Kommunikasjon i en afasigruppe : en samtaleanalytisk tilnærming

Abstract Title Communication in an aphasia group a conversation analytic approach Objective Aphasia is a communication disorder resulting from brain damage, which consequently changes the possibilities to participate in conversations. The objective of this study is to learn more about how individuals with aphasia can use different resources and strategies to work together to communicate in an aphasia group. Clinicians often recommend group intervention for aphasia, but few studies have examined aphasic speakers interaction and use of language in this setting. Increased knowledge about this can contribute to making group approaches to aphasia more theoretically grounded and improve their therapeutic impact. In addition, the study can illuminate aphasic speakers coping strategies, and thereby contribute to extended perspectives on aphasia, as well as on the framework for clinical possibilities and challenges in speech and language therapy. Focus on this matter has increased the last decades, corresponding with the emergence of a social disability model of aphasia, where the consequences to participation and functional communication are seen as more fundamental than linguistic errors. Research questions The main research question in this study is: What can characterize communication in an aphasia group? Three additional questions explicate this: How do the participants cooperate to create mutual understanding? What kind of strategies and resources do the participants use to express themselves and to understand each other when trouble arises in the communication? What influence has the speech and language therapist in this work? The study is based on data from an actual aphasia group where the participants have chronic aphasia, defined as minimum one-year post onset. The participants have different types of aphasia, varying from moderate to severe. The aphasia group uses a total communication approach, based entirely on the participants own conversational topics. Method/Analysis A qualitative case study approach was chosen, using the principals from conversation analysis (CA). Two actual group meetings were videotaped. Chosen sequences from the tapes were transcribed and analyzed based on the conventions of CA in order to secure the reliability of the study. In CA the main focus is on detailed analysis of how the participants themselves respond to each other s utterances in the conversation. The findings were compared to findings from similar studies in order to validate the results. Findings/Conclusion The transcribed sequences were identified as different types of extended collaborative repair, where overcoming trouble in establishing a mutual understanding dominated the collaborative work. Findings from the study revealed that the aphasic participants showed themselves able to participate actively in the conversation, using an array of resources ranging from drawing, communication books, rating scales, maps, gestures and pointing integrated with verbal behaviour. They also demonstrated an ability to help each other and to cooperate in the interaction. The speech and language therapist played an active role in the interaction, often as a catalyst , repeating the participants utterances and writing down keywords in order to accommodate all participants contributions and understandings. Findings from a case study like this one cannot be generalized to characterize general aphasic behaviour, but can reflect a possibility for this kind of interaction. The findings also correspond with findings from other studies focused on repair and cooperation in aphasic interaction. More research is needed to explore this kind of interaction in order to build a theory of aphasia that can incorporate the coping skills of people with aphasia and to take full advantage of the potential of aphasia groups and other types of functional communication intervention