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STUDY GROUP SERIES titles published to date* 1. Infantile Autism: Concepts, Characteristics and Treatment 2. Cellular Organelles and Membranes in Mental Retardation 3. The Brain in Unclassified Mental Retardation 4. Mental Retardation and Behavioural Research 5. Assessment for Learning in the Mentally Handicapped 6. Experiments in the Rehabilitation of the Mentally Handicapped 7. Language, Cognitive Deficits, and Retardation * 1—5 published by Churchill Livingstone Language, Cognitive Deficits, and Retardation Study Group 7 Held at Friends House, London on 11-13 December, 1972 under the auspices of The Institute for Research into Mental and Multiple Handicap Edited by NEIL O'CONNOR, MA, PhD Published for the Institute for Research into Mental and Multiple Handicap BUTTERWORTHS, LONDON AND BOSTON THE BUTTERWORTH GROUP ENGLAND Butterworth & Co. (Publishers) Ltd. London: 88 Kingsway, WC2B 6AB AUSTRALIA Butterworths Pty Ltd. Sydney: 586 Pacific Highway, NSW 2067 Melbourne: 343 Little Collins Street, 3000 Brisbane: 240 Queen Street, 4000 CANADA Butterworth & Co. (Canada) Ltd. Toronto: 2265 Midland Avenue, Scarborough, Ontario MIP 4S1 NEW ZEALAND Butterworths of New Zealand Ltd. Wellington: 26-28 Waring Taylor Street, 1 SOUTH AFRICA Butterworth & Co. (South Africa) (Pty) Ltd. Durban: 152-154 Gale Street U.S.A. Butterworth 161 Ash Street, Reading: Mass. 01867 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, including photocopying and recording, without the written permission of the copyright holder, application for which should be addressed to the publisher. Such written permission must also be obtained before any part of this publication is stored in a retrieval system of any nature. First published 1975 © Butterworth & Co. (Publishers) Ltd., 1975 ISBN 0 407 00007 0 Suggested UDC Number: 159.946.3/.4:159.922.76 Suggested Additional Numbers: 159.953.5:4:159.922.76 371.92:4 616.899-053.4/.5:371.92:4 Printed in England by The Camelot Press Ltd, Southampton Contributors and Participants L. Bartak, MA Lecturer, Department of Child Psychiatry, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF D. C. Bennet, MA, PhD Lecturer in Phonetics and Linguistics, School of Oriental and African Studies, (University of London), Malet Street, London WC1E 7AP R. Beresford, MA Lecturer in Phonetics, Sub-Department of Speech, School of Education (University of Newcastle-upon-Tyne), 46 Leazes Terrace, Newcastle-upon-Tyne NE1 4L2 M. Berger, BA, DipPsychol Senior Lecturer in Child Development, Department of Child Development and Educational Psychology, Institute of Education (University of London), 24 Woburn Square, London WC1H OAA R. Conrad, MA, PhD Research Psychologist, MRC Applied Psychology Unit, 15 Chaucer Road, Cambridge CB2 2EF R. F. Cromer, AB, AM, PhD Research Psychologist, MRC Developmental Psychology Unit, Drayton House, Gordon Street, London WC1H OAN D. Crystal, BA, PhD Reader in Linguistic Science, Department of Linguistic Science (University of Reading), Whiteknights, Reading, Berkshire RG6 2AH IX CONTRIBUTORS AND PARTICIPANTS Barbara J. Dodd, LACST Research Assistant, MRC Developmental Psychology Unit, Drayton House, Gordon Street, London WCIH OAN A. J. Fourcin, BSc, PhD Reader in Experimental Phonetics, Department of Phonetics and Linguistics, University College (University of London), Gower Street, London WC1E 6BT Uta Frith, PhD, DipPsychol Research Psychologist, MRC Developmental Psychology Unit, Drayton House, Gordon Street, London WCIH OAN N. C. Graham, BA, PhD Senior Lecturer, Department of Education (University of Aston), Gosta Green, Birmingham B4 7ET Beate M. Hermelin, BA, PhD Research Psychologist, MRC Developmental Psychology Unit, Drayton House, Gordon Street, London WCIH OAN P. Herriot, BA, MEd, PhD Reader in Psychology, Department of Social Science and Humanities (City University), St. John Street, London EC1Y 4PB Patricia Howlin, BA, MSc Research Psychologist, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF P. N. Johnson-Laird, BA, PhD Lecturer, Centre for Research in Perception & Cognition, Laboratory of Experimental Psychology (University of Sussex), Brighton BN1 9QY A. R. Jonckheere, BSc, PhD Senior Lecturer, Department of Psychology, University College (University of London), Gower Street, London WC1E 6BT E. H. Lenneberg, MA, PhD Professor of Psychology and Neurobiology, Department of Psychology and Neurology (Cornell University), Ithaca, New York 14850, U.S.A. J. McFie, MA, MD, MRCPsych Consultant Psychologist, Charing Cross Hospital, Fulham Palace Road, London W6 8RF x CONTRIBUTORS AND PARTICIPANTS G. P. Morris, BA, PhD (deceased) Senior Clinical Psychologist, Darenth Park Hospital, Dartford, Kent J. Morton, MA, PhD MRC Applied Psychology Unit, 15 Chaucer Road, Cambridge CB2 2EF N. O'Connor, MA, PhD Director, MRC Developmental Psychology Unit, Drayton House, Gordon Street, London WC1H OAN D. M. Ricks, BA, MD, MRCPsych, DPM Hon. Consultant in Mental Handicap, Departments of Paediatrics & Child Psychiatry, University College Hospital, Gower Street, London, WC1 M. Rutter, MD, FRCP, FRCPsych, DPM Professor of Child Psychiatry, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF Joanna Ryan, MA, PhD Research Psychologist, Unit for Research on the Medical Applications of Psychology (University of Cambridge), 5 Salisbury Villas, Station Road, Cambridge CB1 2JQ Hermina Sinclair, DPsych Professor of Psycholinguistics, Ecole de Psychologie et des Sciences de l'Education (Universite de Geneve), Palais Wilson, 1211 Geneve 14, Switzerland N. V. Smith, MA, PhD Reader in Linguistics, University College (University of London), Malet Street, London WC1E 7HP Elizabeth K. Warrington, BSc, PhD Psychologist, Department of Psychology, National Hospital for Nervous Diseases, Queen Square, London WC1N 3BG Lorna Wing, MD, DPM MRC, Social Psychiatry Unit, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF W. Yule, MA, DipPsych Senior Lecturer, Department of Psychology, Institute of Psychiatry (University of London), De Crespigny Park, London SE5 8AF XI Acknowledgements This Study Group was assisted financially by the Kennedy Foundation, to which the Institute extends its gratitude. Thanks are due to the staff of the MRC Developmental Psychology Unit, London, for hospitality and secretarial help. xn Introduction Neil O'Connor The dispute between Chomsky (1959) and Skinner (1957) concerning the roles of imitation and stimulus-response learning in language acquisition is an important issue for our approach to language handicap, whether in the subnormal, the deaf, the autistic or the aphasic child. Many authors (e.g. Brown and Bellugi, 1964; Fraser, Bellugi and Brown, 1963) have contributed to this dispute. Amongst these contributions, Bever, Fodor and Weksel's (1965) characterization of the independent and generative nature of language learning is a cogent attack on any use of a Hullian-type stimulus-response generalization view of language acquisition. Psycholinguists may have presented clinicians with one problem but they themselves face another: i.e. how can language be acquired, if not by imitation ? In other words, how do children match input and output in either phonologi­ cal or syntactic usage? Miller and McNeill (1969) have argued that children derive from individual examples of language a rule system which governs their speech without ever being explicitly exposed to this system. Slobin (1971), agreeing with this observation, assumes an innate capacity to process the surface information and deduce its internal structure. Such views suggest that some language is empirically acquired, but that on the basis of a limited number of examples, a further analysis is made which enables the child to produce entirely novel language. Slobin (1971) has pointed out that children at first learn the correct forms of irregular verbs, but later on misapply to these same verbs the rules for regular verbs, saying 'breaked' when they formerly said 'broke'. This phenomenon is reminiscent of that noted by Lenneberg (1967) concerning the babbling of speech sounds by children who subsequently find the combination of these same sounds difficult. The mechan­ isms are of course different, but the history is superficially similar. In fact, 1 INTRODUCTION although most of the recent research on cognitive deficit and language has centred round the acquisition of syntax, one might say that a parallel revolu­ tion in our approach to language has occurred through the insights of Jakobson (1941) concerning phonological development in young children. Lenneberg (1967) with Down's syndrome children and Smith (1973) with normal children have both offered much evidence bearing on the role of mental and chronological development in phonological growth. Lenneberg has, for example, made some considerable advance in demonstrating the normal nature of babbling in Down's syndrome children. Thus in both syntax and phonology, there have been revolutions in approach which justify a review of the effects which neuropathology and psychopathology might have on language acquisition in the handicapped. This might be especially appropriate in the case of subnormality, which in the past has appeared to reflect normal development in children, though at a slower pace. But further information might be sought by considering the manner in which other types of impairment, e.g. deafness or aphasia, might affect the acquisition of language. How is the new revolution relevant to teaching and learning processes in children with these different kinds of handicap? How can study of these different kinds of pathology help us to understand points of theory concerning the new syntax or the new phonology ? Whilst the current approach to language acquisition raises problems of the association of logic and grammar, similar questions have been at the heart of research concerning subnormality and cognitive handicap for some time. Binet (Binet and Simon, 1908) asked one of these central questions: how is language related to thought? It has been answered by those interested in language development in normal and subnormal children in several ways. Piaget (1946) and his colleagues believe that comprehension precedes and must precede linguistic expression, Luria (1961) has sometimes suggested that some thought cannot occur other than through language, while Vygotsky (1962) has put forward the view that prior to a certain stage of growth, language and thought can develop in parallel and independent ways until at the age of 5, 6 or 7 they come together and thereafter operate as one. Binet, however, offered a more perplexing and perhaps more appealing interpretation. He saw thought as completely independent of language and imagery and much richer than either. Questions arising from impaired development in children cannot be viewed with profit by considering the problem of the subnormal alone. That is why in the following pages aphasic, spastic, deaf and autistic children are discussed. The reasons for this comparative approach have been discussed by O'Connor (1973) elsewhere; briefly, one could say that comparative studies of one psychological phenomenon (such as coding) across several subgroups would have certain advantages in indicating whether a central or peripheral handicap was involved. This strategy seems preferable to studies of one diagnostic 2 O'CONNOR group if one is reviewing disturbances of speech output. This applies whether we consider semantic or syntactic coding. Thus if input is affected without any obvious damage to semantic coding, such a situation might be envisaged as characteristic of the deaf; with autism, language failure may be the product not so much of input deficit as of a failure of semantic coding. These kinds of hypotheses, whatever we believe their resolution will be, can help us to examine our hypothetical models of language acquisition, comprehension and production. If we consider one kind of handicap alone, we cannot easily either understand the cognitive deficit involved or throw any light on the underlying model. If, however, we compare performance in several kinds of deficit on different aspects of language behaviour, it is conceivable that we might learn something both about the deficits and the whole problem of the relationship between semantics and syntax, which Binet rightly foresaw as the key issue in language learning, especially in association with mental or physical handicap. Such problems are discussed in the following pages. It goes without saying that the fundamental issue of the relationship between semantics and syntax, the acquisition of the rules governing them and their interaction are not resolved here. However, progress is made in relation to the problem of how sub-diagnoses affect the model of language learning. Piaget states that comprehension is closely related to the production of language and precedes it. The results with autistic and aphasic children reported here by Bartak and Rutter and with deaf, subnormal and autistic children by Hermelin and O'Connor, which are in accord with one another, suggest that Piaget's view is only part of the story. Sometimes syntax waits on comprehension, but by no means always. Conrad's comments on overt and covert speech are entirely relevant to this problem and echo Luria's (1961) observation about subnormals who, while not lacking speech, do not readily use it as a mediator in coding or recall. A further aspect of Bartak and Rutter's findings concerns gesture and, like Tubbs' (1966) finding with the Illinois Test of Psycholinguistic Ability shows the relevance of another aspect of Piaget's views. 'Signing' appears to be an essential aspect of communication and of the development of language, even if other deficits sometimes prevent the development of speech. Thus dysphasic children, who never learn either to speak or to read adequately, may readily learn a system of communication with plastic signs (Hughes, 1974). Wing also notes the facility of this group with finger sign language, although as all the clinicians who contributed here agree, few autistic children use signs. This comparison might be said to bring us close to the whole question of semantic and syntactic deep structures. The structure of this study group was based on a theoretically hierarchical pattern. Lenneberg and Smith present theoretical papers on syntax and phonology respectively, each matched with clinical papers which give rise to 3

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