The goal of qualitative data analysis is to uncover patterns and develop understandings from often extensive and contrasting data sets (Patton, 2002). All data from this study were organised and analysed under principles drawn from Activity-based Communication Analysis (ACA) (Allwood, 1976; 2007). ACA is an approach open to all methods of data collection, which is concerned with authentic linguistic interaction. The aim of an ACA approach is to develop theory and a greater understanding of the use of language, including multimodal communication, in different social activities (Allwood, 2007). It is based on the assumption that language used in all social interactions is governed by the nature of the social activity, which has certain inherent characteristics.
ACA is influenced by many different schools of thought including those from philosophy, psychology, sociology and linguistics. These influences are reported and discussed thoroughly in Allwood (2000). Wittgenstein (1953) described how language is used and integrated into actions. All interactions are situated within a context and there are circumstances which influence interactions, but the converse is also true (Johansson, 2007). Meaning is determined by use and people take part in ‘language games’ as a result, using the language that is typical for that social activity (Wittgenstein, 1953). Therefore, contexts can change how a person acts and use language in any particular interaction. For example, a person’s communication, including discourse, tone and turn-taking, differs greatly between institutionally contextualised occasions, such as business meetings, and informal settings, such as dinner with close friends. Through past experience of similar social situations and general situational rules, people can decide how to make their next communicative move (Bateson, 1973) and which move would be most appropriate to the situation. In addition, how people present themselves in an interaction is influenced by the interplay between interactional meanings and social structures (Johansson, 2007). Erving Goffman (1974), from the school of interactional sociolinguists, first described this theory as ‘framing’ and ‘footing’. In an interaction a person can ‘frame’ themselves in a particular way and perform appropriately based on past experience, understanding of the context or how they want to be perceived by others. Therefore, the person’s behaviours can change depending on the role they hold in the interaction, for example a position of authority. People may also be influenced in their interactions by a desire to engage in ‘cooperative’ interactions, described by Grice (1975). A ‘cooperative’ interaction included four underpinnings: quantity – the person must be as informative as possible; quality – a desire to be truthful; relation – discussing topics relevant to the discussion; and clarity – brevity when conveying information (Grice, 1975). Brown and Levinson, (1987) suggests that people are also influenced in interactions by a desire to maintain politeness strategies, where both parties in the interaction ‘save face’, i.e. the people involved in the interaction feel affirmed and not embarrassed. Finally, the complexity of interaction is enacted in what is actually said by the people in the interaction and how it is said. This is the focus of the school of linguistics. Conversation and its structure may be analysed through Conversational Analysis (CA) (Sacks, 1992; Sacks et al., 2012). CA focuses on sequences of talk-in-interaction, turn-taking, and repair mechanisms. In contrast to other schools of thought discussed above, CA does not focus on the context of interactions or take into consideration background information which may influence the interaction, focusing
exclusively on analysis of transcribed sequences of interaction and how meaning is created through language use. ACA as an approach allows the incorporation of these interdisciplinary ideas to provide a comprehensive means to analyse the complexity of communication and interaction in context. It takes into account the different characteristics associated with social activities. It allows the researcher to analyse how language and communication can be the goal or the instruments for an activity (Allwood, 2007) while incorporating the identity of the participants; their thoughts, feelings and emotions.
Taking the combination of different theorectical underpinnings into consideration, an ACA approach acknowledges that in interactions there are influencing and influenced factors (Allwood & Ahlsén, 2012). Influencing factors can be: ‘global’, affecting interaction as a whole at a macro level, such as culture; ‘local’, which can have a collective influence on all the participants in the interaction at the meso-level, such as the purpose of the activity, the environment or the materials used; or individual influencing factors, which are at the micro level and are different for each person in the interaction. e.g. the individual’s goals in that interaction (Allwood & Ahlsén, 2012). People in interactions can hold a particular role, thus impacting on the individual influencing factors. These roles include: human beings, who are motivated and rational; members of a community, with cultural beliefs who speak a particular language; members of social institutions and organisations, for example doctors or teachers; role holders in an activity, for example instructors and conversation partners; and individuals as communicators, for example speakers and listeners (Allwood, 2007). The influencing factors discussed above combine and influence how an interaction is enacted. The influenced characteristics of interactions can be collective, such as communication patterns and conversation management, e.g. turn-taking; or individual to the participants, e.g. grammar or vocabulary (Allwood & Ahlsén, 2012). These influenced factors, at the macro, meso and micro levels of interactions, can have enabling or constraining effects on communication and interaction as part of a social activity (Allwood, 2007).
This study aims to explore the conditions that exist in naturalistic interactions in routine rehabilitation to enhance functional communication learning; how these conditions have been produced; and what barriers to and facilitators of the uptake of opportunities for learning exist. ACA as a set of guiding principles allows the researcher to investigate the factors that could influence and be influenced in the rehabilitation activities between PWA
and HCPs. An ACA-informed approach allows the researcher to investigate the influence of the environment and activities, which are likely to be important variables in home-based rehabilitation. It can also be used to examine how interactions may be influenced by aphasia, and the resultant impact this can have on communication and interactions. ACA, therefore, provides a comprehensive approach to analysing ecologically valid interactional data. As ACA does not dictate the methods used to collect data, and therefore provides a suitable vehicle for integrating, fieldnotes, observations of routine rehabilitation and interview data to help address the study’s research questions. The analysis assumes that the interactions taking place in this study came under the influence of a number of key macro, meso and micro factors: for instance, ideas and views governed by the National Health Service (NHS) as an established organisation; and healthcare professionals cast in the role of ‘expert’ and people with aphasia as ‘patients’.