Interaction and language test performance involving persons with dementia

Purpose: Dementia has a significant impact on language and communication. In this study, the aim was to compare the organization of interaction between persons with dementia (PWDs) and speech and language pathologists (SLPs) in two types of conversation, a test conversation and an informal conversation. A further aim was to relate interactional abilities to the PWDs’ performance on an aphasia test battery. Method: Ten PWDs participated in the two types of conversations. In the test conversation, a standardized aphasia test battery was used. All dyads were audio- and video-recorded. Analyses were informed by interaction analytical approaches, such as conversation analysis (CA), combined with quantitative measurements. Results: The results demonstrated that there was a larger number of turns, words, and topic initiations made by the PWDs in the informal conversations. The frequency of occurrence of repair instances was the same in the two conditions, but repairs in the test conversations were mostly resolved within one turn, whereas repairs stretching over several turns were more frequent in the informal conversations. Many of the repairs were initiated with a clarification request or a request for confirmation. Even though a majority of the PWDs demonstrated a rather robust turn-taking ability in the informal conversations, several of them struggled with the aphasia test assignments, in some cases due to visual perception problems. Discussion and conclusion: The results indicate that a thorough analysis of informal conversations is important in assessing language in PWDs. The ecological validity of standardized language tests needs to be discussed, and the results of such tests should be handled carefully.