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Psychologists and other therapists are seeing an increasingly large number of bilingual individuals. Such clients are a special challenge when there has been some type of brain injury or disease because of the seemingly unpredictable effect such disorders may have on language skills, impacting either or both of the client's languages and interfering with internal speech that plays a role in higher cognitive functions such as insight and awareness. While there are many clinical assumptions about which language will show the least impairment or recover the best, such suppositions based on clinical lore are often contradictory. A review of the literature finds that the outcome of brain injury may be influenced by factors such as cerebral representation of a secondary language, method of language acquisition, age of acquisition, premorbid language proficiency, and style of learning in an individual. Neuropsychological concepts that can explain these findings are examined, along with their implications for therapy, and rehabilitation.

The purpose of the study was to examine the relationship between the Luria-Nebraska Neuropsychological Battery-Third Edition (LNNB-III) and the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). Participants were 85 adults referred for neuropsychological evaluation. The mean age of participants was 38.73 years (SD = 16.54) and average education was 13.07 years (SD = 2.60). The sample was predominantly female (52.9%), right-handed (86.3%), and Caucasian (68.6%), with the remainder of the population classified as Hispanic (13.7%), African-American (5.9%), or other (11.8%). Diagnoses included 26% psychiatric disorders, 64% neurological disorders, and 10% with no diagnosis. Pearson product correlation yielded a number of significant relationships between the WAIS-III IQ scores and the LNNB-III scales. The highest correlations were with the LNNB Intelligence, Visual-Spatial, Complex Auditory, and Arithmetic scales. Additionally, significant correlations were found between the WAIS-III subtests and a moderate proportion of the LNNB-III subtests. Correlations were also reported for the new WAIS-III scales, Letter-Number Sequencing and Matrix Reasoning. The results suggest that similar abilities are being assessed on both tests. These findings allow clinicians to not only evaluate the consistency of performance across this testing battery, but provide a useful screening instrument for intelligence.