Conversation in Aphasia Across Communication Partners: Exploring Stability of Microlinguistic Measures and Communicative Success

Abstract

Purpose The aim of this study was to determine if people with aphasia demonstrate differences in microlinguistic skills and communicative success in unstructured, nontherapeutic conversations with a home communication partner (Home-P) as compared to a speech-language pathologist communication partner (SLP-P). Method Eight persons with aphasia participated in 2 unstructured, nontherapeutic 15-minute conversations, 1 each with an unfamiliar SLP-P and a Home-P. Utterance-level analysis evaluated communicative success. Two narrow measures of lexical relevance and sentence frame were used to evaluate independent clauses. Two broad lexical and morphosyntactic measures were used to evaluate elliptical and dependent clauses and to evaluate independent clauses for errors beyond lexical relevance and sentence frame (such as phonological and morphosyntactic errors). Utterances were further evaluated for presence of behaviors indicating lexical retrieval difficulty (pauses, repetitions, and false starts) and for referential cohesion. Results No statistical differences occurred for communicative success or for any of the microlinguistic measures between the SLP-P and Home-P conversation conditions. Four measures (2 of lexical retrieval and 1 each of communicative success and grammaticality) showed high correlations across the 2 conversation samples. Individuals showed variation of no more than 10 percentage points between the 2 conversation conditions for 46 of 56 data points. Variation greater than 10 percentage points tended to occur for the measure of referential cohesion and primarily for 1 participant. Conclusions Preliminary findings suggest that these microlinguistic measures and communicative success have potential for reliable comparison across Home-P and SLP-P conversations, with the possible exception of referential cohesion. However, further research is needed with a larger, more diverse sample. These findings suggest future assessment and treatment implications for clinical and research needs. Supplemental Material https://doi.org/10.23641/asha.7616312

Face-to-Face Communication in Aphasia: The Influence of Conversation Partner Familiarity on a Collaborative Communication Task

“…We found that as instructors, PWA showed a different pattern of behavior when working with a FCP compared to an UFCP (shorter trial times, fewer clarification requests with the UFCP, and stable accuracy scores and self-initiated repairs). The stability to the number of self-initiated repairs is in line with previous studies that have suggested that certain aspects of communication might remain stable across different communicative settings and CPs (Lubinski et al, 1980;Gurland et al, 1982;Leaman and Edmonds, 2019). The higher number of clarification requests with the FCP is also in line with previous research with NHC (Boyle et al, 1994).…”

“…Only a small number of studies have explored the influence of personal common ground on communication for PWA. Leaman and Edmonds (2019) analyzed and compared the unstructured conversations of eight PWA (most with mild anomic aphasia) with a familiar conversation partner (FCP) and an unfamiliar speech and language therapist (SLT). The authors reported no differences on measures of communicative success, on linguistic measures such as grammaticality (morphological and verb tense/ mood errors) and sentence production (correct use of a complete sentence frame and the relevance of lexical items in the frame in the discourse context), or on lexical retrieval behaviors (false starts, repetitions, pauses of 2+ s, etc.).…”

“…However, it is generally accepted that such impairment-based performance measures do not reliably predict communication ability in the real world (Holland, 1982;Kolk and Heeschen, 1992;Wilkinson, 1995;Beeke et al, 2007;Davidson et al, 2008;Armstrong et al, 2011). Perhaps because of the complexity of language and communication, the same level of detailed analysis has not been applied to real-world communication for PWA (Leaman and Edmonds, 2019). Providing reliable assessment and evidence-based interventions at the level of communication has, for that reason, remained problematic in aphasiology (Brady et al, 2016).…”

What is Functional Communication? A Theoretical Framework for Real-World Communication Applied to Aphasia Rehabilitation

“…Research has shown that to guide turn projection during conversation, such as when interlocutors expect a turn to end, adults and children benefit most from having both lexico-syntactic and prosodic information (when this information is congruent, providing multimodal gain). When lexico-syntactic and prosodic information is contrasting, lexico-syntactic information has been shown to be weighed more heavily (Lammertink et al., 2015 ). Based on their research with neurologically healthy controls in children and adults, Lammertink et al ( 2015 ) suggest that to fully benefit from prosodic information for turn structure in conversation, some lexico-syntactic information is necessary.…”

“…When lexico-syntactic and prosodic information is contrasting, lexico-syntactic information has been shown to be weighed more heavily (Lammertink et al., 2015 ). Based on their research with neurologically healthy controls in children and adults, Lammertink et al ( 2015 ) suggest that to fully benefit from prosodic information for turn structure in conversation, some lexico-syntactic information is necessary. This idea is supported by other research (Casillas & Frank, 2017 ; Männel & Friederici, 2010 ).…”