University of Oklahoma Health Sciences Center, Department of Communication Sciences and Disorders, Oklahoma City, OK, USA.
Oklahoma State University, Department of Communication Sciences and Disorders, Stillwater, OK, USA.
J Commun Disord. 2023 Nov-Dec;106:106379. doi: 10.1016/j.jcomdis.2023.106379. Epub 2023 Sep 26.
There is limited research in group communication treatment for people with aphasia but existing studies report benefits of gesture to support conversation. Gesture supports conversation through recipient design features and reducing linguistic demands of lexical retrieval and formulation. Additionally, gesture serves an affiliative function. However, the relationship between gesture use and gestural capacity has not been widely examined. As part of a larger study on group cohesiveness and conversation, this investigation examined the patterns of co-speech gesture within authentic conversations among persons with aphasia to discern the functions of gesture use for the participants, changes in the use of gesture over time, and the relationship between gesture use and gesture ability.
Conversation Analysis (CA) was applied in an embedded case-study design. Three participants received an academic semester of group and individual conversation-based treatment according to Facilitating Authentic Conversation (Damico et al., 2015). Four conversations from the treatment were selected and transcribed for multi-modality communication with CA conventions applied, and then cyclically analysed for patterns of gesture.
Participants demonstrated gesture that served social and linguistic functions: ratifying clinicians' proxy turns, turn-allocation, turn repair, relaying novel visual information, emphasizing content, demonstrating affiliation with the prior speaker, demonstrating their assessment others' talk, and demonstrating humor. All three participants showed an increased rate of gesture per turn and increasingly used gesture to repair conversation breakdown. Increased gesture use over the course of the semester coincided with increased scores for pantomime on the Porch Index of Communicative Ability (Porch, 1981, PICA).
Individuals with aphasia demonstrated increased use of gesture for varied purposes and improved gestural processing following a semester of conversation-based treatment. This is significant because gesture is an effective support for the repair of conversation breakdown typical of persons with aphasia.
针对失语症患者的团体沟通治疗的研究有限，但现有研究报告表明手势对支持对话有帮助。手势通过接收方的设计特点和减少词汇检索和表达的语言需求来支持对话。此外，手势还具有亲和功能。然而，手势的使用与手势能力之间的关系尚未得到广泛研究。作为更大的团体凝聚力和对话研究的一部分，本研究通过对失语症患者在真实对话中的协同言语手势进行考察，以了解参与者使用手势的功能、手势使用随时间的变化以及手势使用与手势能力之间的关系。
采用嵌入式案例研究设计进行会话分析（CA）。根据促进真实对话（Damico 等人，2015），三名参与者接受了一学期的团体和个人基于对话的治疗。从治疗中选择了四场对话进行多模态交流转录，并应用 CA 惯例进行分析，然后对手势模式进行循环分析。
参与者展示了具有社交和语言功能的手势：证实临床医生的代理轮次、轮次分配、轮次修复、传递新的视觉信息、强调内容、与前一位说话者保持亲近、评估他人的谈话、以及展示幽默。所有三名参与者的每轮手势数量都有所增加，并且越来越多地使用手势来修复对话中断。整个学期内手势使用量的增加与 Porch 沟通能力指数（Porch，1981，PICA）中的模仿评分的提高相吻合。
失语症患者在接受一学期基于对话的治疗后，展示了更多样化目的的手势使用，并且改善了手势处理能力。这很重要，因为手势是对典型失语症患者的对话中断进行修复的有效支持。
