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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. Types of inferences.

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Distinguishing pragmatic language impairment from typical sli story comprehension and recall

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

Types of inferences
Types of inferences SLI:

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

Text connecting

Definition: SLI:

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


‘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

Gap filling

Definition SLI:

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


‘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

Participants SLI:

  • 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

Participants SLI:

NVIQ = Raven’s Coloured Matrices

BPVS = British Picture Vocabulary Scales

TROG = Test for Reception of Grammar

Inferencing stories cain oakhill 1999

Topics SLI:

Soccer game

Holiday to Spain

Birthday party


Trip to the seaside


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)

Inferencing stories cain oakhill 19991
Inferencing stories SLI: (Cain & Oakhill, 1999)

Story questions
Story questions SLI:

  • 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?

Story recall
Story recall SLI:

  • 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

Predictions SLI:

  • 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

Results story comprehension
Results: Story Comprehension SLI:

  • 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

Poor comprehenders
Poor comprehenders SLI:

  • 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

Relationship between ccc and story comprehension

r = .393 SLI:

p < .01

Relationship between CCC and story comprehension

Specific deficit in inferencing
Specific deficit in inferencing? SLI:

  • 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)

Story recall1

r = .643 SLI:

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)

Sources of errors on comprehension task
Sources of errors on comprehension task: SLI:

  • 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’

The bottom line
The Bottom Line SLI:

  • 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

Clinical implications
Clinical implications SLI:

  • 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)

Key references
Key References SLI:

  • 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.