patient presenting with a fricative simplification process, whereby target labio-dentals and interdentals are reaiized as labio-dentals, and target alveolars and palato-alveolars as alveolars, we might feel we have a relatively common and uncomplicated simplification of contrasts to deal with. However. if this patient originates from a region (such as London) where the merger of interdentals with labio-dentals is common, and from a class likely to use this feature, then this analysis must be challenged. It may well be that what we have here is simply a process affecting the alveolar vs. palato-alveolar contrast, with the loss of interdentals simply reflecting community norms. Further, apart from issues of analysis, the planning of remediation programmes must be reconsidered. In the case noted above, serious consideration must be given as to whether training in the production of the contrast between interdental and

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labio-dental fricatives should be given, when such a contrast may not exist, or exist only peripherally in the patient’s speech community. Another case reported to me (J. Stephens, personal communication) involved a variable process of final consonant deletion. A clinician spent considerable time training the child involved to produce a final is/ in the word ‘yes’, while the child’s mother produced nothing but ‘yeah’ in answer to the clinician’s questions! One can imagine similar issues arising in a wide range of phonological and syntactic ‘disorders’ from patients of different regional and class backgrounds. It is clearly important, in terms of any clinical sociolinguistics, that such issues can be identified, and remediation issues addressed.

Sex and age Researchers interested in the interaction of speaker’s sex and linguistic variation have identified two broad approaches; what might be termed the ‘macro-linguistic’ and the ‘micro-linguistic’. The first of these is concerned with issues to do with discourse (topic control, turn-taking, length of turn, feedback, tag questions, etc.), politeness phenomena, use of expletives, and patriarchy in the lexicon (see Coates, 1986). The second follows more in the mould of the ‘classical Labovian’ paradigm, and investigates the use of linguistic variables according to the sex of the speaker, While both of these areas are of interest to the interaction between clinician and patient, this paper will treat the first of these topics as outside the scope of ‘core’ sociolinguistics as outlined above and concentrate on the second. This again is important in terms of both analysis of speech/language disorders and their remediation. The research referred to in, for example, Trudgill (1974b) and Wardhaugh (1986), shows that, in general, women are likely to use prestige forms of a linguistic variable more often than men. This clearly interacts with what we examine above. Localized forms (such as the loss of contrast between interdental and labio-dental fricatives) may well be common in working-class speakers; but further, how common they are may well depend on whether the speaker concerned is male or female. If we devise some means of noting these regional/class differences, this must be sensitive enough to note differences due to sex of the speaker. Again, this does of course have implications for planning intervention. A particular linguistic feature may well be a marker of sex differences in a speech community, in that men use a particular variant most often while women use a different one. It is necessary, therefore, that such differences be integrated into remediation programmes: not necessarily an easy task. Age of the speaker also often correlates with linguistic variation, in that certain variants of specific variables reflect older community speech norms, and so are retained by older speakers. This too is going to have an effect on both our understanding of a patient’s linguistic output, and on the design of any treatment regime. An obvious example might be the retention by older RP speakers of yod in certain /#Cju-/ strings where it has been lost by younger speakers; e.g. ‘suit’jsjuti-/sut/, ‘lute’/ljut/+/lut/. Here, one has to be aware both that such pronunciations are perfectly acceptable for the older age group, and-if a general process of yoddeletion is found in the data of an older speaker-one has to decide whether to train just those yod clusters used by younger RP speakers, or to include the types noted above as well.

Martin J . Ball

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Environmental variability

By this term we mean what has been called ‘style’ or ‘register’ differences by other authors; that is to say variability of language caused by the degree of formality of the context of utterance. This in turn can depend on who the interlocutors are (and their comparative status), the topic of the conversation, and the circumstance of the conversation (e.g. casual conversation vs. an interview situation). Clearly. such a feature is important for clinical linguistics, if only because SO much of the data which is used for analysis is obtained in ways that are unusual to say the least in comparison with normal ‘casual’ conversation. Even if we are moving away somewhat from relying solely on standardized tests utilizing set language elicitation procedures, any form of speech collection is still non-normal in some way. This is because the normal context of utterance of the patient will be with family, friends, colleagues. etc.; not with speech,’language clinicians. This, therefore, may clearly have an effect on the reliability of the data collected. Indeed, one of the main interests of sociolinguistics has been in the methodology of data collection, in particular access to the vernacular (i.e. that style of speech that is subject to the least amount of monitoring by the speaker). The problem of gaining access to the vernacular has been termed ‘the observer’s paradox’: the goal of sociolinguists is to record the style of speech used by speakers when they are not being observed by outsiders, and the only way to achieve this is to observe them. It may well be that the goal of clinical linguists is not necessarily the same, i.e. to record speech as used by speakers when not being observed by outsiders. Nevertheless, if all we can gain on occasions is a speech style radically different from that used by the speaker with the friends and family, then we are in great danger of making a false analysis of the linguistic repertoire and abilities normally open to the patient. It might be expected that this false analysis will always err in the direction of underestimation of the patient’s linguistic abilities. However, the converse is also found. in that patients can produce, under the extremely formalizing context of the speech therapy clinic and perhaps of a formal test situation, phonological contrasts (for example) that they do not employ in casual speech. Various methods have been employed by sociolinguists from Labov (1966) onwards to break out of the vicious circle of the observer’s paradox and record examples of casual speech styles. These have involved questions designed to elicit emotional responses (through asking about dangerous or humorous episodes, or reminiscences), through verbal tasks involving the description of a non-linguistic event (such as Labov’s ‘shoelace’ test, or the reporter’s test of DeRenzi and Ferrari, 1978. to group work recording interactions between peers. Not all of these will be appropriate within the clinic, as group interactions in particular may not be easy to set up, except when patients with similar disorders may be attending group sessions. This. however, is not the same as a group of friendsirelatives which happens to include the patient. Nevertheless, techniques such as the reporter’s test have clearly proved their use with certain patient types, and the emotive question may also prove helpful in breaking down any perceived ‘formality’ in a patient’s responses. Other techniques might involve the use of a formal test instrument, followed by a marked change in style by the therapist, who can leave a tape-recorder running, while giving the impression that the investigation is over. The resulting ‘small talk’ may well prove a good source of linguistic material,

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that is relatively informal in style, and could prove an adequate input for profiling techniques (see Crystal, 1982). There is clearly a need for more research on how representative the data are that are collected for clinical linguistics; a start on this is made when we recognize the fact that patients in the speech/language clinic are just as likely as anyone else to have, and to use, a wide range of linguistic styles.

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A clinical sociolinguistics?

It has been shown above that the core areas of sociolinguistics are relevant to clinical linguistics. The problem remains of how they can be integrated into the analysis of disordered speech/language, and the subsequent remediation programmes. Already, some current assessment procedures do make provision for language variation. For example, the phonology profile PROPH (see Crystal, 1982) has a line for the marking of accent conventions for a particular patient. However, this implies that such conventions are already known to the clinician; while most clinicians trained in phonetics and linguistics will be aware that such differences occur, it may not be so easy for them to gain quick and easy access to the material where such details are available. However, to provide, for example, separate PROPH charts for every regional accent system within English (not considering variation due to other factors) would clearly not be feasible. It might appear, then, that the integration of the core areas of sociolinguistics discussed above into clinical linguistic assessments is an impossible task. We suggest that this is not in fact so, and that steps can be taken in this direction without producing something too unwieldy to use. This would involve the construction of ‘clinical sociolinguistic checklists’ (CSCs). Each CSC would be designed for a particu-

base variant

non-base variant .

/a/

/Q/

/[/

-

/v/

sociolinguistic detail London; [ C : X : S ] S. Irish; [S]

S. Wales, Newcastle; [ C ] East Anglia; [ C : X : S ] West; part Lanc; [ C ]



=

/V#/

Scot land maj Eng; S Wales; [ C ; X ; S ]

verb- i ng

a l l ex RP; [ C ; S ] Mid+N. Eng; [ C ]

/-Uk/

Merseyside; [ C ]

Figure 1. Illustrative fragment of a clinical sociolinguistic checklist for phonology (base R P ) . Key: C: class; X: sex; S: style.

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lar linguistic level. e.g. phonology, lexis, or syntax; further each would be designed for a particular patient selection, i.e. there would be no need to include information on British accents in a checklist designed for use in the US. The CSC would contain information on differences from standard forms (i.e. RP for British phonology; or Standard English for syntax), and note what group of speaker (by class. region, sex, age. etc.), or context (formal vs. informal), or both would be likely to use the form in question. In this way clinicians could see at a glance whether it was fikel?, (obviously one cannot make categorical statements in this regard) that the non-standard form used was sociolinguistically acceptable for the patient, or was more likely an example of disordered speech/language. Clearly. the production of a whole range of CSCs for different linguistic levels and population groups would be a major undertaking, and there is not the space in this short article to produce such a set of checklists. However, to demonstrate the type of chart envisaged, Figure 1 depicts an illustrative fragment of a phonology checklist for use in England.

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