Pragmatic impairment: a case study
The question of why a child may be diagnosed as having pragmatic difficulties or pragmatic impairment is one which is currently being asked by researchers and other speech and language professionals. The identifiying criteria for such a diagnosis remain unclear. This paper reports on a detailed case study of a child, Sarah (aged 9;8-10;3), who was reported to have pragmatic impairment as her primary difficulty by her speech and language therapist. The child attends a language unit within a mainstream school in the UK. A number of language (including narrative) and non-verbal tasks have been carried out with the child over a seven-month period, and spontaneous conversational data has also been obtained. The data is explored from grammatical, lexical and pragmatic perspectives. This child's performance is also compared with that of two groups of normal children, 6-year-olds and 8-year-olds. It is argued that Sarah has demonstrable pragmatic impairments, especially with inferencing skills, and that these impairments represent more than a developmental delay. It is also argued that these impairments cannot be explained by other linguistic difficulties that she may have. Sarah's difficulties are discussed in terms of problems building up a 'mental model' (Johnson-Laird, 1983) of situations in order to be able to make effective inferences. It is hope to carry out a further study with children who have a range of specific language impairments to see to what extent such problems are restricted to the pragmatic domain, or influenced by deficits at other levels.