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 Children’s 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. Definition: Child must integrate information explicitly mentioned in the narrative to link ideas in two sentences 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 Text connecting

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

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 Children’s Communication Checklist (CCC; Bishop, 1998) nb: scores of less than 132 indicate pragmatic deficit on CCC

6. Participants NVIQ = Raven’s Coloured Matrices BPVS = British Picture Vocabulary Scales TROG = Test for Reception of Grammar

7. 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 Inferencing stories(Cain & Oakhill, 1999)

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

11. 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

12. 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

14. r = .393 p < .01 Relationship between CCC and story comprehension

15. 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 (χ2 = 4.842; p = .028)

16. r = .643 p < .001 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 < .001)

17. Sources of errors on comprehension task: • Memory • ‘don’t 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 didn’t say that in the story’

18. 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

19. 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)

20. 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 Children’s 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.