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

Abstract

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.

Keywords:

• Aphasia
• Bilingual
• Bilingual Aphasia Test (BAT)
• Cross-language
• Generalisation
• Verb
• Treatment

I wish to acknowledge the participation of the aphasic informant in this project. I also would like to thank both Senior Engineer Bjørn-Helge Mevik and PhD candidate Pernille Hansen, University of Oslo, Norway, for their help with the statistics. I would like to express my gratitude to Dr Marianne Lind, Statped, Norway, to Prof. Hanne Gram Simonsen, University of Oslo, Norway, and to the three anonymous reviewers for their comments on an earlier version of this manuscript.

This project has been financially supported by the Norwegian Extra Foundation for Health and Rehabilitation through EXTRA funds.

Notes

2. ¹ The terms cross-language transfer, cross-language generalisation, cross-linguistic transfer, and cross-linguistic generalisation will be used interchangeably in this article.