Dysarthric talk in everyday social conversation: the nature and repair of simple and complex trouble sources.

Steven Bloch & Ray WilkinsonDept of Human Communication ScienceUniversity College London

Acquired progressive dysarthria in conversation

• How is talk in conversation managed when one person has reduced speech intelligibility?

• Interest in the everyday social consequences of dysarthria - how it is ‘played out’ (accomplished) by people at home?

• How are problems with intelligibility, when they occur, identified and repaired by participants during conversation?

Methodology : Conversation Analysis

• Three couples with MND/ALS - all experiencing mild/moderate dysarthria at recruitment stage

• Videos of naturally occurring interaction

• Data collected at three monthly intervals over a maximum 18-month period

• Data transcribed, repeatedly viewed and analysed for different patterns of interaction through talk

Repair in conversation (Schegloff, Jefferson and Sacks 1977) • Self or other initiation of repair - someone displays a problem or

trouble within current turn or in a following turn

• An identified trouble source - the problem itself

• Self or other completion of the repair - an attempt to resolve the trouble

• Other-initiated self-repair identified as a common pattern within the data for this study

Simple (single) trouble source - Rose and Tom

R: no down near Pahrnam

T: near where?

R: near Pahrnam

T: oh so it’s not so far then

R: no

Simple (single) trouble source - Mary and Stan

M: a big (.) help.

(2.0)

S: mm?

M: a big (0.5) help

S: you get oh it’s a big help

yeah it is

Complex (single) trouble source - Mary and Stan

M: spine (2.0)S: mind the what?M: spine (1.0)S: spine?

Complexity with reference to turn action and not just intelligibility

Multiple trouble source - Rose and Tom

•More than one trouble source

•Multiple attempts to resolve the trouble

• Resolved through serial repair of separate elements within the turn

Multiple trouble source - Mary and Stan

M: there was a another one last week but she couldn’t settle

S: she did what last week?

M: (repair via speech and AAC)

S: this is this woman Gladys?

Repair in dysarthria

• The real social consequence of unintelligibility• Simple and multiple trouble sources• Beyond (un)intelligibility - understandability• Natural speech and AAC are NOT mutually

exclusive resources• Collaborative action between participants

Implications

• Understanding dysarthria beyond intelligibility measures - seeing how people ‘do dysarthria’

• Possible ideas for assessment/outcomes - participants own strategies and resources

• Possible ideas for intervention - what works for each dyad? What causes problems?

• Clinician doesn’t assume expertise in dyads own resources

• Single and multiple NOT simple and complex!

For further information please feel free to contact:

s.bloch@ucl.ac.uk