Abstract
Background. Despite a growing clinical need, there are no clear guidelines on assessment of lexical access in the two languages in individuals with bilingual aphasia. Objective. In this study, we examined the influence of language proficiency on three tasks requiring lexical access in English and Spanish bilingual normal controls and in bilingual individuals with aphasia. Methods. 12 neurologically healthy Spanish-English bilinguals and 10 Spanish-English bilinguals with aphasia participated in the study. All participants completed three lexical retrieval tasks: two picture-naming tasks (BNT, BPNT) and a category generation (CG) task. Results. This study found that across all tasks, the greatest predictors for performance were the effect of group and language ability rating (LAR). Bilingual controls had a greater score or produced more correct responses than participants with bilingual aphasia across all tasks. The results of our study also indicate that normal controls and bilinguals with aphasia make similar types of errors in both English and Spanish and develop similar clustering strategies despite significant performance differences between the groups. Conclusions. Differences between bilingual patients and controls demonstrate a fundamental lexical retrieval deficit in bilingual individuals with aphasia, but one that is further influenced by language proficiency in the two languages.
Highlights
Naming deficits are a commonly acquired disorder, manifesting in all types of aphasia [1, 2]; we are still unclear about the nature and mechanisms underlying lexical processing deficits in monolingual and bilingual individuals with aphasia
The revised hierarchical model (RHM; [3,4,5]) allows for language proficiency differences by proposing connections between both L1 and L2 and the semantic system; these connections differ in their strengths as a function of fluency in L1 relative to L2
For current language use, a significant interaction of group and language was observed (F(1, 42) = 25.7, P < 0.0001) indicating that current language use was higher in English than in Spanish (P < 0.01) for controls, whereas current language use was higher in Spanish than in English (P < 0.001) for patients
Summary
Naming deficits are a commonly acquired disorder, manifesting in all types of aphasia [1, 2]; we are still unclear about the nature and mechanisms underlying lexical processing deficits in monolingual and bilingual individuals with aphasia. With regards to activation of phonological representations from the semantic system, the prevailing theory suggests that activation flows from the semantic system to the phonological system of both languages simultaneously, indicating that lexical access is target language-nonspecific [6, 7]. We examined the influence of language proficiency on three tasks requiring lexical access in English and Spanish bilingual normal controls and in bilingual individuals with aphasia. The results of our study indicate that normal controls and bilinguals with aphasia make similar types of errors in both English and Spanish and develop similar clustering strategies despite significant performance differences between the groups. Differences between bilingual patients and controls demonstrate a fundamental lexical retrieval deficit in bilingual individuals with aphasia, but one that is further influenced by language proficiency in the two languages
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