Discourse analyses Roberts and Orange final …...Reflects communicative competence and complex interrelationships among different types of knowledge: 1. Knowledge of language structural

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Speech-Language and Audiology Canada (SAC) Conference

Ottawa ON 9th May 2014

Discourse Analyses in Adult Communication Disorders:

A Hands-On Tutorial

Angela Roberts, MA, Reg. CASLPO Health and Rehabilitation Sciences Program

and JB Orange, PhD, Reg. CASLPO, SLP (c)

School of Communication Sciences and Disorders Western University

London ON N6G 1H1

[email protected] [email protected]

We, the presenters, do not currently hold and have not held in the past a financial interest, arrangement or affiliation with Speech-Language and Audiology Canada that could be perceived as a direct or indirect conflict of interest in the content of today’s program.

Disclosure

Potential Conflicts of Interest JBO 1.  CIHR - Canadian Dementia Knowledge Translation Network

(CDKTN) 2.  Alzheimer’s Society of Canada and Canadian Nurses

Foundation (Ward-Griffin, McWilliam, Klosek & Wong) Ø  Building partnerships in community-based dementia care delivery

3.  CIHR – Health Services and Policy Research, Gender, Sex and Health (Ward-Griffin et al.) Ø  Research Knowledge Translation in Dementia Care: It Takes a

Community 4.  The Canadian Consortium on Neurodegeneration in Aging

Ø  (ICRSAD, CIHR, Private Donors, Brain Canada, Provincial Agencies, Private Companies)

5.  Ontario Brain Institute (Strong et al.) Ø  Ontario Neurodegenerative Diseases Research Initiative

6.  Canadian Partnership for Stroke Recovery (Teasell et al.) Ø  STRIVE-HOME Videoconferencing delivery of SLP services

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Potential Conflicts of Interest AR 1.  Ontario Brain Institute (Strong et al.)

Ø  Ontario Neurodegenerative Diseases Research Initiative 2.  Ontario Brain Institute (Strong et al.)

Ø  Ontario Neurodegenerative Diseases Research Initiative 3. CIHR Fellowship 4. Canadian Partnership for Stroke Recovery (Teasell et

al.) Ø  STRIVE-HOME Videoconferencing delivery of SLP services

5.  Parkinson Society Canada Graduate Student Award

Aims of Tutorial At the conclusion of the tutorial, participants will be able to: 1.  Select appropriate method(s) for obtaining discourse

sample(s),

2.  Select appropriate discourse analyses methods for specific assessment purposes (e.g., word retrieval),

3.  Demonstrate knowledge of the application of discourse analyses across several acquired adult communication disorders.

Discourse Ø  Actual instances of communicative action in the medium of language, actions

and behaviours (Johnstone, 2008)

Ø  Meaningful symbolic behaviour in any mode (Blommaert, 2005, p.2)

Ø  Analyses consider what happens when people draw on the knowledge they have about language, knowledge based on memories of what they have expressed, read, heard to complete actions in the world Ø  Exchange information Ø  Express feelings Ø  Make events happen Ø  Create beauty Ø  Entertain Ø  Among other functions (Johnstone, 2008)

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Discourse

Discourse

Ø Narrative – real or imagined events 1. Abstract 2. Setting/orientation

3. Complicating action(s)

4. Evaluation 5. Result/resolution

6. Coda (optional – in which the speaker/readers returns listener or reader to present time) (Labov & Waletzky, 1997)

Discourse Ø Procedural – descriptions of specified sequential

steps/actions Ø Expository – extended monologue on personally

relevant material Ø Argumentative – interactants reason-out ideas or

convictions to become more convincing Ø Judicial contexts Ø Political arenas Ø Debating

Ø Conversation

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Discourse -‐ Conversa6on Ø Conversation

Ø A naturally occurring, spontaneous interaction involving two or more participants (McTear, 1985)

Ø Social and interpersonal aspects and functions, in part, as a means of transmitting information

Ø Captures relatively informal collaborative interactions where roles of speakers and listeners are interchanged in a non-automatic manner (McLaughlin, 1984)

Discourse - Conversation

Ø A back-and-forth series of verbal and nonverbal exchanges between two or more participants who observe certain rules and also violate them in an irregular flow of speaker's and listener's turns, acceptable and unacceptable simultaneous activities, acoustic and visual pauses, and a number of other positive and negative behaviors within each turn, differently oriented between speaker and listeners or among listeners, and conditioned by personality, situational context, and cultural background.” (Poyotos, 1982, p. 156)

Theoretical Perspectives on Conversation

Focus on:

Surface structure

Interpretive method:

Sequential behaviour

Conversation Analysis

Discourse Analysis

Discursive Psychology

Critical Discourse Analysis

Feminist Theory

Social, cultural, political contexts

Motive, purpose, intent

Politeness Theory

Post-modernism

Analytic unit:

Turn and sequence within an individual conversation

Across conversations / people, cultures

Ethnomethodology Linguis(c psychology Social semiotics

With Permission, Chris Lind, Flinders University, July 2013

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Theoretical Perspectives on Analysing Conversation

Conversation Analysis -  No psychology (no talk of “motive” or “intent”) ** -  Radical particularism (cc with AR clinical needs) -  Recipient design -  Sequential implicature / Next turn proof procedure ** -  Immediacy of repair ** -  No attribution (i.e., blame) – righting mechanisms ** -  Units of talk: Turn Constructional Units not Sentences -  Goal of interaction: Establish and maintain ongoing mutual

understanding. With Permission, Chris Lind, Flinders University, July 2013

Pragmatics Ø  The relation of signs to interpreters (Morris , 1938)

Ø  The study of the use of language in communication, particularly the relationships between sentences and the context and situations in whey they are used (Richards et al., 1985 – Longman Dictionary of Applied Linguistics)

Ø Reflects communicative competence and complex interrelationships among different types of knowledge: 1.  Knowledge of language structural (i.e., language code) 2.  Presuppositional knowledge – ability to make appropriate

judgements about the form an utterance must take to communicate the speaker’s intent or to understand the intent (Gallagher, 1991)

Pragmatics Ø The organization of communicative action:

1. When and how utterances are used appropriately in verbal interaction

2. Meaning derived from aspects of language use other than the grammar, such as inferences from the situational context, paralinguistic features (i.e., affective prosody, gestures, facial expressions) or general knowledge Ø Necessary to interpret jokes, sarcasm, indirect speech

acts and non-stereotypes metaphors and every single utterance about whether it is to be taken literally or not (Paradis, 1998)

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Selected Examples of Common Clinical Tasks

Ø  Topic Directed Interviews (TDI) – 5 topics (derived from Illes, 1987; 1989) Ø Born and raised Ø Work done or occupations held Ø Family Ø Health right now Ø Typical day

Ø Picture description Ø BDAE – Cookie Theft Ø WAB - Picnic Ø Nicholas and Brookshire stimuli (single and picture

sequence)

Ø Narrative and expository discourse, and conversation

Table 1. Mul6-‐level Discourse Paradigm (Shadden, 1998)

Task Demand Story Retelling

Narrative Generation

Procedural Personal

Stimulus Auditory Visual None None

Linguistic specificity & Complexity

High Moderate Low specificity Md syntax

Low specificity Md syntax

Stimulus Complexity High High (series) None None

Memory High None Low-Md Low-Md

Sequencing/Organization High Mid-High High Low

Task Constraint High Moderate Low-Md Low

Saliency Low Low Variable High

Syntactic Complexity Moderate Low-Md Md-High Md-High

Risk for Interference/cohesion issues

Low Md High Md

Sources of Picture Description Stimuli

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Nicholas and Brookshire, Copyright, 1992

Nicholas and Brookshire, Copyright, 1987

“Cookie TheJ”

(“Frog Where Are You?” Mercer Mayer, 1968)

Personal Narrative Questions Ø  “Tell me what you usually do on Sundays” Ø  “Tell me where you live and describe it to

me” (Brookshire & Nicholas, 1992)

Ø  Topic Directed Interviews (Orange, et al.) Ø  “Tell me about…

Ø  Your health Ø  What you did for a living Ø  Your family Ø  Where you were born and raised Ø  A typical day

Procedural Task

Ø “Tell me how you would go about doing dishes by hand” (Brookshire & Nicholas, 1993)

Ø “Tell me how you would go about writing and sending a letter” (Brookshire & Nicholas, 1993)

Ø …how you would change the batteries in a flashlight

Ø …how you would make a peanut butter and jam sandwich

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Procedural Task Ø Essential Steps

Ø “Steps which must be understood by the listener in order to know what basic actions are required to do the task” (Ulatowska et al., 1983)

Ø Determine a priori Ø Optional Steps

Ø “Clarify, add, or give more detail beyond the essential steps” (Ulatowska et al., 1983)

Procedural Task (Godbout & Doyon, 2000)

A.  Say (or to write) ac6ons of six familiar scripts including a detailed list of 10 to 20 ac6ons describing what people generally do over the course of the ac6vity.

B.  Place the ac6ons in the correct chronological order.

1.  going to the cinema/film theatre 2.  going to a wedding 3.  going to a doctor’s office 4.  going to a restaurant 5.  shopping for groceries 6.  going to the hairdresser/stylist/barber

Discourse Analyses

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Length of Samples for Analysis

Ø In general 3 to 5 minutes enough for structured tasks Ø 4 to 5 samples for most stable data (200 to 300 words);

fewer samples yield higher variability (Nicholas & Brookshire, 1993)

Ø 5 to10 minutes for conversation or less structured tasks

Ø Efficiency = 5 minute samples may be sufficient Ø Discourse repairs = 10 minutes (Boles & Bombard, 1998)

Ø Need to be able to observe 10 to 15 behaviours

Types of Analyses (Monologic Tasks)

Ø Microlinguistic (i.e., within sentences) Ø Microstructural (i.e., across sentences) Ø Macrostructural (i.e., thematic unity) Ø Superstructural (i.e., story grammar,

organization of information)

(Coelho, 2007)

Produc6vity Informa6on content

Grammar structure & Phonological errors

Verbal disrup6ons

(Doyle et al., 2000; Nicholas & Brookshire 1993, 1995; Shadden, 1998)

Example of Multi-level Monologic Discourse Analysis

✓ Words/minute ✓ Mean length uèrance

✓  Lexical produc6vity Type Token Ra6o (%nouns & %verbs)

✓ # Correct informa6on units (CIUs)/minute

✓ % CIUs ✓ % Accurate/complete story proposi6ons

✓ % Gramma6cal & well-‐formed uèrances

✓ % Sound produc6on errors

✓ Mazes/uèrance ✓ Pauses/total words ✓ Mean dura6on of silent pause

✓ Verbal disrup6on behaviours/total words*

Repetitions, word reformulations, substitutions, empty words, insertions (German & Simon, 1991)

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Ø Microlinguistic (i.e., within sentences) Ø Productivity Ø Grammatical Complexity Ø Lexical Diversity

Productivity – Verbosity (rate and amount), rate Morphosyntactic

Ø Total # words Ø Total # utterances Ø MLU (calculated on N=50 utterances) Ø T-units/C-Units

Ø Minimal grammatical unit, usually verb and associated arguments, a clause

Ø % of utterances: Ø Complete Ø Incomplete (i.e., unfinished) Ø Agrammatic

Structural Considerations (microlinguistic)

Ø Total speaking time (including all pauses) Ø Total talking time (time speaking minus all intra-

and inter-sentential pauses longer than 5 seconds) Ø # words/min Ø # complete utterances/min Ø # incomplete utterances/min

Ø  TTR for open class (nouns, verbs, etc.) vs. closed class (pronouns, auxiliary verbs) Ø  Lexical diversity - # different words: total # words Ø  Lexical density - N:V ratio; N:Pronoun Ø  Grammatical intricacy – M # clauses/T-unit


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Syntax Ø Analysis of complexity of sentences

Ø Inventory of syntax types Ø Ratio of independent to dependent clauses Ø % of well formed sentences


Measures of word retrieval difficulty (Shewan, 1988; Haravon et al., 1994; Mayer & Murray, 2003) Diane German

Ø  Word reformulations Ø  Hesitations/pauses/delays Ø  Repetitions Ø  Empty words Ø  substitutions

Ø  % paraphasias (e.g., verbal, semantic, phonemic, neologistic) Ø  % stereotype utterances Ø  % overt utterances by speaker re: anomia Ø  % pauses > 5 seconds Ø  % unintelligible utterances Ø  % corrected errors


Learning Activity 1

Ø Using the discourse sample provided calculate a complexity index (Capilouto & Wright, 2012) Ø Count the number of independent clauses (IC)

Ø Count the number of dependent clauses (DC)

Ø Complexity index = IC + DC/IC

Ø Values > 1 suggest greater complexity

Ø Values of 1 suggest lower complexity

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Ø  Independent clause = Any clause within a sentence that can stand as a complete sentence. Sentences are sometimes made up of a single independent clause.

Ø My dad goes. = 1 independent clause because the intransitive verb ‘goes’ does not require a direct object.

Ø  The boy rides his bike = 1 independent clause because the transitive verb ‘rides’ requires the direct object ‘bike’.

Ø Dependent clause = Any clause within a sentence that cannot stand alone as a complete sentence. A dependent clause cannot stand alone as a complete sentence.

Ø My dad goes to work each day = 1 independent clause and 1 dependent clause.

Ø  The boy rides his bike quickly to the store to buy candy. = 1 independent clause and 2 dependent clauses.

Types of Analyses (Monologic Tasks) Ø Microstructural (i.e., across sentences)

Ø Cohesion and cohesive strategies

Ø  “…interpretation of some element in the discourse is dependent on that of another. The one presupposes the other…the presupposing and the presupposed are integrated into a text.” (Halliday & Hasan, 1976) Ø Reference Ø Lexical Ø Conjunctive Ø Ellipsis Ø Substitution

Referent Error

MD: I'm I'm glad that aunt Bea went to the you

know um in her um in aunt aunt um Mary um if she's if she's gonna um +…

SP: Call her? MD: Call her. SP: Is she gonna call her soon? MD: I don't know.

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Ø Macrostructural (i.e., thematic unity) Ø Variety of scoring systems reported in literature Ø Local Coherence

Ø What is the utterance content relationship to the preceding utterance?

Ø Global Coherence Ø What is the utterance content relationship to the

general topic of the story?

Local Coherence Ø Reflects principle that one idea is thematically

linked with ideas in contiguous utterances Ø % local coherence errors = # of local

coherence errors/# of utterances x 100 Ø Errors

Ø Missing or ambiguous referents = where the referent of a pronoun or subject of a verb are ambiguous or incorrect or missing

Ø Topic switching = abrupt interruption of utterance (cohesion error) and the next utterance introduces new information vs. completing interrupted thought

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Macrostructural (cont.) Ø Measures of Informativeness/information/

content (i.e., accuracy, amount and efficiency) Ø Correct Information Units (Nicholas & Brookshire, 1993)

Ø Main Content Units (i.e., identifying main ideas/key content points based on normative samples) Ø Cookie theft (Nicholas et al., 1985; Nicholas and Brookshire,

1995; Yorkston and Beukelman, 1980) Ø Nicholas and Brookshire stimuli (Capilouto et al., 2005;

Nicholas and Brookshire, 1995; Wright et al., 2005)

Correct Information Units (Nicholas & Brookshire, 1993)

Ø CIU’s – words “accurate, relevant, and informative relative to the eliciting stimuli”

Ø Measure of informativeness Ø Words/minute Ø % CIUs = words in sample that meet CIU

definition/total words Ø More flexible than CU = applied to multiple

discourse genres Ø Cookie Theft, WAB, picture sequences, personal

narrative, procedural (Nicholas & Brookshire, 1993)

Ø Has been applied to connected spoken language (Brookshire & Nicholas, 1994; Oelschlaeger & Thorne, 2000)

Scoring of Main Ideas (Nicholas & Brookshire, 1995)

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Main Ideas “Cookie Theft” (Nicholas & Brookshire, 1995)

1.  The woman (mother) is doing dishes. 2.  The sink (water) is overflowing (running over). 3.  The boy is on a stool. 4.  The boy (kids) is gelng (stealing) cookies (gelng

into the cookie jar). 5.  The stool is 6pping. (The boy is falling). 6.  The girl is reaching for a cookie. (The boy hands the

girl a cookie.) [or some men6on of a plausible ac6on by the girl or loca6on of the girl.

7.  The woman (mother) is not no6cing (paying aèn6on).

(Nicholas & Brookshire, 1995)

Other Main Content Scoring Systems

•  Yorkston and Beukelman (1980) •  Wright et al. (2005) & Capilouto et al. (2006) – captures more of the temporal, causa6ve (i.e., inter-‐rela6onships)

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Learning Activity 2 Ø Using the discourse sample provided:

Ø Determine the number of accurate and complete essential elements (i.e., underlined elements) that are present in your sample. Ø Do not have to be grammatically correct Ø Wording does not have to be exact…but should mean the

same Ø If a referent is not correct (i.e. ‘the man’ for ‘the woman’)

score it incorrect Ø Each underlined phrase is an element

Ø Count each element only once (i.e., if it is repeated do not count twice)

Ø Revised/reformulated essential elements – score the final version

Main Ideas “Cookie TheJ” (Nicholas & Brookshire, 1995)

1.  The woman (mother) is doing dishes. 2.  The sink (water) is overflowing (running over). 3.  The boy is on a stool. 4.  The boy (kids) is gelng (stealing) cookies (gelng

into the cookie jar). 5.  The stool is 6pping. (The boy is falling). 6.  The girl is reaching for a cookie. (The boy hands the

girl a cookie.) [or some men6on of a plausible ac6on by the girl or loca6on of the girl.

7.  The woman (mother) is not no6cing (paying aèn6on).

Types of Analyses (Monologic Tasks) Ø Superstructural (i.e., story grammar,

organization of information) Ø The use of knowledge of schemas (i.e., may

be culturally dependent) to structure stories using a ‘typical’ or ‘expected’ internal structure Ø Episodes: Statements containing information about

the specific goals/identified problems, resolutions/strategies, and results of actions taken by the characters to achieve the story goal/resolve problem.

Ø Initiating events, Attempts, Direct Consequences (Coelho, 2007)

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(Nicholas & Brookshire, 1992)

•  *03: Well we have dissen6on between Joe and Be`y. *03: Joe is silng in his chair. *03: Although he is wearing a 6e. *03: So he must have some anyway business associa6ons. *03: Joe is silng in his chair reading his book. *03: And Be`y comes in and she is quite distressed. *03: There are harsh words spoken. *03: Hands fingers pointed. *03: Be`y stomps out of the room. *03: She re-‐emerges with her coat on carrying a suitcase. *03: Joe has his nose buried in the newspaper. *03: AJer the door slams shut behind Be`y Joe <puts his> [//] <holds his> [//] <puts his head down> on his arm. *03: Oh dear he’s thinking to himself +”/. *03: What have I done? +”/. *03: What am I going to do now? *03: and before he comes up with an answer the door opens. *03: He <swirls> [//] <swivels> around his chair. *03: And looks with amazement at a very dishevelled Be`y. *03: Coming slowly back through the door. *03: She puts her suitcase down. *03: And burst into tears. *03: Joe is uh goes to her. *03: Uh puts his arms around her. *03: While she’s sobbing on his shoulder. *03: He looks out through the door and sees the family car half way up the very solid maple tree on the front yard.

•  *13: Well looks like an argument with a couple. *13: She’s leaving. *13: Uh he’s thinking it over. *13: And <he’s> [//] <this is> about the 6me <he’s uh gelng uh> [/] <he’s gelng> concerned that maybe he should have been a li`le nicer. *13: And <she> [//] <then he> meets her coming in the back door. *13: And um they have uh <they’re saying that they’re sorry> [//]. *13: <He’s saying he’s sorry>. *13: And uh and she’s uh going half way to meet him. *13: And they end up with a hub. *13: And uh they <wa> [//] <need> the car. *13: To uh not sure what. *13: <That> [//] <there’s> a vehicle there. *13: And whether it’s theirs or whether <it’s> [/] <it’s> someones dropped cab that’s dropped his wife [#] off. *13: I’m not sure.

Discourse Measure PD n=1 Control n=1

Total words 119 195

Words/Minute (with pauses)

121.02 131.46

Dura6on 59 seconds 89 seconds

Mean Length of Uèrance 8.5 words 7.8 words

% Open Class Words 44.5% 57.4%

% Well-‐formed/gramma6cal uèrances

42.9% 64%

% CIUs 54.6% 81.5%

% Verbal Disrup6ons/total words

11.7% 2.0%

Main Ideas 4.5/7 (64.3%) [M = .70 (.23) for Capilouto et al. (2005) older par6cipants]

7/7 (100%)

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Interactional Measures

Turn taking Ø  # and % Interrupted, overlapping utterances Ø  # and % statements, questions (also by sub-type),

responses to questions

Topic and Breakdown Measures

Topic and Communication Breakdown and Repair – Coherence

Ø  Off-topic verbosity - Amount and Extent (Arbuckle and Pushkar-Gold, 1995)

Ø  Topic maintenance measures (Orange, Ste. Pierre, & Wilk, 1995) Ø # Topics and subtopics Ø # Relevant topics and subtopics Ø # and % of on-topic utterances Ø # and % off-topic utterances Ø # and % of side-sequence utterances Ø # and % intrusive and perseverative utterances

Ø  Communication Breakdown and Repair (for each member of dyad) Ø # and type of trouble sources (semantic, cognitive, morpho-syntactic, etc.) Ø # and type of signals for repair (requests for clarification, specification, etc.) Ø # and type of repairs (repetition, elaboration, paraphrasing, etc.)

Ø Perception of Conversation Index – Dementia of the Alzheimer’s type (Orange et al., 2008)

Learning Activity 3

Ø Watch the short video clip Ø Record the # of conversation breakdowns

observed Ø For each breakdown record:

Ø The source of the repair (i.e., semantic, hearing, cognitive, morphosyntactic)

Ø Who initiated the repair (i.e., which partner)? Ø How was the need for repair signaled? Ø Was the repair successful?

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Propositional-Ideational Repetitions and Re-Introductions

(Christiansen, 1995)

Ø Repea6ng an idea already stated Ø Does not add new informa6on Ø Prosodic informa6on does not indicate it is done for emphasis or meaning reinforcement /the girl is walking on the grass/ /she is walking on the grass/

Tangential

Ø A “derailment” in the flow of discourse already presented in previous utterances (Marini, et al. 2011)

Ø Additional information that is irrelevant to the goal of the task but triggered by the stimulus

Ø Occurs with normals but greater percentage in those with cognitive-communication problems

Tangential

/the woman is washing dishes/ /it is a really nice day today/ /I think that tree needs to be cut down/ /my garden has a tree that needs to be cut down/

/the girl is reaching for the cookies/ /I like cookies/ /I make chocolate chip cookies every Sunday/

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Bilingualism and Polyglotism

Ø  Language and dialect choice (e.g., with whom and under what constraints)

Ø % monolingual utterances

Ø % mixed utterances

Ø % self-corrections to language spoken by partner

Ø Analyses of where code-switching took place within utterances (i.e., followed grammatical constraints of one or other of spoken languages)

Other Types of Analyses

Ø Gestural and prosodic analyses accompanying spoken discourse

Summary Comments Ø Use discourse to reveal interactive deficits

Ø ABI, RBD, Left hemisphere associated aphasia, progressive disorders

Ø Characteristic discourse patterns across types of impairments

Ø  Use multiple elicitation genres

Ø  Usually 3 to 5 minute samples will be enough; but if looking for more coherence/cohesion/grammar analyses may need longer and multiple tasks

Documents

Discourse analyses Roberts and Orange final …...Reflects communicative competence and complex interrelationships among different types of knowledge: 1. Knowledge of language structural