Aspects of natural conversation in primary progressive aphasia

Abstract

Primary progressive aphasia (PPA) affects a range of language and cognitive domains that impact on conversation. Little is known about the nature of conversation breakdown in the semantic variant of PPA (svPPA, also known as semantic dementia). This paper reports on a study which investigated trouble in conversation, how it is repaired, and the success of repair in the conversation of people with svPPA. Dyadic conversations about everyday activities between seven individuals with svPPA and their partners and seven participants in control dyads were video recorded, transcribed and examined. Individuals with svPPA were active participants in conversation, generally taking an equal proportion of turns in conversation. While there was a wide variety of words per turn across the individual participants with svPPA, as a group their output was not sparse. The patterns of trouble and repair observed were unlike the patterns previously reported in non-fluent variant PPA, logopenic variant PPA and Dementia of the Alzheimer's Type. There was a trend for greater naming impairment to be associated with less successful repair. Finally, in the dyads examined in this study, where one person had svPPA, the contribution of the communication partner appeared to be a critical factor in the success of repair behaviours in conversation. These findings should be considered in planning behavioural interventions with this clinical population and their families to enhance success and satisfaction in conversation. Examining trouble and repair in ten-minute conversations of individuals with svPPA has the potential to enhance assessment and inform clinical practice.