title: Narrative competence in children with pragmatic language impairment: a longitudinal study.
abstract: BACKGROUND
  Children with pragmatic language impairment (PLI) show impairments in the use of language in social contexts. Although the issue has been gaining attention in recent literature, not much is known about the developmental trajectories of children who experience pragmatic language problems. Since narrative competence is an important predictor of both academic and social success, evaluating narrative competence in children with PLI is deemed important.
  
  
  OBJECTIVE
  To examine the development of narrative competence of children with PLI compared with typically developing (TD) children using a prognostic longitudinal design.
  
  
  METHODS
  Using the Dutch adaptation of the Renfrew Bus Story Test, narrative competence was assessed at ages 5-7 for a group of 84 children with PLI and a group of 81 TD children. Groups were compared on measures of narrative productivity, organization of story content and cohesion.
  
  
  RESULTS
  Results showed an increase in narrative competence for both groups across most time points. The PLI group obtained lower scores on measures of narrative productivity and story content organization compared with their TD peers at all time points, but did not show more problems related to narrative cohesion. Most problems in the domain of narrative productivity and story content organization were shown to be independent of lower non-verbal intelligence. The developmental trajectory for the PLI group was largely similar to that of their TD peers, and showed a persistent developmental delay of approximately one year. Furthermore, qualitative differences were visible in the proportion of irrelevant T-units, which was consistently higher in the PLI group. The different narrative measures were found to be relatively stable over time.
  
  
  CONCLUSIONS
  The results of this study suggest that narrative difficulties of children identified as pragmatically impaired persist at least until middle childhood. The persistence of the measured developmental delay, combined with the finding of qualitative differences, support the view of PLI as a deficit, which is consistent with the addition of social communication disorder (SCD) to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
authors.affiliation: Leiden University, Department of Clinical Child and Adolescent Studies, Leiden, the Netherlands.
authors.forename: Mieke P
authors.initials: MP
authors.lastname: Ketelaars
authors.affiliation: Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Kino
authors.initials: K
authors.lastname: Jansonius
authors.affiliation: Royal Dutch Kentalis, Eindhoven, the Netherlands.
authors.forename: Juliane
authors.initials: J
authors.lastname: Cuperus
authors.affiliation: Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands.
authors.forename: Ludo
authors.initials: L
authors.lastname: Verhoeven
mesh_terms: D057189:Checklist; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D033262:Narration; D009426:Netherlands; D011379:Prognosis; D012016:Reference Values; D012919:Social Behavior; D000067404:Social Communication Disorder / Q000175:diagnosis* / Q000523:psychology
keywords: longitudinal; narrative; pragmatic language impairment