Speech acts after mild or severe childhood head injury

Children with head injury have impairments in pragmatic language. We investigated speech acts, a form of pragmatic communication, after mild or severe childhood head injury in relation to two linguistic constituents of speech acts competence (lexical-semantic knowledge, pragmatic inference) and two cognitive resources (world knowledge, working memory). Children with head injury had difficulty producing speech acts, and the magnitude of this deficit varied with head injury severity. Within the head injury group, semantic reference and information were unimportant for speech acts, which were, however, significantly predicted by pragmatic inference and working memory. The results are discussed in relation to three general issues: the effect of severity of childhood head injury on linguistic and cognitive morbidity; the relation between semantic reference, pragmatic inference and more general cognitive resources in the production of speech acts; and why semantic competence at a lexical level may not be sufficient for the production of pragmatic utterances.