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Epistemic stance markers and the function of I don’t know in the talk of
persons with dementia and children with autism
By
Trini Stickle
A dissertation submitted in partial fulfillment of
the requirements for the degree of
Doctor of Philosophy
(English)
at the
UNIVERSITY OF WISCONSIN-MADISON
2015
Date of final oral examination: 10/02/2015
The dissertation is approved by the following members of the Final Oral Committee:
Cecilia E. Ford, Professor, Departments of English & Sociology
Anja Wanner, Professor, Department of English
Thomas Purnell, Associate Professor, Department of English
Douglas W. Maynard, Professor, Department of Sociology
Mary Carnes, MD and Professor, Department of Medicine, Geriatrics division
© Copyright by Trini Stickle 2015
All Rights Reserved
i
Acknowledgement
This work would not have been possible without the generous support and teachings from
my mentors and colleagues. While I wish to express my gratitude to my committee members—
Cecilia Ford, Anja Wanner, Thomas Purnell, Douglas Maynard, and Molly Carnes—I also wish
to thank the many wonderful people whom I have learned from and both laughed and cried with
during my time at UW-Madison.
More importantly, I could not have dreamed of achieving this degree were it not for the
loving support of my family. And, with every breath I have left, I hope to convey my loving
gratitude to them.
Lastly, I want to dedicate this document to my mother Georgia Dunahoo Grant
(December 17, 1938 - June 22, 2014). Although she missed the ultimate completion of it, she
was most confident that this day would come to pass.
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Abstract
This study examines epistemic stance marker use in the talk of persons with mid to late
stages of dementia of the probable Alzheimer’s type and in children with autism. I report the
forms and frequencies of all epistemic stance markers used in naturally-occurring conversations
between 20 persons with dementia and their non-impaired co-participants, and I compare the
resultant 25-conversation corpus of 33,000 words, derived from 4 hours, 51 minutes of audio, to
existing corpora. Overall, persons with dementia use a common variety of epistemic stance
markers with frequencies comparable to other corpora, to include the conversation register of the
Longman Grammar of Spoken and Written English. Moreover, conversation analysis shows that
persons with dementia use I don’t know, the most frequent stance marker, much the same way as
non-impaired persons: to display epistemic stance but also to manage sequences of talk (i.e.
closing or initiating topics) and to manage preference (e.g., disagreeing with co-participants).
A separate conversation analysis of naturally-elicited talk by seven children, ages 6-13,
undergoing clinical evaluation for autism spectrum disorder focuses on their use of I don’t know
in response to emotion-related questions from the Autism Diagnostic Observation Schedule
(ADOS-II). While some of these children do use I don’t know to display epistemic stance and to
signal more talk is forthcoming, more often they use I don’t know to, in effect, resist providing
information requested by the clinicians. In a few of these cases, I observe that the syntactic
interrogatory construction “What about/How about” may unintentionally elicit I don’t know
utterances relative to that of other question formulations.
Two additional observations likely have import to conversation, in general. I show that
American English speakers, like British speakers reported elsewhere, also use I don’t know in
response to compliments to minimize a co-participant's positive assessment and to avoid self-
iii
praise. I also look at a mechanism that is at work within sequence management in which a person
with dementia uses a complement-taking I don’t know utterance as a first-pair part to initiate an
action that I call a “wondering”.
iv
Table of Contents
ACKNOWLEDGEMENT ................................................................................................. I
ABSTRACT ...................................................................................................................... II
TABLE OF CONTENTS ............................................................................................... IV
LIST OF TABLES ....................................................................................................... VIII
CHAPTER 1 ...................................................................................................................... 1
1.0 INTRODUCTION........................................................................................................... 1
1.1 DEMENTIA .................................................................................................................. 1
1.2 AUTISM ...................................................................................................................... 4
1.3 OVERVIEW OF REMAINING CHAPTERS ....................................................................... 5
CHAPTER 2: LITERATURE REVIEW ....................................................................... 8
2.0 INTRODUCTION........................................................................................................... 8
2.1 MEMORY DECLINE AND LINGUISTIC ABILITY IN DEMENTIA ...................................... 8
2.2 THE ACQUISITION OF MENTAL VERB CONSTRUCTIONS FOR CHILDREN WITH ASD ... 9
2.3 EPISTEMIC STANCE .................................................................................................. 10
2.4 CONVERSATION ANALYSIS ...................................................................................... 11
CHAPTER 3: DATA AND METHODS ....................................................................... 17
3.0 INTRODUCTION......................................................................................................... 17
3.1 DATA ....................................................................................................................... 19
3.1.1 Carolina conversations collection ................................................................... 19
3.1.2 Participant selection ........................................................................................ 20
3.1.2.1 Participants with dementia ........................................................................ 20
3.1.2.2 Non-impaired student volunteers .............................................................. 21
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3.1.3 The transcripts ................................................................................................. 22
3.1.4 The corpora ...................................................................................................... 22
3.1.4.1 Longman Grammar of Spoken and Written English (LGSWE) ............... 23
3.1.4.2 Kärkkäinen corpus (2003) ......................................................................... 24
3.1.5 Data norming ................................................................................................... 24
3.1.6 Exploratory data: children with autism and their clinicians ........................... 24
3.2 EPISTEMIC STANCE MARKERS ................................................................................. 25
3.3 CONVERSATION ANALYTIC METHODS ..................................................................... 27
3.3.1 Conversation analysis: general overview ........................................................ 28
3.3.2 Turn construction units: composition .............................................................. 29
3.3.2.1 Syntactic constructions of I don’t know .................................................... 31
3.3.2.2 The prosodic forms of I don’t know ......................................................... 32
3.3.3 Sequential organization: position .................................................................... 32
3.3.4 Topic management ........................................................................................... 33
3.3.5 Preference structure ......................................................................................... 34
CHAPTER 4: FORM AND FREQUENCY OF EPISTEMIC STANCE MARKERS
IN CONVERSATIONS OF PERSONS WITH DEMENTIA ..................................... 37
4.0 INTRODUCTION......................................................................................................... 37
4.1 GRAMMATICAL CLASSES AND FREQUENCIES OF EPISTEMIC STANCE MARKERS:
CORPORA COMPARISONS .......................................................................................... 38
4.1.1 Epistemic stance nouns and participles ........................................................... 41
4.1.2 Epistemic stance adjectives.............................................................................. 42
4.1.3 Epistemic stance adverbials ............................................................................. 44
4.1.4 Epistemic clausal constructions ....................................................................... 46
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4.1.5 Epistemic formulaic expressions...................................................................... 50
4.1.6 Summary of comparisons ................................................................................. 50
4.2 GRAMMATICAL CLASSES AND FREQUENCIES OF EPISTEMIC STANCE MARKERS:
COMPARING PERSONS WITH DEMENTIA TO THEIR NON-IMPAIRED CO-PARTICIPANTS.
.................................................................................................................................. 52
4.2.1 Epistemic stance adjectives.............................................................................. 53
4.2.2 Epistemic stance adverbials ............................................................................. 53
4.2.3 Epistemic clausal constructions ....................................................................... 54
4.2.4 Complexity of linguistic patterns of epistemic clausal constructions .............. 58
4.3 DISCUSSION ............................................................................................................. 62
CHAPTER 5: FUNCTIONS OF I DON’T KNOW IN THE TALK OF PERSONS
WITH DEMENTIA ........................................................................................................ 70
5.0 INTRODUCTION......................................................................................................... 70
5.1 KNOWLEDGE DISPLAYS ........................................................................................... 72
5.2 SEQUENCE MANAGEMENT ....................................................................................... 79
5.2.1 Sequence ending............................................................................................... 80
5.2.2 Sequence initiating ........................................................................................... 85
5.3 PREFERENCE MANAGEMENT ..................................................................................... 95
5.3.1 Disagreement ................................................................................................... 97
5.3.2 Dispreferred response to a directive.............................................................. 103
5.3.3 Minimizing in response to compliments ......................................................... 107
5.4 SUMMARY AND DISCUSSION ................................................................................... 114
CHAPTER 6: CHILDREN’S USE OF I DON’T KNOW DURING CLINICAL
EVALUATIONS FOR AUTISM SPECTRUM DISORDER ................................... 118
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6.0 INTRODUCTION....................................................................................................... 118
6.1 THE DATA .............................................................................................................. 120
6.2 ADOS-II ................................................................................................................ 121
6.3 OVERVIEW OF EPISTEMIC CLAUSES IN THE DATA .................................................. 124
6.4 OVERVIEW OF IDK UTTERANCES IN THE DATA: FORMS AND SEQUENTIAL POSITION
................................................................................................................................ 125
6.4.1 Forms ............................................................................................................. 125
6.4.2 Sequential position ......................................................................................... 127
6.5 I DON’T KNOW AS RESPONSE TO ADOS QUESTIONS ABOUT EMOTIONS .................. 127
6.5.1 Knowledge displays ....................................................................................... 128
6.5.2 Resisting the question .................................................................................... 135
6.5.3 Projecting further talk.................................................................................... 139
6.6 THE SYNTACTIC FORMULATION OF THE EVALUATION QUESTION .......................... 141
6.7 SPECIFICITY AND/OR CONCRETENESS .................................................................... 152
6.7.1 Inclusive We ................................................................................................... 153
6.7.2 Reuse of child’s response ............................................................................... 155
6.8 SUMMARY AND DISCUSSION .................................................................................. 157
CHAPTER 7: MAJOR FINDINGS AND FUTURE DIRECTIONS ....................... 159
REFERENCES .............................................................................................................. 163
APPENDIX A: DEMOGRAPHICS OF PWD AND NI ............................................ 182
APPENDIX B: TRANSCRIPTION SYMBOLS ........................................................ 184
APPENDIX C: MODAL VERBS ................................................................................ 186
APPENDIX D: ADOS-II, MODULE 3: TASK 9 AND TASK 13 MODEL
QUESTIONS ................................................................................................................. 187
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List of Tables
TABLE 4-1. EPISTEMIC STANCE MARKERS BY GRAMMATICAL CLASS (PWDNI) ................................ 40
TABLE 4-2. EPISTEMIC STANCE MARKERS: CORPORA COMPARISON ................................................ 41
TABLE 4-3. EPISTEMIC ADJECTIVES (PWDNI) ................................................................................... 43
TABLE 4-4. EPISTEMIC ADVERBIALS (PWDNI) ................................................................................. 44
TABLE 4-5. MOST FREQUENT ADVERBIAL STANCE MARKERS (BY RANK) ........................................ 45
TABLE 4-6. EPISTEMIC CLAUSAL CONSTRUCTIONS (PWDNI) ............................................................ 47
TABLE 4-7. EPISTEMIC CLAUSAL VERBS: CORPORA COMPARISON ................................................... 48
TABLE 4-8. USE OF EPISTEMIC STANCE MARKERS BY GRAMMATICAL CLASS: PERSONS WITH
DEMENTIA (PWD) AND NON-IMPAIRED (NI)................................................................... 52
TABLE 4-9. USE OF EPISTEMIC STANCE MARKERS: STANCE ADJECTIVES ......................................... 53
TABLE 4-10. USE OF EPISTEMIC STANCE MARKERS: STANCE ADVERBIALS ...................................... 54
TABLE 4-11. USE OF EPISTEMIC STANCE MARKERS: CLAUSAL CONSTRUCTIONS .............................. 55
TABLE 4-12. EPISTEMIC CLAUSAL CONSTRUCTIONS MARKED FOR UNCERTAINTY OR INSUFFICIENT
KNOWLEDGE .............................................................................................................. 57
TABLE 4-13. USE OF EPISTEMIC CLAUSAL CONSTRUCTIONS MARKED FOR UNCERTAINTY OR
INSUFFICIENT KNOWLEDGE (AVERAGE PER SUBJECT) ................................................ 58
TABLE 4-14. SYNTACTIC COMPLEXITY OF EPISTEMIC CLAUSAL CONSTRUCTIONS ........................... 59
TABLE 6-1. DEMOGRAPHICS: CHILDREN WITH ASD ....................................................................... 121
TABLE 6-2. EPISTEMIC CLAUSES SELECTED BY CHILDREN WITH ASD DURING ADOS-II, MODULE 3 125
1
CHAPTER 1
1.0 Introduction
In this study, I investigate the use of linguistic resources that can display epistemic stance
as those linguistic resources occur in the talk of two distinct populations: persons with dementia
and children with autism spectrum disorder. For reasons I will soon make clear, that
investigation narrows to an in-depth analysis of the functions of I don’t know in each population.
1.1 Dementia
Dementia is a distressing and confusing illness. A person’s essence seems to disappear:
memory, thought pathways, language, even sensory experiences become impaired. Living with
dementia is a daily struggle in which the erosion of memory interferes with one’s ability to
interact with the people and objects present in their lives. Memory loss diminishes the ability to
engage with others through both speech and written communication. It inhibits a person’s ability
to recognize familiar faces, voices, and objects. The link between certain memories and
associated sights, smells, sounds, tastes, and touch can be severed. Dementia creates cognitive,
physical, and emotional limitations, and those limitations create stress in the lives both of the
persons with dementia and of their caregivers, family, and friends.
The most common form of progressive irreversible dementia results from Alzheimer’s
disease, accounting for approximately 60-80% of dementia cases (Alzheimer’s Association,
2011).1 Cognitive deterioration is gradual in onset, and the disease is characterized by selective
cognitive and behavioral disturbances that manifest as progressive disruptions in remembering,
in linguistic and communicative abilities, and in executive functions of planning and
1 While diagnostic procedures are improving all the time, confirmation of Alzheimer's disease is achieved
through autopsy. Thus, all persons identified as having dementia are probable cases. For convenience
sake, I will generally use “dementia” or “AD” in this study rather than using the more cumbersome
reference “dementia of the Alzheimer’s type”.
2
organization (American Psychiatric Association, 2013). Persons with dementia display
awareness of episodes of memory loss and awareness that these cognitive deficits may cause
interactional difficulties in their talk with others (Guendouzi & Müller, 2001, p. 93).
My research focuses precisely on episodes in talk in which expressions of either
uncertainty or (not) knowing emerge in the unfolding social interaction of conversation. These
displays of uncertainty or (not) knowing, or expressions of epistemic stance, are ubiquitous in
conversation. Given the hallmark characteristics of memory and other cognitive decline in
persons with dementia, any degradation in their linguistic abilities to display stance has potential
interactional consequence. This area has, however, received very little attention from
interactional researchers. A few previous studies have tangentially reported on possible changes
in the linguistic and interactional competency of persons with dementia to express stance or to
use stance markers effectively or in productive ways (Hamilton, 1994; Irigaray, 1973;
Shakespeare, 1998). But no study to date has investigated the interactional use of epistemic
stance markers by persons with dementia during naturally-occurring conversation. This
dissertation takes up that task, and the analyses that follow are a first step to better understand the
full range of the linguistic resources both available to and used by persons with dementia that can
express epistemic stance.
My investigation begins by first asking what words and phrases that can express
epistemic stance do persons with dementia and their non-impaired co-participants deploy in
naturally-occurring conversation? With what frequency do these epistemic stance markers
appear?2 Comparing those forms and frequencies to corpora that capture the naturally-occurring
2 I use “epistemic stance marker” here to mean those words and phrases that can express epistemic
stance—but do not necessarily do so. The term is a common one in traditional linguistics. I am aware that
the actual function of a phrase must be determined by an analysis of its use in interaction. For a more
extended discussion of my use of this term, see Chapter 3.
3
use of these epistemic stance markers within conversations of non-impaired persons, to what
degree do the participants in my data draw upon resources commonly used to display epistemic
stance? Do these “epistemic stance markers” actually function to display epistemic stance in
conversation, or do they function in other ways?
My findings suggest that the ability to deploy a variety of epistemic stance markers may,
for many persons, remain available well into the late stages of disease. After determining the
forms and frequencies of epistemic stance markers, I then select the most commonly occurring of
those markers, the clausal construction I don’t know, and carry out detailed interactional analyses
of its function(s) in conversation. I conclude that some persons with moderate to severe dementia
of the Alzheimer’s type can use I don’t know utterances in much the same way as non-impaired
persons to display epistemic stance, manage sequences of talk (i.e. sequential organization of
talk, such as closing or initiating topics), and negotiate preference constraints such as disagreeing
with co-participants. That is, I don't know utterances are shown to do many types of work within
the interactions between persons with dementia and their co-participants.
Beyond providing additional evidence for these already established functions for I don’t
know, I also present previously unreported functions. First, I look at a mechanism that is at work
within sequence management in which a person with dementia uses a complement-taking I don’t
know utterance as a first-pair part to initiate an action that I call a “wondering”. I also present
evidence of I don’t know being used in American English in response to compliments to
minimize a co-participant's positive assessment. Moreover, it is also shown that a single I don’t
know utterance can be a vehicle or format for getting more than one action done. Overall, the
analyses presented here speak to the linguistic, interactional, and pragmatic competence with
which persons with dementia can use I don’t know utterances well into the moderate and severe
4
stages of the disease. While such study of this crucial aspect of conversation may shed light on
issues of general relevance to understanding language-in-use, my primary hope is that it
ultimately provide valuable information to assist caregivers and families as they evaluate, try to
understand, and seek to interact with their patients and their loved ones.
1.2 Autism
Autism is a developmental disorder that is primarily characterized by persistent deficits in
social communication and social interaction across multiple contexts (American Psychiatric
Association, 2013). Children with autism spectrum disorder (ASD) exhibit limitations in social
and/or emotional reciprocity. They may be impaired in the expression of their own cognitive and
affective states as well as in their perception and expression of others’ cognitive and affective
states (Tager-Flusberg, 1993). These limitations can create stress in the lives of both the persons
with autism and in those who attempt to interact with them. These social and emotional
limitations may thus interfere with the child’s ability to form and/or enjoy social relationships.
While pursing my research on the forms and frequencies and the interactional uses of
epistemic stance markers in the interactions with participants with dementia, I was also
conducting research in the Douglas Maynard Autism Research Lab.3 While analyzing the
interactions between clinicians and children suspected of being on the autism spectrum, I noticed
that the most commonly occurring clausal construction used by the children during the
administration of the Autism Diagnostic Observation Schedule (ADOS-II) is I don’t know.
Having already refined my methods for analyzing the use and determining the functions of I
don’t know in persons with dementia, I took opportunity to apply these methods within this new
population and context. While the linguistic deficiencies and interactional difficulties within this
3 My work was part of the NSF-funded project, Grant 1257065, The Sociology of Testing and Diagnosis
for Autism Spectrum Disorder.
5
population are markedly different from those in persons with dementia, those deficiencies and
interactional difficulties have potential to likewise affect the deployment and function of
epistemic stance markers.
I show how children with autism use I don’t know to display epistemic stance, resist
providing a valid response to evaluation questions, and signal a response is forthcoming. That is,
I don’t know utterances are shown to do a relatively limited range of interactional work within
this evaluation context. Given the degree to which the children appear to resist questions, I
pursue a syntactic analysis of the formulations of the evaluation questions to determine whether
particular forms of questions might contribute to, or elicit, this resistance. My findings suggest
that the syntactic interrogatory construction “What about/How about” may increase the
children’s use of I don’t know relative to that of other question formulations. I also note that
clinicians’ strategies that increase the specificity and concreteness of the question might
effectively reduce the children’s use of I don’t know and other nonvalid responses to evaluation
questions.
1.3 Overview of Remaining Chapters
In Chapter 2 I review aspects both of linguistic decrement characteristic of dementia and
of deficits in expressing cognitive states in children with autism, any of which could potentially
affect the ways in which the two populations deploy epistemic stance markers. I then turn to a
brief overview of epistemic stance before discussing conversation analysis investigations into the
interactional practices of persons of special populations.
Chapter 3 lays out the methods I used in analyzing the talk of persons with dementia. It
presents my rationale for combining quantitative and qualitative methods, provides necessary
information pertaining to my data source and selection, transcript and corpora production, and
6
comparison corpora. There I also explain my choice of categories for epistemic stance markers.
And I conclude with a fairly lengthy discussion of relevant CA methods.
In Chapter 4 I provide a detailed characterization of the forms and frequencies of
epistemic stance markers used in naturally-occurring conversation by participants with dementia
and their non-impaired co-participants. By first comparing those forms and frequencies of my
overall data set to two corpora of naturally-occurring conversation, I find that the conversations
in my data set, by and large, fit common patterns of epistemic stance marker use for naturally
occurring conversation. I next compare the forms and frequencies of epistemic stance markers
used by the persons with dementia to those of their non-impaired co-participants. Differences in
both forms and frequencies are identified. The descriptive quantitative methods used in this
chapter, in identifying both the most commonly and least commonly used epistemic stance
markers in my data set, present valuable targets for—and allow informed prioritization of—not
only this but also future investigations.
Chapter 5 turns from a quantification of potential stance markers to a conversation
analytic investigation of the functions of I don’t know, the most frequently-occurring epistemic
stance marker identified in Chapter 4. Given the meaning of I don’t know, and given the
presumed memory difficulties of participants with dementia, this frequent usage is unsurprising.
However, this chapter asks how these presumed epistemic stance markers actually function in
conversation. While the primary purpose of the chapter is to present an analysis of the functions
of I don’t know utterances as they are used by persons with dementia, I also compare my findings
to functions noted in the existing literature for presumably non-impaired persons engaged in
mundane conversations. This allows me to assess whether the interactional work being done by I
7
don’t know in the talk of persons with dementia can be considered common relative to that of the
general population.
Chapter 6 moves from my primary focus on persons with dementia, and reports on my
exploratory work on the functions of I don’t know produced by children undergoing evaluation
for and subsequently diagnosed with ASD. Consistent with my methods for an investigation of
the functions of I don’t know for persons with dementia, I likewise carry out detailed
interactional analyses of the function(s) of this clause as achieved by children with ASD while
speaking with clinicians in an evaluation setting.
I conclude in Chapter 7 with a discussion of my major findings and suggest future
investigations that could build upon the findings presented in this dissertation.
8
CHAPTER 2
Literature Review
2.0 Introduction
I review work here on the impact of dementia upon linguistic and interactional
communication systems, report on research pertaining to the acquisition of mental and affective
verbs for children with autism, give a brief overview of epistemic stance in relation to my study
goals, and present studies regarding conversation analysis and the investigation of interactional
practices of persons of special populations. A more extensive review of conversation analytic
methods is provided in Chapter 3, Data and Methods. Literature relevant to the functions of the
epistemic clausal frame I don’t know is best discussed with my findings in Chapter 5.
2.1 Memory Decline and Linguistic Ability in Dementia
As a progressive disease, AD leads to changes in the person's linguistic competency over
time. Scholars have broadly divided the decrement to linguistic systems associated with AD into
early, middle, and late stages (Bayles & Tomoeda, 2007; Kempler, 1995); all stages show signs
of linguistic impairment (Bayles, Tomoeda, & Trosset, 1992). In the early stages, deterioration of
semantic memory (real world knowledge) and episodic memory (biographical experiences)
manifest in language interaction most often when a person displays the inability to "find" the
words—both nouns and verbs—to express thoughts, memories, concepts (for review, Altmann &
McClung, 2008). Discourse is often characterized by repetitiousness, a lack of cohesiveness, and
an increased use of sentence fragments (Bayles, Tomoeda, & Boone, 1985; Bayles, Tomoeda,
Kaszniak, Stern, & Eagans, 1985; Tomoeda & Bayles, 1993). Language comprehension is
generally intact, but the message heard or read is often quickly forgotten (Bayles & Tomoeda,
1993).
9
By the middle stage, problems with word finding, topic management, and cohesiveness
are more pronounced (Bayles & Tomoeda, 1983; Benson, 1979; Kirshner, Webb, Kelly, &
Wells, 1984; Salmon, Butters, & Chan, 1999). Comprehension of complex material such as
sequential instruction is often impaired (Bayles & Tomoeda, 2007). In addition, persons with
middle-stage AD tend to interpret language literally and are often not sensitive to contextual
information (Tomoeda, Bayles, Trosset, Azuma, & McGeagh, 1996). In the late stage, there is
significant variability in linguistic-communication ability across individuals. Some may manifest
muteness; palilalia (the “perseverative repetition of syllables, words, or phrases occurring at the
end of an utterance that interrupts the flow of speech” (Loring & Bowden, 2015); echolalia (the
“perseverative, involuntary repetition of another person’s speech” (Loring & Bowden, 2015); or
the frequent use of clichés or formulaic language (Obler & Albert, 1984). For many persons with
AD, phonological form and simple syntactic construction appear intact (Bayles, Tomoeda, Cruz,
& Mahendra, 2000), but both insensitivity to and production of syntactic errors increase. Yet,
despite the varied deficits, many persons with dementia maintain basic aspects of social
conversation, such as stating their name or successfully displaying routinized or phatic
communications (e.g., How are you? Fine, and you?) (Kim & Bayles, 2007).
2.2 The Acquisition of Mental Verb Constructions for Children with ASD
The spontaneous speech data on autistic children show some impairment or delay in both
their acquisition and expression of cognitive states (Tager-Flusberg, 1993, p. 169). Additional
findings from experimental research suggest that autistic children between the ages of two and four,
unlike typically developing children, almost never speak about cognitive mental states or display an
awareness of knowledge, beliefs, mental entities, pretense, and deceit; however, if such language is
acquired, development often occurs much later for the autistic child (see Baron-Cohen, 1989; Baron-
10
Cohen, Leslie, & Frith, 1985; Perner, Frith, Leslie, & Leekam, 1989). Higher functioning autistic
children, those with intelligence quotients between 70 and 100, have been shown to acquire linguistic
and pragmatic stance marking abilities comparable to typical children. Nonetheless, they may be less
able to display their inferences about mental states—both their own states and those of others
(Dennis, Lazenby, & Lockyer, 2001). This relative inability could feasibly affect the deployment
of epistemic stance markers in conversation.
2.3 Epistemic Stance
When memory loss surfaces within interactions, persons with AD may display self-
awareness of their cognitive difficulties and this recognition of their own decrement persists long
into the progression of the disease (Dourado, Marinho, Soares, Englehardt, & Laks, 2007; Sabat
& Harre, 1992). One way they can display this awareness is through the use of epistemic stance
markers (e.g., I don't know, I think, I guess). In their most transparent function, such epistemic
stance markers allow speakers to express self-evaluations of their knowledge, or lack thereof
(Biber, Johansson, Leech, Conrad, & Finegan, 1999; Lyons, 1977). Generally comprised of
mental verbs, adverbials, or adjectives, epistemic stance markers demonstrate a speaker’s level
of commitment to or certainty of a proposition (Conrad & Biber, 2000). But in addition to
providing a means for speakers to make their mental states hearable to their co-participants, these
markers also perform various social functions separate from their traditional epistemic roles. For
example, in their analysis of spoken language, Conrad and Biber (2000) found that stance
adverbials conveying doubt (e.g., perhaps, maybe) can also function to soften disagreements, and
11
traditional adverbs marking actuality or reality (e.g., really, actually) were found to display
suspicion or disbelief of another’s proposition (p. 73).4
The linguistic resources that allow users to express an epistemic stance are fairly
extensive: modal verbs, lexical verbs, adverbs, adjectives, and adverbial phrases. Given that, and
with the progressive decline in memory associated with dementia, it would be unsurprising to
find patients relying heavily on epistemic stance markers to do epistemic work in conversation.
But in what forms might they do so? And to what degree? And do they retain competence to use
them in conversation to do work other than display epistemic stance? As noted in Chapter 1, no
study to date has been done that explicitly investigates the use of epistemic stance markers in the
talk of persons with dementia. This study helps fill that gap.
2.4 Conversation Analysis
The primary method that I adopt for this project is that of conversation analysis. Heritage
and Atkinson (1984) argue that the strength of CA methodology is to reveal the competencies
that ordinary speakers have and rely on in participating in intelligible, socially organized
interaction. At its most basic, the objective of CA analysis is one of describing the procedures by
which conversationalists produce their own behavior and understand and deal with the behavior
of others. While this methodology was developed with non-impaired participants, the focus of
CA on the collaborative meaning-making strategies of co-participants also allows a window into
the interactional competencies of persons belonging to special populations. It is precisely the
interactional competency that is often lost sight of amidst all the reports of deficit showcased by
experimental inquiries (Guendouzi & Müller, 2005, p. 97). Still, the use of CA to document
4 See Chapter 5 for a discussion of the stance marker I don’t know and the various ways it can function to
display epistemic stance, manage sequences of talk, and negotiate preference constraints.
12
interactions that feature persons whose cognitive abilities are in some way impaired or atypical
remains a fairly new practice for researchers (Antaki & Wilkinson, 2013, p. 540).
Conversation analysis has been applied productively in numerous studies of special
populations, largely in attempts to document what Price-Williams and Sabsay (1979) have called
“communicative competence”. That is, they consider whether members of special populations
display adherence to what is considered typical, systematic ways of participating during
mundane interactions. Largely, these investigations focus on turn taking abilities, initiations and
responses to adjacency pairs, the ability of members of special populations to collaboratively
engage in social actions with others, and ways in which non-impaired co-participants interact
with members of special populations (Antaki & Wilkinson, 2013, for review).
Charles Goodwin, in particular, has been most instrumental in engaging conversation
analysts' attention in the study of interactions by and with members of special populations. His
investigations of the interactions with an aphasiac who retained the ability to say just three
words—yes, no, and and—illustrates how, despite severely limited lexical resources, the
aphasiac was able to expand his communicative resources through alterations in prosodic
contours (C. Goodwin, 1995) and his use of gaze and gesture (C. Goodwin, 2000). In addition to
Goodwin's work, many CA investigations focus on the interactions of persons with various
forms of aphasia (Auer & Rönfeldt, 2004; Wilkinson, Beeke, & Maxim, 2000). Many also
document variations in repair actions (e.g., other-initiated repair to stimulate response, Bloch &
Wilkinson, 2009) and/or the heightened role of co-participant(s) (Heeschen & Schegloff, 2003;
Oelschlaeger & Damico, 2000). Findings in CA have documented the reorganization and
repurposing of interactional resources. Impaired persons are shown to divert their gaze away
from their co-participant and toward an object (e.g., Rossano, 2013; Wilkinson, 2009), gesture
13
toward someone or something (e.g., Simmons-Mackie & Damico, 2009), or alter their prosody
(e.g., Auer & Rönfeldt, 2004) to facilitate and achieve social actions. Through sequential
analysis, cognitively impaired persons are shown to use residual interactional resources in
emergent ways. They are shown to actively participate in creating meaning in conjunction with
the adaptive strategies employed by their co-participants. Similarly, co-participants can
manipulate turn design and mechanisms of talk to facilitate interactions with co-participants who
belong to special populations.
I turn now to studies that concentrate on the effects that dementia can have on language
use and interaction. Turn-taking cues have been shown to remain intact (Hamilton, 1994;
Ramanathan, 1997; Shakespeare, 1998), but the ability to initiate and manage topics declines
with the progression of disease (Garcia & Joanette, 1994; Hutchinson & Jensen, 1980; Mentis,
Briggs-Whittaker, & Gamigna, 1995). The ability to self-repair often becomes impaired in the
later stages of the disease, possibly due to a loss of both self- and other- awareness which
interferes with the ability to recognize interactional trouble, error, or, more generally, affectual
cues (Orange, 1991; Ramanathan, 1997; Shakespeare, 1998). The oftentimes lengthy pauses
taken by persons with dementia may create interactional trouble when co-participants interpret
and respond to them as signals for speaker change (Davis & Bernstein, 2005). Conversation
analytic research has also shown that despite significant deficits caused by cognitive impairment,
persons with dementia can sometimes use their residual interactional resources in emergent ways
to facilitate their interactions with non-impaired co-participants, be this through the use of
“empty words” (e.g., thing and that; Davis and Bernstein, 2005); or the use of repetitiousness
14
and echolalia (deficits by clinical measures) to maintain conversation flow and progress the talk
(Guendouzi & Müller, 2002; Guendouzi & Müller, 2005).5
Despite this work, no interactional studies direct their focus on the use and function of
epistemic stance markers in the conversation of persons with dementia. Three studies have, however,
made some relevant observations about epistemic resources even though tangential to their main
investigations. Irigaray’s investigation of the linguistic and, to a lesser extent, the interactional
competence of 32 persons with senile dementia provides perhaps the first mention of possible
limitations in the expression of epistemic stance for this population (1973). Irigaray conducted a
number of elicitation tasks, as well as engaged her patients in conversation that she describes as
“spontaneous, but semi-elicited talk” (“étude du langage spontané et/ou semi-induit”1973, p. 277).
In her chapter on their interactional competency, she notes that they displayed the inability to claim
utterances as their own (p. 291). As part of her characterization, she reports the absence of I believe
or I think as well as of “modification devices” such as maybe or probably (p. 291).6 Irigaray
conjectures that persons with dementia become unable to recognize or respond to their recipients’
discourse needs, particularly in their inability to provide the necessary discourse resources that
distinguish self from other. She goes so far as to claim that, based on the tasks and talk she observed
in her patients, that the world between speaker and recipient no longer exists (1973, p. 292).
Irigaray’s observations may very well describe the loss of linguistic resources used to display
epistemic stance once persons with dementia reach the late stages of the disease, stages that are
5 Additional linguistic phenomena that have been studied using naturally-occurring talk of persons with
dementia include circumlocutions, neologisms, formulaic language, repetition, word-class effects, and
cohesion (Davis & MacLagan, 2010; MacLagan & Mason, 2005); the use of tense, pronoun usage,
coherence markers (Müller & Wilson, 2008) and empty words (Davis & Bernstein, 2005); and the effects
of dementia on the resilience, decrement, and choice of linguistic resources in bilinguals (Nold, 2005). 6 I have translated from Irigaray’s French “Par ailleurs, les textes enregistrés ne contiennent pas de
modalisateurs – peut- être, sans doute, etc. – autres traces du rappor d’un sujet énonçant à son texte
[. . .]. Et on n’y trouve pas advantage des: je crois, je pense que . . ., etc.” (p. 291).
15
immediately preceding mutism.
Hamilton investigates varied linguistic and interactional resources used by Elsie, a woman
diagnosed with Alzheimer’s disease who was residing in an assisted living facility (1994). Hamilton
traces changes incurred in the patterns of those resources during conversations she had with Elsie
over the course of nearly four and a half years (November, 1981 until March, 1986). Of relevance to
my study, Hamilton notes that Elsie used constructions such as I don’t understand, That’s right, I
think, I guess, I suppose, I don’t remember, and I forgot until approximately six months before
entering a state of near mutism (1994, p. 66). Hamilton does not assess the functions of these
constructs, but I note them here as examples of possible epistemic stance marker use until late stages
of dementia.
Shakespeare, in her study on aspects of confused speech and interactions with confused
speakers, captures on tape the use of epistemic stance markers used by persons with various
cognitive and memory issues, most of whom have been diagnosed with some form of dementia. In
her discussion of identity management, she shows moments in which confused speakers present
claims of uncertainty or not knowing during both naturally-occurring conversations and semi-formal
interview interactions. Shakespeare interprets some of these moments as attempts by the speaker
during moments of memory loss to enlist the help of a “knowing” co-participant such as their spouse
or caregivers (1998, p. 127). This observation of hers suggests that the use of epistemic stance
markers may be put to use by impaired persons for functions other than, or in addition to, displays of
epistemic stance.
To close, Goodwin and others demonstrate that conversation analysis provides a
framework to discover the local sense-making strategies—linguistic, pragmatic, and
interactional—that allow participants, despite severe limitations, to hold meaningful
16
conversations. My investigation of the use and function of epistemic stance markers in the
conversations of persons with dementia emerges directly from consideration of this literature.
17
CHAPTER 3
Data and Methods
3.0 Introduction
This study employs a multi-dimensional approach that combines descriptive quantitative
work, corpora comparison, and conversation analysis. Quantitative and qualitative approaches
that focus on language in use offer distinct affordances in analyzing the linguistic resources that
are used by participants. Quantitative approaches, such as those often used for corpora-based
analysis, can characterize a broader group but the large scale of the data and a reliance on
predetermined criteria can remove these findings from the subtlety of social and local meaning.
Qualitative approaches allow the characterization of finer details of particular interactions, but
these findings offer a very different sort of generalizability regarding language practices. To cite
one instance, conversation analysis can allow us to generalize about phenomena that occur across
languages; for example, the practices of turn-taking have been shown to apply to all speakers no
matter their language (Stivers et al., 2009). But the high reliance on understanding the
relationship among the microfeatures of linguistic and other interactional choices does not
always shed light on how frequently the particular microfeatures actually occur in conversation.
Moreover, the valuable focus on co-participant response, or orientation, does not always reveal
how common certain practices are.
While in the past conversation analysts have not generally quantified their findings, more
recent researchers have turned toward including quantification within their analyses (e.g., on
universals and cultural variation in turn taking, see Stivers et al., 2009; for question-response
sequences across languages, Stivers, Enfield, & Levinson, 2010; and research on interactions
with members of special populations, reference Mates, Mikesell, & Smith, 2010 and Wilkinson,
18
2011). Other researchers have combined corpus linguistics with conversation analysis (CA) (e.g.,
both those who investigate CA-grounded categories, such as Fox, Maschler, & Uhmann, 2010
and Stivers & Hayashi, 2010; and those who investigate linguistic-grounded categories, such as
Clancy, 2011; Santamaría-García, 2011; Walsh, Morton, & O’Keeffe, 2011). My investigation
builds on this trend, acknowledging the relative strengths of both the quantitative and qualitative
approaches with regard to particular types of research questions.
Conversation analysis is well established and has produced a growing body of work
regarding special populations (see Chapter 2). But as I pointed out above, quantification is
relatively new within CA studies, so I want here to briefly state how I see my quantitative
methods supplementing (and not replacing) my CA work. I apply a quantitative (and corpora)
approach in Chapter 4. The quantification in that chapter simply allows identification of the
frequency with which words and phrases that commonly do epistemic work are used. The data
charts allow us to easily identify the most commonly used, the least commonly, and the range in
between. They also, of course, allow us to compare relative uses between and among
populations. The quantification alone, however, cannot tell us anything about the actual
function(s) of those words and phrases, nor can it tell us the reasons for any observed differences
in the relative use. Such issues would require further investigation. What the numbers do
suggest, however, are possibly fruitful avenues for investigation. In this dissertation, I pursue one
of those: the possible function(s) of I don’t know utterances by persons with dementia. That
pursuit does not rely on further quantification after having identified I don’t know as, by far, the
most frequently occurring epistemic stance marker in my data. That said, the quantification in
Chapter 4 is also laying groundwork for future studies, not only for the analyses I pursue in
Chapter 5. For such studies (e.g., those that analyze possible interventions to facilitate
19
communication with persons with dementia) quantification will become even more important, as
it would be necessary, for instance, to define how widespread particular communication
problems actually are and to assess the efficacy of various interventions.7
3.1 Data
The sections below detail the sources of my data, my methods for coding and analyzing
those data, and the corpora to which I compare the data.
3.1.1 Carolina conversations collection
The Alzheimer’s data are part of the Carolina Conversations Collection (CCC), a
specialized web portal housed at the Medical University of South Carolina (Pope & Davis,
2011). The CCC contains collections of conversations with people who are 65 or older, some of
whom have been diagnosed with dementia. When I began my research, transcripts were available
for 30 persons with dementia. All 30 were residents in dementia-designated wings of long-term
care facilities at the time of the recordings. Additionally, the attribution of dementia of the probable
Alzheimer’s type was shared with the researchers by the respective patients and/or their families.8
Moreover, the primary investigators had opportunity to administer to each patient a cognitive
diagnostic tool, the Seven-Minute Screening test (Solomon, Hirschoff, & Kelly, 1998). Most
residents were either unwilling or unable to successfully complete the test (see Davis, 2005; Pope
& Davis, 2011). Finally, the primary investigators of the CCC had established relationships with
each patient and had appropriate informed consent procedures in place. All participants had
indicated, through the informed consent process, their desire to take part in CCC-associated
research.
7 And, of course, quantification can be of great use when trying to establish priorities and solicit funding.
8 The patients’ medical records are not available to CCC researchers.
20
3.1.2 Participant selection
From the 30 available transcripts, I selected 25 dyadic conversations, each composed of a
person with dementia talking with a different non-impaired co-participant. These conversations
involve an elderly person with an Alzheimer’s disease diagnosis, who is also a resident in an
assisted living facility, engaged in a single-session interaction with an undergraduate or graduate
student volunteer. Twenty-four of the 25 conversations are between 8 minutes and 13 minutes
long; one conversation—the most severely impaired participant with dementia—takes just over
30 minutes. Total duration of the audio data is 4 hours, 51 minutes. The five available CCC
transcripts that I did not use were discarded for various reasons: three were conversations
involving more than two participants; one was an abbreviated session that was significantly
shorter than the average (less than two minutes of audio data); one was a longer, multi-session
transcript from which it was difficult to distinguish what portion of the transcript occurred in a
single conversation session.
3.1.2.1 Participants with dementia
The participants with dementia include 20 white, monolingual English speakers between
69 – 90 years old, 12 female and 8 male.9 Each had been diagnosed with Alzheimer’s disease,
within the moderate to severe stages of that disease, and resided in one of several assisted-living
facilities in North Carolina (USA). Demographic information for each participant is available in
Appendix A; it includes sex, age, race, known occupation and education level. (Information about
childhood residence(s) and length of residence in current locations is unavailable.)
9 Five of the persons with dementia are engaged in a second conversation with a different co-participant
for a total of twenty-five conversations.
21
3.1.2.2 Non-impaired student volunteers
The student volunteers, 21 female and 4 male, were all between 20 - 30 years old. All
were enrolled in the gerontology service-learning course Aging and the Lifecourse at UNC,
Charlotte (Hancock, Shenk, & Davis, 2009). As part of the service-learning component of this
course, the students were required to spend 10 hours at one of the local assisted-living facilities
in which data collection and participant consent had been achieved. The goal of this course
component was to accustom college students whose professional goals involved conversing with
adults with dementia to such interactions (Hancock, Shenk, & Davis 2009). In the course of the
conversations, the students did not have to cover any particular topics, nor were the students
required to obtain any specific information during their interactions.
Student volunteers were given one hour of training in the current best practices for
conversing with older persons. Training included the following techniques in communicating
effectively with older persons: the use of 1) go-aheads, 2) indirect questioning, and 3) quilting
(Hancock, Shenk, & Davis, 2009, p. 175). Go-aheads involve the use of simple or minimal
responses to encourage continuation of talk by a participant with dementia; they include such
things as “um huh”, “yeah”, “okay”. Indirect questions inquire about a topic but avoid the use of
interrogatory syntax such as “what”, “where”, “when”, and “why”. For example, to inquire about
a person’s lunch experience, the student is encouraged to avoid asking “What did you have for
lunch?” and, instead, say “Oh, the lunch smells good today”. Quilting brings past events or
narratives into the present conversation. The conversations exhibit several recurring topics that
appear to be driven by the physical or seasonal context. For example, when an interaction takes
place in the room of the person with dementia, the co-participant often asks about family photos
22
or other personal items. Co-participants also use upcoming holidays to elicit talk about family
traditions, current plans to see family, or preferences for those celebrations.
3.1.3 The transcripts
The normalized transcripts provided through the CCC portal were produced using
Transcriber software (http://trans.sourceforge.net). From these CCC audio files and normalized
transcripts, I created highly detailed transcripts that met conversation analytic standards
(Heritage & Atkinson, 1984; Jefferson, 2004; see Appendix B for transcription conventions).
These transcription conventions allow me to complete a detailed analysis of the mechanics of
interaction and the contexts in which epistemic markers are used. Names and identifying
information were permanently removed from the audio and a tone of the exact duration was
substituted in order to maintain the original length of the audio recordings. Pseudonyms were
assigned to the participants in the transcripts to protect privacy. For ease of participant group
identification, participants with dementia are designated in the text by title and surname (e.g.,
Mr. Tappan; Ms. Wittle) and in the transcript by a title and surname abbreviation (e.g., Mr. TPN,
Ms. WTL); non-impaired co-participants are identified with a given name (e.g., Betty, Renee).
3.1.4 The corpora
I manually coded each transcript for the presence of epistemic stance markers, the
identification of which I discuss at length in Section 3.2 below. I then built a corpus from the
transcripts of the twenty-five conversations. I created three Microsoft Word documents that
served as my searchable corpora. A master document contains all utterances of both persons with
dementia (PWD) and the non-impaired co-participants (NI); I refer to this throughout as the
PWDNI corpus. It is comprised of 33,250 words, 17,999 from participants with dementia, and
15,251 from non-impaired co-participants. From this I derived a separate document that
23
contained only the utterances of all PWD participants; and one that contained the utterances of
all NI participants. I next recorded in a Microsoft Excel spreadsheet the counts of each type of
stance marker by each population, cross checking the findings against the master searchable
document (PWDNI). I was then able to identify the grammatical forms and calculate the
frequencies of words and phrases that are commonly used as epistemic stance markers, which I
then compared to two corpora that capture the naturally occurring use of these epistemic stance
markers within conversations of presumably non-impaired persons (Biber, et al., 1999;
Kärkkäinen, 2003; the comparison corpora are discussed below). This comparison allowed me to
query the degree to which the participants in my data are drawing upon resources commonly
used to display epistemic stance. I then compared my corpus of persons with dementia to that of
their non-impaired co-participants. This comparison sought to reveal differences in relative uses
between the two populations, differences that could reflect 1) the presumed linguistic decrement
of persons with dementia, and/or 2) the conversational approaches taken by their co-participants
in interacting with such persons.
3.1.4.1 Longman Grammar of Spoken and Written English (LGSWE)
The Longman Grammar of Spoken and Written English (LGSWE) (Biber et al., 1999)
provides one of the most comprehensive descriptions of the English language; a particular
strength is that it treats the spoken and written forms with equal standing and considers syntactic
classification within the context of use (Hirsh, 2001). I compare my corpus to the spoken register
in the LGSWE—6,410,300 words derived from 3.765 conversations. The conversation data are
comprised of audio-recorded conversations identified to represent the range of English speakers,
from both the UK and the US, across age, sex, social group, and region. The audiotapes were
24
collected over a period of one week and transcribed orthographically for the use of lexicographic
and grammatical research (Biber et al., 1999, p. 29).
3.1.4.2 Kärkkäinen corpus (2003)
I also compare my findings to a small corpus study on epistemic stance markers within
English conversation of presumably non-impaired speakers (Kärkkäinen, 2003). This is the only
study of which I am aware that focuses on epistemic stance markers within spoken English
conversation from a conversation analytic and interactional linguistic perspective. The corpus
contains one hour and forty-three minutes of audio-taped, naturally-occurring conversation
which yields 399 epistemic stance markers. (The exact word count is not given). Kärkkäinen’s
data is derived from the Santa Barbara Corpus of Spoken American English (SBCSAE) (see
Kärkkäinen, 2003, p. 6).
3.1.5 Data norming
Most comparisons that I make between my data and that of the other corpora are in terms
of the relative frequencies (expressed as a percent) of a given stance marker category within each
corpus. However, some comparisons are done on a “per word” basis. In these cases, all data are
normalized to a 1,000 word scale.
3.1.6 Exploratory data: children with autism and their clinicians
I conduct an exploratory investigation of the functions of I don’t know utterances by
children being evaluated for autism spectrum disorder (ASD). These utterances thus occur within
an institutional context. I use conversation analysis to look at both the clinicians’ formulations of
the test questions dealing with emotions and their orientations to the children’s I don’t know
utterances. I also pay close attention to participants’ eye gaze and other bodily behavior. More
details on the data, context, and methods are provided in Chapter 6.
25
3.2 Epistemic Stance Markers
I draw upon the term “epistemic stance marker” as it is a commonly used one in
traditional linguistic literature. As generally used, it is an utterance that relates to the speaker’s
degree of certainty, doubt, imprecision, viewpoint, and limitation. This general usage poses a
difficulty in a conversation analytic study such as mine because the actual function of any
linguistic resource must be determined by a close analysis of interaction. Nevertheless, given the
lack of a widely accepted alternative term to identify those words or phrases across grammatical
categories that are traditionally associated with displaying epistemic stance, I use the traditional
term “epistemic stance marker”. In doing so, however, I make no claims as to the function of any
single form until determining that function within the context of the interaction in which it is
used. In essence, what I call epistemic stance markers in these early chapters are words and
phrases that may potentially be shown to display stance, but they may work instead to do other
functions in interaction.10
Rather than reissue this caveat every time I use the term, I will simply
use “epistemic stance marker” for sake of convenience.
I borrow my categories of epistemic stance markers from the LGSWE (Biber et al.,
1999).11
They include epistemic adverbs (e.g., probably, maybe), predicative adjectives (e.g., [I
am] sure, certain), noun phrases (e.g., [without a] doubt, [it is a] certainty), epistemic clauses
composed of a personal pronoun and a mental verb in both positive and negative forms (e.g., I
know, I don’t know; I remember, I don’t remember), and the verb forms seems and seems like.
10
Those actual determinations will be made in chapters 5 and 6, and I will clearly note whether a given
construction is working as an epistemic stance maker. 11
My decision to draw upon the epistemic categories present in Biber et al. (1999) rather than
Kärkkäinen (2003) is due to Kärkkäinen’s inclusion of evidential markers, words and phrases that convey
how one knows something (e.g., I heard, Bill saw, She said). When comparing my findings with hers, I do
extract the contribution evidentials play within her analysis.
26
Unlike Biber et al. (1999), I have also included formulaic stance markers (e.g., I haven’t
got a clue; I haven’t the foggiest) because both clinical and interactional observations reveal an
increase in the use of formulaic expressions by participants with dementia (Bridges & Van
Lancker Sidtis, 2013; Lindholm & Wray, 2011; Wray, 2010). This increase of formulaic
language as a notable change in the linguistic systems of persons with dementia warrants study
to determine whether these expressions might be functioning to mark epistemic stance.
While both LGSWE (Biber et al., 1999) and Kärkkäinen (2003) discuss the ways that
modal verbs can serve as epistemic stance markers, I choose not to include them, having made
the decision to defer analysis of modal, semi-modal, and emerging modal verbs to a future study.
The reasons are several. First, as Biber et al. (1999) notes, “Modal verbs are problematic, since
they have many meanings and are often ambiguous” (p. 979). Attempts to determine the function
of these verbs, whether it be to mark epistemic stance or to convey likelihood, ability,
permission, or obligation can prove indeterminate, even after detailed interactional analyses.
Second, the theoretical views of modal, semi-modal, and emerging modal verbs are also quite
inconsistent and often contentious (see Cappelli, 2007). Researchers tend to accept the
grammatical definition of modal verbs from convention rather than investigating the patterns of
use: the general tendency in handling modal verbs is not to distinguish between actual function
of modal verbs.12
Finally, as a practical consideration, the sheer number of modal verbs presents
a complexity in determining function that warrants a separate study; they occur 371 times in my
study, not including the semi-modals (e.g., need to, dare to) and emerging modals (e.g., gotta,
hafta). This nearly equals the total number of all other epistemic stance markers combined.13
12
Some exceptions are Hoye (1997), Chafe (1986), and Hyland (1996); they analyze the function of the
modal verbs in discourse. 13
The forms and frequencies of all modal auxiliaries (i.e., can, could, may, might, must, shall, should,
will, would) is provided in Appendix C.
27
3.3 Conversation Analytic Methods
I apply conversation analysis as a necessary follow-up to my quantification and corpora-
analysis. While early corpus studies revealed the extensive variation that exists in the use of
grammatical choices across different genres and registers (Biber et al., 1999), more recent corpus
work on spoken language has highlighted the contextually-dependent nature of the functions of
grammatical choices. Thus it emphasizes the need to move beyond simple consideration of the
grammatical class when considering function (Teubert, 2004). Indeed, Biber and colleagues
emphasize that a corpus analysis must go beyond simply counting linguistic items. During a
thorough corpus analysis, it is “essential to include qualitative, functional interpretations of
qualitative patterns” (1999, p. 5). That is, it is not sufficient to quantify linguistic items alone but
rather to investigate those quantifications in order to arrive at a better understanding of the
importance of those patterns within language in use.
I thus apply the methods of conversation analysis to bring into relief the function(s) of
epistemic stance markers within conversations of naturally occurring talk.14
Specifically, I
employ a turn-by turn sequential analysis to assess the function of each of the 92 occurrences of I
don’t know produced by the participants with dementia. In reporting a representative subset of
these in Chapter 5, I document how each I don’t know emerges within interaction as initiating
actions (first-pair parts) and as responsive actions (second-pair parts). I also pay particular
attention to how each co-participant orients, or responds, to each I don’t know utterance. The
work, or function, of I don’t know utterances is discoverable, in part, through the recipients’
orientation to uses of I don’t know as turns or turn components. What follows is a general
14
Within my study on persons with dementia, naturally-occurring talk refers to conversation which occurs
spontaneously, without any planning or prompting beforehand. In Chapter 6 on autism, I will be
concerned with naturally-elicited talk, that is, with talk that is solicited by a clinician, through the use of a
testing protocol that includes both scripted and non-scripted prompts.
28
overview of CA methods and then a more focused look at turn construction units and sequential
organization.
3.3.1 Conversation analysis: general overview
Conversation analysis (CA) is an analytical method for discovering the orderly practices of
talk, talk as both a form of social action and as a facilitator of other social actions (Heritage, 2009;
Sacks, Schegloff, & Jefferson, 1974; Schegloff, 1996, 2007). CA focuses upon the participants'
own practices (or methods) within talk, with participants' orientations serving as evidentiary
grounding for claims analysts make about how talk works. In particular, CA documents how co-
participants’ online linguistic, prosodic, and embodied choices and their reflexive orientations are
significant to the participants themselves (Garfinkel, 1967, p. 78; Heritage, 1984, pp. 75-102).
Meaning and social actions are negotiated by the participants through these reflexive orientations, or
subsequent vocal or non-vocal displays. Analysts are able to document such actions and meaning-
making through repeated listening and/or observation (via audio and/or video recordings) in which
they attend to the participants' displayed interpretations of one another. Analysts, like the
participants involved in the interaction, employ a wait-and-see approach in their interpretation of
the data; that is, like the participants involved in the interaction, analysts pay close attention to how
turns are constructed and the resources used, and most importantly, what the participants
themselves make of those resources (Garfinkel, 1967; Heritage, 1984). It is the participants' use of
vocal (lexico-grammatical, prosodic) and non-vocal (gaze, bodily movements), as well as the co-
participants' orientations and subsequent turn composition and sequential positioning, that serve as
empirical evidence of the social actions accomplished in the interaction. Thus, talk-in-interaction
consists of the interplay that unfolds as speakers alternately take turns and respond to turns (what
Heritage calls “context shaped and context renewing” 1984, p. 242). By explicating what is
29
produced and oriented to by participants in the turn-by-turn unfolding of talk, CA researchers can
address the collaborative sense-making processes of a given interaction and the actions jointly
accomplished by the participants. Or, as Heritage and Atkinson (1984) describe the main impetus
of CA, its central goal is to [describe and explicate]
the competences that ordinary speakers use and rely on in participating in intelligible,
socially organized interaction. At its most basic, this objective is one of describing the
procedures by which conversationalists produce their own behavior and understand and
deal with the behavior of others. A basic assumption throughout is Garfinkel’s (1967)
proposal that these activities—producing conduct and understanding and dealing with
it—are accomplished as the accountable products of common sets of procedures (p. 1).
The choice of resources from which a participant constructs his or her turn is referred to as turn
design, or “composition”. It is the accumulative effect of turn design that is greatly responsible for
accomplishing the work of the action and for achieving of joint meaning, or intersubjectivity,
between participants (Schegloff & Sacks, 1973). The role of the analyst, then, is to illuminate the
systematic orderliness of talk as it unfolds through the "organized patterns of stable, identifiable
structural features" that make up utterances, turns, and sequences of turns (Heritage, 1984, p. 241).
Working with collections of multiple instances of what appears to be the same kind of turn design,
analysts provide both description and illumination of how a particular action is achieved between
the participants. Using this approach allows me to base my analysis of any given function of an
epistemic marker in what the participants display each to mean.
3.3.2 Turn construction units: composition
Turn construction is central to CA research. Turns are composed of one or more turn-
constructional units (TCUs) that work to project both the action of the turn and junctures where
30
speaker change may occur. TCUs emerge within the talk-in-interaction and, therefore, are seen
as reflexively sensitive to the moment-to-moment contingencies of that interaction in ways that
(traditional notions of) sentences, clauses, or phrases are not. Within TCUs speakers employ a
variety of linguistic and other resources as they select lexis (or words); phonetic and prosodic
resources; syntactic, morphological and other grammatical forms; tempo, laughter, and
aspiration, and other voice qualities; gesture and other bodily movements. The positioning of
these resources within incipient (i.e. developing) TCUs, and multi-unit turns, is key to
understanding how participants make sense and accomplish actions during conversation. The
emergence of turn resources are carefully monitored by the participants and, speakers often
systematically modify emerging utterances by adding to, changing, or repairing their lexical,
syntactic and prosodic content in response to the actions of their recipients (C. Goodwin, 1979).
For example, Schegloff (1996) discusses how turn beginnings can be problematic for speakers:
how do speakers project how the new unit of talk will be organized and what will be done in it
(projection) or how do they show that the next turn fits with what has come before it (tying
problem) (1996, pp. 77-82). The grammar participants choose is essential for working out these
and other interactional contingencies during interaction. The analyst attempts to document the
import of the emerging structure—the lexical, syntactic, prosodic shape of each utterance as well
as participants’ embodiments, gaze, and gesture (when available in the data)—and the effect those
resources have on what the recipient makes of those resources, both in terms of actions and in
intersubjectivity. Therefore, close analyses of the linguistic resources within the emerging
trajectory of turns-at-talk and the actions accomplished through those structures is fundamental to
CA research (See Selting & Couper-Kuhlen, 2001 for a collection; also Ford, 1993; Ford &
31
Thompson, 1996; Fox, 1987; C. Goodwin, 1981; Lerner, 1991; Lerner & Takagi, 1999; Local,
1996; Sorjonen, 1996).
3.3.2.1 Syntactic constructions of I don’t know
The manner in which participants compose their turns—the lexical, syntactic, prosodic
shape of each utterance along with embodiments, gaze, and gesture—is key to understanding how
participants make sense and accomplish actions during conversation. Of particular interest to my
study is how participants compose their turns with I don’t know utterances at different locations
within their TCUs. The IDK utterances are of two major types: 1) those that are grammatically
independent turn construction units (i.e. either standalone utterances or ones that are prosodically
but not syntactically integrated within the larger turn), and 2) those that are complement-taking
(e.g., IDK clauses that take complements such as a noun phrase; a prepositional phrase; a wh-, if-,
that-clause).
In terms of turn composition, I provide here a summary of the different syntactic
constructions as I have labeled them within the data. Independent IDK utterances may be a) stand-
alone; b) turn initial, or prefaced; c) turn medial, or parenthetical; or d) turn final. Constructions
(b)-(d) may be prosodically connected to the turn components, but they are not syntactically
integrated with the rest of the turn components.
(a) IDK standalone: I don’t know.
(b) IDK turn initial: I don’t know, I’m still sleepy this morning.
(c) IDK turn medial: It was, I don't know, about five pounds.
(d) IDK turn final: I think they're coming, I don't know.
32
Complement-taking IDK utterances are produced with some type of grammatical form that makes
the utterance syntactically complete. Examples of complement-taking IDK utterances are presented
in examples (e), (f), (g), and (h).
(e) IDK + wh-complement: I don’t know how to cook.
(f) IDK + if-complement: I don’t know if they will be here.
(g) IDK + noun phrase complement: I don’t even know her name.
(h) IDK + prepositional phrase complement: I don’t know about that.
3.3.2.2 The prosodic forms of I don’t know
All phonetic variants of I don’t know are considered (i.e. I don’t know, I dunno, I donno,
I’ont no).
3.3.3 Sequential organization: position
While the turn construction of every utterance is important to each analysis, CA views the
positioning of each utterance, or the sequence of a turn in relation to what came before it, as
fundamental to the understanding of its meaning and to the analysis of the utterance’s significance
to an action (Levinson, 2013; Schegloff, 1984, 2007). Sequences are often identified as adjacency
pairs. These are conversational sequences that conventionally come in pairs of turns (i.e.
greetings and return greetings, question and answers, invitations and acceptances/declinations),
spoken by two different speakers and adjacently placed (most often) (Schegloff, 2007, p. 13).
The first turn is referred to as the first-pair part (FPP) and the second turn is called the second-
pair part (SPP) (Schegloff, 2007, p. 14). For example:
FPP Speaker A: Wanna go to class together?
SPP Speaker B: Sure.
Together these two turns form a question-answer adjacency pair in which the action of inviting
33
(Speaker A’s first-pair part turn) and acceptance of the invitation (Speaker B’s second-pair part)
take place. In the below conversation, we can see how talk-in-interaction often takes place
through much more than two turns of talk and how actions are accomplished within the orderly
turns.
FPP Speaker A: What time are you going to class? (Presequence)
SPP Speaker B: Quarter to ten. (Response)
FPP Speaker A: Oh, wanna go together? (Invitation)
SPP Speaker B: Sure. (Acceptance)
Speaker A’s first turn servers as a presequence that allows that speaker to project the possibility
of a forthcoming base FPP and it makes relevant some response from the recipient. By projecting
the possibility of an action (in this case an invitation), the presequence makes that next action
contingent upon the recipient SPP to the presequence. Thus, the recipient can respond with a SPP
that works as a go-ahead for that FPP, the invitation, as we see in the example above. Or, the
recipient could have produced an utterance that worked in such a way that “discouraged” the co-
participant from producing the base FPP (Schegloff, 2007, p. 29). For illustration, Speaker B
provides an utterance that works as a go-ahead, and, as a result, Speaker A is shown to provide
the baseline FPP, the invitation: “Oh, wanna go together?” Speaker B’s answer is fitted to the
preceding action, i.e. the question, an acceptance of the invitation: “Sure.”. What is also
demonstrated in this short example is the progressivity of talk. That is, the turns at talk above
move along from one turn to what is “hearably-the-next-one with nothing intervening”
(Schegloff, 2007, p. 15) with nothing intervening in that progression, such as any kind of
insertion sequence or indicators of trouble.
3.3.4 Topic management
Germaine to my study is how the use of I don’t know relates to topic management, the
34
initiation and close of topics. Topic proffering is the act of offering the other participants
something worthy to talk about. Within the CA perspective, topics are “progressively realized”
turn by turn (Schegloff, 1990). When a topic is proffered, the participants can engage with that
topic, that is take it up, or they may not engage with the proffered topic. The taking up of a topic
provides one of the main sources of coherence in conversation. Much of the progressivity of talk
takes place as the participants move from topic to topic either by a topic-close followed by a
topic beginning or by a stepwise move that involves what is being introduced to what has just
been talked about (Jefferson, 1984). I analyze how I don’t know contributes to topic movement
(initiation, uptake, change, or close) within the sequential structure (Erickson, 1990; C.
Goodwin, 1995; Maynard, 1980) in my analysis of the functions of I don’t know.
3.3.5 Preference structure
Another important aspect that contributes to the way in which participants jointly work
either to accomplish actions or to establish intersubjectivity involves preference structure. The
concept of preference in CA does not refer to the psychological motives of individuals but
instead involves what is structurally fitted to or preferred by the sequence of talk in play.
Preference works at two different, but not mutually exclusive, levels of talk. Preference can be
understood as a property of sequence type. A first-pair part can be built to prefer a particular
second-pair part; that is, the preference is hearable to the recipient based on recurrent prefaces of
composition, action formation, and sequential position. For example, when a speaker issues an
invitation, an acceptance by the recipient of the invitation is a preferred action and a declination
is often dispreferred.
Preference must also be understood "as a property of the participants’ way of doing or
enacting a responsive action" (Schegloff, 1988, p. 453). Preferred actions are more
35
straightforward and performed without delay in the response (the SPP), whereas dispreferred
actions are regularly delayed, qualified, and accounted for (Pomerantz & Heritage, 2013). For
example, the preferred response to an invitation is acceptance. The below example taken from
Atkinson and Drew (1979, p. 58) demonstrates that preferred responses are formulated without
any delay or hesitation. Here the acceptance is produced in overlap:
B: Why don't you come up and see me some[times
A: [I would like to
In an example taken from Schegloff (2007), we see the response displays features such as
delay, hesitation, and perturbations within the formulation that indicate a dispreferred response to
an invitation is forthcoming:
(5:19) NB II: 2, 12:18-29 (Schegloff, 2007, p. 69) (excerpt is condensed)
1 Emm: [Wanna c’m] do:wn ‘av [a bah:ta] lu:nch w]ith me?=
2 Nan: [˚It’s js] ( )˚]
3 Emm: =Ah gut s’m beer’n stu:ff,
4 (0.3)
5 Nan:→ ↑Wul yer ril sweet hon: uh:m
6 (.)
7 Emm: [Or d’y]ou’av] sup’n [else ˚( )˚
8 Nan:→ [Let- ] I: ] hu. [n:No: I haf to: uh call
9 Roul’s mother.
Nan’s response is not immediate, but follows after a 0.3 pause (line 4). In line 5, Nan
formulates her turn with an appreciation utterance for the invitation that is directed to Emm. This
formulation pushes the dispreferred part of the utterance, the declination, well into the turn (lines
8-9). Nan’s turn demonstrates classic features of dispreferred turns: delays such as cut offs and
perturbations (“Let-“, “uh”). Additionally, an account follows the declination: “n:No: I haf to: uh
36
call Roul’s mother” (line 9).
Having provided an overview of my methods, I now move to the analytical chapters of this
dissertation. Chapter 4 will address the forms and frequencies of epistemic stance markers used by
persons with dementia and their non-impaired co-participants. Chapter 5 will investigate the
functions of I don’t know in the talk of persons with dementia. Chapter 6 will shift to an assessment
of I don’t know utterances in the talk of children being evaluated for ASD.
37
CHAPTER 4
Form and Frequency of Epistemic Stance Markers in Conversations of Persons with
Dementia
4.0 Introduction
A few previous studies have tangentially reported on possible changes in the linguistic
and interactional competency of persons with dementia to express stance or to use stance
markers effectively or in productive ways (Hamilton, 1994; Irigaray, 1973; Shakespeare, 1998).
These studies thus suggest some possible avenues for investigation, but no study to date has
determined typical and atypical patterns in the use of epistemic stance markers by persons with
dementia. Because displays of epistemic stance are ubiquitous in conversation, and given the
hallmark characteristics of memory and other cognitive decline in persons with dementia, any
degradation in their linguistic abilities to display stance has potential interactional consequence.
The analyses that follow are a first step to better understand the full range of the linguistic
resources both available to and used by persons with dementia that can express epistemic stance.
While such study of this crucial aspect of conversation may shed light on issues of general
relevance to understanding language-in-use, my primary hope is that it ultimately provide
valuable information to assist caregivers and families as they evaluate, try to understand, and
seek to interact with their patients and their loved ones.
This chapter will identify the grammatical forms and calculate the frequencies of
epistemic stance markers, forms classified as such within traditional approaches to linguistics,
that emerge in naturally-occurring conversations between participants with dementia and their
non-impaired co-participants. I will compare those forms and frequencies to two corpora that
capture the naturally occurring use of these epistemic stance markers within conversations of
38
presumably non-impaired persons (Biber, et al., 1999; Kärkkäinen, 2003).This allows me to
query the degree to which the participants in my data are drawing upon resources commonly
used to display epistemic stance. In other words, do they fit patterns previously identified within
the conversations of presumably non-impaired conversants? I want to be clear here that no claim
is being made in this chapter of the discrete and definitive function of any epistemic stance
marker in the data, as the actual function of any given marker may not be clear from form and/or
semantic link(s) alone. I will address questions about function in my interactional investigation
in Chapter 5.
After comparison to other corpora, I will then examine and compare the two groups
represented in my data—persons with dementia (PWD) and their non-impaired co-participants
(NI)—in order to determine whether the forms and/or frequencies of epistemic stance markers
differ between the two groups. Differences could arise for any number of reasons (i.e., atypical
usage on the part of persons with dementia; structural artifacts in the conversation as a result of
the non-impaired co-participants talking with persons with dementia rather than other non-
impaired people). I address noted differences in the discussion. Overall, my findings suggest that
the ability to deploy a variety of epistemic stance devices may, for many persons with dementia,
remain available well into the late stages of disease. The chapter closes with a brief discussion of
the import of my findings.
4.1 Grammatical Classes and Frequencies of Epistemic Stance Markers: Corpora
Comparisons
This section addresses the degree to which participants in my data draw upon linguistic
resources that are commonly used to display epistemic stance during naturally-occurring
conversations. To pursue this question, I first identify the grammatical classes and calculate the
39
frequencies of epistemic stance markers present in my twenty-five conversation data set, which I
refer to as PWDNI. I make no attempt at this time to separate out uses by either persons with
dementia or their non-impaired co-participants. Keeping the data combined in this fashion
captures the conversational context of the linguistic resources used and allows for comparison to
other conversational corpora that capture the naturally occurring patterns of epistemic stance
marker choice within conversations of presumable non-impaired persons. In Section 4.2, I will
present and compare the grammatical classes and frequencies used by each of the two co-
participant groups represented—both the persons with dementia (PWD) and their non-impaired
co-participants (NI)—in order to examine whether these two groups differ in usage.
Overall, the frequency of epistemic stance markers in my twenty-five conversation data
set in comparison to other corpora varies slightly for the most common forms (e.g., clauses,
adverbials, adjectives) and differs little in the forms and frequencies of less common types of
epistemic stance markers (e.g., noun phrases, participles, adjectives).15
Of the 640 epistemic
stance markers coded in this study, two main classes are favored for expressing epistemic stance
between persons with dementia and their non-impaired co-participants. Clausal constructions
(e.g., I know, I don’t know, I guess) prove, by far, to be the most frequent syntactic construction.
Adverbial constructions (e.g., probably, maybe, of course) follow considerably behind, occurring
about one-third as frequently.16
Epistemic adjectives (e.g., sure, true, right) rank third, present at
less than one-fifth the frequency rate of clausal constructions. Noun phrases (e.g., opinion, fact)
expressing epistemic stance are minimal, and epistemic participles (e.g., claimed, maintained)
are non-existent. Additionally, I track the use of formulaic expressions that refer to states of
15
As discussed in Chapter 3, comparisons are made to findings reported in the LGSWE (Biber et al.,
1999) and to Kärkkäinen’s study of epistemic stance makers in American English conversations (2003). 16
Modal verbs are not considered in the frequency count of epistemic stance markers for this study. See
Chapter 3 for an explanation for this decision.
40
knowing because earlier literature suggests that persons with dementia often rely on these
prepackaged chunks as a way to compensate for difficulties that arise in formulating novel
lexical and syntactic strings during the online cognitive stress of conversation (Lindholm &
Wray, 2011; Wray, 2010).17
Such expressions, however, prove to be few. Table 4-1 contains
frequency data by grammatical class; the abbreviation PWDNI represents the entire data set of
both persons with dementia (PWD) and their non-impaired co-participants (NI).
TABLE 4-1. EPISTEMIC STANCE MARKERS BY GRAMMATICAL CLASS (PWDNI)
Class Frequency (number)
Frequency (% of total)
Clauses 398 62.2
Adverbials 149 23.3
Adjectives 73 11.4
Other verbs18
11 1.7
Nouns 3 < 1
Participles 0 0
Formulaic expressions 6 < 1
TOTAL 640 100
The findings above appear to be quite consistent with the forms and frequency of
resources used to display epistemic stance in mundane conversations of presumably non-
impaired co-participants as reported by Kärkkäinen (2003, p. 37); see Table 4-2.19
17
I include those formulaic expressions that function as epistemic stance markers in my overall
calculations recognizing that they do not represent a grammatical classification. I believe the inclusion is
warranted to better reflect the overall types and distribution of stance markers; their low frequency does
not alter the percentages greatly. 18
The category “other verbs” consists entirely of the constructs seems/seems like. I note the occurrence
here but do not discuss this category further. 19
Table 4-2 only includes the grammar categories shared between this study and Kärkkäinen’s study.
Specifically, I omit the categories “other verbs” and “formulaics” here, thereby reducing the total number
of epistemic stance markers to 623. The percentages thus vary slightly from those present in Table 4-1
and reported in later sections. Total stance markers from Kärkkäinen equal 328.
41
TABLE 4-2. EPISTEMIC STANCE MARKERS: CORPORA COMPARISON
Class Stickle (PWDNI) Frequency (%)
Kärkkäinen Frequency (%)
Clauses 63.9 73.8
Adverbials 23.9 22.9
Adjectives 11.7 1.8
Nouns 0.5 0.9
Participles 0.0 0.6
TOTAL 100 100
Each of the following sections, 4.1.1 – 4.1.5, provides a more detailed characterization of
the individual grammatical classes of epistemic stance markers in the PWDNI data. In each
section, I provide a more detailed comparison by grammatical class of the PWDNI data with
each of the two comparison corpora. I begin with the least prevalent class and move to the most
frequent.20
4.1.1 Epistemic stance nouns and participles
Epistemic nouns are rare in the PWDNI conversations. Of noun phrases that have the
potential to express epistemic stance, such as sort of, my opinion, my view (Holmes, 1984), only
constructions using fact are present in the PWDNI: two instances of in fact and one occurrence
of matter of fact are present. Both Kärkkäinen and LGSWE also report low occurrences of
epistemic noun construction within conversation. The LGSWE makes the observation that stance
noun phrases are “extremely rare in conversation, moderately common in academic prose”
(1999, p. 984); however, no explanation is proffered as to why this is the case. Kärkkäinen
reports three occurrences, but the actual noun phrases are not listed. She does, however, note any
noun phrases that she expected but proved absent, such as my view or my opinion. I find no
20
The inclusion criteria for epistemic stance markers of all forms is that the expression must occur at least
two times within the twenty-five conversations and within the utterances of at least two different
speakers. An exception is made for formulaic expressions.
42
instances of these or other expressions such as my guess, with certainty, in all likelihood or
others. Kärkkäinen also makes note of a single instance of I have no idea. I include this and other
formulaic expressions of epistemic stance in Section 4.1.5 on formulaic expressions of epistemic
markers.
I find no participle clauses expressing epistemic stance. Kärkkäinen does report two
occurrences because she tabulates evidential markers such as reporting verbs and quotatives that
would encompass participles such as said, maintained, claimed. My study, as discussed in
Chapter 3, does not consider evidential markers that comment on how one knows, (e.g., hear,
see, was told). Instead, my study considers epistemic markers that comment on the certainty of
what one knows. Likewise, the LGSWE does not include participles as a recognized category for
expressions of epistemic stance.
4.1.2 Epistemic stance adjectives
As we turn our focus from nouns to adjectives, we encounter a noticeable rise in
frequency of use. The epistemic adjectives tabulated for all three studies are more accurately
described as predicative adjectives as opposed to nominative adjectives (e.g., the uncertain
student). Predicative adjectives occur within copular constructions, most often formulated with a
first person pronoun subject: I’m certain of it. In my data, only three lexical tokens account for
all epistemic adjectives present: sure/not sure, true, and right. The example below illustrates the
use of the epistemic stance adjective sure:
Ms. Zachary: I- I was thinking-
(1.2)
Ms. Zachary: They called him granddaddy but I'm not sure.
The use of the predicative adjective right occurs either within a copular construction with the
relative pronoun that as subject:
43
Ms. Wallis: That’s right.
or, in ellipsed form, as shown below:
Ms. Wallis: and it and it feels:: a little bit of damp.
Naomi: Right.
Together, these account for 11.4% of all epistemic stance markers (see Table 4-3).
TABLE 4-3. EPISTEMIC ADJECTIVES (PWDNI)
Type Frequency (number)
Frequency (% of epistemic
adjectives)
Frequency (% of stance
markers, n=640)
I’m sure 28 38.4 4.4
Right/That’s right 23 31.5 3.6
True/That’s true 15 20.5 2.3
I’m not sure 7 9.6 1.1
TOTAL 73 100 11.4
The 11.4% frequency noted here is higher than the 1.5% reported by Kärkkäinen (2003, p. 37).
As inferred from her methodology section, I believe Kärkkäinen counted adjectives in a similar
manner as did I; the different frequencies may simply represent normal variation in small sample
sizes.
In its general discussion of adjectives, the LGSWE reports a high frequency of predicative
adjectives occurring in conversation, noting that both sure and right are among the most
frequent, with true occurring less often (1999, p. 517). This mirrors the prevalence of these
adjectives in my study. Direct comparison of the frequency of epistemic stance adjectives to the
LGSWE is complicated, however, by the fact that LGSWE combines reporting for all forms of
stance (epistemic, attitudinal, and style). That reporting shows stance adjectives accounting for
approximately 7% of all stance markers, a number comparable to that reported above for
PWDNI (1999, pp. 979, 982).
44
All three predicative adjectives found within the PWDNI data fall within the semantic
category of certainty as described within the literature on stance adjectives in English grammars
(Biber et al., 1999; Leech & Svartvik, 1984; Quirk, Greenbaum, Leech, & Svartvik, 1985),
spoken research (Biber & Finegan, 1989; Chafe, 1986) and textual analyses (Hyland, 1996,
1999, 2000).
4.1.3 Epistemic stance adverbials
Moving from adjectives to adverbials, we see a sharp rise both in the number of lexical
tokens and in the frequency of use for the entire class, adverbials occur more than twice as
frequent.21
Epistemic adverbials comprise 23.3% of the total set of epistemic markers (see Table
4-4).
TABLE 4-4. EPISTEMIC ADVERBIALS (PWDNI)
Type Frequency (number)
Frequency (% of epistemic
adverbials)
Frequency (% of stance
markers, n=640)
Really 52 34.9 8.1
Probably 28 18.8 4.4
Maybe 25 16.8 3.9
Sure 15 10.1 2.3
Definitely 10 6.7 1.6
Of course 10 6.7 1.6
Actually 6 4.0 0.9
Certainly 3 2.0 0.5
TOTAL 149 100 23.3
This rate of occurrence of epistemic adverbs in the PWDNI data is slightly elevated as compared
to Kärkkäinen’s finding of 18.8%. The LGSWE reports a higher yet still somewhat comparable
21
The relative frequency comparison between these two and other grammatical classes is provided here to
compare with the relative frequency comparisons across grammatical classes provided in the LGSWE.
This and other relative frequency comparisons do not assume an expected usage relationship between or
among grammatical categories.
45
frequency of 31-32% stance adverbials in conversation (1999, pp. 979, 982).22
The lexical forms
discovered, however, remain incredibly consistent in terms of relative use among each of the
three investigations.23
In my data, the adverbial really accounts for nearly 35% of all adverbials,
an example follows below:
Ms. Walton: It does, it really does.
While ranked only fourth in my data, sure also appears as an epistemic adverb, as illustrated in
the example below:
Ms. Wallis: Sure, it was there and it was mi:ne.
Table 4-5 rank orders the frequency and shows the minor difference in the use of the most
common adverbials noted in each study:
TABLE 4-5. MOST FREQUENT ADVERBIAL STANCE MARKERS (BY RANK)
Type Stickle (PWDNI)
Kärkkäinen (2003, p. 37)
LGSWE (1999, p. 869)
Really 1 NR 1
Probably 2 2 2
Maybe 3 1 3
Sure 4 NR NR
Definitely 5 5 6
Of course 5 4 5
Actually 7 3 3
22
This data is derived from Figures 12.1 and 12.2 on pages 979 and 982, respectively. I have extracted the
data for adverbials and complements, omitting LGSWE’s (semi-)modal verbs, to allow a more relevant
comparison of frequency percentages to the PWDNI data. Also, LGSWE categorizes phrases like I think
and I guess as comment clauses when “they are not integrated into the clause structure” (e.g., I’m going to
get a new one for the basement, I think, p. 865) and includes them in their count of adverbials. In the
PWDNI, these constructions are included as clausal constructions in final position. Simply adjusting for
this categorization difference would bring LGSWE and PWDNI about two percentage points closer in
their relative frequencies of adverbials. 23
Biber et al. note in their introduction that they “report frequencies at a level of precision that we judge
to be replicable, rather than reporting the exact frequency obtained in our analysis. These rounded
frequencies accurately measure the relative use of features . . ..” (1999, p. 39). Consequently, all
comparisons to Biber are estimates, and focus is placed on relative frequencies, when possible.
46
Additionally, a direct comparison between the PWDNI and the LGSWE’s report of rates of
frequency of the seven adverbials for American conversations shown in Table 4-5, when
normalized, are nearly identical across the two studies: the LGSWE reports the combined
frequency at between 3.9 and 4.5 occurrences per thousand words (1999, p. 869) and PWDNI
frequency rate is 4.4 occurrences per thousand words.24
4.1.4 Epistemic clausal constructions
As epistemic clausal constructions are, by far, the largest class of stance markers present
in both PWDNI and in each of the comparison corpora, this grammatical class allows for a
greater exploration of the degree to which the use of specific epistemic stance markers in
PWDNI is typical (or atypical) of that found in LGSWE and Kärkkäinen. Kärkkäinen reports that
conversants have a clear preference for displaying epistemic positions through the use of
epistemic clausal constructions, or what she refers to as epistemic phrases. The LGSWE reports
that “it seems that conversation tends to use a clausal means of expression rather than the more
condensed form afforded by stance adverbials” (1999, p. 860) to express all types of stance
(epistemic, attitudinal, and style).
Epistemic clausal constructions are composed of a personal pronoun with a mental verb
such as think, know, or guess. Below I present several examples of epistemic clausal
constructions from my data:
Ms. Tatter: it comes down to the beginning of the rosary. There is uh, you
say, uh I think it's twel- (.) ten (.) or twelve, uh, prayers,
Ms. Tatter: Good. I do too but uh, I know that this had to be a part of a
rosary.
24
The PWDNI data consists of 33,250 words. As noted in Chapter 3, I have extrapolated the data here to
allow easier comparison to LGSWE, scaling it to a per thousand word occurrence. The reason for the
range in LGSWE is that they note 600 ambiguous uses of really.
47
Ms. Tichner: m’hmm. Now ((throat clear)) my husband had a (1.0) relative, he
was a brother, I believe.
Clausal constructions account for 62.2% of all epistemic markers in my data (see Table
4-6).
TABLE 4-6. EPISTEMIC CLAUSAL CONSTRUCTIONS (PWDNI)
Type Frequency (number)
Frequency (% of epistemic
clausal const.)
Frequency (% of stance
markers, n=640)
I don’t know 106 26.6 16.6
I think 80 20.1 12.5
I know 75 18.8 11.7
I guess 32 8.0 5.0
I don’t think 31 7.8 4.8
I don’t remember/recall 24 6.0 3.8
I remember 12 3.0 1.9
I forgot 9 2.3 1.4
I understand 9 2.3 1.4
I don’t understand 5 1.3 0.8
I believe 5 1.3 0.8
I imagine 4 1.0 0.6
I haven’t forgotten 2 0.5 0.3
I don’t believe 2 0.5 0.3
I doubt 2 0.5 0.3
TOTAL 398 100 62.2%
In Kärkkäinen’s study of mundane English conversations between presumably unimpaired co-
participants, these structures occur at a rate of 60.7% (2003, p. 37). The verbs know, think, guess,
and remember dominate the epistemic clausal constructions in the PWDNI. Comparison between
the PWDNI and Kärkkäinen’s data reveals a strong similarity in the verbs most frequently
chosen to express epistemic stance (see Table 4-7).
48
TABLE 4-7. EPISTEMIC CLAUSAL VERBS: CORPORA COMPARISON
Epistemic mental verbs Stickle (PWDNI) Frequency
(number)
Kärkkäinen Frequency
(number)
Know/don’t know 181 63
Think/don’t think 111 51
Remember/don’t remember 36 11
Guess 32 20
With the exception of a greater occurrence of the verb phrase I don’t remember in the PWDNI,
the rank order of epistemic verb selection for the two data sets is comparable.25
The relative
frequency of the above mental verbs is in accord with the findings of LGSWE. Know and think
are the top two mental verbs in the LGSWE conversation register, just as they are in both PWDNI
and Kärkkäinen. In LGSWE’s conversation data, know occurs “around 7000 times per million
words, think occurs around 5000 times per million words”, a ratio of 1.4:1 (p. 374). The two
verbs occur in PWDNI at a comparable ratio of 1.6:1.26
Moreover, the LGSWE classifies I don’t
know as one of the most frequently occurring lexical bundles, or a combination of words that
recur commonly in a given register; they report that I don’t know occurs over 1,000 times per
million words as a three-word bundle and over a 100 times per million as a four-word bundle
(e.g., I don’t know what, I don’t know why) (1999, pp. 992-994). The frequency of IDK within
multi-word bundles may account, in part, for the resilience of this structure within the talk of
persons with dementia.
25
There is, however, a somewhat greater epistemic clausal variation represented in the PWDNI data. Ten
different mental verbs are used, three more than what Kärkkäinen reports. The additional mental verbs
occurring in the PWDNI include understand (n=14), forgot/forgotten (n=11), and doubt (n=2). 26
LGSWE includes all conjugations of the verb forms: know, knowing, knew, known; think, thinking,
thought. PWDNI focuses only on the first person, singular, present tense forms. Still, in the PWDNI
corpus know and think for this sole conjugation occur at rates of 5.4 and 3.3 times per thousand words,
respectively. This suggests that the absolute frequency for all conjugations would not deviate greatly from
that seen in LGSWE.
49
Further direct comparison of the PWDNI and the LGSWE data on the use of epistemic
marking is complicated by the latter’s combining of all stance markers. Nevertheless, the data it
presents are suggestive of patterns of epistemic verb frequencies and use seen in PWDNI. The
LGSWE reports that the most frequent expression of stance—epistemic, attitudinal, and style—
within conversation is the use of that-complement clauses. LGSWE presents the following
example of an epistemic clausal construction plus an overt that clause: I really doubt [that the
check is there]. (conv) (1999, p. 966). The occurrence of specific mental verbs controlling the
most frequent that-complement clauses suggests a propensity toward epistemic stance marking
in the LGSWE data. The LGSWE reports the four most frequent verb controllers of that-clauses
in conversation to be think, say, know, and guess (Am English) (1999, p. 668). When considering
mental verbs controlling that-complements, the LGSWE reports know, think and guess as most
frequent (1999, p. 669).27
Here we again find similar verb choices for epistemic clausal
constructions noted by PWDNI and Kärkkäinen. Moreover, the adjective + complement clause
construction occurs far less frequently than verb + complement clause in LGSWE; occurrence of
adverbials to mark stance is intermediate (1999, pp. 979, 982). Thus, all three studies exhibit a
similar pattern for stance marking: adjectives < adverbials < clausal constructions.
One further observation warrants mention here. LGSWE notes that a “number of verbs
which collocate strongly with the negator not are particularly frequent in conversation. Notably,
these include mental verbs like: forget, know, mind, remember, think, want, worry” (1999, p.
159). In the PWDNI, the negated form accounts for the majority of all clausal construction uses
of know and remember (59% and 67%, respectively). In the example below, we see the use of a
negated form and non-negated form of the clausal construction I think:
27
The LGSWE reports that as controllers of that-complements the “verbs such as think, feel, and assume
convey a sense of possibility combined with uncertainty, while verbs such as know, find, and see convey a
definite sense of certainty” (1999, p. 666).
50
Ms. Yarrow: I don't think it’s okay,=I think that's bad.
The negated form is also quite common for clauses with think (28%). Kärkkäinen’s data also
show a pronounced usage of the negated form of know (81% negated) as compared with a lower
tendency to negate think (23%). I will return to a discussion of negators in Section 4.2.3.
4.1.5 Epistemic formulaic expressions
As stated earlier in this chapter, previous literature suggests that as persons experience
increased decrement due to neurocognitive disease, an increase in formulaic expression in their
talk is expected (Lindholm & Wray, 2011; Wray, 2010). In the data, however, I note only four
formulaic expressions that could be considered to convey epistemic stance. These four phrases
occur six times, accounting for less than 1% of the epistemic markers. The phrases I don't have
any idea and I'm lost each occurred twice; while I haven't a clue and I'm stuck are each uttered
once. Three of the six instances are used in a single, thirty minute transcript.28
4.1.6 Summary of comparisons
The preceding comparison of corpora to the twenty-five PWDNI conversations sought to
determine the degree to which PWDNI participants draw upon commonly used epistemic stance
markers reflective of naturally occurring conversation. All three corpora exhibit a similar pattern
for stance marking: adjectives < adverbials < clausal constructions. Additionally, in many cases,
the actual frequencies of lexical items are comparable. For instance, know and think are the top
two occurring mental verbs in the LGSWE conversation register, just as they are in both PWDNI
and Kärkkäinen. Similarly, the relative use of the most common lexical forms of adverbial stance
28
I have analyzed this transcript at length and originally intended to close my dissertation with it, but
owing to its complexity and length, I have set it aside for a future study. In some ways, it is, perhaps, the
most interesting among the data given the severe impairment of the person with dementia. I will say here
that the succession of formulaic expressions used suggests that they are working to give voice to a state of
confusion.
51
markers is quite consistent among the three studies. While epistemic adjectives occur more
frequently in my data than in the other studies, this may simply reflect their relative sparsity and
a normal variation in comparing one small data set to a larger one.29
These findings suggest that
the participants in my data are engaged in naturally occurring conversations that draw upon
resources commonly used to display epistemic stance. Thus, at least in terms of these resources,
the findings provide initial evidence that the participants in my data are engaging in back-and-
forth, interactive conversation comparable to conversations of presumably non-impaired
participants despite the fact that one of the participants in each of the interactions has a diagnosis
of dementia and the other participant is interacting with a participant with dementia.
As noted in the Section 4.1.4 on clausal constructions, there is a preponderance in the
PWDNI data of epistemic clausal markers collocated with negators. Additionally, there is an
increased variety in the lexical items used to display stance in the PWDNI; those displays
overwhelmingly denote uncertainty or insufficiencies in knowledge or memory, either
semantically (e.g., doubt, guess) and/or structurally (e.g., don’t know, can’t remember), that may
work to downgrade the epistemic claim of the proposition. The interactional analyses that follow
in Chapter 5 will show whether these resources do, indeed, work to downgrade the epistemic
claim. During the initial count of the data, it seemed clear that the participants with dementia
were using these phrases more frequently than their non-impaired co-participants. But this also
raised the question as to whether the forms and frequencies of other epistemic stance markers
also varied between these two populations, a consideration of which follows in the next section.
29
This statement holds true in comparing my data set to Kärkkäinen’s smaller sample size as well as in
comparing my relatively small data set to the much larger corpus in the LGSWE. Despite differences in
the overall frequencies, the relative frequency of each grammatical class is similar: clausal followed by
adverbs followed by adjectives.
52
4.2 Grammatical Classes and Frequencies of Epistemic Stance Markers: Comparing
Persons with Dementia to their Non-impaired Co-participants.
I want to stress here that the following will only quantify whether a difference exists in
the forms and frequencies of epistemic stance markers used by PWD and NI. Any difference that
might exist between the two groups could potentially be explained in several ways. For instance,
differences could suggest atypical usage on the part of persons with dementia. Alternatively,
something in the structure of the conversations could influence the emergence of different
linguistic resources. And, indeed, differences emerge. Potential explanations for those
differences warrant future interactional analyses.
A close comparison of the distribution of epistemic stance markers chosen by the
participants within the twenty-five conversations reveals general similarities in the use of
linguistic resources by the two subpopulations (see Table 4-8).
TABLE 4-8. USE OF EPISTEMIC STANCE MARKERS BY GRAMMATICAL CLASS:
PERSONS WITH DEMENTIA (PWD) AND NON-IMPAIRED (NI)
Class PWD NI
(# of cases with at least one occurrence)
Adjectives 12 14
Adverbials 19 20
Clausal
constructions
25 21
As can be inferred from the table, use of each class of epistemic stance marker occurs in roughly
similar proportions for both populations. The participants from each population also use various
types of adjectives and adverbs with similar frequency. A different picture emerges, however,
when we consider the frequency with which the participant groups use clausal constructions as
epistemic stance markers, over 69% of which are used by persons with dementia. This disparity
53
is accounted for almost entirely by a greater use of epistemic markers that are overtly marked
(i.e. collocated with negators) and/or semantically denote uncertainty or insufficient knowledge.
Such markers will henceforth be referred to as downgraders. I will return to a discussion of these
clausal constructions after first looking at these two populations with regard to the forms and
frequencies of the other epistemic stance markers.30
4.2.1 Epistemic stance adjectives
The use of adjectives as epistemic markers is fairly consistent within the two populations
(see Table 4-9). The apparent divergence between the two populations, which suggests greater
use of I'm sure and That's right in non-impaired co-participants, is mostly explained by two
outliers. One non-impaired co-participant uses that’s right/right seven times; another one uses
I’m sure six times. Aside from these two participants, any single stance adjective is used no more
than four times by any non-impaired co-participant and no more than three times by any
participant with dementia.
TABLE 4-9. USE OF EPISTEMIC STANCE MARKERS: STANCE ADJECTIVES
Type Frequency (# of occurrences)
Frequency (# of cases with at least one use)
PWD NI PWD NI
I’m sure 11 17 7 7
It’s true/true 8 7 5 3
That’s right/right 6 17 4 8
I’m not sure 4 3 4 2
TOTAL 29 44
4.2.2 Epistemic stance adverbials
The occurrence of stance adverbials, while more frequent than adjectives, is similarly
30
I omit the consideration of stance noun phrases because of the low prevalence in the PWDNI data set.
54
distributed (see Table 4-10). What at first seems to be a greater use by non-impaired co-
participants is largely mitigated when considering individual cases of excessive use. One non-
impaired speaker uses definitely seven times; two others each use really eight times (these three
examples account for over 27% of all adverbials used by NI). Setting aside these two adverbials,
all other epistemic adverbials match the pattern seen with adjectives: no single marker occurs
more than four times in any single non-impaired person’s speech and no more than three times in
the speech of participants with dementia. Moreover, each marker occurs in roughly the same
number of cases for each population, the absence of definitely from PWD being the exception.
For instance, maybe is used by eight persons with dementia and by seven non-impaired co-
participants. Taking these factors into consideration, the use of stance adverbials between the
two populations is very similar.
TABLE 4-10. USE OF EPISTEMIC STANCE MARKERS: STANCE ADVERBIALS
Type Frequency (# of occurrences)
Frequency (# of cases with at least one use)
PWD NI PWD NI
Really 19 33 11 12
Probably 13 15 7 11
Maybe 11 14 8 7
Sure 9 6 6 5
Of course 8 2 5 2
Actually 3 3 2 3
Certainly 2 1 2 1
Definitely 0 10 0 3
TOTAL 65 84
4.2.3 Epistemic clausal constructions
Participants with dementia use a wider variety of epistemic clausal constructions, and this
population uses them at a rate of 2.2 times that of their non-impaired co-participants (see Table
55
4-11). Of the 398 epistemic clausal constructions used within the twenty-five conversations,
participants diagnosed with dementia deploy 275, or over 69% of those epistemic clausal
constructions. Yet, there are important similarities and differences that need explication.
TABLE 4-11. USE OF EPISTEMIC STANCE MARKERS: CLAUSAL CONSTRUCTIONS
Type Frequency (number of occurrences)
Frequency (number of cases with at
least one use) PWD NI PWD NI
I don’t know 92 14 20 9
I think 49 31 21 10
I know 31 44 16 14
I don’t think 29 2 12 2
I don’t remember/recall 22 2 10 2
I guess 20 12 14 6
I forgot 6 3 4 3
I believe 5 0 5 0
I remember 5 7 4 4
I don’t understand 5 0 5 0
I imagine 4 0 4 0
I haven’t forgotten 2 0 2 0
I don’t believe 2 0 2 0
I doubt 2 0 2 0
I understand 1 8 1 6
TOTAL 275 123
On initial consideration, the use of I know between the two populations looks to be different;
however, 3 of the 50 participants account for 33% of all instances of I know. The remaining 47
participants use I know with similar frequency: NI with 26 instances and PWD with 25.31
A
distinct difference does, however, exist between the two populations use of I don’t know. High
31
Two non-impaired participants use the phrase eight and eleven times, respectively. No other non-
impaired person exceeds five uses, with the average for the remaining 23 being 1.1 uses per person. One
person with dementia uses I know six times; no other PWD exceeds four, with the average for the
remaining 24 being 1.0 uses per person.
56
frequency repetition of I don’t know occurs by five participants with dementia, ranging from 8 to
12 occurrences. Moreover, 80% of the PWD subjects use the phrase at least once. In contrast,
only 36% of the NI subjects invoke it. Within the talk of non-impaired participants, the most
frequent use of I don’t know is three occurrences for two cases; for the eight additional non-
impaired participants who use I don’t know, a single occurrence is noted in six cases and two
occurrences are noted in one other case. No other clausal construction displays exceptional
repetitive use by any individual participant from either group. In fact, the frequency of all other
epistemic clausal constructions within individual participants’ talk is no more than six times in
any conversation.
Earlier, I drew attention to the use of downgraders, epistemic markers that are overtly
marked (i.e. collocated with negators) and/or semantically denote uncertainty or insufficient
knowledge. I first present an example of a downgrader that is collocated with a negator:
Ms. Yarrow: I don't remember.
The next example semantically denotes uncertainty or insufficient knowledge:
Mr. Wilken: Well, She:'s at her room,I guess.
Below we can see that the use of epistemic clausal constructions that are syntactically
and/or semantically marked to denote uncertainty or insufficient knowledge are more frequent in
the talk of persons of dementia (see Table 4-12).
57
TABLE 4-12. EPISTEMIC CLAUSAL CONSTRUCTIONS MARKED FOR
UNCERTAINTY OR INSUFFICIENT KNOWLEDGE
Type Number of cases with at least one use
PWD NI
I don’t know 20 9
I don’t think 12 2
I don’t remember/recall 10 2
I guess 14 6
I forgot 4 3
I don’t understand 5 0
I don’t believe 2 0
I doubt 2 0
Not only do persons with dementia use more downgraders than do their non-impaired co-
participants, they use them at a much higher rate. As derived from Table 4-11, the PWD group
uses downgraders for nearly 65% of their clausal constructions, and the NI subjects only 27%. In
terms of absolute numbers, persons with dementia downgrade 178 clausal constructions, their co-
participants 33. Moreover, for those subjects of either group who use downgraders, the most
marked difference between the groups is for the use of I don’t know (see Table 4-13).
58
TABLE 4-13. USE OF EPISTEMIC CLAUSAL CONSTRUCTIONS MARKED FOR
UNCERTAINTY OR INSUFFICIENT KNOWLEDGE (AVERAGE PER SUBJECT)
Type Total # of occurrences
# of cases with at least one use
PWD NI
I don’t know 4.6 1.6
I don’t think 2.4 1.0
I don’t remember/recall 2.2 1.0
I guess 1.4 2.0
I forgot 1.5 1.0
I don’t understand 1.0 0
I don’t believe 1.0 0
I doubt 1.0 0
4.2.4 Complexity of linguistic patterns of epistemic clausal constructions
Clinical experience informs us that persons with dementia retain general syntactic
competence until late stages of the disease (Kempler, 1995), while experimental research
suggests subtle changes to the linguistic system at all stages of the disease (Bayles, Tomoeda, &
Trosset, 1992). As the persons in my study have dementia ranging from moderate to late stages,
and given the frequent use of clausal constructions by both PWD and NI, the data present an
opportunity to investigate whether there were any simplifications of syntax in PWD relative to
that of NI during naturally-occurring conversations. In the context of clausal constructions, from
a linguistic perspective, simplification could be noted by the use of epistemic constructions that
are not integrated within larger syntactic units. For instance, we might expect an increase of
either standalone or parenthetical positioning of epistemic clausal constructions, an example of
the latter illustrated below:
Ms. Walton: Um, when George was here there were, I, we, we- we were wild
ducks I guess t’each other.
59
Such simplification could be indicative of increasing decrement.
Given the distinct differences in the frequency of epistemic clausal constructions
deployed between the two participant groups (who were, indeed, interacting with one another), I
conduct a more nuanced investigation of those differences. As stated earlier, participants
diagnosed with dementia produce epistemic clausal constructions, in general, at a rate of over 2.2
times that of their non-impaired co-participants. While both populations favor the use of
epistemic clausal constructions that take overt complements, participants with dementia use
standalone and/or ellipsed clausal constructions at a slightly higher frequency (see Table 4-14).
TABLE 4-14. SYNTACTIC COMPLEXITY OF EPISTEMIC CLAUSAL CONSTRUCTIONS
Type Frequency (# of occurrences)
Frequency (% of clausal constructions)
PWD NI PWD NI
Complement taking 190 94 69.1 76.4
Intra-turn medial 6 3 2.2 2.4
Stand alone 54 18 19.6 14.6
Intra-turn final 25 8 9.1 6.5
TOTAL 275 123 100 100
In my initial attempt to understand these differences, the following questions are pursued.
First, is the nearly double production of epistemic clausal constructions an artifact of more talk;
that is, do the participants with dementia simply produce more words in these conversations?
Second, is there something about the syntactic environment, specifically, the preceding co-
participant utterance, that would explain the increased production of epistemic clausal
constructions by persons with dementia? Relatedly, is there something about that syntactic
environment that would explain the use of epistemic clausal constructions that controlled overt
complements as compared to the use of standalone (ellipsed) clausal constructions? Next, I look
to see whether there is evidence either of palilalia (e.g., I don’t know. I just don’t know) or of the
60
doubling up of different epistemic clausal constructions (e.g., I don’t know. I don’t remember).32
Finally, I examine the co-participants’ use of epistemic clausal constructions in the near vicinity
of those produced by participants with dementia to see whether there is evidence of echolalia.33
Of the 33,250 words in the PWDNI corpus, participants with dementia produced 17,999
and their non-impaired co-participants produced 15,251. The frequency of epistemic clausal
verbs for participants with dementia occurs 1 in every 65 words; whereas the frequency of
epistemic clausal verbs in the talk of non-impaired participants occurs only 1 in every 124 words.
Taking into consideration the slightly increased word usage by persons with dementia, the rate of
epistemic clausal constructions remains at a nearly 2:1 ratio. Sheer number of words uttered do
not account for the greater frequency of epistemic clausal verbs in the talk of participants
diagnosed with dementia.
Next, I investigate the structure of talk in the vicinity of the epistemic clausal
constructions. Two syntactic environments appear associated with the use of epistemic clausal
constructions by persons with dementia. The first relates to questions asked by the co-participant.
Over 31% of clausal constructions used by persons with dementia are in response to questions.
Moreover, over 55% of the standalone clausal constructions occur in response to questions,
whereas only 20% of the complement taking clausal constructions do (although it is noted that
there are far more complement taking clausal constructions in the data).
Tina: Are you waiting for breakfast?
(0.9)
Ms. Mason: ˚I don't know.˚
32
Palilalia is the “perseverative repetition of syllables, words, or phrases occurring at the end of an
utterance that interrupts the flow of speech” (Loring & Bowden, 2015). 33
Echolalia is the “perseverative, involuntary repetition of another person’s speech” (Loring & Bowden,
2015).
61
As noted earlier, clausal constructions, particularly of a standalone variety, are used at a higher
frequency in persons with dementia. If there is, indeed, a propensity to use these clausal
constructions in response to questions, then an increase in the number of questions asked of them
would increase the number of clausal constructions used by persons with dementia. Thus, the
more frequent use could be an artifact of the structure of the conversation, a point I address
further in the discussion section of this chapter.
The second issue I note is that 37% of clausal constructions used by persons with
dementia occur within the streams of declarative sentences that constitute stories or narratives,
particularly before or after noun phrases, e.g., proper names, common nouns, time references,
etc.
Mr. Wheelock: so I'd just said you know what's going on. so we went down to
uh Puerto Rico,pulled in there and we stayed I think four
days,
While non-impaired participants also saw a similarly frequent use of clausal
constructions in narrative (38%), one significant difference between the two populations is in the
syntagmatic placement of the epistemic clausal constructions. Non-impaired co-participants
seem to favor turn initial placement almost exclusively, whereas participants with dementia often
place the epistemic clausal constructions in medial position. Moreover, the placement of
epistemic clausal constructions that appeared to denote uncertainty or insufficient knowledge is
often seen, for example, to precede or follow noun phrases. No other syntactic patterns are noted
that might help explain the frequency of clausal construction use. A closer investigation of
epistemic clausal constructions that are both integrated (i.e., complement-taking) and non-
integrated (independent) within the larger syntactic units of talk by participants with dementia
talk is further explored in Chapter 5. Finally, twelve occurrences of repetition of epistemic
62
clausal constructions occur in the talk of persons with dementia; for comparison, four instances
of repetition of an epistemic clausal construction are present in the talk of non-impaired
participants. Finally, no instances are found in which participants with dementia seem to be
reusing the epistemic clausal structures in the preceding turns of their co-participants. Thus, there
is no evidence either of echolalia or widespread palilalia.
4.3 Discussion
In this chapter I provide a detailed characterization of the forms and frequencies of
epistemic stance markers, forms classified as such within traditional approaches to linguistics,
that emerge in naturally-occurring conversations between participants with dementia and their
non-impaired co-participants. In Section 4.1, I compare those forms and frequencies to two
corpora that capture the naturally occurring use of these epistemic stance markers within
conversations of presumably non-impaired persons. This allows me to query the degree to which
the participants in my data are drawing upon resources commonly used to display epistemic
stance. In other words, do they fit patterns of use in conversations reported in the corpora
findings? No atypical patterns in types or frequencies are noted, but rather the hierarchy of types
and frequency appear consistent for all three studies. Specifically, the conversation participants
in my data prefer epistemic clausal constructions (e.g., I know, I think, I guess); with adverbials
(e.g., maybe, probably) occurring next at about one-fifth the frequency; and adjectives (e.g.,
sure, true) occurring third, at one-eighth the frequency.
The consistency with which these linguistic resources are present and similarly used
across all three studies raises some general points about these linguistic structures. Most notably,
the fact that epistemic clausal constructions are the most frequently occurring of all epistemic
stance markers across corpora suggests they are the most economical and effective means for
63
conveying epistemic stance for (American) English speakers—if, in fact, that is the actual
function they are performing.34
One reason may be, as noted by Biber, that the marking of stance
through different grammatical structures lies along a semantic cline in which the personal
pronoun plus a mental verb conveys the strongest epistemic claims, with other forms having
increasingly less epistemic force: adverbials and adjectives followed by modal verbs (1999, p.
970). Additionally, the data show that for any given utterance a speaker may choose from several
different places within his/her utterance to use an epistemic clausal construction: turn initial,
medial, turn final, or as a standalone utterance. This distributional flexibility offers a slightly
greater choice than adverbials and greater choice still than adjectives. Also, this distributional
flexibility suggests possible syntagmatic and paradigmatic relationships that may have functional
significance. For example, the placement of epistemic clausal constructions within their stream
of talk by persons with dementia reveals a possible link between syntactic elements within the
narratives structures of storytelling. The possibility of syntagmatic and paradigmatic
relationships warrants further investigation, which is outside the scope of the current study.
The distributional flexibility of epistemic clausal constructions may also lend support for
the idea that these collocations—those comprised of a personal pronoun plus a mental verb with
or without a negator—are undergoing grammaticalization (Hopper & Thompson, 1993;
Kärkkäinen, 2003; Thompson & Mulac, 1991). The theory posits that through frequency of use,
linguistic items become routinized in the language which may result in a reduction of their
grammatical status, quite possibly to functional or near functional categories. In this process, the
equality between like grammatical elements, in this case between the two clausal structures,
becomes broken (Haiman, 1991). Such parataxis results in certain epistemic clausal
constructions being reassigned roles within the sentence structure, something less than that of
34
The interactional analyses that follow in Chapter 5 will identify the actual functions.
64
full clausal status. This weakening affords the epistemic ‘clausal’ structure the flexibility to
embed within the main proposition or (stronger) clausal construction, in medial position, or to be
deployed at the edges of it (initial or final). Often, with grammaticalization a semantic
weakening, or bleaching, occurs along with phonological weakening35
as different functions
emerge. Hopper and Thompson have presented strong evidence for the grammaticalization of
epistemic clausal structures such as I think and I guess; this process may be taking place, or has
taken place, for collocations such as I don’t know. This possibility warrants a close analysis of
the actual function(s) these clauses are performing within interaction.
Returning to my main investigation as reported in Section 4.2, I examine and compare the
two distinct groups represented in my data—persons with dementia (PWD) and non-impaired co-
participants (NI)—in order to determine whether the forms and/or frequencies of epistemic
stance markers differ between the two groups. This comparison sought to document any
differences in the use and frequency that might highlight atypicality in persons with dementia,
possibly as an indicator of linguistic decrement due to disease. From this investigation, a clearer
picture of typical and atypical patterns emerges. Although few differences are found in the forms
and frequencies of less common types of epistemic stance markers (e.g., noun phrases,
participles, adjectives), greater differences exist between the frequency of use for the more
common types of epistemic markers (e.g., adverbials, clausal constructions). Yet, the
distributional relationships among the grammatical forms of epistemic markers for the two
populations remain roughly the same in terms of use: adjectives < adverbials < clausal
constructions. These findings show no decline in the use of epistemic stance markers for the
impaired participants who reside in an assisted living facility and are categorized in the database
35
Phonological weakening, however, was not evident in the utterances of I don’t know used by
participants with dementia.
65
as presenting with mild to severe dementia.36
This finding contrasts with Irigaray’s finding that
her dementia patients did not use expressions conveying stance toward their propositions (1973).
Correspondingly, it both supports and expands the observations made by Hamilton in her
longitudinal study of a single Alzheimer’s patient. Hamilton observed that her subject Elsie’s use
of epistemic stance markers appeared resilient until she entered the late stages of dementia
(1994). Likewise, Shakespeare reported the presence of such linguistic devices, though not
clearly labeled as epistemic stance markers, within the speech of dementia patients who were
moderately but not severely affected; these devices functioned as face-saving devices that were
often mobilized to enlist the help of knowing participants during moments of confusion (1998).
While no claim is made in this chapter as to the function(s) of epistemic clausal constructions
within interaction, the range of epistemic markers and the frequency of their use across all
twenty-five participants with dementia, whose conditions range from mild to severe, suggests
that the ability to deploy epistemic stance devices may, for many persons, remain available well
into the late stages of disease.
More striking are the differences in the frequency with which participants with dementia
use epistemic clausal constructions as compared to their non-impaired co-participants. The
patterns that emerge in the data are demarcated across the line of neurological health. First, the
frequency for which all forms of epistemic clausal constructions are deployed in the speech of
participants with dementia proves over twice that of the non-impaired co-participants. Moreover,
the use of downgraders occurs at a frequency over five times that deployed by their non-impaired
36
Carolina Conversations Collection (CCC) http://carolinaconversations.musc.edu/about. See also Davis,
2005.
66
co-participants.37
I pursue several avenues of potential explanation in the structure of talk itself
that might explain these differences.
Adjusting for differences in the quantity of talk between the participant groups provides
evidence that the increased frequency of epistemic stance markers is not an epiphenomenon of
increased talk by persons with dementia. Moreover, as the persons with dementia do not talk a
great deal more than their co-participants (54% vs 46% of all words spoken), this also suggests
that verbosity, a clinically-recognized symptom for some dementia patients, does not likely
account for the increased production of epistemic clausal stance markers. While there is limited
repetition of phrases in the speech of participants with dementia, this shows no propensity for
palilalia—individuals did not repeatedly reuse the same epistemic clausal constructions.
Similarly, participants with dementia do not show evidence of echolalia. They do not repeat or
reuse the epistemic clausal constructions used in the preceding turns of their co-participants.
Examining the syntagmatic pattern of epistemic clausal constructions deployed by
persons with dementia suggests a possible reason for their two-fold higher use of epistemic
clausal constructions when compared to their non-impaired co-participants. Put simply, they tend
to use clausal constructions in response to questions, and their co-participants ask them a lot of
questions.38
Specifically, non-impaired co-participants often take an interviewer-type role within
the interaction. The elevated use of epistemic clausal constructions by persons with dementia
may thus be, at least in part, an artifact of the interaction. This possibility warrants closer
investigation. However, such a study would entail an extensive quantification and analysis of the
types of questions asked and the nature of the responses given by both groups. This is beyond the
scope of the present study, but part of the motivation for the present study is to lay groundwork
37
Curiously, for both participant groups, adjectives are designed as claims of certainty or assurance of
knowledge. 38
Persons with dementia, in this study, in turn, ask relatively few questions of their co-participants.
67
for precisely this type of future research. Additionally, as it is noted that persons with dementia
use epistemic clausal constructions within declarative statements forming the narrative structures
of stories about as frequently as they do in response to questions, future work should address the
functions of epistemic stance markers in such sequential positions from an interactional
perspective.
Of all the epistemic stance markers noted in this chapter, participants’ with dementia
overwhelmingly favor the use of the epistemic clausal construction I don’t know. This single
phrase accounts for 24% of all stance markers used by persons with dementia. They produce I
don’t know twice as often as any other epistemic clausal construction and nearly three times as
often as their non-impaired co-participants. While this finding strikes one as unsurprising given
the presumed memory difficulties of this group, the actual function(s) of I don’t know in the
interactions between persons with dementia and their non-impaired co-participants remains
unclear without detailed interactional analysis. The next chapter will thus focus on this particular
epistemic stance marker and examine through conversation analytic methods the functions of I
don’t know as deployed by participants with dementia, how this epistemic clausal construction is
oriented to by non-impaired participants, and how the sequences of I don’t know affect the
progressivity of talk for the participants.
I set out in this chapter to use descriptive quantitative methods to bring into relief any
differences in use regarding the forms and frequencies of epistemic stance markers within the
conversations between participants with dementia and their non-impaired co-participants. By
first comparing the forms and frequencies of epistemic stance markers that occurred in my
overall data set to corpora findings, I found that the conversations in my data set, by and large, fit
common patterns for naturally occurring conversation.
68
A second goal is to document any differences in the use and frequency between the
participants with dementia and their non-impaired co-participants that might highlight
atypicality, possibly as an indicator of linguistic decrement due to disease or a structural artifact
of the interaction. During this closer look into the use and frequencies of those markers between
the participants in my data, I find differences in both the forms and the frequency used by the
two populations. Most notably, epistemic clausal constructions are used at a much greater
frequency by participants with dementia than by their co-participants. In particular, epistemic
clausal constructions that might denote uncertainty or insufficient knowledge are used at a
greater frequency by the participants with dementia, with the clausal construction I don’t know
being, by far, the most frequently used. The quantification in this chapter allows identification of
both the most commonly and least commonly used linguistic resources and of both typical and
seemingly atypical uses, thus presenting valuable targets for—and allowing informed
prioritization of—this and future investigation.
This investigation so far leaves unanswered, however, the question of how the epistemic
stance clausal markers actually functioned between the participants. That is, are epistemic stance
markers such as I don’t know displaying claims of uncertainty or insufficient knowledge? Are
they doing other functions in these interactions?
To investigate what function(s) epistemic stance marker are performing within the
conversations between participants with dementia and their non-impaired co-participants, a
different approach is required. In Chapter 5, I move to an interactional analysis that explicates
the functions of I don’t know, the most frequently used marker. Specifically, through sequential
analysis of the turns of talk by persons with dementia and their co-participants, I examine how
various actions (e.g., questions, narratives) and design—syntax and prosody—of both of the
69
participants jointly work in establishing the particular function(s) a given utterance of I don’t
know has in that moment of the interaction. I will pay particular attention to the orientation of the
non-impaired co-participant to each I don’t know utterance in determining the function, or work,
the I don’t know is doing in the conversation.
70
CHAPTER 5
Functions of I don’t know in the Talk of Persons with Dementia
5.0 Introduction
Chapter 4 reported the forms and frequency of epistemic stance markers in the talk of
persons diagnosed with dementia of the probable Alzheimer’s type. Those findings revealed that
persons with dementia, like non-impaired speakers, use epistemic clauses (e.g., I guess, I think)
more frequently than other grammatical structures associated with conveying stance, such as
adverbials and adjectives. Yet, persons with dementia use such clauses at a frequency twice that
of their co-participants and their use of the clause I don’t know is nearly three times greater.
Given the meaning of I don’t know, and given the presumed memory difficulties of participants
with dementia, this frequent usage is unsurprising. However, as I will show in this chapter,
persons with dementia also use the clause I don’t know in many ways other than to display
epistemic stance.
Throughout this chapter, I document what preceding talk or action occasions each
excerpted instance of I don’t know, address the effect(s) of its syntactic and turn composition,
and emphasize co-participant orientations to the I don’t know as evidence for potential
function.39
While the primary purpose of this chapter is to present an analysis of the functions of
I don’t know utterances as they are used by persons with dementia, I also compare my findings to
functions noted in the existing literature for presumably non-impaired co-participants engaged in
mundane conversations, and, at times, I present evidence of the functions of I don’t know from
39
Like many discourse and interactional researchers, I consider all syntactic and turn compositions of I
don’t know that occur within the data. I present a thorough discussion of both the syntactic and turn
compositions of I don’t know and my rationale for this decision in Chapter 3.
71
the talk of non-impaired co-participants within my data collection.40
This allows me to assess
whether the interactional work being done by I don’t know in the talk of persons with dementia
can be considered common to that of the general population. As I will establish in this chapter,
persons with dementia use I don’t know in much the same way as non-impaired persons when
displaying epistemic stance, managing their talk (i.e. sequential organization of talk, such as
closing or initiating topics), and negotiating actions such as disagreeing with co-participants.
Beyond providing additional evidence for these already established functions for I don’t
know, I present previously unreported functions. First, I look at a mechanism that is at work
within sequence management in which persons with dementia in my data use a complement-
taking I don’t know utterance as a first-pair part to initiate an action that I call a “wondering”. I
also present evidence of I don’t know being used in American English in response to
compliments to minimize a co-participant's positive assessment. While the systematic preference
for disagreement in responses to compliments was reported by Pomerantz (1978), the use of I
don't know in such responses is a phenomenon previously reported only for British English
(Diani, 2004; Grant, 2010) and New Zealand English (Grant, 2010).
I have divided the chapter into sections that each highlight a single function of I don’t
know; however, as will become clear, any given I don’t know utterance can be a vehicle or
format for getting more than one action done. In Section 5.1, I present I don’t know utterances
that work to display epistemic stance and are oriented to by the co-participant as doing such
work. Section 5.2 examines the use of I don’t know in sequence management, both to initiate and
to either shift away from or close sequences. Section 5.3 illustrates uses of I don’t know to
manage preference. In Section 5.4, I conclude the chapter with a discussion of the findings.
40
In my analyses, I will focus on the use of I don’t know by the persons with dementia and not by their
non-impaired co-participants, unless noted otherwise.
72
Overall, they suggest that persons with moderate to severe dementia of the Alzheimer’s type can
retain competent linguistic, interactional, and pragmatic use of I don’t know (IDK).
5.1 Knowledge Displays
In this first section, I examine a single, representative case to illustrate how IDK
utterances assert the speaker’s epistemic stance. I will show how IDK utterances can be used by
a person with dementia to reflect an actual lack of knowledge or an uncertainty about the topic at
hand. In the below excerpt (1), the person with dementia uses three IDK utterances. The
epistemic function of each of these is seen through the sequential positioning, the syntactic
construction, on-record displays of remembering, and the co-participant’s orientation, part of
which includes another IDK utterance. The extended analysis below will step through a
consideration of each of these. Excerpt (1) begins with Emily asking a question as to the identity
of the person who cleans Mr. Wilken’s room. Her question contains a candidate answer, a name
of a woman that she references from a previous conversation they had (line 176, below). In
response to Emily’s question, Mr. Wilken uses the indexical that to reference a note which
should both confirm the cleaning of the room and identify the person who cleaned it: “that’ll say
who it was” (line 177).41
(1) WKD 001 (05:46 Eloise)
176 Emily: Was it Eloise? you mentioned Eloise usually does it?
177 Mr. WKD: But that'll say who it was. I can't read it.
178 I generally let Marilyn read it.
179 Emily: It says B, F.
180 Mr. WKD: It says what?
181 Emily: B, F. would it be best friend? I don't- do you know anyone
41
Without video it is impossible to know whether Mr. Wilken is referencing the note by pointing, by his
gaze, or through some other embodied manner.
73
182 B, F? their initials?
183 Mr. WKD: No. B, F. B, F.
184 Emily: Um hmm.
185 Mr. WKD: I don't- (.) know. let's see, her name is: um, Elo- yeah,
186 Eloise, I don't know.
187 Emily: I don't know.
188 Mr. WKD: Oh, I heard another girl sometimes that cleans it, named
189 Nina. uh, I don't- I don't e:ven know her last name.
190 but it gets cleaned every Wednesday.
191 Emily: Every Wednesday.
192 Mr. WKD: Yeah.
193 Emily: It looks, it looks nice.
Let us consider Mr. Wilken’s use of IDK, looking closely at the sequential context to arrive at an
interpretation of the functions. In his first turn construction unit (TCU),42
Mr. Wilken issues what
could be hearable as a tacit directive, line 177, “but that'll say who it was.” that requests Emily to
retrieve the note and read it. His next unit supports this interpretation as he softens the
imposition, the dispreferred action of his request, with an account justifying his request,
specifically, that he is unable to read the note himself, “I can't read it.” (line 177).43
Mr. Wilken
extends this turn with a further unit of accounting, “I generally let Marilyn read it.” (line 178).
Mr. Wilken’s request deploys regular, documented practices that operate tacitly to direct his
42
“Turns are thus incrementally built out of a succession of turn-constructional units (henceforth TCUs),
such as sentences, clauses, phrases, and individual words. Each TCU is a coherent and self-contained
utterance, recognizable in context as ‘possibly complete’. Each TCU’s completion establishes a
transition-relevance place (henceforth TRP or transition space for short) where a change of speakership
becomes a salient possibility that may or may not be realized at any particular TRP” (Clayman, 2013, p.
151). See also Chapter 3 for additional description of the relevance of TCUs. 43
In conversation analytic terminology when speakers provide on-record reasons for what they know or
what they do the term “account” is used to describe the work that such verbal displays are doing (Psathas,
1995, p. 14). The action of giving an account within interaction is related to the larger notion that talk,
like other human/social actions, is morally accountable (see Heritage & Clayman, 2010, p. 15; Stivers,
Mondada, & Steensig, 2011).
74
recipient (Antaki & Kent, 2012; Ervin-Tripp, 1976; M. H. Goodwin, 1990, 2006). These
practices evidence Mr. Wilken's interactional competence for issuing directives or negotiating
requests.
Emily’s response indicates that she has immediately complied with Mr. Wilken’s request:
“It says B, F.” (line 179). To this, Mr. Wilken initiates repair, “It says what?” (line 180), in
which he momentarily halts the progression of the talk to address some interactional trouble
(Schegloff, Jefferson, & Sacks, 1977), which is often due to hearing, or the speaker’s use of a
wrong word, or a misspeak that impacts the recipient’s understanding (Schegloff, 1987, p. 210).
Emily next responds with an attempt to address any such potential problems, the trouble source,
by producing a repeat followed by a candidate answer: “B, F. would it be best friend?” (line
181). At lines 181-182, she initiates a next utterance but cuts off this first attempt. In her self-
repair of that continuing turn, she issues an expansion of the sequence, another first-pair part,
that is comprised of two subsequent questions, “I don't- do you know anyone B, F? their
initials?”. It is here that the epistemic negotiation begins.
Emily’s initiation of this question-answer sequence places the burden of responding with
confirmation or disagreement squarely within Mr. Wilken’s epistemic territory. At line 183, Mr.
Wilken makes a first attempt to provide the information that Emily’s question requests, the
cleaner’s identity, “do you know anyone B, F?” (lines 181-182). He responds with a negative
token, but he repeats the initials twice, “No. B, F. B, F.” (line 183). This repetition seems to do
the action of an on-record attempt at remembering. Emily provides the minimal receipt token
“Um hmm.” (line 184) that both confirms her acceptance of his inability to produce the identity
75
of "B. F." and also works as a continuer (Schegloff, 1982), encouraging Mr. Wilken to go ahead
with an expansion of his talk.44
At this point, line 185, Mr. Wilken initiates a turn with his first IDK, an explicit claim of
insufficient knowledge. His turn composition echoes the structure of Emily’s turn construction:
“do you know” (line 181) that quite fittingly becomes “I don’t- (.) know.” (line 185). Although
his IDK utterance displays some difficulty in its formulation as seen in the micropause after
“don’t”, the utterance demonstrates the coherence of Mr. Wilken’s response with the action put
into play through Emily’s question. Mr. Wilken ends this utterance with falling intonation, which
is generally associated with turn completion (Ford & Thompson, 1996; Local, Kelly, & Wells,
1986). His turn can be heard as doing confirming work that he, indeed, does not know who "B.
F." is. However, he does not end his turn after this TCU but rather immediately continues, in line
185, with what seems to be another on-record attempt at remembering the cleaner’s identity:
“let’s see,”.
In addition to the sequential positioning and syntactic construction that evidence the
epistemic function of the IDK utterances, we also see further evidence in Mr. Wilken’s on-record
attempts at remembering. He continues by formulating the name of another cleaning staff, a
name that he seems to be remembering as the turn unfolds: “her name is: um, Elo- yeah, Eloise,”
(lines 185-186). He hesitates (“um”), cuts off his first attempt at the name (“Elo-”), but then he
produces the full name in his repair solution (“Eloise”) (lines 185-186). Although Mr. Wilken
offers this name on his own here, he is also reusing the candidate name Emily offered when she
initiated this topic (line 176). His reuse of Emily’s candidate name, a name that does not match
the initials B. F., suggests that he cannot recall or does not know (at this moment) the person
who is responsible for cleaning his room. However, without marking either his search or turn
44
This could also be characterized as “doing remembering”.
76
complete with turn final prosody (Ford & Thompson, 1996; Selting, 1996), Mr. Wilken, instead,
attenuates the solution item “Eloise” by ending with an IDK utterance in turn final position (line
186). This turn final IDK both marks and emphasizes the discrepancy between the cleaner’s
identity he seems to recall, “Eloise”, and the initials on the note, “B. F”, he can't place.
Turning to a consideration of the co-participant’s orientation, we see at line 187 that
Emily next produces a stand-alone, syntactically independent IDK utterance. By showing
support of Mr. Wilken’s stance, as well as a shared experience of not knowing, Emily’s
repetition of the IDK utterance may acknowledge the question-answer sequence she initiated has
been sufficiently addressed; her IDK utterance may, then, work as a bid to close this topic and
exit this sequence.45
At line 188, Mr. Wilken, however, continues the topic with a multi-unit turn in which he
offers another possible route to disambiguate the B. F. initials. He introduces the name of another
cleaner, “Oh, I heard another girl sometimes that cleans it, named Nina.” (lines 188-189) to
which he adds, “uh, I don’t- I don’t e:ven know her last name.” (line 189). By adding a new
claim of insufficient knowledge through this IDK utterance plus noun phrase complement, he
asserts what would be taken to qualify as minimal knowledge about another person in this
context (i.e. a rather formal or institutional one). Additionally, he qualifies his knowledge claim
with the adverb even. His articulation of even further emphasizes the extent of his lack of
knowledge through the sound stretch on the vowel in the first syllable (the stressed one) of that
word: “I don’t e:ven know her last name.” (line 189). This intensifies his claim of insufficient
knowledge and seems to provide additional evidence of the problem, that of identifying a person
by initials alone when he does not always know the staff’s surnames.
45
Since there is no expectation that she would know the names of the cleaning staff, the IDK utterance
works to affiliate with Mr. Wilken; that is, Emily’s IDK utterance claims access to and displays an
understanding of Mr. Wilken’s stance (Stivers, 2008).
77
In line 190, Mr. Wilken shifts the topic away from the identity of the person who cleaned
his room to a tangential one, when the room gets cleaned: “but it gets cleaned every
Wednesday.” In line 191, Emily responds by repeating this information, “Every Wednesday.”.
Emily’s repeat response works to acknowledge and accept the shift to this tangential topic. In
doing so, she and Mr. Wilken jointly navigate closure of the question-answer sequence that
pursued the cleaner’s identity without having arrived at an answer. As Emily and Mr. Wilken
move further away from the topic of the cleaner’s identity, they continue their talk with positive
assessments of the room’s cleanliness (line 193ff) before Emily initiates a fully unrelated topic.
In sum, in the excerpt above, the IDK utterances used by the person with dementia appear
to reflect an actual lack of knowledge or an uncertainty about the topic at hand. The first two
IDK utterances are occasioned by the structural environment in which a knowledge claim is the
focus: that is, an elaboration of an answer to an information-seeking question. Additionally, the
syntactic structure of these two IDK utterances reflects coherence with the question asked: Do
you know has become I don’t know. The third IDK utterance (by the person with dementia)
draws upon its syntactic construction (composition) as a complement-taking IDK utterance to
support its work as a display of epistemic stance. The noun phrase complement indexes the
knowledge that is lacking (i.e. a person’s last name). Additional practices of self-repairs and
word searches (Schegloff, Jefferson, & Sacks, 1977) that display the speaker’s on-record
attempts to recall the missing information (i.e. let's see, her name is: um, Elo-) provide additional
support that the IDK utterances are displaying epistemic stance. Thus, the sequential positioning
and/or the syntactic construction of the IDK utterances along with on-record attempts to recall
information give the non-impaired co-participant (and us) insight into what, precisely, is the
object of uncertainty or missing knowledge.
78
The co-participant’s orientation to the IDK utterances provides further evidence of the
epistemic work being done by those utterances. The co-participant’s acknowledgement and
acceptance of the speaker’s IDK utterances as displaying his lack of knowledge are shown in her
affiliative IDK utterance that claims access to and understanding of his stance. Additionally, her
participation in the shift from the topic for which the missing information was the focus to a
tangential topic displays her acceptance that the IDK utterances—Mr. Wilken’s and her own—
work to sufficiently close the question-answer sequence she has initiated. Overall, this joint
negotiation of epistemic stance highlights the interactional competence of the person with
dementia as he converses with his non-impaired co-participant.
With reference to my methodology and presentation, I should note that while I derive my
conclusions above (and throughout this chapter) about the work that IDK utterances are doing in
conversation by a close analysis of my data from interactions between persons with dementia and
their non-impaired interlocutors, other researchers have identified this knowledge function of I
don’t know in presumably non-impaired populations. Tsui (1991), for example, discusses I don’t
know as a claim of uncertainty. I present her single example below:
(Tsui, 1991, p. 607)
A: Where is John?
B: I don’t know.
Tsui states that the I don’t know functions here to reveal the speaker’s inability to provide
information. Beach and Metzger (1997) provide us another example, as below:
[SDCL: Yeah Bros: 242-245] (Beach & Metzger, 1997, p. 568)
C: [Are they] gonna have a full complement of s- of subjects and stuff? er:
B: U:m:, (.) I couldn’t tell you that either. (.) I don’t know.
79
Beach and Metzger discuss how the I don’t know is produced after an inquiry. In the response,
the second speaker (B) produces other talk that supports his/her claim of insufficient knowledge.
Together, the claim and the additional information provided by the speaker demonstrate, or
display, the speaker’s lack of knowledge (1997, p. 568). Neither Tsui nor Beach and Metzger,
however, provide additional transcript evidence showing how the co-participants treat the
knowledge claims. They stop at the turn in which the I don’t know utterance occurs and do not
pursue how it may or may not be further worked out in the talk. While it may be that they
considered co-participant orientation in forming their conclusions, their lack of reporting co-
participant responses makes it difficult at times to assess fully their methods of analysis, their
data and ultimately, their claims.
5.2 Sequence Management
In my analysis of excerpt (1), I mentioned that Emily’s standalone IDK utterance could
be a bid to close the sequence. In this section, I pursue that observation and show how IDK
utterances operate in sequence management, that is, in managing the actions that are enacted
through the coherent, orderly and meaningful successions of turns-at-talk (Schegloff, 2007, p. 2).
IDK utterances in the talk of persons with dementia, like in the talk of non-impaired persons,
allow participants to jointly manage the exiting of a sequence. Somewhat less frequently, an IDK
utterance initiates a sequence, and when doing so, the IDK utterance is generally in the service of
managing a topic. I want to emphasize here that any given use of an IDK utterance may be doing
something in addition to initiating or closing a sequence. It could, for instance, be displaying
epistemic stance. Or a given use could also be negotiating preference constraints, which I will
address more fully in Section 5.3. That is, any given IDK utterance can be a vehicle or format for
getting more than one action done. So, while my emphasis in this section is on sequence
80
management, I am not claiming that sequence management is the sole function of IDK utterances
in these examples. Indeed, given both the semantic content and various types of work being done
through or in part by an IDK utterance, it is sometimes difficult to divorce consideration of one
function from other potential functions. I illustrate this complexity in discussing two sequences
in which complement-taking IDK utterances work to manage topics through an action that I call
a “wondering”. The examples in this section demonstrate that in terms of sequence management,
persons with dementia evidence resilient interactional competence during even moderate and
severe stages of the disease to use IDK as an interactional resource within actions that involve
closing or initiating sequences.
5.2.1 Sequence ending
The excerpts that follow present several examples of IDK utterances that work to close a
sequence for the participants. In each excerpt, the participant with dementia is engaged in a
question-answer sequence. In answering the question posed by the co-participant, the person
with dementia employs an IDK utterance that is oriented to by the co-participant as ending the
sequence; that is, the IDK works to mark the action of the question-answer sequence as
complete. In response, the co-participant begins a new sequence.46
In excerpt (2) Lisa begins a question-answer sequence with a question regarding Ms.
Taddington’s holiday plans to see her family (line 034, below).
(2) TDD 001 (00:41 Thanksgiving I)
034 Lisa: Ho- Are you gonna go see them for Thanksgiving?
035 (1.2)
036 Ms. TDD: I think they're coming, I don't know.
46
The next action could have been initiated by the person with dementia as well. It just so happened in all
of the examples presented here that the non-impaired co-participant initiates a new sequence.
81
037 (0.3)
038 Lisa: What's their names?
At line 036, Ms. Taddington initiates her answer to Lisa’s question with the epistemic hedge I
think, which suggests that her family is coming to see her. This first TCU is not produced with
turn final prosody—it is not produced with falling intonation but rather her utterance is produced
with continuing intonation—and, indeed, Ms. Taddington continues this turn with a second TCU,
the IDK utterance. The IDK utterance is produced with turn final prosody. Ms. Taddington’s turn
is now hearable as syntactically, prosodically, and actionably complete. Lisa treats the turn as
complete and, after a 0.3 second pause,47
Lisa begins a next, tangential question-answer
sequence. In line 038, Lisa asks the names of the family members who Ms. Taddington expects
will visit. Lisa’s initiation of a new sequence provides evidence that she is treating Ms.
Taddington’s utterance (line 036) as completing the previous question-answer sequence.
In excerpt (3) below, Sarah and Ms. Zachary are looking at Ms. Zachary’s extensive bell
collection. Sarah has been asking Ms. Zachary the origin of each one: where or who it came
from. Ms. Zachary displays her inability to recall who gave her the bell in question (line 338).
(3) ZAC 001 (04:42 Bells I)
338 Ms. ZAC: Tsk. I can't remember now.
339 (0.6)
340 Ms. ZAC: I wish I [could-]
341 Sarah: [Maybe ] your husband gave you that one.
342 (1.6)
343 Ms. ZAC: Uh:::. I don't know.
344 Sarah: And that one's pretty too, the one with the hands?
47
The majority of turn transitions occur without any noticeable gap (less than 0.2 seconds of silence)
between co-participant utterances (for a review of this literature, see Couper-Kuhlen, 1986, pp. 115-162).
82
After a 0.6 second pause (line 339), in line 340, Ms. Zachary initiates a turn that further indicates
that she cannot provide the information Sarah has requested: “I wish I [could-]”. But she cuts off
her utterance as Sarah begins a turn in overlap. Sarah provides a candidate answer, line 341,
suggesting that it may have been Ms. Zachary’s husband who gave her the bell. After a nearly 2
second gap of silence (line 342), Ms. Zachary responds with a drawn out uh, which suggests she
is engaged in an on-record attempt to recall the requested information; however, she concludes
her turn with an IDK utterance: “Uh:::. I don't know.” (line 343). At line 344, Sarah responds
with new sequence, in which her first TCU issues a positive first assessment of a different bell,
and her second unit of talk seems an attempt to direct Ms. Zachary’s attention to the bell that she
(Sarah) is now referencing: “And that one's pretty too, the one with the hands?”. While Sarah’s
move to this new sequence follows the successive moves by Ms. Zachary—her inability to
provide an answer to Sarah’s question (lines 338 and 340), the gaps of silence (lines 339 and
342), and her IDK utterance (line 343)—Sarah does not treat the sequence as having ended until
Ms. Zachary produces the IDK utterance. Sarah’s move to a new topic, a different bell, thus
shows she treats the IDK utterance as doing sequence-ending work.
In the next example, excerpt (4), the co-participant orients to the speaker’s IDK turn unit
as doing closing work before the speaker reaches the end of her turn. Sherry has brought up the
upcoming fashion show that will take place at the assisted-living facility and in which Ms.
Walker will take part as one of the models. At line 285 (below), Sherry initiates a question-
answer sequence inquiring as to what Ms. Walker will wear as one of the models. In response,
Ms. Walker provides a detailed and specific description of the outfit (lines 287-302).
(4) WLK 001 (04:42 Fashion)
285 Sherry: So, what are you going to wear in that.
286 (0.6)
83
287 Ms. WLK: Oh:, ah-
288 (1.8)
289 Ms. WLK: Uhm.
290 (0.7)
291 Ms. WLK: Black suit.
292 (0.8)
293 Sherry: Oh, wow˚.
294 Ms. WLK: And ah, (1.5) sorta (0.7) this color.
295 (0.5)
296 Ms. WLK: Only it’s a lighter.
297 (1.0)
298 Ms. WLK: AH DARker,
299 (2.2)
300 Ms. WLK: ah, blouse.
301 (1.3)
302 Ms. WLK: #An::=I’on't know: [˚what else.˚ ]
303 Sherry: [You gonna get] your HAIR done?
304 (0.3)
305 Ms. WLK: Nah:.
306 (0.7)
307 Ms. WLK: h[a ha ] ha: ha ((laughter))
308 Sherry: [he he] ((laughter))
At line 302, Ms. Walker mobilizes an IDK utterance in a reduced articulation form with a wh-
complement: “#An::=I’on't know: ˚what else.˚”. The coordinator and along with the wh-
complement what else could suggest that Ms. Walker is engaged in an ongoing search for
another item to add to her list. However, the reduced form of and (“#An::”) is produced with
creaky voice. While this prosodic cue has long been linked to the final syllable of a turn ending
84
(Local, Wells, & Sebba, 1985), more recent work shows that creak indicative of turn ending may
also occur earlier in the turn (Drugman, Kane, Raitio, & Gobl, 2013), the situation we see with
Ms. Walker’s utterance. Moreover, Ms. Walker’s articulation of know is also produced with a
sound stretch on the vowel, which is another prosodic component of turn completion (Ford &
Couper-Kuhlen, 2004; Local et al., 1986; Schegloff, 2001). Finally, the wh-complement “˚what
else.˚” is produced at a very low volume, suggesting that Ms. Walker’s turn is actually winding
down and that rather than searching for another item to add, she is ending her turn.
Note that Sherry's turn at line 303 overlaps with Ms. Walker's complement clause. This
overlap suggests that she hears the IDK utterance (with its preceding and coordinator) as doing
closing work and as possibly complete in itself. Sherry's overlapping turn, the question at line
303, initiates two actions: it introduces a shift in the topic, moving away from clothing to hair,
and it requests an answer from Ms. Walker on whether she will get her hair done. In shifting the
topic in this way, Sherry shows an orientation to Ms. Walker’s utterance at line 302 as ending or
closing the question-answer sequence on the topic of clothing. That is, Ms. Walker’s extended
turn (lines 287-302)—the list of clothing—is treated by Sherry as completing the question-
answer sequence she initiated at line 285. Ms. Walker then picks up (line 305ff) the new topic
offered by Sherry, further evidencing Ms. Walker’s participation in the closing of the clothes
topic and her uptake of this tangential topic, her hair.
In excerpts (2-4) we see persons with dementia mobilizing IDK utterances that are
oriented to as sequence exiting devices. These usages resonate with an observation by Ford and
Thompson (1996) in which they note that, “claims of uncertainty . . . seem to be associated with
topic closing” (p. 170). Its use is also similar to that reported elsewhere among non-impaired
persons. One of the earliest observations in this line of analysis comes from Östman, who
85
proposes that a speaker can mobilize I don’t know to end a turn, yield the floor, and/or close a
topic. Östman provides only one example of this function, as shown below:
(DAL 76-EH-2) (Östman. 1981, p. 27) [line numbers added; transcription symbols from
original]
001 I saw Mr. CALwin today – he came up HERE – and I gave
002 him a piece of my ( ) – I was SO MA:D – I was out
003 there picking up those ( ) – and he came UP – and I
004 told him – and he said well we hate to kill that ( ) --
005 he said – he said we HATE to KILL it and I said well I
006 DON’T – and he said well they don’t come about (with the
007 dark none) – so I don’t KNOW – I don’t know.
In the above excerpt, the speaker deploys two I don’t know utterances (line 007) in the service of
ending his turn or yielding his turn to another participant. Östman presents this as a case in which
the speaker’s use of I don’t know is, in essence, a claim that “‘I don’t really have anything more
to say about this’” or “‘I don’t know what [more] to think about that’” (1981, p. 27). I will return
to this observation by Östman in the next section.
5.2.2 Sequence initiating
It is relatively straightforward to see how an IDK utterance that provides an answer to a
question-answer sequence can work to close a sequence. This is particularly the case when we
can demonstrate, as above, that co-participants orient to the IDK utterance as doing closing work
by initiating a new sequence. The situation can be a bit more complicated when an IDK utterance
is used as or within a first-pair part to initiate a sequence, such as when proffering or renewing a
topic. On the surface, it would seem a simple matter to identify this function of sequence
initiation by sequence organization. However, the question arises as to what, if anything, the IDK
utterance may be doing other than simply working to initiate the sequence. Although my
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emphasis in this section is in demonstrating the sequence-initiating function of IDK utterances, I
also examine to a degree what other types of work, or functions, could be carried out in the
sequence. As only two of the IDK utterances in my data are sequence initiating, I include both of
the examples here. In excerpt (5), I propose the concept of a “wondering” action, a type of
thinking out loud in which a complement-taking IDK utterance is used as a first-pair part that can
invite the co-participant to jointly engage with the speaker in wondering about the topic at
hand.48
In this particular case, the IDK utterance that poses the “wondering” is also renewing a
topic. Excerpt (6) then provides supporting evidence for the analysis presented in excerpt (5). In
excerpt (7), I present the use of a complement-taking IDK utterance that, as a first-pair part
“wondering”, engages the recipient in jointly working through the topic proffered by the
speaker’s “wondering.
In excerpt (5) below, the complement-taking IDK renews the topic of food, but it does so
as the speaker’s on-record “wondering”. The student volunteer Rebecca finds Ms. Wittle, her co-
participant, eating her dinner in the cafeteria. Their conversation begins first with some talk
about Ms. Wittle’s dinner food and then ends with Rebecca’s positive assessment of peas (line
034, below). After a ten second gap of silence during which Ms. Wittle could be engaged in
eating her food (line 035),49
she renews the topic of dinner food with a complement-taking IDK
utterance (line 036).
(5) WTL 001 (01:09 Lettuce)
034 Rebecca: Peas are delicious, too.
035 (10.3)
036 Ms. WTL: I don't know where the l↑ettuce came from.
48
In Chapter 7 I suggest that in such “wonderings” I don’t know may work as a response mobilizing
device (Stivers & Rossano, 2010) that holds recipients more or less accountable for their responses. 49
Without video data it is unclear what is occurring during this long period of no talk.
87
037 (2.3)
038 Rebecca: It's healthy?
039 (0.9)
040 Rebecca: N’he n’he hmm ((nasal laughter))
041 lettuce, peas, rice.
042 (0.8)
043 Ms. WTL: Um’hmm.
044 (5.8)
At line 036, Ms. Wittle produces a first-pair part in the form of a complement-taking IDK
utterance that initiates a “wondering” action regarding a specific item from her dinner: “I don't
know where the l↑ettuce came from” (line 036). While the participants had discussed the
contents of Ms. Wittle’s dinner in the previous turns, this is the first talk of either lettuce or of
where an item comes from. The turn composition places the “wondering” as something I don’t
know while the wh-complement introduces the topic of “wonder”, in this case, the lettuce
(“where the lettuce came from.”). The IDK utterance may be hearable as something the speaker
is interested in and could invite the co-participant to take up that topic. I will present additional
evidence in excerpt (6) that the topic of where food comes from is, indeed, one of interest to Ms.
Wittle.
Nearly two and a half seconds of silence follows Ms. Wittle’s “wondering” (line 037).
Such gaps of silence have previously been shown to indicate trouble in the talk (Sacks et al.,
1974), the non-presence of the recipient (Gurevich, 1989), or a disalignment with or challenge to
the preceding action within the talk (Burton, 1981). Without video evidence, we cannot be
certain what Rebecca is occupied with during this gap. When Rebecca does respond, her
utterance “It’s healthy?” (line 038) does not seem to fit with a query of where the lettuce came
from. Rather, Rebecca’s response is more fitted to the question of why would lettuce be served,
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and this may be evidence that Rebecca misheard Ms. Wittle’s utterance; however, Ms. Wittle’s
turn is produced in the clear and no competing noise is present in the recording. Moreover,
Rebecca’s utterance is produced with rising intonation, which suggests that her answer is a best
guess, or a try marker (Sacks & Schegloff, 1979), in which she is giving her best account for
why lettuce would be served as part of the dinner meal and which may be evidence that she hears
Ms. Wittle’s initiating action to be a complaint. Whatever we make of Rebecca’s response to and
possible misinterpretation of Ms. Wittle’s IDK complement-taking utterance, that utterance does
work to renew the topic of food and initiate a new sequence, the “wondering” about the origin of
this food. This “wondering” seems to allow Ms. Wittle a means to direct the trajectory of talk in
which the two participants may continue their talk about the dinner food, but it also may be an
attempt to extend their talk beyond the more narrow topic of dinner food to food in general.
Although Rebecca produces a response, neither the topic of where the lettuce comes from nor the
comment about it being healthy is expanded upon at this point. Instead, the sequence winds
down as Rebecca produces laughter (line 040) and a summary list of the food on Ms. Wittle’s
plate: “lettuce, peas, rice” (line 041). The participants continue their talk with food-related topics
for the remaining ten minutes of the conversation.
Given the ill-fittedness of Rebecca’s response to Ms. Wittle, I would like to further
consider Ms. Wittle’s complement-taking IDK utterance. In particular, I provide excerpt (6) as
support for my suggestion that Ms. Wittle’s IDK utterance in (5) may be part of a more general
interest in the origins of the food that she is pursuing in her conversation with Rebecca, even
though Rebecca may have either misheard or misinterpreted Ms. Wittle’s talk. Excerpt (6), as
shown below, takes place two minutes and ten seconds after the “wondering” about the lettuce
and as the conversation turns back to peas, one of the other items that we have learned from this
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conversation is part of Ms. Wittle’s dinner. Peas have also been the last item mentioned by
Rebecca prior to Ms. Wittle’s wondering about where the lettuce came from (line 034 above).
(6) WTL 001 (02:55 Peas and Southern Illinois)
095 Ms. WTL: They are,(1.1) manufactured, uh, (3.5) or grown,
096 (1.1)
097 Ms. WTL: in, (0.4) S::::outhern uh (1.4) eh, ah,
098 I wanna say, Illinois and that’s (.) wrong.
099 (1.0)
100 Rebecca: Really?
101 Ms. WTL: Ye:s.
102 Rebecca: M’humh.
The above excerpt, when combined with Ms. Wittle’s earlier first-pair part, “I don't know where
the l↑ettuce came from.” (excerpt (5), line 036), suggests that the general topic of the origin of
produce is of interest to her. With this further evidence of Ms. Wittle's current interest in food
origins, I propose that her sequence-initiating topic of lettuce should be taken at face value: Ms.
Wittle’s utterance is an online display of her wondering about where the lettuce came from. I
will return to a more general discussion about the type of first-turn action that I call a
“wondering” after examining another sequence-initiating use of IDK.
In the following excerpt (7), a sequence-initiating IDK utterance, the participants have
been talking for over eight minutes of what amounts to a ten-minute conversation. Mr. Tappan
and Amanda, a student volunteer, have ended a sequence of talk about Mr. Tappan’s wife and
their marriage. Mr. Tappan’s deceased wife has been a recurring topic of talk and one that has
raised emotional displays and displays of disorientation earlier in the conversation. At one point,
Mr. Tappan began to weep. In another segment, he talks of his wife as if she were alive. In the
sequence most recently concluded, Mr. Tappan has revealed that his wife had been his teacher
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before they married (lines 258 and 260, below). After Amanda’s positive assessment of Mr.
Tappan’s affection toward his wife (line 261), the sequence on Mr. Tappan’s wife winds down
with joint laughter. After nearly a seven second gap of silence occurs (line 264), Mr. Tappan
produces a complement-taking IDK utterance (line 265) that initiates a new sequence.
(7) TPN 001 (08:29 Sayin’ too much)
258 Mr. TPN: h- Had a good teacher.
259 Amanda: he ((laughter))
260 Mr. TPN: Liked her so much I married her.
261 Amanda: You liked her so:: much. that's a good thing.
262 he [he he] he he he ohh
263 Mr. TPN: [he he]
264 (6.6)
265 Mr. TPN: I don’t know if I’m gonna end up sayin’ too much.
266 Amanda: No:, c[ourse not. ]
267 Mr. TPN: [An’ you're ] recording it and you can hold it over my
268 head th[en-]
269 Amanda: [You] can (.) never say too much.
270 Mr. TPN: OH: y(h)es you he he ((laughter)) [can.
271 Amanda: [he he he ((laughter))
272 [Well,] that's [true. wait, let me]
273 Mr. TPN: [But- ] [that's from your ] angle. ((cough))
274 Amanda: he he he [( ) he he he] ((laughter))
275 Mr. TPN: [From my angle ] I could, yeah.
276 Amanda: he he he I don't think you're saying too much.
277 Mr. TPN: Huh?
278 Amanda: You're not saying too much right now.
279 Mr. TPN: Purposely.
280 Amanda: That's a good thing.
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281 Mr. TPN: he [he he ((laughter))
282 Amanda: [he he ((laughter))
Mr. Tappan uses a complement-taking IDK utterance to introduce a sequence of meta-talk on
whether he could “end up sayin’ too much” (line 265), perhaps about his having married his
teacher. This utterance could be heard as a self-deprecating remark in which Mr. Tappan is
characterizing himself as the type of person who could very well reveal too much or that he
could end up talking too long. The IDK plus if-complement could also be a bid to end any further
talk on his wife or the conversation they are engaged in. His turn may also tacitly solicit
Amanda’s view on whether he or they should stop talking.
In line 266, Amanda issues the negative token, “No:” that displays her disagreement with
any propositions hearable in Mr. Tappan’s IDK utterance: 1) Mr. Tappan is not the type of
person who is likely to say too much; in which case, Amanda’s negative token here would be a
preferred response to his turn as a self-deprecating remark (Pomerantz, 1984a). Or, 2) He is not
going to say something she might find unacceptable. Or, 3) they should not end their
conversation because he has or they have not been talking too much or too long. In short,
Amanda’s “No” encourages more talk.
Amanda’s next TCU works to emphasize or reinforce her negative response: “c[ourse not
]” (line 266). Mr. Tappan, possibly orienting to Amanda’s vowel stretch on her formulation of
“No:.” as turn ending, begins his next utterance in overlap with this TCU of Amanda’s. Mr.
Tappan’s overlapping turn clarifies that saying too much could have social consequence: “[An’
you're] recording it and you can hold it over my head th[en-]” (lines 267-268). Mr. Tappan’s
utterance suggests that his talk could be socially sanctionable (that “it” could be held over his
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head) and may indicate a social impropriety of talking about either marrying his teacher or of
their courtship.50
In line 269, Amanda begins a turn in overlap with Mr. Tappan’s turn. He elects to drop
out, and Amanda continues. She displays disagreement with his proposition that he (or anyone)
can say too much: “[You] can (.) never say too much.”. Amanda’s turn is produced without
hesitation or perturbations; her disagreement is not mitigated in any way and shows no
characteristics typical of a dispreferred action. In line 270, Mr. Tappan immediately responds
with strong disagreement: “OH: y(h)es you he he ((laughter)) [can.”. By initiating his
disagreement with a loud and extended Oh-preface, Mr. Tappan upgrades his epistemic stance
(Heritage, 2002) and now makes the explicit claim that one can say too much. Mr. Tappan’s
disagreement also does not show characteristics typical of a dispreferred action (e.g., hesitation,
perturbation, hedging). The absence of mitigation devices in both Amanda and Mr. Tappan’s
disagreement utterances may evidence they are jointly negotiating this sequence as non-serious
talk. Supporting this interpretation, we can note that Mr. Tappan incorporates within his turn
affiliative-seeking laughter (Glenn, 2003, p. 109), and Amanda does join in the laughter (line
271). She then displays a change in her stance that shows agreement with Mr. Tappan: “[Well,]
that's [true.” (line 272).
Amanda and Mr. Tappan continue with their non-serious talk about saying too much
(lines 272ff). Whatever other action this sequence of talk may be doing, I present Mr. Tappan’s
complement-taking IDK utterance as a sequence-initiating turn that works to further transition
the participants’ talk from serious topics, such as Mr. Tappan’s wife and their marriage, to a
topic that initiates what develops into a joking sequence. Mr. Tappan’s complement-taking IDK
50
Tsui (1991) has discussed I don’t know as minimizing “impolite beliefs”, but in her examples the I
don’t know immediately precedes the socially-questionable talk: “I don’t know, she’s a bit funny” (p.
618).
93
utterance, could also be paraphrased as "I wonder whether I may say too much". The utterance
serves to initiate a sequence in which he and Amanda jointly speculate about the proffered topic
of Mr. Tappan’s “wondering”. In this excerpt, Amanda does join in the action of wondering and
guessing. She and Mr. Tappan negotiate their non-serious disagreement through the joking-
sequence; they are able to jointly establish that, indeed, Mr. Tappan could “end up sayin’ too
much”—just as he had initially wondered.
In both excerpts (5) and (7) a complement-taking IDK utterance initiates a sequence. The
claimed deficiency in the speaker’s own knowledge that is voiced through the I don’t know,
whether an actual knowledge deficiency or not, allows that speaker to initiate a “wondering”. At
this point it may help to recall Section 5.2.1, in which it was suggested that turn final, second-
pair part I don’t know utterances might be paraphrased as, "I don’t really know what to think
about that" and thus may resist further talk on the topic in play (Östman, 1981, p. 27). I propose
a parallel here that first-pair part, complement-taking I don’t know utterances may be
paraphrased as “I don’t really know what to think about this” and thus may invite further talk on
the topic of the “wondering”. Such turns could serve to proffer sequences of joint speculation
about possible solutions to the wondering: the recipients could thus join in the action of
wondering and guessing.
Weatherall has noted that the existing literature on I don’t know has overwhelmingly
considered its use in second-pair parts (2011, p. 320), like the IDK utterances examined in
excerpts (2 - 4) above. Thus, the existing literature does not explicitly address the use of I don’t
know utterances in sequence-initiating turns like those of excerpts 5 and 7. However, as
Weatherall's study focuses on I don’t know as first-pair parts, I draw on it to illustrate this
function in non-impaired populations. From extract 10 (reprinted below) and others, she builds a
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case that speakers use I don’t know to buffer the entrance of dispreferred actions such as
criticisms and complaints into the conversation.51
[Extract 10 TG Bookstore] (Weatherall, 2011, pp. 326-327; borrowed from Schegloff, 2007,
p. 277)
[line numbering is original to Schegloff, 2007]
9:10 Bee: [B’t I still have one more book tuh buy I can’t get it,
9:11 (0.8)
9:12 Bee: ◦So uh,
9:13 (0.6)
9:14 Bee: I don’know. The school- school uh, (1.0) bookstore doesn’t
9:15 carry anything anymo(h)uh,
9:16 Ava: Mno?hh
Bee’s I don’t know, at line 9:14, precedes a new sequence, a topic proffer introducing the
limitations of Bee’s campus bookstore, a possible next complaint in her extended complaint
sequence about the difficulties she is experiencing buying books for her upcoming courses. The
IDK utterance seems to provide an additional boundary between the talk of needing one more
book (line 9:10) in conjunction with the gaps of silence (lines 9:11 and 9:13) and what may be
the start of a summative so statement (line 9:12). Whatever other work Bee’s I don’t know may
or may not be doing, I present this simply to show that the use of sequence-initiating IDK
utterances is not unique to persons with dementia.
51
My analysis of excerpt (7) is similar to Weatherall’s work cited here (2011); however, I believe there
are nuances that distinguish how IDK utterances work in the initiation of the actions she describes (e.g.,
criticisms, complaints) and what I see as delicate actions (e.g., requesting a co-participants view of self, a
risky topic). I expect to flesh out these nuances in future work.
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5.3 Preference management
For the cases so far considered, in which we see IDK utterances used to display epistemic
stance or to manage sequences, my data provide evidence that persons with dementia can retain
linguistic, interactional, and pragmatic competence that appears indistinct from non-impaired
persons even during moderate to severe stages of the disease—and the co-participants generally
orient accordingly. In this section I provide evidence that persons diagnosed with dementia can also
retain their interactional competence for managing preference constraints in conversation in which
they mobilize IDK utterances.
Preference principles are implicit practices that participants follow within interaction to best
ensure the progressivity of the social action of talk and also ensure social solidarity and support
affiliation. These principles are, in part, responsible for the systematic orderliness of talk as a social
action and greatly influence the selection of resources used to construct turns of talk, the kinds of
actions turns initiate, and co-participant interpretation of their co-participants’ turns. Turns that
further the advancement, or progressivity, of the on-going action are preferred. Turns that halt the
advancement, or progressivity, of the on-going action, even momentarily, are dispreferred.
Preference principles are so strongly observed that participants have been shown to design their
turns (construction and action) so that some dispreferred turns initially look like preferred ones.52
52
Schegloff (2007) provides examples in which the dispreferred part of the utterance is pushed into the
turn, after a more preferred part. I present one of his examples below in which the recipient of an
invitation expresses appreciation before producing the dispreferred turn of declining the invitation:
(5:19) NB II: 2, 12:18-29 (Schegloff, 2007, p. 69) (excerpt is reduced here) 1 Emm: [Wanna c’m] do:wn ‘av [a bah:ta] lu:nch w]ith me?=
2 Nan: [˚It’s js] ( )˚]
3 Emm: =Ah gut s’m beer’n stu:ff,
4 (0.3)
5 Nan:→ ↑Wul yer ril sweet hon: uh:m
6 (.)
7 Emm: [Or d’y]ou’av] sup’n [else ˚( )˚
8 Nan:→ [Let- ] I: ] hu. [n:No: I haf to: uh call
9 Roul’s mother.
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The effects of preference principles are noticeable in how they influence turn design in order to
promote sociality—persons working together to accomplish social actions.
In the current section, I present examples in which participants with dementia construct their
turns with IDK utterances to manage preference constraints at both the turn and sequence levels of
talk. These IDK utterances are subsequently shown to be treated by co-participants as doing this
kind of work. Thus, what I show in my analyses is how preference functions of IDK utterances are
worked out within the interaction between the participants as evidenced by both the non-impaired
co-participants’ turns and by those of persons with dementia. These include the managing of overt
and tacit disagreement and not fulfilling a preferred, next action made relevant by a co-participant’s
preceding action (e.g., not answering questions, not responding to directives/imperatives). By
drawing upon the semantic, or literal, meaning of I don’t know speakers can introduce a claim of
uncertainty or insufficient knowledge within their turn compositions. However, these claims may or
may not reflect actual lack of knowledge or uncertainty but may instead serve mainly as resources
for mitigating dispreferred actions.
I first present examples of IDK utterances working to manage preference constraints in ways
that have also been noted in the literature on mundane conversations of non-impaired participant
interactions. I then present examples of IDK utterances produced as responses to compliments that
work to minimize the positive assessment of the compliment. This use of IDK utterances as second-
pair parts to compliments, to my knowledge, has not previously been documented as a practice
within American English conversation.
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5.3.1 Disagreement
In excerpt (8), a disagreement arises about whether a relative will visit for the holidays.
The participant with dementia employs an IDK utterance along with other epistemic downgrades
to soften his initially strong disagreement (line 109, below).
(8) TYR 001 (02:21 She isn’t)
106 Jackie: ((throat clear)) So she's gonna come here to see you on
107 christmas day=I'm sure she is:.
108 (1.8)
109 Mr. TYR: Eh- sh- she’s isn’t.
110 (1.2)
111 Mr. TYR: I- I doubt that she will because she is ah havin’ an operation
112 on her back again.
113 (0.9)
114 ?: .tsk
115 Mr. TYR: Next week.
116 (0.6)
117 Jackie: Aw::.=
118 Mr. TYR: =So I don't know about that.
119 Jackie: AW, I'm sorry to h↑ear that.
120 (3.3)
121 Jackie: tsk. Speaking o:f operations=I know you had some done on your
fa:ce:.
In lines 106-107, Jackie states her belief that Mr. Tyler’s daughter will visit during the Christmas
holiday: “So she's gonna come here to see you on christmas day=I'm sure she is:.”. Although
Jackie has no apparent epistemic authority for such a strong claim, she seems to be voicing the
general expectation that family members visit during holidays. Before he produces his verbally
clear response, Mr. Tyler projects a forthcoming dispreferred action in a couple of classic ways.
98
First, he allows a nearly two second gap of silence to emerge (line 108) prior to his first
responsive vocalization. When he begins to respond, he produces a perturbation (“eh-“) and a cut
off (“sh-”). However, he then follows these cues with his strong, verbal, disagreement with
Jackie’s claim that his daughter will visit: “she’s isn’t.” (line 109).53
Jackie produces no verbal
response to Mr. Tyler’s utterance and over a second of silence occurs (line 110).
In line 111, Mr. Tyler begins to retract the strong certainty of his claim and to produce an
account for his disagreement. In his next utterance, Mr. Tyler reduces the strength of his earlier
declarative “she’s isn’t” (line 109) as he begins his utterance with “I- I doubt that she will” (line
111). He then provides an account, formulated as an adverbial clause (Ford, 1994), for why his
daughter may not be able to visit: “because she is ah havin’ an operation on her back again.”
(lines 111-112). Mr. Tyler’s turn design explains the reason for his dispreferred response, and it
simultaneously introduces new information: that his daughter is having surgery.
Mr. Tyler’s account is hearable as ‘bad news’ in two different ways: the daughter won’t
be able to visit him and she has to have back surgery. The account enters into the discourse only
out of necessity; it is produced with perturbations, and it enters into the talk incrementally
(Maynard, 2003). The delivery of this bad news is met with nearly a second of silence before one
of the participants produces a lip smack indicating incipient talk (line 114), but no talk by either
participant is immediate. It is Mr. Tyler who produces an increment that adds information on the
timing of his daughter’s surgery—“next week” (line 115)—putting it closer to the holiday and
providing an additional reason why his daughter may not be able to visit. This increment renews
53
Mr. Tyler’s formulation of “she isn’t” (line 109) is produced with an unvoiced interdental sibilant
attached to the pronoun “she”. This may be caused by any number of issues—denture slippage, a
premature production of the “s” in “isn’t”, or some other cause. I clarify the transcription in order to
prevent any possible misreading.
99
the relevance of a response from Jackie. It also indexes that a response had been relevant prior to
the increment and that a response continues to be relevant now.
While Mr. Tyler’s explanation seems to support his strong stand that his daughter will not
be visiting him, he continues to reduce the strength of his disagreement with his IDK utterance.
First, the utterance itself is prefaced with a turn-initial “so” (line 118), commonly used to
formulate upshots (Raymond, 2004). The IDK utterance works to further mitigate his strong
disagreement by giving voice to his uncertainty, and the prepositional phrase complement “about
that” (line 118) indexes Jackie’s claim that his daughter will visit (“I’m sure she is”, line 107) as
the object of his uncertainty. The turn composition allows Mr. Tyler to maintain his
disagreement with Jackie, albeit in mitigated form. Mr. Tyler’s IDK utterance may be doing
double duty here, as it may also serve as a possible sequence closing, a bid to close the topic on
whether or not he will have visitors during the holiday.
Jackie initiates a palliative response “Aw::.=” (line 117) which is cut off and then joined
by Mr. Tyler’s so-prefaced IDK utterance. Jackie’s palliative response, “AW, I'm sorry to h↑ear
that” (line 119), becomes fully articulated after Mr. Tyler’s IDK utterance and displays her
uptake of Mr. Tyler’s news. Once Jackie has produced the relevant uptake in her response to the
bad news of the daughter’s surgery and the consequence that her co-participant may indeed be
alone during the holidays, the sequence is brought to a close and the participants move on to the
next topic. After over 3 seconds of silence (line 120), Jackie moves the talk from the discussion
about Mr. Tyler’s daughter and her impending surgery to the next topic, his recent surgery (line
121). The two participants continue to have a lengthy discussion about recent events during
which Mr. Tyler turns the topic to Jackie’s immediate and future plans.
100
In excerpt (8), then, we first see a strong, overt disagreement ("she’s isn’t"), followed by
a softening (“I doubt that she will”) that includes a reason (“she is ah havin’ an operation on her
back again”), and then concludes with an upshot constructed with an IDK utterance and an
indexical that (“So, I don’t know about that”). These practices allow the speaker to maintain
disagreement, yet they do so in a manner more preferable than the original disagreement. Mr.
Tyler thus demonstrates acuity for the socially and interactionally dispreferred actions of
disagreement, despite having clear reason for it.
Excerpt (9) presents a second example of managing disagreement with an IDK utterance.
The participants have been discussing Mr. Wheelock’s health issues. In lines 210-211 (below), Luke
initiates a troubles-telling sequence with a typical inquiry approach (Jefferson, 1988) that displays
his previous knowledge of Mr. Wheelock’s trouble, his mobility difficulties.
(9) WHE 001 (08:28 End of the road I)
210 Luke: How has your uh, stability been, like with your knees and
211 everything?
212 Mr. WHE: ah, They're not doing too good.
213 Luke: Oh really?
214 Mr. WHE: I'm having trouble walking now.
215 Luke: Yeah. (0.3) hmm. (.) do you- do you use this walker very much.
216 do you-
217 Mr. WHE: Yeah, I have to use either the walker or or a wheelchair.
218 Luke: Yeah I know you, (.) I saw use the wheelchair the last time I
219 was here. but uh,
220 Mr. WHE: Yeah, I think I'll get close to the end of the road I
221 think.
222 Luke: Oh no. don't say that, you've got plenty of years
223 left on you.
101
224 Mr. WHE: I don't know.
Mr. Wheelock responds to the Luke’s trouble inquiry with confirmation of his continued health
problems (line 212). In line 213, Luke provides receipt of the Mr. Wheelock’s trouble with the
announcement response “Oh really?” that works to encourage further talk from Mr. Wheelock on
his health issues. Luke and Mr. Wheelock engage in this troubles talk sequence about his
mobility difficulties for several turns of talk (lines 214-219). Instead of moving to close this
troubles telling sequence,54
in lines 220-221, Mr. Wheelock proffers a tangential topic through
his use of the end of the road cliché: “Yeah, I think I'll get close to the end of the road I think.”.
This turn moves the troubles-telling about his daily mobility issues to greater trouble: the
possibility that the end of his life is near.
Luke’s immediate TCU “Oh no.” (line 222) displays strong disagreement, which suggests
he may have heard Mr. Wheelock’s end of the road comment as something similar to a negative
self-assessment.55
If so, then Luke’s strong disagreement would be a preferred next move
(Pomerantz, 1984a). In line 222 Luke’s next TCU seems to provide both further disagreement
and what could be hearable as mild chastisement “don’t say that,”. This unit of Luke’s turn
suggests that Mr. Wheelock’s end of the road utterance, be it negative self-assessment or end-of-
life talk, is socially sanctionable. In lines 222-223, Luke continues with a third unit of talk that
confirms he has heard Mr. Wheelock’s cliché as the speculation of death; Luke explicitly
counters such a claim: “you’ve got plenty of years left on you.”. Mr. Wheelock, in turn, responds
with a standalone IDK utterance: “I don’t know.” (line 224).
54
Moves to close troubles telling often take the form of one of the following: an optimistic projection, a
return to the status quo, or making light of the situation (Jefferson, 1988, pp. 431-434). 55
This is one of several cases in my data during which the person with dementia apparently raises the
issue of his or her approaching end of life. It seems as though each wants to talk about death. Luke’s
response, to deny or avoid this line of talk, is not unusual.
102
Luke’s orientation to Mr. Wheelock’s IDK utterance, in excerpt 10 below, suggests that
Mr. Wheelock’s IDK utterance (line 224) works to voice mitigated disagreement.
(10) WHE 001 (08:33 End of the road II)
224 Mr. WHE: I don't know.
225 Luke: You look, you look good. you look like you're in,
226 I mean you've got, your eyesight's going a little bit but
227 I know people that are a lot worse off than you.
228 I mean- you seem to be in decently good health.
229 you've got good people taking care of you so.
230 Mr. WHE: Yeah. if it wasn't for my eyesight and not able to walk I'd be
231 in good shape.
In lines 225, 228, and 229, Luke provides positive assessments of both Mr. Wheelock’s health and
his medical care. These actions work both to counter Mr. Wheelock’s claim that his death is
imminent and to bolster Luke’s own counter claim that Mr. Wheelock still has many years ahead.
Luke first compliments Mr. Wheelock on his general appearance, “You look, you look good.” (line
225). Luke then minimizes Mr. Wheelock’s ailments, “I mean you’ve got, your eyesight’s going a
little bit but” (line 226) and “I know people that are a lot worse off than you.” (line 227). This turn
could be heard as Luke continuing his mild chastisement of Mr. Wheelock’s talk about death. In
line 228, Luke’s assessment of Mr. Wheelock directly contradicts Mr. Wheelock’s self-assessment:
“I mean- you seem to be in decently good health.” Luke’s “I mean” preface may render Luke’s
utterances as more apposite responses to Mr. Wheelock’s troubles-telling while working to maintain
or repair solidarity during this spate of talk (Maynard, 2015, forthcoming). Luke ends his turn with a
brightside telling (Holt, 1993) reminding Mr. Wheelock, “you've got good people taking care of you
so.” (line 229).
103
I argue that the practices employed by Mr. Tyler and Mr. Wheelock show that participants
with dementia can be aware of the interactional consequence of adhering or not adhering to
preference constraints. We see this in their use of IDK utterances to voice disagreement with their
co-participants. In Mr. Tyler’s case, the complement-taking IDK utterance mitigates a strong
disagreement that he has previously voiced but, through the complement, maintains that
disagreement. In Mr. Wheelock’s case, the standalone IDK utterance expresses mitigated
disagreement, which is more preferred than overt disagreement. In each case, the conversation
proceeds so that the person with dementia reaches some level of agreement with his non-impaired
co-participant on the topic at hand, as seen by the orientation of that non-impaired co-participant.
5.3.2 Dispreferred response to a directive
In addition to managing the preference constraints of disagreeing, an IDK utterance can be
used as a way to manage a dispreferred response to a co-participant’s directive. In excerpt (11), the
non-impaired co-participant initiates a sequence through imperative syntax, which requests that the
person with dementia talk about his deceased wife. In order for the participant with dementia to
respond in a preferred way to the request of his co-participant, he would produce a response that
complies with the request (Pomerantz, 1978, 1984a; Sacks, 1973, 1987; Schegloff, 2007; Schegloff
et al., 1977). In this sequence, the preferred response to comply with the request would be a telling:
Mr. Tappan would provide some story or information about his wife or their life together. Instead of
complying, Mr. Tappan deploys complement-taking IDK utterances as one type of a series of
practices, all of which effectively avoid fully complying with Amanda’s request.
Amanda initiates this interaction by employing imperative syntax as a way to request that
Mr. Tappan talk about his deceased wife: “So, Irving, tell me abou:t=>Emily<.” (line 001, below).
(11) TPN 001 (00:37 Emily)
104
001 Amanda: So, Irving, tell me abou:t=>Emily<.
002 Mr. TPN: What do you want to know about her.
003 Amanda: hh Everything.
004 Mr. TPN: I don't know where to start.
005 Amanda: Ah, how old was she when you guys met.
006 Mr. TPN: How old was she?
007 oh, she was one year old and she was two years old and then
008 three years old. she got all the way up to where she is now
009 and I'm not going to reveal her age.
010 Amanda: he he he ((laughter))
011 Mr. TPN: 'Cause she'll [beat me up
012 Amanda: [ahh
013 Mr. TPN: [if I do.]
014 Amanda: [he he he ] ((laughter))
015 smart man. he he he
016 you're a smart man. he [he he]
017 Mr. TPN: [he he]
Mr. Tappan’s first response is constructed as a wh-question: “What do you want to know about
her.” (line 002). While the utterance seeks clarification on the information Amanda is requesting in
line 001, it delays the response that Amanda's first-pair part directive (line 001) has made
conditionally relevant: a telling. In line 003, Amanda's response clarifies that she is open to any
possible telling Mr. Tappan could provide. Instead of providing a focus to her inquiry and asking for
something specific, she opens the topic to anything and “hh Everything.” (line 003). Her response is
preceded by audible out-breaths which could display exasperation. To this, in line 004, Mr. Tappan
produces a complement-taking IDK utterance: “I don’t know where to start.” (line 004). Mr.
Tappan’s utterance seems to be an on-record display of his difficulty with how to begin his telling,
yet it effectively and structurally works to put off any preferred response to Amanda’s imperative:
105
“tell me abou:t=>Emily<.” (line 001). Whether Mr. Tappan’s response is due to resistance, refusal,
inability, or lack of memory we cannot tell. But, to this point he has not provided a preferred
response to Amanda’s request and he has thus delayed the progress of the sequence.
In her next turn (line 005), Amanda does narrow her inquiry with a specific question and
provides Mr. Tappan a starting point: “Ah how old was she when you guys met.”. Mr. Tappan
repeats Amanda’s question, “How old was she.” (line 006) and then continues his response with
what seems to be nonsensical or humorous talk about his wife that works as a sort of teasing
directed at Amanda: “oh she was one year old and she was two years old” (line 007ff). He ends
this turn by referring to his late wife as if she were alive: “and I'm not going to reveal her age.
'Cause she'll [beat me up.” (lines 009, 011). Mr. Tappan draws upon a cultural notion that women
do not like others to know how old they are. By laughing, Amanda treats Mr. Tappan’s response as
non-serious (line 010) and the two continue this topic of not revealing his wife’s age in a non-
serious way for several turns (lines 012-017). Amanda’s request for information—Emily’s age
when Mr. Tappan first met her—has only been oddly fulfilled with the non-serious talk about her
ages that he has provided.
How does the IDK utterance work in this sequential context? In this excerpt, we see that
Mr. Tappan effectively puts off fulfilling the action of Amanda’s directive, her request that he
talk about his wife. First, he responds to the imperative with his own clarification question
("What do you want to know", line 002), followed by his complement-taking IDK (“I don’t
know where to start”, line 004), and then echoes her question (“How old was she?”, line 006)
before finally responding with non-serious talk (“She was one year old and she was two years
old” lines 007ff). Each of Mr. Tappan’s responses effectively postpones, or avoids altogether, his
complying with a preferred response to the requests Amanda made at the start of their
106
conversation. Thus, the evidence for what work the IDK utterance with its wh-complement (line
004) is doing is seen in it being one utterance of many types all of which work to the same end
within the sequence: these practices ultimately work to derail the trajectory of the sequence and
to avoid compliance with the request that Mr. Tappan talk about his wife.56
Amanda’s orientation
to Mr. Tappan’s responses—be they reluctance, refusal, or inability—shows that she accepts
them as completing the sequence of talk, albeit in a dispreferred rather than preferred manner.
Interim summary of preference management
To this point I have shown evidence that IDK utterances, both standalone and
complement-taking, display epistemic stance and work to either close or initiate sequences. I
have also shown IDK utterances in the service of managing preference constraints associated
with disagreeing and in providing a dispreferred action to a directive. The ways in which Mr.
Wheelock and Mr. Tyler use IDK utterances to avoid or mitigate overt disagreement,
respectively, have been reported for non-impaired populations (Beach & Metzger, 1997; Diani,
2004; Tsui, 1991). Mr. Tappan’s use of a complement-taking IDK utterance to perform a
dispreferred rather than preferred response has parallels in findings that show non-impaired
persons using IDK utterances to “avoid” commitment to various actions such as invitations,
requests, or offerings and in “failing” to provide second assessments (Beach & Metzger, 1997;
Diani, 2004; Tsui, 1991).57
The evidence presented here, both in the utterances by persons with
dementia and the orientations of their non-impaired co-participants, shows that persons with
dementia may retain at least some ability to perform several interactional practices.
56
Near the end of the conversation, Mr. Tappan does finally talk briefly about his wife Emily, mentioning
that she had been his teacher before they married (presented in excerpt (7)); however, aside from this, Mr.
Tappan is no more forthcoming about his wife than he is in the excerpt above. 57
The literature also addresses functions of I don’t know for which I did not find parallels in my data.
These include speakers using I don’t know to minimize impolite beliefs (Tsui, 1991), to distance
themselves from their propositions (Potter, 2004; Wooffitt, 2005) and to buffer criticisms, complaints,
and self-deprecations into the discourse (Weatherall, 2011).
107
5.3.3 Minimizing in response to compliments
I conclude my analysis of preference management with the first discussion of IDK
utterances in American English that work to minimize the positive assessment of a compliment.
As Pomerantz has shown, the compliment is a positive assessment made about the recipient and,
as an assessment, the preferred response is agreement in the form of a second assessment;
however, Pomerantz finds that a competing constraint is that speakers should not praise
themselves (1978, p. 81). Thus, agreement with the compliment can be taken as an act of self-
praise, an action that is routinely sanctioned within interaction (1978, p. 89). The use of an IDK
utterance works to satisfy these two concurrent and competing constraints. The IDK can cast
doubt on the veracity of the claim while it can work within the turn composition to both qualify
and show receipt of the compliment. While this function has been shown in British (Diani, 2004;
Grant, 2010) and New Zealand English (Grant, 2010) speakers, we shall see in the examples
below that IDK utterances are mobilized also by American English speakers to minimize the
positive assessment of compliments.
In excerpt (12), the co-participant Renee begins to talk about a presentation that she has
the next day in school (line 107, below). In doing so, she reveals her trepidation about the
assignment: “I don't like doing that” (line 115). Ms. Tatter responds in an affiliative manner in
which she reveals information about her childhood experience of participating in school plays
(lines 116-119). Renee issues two questions, each which contain an embedded compliment (lines
120, 122). Ms. Tatter uses an IDK utterance in response to each compliment.
(12) TTR 002 (07:25 Top star)
107 Renee: I have a presentation to do tomorrow.
108 Ms. TTR: You do?
109 Renee: Yeah.
108
110 Ms. TTR: And it will be vocal?
111 Renee: Um hmm.
112 Ms. TTR: Um hmm.
113 Renee: And I have to stand in front of the class.
114 Ms. TTR: Oh.
115 Renee: I don't like doing that.
116 Ms. TTR: It was always nerve- nerve racking to me, ner- nerve
117 racking to me. But it seems like whatever we had in school,
118 plays and all I always seemed to get the hardest, longest
119 [part.]
120 Renee: [ha ha] You must have been good then huh?
121 Ms. TTR: I don't know but I got a lot, got a lot ah-=
122 Renee: =So you were like the top star?
123 Ms. TTR: I don't know if I was the top star or not but uh, I always
124 was afraid when I got in front of all the people and uh, I, I
125 obviously must have done okay but I, I shook and shuddered.
126 Renee: Um hmm.
127 Ms. TTR: Just, just, just, just
128 Renee: Me too.
In each of Ms. Tatter’s responses (lines 121, 123) to Renee’s compliments, the IDK utterance
displays mitigated disagreement with Renee’s suggestion that Ms. Tatter “must have been good
then huh?” (line 120) or that she was “the top star” (line 122).58
Ms. Tatter’s disagreement allows
her to refrain from endorsing Renee’s positive assessment and from providing a second positive
assessment (about herself), the generally preferred next action to a first assessment. Her use of
the IDK utterance works to satisfy the preference constraint that speakers should not praise
themselves.
58
The use of IDK utterances that function to disagree is discussed in Section 5.3.1.
109
Ms. Tatter’s cut off at line 121 may suggest she stopped short of saying something that
could have been heard as a self-praise: “I don't know but I got a lot, got a lot ah-”. Ms. Tatter’s
second IDK utterance works with the if-complement clause to question the premise of Renee’s
compliment, drawing upon Renee’s wording: “I don’t know if I was the top star or not” (line
123).
In Ms. Tatter’s continuing turn, lines 123-124, she displays a shared discomfort with
Renee’s dislike of standing in front of the class: “but uh, I always was afraid when I got in front
of all the people”. In line 125, Ms. Tatter does, however, add a positive, but weak, self-
assessment that she “obviously must have done okay”. This positive self-assessment is
immediately minimized by Ms. Tatter’s next TCU: “but I, I shook and shuddered.” (line 125).
This could be heard as self-deprecating, but it also refocuses the topic to Renee’s apprehension.
Ms. Tatter deflects the talk away from herself and the expectations of responding further to the
compliments that she was “good” or a “top star”.
Excerpt (13) provides a second example of IDK utterances used as responses that work to
minimize compliments. In this segment of talk, Ms. Walton has issued several positive
assessments of the assisted-living facility, its staff, and the other residents. Terry provides a
second assessment (line 095, below) and then amends her compliment to include a positive
assessment of Ms. Walton as a stellar member of the community they are praising (line 097)
(below).
(13) WLT 002 (09:16 Busybody)
093 Ms. WLT: Yes, it is a nice place to be, safe place and peop-
094 everybody so congenial um you know?
095 Terry: They really are congenial, very much so-, you're blessed.
096 Ms. WLT: Really are.
110
097 Terry: And they're blessed to have you also.
098 Ms. WLT: I don't know about that cause Ms. Walton is a busybody.
099 always busy busy.
100 Terry: But a nice busybody.
101 Ms. WLT: I don't know.
102 Terry: But a nice one?
103 Ms. WLT: I don't know about that.
104 Ms. WLT: You saith— you- he saith- ye praise yourself i(t)s a scandal
105 and be if you're nice let somebody else say it.
106 don't you say it yourself because one who brags on himself
107 ain't shit.
108 Terry: OKAY.
109 Ms. WLT: Self praise take care of yourself but don't be bragging
110 around on yourself. folks know whether you are this
111 and that, you let them say it.
112 Terry: I'm going to keep that in mind.
113 Ms. WLT: Yeah, you don't do your own bragging on yourself.
Ms. Walton’s IDK utterance and prepositional phrase complement work to disagree with Terry’s
compliment: “I don’t know about that.” (line 098). The adverbial clause provides an account, or
reason, why Terry’s positive assessment may not be warranted: “cause Ms. Walton is a busybody,
always busy busy.” (lines 098-099).59
Ms. Walton’s use of the third person formulation further
distances herself from the compliment and all the talk—positive and negative—about herself. The
conflicting evidence that Ms. Walton provides about herself undermines Terry’s claim that the
facility is blessed to have her.
59
Weatherall (2011) presents first-pair parts initiated by an I don’t know as a way to buffer self-deprecating
remarks. The utterance by Ms. Walton is not a first-pair part but rather it is a second-pair part that directly
follows a first turn compliment action. Therefore, I see it as a responsive turn used to minimize the
compliment. It could be that self-deprecation works along with the I don’t know to minimize the compliment.
111
In line 100, Terry reuses Ms. Walton’s negative assessment and turns it into a compliment:
“But a nice busybody.”. Ms. Walton responds with a standalone IDK that expresses disagreement.
Terry repeats the compliment but does so with rising intonation that works to engage Ms. Walton
with the utterance: “But a nice one?” (line 102). Ms. Walton initially responds with an IDK
utterance (line 103) that, like her first IDK utterance (line 098), has a prepositional complement
“about that” (line 103) which works to minimize Terry’s second compliment about Ms. Walton
being “nice”.
Following Ms. Walton’s final IDK utterance, she begins to explicitly engage in talk that
explains why she has not aligned with Terry’s action and why it is she cannot explicitly agree
with the compliments. Ms. Walton begins what appears to be a paraphrase of Proverbs 27:2, or at
least of its sentiment: “You saith— you- he saith- ye praise yourself i(t)s a scandal” (line 104).
She performs her talk in an English dialect reminiscent of that found in the King James Version
employing such language as “ye” and “saith”. The actual verse says, “Let another man praise
thee, and not thine own mouth; a stranger, and not thine own lips”. The sentiment here suggests
that Ms. Walton is averse to affirming the compliments given to her. This analysis is
strengthened in that she incorporates one of the compliments (about being nice) into her
imperative “if you’re nice let somebody else say it.” (line 105). She completes this multi-unit
turn with a humorously vulgar assessment of a person who engages in self-praise: if you “say it
yourself . . . [you] aint’ shit.” (lines 106-107). To this Terry produces a loud “OKAY.” (line
108), as receipt of Ms. Walton’s assessment of someone who would engage in self-praise. In the
utterances that follow, Ms. Walton reinforces the observation that self-praise is socially
sanctionable (Pomerantz, 1978): “Self praise take care of yourself but don't be bragging around
on yourself. folks know whether you are this and that, you let them say it.” (lines 109-111). In
112
doing so, she provides overt evidence that she is not affirming the compliments because doing
so, in her view, would be equivalent to bragging or self-praise. Terry treats Ms. Walton’s talk as
instructional: “I'm going to keep that in mind.” (line 112). Ms. Walton provides the upshot with
her final utterance on the topic, which acts as a sequence closing third turn “Yeah, you don't do
your own bragging on yourself.” (line 113). After this utterance, the participants move on to a
fully new topic.
Diani (2004) reports the above phenomenon in British English, providing two examples in
which non-impaired recipients of the compliments respond with Oh prefaced I don’t know
utterances. She refers to the phenomenon as de-intensifying the compliment and aligns her
observation with Leech’s Modesty Maximum that “‘speakers minimize praise of self’” (as cited in
Diani, 2004, p. 163). Grant (2010) notes the above phenomenon of I don’t know as a compliment
minimizer in British and New Zealand Englishes (also non-impaired participants). She states that
“[b]ecause many English speakers are uncomfortable with compliments, using the phrases [i.e. the
phonetic variants of I don’t know] as epistemic devices downplays the speaker’s confidence in the
truth of the compliments so this is a possible explanation” (2010, p. 2294). Grant provides the
following example from British English:
[497, WSC] (Grant, 2010, p. 2292)
Kathleen: Your clever < -- > aren’t you Oh trust < -- > her!
Lorna: I dunno.
This downplay of or disagreement with the validity of the compliment is even more stark if the
speaker is not the recipient of the compliment. An example helps further illustrate. In Pomerantz’s
analysis of compliment responses within American English data, she focuses her analysis on several
linguistic resources that allow co-participants to disagree with the positive assessment that
113
comprises the compliment (1978).60
One of her examples has the phrase I don’t know in second
position to a compliment; the example is recreated below (1978, p. 99):
(JS:11:152)
L: (Lookit how pretty that looks.)
J: Yeah.
A: I don’t know.
B: ( ).
E: Oh that does look pretty with the ( )
[
M: It isn’t a very good
( ) though.
Here Pomerantz points out that M, the recipient of the compliment, uses “though” to display
disagreement with L’s assessment, or compliment, but she makes no mention of A’s use of I
don’t know. A, who is not the recipient of the compliment, uses the I don’t know to display A’s
skepticism toward L’s positive assessment. In doing so, A’s I don’t know works to undermine the
compliment to M. However, A may also be avoiding more overt disagreement with the
assessment. In contrast, a recipient of the compliment who uses I don’t know in response is also
undermining the assessment, but this also serves to satisfy the preference constraint not to
engage in self-praise. Subsequent talk by the recipient will often demonstrate that the recipient
does not, in fact, disagree with the assessment. The use of IDK utterances as a compliment
minimizer that I demonstrate here may arise within particular regional cultures or dialects. More
investigation should show whether this practice is more widespread in American English.
60
Pomerantz’s 1978 data come from Southern California speakers (personal communication).
114
5.4 Summary and discussion
In this chapter, I present evidence that persons with moderate to severe dementia of the
Alzheimer’s type can use I don’t know utterances to display epistemic stance, manage sequences
of talk, and negotiate preference constraints in ways indistinguishable from non-impaired
speakers. That is, I don't know utterances are shown to do many types of work within the
interactions between persons with dementia and their co-participants. Moreover, the analyses
presented here speak to the linguistic, interactional, and pragmatic competence with which
persons with dementia can use I don’t know utterances well into the moderate and severe stages
of the disease.
In Section 5.1, I present several lines of evidence that persons with dementia can use I
don’t know utterances to display epistemic stance. An analysis of sequential placement shows
how an I don’t know utterance can be occasioned by the structural environment in which a
knowledge claim is the focus, such as an answer to an information-seeking question.
Consideration of turn construction (composition) further shows the role of IDK utterances in
displaying epistemic stance. For example, in complement-taking I don’t know utterances, the
complement can index what knowledge is lacking: I don’t know what her name is. Additionally,
other practices such as self-repairs and word searches that show the speaker’s on-record attempts
to recall the missing information and which are produced in conjunction with the I don’t know
utterance further demonstrate its function as a display of epistemic stance. Co-participants’
orientations to I don’t know utterances also provide evidence of the epistemic work being done.
After a speaker’s I don’t know utterance, a co-participant who initiates a new action, such as
shifting from the current topic or bidding to close the sequence may display the co-participant’s
acceptance of the I don’t know utterance as sufficiently completing the previous action.
115
The I don’t know utterances in excerpt (1), as well as in other examples within this
chapter, show that persons with dementia can and do use I don’t know to display their epistemic
stance; however, this chapter provides extensive evidence that this is only one of many functions
of I don’t know utterances available to persons who are well into the moderate and severe stages
of dementia.
In Section 5.2, I show that participants with dementia use I don’t know utterances to close
and initiate sequences of talk. Co-participant orientations to I don’t know utterances that serve to
close sequences are relatively straightforward: the recipients shift or bid to close the topic/action
and introduce a new sequence. In one example we see a recipient initiate a new sequence upon
receipt of her co-participant’s I don’t know utterance before the speaker has actually completed
her turn. This may be evidence that the practice of closing a sequence with an I don’t know
utterance is a common one.
I also introduce what I have termed a “wondering” in discussing how complement-taking
I don’t know utterances can initiate new sequences. These I don’t know utterances as first-pair
parts can draw upon the claimed deficiency in the speaker’s own knowledge that is voiced
through an I don’t know, whether an actual knowledge deficiency or not, to allow that speaker to
initiate a “wondering” action. The topic of the “wondering” is introduced for consideration
through a complement clause in a way that could be paraphrased as, I’m wondering about X. The
I don’t know utterances can, in this way, initiate sequences of joint speculation about possible
solutions to the “wondering”: the recipient may thus join in the action of wondering about or
commenting on the topic at hand.
By initiating the sequence with a complement-taking I don’t know utterance, this
“wondering” can now be heard as a sort of thinking out loud. As such, it remains an open
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question as to what preference constraint this construction might impose on the co-participant
relative to the constraints imposed by alternative constructs such as a direct question. As Stivers
and Rossano (2010) have stated, we still know little about how it is that “speakers can hold
recipients more accountable for responding or not”; thus, they encourage focused investigation
on how participant response is mobilized to greater or lesser degrees as a result of sequential
position, action, and turn design (2010, p. 3). I will return to a discussion of this concept in
Chapter 7.
In Section 5.3, some participants with dementia are shown to maintain ability to manage
preference through their use of I don’t know utterances. For example, they are able to alter their
linguistic and syntactic choices during the ongoing moment-to-moment talk in an effort to
mitigate or avoid dispreferred actions, such as disagreeing, or to effectively avoid taking up an
action put in play by a co-participant. While I observed fewer types of preference management
associated with I don’t know utterances in this population than have been discussed in the
literature for non-impaired populations—e.g., responses to invitations, offers, and requests;
providing of second assessments; prefacing self-deprecation, criticisms, and complaints—this
may simply reflect the lack of topics and actions in my data set that would warrant those types of
preference management.
I also present in Section 5.3 the first observation of I don’t know utterances used to
minimize the positive assessment of a compliment as a practice of American English
conversation. A recipient of a compliment can deploy an I don’t know utterance to display
mitigated or tacit disagreement with a compliment. In doing so, the recipient complies with the
preference constraint to respond to the assessment sequence without having to produce a second
assessment about self, or engage in self-praise. As both my examples arise from elderly persons
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from the Carolinas, additional investigation of this phenomenon could show whether this
practice is a current and/or more widespread practice in American English.
Throughout Chapter 5, I build my analyses of the functions of I don’t know utterances on
sequential position, turn composition, the action or actions jointly negotiated within the sequence
of talk containing the I don’t know utterance, and through careful consideration of the co-
participants’ orientations to those utterances. In Chapter 6, I continue my investigation of the
functions of I don’t know, turning my attention to both a different special population and
institutional context: the talk of children undergoing an evaluation for and who receive a
diagnosis of autism spectrum disorder.
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CHAPTER 6
Children’s Use of I don’t know during Clinical Evaluations for
Autism Spectrum Disorder
6.0 Introduction
In this chapter, I conduct an exploratory investigation of the functions of I don’t know
utterances within a different special population. I turn my attention to the talk of children who
are undergoing evaluation for Autism Spectrum Disorder (ASD) and who subsequently receive
an ASD diagnosis. Specifically, I examine the children’s I don’t know (IDK) utterances in
response to questions that target emotional experiences on the Autism Diagnostic Observation
Schedule (ADOS-II). These questions are designed to tap into the children’s capacity for abstract
thinking and to provide insight as to how children with ASD express both their own emotional
experiences and their perceptions of other’s emotional experiences (Lord, Rutter, DiLavore, &
Risi, 1999).
I investigate how IDK utterances are functioning within the evaluation context by asking
what contributes to the children’s use of the IDK construction: Are there types of information
requested that lead to the use of IDK utterances across children with ASD? Do certain syntactic
formulations of the evaluation questions presented by clinicians contribute to the children’s use
of IDK utterances? I do so by examining the turn composition and sequential placement of IDK
utterances produced by the children as well as each clinician’s orientation to those utterances. I
also pay close attention to participants’ eye gaze, other bodily behavior, and prosody, as these
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multimodal aspects of interaction both contribute to and help reveal how the participants make
sense of their interactions.61
Overall, my findings reveal three functions of the IDK utterances used by children
undergoing evaluation for ASD. In a few instances, these children use IDK utterances to display
epistemic stance, that is, a lack of knowledge or uncertainty regarding the information requested
by the evaluation question, and the clinician orients to the utterances as such. In nearly all of the
other cases, the IDK utterances simply function to resist fulfilling the action of the question; in
essence, the children produce the IDK utterances in place of providing the information requested
by the evaluation question. In a single case, the IDK utterance works to project more talk.
Finding little variation in the function of the IDK utterances, I turn my attention to a
closer look at the evaluation question preceding the IDK utterance. I examine the clinician’s
formulation of the evaluation question, investigating the syntactic variations of each question in
relation to valid responses and nonvalid responses (e.g., IDK utterances, “no”, lateral headshake,
and silence).62
I report that the children may be having difficulty responding to a few questions
formulated with a “what about” construct. Lastly, I consider two practices used by the clinicians
that might encourage the production of valid responses from the children: 1) formulating a
question to use the inclusive we, and 2) incorporating a child’s previous answer into a question.
In Section 6.1, I provide the demographic characteristics of the participants. In Section
6.2, I summarize the testing protocol of the Autism Diagnostic Observation Schedule (ADOS-II).
In Section 6.3, I present an overview of the clauses associated with epistemic stance used by the
61
In contrast to the data of Chapter 5, the data used for this chapter contain video recordings that allow
me to draw upon multimodal aspects of each interaction. 62
I will refer to a response that provides some information of the child’s experience with the emotion or
social experience that is related to the evaluation question as a valid response. Responses that do not
provide such information—IDK utterances, silence, lateral head shakes, “no”—are in this sense not valid
responses.
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children in my data set. In Section 6.4, I discuss the types and frequencies of both the forms and
the sequential positioning of all IDK utterances produced by the children. In Section 6.5, I
analyze the functions of IDK utterances mobilized during questions about emotions (ADOS-II,
tasks 9 and 13). I pay careful attention to 1) the clinicians’ orientations to the children’s IDK
utterances and 2) the children’s concurrent and subsequent behaviors as they relate to the
progressivity of talk. I report on three functions: 1) knowledge claims, 2) resisting the question,
and 3) projecting more talk. In Section 6.6, I discuss the effect of syntactic variations of the
evaluation questions as a contributing factor to the frequent use of IDK utterances to resist the
question. In this section, I discuss one format, the “What/how about” question construction. In
Section 6.7, I consider two practices that are employed by clinicians which might encourage the
production of valid responses from the children. In Section 6.8, I conclude the chapter with a
summary and discussion of the findings.
6.1 The Data
My data come from my work on the NSF-funded project “A Sociology of Testing and
Diagnosis of Autism Spectrum Disorder” that was supported by grants from the University of
Wisconsin Graduate School, the National Science Foundation (#1257065, Doug Maynard,
Principal Investigator), and the Waisman Center’s University Center for Excellence in
Developmental Disabilities grant from National Institute for Child Health and Human
Development (#P30 HD03352). Data collection occurred between July, 2013 and June, 2015.
The participants in this study are five clinicians and seven children. Four of the clinicians
are developmental psychologists and one is a clinical psychiatrist. All clinicians are female; they
are represented in the transcripts by the abbreviation PY. Of the children, six are males and one
is female; they are between the ages of 6;9 and 13;7 years old. Table 6-1 provides the case
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number, child’s pseudonym, and age (yr;mo). In the transcripts, each child is designated as CH.
Occasionally, the child’s mother (MO) or father (FA) is in the room during the evaluations and
the child or clinician may interact with them during the evaluation. In each evaluation the
clinician is administering the Autism Diagnostic Observation Schedule II, Module 3 (2012); each
evaluation occurred at a clinic for developmental disabilities located in the Midwest, United
States. All seven children receive an Autism Spectrum Disorder diagnosis. The duration of each
evaluation is between 57 minutes and 1 hour, 15 minutes, for a total duration of 8 hours and 46
minutes of video data.
TABLE 6-1. DEMOGRAPHICS: CHILDREN WITH ASD
Case Pseudonym Age
(yr; mo)
24 Dan 9:3
28 Malcolm 13;1
39 Melody 12;7
40 Wade 13;7
42 Tanner 6;7
44 Justin 10;0
46 Gordon 11;2
6.2 ADOS-II
The most widely used diagnostic assessment for autism spectrum disorder is the Autism
Diagnostic Observation Schedule-II (ADOS-II; Lord, Rutter, DiLavore, & Risi, 1999). The
ADOS-II is considered the “gold standard” in autism assessment (Kline-Tasman, Risi, & Lord,
2007). The evaluation is a standardized assessment of communication, social interaction,
play/imagination, and stereotyped behaviors and interests for individuals who are thought to
have autism. The current version of the ADOS-II can be used with a broad range of examinees,
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both in terms of age and expressive language abilities, and in a variety of settings (DiLavore,
Lord, & Rutter, 1995). Additionally, the ADOS-II has gone through a number of validation
measures in order to provide more consistent differential diagnosis between children and
adolescents on the autism spectrum and those with other developmental disabilities that are not
on the spectrum (Lord et al., 1999).
The ADOS-II consists of four modules. One module is administered to an examinee
during a comprehensive evaluation. Each module includes items from four subscales:
Communication, Reciprocal Social Interaction, Play/Creativity/Imagination, and Stereotyped
Behaviors and Restricted Interests. Each of the ADOS-II modules is developed for individuals of
different age-language levels. Module 1 is designed either for nonverbal examinees or for those
who do not consistently use spontaneous phrase speech (Lord et al., 2000). Module 2 is designed
for use either with young children who are “verbally fluent” (i.e. individuals who “produce a
range of flexible sentence types, provide language beyond the immediate context, and describe
logical connections within a sentence”) or with older children who exhibit some spontaneous
phrase speech but who are not “verbally fluent” (Lord et al., 1999, p. 5). Module 3, which was
used to evaluate all the children in my data set, is for older children and younger adolescents who
display fluent, spontaneous speech. It contains fourteen different tasks; four of these are
dedicated to social or emotional topics, two of which will later be the focus of this chapter.
Module 4 is typically administered to older adolescents and adults with fluent expressive
language abilities but who are less suited to some of the imaginative play activities of Module 3.
Emotion questions (Task 9)
As reported in the ADOS-II, Module 3 evaluation form (Lord, Luyster, Gotham, &
Guthrie, 2012, p. 7), the role of the emotion questions, task 9, is threefold. First, these questions
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provide an opportunity for the child to display verbal fluency in describing an abstract topic, the
experience of different emotions. Secondly, these questions allow clinicians to elicit information
that demonstrates the child’s typical social relationships, including their ability to perceive and
interpret others’ emotional states. Lastly, these questions provide opportunity during the
evaluation for the child to demonstrate creative language expression.63
The task of describing
one’s emotions is characterized in the manual as a challenge for many people, not only persons
or children with ASD. For this reason, evaluators are encouraged to watch for signs of stress in
the child during this task. To help reduce stress in the child, evaluators are provided a detailed
protocol on how to administer the questions. This protocol includes both the initial prompt
(“Now I’d like to ask you a few questions”) as well as the wording for each emotion question
and each follow-up question for five different emotions: happiness, sadness, anger, fear, and
being “relaxed” (i.e., contentment). The children are asked what elicits a particular, identified
emotion. The wording for each follow-up question is also provided; these questions ask that the
children describe how a particular emotion makes them feel; that is, how they would describe
their bodily, or physical, experience of that emotion.64
On the emotion fear, a third question that
asks what the children do when they are experiencing fear is sometimes included. The evaluator
is able to select the order of the emotion questions, particularly if one emotion is more fitted
within the context of talk that can spontaneously arise during this segment of the evaluation or
that has arisen in the course to the evaluation prior to this task. Additionally, the clinician may
63
See Appendix D for the ADOS-II, Module 3 questions for tasks 9 and 10. 64
The transcripts related to questions that ask the child to provide information on what things or activities
elicit a certain emotion are identified with the emotion plus I (e.g., Happy I); transcripts corresponding to
follow-up questions on what a particular emotion feels like are designated using the emotion plus II (e.g.,
Happy II). When both the initial and follow-up questions are asked in close proximity and the analyses for
all questions occurs using a single transcript, the transcript is labeled with the emotion and I & II (e.g.,
Happy I & II).
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move on to the next evaluation task once the child has provided “detailed” descriptions of at least
two emotions.
The presentation of the emotion questions in the ADOS-II, Manual 3 evaluation booklet
(2012) follows this order: happiness, fear, anger, sadness, and contentment. This order is
generally adhered to by the clinicians within my data, with minor variation. Additionally, not all
questions are asked of each child. As stated above, questions can be omitted once the child
provides a detailed response to two emotions questions. The clinician can omit a question, cease
the pursuit of a particular emotion question, or advance the evaluation to the next task,
particularly if the clinician believes the child is displaying signs of stress. The clinicians
occasionally modify these questions in the course of the evaluation; I note any such
modifications only if I deem the modification as relevant to my analysis.
6.3 Overview of Epistemic Clauses in the Data
Consonant with my close investigation of I don’t know in the talk of participants with
dementia (Chapter 5) and guided by my understanding of the use of grammatical structures that
are associated with the use of epistemic stance markers (Chapter 4), I focused my initial
observations on the use of all epistemic clauses deployed by children in the ADOS-II, Module 3
evaluations. These epistemic clauses consist of a first person pronoun plus a mental verb, both
with and without a negator (e.g., I think, I don’t think, I guess, I know, I don’t know), see Table
6-2. Overall, the children with ASD exhibit less variety in their selection of epistemic clauses
than do persons with dementia, however, the relative frequencies of the epistemic clauses that
they do use is similar to that found in persons with dementia and non-impaired speakers.
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TABLE 6-2. EPISTEMIC CLAUSES SELECTED BY CHILDREN WITH ASD DURING
ADOS-II, MODULE 3
I don’t know 84
I think 43
I guess 19
I know 8
I don’t think 7
I remember 1
Total 162
Only six different epistemic clausal constructions appear in the talk of the children undergoing the
ADOS evaluation within my data set as compared with 15 different constructions in the talk of
persons with dementia. Of the 162 epistemic clauses that emerged in the talk of children during the
evaluation, the use of I don’t know (n = 84) is nearly twice that of the next most frequent epistemic
clause, I think (n = 43). The nearly 2:1 ratio of I don’t know to I think (and the frequent use of both
relative to other constructs) is comparable to that seen in persons with dementia (see Section 4.2.3)
As in the previous chapter, I will restrict my analyses to the most frequently occurring clause, I don’t
know.
6.4 Overview of IDK Utterances in the Data: Forms and Sequential Position
Before I move to my interactional analyses, I present several general observations on the
emergence of IDK utterances within the structure of the exam. These include an overview of the
turn construction (forms) and sequential position of the IDK responses within my data collection.
6.4.1 Forms
In terms of turn composition, I first provide a summary of the different syntactic
constructions present within the data. Independent IDK utterances may be: a) stand-alone; b) turn
initial, or prefaced; c) turn medial, or parenthetical; or d) turn final. Constructions (b) – (d) may
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be prosodically connected to the turn, but they are not syntactically integrated with the rest of the
turn components. Complement-taking IDK utterances are produced with some type of
grammatical form that functions as a complement to the IDK clause. As previously noted in
Chapter 3, using utterances from my dementia data, the examples of complement-taking IDK
utterances are presented in examples (e), (f), and (g).65
Independent IDK utterances
(a) IDK standalone: I don’t know.
(b) IDK turn initial (preface): I don’t know, I’m still sleepy this morning.
(c) IDK turn medial (parenthetical): It was, I don't know, about five pounds.
(d) IDK turn final: I think they're coming, I don't know.
Complement-taking IDK utterances
(e) IDK + wh-complement: I don’t know how to cook.
(f) IDK + if-complement: I don’t know if they will be here.
(g) IDK + noun phrase complement: I don’t even know her last name.
Syntactic composition of the IDK utterances produced by children with ASD in my data are
predominantly standalone, accounting for 55 (65%) of the IDK utterances. An additional 18
(21%) are complement-taking IDK utterances. The remaining 11 (13%) include all other
independent forms—prefaces, medial, and final—and they do not figure prominently in the
analyses presented here.66
65
As in my analyses of IDK utterances within the talk of persons with dementia, I consider IDK
utterances that are both grammatically independent turn construction units (i.e. standalone or that are
prosodically but not syntactically integrated within the larger turn component) and those that are
complement-taking (e.g., IDK clauses that take complements such as a noun phrase; a prepositional
phrase; a wh-, if-, that-clause). Just as recipients of IDK utterances must attend to whatever turn
compositions that their interlocutors produce, I, too, as an analyst consider all turn compositions of IDK
utterances as they are produced by speakers and attended to by their co-participants in my data. 66
These include four prefaces, six medials, and one final.
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All phonetic variants of I don’t know are considered (i.e., I don’t know, I dunno, I donno,
I du no, I ‘ont no); however, I did not find connections between articulation patterns and
functions.67
6.4.2 Sequential position
In terms of sequential position, or where the IDK utterances emerge in the sequential
ordering of actions within the evaluation talk, of the 84 IDK utterances, 68 (81%) follow as
second-pair parts within question-answer sequences that are initiated by clinicians as part of the
evaluation protocol. Nine IDK utterances (11%) occur within multiunit turns that follow from
clinicians’ questions. Seven (8%) occur in the talk of children while they are engaged in an
independent task that their clinician has asked them to do (e.g., the child has been directed to
play with particular toys independently while the clinician “catches up on notes”68
). These last
IDK utterances are first-pair parts that, in this setting, work to garner the clinician’s attention,
engagement, and/or assistance.69
6.5 I don’t know as Response to ADOS Questions about Emotions
In this section, I provide analyses of excerpts that represent two of the four tasks that
evaluate emotional and social competence in children suspected of being on the autism spectrum.
The task 9 evaluation questions address the emotions of happiness, fear, anger, sadness, and
contentment. Task 13 addresses loneliness. Overall, 23 of the 84 IDK utterances in my data are
in response to these two task questions; the below excerpts contain 14 of these. Two of the
67
Likewise, I did not find connections between articulation patterns and functions in the IDK utterances
produced by persons with dementia. 68
ADOS-II, Module 3, task 11. 69
These last seven examples fit the characterization of a “wondering” that I introduced in the previous
chapter. The use of such wonderings by children with ASD invites further investigation, especially as
they appear to be attempts by the child to initiate interaction.
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children, Melody and Tanner, did not produce IDK utterances during these tasks; utterances from
each of the other five children are represented.
I begin my analyses with the function of the IDK responses by the children during tasks 9
and 13. I then consider possible effects that variation in clinicians’ syntactic formulation of the
task question(s) could have on the frequency of IDK utterances.
6.5.1 Knowledge displays
In this first section, I examine three excerpts in which the children use IDK utterances to
express their epistemic stance. Two of these are complement-taking utterances in which the
complements give explicit voice to the reason for the knowledge claim. The other is a turn final
IDK utterance that works to downgrade the child’s preceding utterance. Each IDK utterance is
structurally occasioned by the evaluation context; that is, the exam questions make knowledge
claims the focus. In each case, the IDK utterance is also accompanied by verbal and/or embodied
behaviors that provide evidence that the utterance works to display stance. Moreover, in each
case the clinician’s orientation confirms that the child’s response is heard as an epistemic claim. I
conclude the section with an ambiguous case of a standalone IDK in which the context of the
conversation suggests an epistemic function but for which other evidence is lacking.
In excerpt (1) below, the child’s complement-taking IDK utterance functions to identify
his difficulty with describing his emotions. In line 566, the excerpt begins with the clinician
asking the child, “And, uhm ah so can you describe how you feel when you’re happy.”.
(1) Case 46 Gordon, age 11;2 (Happy II, p. 12)
566 PY: And, uhm ah so can you describe how you feel when you’re happy.
567 CH: Like (.) some (.) like (.) well I don’t really know how to
568 describe when like I’m happy, like ((diverts gaze upward toward
569 ceiling)) it’s like, ah feeling- ((takes right hand with index
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570 finger pointed toward abdomen and makes circular motion)) you
571 can’t describe- like jealousy, you can’t describe that feeling.
572 PY: M’huh. m’huh. m’huh, yeah. it’s hard to describe that. really hard.
573 okay and, uhm what things are you afraid of?
In lines 567-568, Gordon begins his turn with features that evidence some difficulty with his
formulation of the answer to the evaluation question: “Like (.) some (.) like (.) well I don’t really
know how to describe when like I’m happy,”. First, he restarts his turn four times, with each
restart separated by a micropause. He uses a well-prefaced utterance that indicates his response is
not going to be straightforward (Schegloff & Lerner, 2009). His production of the IDK utterance
employs the adverb really that places emphasis on the verb know or, in this case, don’t know: “I
don’t really know”. Employing a complement-taking IDK, the child uses the complement to
identify his difficulty: “how to describe when like I’m happy”. In another possible sign of
difficulty (Rossano, 2013; Wilkinson, 2009), he then looks toward the ceiling, which could serve
as a bodily on-record display to his recipient that he is searching for an answer ((diverts gaze
upward toward ceiling)) (lines 568-569). He then begins another unit of talk only to cut it off
“it’s like, ah feeling- (line 569). The cut-off is soon followed by a gesture that suggests an
attempt to provide an iconic, embodied version of an answer that he has not been able to
verbalize; this gesture is something along the lines of stomach churning: “it’s like, ah feeling-
((takes right hand with index finger pointed toward abdomen and makes circular motion)) (lines
569-570). He ends his turn with a tacit claim that potentially anyone (if “you,” is heard as a
general or categorical reference) would have difficulty: “you can’t describe- like jealousy, you
can’t describe that feeling.” (lines 570-571).70
70
The function of “you” has been shown to be “systematically ambiguous” because it does not distinguish
between singular and plural, or between addressing someone personally rather than referring to
130
In line 572, the clinician initiates her response with a series of three minimal tokens of
receipt and then an agreement token: “M’huh. m’huh. m’huh, yeah.” She then provides a second
assessment of the task: “it’s hard to describe that. really hard.”(line 572). She upgrades his
assessment with the characterization that describing emotions, or at least one of these mentioned
emotions, is “really hard”. The clinician then moves to the next emotion question, closing the
sequence on happiness: “okay and, uhm what things are you afraid of?” (line 573).
In this excerpt, the child’s IDK utterance is produced along with verbal and nonverbal
behaviors—perturbations, halts in his turn, shift in gaze, the use of gesture indicative of churning
in his stomach, and the syntactic composition of his turn—all of which work to identify the
difficulty he is having providing a description of happiness. The child’s gesture evidences that,
while he cannot describe at the moment how it feels to be happy, he is engaged in a search for
the information to the question being asked.71
The clinician displays agreement and affiliation
with the child’s stance before moving to close this sequence and initiate a new question-answer
sequence, all evidencing that the child’s response is heard as his present inability to provide a
valid answer.
In excerpt (2) below, Justin has produced a valid response to the question of what kinds
of things make him sad (“Like when my little brother breaks something that belongs to me”,
lines 529-532). Yet when asked what it feels like when he is sad, he mobilizes, as part of his
answer, an IDK utterance to express uncertainty with that answer.
“everyone” (Sacks, 1992, pp. 348–53); that is, “you” can be used in a categorical and generic sense or in a
personal sense (Watson, 1987, pp. 268–70). 71
In a later segment of the evaluation, presented in excerpt (19), Gordon is asked about how it feels when
he is sad. In a manner similar to what is described above, he gazes to the ceiling, touches his chest,
vocalizes that it is difficult to describe. The gestural behavior in this latter instance is, however, followed
by an elaborate physical description of feeling sad. This description includes “I might shiver” and “it’s
kinda like your stomach is flopping around”. I mention this as evidence that Gordon’s gestures may,
indeed, be giving “voice” to his feelings about emotions. This latter example also shows that he does not
have a general inability to describe emotions and how they feel.
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(2) Case 44 Justin, age 10;0 (Sadness II, pp. 11-12)
529 PY: We all have times when we feel sad what kinds of things make you
530 ((looks at CH)) feel sad. ((looks down at booklet))
531 (0.4)
532 CH: Like when my little brother breaks something that belongs to me.
533 PY: Oh, my. Yeah that’s kinda sad. So when you feel sad, what’s that
534 like=can you describe what that’s like when your brother breaks
535 somethin’ [or-
536 CH: [((gazes up toward ceiling)) It’s like you’re mad and
537 sad, I dunno.
538 PY: M’huh, m’huh. (.) .tsk okay what bout feeling relaxed ((directs
539 gaze at CH)) what kinds of things make you feel relaxed.
The clinician contextualizes the evaluation question with Justin’s previous response: “So when
you feel sad, what’s that like=can you describe what that’s like when your brother breaks
somethin’ [or-” (lines 533-535).72
The clinician cuts off her question (“somethin’ or-”, line 535)
as Justin directs his gaze toward the ceiling (line 536), possibly indicating that she sees Justin’s
gesture as a search for an answer. Her use of the preposition “like” requests that the child provide
a characterization of this experience. At lines 536-537, Justin formulates his response by drawing
upon the syntax of the question used: “it’s like you’re mad and sad, I dunno.” He uses the “like”
construction to characterize the complexity of this experience as one that evokes two emotions.
The turn final IDK utterance works as an epistemic downgrade that attenuates the certainty of
that characterization. Here the child displays his difficulty either in capturing the precise
emotion(s) he experiences or in describing those rather than simply naming them. The clinician’s
response displays her acceptance of his characterization, “M’huh, m’huh.”, line 538. She then
72
On the functions of turn-final or, see Drake, 2015.
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moves to the next emotion: “(.) .tsk okay what bout feeling relaxed ((directs gaze at CH)) what
kinds of things make you feel relaxed.” (lines 538-539). Here we see the IDK utterance also
works to close the child’s turn and serves in the closing of the sequence, as evidenced in the
clinician’s orientation to move to another question-answer sequence.
As did the IDK utterance presented in excerpt (2) above, the next IDK utterance
presented takes a complement in a display of epistemic stance. Prior to the question presented in
(3) below, Gordon has stated in a response to a series of questions that he “sometimes” feels
lonely, that he believes other kids his age feel lonely, and that he does many things to help
himself feel better when he is lonely. In line 1203, the clinician then asks, “M’hm. M’hm. okay,
and what and what about other things that people do to help themselves feel better when they’re
lonely.”
(3) Case 46 Gordon, age 11;2 (Loneliness II, p. 24)
1203 PY: M’hm. M’hm. okay, and what and what about other things that
1204 people do to help themselves feel better when they’re lonely.
1205 (0.3)
1206 CH: I donno ‘cuz they never tell me.
1207 PY: M’huh. [okay.
1208 CH: [or show me.
1209 PY: Uh’huh, okay. yeah, but, hopefully they have something that helps
1210 them feel a little bit better. ((turns to cabinet))
1211 Okay, very good, we’ve got one more thing to do, this is real
1212 simple.
After a 0.3 second pause, the child mobilizes a complement-taking IDK utterance through which he
makes no claim of knowing how others manage their loneliness: “I donno ‘cuz they never tell me.”
(line 1206). Through this turn composition, the child makes an epistemic claim, “I donno”, in which
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the reason he lacks this knowledge is explicitly addressed through the adverbial complement: “‘cuz
they never tell me.”. As the clinician produces two minimal tokens that display receipt of the child’s
claim of insufficient knowledge, “M’huh. [okay.” (line 1207), the child continues in overlap with
additional reason for his lack of knowledge regarding what others do when they are lonely: “[or
show me.” (line 1208) (on accounts following negation, see Ford, 2001). In his complement-taking
IDK utterance, the child displays that any claim to knowledge would rely on his experience of
hearing or seeing what others do. The clinician provides receipt of this additional information:
“Uh’huh, okay. yeah,” (line 1209) with a summative statement on the issue of others’ experiencing
loneliness: “but, hopefully they have something that helps them feel a little bit better.” (lines 1209-
1210). She then transitions to the next test activity (lines 1211-1212).
The IDK utterances presented so far are used by each of the children to reflect an actual lack
of knowledge or an uncertainty about the topic at hand. All of the IDK utterances are occasioned by
the structural environment in which a knowledge claim is the focus, that is, an answer to the
information-seeking questions of the ADOS evaluation. The sequential positioning and/or the
syntactic construction of the IDK utterances along with on-record attempts to recall information give
the clinician (and us) insight into what, precisely, is the object of uncertainty or missing knowledge.
Furthermore, the clinicians’ orientations to the IDK utterances provide additional evidence of the
epistemic work being done; the clinicians acknowledge, and in one instance affiliate with, the
children’s IDK utterances as displaying lack of knowledge.
In the example that follows, the standalone IDK utterance lacks a complement to clarify the
point of uncertainty and the clinician’s orientation does not clearly suggest an epistemic function.
The context of the conversation does, however, suggest such a function. Excerpt (4) begins with the
clinician checking Dan’s understanding of the word lonely (lines 928-933). In line 934, she asks,
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“Do you think kids your age ever feel lonely?”
(4) Case 1 Dan, age 9;3 (Loneliness II, p. 20)
928 PY: Dan, do you know what the word lo:nely means, have you ever heard
929 that word?
930 CH: Yes.
931 PY: So it means that um, somebody’s feeling sad about being by
932 themselves.
933 CH: Or scared by themselves.
934 PY: Or scared, yeah. Do you think kids your age ever feel lonely?
935 CH: I don’t know.
936 PY: Not sure? Do you: ever feel that way?
937 CH: No.
938 PY: What do you think somebody could do:, if they were feeling lonely?
939 to make themselves feel better.
In response to this question, Dan mobilizes a standalone IDK utterance, “I don’t know.”
(line 935). This utterance could be heard to display his lack of knowledge about what others do,
much like Gordon’s claim which is made explicit in a complement-taking IDK utterance.
However, Dan does not make this claim explicit. At line 936, the clinician responds to Dan’s
IDK utterance, “Not sure?”, which could be heard as a clarification request that renews further
talk from the child. The clinician, however, does not wait for a response from Dan. Instead, she
immediately presents the next question in the task, “Do you: ever feel that way?” (line 936). The
clinician’s stress and sound stretch on her formulation of “you:” reinforces that she is asking Dan
what he knows about himself in contrast to what he claims not to know about others. Dan
immediately produces a negative token, “No.” (line 937). He is able to unequivocally state that
he does not ever feel lonely. Dan’s negative claim demonstrates that he is able to report on his
own experiences, whereas his IDK utterance suggests an apparent inability to report on the
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experiences of others.
That said, as an immediate second-pair part to the clinician’s question, Dan’s IDK
utterance does not provide the requested information. I present this example because it illustrates
the difficulty in interpreting the function of a standalone IDK utterance: the utterance might be
displaying epistemic stance—the child may truly not know—but lacking any additional
corroborating evidence such as a complement or an explicit acknowledgement by the clinician,
we as analysts cannot conclusively determine that it does, in fact, function in the interaction to
display stance. In not providing the requested information, the IDK utterance may instead be
resisting the question, a function I address in this next section.
6.5.2 Resisting the question
As just discussed, an IDK utterance may work within the immediate evaluation question-
answer sequence to resist providing a valid response. I do not necessarily mean that in such cases the
child is engaging in an active strategy of resistance.73
That is possible, but I use the term in a more
limited way: resist simply means that the child either does not respond or produces some response,
such as an IDK utterance or lateral head shake, in lieu of a valid response.74
In the cases that follow,
an IDK utterance is produced instead of a valid response. These IDK utterances are not accompanied
by verbal or nonverbal behaviors that would suggest them to be knowledge claims. They are also not
accompanied by cues that additional talk is forthcoming. In every case, they are standalone IDK
utterances.
In excerpt (5) below, the child Malcolm uses an IDK utterance to resist a single evaluation
question. As the excerpt begins, he has provided both ample examples and descriptions of his
73
The use of IDK utterances by neurotypical children as part of a strategy of resistance has been
discussed (see Hutchby 2002, 2005). 74
As a reminder, “valid” here means a response that provides some information that is sought by the
question.
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emotional experiences (e.g., video games make him happy; being afraid makes his body stand
still; people saying stupid things makes him mad). At lines 1933-1934, the clinician then poses a
follow-up question about Malcolm’s experiences of anger.
(5) Case 28 Malcolm, age 13;1 (Angry II, p. 15)
1933 PY: And ((gestures with hand toward self)) how do you feel inside when
1934 you’re real angry.
1935 (0.2)
1936 CH: I dunno. ((directs gaze to left))
1937 ((CH rubs cheek with right hand))
1938 [ (0.4) ]
1939 PY: [((observes CH; writes in booklet))]
1940 PY: That’s okay. (.) And, most people have times when they feel sa:d,
1941 what kinds of things make you feel that way.
After a slight pause (0.2 seconds, line 1935), the child responds with the standalone IDK
utterance “I dunno.” (line 1936). As he does so, he directs his gaze to the left of the clinician, not
directly at her, and begins to rub his cheek with his right hand (lines 1936-1937). As he looks
away from the clinician and has begun “playing” with his face, these bodily actions may indicate
he is either having difficulty with the question or he is disengaging from the question-answer
task. The clinician takes 0.4 seconds to observe the child’s behavior while she adds notes to the
evaluation form (lines 1938-1939). In line 1940, she responds with the palliative “That’s okay.”.
This response works to accept his standalone IDK utterance as a substitute for the information
requested by the question. In this way, Malcolm’s standalone IDK resists providing a valid
response to this question and serves in the closing of this sequence, which is completed by the
clinician’s move to the next question-answer sequence on sadness (lines 1940-1941).
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In excerpt (6), the child produces a series of standalone IDK utterances that work to resist
providing information to a series of evaluation questions.
(6) Case 24 Dan, age 9;3 (Anger I & II and Sadness I & II, p. 17)
785 PY: What about feeling mad or angry? ((CH looks down))
786 What kinds of things make you feel that way.
787 CH: Ah:: I dunno.
788 ((CH looks over at MO))
789 PY: How does your body feel when you’re mad or angry.
790 CH: >I dunno<.=
791 PY: =not sure. Most people feel mad sometimes.
792 CH: I’m making this go backwards ((talking about the fire truck))
793 [on two wheels. ]
794 PY: [It’s going backwards?]
795 ((CH sideways glance at PY))75
796 PY: And Dan, most people have times when they feel sad, what kinds of
797 things make you feel sad.
798 ((CH playing with truck))
799 CH: Uh:m, (.) ((turns truck in a circle)) ah: I dunno.
800 PY: Not sure?
801 (0.3)
802 PY: How do you feel when you’re sad. (.) Can you describe it. How does
803 your body feel.
804 CH: Ah:: (.) uh I don=know.
75
I note here that Dan does not direct his gaze at the clinician upon producing an IDK utterance, a No
utterance, or a lateral head shake when made in response to one of the evaluation questions. However,
over a dozen times when providing a valid response to an evaluation question, responding to an off-script
conversation, or initiating a topic he looks or glances at the clinician upon completion of his turn. Dan
could be using gaze to signal the end of his turn and to select the next speaker. But the fact that he does
not use this gesture when providing a nonvalid response to an evaluation question might also suggest
either that he is aware that he has not provided the requested information or he is not finished with his
turn. A closer look at the coordination of Dan’s gaze with his valid and nonvalid responses is warranted.
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805 PY: That’s okay. you’re doing a great job answering all my questions.
806 We’re gonna switch to something a little bit different.
At lines 785-786, the clinician issues evaluation questions on anger: “What about feeling mad or
angry? What kinds of things make you feel that way.” In line 787, the child produces the
perturbation “Ah::” with a sound stretch which indicates additional talk is forthcoming. Instead
of providing an action or an event that makes him angry, the child produces a standalone “I
dunno.”. His utterance is formulated with turn final prosody signaling no additional talk, thus
marking the end of his turn. The standalone IDK fills the information slot requested by the wh-
question, specifically the “what” that makes him angry, thus working to resist providing the
clinician with that information.
At line 789, the clinician responds with the next question, “How does your body feel
when you’re mad or angry.” To this, at line 790, the child produces an immediate “>I dunno<.=”.
This standalone IDK utterance, unlike the child’s previous one, is produced without a preceding
perturbation and with quicker articulation but also with turn final prosody. The clinician’s
response is immediate as well. She latches her next utterance to the child’s utterance, “=Not sure.
most people feel mad sometimes.” (line 791). The child produces an immediate next turn in
which he shifts the topic of talk from the evaluation questions to the toy truck he has in front of
him, “I’m making this go backwards ((talking about the fire truck)) [on two wheels. ]” (lines
792-793).
The clinician does engage with this topic in overlap with Dan’s continued talk about the
truck, “[It’s going backwards?]” (line 794). As Dan completes his talk, he diverts his gaze
toward the clinician (line 795); a move that may indicate his turn is complete and works to
secure the clinician’s (continued) engagement with the topic he has proffered. At this point, the
clinician returns the talk to the evaluation frame, first by addressing the child by his name and
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then issuing the next evaluation question “And Dan, most people have times when they feel sad,
what kinds of things make you feel sad.” (lines 796-797). The child continues to play with the
firetruck (line 798) before engaging with the question and responding with yet another IDK
utterance, this time prefaced by two perturbations: “Uh:m, (.) ((turns truck in a circle)) ah: I
dunno.” (line 799). The two perturbations, the micropause, and the child’s continual engagement
with the toy work with the standalone IDK utterance to again resist providing the information
requested by an evaluation question.
The clinician now produces a clarification question along with rising intonation and a
pause which renews the relevance for a valid response to this question: “Not sure? (0.3)” (lines
800-801). When no response is forthcoming, the clinician issues a multiunit turn of three
questions, “How do you feel when you’re sad. (.) Can you describe it. How does your body feel.”
(lines 802-803). The child responds with another IDK utterance: “Ah:: (.) uh I don=know.” (line
804). Here again we see perturbations and a micropause precede the IDK utterance. Although it
is impossible to know to which question in the series Dan’s standalone IDK is directly in
response to, it resists providing information requested by any of the three questions.
Overall, in response to varied questions about two different emotions, Dan’s succession
of four standalone IDK utterances with turn final prosody works to effectively resist providing
any information about his experiences with these emotions. It is at this point (lines 805-806) that
the clinician moves to the next evaluation task: “That’s okay. you’re doing a great job answering
all my questions. We’re gonna switch to something a little bit different.”.
6.5.3 Projecting further talk
In contrast to IDK utterances which resist providing a valid response, in this section I
propose that an IDK response can be produced en route to a valid response. I present a single
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IDK utterance that functions to project more talk is forthcoming through its continuing
intonation and the subsequent production of a valid response within the same turn.
In excerpt (7) below, the child produces an IDK utterance in turn medial position with
continuing intonation and immediately preceding a valid response. As the clinician asks about
the child’s experiences with loneliness (line 1195), the child reports that he does experience being
lonely “Sometimes” (line 1196). When asked if he believes kids his “age ever feel lonely” (line
1197), he reports that he does believe others experience loneliness “Sometimes” (line 1198). When
the clinician issues the evaluation question on whether he has strategies to ameliorate his loneliness
(line 1199), the child confirms that he does (line 1200).
(7) Case 46 Gordon, age 11;2 (Loneliness II and III, p. 24)
1195 PY: Do you ever feel lonely?
1196 CH: Sometimes.
1197 PY: M’huh. Do you think other kids your age ever feel lonely?
1198 CH: Sometimes.
1199 PY: M’huh. Are there things that you do to help yourself feel better?
1200 CH: Ye- Y-yeah.
1201 PY: M’huh.,h tsk. what. ((looks up at CH))
1202 CH: Well, like, I::, don’t know, I do a lot of things.
1203 PY: M’hm. M’hm. okay, and what and what about other things that
1204 people do to help themselves feel better when they’re lonely.
Next, the clinician asks for specific examples of what the child does when he is lonely (“What.”, line
1201). The child responds, “Well, like, I::, don’t know, I do a lot of things.” (line 1202). His turn
begins with a well-preface that signals a straightforward answer is not likely (Schegloff & Lerner,
2009). The child next produces the word like which suggests he is searching for a characterization of
the actions he takes when lonely. As he produces the clause “I::, don’t know,”, he does a vowel
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stretch on the pronoun I that seems be part of his search for what it is he does. The know is
formulated with continuing intonation, signaling that his turn is not yet complete and that he is still
engaged in an on-record search for the things he does when he is lonely. In his second unit of talk, he
formulates his answer as “I do a lot of things.” While this utterance does not reveal specific actions
that he does, it serves to fill the slot requested by the question. It indicates to the recipient that the
child, indeed, takes actions and that these actions are numerous. Thus, the IDK functions as a way to
hold his turn and signal more talk is forthcoming while he continues his search for a valid response.
The clinician accepts this utterance as satisfactorily completing the question-answer sequence and
proceeds to the next question: “M’hm. M’hm. okay, and what and what about other things that
people do to help themselves feel better when they’re lonely.” (lines 1203-1204). In sum, the child’s
IDK utterance in this sequence functions along with other verbal practices—the well-preface, the use
of like, the sound stretch and continuing intonation—to project a valid response to the question. The
IDK utterance may be glossed as I don’t know what to say right now.
I present this single case of an IDK utterance that works to project forthcoming talk
(Schegloff, 1996), which in this instance is a valid response. I suggest that an initial second-pair
part IDK utterance produced after a question may be a place holder produced en route to a
forthcoming utterance. In this example, the IDK utterance is formulated with continuing prosody
within the stream of talk. The production of the IDK seems akin to sound stretches and
perturbations in that they project additional talk and, thereby, override the syntactic and action
completeness of the IDK utterance.
6.6 The Syntactic Formulation of the Evaluation Question
Finding little variation in the functions of the IDK utterances, I turn my attention to a
closer look at the evaluation question preceding the IDK utterance. My question here is whether
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something in the syntax of the questions could account for the frequent use of IDK utterances to
resist the question. I examine the clinician’s formulation of the evaluation question, investigating
the syntactic variations of each question in relation to valid responses and nonvalid responses
(e.g., IDK utterances, no or other negative responses (e.g., m’hm), lateral headshakes, and
silence). In this next section, I walk through my analyses for the questions on happiness to
illustrate the approach I took to assessing all the emotions.
In excerpt (8), the child is presented with the first question on happiness. The clinician
formulates this exactly as the question is modeled in the ADOS manual (line 539, below), and
the child produces a valid response (lines 540-541).
(8) Case 46 Gordon, age 11;2 (Happy I, p. 12)
539 PY: What do you like doing that makes you feel h-happy and cheerful.
540 CH: Uhm, well sometimes (.) like yesterday (when I get home) sometimes
541 I play with my d↑og.
The clinician’s question matches the first model question, with only a slight hesitancy in her
production of the emotion word happy. Although the child begins his response with some
hesitancy (“Uhm, “well sometimes”, and a micropause), he produces an answer that is fitted to
the question of what he likes doing that makes him happy: “Uhm, well sometimes (.) like
yesterday (when I get home) sometimes I play with my d↑og.” (lines 540-541). In considering
the possible effects of syntactic variation on the children’s valid and nonvalid responses, I looked
closely at the variants of this question as it is posed to five additional children. In one case it is
formulated exactly as above (line 539); in another the word “feel” is omitted; and in another the
word “cheerful” is left off. In all three cases the children produce valid responses. In the fourth
and fifth cases, the “doing” has been replaced with “to do": one child produces an IDK utterance
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while the other gives a valid response.76
I consider each below, beginning with the valid
response.
As excerpt (9) begins, the clinician has just initiated the first question of task 9 on
emotions. She asks, “So, what do you like to do that makes you feel happy and cheerful?” (line
648).
(9) Case 28 Malcolm, age 13;1 (Happy I, p. 14)
648 PY: So, what do you like to do that makes you feel happy ˚and
649 cheerful˚.
650 CH: [((places hand on chin; rocks laterally; looks to the ceiling))]
651 [ (6.3) ]
652 CH: Play video games.
653 PY: Okay. and how do you feel when you’re happy. can you describe it?
The child initially responds with embodied behaviors that seem to be on-record displays that he
is contemplating the question and that a response is forthcoming: he places his hand on his chin,
rocks back and forth, and directs his gaze upward (line 650). And, while he continues this
embodied behavior for over six seconds (line 651), the child does respond by naming an activity:
“Play video games” (line 652). This response fills the wh-question slot of “what” he likes “to do”
that makes him happy and cheerful. In line 653, we see the clinician provides receipt of this
response, “Okay.” and moves to the next questions: “and how do you feel when you’re happy.
can you describe it?”.
Turning to the IDK utterance, as excerpt (10) begins, the clinician has just initiated the
first question of task 9 on emotions. She asks, “So Dan, what do you like to do that makes you
feel happy and cheerful?” (line 653).
(10) Case 24 Dan, age 9;3 (Happy I, p. 14)
76
Both of these also begin with a so preface, as does one of the other valid responses mentioned earlier.
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653 PY: So Dan, what do you like to do that makes you feel happy and
654 cheerful?
655 CH: ((CH’s gaze is directed at toy fire truck)) U:m, I dunno.
656 MO: How ‘bout riding your bike?
657 CH: ((looks sideways toward mother’s direction)) Un%un.
658 PY: How ‘bout playing with your cars.
659 CH: ((looking down at toy; lateral head shake))
660 PY: No:?
661 CH: I [barely play ] with my cars thou:gh.
662 [CH sideways glances at PY]
663 PY: ((leans in toward CH)) You rarely play with your cars?
664 (0.2)
665 PY: >Did you say<=
666 CH: = I barely.
667 PY: Oh, you barely.
Despite the clinician having addressed Dan by name, the child does not look up from the
firetruck, “((CH’s gaze is directed at toy fire truck))” (line 655). He responds first with an
extended perturbation produced with continuing intonation “U:m,” (line 655) that projects
additional verbal response. The child continues his turn with a standalone IDK utterance: “I
dunno.” (line 655). His utterance is produced with falling, or turn final, prosody, it is
syntactically complete, and it is actionably complete, at least in terms of the question-action
sequence action. Thus, all features are present that indicate to his co-participant that the child’s
turn is complete (Ford & Thompson, 1996; Sacks et al., 1974; Schegloff, 1980, 1996; Selting,
1996).
At this point, the mother provides a candidate answer: “How ‘bout riding your bike?”
(line 656). Her immediate response suggests that she does not accept the child’s “I dunno” as a
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sufficient response to the evaluation question. By providing a specific activity—likely one in
which she knows him to participate and believes him to enjoy—the mother’s action suggests that
what her child needs is a context from which he may locate his experience(s) with happiness.
Her candidate answer, however, is not successful. The child instead directs his eyes quickly
toward his mother—a movement described in the ASD literature as sideways looking.77
He then
produces a negative response, “Un%un.”78
(line 657).
In an unscripted turn of talk (i.e. not part of the ADOS manual protocol), the clinician
provides a next candidate answer, an activity that she has learned in the few minutes prior to the
exam that the child likes to do: “How ‘bout playing with your cars.” (line 658). This utterance
indicates that she, like the mother, does not accept the IDK utterance as sufficiently closing this
first question-answer sequence on happiness. The clinician’s candidate answer renews the
relevance for a response and evidences that she is treating the child’s IDK utterance as not valid.
The clinician’s candidate answer is, however, unsuccessful in soliciting a response from the
child. The child responds, instead, with a lateral head shake; he does not direct his gaze at or
toward the clinician (line 659). In line 660, the clinician provides a verbal negative token “No:?”,
which she formulates with both a sound stretch and rising intonation that seem to request
clarification of his lateral head shake. In line 661, the child does respond with additional
information about playing with his cars: “I [barely play ] with my cars thou:gh”. The topic of
cars then quickly changes as the child claims to barely play with cars because he always sleeps, a
topic he soon shifts to talk about his presumed sleepwalking, which he discusses at some length.
77
See Richer & Coates, 2001; Richer, 1976; Richer & Richards, 1975. Indirect looking was initially noted
by Kanner as a symptom of ASD (1943). 78
This is produced with duplicative un utterances divided by a glottal stop, indicated by the percentage
symbol (%).
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Although the child does not provide the information requested, he does remain engaged with the
clinician.
The child’s IDK utterance essentially fills the information slot requested by the question.
That is, it is a fitted answer to the “what” of the wh-question formulation; the IDK substitutes for
a more informative answer of what activity(ies) make(s) him happy. I note here that the model
question itself presumes that there are such activities. It asks “what” the child likes doing that
makes him or her happy rather than asking whether there is anything that does so (Pomerantz,
1988). The two candidate answers reinforce and renew this expectation for an answer.
Nevertheless, despite the implicit expectations of an answer, despite the candidate answers, and
despite the fact that other children can produce valid responses to this particular syntactic
construction, the child responds with the IDK utterance.79
The child’s IDK utterance works to
resist providing an explicit answer to what he likes to do that makes him happy, but his
engagement with the clinician on a topic of apparent interest to him—and his engagement on
some of the other evaluation questions—does not evidence a general resistance to interaction.80
In a manner similar to what I just demonstrated for Happy I, I looked at the turns
construction of the model question(s) and its variants within each of the other emotions for tasks
9 and 13 (Happy II, Anger I & II, Loneliness I, etc.) and considered whether something specific
79
In looking closely at the responses across the emotion questions, I noted that the formulation of an
auxiliary do and a lexical do together in the same question occurs four times, to include the example
covered in excerpt (10). Dan’s example here is the only instance in which a nonvalid response is given. 80
It is, perhaps, worth speculating whether Dan’s telling of the tale about his sleepwalking, or the
presumed fact that he does sleepwalk, makes him happy. In a later segment of the evaluation, Dan says
that he feels like “I wanna run and jump” when he feels happy. When the clinician asks whether running
and jumping “make” Dan happy; he does not reply, but he talks at length about how he runs, and jumps,
and slides, and how he learned to do it. Clearly, he relishes talking about those activities; and this also
serves as tacit acknowledgement that he does experience happiness. Perhaps in each case Dan is, in a
way, describing the experience of things that make him happy and how it feels without explicitly
engaging the question. That is, might he be “showing” through his narrative rather than telling through a
more direct engagement with the question?
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to a given syntactic construction might be occasioning IDK utterances. Some syntactic
constructions also occurred across emotions. For example, the following construct occurred
across several emotions: “What kinds of things make you feel X”, where “X” is either the name
of the applicable emotion or the phrase “that way”. For each construct, I paid close attention to
the range of responses: were they all valid, a mix of valid and IDK utterances, predominately
IDK utterances, and so on. No single construction appears to be disproportionally responded to
with an IDK utterance (or with a lateral head shake, other negative response, or silence)—with
one exception, to which I will now turn.
“What/How about” question formulation
The single syntactic construction linked to nonvalid responses is the “What/How about”
formulation. In the ADOS manual the “What/How about” constructions form the first part of
two-part question series that are used across three emotions: fear, anger, and relaxation. I present
the model questions below:
a) What about things that you’re afraid of? What makes you feel frightened or anxious?
b) What about feeling angry? What kinds of things make you feel that way?
c) How about feeling relaxed or content? What kinds of things make you feel that way?
The clinicians generally present both questions of the relevant series within a single turn. When
they do so, the questions do not pose much difficulty to the children during the evaluation. In
excerpt (11) I present the two-part question series on fear to illustrate.
(11) Case 24 Dan, age 9;3 (Fear I, p. 16)
763 PY: What about things you’re afraid of? (.) What makes you feel
764 frightened or:- anxious. ((looks down at evaluation book))
765 CH: Uh::m, when it’s halloween and it’s dark.
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The clinician issues the two-part question series (lines 763-764) and the child produces a valid
response: “Uh::m, when it’s Halloween and it’s dark.” (line 765). The child begins his turn with
the perturbation “Uh::m,” that is produced with a sound stretch and continuing intonation
projecting more talk. He then produces the information requested by the second part of the
question, or the “what” that makes him frightened or anxious: “when it’s Halloween and it’s
dark.”
This two-part question series, along with those for anger and relaxation, are asked ten
times to a total of five children. Valid responses, such as Dan’s above, are produced 8 of the 10
times. This holds true even though the clinicians may vary the wording within an individual
question (e.g., changing “feel that way” to “feel angry”). In the remaining 2 of the 10 cases, each
child produces an IDK utterance. My concern here, however, is not specifically with these IDK
utterances. It is to emphasize that the two-part question series that begins with either a What
about or a How about construction rarely poses problems for the children. There are, however,
four times within the data that the clinicians only present the first part of the series, the
“What/How about” question, and do not produce the second part of the question series. In all
four instances, a nonvalid response results, two of which are IDK utterances. I present those two
interactions below.
Excerpt (12) begins with Justin describing how it is he knows when he is happy (line 497,
below), followed by the clinician’s acceptance of this response (line 498), and her subsequent
move to a question on the child’s experiences with fear. At lines 498-499, we see that she issues
only the first part of the two-part question: “And what about things you’re afraid of.”
(12) Case 44 Justin, age 10;0 (Fear I, p. 11)
497 CH: ‘Cuz when I unlock something I start to laugh.
498 PY: M’huh ((vertical head nod)) m’huh, okay. And what about things
149
499 you’re afraid of.
500 CH: I don’t know.
501 PY: M’huh. okay. tsk. When you feel frightened and you’re anxious how
502 does it feel.
In response to the single question that employs the “what about” question formulation, at line
500, the child produces a standalone IDK utterance. The clinician immediately moves to another
question about fear: “M’huh. okay. tsk. When you feel frightened and you’re anxious how does it
feel.” (lines 501-502).
In excerpt (13) below, the clinician provides a transition from the previous question-
answer sequence on happiness (line 592). At line 594, she asks Wade the single “What about”
question on fear: “What about things you’re afraid of.”
(13) Case 28 Wade, age 13;7 (Fear I, p. 13)
592 PY: Okay let’s try a different one.
593 CH: ((yawns))
594 PY: What about things you’re afraid of.
595 [ (12.7) ]
596 CH: [((makes faces in one-way mirror across from him))]
597 CH: I dunno.
598 [ (7.9) ]
599 [((PY writes in evaluation booklet; child makes faces in mirror))]
600 PY: ↑Anyth↑ing? (0.3) you can think of? (.) n↑o. (.) n’kay.
601 (0.4)
Although the child did engage with the earlier questions on the emotion happy, and actually
talked at some length, he now provides no initial verbal response to this new question but instead
stares ahead and begins making faces into the one-way mirror immediately in front of him.
Nearly 13 seconds of silence occurs in which the clinician observes the child’s actions (lines
150
595-596). In line 597, the child produces a standalone IDK utterance: “I dunno.”. The clinician
does not immediately respond to the IDK utterance. For nearly eight seconds, the clinician
continues to take notes, and the child continues to make faces in the mirror (lines 598-599).
At line 600, the clinician presses the child; she initiates a multiunit turn in which she
produces the utterance“↑Anyth↑ing?” with questioning intonation that renews the relevancy of a
next response from the child. After a 0.3 second pause in which the child provides no response,
she adds the increment: “you can think of?” (line 600). While this increment renews, again, the
relevance of a response from the child, the clinician does not wait long for a response; she
continues her turn after a micropause and issues a candidate understanding “(.) n↑o.”. After a
micropause, the clinician closes this question-answer sequence on the emotion fear: “(.) n’kay.”
(line 600). She never issues the second part of the model question, instead moving to the next
emotion.
In a third example of a “What/how about” question formulation, excerpt (14) below, the
child produces no response at all. However, when the second part of the series is issued by the
clinician in her next turn, then the child issues a valid response. At line 622, the clinician
produces only the first of the two-part sequence on relaxation: “How about feeling like relaxed
or content.” 81
(14) Case 40 Wade, age 13;7 (Relaxed, p. 13)
622 PY: How about feeling like relaxed or content.
623 (0.7)
624 PY: What kinds of things make you feel that way.
625 (0.9)
626 CH: Uhm, (0.5) the mall.
81
Her formulation varies from the model with the addition of the preposition “like”.
151
The child produces no response and 0.7 seconds of silence occurs (line 623) before the clinician
produces the second-part of this question series, “What kinds of things make you feel that way.”
(line 624). After a 0.9 seconds of silence,82
the child does produce a valid response, “Uhm, (0.5)
the mall.” (line 626).
I conjecture that the child is helped by the second part of the question series. Like the
eight children in the data who produce valid responses when issued both questions in the series
within the clinician’s single turn, when this child is finally provided both parts, he now has more
information as to what specifically is being requested and he, too, then provides a valid response.
Basically, the “What/How about” construct is ambiguous when it lacks the second part of the
series. When the second-part is provided, either immediately or as a follow-up, the request is
clarified.
Further evidence for the difficulty created when the “What/How about” question is posed
alone is shown in the fourth nonvalid response. In excerpt (15) below, the clinician issues the
“What about” formulation, “What about feeling angry?” (line 602) without providing the second
part (What kinds of things make you feel that way?).
(15) Case 40 Wade, age 13;7 (Anger II, p. 12)
602 PY: What about feeling angry?
603 CH: ((vertical head shake)) ˚Yeah.˚
604 [ (4.6) ]
605 CH: [((stares into mirror/making faces with hands))]
The child responds with a vertical head shake and a quietly produced “˚Yeah.˚” (line
603). His nonverbal and verbal responses are fitted to a yes/no question, and they serve to affirm
82
This gap of silence could, itself, exert pressure for a response; however, at several points in this
evaluation the clinician has allowed gaps of silence, one being as long as 12.7 seconds, with no response
from this child.
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that he recognizes the vocabulary of “feeling angry”, and may serve as a kind of “go-ahead” for a
fuller question. Through the child’s response we can see where the trouble originates. When the
“What/How about” question is produced alone, what information is the “what/how about”
requesting? A fuller question is required.
The possible link demonstrated here between “What/how about” question constructions
and the emergence of nonvalid responses warrants further investigation. Several lines of
evidence in this exploratory study suggest these question formulations are problematic. First, in
each of the four cases in which a what about or how about construction is presented alone, the
child produces a nonvalid response. In contrast, in 8 of the 10 instances in which the “what/how
about” question is joined to a second question that more clearly specifies the information sought,
the response from the child is valid. Finally, in those cases in which the child was presented only
with the “what/how about” construct and produced a nonvalid response, subsequent presses by
the clinician with what should have been the second part of the series produces a valid response
two of the three times such a press is used (as in excerpt (14) above).
6.7 Specificity and/or Concreteness
In looking closely at the clinician’s formulations of the evaluation questions as a possible
contributing factor to the frequency of IDK utterances, I also noted two practices used by some
clinicians that might encourage the production of valid responses from the children: 1)
formulating a question to use the inclusive we, and 2) incorporating a child’s previous answer
into a question. I propose (tentatively, of course, given the very small sample size) that these
practices might prove more successful at achieving valid responses as they build into the
question specificity and/or concreteness and can foster a social solidarity between the clinician
and child.
153
6.7.1 Inclusive We
The ADOS-II manual provides a prefatory statement to the first emotion question on
sadness: “Most people have times when they are sad. What kinds of things make you feel that
way?” (emphasis added). In my data, this construction is employed within four of the six
evaluations. Three of the four questions that employ the Most people preface are responded to
with an IDK utterance. There are two evaluations, however, in which the clinician substitutes we
all for most people and we for they; both receive a valid response. I present those excerpts (16) &
(17) below.
(16) Case 44 Justin, age 10;0 (Sadness I, p. 11)
529 PY: We all have times when we feel sad what kinds of things make you
530 ((looks at CH)) feel sad.
531 CH: Like when my little brother breaks something that belongs to me.
It could be asked what evidence there is that the children actually focus on or pay attention to the
prefatory statement that includes the we all. And in the above excerpt, there is no such evidence.
But note the response in the excerpt below in which a different child responds to a we
formulation that is nearly identical to that of the preceding excerpt.
(17) Case 46 Gordon, age 11;2 (Sadness I, p. 14)
692 PY: Okay, well, we all have times when we feel sad. What kinds of
693 things make you feel sad.
694 CH: Maybe it’s sad when you listenuh music.
695 PY: M’huh.
At line 694, Gordon responds by providing an activity that could invoke sadness: “Maybe it’s
sad when you listenuh music.”. He hedges his response with the adverb maybe and then
formulates the experience using the generic you. His choice of the you suggests that Gordon may
be focused on the collective aspect of the question as it is posed to him (see footnote 71). Here
154
the possible generic you, like we, opens up the experience—sadness resulting from listening to
music—as one that is available to the clinician, others, and himself.83
I next present in excerpt (18) one of the cases in which the clinician asks the most people
form of the prefatory statement and question. While the child produces an IDK utterance in
response, his answer does demonstrate that he was attentive both to the prefatory statement
“Most people have times when they feel sa:d,” and the question “What kinds of things make you
feel that way?” (lines 736-737)
(18) Case 28 Malcolm, age 13;1 (Sadness I and II, p. 16)
736 PY: And, most people have times when they feel sa:d, what kinds of
737 things make you feel that way.
738 CH: I dunno.
739 (.)
740 CH: I just feel sad.
741 (.)
742 CH: I usually just feel sad at night.
743 PY: Okay.
After the question, the child immediately produces a standalone “I dunno.” (line 738). While his
utterance is formulated with turn final prosody, after a micropause, he expands his answer: “I
dunno. (.) I just feel sad. (.) I usually just feel sad at night.” (lines 738-742). The IDK seems to
function as an epistemic claim in response to the last question posed by the clinician: “what
kinds of things make you feel that way.” (lines 736-737).84
Of more relevance for my analysis
83
In excerpt (19) I will show that the clinician orients to Gordon’s response that listening to music elicits
sadness as one that reflects Gordon’s experience and of which he is able to provide a visceral description. 84
I note here that the version of the question presented to Malcolm ends in “feel that way”, whereas that
presented in the two preceding transcripts end in “feel sad”. (The version presented to Malcolm is the
scripted version.) In not defining the emotion that is being asked, it may force Malcolm to be more
attentive to the preface. As an aside, I looked across all cases in which a question was phrased as “feel
that way?” versus “feel x” (where x is the emotion in question), and I saw no apparent correlation with
155
here are the child’s next two utterances that provide information about his experiences with
sadness. These utterances show that Malcolm is orienting to the preface “Most people have times
when they feel sa:d” as a request for information. Malcolm’s “I just feel sad.” works to display
that he, like “most people”, experiences sadness. His next unit of talk provides the “times” that
he feels sad: “I usually just feel sad at night.”
While the We construction (e.g., “We all have times when we feel x”) is similar to the
preface provided by the ADOS-II manual for the emotion sadness—“Most people have times
when they feel sad”—the We construction provides concreteness in its inclusion of both the child
and the clinician (and by extension everyone else) as having experienced the emotion in
question. In this way, the “we” construction is a way the clinician builds into the formulation an
expectation that the child does have the requisite knowledge to answer the question (Pomerantz,
1988). In contrast, the Most people construction presents the emotional experience as one that
only a subset of persons experience, something “they” feel, and this could allow the child to
identify as someone who is not a part of “most people” or “they”. Moreover, the inclusive We
may help build social solidarity between the child and clinician thereby fostering a rapport within
which the child is better able to address and share his or her emotional experiences. The
combination of increased expectation for an answer, the inclusiveness of the statement, and the
potential for social solidarity may all work to elicit a more valid response than the alternative
construct presented in the ADOS manual.
6.7.2 Reuse of child’s response
There is one final point that I want to touch on about this issue of concreteness. It
involves an interviewing technique of asking questions that reuse information that the child has
responses. There are numerous cases in which the children answer both versions with valid responses, and
cases in which they respond to both versions with nonvalid responses.
156
provided earlier in the evaluation. In the below excerpt (19), the clinician asks Gordon what he
feels like when he is sad. She does so by including in her question an experience with sadness,
that of listening to music, that he has mentioned in response to an earlier question. She asks “can
you you describe what that’s like when you see a sad mo:vie, or you listen to sad music, yeah.”
(lines 806-808).
(19) Case 46 Gordon, age 11;2 (Sadness II, p. 16)
806 PY: Well when you feel sad inside, tsk. uhm can you you describe what
807 that’s like like when you see a sad mo:vie, or you listen to sad
808 music, yeah.
809 CH: ((gazes to the ceiling)) It’s kinda like where it feels like
810 ((touches chest and diverts gaze to PY)) I might shiver or stuff.
811 [(it does.)]
812 PY: [Yeah. ]
Gordon is able to provide a characterization of sadness, particularly what it feels like “inside” his
body: “((gazes to the ceiling)) It’s kinda like where it feels like ((touches chest and diverts gaze
to PY)) I might shiver or stuff.” (lines 809-810). Upon receipt of the question, he diverts his gaze
to the ceiling in a possible on-record display of searching for a characterization of sadness. As he
begins a verbal response, he constructs his turn by incorporating the approximate “like”, thus
suggesting that he is describing a “kinda” generic experience of sadness. As his turn continues,
however, he uses an embodiment (touching his chest, line 810) that moves the description from a
generic one to his physical account: “I might shiver or stuff.”.
In my data, Gordon is the only child, of the five who are asked, who is able to provide a
description of what sadness feels like. One produces a standalone IDK, another responds with
silence, and a third says simply “No” to the question of whether he can describe it. The fifth
child does make an attempt, uttering that “it’s like you’re mad and sad, I dunno”. While this is
157
not a description like Gordon’s, it is the only other attempt to provide a description. It is also the
only other case in which the clinician incorporates the child’s previous answer into the question:
“So when you feel sad, what’s that like=can you describe what that’s like when your brother
breaks something or-’” (see excerpt (2), lines 533-535).85
6.8 Summary and Discussion
In this chapter, I present my findings on the children’s use of I don’t know utterances
during their evaluations for Autism Spectrum Disorder. Specifically, I report that these children
use I don’t know utterances to display epistemic stance, resist providing the requested
information of evaluation questions, and project more talk (Section 6.5). I also show that
syntactic variation in the clinicians’ formulations of the ADOS-II evaluation questions contribute
very little to the frequency of I don’t know utterances, with the exception of the “What/How
about” construction (Section 6.6). Additionally, I note two practices that some clinicians use that
may achieve valid responses: 1) the use of inclusive We in the formulation of questions, and 2)
the reuse of children’s previous responses within the subsequent question formulations. I propose
that these practices build into the question specificity and/or concreteness and can foster a social
solidarity that help children recall and share their emotional experiences (Section 6.7).
Overall, my findings in Chapter 6 suggest that at least some children who are diagnosed
with ASD can use I don’t know effectively to display epistemic stance. I note that all of the
displays of epistemic stance occur in response to questions that ask children to describe either
how their emotions feel (or their bodily experiences of an emotion) or to comment on other
children’s experiences of emotions (i.e., all responses are to the Happy II, Fear II, Sadness II, and
Loneliness II questions). Although my data set is small, these findings align with the current
85
The same clinician evaluated both Gordon and Justin.
158
understanding that children with ASD do have difficulty in describing their emotional states and
inferring other people’s mental or affective states, at least when they are asked abstract questions
about what others feel or experience. Further investigation of the function of other epistemic
clausal constructions, such as I think, I guess, I doubt, within the ADOS evaluation as well as in
mundane conversation could provide insight to the noted deficits and delays in the acquisition
and expression of cognitive states observed in children with ASD (Tager-Flusberg, 1993).
Moreover, if children with ASD do have a general difficulty in being able to describe
emotional states that is being reflected in their conversation, then it is important to keep this
possibility in mind when we consider the notion of “resisting” the question within the evaluation
frame. Successive displays of I don’t know and/or disengagement from the interaction may be
evidence of those difficulties. On the other hand, as I observed that difficulty in providing an
answer to a question may be linked to at least one syntactic construct, displays of nonvalid
responses may sometimes arise because of the question format and not the child’s deficit.
159
CHAPTER 7
Major Findings and Future Directions
By looking closely at the language within conversations, we begin to understand how
language emerges to fit within specific contexts and to accomplish an array of social actions. The
collaboratively-achieved actions of conversation, which are built upon the competencies of all
participants involved and ordered by the general mechanisms of talk, could be in jeopardy if the
linguistic and interactional competencies of the participants are affected in particular ways by the
presence of disease or other disorders, such as dementia or autism.
In chapter 4, I document how the use of epistemic stance markers in conversations by
persons with dementia and their non-impaired co-participants, by and large, fit common patterns
of epistemic stance marker use for naturally occurring conversation. I show differences in the
specific forms and frequencies of epistemic stance markers in the talk of persons with dementia
as compared to their non-impaired co-participants. Most prominently, epistemic clausal
constructions that might denote uncertainty or insufficient knowledge are used at a greater
frequency by the participants with dementia, with the clausal construction I don’t know occurring
more often than any other epistemic stance marker.
Chapter 5 investigates in depth the use of this clausal construction and shows that persons
with dementia use I don’t know in much the same way as non-impaired persons: not only to
display epistemic stance but also to manage their sequences of talk (i.e. closing or initiating
topics) and to manage preference (i.e. actions such as disagreeing with co-participants or
minimizing compliments). Overall, the findings in chapters 4 and 5 suggest that many persons
with dementia can deploy a variety of epistemic stance markers and, in the case of IDK
160
utterances, use them in varied ways. Moreover, these constructions may, for many persons,
remain available well into the late stages of disease.
In documenting numerous functions of the clausal structure I don’t know in this
population, I have shown that the use of epistemic stance markers—particularly a common one
that could denote memory loss in persons with dementia—does not necessarily reflect cognitive
decline. Interlocutors of persons with dementia should thus remain alert to a conversation’s
nuances, as they might with a non-impaired individual. For instance, in a couple of cases in my
data that I have not reported here but have analyzed, the non-impaired co-participants appear to
orient to I don’t know utterances as solely indicating memory difficulty, and interactional trouble
arises. These interactions and others warrant follow-up analysis, with particular attention paid to
ways in which co-participants might orient in order to avoid or mitigate any interactional trouble.
Finally, Chapter 4 provides data on many common epistemic stance markers other than I don’t
know in the talk of persons with dementia that could also be studied productively from an
interactional perspective.
When I turned my attention to children with autism spectrum disorder and their use of I
don’t know, their most frequent epistemic (and mental verb) construction, I observed a limited
range of functions within the evaluation context. The children do use I don’t know to display
epistemic stance, to resist providing a valid response to evaluation questions, and to signal a
response is forthcoming. But, by and large, I don’t know is used most frequently to resist
providing a valid response to the question asked. While I show that certain syntactic
formulations (i.e. what / how about) of the evaluation questions contribute to the children’s use
of I don’t know, more work is needed here to determine whether the evaluators might be
161
unintentionally prompting some of this resistance, whether through verbal formulations and/or
nonverbal actions.
In Section 6.4.2 I noted that seven IDK utterances occur in the talk of children while they
are engaged in an independent task that their clinician has asked them to do (e.g., the child has
been directed to play with particular toys independently while the clinician “catches up on
notes”). As I mentioned in an associated footnote, these utterances appear to fit the
characterization of what in Chapter 5 I call a “wondering” action, a type of thinking out loud in
which a complement-taking IDK utterance is used as a first-pair part that can invite the co-
participant to jointly engage with the speaker in wondering about or commenting on the topic at
hand.
The use of a complement-taking I don’t know utterance as a “wondering”, through its
sequential placement, turn design, and action functions as a response mobilizing device. As such,
it remains an open question as to what preference constraint this construction might impose on
the co-participant relative to the constraints imposed by alternative constructs, such as a direct
question or a first assessment, that could also proffer or renew the topic associated with the
“wondering”. As Stivers and Rossano (2010) have stated, we still know little about how it is that
“speakers can hold recipients more accountable for responding or not”; thus, they encourage
focused investigations on how participant response is mobilized to more or less degrees as a
result of the sequential position, action, and turn design of the speaker’s preceding talk (2010, p.
3). I suggest that a first-pair part, complement-taking I don’t know utterance allows the speaker
to initiate an action as an on-record “wondering” that is self-focused and claims no epistemic
authority on the topic at hand. As such, it could potentially impose relatively little pressure and
accountability for a co-participant to respond in any particular way to the topic. Moreover, it
162
could suggest that the speaker views the co-participant as having at least as much, if not more,
epistemic authority on the topic. As my data contain few examples of first-pair parts that use I
don’t know to initiate sequences, further investigation is needed into this phenomenon that I call
a “wondering” and into the preference constraints that it may impose. This could be especially
intriguing to pursue in the conversation of children with autism, as the instances of “wondering”
that I earlier noted appear to be attempts by the child to initiate social interaction.
163
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Appendix A: Demographics of PWD and NI
Case Pseudonyms Age Sex Race Education
(# yrs)
Occupation Excerpt (#) &
Section #
MSN
001
Ms. Mason 80-
89
F W 9-12 Housewife Section 4.2.4
Tina F UK 13-16 Student
TAB
001
Ms. Tabber 90+ F W UK Unknown Not included
Patricia F W 13-16 Student
TDD
001
Ms.
Taddington
80-
89
F W UK Unknown Excerpt (2)
Lisa F W 13-16 Student
TGG
001
Ms. Taggart 70-
79
F W UK Unknown Not included
Amelia F W 13-16 Student
THW
001
Mr. Thatcher 70-
79
M W UK Unknown Not included
Jim M UK 13-16 Student
TIC
001
Ms. Tichner 80-
89
F W 13-16 Mill worker Section 4.1.4
Julie F UK 13-16 Student
TPN
001
Mr. Tappan 80-
89
M W 13-16 Music store
owner
Excerpts (7) &
(11)
Amanda F W 13-16 Student
TTR
001
Ms. Tatter 80-
89
F W UK Unknown Section 4.1.4
Tom M W 13-16 Student
TTR
002
Ms. Tatter 80-
89
F W UK Unknown Excerpt (12)
Renee F UK 13-16 student
TYR
001
Mr. Tyler 70-
79
M W UK Unknown Excerpt (8)
Jackie F AA 13-16 Student
WAL
001
Ms. Wallis 80-
89
F W UK Mill worker Sections 4.1.2 &
4.1.3
Beth F W 13-16 Student
WAL
002
Ms. Wallis 80-
89
F W UK Mill worker Section 4.1.2
Naomi F UK 13-16 Student
WEA
001
Mr. Wealdon 70-
79
M W 9-12 Air Force Not included
Marybeth F W 13-16 Student
183
WHE
001
Mr.
Wheelock
80-
89
M W 13-16 Army
(finance)
Excerpts (9) &
(10)
Luke M W 13-16 Student
WHE
002
Mr.
Wheelock
80-
89
M W 13-16 Army
(finance)
Section 4.2.4
Isabel F W 13-16 Student
WKD
001
Mr. Wilken 80-
89
M W 13-16 Postal service Excerpt (1) &
Section 4.2.3
Emily F W 13-16 Student
WLK
001
Ms. Walker 60-
69
F UK 9-12 Cafeteria
worker
Excerpt (4)
Sherry F W 13-16 Student
WLP
001
Ms. Wallop 80-
89
F W UK Nurse Not included
Tammy F W 13-16 Student
WLT
001
Ms. Walton 80-
89
F AA 17+ Social worker Section 4.1.3
Tanya F W 13-16 Student
WLT
002
Ms. Walton 80-
89
F AA 17+ Social worker Excerpt (13) &
Section 4.2.4
Terry F W 13-16 Student
WTL
001
Ms. Wittle UK F UK UK Unknown Excerpts (5) &
(6)
Rebecca F UK 13-16 Student
YGR
001
Ms. Yager 70-
79
F W 13-16 Secretary for
CPA
Not included
Katie F W 13-16 Student
YRW
001
Ms. Yarrow 80-
89
F W UK Food services Sections 4.1.4 &
4.2.3
Tamara F AA 13-16 Student
ZAC
001
Ms. Zachary 80-
89
F W 9-12 Inspector
(factory)
Excerpt (3) and
Section 4.1.2
Sarah F W 13-16 Student
ZAC
002
Ms. Zachary 80-
89
F W 9-12 Inspector
(factory)
Not included
Tim M AA 13-16 Student
184
Appendix B: Transcription Symbols
Meaning
1. word word
Pauses
2. pause, timed ... (1.2)
3. pause, short. of less than 2/10 of a second: . .. (.)
4. latching =
5. syllable stretch (prosodic length) :
Sequence
6. overlap [ ]
Disfluency
7. truncated/cut-off word wor-
Vocalism
8. inhale .hhh
9. exhale hhh
10. vocalism/noise ((sniffle))
11. click/lip smack .tsk
12. laugh pulse he, ha
13. nasal laugh mn’ha mn’he
14. laughter or aspiration within a word wo(h)rd
15. tremulous voice ~
16. creaky voice/vocal fry #
Manner/Quality
17. slow speech <words>
18. fast speech >words<
19. attenuated speech °words°
20. volume increase WORD
21. smile quality £
Metatranscription
22. unintelligible ( )
23. uncertainty/best guess (word)
185
Participation
24. speaker/turn attribution Jill:
25. unidentified speaker ( ):
26. uncertain speaker (Jill):
Boundary/Closure
27. terminative .
28. continuative ,
29. truncated intonation unit —
30. rising intonation (final) ?
Prosody
31. high pitch on syllable ↑
32. low pitch on syllable ↓
186
Appendix C: Modal Verbs
TABLE C-1. EPISTEMIC STANCE MODAL VERBS (POSITIVE)
Type Frequency (# of occurrences)
Frequency (# of cases with
at least one use)
PWD NI PWD NI
Can 45 33 16 14
Could 26 8 15 7
May 1 1 1 1
Might 4 11 3 5
Must 9 6 6 6
Should 18 7 8 6
Will 8 14 4 6
Would 32 36 12 16
TOTAL 143 116
TABLE C-2. EPISTEMIC STANCE MODAL VERBS (NEGATIVE)
Type Frequency (# of occurrences)
Frequency (# of cases with
at least one use)
PWD NI PWD NI
Cannot/n’t 50 12 17 8
Could not/n’t 6 2 4 2
May not 1 0 1 0
Should not/n’t 10 0 7 0
Will not/won’t 12 3 5 3
Would not/n’t 14 2 9 2
TOTAL 93 19
*There were no instances of shall, shall not / shan’t, might not, must not.
187
Appendix D: ADOS-II, Module 3: Task 9 and Task 13 Model Questions
Task 9 questions (2012, p. 7)
Emotion I86
Emotion II
Happy I
What do you like doing that makes you feel happy and
cheerful? What kinds of things make you feel this way?
Happy II
How do you feel when you’re happy? Can you describe it?
Fear I
What about things that you’re afraid of? What makes you feel
frightened or anxious?
Fear II
How does it feel?
Anger I
What about feeling angry? What kinds of things make you feel
that way?
Anger II
How do you feel inside when you’re angry?
Sadness I
Most people have times when they feel sad. What kinds of
things make you feel that way?
Sadness II
How do you feel when you’re sad? What is it like when you’re
sad? Can you describe that?
Relaxation
How about feeling relaxed or content? What kinds of things
make you feel that way?
NA
Task 13 questions (2012, p. 10)
Do you ever feel lonely?
Do you think other kids/people your age ever feel lonely?
Are there things that you do to help yourself feel better? What about things other people do to help themselves feel better when
they’re lonely?
86
I have designated the emotion questions as I or II. Those that ask the child to provide information on
what things or activities elicit a certain emotion are identified with the emotion plus I (e.g., Happy I);
those that ask what a particular emotion feels like are designated using the emotion plus II (e.g., Happy
II).
