title: Multiple repair sequences in everyday conversations involving people with Parkinson's disease.
abstract: BACKGROUND
  Features of dysarthria associated with Parkinson's disease (PD), such as low volume, variable rate of speech and increased pauses, impact speaker intelligibility. Those affected report restricted interactional participation, although this area is under explored.
  
  
  OBJECTIVE
  To examine naturally occurring instances of problems with intelligibility that resulted in multiple attempts at repair in order to consider repair initiation strategies that might restrict or enhance participation.
  
  
  METHODS
  Thirteen people with PD (PwPD) video-recorded over 10 h of informal conversation data in their home setting involving familiar conversation partners (CPs). Using a conversation analytic (CA) approach, and drawing on an existing typology of repair initiators (RIs) for everyday talk-in-interaction and their relative power to locate a turn's repairable element, the design and ordering of RIs used by CPs was addressed, alongside their local consequences.
  
  
  RESULTS
  CPs tended to increase the specificity of their RIs in line with the existing typology, progressing from open class forms (e.g. 'mm?') to more specific forms (e.g. questions/partial repeats). Repeated open class repair initiators (OCRIs) were used where PD speakers' self-repair attempts provided limited information. Sometimes, however, specificity was increased too soon, before enough syntactic knowledge was gleaned, which resulted in an extended repair sequence. Where one OCRI followed another, the second always took a different form: lexically or in terms of prosodic/non-verbal features. RI forms not described in the existing typology were also identified, such as 'prompts to modify speech' (e.g. 'Speak louder') and repeating/rephrasing the original first pair part (e.g. question), and their effectiveness examined.
  
  
  CONCLUSIONS
  First steps are presented towards the design of a communication intervention promoting the efficient resolution of repair to moderate social withdrawal and increase participation for this client group. Future research will need to explore the feasibility and acceptability of such a resource.
authors.affiliation: Department of English and Language Sciences, University of St Mark & St John, Plymouth, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Griffiths
authors.affiliation: Centre for Academic Primary Care, School for Social and Community Medicine, Canynge Hall, Bristol, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Barnes
authors.affiliation: University of Exeter Medical School, Exeter, UK.
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
authors.affiliation: Department of Human Communication Sciences, University of Sheffield, Sheffield, UK.
authors.forename: Ray
authors.initials: R
authors.lastname: Wilkinson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004401:Dysarthria / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D013061:Speech Acoustics; D013064:Speech Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D013065:Speech Intelligibility; D014705:Verbal Behavior
keywords: Parkinson's disease; conversation analysis; dysarthria; multiple repair