Conversation repair: Ecological validity of outcome measures in acquired hearing impairment

Objective: Everyday conversation is the most widely reported difficulty arising from adult acquired hearing impairment (HI), yet no clinical method currently exists by which direct observation of conversational ability can be measured. This review of recent research argues that specific patterns of conversation repair arise in interaction involving adults who have acquired HI and that they may be of utility in assessing the outcome of intervention. Methods: This brief review paper presents a summary of data on the conduct of repair in free and unstructured conversations between HI adults and their frequent communication partners using Conversation Analysis as the guiding theory and analytic method. Results: Results indicate that certain types of repair are influenced by one participant in the conversation having an acquired hearing impairment. Further, these patterns of repair behaviour are resolved in concert by the participants in the conversation. Discussion: Patterns of repair behaviour may be used as criterion variables in assessing the need for and outcome of audiological intervention, including implantation, hearing aid fitting and/or conversation-based therapy. Previous research has shown that these measures are both consistent across time in the absence of intervention and that they are sensitive to intervention. Conclusion: These findings support the potential for conversationally-oriented therapy models of assessment and intervention and suggest a framework by which clinical tasks might be analysed with respect to their conversation 'reality'. This initial evidence needs to be supported by investigations across larger samples of adults with acquired hearing impairment.