Therapy for naming difficulties in bilingual aphasia: which language benefits?

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractBackground: The majority of the world's population is bilingual. Yet, therapy studies involving bilingual people with aphasia are rare and have produced conflicting results. One recent study suggested that therapy can assist word retrieval in bilingual aphasia, with effects generalising to related words in the untreated language. However, this cross-linguistic generalisation only occurred into the person's stronger language (L1). While indicative, these findings were derived from just three participants, and only one received therapy in both languages.Aims: This study addressed the following questions. Do bilingual people with aphasia respond to naming therapy techniques developed for the monolingual population? Do languages respond differently to therapy and, if so, are gains influenced by language dominance? Does cross-linguistic generalisation occur and does this depend on the therapy approach? Is cross-linguistic generalisation more likely following treatment in L2 or L1? Methods & Procedures: The study involved five aphasic participants who were bilingual in English and Bengali. Testing showed that their severity and dominance patterns varied, so the study adopted a case series rather than a group design. Each person received two phases of naming therapy, one in Bengali and one in English. Each phase treated two groups of words with semantic and phonological tasks, respectively. The effects of therapy were measured with a picture-naming task involving both treated and untreated (control) items. This was administered in both languages on four occasions: two pre-therapy, one immediately post-therapy and one 4 weeks after therapy had ceased. Testing and therapy in Bengali was administered by bilingual co-workers. Outcomes & Results: Four of the five participants made significant gains from at least one episode of therapy. Benefits arose in both languages and from both semantic and phonological tasks. There were three instances of cross-linguistic generalisation, which occurred when items had been treated in the person's dominant language using semantic tasks. Conclusions & Implications:This study suggests that 'typical' naming treatments can be effective for some bilingual people with aphasia, with both L1 and L2 benefiting. It offers evidence of cross-linguistic generalisation, and suggests that this is most likely to arise from semantic therapy approaches. In contrast to the results in the academic literature, the direction of generalisation was from L1 to L2. The theoretical implications of these findings are considered. Finally, the results support the use of bilingual co-workers in therapy delivery.

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

“…A lack of generalisation across languages has been reported in a large number of other studies (Abutalebi et al, 2009;Ansaldo, Saidi, & Ruiz, 2010;Byng, Coltheart, Masterson, Prior, & Riddoch, 1984;Bychowsky, 1919;Croft et al, 2011;Galvez & Hinckley, 2003;Gil & Goral, 2004;Goral et al, 2010;Halpern, 1949;Hinckley et al, 2005;Laganaro & Overton-Venet, 2001;Kiran & Roberts, 2010;Kohnert, 2004;Meinzer et al, 2007;Miertsch et al, 2009 (for L1);Miller, 1993;Minkowski, 1927Minkowski, , 1949Minkowski, , 1964Sasanuma & Park, 1995;Watamori & Sasanuma, 1976. Abutalebi et al (2009) reported improved naming in L2 (Italian) but no improvement of naming in L1 (Spanish) following intervention in L2.…”

“…Spoken expression and reading was regained in Russian only, after the onset of treatment. Croft et al (2011) found no cross-language therapy benefits following phonological naming intervention from L1 to L2 or from L2 to L1 for a group of mixed proficiency bilinguals with aphasia who spoke Bengali (L1) and English (L2). Semantic naming intervention in L2 benefited L1 for one of the five participants, and in L1 benefited L2 for two participants.…”

“…Improved naming and spoken expression in the untreated second language (L2) following treatment in the first language (L1) have been reported in several studies (Chlenov, 1948;Croft et al, 2011;Edmonds & Kiran, 2006;Hinckley et al, 2005;Junqué et al, 1989;Kiran & Edmonds, 2004). Edmonds and Kiran (2006) investigated therapy transfer subsequent to semantic naming treatment in L1 (Spanish) and L2 (English) for 3 proficient bilinguals with non-fluent aphasia and naming deficits (see also Kiran & Edmonds, 2004).…”

“…As is discussed further below, a number of studies have reported mixed results, with therapy transfer from the treated to the untreated language occurring only for some but not other participants (Croft et al, 2011;Hinckley et al, 2005;Kiran & Edmonds, 2004;Kiran & Roberts, 2010;Watamori & Sasanuma, 1978), for some but not other languages (Filiputti et al, 2002), or for some, but not other lexical items (Kohnert, 2004;.…”

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

“…Concerning cross-language generalisation patterns induced by semantic or phonological therapies, semantic therapy has been reported to induce CLG in studies with bilingual aphasic patients (Croft, Marshall, Pring, & Hardwick, 2011;Edmonds & Kiran, 2006;Kiran et al, 2013;Kohnert, 2004;Miertsch, Meisela, & Isel, 2009). In contrast, although Hinckley (2003) and Marangolo et al (Marangolo, Rizzi, Peran, Piras, & Sabatini, 2009) showed some level of CLG with mixed semantic-phonological therapy or using phonological therapy in L2, CLG was not found after phonological therapy in Meinzer et al (Meinzer, Obleser, Flaisch, Eulitz, & Rockstroh, 2007), or transfer was limited to phonologically similar words (cognates) (Kohnert, 2004;Pillon & de Partz, 2005).…”