Semantic trouble sources and their repair in conversations affected by Parkinson's disease

Abstract

BackgroundIt is known that dysarthria arising from Parkinson's disease may affect intelligibility in conversational interaction. Research has also shown that Parkinson's disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems.AimsTo describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinson's disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding.Methods & ProceduresTwelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinson's disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinson's disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis.Outcomes & ResultsIn 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinson's disease. The problematic contributions were typically characterized by more or less explicit symptoms of word search or use of atypical wording. The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been.Conclusions & ImplicationsIn clinical work with people with Parkinson's disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics to understand more fully the impact of Parkinson's disease on everyday conversational interaction.

Speech and Communication Changes Reported by People with Parkinson’s Disease

“…Word-finding problems in people with PD have also been found to impact conversational interaction quite substantially. In a study by Saldert et al [20] it was shown that 70% of instances of other-initiated repairs were caused by word-finding problems or atypical wording by the conversation partner with PD. Typically, the non-impaired conversation partner either rephrased the utterance or suggested a way to express what the intended meaning could be in some other collaborative way.…”

Cognitive and Psychological Anomalies in Parkinsons Disease: An Insight into Non-Motor Characteristic Features

“…The functional anomalies related to behavior or intelligence is highly governed by the implication of cognitive attributes in human [44]. The major cognitive differences a physician trace in the early stage of PD includes abnormalities in execution of functions, attention difficulties, slow thinking, trouble in word selection, difficulties in remembering information, learning, hampered spatial learning and imaging capability [45,46].…”

Communication impairment in patients with Parkinson's disease: challenges and solutions

“…Saldert et al 53 and Griffiths et al 54 examined in detail naturally occurring conversations between PD patients and nonimpaired others (Griffiths et al 55 for a more general discussion on the use of CA for analyzing PD interactional difficulties). These interactions were recorded and analyzed using common CA techniques.…”

“…And, in fact, this difficulty appears to frequently result in the deletion of PD turns at talk. Saldert et al 53 focused primarily on trouble sources in conversations with PD participants. An important contribution of their work was the identification of cognitive difficulties as contributing to the initiation of repair sequences.…”