The aim of the study was to investigate and compare the ability to make inferences in three groups of children ranging from 5;2 to 10;9 years: 10 children with cerebral palsy (CP), 10 children with spina bifida and hydrocephalus (SBH) and 10 children with pragmatic language impairment (PLI). The relationship between inferential and literal comprehension was investigated by analysing atypical responses. For this analysis an analytic framework was developed. The PLI group performed significantly worse on inferential questions than the CP group. It was only in the PLI group that problems with inferential questions exceeded the problems with literal questions, and the CP group even performed significantly better in this condition. Inferential comprehension was found to be related to language comprehension in the CP group, but was more related to the ability to predict future developments in the SBH- and PLI-groups. The PLI group relied more on world knowledge and associations than on text-related factors when delivering an atypical response compared to the CP group. The analysis of atypical responses proved to be a promising tool for the planning of an adequate intervention. (Contains 3 figures and 3 tables.)