Jack S. Damico

Reformulating the definition of compensatory strategies in aphasia

Abstract Based on authentic data from an ethnographic study of compensatory strategies in adults with aphasia, an operational definition of compensatory strategies has been formulated. By employing seven characteristics derived from the data, this definition provides a perspective on compensation that is different from previous definitions and examples. Several assessment and treatment implications are discussed.

A demonstration of the advantages of qualitative methodologies in stuttering research

Abstract Much of the recent literature in the field of stuttering has a primary reliance on experimental designs and quantitative analysis. Since human communication is complex and multidimensional, it is difficult to study in an unnatural experimental setting. This paper proposes an alternative methodology for queries into the complex behaviors that are associated with stuttering. Qualitative methodologies have already been used as effective research tools in anthropology, sociology, and several other social sciences. Their emergence in the field of speech-language pathology is recent. The purpose of these paper is to justify the use of qualitative methodologies as an adjunct and/or alternative to more traditional experimental methodologies. Educational Objectives: The reader will learn and be able to (1) describe the objectives of qualitative research, (2) contrast quantitative and qualitative research goals and methods, and (3) list the major strengths and weaknesses of qualitative research.

Qualitative methods in aphasia research: conversation analysis

The conversational behaviours of individuals with aphasia are becoming a more important consideration in clinical aphasiology. This is due to the increased focus on conversational dyads and conversational partners via supported conversation for adults with aphasia. This article provides an overview of a well-established analytic framework to investigate conversation in authentic settings. This framework, conversation analysis, is described according to its development and primary principles. Several examples of its application to clinical aphasiology are provided.

Qualitative methods in aphasia research: basic issues

As clinical aphasiologists seek different ways to understand the complexity of aphasia within naturalistic and social contexts, there is an increasing need to provide background information on various research paradigms not widely used in the field. Consistent with recent calls for qualitative research in clinical aphasiology, this article provides information on the rationale, design characteristics, strengths and weaknesses of this research paradigm and its usefulness in clinical aphasiology.

Access and social inclusion in aphasia: Interactional principles and applications

Background: People with aphasia are often excluded from full participation in communicative events and social interactions. Many consider the aphasic language deficit as the cause of social exclusion. However, social exclusion is a complex process that is situated within the wider realm of human social action. While the aphasia literature has provided data on resources and strategies that impact on inclusion and participation, other realms of social science have targeted social action in all its authenticity and complexity, and have focused on how social action is effectively established, negotiated, and sustained. A study of this literature can expand our understanding of issues involved in inclusion, participation, and communicative access of people with aphasia. Aims: This article will review a selected corpus of social science research that is outside the clinicians typical experience, but that is relevant to the issues of accessibility and social inclusion in aphasia. Main Contribution: Four interactional principles relevant to the enhancement of social accessibility and social inclusion will be discussed. These four principles concern social constructionism, local negotiation of social action, the collaborative nature of social action, and ways that social dimensions are manifested in social action. Understanding of broad principles of social interaction will improve our ability to enable social participation and inclusion of people with aphasia. Conclusions: This paper will describe four principles of human social interaction and highlight clinical implications involving various therapeutic strategies and communicative values related to communicative inclusion and social participation.

Partnership in conversation : A study of word search strategies

Conversation analysis was used to investigate a conversational partners strategies when assisting with the word searches of an aphasic person. The purpose was to identify and detail how such strategies were accomplished and to examine the implications of these strategies from a social and participatory perspective. Review of a large, authentic database resulted in identification of 38 videotaped conversation sequences characterized by the initiation of a word search by an aphasic speaker and the joining of this search by the conversation partner. Sequences were analyzed on a turn-by-turn basis to identify patterns of sequential organization based on similarities in contextual and functional features and to infer social implications. Results were that four conversation strategies were systematically used: guess, alternative guess, completion, and closing strategies. Each was accomplished collaboratively with specific interactional resources and techniques and were used differentially for social purposes. Implications for clinical practices involving training of conversation partners are discussed.

Spontaneous verbal repetition: A social strategy in aphasic conversation

Abstract This study investigated the spontaneous verbal repetition of a person with aphasia during conversation. Research questions were: Does repetition occur as a spontaneous verbal behaviour? How is repetion effectively used? What are the motivations for its use? A person with aphasia and his wife video recorded eight of their naturally occurring conversations which were subsequently transcribed and sequenced into turns-at-talk. Frequency of repetition and the sequential organization of conversation sequences containing repetition were analysed. Repetition was a frequent behaviour, occurring an average of 8% of the time for all conversations. Repetition was effectively used to meet the social needs of the conversation relating to displays of uncertainty, agreement, alignment and acknowledgement. Motivations for repetition related to its use as a compensatory strategy to overcome specific language barriers and to establish perceptions of conversational proficiency.

Joint productions as a conversational strategy in aphasia

To address the longstanding question of the conversational ability of persons with aphasia, this study investigated the spontaneous occurrence of a specific type of conversational collaboration, joint production, that is known to occur in the conversation of ordinary speakers. A person with aphasia and his wife videorecorded eight of their naturally occurring conversations. These conversations were analysed and three types of joint productions were identified: word search, turn completion and appendor production. Additional sequential analysis revealed the linguistic, paralinguistic and contextual resources available to the interactants in designing their joint production. Results showed that, despite the presence of aphasia, this couple was able to successfully employ joint production as an interactive technique leading to conversational success. Implications of this study are discussed relative to the understanding of communicative ability of persons with aphasia and how aphasia is diagnostically and therapeutically approached.

Management of Discourse in Group Therapy for Aphasia.

A qualitative study of group therapy for aphasia was undertaken in order to discover interaction patterns and discourse management strategies that help define “social” or “conversation” group therapy for aphasia. Specifically, an analysis of the discourse of clients and therapists was conducted to identify patterns across therapists and settings. Six group communication therapy sessions involving individuals with aphasia were videotaped and analyzed. Within the well-managed social group therapy sessions studied, a variety of discourse management features were identified, including establishing the feel of discourse equality, focusing on everyday communicative events and genres, employing multiple communication modes, mediating communication, calibrating corrections, aiding turn allocation, and judiciously employing teachable moments. The discourse patterns identified in these social conversation groups differ from discourse patterns associated with traditional impairment-focused therapy described in the aphasia literature.

Intervention Outcomes: A Clinical Application of Qualitative Methods.

&NA; A clinical application of assessment methods adapted from qualitative research is described. Specifically, data were collected via ethnographic interviewing and journal writing before, during, and after intervention in a case of adult aphasia. The data were categorized to provide insight into contexts of communication, social relationships, and feelings about life with aphasia. By analyzing the reports of the client and significant others over the course of treatment, changes in social participation and psychosocial well‐being were documented. These descriptive data provided a socially valid and consumer focused method of tracking outcome in this case.