ABSTRACT

Background: Collaborative referencing tasks have evolved from historically being used as experiments to study human interactions in various disciplines, to being adapted as a clinical intervention for individuals with cognitive-communication disorders such as aphasia. For both neurotypical adults and adults with cognitive-communication disorders, evidence on successful referencing is heavily based on spoken language data. The patterns of collaborative referencing in individuals with severe spoken language impairments who extensively use hand gestures for communication remain unclear. Aims: We aimed to investigate the patterns of collaborative referencing between Clyde, an individual with severe Wernicke’s aphasia using co-speech hand gestures, and a clinician-partner during the collaborative referencing intervention (CRI). Methods & Procedures: This case study included 15 CRI sessions between Clyde and the clinician-partner. Each session consisted of a photo-matching game in which the pair completed six trials with alternating turns to describe and match treatment cards over a low barrier. Data analysis included (a) measuring the mean card placement accuracy; (b) measuring the mean length of CRI trials; and (c) analysing the frequency and type of hand gestures used in no common ground and common ground conditions, and then examining if the multimodal references (i.e., labels for treatment cards produced using verbal expressions and hand gestures) simplified across CRI sessions. Outcomes & Results: Largely, the results were consistent with previous evidence on CRI: the pair scored 99.63% mean card placement accuracy and completed each trial in shorter time periods, indicating reduced collaborative effort. During the no common ground condition, the pair used a high frequency of hand gestures and a variety of gesture-type combinations to reference each card, while they used a low frequency of hand gestures dominated by iconic gestures in the common ground condition. The multimodal references were found to be simplified across sessions by the shift from using indefinite to definite verbal references, and reduced frequency and specific (iconic) types of hand gestures. Conclusions: Despite severe spoken language impairments, speakers and partners can develop common ground for successful collaborative referencing by effectively using hand gestures. Clinical implications including the role of clinicians in being a skilful and multimodal communication partner and the rich communicative environment offered by CRI will be discussed.

摘要

背景：协作参考任务已经从历史上被用作研究不同学科中人类互动的实验，发展到被改编为患有认知交流障碍（如失语症）的个体的临床干预。对于神经典型的成年人和患有认知交流障碍的成年人，成功参考的证据很大程度上基于口语数据。广泛使用手势进行交流的严重口语障碍个体的协作参考模式仍不清楚。目标：我们旨在调查 Clyde（一名使用共同语音手势的严重 Wernicke 失语症患者）与临床医生合作伙伴在协作参考干预 (CRI) 期间的协作参考模式。方法和程序：本案例研究包括 Clyde 和临床医生合作伙伴之间的 15 次 CRI 会议。每节课都包括一个照片匹配游戏，在这个游戏中，两人完成了六次交替轮流的试验，以描述和匹配低障碍的治疗卡。数据分析包括 (a) 测量平均卡片放置精度；(b) 测量 CRI 试验的平均长度；(c) 分析在无共同点和共同点条件下使用的手势的频率和类型，然后检查多模式参考（即使用口头表达和手势制作的治疗卡的标签）是否在 CRI 会话中简化。结果和结果：在很大程度上，结果与 CRI 先前的证据一致：两人的平均卡片放置准确度得分为 99.63%，并且在更短的时间内完成了每次试验，表明协作努力减少。在无共同点条件下，两人使用高频手势和多种手势类型组合来参考每张卡片，而在共同点条件下，他们使用以标志性手势为主的低频手势。通过从使用不确定的口头参考转变为使用明确的口头参考，以及减少手势的频率和特定（标志性）类型，发现多模式参考在各个会话中得到了简化。结论：尽管有严重的口语障碍，但说话者和合作伙伴可以通过有效地使用手势为成功的协作参考建立共同基础。将讨论临床意义，包括临床医生在成为熟练和多模式交流合作伙伴中的作用以及 CRI 提供的丰富交流环境。