Interactional problems, adaptation and code-switching in interactions involving Malay-English bilingual speakers with Traumatic Brain Injury: A conversation analysis study

Background:
This thesis is an exploration of talk-in-interaction involving Malay-English bilinguals who
have suffered a traumatic brain injury (TBI) and their conversation partners. Current TBI
studies focus on a monolingual population, which may omit the possible influence of
bilingualism on spontaneous communication. TBI studied from a conversation analysis
(CA) perspective is an emerging area compared to impairment or discourse based
approaches. However, compared to other acquired neurogenic disorders such as aphasia
and dementia, CA studies in TBI are lacking.
Aims:
The key aims are: 1) to understand the problems in conversations involving persons with
TBI; 2) to understand how conversation partners adapt their practices of speaking in
interactions involving persons with TBI; and 3) to understand the function of code-
switching behaviour in persons with TBI.
Methods:
Conversation analytic methods enabled a systematic analysis of talk-in-interaction using
naturalistic data. Three participants with TBI of differing severities (mild, moderate and
severe) and their conversation partners contributed to 95 minutes of self-recorded audio
interactional data. These included a combination of dyadic and multiparty interactions
recorded in the home, clinic and outdoor settings. The interaction data were sampled at at
least two time points (five months apart), with one participant (with severe TBI) contributing
to data over four years. Two neurotypical dyads contributed to 20 minutes of data as a
form of comparison when studying code-switching behaviour.
Results:
The data showed that there were interactional problems in conversations involving
persons with TBI. These problems included atypical physical and verbal actions (e.g.
touching, singing) and problems with understandability on the part of the person with TBI
or their conversation partner. The data also revealed adaptive behaviour by conversation
partners of persons with TBI within talk-in-interaction. These included displaying “teacher-
like” behaviours (e.g. asking test questions) and the adoption of particular interactional
roles within multi-party interactions (e.g. clarifying for the person with TBI or for the
conversation partner). Lastly, code-switching functions in conversations involving persons
with TBI and neurotypical dyads revealed similarities (e.g. using code-switching to
emphasise a point), and differences (e.g. the use of code-switching as a scaffolding tool
by the conversation partner). The conversations also revealed inappropriate code-
switching i.e. using a language unfamiliar to the conversation partner.
Theoretical implications:
There are three key theoretical implications from this study. Firstly, findings from
monolingual TBI literature were replicated. These include the presence of inappropriate
touching and singing, self-initiation of repair resulting in delays in TCU progressivity,
understandability problems resulting from agrammatism, and the use of test questions by conversation partners. Secondly, this study details multi-party interaction in more depth
than previous studies, demonstrating the collaborative behaviour of familiar and unfamiliar
conversation partners in helping the bilingual with TBI navigate multi-party conversations.
Lastly, using CA methodology in analyzing the interaction between TBI and neurotypical
bilinguals allowed the establishment of examples of typical (e.g. to emphasize a point) and
atypical (e.g. code-switching into a language not understood by the conversation partner) code-switching behaviour.