Rethinking agrammatism : using conversation analysis to investigate the talk of individuals with aphasia
This thesis applies Conversation Analysis (CA) to the phenomenon of agrammatism, a particular type of aphasia (a language difficulty acquired most commonly after stroke) which is characterised by grammatical impairment. Although mainstream research has done much to characterise the nature of the underlying disorder, most studies have analysed elicited, task-based data by applying the theoretical concepts of a standard grammar the well-formed sentence, clause and phrase. As a result, little is known about the grammar that people with agrammatism use in real, everyday talk-in-interaction with habitual conversational partners. This study investigates the utility of CA as a tool for the exploration of conversational grammar in agrammatic aphasia. The data comprise video-recordings of the conversation of two adults with agrammatic aphasia, recorded in the home talking to a family member or friend. Conversation is contrasted with single word-, sentence- and narrative-level language samples elicited via commonly used clinical assessments. The data-driven procedures of CA reveal recurring turn construction formats in the talk of the individuals with aphasia. Cognitive neuropsychological, linguistic and psycholinguistic methodologies are drawn on to analyse the elicited language samples, in order to produce the type of clinical profile of agrammatism on which speech and language therapy is based. A comparison of the two samples finds that turn construction for conversation differs from sentence construction for testing. The thesis concludes that the conversation of both aphasic speakers exhibits structure and systematicity, a 'grammatical' organisation, but that the constructions documented do not resemble the sentences, clauses and phrases of a standard grammar. Rather, their form is shaped by the interactional demands of taking a turn at talk. The study questions the widely-held assumption that elicited language tests provide a view of grammatical impairment that is synonymous with the reality of the condition for the person who lives, and most crucially talks with it.