Date of Award

1993

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Communication Sciences and Disorders

First Advisor

Jack S. Damico

Abstract

An ethnographic investigation of compensatory strategies in two individuals with nonfluent aphasia was undertaken. Data were collected from videorecordings of natural conversations between subjects and a variety of partners, observations of speech-language pathology assessment and therapy sessions, participant observations, ethnographic interviews, lamination sessions and documentary evidence. Data were analyzed to identify compensatory strategies employed by the aphasic subjects, to determine patterns of occurrence and functions of compensatory strategies, to determine the expectations and practices of speech-language pathologists, and to identify underlying themes relative to compensatory strategy usage. An operational definition of compensatory strategy was derived from the data, and every compensatory strategy used by each subject was identified in videorecorded samples and subjected to behavioral coding across 38 dimensions of relevant contextual variables. Usage patterns and a rich, authentic description of 25 compensatory behaviors were drawn from these data and triangulated with observations, interviews and lamination sessions to ensure reliability and authenticity. Results indicated that subjects adopted a variety of idiosyncratic, contextually flexible compensatory strategies to satisfy transactional and interactional goals of communication. Identified compensatory behaviors included strategies specifically taught by the speech-language pathologists and natural, untrained compensations. Compensatory strategies were adjusted to contexts and conversational goals. The usage patterns suggested several overall motivations including: the need to exchange information, the drive to conserve energy, the desire to maintain autonomy, and the need for social acceptance. Although speech-language pathologists interviewed and the aphasia literature reviewed defined strategies primarily in terms of "message transmission", many of the compensations adopted by the subjects subserved the goal of "promoting interaction" rather than conveying information. In fact, the flexibility and contextual sensitivity of compensatory strategies indicated the primacy of social motivations in communication. The results raised questions about traditional definitions of compensatory strategies and traditional aphasia management practices, and suggested the need to employ socially driven models of communication in aphasia.

Pages

397

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