Cross-Linguistic and Multicultural Considerations in Evaluating Bilingual Adults With Aphasia

Abstract

Purpose: The current study delineated a clinical and theoretical framework that clinicians and researchers can use to guide the assessment of bilingual aphasia at morphosyntactic, lexical-semantic, and phonological levels of language processing.

Method: This tutorial outlines cross-linguistic and multicultural considerations that should be addressed in evaluating bilingual adults with aphasia (BWAs).

Results: At the morphosyntactic level, we presented three features that should be taken into account when evaluating linguistic symptoms in languages considering whether they are typologically similar or dissimilar: word order, pro(noun)-drop, and morphological inflections of verbs. We suggest that clinicians need to conduct additional error analyses that reflect typological differences in syntactic templates, argument-deletion phenomena, and morphological inflections to better understand linguistic characteristics of impairments arising from the interactions of the two languages that may differ in many ways. At the lexical-semantic level, we addressed three cross-linguistic features that may impact naming performance in BWAs: cognates, lexical frequency, and semantic typicality. The presence of cognates between the two languages can lead to differential interpretations of naming performance. In addition, the same lexical items may exhibit varying lexical frequency and typicality across languages due to cultural and linguistic differences. We suggest that clinicians should thoroughly prepare the testing items considering the linguistic distance. Finally, we emphasized differences in segmental and suprasegmental features of phonology that could contribute to cross-linguistic phenomena during assessment of two or more languages.

Conclusions: This cross-linguistic assessment framework contributes to a better understanding of linguistic impairments and communication difficulties experienced by BWAs. This framework can be utilized in current clinical practice to facilitate culturally and linguistically appropriate assessment and treatment approaches for BWAs.

Figure 1.

Overall framework of the cross-linguistic considerations in the assessment of bilingual aphasia.

Figure 2.

Clinical implications of morphosyntactic features among English, Spanish, Korean, and Chinese. SVO = subject–verb–object; SOV = subject–object–verb; BWAs = bilingual adults with aphasia.

Figure 3.

Clinical implications of lexical–semantic differences among English, Spanish, Korean, and Chinese. BNT = Boston Naming Test.

Figure 4.

Clinical implications of phonological differences and similarities among English, Spanish, Korean, and Chinese.