The impact of cognitive neuropsychological impairments on conversational ability in aphasia

Abstract

Cognitive neuropsychology and pragmatics have influenced much of the recent aphasiology research. In order to capitalise on the apparently complementaiy strengths of these two theoretical paradigms in the management of aphasia, it is necessary to understand the relationships that exist between cognitive neuropsychological impairments and pragmatic abilities. This thesis seeks to address the issue of the integration of the two approaches using a single case study design. First, a comprehensive cognitive neuropsychological investigation of the each of three aphasic subjects' processing of single words and sentences is undertaken. Second, an analysis of the subjects' discourse with two different interlocutors is carried out, applying the data-driven principles of conversation analysis. Throughout the second strand of analysis, attempts are made to identify the impact of any impairments found in cognitive neuropsychological investigations on the conversation. The findings identify two important factors in determining the impact of aphasia on conversational interaction. These are: 1) the precise nature of the cognitive neuropsychological impairments; 2) the strategies adopted by both the aphasic person and their interlocutors to deal with the consequences of the linguistic impairments. From the findings, implications are drawn for the provision of an integrated approach to aphasia management which capitalises upon the complementary benefits to be derived from the application of cognitive neuropsychology and conversation analysis.