DISORDERS OF NONVERBAL COMMUNCIATION
C. Woodruff Starkweather Temple University, Philadelphia, Pennsylvania
The idea that nonverbal communication can be disordered is explored, and several types of nonverbal communication disorders are described. The characteristics of these disorders and a number of possible explanations for their acquisition are offered. Finally, suggestions for therapeutic procedures are made.
T w o people having a conversation do more than talk. T h e i r hands and faces move, their eyes meet and look away, their heads nod and tilt, and their bodies move in a n u m b e r of ways. Each conversational partner receives information from these nonverbal signals that influences his sense of the relationship. In animals, including some simple ones, information about the social organization of the species is shared through a refined signal system (Wilson, 1975). Some of these animal systems strongly resemble the nonverbal communication of h u m a n beings. For example, under similar circumstances, some of the facial expressions and gestures of monkeys are remarkably like our own (Marler, 1965, p. 571). Because of these and other interspecies similarities, it is not difficult to spot the pleasures and pains of animals. T o the communications specialist, any form of communication so basic that it can occasionally cross from one species to another is worth studying. Egolf and Chester (1973) have shown that speech-language pathologists should be aware of nonverbal communication because of the i m p o r t a n t role it plays in speech therapy. Clients demonstrate nonverbally their reactions to therapy materials, to therapeutic procedures, and to the clinician. Sometimes these reactions are better indicators of the client's attitudes than his verbal expressions. In certain cases, such as severe dysarthria, severe verbal apraxia, and extreme glossectomy, the prognosis is so poor that nonspeech modes of communication, such as signing, have been advocated (Silverman, 19761). W h e n verbal communication is this seriously disrupted, nonverbal channels become all the more important. Nonverbal communication is also worth studying because it may play a role ]F. H. Silvennan, personal comnmnication. 535
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in the acquisition of language, although the evidence is not yet clear on this point. We do know that nonverbal communication is an important aspect of vicarious conditioning (Miller, 1967; Miller, Banks, and Ogawa, 1962, 1963; Miller, Murphy, and Mirsky, 1959), and vicarious conditioning is a learning process with properties that help to explain the acquisition of rule-governed behavior (Bandura, 1969). It seems fair to conclude that nonverbal communication is an important process to the speech-language pathologist because (1) it is an important aspect of the way people interact with one another, (2) it has an obvious role in the therapeutic process, and (3) it may play a role in language acquisition. But in addition to cultivating an interest in nonverbal communication, speech-language pathologists should also be aware that nonverbal communication processes can be impaired. Like verbal communication, nonverbal communication can be disrupted by physiological, psychological, and sociological processes, and when this occurs a disorder of nonverbal communication may develop. It seems logical that we, as specialists in disorders of human communication, identify and treat these disorders. But what is a disorder of nonverbal communication? T o answer this question, first we need to know what the function of nonverbal communication is. T h e facial expressions, gestures, and body movements of nonverbal communication that are performed along with speech and language serve as a kind of accompaniment to our verbal signals, enriching our communicative behavior with a background of movement. These movements tend to occur in rhythmic patterns that follow the rhythms of speech (Smith and Williamson, 1977). Why do we perform these accompanying gestures while talking? A number of answers have been suggested, all of which have some merit, but in general our nonverbal signals help to clarify the nature of the relationship between two communicators. Matters of status or dominance, sexual receptivity, kinship, and aggression are made evident by nonverbal signals. It is possible to summarize these topics of nonverbal communication by saying that they are all related to the speaker's and listener's affective states-their attitudes toward each other. A disorder of nonverbal communication exists when a person is unable to communicate his affective state o1 communicates poorly. We are able to recognize such a disorder when the content of a person's verbal communication is different from the message he is sending nonverbally--for example, when his words are friendly but his manner hostile. Of course, we have no way of knowing whether such a person is friendly and sending inaccurate nonverbal signals or if he is hostile and not speaking honestly about his feelings. But in a way it does not matter whether the person is failing to communicate nonverbally, as in the first case, or just not lying very well, as in the second. In both cases, his credibility is poor and his intention to communicate friendliness, whether genuine or not, is being subverted. His genuineness seems more a matter for the psychologist, while his communicative ability is our concern.
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STARKWEATHER: Nonverbal Communication
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Surely we would be interested in treating clients of the first type who, through no fault of their own, send unintended hostile messages, but one wonders whether we should treat those whose only problem is that they do not lie adeptly. Certainly such clients would not have a high priority on the speechlanguage clinician's case load. On the other hand, some clients whose nonverbal communication is more candid than their professional or personal life requires might have a serious need for our services. We should not close the door on them without considering the extent to which their problem prevents them from obtaining economic and social gratification. Another factor to consider in determining whether there is or is not a disorder of nonverbal communication is the frequency with which these unintended nonverbal messages are sent. Discrepancies between verbal and nonverbal content occur in all of us from time to time, and a disorder should not be said to exist unless the discrepancies are frequent and severe enough to disrupt the client's social, professional, or academic activities. How often these discrepancies have to occur and how great the difference must be between verbal and nonverbal messages in order to constitute a disorder are judgments that have no well-developed criteria, only rough, unquantified, and partially subjective ones. Furthermore, we have no way of assigning nonverbal messages to specific behaviors other than our own subjective impressions. Since disorders of nonverbal communication are a new concept, more refined and objective ways of identifying them require development. Until these more operational ways of identifying nonverbal disorders have been developed, we should not treat them in routine practice, but we can and should treat them on an experimental basis, testing to determine the effectiveness of different treatments. Even if nonverbal disorders were easy to recognize, it is unlikely that clients would come to a clinic complaining of difficulty in communicating affect, nor would physicians, teachers, or guidance counselors refer clients to a speech-language pathologist for this reason. There is no pattern or syndrome characterized by a disability in communicating affect that our usual referral sources are likely to recognize as a problem that we would be particularly good at solving. If speech-language clinicians develop ways to identify and treat disorders, it will also be our job to educate our referral sources in the recognition of nonverbal disorders and teach them that we are interested in helping people who have them. But we do not need to wait for this; many of the clients we treat for verbal comnmnication disorders may also be impaired in their ability to communicate nonverbally, often as a part of their verbal disorder or as a by-product of it. We should be prepared to assist them in becoming more effective conmmnicators in both ways. For example, stutterers often colnmunicate affect poorly as a result of nonverbal idiosyncracies and avoidance reactions. This is an obvious example, but nonverbal disorders can complicate the communicative impairments of aphasics, the cerebral palsied, the retarded, or laryngectomees. In fact, we should be alert to the
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nonverbal communicative skills of all our clients. Most will be unimpaired, but some will not be as fortunate, and when a verbal impairment exists, the nonverbal channel becomes more i m p o r t a n t to the client's overall communicative effectiveness. TYPES
OF
NONVERBAL
DISORDERS
Since nonverbal communication serves to communicate attitudes and feelings, individual behaviors can be considered pathological when they hinder, weaken, or subvert this purpose. This might h a p p e n in several ways. Nonverbal communication can fail because too much or too little affect is transmitted or because the wrong attitude is signalled or received. A person whose nonverbal behavior is highly animated, with extravagant gestures when he is speaking about neutral topics may seem insincere or stagy. If this pattern of discrepancy between verbal content and nonverbal behavior occurs too frequently or if the discrepancy is too large, it might seriously impair the person's a b i l i t y to get along with others. Conversely, someone whose still face and hands and monotonous vocal melody suggest little involvement, disinterest in interacting, or aloofness, even when the content of his speech suggests the opposite, will also find it hard to relate to others if the v e r b a l / n o n v e r b a l discrepancy is too large or if instances of the discrepancy occur too often. Occasionally, someone may send an affective "statement" through nonverbal channels that is not true. T h e y appear frivolous despite serious intent, nervous when calm, or uncaring when they feel sympathetic. Like slips of the tongue or paraphasic errors, these little misstatements of affect occur in everyone from time to time and would not be considered disorders unless they occurred very frequently. Egolf and Chester (1973) describe nine ways that affect can be communicated nonverbally: personal attributes, dress, eye movements, body distance, timing, touch, objects, body movement, and voice. Although any of these nine dimensions might be misused or even disordered, four of them stand out as areas we should be particularly concerned With-specifically eye movement, timing, body movement, and w)ice. Several types of clients ]nay be impaired in their ability to communicate affect through eye movement. Certainly, both stutterers and autistic children frequently fail to maintain eye contact as do many other types of clients. Even more disruptive to nonverbal communication are habituated mannerisms of eye m o v e m e n t - b l i n k i n g , squeezing, or fluttering of the e y e l i d s - t h a t occur too often. We see these behaviors in stutterers, but they also may occur in nonstutterers (Yates, 1958). Eye contact is not only a matter of looking your listener in the eye when you talk to him. T h e r e are complex cultural rules that determine when it is appropriate to look or not look at someone else or how much eye contact is acceptable (Ellsworth and Ludwig, 1972). Deviations from these rules, if excessive or frequent, could impair a person's nonverbal communicative effectiveness.
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STARKWEATHER: Nonverbal Communication 539
Chronemics, the use of time to communicate affect, takes several forms. Egolf and Chester (1973) refer to the length of time a person may be late for a meeting, rate of speech, and the duration of silences as chronemic ways of communicating nonverbally. Of these three behaviors, only the last two are of concern to the speech-language pathologist. Speech rate is already well known in speech pathology as an aspect of communicating that can be disrupted. T h e excessive speech rate of clutterers has been described by Weiss (1964), and slow rate has been described as an aspect of a n u m b e r of different disorders, including stuttering (Van Riper, 1971), cluttering (Perkins, 1971), and cerebral palsy (Paine, 1962; Ingrain and Barn, 1961). T h e duration of silences can be excessive in some stutterers, as most clinicians know, and in some aphasics (Chester and Egolf, 1972). As a nonverbal signal, slow speech rate may tell the listener that the speaker is disinterested or bored. It may also be interpreted as stupidity. R a p i d rate probably suggests nervousness. Long silences may not signal any particular affective state, but they can be agonizing to the listener. In this and in other aspects of nonverbal communication disorders, one of the major goals of research will have to be the specification of the messages that are sent by various signals. It is acceptable to speculate about these messages now, but if we are ever to advance beyond the experimental stage in treating nonverbal disorders, we will need to find a better way of specifying their effect on listeners. Kinesic nonverbal communication refers to the use of movement to convey attitudes and feelings. Movements of the whole body or parts of the body are powerful signalers of mood and attitude, and facial and h a n d movements are particularly important. T w o types of kinesic disorders may be identified. In the first type, there is an inappropriate a m o u n t of movement, either too much or too little, usually of tile whole body. T o o much movement, like too rapid speaking, signals nervousness. T o o little movement indicates passivity, apathy, or fear. Again, we need evidence about what these different disorders mean, but when the signals are too frequent or too extensive for the verbal signals they accompany, nonverbal communication is disordered. Another more common type of kinesic disorder is tile idiosyncratic mannerism. Everyone has mannerisms, but when they distract listeners or impair the speaker's credibility by signaling that his belief or attitude is different from what he says it is, a disorder of nonverbal communication exists. One of the author's clients, for example, sniffed habitually as he spoke. T h e behavior had originated as a postponement device in a stuttering pattern, but as stuttering behavior decreased during therapy, he began to use it as a way of stalling for time when he was uncertain about what he wanted to say. We felt that it had to be reduced in frequency because it may have served as a way for stuttering behaviors to become reinstated. We were fascinated by the way this one behavior affected tile client's nonverbal communication. His continuous sniffing made him appear aloof, pompous, and disdainful, even though nothing he said indicated that these were his attitudes.
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Many clients develop a special kind of idiosyncratic mannerism as they try to cope with a verbal communication disorder, such as misarticulation or stuttering. These coping behaviors alleviate or postpone the distress brought on by self- or listener-reactions to the verbal disorder, as in the stutterer just described. Another example of coping behavior is described by Westlake and R u t h e r f o r d (1966). T h e y report a young cleft-palate speaker who tried to cover her face when she spoke. Her attempts to reduce her embarrassment made her more difficuh to understand. T h e y impaired her ability to communicate verbally, but they also interfered with her nonverbal communication by making her listeners feel uncomfortable and uncertain of her intentions. Anyone with impaired verbal communication will try to minimize the impact of the impairment. This is often done with movements of the hands, as in the preceding example, or with other parts of the body, by turning the head away, or looking down. With repeated use, these behaviors become more and more automatic and as this happens they are likely to change and lose their original character. W i t h continued use, the behaviors appear more and more bizarre, a phen()menon which Froeschels (1961) noted about the accessory features of stutterers, but which is also well known among clinical psychologists who deal with obsessive-coml)ulsive disorders (Wolpe, 1969, pp. 233-234; Meyer, 1966). If they become bizarre enough, it is hard for an observer to tell why the person is pert'orming them, and when the purpose ot an act is not clear to an observer, the behavior is likely to be judged as deviant (Bandura, 1969) and can become a serious distraction to verbal communication and a barrier to effective nonverbal comlnunication as well. It is difficult to feel secure about a person's attitudes or feelings if he continuously performs an act that is odd and apparently purposeless. Vocalics refers to the communication of attitudes and feelings by voice. Hypo- and hypervalving seem to signal fear or tension, as can a rise in pitch, a tremulous voice, or very low vocal intensity. Raised pitch might also be interpreted as anger. These effects of vocal deviation are familiar to most speech-language clinicians as aspects of voice disorders and do not require further elaboration. However, it is useful for the clinician to be aware that when a stutterer raises his vocal pitch, his listeners may think he is afraid, or when a client with a sensorineural hearing loss talks very loudly he may sound angry or hostile. These are nonverbal side effects of verbal disorders, but there are certainly other people who simply talk too loudly or too softly (Nichols, Dembowski, and Dewey, 1971), who use inappropriate prosody, and who deviate enough from cultural expectations that they find it difficult to make friends or kee t) a job. SOURCES
OF
NONVERBAL
DISORDERS
We find nonverbal disorders frequently among certain types of clients. Lovaas (1973) and Kanner (1951a, b) report a wide variety of nonverbal dis-
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STARKWEATHER- Nonverbal Communication 541
orders among autistic children, ranging from tantrums and absence of eye contact to selfstimulatory behaviors such as finger flicking and head banging. T h e occurrence of nonverbal disorders among stutterers does not require documentation. Others, too, as we have seen, may show various types of nonverbal disorders in several of the dimensions of nonverbal communication. Although it is valuable to be aware of the types of clients who may be most likely to present disorders of nonverbal communication, it may be more interesting to speculate how these disorders are acquired. Other writers have theorized how deviations of voice and speech rate might have been acquired, but no one has yet suggested ways in which disorders of eye movement or of facial, hand, or body movements may develop. In this discussion, we will restrict ourselves to these last few types of nonverbal disorders, all of which might be called idiosyncratic mannerisms. First, it seems evident without elaborate argument or documentation that mannerisms are learned. Some might disagree with this premise, but the wide individual variation in the form these behaviors take, argues strongly that they are acquired as a result of individual experience. From that premise it is interesting to see if there are certain conditioning processes that are more likely than others to produce these behaviors. T h e first conditioning process to be discussed as a possible source for idiosyncratic mannerisms interfering with nonverbal communication is superstitious conditioning. Skinner (1948) first described this pattern of responding as individualized, stereotyped, routine behavior that develops in a situation where reinforcement is noncontingently available at fixed intervals. When pigeons were placed in situations where food was made available at fixed intervals regardless of what the birds did, they developed stereotyped patterns of bowing or turning, because by chance these responses occurred immediately before the food was delivered. Nonverbal idiosyncratic mannerisms have certain characteristics that suggest superstitious conditioning: (1) they occur in conjunction with another response (verbal communication) that receives reinforcement, and (2) they are highly stereotyped in form. In fact, their individuality from person to person is so extreme that it is difficult to describe them in general terms. Idiosyncracies are, after all, idiosyncracies. Although nonverbal mannerisms may look like superstitiously conditioned behaviors, one wonders what the mechanism of reinforcement might be. Communication, or the opportunity to exercise communicative processes, has been found to be a reinforcing stimulus (Pinkowitz, 1975; Haroldson, Martin, and Starr, 1968; Wolf, Risley, and Mees, 1964; Hamilton, Stephens, and Allen, 1967; Sloane, Johnston, and Bijou, 19682; Burchard and Taylor, 1965). As a person communicates, the reinforcement that is inherent in communication becomes available. It is neither possible to say when this reinforcement is delivered nor what the mechanism is, but it makes sense to assume that mak2H. N. Sloane, Jr., M. K. Johnston, and S. W. Bijou, personal communication.
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ing a point, getting an idea across, completing an utterance, or just making social contact with another person are salient moments in any series of communicative acts. When some nonverbal behavior occurs by chance shortly before one of these supposed moments of reinforcement, the circumstances are perfect for the learning of superstitious behavior. T h a t these behaviors have a stereotyped quality makes the foot tapper, eye blinker, and eye rubber seem all the more like one of Skinner's pigeons. There are other possible ways, in addition to superstitious conditioning, in which idiosyncratic behavior might be acquired. One of these is vicarious conditioning. Certain types of people are powerful models, particularly those with high status, evident competence, or who share many characteristics with the observer (Bandura, 1969). Communicative behavior in general seems to be influenced by vicarious conditioning more readily than by other, more direct, processes (Bandura and Harris, 1966). It seems likely, too, that vicarious conditioning is the process by which slang expressions, hackneyed phrases, and verbal fads are acquired. Most of us have found ourselves with new verbal or nonverbal habits, for example dialects, after being exposed to speakers who already have them. There is nothing about idiosyncratic behaviors that suggests vicarious conditioning as a particularly good explanation of their occurrence except the susceptibility that all communicative behavior seems to have to this form of conditioning. Nevertheless, it is a possible source. Another possible source of nonverbal disorders lies in some of the consequences of physiological anxiety. During autonomic arousal, increased muscle tonus makes it more likely that repetitive movements, such as shaking hands or knees, may occur (Bowman, 1971). Increased tonus also makes it more likely that other repetitive behaviors, such as eye blinking, foot tapping, or hand rubbing will occur more often. If these behaviors are occurring more often, there is more chance of their being reinforced, either accidentally or because they have somehow been instrumental in relieving the anxiety that produced them. "/'here is no evidence that these behaviors are in fact related to autonomic arousal, although we often judge individuals with idiosyncracies as anxious. This might, however, be a fruitful line of investigation. Coping behaviors are probably acquired through avoidance conditioning. In this type of conditioning there is: (1) a cue, (2) an aversive stimulus, and (3) a response that helps the client avoid the aversive stimulus. The cue acts as a signal that the aversive stimulus will follow unless the response is performed. For example, a red traffic light (cue) signals to a driver that he might crash (aversive stimulus) if he does not apply the brakes (response). Each time he does not crash after applying the brakes he is reinforced, which strengthens the tendency to apply the brakes the next time he sees a red light. It is the repeated nonoccurrence of the aversive stimulus following performance of the response that leads to the habitual use of avoidance behavior whenever the cue occurs. Responses learned by avoidance conditioning have several characteristics:
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STARKWEATHER: NonverbaJ Communication 543
(1) They occur at high, stable rates (Kimble, 1961). We would call them compulsive. In fact, Bandura (1969) and others have described the compulsive and obsessive behaviors of patients in psychotherapy as based on avoidance conditioning because of their dependence on situational cues and the difficulty of extinguishing them. (2) Avoidance responses, although originally motivated by fear, are often unaccompanied by autonomic arousal once the behavior is well established (Notterman, Schoenfeld, and Bersh, 1952). Finally, (3), once acquired, these responses will continue to occur at stable rates for long periods of time without further exposure to the aversive stimulus (Sidman, 1955). In the case of stuttering, a client acquires a habit of, for example, turning his head to one side because this behavior forestalls or prevents stuttering. His anticipation of stuttering is the cue, head turning the avoidance response, and stuttering the aversive stimulus. Similarly, a person who is hard of hearing might be embarrassed to ask someone to repeat a statement because it would reveal his disability. T o avoid this embarrassment at a party, for example, he might stand to one side or read a magazine, thus withdrawing from social interaction (O'Neill, 1964). In this case, the social situation that demands listening is the cue, withdrawing from communication the avoidance response, and embarrassment the aversive stimulus. Nearly anyone handicapped in his ability to interact with other people may develop avoidance behaviors as a way of dealing with aversive stimuli such as embarrassment, shame, failure, or rejection. The responses they use to prevent these unpleasant feelings take many different forms, but if they occur too often or if they look too bizarre they will be judged as deviant by listeners. There is a strong possibility that these responses will interfere with nonverbal communication. T h e sources for nonverbal mannerisms that are described above are only hypothetical possibilities, suggestions of ways these behaviors might develop. We have derived these suggestions from the characteristics of mannerisms, characteristics that they share with behaviors that are known or strongly suspected of having been acquired by one of these processes. Since they are based on shared characteristics instead of direct observation, these suggestions should not be dignified by the word theory. Perhaps they will encourage research into the origins of disorders of nonverbal communication, an area in which there is essentially no data at all. THERAPIES NONVERBAL
FOR
COMMUNICATION
DISORDERS
Many clients whose nonverbal communication detracts from their overall communicative effectiveness will be able to change their behavior with no more than a few minutes of counseling. But others in whom the behaviors have become automatic will require therapy. It seems reasonable to turn to the behavior therapies to treat disorders with characteristics suggesting origins
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in conditioning processes. For problems such as nonverbal communication disorders in which the behaviors may have been acquired by any of a number of conditioning processes, an eclectic learning theory approach (Starkweather, 1977) seems most appropriate. In this view, a behavioral analysis is performed in which the characteristics of the behaviors themselves, the events that precede and follow them, the presence or absence of models, and other aspects of the client's environment are examined. From this analysis, a determination is made about the type of conditioning process that is responsible for the behavior's continued performance. Long-range and intermediate behavioral objectives are specified and experiences are selected with an eye to reversing the conditioning process. Thus, for deficits of behavior, both positive reinforcement and modeling may be effective depending on the nature of the response to be increased, while for positively reinforced behavior, simple extinction supplemented by the reinforcement or modeling of incompatible behaviors is appropriate. For avoidance behaviors, appropriate techniques prevent the avoidance response from occurring, and force the client to experience the threatening stimulus without any adverse consequences. These treatments are supplemented by hierarchical arrangement of threatening stimuli, incentives for approach responses, and extinction for any current reinforcers. In addition, massing of avoidance behavior may also be valuable. Behaviors related to classically conditioned fear may be diminished through systematic desensitization and counterconditioning. CONCLUSIONS
With increased understanding of the various forms of nonverbal communication, it has become apparent that individuals become disabled in their ability to communicate attitudes that bear on interpersonal relationships. As a result, they communicate excessive, deficient, or unintended affect, and the disorder invades several of the dimensions of nonverbal communication. It may or may not be part of a more extensive "traditional" disorder. It is appropriate that speech-language pathologists should be interested in the nature of these disorders and their treatment. Speculation about these disorders begins with the assumption that they are learned as a result of individual patterns of experience, and three conditioning processes-superstitious, vicarious, and avoidance conditioning-can be identified as hypothetical sources of their development. It is equally reasonable if these disorders are learned to turn to behavioral therapies for their treatment. ACKNOWLEDGMENT
Requests for reprints should be directed to C. W. Starkweather, Department of Speech, Temple University, Philadelphia, Pennsylvania 19122.
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REFERENCES BANDURA, A., Principles of Behavior Modification. New York: Holt (1969). BANDURA,A., and HnRRIS, M. B., Modification of syntactic style. J. exp. Child Psychol., 4, 341352 (1966). BOWMAN, J. P., The Muscle Spindle and Neural Control of the Tongue. Springfield, II1.: Charles C Thomas (1971). BURCHARD, J., and TAYLOR, V., JR., The modification of delinquent behavior through operant conditioning. Behav. Res. Ther., 2, 245-250 (1965). CHESTER, S. L., and EGOLr, D. B., Nonverbal communication and aphasia therapy. Convention address presented at the Annual Convention of the American Speech and Hearing Association, San Francisco (1972). E6oLr, D. B., and CHESTER, S. L., Nonverbal communication and the disorders of speech and language. Asha, 15, 511-518 (1973). EL~WORTI-I, P. C., and LUDWIG, L. M., Visual behavior in social interaction. J. Commun., 22, 375-403 (1972). FROESCnELS, E., New viewpoints on stuttering. Folia phoniat., 13, 188-201 (1961). HAMILTON, J., STEPHENS, L., and ALL~N, P., Controlling aggressive and destructive behavior in severely retarded institutionalized residents. Am. J. ment. Defic., 71, 852-856 (1967). HAROLDSON, S. K., MARTIN, R. R., and STAaR, C. D., Time-out as a punishment for stuttering. J. Speech Hea*cing Dis., 11, 560-566 (1968). INGaAM, T., and BARn, J., A description and classification of common speech disorders associated with cerebral palsy. Cerebr. Palsy Bull., 3, 57-69 (1961). KANNER, L., The conception of wholes and parts in early infantile autism. Am. 1. Psychiat., 108, 23-26 (1951a). KANNER, L., Discussion. Am. J. Orthopsychiat., 21, 569-570 (1951b). KIMBLE, G., (Ed.), Hilgard and Marquis' Conditioning and Learning. (rev. ed.) New York: Appleton (1961). LOVAAS, O. I., KOEC,EL, R., SIMMONS, J. Q., and LoNe, J. S., Some generalizations and follow-up measures on autistic children in behavior therapy. ]. appl. Behavl Analysis, 6, 131-166 (1973). MAgLER, P. B., Communication in monkeys and apes. In I. De Vore (Ed.), Primate Behavior: Field Studies of Monkeys and Apes. New York: Holt (1965). MFYER, V., Modification of expectations in cases with obsessional rituals. Behav. Res. Ther., 4, 273-280 (1966). MILLER, R. E., Experimental approaches to the physiological and behavioral concomitants of affective communication in rhesus monkeys. In S. A. Altmann (Ed.), Social Communication among Primates. Chicago: Univ. of Chicago Press (1967). MILLER, g.. E., BANKS, J. H., and OGAWA, N., Communication of affect in "cooperative condiditioning" of rhesus monkeys. 1. abnorm, soc. Psychol., 64, 24-30 (1962). MILLER, R. E., MURPHY, j. w., and MIRSKY, I. A., Communication of affect between feral and socially isolated monkeys. ]. Pers. soc. Psychol., 7, 231-239 (1959). NICHOLS, A. C., DEMBOWSKI, P. j., and DEWEY, A. L., The "soft-spoken" woman: I. Comfortable loudness and loudness adjustments. J. commun. Dis., 4, 134-139 (1971). NOTTERMAN, J. M., SCHOENFELD, W. N., and BERSH, P. j., A comparison of three extinction procedures following heart rate i:onditioning. J. abnorm, soc. Psychol., 47, 674-677 (1952). O'NEILL, j. j., The Hard of Hearing, Englewood Cliffs, N.J.: Prentice-Hall (1964). PAINE, g., Minimal chronic brain syndromes in children. Dev. Med. Child Neurol., 4, 21-27 (1962). PERKINS, W., Speech Pathology. St. Louis: C. V. Mosby (1971). PINKOWITZ, Y., Communicative activity as a reinforcing event. Master's thesis, Hunter College (1975). SIDMAN, M., On the persistence of avoidance behaviors. ]. abnorm, soc. Psychol., 50, 217-220 (1955). SKINNER, B. F., Superstition in the pigeon. J. exp. Psychol., 28, 168-172 (1948). SMITH, D. D., and WILLIAMSON, L. K., Interpersonal Communication: Roles, Rules, Strategies and Games. Dubuque, Iowa: W. C. Brown (1977). STARKWEATHER, C. W., Eclectic learning theory and stuttering therapy. Communicative Dis., 2:8 (1977).
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VAN RIPER, C., The Nature of Stuttering. Englewood Cliffs, N.J.: Prentice-Hall (1971). WEISS, D., Cluttering. Englewood Cliffs, N.J.: Prentice-Hall (1964). WmTeAKE, H., and RtrrnEv,VoRi), D., CleJt Palate. Englewood Cliffs, N.J.: Prentice-Hall (1966). WILSON, E. 0., Sociobiology: The New Synthesis. Cambridge, Mass.: Harvard Univ. Press (1975). WOLF, M., RISLEY, T., and MrES, H., Applications of operant conditioning procedures to the behavior problems of an autistic child. Behav. Res. Ther., 1, 305-312 (1964). WOLPE, j., The Practice o] Behavior Therapy. New York: Pergamon (1969). YATES, A. J., The application of learning theory to the treatment of tics. J. Abnorm. soc. Psychol., 56, 175-182 (1958). Received June 14, 1976. Accepted May 23, 1977.
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C. Woodruff Starkweather Temple University, Philadelphia, Pennsylvania
The idea that nonverbal communication can be disordered is explored, and several types of nonverbal communication disorders are described. The characteristics of these disorders and a number of possible explanations for their acquisition are offered. Finally, suggestions for therapeutic procedures are made.
T w o people having a conversation do more than talk. T h e i r hands and faces move, their eyes meet and look away, their heads nod and tilt, and their bodies move in a n u m b e r of ways. Each conversational partner receives information from these nonverbal signals that influences his sense of the relationship. In animals, including some simple ones, information about the social organization of the species is shared through a refined signal system (Wilson, 1975). Some of these animal systems strongly resemble the nonverbal communication of h u m a n beings. For example, under similar circumstances, some of the facial expressions and gestures of monkeys are remarkably like our own (Marler, 1965, p. 571). Because of these and other interspecies similarities, it is not difficult to spot the pleasures and pains of animals. T o the communications specialist, any form of communication so basic that it can occasionally cross from one species to another is worth studying. Egolf and Chester (1973) have shown that speech-language pathologists should be aware of nonverbal communication because of the i m p o r t a n t role it plays in speech therapy. Clients demonstrate nonverbally their reactions to therapy materials, to therapeutic procedures, and to the clinician. Sometimes these reactions are better indicators of the client's attitudes than his verbal expressions. In certain cases, such as severe dysarthria, severe verbal apraxia, and extreme glossectomy, the prognosis is so poor that nonspeech modes of communication, such as signing, have been advocated (Silverman, 19761). W h e n verbal communication is this seriously disrupted, nonverbal channels become all the more important. Nonverbal communication is also worth studying because it may play a role ]F. H. Silvennan, personal comnmnication. 535
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in the acquisition of language, although the evidence is not yet clear on this point. We do know that nonverbal communication is an important aspect of vicarious conditioning (Miller, 1967; Miller, Banks, and Ogawa, 1962, 1963; Miller, Murphy, and Mirsky, 1959), and vicarious conditioning is a learning process with properties that help to explain the acquisition of rule-governed behavior (Bandura, 1969). It seems fair to conclude that nonverbal communication is an important process to the speech-language pathologist because (1) it is an important aspect of the way people interact with one another, (2) it has an obvious role in the therapeutic process, and (3) it may play a role in language acquisition. But in addition to cultivating an interest in nonverbal communication, speech-language pathologists should also be aware that nonverbal communication processes can be impaired. Like verbal communication, nonverbal communication can be disrupted by physiological, psychological, and sociological processes, and when this occurs a disorder of nonverbal communication may develop. It seems logical that we, as specialists in disorders of human communication, identify and treat these disorders. But what is a disorder of nonverbal communication? T o answer this question, first we need to know what the function of nonverbal communication is. T h e facial expressions, gestures, and body movements of nonverbal communication that are performed along with speech and language serve as a kind of accompaniment to our verbal signals, enriching our communicative behavior with a background of movement. These movements tend to occur in rhythmic patterns that follow the rhythms of speech (Smith and Williamson, 1977). Why do we perform these accompanying gestures while talking? A number of answers have been suggested, all of which have some merit, but in general our nonverbal signals help to clarify the nature of the relationship between two communicators. Matters of status or dominance, sexual receptivity, kinship, and aggression are made evident by nonverbal signals. It is possible to summarize these topics of nonverbal communication by saying that they are all related to the speaker's and listener's affective states-their attitudes toward each other. A disorder of nonverbal communication exists when a person is unable to communicate his affective state o1 communicates poorly. We are able to recognize such a disorder when the content of a person's verbal communication is different from the message he is sending nonverbally--for example, when his words are friendly but his manner hostile. Of course, we have no way of knowing whether such a person is friendly and sending inaccurate nonverbal signals or if he is hostile and not speaking honestly about his feelings. But in a way it does not matter whether the person is failing to communicate nonverbally, as in the first case, or just not lying very well, as in the second. In both cases, his credibility is poor and his intention to communicate friendliness, whether genuine or not, is being subverted. His genuineness seems more a matter for the psychologist, while his communicative ability is our concern.
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537
Surely we would be interested in treating clients of the first type who, through no fault of their own, send unintended hostile messages, but one wonders whether we should treat those whose only problem is that they do not lie adeptly. Certainly such clients would not have a high priority on the speechlanguage clinician's case load. On the other hand, some clients whose nonverbal communication is more candid than their professional or personal life requires might have a serious need for our services. We should not close the door on them without considering the extent to which their problem prevents them from obtaining economic and social gratification. Another factor to consider in determining whether there is or is not a disorder of nonverbal communication is the frequency with which these unintended nonverbal messages are sent. Discrepancies between verbal and nonverbal content occur in all of us from time to time, and a disorder should not be said to exist unless the discrepancies are frequent and severe enough to disrupt the client's social, professional, or academic activities. How often these discrepancies have to occur and how great the difference must be between verbal and nonverbal messages in order to constitute a disorder are judgments that have no well-developed criteria, only rough, unquantified, and partially subjective ones. Furthermore, we have no way of assigning nonverbal messages to specific behaviors other than our own subjective impressions. Since disorders of nonverbal communication are a new concept, more refined and objective ways of identifying them require development. Until these more operational ways of identifying nonverbal disorders have been developed, we should not treat them in routine practice, but we can and should treat them on an experimental basis, testing to determine the effectiveness of different treatments. Even if nonverbal disorders were easy to recognize, it is unlikely that clients would come to a clinic complaining of difficulty in communicating affect, nor would physicians, teachers, or guidance counselors refer clients to a speech-language pathologist for this reason. There is no pattern or syndrome characterized by a disability in communicating affect that our usual referral sources are likely to recognize as a problem that we would be particularly good at solving. If speech-language clinicians develop ways to identify and treat disorders, it will also be our job to educate our referral sources in the recognition of nonverbal disorders and teach them that we are interested in helping people who have them. But we do not need to wait for this; many of the clients we treat for verbal comnmnication disorders may also be impaired in their ability to communicate nonverbally, often as a part of their verbal disorder or as a by-product of it. We should be prepared to assist them in becoming more effective conmmnicators in both ways. For example, stutterers often colnmunicate affect poorly as a result of nonverbal idiosyncracies and avoidance reactions. This is an obvious example, but nonverbal disorders can complicate the communicative impairments of aphasics, the cerebral palsied, the retarded, or laryngectomees. In fact, we should be alert to the
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nonverbal communicative skills of all our clients. Most will be unimpaired, but some will not be as fortunate, and when a verbal impairment exists, the nonverbal channel becomes more i m p o r t a n t to the client's overall communicative effectiveness. TYPES
OF
NONVERBAL
DISORDERS
Since nonverbal communication serves to communicate attitudes and feelings, individual behaviors can be considered pathological when they hinder, weaken, or subvert this purpose. This might h a p p e n in several ways. Nonverbal communication can fail because too much or too little affect is transmitted or because the wrong attitude is signalled or received. A person whose nonverbal behavior is highly animated, with extravagant gestures when he is speaking about neutral topics may seem insincere or stagy. If this pattern of discrepancy between verbal content and nonverbal behavior occurs too frequently or if the discrepancy is too large, it might seriously impair the person's a b i l i t y to get along with others. Conversely, someone whose still face and hands and monotonous vocal melody suggest little involvement, disinterest in interacting, or aloofness, even when the content of his speech suggests the opposite, will also find it hard to relate to others if the v e r b a l / n o n v e r b a l discrepancy is too large or if instances of the discrepancy occur too often. Occasionally, someone may send an affective "statement" through nonverbal channels that is not true. T h e y appear frivolous despite serious intent, nervous when calm, or uncaring when they feel sympathetic. Like slips of the tongue or paraphasic errors, these little misstatements of affect occur in everyone from time to time and would not be considered disorders unless they occurred very frequently. Egolf and Chester (1973) describe nine ways that affect can be communicated nonverbally: personal attributes, dress, eye movements, body distance, timing, touch, objects, body movement, and voice. Although any of these nine dimensions might be misused or even disordered, four of them stand out as areas we should be particularly concerned With-specifically eye movement, timing, body movement, and w)ice. Several types of clients ]nay be impaired in their ability to communicate affect through eye movement. Certainly, both stutterers and autistic children frequently fail to maintain eye contact as do many other types of clients. Even more disruptive to nonverbal communication are habituated mannerisms of eye m o v e m e n t - b l i n k i n g , squeezing, or fluttering of the e y e l i d s - t h a t occur too often. We see these behaviors in stutterers, but they also may occur in nonstutterers (Yates, 1958). Eye contact is not only a matter of looking your listener in the eye when you talk to him. T h e r e are complex cultural rules that determine when it is appropriate to look or not look at someone else or how much eye contact is acceptable (Ellsworth and Ludwig, 1972). Deviations from these rules, if excessive or frequent, could impair a person's nonverbal communicative effectiveness.
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STARKWEATHER: Nonverbal Communication 539
Chronemics, the use of time to communicate affect, takes several forms. Egolf and Chester (1973) refer to the length of time a person may be late for a meeting, rate of speech, and the duration of silences as chronemic ways of communicating nonverbally. Of these three behaviors, only the last two are of concern to the speech-language pathologist. Speech rate is already well known in speech pathology as an aspect of communicating that can be disrupted. T h e excessive speech rate of clutterers has been described by Weiss (1964), and slow rate has been described as an aspect of a n u m b e r of different disorders, including stuttering (Van Riper, 1971), cluttering (Perkins, 1971), and cerebral palsy (Paine, 1962; Ingrain and Barn, 1961). T h e duration of silences can be excessive in some stutterers, as most clinicians know, and in some aphasics (Chester and Egolf, 1972). As a nonverbal signal, slow speech rate may tell the listener that the speaker is disinterested or bored. It may also be interpreted as stupidity. R a p i d rate probably suggests nervousness. Long silences may not signal any particular affective state, but they can be agonizing to the listener. In this and in other aspects of nonverbal communication disorders, one of the major goals of research will have to be the specification of the messages that are sent by various signals. It is acceptable to speculate about these messages now, but if we are ever to advance beyond the experimental stage in treating nonverbal disorders, we will need to find a better way of specifying their effect on listeners. Kinesic nonverbal communication refers to the use of movement to convey attitudes and feelings. Movements of the whole body or parts of the body are powerful signalers of mood and attitude, and facial and h a n d movements are particularly important. T w o types of kinesic disorders may be identified. In the first type, there is an inappropriate a m o u n t of movement, either too much or too little, usually of tile whole body. T o o much movement, like too rapid speaking, signals nervousness. T o o little movement indicates passivity, apathy, or fear. Again, we need evidence about what these different disorders mean, but when the signals are too frequent or too extensive for the verbal signals they accompany, nonverbal communication is disordered. Another more common type of kinesic disorder is tile idiosyncratic mannerism. Everyone has mannerisms, but when they distract listeners or impair the speaker's credibility by signaling that his belief or attitude is different from what he says it is, a disorder of nonverbal communication exists. One of the author's clients, for example, sniffed habitually as he spoke. T h e behavior had originated as a postponement device in a stuttering pattern, but as stuttering behavior decreased during therapy, he began to use it as a way of stalling for time when he was uncertain about what he wanted to say. We felt that it had to be reduced in frequency because it may have served as a way for stuttering behaviors to become reinstated. We were fascinated by the way this one behavior affected tile client's nonverbal communication. His continuous sniffing made him appear aloof, pompous, and disdainful, even though nothing he said indicated that these were his attitudes.
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Many clients develop a special kind of idiosyncratic mannerism as they try to cope with a verbal communication disorder, such as misarticulation or stuttering. These coping behaviors alleviate or postpone the distress brought on by self- or listener-reactions to the verbal disorder, as in the stutterer just described. Another example of coping behavior is described by Westlake and R u t h e r f o r d (1966). T h e y report a young cleft-palate speaker who tried to cover her face when she spoke. Her attempts to reduce her embarrassment made her more difficuh to understand. T h e y impaired her ability to communicate verbally, but they also interfered with her nonverbal communication by making her listeners feel uncomfortable and uncertain of her intentions. Anyone with impaired verbal communication will try to minimize the impact of the impairment. This is often done with movements of the hands, as in the preceding example, or with other parts of the body, by turning the head away, or looking down. With repeated use, these behaviors become more and more automatic and as this happens they are likely to change and lose their original character. W i t h continued use, the behaviors appear more and more bizarre, a phen()menon which Froeschels (1961) noted about the accessory features of stutterers, but which is also well known among clinical psychologists who deal with obsessive-coml)ulsive disorders (Wolpe, 1969, pp. 233-234; Meyer, 1966). If they become bizarre enough, it is hard for an observer to tell why the person is pert'orming them, and when the purpose ot an act is not clear to an observer, the behavior is likely to be judged as deviant (Bandura, 1969) and can become a serious distraction to verbal communication and a barrier to effective nonverbal comlnunication as well. It is difficult to feel secure about a person's attitudes or feelings if he continuously performs an act that is odd and apparently purposeless. Vocalics refers to the communication of attitudes and feelings by voice. Hypo- and hypervalving seem to signal fear or tension, as can a rise in pitch, a tremulous voice, or very low vocal intensity. Raised pitch might also be interpreted as anger. These effects of vocal deviation are familiar to most speech-language clinicians as aspects of voice disorders and do not require further elaboration. However, it is useful for the clinician to be aware that when a stutterer raises his vocal pitch, his listeners may think he is afraid, or when a client with a sensorineural hearing loss talks very loudly he may sound angry or hostile. These are nonverbal side effects of verbal disorders, but there are certainly other people who simply talk too loudly or too softly (Nichols, Dembowski, and Dewey, 1971), who use inappropriate prosody, and who deviate enough from cultural expectations that they find it difficult to make friends or kee t) a job. SOURCES
OF
NONVERBAL
DISORDERS
We find nonverbal disorders frequently among certain types of clients. Lovaas (1973) and Kanner (1951a, b) report a wide variety of nonverbal dis-
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STARKWEATHER- Nonverbal Communication 541
orders among autistic children, ranging from tantrums and absence of eye contact to selfstimulatory behaviors such as finger flicking and head banging. T h e occurrence of nonverbal disorders among stutterers does not require documentation. Others, too, as we have seen, may show various types of nonverbal disorders in several of the dimensions of nonverbal communication. Although it is valuable to be aware of the types of clients who may be most likely to present disorders of nonverbal communication, it may be more interesting to speculate how these disorders are acquired. Other writers have theorized how deviations of voice and speech rate might have been acquired, but no one has yet suggested ways in which disorders of eye movement or of facial, hand, or body movements may develop. In this discussion, we will restrict ourselves to these last few types of nonverbal disorders, all of which might be called idiosyncratic mannerisms. First, it seems evident without elaborate argument or documentation that mannerisms are learned. Some might disagree with this premise, but the wide individual variation in the form these behaviors take, argues strongly that they are acquired as a result of individual experience. From that premise it is interesting to see if there are certain conditioning processes that are more likely than others to produce these behaviors. T h e first conditioning process to be discussed as a possible source for idiosyncratic mannerisms interfering with nonverbal communication is superstitious conditioning. Skinner (1948) first described this pattern of responding as individualized, stereotyped, routine behavior that develops in a situation where reinforcement is noncontingently available at fixed intervals. When pigeons were placed in situations where food was made available at fixed intervals regardless of what the birds did, they developed stereotyped patterns of bowing or turning, because by chance these responses occurred immediately before the food was delivered. Nonverbal idiosyncratic mannerisms have certain characteristics that suggest superstitious conditioning: (1) they occur in conjunction with another response (verbal communication) that receives reinforcement, and (2) they are highly stereotyped in form. In fact, their individuality from person to person is so extreme that it is difficult to describe them in general terms. Idiosyncracies are, after all, idiosyncracies. Although nonverbal mannerisms may look like superstitiously conditioned behaviors, one wonders what the mechanism of reinforcement might be. Communication, or the opportunity to exercise communicative processes, has been found to be a reinforcing stimulus (Pinkowitz, 1975; Haroldson, Martin, and Starr, 1968; Wolf, Risley, and Mees, 1964; Hamilton, Stephens, and Allen, 1967; Sloane, Johnston, and Bijou, 19682; Burchard and Taylor, 1965). As a person communicates, the reinforcement that is inherent in communication becomes available. It is neither possible to say when this reinforcement is delivered nor what the mechanism is, but it makes sense to assume that mak2H. N. Sloane, Jr., M. K. Johnston, and S. W. Bijou, personal communication.
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ing a point, getting an idea across, completing an utterance, or just making social contact with another person are salient moments in any series of communicative acts. When some nonverbal behavior occurs by chance shortly before one of these supposed moments of reinforcement, the circumstances are perfect for the learning of superstitious behavior. T h a t these behaviors have a stereotyped quality makes the foot tapper, eye blinker, and eye rubber seem all the more like one of Skinner's pigeons. There are other possible ways, in addition to superstitious conditioning, in which idiosyncratic behavior might be acquired. One of these is vicarious conditioning. Certain types of people are powerful models, particularly those with high status, evident competence, or who share many characteristics with the observer (Bandura, 1969). Communicative behavior in general seems to be influenced by vicarious conditioning more readily than by other, more direct, processes (Bandura and Harris, 1966). It seems likely, too, that vicarious conditioning is the process by which slang expressions, hackneyed phrases, and verbal fads are acquired. Most of us have found ourselves with new verbal or nonverbal habits, for example dialects, after being exposed to speakers who already have them. There is nothing about idiosyncratic behaviors that suggests vicarious conditioning as a particularly good explanation of their occurrence except the susceptibility that all communicative behavior seems to have to this form of conditioning. Nevertheless, it is a possible source. Another possible source of nonverbal disorders lies in some of the consequences of physiological anxiety. During autonomic arousal, increased muscle tonus makes it more likely that repetitive movements, such as shaking hands or knees, may occur (Bowman, 1971). Increased tonus also makes it more likely that other repetitive behaviors, such as eye blinking, foot tapping, or hand rubbing will occur more often. If these behaviors are occurring more often, there is more chance of their being reinforced, either accidentally or because they have somehow been instrumental in relieving the anxiety that produced them. "/'here is no evidence that these behaviors are in fact related to autonomic arousal, although we often judge individuals with idiosyncracies as anxious. This might, however, be a fruitful line of investigation. Coping behaviors are probably acquired through avoidance conditioning. In this type of conditioning there is: (1) a cue, (2) an aversive stimulus, and (3) a response that helps the client avoid the aversive stimulus. The cue acts as a signal that the aversive stimulus will follow unless the response is performed. For example, a red traffic light (cue) signals to a driver that he might crash (aversive stimulus) if he does not apply the brakes (response). Each time he does not crash after applying the brakes he is reinforced, which strengthens the tendency to apply the brakes the next time he sees a red light. It is the repeated nonoccurrence of the aversive stimulus following performance of the response that leads to the habitual use of avoidance behavior whenever the cue occurs. Responses learned by avoidance conditioning have several characteristics:
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STARKWEATHER: NonverbaJ Communication 543
(1) They occur at high, stable rates (Kimble, 1961). We would call them compulsive. In fact, Bandura (1969) and others have described the compulsive and obsessive behaviors of patients in psychotherapy as based on avoidance conditioning because of their dependence on situational cues and the difficulty of extinguishing them. (2) Avoidance responses, although originally motivated by fear, are often unaccompanied by autonomic arousal once the behavior is well established (Notterman, Schoenfeld, and Bersh, 1952). Finally, (3), once acquired, these responses will continue to occur at stable rates for long periods of time without further exposure to the aversive stimulus (Sidman, 1955). In the case of stuttering, a client acquires a habit of, for example, turning his head to one side because this behavior forestalls or prevents stuttering. His anticipation of stuttering is the cue, head turning the avoidance response, and stuttering the aversive stimulus. Similarly, a person who is hard of hearing might be embarrassed to ask someone to repeat a statement because it would reveal his disability. T o avoid this embarrassment at a party, for example, he might stand to one side or read a magazine, thus withdrawing from social interaction (O'Neill, 1964). In this case, the social situation that demands listening is the cue, withdrawing from communication the avoidance response, and embarrassment the aversive stimulus. Nearly anyone handicapped in his ability to interact with other people may develop avoidance behaviors as a way of dealing with aversive stimuli such as embarrassment, shame, failure, or rejection. The responses they use to prevent these unpleasant feelings take many different forms, but if they occur too often or if they look too bizarre they will be judged as deviant by listeners. There is a strong possibility that these responses will interfere with nonverbal communication. T h e sources for nonverbal mannerisms that are described above are only hypothetical possibilities, suggestions of ways these behaviors might develop. We have derived these suggestions from the characteristics of mannerisms, characteristics that they share with behaviors that are known or strongly suspected of having been acquired by one of these processes. Since they are based on shared characteristics instead of direct observation, these suggestions should not be dignified by the word theory. Perhaps they will encourage research into the origins of disorders of nonverbal communication, an area in which there is essentially no data at all. THERAPIES NONVERBAL
FOR
COMMUNICATION
DISORDERS
Many clients whose nonverbal communication detracts from their overall communicative effectiveness will be able to change their behavior with no more than a few minutes of counseling. But others in whom the behaviors have become automatic will require therapy. It seems reasonable to turn to the behavior therapies to treat disorders with characteristics suggesting origins
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in conditioning processes. For problems such as nonverbal communication disorders in which the behaviors may have been acquired by any of a number of conditioning processes, an eclectic learning theory approach (Starkweather, 1977) seems most appropriate. In this view, a behavioral analysis is performed in which the characteristics of the behaviors themselves, the events that precede and follow them, the presence or absence of models, and other aspects of the client's environment are examined. From this analysis, a determination is made about the type of conditioning process that is responsible for the behavior's continued performance. Long-range and intermediate behavioral objectives are specified and experiences are selected with an eye to reversing the conditioning process. Thus, for deficits of behavior, both positive reinforcement and modeling may be effective depending on the nature of the response to be increased, while for positively reinforced behavior, simple extinction supplemented by the reinforcement or modeling of incompatible behaviors is appropriate. For avoidance behaviors, appropriate techniques prevent the avoidance response from occurring, and force the client to experience the threatening stimulus without any adverse consequences. These treatments are supplemented by hierarchical arrangement of threatening stimuli, incentives for approach responses, and extinction for any current reinforcers. In addition, massing of avoidance behavior may also be valuable. Behaviors related to classically conditioned fear may be diminished through systematic desensitization and counterconditioning. CONCLUSIONS
With increased understanding of the various forms of nonverbal communication, it has become apparent that individuals become disabled in their ability to communicate attitudes that bear on interpersonal relationships. As a result, they communicate excessive, deficient, or unintended affect, and the disorder invades several of the dimensions of nonverbal communication. It may or may not be part of a more extensive "traditional" disorder. It is appropriate that speech-language pathologists should be interested in the nature of these disorders and their treatment. Speculation about these disorders begins with the assumption that they are learned as a result of individual patterns of experience, and three conditioning processes-superstitious, vicarious, and avoidance conditioning-can be identified as hypothetical sources of their development. It is equally reasonable if these disorders are learned to turn to behavioral therapies for their treatment. ACKNOWLEDGMENT
Requests for reprints should be directed to C. W. Starkweather, Department of Speech, Temple University, Philadelphia, Pennsylvania 19122.
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