Bilingual Aphasia Test Research Articles

Validation of the self-report classification tool to determine language dominance in Kannada-English bilinguals

Background In recent times, the efforts to profile the language characteristics of bilinguals have been extended from mere documentation of proficiency in each language to the determination of language dominance that captures both proficiency and usage (i.e., frequency & contexts) of each language. In multilingual countries, individuals are immersed in various languages in different contexts. With the broader intention to improve the linguistic profiling of bilinguals in countries with similar characteristics, we aimed to adapt and validate the Self-report classification tool in Indian Kannada-English bilinguals. Methods A group of 88 adult Kannada-English bilingual participants self-rated their language proficiency. We measured their language dominance with the adapted tool. Finally, to objectively measure their language abilities, we used the short version of the Bilingual Aphasia Test. Results Discriminant analysis of the ratings showed that the self-report classification tool accurately classified our participants into three groups based on language dominance. Both the self-rating and the objective measure of language proficiency supported the (dominance) classifications by the adapted tool. Conclusion Findings show that the adapted self-report classification tool is valid for determining language dominance in Kannada-English bilinguals. Further, the current study shows that this tool is adaptable to novel bilingual language dyads.

Cross-linguistic Generalizations in the Verb-Production Treatment of Bilingual Aphasic Speakers

Objectives: This study investigates cross- linguistic generalizations in the verb-production therapy for one bilingual speaker with non-fluent aphasia. Methods: Intensive sixty-hour treatment sessions over a period of 12 weeks was provided for an unbalanced bilingual speaker with mild to severe aphasia. A combination of semantically and phonologically cued verbs as well as communication-based treatment were administrated. The treatment was provided in the patient’s L1. The Bilingual Aphasia Test and action-naming pictures from The Newcastle University Aphasia Therapy Resources were used for the pre-and-post-therapy assessments for both languages. Results: A cross-language generalization was reported from L1 to L2. A significant generalization was found in one linguistic domain, i.e., semantics. A within-language generalization was found, i.e., the untrained verbs of L1 showed significant improvement. Nonetheless, inhibition of the semantic domain of the patient’s L1 was reported. Providing treatment for the stronger language of a bilingual aphasic individual could lead to cross-language transfer to the untreated weaker language. Conclusions: We suggest that the cross-language generalization is reported due to the structural overlap between the two languages.

Language abilities, not cognitive control, predict language mixing behavior in bilingual speakers with aphasia

PurposeLanguage Mixing (LM) occurs among neurotypical bilinguals as well as among bilingual persons with aphasia (BiPWAs). The current study aimed to investigate whether LM in BiPWAs stems from a linguistic impairment, an impairment in cognitive control, or both. MethodTwenty Russian-Hebrew-speaking BiPWAs were split into two groups based on aphasia severity (Severe/Moderate vs. Mild). Frequencies and patterns of LM in narrative production by BiPWAs in L1-Russian and in L2-Hebrew were analyzed. To investigate the underlying mechanisms of LM, all participants completed linguistic background questionnaires, the Bilingual Aphasia Test (BAT) in both languages, and a battery of 10 cognitive tests. ResultsThe results indicated an effect of aphasia severity and an effect of language. Higher LM frequency was observed in BiPWAs with severe/moderate aphasia symptoms as compared to BiPWAs with mild symptoms. In both groups, higher LM frequency was observed in L2-Hebrew narratives, the weaker post-stroke language for most participants in the sample. The results also showed qualitative LM differences in L1-Russsian and L2-Hebrew contexts. In L1-Russian narratives, BiPWAs mainly switched to L2-Hebrew nouns, while in L2-Hebrew narratives, they mainly inserted L1-Russian discourse markers and function words. ConclusionsLinguistic factors such as pre- and post-stroke self-rated language proficiency and level of language impairment due to aphasia were found to predict LM frequency in L1-Russian and in L2-Hebrew. Cognitive abilities did not predict LM frequency. Based on our findings, we suggest that LM behavior in BiPWAs might be primarily related to language skills in L1 and L2, rather than to cognitive control impairments.

Semantic Feature Analysis (SFA) treatment in L1 and L2 in bilingual aphasia: Effects of cognitive and language factors

ABSTRACT Background Semantic Feature Analysis (SFA) treatment has been proven to be effective in alleviating word finding difficulties in individuals with aphasia. However, there is no consensus on the impact of SFA on naming abilities and general language skills in bilingual persons with aphasia (BiPWAs), nor on factors that determine the success of the SFA treatment. Aims This study aimed to investigate the efficacy of SFA treatment in a group of L1-Russian – L2-Hebrew chronic stage BiPWAs and to evaluate the contribution of background factors, language and cognitive measures on the treatment success. Methods & Procedures The current study included two groups of BiPWAs. In the experimental group (n=10), six individuals received SFA therapy in both languages and four individuals in L2. The delayed-treatment group (n=10) did not receive therapy and served as a control group. All BiPWAs completed the Bilingual Aphasia Test (BAT) in both languages, as well as a battery of 10 cognitive tests and linguistic background questionnaires. Outcome & Results The results indicated a direct effect of SFA treatment on naming as well as within-language generalization and cross-language transfer. Importantly, we found significant improvements of general language skills in the treated and untreated languages in BiPWAs who received SFA treatment, while no such improvement was observed in the control group. Non-verbal inhibition and verbal working memory in L1-Russian predicted success of SFA treatment in BiPWAs. Conclusions SFA therapy has positive effects on naming ability of BiPWAs. In addition, SFA therapy affects general language skills in BiPWAs. Yet, within-language generalization, cross-linguistic transfer, and maintenance of the treatment results vary across individuals. The success of SFA treatment in BiPWAs is predicted by cognitive functions rather than background factors of bilingualism.

Redazione e validazione della versione di screening del Bilingual Aphasia Test (BAT) in cinese mandarino

This work describes the implementation of the Bilingual Aphasia Test (BAT) screening version for Mandarin Chinese. This short version is derived from the Full BAT, according to the authors specification, and allows to assess linguistic abilities of the two (or more) languages spoken by a bilingual patient. This tool has been initially developed in a traditional paper and pencil form, and then adapted in a digital format to be remotely administered through the web. Preliminary results of tuning and validation of this screening are available and confirm the foreseen high percentage of accuracy obtained on a normative sample.

Performance of Korean-English bilinguals on an adaptation of the screening bilingual aphasia test.

The use of standardized tests specifically designed for and normed on bilingual groups is crucial for the accurate diagnosis and language profiling of bilingual speakers with aphasia. Currently, there is a dearth of norms and supporting psychometric data for the few available bilingual aphasia assessments. The only available aphasia test for Korean-English (KE) bilinguals is the Korean-English Bilingual Aphasia Test (KE-BAT). The absence of bilingual normative data for the KE-BAT limits its clinical and research utility. (1) To revise the original screening KE-BAT to clarify ambiguities in its instructions and stimuli; and (2) to examine subtest and item performance across the two languages for the revised screening KE-BAT with a local sample of highly proficient KE bilinguals. The original screening KE-BAT was first revised to replace unrecognizable drawings, address ambiguities in the instructions and stimuli, and increase the number of items on naming subtests. This revised test is henceforth referred to as the adapted screening KE-BAT (AS KE-BAT). A total of 21 neurologically healthy, highly proficient and college-educated KE bilinguals (19-34 years old) were recruited from a large city in the United States. Participants completed three measures of language proficiency and the AS KE-BAT including the KE translation test (Part C). Total and subtest scores were compared across the two languages, and individual item accuracy was calculated. Incorrect responses of low scoring items were examined. Performance was comparable across Korean and English for all subtests, except for the spontaneous speech subtest. The item accuracy of 17 items (7% of total items) in the AS KE-BAT fell to < 80%, and four items (1.6% of total items) had an accuracy < 60%. Incorrect responses of low scoring items were caused by phoneme misperception, lexical substitution and morphosyntactic L2 patterns. The results of the study highlight the importance of empirically examining the performance of neurotypical bilinguals on bilingual aphasia assessments to establish their psychometric properties. Based on the small-sized local bilingual normative sample obtained in this study, appropriate cut-off criteria, recommendations for clinical interpretation and further modifications of the AS KE-BAT are proposed. What is already known on the subject The pair of English and Korean aphasia assessments (e.g., Western Aphasia Battery-Revised; WAB-R) (Kertesz 2012) and Korean Western Aphasia Battery (Kim and Na 2001) cannot be used to assess language impairments in KE bilinguals with aphasia since these tests have not been designed for and normed on the bilingual group. Clinical utility of the Korean-English Bilingual Aphasia Test (KE-BAT), which is the only resource currently available to assess KE bilinguals with aphasia, is greatly compromised by the lack of KE bilingual normative data. What this study adds to existing knowledge This study provides cut-off scores, comparability of test performance and item difficulty metrics and it identifies additional ways in which items and spontaneous speech scoring of the adapted screening KE-BAT (AS KE-BAT) could be modified. Suggested guidelines allow improved interpretations of the linguistic performance of local KE bilinguals with aphasia who have a similar demographic and linguistic background. What are the potential or actual clinical implications of this work? The AS KE-BAT with cut-off criteria of 95% for Part B and 80% for Part C is suitable for the language assessment of highly proficient and young KE bilinguals with a high level of education and it yields comparable performance across the two languages. Clinicians may decide to adjust spontaneous speech scoring criteria if the client's language history is suggestive of code-switching and use the item difficulty data to guide test item selection for this group of bilinguals.

Bilingual Aphasia Test in Urdu and its Clinical Implications.

doi: https://doi.org/10.12669/pjms.37.5.4572&#x0D; How to cite this:Ali N, Rafi MS. Bilingual Aphasia Test in Urdu and its Clinical Implications. Pak J Med Sci. 2021;37(5):1545-1546. doi: https://doi.org/10.12669/pjms.37.5.4572

Investigation of Speech and Language in a Persian Patient with Crossed Aphasia in Dextrals: A Case Report

Introduction: In the current study, we report a patient of crossed aphasia in dextrals (CAD) that presented with aphasia and typical neuropsychological deficits following right hemisphere brain damage. To the best of the authors’ knowledge, it is the first Persian language patient of CAD reported internationally. Case Presentation: The patient was a 59-year-old right-handed female with no history of left-handedness or ambidexterity in her family. Right handedness was measured in the current patient by the Edinburgh right-handedness inventory. Speech and language functions were measured by the Persian Western-Aphasia Battery (P-WAB) and the Bilingual Aphasia test (BAT). Also, the bedside version of Persian WAB (P-WAB-1) was used. Hemianopia/neglect was investigated by line bisection, painting, and cancellation tasks that confirmed left visuospatial neglect. Telegraphic speech was her dominant output feature. She had a problem with sentence construction; also, her morphological derivation skills were impaired. The syntactic structures of utterances were very simple. In writing tasks, her sample was unintelligible semantically. The auditory comprehension of the patient was impaired at the level of semi-complex and complex commands. It should be mentioned that difficulty in topic maintenance was observed in storytelling. Left visuospatial neglect was confirmed in the patient by assessments. The results confirmed the presence of neglect and language disorder, typologically consistent with Broca’s aphasia. Conclusions: The current study patient represented the typical symptoms of language dominant left hemisphere damage and a range of deficits indicating right hemisphere pathology. Analysis of patient symptoms confirmed the right hemisphere language dominance.

Semantic and phonological aspects of lexical retrieval in bilingual aphasia

Semantic and phonological aspects of lexical retrieval in bilingual aphasia

The Effect of Frontal Lobe Traumatic Brain Injury on Sentence Comprehension and Working Memory

Background: This study was conducted to examine the sentence comprehension and working memory in individuals with mild and moderate frontal lobe traumatic brain injury (TBI) and determine the relationship between them. Methods: Participants included 18 patients with mild TBI, 17 patients with moderate TBI and 18 non-TBI individuals. The digit span subtest of the Wechsler intelligence scale-IV (WISC-IV) and a N-back test were used to evaluate working memory. Moreover, the syntactic comprehension subtest of Bilingual Aphasia Test (BAT) was used for sentence comprehension assessment. Results: The results showed that patients withmild and moderate TBI had a lower performance in comprehension of non-canonical sentences and working memory compared to the non-TBI group. There was also a significant correlation between sentence comprehension and working memory in the TBI groups. Conclusions: Sentence comprehension and working memory in TBI patients with frontal lobe damage are significantly lower than that of the non-TBI group, which may lead to some daily communication problems in these individuals.

Diglossic aphasia and the adaptation of the Bilingual Aphasia Test to Palestinian Arabic and Modern Standard Arabic

Abstract The Bilingual Aphasia Test (BAT) is a criterion-referenced test developed in multiple languages and language-pairs to identify differential recovery in bilingual aphasia. It was developed to allow equivalent and culturally non-biased examination of all languages spoken by bi- or multi-lingual individuals with aphasia, to enable valid comparison of the residual abilities in each of the languages spoken. This comparison is critical for clinical practice to inform clinical decision-making, especially with respect to language of intervention and progress evaluation for bilingual adults with aphasia. This paper describes the adaptation of the BAT to expand its use to examine recovery patterns in adults with aphasia within an Arabic diglossic situation – specifically, Modern Standard Arabic (MSA) and Palestinian Arabic (PA). In diglossia, two language varieties co-exist, one acquired naturally and used for daily communication, and the other learned formally in school, used for formal communication settings, reading and writing and typically considered to be of a higher value by its community members. The theoretical, clinical and social impacts of this unique adaptation of the BAT to a diglossic situation are discussed.

Short Version of the Bilingual Aphasia Test in Malayalam.

Background:Brain damage can impair the use of all languages in bilingual persons. For effective management of aphasia (i.e., impaired language) in such persons, assessment of all languages is essential. The most widely used test for this purpose – the Bilingual Aphasia Test (BAT) – is cumbersome and requires a considerable amount of time for administration. To overcome this limitation, a short version of the BAT has been recommended.Objective:The objective of this study was to derive a short version of BAT for Malayalam-English bilingual persons with aphasia and to establish the test–retest reliability as well as the content and construct validities of this version.Methods:Following the recommendations of the test developers, we used seven subtests from the draft of an adapted full version of Malayalam BAT. These subtests in Malayalam and their counterparts in English were administered on a group of 22 Malayalam-English bilingual participants with aphasia. The scores obtained from these two languages were used to establish content and construct validities of the short version of the BAT in Malayalam. Further, we readministered the short version of BAT in a group of ten participants with aphasia to examine the test–retest reliability within 14 days from the date of first administration.Results:The short version of BAT in Malayalam revealed high test–retest reliability as well as content and construct validities. The administration time ranged between 30 and 45 min.Conclusions:Thus, the short version of the BAT in Malayalam can be considered a valid and reliable language test that can be quickly administered in Malayalam-English bilingual persons with aphasia.

Fluency in the narratives of a bilingual person with non-fluent aphasia and a neurogenic stutter

Fluency in the narratives of a bilingual person with non-fluent aphasia and a neurogenic stutter

Semantic feature analysis targeting verbs in a quadrilingual speaker with aphasia

Background: Semantic feature analysis (SFA) is a treatment approach aimed at enhancing lexical retrieval by improving access to the semantic network in speakers with aphasia. Although there are promising results on trained items, previous studies exploring the impact of SFA on verb production in monolingual speakers have shown mixed results for generalisation to untrained items and discourse. There are few published studies investigating SFA and action naming in multilingual speakers.Aims: The study explores the impact of SFA on trained and untrained verbs, semantics and syntax, and narrative production in the trained and untrained languages of a multilingual speaker (Japanese–English–German–Norwegian) with moderate non-fluent aphasia. Treatment was conducted in a late-acquired language (Norwegian).Methods & Procedures: SFA was provided during an intensive schedule of about 22 hr of therapy, with approximately 10 hr per week over two and a half weeks. The treatment focused on the production of verbs in sentence contexts.Outcomes & Results: Outcome measures include the Bilingual Aphasia Test, an action-naming test, and production of semi-spontaneous narratives.Outcomes in the treated language: Overall, the participant responded positively to the SFA treatment. The trained verbs improved significantly, but no transfer was observed to untrained verbs. There were no changes in the formal testing of semantics or syntax, but improvements were noted in narrative production.Cross-linguistic outcomes: Transfer to verbs in untreated German was evident. There were significant increases in the semantics and syntax in both English and German. The participant showed an improvement in discourse in English and German, although not in Japanese.Conclusions: SFA treatment in a late-acquired language can lead to gains in the treated language and transfer to both stronger and weaker languages, with different patterns for the various languages. This indicates that SFA may be a promising method for treating multilingual speakers with aphasia. The authors further advocate the use of narratives as an assessment tool. In addition to enhancing the ecological validity of the findings, the narratives provided information not obtainable from the other assessment tools for within- and cross-linguistic therapy gains for the participant.

Language specificity of lexical-phonological therapy in bilingual aphasia: A clinical and electrophysiological study

Based on findings for overlapping representations of bilingual people's first (L1) and second (L2) languages, unilingual therapies of bilingual aphasia have been proposed to benefit the untrained language. However, the generalisation patterns of intra- and cross-language and phonological therapy and their neural bases remain unclear. We tested whether the effects of an intensive lexical-phonological training (LPT) in L2 transferred to L1 word production in a Persian-French bilingual stroke patient with Broca's aphasia. Language performance was assessed using the Bilingual Aphasia Test, a 144-item picture naming (PN) task and a word–picture verification (WPV) task. Electroencephalography (EEG) was recorded during PN and WPV in both languages before and after an LPT in French on a wordlist from the PN task. After the therapy, naming improved only for the treated L2 items. The naming performance improved neither in the untrained L2 items nor in the corresponding items in L1. EEG analyses revealed a Language x Session topographic interaction at 540 ms post-stimulus, driven by a modification of the electrophysiological response to the treated L2 but not L1 items. These results indicate that LPT modified the brain networks engaged in the phonological-phonetic processing during naming only in the trained language for the trained items.

Language intervention in Arabic–English bilingual aphasia: A case study

Background: Bilingual speech and language therapists (SLTs) who speak the languages of their bilingual patients are not always available; hence, the question of cross-language transfer in bilingual aphasia rehabilitation has arisen.Aims: The study aims to determine whether treatment provided in the L2 of a bilingual Arabic–English speaker with moderate to severe chronic aphasia will lead to improvement in both the treated L2 and the untreated L1 (cross-language transfer). Furthermore, the study aims to describe how treatment may be conducted in the mutual, non-native language of both the client and the SLT in an ordinary clinical setting.Methods & Procedures: Language measurements were made in both languages pre- and post-treatment using the Bilingual Aphasia Test (BAT). Therapy was provided in the participant’s L2 (English) 3 hours a week for 10 weeks. The treatment targeted the production of semantically and phonologically cued verbs, as well as communication-based treatment of verbs. All procedures focused on producing verbs in complete sentences.Outcomes & Results: Results demonstrate a significant increase in the overall BAT scores in both languages, with the greatest improvement occurring for semantically cued verbs in the participant’s L1 (Arabic). Moreover, there was a positive change in the participant’s language behaviour at home, as reported by his family.Conclusions: The treatment of the weaker L2 of bilingual aphasic patients can lead to cross-language transfer to the untreated L1. This transfer may be due to a shared conceptual system for the two languages, or it may be explained by the fact that the L1 was the dominant language at the time of treatment. The success of providing therapy in the SLTs L2 suggests that the provision of therapy in a mutual, non-native language of both the client and the SLT could constitute an effective intervention.

A language teacher in the haze of bilingual aphasia: A Kurdish-Persian case

Following the call for more reflection on bilingual aphasia in different languages, the present study seeks to illuminate the recovery pattern of languages in an aphasic bilingual Kurdish-Persian individual. The standardized versions of the Bilingual Aphasia Test (Paradis, 1987) were administered. The findings revealed non-parallel recovery of languages. The study showed a combination of influential variables may explain the recovery pattern of languages post-stroke. There were also implications for cross-linguistic studies on aphasia.

Adaptation of the Bilingual Aphasia Test (BAT) to Sardinian: Clinical and social implications

Abstract The Bilingual Aphasia Test (BAT) was developed between 1976 and 1982. At present, it has been adapted to over 60 languages and 150 language pairs. Its main function is to assess and compare the residual linguistic abilities in each language of an aphasic patient. The BAT is not only used for bilingual aphasia assessment, but also for the evaluation of the effects of treatment as well as for the assessment of language disorders in bilinguals and monolinguals. Furthermore, it is also used for research in psycholinguistics experiments and in combination with modern neuroimaging and neurophysiological techniques. This article describes the adaptation of the BAT to the Sardinian variety of Logudorese and in particular to the sub-variety spoken in the town of Bitti (central Logudorese). To our knowledge, this is the first adaptation of the Bilingual Aphasia Test to Sardinian. At the moment, there are no published aphasia tests in Sardinian, and for this reason this adaptation provides the first standardized test for assessment in this language.

Thalamic and Striatocapsular Bilingual Aphasia

In the present study, the linguistic performances of 8 bilingual aphasics with subcortical lesions in striatocapsular or thalamic areas have been assessed by means of Bilingual Aphasia Test. Based on this limited collected data, it is suggested that: (1) The thalamus and striatocapsular area have a more important role in production than comprehension and also in the processing of grammatically complex structures; (2) Speech production and comprehension are more severely impaired following striatocapsular lesions than thalamic lesions, whereas “naming” might be more impaired as a result of thalamic lesions; (3) Degree of proficiency and the language of patient's environment may not correlate with the pattern of recovery, whereas the age of second language acquisition might correlate with the pattern of recovery in subcortical bilingual aphasia; (4) It is likely that the second language acquired at an older age is represented more subcortically than the first language; and (5) In bilinguals, language is subcortically lateralized in the left striatocapsular and thalamic areas.

Language intervention in French–English bilingual aphasia: Evidence of limited therapy transfer

Abstract This study investigated the effect of treatment in the second language (L2) for a previously proficient French-English bilingual with aphasia, at 5 years post-stroke. Assessment on the Bilingual Aphasia Test (BAT) enabled objective measurement of language skills in each language, and comparison across languages, before and after treatment in L2 (English). Previous therapy had been provided exclusively in L1 (French). Pre-treatment assessment on the BAT revealed greater impairment in L2 than L1, indicating differential recovery and limited transfer from previous L1 intervention. Following treatment, re-assessment on the BAT in French and English showed significant gains in spoken expression and syntactic comprehension in L2 but not L1. Translation in both directions was unchanged. Gains in L2 did not exceed L1 pre-treatment scores. These results demonstrate language-specific improvement following treatment in L2, and indicate caution in assuming therapy transfer will occur in proficient, highly motivated late bilinguals. The use of the BAT as a cross-linguistically valid assessment tool is recommended for future bilingual aphasia research.