Adriana Lavi


The purpose of this study was bi-fold: to develop and analyze the validity and reliability of a comprehensive pragmatic language diagnostic tool, the Clinical Assessment of Pragmatics as well as comparatively examine and analyze pragmatic language profiles of three groups of adolescents. These included students with Language Impairment (LI), High-Functioning Autism (HFA) and typically developing students. During the validation phase of the study, thirty participants, ages 14 to 16 years old, were administered 3 pragmatic judgment and 3 pragmatic performance subtests comprised of 10 items each for a total of 60 test items. A series of validity and reliability measures were employed for the purpose of validating target diagnostic tool. During the second part of this study, one hundred and twenty participants, ages 14 to 16 years old, were administered the CAPs to comparatively analyze their receptive and expressive pragmatic language performance. Study results revealed that this instrument provides a valid and reliable comprehensive measure of pragmatic language skills. Both test-retest and interrater reliability were found to be strong. Experts rated the CAPs highly for both content and clarity. Concurrent validity was obtained on three of the CAPs subtests and was found to correlate to three existing pragmatic language instruments and measures (the Clinical Assessment of Spoken Language – Pragmatic Judgement subtest, the Test of Pragmatic Language and the Social Language Development Test, adolescent). Further, the results revealed significant differences among all groups of students on expressive and receptive pragmatic language tasks. Students with HFA and SLI demonstrated adequate performances on instrumental pragmatic language tasks. However, they had significant difficulties on higher order pragmatics such as perceiving irony, sarcasm, and expressing sorrow or support. Furthermore, the HFA group was distinguished by profound deficits in students’ ability to recognize and appropriately use facial expressions. CAPs is a tool which is both valid and reliable and can be used as a means of determining whether school-aged students present with deficits in pragmatic language skills, specifically, high-functioning autism or specific language impairment.

LLU Discipline

Rehabilitation Sciences


Physical Therapy


School of Allied Health Professions

First Advisor

Mainess, Karen J.

Second Advisor

Daher, Noha S.

Third Advisor

Jacob, John

Degree Name

Doctor of Philosophy (Medical Science)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Language Disorders

Subject - Local

Pragmatic Language; Language Impairment; Instrumental Performance Appraisal; Paralingistic Decoding



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives