Discourse Marker Use in People With Aphasia: Familiarity of Listeners

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 Discourse Marker Use in People With Aphasia
Familiarity of Listeners 

• Kelly Haylett, B.A.
• Lisa LaSalle, Ph.D.
• Communication Sciences Disorders
• University of Wisconsin-Eau Claire

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Introduction

• The Limited Capacity Processor Model (LCP) states
  that a limited amount of cognitive resources are
  available to be allocated to a number of tasks at
  any given time.
• According the LCP, speech fluency deteriorates
  when multiple demands are placed on the speakers
  cognitive, affective, linguistic, and motor
  skills and abilities.
• Tasks like speaking to an unfamiliar listener,
  retelling a story unfamiliar to the listener,
  etc., act to increase affective and cognitive
  processing, contributing to deteriorated fluency.
• Speakers with aphasia are generally disfluent
  speakers, and they produce a wide variety of
  types of disfluencies, errors or paraphasias,
  labeled in a variety of different ways (e.g.,
  verbal self-corrections or revisions).

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• Discourse markers (DMs) are speakers (non)verbal
  ways to mark info to the listener
  parenthetically.
• Some consider DMs separate from disfluencies,
  just as paraphasias are not disfluencies, because
  they are uncorrected. Unlike paraphasias,
  though, sometimes DMs appear helpful to the
  listener.
• Jucker and Ziv (1996) however, have included
  interjections and revisions as types of DMs.
• DMs may assist the forward flow of communication
  rather than hinder it. For example, but I
  dont know is a truth-level marker, and may
  function as a way to invite the listener to
  comment if s/he does know.
• On the other hand, a self-correction or revision
  functions to fix the problem the speaker has
  noted in his/her own speech and so otherwise does
  not add information that might benefit the
  listener.
• Table 1 shows DM types according to how they
  function.

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Table 1 Discourse Marker Types(Simmons-Mackie
Damico, 1996, p. 39-41)

• Initiation
• Gaining listener attention
• Termination/Reorientation
• End of or reorganization of thoughts
• Participant Role
• Speaking Turns
• Affiliation
• Reinforcing for the listener
• Truth Level Markers
• Hedges or Qualifiers

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• Speakers typically invite listeners to help them
  convey info, or they qualify the info they
  provide via various types of (non)verbal
  behaviors (e.g., Im not sure).
• Speakers with aphasia compensate for the fact
  that they no longer have effective verbal ways to
  convey info, and they use what Simmons-Mackie and
  Damico (1996) refer to as a tool box of
  compensatory strategies, DMs being one of those.
  
• Much of the research to date on people with
  aphasia has been linguistic in nature, and
  linguistic analysis treats parenthetical remarks
  like artifact.
• If we knew more about how DMs, errors and
  disfluencies function for speakers with aphasia,
  we could give these usually parenthesed-off
  behaviors their due credit.
• For a person with aphasia, these behaviors could
  serve as signs of overflow, as in the LCP model,
  or serve as invitations to the clinician to help
  scaffold info, as when discourse markers are
  used.

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Purpose

• Therefore, the purpose of this preliminary study
  was to investigate the use of discourse markers,
  disfluencies, and paraphasias in speakers with
  aphasia when they engage in a retell situation
  with a familiar and an unfamiliar listener.

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Methods Participants

• Two women (C,S) with mild aphasia were
  recruited on the basis of being similar.
• Both were five years post-onset.
• Both scored a 1 on describing task number 12 from
  the Minnesota Test for Differential Diagnosis of
  Aphasia (MTDDA 1965).
• Both scored 5.6 on the Social communication
  subtest of the ASHA Functional Assessment of
  Communication Skills for Adults (FACS 1995). On
  the Communication of basic needs subtest of the
  FACS, Participant C scored a 7.0 Participant S,
  a 6.67.
• The familiar listener was C and Ss clinician
  the unfamiliar listener was another SLP who had
  not previously met C or S.

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Procedures

• Two five min clips from an ABC TV news show about
  gender differences was used, and were selected.
  Clip 1 was played to Participant C and Clip
  2,Participant S.
• Each participant watched the clip alone so that
  they could retell about it to a listener who had
  not seen it.
• The familiar and unfamiliar listener conditions
  were counterbalanced.
• Listeners were instructed to mostly listen, and
  speak as they felt they needed. Naturalness of
  the setting and the situation was emphasized.
  Listeners requested something like, So so tell
  me about what you watched.

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Coding procedures

• Participants were audio-videorecorded, verbatim
  transcripts were prepared, and the transcripts
  were coded as follows
• Discourse markers part of the final message
  considered a mark for the listener (e.g., I
  forget his name).
• Paraphasias non-words that were uncorrected
• Interjections um, uh ah (clusters of
  interjections counted as one)
• Revisions corrected errors, phonological,
  morphological, syntactic, and semantic in type
• Repetitions sound-syllable, word or
  phrase-level iterations
• Interrater reliability All codes in the
  transcript were mutually agreed upon between the
  first and second authors. Where disagreements
  occurred, code definitions were further
  elaborated upon.

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Results

• As can be seen in Figure 1, the two participants
  produced somewhat more behaviors of all types
  (discourse markers, disfluencies and paraphasias)
  when speaking to the familiar listener.
• All three figures show that Participant S
  produced more interjections and other types of
  disfluencies. However, both participants data
  can be categorized in the following way

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(No Transcript)
12
(No Transcript)
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disfluencies
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• Figure 2 shows interjections separately because
  they were the most prevalent disfluency type,
  produced on 7-25 of sample words.
• Figure 3 shows that revisions and repetitions
  were the next most frequently occurring
  disfluency types there is a trend for higher
  occurrence in the familiar listener condition.
• Whereas discourse markers tend to occur more
  frequently in the Unfamiliar listener condition,
  and paraphasias are questionable due to
  inter-subject variability.
• Discourse markers tended to be of the truth-level
  type (4/6 Participant C 5/6 Participant S)
  (e.g., or something like that). Initiation
  (e.g., First of all) or participant role (e.g.,
  so..) functions were identified for the other
  3/12 (25) DMs.

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Discussion

• Little or no support for the idea of cognitive
  overflow was found in this preliminary study.
  Support would have come from finding more
  disfluencies in the Unfamiliar listener condition
  than in the Familiar.
• Perhaps Jucker Zin (1996) and others are
  correct that interjections and revisions function
  like discourse markers, as a way to mark for the
  listener info to the effect of hold on, Im
  formulating. Perhaps the speaker is freed-up to
  use more interjections and revisions when
  speaking to a familiar listener because she is
  more expressive due to lower demands in this
  condition.
• On the other hand, discourse markers may occur
  more frequently in the Unfamiliar listener
  condition because the speaker with aphasia feels
  an obligation to a stranger to get it right,
  that is to communicate qualifiers and mostly
  truth-level information.

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• Future investigations into nonverbal behaviors
  and consistency of discourse marker use from more
  samples should prove useful to those who are
  interested in the idea that People with aphasia
  communicate better than they talk (Holland,
  1982).
• Simmons-Mackie and Damico (2002) provide the
  potential use of base layer and gaze/gesture
  layer of analysis, for example.
• It should be noted that we did not ask listeners
  to do any work toward supporting the speakers.
  Future research should investigate strategies
  such as listener scaffolding in a retell (e.g.,
  first episode is restated before the next is
  retold), and use of hierarchical models (e.g.,
  first the familiar than the unfamiliar listener
  is introduced to the client or patient), and the
  effect of these strategies on the fluency of
  speakers with aphasia.  

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References

• Holland, A. (1982). Observing functional
  communication in aphasic adults. Journal of
  Speech and Hearing Disorders, 47, 50-56.
• Jucker, A. H., Ziv, Y. (1998). Discourse
  markers descriptions and theory. Philadelphia J.
  Benjamins.
• Schuell, H. (1965). Minnesota Test for
  Differential Diagnosis of Aphasia. Minneapolis,
  MN. University of Minnesota Press.
• Simmons-Mackie, N. N., Damico, J. S. (2002).The
  base layer and the gaze/gesture layer of
• transcription. Clinical Linguistics and
  Phonetics, 16, 317-327.
• Simmons-Mackie, N. N., Damico, J. S. (1996).
  The contribution of discourse markers to
  communicative competence in aphasia. American
  Journal of Speech-Language Pathology, 5, 37-43.

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