Children with cerebral palsy, spina bifida and pragmatic language impairment: differences and similarities in pragmatic ability.

Pragmatically related abilities were studied in three clinical groups of children from 5 to 11 years of age; children with cerebral palsy (CP; n=10), children with spina bifida and hydrocephalus (SBH; n=10) and children with pragmatic language impairment (PLI; n=10), in order to explore pragmatic abilities within each group. A range of pragmatic, linguistic and cognitive assessments were performed, and comparisons between the groups were made. In addition, connections between variables were studied. The most salient result was the many similarities and the lack of clear boundaries between the groups. The only significant differences found concerned short-term memory and inference ability, where all three groups experienced problems but to varying extent. Different patterns of variance were found in the groups, indicating that different underlying abilities such as reception of grammar, inferential comprehension and lexical comprehension seem to affect pragmatic ability in somewhat different ways. The results suggest that the children with CP and SBH in this study shared a number of pragmatically related traits, being more similar than would be expected according to earlier research. Finally, it is suggested that pragmatic assessment is further subdivided into a socially versus a linguistically related assessment.