Different approaches in aphasia assessments: a comparison between test and everyday conversations

Abstract

Background: When it comes to aphasia assessments, many speech and language pathologists (SLPs) rely heavily on norm-referenced language tests, even though they are aware that certain important language skills can only be evaluated by analysis of conversational discourse. The formalized aphasia test situation is a typical example of institutional interaction, which differs in systematic ways from everyday conversations. This article examines conversations between persons with aphasia (PWAs) and SLPs in the two different contexts, a topic where previous research is limited. Aims: The aim is to compare the interactions between PWAs and SLPs in test conversations and in more everyday-like conversations and to relate the interactional data to the participants’ performance on the aphasia test battery. Methods & Procedures: Ten PWAs and three SLPs participated in the study. Each PWA participated in two conversations with an SLP, a test conversation, while performing tasks targeting the ability to produce sentences and narratives from an aphasia test battery, and a more everyday-like conversation. The conversations were audio and video recorded and thereafter transcribed. Three main observations considered to be important mechanisms for interaction organization were identified and calculated in the transcriptions. The test results were summarized and analyzed. Outcomes & results: The results demonstrated that there were a larger number of turns produced by the PWAs in the everyday conversations compared to the test conversations. Furthermore, there were more communicative initiatives and nonverbal contributions in the everyday conversations. The number of repairs initiated by the PWAs were equivalent, but looking at repair characteristics, it was found that repairs resolved within the same turn were found in the test conversations while repairs stretching over several turns were more frequent in the everyday conversations. Conclusions: The results of the present study demonstrated differences of the interaction between PWAs and SLPs in test conversations and in more everyday-like conversations. Furthermore, there seemed to be no obvious relationship between the participant’s actual test scores on the aphasia test battery and aspects of conversation that can be related to being a competent speaker.