title: Adapting to conversation with semantic dementia: using enactment as a compensatory strategy in everyday social interaction.
abstract: BACKGROUND
  Studies to date in semantic dementia have examined communication in clinical or experimental settings. There is a paucity of research describing the everyday interactional skills and difficulties seen in this condition.
  
  
  OBJECTIVE
  To examine the everyday conversation, at home, of an individual with semantic dementia.
  
  
  METHODS
  A 71-year-old man with semantic dementia and his wife were given a video camera and asked to record natural conversation in the home situation with no researcher present. Recordings were also made in the home environment, with the individual with semantic dementia in conversation with a member of the research team. Conversation analysis was used to transcribe and analyse the data. Recurring features were noted to identify conversational patterns.
  
  
  RESULTS
  Analysis demonstrated a repeated practice by the speaker with semantic dementia of acting out a diversity of scenes (enactment). As such, the speaker regularly used direct reported speech along with paralinguistic features (such as pitch and loudness) and non-vocal communication (such as body posture, pointing and facial expression) as an adaptive strategy to communicate with others in conversation.
  
  
  CONCLUSIONS
  This case shows that while severe difficulties may be present on neuropsychological assessment, relatively effective communicative strategies may be evident in conversation. A repeated practice of enactment in conversation allowed this individual to act out, or perform what he wanted to say, allowing him to generate a greater level of meaningful communication than his limited vocabulary alone could achieve through describing the events concerned. Such spontaneously acquired adaptive strategies require further attention in both research and clinical settings in semantic dementia and analysis of interaction in this condition, using conversation analysis, may be helpful.
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester/Pennine Care NHS Foundation Trust, Manchester, UK.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kindell
authors.forename: Karen
authors.initials: K
authors.lastname: Sage
authors.forename: John
authors.initials: J
authors.lastname: Keady
authors.forename: Ray
authors.initials: R
authors.lastname: Wilkinson
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003147:Communication Disorders / Q000523:psychology* / Q000534:rehabilitation*; D057180:Frontotemporal Dementia / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D012660:Semantics; D012919:Social Behavior; D018454:Spouses / Q000523:psychology; D014741:Video Recording
keywords: adaptation; compensatory strategy; conversation; enactment; semantic dementia
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