A multimodal analysis of enactment in aphasia

Background: Enactment is a discourse phenomenon wherein a speaker employs direct speech and/or other behaviour such as gesture, body movement, and/or prosody to depict aspect(s) of a reported scene or event. Enactment is an identified communicative resource in people with aphasia (PWA) (Wilkinson, Beeke, & Maxim, 2010). Previous studies have suggested that the use of enactment allows PWA to exploit residual non-verbal and paralinguistic skills while employing simpler syntactic structures (Groenewold, Bastiaanse, & Huiskes, 2013).

To date, the co-occurrence of verbal, paralinguistic, and non-verbal components of communication and the exact way(s) in which they complement each other from an interpersonal perspective have rarely been studied in aphasia. This study is a first application of systematic multimodal analysis (Stec, 2016) of everyday interaction in aphasia, using enactment as a focus.

Aims: This study addresses the following research questions:

1. How are the communicative components of intonation, gesture and gaze associated with talk in the realisation of enactments by PWA in everyday interaction?

2. To what extent do they resemble characteristics of enactments produced by NBD speakers?

Methods and procedures: A 40-min video-recorded conversation between an individual with agrammatic aphasia and her non-brain-damaged (NBD) sister-in-law was analysed using a multimodal framework. The following characteristics were assessed using categorisation systems as applied in previous research: Intonation (Debras, 2015; Stec, 2016); Gesture (Debras, 2015; Sidnell, 2006); Gaze (Debras, 2015; Sidnell, 2006; Stec, 2016); and Affiliation (speakers’ endorsement of vs. dis(s)tancing from a stance attributed to an enacted speaker based on analysis of the sequential context, Debras, 2015). Finally, the co-occurrence of these characteristics and verbal indicators of enactment (e.g., person reference and reporting verb) was assessed.

Outcomes and results: The PWA produced 36 enactments. Twenty-two (61.1%) were preceded by a verbal indicator. During 19 enactments (52.7%), the PWA gazed at the addressee. Twenty-five enactments (69.4%) represented affiliation with the enacted character.

Enactments that were not preceded by a verbal indicator co-occurred with an intonation shift more often (85.7%) than verbally indicated enactments (62.7%). However, they co-occurred less often with a shift in gesturing style (42.9%) than verbally indicated enactments (63.6%).

Enactments representing affiliation with the enacted character co-occurred with shifts in intonation and gesture more often (84.0% and 56.0%, respectively) than those representing disaffiliation (70.0% and 50.0%, respectively).

Conclusions: Patterns found for the PWA differed from patterns reported for NBD speakers in several ways: First, the PWA used intonation and gesture shifts “flagging” enactment more often than NBD speakers (Stec, 2016). Second, the PWA used shifts in gesturing style more often for verbally indicated enactments than for “bare” enactments. This complementary (rather than substitutional) use of gesture could suggest that PWA exploit gesture in an even more animated way than NBD speakers. It might also reflect that enactment facilitates gesture usage by providing a functional/motivational context, or that gesture facilitates concurrent verbal indicators of enactment.

Third, whereas NBD speakers typically gaze away to indicate enactment is in progress (Sidnell, 2006), the PWA often gazed at her addressee. This could be related to her checking that she had been understood or a strategy for emphasis by engaging with the listener.

Finally, an opposite pattern (from Debras, 2015) was found for the relation between (dis)affiliation and intonation and gesture shifts.

Unpacking interplay between verbal, non-verbal, and paralinguistic devices in interaction has the potential to reveal new insights beyond representational content to encompass the way(s) in which PWA engage their listeners from an interpersonal perspective. Even though the findings must be interpreted with caution, differences between the PWA and NBD speakers found in this preliminary study point to the potential of multimodal analysis in understanding strategies involved for PWA.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work is part of the research programme. The use of direct speech as a compensatory device in aphasic interaction with project number 446-16-008, which is financed by the Netherlands Organisation for Scientific.