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The Handbook of
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The Handbook of
Language and Speech
Disorders

Edited by

Jack S. Damico, Nicole Müller, and

Martin J. Ball
Second Edition
This edition first published 2021
© 2021 John Wiley & Sons Ltd

Edition History
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Library of Congress Cataloging‐in‐Publication Data

Names: Damico, Jack S., 1952– editor. | Müller, Nicole, 1963– editor. | Ball,
Martin J. (Martin John), editor.
Title: The handbook of language and speech disorders / edited Jack S.
Damico, Nicole Müller, and Martin J. Ball.
Description: Second edition. | Hoboken, NJ : Wiley-Blackwell, 2021. |
Series: Blackwell handbooks in linguistics | Includes bibliographical
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Subjects: LCSH: Speech disorders. | Language disorders. | Communicative
disorders.
Classification: LCC RC423 .H3258 2021 (print) | LCC RC423 (ebook) | DDC
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10 9 8 7 6 5 4 3 2 1
Contents

List of Figures vii

Notes on Contributors ix

Introduction1
Jack S. Damico, Nicole Müller, and Martin J. Ball

Part I Foundations 5
1 Labeling as a Sociocultural Process in Communicative Disorders 7
Jack S. Damico, Nicole Müller, and Martin J. Ball
2 Diversity Considerations in Speech and Language Disorders:
A Focus on Training 33
Elena Babatsouli
3 Hearing Loss and Cochlear Implants 53
David Jackson Morris and Daan Van de Velde
4 Intelligibility Impairment 81
Katherine C. Hustad and Stephanie A. Borrie
5 Genetic Syndromes and Communication Disorders 95
Vesna Stojanovik
6 Principles of Assessment and Intervention 110
Bonnie Brinton, Martin Fujiki, and Robert Brinton Fujiki

Part II Language Disorders 129

7 Autism Spectrum Disorders 131
Patricia A. Prelock
8 Language Acquisition and Language Delay 152
Paul Fletcher
9 Developmental Language Disorder 171
Sandra L. Gillam, Sarai Holbrook, and Alan G. Kamhi
10 Pragmatic Impairment 192
Louise Cummings
11 Learning Disabilities 209
Christine Brennan
vi Contents

12 Literacy and Literacy Impairments 237

Holly Damico, Jack S. Damico, and Ryan Nelson
13 Language and Literacy in the Context of Early Life Adversity 266
Pamela Snow, Suze Leitão, and Natalie Kippin
14 Aphasia 286
Chris Code

Part III Speech Disorders 311

15 Children with Speech Sound Disorders 313
Susan Rvachew
16 Dysarthria 334
Ingo Hertrich, Hermann Ackermann, and Wolfram Ziegler
17 Apraxia of Speech 368
Adam Jacks and Katarina L. Haley
18 Augmentative and Alternative Communication: An Introduction 391
Kathryn D. R. Drager, Erinn H. Finke, and Elizabeth C.
Serpentine
19 Fluency and Fluency Disorders 414
John A. Tetnowski, Kathleen Scaler Scott, and Brittany
Falcon Rutland
20 Describing, Assessing, and Treating Voice Disorders 445
Richard J. Morris and Archie B. Harmon
21 Speech Disorders Related to Cleft Palate and
Velopharyngeal Dysfunction 468
Debbie Sell, Valerie Pereira, Yvonne Wren, and Jane Russell
22 Speech Disorders Related to Head and Neck Cancer:
Laryngectomy, Glossectomy, and Velopharyngeal and
Maxillofacial Defects 495
Tim Bressmann

Part IV Cognitive and Intellectual Disorders 529

23 ADHD and Communication Disorders 531
Carol Westby and Silvana M. R. Watson
24 Communication Deficits Associated with Right Hemisphere
Brain Damage 571
Margaret Lehman Blake
25 Traumatic Brain Injury 590
Karen Lê and Jennifer Mozeiko
26 Dementia 613
Nicole Müller and Zaneta Mok

Author Index 643

Subject Index 666
List of Figures

3.1 Age‐related hearing loss not caused by disease, noise or substance

exposure, as described in ISO 7029 (2012) for 40, 60 and 80 years of
age. Data are the means from the male and female values: thick line is
the median; boxes are the 25th and the 75th percentiles; and, whiskers
are the 10th and the 90th percentiles.   54
3.2 Descriptive model of an average postlingually deafened CI candidate
showing auditory performance as a function of hearing ability over
the entire patient journey. The duration of the decline of moderate
hearing loss (mHL) and severe/profound hearing loss (s/p HL) is
assumed to be 20 and 10 years, respectively.    59
6.1 Concentric circles of influence that impact quality of life.    113
8.1 Data from 4,867 parent reports on their (US) children’s performance
on the Words and Sentences form of the MBCDI.    155
8.2 Language Development Scale scores by family background for 132
UK children at 42 months.    156
14.1 The Wernicke-Lichtheim model.   290
14.2 The cognitive neuropsychological information processing model.   291
19.1 Trends in recovery from stuttering. Note the rapid decrease in stuttering
for the “recovered group” (●), while a slower decrease is noted for the
“persistent group” (◆). The control group shows little change (△).    427
19.2 The demands and capacities model—whenever demand exceeds
capacity, stuttering can occur.   431
21.1 Main categories of cleft lip and/or palate.   469
21.2 Consonant errors typical of speech in children born with cleft palate
(cleft speech characteristics). Palate in rest position for anterior and
posterior CSCs.   473
22.1 The double sigmoid curve model illustrates the fine balance between
tumor control and long-term radiation side-effects. As the radiation
dose increases over time, the cells in the radiated tissue start dying.
This process can be expressed as a sigmoid function. The tumor cells
are more vulnerable to the radiation. However, the surrounding
healthy tissue is also stressed by the radiation. The double sigmoid
viii List of Figures

curve model allows the radiation oncologist to determine a

­theoretical cutoff point at which the tumor is largely controlled
but the side-effects are still tolerable for the patient.   499
22.2 Permanent tracheostoma following total laryngectomy.   502
22.3 Tracheostoma cover.   503
22.4 Heat and moisture exchanger (“artificial nose”).   504
22.5 Transcervical electrolarynx.   505
22.6 Sound production with a transcervical electrolarynx.   506
22.7 Position of the transcervical electrolarynx on the neck.   507
22.8 An oral electrolarynx. The metal box contains the batteries and the
controls for the external oscillator. A tube is used to transmit the
sound from the oscillator into the oral cavity.   507
22.9 Sound production with an oral electrolarynx.   508
22.10 A laryngectomee using an oral electrolarynx.   508
22.11 Production of esophageal speech. (a) Air is injected into the upper
esophagus by building up pressure in the oral cavity. (b) As the air is
ejected from the upper esophagus, it vibrates the upper esophageal
sphincter and generates sound.   510
22.12 Sound production using a tracheoesophageal voice prosthesis.   512
22.13 Tracheoesophageal voice prostheses.   513
22.14 A large lateral lingual carcinoma.   516
22.15 Comparison of two patients with lateral lingual resections of
similar sizes. (a) Reconstruction using a local closure approach.
(b) Reconstruction using a radial forearm free-flap.   517
22.16 Patient with an extensive velopharyngeal resection.   520
22.17 Speech bulb appliance.   520
22.18 Patient with an extensive facial resection, including exenteration of
the right eye.   521
Notes on Contributors

Hermann Ackermann has a Master’s degree in philosophy and psychology, and a

medical degree (speciality: clinical neurology and neurophysiology). Besides his
clinical training in the field of neurology, he did postgraduate work, especially on
Parkinsonian and cerebellar dysarthria in the laboratory of Professor Wolfram
Ziegler, Departments of Neuropsychology at the Max Planck Institute for
Psychiatry, and the City Hospital Bogenhausen, Munich. Since 1996, he has been
Professor of Neurological Rehabilitation at the Medical School, University of
Tübingen, and head of the Research Group Neurophonetics at the HERTIE‐
Institute for Clinical Neurosciences, University of Tübingen. He is also head of the
Department of Neurological Rehabilitation at the Rehabilitation Center
Hohenurach, Bad Urach, associated with the University of Tübingen. His research
focuses on the brain correlates of speech production and speech perception, using
functional magnetic resonance imaging and magnetoencephalography.

Elena Babatsouli is an Assistant Professor in the Department of Communicative

Disorders at the University of Louisiana at Lafayette, the founding co‐editor of the
Journal of Monolingual and Bilingual Speech, President of the Association of
Monolingual and Bilingual Speech, and founder of the International Symposium
on Monolingual and Bilingual Speech. She received a BA in English from Royal
Holloway, University of London, an MA in Languages and Business from London
South Bank University, and a PhD in Linguistics from the University of Crete.
Elena’s research interests are on child/adult bilingual and monolingual (cross‐lin-
guistically) phonological acquisition and assessment, second‐language acquisi-
tion, speech sound disorders, culturally responsive practices in speech and
language sciences, phonetics/phonology, morphology, psycholinguistics, clinical
linguistics, and measures/quantitative methods. She has thirty publications, five
edited books, three conference proceedings, and two edited special issues in
journals.

Martin J. Ball is Honorary Professor of Linguistics at Bangor University, Wales,

having previously held positions in Wales, Ireland, the US, and Sweden. He holds
a PhD from the University of Wales, and a DLitt from Bangor University. He
x Notes on Contributors

co‐edits the journals Clinical Linguistics and Phonetics and Journal of Multilingual and
Bilingual Speech, as well as book series for Multilingual Matters and Equinox
Publishers. He has published widely in communication disorders, phonetics,
sociolinguistics, bilingualism, and Welsh linguistics. Recently he completed co‐
editing the four‐volume Encyclopedia of Human Communication Sciences and Disorders
for Sage publishers. He is an honorary fellow of the Royal College of Speech and
Language Therapists, and a fellow of the Learned Society of Wales. He currently
lives in Cork, Ireland.

Margaret Lehman Blake, PhD, CCC‐SLP, is a Professor in the Department of

Communication Sciences and Disorders at the University of Houston. She earned
her PhD from the University of Pittsburgh and completed a postdoctoral fellowship
at the Mayo Clinic. Her research focuses on cognitive‐communication disorders
associated with right hemisphere brain damage (RHD), to understand the under-
lying deficits and to develop treatments. She has authored many articles, chapters,
and the book The Right Hemisphere and Disorders of Cognition and Communication.
She has presented nationally and internationally on evidence‐based practice for
disorders associated with RHD. She is a recipient of the University of Houston
Teaching Excellence Award and has served as the President of the Academy of
Neurologic Communication Disorders & Sciences (ANCDS).

Stephanie A. Borrie, PhD, is an Associate Professor of Communication Disorders

at Utah State University. She is also the director of the Human Interaction Lab,
which takes a dyadic approach to the study of speech communication. Her research
investigates how listeners understand and adapt to speakers with dysarthria,
laying the groundwork for listener‐targeted interventions to improve intelligi-
bility of dysarthric speech. She also investigates the coordinative nature of spoken
dialog, extending the study of speech impairment to the realm of conversation.
Her research is currently funded by the National Institutes of Health, National
Institute on Deafness and other Communication Disorders (USA). She serves as an
editor for the Journal of Speech, Language, Hearing Research, a journal of the American
Speech, Language, and Hearing Association.

Christine Brennan is an Assistant Professor in the Department of Speech,

Language, and Hearing Sciences at the University of Colorado, Boulder, where she
is also a member of the Institute of Cognitive Science and Intermountain
Neuroimaging Consortium (INC). She holds a PhD and a clinical MA from
Northwestern University, Illinois. She is a certified speech‐language pathologist
and a cognitive neuroscientist. As the director of the ANCHAR Lab (Applied
Neuroscience for Communication, Hearing, And Reading), her current research
examines the relationship between speech sound processing and reading skill in
children and adults with and without reading disabilities. She also engages in
research examining clinical outcomes for children and adults with various types of
learning disabilities, including developmental and intellectual disabilities.
Presently, she is the only speech‐language pathologist serving on the professional
 Notes on Contributors xi

advisory board for the PRISMS (Parents and Researchers Interested in Smith‐
Magenis Syndrome) organization. She lives in Louisville, Colorado.

Tim Bressmann is an Associate Professor in the Department of Speech‐Language

Pathology at the University of Toronto. He studied at the University of Freiburg
and Trinity College Dublin before obtaining an MA in Clinical Linguistics from the
University of Bielefeld. He then worked as a clinician in different hospitals while
also studying for his PhD in Phonetics at the University of Munich. Tim Bressmann’s
research focuses on speech production in individuals with craniofacial syndromes
and head and neck cancer. He is a Section Editor of the Cleft Palate‐Craniofacial
Journal and an Associate Editor of Clinical Linguistics and Phonetics.

Bonnie Brinton is professor emeritus at Brigham Young University (BYU), Provo,

Utah. Her work focuses on assessment and intervention with children who expe-
rience difficulty with social communication. Dr Brinton has been a professor at the
University of Nevada, a research scientist at the Schiefelbusch Institute for Lifespan
Studies, University of Kansas, and Dean of Graduate Studies at BYU. She is a fel-
low of the American Speech‐Language‐Hearing Association and received Honors
of the Association in 2019.

Chris Code is Professorial Research Fellow in the Department of Psychology,

Washington Singer Labs, University of Exeter, England. He is the Foundation
Professor of Communication Sciences and Disorders at the University of Sydney
and past Research Manager for Speakability, and Patron of AphasiaNow. He is also
co‐founding Editor of the journal Aphasiology. His research interests include the
cognitive neuroscience of language and speech, psychosocial consequences of
aphasia, recovery and treatment of aphasia, the evolution of speech and language,
number processing, and apraxia.

Louise Cummings is Professor in the Department of English and Associate Dean

in the Faculty of Humanities at The Hong Kong Polytechnic University. She teaches
and conducts research in pragmatics, clinical linguistics, and health reasoning. She
is the author and editor of 18 books, including most recently Fallacies in Medicine
and Health (Palgrave Macmillan, 2020), Language in Dementia (Cambridge University
Press, 2020) and Pragmatic Language Disorders (Springer, 2021). She is editor of the
book series Routledge Research in Speech‐Language Pathology. Louise Cummings has
been a Visiting Fellow in the Department of Philosophy at Harvard University,
and the Centre for Research in the Arts, Social Sciences and Humanities (CRASSH)
at Cambridge University. She is a member of the Royal College of Speech and
Language Therapists, the Health & Care Professions Council in the UK, and the
Hong Kong Academy of Humanities.

Holly Damico is an Associate Professor at the University of Louisiana at Lafayette,

and a Hawthorne‐BoRSF Endowed Professor. She co‐founded and co‐directs the
Summer Language and Literacy Project. Her clinical and research interests include
language and literacy acquisition and intervention as contextualized and social
xii Notes on Contributors

transactional processes, with a focus on qualitative research methods. She has

authored and co‐authored 18 peer‐reviewed book chapters and articles in those
areas. She received the 2017–18 Rising Star Researcher Award in Liberal Arts at UL
Lafayette.

Jack S. Damico is a clinical linguist and a speech‐language pathologist with a

Master’s degree in communicative disorders and a PhD in linguistics. With over
12 years of clinical experience as a speech‐language pathologist in the public
schools, medical settings, and in private practice, his research focuses on the
authentic implications for individuals with atypical language and communication
skills, and on the development of clinical applications to assist in overcoming com-
municative problems. Working primarily in the areas of aphasia in adults and lan-
guage and literacy difficulties in children from both monolingual and bilingual
backgrounds, he specializes in the utilization of various qualitative research meth-
odologies to investigate language and communication as social action. An ASHA
Fellow, he is the co-editor of the Journal of Interactional Research in Communication
Disorders. He has recently joined the University of Colorado Boulder faculty after
28 years as the Doris B. Hawthorne Eminent Scholar Chair at the University of
Louisiana at Lafayette.

Kathryn D. R. Drager, PhD, CCC‐SLP, is a Professor of Communication Sciences

and Disorders, and Associate Dean for Research and Graduate Education in the
College of Health and Human Development, at the Pennsylvania State University.
Her research interests include AAC for individuals with severe expressive com-
munication disorders, especially for children, adolescents, and adults with severe
disabilities who are at the beginning stages of communication, including children
with autism. She is also interested in issues faced by the global community in
AAC. She has more than 60 publications and over 160 presentations at local,
national, and international conferences. She has served several terms and is cur-
rently on the Associate Editor board of Augmentative and Alternative Communication.

Erinn H. Finke, PhD, CCC‐SLP, is an Associate Professor of Audiology and Speech

Pathology, at the University of Tennessee Health Science Center. Her research is
focused on understanding and improving friendship outcomes and interactions
for individuals with autism spectrum disorder, including those who use augmen-
tative and alternative communication. She is also interested in how technology
(games and applications) can be used to provide a supportive context for social
interactions. She has more than 20 publications and over 60 presentations at local,
national, and international conferences. She is currently a Section Editor for the
American Journal of Speech‐Language Pathology.

Paul Fletcher is Emeritus Professor of Speech and Hearing Sciences, University

College Cork, Ireland. He previously held professorial positions at the University
of Reading and the University of Hong Kong. He has published widely on lan-
guage development and language impairment in children learning English, and
more recently in children acquiring Cantonese and Mandarin. His primary
 Notes on Contributors xiii

research interest is the acquisition of grammar, but he has also worked on vocabu-
lary, particularly the assessment of vocabulary development in young children via
parent report. He is a past president of the International Association for the Study
of Child Language, and an honorary member of the Irish Association of Speech
and Language Therapists.

Martin Fujiki is professor emeritus at Brigham Young University (BYU), Provo,

Utah. His work focuses on social competence in children with developmental lan-
guage disorders. Dr Fujiki has been a professor at the University of Nevada and
BYU, and a research scientist at the Schiefelbusch Institute for Lifespan Studies,
University of Kansas. He is a fellow of the American Speech‐Language‐Hearing
Association and received Honors of the Association in 2015.

Robert Brinton Fujiki earned a BFA in Music‐Dance Theater and an MS in

Communication Disorders from Brigham Young University. He is currently a PhD
candidate at Purdue University. He has clinical and research experience in voice
and swallowing disorders in adults and children.

Sandra L. Gillam is a Professor in the Department of Communicative Disorders

and Deaf Education at Utah State University, and a past Vice President for Speech
Language Pathology Practice for the American Speech Language Association. She
holds a PhD from the University of Memphis. Her research interests include
assessment and intervention of language and literacy impairments, multicultural
populations, and processes involved in text comprehension. Sandi was the PI on a
Goal II IES grant to develop narrative intervention procedures, and is currently
Co‐PI on a Goal III grant to conduct a randomized controlled trial of the narrative
program.

Katarina L. Haley, PhD, CCC‐SLP, is Professor in the Division of Speech and

Hearing Sciences, Department of Allied Health Sciences, University of North
Carolina School of Medicine. She holds PhD and MS degrees from Vanderbilt
University in Nashville, Tennessee, and a BS from Karolinska Institutet in
Stockholm, Sweden. She teaches courses on neurological communication disor-
ders, particularly aphasia. She specializes in assessment and treatment of adults
with left hemisphere brain lesions. Her research focuses on speech production,
apraxia of speech, development of quantitative speech assessment procedures,
and client‐centered treatment.

Archie B. Harmon is an Assistant Professor of Otolaryngology at Washington

University School of Medicine in St Louis. Dr Harmon is a fellowship‐trained
speech pathologist with clinical expertise in voice therapeutic outcomes, the aging
larynx, and paradoxical vocal fold motion. His research interests include voice
treatment adherence and voice therapy outcomes.

Ingo Hertrich is Professor at the University of Tübingen, Germany, working as

lecturer in phonetics and phonology at the Linguistics Department, and researcher
xiv Notes on Contributors

in Neurobiology of Language at the Department of Neurology and Stroke and the

Hertie Institute for Clinical Brain Research. He holds a PhD from the University of
Munich in physical anthropology. He has published in the fields of acoustic pho-
netics, kinematic analysis of speech articulation, voice analysis, magnetoencepha-
lography, functional magnetic resonance imaging, and transcranial magnetic
stimulation. These studies considered various clinical aspects, but also included
experimental work with healthy subjects in order to contribute to a functional‐
anatomic model of speech and language processing in the brain.

Sarai Holbrook is an assistant professor in the School of Communication Sciences

and Disorders in the College of Professional Studies at the University of Wisconsin‐
Stevens Point. She holds the Certificate of Clinical Competence in speech‐language
pathology from the American Speech‐Language‐Hearing Association. Her research
interests include assessment and intervention for social communication in children
with autism spectrum disorder, language intervention for children with develop-
mental language disorder, and the scholarship of teaching and learning.

Katherine C. Hustad, PhD, CCC‐SLP, is Professor of Communication Sciences and

Disorders at the University of Wisconsin – Madison. She is also an investigator at
the Waisman Center. Professor Hustad’s research focuses on characterizing and
enhancing speech, language, and communication development and outcomes in
children with cerebral palsy. She also studies variables that influence speech intel-
ligibility, with a special emphasis on augmentative/alternative communication
interventions. A primary objective of her work is to generate a theoretically driven,
data‐based longitudinal model of speech and language development in cerebral
palsy that can be used to predict outcomes, develop and test interventions, and
guide treatment decisions. Professor Hustad has a strong interest in bridging
research with clinical practice. Her work has been funded by the National Institutes
of Health, National Institute on Deafness and other Communication Disorders
(USA) since 2003. She is a fellow of the American Speech, Language, and Hearing
Association.

Adam Jacks, PhD, CCC‐SLP, is Associate Professor in the Division of Speech and
Hearing Sciences, Department of Allied Health Sciences, University of North
Carolina School of Medicine. He holds PhD and MA degrees from the University
of Texas at Austin and a BA from Duke University in Durham, North Carolina. He
teaches courses on speech science and motor speech disorders. His research
focuses on understanding the link between neuropathology and behavioral mani-
festations of neurological speech disorders, investigating novel interventions for
people with aphasia and apraxia of speech, and identifying factors associated with
improved quality of life with aphasia.

Alan G. Kamhi is a Professor of Communication Sciences and Disorders at UNC‐

Greensboro Department of Communication Sciences and Disorders at the
University of North Carolina‐Greensboro. His early research focused on linguistic
and cognitive abilities of children with specific language impairments (SLI) and
 Notes on Contributors xv

mental handicaps. Later research focused on language‐learning disabilities, culmi-

nating in a book co‐edited with Hugh Catts, on language and reading disabilities.
The third edition of this book was published in 2012. Recent articles have consid-
ered how to balance certainty and uncertainty in clinical practice, what SLPs need
to know about auditory processing disorders, how to improve clinical practices for
children with language and learning disorders, and how to assess and treat reading
comprehension problems.

Natalie Kippin is a certified practicing speech‐language pathologist and is cur-

rently completing a PhD with Telethon Kids Institute and Curtin University in
Perth, Western Australia. She is a Member of Speech Pathology Australia and the
Public Health Association of Australia. Natalie’s clinical and research areas include
the oral and written communication skills of adolescents who are involved with
youth justice, including those who have been exposed to alcohol prenatally. Natalie
is the inaugural Chair of the justice‐related child health research interest group at
Telethon Kids Institute. She also has a background in health promotion and has
worked as a youth custodial officer in an Australian youth detention centre.

Karen Lê is a speech‐language pathologist in the VA Connecticut Healthcare

System where she developed the cognitive‐communication rehabilitation program,
and serves on the interdisciplinary Polytrauma Support Clinic Team. She is a
member of the Student Veteran Community of Practice Workgroup within the VA.
Her research interests include the study of discourse following traumatic brain
injury, the development of sensitive and reliable discourse measures for clinical
use, discourse intervention, and the impact of mental health and neurologic
comorbidities on discourse ability. She holds a PhD from the Department of
Speech, Language, and Hearing Sciences at the University of Connecticut.

Suze Leitão is an Associate Professor of Speech Pathology at Curtin University,

Western Australia, Director of Graduate Research, and a clinical speech patholo-
gist. She is a Life Member and Fellow of Speech Pathology Australia, recently com-
pleting nine years as the Chair of the National Ethics Board of SPA. She is on the
Board of the International Journal of Speech‐Language Pathology and Child Language
Teaching and Therapy. Her research interests encompass theory, assessment, and
intervention for children and young people with language disorder and develop-
mental language disorder. She has published extensively in these areas with her
research group: Language and Literacy in Young People. She grew up in Europe,
trained and lived in the UK, and currently lives in Fremantle, Western Australia.

Zaneta Mok is a lecturer in speech pathology at Australian Catholic University.

She also works in a quality and research capacity at a major Australian hospital
service. Her research interests include aphasia and dementia, and speech pathology
in culturally and linguistically diverse communities. She is especially interested in
topics related to social interaction and functional discourse. Her recent publica-
tions include papers on outcome measures for communication partner training,
and repair mechanisms in conversations involving people with dementia.
xvi Notes on Contributors

David Jackson Morris is an Associate Professor at the Department of Nordic

Studies and Linguistics, University of Copenhagen, Denmark. He is originally
from Australia and is a graduate of Griffith University and the University of
Queensland. He holds a PhD from the University of Copenhagen and has also
held positions at Lund University, Sweden. Prior to postgraduate studies in
Scandinavia, David worked in the diagnostic instrument and hearing aid indus-
tries. With a diverse network of collaborators he investigates receptive communi-
cation, particularly electrophysiological measures of speech perception, cochlear
implant listening, phonemic restoration, and clinical issues involved in resolving
functional hearing loss. As an educator David lectures in a combined Speech
Pathology and Audiology degree program and convenes a graduate course in
electroencephalography methods.
Richard J. Morris, PhD, is a Professor in the School of Communication Science and
Disorders at Florida State University. Dr Morris is the director of the Special
Summer Program in Communication Disorders at the FSU London Centre. He has
taught courses on the anatomy and physiology of speech and hearing, the acous-
tics of speech, critical thinking and communication disorders, voice disorders, eth-
ical research practice, and acoustics of the singing voice. His main research interests
are acoustic and physiological phonetics, and the assessment and teaching of criti-
cal thinking skills. He has presented and published papers on age‐related changes
in speech and voice, speech acoustics, the effects of neuromuscular electrical stim-
ulation on voice, the acoustics and physiology of the classically trained singing
voice, acoustics of choral singing, the assessment of thinking skills, and the
teaching of thinking skills.
Jennifer Mozeiko is a licensed speech‐language pathologist, Assistant Professor,
and researcher directing the Aphasia Rehab Lab at the University of Connecticut.
After earning her BA, she worked at the Harvard School of Public Health, spent a
year teaching English in Hong Kong, and then returned to Boston where she
worked in e‐commerce for several years before pursuing her interest in language
disorders following brain injury. She received her MA and PhD at the University
of Connecticut where she is now a faculty member. Her research is focused on
improving treatment and the quality of life of people with acquired brain injury.

Nicole Müller is Professor and Head of the Department of Speech and Hearing
Sciences, University College Cork, Ireland and Visiting Professor at Linköping
University, Sweden. She has previously held professorships in the United States
and Sweden. Her research interests include multilingualism and neurogenic and
neurodegenerative conditions leading to cognitive‐communicative impairments.
She is co‐editor of the journal Clinical Linguistics and Phonetics (Taylor & Francis)
and of the book series Communication Disorders Across Languages (Multilingual
Matters). She has published widely in journal and book form and was awarded
a Fulbright scholarship in 2014 to study bilingual Irish–English communication
in a retirement home in the west of Ireland. Among her recent publications are
co‐edited collections on sonority and on cross‐linguistic language acquisition.
 Notes on Contributors xvii

Ryan Nelson, PhD, CCC‐SLP, holds the rank of associate professor and Head of
the Department of Communicative Disorders at the University of Louisiana at
Lafayette. Prior to joining the faculty at UL Lafayette, Dr Nelson held the rank of
assistant professor at the University of Texas at El Paso. He has worked as a speech‐
language pathologist in public school settings and in private practice. His work
embodies collaboration with mentors, former students, and colleagues from many
disciplines. Dr Nelson has published and presented nationally and internationally
in the areas of language impairment, literacy, counseling in communicative disor-
ders, qualitative research, eye‐tracking, and autism.

Valerie Pereira is Senior Lecturer at the Chinese University of Hong Kong,

Department of Otorhinolaryngology, Head & Neck Surgery. She is a major
academic teaching staff member for the Master of Science in Speech‐Language
Pathology, and is the Programme Leader of the Professional Diploma in
Communication Disorders and Sciences. She is also an Honorary Assistant
Professor with the University of Hong Kong, Department of Oral Maxillofacial
Surgery, as the Speech Therapist for the Joint Cleft & Nasendoscopy Clinics. She
obtained her PhD from UCL Institute of Child Health, London, UK, with a disser-
tation titled The effect of maxillary osteotomy on speech, nasality and velopharyngeal
function, and was previously with the North Thames Regional Cleft Service and
the Supraregional Craniofacial Service, both based at Great Ormond Street
Hospital for Children NHS Foundation Trust in London. She is the current Chair
of the Cleft Palate and Craniofacial Committee of the International Association of
Communication Sciences and Disorders.

Patricia A. Prelock, PhD, is Provost and Senior Vice‐President, University of

Vermont. She is a Professor of Communication Sciences & Disorders in the College
of Nursing and Health Sciences, and Professor of Pediatrics in the College of
Medicine at the University of Vermont. She received her PhD from the University
of Pittsburgh. Dr Prelock is an Associate Editor for the Journal of Autism and
Developmental Disorders. She was named an ASHA Fellow in 2000 and a University
of Vermont Scholar in 2003. In 2015 Dr Prelock was named a Distinguished Alumna
of the University of Pittsburgh. In 2016, she received the ASHA Honors of the
Association. She is a Board‐Certified Specialist in Child Language and was named
a Fellow in the National Academies of Practice (NAP) in speech‐language
pathology in 2018. She was the 2013 President for the American Speech‐Language‐
Hearing Association.
Susan Rvachew, PhD, S‐LP(C), ASHA Fellow, is a Professor at McGill University
and Director of the School of Communication Sciences and Disorders. Her research
is concerned with the normal development of speech and phonology, the treatment
of speech sound disorders in children, and the relationship between phonological
disorders and delays in the acquisition of literacy skills. Dr Rvachew has pub-
lished over 90 articles, chapters and encyclopedia entries as well as two books. She
has also developed three phonology assessments for French‐speaking children,
and three English‐language software tools for assessment and intervention.
xviii Notes on Contributors

Jane Russell is now retired from clinical and academic work. For many years she
was Lead Specialist Speech & Language Therapist working with children and adults
with orofacial anomalies and velopharyngeal dysfunction at the West Midlands
Centre for Cleft Palate based in Birmingham, UK. She specialized in this field from
1978, and in 1991 completed her PhD with a dissertation entitled Speech development
in children with cleft lip and palate. She is a Fellow of the Royal College of Speech and
Language Therapists. Following retirement from clinical work, Jane continued to
contribute to research in various ways including speech analysis. Unfortunately, she
could no longer continue with this, after a change in personal circumstances in 2017.

Brittany Falcon Rutland, MCD, CCC‐SLP is a doctoral candidate at the University

of Louisiana at Lafayette where she is specializing in fluency disorders. She is a
person who stutters and has nine years of experience working in a private practice
with children and adults who stutter. She has presented at local, national, and
international conferences.

Kathleen Scaler Scott is a practicing speech‐language pathologist, Board Certified

Fluency Specialist, and Associate Professor of Speech‐Language Pathology at
Monmouth University, New Jersey, USA. Her research interests are largely in clut-
tering, atypical disfluency, and clinician training and treatment effectiveness. She
is the co‐editor of Cluttering: A Handbook of Research, Intervention, and Education
(Psychology Press, 2011), co‐author of Managing Cluttering: A Comprehensive
Guidebook of Activities (Pro‐Ed, Inc., 2013), and author of the newly released book
Fluency Plus: Managing Fluency Disorders in Individuals with Multiple Diagnoses
(SLACK, Inc.). Dr Scaler Scott has spoken nationally and internationally on the
topics of fluency and social pragmatic disorders. She was the first Coordinator of
the International Cluttering Association, and is the recipient of the 2018 Deso
Weiss Award for Excellence in the Field of Cluttering, and the 2018 Professional of
the Year award from the National Stuttering Association.

Debbie Sell, PhD, OBE, is a Senior Research Fellow at Great Ormond Street
Hospital NHS Foundation Trust (GOSH), London, UK, previously having been
Head of Speech and Language Therapy (SLT) Services and Lead Therapist in the
North Thames Regional Cleft Service there. Debbie now focuses on research, men-
toring, supervision, teaching, and independent clinical practice. Her PhD study in
Sri Lanka (speech in patients with unoperated and late operated cleft palate) led to
that country’s only SLT training course. Debbie has led on developing and testing
speech outcome tools in cleft palate/VPI, setting standards for measuring speech
outcomes and has participated in several multicenter national and international
studies of speech outcome. Debbie’s current interests focus on parents under-
taking articulation therapy in children with cleft palate, supported by therapists
and technology, and is a co‐Founder, together with Dr Triona Sweeney, of Speech
at Home ([email protected]). Debbie is a Fellow of the Royal College of
Speech and Language Therapists, has co-edited two text books and has more than
90 peer reviewed publications.
 Notes on Contributors xix

Elizabeth C. Serpentine, PhD, CCC‐SLP, is a speech‐language pathologist with

almost 20 years of experience in the public school system. She currently works in
the Lower Merion School District and also teaches as an adjunct instructor in the
Department of Special Education at Saint Joseph’s University, and in the
Department of Communication Sciences and Disorders at Baylor University. She
also holds a Supervisor of Special Education Certificate in the state of Pennsylvania.
Her areas of clinical and research expertise include the use of evidence‐based prac-
tice, social competence, and transition/employment issues for individuals with
autism spectrum disorder.

Pamela Snow is Professor of Cognitive Psychology in the School of Education at

La Trobe University, Bendigo, Australia. She is a speech‐language pathologist
and a registered psychologist. Her research spans various aspects of risk in
childhood and adolescence, particularly as these pertain to the emergence of oral
language skills and the transition to literacy in the school years. Accordingly, she
has researched children and adolescents in state care, adolescents in the youth
justice system and also those in flexible education settings, and early years
reading instruction practice in mainstream schools. She is a Life Member of
Speech Pathology Australia, and in 2017 co‐authored Making Sense of Interventions
for Children with Developmental Disorders with Dr Caroline Bowen, AM. Pamela is
on the Editorial Board of First Language and is an Associate Editor of The Reading
League Journal.

Vesna Stojanovik is a Professor of Clinical Linguistics at the School of Psychology

and Clinical Language Sciences at the University of Reading. She holds a BA in
English Language and Literature and French Language and Literature from the
University of Ss Cyril and Methodius, Skopje, North Macedonia; an MA in
Linguistics and English Language Teaching from the University of Leeds, and a
PhD in Human Communication Sciences from the University of Sheffield. Her
main research interests include speech, language, and communication disorders in
atypical populations, particularly children affected by genetic syndromes such as
Williams and Down syndrome, as well as early intervention for children with
Down syndrome. Vesna is currently the vice‐president of the International Clinical
Phonetics and Linguistics Association.

John A. Tetnowski is the Jeanette Sias Endowed Chair in Communication Sciences

and Disorders at Oklahoma State University. He has over 80 publications in the
areas of fluency disorders, research methodologies, and clinical interventions. He
is a board‐certified fluency specialist and holds the Certificate of Clinical
Competence from the American Speech‐Language‐Hearing Association. He has
mentored 15 doctoral students to completion and has presented his work on five
continents. He is a fellow of the American Speech‐Language‐Hearing Association.
Previously, he was the Ben Blanco Endowed Professor of Communicative Disorders
at the University of Louisiana‐Lafayette.
xx Notes on Contributors

Daan van de Velde is lecturer and researcher at Leiden University Centre for
Linguistics (LUCL) in the Netherlands, where he completed studies in General
Linguistics and French Language and Culture. He holds a PhD from Leiden
University on the topic of speech perception and production by cochlear implant
users. He lectures and performs research in the field of (clinical) phonetics, applied
linguistics, and psycholinguistics, including topics such as the comparison of lan-
guage and music, and perception and production of prosody. Other areas of
interest are language and speech technology and language change. Daan is co‐
developer of a software application allowing Dutch university students to auton-
omously practice their pronunciation of French.

Silvana M. R. Watson is a professor of special education at Old Dominion

University, Norfolk, VA. She earned her doctoral and master’s degrees in special
education at the University of New Mexico, Albuquerque. She has published and
presented nationally and internationally on attention deficit disorders, executive
functions, intervention for students with learning disabilities, and on issues of
multilingual learners. She received a Fulbright Scholar award and conducted
research in Portugal. She currently is the principal investigator of a professional
development grant to prepare in‐service and pre‐service teachers to assess and
instruct English learners with and without disabilities. Dr Watson is a co‐principal
investigator of a National Science Foundation grant to study the effects of pair
programming on undergraduate students with learning disabilities. She is a past
president of the Council for Learning Disabilities.

Carol Westby is a consultant for Bilingual Multicultural Services in Albuquerque,

New Mexico, and holds an affiliated appointment in Communication Disorders at
Brigham Young University in Provo, UT. She has published and presented nation-
ally and internationally on play, theory of mind, language‐literacy relationships,
ADHD, narrative/expository development and facilitation, screen time, under-
standing and working with children and families who have experienced trauma,
and issues in assessment and intervention with culturally/linguistically diverse
populations She is a fellow of the American‐Speech‐Language‐Hearing Association
(ASHA), has received the Honors of ASHA, and is Board Certified in Child
Language. Dr Westby has received the Distinguished Alumnus Award from
Geneva College and the University of Iowa’s Department of Speech Pathology
and Audiology, and the ASHA Award for Contributions to Multicultural Affairs.

Yvonne Wren is Director of Bristol Speech and Language Therapy Research Unit,
North Bristol NHS Trust, and Senior Research Fellow at the University of Bristol.
She is Chair of the Child Speech Committee of the International Association of
Communication Sciences and Disorders, and founded the UK and Ireland Child
Speech Disorder Research Network. She is Chief Investigator of the Cleft Collective
Speech and Language Study, a national clinical cohort study of children born with
cleft lip and palate in the UK. She is on the Research Council for the charity The
Scar Free Foundation, and a trustee for ICAN, the charity serving the needs of
 Notes on Contributors xxi

children with communication impairments. She was Associate Editor of Folia

Phoniatrica et Logopedica from 2016–2019 and co‐edited the book Creating Practice
Based Evidence: A Guide for SLTs (JR Press), now in its second edition.

Wolfram Ziegler is Professor of Neurophonetics and head of the Clinical

Neuropsychology Research Group (EKN) at the Institute of Phonetics and Speech
Processing, University of Munich. He has a diploma and PhD in Mathematics
from the Technical University of Munich and spent 10 years as a research assistant
at the Max Planck Institute for Psychiatry. From 1995 to 2015 he headed the EKN
at the Clinic for Neuropsychology, City Hospital Bogenhausen in Munich, and
since 2015 at the LMU Munich. His research focus is on speech and language dis-
orders in neurologic populations.
 Introduction
JACK S. DAMICO1, NICOLE MÜLLER2,
AND MARTIN J. BALL3
1
University of Colorado, Boulder, CO, USA
2
University College Cork, Ireland, and Linköping University, Sweden
3
Bangor University, Wales

It is now just under a decade since the first edition of this Handbook appeared, and
in that time the field of communication disorders has progressed on many fronts.
Certain areas have come to prominence that were not previously the focus of
research. Among these areas are the speech and language consequences for chil-
dren who have received cochlear implants, genetic syndromes other than Down
syndrome, and literacy problems (especially the role of writing as well as reading).
In this second edition, and to reflect these and other recent developments in the
field, we recruited internationally renowned experts as new chapter authors. The
chapters on hearing impairment, literacy, and genetic syndromes have been radi-
cally refocused, while all other chapters present updated material. Further, the
chapter on language delay (apart from having a new author) encompasses pat-
terns of typical as well as disordered language development. The chapter on
specific language impairment was retitled to reflect the now‐accepted label of this
disorder: developmental language disorder.
We have retained the four‐part structure of the Handbook as we feel it is a useful
way to present the main topics within language and speech disorders. In Part I the
chapters address foundational issues. Thus, the first chapter by Jack Damico,
Nicole Müller and Martin Ball examines labeling. By this term the authors mean
the tendency of people to label others as deviating from a norm—a common prac-
tice with communication disorders. The chapter discusses the social background
to labeling and points to ways in which communication specialists can become
aware of labeling and avoid its negative consequences.
In Chapter 2, Elena Babatsouli discusses diversity issues in communication dis-
orders, dealing with a range of topics including diversity in terms of language,
gender, ethnicity, socioeconomic status, and others. As well as describing a variety
of diversity concerns. the author also addresses the application of this information
to clinical situations.

The Handbook of Language and Speech Disorders, Second Edition. Edited by Jack S. Damico,
Nicole Müller, and Martin J. Ball.
© 2021 John Wiley & Sons Ltd. Published 2021 by John Wiley & Sons Ltd.
2 Introduction

The Handbook is primarily concerned with language and speech disorders and
does not aim to cover hearing impairment in detail. Nevertheless, hearing loss and
rehabilitation (through, for example, cochlear implantation) do impact speech and
language abilities. Chapter 3 by David Morris and Daan van de Velde discusses this
area. Recent developments in cochlear implants are examined in detail and the
authors also describe auditory brainstem implants for those for whom cochlear
implants are not suitable. Intelligibility impairment can be found in a wide range of
language and speech deficits from child speech disorders, through aphasic language
disorders, to adult acquired motor speech disorders. In Chapter 4, Katherine Hustad
and Stephanie Borrie first define intelligibility (a not uncontroversial task!) and then
describe ways of measuring it and developmental aspects of intelligibility.
Chapter 5 presents a range of genetic syndromes that can affect language and
speech. Vesna Stojanovik covers Williams syndrome and Down syndrome in
detail, dealing with communication problems encountered by these speakers. She
also points forward to the need for neurocognitive investigations of typical
development to better understand the impairments found in genetic syndromes.
The final chapter in Part I of the book also applies across the field of language
and speech disorders. Bonnie Brinton, Martin Fujiki, and Robert Brinton Fujiki dis-
cuss the related areas of assessment and intervention in speech‐language pathology.
They stress the importance of the social context of communication and the need to
bear this in mind in both assessment and intervention. The chapter provides step‐
by‐step advice on how to undertake these two aspects of the speech‐language
pathologist’s practice, whatever communication problem is involved.
Part II of the Handbook contains eight chapters dealing with different language dis-
orders. In disordered language, various linguistic features can be disturbed, ranging
from lexical items (e.g., word‐finding difficulties), through morphology and syntax
(missing or incorrect affixes, sentence ordering difficulties) to semantics and prag-
matics (inaccurate assigning of meaning to words, inappropriate use of language for
a specific context). The chapters in this part of the book highlight which of these fea-
tures are most important in the specific disorder under discussion, but they are not
limited to this. For example, Patricia Prelock, in her chapter on autism, describes the
linguistic markers of this disorder, but also discusses at length the recent changes to
the classification of autism and highlights the importance of appropriate assessment
and intervention. Paul Fletcher in Chapter 8 outlines the typical trajectories of lan-
guage acquisition, highlighting the wide variation in this process between individ-
uals encompassing both vocabulary and grammar. He also points to good practice in
assessment upon which to base appropriate intervention for children with various
patterns of delay in language acquisition. Sandi Gillam, Sarai Holbrook, and Alan
Kamhi in Chapter 9 focus on the language disorder formerly termed “specific lan-
guage impairment” and recently renamed “developmental language disorder.” The
authors discuss the attempts to characterize the disorder and to discover the under-
lying causes, but also point to successful therapeutic strategies and the need for early
intervention. In Chapter 10 Louise Cummings addresses the pragmatics of language
use. She illustrates many types of pragmatic impairments from a variety of speakers
and discusses ways of assessing pragmatic impairment and intervention strategies.
 Introduction 3

In Chapter 11, Christine Brennan examines learning disabilities and their impact
on the development of communication. In particular, she points to the different
outcomes in adulthood between treated and untreated learning difficulties. The
following chapter by Holly Damico, Jack Damico, and Ryan Nelson deals with
literacy impairments. A development in this second edition has been to look more
closely at writing rather than concentrating mainly on reading. The chapter stresses
the importance of a meaning‐based approach to literacy teaching and interven-
tion. Pamela Snow, Suze Leitão, and Natalie Kippin in Chapter 13 describe com-
munication outcomes in children who have suffered early life adversity. They note
that such children may not only demonstrate less‐developed language skills, but
will also have trouble in moving from speaking and listening to reading and
writing. The last chapter of Part II deals with aphasia, a multifaceted disorder
affecting both the production and perception of communication. Chris Code pro-
vides a detailed description of the many types of aphasia, and then concentrates
on effective intervention strategies and the need to reintegrate people with aphasia
into the community.
Part III of the Handbook also contains eight chapters, this time dealing with
speech disorders. Speech disorders can range from impairments to the speech pro-
duction mechanisms to problems with the organization of speech sounds in the
linguistic system. Causes can range from delays to normal developmental path-
ways to acquired neurological damage due to stroke or other injury via genetic or
surgical damage to vocal organs. The first three chapters deal with what are often
considered the core areas of speech disorders. Thus, Chapter 15 by Susan Rvachew
describes child speech disorders; Ingo Hertrich, Hermann Ackermann, and
Wolfram Ziegler deal with dysarthria in Chapter 16; and in Chapter 17, Adam
Jacks and Katarina L. Haley cover apraxia of speech. The focus of Chapter 15 is the
heterogeneity of child speech disorders and the need to tailor intervention to the
four main subtypes identified in the chapter. Hertrich and colleagues address the
wide range of dysarthria subtypes and how they relate to specific neurological
conditions. They include assessment and treatment methods, and how to measure
the efficacy of therapy. As well as presenting the characteristics of apraxia of
speech, Jacks and Haley argue for a common set of speech characteristics to be
used in the diagnosis of apraxia of speech in both children and adults. They also
discuss treatment approaches and describe those approaches that so far seem most
efficacious.
Chapter 18 by Kathryn Drager, Erinn Finke, and Elizabeth Serpentine deals
with augmentative and alternative communication (AAC) for those with minimal
or no speech abilities. The authors describe the range of AAC approaches and
stress the need for individually tailored solutions to the communication needs of a
highly variable clinical population.
The next two chapters cover two specialized areas of speech impairment: flu-
ency disorders and voice disorders. In Chapter 19, John Tetnowski, Kathy Scaler
Scott, and Brittany Rutland describe normal and disordered fluency. In particular
they point to major advances in both understanding the underlying causes of
stuttering and in assessment and treatment, since their chapter in the first edition
4 Introduction

of this Handbook. Richard Morris and Archie Harmon also present an updated
chapter on voice and voice disorders. They too bring updated information to their
description of voice disorders, their prevalence, and assessment and treatment
issues.
The final two chapters of Part III deal with speech disorders derived from ge-
netic and medical factors. Debbie Sell, Valerie Pereira, Yvonne Wren, and Jane
Russell have updated Russell’s chapter from the first edition of the Handbook with
details of the most recent research in cleft palate and velopharyngeal impairments.
They stress the importance of the role of the speech‐language professional in the
team treating children with cleft palate, especially in terms of timing of surgical
intervention and of speech therapy. Tim Bressmann, in Chapter 22, describes the
various speech outcomes encountered in cases of laryngectomy, glossectomy, and
disorders related to head and neck cancer. The author deals also with the surgical
procedures undertaken with the various disorders, and describes the different
rehabilitation options available to ameliorate the resultant impairments to speech
production.
The final part of the Handbook contains four chapters dealing with communica-
tion disorders linked to cognitive and intellectual impairments. Chapter 23,
authored by Carol Westby and Silvana Watson, covers attention deficit hyperac-
tivity disorder (ADHD) and its impact on communication. The authors point to
the increasing incidence of ADHD in children, and the need for research‐based
interventions with this population. Margaret Lehman Blake, in Chapter 24, exam-
ines the range of communication problems encountered with right hemisphere
brain damage. She describes difficulties this population may encounter with com-
prehension, and with managing conversation, and the need to develop treatment
approaches based on the wide literature concerning this disorder.
Chapter 25, by Karen Lê and Jennifer Mozeiko, deals with traumatic brain
injury (TBI). A major focus of the chapter is the complex and dynamic nature of
discourse, and how TBI disrupts discourse in its many facets. The authors suggest
that the impairments seen in TBI may be ascribed to disruptions in cognitive sys-
tems, or they may be viewed as manifestations of underlying pragmatic impair-
ments. The potential causes are not only of theoretical importance but have clinical
implications as well.
The final chapter, by Nicole Müller and Zaneta Mok, covers the wide area of
dementia and its impact on communication. The authors describe the more
common dementia types, risk factors for dementia, and diagnosis, assessment,
and intervention. They go on to consider bilingualism and dementia, and con-
clude with a section on interactional approaches.
This Handbook presents current research and thinking across the wide range of
topics falling under the heading of language and speech disorders. It will prove
invaluable to those working with communication impairments and those just
entering the field alike. In this second edition we have taken the opportunity to
update the chapters and, in some cases, to redirect the main emphasis in a topic.
We are confident that the current collection reflects the current status of this impor-
tant field of investigation.
Part I Foundations
1 Labeling as a Sociocultural
Process in Communicative
Disorders
JACK S. DAMICO1, NICOLE MÜLLER2,
AND MARTIN J. BALL3
1
University of Colorado, Boulder, CO, USA
2
University College Cork, Ireland, and Linköping University, Sweden
3
Bangor University, Wales

1.1 Introduction
As a discipline oriented to communication, learning and social action, speech-
language pathologists are increasingly cognizant of the fact that our discipline
stands with several other disciplines as firmly located within the social sciences.
While we must acknowledge our debts to psychology, education, and medicine,
our theoretical orientation over the past 30 years has been influenced by linguistics,
sociology, and anthropology. In parallel with the other social sciences, our research
methodologies and our clinical practices are progressively increasing our focus on
naturalistic inquiry, authentic social contexts, interpretive and interactional per-
spectives, and the qualitative research paradigm (Duchan, 2010; Goodwin, 2014).
This increased turn to the social sciences holds many advantages for our disci-
pline. One of these advantages is how we can adopt aspects of social action theory
to understand the complex process of labeling.
The term labeling within the human and social sciences refers to the tendency of
providing an appraisal and/or a descriptor of others based upon any deviation
from the perceived norm that is sufficient to garner attention (Matsueda, 2014); the
typical outcome of labeling is some sort of categorization that creates differentiation.
Social scientists have recognized that this process is ubiquitous in society. We are
constantly observing and appraising others from our normative and interpretive

The Handbook of Language and Speech Disorders, Second Edition. Edited by Jack S. Damico,
Nicole Müller, and Martin J. Ball.
© 2021 John Wiley & Sons Ltd. Published 2021 by John Wiley & Sons Ltd.
8 Foundations

perspectives. We note features of an individual’s appearance and behavior, and if

even a subtle deviation from the perceived norm is identified, we have a propen-
sity to create and use a label as mental shorthand. For example, if someone is
observed as experiencing a brief unintelligibility while they are conversing, they
may be labeled as exhibiting a communication deficit. Whether this label is accu-
rate or appropriate is beside the point; it is sufficient to recognize that based upon
some perceived deviation, there is a tendency to assign a label.
While this tendency toward labeling is common across all social actors, as pro-
fessionals we formalize this tendency and treat it as a specialized circumstance
referred to as “diagnosis” and, as sociologist Howard Becker (1963) has suggested,
in such circumstances the label has power to create positive and negative conse-
quences. As a result, care must be taken when assigning labels to others, whether
we are in commonplace circumstances or within our professional venues
(Conrad, 2007). To understand the impact of labeling and how it functions, this
chapter will briefly discuss the social theory behind labeling; describe the role of
labeling within the formalized diagnostic process, including some of the mecha-
nisms employed to help establish the practice of assigning diagnostic labels for
various perceived deviations; and detail some of the consequences of labeling via
diagnostic categories in speech-language pathology.

1.2 Labeling Theory

To understand the impact of labeling in specialized circumstances, it is helpful to
review the theoretical foundation underlying labeling as a social process. Based
upon the work of several early sociologists, but especially George Herbert Mead
and Charles Horton Cooley, Herbert Blumer (1969) coined the term symbolic inter-
actionism to describe how social interaction is used to create shared meanings
within society using common language or symbols. He stated that individuals
interpret significant symbols (language) reciprocally and then jointly construct a
common interpretation within a context or situation which then calls for a specific
meaningful social action. In effect, as Berger and Luckmann suggested in The Social
Construction of Reality (1967), our systematic and comprehensible social world is
constructed by our mutually agreed-upon interpretations. An important
consequence of this process is that the outcome of any social action is not only the
objective behaviors exhibited, but also how the situation and behaviors are defined
and interpreted by the interactants. This is a primary reason that society or social
reality is an ever-changing social process, rather than a static structure that con-
sists of unchanging functional positions or stances. Each of us as social actors not
only adapt to societal constraints but we also (and continually) contribute to the
creation and re-creation of these constraints (Matsueda, 2014; Shotter, 1993).
Blumer’s work had a significant impact on labeling theory. This idea of con-
structed societal reality via social interaction and meaning negotiation between
individuals was applied to definitions of deviancy, and it was argued that
regardless of whether a person is objectively deviant in their appearance or actions,
 Labeling as a Sociocultural Process in Communicative Disorders 9

if others defined that person or those actions as deviant, then consequences

inherent in the concept of one being “set apart” accrued. Symbolic interactionism
implied that the labeling/appraisal of individuals by social groups affects one’s
self-identity; the self is a construction based on appraisals made by significant
others (Matsueda, 1992).
The next step for labeling theory was to employ Blumer’s ideas but also to make
several facets of the interpretive process inherent in symbolic interactionism more
salient. The first question concerning saliency was that if significant others
appraise, judge, and create the concept of who or what is deviant, and if this has
an impact on the various social actions, including one’s self-identity, who are these
significant others? Research and theory defined these significant others as mem-
bers of primary groups, such as families and peers, and they were referred to as
reference groups since it was understood that they provide an individual with a
point of perspective and a comparison group (Matsueda, 1992). By extension, in
specific situations or contexts, those individuals with various kinds of societal des-
ignations or roles (e.g., speech-language pathologists in a diagnostic clinic, teachers
in a classroom, police officers on a beat) became the reference groups who made
decisions on the labeling of deviancies. The second question revolved around the
idea of how deviancy was typically formulated. Erikson (1966) discovered that the
labeling of deviancy entails a very explicit process of selection. He found that,
although even the most deviant social actors engage frequently in conventional
routine behaviors, they tend to exhibit moments of deviation as a measure of the
kind of persons they really are. In his research, Erikson demonstrated via an exam-
ination of the Salem witchcraft trials that this very selective labeling serves a soci-
etal purpose of helping a community define its social and moral boundaries so
that they could develop a sense of group identity. That is, labeling some individ-
uals via interpretations of their behaviors or appearances as outliers served to
define the rest of the group as a community.
The third question regarding the interpretation of deviancy through labeling
involved the reasons or process of deciding whether a behavior or appearance was
sufficiently different to warrant the label of deviant. Edwin Lemert (1967)
established the concepts of primary and secondary deviance to address this
question. Primary deviance refers to initial acts of deviance that arise from original
causes like social or cultural factors or psychological and physiological limitations.
He believed that these were often situational, transient, and idiosyncratic, and
therefore they could be dismissed by others. In these situations, these individuals
experienced only minor consequences that impacted their persons and their status,
social relationships, and future behaviors. Secondary deviance, however, was more
severe. Lemert defined this level of deviancy as occurring when society’s negative
response to a person’s initial deviance (e.g., stigmatizing, punishing, segregating
the offender) caused fundamental changes in the person’s status, self-identity, or
personality. In these cases, there is an explicit response involving societal reactions
to the deviant behavior or appearance; this results in the “secondary deviant’s life
and identity (being) organized around the facts of deviance” (Lemert, 1967, p. 41).
Tied into the distinction between primary and secondary deviancy was the fact
10 Foundations

that the most important societal reaction, the one that often triggered secondary
deviancy, was the response of social institutions of control—the criminal justice
system, special education regulations, mental health institutions—that are legiti-
mated by the state (Goffman, 1964; Lemert, 1967).
Given this theoretical orientation and the work of others, Howard Becker inves-
tigated labeling as a theoretical social construct in his 1963 book Outsiders: Studies
in the Sociology of Deviance. In this book, Becker was especially interested in the
construct of deviancy in society—why some acts are thought to be deviant and
who has the power to label individuals and/or their behavior as deviant. Becker
examined the impact of such labeling on society and the individual. Based upon
his work, he believed that labeling is a sociopolitical act, since his research indi-
cated that once a label has been assigned, how we respond to the label (and the
underlying acts that characterize it) depends on whether the label and its under-
lying actions have become sanctioned within the society. He believed that it is not
the label or the actions of the individual so labeled that are deviant, but rather, the
responses of society that defines it as such. Importantly, Becker believed that the
responses of the powerful in the society (e.g., judges, legislators, physicians, diag-
nosticians) often determine how we are expected to view such labels and the
actions that are characteristic of the labels.
Becker, led by symbolic interactionism, made two primary contributions to
labeling theory, and his work, though somewhat controversial, is the primary
current standard for labeling theory. The two major contributions were, first, that
he offered an explicit labeling definition of deviance: “. . .deviance is not a quality
of the act the person commits, but rather, a consequence of the application by
others of rules and sanctions to an offender” (1963, p. 9). His second contribution
was that he expanded the scope of societal reactions to encompass the creation and
enforcement of social rules. Basically, this meant that the creation of deviancy
begins not at the point when a person violates some rule, but earlier when social
groups first create those rules. Becker also contrasted the positions he staked out
for labeling theory with conventional theories of deviance. This enabled a greater
constructivist orientation.
Based upon this work in sociology, labeling theory has become an important
mechanism for understanding how and why the labeling of individuals as deviant
or the assigning of a diagnostic label (in the case of speech-language pathologists)
may result in unintended consequences. Erikson summed up labeling theory suc-
cinctly when he argued that “Deviance (as a basis of labeling) is not a property
inherent in certain forms of behavior; it is a property conferred upon those forms by
the audiences which directly or indirectly witness them” (1962, p. 311).

1.3 Labeling within a Diagnostic Process

Based upon labeling theory, it is clear that this social process is active in the diag-
nostic process within which speech-language pathologists are frequently engaged;
labeling as a specialized circumstance is most evident in the educational and clinical
 Labeling as a Sociocultural Process in Communicative Disorders 11

disciplines during those events referred to as “diagnosis.” Since the early 1960s, but
especially since the widespread funding of special education in the United States,
there has been a tendency to refer students to special education for language-based
learning problems and for communication disorders of various kinds (e.g.,
Department of Education [DoE], 2002; Kretschmer, 1991; Richardson & Parker, 1993).
Similarly, adults with various communication problems are also referred in order to
initiate rehabilitation (e.g., Edwards & Bastiaanse, 2007; McDonald, 2007; Thompkins,
Marshall, & Phillips, 1980). When an individual (or their caretaker) is in search of an
explanation for mental, physical, emotional, or behavioral differences, or when
someone seeks assistance with learning or adaptive problems, this individual
undergoes a diagnostic process (Flower, 1984). The referral for this evaluation is fol-
lowed by an assessment process that is intended to provide a diagnostic label.
There have been numerous discussions on the process of evaluation in commu-
nication disorders. In general, the process is as follows: (a) a referral is made to the
speech-language pathologist (SLP) by a teacher, nurse, physician, administrator,
another professional, or family member; (b) the SLP reviews the referral and deter-
mines the types of information that should be collected; (c) an appointment is
made for the SLP to evaluate the referred individual in a setting chosen by the
professional; (d) a set of tests and other diagnostic procedures are chosen for the
assessment session; (e) the assessment is completed at the appointed time(s); (f)
the data from the assessment session are combined with any other data obtained
by the SLP to provide diagnostic interpretation involving differential and descrip-
tive diagnosis; and (g) a diagnostic label or category is assigned. Once the diag-
nosis is assigned, then other decisions addressing educational and/or therapeutic
issues are considered and implemented.
Following Matsueda (1992) and the idea of reference groups that employ soci-
etal mechanisms to justify the diagnostic process and the resulting labels assigned,
there are various sanctioned instruments and documents that are employed to
justify and legitimize the diagnostic process. Within the diagnostic realm, the first
mechanisms of influence developed by individuals in positions of power are
instruments like the Diagnostic and Statistical Manual of Mental Disorders published
by the American Psychiatric Association, the classifications and position papers
published by the American Speech-Language-Hearing Association, and codified
laws and regulations sanctioned by governmental entities. These documents and
codes create an expectation of societal support and need for those perceived devi-
ancies characterized as communication disorders. However, there are other ways
that diagnostic labeling is implemented and supported in society: medicalization
and diagnostic legitimization. A brief discussion of these two primary and influen-
tial mechanisms will demonstrate the subjective nature and the power of labeling.

1.3.1 Medicalization
Perhaps the most salient demonstration of a mechanism of symbolic interaction-
ism and its impact on labeling at the societal level involves what has been termed
“medicalization theory” (Williams & Calnan, 1996). This explanatory mechanism
12 Foundations

involves the impact of society and its values acting through a particular societal
institution—medicine—to create new diagnostic categories or to redefine or
expand old categories according to current sociocultural values and beliefs
(Conrad, 2007; Halpern, 1990; Zola, 1972). In addition to the extension of medical
boundaries, in the process of medicalization, nonmedical problems become
defined and labeled as medical problems, usually as disorders or illnesses. For
example, over the past 40 years there have been numerous new medical categories
that did not exist before that time. Medical categories and labels like attention def-
icit hyperactivity disorder (ADHD), anorexia, chronic fatigue syndrome, fibromy-
algia, and post-traumatic stress disorders have all been established in this
time-frame, and other categories have been redefined to create expansions
(Conrad, 2009; Conrad & Potter, 2000; Erchak & Rosenfeld, 1989; Halpern, 1990;
Klasen, 2000; Rosenfeld, 1997; Zola, 2009).
One example of redefinition through medicalization involves cognitive changes
associated with high old age. Until a few decades ago, the notion of senility was
accepted both socially and medically, and highly “successful” aging, that is, a
person living into their 80s or 90s without noticeable deterioration of memory, ori-
entation, or other cognitive skills was considered the exception rather than the
norm. However, a combination of social and medical factors have moved what
was formerly understood as senility firmly into the realm of dementia (in public
and media discourses more often than not identified with Alzheimer’s disease),
that is, a disease process socially constructed as something that is, by definition,
not part of “normal” aging (even though the well-established major risk factor for
a diagnosis of Alzheimer’s disease is old age). While some researchers argue that
conflating the low-functioning end of a normal distribution with a genuine disease
process may be less than helpful in leading to an understanding of either normal
or pathological aging, age-related “dementing” is, in public discourses in the
United States and other industrialized nations, at present framed virtually exclu-
sively within a disease model (Fox, 1989; Guendouzi & Müller, 2006; Müller &
Schrauf, 2014)
Conrad and Potter (2000) have provided excellent demonstrations of medical-
ization for category expansion with adult ADHD. Their work details numerous
societal factors to create a perception that is then followed by the medical institu-
tional response. For example, there was the emergence of publications aimed at
lay readers that heralded the new category, research published with one function
but reinterpreted by the media and advocacy groups for their purposes (Zametkin
et al., 1990), major news media with their own spin on the issue, popular maga-
zines, organizational stakeholders like Children and Adults with Attention Deficit
Disorders (CHADD), and manufacturers of primary drugs for ADHD. Conrad
and Potter (2000) detail a set of early claims regarding ADHD in adults that started
gaining some attention, and then a strong movement into the public sphere when
news organizations began to profile ADHD in adults. Over time, and with the col-
laboration of sympathetic professionals (Brown, 1995), diagnostic institutionaliza-
tion occurred through increased attention and support provided by professional
publications, research journals, and changes in the medical diagnostic criteria. As
 Labeling as a Sociocultural Process in Communicative Disorders 13

detailed by many researchers (Cherkes-Julkowski, Sharp, & Stolzenberg, 1997;

Conrad, 1976, 2009; Damico & Augustine, 1995; Reid, Maag, & Vasa, 1994; Searight
& McLaren, 1998), once the category is institutionalized, the stakeholders then
engage in various forms of verification to stabilize this diagnostic category. For
example, the condition of adult ADHD is a convenient way to medicalize academic
or occupational underperformance of young adults in a competitive society. In a
social context that includes an orientation to drug management of many condi-
tions, a focus on genetic foci to explain behavioral and societal tendencies, and the
rise of managed care so that a diagnostic label may be needed to receive remuner-
ation for services sought or provided, medicalization is more easily understood.
The problem, of course, is that since this is a constructive process, often more
influenced by social rather than biological factors, many of these diagnostic cate-
gories may be complicated by ambiguity and subjectivity, and this lack of defini-
tional rigor may result in various types of problems. Most relevant to the clinical
context is the concern over the authenticity or the construct validity of the various
diagnostic categories. In his book, Illness and Culture in the Postmodern Age, Morris
(1998) has discussed this possibility for several illnesses and diagnostic categories.
He suggested that ADHD and some other socially constructed diagnostic cate-
gories (e.g., alexithymia, Gulf War syndrome, chronic fatigue syndrome, multiple
personality disorder) may be defined as “postmodern illnesses.” This term refers
to categories of illness or behavioral states that are vaguely and subjectively
defined and that are controversial regarding their legitimacy as real illnesses.
Accordingly, these diagnostic categories often puzzle mainstream medicine, are
sensationalized and augmented by the popular media, are confusing to the gen-
eral public, and have a tendency for being abused (Morris, 1998).
Morris explains this pattern of attention and abuse by suggesting that, rather
than being legitimate and objective disease states or disability conditions, these
specific illnesses represent changing patterns of human experience and affliction
that are shaped by the convergence of biological states, cultural beliefs and social
actions. For example, identification of a child as exhibiting ADHD may often be
less the result of a neurological or biological condition and more due to a devel-
oping tendency of society to treat teachers’ and parents’ anxieties regarding
childhood by routinely drugging children into good behavior; that is, social con-
trol through medication (Damico, Müller, & Ball, 2004). Whether an accurate
depiction or not, the constructive nature of these categories and labels cannot be
ignored.
The medicalization of social problems is a complex process, rather than a dis-
crete step; it is better conceptualized in terms of degrees of medicalization. Further,
this constructive process is usually a collective action. Although various non-pro-
fessional groups and individuals can propose the creation of new or expanded
categories or labels, it usually takes sympathetic professionals for success
(Brown, 1995). The final requirement for the establishment and application of
socially constructed labels and diagnostic categories does, in fact, rely on
professional collaboration and this may be referred to as “legitimization” or
“professionalization.”
14 Foundations

1.3.2 Diagnostic Legitimization

The collaborative process of diagnostic legitimization, whether considered a com-
ponent of medicalization or a separate process, occurs when professional institu-
tions provide a legitimate cover for the socially constructed categories. Examples
of this relevant to our current discussion are some of the diagnostic categories that
are enshrined in the American Psychiatric Association’s Diagnostic and Statistical
Manual (DSM) or the World Health Organization’s International Classification of
Diseases (ICD). Once diagnostic legitimization occurs, many lay people and profes-
sionals then treat the diagnostic category as an objective fact or reality.
While the American Psychiatric Association’s Diagnostic and Statistical Manual
(DSM) and the World Health Organization’s International Classification of Diseases
(ICD) are often considered as standards for objectivity in medical and behavioral
diagnoses—tools that employ rigid standards and objective criteria that are above
reproach—many diagnostic categories or labels that are listed and described in the
DSM or ICD do not employ objective criteria, nor are they indicators of objective
conditions. Rather, like all diagnostic labels, they are social constructions influ-
enced by various social and cultural factors (Coles, 1987; Conrad, 2009; Cooksey &
Brown, 1998; Elliott & Grigorenko, 2014; Gernsbacher, Dawson, & Goldsmith, 2005;
Kroska & Harkness, 2008; Kutchins & Kirk, 1997; Reid et al., 1994; Reid &
Katsiyannis, 1995; Rutter & Tuma, 1988; Searight & McLaren, 1998). The DSM is a
document that has been described as a mechanism that can be used to “secure psy-
chiatric turf” (Kirk & Kutchins, 1992). Numerous researchers have suggested that
the DSM is a way of sanctioning the diagnostic categories by providing apparent
objectivity by using the socially constructed authoritative voice of psychiatry.
What is lost in what Cooksey and Brown referred to as this “diagnostic project” is
the reality that the DSM (and ICD) are based upon the same variables that are
involved in all social constructions of institutional touchstones: sociocultural
values and assumptions, political compromise, scientific evidence, and material
for insurance forms.
The subjective and fluid nature of many of these diagnostic categories has been
widely discussed in the literature with reference to various diagnostic categories
(e.g., Aspel, Willis, & Faust, 1998; Augustine & Damico, 1995; Barsky & Boros, 1995;
Broom & Woodward, 1996; Brown, 1995; Conrad, 2009; Cooksey & Brown, 1998;
Elliott & Grigorenko, 2014; Jensen, Mrazek, & Knapp, 1997; Kaufmann, Hallahan,
& Lloyd, 1998; Kavale & Forness, 1998, 2000; Kirk & Kutchins, 1992; Kutchins &
Kirk, 1997; Marshall, 1996; Prior & Sanson, 1986; Reid et al., 1994; Reid &
Katsiyannis, 1995; Rutter & Tuma, 1988; Scott, 1990). Given recent claims for
significant increases in the incidence of autism in the United States, an example for
how social construction influences the process of legitimatization in autism and
how this very process creates the perception of an “autism epidemic” is especially
illustrative (Baker, 2008; Gernsbacher et al., 2005).
Gernsbacher et al. (2005) convincingly argue that the “autism epidemic” does
not really exist. Rather they discuss the role that the DSM and societal influences
play in the increased incidence of autism, owing to the labeling process and the
 Labeling as a Sociocultural Process in Communicative Disorders 15

changes in the DSM diagnostic criteria due to various socially oriented factors in
different editions of this major diagnostic manual. For example, in the DSM-III a
diagnosis of autism required satisfying six mandatory criteria (American
Psychiatric Association [APA], 1980), but in DSM-IV (APA, 1994) the diagnosis is
fulfilled by meeting only 50% of 16 optional criteria. Further, the criteria them-
selves were made more subjective and inclusive by changes in the phrasing
employed. In the DSM-III one of the criteria was manifestation of “a pervasive lack
of responsiveness to other people” (1980, p. 89) while the closest criterion to this
in the DSM-IV is that an individual must demonstrate “a lack of spontaneous
seeking to share . . . achievements with other people (1994, p. 70). Similarly, the
1980 mandatory criteria of “gross deficits in language development” and “bizarre
responses to various aspects of the environment” were changed to “difficulty
sustaining a conversation” and “persistent preoccupation with parts of objects”
respectively. Finally, the numbers of diagnostic categories for autism were changed
from two in DSM-III (infantile autism and childhood onset pervasive develop-
mental disorders) to five in DSM-IV-R (autistic disorder, pervasive developmental
disorder not otherwise specified, childhood disintegrative disorder, Rhett syn-
drome, Asperger’s disorder). In the DSM-5 (American Psychiatric Association,
2013), the category of Asperger’s disorder, always a bit controversial given its sub-
clinical nature, was even modified and taken out of the Pervasive Developmental
Disorder category (e.g., Matson, Kozlowski, Hattier, Horovitz, & Sipes, 2012;
Waterhouse, 2013; Waterhouse & Gillberg, 2014).
Given these changes to the diagnostic criteria between DSM-III and DSM-IV-R,
it is not surprising that there appear to be many more diagnoses of autism over the
time span discussed. Indeed, the new and milder categories or variants of autism
appear to account for 75% of the new diagnoses (Chakrabarti & Fombonne, 2001),
and when other socially driven changes (e.g., establishment of threshold and sub-
threshold symptoms, a decision to co-diagnose, attempts to identify children at
progressively younger ages) are also considered, it is no wonder there appear to be
significant increases in incidence that necessitated the change in categories in
DSM-5. The point, however, is that led by advocacy groups championing more
relaxed and inclusive criteria, the reality of autism has changed according to social
considerations. Discussions on the role of social variables in reconceptualizing
autism, its causes, and its incidence may be found in the work of various researchers
in the history and epidemiology of autism (e.g., Baker, 2008; Fombonne, 2003;
Gernsbacher et al., 2005; Silverman, 2004; Waterhouse, 2013; Worley &
Matson, 2012).
Based upon such mechanisms of influence and the actual individuals with
sufficient societal power to both label and make the consequences of the label
operational, the diagnostic process nearly always produces a label that is attached
as an indication of some deviant facet of communication. Since evaluation is a
formal process with recognized professionals sanctioned within our society, the
label becomes a powerful designation used to identify and to categorize the labeled
individual. For purposes of this chapter, there are two basic types of labels: a
generalized positive or negative descriptor (e.g., gifted, disorder, deficit, disability,
16 Foundations

handicap), and more specific identifying terms that provide more descriptive and
explanatory power (e.g., specific language impairment, autistic, speech-sound dis-
ordered, stutterer, aphasic, learning disabled). Both label types are employed
depending on who is discussing them and the objectives of one’s discussion
regarding how to address these identified deviancies. This process of diagnosis is
an accepted and even necessary practice when dealing with exceptionalities like
communicative disorders. In order to provide services, to access fiscal resources,
to obtain accommodations, or even to come to an understanding of how to address
disabilities in a remedial process, an official diagnosis, an objective label assigned
to an individual and his or her difficulty is often necessary. While it is commonplace
to obtain these diagnostic labels and to employ them as if they are discrete, concrete
and fixed, the work of Becker and many others demonstrate that this process is
actually much more subjective and fluid than many professionals and the general
public realize (e.g., Aspel et al., 1998; Augustine & Damico, 1995; Carroll, 1997;
Conrad, 2009; Conrad & Potter, 2000; Elliott & Grigorenko, 2014; Fraser &
Christopher, 2007; Wilson, 2000). This is because the assignment of labels based
upon clinical and psychiatric diagnoses is historically and culturally situated. That
is, they may appear, expand or contract over time depending on how the society
and the involved professions form and hold particular beliefs and ideologies
(Conrad, 2009; Cooksey & Brown, 1998).

1.4 The Impact of Labeling

The use of diagnostic terms like language disorder, childhood apraxia, dementia,
learning disability, specific language impairment (now usually referred to as develop-
mental language disorder), autism, ADHD, auditory processing disorder, and many
others, as labels for individuals and their impairments is not always objective or valid
and, as a result, there are many possible consequences inherent in the diagnostic
process that can have an impact on the diagnosed individual. If the label or diagnostic
category appears valid and is correctly attached to an individual, positive conse-
quences may accrue. However, there may also be problems. For example, some
diagnostic categories themselves are suspect and merely function as mechanisms
of current societal values, power or control (e.g., Abberley, 1987; Conrad, 1992;
Mehan, 1996; O’Connor & Fernandez, 2006). If the label or category is invalid or if the
individual is misdiagnosed, the resulting consequences are frequently negative.

1.4.1 Positive Consequences

Receiving a diagnosis in the form of a disability label may start a cascade of con-
structive consequences if the diagnosis is an accurate one. The first constructive
consequence is that the diagnosis may transform an unorganized and unclear set of
complaints and symptoms into a more organized and comprehensible disorder
(Balint, 1957). Once framed with a label, the disorder becomes easier to conceptu-
alize, discuss, and act upon. It is often the case that organized categories help all
 Labeling as a Sociocultural Process in Communicative Disorders 17

involved parties achieve greater understanding and communication about complex

behavioral entities that are generalized by the labels (Damico, 2019; Darley, 1975;
Leyens, Yzerbyt, & Schadron, 1994). In a study of children with ADHD, for
example, one of the authors (Damico & Augustine, 1995) found that parents of
many children eventually diagnosed as exhibiting ADHD often had nagging feel-
ings that something was wrong but they could not put their finger on the problem.
Indeed, based upon an interviewee’s comment, the researchers in the study
explained this phase of confusion as a period of “undefined malaise” (Damico &
Augustine, 1995, p. 261) in which the parents did not know how to characterize
their children’s problems or where to turn for assistance. Once a diagnosis was
provided, however, the parents felt that they had a better understanding and could
proceed in a positive direction.
In line with the first consequence, once a valid and accurate label is obtained it
can also lead to opportunities and extra resources that are not available without a diag-
nostic label (Gillman, Heyman, & Swain, 2000; Sutcliffe & Simons, 1993). As previ-
ously stated, many governmental regulatory bodies, educational remedial
guidelines, and insurance providers require a standard diagnosis before treatment
is provided. Federal and state special education regulations, for example, require
official diagnoses before intervention is even planned. In the ADHD study just
reported (Damico & Augustine, 1995), school systems did not tend to orient to the
needs of the students studied until a formal diagnosis was obtained. When the
formal label was delivered to the schools, however, it acted as a catalyst. Various
accommodations and services not previously offered to the child and parents now
were provided. The label, therefore, had a reactive power over the schools, the par-
ents, and even the children. This need to employ diagnostic labels to achieve such
ends is not unique to ADHD. Numerous researchers have discussed this issue
across many of the communicative and cognitive exceptionalities (Gibbs &
Elliott, 2015; Gipps, 1999; Glaser & Silver, 1994; Klassen, Tze, Betts, & Gordon, 2011;
Messick, 1984; Rogers, 2002; Rolison & Medway, 1985; Skrtic, 1991; Sleeter, 1996).
Positive impact, however, goes even further with services provided. An appro-
priate label does not just create reactionary influences to provide service delivery;
it also enables a discerning clinician to carefully prepare a treatment plan that is tai-
lored to the needs of the individual now accurately identified and labeled. In doing so,
having the valid diagnostic label may lead to specific intervention that will over-
come the identified deficits (Archer & Green, 1996; Brinton & Fujiki, 2010;
Gross, 1994; Kamhi, 2014; Müller, Cannon, Kornblum, Clark, & Powers, 2016). In
effect, strong assessment resulting in an accurate diagnosis is essential for good
intervention to occur. To use a metaphor from Brinton and Fujiki (2010), “you must
know where you are going to plan your route.”
Finally, an accurate diagnosis may have positive psychological and social con-
sequences. For instance, individuals affected by various behavioral or medical
symptoms can legitimate their problems and achieve self-understanding once an accu-
rate and valid diagnostic label is provided (Broom & Woodward, 1996). The indi-
viduals with impairment can address feelings of confusion, isolation, or inadequacy
and construct new identities, and this, in turn, can assist in dealing more
18 Foundations

effectively with their problems (Gross, 1994; Gus, 2000; Kelly & Norwich, 2004;
Riddick, 2000). Therefore, the diagnostic label can have a substantial positive
impact on the lives of the individuals with disabilities (Broom & Woodward, 1996;
Damico & Augustine, 1995; Gibbs & Elliott, 2015; Link, Cullen, Struening, Shrout,
& Dohrenwend, 1989).

1.4.2 Negative Consequences

Labels, however, may also have negative effects. This is particularly true if the
applied labels are not valid, or if a valid label is inappropriately or incorrectly
applied. The most obvious destructive consequence occurs when an inaccurate label
is applied. There are two ways that this may happen. For instance, a schoolchild
may exhibit communicative or academic difficulties that are not due to actual
impairment, but is misdiagnosed and labeled as disordered. In such a case, the
mislabeled individual may be placed in special education or other remedial
program. Often this means that the curriculum is reduced so that more time and
effort may be spent on content that is deemed most important and salient, or that
specific learning strategies are employed that may be necessary for impaired
learners, but that limit learning by average students (Grigorenko, 2009; Van
Kraayenoord, 2010). In these cases, inappropriate labeling provides poor opportu-
nities for normal learners, and the expectations directed toward the inappropri-
ately labeled individuals are reduced (Brantlinger, 1997; Connor & Ferri, 2005;
Frattura & Capper, 2006; Rogers, 2002). Such situations often arise in contexts
where students have language or learning difficulties arising out of cultural or lan-
guage differences. When such students are referred for assessment, they are often
mislabeled (Artiles & Ortiz, 2002; Cummins, 2000; Hamayan, Marler, Sanchez-
Lopez, & Damico, 2013; Trueba, 1988; Wilkinson & Ortiz, 1986). Their difficulties
due to differences are categorized as disorders, and they are placed inappropri-
ately in special education (Connor, 2006; Hamayan et al., 2013; Magnuson &
Waldfogel, 2005; Trent, Artiles, & Englert, 1998).
The second type of misdiagnosis occurs when an individual with a difficulty
due to some actual impairment is identified as having a different impairment. In
these instances, the genuine impairment is not adequately addressed, remedial
plans and the expectations for improvement may be inappropriate, and little
positive change occurs. Labeling is particularly problematic in these cases due to
the tendency to attach a stereotype to a label, and then to focus on the stereotypic
behaviors in the labeled individuals regardless of the presence of other, even
conflicting, symptoms (Madon, Hilbert, Kyriakatos, & Vogel, 2006).
Perhaps the most interesting, and potentially most serious, scenario for misdi-
agnosis occurs when the actual label applied is suspect, that is, when a diagnostic
category itself may be invalid. Due to the subjective and fluid nature of labeling
and application of diagnostic categories, numerous categories have been chal-
lenged in the research literature (Elliott & Grigorenko, 2014; Fairbanks, 1992; Van
Kraayenoord, 2010). These challenges focus on the construct validity of the diag-
nostic categories themselves or indicate that the definitions used are too broad or
 Labeling as a Sociocultural Process in Communicative Disorders 19

subjective. For example, these claims have been made with regard to the recent
definition of autism spectrum disorders (Bagatell, 2010; Gernsbacher et al., 2005;
Waterhouse, 2013), dyslexia, auditory processing disorders (Cacace &
McFarland, 1998), attention deficit hyperactivity disorder (Bussing, Schoenberg, &
Rogers, 1998; Conrad & Potter, 2000; Prior & Sanson, 1986; Reid & Katsiyannis, 1995;
Searight & McLaren, 1998), and specific language impairment (Cole, Schwartz,
Notari, Dale, & Mills, 1995; Conti-Ramsden, Crutchley, & Botting, 1999;
Dollaghan, 2004; Peña, Spaulding, & Plante, 2006; Ukrainetz McFadden, 1996).
While the most obvious harmful consequences may result from errors in
labeling, the negative impact of the process is more complex and insidious. It must
be remembered that labels are actually summaries of complex symptoms, a
“mental shorthand” that plays into the human inclination to stereotype and make
generalizations (Leyens et al., 1994). While this propensity does assist in commu-
nicating ideas underlying the labels, there is also the tendency to stop looking at
the individual and start assuming that he or she is defined by the label and its
characteristics. This assumption enables the professional to stereotype the unique
aspects of the labeled individual so that all children with the same label are consid-
ered similar. This results in a failure to notice and account for personal strengths
and difficulties. The consequence is a reduction of individual differences and a limita-
tion on the ways in which the individual is perceived and treated (Lubinski, 2000; Madon
et al., 2006).
Another negative consequence of labeling arises from the very practice of
assigning a label. If the intent is to label an individual, then often there is an
assumption that not only the symptoms, but their origins exist within the
individual being labeled. Consequently, there is a predisposition to localize the prob-
lems within the individual rather than to search for multiple factors and extraneous
variables, including, for example, teaching styles, prior exposure to opportunities
to learn and apply the targeted skills, and diversity issues in schoolchildren
(Brown, 1995; Coles, 1987; Conrad, 2000; Forness, 1976; McDermott, 1987, 1993;
Rapley, 2004). The decision to focus on intrinsic causal factors rather than extrinsic
factors (or at least a combination) is likely a primary reason for the overrepresen-
tation of various ethnic and socioeconomic groups in some aspects of special edu-
cation (e.g., Cummins, 2000; Damico, 1991; Hamayan et al., 2013; Hood, McDermott,
& Cole, 1980; McDermott & Varenne, 1995; McNamara, 1998). Treating labels as
verification of intrinsic disability may also be based on the assumption that the
source of all educational difficulties is related to causes that are intrinsic to stu-
dents (Carroll, 1997; Gutkin & Nemeth, 1997). This assumption is exacerbated by
the general lack of familiarity that the public has with the principles of language
and learning in academic and communicative contexts.
Unfortunately, this belief in the primacy of intrinsic causal factors, exacerbated
by labeling, frequently results in negative consequences. The label is often used to
“explain away” the problem, so that if, for example, a child experiences poor
teaching or unresponsive therapy, the propensity is to place blame on the child,
not the methods or the teacher/therapist. The within-child deficit model makes
for an easy and effective excuse.
20 Foundations

Since most people are not oriented to the complexity of human meaning
making and the importance of systems theory when addressing learning and com-
municative processes (MacWhinney, 1998; Nelson, 2003; Perkins, 2005; Thelen &
Smith, 1998; van Geert, 1998), they are often willing to localize problems in the
individual; it is simply easier to do so. To ignore the complexity is often soothing
even if it is misdirected. The problem with using the label to reduce the complexity,
of course, is that poor results ensue. Even if teachers or rehabilitative professionals
are dedicated to the remediation process, their best attempts at assistance often are
misguided and ineffective. In fact, research has documented that labeling with a
focus on an intrinsic deficit model typically results in overlooking various envi-
ronmental factors that may have generated or exacerbated the difficulty (Barsky &
Boros, 1995; Boxer, Challen, & McCarthy, 1991; Brown, 1995; Coles, 1987; Dudley-
Marling & Dippo, 1995). As Brechin (1999) discussed, “If the whole problem, by
definition, lies with the individual [via a label], then our understandings and inter-
ventions start and stop with the individual” (p. 1, original emphasis).
Labeling as a process is often discussed within the sociological literature and it is
frequently linked with assessment. This is due to the fact that most test development
was designed for selection purposes (Glaser & Silver, 1994), that is, to determine who
should be admitted to and benefit from what educational opportunity (Carroll, 1997;
Damico, 2019; Glaser & Silver, 1994; Lohman, 1997). To create divisions for selection,
however, a label must be supplied. Consequently, labels often become the hand-
maidens of societal biases and prejudices. Within this function, labeling has particu-
larly damaging consequences. Assessment and the resultant labels assigned to many
students are often used to create a kind of social stratification system, a way to keep
people in their place (Artiles, Higareda, Rueda, & Salazar, 2005; Bradley &
Corwyn, 2002; Cummins, 2000; Ogbu & Simons, 1998; Ruiz-de-Velasco & Fix, 2000).
This labeling process and its resultant placements are a reflection of how power and
control is exerted in assessment to fulfill societal roles of cultural and social reproduction
(Abberley, 1987; Apple, 1982; Kavale & Forness, 1998; Loseke, 1999). The assignment
of a label and the various consequences play a key role in cultural reproduction and social
stratification (Gipps, 1999). In his discussion of the impact of assessment and labeling
theory in education in the United Kingdom, Broadfoot (1996) stated,

. . . because assessment procedures are so closely bound up with the legitimization of

particular educational practices, because they are the overt means of communication
from schools to society and . . . the covert means of that society’s response in the form
of control, assessment may be the most important of the three message systems.
Assessment procedures may well be the system that determines curriculum and ped-
agogy and, hence, social reproduction. (p. 87–88)

Within the realm of special education, labeling students and placing them in reme-
dial programs—even if only for a half an hour a day—effectively removes these
students from general schooling and places them in groups of students of similar
ability for instructional purposes; they are socially isolated (Connor & Ferri, 2005;
Fine, 1991; Gelb & Mizokawa, 1986; Gill & Maynard, 1995; Messick, 1980).
Another random document with
no related content on Scribd:
 – Köszönöm, köszönöm, – mondogatta. Én rám úgysem
várakozik pihenés és nem tenném alaposan meggondolva, ha
kényeztetném magamat. Íme itt van minden átadni valóm. (És
kabátja oldalán az egyik zsákból kulcsokat, a másikból irásokat
húzott elő.) A számadások eddig az óráig vannak vezetve. Bocsáss
meg, hogy írásom egy kissé kuszált – mélyen tisztelt barátom
szarkalábaknak szokta nevezni; – de szemeim egy-két napja még
gyöngébbek, mint rendesen. Azt hiszem, két tétel fel fog tünni a
számadásban. De tudakozódjál csak utána és mindenki
egyértelműleg oda fog nyilatkozni, hogy a mi asztalosunk, a ki a
koporsót készítette, általánosan ismert nagy csaló. A másik a
kántistáknak kiszolgáltatott bor nagy mennyisége lesz. De a deákok
mind részegesek és követelők. Fogd kérlek a kulcsokat is, és vedd
figyelembe abbeli kérésemet, hogy a tételeket azonnal vesd össze a
pénzes ládával, mert nem szeretném, ha úgy tekintenének, mit a ki
megszökött a kastélyból, hova utóvégre nagylelkű barátsággal
fogadtatott.
– Hogy-hogy? Mit mondasz, Istók? – kérdé Béla nagy szemeket
meresztve az öregre, ki minden ellenzése daczára fölemelkedett
helyéről, és így folytatá:
– Mélyen… azaz szerelmes öcsém, igen, én megyek és még ma
szeretnék benn lenni Karámoson. Mert, ha meggondolom, mire
magyarázhatnák az emberek tovább itt tartózkodásomat, okvetlen
arra kellett határozni magamat, hogy távozzam e házból. Eddig csak
volt mit tennem, hogy senkise vethesse szememre kenyeremet. Az
én mélyen tisztelt, boldogult barátom kissé hiányos volt a
klasszikusokban, a jusban és a theologiában, melyek nélkül az
életben sok lépésünkben fennakadunk. Az én kötelességem volt e
hiányosságokat tőlem telhetőleg kipótolni. Mostanában pedig, hogy
a szobához kötötte a betegség, gyönge tehetségeimen kívül
lábaimmal is igyekeztem szolgálatára lenni. Minderre azonban a te
fényes elmédnek és fiatal erődnek semmi szüksége s ennélfogva
énnekem ebben a házban semmi tennivalóm.
– Istók bátyám! – csitítá a már-már elérzékenyülő öreget Béla,
megragadva kezeit. De ez alig figyelt rá és megindúltan beszélt
tovább:
– Igen, öcsém, én megindulok innen, hol ennekutána mindenki
csak ingyenélőnek tartana. És méltán. Tisztán állok előtted; ha hinni
akarsz nekem, elhiheted, hogy semmit sem szereztem és egy garas
nélkül távozom. Nemzetségem: a Pallérosi Pallérok a Tiszán túl
virágzanak; majd azok szereznek nékem valami kenyeret. Nézd,
ebben az öltözetben állítottam be először – már több harmincz
esztendejénél – a karámosi vármegyeházán az én mélyen tisztelt
barátomhoz, kinek akkor egy reprezentácziót kellett készítenem.
Ugyanezek a csizmák, ugyanez a kabát, ugyanez a kalap volt
rajtam. Ugyancsak azokban indulok most meg, – csupán csak a
kalapomra varrott Kata egy gyászfátylat. Ha meggondolom… Már
össze van kötve odalenn a batyum; a könyveim is mind akkorról
valók. Ha eszembe veszem… De nem. Mit mondjak egyebet? Iszen
te sorra meg tudsz gondolni magad is mindent. Íme, ezekben
óhajtottam eléd terjeszteni nyomós okaimat, melyek arra az alázatos
kérésre bátorítottak, hogy a számadásokat és a pénzes ládát
minden további haladék nélkül vizsgáld át.
A mentor, erőt véve magán, ismételt csuklások és fennakadások
között valahogyan bevégezte szavait, melyek sajátságos keveréke
voltak a beszámoló előadásnak, védbeszédnek és a
búcsúszónoklatnak. Béla félrelökte maga elől a kulcsokat és
papirosokat, s borús szívének igazi, meleg elérzékenyedésével
szólalt meg:
– Nem úgy, nem úgy, hajdani pártfogóm te! Az én lelkemet sok
teher nyomja már s nincs kedvem még a hálátlanság vádjával is
megszaporítni őket. Kinek köszönök én mindent, a mim van? Ki
mentette meg egykor szegény anyámat az éhenhalástól? Ki hozott
engem ide? Ki szerezte meg nekem bátyám derék szívét? Csak
törüld meg szemeidet, Istók. Akkor lenne okod a fájdalomra, ha most
hálátlanúl elfogadnám búcsúra nyujtott kezedet s kivezetnélek az
utczaajtóig, hogy vén napjaidra szélnek eresszelek.
– Te mester vagy a logikában, Béla, – akadozott Istók, könnyei
közt gyönyörködve kedvenczében. Akaratod ellenére is azt
bizonyítja minden szavad, hogy itt én rám és az én gyönge
tehetségeimre semmi szükség. A hálát ne emlegesd, mert abból
csak a te éles okoskodásod tudja azt a következtetést vonni, hogy
maradjak. A mi neked igazságnak tetszik, az csak látszat. Ha
meggondoljuk, hogy az én mélyen tisztelt barátomnak (halála óta
mindig a legünnepélyesebb formában emlékezett meg róla)
tulajdonképen nem is volt mást mit tennie, mint a mit tett, egészen
más eredményre jutunk. Mert Ágnes… no de nem fizetem rosszal a
jót. Most egy kenyéren vagyunk vele, pedig mindig igen büszke volt
hozzám. Neki sincs semmije a rajta valón kívül, csakhogy az ő
viselője még divatos, az enyém meg már ócska. Bekövetkezett,
hogy íme, csak ez a különbség köztünk. De nem is panaszkodom rá,
inkább beismerem, hogy a mi boldogult jótevőnk nagyon hirtelen
indulatú volt. Nem hiába keveset törődött a klasszikusokkal.
Istók beszédközben észrevette, hogy egészen eltávolodott a
tárgytól, melyről tulajdonképen szólani akart. De a jó vitatkozó
szokása szerint hamar összeszedte magát s egy ugrással helyén
termett.
– Ne emlegesd a háladatosságot, Béla. Mert kisértetben vagyok,
hogy azt a kérdést intézzem magamhoz: nem alacsony számítás
vezérelte-e eleitől fogva lépéseimet, hogy helyemet napjaim végeig
biztosítsam? És ha valami kételkedés maradna bennem, vagy ha
mások is azt hinnék – pedig a ti gyanakodó prókátortok mindenkiről
maga után itél – az még rosszabb lenne, mint ha ingyenélőnek
tartanának. Azért csak nézd át gyorsan, pontosan és kímélet nélkül
számadásaimat s engedd meg, hogy a kis Pirók utánam hozza a
batyut.
Béla azonban az iratok helyett újra az ő vonakodó kezeit ragadta
meg.
– Nem hallottad-e soha, öreg barátom, – mondá, – hogy a hű
tiszt, életének derekasan végzett munkája után, nyugalomba tétetik.
Ki meri mondani, hogy nem érdemli meg a kenyerét? Te harmincz
esztendeje töröd fejedet, őrködől híven és sáfárkodol becsületesen;
ki érdemli meg nálad jobban a pihenést? A mivel csak elláthatlak, a
mit kedvedre tehetek, azt te mind-mind sokszorosan megszolgáltad.
Míg ez a ház áll, te úr leszel abban, akár én. Ez az utolsó szavam,
Istók, és nem várok rá feleletet.
Pallérosi Pallér István izgatottan mozgott ide-oda, elővette meg
zsebre dugta kék tarka keszkenőjét és Béla kezét szorongatva,
mondatait be nem fejezve, dadogta:
– Mégis, ha meggondolom… ha megfontolom…
És meggondolta, hogy a klasszikus irodalom, a jus és theologia
terén való harmincz esztendős működésével bizonyára elég fontos
és terhes szolgálatott tett e családnak arra, hogy kénytelen
nyugalomba lépését a világon senki se hányhassa szemére.
 XII. FEJEZET.
Frank és Kordélia.

Hónapok teltek el s Béla eléggé unta magát a nagy,

barátságtalan kastélyban, mely gazdáját gyászolta. A temetés után
még egy-két napra ott maradt nála hajdani tanulótársa, a kántus-
prézes s tőle telhetőleg igyekezett fölvidítani egyhangú óráit.
Dunaszögön esze ágába sem jutott volna valakinek kétségbe vonni,
hogy hét vármegyén Mányóki Bertalannál különb mulató akad. A
híres Győri Mikének te-tu pajtása volt, ki – mikor negyvenhárom
esztendős korában végre sikerült megválnia a kollégiumtól és
elszakadnia Szlavoniába lévitának, (mire nézve nem kívántatott meg
a papi cenzura,) – minden dicsőségét Bertalanra hagyta. Az utód
nem volt méltatlan nagy nevű mesterére, ki a kálvinista
deákmulatságok hahotára keltő fűszerének hosszú időn keresztül
legünnepeltebb szállítója volt. A tanítvány más agyagból gyuratott;
de nem kisebb szerepre és hírre hivatva. Mike halavány, puffadt,
örökkomoly arczát nála borvirágos, örök-nevető kép helyettesítette;
a komoly méltósággal elkövetett csínyeket víg meggondolatlanság; a
szónoki páthoszt a versíró könnyelműsége. A Mányóki-féle hiteles
és apokryph versek gyűjteménye ma is megvan sok, Dunaszögről
került lelkipásztor titkos fiókjában, honnan a szentlélektől kevésbbé
bolygatott órákban elő-elővétetik a megbecsülhetetlen kézirat. Víg
czimborák közt poharazva, vagy a kollegiumban pipájával az ágyra
heveredve, neki egy-egy vers csak annyi volt, mint másnak egy jóízű
nevetés. Egy tekintetben hasonlított a nagy vallásalapítókhoz, noha
a papi vizsgán már három ízben megbukott. (Mondják ugyan, hogy
csak készakarva, mert Mike példája elrettentette a Bergengócziába
meneteltől.) Ez a hasonlatosság abban állt, hogy maga nem igen írt
le semmit; gondolatait, rímeit és tréfáit a körüle sereglett tanítványok
tették papirra és adták kézről-kézre. Még az a komoly versezet is,
melyet nagys. Kálozdi Kálozdy Benedek úr halálára készített és Béla
megvígasztalására magával hozott, idegen kézírás volt. A többit
aztán estéről estére úgy rögtönözte az ebédlő nagy asztala mellett,
melyen négy különféle pohár állott előtte s egyiknek sem igen volt
hosszú pihenője. Istók kedvét a tréfás poéta – különösen a Biró
Eulália kisasszonyra készített versezettel, (ő jelent meg Bogádról
egyedül a temetésen,) – szinte könnyekre fakasztotta. Került
mindenre vers, csak a pohár tele legyen előtte. Adomáinak, iskolai
tréfáinak sem volt vége-hossza. Egyszer előhozakodott Hajós
professzorról is, kit az ő kedves barátja, Mátyás, a faképnél hagyott
s már tovább is akarta fűzni a beszédet, mikor hirtelen csak eszébe
jutott valami és félbeszakította. Egy késő este Mihály huszárral volt
valami koczódásuk, melynek oka alig lehetett más, mint Zsuzska
menyecske. A poéta kétségkívül igen jól érezte magát a kastélyban s
nem épen kellemesen érintette a szénior sürgető levele, melyet
nagyobb nyomaték kedvéért a kollégium pecsétjével is ellátott.
Hivatalos tekintélylyel hivatott föl ebben Bertalan a haladék nélkül
való hazatérésre, miután a dunaszögi kántusban olyan fejetlenség
tört ki, hogy legutóbbi fellépéseik már inkább macskazenéhez, mint
műelőadáshoz hasonlítván, az iskolai hatóság figyelmét is magokra
vonták. Mit volt mit tennie a poétának?! Összeszedte holmiját,
rímekben vett búcsút a fenyves madaraitól és a kis ér békáitól s
hazafelé indúlt, a vendégszerető kastélynak egyebek közt ezeket
kívánva:

Fala romlást soh’se lásson,

Idő foga rajt’ elvásson.
Földindulást, vakandturást
Föl se vegyen, – ugy legyen.

Béla magára maradt s a tisztesség úgy parancsolta, hogy még

egy ideig magára maradjon. Tétlenül hevert pamlagán, únottan és
ásítva forgatta könyveit s a kényszerű magány már-már visszaterelte
melanchóliájába. Az emlékek, melyeket párizsi kedvesétől vett, azok
is csak emlékek voltak, melyeknek ama régibbekkel, tisztábbakkal,
szíve szerint valóbbakkal folytatott küzdelmökben háttérbe, a ködös,
távoli, hatástalan háttérbe kellett vonulniok. Az első emlék egy nem
jelentéktelen összegről szóló adóslevél volt, melyet be kellett
váltania. A vasasláda nem volt tele s Istók nem tudott jobb módot,
mint Landsman Emánuelhez folyamodni, ki az egykori Péterfi-
jószágok nagy részét kezére kerítette. Az új földesúr mindig tiszta
fehér mellényt viselt, fénymázas magyar csizmákban járt, paripát
tartott, hazai bajuszpedrővel élt és mindenben gavallért adott.
Egyszerüen átnyújtotta Bélának tárczáját s a tárczával együtt
tenyerét is, hogy barátok között az efféle írás nélkül is megeshetik.
Béla nem volt ósdi gondolkodású ember, felcsapott az eléje nyújtott
tenyérbe s ajánlotta Landsmannak, hogy változtassa meg a nevét
Hazafira. A kölcsön nagy része Párizsba vándorolt. No, de nem
hiába. Megérkezett érte a másik emlék: a Vénus-kép. Béla
elragadtatása fölötte korántsem volt akkora, mint vágya utána, mikor
Párizstól búcsút vett. Fölakasztatta ágya fölé a legelésző tehenek és
ebédvivő parasztasszonyok idylljei közé. De nem igen állt meg előtte
s szó sem volt róla, hogy elmélázott volna rajta, mint ama kis
haszontalanságok fölött nem egyszer tette, melyeket íróasztalának
fiókjai rejtegettek. Erélyesen megvédelmezte azonban a szép
jövevényt Istók ellen, ki Kata asszony, Zsuzska és Sára által
felbujtogatva, s teljesen megfeledkezve ifjúságának sikamlós
emlékeiről, a legpuritánabb szempontból fejtette ki, hogy: ha
meggondoljuk, miszerint az, ki ilyen paradicsomi meztelenségben
kész volt a piktornak megmutatni magát, semmiesetre sem lehet
tisztességes személy; egy jófélének arczképe pedig nem méltó arra,
hogy Kálozdy Béla szobáját ékesítse, minek folytán vagy a kulcsárné
által nagy kitartással sürgetett tűzhalálra, vagy legalább örökös
számüzetésre lenne itélendő. Béla mosolygott, egy tekintetet vetett a
rózsaarczra, nefelejts-szemekre és liliom-tagokra s Vénus a helyén
maradt.
A hogy a környékbeli ismerősök elvégezték részvét-
látogatásukat, nem igen jött vendég a kastélyba; kivéve a papot, ki a
hazafias társaságnak s patrónusai iránt való tisztelet köteles
kifejezéseinek sohasem szokott ellenállani, s a doktort, ki
ütemdorongjával igen gyakran megjelent, miután éles szemei a
messze földeken járt Béla társaságában a legjobb alkalmat fedezték
fel arra, hogy a földleírásban magát az olvasás fáradsága nélkül és
lehető legjutányosabban tökéletesítse. Mások nem igen jöttek,
különösen mivel Béla a vidék fiatalsága előtt tudós hírben állt. Így
hát sokáig egyedül barangolta be a környéket, puskáját vállára vetve
s Flóra csaholó, kéznyaldosó társaságában vizi szárnyasokra
leskelődve. De e magányos, merengő, vadászgató séták nem igen
voltak jó hatással zavart kedélyére. A gazdasággal mitsem törődött;
az ingó kalászok, megdőlt rendek, gondosan kötözött kévék, sorjába
rakott keresztek, telő magtár nem igen érdekelték. Hanem meg-
megállította a buzavirág rejtőzködő mosolya s a pipacs messze rikító
színe; elhallgatta az aratók nótáit, s ki tudja, mi fölött mosolygott
olyan keserűen, mikor az örökké egy körben járó nyomtató lovak
végetlen munkája előtt álldogált. Csak mámorra és gyönyörökre
áhító, mindent lemosolygó szíve ismét és ismét benne volt ábrándjai
kellős közepén. Minden, a mi körülötte mindenki számára élet volt,
neki romokat jelentett. Íme, a maga ura végre, senki parancsa alatt
nem áll, emberi hatalom szíve vágyainak nem állhatja útját,
vagyonáért ezer az irígye; és íme mit ér neki mindez?! Ama királyok
boldogságára gondolt, kik leszálltak trónjaikról és harczba indúltak
az ismeretlen ellen. Az ő élete kardvillogás, sebek és dicsőség
nélkül fog eltelni: egyetlen sebben vérzik el. Nem az ismeretlen áll
vele szemben, hanem a lehetetlen, mely ellankasztja, kineveti,
semmivé teszi. Egy halálos bűn, melyet semmiféle harcz nem tehet
erénynyé; egy, csak neki látható virág, melyet sohasem szakíthat le;
egy ki-kiújuló fájdalom, melyet sohasem gyógyíthat meg; egy vég
nélküli szerelem, mely sohasem találhatja fel többé tárgyát. Minden,
minden haszontalan; ha küzdelmében a világ minden hatalma
oldalán lenne is, az is haszontalan. Kivel, kivel ossza meg uraságát?
A mezei virágokból kötött bokrétát kinek adja? Hol van legalább a
sír, melyre letegye? A szőllőlugasban a kert végén ki mellé üljön? E
régi családi ékességek a szekrényben: a grófnő függői, karpereczei,
igazgyöngyei kire várnak? Hisz semmi, semmi egyéb nincsen belőle,
mint az a kis arczkép. Micsoda menedéke van egyéb a kaczagás
bölcsességénél, melyet Párizsban tanult? A sok ködképben előtte mi
az igazság? Eh! – és Flórának füttyentve hazafelé indult.
E czéltalan és emésztő merengés azonban kénytelen volt
nemsokára más gondolatoknak engedni helyet. Béla semmi részletet
nem tudott, nem is tudhatott azok felől, a mik bátyja halálát a
kanczelláriában megelőzék. Csak annyit tudott, hogy Ágnes minden
nélkül maradt s betegen fekszik Bogádon. A hányszor Mihály huszár
odaát járt, mindig azzal a hírrel jött haza: a kisasszony azt izeni,
hogy egészen jól van, csak gyönge egy kicsit. De mikor Kurz doktor
hallotta ezeket az üzeneteket, a doronggal igen sokáig egész
határozottsággal ütött a markába és azt erősítette, hogy ha ő most is
élet és halál közt lebegőnek állítja Ágnes kisasszonyt, meg van
győződve róla, hogy fején találta a szeget. Suum cuique etc. Béla
nem tudta ráhatározni magát, hogy átlovagoljon Bogádra. A későbbi
hírek nem kevésbbé szomorúak voltak. A szegény Ágnest, kinek
immár senkije és semmi reménysége az ég alatt, a két vén
kisasszony csak társalkodónőnek és mindenesetre nem csekély
tehernek nézi. Eufrozina csípős és türelmetlen iránta: fürteit minden
reggel vele fésülteti, sütteti, bodoríttatja, pakoltatja és bámultatja.
Eulália kegyesen kijelentette, miután az első gyászruhája elkopott és
másikat akart varratni magának, hogy sajátképen nem is lehet tudni,
kije volt neki a boldogult; hogy továbbá az ő fiatal korában nem
hónapokig, hanem esztendőkig tartott egy ruha; hogy végül az igazi
keresztyén lélekben és szívben gyászol, nem pedig ruhában és
czifrálkodásban. Mindaketten pedig igen nagy igyekezettel
csalogatnak egy szegény, félszeg, nevetséges, koravén falusi
embert, valami Biró Mártont, (ágról-szegről rokonuk is,) hogy nem
tenne rosszúl, ha Ágnessel megpróbálkoznék.
E hírek, melyeket Palkóné, Ágnes egykori szobaleánya,
kegyetlen és hajmeresztő részletekkel színezett ki, gyakran
foglalkoztatták Béla lelkét. Emlékei, melyekben egykori
menyasszonya mindig sötéten és visszataszítólag jelent meg szemei
előtt, epesztették ugyan rossz óráiban, de keserű végük rendesen az
volt, hogy egy vén kastély víg czimborák és szép asszony nélkül ép
oly unalmas, mint maga az élet. Mindig többet és többet forgott
fejében Ágnes sorsa, kivel szenvedéseinek hírei napról-napra
jobban kiengesztelték tévútakon járó, de nem romlott szívét.
Sárának minden méltatlankodó, panaszkodó, síró-rívó szava
érdekelte, foglalkoztatta, bántotta. Megemlékezett a leány igéretére,
hogy mire hazatér, minden kötelezettsége alól fel fogja szabadítani
és atyjának egész haragját kész a fejére venni. Istók elejtett,
összefüggetlen szavaiból azt kell hinnie, hogy épen ezt tette ama
gyászos, márcziusi napon. Ha hatalmában áll, bizonyára nem
fogadja el az áldozatot; de a haragos ég gyorsabban vetette magát
közbe nála. Sokszor, mind gyakrabban, egyre kevesebb
megszakítással nehezedett lelkére a sejtés, hogy Ágnes egész
szerencsétlenségének ő az oka. Az útszéli bokrokat keservesen
megvagdosta vesszejével. Ez a szerelem, Béla, ez a szerelem! E
lány, e bátor szívű és elszánt teremtés, kit te megvetettél és
gyűlölsz, tiszta lelkének nyugalmát és életének minden reménységét
feláldozza érted. Mit tehetsz érette, hogyan szabadíthatod meg?
Béla megszégyenülve hallgatta a sok mendemondát, mely hol
gúnyolódó, hol szánakozó hangon jutott füleihez s az utolsó hírre,
mely már Ágnes jövőjével játszott, látható zavarba jött. Míg a tarolt
mezőkön bolyongott s a nyugvó nap bearanyozta mögötte a kastélyt,
szívének legnemesebb húrjai rezdültek meg s tétova, kóválygó,
alaktalan gondolatai férfias elhatározássá szilárdultak. Az út, melyen
idáig jutott, kanyargó, mocsáros, csalékony volt; de mégis csak
odavezette, a hova jutnia kellett. Miért legyen ő rosszabb a frank
királynál, ki egy miatta megátkozott menyasszonyt vitt udvarába?! És
még hozzá áldozat-e az, a mit hozni szándékozik? Hisz neki nincsen
semmi, de semmi terve az életre, melyet lerontana. Mindegy,
valóban mindegy, asszonynyal tölti-e el napjait vagy asszony nélkül.
Egészen egyre megy, hogy vele vagy egy mással. De nem,
mégsem. A kéz, mely után nyúl, hű, feláldozó, szerető kéz, és ez is
valami. Levette kalapját, hogy a föllebbent szellő fujja ki egy kissé
fejét. A csöndesen folydogáló ér mellett megállt és körültekintett.
Régen mosolygott rá oly jó szívvel a természet, mint ez este. Egy
vidám dallamot fütyörészve ért haza.
– Bátyám, – mondá Istóknak, – a tizenegyedikiből hozass fel ma
estére. Bátorságot kell szereznem valahogy, mert holnap
leánynézőbe indulok.
Nem mondhatott volna semmit a mentornak, a min akár jobban
elcsodálkozzék, akár jobban megörüljön. Egy darabig némán nézett
rá, azután csöndesen emelni kezdte két foltos karját és gyöngéden
Béla vállára nyugtatta.
 – Értelek, fiam, – mondá és kis szürke szemei boldogan
mosolyogtak. Tudom, kire gondolsz, és tudom azt is, hogy meg
akarod szabadítani a nyomoruságtól. Egyetlen pillanatra sem
ingadoztam soha abbeli meggyőződésemben, hogy te (ne vedd
sértésnek) a legnemesebb anyagból vagy formálva. Ha eszembe
jutott, hogyan jártál a parasztgyerekekkel együtt betlehemezni meg
háromkirályozni, hogy egy-két fillért vihess haza szoronkodó
szülédnek, nem mondhattam egyebet, mint hogy ennek a ficzkónak
(bocsáss meg,) helyén van a szive. Ime, most is ott látja és egész
életében ott fogja látni maga előtt a betlehembeli csillagot s az után
indul. Az én áldásom… de ha fontolóra veszem, egy ilyen szegény
ember áldjon meg, Béla.
– Köszönöm, öreg barátom, köszönöm, – mondá az ifju és
megrázta Istók kezeit. De a mentor, a mint kiszabadithatta jobbját,
megint csak átölelte kedvenczét.
– Úgy, úgy, Béla, – folytatta. Már-már tartottam tőle, hogy az ilyen
magamféle magányos életre adod a fejedet. Pedig én is csak azért
maradtam így, mivel az én mélyen tisztelt néhai barátomtól sohasem
tudtam elszakadni. Mint Pallérossi Pallér István, kinek jogi és
theologiai bizonyítványai egészen rendben vannak, kaphattam volna
én leányt eleget, talán kedvemre valót is. A leányok sokat adnak a
nemeslevélre, meg a végzett emberekre. A te jövendőbelid, az igaz,
egy kicsit büszke hozzám; de azt hiszem, ha a te fényes logikáddal
megmagyarázod neki, hogy ki vagyok, és megérteted vele, hogy
eddigi szolgálataimmal kiérdemeltem mostani nyugodalmamat,
akkor meg vagyok győződve róla, hogy a szíve jobban fog felém
hajlani. Hát a tizenegyedikiből mondtad ugy-e?
– Abból, bátyám. Hanem megállj egy perczre. Hivasd fel a papot
is, meg az ispánt s hozass kártyát. Az éjszaka úgysem tudnék aludni
s nem szívesen maradnék szobámban. Töltsük vigan az időt
reggelig.
A vigan töltött éjre következő hüvös, szeles reggelen már híre
ment a dolognak a kastélyban, a mikor Béla föl akart lépni a könnyü
kocsiba, lelkendezve szaladt feléje Sári ifjasszony egy frissen
szakított rózsával, hogy azt tüzze gomblyukába; isten őrizz, hogy a
nélkül meginduljanak, mert nem lesz szerencsés az utjok. Az öreg
János is lám megegyengette, kiigazgatta kalapja mellett a bokrétáját
és vigan hajtattak Bogád felé.
Már bámultak rájuk a Biróék sárgára festett kastélyának magas
oszlopai, e sok kapitulácziót kiszolgált strázsák; a tágas udvar egész
rideg tisztaságában terült el előttük; a kút körül a három szomorúfűz
bólintgatva köszöntötte őket. Míg a kapunyitással vesződtek, a két
házi kisasszony kisietett Béla elé, kinek hazaérkezte óta ez volt első
látogatása Bogádon. Eufrozina fürtjei kifogástalan rendben rezegtek
ránczos arcza körül, Eulália kegyes kezei szokás szerint
összekulcsolva.
– Mikép vigasztaljuk fájdalmában mi, világtól elzárkódott szegény
leányok! – mondá az első s csókra nyújtott kezével finoman és
uriasan szorongatta az ifju jobbját.
– Ilyen csapások megpróbálják a hitet, – szólt a második. De a
mai világ oly keveset törődik a vallással!
– Köszönöm kegyességöket, kedves nénéim, – mondá Béla, –
nagyon köszönöm. Remélem, semmi bajt nem találok a háznál.
Ágnes is bizonyára már egészen jól van. Vele szeretnék egy-két szót
szólani minél előbb.
– Azonnal, kedves öcsém, azonnal, – biztatta Eufrozina,
miközben befelé indultak. Szegény gyermek, mily nagy öröme lesz,
ha önt viszontlátja! Ivánfi van nála épen, azért nem jöhetett ki. Mi
igazán nem szeretjük, sem én, sem Eulália, hogy ez az úr annyit jön
ide, mióta Ágnes árván maradt. Nincs modorában semmi finomság
és olyan ügyetlen, akár egy deák. És senki sem tudja látogatásainak
okát. Mit akar ő egy vagyontalan leánynyal? Ha szegény
gyermekünk nem lenne annyira eszes és vigyázó, már komolyabb
aggodalmak is ébredtek volna bennünk.
– Mert a világ rossz, – egészíté ki az ájtatos testvér. Foglaljon
helyet, Béla. Ágnes egy pillanat mulva itt lesz.
 A vendég egy perczre magányosan maradt a sárga szobában.
Kissé fel volt indulva s izgatottan jártatta körül tekintetét a sárga
társalgóban. A dusan megrakott pipere-asztal ezüst sárkányai
fogaikat mutogatták neki s a copfos porczellán-khinaiak jóizüen
mosolyogtak rajta. A szél zirgett-zörgött odakünn s Béla minden
neszre összezörrent.
Egyszer csak kinyilt előtte csöndesen, zajtalanul a szemközti ajtó
s egyszerű, fekete ruhában előtte állott Ágnes. Szintelenül,
nyugodtan, mozdulatlanul állt ott. Mintha tegnap, tegnapelőtt s
mindennap látta és sohasem szerette volna Bélát. Semmit, egy
hangot sem hallhatott ez, a mint eléje sietett, a kéz, az arcz, a kebel,
a szemek meleg beszédéből. Csak ajkai szólaltak meg:
– Jó napot, Béla.
– Jobbakat kivánok neked, Ágnes, mint az enyimek.
Leültek. Béla soká nézegette a szőnyeg rózsáit lábainál,
megfordult tekintete a csufondáros khinaiakon is, csak a leánynak
nagy, okos, megtört szemeit kerülte, melyek rajta nyugodtak. A
csöndet utoljára is Ágnes törte meg.
– Eufrozina néném azt mondta, hogy beszéded van velem.
Áteshetünk rajta?
– Igen, Ágnes. Elfeledtem, hogy vendéged van s perczeidhez
előbbvaló joga van másnak, mint nekem. Rövid leszek, pedig sok
mondanivalóm van. Ágnes!
Kezét nyujtotta Béla a lány elé, de ez visszahúzódott tőle. E
vonakodás, e váratlan hidegség, e meglepő nyugalom még nagyobb
zavarba ejtette a kérőt, ki kesztyüjét tépve s akadozva beszélt:
– Fogadd, fogadd el kezemet. Nemcsak e pillanatokra nyujtom.
Megértem, megcsodáltalak, megismertelek és nőül akarlak venni.
Nemesnek tudlak, szépnek látlak, enyimnek óhajtanálak. Megvan
még a gyűrüm? A régi még a szíved? Feledd el azt a sebet, mely az
enyimen van; hisz az csakis az enyim, s te talán boldog is lehetsz
miatta. Nem voltam mindig az, – Istenem, nem voltam; – de most jó
vagyok. Becsülj meg, Ágnes és fogadj el.
A lányt nem lepte meg kérőjének izgatott, heves beszéde.
Arczáról nem kergette el a fájó nyugalmat, nem volt képes megnyitni
szívét. Meggondoltan és hevülés nélkül adatott meg a felelet:
– Ismerlek, Béla, jobban ismerlek, mint te engem. Tudom, hogy
nem szeretsz. Tudom, hogy bátyám rettentő halála – bocsássa meg
nekem az ég – meghatott és rövid pillanatokra kijózanított
mámorodból. Tudom, hogy szívednek egy nemes hangja hitt ide,
hogy összeilleszd az elszakított iratot, leródd háládat jótevőd iránt és
megmentsd egy szegény leány jövendőjét. Azt hiszed, hogy ma
könyörülettel is beérem, mert szíved mást semmit nem adhat
nekem. Ez pedig nagyon kevés ár azokért a rettenetes éjtszakákért,
melyek a kálozdi kastélyban várnának rám. Maradj meg te utadon.
Hagyd a földön a gyűrüt, melyet elhajítottál és keresd az örömeket
azoknál, kikhez nem irgalommal közelitettél, mint hozzám.
– Ágnes, hát remény nélkül bocsátasz el?
– Maradj hű magadhoz, Béla, és ne akarj senkit megcsalni
remények emlegetésével. Neked nincsenek reményeid. Ennyi volt, a
mit kelletlenül mondtam. Most itt a kezem, melyet azért a perczért
megérdemlesz, mikor reám gondoltál. Fogd meg, egy pillanatra a
tied. Így. És most bocsáss engem is a magam utjára. Hadd
imádkozom le vétkemet és tegyek jóvá a mennyit lehet, egy minden
izében derék ember boldogításával, kinek önzetlen szerelme
meghatott.
Kinyitotta az ajtót és bevezette Ivánfit. A báró sugárzó arczczal
köszöntötte Bélát. A sok elpazarolt esztendő bizonyítványa mind
eltünt homloka pergamentjéről. Boldog és fiatal volt, mintha csak
most kezdené az életet.
– Legyenek jó rokonok, – mondá ujolag fölcsendülő hangon
Ágnes. A régi barátságot kössék atyafisággá. Béla, ki majdnem
testvérem volt, – és leendő férjem.
 – Im, itt a kezem, Béla barátom, – szólt a báró s minden
pillanatban Ágnesre szökött a szeme. Sokat beszélnek róla, hogy ön
milyen tudós. Én nem vagyok az; de tudomány nélkül is boldog, igen
boldog ember vagyok. Nem kivánok egyebet, mint hogy önt is
ennyire segítse bölcsessége. Ejnye, ez nem is volt épen rosszul
mondva. Szorítsunk hát még egyszer kezet. Iszen olykor a
tudósoknak is szükségük van ilyen magamféle egyszerű barátokra.
A hosszú ebéd, melyre a nénék Bélát erőnek erejével ott fogták,
nem igen izlett neki. Szerelmi nyil nem törött szívébe; de hát a minap
a kis kertész – kinek fiatal lelkesedése sokáig kerülgette a ránczos,
vén Sörösné pénzes ládáját – mikor kikosarazták, világgá akart
bujdosni. Béla a nélkül, hogy nyugtalan vagy bánatos lett volna,
kedvetlenségét nem tudta egészen legyőzni. Híven megtette
kötelességét; nemesnek érezte a sugallatot, mely után indult;
becsületesnek a kezet, melylyel kényszerítetlenül akart aláírni egy
kötelezőt. Ezen a napon bizonyára semmi oka elégedetlennek lenni
magával. De a kudarcz mégis csak kudarcz marad s várakozó
házanépének, mely rózsával bocsátotta el, kosarat visz haza.
Össze-összekoczintotta poharát a boldog vőlegénynyel s a
kisasszonyok mind a husz fogás étel után újra kezdték az ámulást-
bámulást a dolgoknak nem várt fordulata fölött.
Már estére járt az idő, hogy az öreg János kifordult a bogádi
kastély udvaráról, melyben minden kavics a maga helyén volt. Az idő
egyre gonoszabbul viselte magát. Az ég egészen szürkés sárgába
borult, mintha a kavargó förgeteg telehordta volna porral. A szél
esze nélkül nyargalt jobbra balra; rohanó paripáját verte, csapdosta
s füttyögetett neki. A völgyben, szántóföldeken, réteken, a halmok
oldalán, a szőllők közt mindent összetiport s valósággal
tébolyodottan csapkodta hol erre, hol arra óriási porköpönyegét.
Nem vetett rohanásának határt az erdő; a szélső fáknak hajába
kapott, tépte, czibálta őket, mig sikerült neki kiszakítani gyökerestől
és lehajigálni az árokba. Aztán tüszkölve, jajgatva, tombolva
befurakodott a sűrűbe, ott törte-marta magát, dühöngött, pusztított,
féktelenkedett és mikor a tulsó oldalon nagy-nehezen ki tudott
szabadulni a kelepczéből, melybe maga keverte magát,
megkönnyebbülten és nagyokat sóhajtozott. De csak ujra felhangzott
szilaj füttye s a szabadban folytatta veszett tánczát. A lenyugvó nap
széles, vörös karikáját, mocskos, sárga köd homályosította s az
egész láthatárt letiprott áldozatok, hajlongó tehetetlenség, messze
siró jajszavak, erőszakos dulakodás és lomhán hullámzó, nehéz,
szürke felhők töltötték be.
E csúf időben vergődtek hazafelé Béla és az öreg János. A mint
az esőmosta fakereszthez értek, hol a kálozdi és karámosi út külön
válik, egy furcsa jelenet állította meg őket. Két, szörnyen megrakott
és feldült szekér egész csapat szitkozódó, szaladgáló, sántító,
fejevesztett embertől, asszonytól és gyerektől körülfogva. Béla
kivehetett annyit, úgy a hallottakból, – csak egy-két ölnyire voltak
tőle, – mint a látottakból, hogy az első szekérnek egyik igavonó
állatja sánta volt, elesett és ezzel minden szerencsétlenség főfő
okozójává lett, mert az utószállítmány négylábu vezetői vakok lévén,
neki mentek az előttük heverő romoknak, megbotlottak és azon
vakon követték előljáróik szomorú példáját. A baj, melyet
tétovázásuk és előrenemlátásukkal előidéztek, sokkal nagyobb volt,
semhogy joguk lett volna oly nyugodtan, minden további lelkifurdalás
nélkül féloldalt elnyujtózni az árokszélen. A tornyokká rakott
szekerek kötelei megoldozódtak s a legcsodálatosabb mindenféle
hevert és röpült szerteszét. Mintha az egyik valami fejedelmi
kincstárból, a másik meg egy zsibárus-boltból rakodott volna meg. Itt
egy aranyos trónus egyik lábát keresik a számtalan csónakorru
paraszt csizma közt; a szél kaczagva kap fel egy koronát és egész
tuczat fehér, fekete, vörös parókával indíttat hajrá-versenyt utána,
mely hol a levegőben, hol a földön foly, de mindig távolabb a
szekerektől; rettenetes fejező pallosok, ijesztgető gyiklesők, rozsdás
kardok és dárdák élére egy szinehagyott, jámbor reverenda került;
czifra menték, sárga csizmák, tollas barétek, apró selyem czipők
fölött egy kis kutya jajgat, melynek a lábával történt
szerencsétlensége; bilincsek, könyvek, puskák, végetlen vászon-
végek, óriási és érthetetlen mázolások, nagyszemű gyöngyök, fekete
álarczok, rongyos dominók, mindenféle papiros-szörnyetegek,
rézgyertyatartók, szemfedők, koporsók, keresztek, félig leégett
fáklyák, mindez összevissza martalékául a víg kedvre kerekedett
viharnak.
 A mint az esőmosta fakereszthez értek, egy furcsa jelenet
állította meg őket.

A csoport, mely hol dolgozva, hol lármázva, hol kétségbeesve

állta körül a romokat, nem volt érdektelen. Uroknak és mesteröknek
egy sovány ember látszott, ki mérges tekintetét egész tragikus
vadsággal jártatta körül a pusztulás képein. Kis fejével, csontos,
régen borotvált, tüskés arczával, kidüledt szemeivel, nagy, horgas
orrával és hosszú nyakán sokszorosan körülcsavart piszkos sáljával
rendkivül hasonlított az örves keselyühöz, mely tudvalevőleg szintén
hussal táplálkozik, mint a tragikus hősök. A vihar elől kissé védett
erdőszélben ült egy fatörzsön s balját méltóságosan térdére
illesztve, jobbjával pedig egy pálinkás üveget tartogatva, a
szomorujátékokból megszokott erőteljes kifejezésekkel osztogatta
parancsait két nyurga és egy, a természet érthetetlen csodája által
jócskán meghízott alattvalójának, kik a feldűlt kocsik és szerteheverő
ruhatár körül izzadtak, s az elszunnyadt lovakkal vesződő
parasztoknak. Mint erős tölgyre a gyönge folyondár, úgy kuszott fel
hozzá egy megviselt arczu, de szende szemű nő-alak, kinek
főkötőjén ezüstös csipkék voltak s erősen igyekezett szakadt
keztyűs kezeivel minél szorosabbra kötni egy batyut, melyből a szél
különféle szinű, alaku és tömöttségű bajuszokat és szakállakat
ragadozott el. Távolabb egy másik nőt élesztgettek, ki úgy látszott,
legrosszabbul járt a balesetben.
– Förtelem és ocsmányság! – kiabált a keselyü, egyet-egyet
húzva a butykosból. Bendeguz, jobban húzd meg azt a nyomorult,
kötelet, mert porrá omlik az egész trónus! Rajta fiaim, munkához!
(Megint egyet húzott s a parasztok felé fordult.) A kendtek gebéi
alávaló párák. Kálmánka édes, a szél megint ott viszi a Friczi-
parókát! (A sápadt, kis Kálmánka, kinek a paróka-vadászatban már
egészen elfogyott a lélegzete, megint futásnak eredt.) Gézenguzok!
Mária, te is megerőltethetnéd egy kissé a kacsóidat!
A folyondár úgy felpattant e méltatlanságra, mintha a legerősebb
paprika lett volna.
– Azt hiszed, Pető? Hát a kisasszony ellen semmi kifogásod, a ki
amott oly édesdeden szunnyad? Mi csak teszünk valamit és
segítünk, (egyszerre három bajusz röpült ki kezei közül,) hanem neki
úgy látszik, kiváltsága van az ájulásokra. Sohasem hittem, hogy az ő
hősnői idegei oly gyöngék, mikor a dolgot kell kikerülni.
Ekkor lépett hozzájok Béla.
– Uraim, – mondá, – úgy látom, önök művészek és bajba
keveredtek. Azonnal besötétedik egészen; nem segíthetnék-e
valamivel?
– Azok vagyunk, – felelt a keselyű, – művészek. A művészet
pedig és a sorsharag egy méhből születtek. A hires Hollaki-társaság
vagyunk. Magam lennék az igazgató, Hollaki Pető. Mint
hősszinészről bizonyosan hallott rólam az úr; direkczióba még nem
régen fogtam. Ez nőm, utólérhetlen szende. A ki ott el van ájulva, az
a drámai hősnő, még pedig…
– Az ott vele az intrikus, – vágott férje szavaiba a megviselt arczu
szende. Amazok…
– De talán ne vesztegetnők az időt, – mondá Béla, – mert
egészen ránk esteledik. Bizonyára szerencsém lesz majd
megismerkedni valamennyiükkel. Hisz, a mint tudom, Karámosra
készülnek. Talán a nőket bevihetném kocsimon?
– Igen, a nőket vigye be az úr kocsiján, – kapott rajta az igazgató.
Az egyik úgyis el van ájulva, a másik meg itt sorba eregeti szélnek
valamennyi bajuszomat. Mi megfeszített munkánkkal is úgysem
tudom, mikor leszünk készen s kérdés, az új felpakolás után jut-e
mindnyájunknak hely a szekereken. Meg Kálmánkát is bevihetné, ha
már igazi nagylelküség dagasztja kebelét. Csak a Fekete Sas előtt
tegye majd le őket az úr. Hé Miklós meg Bendeguz, hozzátok ide
Ilonát!
A folyondár egy percz alatt felkúszott a kocsira, elfoglalta a jobbik
helyet és maga mellé húzta a fuldokló Kálmánkát. Az éledező hősnőt
is oda szállították s miután a szende állandóan félrefordította volna
fejét, elhelyezték a szabadon hagyott sarokban. Kisérője, az intrikus
– egy kiélt arczu, sötét szemű ficzkó, – a mint Bélát megpillantotta,
szinte hátratántorodva, vadul borzongott össze. De az már kezébe
vette az ostort és gyeplüt, közéjük csapott a lovaknak és nem látott
belőle semmit, a mi mögötte történt. Útközben tisztulni kezdett az idő
s a kóválygó, sűrű fellegek közül ki-kibukkant a teli hold. Béla
egyszer hátratekintett világánál s szenvedő vendégében egyikét látta
a leghódítóbb nőalakoknak. Fekete öltözetében, hosszas,
szenvedélyes és halavány arczával, a két ezüstös csillaggal nagy,
fekete szemeiben, a hold titokzatos világánál úgy tetszett neki,
mintha az éj királynéja lenne. Azután visszatekintett még többször,
sőt egy kerülőt is tett a Fekete Sasig. A hogy beértek a nagy, ronda
udvarra és leszálltak:
 – Remélem, lesz szerencsénk a holnapi előadáson, – mondá
kecses mosolylyal a szende.
– Köszönöm, uram, – szólt a királyné és egy szép, vékony, fehér
kezet nyujtott eléje.