Everyday conversation after right hemisphere damage: a methodological demonstration and some preliminary findings

Right hemisphere damage impairs lexical processing, prosodic processing, and discourse and pragmatics. Clinicians and researchers have observed that conversation is a challenging communicative activity for people with right hemisphere communication disorder, but previous studies have yielded inconsistent, equivocal, and marginal results, with few clear demonstrations of conversational dysfunction. There are also no empirical studies of everyday conversations involving people with right hemisphere damage and their familiar communication partners (e.g., family, friends). This study explores how a man with conversational problems following right hemisphere stroke formulated responses to communicative acts addressed to him in everyday conversation. It focuses on communicative acts that were “response mobilising”, i.e., set out clear expectations about who should speak, and how they should respond. This study employed an empirical descriptive case study design to examine 43 min of triadic conversation between the man with right hemisphere damage, his spouse, and a family friend. 61 communicative acts addressed to the man with right hemisphere damage were analysed using conversation analytic techniques. Few instances were found in which the man with right hemisphere damage was insensitive to the communicative contingencies implemented through these communicative acts. However, the instances where he was insensitive to them were salient. The findings of this study indicate that response mobilising communicative acts hold some potential for describing behavioural presentation of right hemisphere communication disorder in conversation.