Narrative and Other Pragmatic Language Abilities of Children With a History of Maltreatment

Abstract

Introduction In any given year, about 3.5 million children in the United States are suspected of having experienced maltreatment resulting in complex trauma involving the exposure to traumatic events and the long-term effects of this exposure on the child's psychological, emotional, social, linguistic, and communicative development. Method In this study, we analyzed retrospective data on the pragmatic language and social communication skills exhibited by children between the ages of 5 and 15 years with a documented history of maltreatment. Researchers analyzed the children's performance on the Hyter Pragmatic Protocol–Revised and the Clinical Evaluation of Language Fundamentals–Fifth Edition Screening Test to determine their syntactic, semantic, and pragmatic abilities. Analyses were also conducted to determine if children with different genders, ages, and numbers of exposures demonstrated differences in performance. Results Results showed that many children with trauma exposure demonstrated specific deficits in both narrative and expository language skills. High percentages of children exhibited difficulty using narrative cohesion, narrative coherence, expository content, expository structure, and expository coherence on the Hyter Pragmatic Protocol–Revised. The number of maltreatment exposures did not significantly impact performance on narrative measures. Female participants tended to perform better on pragmatic language tests. Younger children performed better than older children on narrative cohesion and produced a landscape of action in their narratives. Most children received passing scores on the Clinical Evaluation of Language Fundamentals–Fifth Edition Screening Test, and there were no significant differences in pass rates among age, gender, and number of exposures. Conclusions Clinical implications for assessment are discussed. Implications include the need for clinicians to test pragmatic language, especially the narrative language of children exposed to complex trauma. Because older children with trauma exposure demonstrated lower scores on certain tests of narrative language, there is a need for periodic reassessment of these pragmatic skills as children age.