ABSTRACT

Background

Language problems in dementia resemble the symptoms of aphasia in many respects. Persons with aphasia (PWA) and persons with dementia (PWD) present rather similar results on standardised language tests and cognitive screening tools. There is limited research that compares PWA’s and PWD’s language abilities, and a particularly small number of studies have an interactional focus.

Aims

In this study, we will contribute to the emergent discussion about interaction in aphasia and dementia. The aim was to investigate instances of trouble in conversations involving PWD, PWA and speech and language pathologists (SLPs), with a particular focus on trouble domain and interactional consequences.

Methods & Procedures

Ten PWD and 10 PWA were video-recorded during informal conversations with SLPs. Ten minutes of each conversation were transcribed thoroughly according to Conversation Analytical principles and instances of trouble were identified and calculated throughout the data. Thereafter, the instances of trouble were categorised by trouble domain: as connected to either primarily linguistic or cognitive issues.

Outcomes & results

At first glance, the conversations between the PWD and PWA seemed rather similar when looking at the number of turns and the number of instances of trouble. The analyses, however, reveal that significantly more turns were spent on trouble solving in the conversations involving the PWA. The vast majority of the troubles involving the PWA were categorised as being connected primarily to linguistic issues, whereas trouble among the PWD were more evenly distributed between the trouble domains. The SLPs took a more active role in supporting the conversations of the PWA than for the PWD.

Conclusions

The results indicate that many conversational troubles involving PWD are connected to primarily linguistic issues. However, PWD seem to have less severe linguistic problems compared to PWA. The analyses also reveal that many of the language problems described in PWD might be a direct consequence of cognitive issues, and that SLPs may take a more passive role in trouble solving in conversations involving PWD. The lack of personal common ground and preconceived notions about the medical conditions are discussed as potential motives for the SLPs’ behaviour. The analysis of instances of trouble in informal conversations might contribute to both research and clinical assessment of language abilities in PWA and PWD.

中文翻译：

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失语症和痴呆症的问题实例：对问题域和交互后果的分析

摘要

背景

痴呆症的语言问题在许多方面类似于失语症的症状。失语症患者 (PWA) 和痴呆症患者 (PWD) 在标准化语言测试和认知筛查工具上的结果非常相似。比较 PWA 和 PWD 的语言能力的研究有限，特别少数的研究关注交互。

目标

在这项研究中，我们将为有关失语症和痴呆症相互作用的新兴讨论做出贡献。目的是调查涉及 PWD、PWA 和言语和语言病理学家 (SLP) 的对话中的问题实例，特别关注问题域和交互后果。

方法和程序

在与 SLP 的非正式对话中，对 10 个 PWD 和 10 个 PWA 进行了录像。根据对话分析原则，每场对话的十分钟都被彻底转录，并且在整个数据中识别和计算了问题实例。此后，故障实例按故障域分类：主要与语言或认知问题相关。

结果和结果

乍一看，PWD 和 PWA 之间的对话在查看转弯次数和发生故障的次数时似乎非常相似。然而，分析表明，在涉及 PWA 的对话中，用于解决问题的次数明显更多。涉及 PWA 的绝大多数问题被归类为主要与语言问题有关，而 PWD 中的问题更均匀地分布在问题域之间。与 PWD 相比，SLP 在支持 PWA 的对话方面发挥了更积极的作用。

结论

结果表明，许多涉及 PWD 的会话问题主要与语言问题有关。然而，与 PWA 相比，PWD 似乎没有那么严重的语言问题。分析还表明，PWD 中描述的许多语言问题可能是认知问题的直接后果，并且 SLP 在涉及 PWD 的对话中可能在解决问题方面扮演更被动的角色。缺乏个人共同点和对医疗状况的先入为主的观念被讨论为 SLP 行为的潜在动机。对非正式对话中的麻烦事例的分析可能有助于 PWA 和 PWD 语言能力的研究和临床评估。