Collaborative turn-construction practices of people with primary progressive aphasia and their family conversation partners

Authors

  • Anna Volkmer University College London
  • Shreeya Mistry University College London
  • Daniella Thompson University College London
  • Jason D. Warren University College London
  • Suzanne Beeke University College London

DOI:

https://doi.org/10.1558/jircd.25504

Keywords:

primary progressive aphasia, turn construction, dementia, collaboration

Abstract

Background: Primary progressive aphasia describes a group of three rare language-led dementias: semantic, logopenic, and non-fluent. The small number of conversation analysis studies to date suggest that repair and turn-construction practices in primary progressive aphasia are similar to those seen in post-stroke aphasia. This study investigates the collaborative aspect of these practices between people with primary progressive aphasia and their conversation partners.

Method: Conversation analysis was used to investigate collaboration in repair and turn-construction practices in 10-minute video recordings of natural conversation collected from two dyads, one with logopenic and one with mixed primary progressive aphasia.

Results: This study demonstrates that people with primary progressive aphasia have a range of practices available to construct their turns, and that their conversation partners collaborate to co-construct talk.

Discussion: Findings demonstrate that collaboration can support interaction or lead to further interactional trouble. Collaborative practices are important targets for speech and language therapy interventions.

Author Biographies

  • Anna Volkmer, University College London

    Anna Volkmer, PhD, is a senior researcher at UCL. Her research focuses on developing interventions for people with dementia and their families, using CA, mixed methods, and other qualitative methods to better understand and meet the needs of people with dementia. She is lead author of Better Conversations with PPA, a training intervention soon to be available for SLTs working with people with PPA. She also leads the speech and language therapy service within the Cognitive Disorders Clinic at the National Hospital for Neurology and Neurosurgery.

  • Shreeya Mistry, University College London

    Shreeya Mistry is a newly qualified SLT who became interested in working on the Better Conversations with PPA projects while completing her MSc at UCL. She now works with adults with acquired neurological conditions.

  • Daniella Thompson, University College London

    Daniella Thompson is a qualified SLT. She is currently working as a pediatric SLT, supporting children and young people with a variety of speech, language, and communication needs.

  • Jason D. Warren, University College London

    Jason D. Warren is a clinical cognitive neurologist and leads the Brain Behaviour Group at the Dementia Research Centre. His work uses complex sound as a paradigm to understand disordered information processing in neurodegenerative disease. He is currently Professor of Neurology at UCL, and jointly runs the specialist Cognitive Disorders Clinic at the National Hospital for Neurology and Neurosurgery. Special interests include the progressive aphasias, auditory and emotional cognition in dementia, neurology of music in dementia, and functional imaging of neurodegenerative diseases.

  • Suzanne Beeke, University College London

    Suzanne Beeke, PhD, is an associate professor at UCL. She trained as an SLT, and her research focuses on understanding the impact of language, communication, and cognitive disorders on the everyday conversations of adults with acquired neurological conditions talking to family, friends, and health and social care professionals. She leads the Better Conversations Lab, using CA to understand communication difficulties and needs, and to underpin interventions. She is lead author of Better Conversations with Aphasia, a free online training resource and therapy program available at https://extendstore.ucl.ac.uk.

References

Aaltonen, T., and Laakso, M. (2011). Halting aphasic interaction. Creation of intersubjectivity and spousal relationship in situ. Communication and Medicine, 7(2), 95–106. https://doi.org/10.1558/cam.v7i2.95

Alzheimer’s Research UK (2023). Dementia statistics hub. Retrieved January 2023 from https://www.dementiastatistics.org/statistics-about-dementia/prevalence-2

Antaki, C. (Ed.) (2011). Applied conversation analysis: Intervention and change in institutional talk. Basingstoke: Palgrave Macmillan. https://doi.org/10.1057/9780230316874

Atkinson, J. M., and Heritage, J. (1984). Structures of social action: Studies in conversation analysis. New York: Cambridge University Press.

Baker, C., Worrall, L., Rose, M., Hudson, K., Ryan, B., and O’Byrne, L. (2018). A systematic review of rehabilitation interventions to prevent and treat depression in post-stroke aphasia. Disability and rehabilitation, 40(16), 1870–1892. https://doi.org/10.1080/09638288.2017.1315181

Bauer, A., and Kulke, F. (2004). Language exercises for dinner: Aspects of aphasia management in family settings. Aphasiology, 18(12), 1135–1160. https://doi.org/10.1080/02687030444000570

Beckley, F., Best, W., Johnson, F., Edwards, S., Maxim, J., and Beeke, S. (2013). Conversation therapy for agrammatism: Exploring the therapeutic process of engagement and learning by a person with aphasia. International Journal of Language & Communication Disorders, 48(2), 220–239. https://doi.org/10.1111/j.1460-6984.2012.00204.x

Beeke, S., Wilkinson, R., and Maxim, J. (2007). Grammar without sentence structure: A conversation analytic investigation of agrammatism. Aphasiology, 21(3–4), 256–282. https://doi.org/10.1080/02687030600911344

Beeke, S., Beckley, F., Best, W., Johnson, F., Edwards, S., and Maxim, J. (2013a). Extended turn construction and test question sequences in the conversations of three speakers with agrammatic aphasia. Clinical Linguistics & Phonetics, 27(10–11), 784–804. https://doi.org/10.3109/02699206.2013.808267

Beeke, S., Sirman, N., Beckley, F., Maxim, J., Edwards, S., …, and Best, W. (2013b). Better Conversations with Aphasia: A learning resource. https://extendstore.ucl.ac.uk/catalog?category=13

Best, W., Maxim, J., Heilemann, C., Beckley, F., Johnson, F., …, and Beeke, S. (2016). Conversation therapy with people with aphasia and conversation partners using video feedback: A group and case series investigation of changes in interaction. Frontiers in Human Neuroscience, 7(10), 562. https://doi.org/10.3389/fnhum.2016.00562

Bloch, S., and Beeke, S. (2008). Co-constructed talk in the conversations of people with dysarthria and aphasia. Clinical Linguistics & Phonetics, 22(12), 974–990. https://doi.org/10.1080/02699200802394831

Coyle-Gilchrist, I. T., Dick, K. M., Patterson, K., Vazquez Rodriquez, P., Wehmann, E., ..., and Rowe, J. B. (2016). Prevalence, characteristics, and survival of frontotemporal lobar degeneration syndromes. Neurology, 86(18), 1736–1743. https://doi.org/10.1212/WNL.0000000000002638

Goodwin, C. (1995). Co-constructing meaning in conversations with an aphasic man. Research on Language and Social Interaction, 28(3), 233–260. https://doi.org/10.1207/s15327973rlsi2803_4

Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., …, and Grossman, M. (2011). Classification of primary progressive aphasia and its variants. Neurology, 76(11), 1006. https://doi.org/10.1212/WNL.0b013e31821103e6

Heritage, J. (2012). Epistemics in conversation. In J. Sidnell and T. Stivers (Eds.), The handbook of conversation analysis (pp. 370–394). Malden: Blackwell. https://doi.org/10.1002/9781118325001.ch18

Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. H. Lerner (Ed.), Conversation analysis: Studies from the first generation (pp. 13–31). Amsterdam: John Benjamins Publishing Company. https://doi.org/10.1075/pbns.125.02jef

Jones, D. (2015). A family living with Alzheimer’s disease: The communicative challenges. Dementia, 14(5), 555–573. https://doi.org/10.1177/1471301213502213

Kindell, J., Sage, K., Keady, J., and Wilkinson, R. (2013). Adapting to conversation with semantic dementia: Using enactment as a compensatory strategy in everyday social interaction. International Journal of Language & Communication Disorders, 48(5), 497–507. https://doi.org/10.1111/1460-6984.12023

Kindell, J., Keady, J., Sage, K., and Wilkinson, R. (2017). Everyday conversation in dementia: A review of the literature to inform research and practice. International Journal of Language & Communication Disorders, 52(4), 392–406. https://doi.org/10.1111/1460-6984.12298

Kitzinger, C., and Jones, D. (2007). IV. When May calls home: The opening moments of family telephone conversations with an Alzheimer’s patient. Feminism & Psychology, 17(2), 184–202. https://doi.org/10.1177/0959353507076550

Laakso, M., and Klippi, A. (1999). A closer look at the ‘hint and guess’ sequences in aphasic conversation. Aphasiology, 13(4–5), 345–363. https://doi.org/10.1080/026870399402136

Lindholm, C. (2015). Parallel realities: The interactional management of confabulation in dementia care encounters. Research on Language and Social Interaction, 48(2), 176–199. https://doi.org/10.1080/08351813.2015.1025502

Lock, S., Wilkinson, R., and Bryan, K. (2001). SPPARC: Supporting partners of people with aphasia in relationships & conversation. Milton Keynes: Speechmark. https://doi.org/10.3109/13682820109177853

Marshall, C. R., Hardy, C. J. D., Volkmer, A., Russell, L. L., Bond, R. L., …, and Warren, J. D. (2018). Primary progressive aphasia: A clinical approach. Journal of Neurology, 265(6), 1474–1490. https://doi.org/10.1007/s00415-018-8762-6

Mazeland, H., and Huiskes, M. (2001). Dutch ‘but’ as a sequential conjunction: Its use as a resumption marker. Studies in Interactional Linguistics, 10, 141–169. https://doi.org/10.1075/sidag.10.08maz

Mikesell, L. (2010). Repetitional responses in frontotemporal dementia discourse: Asserting agency or demonstrating confusion? Discourse Studies, 12(4), 465–500. https://doi.org/10.1177/1461445610370127

Peräkylä, A. (2004). Reliability and validity in research based on naturally occurring social interaction. In D. Silverman (Ed.), Qualitative research: Theory, method and practice (2nd ed., pp. 283–304). London: Sage Publications.

Perkins, M. R. (2010). Pragmatic impairment. In J. S. Damico, N. Müller, and M. J. Ball (Eds.), The handbook of language and speech disorders (pp. 227–246). Chichester: Wiley-Blackwell. https://doi.org/10.1002/9781444318975.ch10

Ruksenaite, J., Volkmer, A., Jiang, J., Johnson, J., Marshall, C. R., …, and Hardy, C. J. (2021). Primary progressive aphasia: Toward a pathophysiological synthesis. Current Neurology and Neuroscience Reports, 21(3), 1–2. https://doi.org/10.1007/s11910-021-01097-z

Schegloff, E. A. (2007). Sequence organization in interaction (vol. 1). Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9780511791208

Simmons-Mackie, N., Raymer, A., and Cherney, L. R. (2016). Communication partner training in aphasia: An updated systematic review. Archives of Physical Medicine and Rehabilitation, 97(12), 2202–2221. https://doi.org/10.1016/j.apmr.2016.03.023

Suárez-González, A., Cassani, A., Gopalan, R., Stott, J., and Savage, S. (2021). When it is not primary progressive aphasia: A scoping review of spoken language impairment in other neurodegenerative dementias. Translational Research & Clinical Interventions, 7(1), e12205. https://doi.org/10.1002/trc2.12205

Swinburn, K., Porter, G., and Howard, D. (2004). Comprehensive Aphasia Test (CAT). Washington DC: APA PsycNet. https://doi.org/10.1037/t13733-000

Taylor, C., Croot, K., Power, E., Savage, S. A., Hodges, J. R., and Togher, L. (2014). Trouble and repair during conversations of people with primary progressive aphasia. Journal, 28(8–9), 1069–1091. https://doi.org/10.1080/02687038.2014.930411

Taylor-Rubin, C., Croot, K., Power, E., Savage, S. A., Hodges, J. R., and Togher, L. (2017). Communication behaviors associated with successful conversation in semantic variant primary progressive aphasia. International Psychogeriatrics, 29(10), 1619–1632. https://doi.org/10.1017/S1041610217000813

Volkmer, A., Spector, A., Warren, J. D., and Beeke, S. (2018). The ‘Better Conversations with primary progressive aphasia (BCPPA)’ program for people with PPA (primary progressive aphasia): Protocol for a randomised controlled pilot study. Pilot and Feasibility Studies, 4(1), 1–10. https://doi.org/10.1186/s40814-018-0349-6

Volkmer, A., Spector, A., Warren, J. D., and Beeke, S. (2019). Speech and language therapy for primary progressive aphasia across the UK: A survey of current practice. International Journal of Language & Communication Disorders, 54(6), 914–926. https://doi.org/10.1111/1460-6984.12495

Volkmer, A., Spector, A., Warren, J. D., and Beeke, S. (2020). Speech and language therapy for primary progressive aphasia: Referral patterns and barriers to service provision across the UK. Dementia, 19(5), 1349–1363. https://doi.org/10.1177/1471301218797240

Volkmer, A., Spector, A., Swinburn, K., Warren, J. D., and Beeke, S. (2021). Using the Medical Research Council framework and public involvement in the development of a communication partner training intervention for people with primary progressive aphasia (PPA): Better Conversations with PPA. BMC Geriatrics, 21(1), 642. https://doi.org/10.1186/s12877-021-02561-8

Volkmer, A., Farrington-Douglas, C., Crutch, S. J., Beeke, S., Warren, J. D., and Yong, K. X. X. (2022). Better Conversations: A language and communication intervention for aphasia in posterior cortical atrophy. Neurocase, 28(4), 356–363. https://doi.org/10.1080/13554794.2022.2125326

Volkmer, A., Walton, H., Swinburn, K., Spector, A., Warren, J. D., and Beeke, S. (2023). Results from a randomised controlled pilot study of the Better Conversations with primary progressive aphasia (BCPPA) communication partner training program for people with PPA and their communication partners. Pilot and Feasibility Studies, 9, 87. https://doi.org/10.1186/s40814-023-01301-6

Wilkinson, R. (2019). Atypical interaction: Conversation analysis and communicative impairments. Research on Language and Social Interaction, 52(3), 281–299. https://doi.org/10.1080/08351813.2019.1631045

Published

2023-10-25

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Articles

How to Cite

Volkmer, A., Mistry, S., Thompson, D., Warren, J. D., & Beeke, S. (2023). Collaborative turn-construction practices of people with primary progressive aphasia and their family conversation partners. Journal of Interactional Research in Communication Disorders, 14(3), 456-485. https://doi.org/10.1558/jircd.25504