Practitioner review: The assessment of language pragmatics

Background: The assessment of pragmatics expressed in spoken language is a central issue in the evaluation of children with communication impairments and related disorders. A developmental approach to assessment has remained problematic due to the complex interaction of social, linguistic, cognitive and cultural influences on pragmatics. Method: A selective review and critique of current formal and informal testing methods and pragmatic analytic procedures. Results: Formal testing of pragmatics has limited potential to reveal the typical pragmatic abnormalities in interaction but has a significant role to play in the assessment of comprehension of pragmatic intent. Clinical assessment of pragmatics with the pre-school child should focus on elicitation of communicative intent via naturalistic methods as part of an overall assessment of social communication skills. Assessments for older children should include a comprehensive investigation of speech acts, conversational and narrative abilities, the understanding of implicature and intent as well as the child's ability to employ contextual cues to understanding. Practical recommendations are made regarding the choice of a core set of pragmatic assessments and elicitation techniques. The practitioner's attention is drawn to the lack of the usual safeguards of reliability and validity that have persisted in some language pragmatics assessments. Conclusions: A core set of pragmatic assessment tools can be identified from the proliferation of instruments in current use. Further research is required to establish clearer norms and ranges in the development of pragmatic ability, particularly with respect to the understanding of inference, topic management and coherence.