Right hemisphere damage and other-initiated repair in everyday conversation

Right hemisphere damage causes communication problems in conversation, but its precise effects have been challenging to study. As such, there are few clinical assessments focused on right hemisphere damage and conversation, and essentially no evidence-based interventions. Other-initiated repair sequences (i.e. moments when a problem of hearing or understanding are indicated and addressed) are a well-described aspect of interaction, with a large body of empirical research evidencing their organisation. Because of the communicative activities they implicate, these sequences may also be a site in which the symptoms of right hemisphere communication disorder become salient. This study explores the organisation of other-initiated repair sequences in interactions involving people with right hemisphere communication disorder using conversation analysis. Two people with right hemisphere communication disorder caused by stroke and four of their familiar conversation partners were recorded in triadic interactions; 104 minutes of recordings were collected, and 28 other-initiated repair sequences were subjected to analysis. This included other-initiations of repair produced by participants with right hemisphere communication disorder, and other-initiations of repair addressed to them. Participants with right hemisphere communication disorder were found to implement efficacious other-initiations of repair, to recognise core aspects of the trouble sources indicated in their own turns, and to design suitable repair solutions. That is, their inferences about communication problems were successful. However, one participant with right hemisphere communication disorder displayed difficulty managing aspects of the repair sequences, with her conversation partners also orienting towards her difficulties. It is argued that her difficulties were driven by problems dealing with multifaceted and ambiguous conversational moments. These observed difficulties suggest that other-initiated repair sequences may be valuable for detecting right hemisphere communication disorder, and highlight the possible role of conversational sampling in clinical assessment.