This paper reviews new theoretical and practical developments in working with partners of people with aphasia and describes the development of a clinician's resource entitled 'SPPARC: Supporting Partners of People with Aphasia in Relationships and Conversation'. It focuses particularly on one part of that resource: the SPPARC Conversation Training Programme, which adapts conversation analysis for clinical use. The paper describes the stages involved in assessing and working on conversation in everyday life.

No abstract

Background: In recent years conversation has become an area of interest for aphasia therapy, with several studies using conversation analysis (CA) to target and evaluate therapy. Most of these studies have focused on the main conversation partner of the person with aphasia, and in particular have targeted the partner's pedagogic behaviours in relation to the person with aphasia. Evaluations of therapy have primarily taken the form of qualitative analyses of change in conversational behaviours. Aims: This single-case intervention study aims to advance research into interaction-focused intervention for aphasia in the following ways: by targeting intervention at the person with aphasia and the main conversation partner as a couple; by focusing on conversational behaviours where the person with aphasia can be seen to be restricted by the conversational actions of the conversation partner, in particular by recurrent questioning using closed questions and yes/no interrogatives; and by using a novel combination of qualitative and quantitative approaches to evaluate the intervention. Methods Procedures: CA was used to target and evaluate interaction-focused intervention for a couple where one partner has aphasia. Evidence for change was evaluated using qualitative and quantitative evidence of change in conversational behaviours; evidence from naive raters of pre- and post-intervention conversation extracts; and interview/other feedback from the conversation partner. Outcomes Results: There was evidence that the intervention had changed the couple's conversational behaviours. In particular, the conversational behaviours of the non-aphasic partner were in general less restricting for the person with aphasia in that she was now using fewer questions and more instance of other types of turns, such as paraphrases. Following intervention the person with aphasia had also changed in that he was now producing turns that had more sentences, or attempts at sentences, and which developed the topic of talk across several of his turns. Conclusions: The study provides evidence that directly targeting the conversational behaviours of the person with aphasia and/or a main conversational partner can produce positive change, and can achieve this in a way that is ecologically valid. In particular, it highlights the usefulness of targeting conversational behaviours that are proving to be maladaptive for the participants. It provides further evidence that creating change in the non-aphasic partner's conversational behaviour may facilitate change in the person with aphasia's conversational and linguistic performance

This paper discusses the implementation and evaluation of an interaction-focused intervention single case study for a couple where one partner has aphasia. Drawing on conversation analytic research, naturally occurring conversations of the couple at home pre-and post-intervention were collected and analysed. Analysis of the speaker with aphasia's topic initiating turns in the pre-intervention conversation showed that in each case a feature of the attempt was that the speaker had difficulty in getting the topic initiation accepted and established. Drawing on conversation analytic work on topic initiations in normal conversation, intervention focused on training the couple to co-produce these topic initiating turns of the speaker with aphasia in a collaborative and step-by-step manner. Post-intervention, there was evidence that the couple were now using this new method, albeit in a slightly different way to that worked on in the intervention sessions. Drawing on work into adaptation by speakers with aphasia and their conversation partners, these results are discussed in terms of a process of mutual adaptation by the couple.

This study focuses on the assessment and treatment of the conversations of a couple where one partner has aphasia. The assessment and treatment, informed by conversation analysis, are described, and some implications for the relation between language and psychosocial issues discussed.

The quantitative and qualitative use of cohesive ties in the expository discourse of groups of normal young adults, normal older adults, older people with anomic aphasia and older people with probable Alzheimer's Disease (AD) was investigated. Lack of a published suitable diagnostic tooJ which can differentiate the language disorder of fluent aphasia and the language disorder associated with AD, plus a dearth of normative data concerning the use of cohesion in the above groups, were the main foci of the investigation. It aimed to describe patterns of cohesion for each group, to compare group patterns and to focus specifically on whether any variations in use could significantly differentiate the discourse of people with AD from that of people with anomic aphasia. Discourse samples were subjected to analysis for appropriate and disrupted cohesive ties. Results revealed both quantitative and quditative differences in the discourse cohesion of the groups, indicating how language use changes through senescence and pathology. Significant differences in the quantity and patterns of use of cohesive ties in the discourse of people with anomic aphasia and people with AD revealed that cohesion analysis can differentiate the language disorders found in these two groups. Knowing the meaning, getting the point, bridging the gap and carrying the message: aspects of discourse following closed head injury in childhood and adolescence. Brain and Language, 39, 428-446. FOLSTEIN, M. F., FOLSTEIN, S. E., and MCHUGH, P. R. (1975) 'Mini-mental state'-a practical method of grading the cognitive status of patients for the clinician.

No abstract

No abstract