Conversational repair by individuals with dementia of the Alzheimer's type

Conversational repair was examined in videotaped samples of spontaneous mealtime talk of 6 normal elderly adults, 5 subjects with early stage dementia of the Alzheimer's type (EDAT) and 5 subjects with middle stage DAT (MDAT) with a family member who acted as a conversational partner. The overall percentage of utterances involved in communication breakdown and repair and the specific proportions of utterances related to conversation problems, signals identifying problems, and repairs, were evaluated. Using the normal dyads as a control group, results showed the differential effects of DAT onset and progression on the conversational repair behavior of both subjects with DAT and their conversational partner. The percentage of conversation involved in repair was significantly higher for MDAT versus control and EDAT dyads. Despite the increase of conversational troubles with DAT onset and progression, the difficulties were repaired successfully the majority of the time. Subjects with EDAT produced more requests for repair than did their conversational partners. However, conversational partners of EDAT subjects used more elaboration repairs than did EDAT subjects. The opposite pattern was observed in the MDAT group where subjects with MDAT created and repaired more conversational problems than did their conversational partner. MDAT subjects produced more discourse trouble sources than did EDAT subjects. It was also observed that MDAT subjects and conversational partners frequently used nonspecific terms to signal misunderstandings. The findings have important implications for developing family caregiver communication enhancement strategies that are specific to the clinical stage of DAT.

Strategies for improving productive thinking in the language impaired adult

The purpose of this article is to discuss a cognitive approach to therapy with a language impaired adult. Two types of productive thinking are explored in this research: concept awareness and problem solving. These are dynamic and creative processes underlying the development and use of cognition and language. This single subject study follows an ABAB design and describes techniques used in therapy and methods for measuring productive thinking in a 66-yr-old moderately language impaired adult. Results indicate a sharp increase in the subject's thought productivity in a variety of contexts. A critical appraisal of reasons for therapy effectiveness are given.

Why so little interest in whether or not old people talk: a review of recent research on verbal communication among the elderly

This paper is concerned with the spoken communication of chronically ill and aging residents of long term care institutions. Social gerontologists and speech pathologists have investigated areas related to spoken communication, however, there has been almost no investigation of communication from the patients' and staff perspective. Spoken communication is a vital component of social interaction and psychological well being and underlies such concepts as isolation, integration, and adjustment, and is a fertile area for investigation and analysis.