Patterns of Conversation Trouble Source and Repair as Indices of Improved Conversation in Aphasia: A Multiple-Case Study Using Conversation Analysis.

Abstract

Purpose Social approaches to intervention for aphasia are being increasingly employed to address the functional communication barriers experienced by persons with aphasia. One specific approach is the use of conversation-based treatment in both group and two-person dyads. Although there are several methods to measure improvement for stimulation and cognitive neurolinguistic approaches, researchers have consistently indicated a need for outcome measures that can objectively demonstrate improved communication following conversation treatment. This study aims to demonstrate the utility for examining the patterns of conversation trouble source and repair as indices for improved communication as a positive response to intervention. Method The conversations of 20 consecutive participants, before and after 3 months, or 40 hr, of group and individual conversation-based treatment, were transcribed using conventions of conversation analysis, and sociolinguistic discourse analysis was applied. Measures of trouble source and repair were aggregated and subjected to statistical analysis. Results Persons with aphasia demonstrated statistically significant improvement in patterns of conversation trouble source and repair posttreatment for the rate of conversation trouble source and the length of repair. However, measures of self-initiation and self-completion of repair did not reach significance. Conclusion The study indicates that, following conversation-based treatment, the conversations of persons with aphasias were more efficient, experiencing fewer trouble sources and shorter repair sequences. These findings suggest that measures of conversation for the rate of trouble source and length of the repair sequence are valid indices of improved conversation.