Richard Body

Inflexibility as an interactional phenomenon: Using conversation analysis to re-examine a symptom of autism.

Many accounts of autism spectrum disorder (ASD) imply that the conditions behavioural ‘symptoms’ are direct reflexes of underlying deficits. In doing so, however, they invariably overlook the social contexts in which symptomatic behaviours occur and are identified as pathological. This study addresses this issue, using conversation analysis (CA) to examine the emergence of inflexibility, a behavioural trait symptomatic of ASD, during play involving an adult and diagnosed child. We argue that ‘inflexibility’ is the product of the childs strategic attempts to retain control over the unfolding interaction, within a context where such attempts breach normative expectations about adult–child play. Furthermore, it demonstrates that the adult does not resist these attempts, on occasion even explicitly providing opportunity for subsequent inflexibility. This challenges the assumption that ASDs behavioural profile solely represents the endpoint of underlying deficit, and demonstrates how ‘non-impaired’ speakers can be implicated in the manifestation of symptomatic behaviours.

Validation of linguistic analyses in narrative discourse after traumatic brain injury

Narrative discourse tasks are a common feature of assessment and research after traumatic brain injury (TBI) and other types of brain damage. Although stimulus materials and analysis methods have been developed from a variety of theoretical perspectives, many do not challenge cognitive–linguistic skills sufficiently to highlight individual difficulties in assessment after TBI. This study employed a complex story recall task and it aimed to develop analysis methods that were sensitive to differences in recalled narratives and which could be validated against the perceptions of external raters. Twenty TBI adults and 20 matched control subjects were tested and their narratives analysed in terms of six measures (T-units, Noun:Pronoun Ratio, Scenes, Errors, Comments and Tentative Statements). Two groups of raters (one professionally trained, the other not) judged the transcribed narratives on ratings of Content and Clarity. Multiple regression analyses established that two of the linguistic measures in combination predicted ratings of Content, while a further three in combination predicted ratings of Clarity. Cut-off scores were established in order to categorize the TBI and control subjects’ performance. The validated measures provide the foundation for analyses of complex narrative as a means of assessment after TBI.

Topic repetitiveness after traumatic brain injury: an emergent, jointly managed behaviour.

Topic repetitiveness is a common component of pragmatic impairment and a powerful contributor to social exclusion. Despite this, description, characterization and intervention remain underdeveloped. This article explores the nature of repetitiveness in traumatic brain injury (TBI). A case study of one individual after TBI provides the basis for a conceptualization of topic repetitiveness in terms of two major strands of thinking in pragmatics. Firstly, it is viewed as an emergent response to underlying deficits in non‐linguistic abilities. Secondly, it is described in terms of joint management of topic development between the person with TBI and his interlocutor.

A discursive psychology critique of semantic verbal fluency assessment and its interpretation

Semantic verbal fluency (SVF), a psychological assessment method used in experimental research and clinical practice, requires participants to produce as many words as possible from a given superordinate category (e.g., “animals,” “vehicles”). Features of responses, such as the prototypicality and ordering of items, are then interpreted as if revealing details about the organisation—or, in instances of ostensibly atypical performance, disorganisation—of participants’ underlying conceptual and/or semantic systems. In this paper, we draw upon perspectives from Discursive Psychology, particularly the work of Derek Edwards (e.g., Edwards, 1997), to argue against this position. Following critical discussion of SVF’s strongly cognitivist theoretical foundations, we present analyses of social interactions across various contexts, including the real-life administration of the paradigm with a child with autism, to suggest that performance is unavoidably socially mediated rather than solely internally driven. Our arguments challenge SVF’s validity and its role in the description of “cognitive disorder.”

Uncovering the dynamic in static assessment interaction

Traditional approaches to standardized assessment are underpinned by the assumption that between-assessor variation in delivery can effectively be eliminated. However, fine-grained analyses of the administration of such assessments (e.g. Maynard and Marlaire, 1992) have established that significant subtle interactional variations occur even in procedures with regimented protocols, and that such variations can demonstrably affect examinee performance. In this article we draw upon the Vygotskian thinking that underpins dynamic assessment (DA) to posit that these spontaneous variations may provide clinically relevant information about an examinee’s learning potential. To illustrate this possibility, we apply the methodology of conversation analysis to examine a real-life picture-naming task involving a child with autism. Complex interactional processes above and beyond what might be assumed to occur during assessment are identified. In interpreting these as significant for a deeper understanding of the child’s profile of abilities, we argue that there is clinical value in empirically re-examining routine assessment from alternative methodological perspectives.

Decision making and somatic markers in conversation after traumatic brain injury

Background: Social decision making has been investigated in a range of client groups, resulting in the identification of the ventromedial prefrontal cortex (VMPC) as a significant structure in social decision making and the formulation of the somatic marker hypothesis (Damasio, 1994) to explain some of the mechanisms involved. The vulnerability of the VMPC following traumatic brain injury (TBI) suggests a potential degree of overlap between decision‐making research and behaviour observed following TBI. Despite this, relatively little awareness of these concepts is evident in research on TBI in general and on communication after TBI in particular. The author would like to thank Mark Parker and Mick Perkins for discussion of the issues contained in this article, the latter also for helpful comments on the text. Aims: To review the literature on decision making and the mechanisms thought to mediate it. To examine the potential application of decision‐making theory to conversational behaviour following TBI. Main Contribution: The article will highlight the potential role of decision making in conversation, together with the mechanisms that support it, thereby raising awareness among clinicians and researchers of a potentially important contributor to communication after TBI. Conclusions: Social decision making and the somatic marker hypothesis are important constructs for our understanding of behaviours associated with TBI, including conversation.

A Normative Database and Determinants of Lexical Retrieval for 186 Arabic Nouns: Effects of Psycholinguistic and Morpho-Syntactic Variables on Naming Latency.

Research into lexical retrieval requires pictorial stimuli standardised for key psycholinguistic variables. Such databases exist in a number of languages but not in Arabic. In addition there are few studies of the effects of psycholinguistic and morpho-syntactic variables on Arabic lexical retrieval. The current study identified a set of culturally and linguistically appropriate concept labels, and corresponding photographic representations for Levantine Arabic. The set included masculine and feminine nouns, nouns from both types of plural formation (sound and broken), and both rational and irrational nouns. Levantine Arabic speakers provided norms for visual complexity, imageability, age of acquisition, naming latency and name agreement. This delivered a normative database for a set of 186 Arabic nouns. The effects of the morpho-syntactic and the psycholinguistic variables on lexical retrieval were explored using the database. Imageability and age of acquisition were the only significant determinants of successful lexical retrieval in Arabic. None of the other variables, including all the linguistic variables, had any effect on production time. The normative database is available for the use of clinicians and researchers in the Arab world in the domains of speech and language pathology, neurolinguistics and psycholinguistics. The database and the photographic representations will be soon available for free download from the first author’s personal webpage or via email.

The case for multimodal analysis of atypical interaction: questions, answers and gaze in play involving a child with autism.

Abstract Conversation Analysis (CA) continues to accrue interest within clinical linguistics as a methodology that can enable elucidation of structural and sequential orderliness in interactions involving participants who produce ostensibly disordered communication behaviours. However, it can be challenging to apply CA to re-examine clinical phenomena that have initially been defined in terms of linguistics, as a logical starting point for analysis may be to focus primarily on the organisation of language (“talk”) in such interactions. In this article, we argue that CA’s methodological power can only be fully exploited in this research context when a multimodal analytic orientation is adopted, where due consideration is given to participants’ co-ordinated use of multiple semiotic resources including, but not limited to, talk (e.g. gaze, embodied action, object use and so forth). To evidence this argument, a two-layered analysis of unusual question-answer sequences in a play episode involving a child with autism is presented. It is thereby demonstrated that only when the scope of enquiry is broadened to include gaze and other embodied action can an account be generated of orderliness within these sequences. This finding has important implications for CA’s application as a research methodology within clinical linguistics.

They can because they think they can.

Based on interviews with practising speech and language therapists, Hersh (2010) identifies three key areas that constitute challenging aspects of ending therapy, fundamentally to do with client and clinician expectations of what therapy has to offer, managing therapy relationships that need to be robust yet temporary, and balancing client empowerment with the need to achieve fair distribution of resources. In this commentary I take a closer look at the first two of these aspects by dissecting an incident from my own therapy experience. I highlight particularly the importance of the way therapy is set up to the way in which it ends. Given the increasing importance attributed to client involvement in decisions regarding therapy, I also reflect briefly on the centrality of established evaluation measures to the potential for achieving informed consent and informed participation.

An integrated approach to team assessment in head injury

The development of multidisciplinary teams for the assessment and treatment of traumatic brain injury has not seen a parallel development in methods of coordinating and collating the information gathered by different professions. The team at the Head Injury Rehabilitation Centre (HIRC), Sheffield uses a process of assessment that encourages the coordination of such information, particularly across the areas that do not fall neatly into the remit of specific disciplines. The framework of the assessment is presented, together with discussion of methods of gathering information and of sharing that information. The advantages of this approach are discussed in terms of benefits for the client, for the professionals involved in the assessment and for other services that might be involved with the client.