Aphasiology The conversational value of laughter for

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Aphasiology

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The conversational value of laughter for a person with aphasia M. L. Madden; M. L. Oelschlaeger; J. S. Damico

To cite this Article Madden, M. L., Oelschlaeger, M. L. and Damico, J. S.(2002) 'The conversational value of laughter for a

person with aphasia', Aphasiology, 16: 12, 1199 — 1212 To link to this Article: DOI: 10.1080/02687030244000437 URL: http://dx.doi.org/10.1080/02687030244000437

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APHASIOLOGY, 2002, 16 (12), 1199–1212

The conversational value of laughter for a person with aphasia M.L. Madden and M.L. Oelschlaeger Northern Arizona University, USA

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J.S. Damico University of Louisiana at Lafayette, USA Background: In clinical aphasiology, laughter has been mentioned as an important ingredient in treatment but few studies have directly investigated its contribution. Aims: To increase our understanding, we designed this study to specifically investigate laughter as a conversational resource. Methods & Procedures: A naturally occurring conversation was videotaped and subsequently reviewed to identify conversational segments that included the laughter of a person with aphasia. Using conversational analysis, 47 laughter segments were coded and categorised to reveal similarities and differences in their sequential organisation. Outcomes & Results: Results showed four ways in which laughter was used to achieve conversational goals: as a turn-taking cue, a display of understanding, an orienting cue, and as instruction to hear. Descriptive comparison of laughter uses in aphasic and nonaphasic conversation showed similarities in organisational structure of laughter segments but differences in conversational context. Laughter was frequently associated with ‘‘trouble spots’’ in this study: no report of laughter associated with ‘‘trouble spots’’ was noted in nonaphasic literature. Conclusions: From a theoretical perspective, these results, in concert with those from previous studies of conversation, provide evidence that a nonlinguistic behaviour— laughter—contributes to the re-establishment of social interaction and meaning-making despite linguistic deficits. From a clinical perspective, laughter may be recognised as a viable conversational strategy, allowing for increased communicative access that positively impacts perceptions of competence and psychosocial well-being of persons with aphasia.

Laughter has generally been regarded as a non-speech phenomenon, akin to coughs and sighs. But in recent studies of ordinary speakers, laughter has been distinguished from other non-speech utterances as an integral part of conversation that is systematically produced and socially organised (Glenn, 1987, 1991; Jefferson, 1984; Jefferson, Sacks, & Schegloff, 1987; Pache, 1992; Sacks, 1974; Stewart, 1997). More specifically, Jefferson et al. (1987) characterise laughter as an interactional mechanism that functions as ‘‘a relevant, consequential response to a prior utterance, but has a significant bearing on a, or some next action(s)’’ (p.159). In other words, laughter itself can serve as a meaningful Address correspondenc e to: Mary L. Oelschlaeger PhD, Department of Communication Sciences and Disorders, Northern Arizona University, P.O. Box 15045, Flagstaff, Arizona 86011, USA. Email: [email protected] We are indebted to V and E for welcoming us into their world as participants in this study and to ASHA’s Research in Higher Education Mentoring Program for partially funding this research. # 2002 Psychology Press Ltd http://www.tandf.co.uk/journals/pp/02687038.html

DOI:10.1080/02687030244000437


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MADDEN, OELSCHLAGER, DAMICO

response to an utterance, and laughter can also determine the nature of the next utterance in the conversation. In clinical aphasiology, humour/laughter is also mentioned as an important ingredient in rehabilitation (Beeson & Holland, 1994; Cochrane, 1983; Holland & Halper, 1996; Kagan 1998). However, only two studies have directly investigated laughter and aphasia (Norris & Drummond, 1998; Potter & Goodman, 1983). In Potter and Goodman’s study (1983), the value of laughter to improve therapy performance was investigated. Laughter was introduced into therapy sessions through a laughter audiotape, clinician laughter, and encouragement of aphasic patient laughter. Each of the two subjects was asked to perform a specific therapy task. The therapy task for each differed: for Subject A, it was gesturing the function of an object; for Subject B, it was imitation of plosive phonemes. Descriptive analysis of task performance showed that the number of correct responses of both subjects increased when therapeutic sessions included laughter when compared to sessions without laughter. Norris and Drummond’s (1998) study differed from that of Potter and Goodman in that they investigated the influence of laughter on specific aspects of aphasic conversation. Their study compared the duration, frequency, and speech context of laughter for five aphasic and five nonaphasic adults. The study produced three significant findings. First, the average duration of laughter was longer for aphasic adults. This finding led the authors to suggest that aphasic speakers may use laughter to prolong their role as speaker in conversation. Second, increased frequency of laughter was associated with speech context. Specifically, aphasic laughter occurred more frequently with the speech act of protesting or rejecting when compared with nonaphasic speakers. Based on this finding, the authors inferred that aphasic speakers may use laughter as a politeness marker to inform the communicative partner that he/she misunderstood the aphasic speaker’s communicative intent. A third finding was that aphasic individuals laugh more than nonaphasic individuals when initiating conversation. From this finding, it was inferred that aphasic speakers may use laughter when they desire to assume the role of speaker in discourse. Potter and Goodman (1983) and Norris and Drummond (1998) provide important insights into laughter as a potential communicative resource in aphasia. However, because the study of laughter is limited to these two studies, additional study appears warranted.

PURPOSE OF THE STUDY The purpose of this study was to further our understanding of the strategic function of laughter as an interactive tool in aphasic conversation. Using the qualitative research methodology of conversation analysis, we asked the following two questions: Question 1: How is laughter effectively employed by a person with aphasia to enhance conversation? That is, how is the conversational interaction influenced by laughter? Question 2: Are the laughter strategies1 utilised by an aphasic speaker the same as or different from those used by nonaphasic speakers?

1 The term ‘‘strategy’’ is used in its linguistic sense: to convey a systematic way of using language. As such, it does not connote conscious planning.

CONVERSATIONAL VALUE OF LAUGHTER

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METHOD Historically, clinical aphasiology has employed both quantitative and qualitative research methods to obtain a holistic view of aphasia (Damico, Simmons-Mackie, Oelschlaeger, Elman, & Armstrong, 1999b). However, Damico, Oelschlaeger, and Simmons-Mackie (1999a) also noted a recent call for more qualitative research methodologies to augment quantitative findings. As laughter has been noted to be a complex social and communicative phenomenon in the conversation of nonaphasic speakers, and because the two previous studies of laughter and aphasia used quantitative comparisons, we elected to employ the qualitative methodology of conversation analysis (CA) in this study. Conversation analysis is an accepted empirical research methodology within the social sciences designed for investigation of the complexities of natural conversation. It has been extensively applied in the study of ordinary persons (Atkinson & Heritage, 1984; Sacks, 1992: Sacks, Schegloff, & Jefferson, 1974) and, more recently, in the study of aphasic conversation (Goodwin, 1995; Klippi, 1991; Lindsay & Wilkinson, 1999; Oelschlaeger, 1999; Oelschlaeger & Damico, 1998a, b, 2000.) As the methodology of CA was reviewed in these articles, readers are referred to them for a more extensive discussion.

Participants One married couple, V and E, were selected from a stroke support group, based on their willingness to participate in this study. V was a 68-year-old retired law-enforcement officer with a 14-month history of aphasia and right hemiparesis. His Western Aphasia Battery (Kertesz, 1982) Aphasia Quotient was 76.4 (see Appendix A for subtest scores), with a classification of anomic aphasia. He followed conversation easily and was often able to express his ideas despite his moderate loss of fluency and frequent word-finding difficulty. His wife of 48 years, E, was a normal communicator with no discernable communication impairments. An additional primary conversational participant was M, the researcher responsible for data collection.

Data collection Data were collected by the second author as part of a larger study of conversation and aphasia (Oelschlaeger, 1999; Oelschlaeger & Damico, 1998a, b, 2000). Conversations were videotaped at V and E’s home, and involved V, E, & M with an occasional remark from a research assistant, P. Four conversations over a period of 6 weeks were collected. No time constraints were placed on the conversations, allowing initiation of several topics to assure the development of natural conversational patterns and the collection of authentic data.

Data analysis Conversations were transcribed orthographically and organised into ‘‘turns-at-talk’’ (Jefferson, 1979) for all participants. The videotapes were then recurrently reviewed to distinguish behaviours of interest. To remain consistent with the fundamentals of qualitative research, the decision to target laughter as the focus of this study was not


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made prior to data collection. Rather, laughter emerged as a topic of interest through observations that V frequently produced laughter in conversations. Following the identification of laughter as the focus of investigation, the videotapes were again recurrently reviewed to identify laughter segments. For the purpose of this study, laughter segments were defined as turns-at-talk between V and the conversational participants that included instances of V laughing. The first conversation in the data-collection series was then chosen for detailed analysis. Its selection was based on the informal observation that the frequency of V’s laughter was greater in this conversation than in any of the others. To be sure, as it was the initial conversation between participants, it contained several question and answer sequences as M became acquainted with V and E. However, given the behavioural focus of this study, the frequency of laughter in this initial conversation maximised the opportunity to compare instances of laughter according to their similarities and differences to reveal organisational patterns. As validity of findings in qualitative research is dependent on adequacy and authenticity of observations, its selection for data analysis appeared justified. Laughter was defined as an audible non-linguistic production of a single ‘‘heh’’ or multiple ‘‘heh, heh’’ (Jefferson, 1985) that was either initiated by V or produced by V in response to a conversation partner’s turn-at-talk. All laughter segments included the turnat-talk immediately preceding and following V’s laughter. This was necessary to demonstrate how laughter determined the nature of the next utterance, or how it served as a meaningful response to a prior utterance. Some segments also included laughter of other conversation participants, when such laughter demonstrated a particular laughter strategy. Table 1 summarises information about conversational parameters related to conversation length, turns-at-talk for each participant, and number of laughter segments. There were a total of 647 turns-at-talk, relatively equally distributed between the three primary conversation participants, V, E, and M. V’s 47 laughter segments occurred in 21% of his turns. Once identified, the 47 laughter segments were coded and categorised to reveal similarities and differences in patterns of organisation. Initial coding of data was performed by the first and second authors independently. Each reviewed the conversation and identified laughter segments. The next level of analysis involved the comparison of the organisational features of each segment which was performed by the first and third authors. Following this detailed analysis, laughter segments were grouped according to their organisational similarity. All three authors reviewed the groupings to define categories in terms of the social action and meaning of segments. Lastly, the categories of V’s use of laughter were descriptively compared to those reported in the literature of nonaphasic speakers.

TABLE 1 Conversation length, frequency of participant turns-at-talk, and number of laughter segments Conversation length 33 minutes

V’s laughter segments

Turns-at-talk for each participant V 219

E 195

M 227

47


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Reliability


To determine the reliability of identification of laughter segments, an initial count of laughter segments was completed by the primary investigator. Intrarater reliability was determined 8 weeks later when the primary rater reviewed the videotape, and again identified V’s laughter. Intrarater reliability was established at 91.4%. Data for interrater reliability were generated by having a second rater independently view the videotape and identify laughter segments. Interrater reliability was established at 89.3% Both interrater and intrarater reliability for identification of V’s laughter segments were calculated by dividing the number of agreements by the sum of the agreements and disagreements and multiplying by 100.

RESULTS Employment of laughter in conversation The first question this study asked was how laughter is used by a person with aphasia to enhance conversation. To investigate this issue, all conversational interactions including V’s laughter were analysed and grouped into categories based on their similarities in function. This process revealed that laughter was employed by V to enhance the conversation in four distinct ways. Specifically, laughter was used as (a) a turn-taking cue; (b) an instruction to hear; (c) a display of understanding; and (d) an orienting cue. A prototypical example of each use of laughter is discussed next. Transcription markings are described in Appendix B and are included when deemed necessary for understanding the ongoing data presentation and discussion throughout this paper. Laughter as a turn-taking cue One strategic use of laughter is as a turn-taking cue: V’s laughter at the end of his turnat-talk served as a cue to other conversational participants that he was finished speaking and that they could assume speakership. This is shown in Example 1. Example (1) 40 M: Yeah, that’s right, in the past week in the life of the Browers. 41 How was last week? V:

42

43

V:

G(h)o a(h)he-(heh)= E:

,,,- - - - V - - - - - - - - - - - x

E:

,,,- - down - - - - - - - - - - - - - - - - - - - - - - - - - - - - ,,,- V - x

E:

= What’d we do, well you went to therapy. V:

44 45

V: E:

,,,- - - - E - - - - - - - - - - - - x

x---E----------- --- - - - - - --------------x

Tue-Tuesday, um:: Thursday, Friday

In line 41, V and E simultaneously look at each other after M’s question about their activities of the past week. V is the first to speak (line 42) but, as he speaks ‘‘go ahe-’’, he continues to gaze at E and intersperses his words with laughter. As V laughs, E quickly joins the conversation and in doing so, she establishes the topic of last week’s therapy as a focus for responding to M’s initial question.


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Discussion of laughter as a turn-taking cue. Any activity involving the exchange of speech, whether it be an interview, meeting, or conversation, is organised by each participant taking turns in speaking. Sacks et al. (1974) stated that conversational turns are accomplished either by the current speaker specifically selecting the next speaker, or by allowing other speakers to self-select who will take the next turn. The current speaker can use gestural, linguistic, and non-linguistic behaviours to select the next speaker. In Example 1, M asks a question that either V or E could answer as they share knowledge of the events of the prior week. M does not select who will answer as neither V nor E immediately respond. Rather, they begin a negotiation of speakership. V turns his gaze towards E to direct attention to her as the next speaker. However E simultaneously looks at V, in effect selecting him as speaker. At this point (line 42), V upgrades his designation of E as next speaker by verbally prompting her with ‘‘Go ahe-’’ combined with in-speech laughter. His laughter in effect signals a potential end to his speaking effort and provides an opportunity for her to talk (O’Donnell-Trujillo & Adams, 1983). It is the final ‘‘heh’’ following V’s ‘‘Go ahe-’’ that ultimately leads E to accept speakership in line 43, and she does so without hesitation. In this instance, V’s laughter serves as a marker for a ‘‘transition-relevance place’’ (Sacks et al., 1974, p. 703), or the point in conversation where the transfer of speakership to another partner is completed. Put another way, laughter is used by V to more clearly distinguish and strengthen the transition-relevance place that he had been attempting to construct through gaze and verbal cueing. In doing this, laughter is successfully employed to reach V’s conversational goal of constructing a turn at talk and selecting the next speaker. Laughter as an instruction to hear A second use of laughter, as an instruction to hear, occurs when laughter is employed by V to inform the listener on how to interpret his talk. In this instance, V’s laughter indicates that the topic import of what he is saying should be understood as humorous , not serious. The data contain three conversational contexts when laughter was used as an instruction to hear by V. One was a conversational exchange containing a potential social impropriety (i.e., lack of accord with ‘‘good manners’’ or public decorum.) Another was when a ‘‘trouble spot’’ occurred. Trouble spots are breakdowns in conversation resulting from speaking difficulty (Ferguson, 1992.) The third conversational context was ‘‘troubles telling’’—when a person speaks of some difficulty they are experiencing (Jefferson, 1984). V’s use of laughter in each of these contexts is presented in the following examples. Context: Social impropriety. This sequence is part of an exchange in which M had asked E and V about the recording of their conversations. They explain that they did not tape many sessions because E had trouble operating the recorder. Example (2) 9 M: (looking toward V) That’s the play. She turned on the play and forgot to 10 do the record button? Did you help her out with that? 11 E: I don’t know that much about that stuff so I . . . 12 V: I told her but I finally said get out (heh-heh). (V makes an overhand arm gesture toward E—as if ‘‘waving’’ her away). (E turns to V, playfully pushes V’s lowered arm and speaks in ‘‘smile


13 14

E:

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voice’’). I kept asking you about it and you said I, I’m not sure, I’m not sure. So I, ’cuz I don’t know that . . .

In line 12, V states that he told E how to operate the recorder, but finally gave up on assisting her and told her to ‘‘get out’’. Following his talk, he laughs and makes a dismissing-type of gesture. E adopts his humorous attitude towards the topic as she playfully responds and the conversation continues.


Context: Trouble spot. Prior to the exchange in this example, V asks M about his post-stroke fatigue. M answers that many stroke survivors report that fatigue diminishes as time passes and asks him if his fatigue has lessened. Example (3) V:

119

120

121

V:

No, like it’s gone down loosier, gone down= E:

x- - - - - - - - - - - - - - V- - - - - - - - - - - - - - - - - - - - - - - - - - - x

E:

x- -V- - - -x

E:

=Worse. V:

x- -down—x

V:

x- - - -,,,E - - - - - - - - - - - - - - - - - - - - - - - - - - - - x

V:

Derser. Worser? Worser he:::::eh, heh (As V is laughing, he reaches and E:

122

M:

x-M-,,,- - - away - - - - - - - - - - - - - - ,,,- - E - ,,,- - - down and away-x

x- - - - - - - - - - - - - - - V - - - - - - - - - - - - - - - - -x

grasps E’s hand. E grasps V’s hand and smiles in response) That’s a good word, heh, heh.

In line 119, V attempts to tell M that his fatigue has worsened, but he experiences his first word-finding difficulty of this sequence. Instead of producing the word ‘‘worse’’, he utters ‘‘loosier’’. He then looks towards E and paraphrases his effort (i.e., ‘‘gone down’’) to acknowledge he is having difficulty. E joins V’s so far unsuccessful word search (Oelschlaeger & Damico, 2000) by providing the word ‘‘worse’’ in line 120. In line 121, V acknowledges E’s offer as his desired word by attempting to produce it, but he instead generates the string of phonemic paraphasias, ‘‘Derser. Worser? Worser’’. At this point, V’s verbal effort dissolves into laughter. Context: Troubles telling. In this example, E and V are telling M about their previous week. Line 47 constitutes the beginning of a dialogue in which V begins to explain that he had a difficult day on Sunday because a golf outing left him more exhausted than it would have before his stroke. Example (4) 47 V: Then came Sunday. . .o:h God= 48 E: =You tell them, you tell them what you did Sunday. 49 M: Another good Sunday? 50 V: No, hwack, he::::eh (V lifts hand and gives the ‘‘thumbs down’’ signal, simultaneously making the sound effect of ‘‘hwack’’, then laughs) 51 E: No, you did it. Tell her what you did. 52 V: We went out to play golf.

In line 47, V’s exclamation of ‘‘oh, God’’ indicates that something significant occurred on Sunday. The implication of V’s ‘‘oh, God’’ is unclear to M, and she asks if it was a

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good day (line 49). V then clarifies (line 50) that Sunday was difficult for him by his verbal response of ‘‘no, hwack’’ combined with a ‘‘thumbs down’’ hand gesture. As such, he describes the topic, Sunday’s events, as troublesome. He ends this ‘‘talk’’ with laughter. Discussion of laughter as an instruction to hear. Several communicative goals were achieved through use of laughter as an instruction to hear. First, laughter served to smooth out a potential social impropriety. In Example 2, V reveals E’s lack of knowledge about recording devices and then states that he gave up on assisting her by telling her to ‘‘get out’’. If V’s utterance of ‘‘get out’’ were taken literally, it could be interpreted by E as aggressive, and the conversation likely would digress into an interaction centred on disagreement and blame. However, V ends his utterance with laughter, thus sequentially implicating that his words are to be interpreted as a joke rather than a disparaging comment. And indeed, E does interpret V’s ‘‘get out’’ as humorous, smiling and playfully pushing on V’s arm. Therefore, V’s use of laughter to ‘‘mark an utterance as non-serious’’ tells listeners how to interpret his comment. It allows him to avoid an interactional breakdown and to affiliate with E through his teasing about her lack of mechanical knowledge. Conversation repair (Schegloff, Jefferson, & Sacks, 1977) is also facilitated through the use of laughter as an instruction to hear. Example 3 illustrates the effectiveness of laughter in diminishing the relevance of a conversational breakdown. In this example, V’s combination of speech production problems followed by laughter demonstrates that V is aware of his word-finding difficulty, that it is not a serious issue for him, and that it is acceptable for his conversation partners to laugh with him about the situation. M responds to his laughter in the desired manner as she does not continue word search efforts, but rather jokes about his paraphasias. Finally, laughter instructs the listener that V can cope with the troubles he is experiencing in life. In Example 4, following M’s request for information, V indicates that he had a bad day with ‘‘No, hwack’’ and a ‘‘thumbs down’’ gesture with his hand. But he follows his communication of troubling news with laughter, thus exhibiting his ‘‘trouble-resistance’’ to his bad day (Jefferson, 1984). By laughing in the face of trouble, his listeners are ‘‘instructed’’ to view his problem from non-serious perspective. As such, V’s laughter indicates that no further time or attention need be given to this topic. An interesting incidental observation in this laughter segment is the recipient’s response to V’s laughter. Neither M nor E laughs in response to V’s troubles-telling. This is somewhat unusual in that it is common for laughter to beget more laughter (Jefferson, 1979). However, in the study of nonaphasic speakers, Jefferson (1984) reports that a troubles-telling context is unique in that it is not uncommon for recipients to decline to laugh in this context. Instead, listeners may provide a notably serious reply. In doing so, the recipient is demonstrating ‘‘troubles-receptiveness’’ by recognising that the speaker is troubled and therefore the speaker’s description of problems requires a serious response. E shows her ‘‘troubles-receptiveness’’ to V’s report of a bad day by choosing not to laugh in response to his laughter. She instead takes his utterance seriously and offers the words of encouragement, ‘‘No you did it. Tell her what you did’’. V responds in line 53 by stating that he and E went to play golf. In Example 4, V’s laughter conveyed the message that his struggle with exhaustion would not get the better of him, and this problem did not require conversational attention at that time. In other words, V and E successfully completed a troubles-telling sequential interaction to temporarily move the conversational topic from V’s troubles to the more neutral topic of golf.


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Laughter as a display of understanding


A third strategic use of laughter is as an indication that V understood his conversational partner’s talk. That is, laughter serves to show V’s conversational partners that he not only heard their talk, but also that he understood their talk as humorous. This display of understanding is illustrated in the next example. Here, M and V have been discussing automobiles. M then asks V which car he would buy if he could have any type he wanted. Example (5) 325 M: If you went to buy a new car today= 326 V: =Any kind? 327 M: Yes. 328 V: Any kind? 329 M: Well, now let’s not do the Ferrari (elevated pitch, sarcastic tone) 330 V: he:::eh, heh, heh 331 M: (turning gaze to E) All of a sudden I see him driving a Porsche down the road.

In line 325, M asks about what type of car V would want if there were no limitations placed upon his request. V then enquires in line 326 whether there indeed are no limitations on his desires. Once M confirms that there are no constraints, V enquires once again in line 328. At this point, M senses some mischief on V’s part, and sets boundaries on his potential answer by stating in a joking manner (i.e., elevated pitch, sarcastic tone), ‘‘Well, now let’s not do the Ferrari’’ (line 329). V responds to M’s ‘‘Ferrari’’ statement with laughter in line 330, and M completes the sequence in line 331 by extending her humorous statement with a reference to the Porsche. Discussion of laughter as a display of understanding. Laughter can be employed to display ‘‘that a message was heard, and of course, how it was heard’’ (O’Donnell-Trujillo & Adams, 1983, p. 182). In Example 5, laughter serves as an indicator of understanding because it is a ‘‘relevant, consequential action to some prior’’ (Jefferson et al., 1987, p. 156). In other words, a recipient’s appropriately placed laughter can indicate that the recipient has adequately and accurately processed the speaker’s utterance and, in this case, understood the speaker’s intent as a joke. V effectively employs this conversational strategy of using laughter to display understanding in Example 5. Of relevance to this study is the fact that V could have chosen an alternate method to display his understanding of M’s request, such as stating a name of a car. However in line 330, V laughs in response to M’s implication that he would possibly choose a Ferrari if he could have any car he wanted. With his laughter, V displays his knowledge that the image of him driving a Ferrari is amusing, and that he understood the humorous intent of M’s prior utterance. The sequential effect of V’s display of understanding is that it signals to M that her ‘‘Ferrari’’ utterance has been appreciated and it is acceptable for M to continue her line of joking about sports cars, which she does in line 331. Laughter as an orienting cue The fourth strategic use of laughter is as an orienting cue to direct the conversation towards a particular topic. As presented in Example 6, V’s laughter diverts attention away from a current conversational topic to something that is of interest to him. In this instance, E, V, and M are discussing V’s participation in a golf tournament as a golf cart driver. In the pursuit of this topic, the subject of V’s fatigue again surfaces.

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Example (6) 86 E: Monday he was, he w- he was just so exhausted. Because, you know 87 driving, it’s not that you’re just driving the cart but you’re going over 88 bumps and you know, you’re going over roots and all that stuff 89 V: heh, heh, even, even, I, even h- what’s her name. . .she’s no= 90 E: =Oh, he bumped another cart, heh, heh 91 M: Did you? (turns gaze to V)

In line 86, E explains that V was exhausted earlier in the week from driving a golf cart. V begins his participation with a pre-utterance laugh in line 89 and then attempts to make a statement but experiences speech production difficulties. As E knows the events that happened, she assists his speaking effort in line 90 by speaking V’s thoughts for him. M then turns her attention to V and pursues the topic of the golf cart bump. Discussion of laughter as an orienting cue. In ordinary conversation, it is not uncommon for a speaker to turn the focus of conversation to topics of personal interest. In Example 6, V uses laughter as an orienting cue, to refocus M and E on a topic he desires to discuss. As preutterance phenomenon, V’s heh-heh gives forewarning to E and M that he is switching the topic from a troublesome subject (i.e., his exhaustion) to something that he considers humorous (i.e., his golf cart accident). Problematically, he experiences verbal difficulties. E then assists V in his new topic introduction by providing a clarification that V bumped into another cart on the golf course. Once E identifies that V bumped into another cart, both M and E’s attention is refocused on that topic. E’s laughter at the end of this turn acknowledges the humorous nature of the topic V is initiating. M sequentially joins in the topic change with her question, ‘‘Did you’’ in line 91. V’s success in implementing laughter to orient his conversation partners to another topic is evidenced by the fact that the subject of V’s fatigue is not discussed again in the rest of the conversation.

Similarities and differences in the use of laughter The second question this study asked was whether the laughter strategies utilised by this aphasic individual are the same as or different from those used in conversation of nonaphasic speakers. To answer this question, the laughter strategies evidenced by V were compared to those reported in the literature on laughter in nonaphasic conversation. Results of this descriptive comparison indicate that V’s laughter strategies were much the same as those of ordinary speakers. More specifically, the use of laughter to achieve conversational goals relating to turn taking, instructions to hear, display of understanding (described as ‘‘hearership’’ in studies of nonaphasic speakers) and as an orienting cue are all reported in the literature of nonaphasic speakers (e.g., Glenn, 1987, 1991; Jefferson, 1979, 1984, 1987; Jefferson et al., 1987; O’Donnell-Trujillo & Adams, 1983; Stewart, 1997). Such a similarity in findings suggests that laughter, as a nonlinguistic behaviour, is a ‘‘natural’’ resource for persons with aphasia. As such, the strategic use of laughter in conversation supports the identification of persons with aphasia as competent conversational partners and strengthens their social participation in conversation. Despite the similarity of laughter strategies in nonaphasic and aphasic conversation, one unique difference in the application of strategies was noted. This difference related to the conversational context in which a specific laughter strategy was evidenced. As noted earlier, laughter as an instruction to hear occurred in three conversational contexts: social impropriety, troubles telling, and ‘‘trouble spot’’. Although the use of laughter in social



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impropriety and troubles-telling contexts were noted in the nonaphasic literature, we found no report of laughter as an instruction to hear associated with a ‘‘trouble spot’’. The significance of this difference is heightened by the fact that ‘‘trouble spots’’, at least as defined as word-finding difficulty, do occur in conversations of nonaphasic speakers (Goodwin & Goodwin, 1986). It is not surprising that such a difference in the application of the laughter strategy of instruction to hear occurs in V’s conversation when compared to nonaphasic speakers given the different kinds and frequency of breakdowns in aphasic conversation (Ferguson, 1992, 1994). To be sure, nonaphasic speakers have word-finding difficulty. However, the kind and number of instances is greater in aphasic conversation. Thus, the opportunity for employment of laughter strategies is also greater in aphasic than nonaphasic conversation. That such a difference is predicated in these qualitative and quantitative dimensions is supported by recognition that 21% of V’s conversational turns included laughter. This frequency is most likely due to V’s attempt to deal with his conversation breakdowns and his strategic use of laughter to assist his conversational negotiations despite his aphasia.

DISCUSSION In the field of clinical aphasiology, humour has been discussed as an important ingredient in aphasia rehabilitation. However, the number of studies directly investigating laughter and aphasia are limited. Although previous investigations provide important insights to laughter vis-aÁ -vis the impairment of aphasia and its traditional treatment methods, little attention has been given to noting how laughter functions naturally to assist in negotiating conversation. The data presented in this study address this issue. From a practical strategic perspective, laughter appears to play a compensatory function. As demonstrated in this study, V’s laughter holds ‘‘conditional relevance’’ (Schegloff, 1968), in that it constructs a context that shapes the response of the participant. In other words, when V laughs, his conversational partners are able to interpret his communicative intent or level of understanding, and then can determine the best course of action to sustain the conversation. Throughou t the data, V demonstrates word-finding difficulties and paraphasic productions that threaten a sequential breakdown in conversation. However, he retains the ability to strategically place laughter in his turns-at-talk to maintain or repair the sequential conversational flow. V’s underlying proficiency in utilising laughter, combined with the interpretive skills of his conversation partners, creates a collaboration that not only enables V to get his intended message across, but also allows him to be considered as a capable conversational partner. V’s residual ability to use laughter to achieve communicative goals is not unexpected given the power and need for social interaction despite the deficits of aphasia. From a theoretical perspective, these data (along with previous conversational studies) provide evidence of the importance of the strategic use of social action as a way to re-establish social interaction and meaning-making despite linguistic deficits. From a clinical perspective, this study demonstrates how laughter may be used to enhance everyday conversational efforts. In this regard, laughter may be considered a viable strategy that may allow the aphasic individual to feel more competent and may also increase communicative access noted to have a direct impact on psychosocial wellbeing and quality of life (Kagan, 1998; Lyon, 1992, 1999. To that end, this study joins a growing body of research (Goodwin, 1995; Klippi, 1991; Oelschlaeger & Damico,


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1998a, b, 2000; Simmons-Mackie & Damico, 1996, 1997) designed to investigate linguistic and non-linguistic skills that remain intact regardless of the impairment of aphasia. The results of this study, as they reveal the effective use of laughter by a person with aphasia, suggest that laughter is potentially meaningful as a clinically targeted behaviour for other persons with aphasia for two reasons. First, it is a non-linguistic skill that, in some instances, can manipulate conversation in a similar way as do nonaphasic speakers. Second, laughter facilitates V’s participation in everyday interactions as a proficient conversationalist. This study of laughter reveals the value of underlying proficiencies, the significance of collaboration, the strategic importance of laughter placement, and the general complexities of interaction. All of these issues are important to both clinicians and conversational partners who strive to achieve communicative success in naturally-occurring conversation. Manuscript received 12 June 2001 Manuscript accepted 15 March 2002

REFERENCES Atkinson, J., & Heritage, J. (1984). Structures of social action. Cambridge: Cambridge University Press. Beeson, P.M., & Holland, A. (1994). Aphasia groups: An approach to long-term rehabilitation. [Videotape] Available from Telerounds, National Center for Neurogeni c Communication Disorders, University of Arizona, PO Box 210071, Tucson, AZ 85721-0071 , USA. Berk, L. (1989a). Neuroendocrin e and stress hormone changes during mirthful laughter. The American Journal of the Medical Sciences, 298, 390–396. Cochrane, M. (1983). Language and the atmosphere of delight. In H. Winitz (Ed.), Treating language disorders: For clinicians by clinicians (pp. 143–162). Baltimore: University Park Press. Damico, J., Oelschlaeger, M., & Simmon-Mackie, N. (1999a). Qualitative methods in aphasia research: Conversation analysis. Aphasiology, 13, 667–669. Damico, J., Simmons-Mackie, N., Oelschlaeger, M., Elman, R., & Armstrong, E. (1999b). Qualitative methods in aphasia research: Basic issues. Aphasiology, 13, 651–665. Ferguson, A. (1992). Conversationa l repair of word finding difficulty. In M. Lemme (Ed.), Clinical Aphasiology: Conference Proceedings (Vol. 21, pp. 299–307). Austin, TX: Pro-Ed. Ferguson, A. (1994). The influence of aphasia, familiarity, and activity on conversational repair. Aphasiology, 8, 143–157. Glenn, P. (1987). Laugh and the world laughs with you: Shared laughter sequencing in conversation (Doctoral dissertation, University of Texas at Austin, 1987). Dissertation Abstracts International. Glenn, P. (1991). Current speaker initiation of two-party shared laughter. Research on Language and Social Interaction, 25, 139–162. Goodwin, C. (1995). Co-constructing meaning in conversation s with an aphasic man. In S. Jacoby & E. Ochs (Eds.), Research in language and social interaction [Special issue of Construction], 28, 233–260. Goodwin, M.H., & Goodwin, C. (1986). Gesture and coparticipation in the activity of searching for a word. Semiotica, 62, 51–72. Holland, A., & Halper, A. (1996). Talking to individuals with aphasia: A challenge for the rehabilitation team. Topics in Stroke Rehabilitation, 2, 27–37. Jefferson, G. (1979). A technique for inviting laughter and its subsequen t acceptance /declination. In G. Psathas (Ed.), Everyday language: Studies in ethnomethodolog y (pp. 79–96). New York: Irvington Publishers. Jefferson, G. (1984). On the organization of laughter in talk about troubles. In J.M. Atkinson & J. Hertiage (Eds.), Structures of social action: Studies in conversation analysis (pp. 346–369). Cambridge: Cambridge University Press. Jefferson, G. (1985). An exercise in the transcription and analysis of laughter. In T.A. Van Djik (Ed.), Handbook of discourse analysis (pp. 25–34). London: Academic Press. Jefferson, G. (1987). On exposed and embedded correction in conversation . In G. Button & J. Lee (Eds.), Talk and social organisation (pp. 86–100). Clevendon, UK: Multilingual Matters Ltd. Jefferson, G., Sacks, H., & Schegloff, E. (1987). Notes on laughter in the pursuit of intimacy. In G. Button & J. Lee (Eds.), Talk and social organisation (pp. 152–205). Clevedon, UK: Multilingual Matters Ltd.



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Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners. Aphasiology, 12, 816–830. Kertesz, A. (1982). Western Aphasia Battery. New York: Grune & Stratton. Klippi, A. (1991). Conversationa l dynamics between aphasics. Aphasiology, 5, 373–378. Lindsay, J., & Wilkinson, R. (1999). Repair sequences in aphasic talk: A comparison of aphasic-speech and language therapist and aphasic-spous e conversations . Aphasiology, 13, 305–326. Lyon, J. (1992). Communication use and participation in life for adults with aphasia in natural settings: The scope of the problem. American Journal of Speech-Languag e Pathology, 1, 7–14. Lyon, J. (1999). A commentary on qualitative research in aphasia. Aphasiology, 13, 689–690. Norris, M., & Drummond, S. (1998). Communicative functions of laughter in aphasia. Journal of Neurolinguistics, 11, 391–402. O’Donnell-Trujillo, N., & Adams, K. (1983). Heheh in conversation : Some coordinating accomplishment s of laughter. The Western Journal of Communication, 53, 175–191. Oelschlaeger, M.L. (1999). Participation of a conversation partner in the word searches of a person with aphasia. American Journal of Speech-Languag e Pathology, 8, 62–71. Oelschlaeger, M.L., & Damico, J.S. (1998a). Joint productions as a conversationa l strategy in aphasia. Clinical Linguistics & Phonetics, 12, 459–480. Oelschlaeger, M.L., & Damico, J.S. (1998b). Spontaneous verbal repetition: A social strategy in aphasic conversation. Aphasiology, 12, 971–988. Oelschlaeger, M.L., & Damico, J.S. (2000). Partnership in conversation: A study of word search strategies. Journal of Communication Disorders, 33, 205–225. Pache, I. (1992). Maybe there is some anger behind that laughter: Humor and laughter in a multi-cultural women’s group. Working Papers on Language, Gender, and Sexism, 2, 87–97. Potter, R., & Goodman, N. (1983). The implementation of laughter as a therapy facilitator with adult aphasics. Journal of Communication Disorders, 16, 41–48. Sacks, H. (1974). An analysis of a joke’s telling in conversation . In R. Bauman & J. Sherzer (Eds.), Explorations in the ethnograpy of speaking (pp. 337–353). Cambridge: Cambridge University Press. Sacks, H. (1992). Lectures on conversation: Volumes I and II. Oxford: Blackwell. Sacks, H., Schegloff, E., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50, 696–735. Schegloff, E. (1968). Sequencing in conversationa l openings. American Anthropologis t, 70, 1075–1095. Schlegloff, E., Jefferson, G., & Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation . Language, 53, 361–382. Simmons-Mackie, N.N., & Damico, J.S. (1996). The contribution of discourse markers to communicative competence in aphasia. American Journal of Speech-Languag e Pathology, 5, 37–43. Simmons-Mackie, N.N., & Damico, J.S. (1997). Reformulating the definition of compensator y strategies in aphasia. Aphasiology, 11, 761–781. Stewart, S. (1997, February). The many faces of conversational laughter. Paper presented at the annual meeting of the Conference on Linguistics and Literature, Denton, TX.

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APPENDIX A Western Aphasia Battery Scores


Subtest

Subtest Score

Spontaneou s Speech Information Content Fluency Total Comprehension Yes/No Questions Auditory Word Recognition Sequential Commands Total Repetition Naming Object Naming Word Fluency Sentence Completion Responsive Speech Total

8/10 6/10 14/20 60/60 60/60 62/80 182/200 89/100 38/60 4/20 10/10 10/10 62/100 76.4 Anomic Aphasia

Aphasia Quotient WAB Aphasia Classification

APPENDIX B Transcription of talk Talk is transcribed using a simplified version of the Jefferson transcription system (Sacks et al., 1974). 1. 2. 3.

: : a colon is used as a sound production marker, indicating that the prior syllable is prolonged. - : a short dash indicates a ‘cut off’ of the prior word or sound. = : the equals sign indicates ‘latching’, i.e., no interval between the end of a prior and start of the next piece of talk.

Transcription of gaze and gesture Gaze and gesture transcription is based on a system described by Goodwin and Goodwin (1986). 1.

Gaze of the speaker is marked above the turn at talk. A dashed line indicates that the V:

2. 3. 4. 5. 6.

,,, - - - - - - -E- - - - - - - - - -x

speaker is gazing towards the listener, e.g., V: G(h)o (h)he-(heh)= Gaze of the listener is marked below the turn at talk. A dashed line indicates that the listener is gazing towards the speaker. x : marks the beginning and end of the direction of gaze. ,,, : indicates a shift of gaze from one direction to another. Specific gaze direction is described orthographicall y through indication of the person or place of the direction of gaze (i.e., mid-distance, away, or initial of person). Gesture of the speaker or listener is described orthographically .