Clinical note: acquired pragmatic impairments and aphasia

Recent advances in the field of communication sciences have led to the description of acquired communication disorders affecting pragmatic skills in patients with brain damage. The present article discusses the impact of such findings on the clinical concept of aphasia. Through reference to a number of articles contained in this Special Issue, it must be reiterated that pragmatic and other linguistic components of communication abilites are two sides of a same coin-that of language-and intimately interrelated. It is also argued that the difference between traditional (e.g., syntax) and pragmatic components of language cannot be explained in simple terms such as the former being subserved only by linguistic processes and the latter by other cognitive processes. Pragmatic components are thus to be considered as part of language. The evolution of the concept of language has a direct impact on the clinical concept of aphasia. Indeed, if aphasia corresponds to an acquired impairment of language, then pragmatic impairments must be considered part of aphasia. The inclusion of pragmatic impairments in the concept of aphasia does not hold only when they occur within the frame of classic types of aphasia, but also when they occur in isolation. Consequently, a new type of aphasia-pragmatic aphasia-should be considered and defined in order to describe the clinical condition of those individuals suffering from acquired pragmatic disorders as those reported among right-hemisphere-damaged right-handers. It is concluded that the recent evolution around the concept of language should be followed by an evolution of the concept of aphasia per se.