Conversation repair: Ecological validity of outcome measures in acquired hearing impairment

Abstract

Objective

Everyday conversation is the most widely reported difficulty arising from adult acquired hearing impairment (HI), yet no clinical method currently exists by which direct observation of conversational ability can be measured. This review of recent research argues that specific patterns of conversation repair arise in interaction involving adults who have acquired HI and that they may be of utility in assessing the outcome of intervention.

Methods

This brief review paper presents a summary of data on the conduct of repair in free and unstructured conversations between HI adults and their frequent communication partners using Conversation Analysis as the guiding theory and analytic method.

Results

Results indicate that certain types of repair are influenced by one participant in the conversation having an acquired hearing impairment. Further, these patterns of repair behaviour are resolved in concert by the participants in the conversation.

Discussion

Patterns of repair behaviour may be used as criterion variables in assessing the need for and outcome of audiological intervention, including implantation, hearing aid fitting and/or conversation-based therapy. Previous research has shown that these measures are both consistent across time in the absence of intervention and that they are sensitive to intervention.

Conclusion

These findings support the potential for conversationally-oriented therapy models of assessment and intervention and suggest a framework by which clinical tasks might be analysed with respect to their conversation ‘reality’. This initial evidence needs to be supported by investigations across larger samples of adults with acquired hearing impairment.

Keywords:

• Acquired hearing impairment
• Conversation Analysis
• Repair
• Conversation-based therapy
• Aural rehabilitation

Acknowledgements

The author acknowledges with thanks Med-El UK, the South of England Cochlear Implant Centre, Southampton and Flinders University, South Australia for their financial support in the presentation of this paper at the British Cochlear Implant Group conference in Manchester, in March 2012. Thanks also to Elise Okell for valuable comments on drafts of this paper.