Language and Communication Research, University College London, UK.
Int J Lang Commun Disord. 2011 Sep-Oct;46(5):510-23. doi: 10.1111/j.1460-6984.2011.00076.x. Epub 2011 Aug 9.
People with acquired progressive dysarthria typically experience increased problems with intelligibility in everyday conversation as their disease progresses. Such problems are likely to impact on both the person with dysarthria and those with whom they interact. If this is the case then we may ask questions not just about the nature of these problems but how it is that such problems are dealt with by participants when they occur.
To investigate ways through which problems resulting from dysarthria in everyday conversation are resolved by participants. Further, to examine some of the features of repair resolution, particularly where understanding of self-repair attempts themselves prove difficult.
METHODS & PROCEDURES: Video data of natural conversation from two dyads were selected for this paper. One dyad features a 58 year-old man with multiple sclerosis and moderate intelligibility problems, the other a 79 year-old woman with motor neurone disease with mild to moderate intelligibility problems. Both elected to be recorded in conversation with their spouses. The dyads were video-recorded at home with no researcher present. Using the methods of Conversation Analysis (CA) a collection of sequences was identified and transcribed. The sequences were analysed with reference to how the participants resolve problems in the understanding of dysarthric speech.
OUTCOMES & RESULTS: It is shown how some problems resulting from dysarthria in conversation can be resolved relatively quickly, particularly where a specific element of a prior turn is highlighted by the recipient as problematic. In other instances, the recipient's understanding problem may be more global. These result in longer repair sequences in which problematic elements are addressed individually. Such a resolution method is ultimately successful but may also be characterised by additional understanding problems. These findings draw attention to an important distinction between intelligibility and understandability.
CONCLUSIONS & IMPLICATIONS: It is concluded that problems resulting from dysarthria in conversation can require extensive repair work involving both parties. This has implications for the assessment of dysarthria in everyday conversation and also the promotion of intervention strategies that encompass the activities of both participants when dealing with dysarthria in interaction. These findings may be usefully employed in informing both direct clinical work and through training those who work with this client group and their significant others.
后天进行性构音障碍患者随着疾病的发展，在日常会话中通常会遇到更多的言语清晰度问题。这些问题可能会对构音障碍患者及其交流对象产生影响。如果是这样，那么我们可能不仅会询问这些问题的性质，还会询问当问题出现时参与者是如何处理这些问题的。
探讨日常会话中因构音障碍而产生的问题是如何被参与者解决的。此外，还研究了一些修复解决方案的特点，特别是在自我修复尝试本身的理解存在困难的情况下。
本文选取了两个二人组的自然会话视频数据。一个二人组的成员是一名 58 岁的多发性硬化症患者，言语清晰度问题中度严重；另一个二人组的成员是一名 79 岁的运动神经元病患者，言语清晰度问题轻度至中度严重。这两个人都选择和他们的配偶在对话中被记录。二人组在家中进行视频录制，没有研究人员在场。使用会话分析（CA）的方法，确定并转录了一系列序列。根据参与者如何解决构音障碍言语理解问题，对这些序列进行了分析。
结果表明，在会话中，一些因构音障碍而产生的问题可以相对较快地解决，特别是当接收者将前一个回合的特定元素标记为有问题时。在其他情况下，接收者的理解问题可能更为全局性。这会导致更长的修复序列，其中逐个解决有问题的元素。这种解决方法最终是成功的，但也可能伴随着额外的理解问题。这些发现提请人们注意可懂度和清晰度之间的重要区别。
会话中因构音障碍而产生的问题可能需要双方进行广泛的修复工作。这对日常会话中构音障碍的评估以及促进涵盖参与者在互动中处理构音障碍时的活动的干预策略都有影响。这些发现可用于直接指导临床工作，并通过培训与这一客户群体及其重要他人合作的人员，为他们提供信息。
