1. Dysarthric talk in everyday social conversation: the nature and repair of simple and complex trouble sources. Steven Bloch & Ray Wilkinson Dept of Human Communication Science University College London

2. Acquired progressive dysarthria in conversation How is talk in conversation managed when one person has reduced speech intelligibility? Interest in the everyday social consequences of dysarthria - how it is ‘played out’ (accomplished) by people at home? How are problems with intelligibility, when they occur, identified and repaired by participants during conversation?

3. Methodology : Conversation Analysis Three couples with MND/ALS - all experiencing mild/moderate dysarthria at recruitment stage Videos of naturally occurring interaction Data collected at three monthly intervals over a maximum 18-month period Data transcribed, repeatedly viewed and analysed for different patterns of interaction through talk

4. Repair in conversation (Schegloff, Jefferson and Sacks 1977) Self or other initiation of repair - someone displays a problem or trouble within current turn or in a following turn An identified trouble source - the problem itself Self or other completion of the repair - an attempt to resolve the trouble Other-initiated self-repair identified as a common pattern within the data for this study

5. Simple (single) trouble source - Rose and Tom R: no down near Pahrnam T: near where? R: near Pahrnam T: oh so it’s not so far then R: no

6. Simple (single) trouble source - Mary and Stan M: a big (.) help. (2.0) S: mm? M: a big (0.5) help S: you get oh it’s a big help yeah it is

7. Complex (single) trouble source - Mary and Stan M: spine (2.0) S: mind the what? M: spine (1.0) S: spine? Complexity with reference to turn action and not just intelligibility

8. Multiple trouble source - Rose and Tom More than one trouble source Multiple attempts to resolve the trouble Resolved through serial repair of separate elements within the turn

9. Multiple trouble source - Mary and Stan M: there was a another one last week but she couldn’t settle S: she did what last week? M: (repair via speech and AAC) S: this is this woman Gladys?

10. Repair in dysarthria The real social consequence of unintelligibility Simple and multiple trouble sources Beyond (un)intelligibility - understandability Natural speech and AAC are NOT mutually exclusive resources Collaborative action between participants

11. Implications Understanding dysarthria beyond intelligibility measures - seeing how people ‘do dysarthria’ Possible ideas for assessment/outcomes - participants own strategies and resources Possible ideas for intervention - what works for each dyad? What causes problems? Clinician doesn’t assume expertise in dyads own resources Single and multiple NOT simple and complex!

12. For further information please feel free to contact: s.bloch@ucl.ac.uk