Collaborative participation in aphasic conversation before and after intensive language-action therapy

ABSTRACT

This study applies conversation analysis to compare everyday conversation samples between a person with aphasia (PWA) and a familiar communication partner (CP) before and after intensive language-action therapy (ILAT). Our analysis concentrated on collaborative repair sequences with the assumption that impairment-focused therapy would translate into a change in the nature of trouble sources, which engender collaborative repair action typical of aphasic conversation. The most frequent repair initiation technique used by the CP was candidate understandings. The function of candidate understandings changed from addressing specific trouble sources pre-ILAT to concluding longer stretches of the PWA’s talk post-ILAT. Alongside with these findings, we documented a clinically significant increase in the Western Aphasia Battery’s aphasia quotient post-ILAT. Our results suggest that instead of mere frequency count of conversational behaviours, examining the type and function of repair actions might provide insight into therapy-related changes in conversation following impairment-focused therapy.

KEYWORDS:

• Aphasia
• conversation analysis
• everyday conversation
• outcome measurement
• repair action

Acknowledgements

We thank the two anonymous reviewers for insightful comments on a previous version of this article. We also thank our colleagues Paula Heikkinen, Riitta-Leena Manninen, and Antti Ahvenainen for participating in the data collection.

Declaration of interest

We report no conflicts of interest.

Funding

The study Treatment-induced speech and language improvement and neuroplasticity after stroke received financial support from Tekes, the Finnish Funding Agency for Innovation [Strategic Center for Health and Well-being, financing 1104/10]. The data reported in this article were collected as a part of the research project.

Notes

¹ Statistical testing was not performed, cf. recommendations of Ledford, Wolery and Gast (2014).

² In addition to the traditional Jeffersonian transcript system (Jefferson, 2004), Riitta’s gaze was transcribed above the line: the gaze starts or shifts where the writing begins and the dotted line describes continuation of the action. Phonemic or phonological errors are italicized.

Additional information

Funding

The study Treatment-induced speech and language improvement and neuroplasticity after stroke received financial support from Tekes, the Finnish Funding Agency for Innovation [Strategic Center for Health and Well-being, financing 1104/10]. The data reported in this article were collected as a part of the research project.