Extenders, intersubjectivity, and the social construction of dementia

1. Extenders, intersubjectivity, and the social construction of dementia Margaret Maclagan and Boyd Davis NWAV-34

2. Fixed topics & formulaic phrases • As Alzheimer’s Disease (AD) progresses, speakers begin to lose their ability to manage and develop conversational topics. • AD speakers often use formulaic phrases to end turns and maintain the conversation, even as content diminishes.

3. Fixed/formulaic phrases defined • A sequence, continuous or discontinuous, of words or other elements which is, or appears to be, prefabricated; that is, stored and retrieved whole from memory at the time of use, rather than being subject to generation or analysis by the language grammar (Wray 2002:9)

4. Extenders defined • Extenders are formulaic phrases such as and something like that and that sort of thing (Overstreet 1999) This presentation will exemplify their multiple roles in both impaired and non-impaired speech, from two countries

5. Data sets: unimpaired women 55+ NZ unimpaired female speakers: from the Canterbury Corpus (ONZE) University of Canterbury US unimpaired female speakers: from New South Voices Corpus, UNC Charlotte 2000: Mills § 1979: Gluyas§

6. Collection of unimpaired speech • In NZ: the Canterbury Corpus was collected on audio tape (Sony Walkman, various models) and digitized in wav format. No cleaning or enhancements. Not online. • US: the WSOC 1979 monitor corpus was collected reel-to-reel; original media for the CNCC is partly analog tape and partly digital (Sony DAT, minidisc); digitized and/or remastered in wav and mp3 formats; no cleaning or enhancements. Online. • We have amplified for this presentation

7. Data sets, for our impaired speakers NZ speakers are collected on DAT recorder (Sony DAT walkman) and digitized to wav. Nocleaning or enhancements. US speakers are collected on Olympus DS 330 voice recorder and saved as wav. No cleaning or enhancements Getting good quality, quiet recordings is sometimes difficult.

8. Transcriptions and conversations Transcriptions indicate pauses, repetition and hesitation phenomena; we are experimenting with discourse tagging from a tagset adapted from CHILDES by Byrne, Orange and Ryan 2005. We deliberately try to ‘quilt’ routines (Moore & Davis 2005) • echoing formulaic phrases and • re-introducing information from previous conversations.

9. Looking for variation and style Macaulay claims: ‘The working hypotheses for the quantitative analysis of discourse features are as follows: • 1. All speakers have the same opportunity to use certain discourse features in the recording sessions. • 2. Variation in the frequency of any of these features reflects a different discourse style. • 3. Differences in using a discourse feature that correlate with membership of a social category such as age, gender, or social class show that such variation is not simply idiosyncratic’ (2005:13)

10. Extenders used by unimpaired women We find that women over 55 • without dementia • speaking 2 national varieties of English, New Zealand and Southeastern US (NC) • use extenders in similar ways for social interaction

11. Extender: Unimpaired/US • FW: And I remember, going through the lobby of the hotel where we stayed at with my bathing suit on and with one of those God-awful swim caps that everybody that you see when you look in the 40s movies and it felt like I was in a vacuum when I was walking! I could hear my feet in my ears! Going clunk, clunk, clunk! • DS: Was it one of the swim caps with the flowers? • FW: No it didn’t have flowers, just the swim caps with the, the strap that hooked all the way under. And no matter what you did, your hair still got wet! • DS: [Laughter] • FW: I think you were supposed to be totally vacuum-proof and all that stuff! But it still got wet. §

12. Speakers with dementia compared • Dementia may be considered a social construct as well as a physiological phenomenon. • When we compare female speakers within and across national varieties of English, using dementia as a ‘social category’, we find their use of extenders to be similar.

13. Pragmatic manipulation of extenders • As confusion increases, speakers manipulate extenders to maintain conversational interaction with non-impaired partners: • Provide turn construction • Sustain appearance of flow and coherence • Seem to appeal to shared knowledge • Self-present as competent

14. Extenders: NZ/impaired KT has early moderate AD KT: you look forward to your . whole holiday don’t you <you do> going away and that sort of thing<yeah> yeah so no it’s just a break away you know MM: and this is the time when everyone goes away KT: yes . mm . yeah they do . well people are working and that and they . look forward to it don’t they . you got to have a holiday MM: did . yes you do . you have to have one KT: yes mm . relax and sit around and MM: yes KT: [laughs] yes so . that’s the way it is I’m afraid §

15. Formulaic phrases: NZ/impaired Interaction with KT seems empty • Formulaic phrases allow her to interact with others • Uses very few extenders • Often uses fixed phrases or tag questions to end her turn and keep the listener responding to her • These still have some semantic content • the way it goes, (isn’t it?) – 1:5, 2:5, 3:5, 4:9 • keep it/that/things tidy: 1:1, 2:1, 3:1, 4:2 • that’s the main thing: 1:3, 3:2, 4:5 • That's the way it goes, happy days they say, don't they

16. Quilting formulaic phrase and script: NZ/very early impaired M: so when you I think you went to England when you were young? J: hmm? M: you went to England when you were young? J: when I what? M: when you were younger? J: yes I did yes - yes a few years after I was was marri ah after I was left school <right> yes <yea> yes with my parents <hmm> - e er ah - - [unclear] it’s getting hazy now <yea yea> it’s a long while ago M: it does and did you stay in one placeJ: ah well we stayed in London most of the time <right> and . places out of London <right> but um - I think we bought a car I think I’ve been twice M: oh have you J: and I’m not quite sure which time it was that we bought a car . because we were going to bring it home . and we did your touring in it M: ah yes J: and then had it sent out home <right> yes

17. Formulaic phrases: US/impaired GM also uses favorite formulaic phrases for ‘small stories’ GM: Yes. He was a preacher that preached ‘hell hot and heaven beautiful!’ (They both laugh) BD: Heaven beautiful GM: Yes. ‘Hell hot and heaven beautiful!’ That was one of his messages. I don't know ... he preached all right. He was an evangelistic-type preacher. 5-31-2000 BD: Well tell me, what does he preach about? GM: Hell hot and heaven beautiful. That’s all I know. BD: Well that’s true. GM: He done evangelistic work. 4-30-2002

18. Quilting phrase and story: US/impaired BD: I'm glad I got to see you for this program! BM: Well, I'm glad I got to see you, too. BD: Stay healthy until I see you next week. BM: Do what? BD: Stay healthy until I see you next week. BM: Ok. BD: Then we'll share more memories. BM: I'm the daughter of a Baptist Minister (favorite phrase introducing favorite story). BD: And those are all Baptist hymns, aren't they? BM: Yes! I was so glad to hear that! (Laughs) He made a Baptist out of me, of course! §

19. Extenders: US/impaired BD: So what do you want to do today Ms. __? BM: Catch up on my homework (laughs) BD: What homework do you have? BM: Well I- I [uncl] have a lot of personal letters that I need to answer MA: I couldn’t hear that thought think it again BM: Huh? MA: I didn’t- I couldn’t hear your thoughts think it again, repeat it BM: Uh catch up on my my p-personal le- letters to write and all that kind of stuff

20. Sustaining the appearance of competence in order to sustain ‘the self as a validated being in the fabric of social interaction’… [Kitwood’s] emphasis on the relational aspects of personhood is key: for if a disease process causes an intellectual impairment, it is possible for social relations to prevent this becoming a disability. . . .[However,] in postulating that personhood can ultimately be sustained, he prevents the initiation of a grieving process…. (Davis, D. 2004)

21. Flow, extenders & competence, 2000 GM: My Mother's sister lived there and she had girls about my age and we went over in the woods and made playhouses. We raked pine needles and made playhouses...it would rain all the way around. We would rake pine needles and then we would rake some more. Made beds and tables.(Laughs) BD: (Laughs) What fun! GM: We had a good time together. BD: That does sound like fun! GM: It was nice to have girlfriends and cousins. BD: Cousins are great! GM: My Mother's sister and her family lived on our farm; on my Daddy's farm. And we were just like sisters, almost. We played together and went to school together and went to church together...everything like that.

22. Formulaic phrases simulate flow, 2001 GM: I’m married but my husband is working…off…I forgot, I can’t think where he’s working now. BD: You told me one time, he went to Detroit. Did you go to Michigan? GM: Been what? BD: [Louder] Did you go…to Michigan? GM: Yeah, I lived in Michigan one time. My husband was working at the Ford plant, I believe it was.

23. Extenders keep things going, 2002 BD: I’m glad to see you. GM: Uh...did you ever know Preacher Mason? BD: I’ve heard Preacher Mason’s name. GM: That was my husband. I don’t know where he is now. He’s off in some foreign country or something.

24. Extenders as discourse gestures • As AD progresses, extenders bridge the growing gap between propositional and pragmatic competence, acting like gestures. • Kontos (2004) uses Merleau-Ponty’s claim that speech is a gestural system to argue “that selfhood persists even with severe dementia, because it is an embodied dimension of human existence (838). Even when speech conveys no linguistic meaning, individuals can vocalise and gesture (840).

25. “Conclusions”: tentative at best • Both the NZ and the US women show stages in the loss of content and the expansion of extenders: --normal interaction, formulaic phrases are minimal or idiosyncratic --fixed topics and favorite formulaic phrases --increasing use of extenders as interactional abilities decline