Understanding the role of silence in conversations with people with aphasia.

This thesis demonstrates how silences are used and understood by people with aphasia (PWA) and their communication partners (CPs), highlighting the difference between silence as a reflex of communication difficulties resulting from aphasia, versus its use as a purposive communicative practice.

Aphasia has a significant impact on the production and comprehension of speech, resulting in difficulties with relationships, careers, and mental health. Healthcare guidance encourages allowing extra silences in talk and giving PWA extra time to respond. This implies that silences have no communicative value and result only as an artefact of aphasia. However, prior research has shown that silences have many communicative functions within interaction. To investigate this, eleven hours of video-recorded conversations between nine dyads of PWA and their CPs were analysed using the methodology of Conversation Analysis.

This research found that PWA use silence to convey communicative content in multiple ways: as part of a dispreferred response, signalling difficulty with their turn, as space to produce a display of affect, to invite their CP to talk, and as part of providing a legitimate display of understanding. When silences result from aphasia, PWA can account for silences using turn-holding devices, or mask silences through displays of embodied thinking. PWA’s silences are also part of claiming to undertake certain mental processes, such as doing thinking, word selection, and displaying understanding. CPs are receptive to these uses of silence and allow more time if the PWA signals it is required.

These novel findings are positive for PWA, demonstrating that their communicative capabilities can overcome their impacted speech and that they possess more resources than previous research has indicated. The findings also demonstrate that the healthcare guidance requires further development so that it acknowledges the variable impact of aphasia on PWA’s use of silences, and the preserved communicative abilities of PWA.