The language pragmatics of children with spina bifida: A multiple-case study.

摘要

Five children and adolescents, age 9 years, 8 months to 15 years, 10 months, participated in a multiple case study designed to describe the expressive and receptive language skills of individuals with spina bifida myelomeningocele (SBM), a neural tube disorder associated with numerous physical impairments. Often SBM children give the appearance of having strong verbal skills when, in fact, they may have little comprehension of spoken words. This disparity can cause misperceptions between the children and others. While early researchers provided data concerning the unique language characteristics of this population, aspects of SBM children's language pragmatics are still not understood. To elucidate this problem, the participants were administered the Clinical Evaluation of Language Fundamental- Fourth Edition (CELF-4) which includes two pragmatic checklists. The participants' IQs were measured by the Wechsler Abbreviated Scale of Intelligence (WASI). Results showed the participants' IQs ranging from extremely low to high average. Four of the five participants had higher verbal than performance scores. Likewise, four of the five had higher expressive than receptive language scores. All of these results are in keeping with past research findings. Overall, IQ scores were associated with subtest performance on the CELF-4. However, surprisingly high, and in some cases low, subtest scores highlighted the uneven development of communication skills in this population. While all participants demonstrated deficits in communication skills on the standardized test, endorsements on the Pragmatic Profile from teachers, parents, and in some cases both, found the participants to have adequate communication skills needed for success in the classroom and at home. This raises questions regarding the ability of others to accurately assess the pragmatic skills of SBM children due to the children's tendency to act as if they comprehend oral speech when they do not. The participants reported awareness of their communication problems, and in some cases, endorsed more problems than their parents or teachers. The most salient finding was reports from parents, teachers and participants indicating the participants' difficulty with nonverbal communication. It appears that the participants have trouble interpreting body language, facial expressions, and gestures. All the participants were able to interpret voice intonation.