Interaction and language test performance involving persons with dementia

A comparison between test conversation and informal conversation


  • Karin Myrberg Linköping University/Uppsala University/Region Gävleborg
  • Christina Samuelsson Karolinska Institute
  • Lars-Christer Hydén Linköping University



dementia, language assessment, informal conversation, repair, topic initiation, requests for clarification/confirmation


Purpose: Dementia has a significant impact on language and communication. In this study, the aim was to compare the organization of interaction between persons with dementia (PWDs) and speech and language pathologists (SLPs) in two types of conversation, a test conversation and an informal conversation. A further aim was to relate interactional abilities to the PWDs’ performance on an aphasia test battery.

Method: Ten PWDs participated in the two types of conversations. In the test conversation, a standardized aphasia test battery was used. All dyads were audio- and video-recorded. Analyses were informed by interaction analytical approaches, such as conversation analysis (CA), combined with quantitative measurements.

Results: The results demonstrated that there was a larger number of turns, words, and topic initiations made by the PWDs in the informal conversations. The frequency of occurrence of repair instances was the same in the two conditions, but repairs in the test conversations were mostly resolved within one turn, whereas repairs stretching over several turns were more frequent in the informal conversations. Many of the repairs were initiated with a clarification request or a request for confirmation. Even though a majority of the PWDs demonstrated a rather robust turn-taking ability in the informal conversations, several of them struggled with the aphasia test assignments, in some cases due to visual perception problems.

Discussion and conclusion: The results indicate that a thorough analysis of informal conversations is important in assessing language in PWDs. The ecological validity of standardized language tests needs to be discussed, and the results of such tests should be handled carefully. 

Author Biographies

Karin Myrberg, Linköping University/Uppsala University/Region Gävleborg

Karin Myrberg is a PhD student at the Division of Speech and Language Pathology, Audiology and Otorhinolaryngology, Linköping University, Sweden. Her research involves persons with aphasia and dementia, with a focus on language assessments, tests, and informal conversations. A recent (2020) publication is ‘The mini-mental state examination (MMSE) from a language perspective: An analysis of test interaction,’ in Clinical Linguistics and Phonetics, 34(7), 652–670.

Christina Samuelsson, Karolinska Institute

Christina Samuelsson received her PhD from Lund University, Sweden. Her current position is as a full professor of Speech Language Pathology at the Karolinska Institute, Stockholm. Her research concerns interactional perspectives on communicative disabilities. She has published articles in international journals, and edited books, including the chapter, ‘Dialogical perspectives on aided communication’ in Aided communication in everyday interaction (Havant: J&R Press, 2013).

Lars-Christer Hydén, Linköping University

Lars-Christer Hydén received his PhD in Psychology from Stockholm University, Sweden. His current position is as a full professor of Social Psychology at Linköping University. His research concerns how people living with dementia interact, use language, and tell stories. He has published articles in international journals and books, for instance, Entangled narratives. Collaborative storytelling and the re-imagining of dementia (New York: Oxford University Press, 2018).


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How to Cite

Myrberg, K., Samuelsson, C., & Hydén, L.-C. (2021). Interaction and language test performance involving persons with dementia: A comparison between test conversation and informal conversation. Journal of Interactional Research in Communication Disorders, 10(2), 179–206.