‘We have two book reviews for readers in thi issue. The fist sa review of, ' book about World Wide Web accessibility for perions who have dasblities. The second reviews a mammoth book about adiology treatment a volume thats one ofthe most comprehensive in it category. ‘As lays enjoy your reading. continue to encourage researcher and cine dans to consider submitting ther research to The Volt Revie With ‘we can guarantee a large ae interested readership and timely publication. Nancy Tye Murr Coa ne fo the Dest The Volts Review, Volume 1020), 5-56 Conversational Topic Shifting and its Effect on Communication Breakdowns for Individuals with Hearing Loss Rachel Caissie, PhD. ‘Thistle herr of omnia fleaing cms sphere eal arog rig communi nacho th pp rings lene ul wth on acted esr rape engin {Smads meron Fork cnet pring has Wet ur tes warplane pet tp aig pearance ‘esi Th fg of exe of oman baton at ody lid ‘Sch peel prierpi manpultion alle, Re he a te fos sare (atin rer hes pres ae pei ha nn oredr ‘apes Home ember of cman Preise ~ a i of alin rel paring ans ~ need hearts i tp, hr gh ‘lading rope tie ot, besos ee mae ly are pes wee ‘id oh hing an hog rede of es pe Th ol of ie ay hae a mpc fr cots ry net fr da th hag os, Introduction Bedrosian (1999) described conversational topic as “in nonvegetaran ‘terms, the meat of conversation” (p36) Indeed, topc plays sucha vita role in conversation that one cannot have a canvertahenal exchange witht a subject mater or topic. The importance of topic s made evident further by the foc that when one remembers a particular conversation with someone t ‘is usually the topic ofthe conversation that first comes to mind, Given the ‘central role of topic, it snot surprising that sklls in topic manipulation (ic topic introduction shifting, and maintenance) are essntial for proving con. ‘ersitional coherence and continuity (Brinton de Fuji, 1985; Ments, 1994), Rachel Case ism sti profsor athe Sch of Haman Conomanisition Dds, Daihowsie Unio im Halt, Non Seo, Cana Her an res of rehire ‘he conceratlpromanc 9 ads ath ering. “Comuersational Towle Shitiee 4s.CConvertstional topic manipulation skills of various communication: disordered populations are the subject of a fairly large body of iterature (Geerosian, 1993; Brinton & Fu, 199; Fey, 1986; Garcia & Joanete, 1997; “Mente 1994 1, Willams, & Della Volpe, 1985) For adults with hearing loss, conversational topic has been examined in the context of sratogies used to dominate conversations (Cassie, Dawe, Donovan, Brooks, & MacDorald, 1935; Tyedurray, Wit, & Schur, 1995). That i, reports have shown that some individuals with hearing los frequenty try to contol conversations by Introducing selorlented tops (Le, topics that relate fo themselves or their ‘wn interests rather than their partner interests) "Another aspect of conversational topic important to individual with hear- {ng losis the possible relationship between topic shifting by conversational partners and message misperception by people with hearing loss. Clinical documentation suggests that topic shifting by partners enhances the risk of ‘misperception, leading to communication breakdowns, and that partners feed tobe attuned to tis increased Hkelinood of conversational disfaency at the time of topic change. Infact a frequent recommendation for promoting ‘communiation with people with hearing loss and for minimizing the risk of breakdowns i that partners avoid changing topics abruptly or in an une pected manner during conversation: rather, partners should be very careful when introducing new topics or shifts in topics (Erber, 1983, 1996; Lane & Molynesux, 1992; Lubinski & Welland, 1997; TyeMurray & Schum, 1994; ‘Wayner & Abrahamson, 1936) But how should topics be manipulated during conversation? Several ‘experts have waillen about topie management, describing various ways fesublith maintain and chift conversational topics (Bedrosian, 1995; Brinton 4 Fusiki, 198% Foster 1985; Garcia é Joanette, 1997; Lund & Duchan, 198; ‘Ments, 194; Wanska & Bedrosian, 1985), According to these experts a new topic may be iitsted atthe beginning of a conversation, after a previous topic has been terminated, or after a period of sllence Brief side topics, such ts those triggered by an event or interruption by someone outside the con ‘verstion, may be inroduced within current topic. Atopic that had been ter ‘inated may be reintroduced later in the conversation. Tn these types of topic initiations, the new topic isnot related othe imme tintely previous tople and unless topic intnion i preceded by a phrace (eg. “By the way” or "Coming back to.) to signal e neve topic. the topic change can be quite abrupt. In contrast when topes are changed through “shading” of the curent topic, the content ofthe new topic is derived from {he topic that immediately preceded iso that some continuity in the conver- sation low is preserved. In other words, top shading involves a smooth transition in which the new topic is diecly related to its predecessor “The following example helps explain this point Hacbond: “Iwas thinking of aching the MacMilian gis to help ws ‘with the blueberry harvest” initiation of new topic] Wife: “Oh, that would bea good idea.” Hushaxd: "They'told enough now, and | thought that they might be interested ina short summer jb.” Wie “Veah, they'd be good workers, Doos thei ahr tl coach ‘the baseball team?” [tapi shading] “Hush: "Yeah, he's a great coach.” In this example, there is a shift in topic fom “blusberry harvest” to “base ball team,” but the new topic i relate to the previous one (Le, both topics have the “MacMilian gis” in common) (Once a topic has been introduced, topic maintenance involves subsequent speaking fume inthe conversation that contribute 9 developing the subj ‘alter. As pointed aut by Mente (199) topics may be maintained using 0 broad types of speaking tums those thst provide new content information ts the conversation (eg, responding to a partner's question. providing new “unsolicited informatio, requesting information froma partner) and those tha da not provide new content information tothe conversation (e, repeating ‘ld information r sip acknowledging a partners previous contribution) 1s wel known that contextual caes enhance the perception of message for individual with hearing loss (Erber, 196; Lind bet «Doyle, 199, Ty ‘Murray, 1998) For example, the environment in which a conversation take place, the topic of conversion, the participant’ attributes, and languag ules all provide some degree of redundancy and supplementary cues thal help people with hearing loss make educated guess about what their part ‘ers have jut sid or anticipate what they are aboxt to say next. As argue by Erber (1996) while conversational topics ae developing. new informatio about the subjct matter and the partiipants’ opinions and atitudes i bein ‘ccumuloted. Tis leads to a progressively larger pool of contextual cues ‘which facilitate the perception ofthe partner” speaking turns. However in tiation of new topics by partners Ike) creates perceptual difculties for peo ple wilh hearing loss Because a newtopic generally comes with new seman ti content new contextual information and thereere — atleast nally — relucnd degree of redundancy. The aity of an incividual with hearing los to Bilin the words that have been missed may be temporarily diminishe tint the new topic has been established over a mamber of opoalng tena nd ‘more contextual information has become evallable ‘Although no one would dispute that topic changes by partners can be dif ‘ul for people wit hearing los, few researchers have investigated the occur rence of commtication breakdowns following diferent types of topic hit by partners during typical everyday conversations. It isnot clear how mud impact topic shifting has on conversational uency, and whether certain type of topic manipulation behaviors by partners influence the ikl of com ‘munication breakdowns, For example, smooth shit in topic (Le, topic shad ng) may make topic transitions easier forthe indvidval with hearing los Deeause the content ofthe new topic selated tots redecessor and, thereforeyears) and exhibited a purc-tone threshold average of 575 dB HL (SD. seme contextual information is provided. In contrast the initiation ofa new tpl unrelated to is predecessor may create more perceptual dificult "These isues have not received extensive investigation. Therefore, the pur pose ofthis study was to investigate the extent to which diferent types of {opie manipulation behaviors of conversational partners inluence the occur- rence of communication breakdowns in individvals with hearing los during {plea fcetoface conversations. Method Participants leven adult, all males, with an acquired bilateral sensorineural hearing ‘es parte inthe ty They cane in ag mn 91078 ys Man = 2 6) Inthe right ear and 47: dB HL (SD » 172)in the lft ear. All participants were full-ene hearing aid users. ‘Two female university students with normal eating aso patticipated in the study and served as unfamiliar conversational partners. Each conversed with approximately half the adults with hearing loss. Beease both gender and age have been noted (o influence conversational structure and content (Gallberg, 1995; Lane & Molyneaux, 1992; Stover & Haynes, 1989; Shadden, 1897), and because one's conversational behaviors may change depending on + one's familiarity with the conversational parter (Cassie etal, 1998, Tye Murray otal, 1995; Li et al, 1995), all dyads participating in ths study were restricted to one older male conversing with an unfamiliar younger female 50 that posible effects of age, gender, and partner familiarity would be cnsis- tent across dyads, Procedure Eachindividual with hearing os was videotaped engaged in a 20-minute con veraton with a partner The faceo-face conversations occurred ina therapy ‘oom in the presence of multtalker background noise (AUDITEC* of St. Lous, MO) delivered at 65 dB SPL tough two loudspeaker located on each side of the indivi wit hearing les. Noize wee presented to simmlate mote type rrallfe communicative interactions, The camera was placed in an adjacent ‘bservation room ae ling was done through the one-way’ ior so thatthe ‘ol the camera in the therpy room would not distract the parilpants Each dyadic member wore an FM mic transits, which outed the audio Sigal ‘oan FM reeiver connected to the camera and recording equipment. ‘artcipants were asked simply to carry outa small conversation on any topics of their choice. Specific topics were not imposed on the dyads to allow {or the interaction tobe as natural as possible Mereover, given that the focus ofthe study was on tpic manipulation behaviors, was believed that impos 8 Caissie Jing conversational topics would have been unsuitable. Among the topics di cused were general subjcts such as health, heering loss, hobbies, trav work, studies, grandchildren, or the participants’ recent activities. The co ‘ersetional parners and participants with Rearing lose were awvaze that investigation amined conversational difficulties in people with hearin Joss; however, participants were not told thatthe focus of the study was the analysis of communication breakdowns following topic manipula ‘behaviors by conversational partners, "The first five minutes of each conversational sample were use to lett ereeption ofthe partes previous contribution. A breaklown was evident ‘en the individual with 2 hearing loss used a request for clarification (@, ‘What”) or made a contibution tothe conversation that revealed mispercep. son ofthe partners previous tum (eg. saying "Yeah, yeah” or nodding in ‘sponse tothe questinn “Howe many chldeem to yon hate?”) The numberof ‘Dmmunicetion breakdowns follwing each partner topic type were tallied, ‘The number of clarfiation request-partner repair strategy sequences ‘ediod to succesfull repair a communication breakdown were also calc Hed for each topic type. Communication breakdowns were divided into howe that were resolved in one clarification request-repair strategy sequence, ‘v0 or more clafication request-epait strategy sequences, and those that ‘ere never resolved (Le, there was a lack of clarscationzequest by the per~ ‘on with hearing loss despite an obvious misperception, or the partner's ‘pair attempt didnot successflly resolve the misperception). ‘Table Number of Occurence of Parnes Topic Types and Communication rake Foley Ech tp per Each Coen Spe = (Commacaton Breakdowns) Dyad Topic CB afer Tipe CB ater Tope Car Tape Baer inion Toe ing ge Si” i 1 2 Ayala 7 eo neee a SEE] oneer igen ns | 32 . %® 0 6 42 5 # 0 & 3 5 1 5 6 0 » 6 2 2 6 0 8 8 7 3 2 2p 0 @ 6 s 4 4 oaeen eee wo4 2 5 0 6 0 noo 3 6 0 Bo Teal a m0 wo Mean 17, ws 0 0 oD EAB NRE Os END 2 BOSC BOO? GEE O EEC ERTCT oles 8 oe % 10% Results (On average, the partners contributed 65 speaking turns (SD = 17) during each 15-minute conversation. As Hlustrated in Table, in each conversation, Sample the majority ofthe turns was ied to extend the topic of conversation, When topics were shied it was done primarily high chang othe arm rent topic rather than through initiation ofa new top ‘The rumber of communiation breakdown flloing each topic type by partners also shown in Table [For each topic type, the percentage of furs that were followed by a breakdown was determined by calculating the ratio ‘ofthe mean nurnber of breakdowns following a particla topic type over the ‘mean umber of ocsucrence of that topic type, mulipied by 100. Overall, 1% of the parnees’ speaking turns were misperceined by the person with hearing loss, thus yielding breakdowns in communication, However, a5 depicted in Table |, the proportion of communication breakclowns was great. es after topic shading by the partner. Tat is, 40% ofthe turns used to Shade‘Table Number (Percentage) of Communication Breakdowns Reslved in One Gernot Saag Tum Sequence, Two or Mare Clanfcaton Reguestepatr Steg Sequences and Not Resolved Ti iting ‘pic exeson One sequence 668) 250698) “Two ormor sequences 608%) 30%) Unaaccesl esaton 15055) Ton commuriaion breakdown 2.0005) the ope of convertion were flowed by commanicaton breakdown tn compan. 18% ofthe turns tat the partner sued to nate new topic ‘eed in a communsation edown Onto other hand fewer cones ‘ton breakdowns orc ster pater topic evenion copia nance (Df and Os respecte) Table I shoes the results pertaining to the numer of clarifeation request parner ee sate sequen needed to sacral msl he Communication breskdovee:Bectse the fot! number of cmnmanicaon Sreskdowe flowing top ination by the partner Gee ble Das oo Small o permit aden analy of tp Sojunces tho coding category ‘ras combined wih ple shading, Since both of these categories rere tos change in opis the eselng category was abled topic citing in Table Ieshould abo be need that because there were no octarences of commun cation breakdovs folowing topic maintenance bythe partner this coding Sstgory not ince in Th ‘Ove, 7 commurication breakdowns occured in all conversion sam ples As shown n Table It more than hal of the comeaniatin breakdowns that ocare eter ater topic shitig (6) o ate ope extension (SO) were rsclved in one darfiatonsequestwepir striegy eaqunce: The pro- orton of communist brekowne that reuied to or ere careation fequst separ stategy sequences wos restr for beat downs occuring afer topic shifting (107) han or rechdowe nay es tpl ster 7) fer some cammnriestonbesdowa, the poo with herng ov did ot tempt orequst claritin desptea msperepton othe partners ep ‘ategy ws not sucesful in rescvig the misperception tants where $here wat am uraarenl eolutono communion oeakdown ene >ermore een afer tpi extension 33%) than fer tape sng Ge) Discussion ‘The purpose of this study was to examine the occurrence and resolution of ‘ommunication breakdowns following topic manipulation behaviors of part ‘ners during typical socal conversations. The resis show that topic shitin by partners, especially when performed trough shading ofthe current opi creates considerable conversational dificultes for people with hearing los Infact, not only i a greater number of communeation breakdowns occ immediately after the partners shifted the convesational topic, but thes breakdowns also took longer to repait, compared to those that cccurred afte the partners extended the topic. “The pertinence ofthese results for individuals wih hearing loss s evident considering that dally socal conversations are plagued with topic changes. ‘other words, atypical conversation moves quickly rom top # topic (tbe 1986) In this study for eample there was an average of 8 tope shifts (op Initiation and toplc shading) during each 15-minute sample, meaning tha {opis were shifted an average of every L7 minutes Conversational topic shifting during adult conversational exchanges mos ‘often involves a change in the focus of the current topic (Le, people general ly change the topic through shading rather than making a discrete tanto Jn topi) Infact topic shading i considered to bea smooth way of shin topics that requires more sophisticated ingistc skis than the ination of new topic unseated othe previous one (Mentis, 1998) It was expected tha topic shading by partners would have made topic tanstions eater for th individual with a hearing los, because in topic shading the new subject mat ter is related tothe immediately preceding topic, and thus some cantextua information is available. Surprisingly the highest percentage of communica tion breakdowns occurred after the topic wat changed through shading Is contrast, initiation ofa brand new tople untested “othe previous topic wa found to cause fewer communication breakdowns than top shading Unlike tope shading, there are certain cues in tpic inition that signal that a neve topic is likely to begin. That, a brand new topics typealy in tiated atthe beginning of a conversation, affer a period Of silence or afte both communicators consider the previous topic tobe terminated (ue, he the partners have nothing more to contebute tothe current topic) If Us speakers are cooperative conversationaists, the new topic is generally sig raled using a phase such as “by the way.” or "not to change the fopi but.” These cues may help individuals with hesring loss to anticipate ew content or subject matter at that speciic moment inthe romvereaion consequently, they may be moze attuned and may make an extra efot & concentrate on the partner's next speaking tum. Ther greater effort ina lead to fewer commnication breakdowns. In contrast, ees signaling upcoming topic shading are generally not ob ows. Therefore, there may have been more percepaal diicutiessssocatd With topic shading — as compared to topic initiation — because te parti [pants with hearing loss may net have been anticipating a change in the su Ject matter at that moment in the conversation, and hence they may have been taken Somewhat by surprise. Even ifthe new subject matter ws relat led othe previous topic the sudden, unsuspected change in focus ofthe cue‘ent topic may have contributed tothe perceptual difficulties, causing break: dlowna in communication. Results pertaining to the proportion of communication breakdowns fol- lowing topic inidation as opposed to those following topic shading should be viewed with caution because occurrences of topic initiation were small Ite, there were a small number of data points to derive the percentage of breakdowns after topic ination). The small number of occurrences of topic initiation was not surprising considering that during natural conversation between adults topics are primarily shifted through shading, Pechape the decurrence of communication breakdowns after these two types of topic shifts could be further examined by investigating structured rather than nat al conversations where the partners would be instructed to inate new ‘pics frequently ‘On the other hand, when conversational topics have been established and ure in the proces of being developed, there i a reduced likelihood of com- ‘munication breakdown. As pointed out by Erber (1996), "The more two peo ‘le talk, the more predictable the content ofthe conversation i likely tobe inless ofcourse the topic s changed." (. 172). A expected, the proporion. of communication breakdowns that occurred immeditey after topie mate "ance or topic extension by the partner was very small Topic maintenance, in ‘ac create! no perceptual dificules, which ie not surpesing considering ‘hat this type of topic manipulation provides no new information tothe con veesation. Although new information is contbuted with topic extension ths topic type created no substantial perceptual dfficlties, When the topic is ‘extended over a numberof speaking tums, an abundance of contextual cats is generated, which likely enhances the perception of new information. ‘The participants with hearing loss tended fo request clarification less fe- quently for communication breakdowns that occured after topic extension, than for breakdowns that occurred after tople shifting. When the topic is Jnown and is extended over a number of tums, individuals with hearing loss may fel more comfortable etng some misperceptions goby since they nay Jee these do not pose a significant threat 0 conversational feney. In other words, because they know the topic under discussion, they can contribute a tum thats topically relevant egardles of whether they fully understood the pariner’s immediatly preceding contribution or only graced the gat of ‘When topics are changed, however those with hearing loss may fee greater seed to request clarification of misperceptions to ensure that they know what the curent topic i and the new direction the conversation is taking, ach dyad used in this study consisted of one older male adull and one younger femate adult We believed it was important to contol for posible ttiects of dyadic members’ age, gender and familaniy with one another, on conversation structure; therefore, these parcipant characteristics were hep constant across dyads. It should be stressed thatthe results ofthis study reflect the communication behaviors of older males with harig loss in conversation with younger females. It would be interesting for future esearch to exaanine the facts foi sing on te ocurenee of conmunienn downs ‘iter pel pans suck ws stand an we ded Thame Hour of way putes ne coperae conventions ung conmartenve nacional i ering ns Mey convo cea ane ecded when pars speech te {Segupt suse confoe conrying es tange eee name (28 sin sts and oe appoplsepir lei epee cEcnuntatioy teeisowne (Coa & Cleon, 19% Biber 10 Ty ‘Mary 18) non pater may hae crienle power ines Mee bcinot of conmeninton breakdowns by apn aegen oe fy ty chang ope rng ogung eerste: Re fs say Saget te cy ced onda tat paren Sng or {SERng topes ine cl ana ght be ceo ecg he tro of emenncton reads nice sl sho heen ‘hen pc tng was done smoot Ces aoah shi) hee was ncn of Sumuricaten ecw Wher pene we rose ‘Mean tp wold bedetati erty coon fa te nl writhing amare he pie ange blo hey expand on the ne Upc Sune cnimation songs have Sen wey mica fr ovlng ‘Sasson bed (Caos Gham 1) Using single yt txemphuing «fy werd ange he tops inden canst ‘Xaplon belt epundng one ope eidoarely wuld hell promot Svea chy spel ate ame when east eanng ibe aevulneatetecovenacal dadueny es hon aer opto ‘Sons by pute) References Bedrsian J. (1988). Making minds meet: Assessment of conversational topic ‘in adulis with mild to moderate mental retardstion, Tpics i Language Disorders, 13, 36-46 Brinton, B, & Fuk, M. (1989). Conversational menagement with language ‘paired chiro, Rockville, MD: Aspen Publishers Ine Caisse, R, & Gibson, C. (1957). The effectiveness of repair strateples used by ‘people with hearing Inet and thei conversational partners. The Vale Revieo, 9, 203-018, CCaisie, R, Dave, Ay Donovan, C, Brooks, H,, & MacDonald, 5. (1998), ‘Conversational performance of adults with a heizing lots Journal of the Aauiony of Rehabiatse Audigy, XXXL, 45.67, [Exber, N. (1953). Commaniction and adult hearing Tos. Melbourne, Australi CCavis Pu Exber,N. (196). Commotion therapy for adults ith sonoy les. Victoria, ‘Australia: Clavs Publishing, ey, ME. (986). Language itecontion with young cider, Boston: College Pres, IneFoster, $. (1988). The development of discourse topic skills by infants and omg hl. pi Linge Dir 308 The dynamics of commaricaton development. Egload Cis, NF: Prentice-Hall bilitation curvculum. Austin, TX: Hear Again. The ot Reiw Vom 1022), 57.73 Hearing Aid Fitting in Infants Brenda M. Hoover, MA. ‘The combination of chiro with hawring os beng ent eal fee ak normal decisions when fling elation on ifs and young dren Introduction Although audiologists have been fiting heating aids on children for ‘Brod Mase a Sor Aust a i Teo Natl Rsro Hl Ora, Seem ais tin ot oe a ng amplfton set