Verbal play as an interactional discourse resource in early stage Alzheimer's disease

Abstract

Background: Verbal play, the creative and playful use of language to make puns, rhyme words, and tease, is a pervasive and enjoyable component of social communication and serves important interpersonal functions. The current study examines the use of verbal play in the communicative interactions of individuals with Alzheimer's disease as part of a broader programme of research on language-and-memory-in-use. We thank M. Cartier, M. Hauser, K. Leners, L. Savicki, and L. Steinmetz in the Communication and Memory Laboratory for assistance in data coding, and Rupa Gupta and Margaret Miller for helpful comments on a previous version this manuscript. Funding from NIDCD grant 1F32DC008825, Fraternal Order of the Eagles, and NINDS P50 NS19632. Aims: To document the frequency of verbal play in the communicative interactions of individuals with very mild Alzheimer's disease (AD) and their familiar communication partners and to characterise the interactional forms, resources, and functions of playful episodes. Methods & Procedures: Using quantitative group comparisons and detailed discourse analysis we analysed verbal play in the interactional discourse of five participants with very mild AD and five healthy (demographically matched) comparison participants. Each participant interacted with a familiar partner while completing a collaborative referencing task, and with a researcher between task trials. Outcomes & Results: A total of 1098 verbal play episodes were coded. Despite being in the early stages of AD, all the AD participants used verbal play. There were no significant group differences in the frequency of verbal play episodes or in the interactional forms, resources, or functions of those playful episodes between AD and healthy comparison pair sessions. Conclusions: The successful use of verbal play in the interactions of individuals with very mild AD and their partners highlights an area of preserved social communication. These findings represent an important step, both clinically and for research, in documenting the rich ways in which individuals with early stage AD orchestrate interactionally meaningful communication with their partners through the use of interactional discourse resources like verbal play. This work also offers a promising clinical tool for tracking and targeting verbal play across disease progression.