Ethnomethodological conversation analysis meets integrational linguistics: Towards a new analytical perspective on atypical interaction

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 “troubletalk,”
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. nonratified
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.