Language Use in Aphasia Testing in German-Speaking Switzerland

Abstract

This paper presents data on the use of Swiss German dialects and standard High German in situations of aphasia testing. In the German-speaking part of Switzerland, the use of dialect vs. standard language depends on context (Rash, 2002) and does not correlate with the social status of the speaker (Werlen, 2004). Dialect is used in oral communication among Swiss-German speakers, except in contexts such as class, parliament or partly church. The dialect is native language, whereas many speakers feel not comfortable when speaking High German. The fact that standardised tools are only available in High German to assess aphasia raises a number of questions: (1) What does the language use of speechlanguage pathologists (SLPs) look like? (2) Does code-switching between Swiss and High German occur in SLPs and patients in aphasia-testing situations? (3) Do SLPs see the need for a diagnostic tool that accounts for the Swiss language situation? Two different methods have been employed to address these questions. To answer the first and the third question, an online questionnaire was sent to SLPs working in Germanspeaking Switzerland in different settings like hospitals, rehabilitation centres and SLPs’ practices. In addition to demographic, working-situation and test-use details, the questionnaire collected data about the varieties used in daily life and in clinical settings, as well as suggestions for relevant aspects for test development for Switzerland. 82 SLPs from 17 cantons completed the questionnaire. The second question was addressed with a case study involving two SLPs testing one client each with the Aachen Aphasia Test (AAT; Huber et al., 1983), a standardised test specifically developed for the German language containing several subtests targeting different linguistic modalities. SLP-patient interactions were video-recorded, transcribed, and analysed with respect to code-switching. Results show that not only native speakers of Swiss German (81% of participants), but all SLPs indicate to use dialect in clinical contexts (80/82) and in their daily life (77), even though some individual cases might involve a non-Swiss dialect or a light adaptation of High German towards Swiss German. Most SLPs use both Swiss and High German for communication with their patients, and many use also other languages, such as Italian or French. The case studies on variety use in testing situations reveal that both SLPs and patients code-switch between varieties, with patients showing more code-switching, in some instances possibly to bypass word-finding problems in High German. SLPs’ code-switching shows some systematicity; in addition the pronunciation of Swiss High German varies. The survey data show that a large majority of SLPs (63/82) regard a taking-into-account of the Swiss language situation as important for aphasia test developments. Most think that all linguistic levels should be included in this.