Multimodality in speech-language therapy for aphasia: the use of audible, visible and tactile resources for producing speech sounds

Difficulties in articulating speech sounds are recurrent in people with aphasia. Some tasks performed during speech-language therapy are devoted to the treatment of these difficulties. This paper analyzes the way speech-language therapists correct and instruct aphasic patients about the pronunciation of linguistic items and model pronunciation through auditory, visual and tactile resources, thus configuring it as a multimodal and multi-sensory experience.
The research is grounded in Multimodal Conversation Analysis (Goodwin, 2000; Mondada, 2016) and is based on the transcription and analysis of excerpts issued of a large corpus of video-recordings (60 hours) that were made in France and in the French-speaking part of Switzerland. Data was collected in different therapeutic settings (hospital, rehabilitation clinic, private speech-therapy office) along the recovery of people who developed aphasia as a consequence of a stroke.
The analysis of data shows that the correction of patients’ productions is initiated by therapists verbally, through repetition of the target item with prosodic features such as emphasis and volume. When these forms of cues reveal ineffective, therapists make relevant other types of visual and haptic cues: by using their body as an “instructional tool”, they represent, with gestures and face expressions, features of the target sound. They can also touch and manipulate patients’ face in order to help them to correctly realize specific articulatory movements.
The paper focuses on the on the range of ordered, incremental and embodied resources used by the therapists in order to model pronunciation and on the practices used in order to enhance the patients’ visual attention towards these resources (e.g. pointing gestures, directives, verbal and haptic summons) (cf. Ronkainen, 2011). It offers an investigation on how multimodal therapies (whose efficacy is often claimed in aphasia literature, see Pierce et al., 2019) are concretely implemented in face-to-face interaction. Finally, a vision of the therapeutic process as an embodied, multimodal and multi-sensory experience is proposed and discussed.


References

Goodwin, C. (2000). Action and embodiment within situated human interaction. Journal of Pragmatics, 32(10), 1489-1522.
Mondada, L. (2016). Challenges of multimodality: Language and the body in social interaction. Journal of Sociolinguistics, 20(3), 336-366.
Pierce, J. E., O'Halloran, R., Togher, L., & Rose, M. L. (2019). What Is Meant by “Multimodal Therapy” for Aphasia? American Journal of Speech-Language Pathology, 28(2), 706-716.
Ronkainen, R. J. (2011). Enhancing listening and imitation skills in children with cochlear implants-the use of multimodal resources in speech therapy. Journal of Interactional Research in Communication Disorders, 2(2), 245-269.