Using Conversation Analysis to Assess and Treat People with Aphasia

Abstract

This article gives an overview of the application to aphasia of conversation analysis (CA), a qualitative methodology for the analysis of recorded, naturally occurring talk produced in everyday human interaction. CA, like pragmatics, considers language use in context, but it differs from other analytical frameworks because the clinician is not making interpretations about how an aspect of language should be coded or judging whether an utterance is successful or adequate in terms of communication. We first outline the CA methodology before discussing its application to the assessment of aphasia, principally through the use of two published assessment tools. We then move on to illustrate applications of CA in the field of aphasia therapy by discussing two single case study interventions. Key conversation behaviors are illustrated with transcripts from interactions recorded by the person with aphasia and the person's habitual conversation partner in the home environment. Finally, we explore the implications of using CA as a tool for assessment and treatment in aphasia.

Redesigning therapy for agrammatism: Initial findings from the ongoing evaluation of a conversation-based intervention study

“…Because interaction is a complex and multifaceted contextual phenomenon, it does not lend itself to analysis by the imposition of top-down decontextualized classification methods. Neither does it react well to attempts to constrain the data collection process (for a review, see Beeke, Maxim, & Wilkinson, 2007, and Beeke, submitted for publication). As a result, clinicians have begun to turn their attentions to the direct analysis of samples of everyday conversation (Oelschlaeger & Thorne, 1999;Ramsberger & Menn, 2003;Ramsberger & Rende, 2002).…”

Functionally relevant items in the treatment of aphasia (part I): Challenges for current practice

“…The person with aphasia and their communication partners may also be asked to keep communication diaries to provide a more objective measure of conversational topics and enable detection of their personal strengths and weaknesses (e.g., Simmons-Mackie & Damico, 2001). Analyses of authentic conversation samples can also offer a window onto people's communication (see, e.g., Beeke, Maxim, & Wilkinson, 2007;Lesser & Perkins, 1999;Perkins, Crisp, & Walshaw, 1999) and can be used to provide information on people's lexical choices (e.g., Schegloff, Koshik, Jacoby, & Olsher, 2002). A question that remains unanswered, however, is how many different speech samples and how much time is needed to infer truly individualised sets of vocabularies.…”

On the intersection of phonetic detail and the organization of interaction: Clinical connections

“…The imperatives are themselves extensions and developments of core aspects of Conversation Analysis (CA; Sidnell & Stivers, 2013), and reflect practices in certain studies of atypical speech and language behaviours (e.g. ; Wootton, 1990Wootton, , 1999Wells & Local, 1993;Goodwin, 1995Goodwin, , 2003Radford & Tarplee, 2000;Beeke, Maxim, & Wilkinson, 2007;Wilkinson, 2007;Schegloff & Lerner, 2009). Since they provide the framework for the observations we make in this paper we reproduce them here in a concise form from Local and Walker (2005); throughout this article ÔIÕ followed by a number is used to refer to a particular imperative.…”