Charting the decline of pragmatics in adults with neurodegenerative disorders

Abstract Neurodegenerative diseases are one of the biggest health challenges of our time. They deprive individuals of their independence, reduce a person’s quality of life, and are a significant health and economic burden on societies around the world. A wide range of clinicians is involved in assessing, diagnosing and treating people with neurodegenerative diseases. But while neurologists, psychiatrists and geriatricians bring extensive medical expertise to the clinical care of patients, they lack knowledge of the language and communication processes that are disrupted by neurodegenerative disease. The assessment and treatment of language and communication in such patients falls within the remit of speech-language pathologists. This article examines what speech-language pathologists need to know in order to assess pragmatic language impairments in adults with neurodegenerative disease. Authentic language data are used to develop an informal ‘checklist’ that speech-language pathologists can consult to characterize the pragmatic language skills of adults with neurodegenerative disorders. The article begins with some general observations about assessment, such as the need to consider pragmatic strengths as well as weaknesses. It concludes with recommendations that, if adopted, can facilitate the pragmatic assessment of patients with neurodegenerative disorders by speech-language pathologists.