言語聴覚士の 「患者の発話を待つ」 という臨床技能の検討：失語症患者への言語聴覚療法場面における相互行為分析

抄録

The present study aims to elucidate waiting for a patient's reaction as a clinical skill of speech-language-hearing therapists (STs). Our analysis focused on the timing and methods employed by STs when they provide a verbal support to their aphasia patients who had difficulty in speaking. Video recordings of novice and experienced STs providing speech therapy to aphasia patients were documented. The results indicated that experienced STs organized a therapeutic sequence responding not only to patients' utterances, but to nonverbal behaviors such as facial expressions and gestures as well, and arranged a timing of handing a verbal support accordingly. In this study, we call this STs' practice a gradual hint-presentation sequence organization. The sequence consisted of STs' step-by-step processes towards their final hint presentation to the patients, through which STs became able to infer the situation of aphasia patients in a word finding difficulty. These processes are considered to be a procedure in which STs attempted to put off their hint presentation to the maximum extent possible. These results suggest that STs can elicit a word from aphasia patients through multimodal interaction with them. The establishment of multimodal interaction with patients appears to constitute one of important aspects in clinical skills STs should strive for.