Acquired dysarthria in conversation: identifying sources of understandability problems.

BACKGROUND: Acquired progressive dysarthria is traditionally assessed, rated, and researched using measures of speech perception and intelligibility. The focus is commonly on the individual with dysarthria and how speech deviates from a normative range. A complementary approach is to consider the features and consequences of dysarthric speech as it is produced as a turn-at-talk in everyday interaction and in particular the ways in which this talk may be identified by its recipient as problematic to understand. AIMS: To investigate how dysarthric turns-at-talk in everyday conversation may be problematic to understand. Further, to describe how recipients of dysarthric talk identify the source of problematic understandings to the dysarthric speaker. METHODS & PROCEDURES: Video data of natural conversation from two dyads were selected for this paper. The dyads were video-recorded at home, at 3-monthly intervals, over a maximum period of 18 months. Using the methods of conversation analysis a collection of sequences was identified and transcribed. The sequences were analysed with reference to how the recipients of dysarthric talk, through the use of other-initiations of repair, identified some element of that talk as problematic. OUTCOMES &
RESULTS: This work shows how a recipient of a dysarthric talk turn in everyday conversation goes about displaying the problematicity of that turn to its speaker. Whilst displaying that a problem exists with a prior turn, the recipient may have difficulty in knowing what that problem actually is. CONCLUSIONS & IMPLICATIONS: It is proposed that clinicians and researchers should consider the effects of dysarthric speech in interaction. Specifically, the nature of dysarthric troubles and the practices used to signal understanding problems as they occur in everyday interaction should be fully explored. This consideration may have relevance for clinical assessment and intervention.