Adapting in interaction involving Mandarin speakers with aphasia: A conversation analysis of turn initial responses to healthcare professionals' questions.

backgroundAphasia is a communication disorder caused by brain damage. People with aphasia (PWA) often experience difficulties in interaction.

methodsThis study uses conversation analysis (CA) and examines the interactions of 10 PWA (5 fluent and 5 non-fluent speakers) and their healthcare professionals.

aimsThe study aims to to explore how Mandarin-speaking PWA adapt to difficulties in initiating responses to questions from healthcare professionals. It also examines how the ways PWA adapt may vary across different types of aphasia.

resultsTwo adaptive practices were identified: turn initial repeats and turn initial iconic gesture. The findings suggest that fluent speakers with aphasia tended to adapt with turn initial repeats, while non-fluent speakers relied more on iconic gestures in starting a response turn. These practices allow PWA to maintain progressivity in responding to questions and assist them in formulating answers. CONCLUSIONS & IMPLICATIONS: The study provides empirical evidence on how linguistic and multimodal resources can enhance everyday interactions and be applied in interaction-focused therapy for Mandarin-speaking PWA. WHAT THIS PAPER ADDS: What is already known on the subject Existing research has primarily focused on communication challenges and adaptation strategies among individuals with aphasia who speak English, German and Finnish. There is a noticeable gap in the literature concerning Mandarin speakers with aphasia and their experiences in everyday communication. To our knowledge, no study has yet explored the specific challenges they encounter and how they cope with them. What this paper adds to the existing knowledge This study explores the communication challenges faced by Mandarin speakers with aphasia during interactions with health professionals, with a particular focus on turn initial responses to questions. Two distinct approaches (i.e., 'turn initial repeat' and 'turn initial iconic gesture') to manage communicative difficulties were identified, with a possible relation between approaches and aphasia types. Fluent speakers compensated with 'turn initial repeat' whereas non-fluent speakers employed 'turn initial iconic gesture' for successful communication with their health professionals. What are the potential or actual clinical implications of this work? The strategies initiated in response to question difficulties contribute to effective turn construction and represent valuable resources for PWA managing aphasia. The study offers empirical evidence on how these communication resources (both linguistical and multimodal) can enhance everyday interactions and be integrated into interaction-focused therapy for Mandarin speakers with aphasia.