Purpose: To evaluate the clinical utility of the narrative scoring scheme (NSS) as an index of narrative macrostructure for young school-age children. Method: Oral retells of a wordless picture book were elicited from 129 typically developing children, ages 5-7. A series of correlations and hierarchical regression equations were completed using microstructural measures of vocabulary and grammar to predict NSS scores. Results: While the NSS was significantly correlated with age and each of the microstructural measures, the hierarchical regression analyses revealed a unique relationship between vocabulary and narrative macrostructure. Conclusion: The NSS is an efficient and informative tool for documenting children's development of narrative macrostructure. The relationship between the NSS and microstructural measures demonstrates that it is a robust measure of children's overall oral narrative competence and a powerful tool for clinicians and researchers. The unique relationship between lexical diversity and the NSS confirmed that a special relationship exists between vocabulary and narrative organization skills in young school-age children. (Contains 4 tables.)