Pragmatic ability in children with early onset brain damage and children with pragmatic language impairnent

The general purpose was to study pragmatically related abilities in children with early-onset brain damage, i.e. children with cerebral palsy (CP) and children with spina bifida and hydrocephalus (SBH), and in a group of children with pragmatic language impairment (PLI).

In study I and III children with CP, SBH and PLI were compared. In study I pragmatically related abilities were assessed. No significant differences between the CP group and the SBH group occurred, both groups having pragmatically related problems. The three groups all had problems with story comprehension and narrative ability.

In study III literal and inferential understanding were analyzed. No significant differences occurred between the CP group and the SBH group. The PLI group made fewer inferences and had significantly less typical answers compared to the CP group.

In study II, conversations during intervention between children with CP and their physiotherapists (PTs) and speech language therapists (SLTs) were studied. The PTs talked significantly more about topics not directly related to the intervention compared to the SLTs.

In study IV narrative ability in children with CP was explored. The difficulties with story recall, compared to the norms of the test and the results of a group of TD children, could be related to problems with explicitness and causal conjunctions.

In conclusion, the children with CP and the children with SBH represented in this thesis both have pragmatically related problems. The problems occur mainly in relation to higher-level language skills as narrative ability, and are mainly manifested at a textual level.