Research has identified language impairment as a pervasive disability (Bishop & Edmundson, 1987; Greenhalgh & Strong, 2001). Classroom communication behaviors have a role in the maintenance of special education eligibility and functional communication difficulties for young children with language impairment. This paper reviews the theoretical and experimental literature on narrative skills and language impairment as well as empirical support for understanding language delays as part of a group of risk factors that affect child development. The present study describes patterns in the communication skills of a small group of young children with a predetermined diagnosis of language impairment using a case and field mixed methods research design. The study contributes to our conceptual understanding of the pervasive nature of language impairment by focusing on patterns in oral narrative skills and their relationship to communication at school, at home, and in the community. Study results differentiate participants by the severity of utterance formulation difficulties as well as social communication differences and emotional health symptoms to identify patterns. This study was unique in that information from classroom teachers and parents in addition to an analysis of multiple language samples created a thick description of patterns across participants. Discussion elaborates upon patterns in the data and implications for assessment and practice implications for school based services from a speech-language pathologist. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]