De Letter, Miet

Muntigl, Peter

Van der Straeten, Charis

English

Ghent University Academic Bibliography

  A LONGITUDINAL STUDY OF REPAIR STRATEGIES IN PRIMARY PROGRESSIVE APHASIA USING CONVERSATION ANALYSIS Charis Van der Straeten, Miet De Letter1, Peter Muntigl2  1 Department of Speech, Language and Hearing Sciences, 2 Department of Linguistics, Ghent University Primary Progressive Aphasia (PPA) Progressive Nonfluent Aphasia (PNFA) → agrammatism Logopenic Progressive Aphasia (LPA) → impaired word finding Semantic Dementia (SD) → impaired naming and single-word comprehension BACKGROUND Primary progressive aphasia (PPA) is a spectrum of neurological  syndromes characterized by an isolated degeneration of language capabilities. Other cognitive domains remain intact during the first two years of the disease progression. In 2011, Gorno-Tempini et al. established a consensus taxonomy of PPA. This classification differentiates three types of PPA, each characterized by specific linguistic correlates (see Figure 1).  A systematic review on spontaneous speech, conversation and interaction in PPA was conducted until October 2015. Following results were found: • The characteristics of spontaneous speech of each PPA subtype were similar to the known consensus criteria.  • Differentiation between PPA subtypes for conversation and interaction was not possible due to the scarcity of publications on the subject.  • The longitudinal evolution of spontaneous speech was primarily characterized by increased severity of initial symptoms. No information on the longitudinal evolution of conversation and interaction in PPA was found. METHOD Data: patient-therapist conversations • 2 participants: M.J.G. (PNFA) and R.G. (LPA) • Videos of initial and follow-up appointments • Detailed transcription of verbal, paraverbal and nonverbal content (see Figure 2)  Repair: re-establishing the flow of conversation through 4 possible trajectories 1. Self-initiated self-repair (SISR) 2. Self-initiated other-repair (SIOR) 3. Other-initiated self-repair (OISR) 4. Other-initiated other-repair (OIOR) 17 s.i.s.r. (2) Pat #h h h# kheb #e e e# veel aangat gat hè, .h twat (0.6) twas (.) #h:# goed -----------------------------------------------------------------------------------------------------------> P: verbreekt oogcontact (kijkt naar links)                                                                    P: knikt meermaals licht                               P: knikt eenmaal                                                                                                                                          diep                                                           18 s.i.s.r. (2)  (0.9) twas (0.7) #h::# medde (0.6) medde=medden bus, (0.6) #w:a#s:  --------------------------------------------------------------------------------------------------------------> P: knikt meermaals ---->             P: tikt op tafel                P: knippert eenmaal                                                                                                                                    19 s.i.s.r.  tee:ne (0.5) e::h (3.9) #l:# ↓ja: (3.5) kweet nie mier. (1.0) #oe# noemde  P: knijpt ogen tot  spleetjes ------------->                                 P: knippert zesmaal met ogen                                            P: draait hoofd naar links                                                      P: klopt op tafel                                                                         P: schudt hoofd meermaals licht                                                                                                                   P: kijkt naar links boven 20 s.i.s.r. (3) s.i.o.r.  noemdehe dat.h da:  (0.5) #he#kend munt. (0.6) punt                                P: kijkt naar links 21   (1.4) 22  Fam Luzern. 23   (1.0) P: draait hoofd volledig naar links (richting F)  24  Pat Luzerne. ja:ja: °ja°                 P: draait hoofd snel naar voor                     + oogcontact T                    + knikt meermaals -->  Figure 2: Realistic example of transcribed video data, including verbal, paraverbal and nonverbal content (R.G., March 2014). Figure 1: Consensus taxonomy and main linguistic correlates of the three primary progressive aphasia subtypes (Gorno-Tempini et al., 2011). M.J.G. (PNFA, °1938) R.G. (LPA, °1937) moment April 2010 March 2011 September 2011 February 2013 September 2013 March 2014 September 2014 duration 1’05” 3’10” 3’10” 3’05” 3’45” 3’25” 3’55” number of repairs 11 30 32 17 14 25 22 SISR (%) 100,0 (11/11) 80,0 (24/30) 90,6 (29/32) 94,1 (16/17) 85,7 (12/14) 88,0 (22/25) 90,9 (20/22) OISR (%) 0 3,3 (1/30) 0 0 0 0 0 SIOR (%) 0 10,0 (3/30) 3,1 (1/32) 0 0 12,0 (3/25) 9,1 (2/22) OIOR (%) 0 6,7 (2/30) 6,3 (2/32) 5,9 (1/17) 14,3 (2/14) 0 0 Quantitative results of analysis of repair strategies in M.J.G. and R.G.  Participant M.J.G. • Relative decrease of SISR, but increase in relative importance of SISR reformulation → self-initiated syntactical reformulation due to awareness of increased agrammatism? • Inadequate laughter  → evolution towards pseudobulbar behavior (cfr. FTD)  Participant R.G. • Higher complexity in repair trajectories  → increasing severity of core symptoms of LPA?  Systematic review: increased word-finding difficulty in PNFA and LPA  M.J.G.: ↑ SIOR and OIOR → shared responsibility  R.G.: starting 2014 ↑ SIOR → own initiative Contact charis.vanderstraeten@ugent.be CONCLUSION These findings demonstrate the evolution in the use of repair strategies throughout the progression of PPA. Though not (yet) generalisable, there are clear indications for differences between patients with PNFA and LPA. Further research within this subject is required for a clearer and more universally applicable view on repair sequences in PPA patients. These findings were used as basis for a preliminary longitudinal study on conversational quality in PPA. The study was exploratory in nature and the aim was to map the evolution of the use of repair strategies during the first two years of disease progression using conversation analysis (CA) (Schegloff, Jefferson & Sacks, 1977). RESULTS AND DISCUSSION REFERENCES Gorno-Tempini et al. (2011). Classification of primary progressive aphasia and its variants. Neurology, 76(11), 1006-1014. Schegloff, E.A., Jefferson, G., Sacks, H. (1977). The Preference for Self-Correction in the Organisation of Repair in Conversation. Language, 53, 361-382. 

A longitudinal study of repair strategies in primary progressive aphasia using conversation analysis

https://biblio.ugent.be/publication/8519445/file/8519446.pdf

A longitudinal study of repair strategies in primary progressive aphasia using conversation analysis

Abstract

Similar works

Full text

Available Versions

Ghent University Academic Bibliography