ABSTRACT

Background: Conversation is central to building and maintaining relationships. Thus, it is unsurprising that people with aphasia and their familiar conversation partners often desire improved conversational ability. However, to facilitate real-world communication, focusing on improving aphasic language difficulties is not enough. We also need a comprehensive understanding of how social actions are accomplished in everyday aphasic conversation, including the means of participation people with aphasia possess.

Aims: To investigate the in-situ participation of people with non-fluent aphasia by analysing how they bring up, i.e., initiate, issues of importance to them in home-based authentic conversations with their familiar conversation partners.

Methodology: Using conversation analysis, we examined 6 hours of video-recorded everyday conversations of two dyads, each consisting of a person with severe/moderate Broca’s aphasia and their spouse. We analysed 89 instances of the persons with aphasia initiating talk and how these initiations were produced, where in the conversation such initiations appeared, and what the initiations accomplished socially.

Outcomes & Results: We identified two descriptive groupings of initiations by the persons with aphasia: formulaic initiations, and initiations striving for propositional content. Formulaic initiations were used in unproblematic ways to accomplish social actions like offerings, or to assess or summarize a topic after it has lapsed. Such initiations are considered important in building social cohesion. Most initiations strived for propositional content, i.e., entailed a content word, or an attempt to produce one. Such initiations were regularly intertwined with multimodal and material resources usually resulting in recognizable social actions like topic initiation irrespective of whether they included an identifiable content word or not. However, the achievement of topic initiation was crucially dependent on interactional work by the spouse. Finally, we discovered a difference in the sequential environment of propositional initiations between the dyads as only one of the spouses regularly provided slots for the person with aphasia to initiate talk.

Conclusions: Our analysis revealed persons with Broca’s aphasia participated in conversation through initiations relying on formulaic language and initiations striving for propositional content. The latter demonstrated the pronounced multimodality and interactivity of aphasic conversation. Our findings highlight the significance of the conversation partner’s skills to facilitate the person with aphasia to initiate talk. Thus, our results imply the importance of providing conversation partner training to promote participation in aphasia.

摘要

背景：对话是建立和维持关系的核心。因此，失语症患者及其熟悉的对话伙伴通常希望提高对话能力也就不足为奇了。然而，为了促进现实世界的交流，只关注改善失语症是不够的。我们还需要全面了解如何在日常失语症对话中完成社交行为，包括失语症患者所拥有的参与方式。

目的：通过分析非流利性失语症患者在与他们熟悉的对话伙伴进行的家庭真实对话中如何提出（即发起对他们重要的问题）的方式来调查他们的现场参与。

方法：使用对话分析，我们检查了两个对的 6 小时视频录制的日常对话，每个由一个患有重度/中度布罗卡失语症的人和他们的配偶组成。我们分析了 89 例失语症患者开始谈话以及这些启蒙是如何产生的，这些启蒙在谈话中出现的位置，以及这些启蒙在社会上取得了什么成就。

结果和结果：我们确定了失语症患者的两种描述性启蒙分组：公式启蒙和追求命题内容的启蒙。公式化的启蒙以毫无问题的方式用于完成诸如奉献之类的社交活动，或者在主题失效后对其进行评估或总结。这种启动被认为对建立社会凝聚力很重要。大多数启蒙都争取命题内容，即包含一个内容词，或试图产生一个内容词。此类启动经常与多模式和物质资源交织在一起，通常会导致可识别的社会行为，例如主题启动，无论它们是否包含可识别的内容词。然而，话题启动的成功很大程度上取决于配偶的互动工作。最后，

结论：我们的分析表明，布罗卡失语症患者通过依赖公式化语言的启蒙和追求命题内容的启蒙参与对话。后者展示了失语对话的显着多模态和交互性。我们的研究结果强调了谈话伙伴的技能对于促进失语症患者开始谈话的重要性。因此，我们的结果表明提供对话伙伴培训以促进参与失语症的重要性。