Why pragmatic impairment? A case study in the comprehension of inferential meaning

This paper discusses a case study of Sarah (aged 9;8-10;3) who is reported to have pragmatic difficulties. The focus is on her comprehension of questions, which are asked on the basis of pictures and heard stories. Particular focus is on the pragmatic (or inferential) demands of the input questions and their relationship to the (in)appropriacy of the answer. Data from 16 normally functioning 6- and 8-year-old children are also presented for comparative purposes. The study shows that Sarah has difficulty with questions which require her to go beyond visually presented or verbally stated information. On one set of tasks she was to answer questions on the basis of composite pictures: for some of the questions, the answer was obvious from the picture (descriptive questions) and for others information needed to be inferred beyond the picture (for example, by imagining what had happened before and what is likely to happen next). Sarah's performance was poorer on the inferential questions than the descriptive questions and poorer than the performance of 6- and 8-year-old normally functioning control children. Although the control children also found the inferential questions more difficult than the descriptive questions, this difficulty was not as pronounced as Sarah's. This trend was also apparent in a set of tasks which required the children to answer questions on the basis of verbally told stories. This study suggests that pragmatically impaired children may have difficulty going beyond explicitly presented information and this would manifest as pragmatic production and comprehension problems. In cognitive terms, this may indicate difficulty with the process of inferencing.