Discourse Elicitation in Aphasia: An Indian Framework

Discourse Elicitation in Aphasia: An Indian Framework

S. P. Goswami (All India Institute of Speech and Hearing, India), Brajesh Priyadarshi (All India Institute of Speech and Hearing, India) and Sharon Mathews (All India Institute of Speech and Hearing, India)
DOI: 10.4018/978-1-5225-4955-0.ch012

Abstract

Persons with aphasia (PWA) face varying difficulties of communication breakdown through different stages of recovery. With speech-language therapy, significant recovery may be seen at unitary levels, but the ultimate success of therapy is evident when the PWA uses all of the units as a whole and is able to communicate optimally to sustain social identities. An individualized intervention program as the focus, a protocol is proposed with seven semi-structured interviews aimed at eliciting discourse incorporating the philosophies of the social model, LPAA, SCA, AphasiaBank Protocol, and Protocol to Measure Participation of Persons with Aphasia. The interviews with the PWA and their communication partners in individual and joint sessions can help the clinician answer questions regarding the PWA's physical abilities, dietary issues, functional independence, personal traits, relationships at home, different social roles played, and subsequently plan a treatment program, and track the holistic recovery of the PWA.
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Assessment Of Discourse

The proliferation of research on discourse analysis has occurred concomitantly with changes in health care that emphasizes the need for determining functional goals for communicatively impaired PWA and measuring functional outcomes in clinical practice. The environment determines the nature of communication; if the environment changes, the communication changes accordingly. Functional communication goals for a specific person can be determined only with respect to that persons’ own social and physical setting and therefore can be defined only with respect to the individual (Hartley, 1995). Discourse analysis procedures provide the clinician with a set of evaluation tools that (a) describe the impairment in objective and measurable terms, (b) help identify the underlying cognitive or linguistic processes that contribute to the discourse impairment, (c) assist in treatment planning, and (d) are sensitive to changes over time. It is important to consider the discourse of PWA. However, the systematic application of discourse analysis procedures may not be warranted for all individuals, particularly, if the communication problem is severe and the output is limited. Therefore, for each PWA, clinicians must make decisions about when and what kind of discourse is to be sampled and how the discourse is to be analyzed.

Key Terms in this Chapter

Language: It is an arbitrary system of communication consisting of symbols like words, gestures, signs, and written text. It follows a set of rules to convey information and ideas in a group or within a community.

Cohesion: It is one of the integral parts of discourse which refers to the continuity in text or speech, within and between sentences giving lexical and semantic links in the discourse. The cohesiveness determines the connectivity and overall understanding of a discourse.

Communication: Communication is the act of exchanging one’s ideas, thoughts, and opinions effectively with one or multiple participants. This transferring of information can be made using verbal or nonverbal modes.

Social Identity: The identity of a person in the society is the sense of understanding of the person’s beliefs and opinions which builds a perception of their recognition in a particular social group.

Discourse: Discourse refers to the continuity and appropriateness of the use of words during conversation. It reflects the ability of an individual to retain the theme of conversation using varied linguistic components. In persons with aphasia, loss of language should not be viewed only from a linguistic perspective pertaining to phonology, syntax, and semantics but also from a holistic view including discourse in communication. Thus, discourse should be an integral component in the assessment and treatment of persons with aphasia.

Life Participation Approach: This is a service delivery model in aphasia which is more individual-centered and advocates the activities which are focused to improve the activity and participation of an individual from a holistic perspective.

Aphasia: It is the condition resulting from any kind of damage to the brain leading to impaired ability to comprehend speech or formulate language in terms of verbal or even written mode.

Recovery: Recovery in aphasia refers to the improvement in the condition post-stroke where the individual regains the lost skills and is able to gain independency thereby improving quality of life. The recovery is, however, dependent on various factors including severity of the stroke and the individual’s ability.

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