Communicative strategies used by spouses of individuals with communication disorders related to stroke-induced aphasia and Parkinson's disease

Abstract

Background: A communicative disability interferes with the affected person's ability to take active part in social interaction, but non-disabled communication partners may use different strategies to support communication. However, it is not known whether similar strategies can be used to compensate for different types of communicative disabilities, nor what factors contribute to the development of a particular approach by communication partners.

Aims: To develop a set of categories to describe the strategies used by communication partners of adults who have problems expressing themselves due to neurogenic communicative disabilities. The reliability of assessment was a particular focus.

Methods & procedures: The material explored consisted of 21 video-recorded everyday conversations involving seven couples where one spouse had a communicative disability. Three of the dyads included a person with dysarthria and anomia related to later stages of Parkinson's disease, while four of them included a person with stroke-induced aphasia involving anomia. First a qualitative interaction analysis was performed to explore the strategies used by the communication partners when their spouses had problems expressing themselves. The strategies were then categorized, the reliability of the categorizations was explored and the relative frequency of the various strategies was examined.

Outcomes & results: The analysis of the conversational interactions resulted in a set of nine different strategies used by the communication partners without a communicative disability. Each of these categories belonged to one of three overall themes: No participation in repair; Request for clarification or modification; and Providing candidate solutions. The reliability of the categorization was satisfactory. There were no statistically significant differences between diagnoses in the frequency of use of strategies, but the spouses of the persons with Parkinson's disease tended to use open-class initiations of repair more often than the spouses of the persons with aphasia.

Conclusions & implications: The types of strategies used by spouses of persons with neurogenic communicative disabilities seem to be more strongly associated with individual characteristics of communicative ability than with the type of disorder involved. The set of categories developed in this study needs to be trialled on larger groups of participants, and modified if and as necessary, before it can be regarded as a valid system for the description of such strategies in general. Once this has been done it may become a useful instrument in the assessment of the strategies used by communication partners of individuals with communicative disabilities.

Keywords: Parkinson's disease; aphasia; communication partners; conversational interaction; repair; supporting communication.