Conversational Practices of a Frontotemporal Dementia Patient and His Interlocutors

Frontotemporal dementia (FTD) is a dementia difficult to diagnose because, in the early stages, it leaves patients with intact cognitive functioning and a range of social deficits. For example, FTD causes changes in tactfulness and manners, violations of interpersonal space, and emotional appropriateness (Jagust, Reed, Seab, Kramer, & Budinger, 1989). Until recently (for exceptions see Mates, Mikesell, & Smith, in press) these characterizations have come from (a) brief clinical interviews and observations from neuropsychological testing and (b) caregivers' secondhand reports. Given the social nature of FTD, research is needed to examine the ordinary interactions of FTD patients, ones not colored by caregivers' memories or constrained by the structure of a clinic. Using conversation analysis, this article explores two common conversational practices of one patient, SD. This research shows that while SD's practices may appear appropriate in single, isolated turns, they are often inappropriate in more extended sequences. SD can respond locally to individual turns, that is, he can display local understanding, but he often misunderstands the aims of the sequence, often failing to demonstrate understanding. SD, for instance, shows difficulty understanding the interlocutor's goal of open-ended first pair-parts (FPPs) (eg., wh-questions). As such, SD's interlocutors design their talk to adapt to his incompetencies by constraining their FPPs. These constraints are in an attempt to elicit a more appropriate response from SD and enable him to produce a more appropriate response incrementally, turn-by-turn.

Lisa Mikesell
Affiliation: Department of Applied Linguistics, University of California, Los Angeles
Research on Language & Social Interaction, Volume 42, Issue 2 April 2009 , pages 135 - 162

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