Abstract

Background: Despite substantial literature exploring language treatment effects in multilingual people with aphasia (PWA), inconsistent results reported across studies make it difficult to draw firm conclusions. Methods: We highlight and illustrate variables that have been implicated in affecting cross-language treatment effects in multilingual PWA. Main contribution: We argue that opposing effects of activation and inhibition across languages, influenced by pertinent variables, such as age of language acquisition, patterns of language use, and treatment-related factors, contribute to the complex picture that has emerged from current studies of treatment in multilingual PWA. We propose a new integrated model—Treatment Effects in Aphasia in Multilingual people (the TEAM model)—to capture this complexity.

Highlights

  • This paper addresses the variables and mechanisms that affect efficacy of language treatment provided for multilingual people who acquire language impairments

  • We review and discuss the variables that have been implicated in affecting the patterns of improvement among multilingual individuals and that contribute to levels of language activation and inhibition that have been proposed to account for the patterns observed

  • We discuss nine key variables that have dominated the literature on cross-language treatment in multilingual people with aphasia (PWA): three multilingualism-related variables; two stroke-related variables; language abilities post-stroke, a variable that combines multilingualism-related and stroke-related effects; two treatment-related variables; and linguistic distance, a multilingualism-related variable that interacts with treatment focus

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Summary

Introduction

This paper addresses the variables and mechanisms that affect efficacy of language treatment provided for multilingual people who acquire language impairments (aphasia). To this end, we discuss nine key variables that have dominated the literature on cross-language treatment in multilingual PWA: three multilingualism-related variables (age of language acquisition, language use and exposure, language proficiency pre stroke); two stroke-related variables (brain lesion site, time post-onset); language abilities post-stroke, a variable that combines multilingualism-related and stroke-related effects; two treatment-related variables (focus of treatment, language of treatment); and linguistic distance, a multilingualism-related variable that interacts with treatment focus.

Age of Language Acquisition
Language Use and Exposure
Language Proficiency
Post-Stroke Language Abilities
Lesion Site
Time Post-Onset
Treatment
Treatment Focus
Language of Treatment
Mechanisms Accounting for Observed Response to Treatment in Multilingual PWA
Activation
Inhibition
Conclusions
Limitations and Future
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