title: Semantic trouble sources and their repair in conversations affected by Parkinson's disease.
abstract: BACKGROUND
  It is known that dysarthria arising from Parkinson's disease may affect intelligibility in conversational interaction. Research has also shown that Parkinson's disease may affect cognition and cause word-retrieval difficulties and pragmatic problems in the use of language. However, it is not known whether or how these problems become manifest in everyday conversations or how conversation partners handle such problems.
  
  
  OBJECTIVE
  To describe the pragmatic problems related to the use of words that occur in everyday conversational interaction in dyads including an individual with Parkinson's disease, and to explore how interactants in conversation handle the problems to re-establish mutual understanding.
  
  
  METHODS
  Twelve video-recorded everyday conversations involving three couples where one of the individuals had Parkinson's disease were included in the study. All instances of other-initiated repair following a contribution from the people with Parkinson's disease were analysed. Those instances involving a trouble source relating to the use of words were analysed with a qualitative interaction analysis based on the principles of conversation analysis.
  
  
  RESULTS
  In 70% of the instances of other-initiated repair the trouble source could be related to the semantic content produced by the individual with Parkinson's disease. The problematic contributions were typically characterized by more or less explicit symptoms of word search or use of atypical wording. The conversation partners completed the repair work collaboratively, but typically the non-impaired individual made a rephrasing or provided a suggestion for what the intended meaning had been.
  
  
  CONCLUSIONS
  In clinical work with people with Parkinson's disease and their conversation partners it is important to establish what type of trouble sources occur in conversations in a specific dyad. It may often be necessary to look beyond intelligibility and into aspects of pragmatics to understand more fully the impact of Parkinson's disease on everyday conversational interaction.
authors.affiliation: Institute of Neuroscience and Physiology, Division of Speech-Language Pathology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Saldert
authors.forename: Ulrika
authors.initials: U
authors.lastname: Ferm
authors.forename: Steven
authors.initials: S
authors.lastname: Bloch
mesh_terms: D000368:Aged; D000849:Anomia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003147:Communication Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D032882:Comprehension; D003299:Cooperative Behavior; D004401:Dysarthria / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010300:Parkinson Disease / Q000628:therapy*; D012660:Semantics; D013065:Speech Intelligibility; D018454:Spouses; D014705:Verbal Behavior; D014825:Vocabulary
keywords: Parkinson's disease; anomia; communication partners; conversational interaction; pragmatics; repair