Cross-linguistic generalization in treatment of bilingual aphasia

Padilla, Christna T. and Mayer, Jamie (2012) Cross-linguistic generalization in treatment of bilingual aphasia. [Clinical Aphasiology Paper]

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Abstract

For individuals who speak more than one language, aphasia following left-hemisphere stroke or focal brain injury impacts all of their languages to varying degrees. At this time, there is limited research regarding the most effective form of treatment for bilingual aphasia, specifically whether to target one or all languages. Some research has suggested that treating individuals with bilingual aphasia in their non-dominant language (L2) yields positive results in their dominant language (L1) (e.g., Edmonds & Kiran, 2006; Kiran & Roberts, 2010; Kohnert, 2004; Langanaro & Overton Venet, 2001; Marangolo et al., 2009). These findings derive from the mixed model of bilingual language distribution (de Groot, 1992) and the Complexity Account of Treatment Efficacy (CATE; Thompson et al., 2003). Per de Groot’s model, there is one semantic system with separate lexicons for each language, and the lexicons have direct access both to the semantic system and one another. The strength of the connection between each lexicon and the semantic system, and between the lexicons themselves, depends upon the individual’s proficiency level in each language. Thus, an individual more proficient in Spanish than English would have a weaker link between his/her English lexicon and the semantic system but a stronger link from the English to the Spanish lexicon. The act of speaking English could, therefore, be considered a more complex process than speaking Spanish, as the individual would rely more heavily on the link from the English to the Spanish lexicon to access the semantic system. According to CATE (Thompson, et al., 2003), training an individual on more complex tasks will yield generalization to less complex, related tasks; therefore training this individual in English (more complex process) should yield generalization to Spanish (less complex process). Edmonds and Kiran (2006) found that treating English-dominant English/Spanish bilinguals in Spanish had positive effects on their English, and that treating an equally proficient Spanish/English bilingual in Spanish had positive effects in both languages. To our knowledge, no studies have specifically examined whether it is effective to treat bilingual individuals whose non-dominant language is English in English only. Considering that fewer than 6% of AHSA-certified SLPs speak a language other than English (ASHA, 2010) while the fastest growing U.S. subgroup is comprised of elderly Hispanic individuals (ASHA, 1991), it is reasonable to assume that monolingual SLPs will increasingly be called upon to treat bilingual individuals with aphasia. The purpose of this study was to determine whether treating Spanish/English bilinguals, whose non-dominant language is English, in English would improve both of their languages.

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