Distinguishing pragmatic language impairment from typical SLI: Story comprehension and recall

1
Distinguishing pragmatic language impairment
from typical SLI Story comprehension and recall

• Courtenay Frazier Norbury
• Dorothy V. M. Bishop
• Oxford Study of Childrens Communication
  Impairments

2
Types of inferences

• Previous studies of inferencing ability in
  children with language impairment have contrasted
  literal versus inferential comprehension only
• Two types of inferences investigated here
  text connecting
• gap filling

3
Text connecting

• Example
• Helen looked down on the beach from her hotel
  window. She could see a man selling ice cream.
• Infer that the man selling ice cream was on the
  beach

• Definition
• Child must integrate information explicitly
  mentioned in the narrative to link ideas in two
  sentences

4
Gap filling

• Example
• Sam went on holiday to Spain. The journey took
  over 2 hours. He looked down on the mountains as
  they passed overhead.
• Infer Sam flew to Spain on an aeroplane

• Definition
• Child is required to integrate his own
  knowledge with information in the narrative to
  fill in details not explicitly stated.

5
Participants

• Four groups of children
• Control (n 10)
• Specific Language Impairment (SLI)(n 11)
• Pragmatic Language Impairment (PLI) (n 12)
• High functioning autism (n 9)
• Children assigned to these groups using the
  Childrens Communication Checklist (CCC Bishop,
  1998)

nb scores of less than 132 indicate pragmatic
deficit on CCC
6
Participants
NVIQ Ravens Coloured Matrices BPVS British
Picture Vocabulary Scales TROG Test for
Reception of Grammar
7
Inferencing stories(Cain Oakhill, 1999)

• Topics
• Soccer game
• Holiday to Spain
• Birthday party
• Funfair
• Trip to the seaside

• Task
• Listen to a short story
• Answer 6 questions about it
• Graded prompts given until child arrives at the
  correct response

8
Inferencing stories(Cain Oakhill, 1999)
9
Story questions

• 2 literal
• Where did Helen Sam go on holiday?
• How often did Helen Sam go to the beach?
• 2 text connecting
• Where was the man selling ice-cream?
• Where did they carry their luggage?
• 2 gap filling
• How did Helen Sam travel to Spain?
• How did they travel around the bay?

10
Story recall

• Children asked to retell last story AFTER all
  questions had been answered
• Two points given for each story proposition
  mentioned by the child
• One initial prompt given to all children,
  otherwise further encouragement did not contain
  information about the story

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Predictions

• Children with pragmatic impairments (PLI and high
  functioning autism) will demonstrate story
  comprehension deficits, particularly on
  inferencing questions
• Children with poor story comprehension scores
  will have more difficulty recalling a story

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Results Story Comprehension

• No significant group differences on story
  comprehension, but lots of variation in PLI group
• Main effect of question type, with gap filling
  inferences more difficult for everyone

13
Poor comprehenders

• Children with pragmatic deficits showed greater
  variation in scores
• Categorically, children with pragmatic deficits
  were more likely to be poor comprehenders (scores
  below 90)
• For children with PLI, poor comprehenders had
  significantly lower scores on receptive grammar
  (TROG)

Percentage of poor comprehenders in each sub-group
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Relationship between CCC and story comprehension
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Specific deficit in inferencing?

• Specific problems with inferencing identified by
  using a difference score
• (mean literal score - mean gap filling score)
• Children with pragmatic deficits (i.e. CCC scores
  below 132) more likely to have large difference
  scores (?2 4.842 p .028)

16
Story recall

• No significant group differences on story recall
• Strong relationship between story recall and
  total comprehension
• This relationship holds even when digit span
  taken into account

(r .6 p lt .001)
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Sources of errors on comprehension task

• Memory
• dont know largest error response
• Comprehension failure
• Q how did they travel around the bay?
• A they talked
• Failure to take context into account (wrong
  inference)
• Q where was the man selling ice cream?
• A in the ice cream shop
• Lack of general knowledge
• Q how did Helen and Sam travel to Spain?
• A they walked (child never been on aeroplane
  or to Spain)
• Failure to recognize an inference is required
• child responds you didnt say that in the story

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The Bottom Line

• Children with pragmatic language deficits (as
  measured by CCC) are at increased risk for
  deficits in story comprehension and inferencing
• This risk is compounded by structural language
  deficits, particularly in receptive grammar (as
  measured by TROG)
• Good story comprehension aids recall by enabling
  children to build an integrated representation of
  the story

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Clinical implications

• In combination with other standardized language
  measures, the CCC can help identify children with
  potential inferencing deficits
• Intervention could focus on
• comprehension monitoring (for unfamiliar words or
  experiences)
• integrating story information in context
• recognizing when and why inferences occur
• (see Yuill Oakhill, 1988 for inference training
  with poor reading comprehenders)

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Key References

• Bishop, D.V.M Adams, C. (1992) Comprehension
  problems in children with specific language
  impairment Literal and inferential meaning.
  Journal of Speech and Hearing Research, 35,
  119-129.
• Bishop, D.V.M. (1998) Development of the
  Childrens Communication Checklist (CCC) A
  method for assessing qualitative aspects of
  communicative impairment in children. Journal of
  Child Psychology and Psychiatry, 39(6), 879-891.
• Cain, K. Oakhill, J. (1999) Inference making
  ability and its relation to comprehension failure
  in young children. Reading and writing An
  Interdisciplinary Journal,11, 489-503.
• Yuill, N. Oakhill, J. (1988) Effects of
  inference awareness training on poor reading
  comprehension. Applied Cognitive Psychology, 2,
  33-45.