“如果你只是和我待在一起并等待……你就会明白我的意思”：时间对会话自我修复的交际益处，适用于失语症患者。
"If You Just Stay With Me and Wait…You'll Get an Idea of What I'm Saying": The Communicative Benefits of Time for Conversational Self-Repair for People With Aphasia.
机构信息
Department of Hearing and Speech, University of Kansas Medical Center, Kansas City.
Department of Communication Sciences and Disorders, Bowling Green State University, OH.
出版信息
Am J Speech Lang Pathol. 2022 May 10;31(3):1264-1283. doi: 10.1044/2022_AJSLP-21-00199. Epub 2022 Mar 30.
PURPOSE
This study investigated the communicative benefits of self-repair during conversation for persons with aphasia (PWAs). Self-repair of trouble sources is an interactional priority that emphasizes autonomy and competence. Of equal importance, conversationalists desire to minimize silences and work together to ensure forward movement (progressivity) of conversation. Simultaneously achieving progressivity and self-repair is challenging in aphasia, and PWAs and their partners often make trade-off decisions between these two activities. Conversation-level aphasia interventions usually focus on supportive techniques that promote participation while maintaining progressivity, effectively favoring progressivity over self-repair. This study evaluates the benefits of an alternative approach that shifts the emphasis to self-repair, thereby highlighting potential trade-off costs of routinely forgoing self-repair to achieve progressivity.
METHOD
Ten people with mild-to-moderate aphasia each held two conversations with two different partners. When trouble sources characterized by silent and/or filled pauses occurred, partners maintained a supportive and engaged stance, allowing PWAs time to self-repair. We analyzed language produced during these "edited turns" using three paradigms considering form, content, and use.
RESULTS
The data yielded 311 edited turns. For form, on average, each edited turn resulted in 3.72 words; for content, most edited turns contained autobiographical information; for use, approximately 40% of edited turns introduced new information, and 40% added to the ongoing topic. The remainder were either ambiguous or comments such as, "I can't think of it."
CONCLUSIONS
When given engaged support and time to self-repair, PWAs contributed meaningful personal information to conversations for approximately 80% of edited turns. Importantly, self-repair often resulted in self-expression that directed the conversation, which is a communicative role critical for empowering agency and identity. This research opens a dialogue about benefits and limitations of approaches that prioritize either progressivity or self-repair and how to balance the two to optimize therapeutic benefits for each individual.
SUPPLEMENTAL MATERIAL
目的
本研究旨在探讨言语障碍者（PWAs）在会话中自我修复对交际的益处。自我修复是一种互动优先事项，强调自主性和能力。同样重要的是，会话者希望尽量减少沉默，并共同努力确保会话的顺利进行（推进性）。在失语症中，同时实现推进性和自我修复具有挑战性，PWAs 和他们的伙伴经常在这两个活动之间做出权衡决策。会话层面的失语症干预通常侧重于促进参与的支持性技术，有效地优先考虑推进性而不是自我修复。本研究评估了一种替代方法的益处，该方法将重点转移到自我修复上，从而突出了为实现推进性而通常放弃自我修复的潜在权衡成本。
方法
10 名轻度至中度失语症患者每人与两名不同的伙伴进行两次对话。当出现以沉默和/或填充停顿为特征的问题源时，伙伴们保持支持和参与的姿态，让 PWAs 有时间自我修复。我们使用三种范式分析这些“编辑回合”中的语言，分别考虑形式、内容和用途。
结果
数据产生了 311 个编辑回合。就形式而言，每个编辑回合平均产生 3.72 个词；就内容而言，大多数编辑回合包含自传信息；就用途而言，大约 40%的编辑回合引入了新信息，40%的编辑回合增加了正在进行的话题。其余的要么模棱两可，要么是评论，如“我想不起来了”。
结论
当给予积极的支持和时间进行自我修复时，PWAs 在大约 80%的编辑回合中对对话贡献了有意义的个人信息。重要的是，自我修复经常导致自我表达，从而指导对话，这是一个赋予代理和身份的关键交际角色。这项研究开启了一个关于优先考虑推进性或自我修复的方法的益处和局限性的对话，以及如何平衡两者以优化每个个体的治疗益处。
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