HOW TO COMMUNICATE WITH A SPEECH IMPAIRED PERSON? A CASE STUDY OF A SUBJECT WITH MOSAIC PATAU SYNDROME

1. Introduction Any oral communication is an unsmooth system by its nature, characterized by various interferences, complications, misunderstandings and faltering. More problems arise when one conversation partner possesses very limited opportunities for self-expression. People with impaired speech encounter difficulties in asserting themselves, because the lack of speech complicates communication significantly and decreases drastically the possibilities of making oneself understood. Problems accompanying speech disorders cause unevenness of communication and impede achievement of the goals or realization of the intentions that the involved parties had at the beginning of communication. The author of the current study considers it important to develop a suitable communication methodology for individuals with expressive speech impairment and for their communication partners. In order to accomplish this objective, it is first necessary to explore communication of this type. The subject of the research is a female born in 1990. Her clinical picture involves the mosaic form of Patau syndrome, also known as trisomy 13, which has caused severe mental retardation and restrains the development of her speech. The accompanying diagnosis is dyspraxia--language impairment, which has mainly affected the production of speech, but not the ability to comprehend the talk addressed to her. She was diagnosed in 2006 at the Genetics Institute of the United Laboratories of Tartu University Hospital (Ounap 2006). Research questions. The current article belongs to the field of qualitative research, and seeks an answer to the question how to communicate with a specific person with impaired speech so that all participants of the communicative situation would understand each other, in other words--how to reach a positive end result and to achieve the goal, which was the reason for starting the communication. In order to respond to this question, both successful and unsuccessful communication events are analysed. Three communicative situations are under observation (two between the mother and the daughter, and one with three participants). The first two occasions required several conversation rounds and corrections, before the message that the study subject wished to transfer was revealed. No misunderstandings occurred in the third communication event and two communicators comprehended each other quickly. In order to formulate the answer to the main question, it is necessary to determine the communication modalities which the study subject utilizes for expressing herself in these three situations, and to explore which communication modalities are more understandable to her interlocutor(s) and which cause confusion for some reason. Domain and methods. This article belongs to the domain of clinical communication studies. Discourse analysis (DA) has been used for analysing the material. The means of linguistic anthropology have also been applied, particularly the SPEAKING model of Dell Hymes (Hymes 1972), which was developed for assessing how language is used in specific speech communities, and Michael Agar's (1994) MAR analysis. A suitable collective designation for close observation belonging to the frame of discourse analysis and methods of Hymes and Agar is qualitative microanalysis, which enables to focus on the details of communication. The study concentrates on communicative situations as events of oral discourse, discourse is disserted as language (or some other communication modality) in use, and the analysis explores the role of each specific modality on construction of meaning. 2. Medical background data of the subject. Previous researches on the communication of people with the mosaic form of Patau syndrome and dyspraxia Unsmooth co-functioning of the human brain and linguistic capability, and the occurrence of communicative problems is undoubtedly a topic of vital importance. Communication in the clinical context is of interest in medicine, psychology, special education, linguistic anthropology, sociolinguistics, pragmatics, semiotics and gesture studies, when only a few domains are to be mentioned. …