Aphasia in Bilingual Speakers and types of it.

This is about aphasia in bilingual speakers.

1. Aphasia in Bilingual Speakers By : Fatemeh Hakimian

2. APHASIA Aphasia is a language disorder that affects a person's ability to communicate. It can impact speaking, listening, reading, and writing. It is caused by damage to the brain, such as Stroke Head injury Brain tumor Neurological diseases (like Alzheimer’s)

3. A PERSON WITH APHASIA MIGHT Speak in short or incomplete sentences Speak in sentences that don't make sense Substitute one word for another or one sound for another Speak unrecognizable words Not understanding other people's conversation Write sentences that don't make sense

4. CLASSIFICATION OF APHASIA Fluent Non-Fluent Broca’s Aphasia Transcortical motor Aphasia Wernick’s Aphasia Conduction Aphasia Transcortical Aphasia Isolation Aphasia Global Aphasia Anomic Aphasia Given by Goodglass (1974)

5. Types Of Fluent Aphasia People with this type of aphasia have difficulty or inability to understand others’ speech, and produce meaningless speech Symptoms of this type of aphasia are fluent speech with some anomia, poor language comprehension, and echolalia. The main symptom of this type of aphasia is difficulty repeating something someone has just said This aphasia is characterized by difficulty finding names and difficulty substituting indefinite nouns and pronouns with substantive words . Wernicke's aphasia Conduction aphasia Transcortical aphasia Anomic aphasia

6. The people with this affliction have poor language comprehension and speak in slow Types Of Non-Fluent Aphasia This type of aphasia manifests with difficulties initiating well-articulated conversational speech People with this aphasia do not speak unless they are strongly encouraged to do so and when they do speak it is labored and non-fluent Isolation aphasia is a form of aphasia in which comprehension and production of language are severely impaired, but repetition is preserved Broca's aphasia Global aphasia Transcortical motor aphasia Isolation Aphasia

7. Who is a Bilingual? A bilingual is a person who has the ability to communicate in two languages, either equally or with varying proficiency. A person with aphasia typically maintains their cognitive skills and have NOT lost their intelligence.

8. Bilingual aphasia is a language disorder that affects one or more languages in a bilingual or multilingual individual. When Aphasia Happens to a Bilingual Person…

9. Paradis’ Neurolinguistics Theory Message formulation ( cognitive ) Metalinguistic knowledge ( conscious monitoring ) Implicit linguistic competence ( grammar, syntax ) Pragmatic system ( contextual use ) Motivational system ( speech drive ) M P M I M

10. Patterns of Recovery in Bilingual Aphasia Differential Recovery: Greater inhibition of one language; L1 recovers more often than L2. Selective Recovery: One language remains impaired while the other recovers; the activation threshold of the impaired language stays high. Parallel Recovery: Both languages improve simultaneously and to a similar extent.

11. Patterns of Recovery in Bilingual Aphasia Successive Recovery: Complete recovery of one language precedes recovery of the other. Alternating Recovery: The first recovered language is later lost due to the recovery of the other language. Alternating Antagonistic Recovery: The language in use switches day-to-day; the patient speaks one language one day and the other the next.

12. Recovery Theories in Bilingual Aphasia The native language is more resistant to brain damage. The language used most frequently before aphasia recovers first. The language with more emotional significance may be preserved better . Ribot’s Law Pitres’ Principle Minkowski’s Affective Hypothesis

13. What Affects Language Recovery? I IV II V III VI Frequency of use Emotional connection Brain lesion location & severity Type of bilingualism (compound vs coordinate) Language of the environment and therapy Age of acquisition

14. Feature T.B. (Farsi–English) H.J. (Farsi–Azari) Age / Handedness 26 / Right-handed 63 / Right-handed First Language (L1) Farsi Azari Second Language (L2) English (10 years education, university in Canada) Farsi (dominant in adulthood) Cause of Aphasia AVM + 3 surgeries (left temporo-parieto-occipital) Stroke (CVA from atrial fibrillation) Aphasia Type Transcortical Motor Aphasia Wernicke’s Aphasia Better Recovered Language Farsi (L1) Azari (childhood L1 reemerged) Notable Feature Therapy started in English, but Farsi recovered better Could not switch back to dominant L2 (Farsi) Recovery Pattern Differential Recovery Reversal of Language Dominance Case study

15. The two cases show contrasting recovery patterns in bilingual aphasia, supporting the modular representation of language in the brain (Paradis, 2004). T.B. – L1 (Farsi) recovered better despite therapy and the environment in English. Suggests a strong role of automaticity and emotional grounding in L1. H.J. – Spontaneous use of childhood language (Azari) post-stroke, despite decades of using Farsi. Indicates influence of early acquisition and affective factors. Conclusion : Recovery is shaped not only by the dominant or therapy language but also by: Age of acquisition, Emotional salience site. Each bilingual's brain stores and retrieves languages non-uniformly.

16. Bilingual Aphasia Test (BAT) Bilingual Aphasia Assessment Designed by Michael Paradis A specialized test for assessing both languages in bilingual individuals Provides equivalent tasks in both languages to avoid linguistic bias Structure of the BAT: Language History Questionnaire ▸ Age of acquisition, language dominance, frequency of use Linguistic Competence Tasks ▸ Comprehension, production, repetition, naming, reading, writing (Optional) Translation and metalinguistic awareness tasks

17. Speech Therapy Intervention In speech therapy , the SLP will: Test a person’s language skills , including their understanding of writing, and their understanding of objects and pictures. Treat the problems the person is having. Educate the person and their family in ways to communicate. Identify the appropriateness of augmentative communication (AAC) methods if the person cannot communicate through natural means.

18. Communication Tips Speak slowly . Give time for a response . Try gestures, drawing . Get the person's attention before speaking . Keep it simple - don't talk down to the person . Some people are okay with you helping them to finish their sentence , while others are not ok. Please ask the person. Crowds and background noise can be difficult . Repeat . Keep them engaged in conversation . Do not ignore individuals in a group conversation.

19. Recovery As a person's brain heals, a person's skills may improve. Spontaneous recovery is improvement right after the stroke. (generally over a period of 6 months) Recovery varies from person to person, ranging from days to little or no improvement over time. A person with aphasia should seek treatment from a speech-language pathologist (SLP) who is trained to work with people who have speech and language problems like aphasia. Treatment may happen in hospitals, rehabilitation centers, nursing homes, clinics, private practice, or the person's home.

20. Final Thought "Bilingual aphasia isn’t just about language loss — it’s about restoring identity, connection, and the ability to be heard again. With the right tools, therapy, and awareness, recovery becomes a new way to reconnect."

21. References 1. Lahiri, D., Ardila, A., Dubey, S., Mukherjee, A., Chatterjee, K., & Ray, B. K. (2020). Effect of bilingualism on aphasia recovery. Aphasiology, 35(8), 1103–1124. https://doi.org/10.1080/02687038.2020.1812032 2. Sarno, M. T. (Ed.). Aphasia: Evaluation and Treatment (3rd ed.). Department of Rehabilitation Medicine, New York University School of Medicine. 3. Lorenzen, B., & Murray, L. L. (2008). Bilingual aphasia: A theoretical and clinical review. Indiana University, Bloomington. 4. Nilipour , R. (1989). Task-specific agrammatism in a Farsi-English bilingual patient. College of Rehabilitation Sciences, Tehran. 5. Nilipour , R., & Ashayeri , H. (1989). Alternating antagonism between two languages with successive recovery of a third in a trilingual aphasic patient. College of Rehabilitation Sciences, Tehran. 6. Nilipour , R., Pourshahbaz , A., & Ghoreyshi , Z. S. (1988). Reliability and validity of bedside version of Persian WAB (P-WAB-1). University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 7. Paradis, M. (2000). Bilingual aphasia: A theoretical and clinical review. Aphasiology, 14(9), 883–900. https://doi.org/10.1080/02687030050205723 8. Khachatryan, E., Vanhoof, G., Beyens , H., Goeleven , A., Thijs, V., & Van Hulle, M. M. (2016). Language processing in bilingual aphasia: a new insight into the problem. 9. Lambert, W. E., & Fillenbaum , S. (1959). A pilot study of aphasia among bilinguals. McGill University.

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