Institutional Life
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The thesis provides insight into the communication challenges of daily life for an individual with acquired brain injury in an institution. The thesis creates a new analysis perspective that can identify areas of attention for health... more
The thesis provides insight into the communication challenges of daily life for an individual with acquired brain injury in an institution. The thesis creates a new analysis perspective that can identify areas of attention for health professionals and thus contribute to improving the quality of life for the individual with acquired brain injury.
The main contribution of this thesis is aligning methodology from ethnomethodological conversation analysis (EMCA) with theoretical principles from integrational linguistics, promoting a quality of life-focused analytical approach to acquired brain injury (ABI) and aphasia in the context of everyday institutional life. While a pure EMCA approach focuses on the joint construction of meaning and identity through a lens of social order, the integrational perspective can add a critical analysis of the content of the interaction, centering the analysis on the perspective of one participant: the individual with impairments’ participant perspective.
In the first part of the thesis, the extent to which the two approaches can be combined is under scrutiny, investigating theoretically how they may be applied in order to investigate the participants’ experience empirically. By singling out the perspective of the individual who has impairments in the social ensemble, the analysis aims at enhancing life quality, seen from the perspective of the individual who has impairments in accordance with the International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2001, 2013).
The second part of the thesis investigates the participant’s experience in an analysis of interactional conditions between individuals who have impairments due to ABI and their neurotypical co-participants in everyday life at a care home. The study used video ethnography to record institutional life using several cameras, both stationary cameras and portable (GoPro Hero) cameras. The analysis of this thesis approaches interaction in a fine-grained analysis, drawing on video analysis with the tools from EMCA, and theoretical principles from integrational linguistics. This new approach is discussed thoroughly as divergences and agreements between the two are being analyzed. An illustrative analysis probes this new analytical perspective to elaborate on combining the two approaches in investigating the interactional consequences of living with ABI and aphasia for one case participant.
In this thesis, a single-case study examines the (joint)interaction between one individual who has functional impairment and the co-present participants. This case participant uses a wheelchair to move around with help from assistant therapists (due to partial paralysis and spasticity from traumatic ABI years prior) and their speech has aphasia characteristics. The co-participants include other individuals who have impairments due to ABI, occupational therapists, pedagogues, students of occupational therapy and the participant researchers. The study focuses on the trajectory of the case participant’s participation during three significant recording days during the data collection. In the fall of 2012, a series of meetings, breaks between meetings and one excursion were video recorded (30 hours). These pilot phase recordings form part of a larger study on routines of everyday institutional life with ABI.
In the analysis, the innovative approach identifies a novel discrepancy between the case individual and the therapists in what interaction analysis refers to as “trouble-talk,” meaning the organization of the conversation regarding problematic issues/talk about problems in understanding, which was often characterized by several repairs possibly without agreeing. Through detailed description and analysis, both the case participant and their display are characterized as competent. This is contrasted with the therapists conveying and responding to the participant as incompetent (i.e. non-ratified participant) in encounters due to their impairments. Seemingly, they perceive and orient to the case participant as someone who does not understand the situation correctly, sometimes merely complaining about institutional life. This asymmetrical relationship conceptualizes the case participant as a non-ratified participant, resulting in the case participant’s recurrent withdrawal from dialogues. This is deemed an undesired institutional ramification due to an uneven relationship between individuals who have impairments and individuals who do not have impairments. However, the analysis also demonstrates the individual’s creative participation and demonstrable “integrational proficiency” (Harris, 2009a, p. 71) in their drawing on other situated resources than “language” (Goode, 1994b) to express themself and participate creatively, such as gesture, repetition of others’ and own contributions and gaze. The contrast demonstrated in the gatekeeping of participation and the identifiable integrational proficiency demonstrates by use of the new participant’s perspective that the case individual competently participates, resulting in a deep analysis of participation with ABI and aphasia.
The combination of EMCA tools and integrational linguistic theory thus offers a novel empirical insight into the workings of communication and language and its institutional ramifications. With the new participant’s perspective, this thesis considers practices as complex and entangled with recurrent inclusion/exclusion practices in interaction that professional practitioners could pay more attention to by downgrading the force of apparent misalignments in gatekeeping trouble-talk consciously e.g. with a “let it pass strategy” (Wilkinson, 2011) as focal point.
This thesis has the form of a monograph, drawing on three background publications (Klemmensen, 2018; Nielsen, 2015; Raudaskoski & Klemmensen, 2019). Parts of Klemmensen (2018) significant to answer the research question are adapted to this thesis. The book chapter (Nielsen, 2015) and the research article (Raudaskoski & Klemmensen, 2019) are discussed at relevant places. However, the latter two are not submitted for the assessment of this thesis.
Listen to radio features with Charlotte Klemmensen about the findings (in Danish)
https://www.dr.dk/radio/p1/p1-morgen/p1-morgen-2020-10-28#!00:27:25
The main contribution of this thesis is aligning methodology from ethnomethodological conversation analysis (EMCA) with theoretical principles from integrational linguistics, promoting a quality of life-focused analytical approach to acquired brain injury (ABI) and aphasia in the context of everyday institutional life. While a pure EMCA approach focuses on the joint construction of meaning and identity through a lens of social order, the integrational perspective can add a critical analysis of the content of the interaction, centering the analysis on the perspective of one participant: the individual with impairments’ participant perspective.
In the first part of the thesis, the extent to which the two approaches can be combined is under scrutiny, investigating theoretically how they may be applied in order to investigate the participants’ experience empirically. By singling out the perspective of the individual who has impairments in the social ensemble, the analysis aims at enhancing life quality, seen from the perspective of the individual who has impairments in accordance with the International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2001, 2013).
The second part of the thesis investigates the participant’s experience in an analysis of interactional conditions between individuals who have impairments due to ABI and their neurotypical co-participants in everyday life at a care home. The study used video ethnography to record institutional life using several cameras, both stationary cameras and portable (GoPro Hero) cameras. The analysis of this thesis approaches interaction in a fine-grained analysis, drawing on video analysis with the tools from EMCA, and theoretical principles from integrational linguistics. This new approach is discussed thoroughly as divergences and agreements between the two are being analyzed. An illustrative analysis probes this new analytical perspective to elaborate on combining the two approaches in investigating the interactional consequences of living with ABI and aphasia for one case participant.
In this thesis, a single-case study examines the (joint)interaction between one individual who has functional impairment and the co-present participants. This case participant uses a wheelchair to move around with help from assistant therapists (due to partial paralysis and spasticity from traumatic ABI years prior) and their speech has aphasia characteristics. The co-participants include other individuals who have impairments due to ABI, occupational therapists, pedagogues, students of occupational therapy and the participant researchers. The study focuses on the trajectory of the case participant’s participation during three significant recording days during the data collection. In the fall of 2012, a series of meetings, breaks between meetings and one excursion were video recorded (30 hours). These pilot phase recordings form part of a larger study on routines of everyday institutional life with ABI.
In the analysis, the innovative approach identifies a novel discrepancy between the case individual and the therapists in what interaction analysis refers to as “trouble-talk,” meaning the organization of the conversation regarding problematic issues/talk about problems in understanding, which was often characterized by several repairs possibly without agreeing. Through detailed description and analysis, both the case participant and their display are characterized as competent. This is contrasted with the therapists conveying and responding to the participant as incompetent (i.e. non-ratified participant) in encounters due to their impairments. Seemingly, they perceive and orient to the case participant as someone who does not understand the situation correctly, sometimes merely complaining about institutional life. This asymmetrical relationship conceptualizes the case participant as a non-ratified participant, resulting in the case participant’s recurrent withdrawal from dialogues. This is deemed an undesired institutional ramification due to an uneven relationship between individuals who have impairments and individuals who do not have impairments. However, the analysis also demonstrates the individual’s creative participation and demonstrable “integrational proficiency” (Harris, 2009a, p. 71) in their drawing on other situated resources than “language” (Goode, 1994b) to express themself and participate creatively, such as gesture, repetition of others’ and own contributions and gaze. The contrast demonstrated in the gatekeeping of participation and the identifiable integrational proficiency demonstrates by use of the new participant’s perspective that the case individual competently participates, resulting in a deep analysis of participation with ABI and aphasia.
The combination of EMCA tools and integrational linguistic theory thus offers a novel empirical insight into the workings of communication and language and its institutional ramifications. With the new participant’s perspective, this thesis considers practices as complex and entangled with recurrent inclusion/exclusion practices in interaction that professional practitioners could pay more attention to by downgrading the force of apparent misalignments in gatekeeping trouble-talk consciously e.g. with a “let it pass strategy” (Wilkinson, 2011) as focal point.
This thesis has the form of a monograph, drawing on three background publications (Klemmensen, 2018; Nielsen, 2015; Raudaskoski & Klemmensen, 2019). Parts of Klemmensen (2018) significant to answer the research question are adapted to this thesis. The book chapter (Nielsen, 2015) and the research article (Raudaskoski & Klemmensen, 2019) are discussed at relevant places. However, the latter two are not submitted for the assessment of this thesis.
Listen to radio features with Charlotte Klemmensen about the findings (in Danish)
https://www.dr.dk/radio/p1/p1-morgen/p1-morgen-2020-10-28#!00:27:25
https://www.dr.dk/radio/p1/p1-morgen/p1-morgen-2020-10-28#!00:27:25 The thesis provides insight into the communication challenges of daily life for an individual with acquired brain injury in an institution. The thesis creates a new... more
https://www.dr.dk/radio/p1/p1-morgen/p1-morgen-2020-10-28#!00:27:25
The thesis provides insight into the communication challenges of daily life for an individual with acquired brain injury in an institution. The thesis creates a new analysis perspective that can identify areas of attention for health professionals and thus contribute to improving the quality of life for the individual with acquired brain injury.
Thesis:
https://www.kommunikation.aau.dk/nyheder/Nyhed/phd-thesis-by-charlotte-marie-bisgaard-klemmensen--ethnomethodological-conversation-analysis-meets-integrational-linguistics.cid484484
The thesis provides insight into the communication challenges of daily life for an individual with acquired brain injury in an institution. The thesis creates a new analysis perspective that can identify areas of attention for health professionals and thus contribute to improving the quality of life for the individual with acquired brain injury.
Thesis:
https://www.kommunikation.aau.dk/nyheder/Nyhed/phd-thesis-by-charlotte-marie-bisgaard-klemmensen--ethnomethodological-conversation-analysis-meets-integrational-linguistics.cid484484