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In multilingual people, semantic knowledge is predominantly shared across languages. Providing semantic-focused treatment to people with aphasia has been posited to strengthen connectivity within association cortices that subserve semantic knowledge. In multilingual people, such treatment should result in within- and cross-language generalisation to all languages, although not equally. We investigated treatment effects in two multilingual participants with aphasia who received verb-based semantic treatment in two pre-stroke highly proficient languages. We compared within- and cross-language generalisation patterns across languages, finding within- and cross-language generalisation after treatment in the less-impaired, pre-morbidly more-proficient first-acquired language (L1). This observation supports the theory that connectivity is greater between the lexicon of a pre-morbidly more-proficient L1 and the shared semantic system than the lexicon of a pre-morbidly less-proficient later-acquired language. Our findings of within- and cross-language generalisation patterns could also be explained by both the Competing Mechanisms Theory and the theory of lingering suppression.

Purpose: This article describes a framework for developing international research collaborations among graduate students. Central to this framework is the utility of institutional and association-based academic mentorship programs in developing collaborative partnerships. We illustrate how the American Speech-Language-Hearing Association's Mentoring Academic Research Careers program served as a vehicle for fostering remote collaboration and provided training experiences for graduate students during the COVID-19 pandemic. Conclusions: This model successfully supported doctoral students in developing an ongoing and sustainable research partnership during a challenging time when in-person networking opportunities were unavailable. This partnership provided a unique pathway for professional development that complemented formal academic training. More broadly, international collaboration experiences such as these provide valuable, skill-based training for all students, such that they are better equipped to serve diverse populations and as members of diverse teams. We offer recommendations for others endeavoring to develop international collaboration initiatives for students paired with mentorship.

Active collaboration between speech-language pathologists (SLPs) and persons with aphasia (PWA) is essential for personalizing aphasia treatment and optimizing clinical outcomes during aphasia rehabilitation. Studies have demonstrated the feasibility and effectiveness of collaboration between SLPs and PWA during the goal setting phase of the intervention process in aphasia rehabilitation. However, it remains unclear whether this collaboration as well as PWA’s feedback can be applied and be beneficial to all phases of aphasia rehabilitation. Here we introduce a theoretical framework of self-regulated learning (SRL) for aphasia rehabilitation that spotlights the role of PWA’s feedback in all phases of the rehabilitation process. We review studies on models of SRL in educational psychology and evidence from clinical aphasiology and neurolinguistics. Based on the evidence, we argue that PWA’s feedback is beneficial for optimizing all phases of the intervention process in aphasia rehabilitation. To make this work, communicative barriers to collaborative, patient-centered goal setting must be minimized or eliminated to facilitate alternative channels for receiving PWA’s feedback which will promote their engagement in aphasia rehabilitation. Also, insights from PWA’s feedback can help SLPs to select tasks and treatments that promote PWA’s engagement in the intervention process, which, in turn, can maximize aphasia recovery. PWA can be active participants in the whole intervention process and SLPs can use information from PWA’s feedback to improve the personalization of the whole intervention process to maximize clinical outcomes.

Chronic severe Wernicke’s aphasia has a poor prognosis and is challenging to treat. Furthermore, even when there is potential for improvement, formal assessments using accuracy scores only to measu...

Language difficulties can arise from reduced exposure to any given language (e.g. attrition) or after brain damage (e.g. aphasia). The manifestations of attrition and aphasia are often similar so differentiating between their effects on language loss and recovery is challenging. We investigated treatment effects for an English-Hebrew bilingual person with stroke-induced aphasia who had minimal contact with his Hebrew for over 14 years. We asked whether his attrited language could be rehabilitated, how effects of attrition and aphasia can be dissociated, and how such dissociation aids our understanding of the mechanisms involved in language recovery in aphasia. We administered a verb-based semantic treatment in Hebrew three times a week for six weeks (totalling 29 hours of therapy) and assessed changes in both Hebrew and English comprehension and production abilities across a variety of language tasks. Quantitative analyses demonstrated improvement in Hebrew production across language tasks, including those involving lexical retrieval processes that were trained during treatment. Improvement to English occurred in these same lexical retrieval tasks only. We interpret these results as indicating that the participant's attrited language (Hebrew) could be rehabilitated with both specific treatment and general exposure to Hebrew contributing to improvement. Furthermore, treatment effects transferred to the untreated English. Qualitative analyses indicated that an interaction among aphasia, incomplete mastery of Hebrew pre-stroke, and attrition contributed to the participant's language difficulties post-stroke. We conclude that partially shared underlying mechanisms of attrition and aphasia drive language processing and changes to it with treatment.

We summarize recent published work concerning assessment and treatment of aphasia in bilingual and multilingual people and review current related models of treatment outcomes. As well, we discuss studies that address the recently debated topic of cognitive processes in bilingual individuals with aphasia, with a focus on the effects of bilingualism on aphasia recovery and its potential protective effects. Providing assessment and treatment tools that best serve multilingual individuals with aphasia and unpacking the variables and mechanisms that underlie response to treatment have emerged as goals of several recent studies. Additionally, while findings are still contradictory, some empirical studies reported that aphasia may manifest less severely in multilingual individuals and may improve faster compared to in monolingual counterparts. The findings of recent studies with the focus of aphasia in multilingual individuals are crucial to understanding theoretical and clinical aspects of brain-related language impairment in multilingual people and to the study of language representation and processing in the brain.

Background: While many studies that focus on assessment or intervention in multilingual people with aphasia report both pre-stroke proficiencies and post-stroke language abilities, the relationship...

Background: Persons with aphasia often show variability in language behavior. It is thus a common practice to evaluate their skills on multiple occasions, for research and clinical purposes. This r...

Most dictionary definitions for the term compound word characterize it as a word that itself contains two or more words. Thus, a compound word such as goldfish is composed of the constituent words gold and fish. In this report, we present evidence that compound words such as goldfish might not contain the words gold and fish, but rather positionally bound compound constituents (e.g., gold- and -fish) that are distinct and often in competition with their whole word counterparts. This conceptualization has significant methodological consequences: it calls into question the assumption that, in a traditional visual constituent priming paradigm, the participant can be said to be presented with constituents as primes. We claim that they are not presented with constituents. Rather, they are presented with competing free-standing words. We present evidence for the processing of Hebrew compound words that supports this perspective by revealing that, counter-intuitively, prime constituent frequency has an attenuating effect on constituent priming. We relate our findings to previous findings in the study of German compound processing to show that the effect that we report is fundamentally morphological rather than positional or visual in nature. In contrast to German in which compounds are always head-final morphologically, Hebrew compounds are always head initial. In addition, whereas German compounds are written as single words, Hebrew compounds are always written with spaces between constituents. Thus, the commonality of patterning across German and Hebrew is independent of visual form and constituent ordering, revealing, as we claim, core features of the constituent priming paradigm and compound processing.

Background: Cross-language generalisation has been reported in about half of all published cases of bilingual aphasia treatment. However, many of those studies report data from only single-...

Background: Language assessment in Alzheimer’s disease (AD) demonstrates deficits in single-word production, but rarely includes connected speech.Aims: If Alzheimer’s disease leads to deficits in lexical retrieval, we should find reduced word output in connected speech, limited lexical diversity, an increase in retrieval errors, and an association between scores on tests of single-word production and measures of word retrieval in context. The purpose of this review was to investigate these hypotheses across studies of connected speech in AD.Main Contribution: A search of Medline and PsychNET identified 51 articles (published in 1985–2016) that reported data from 1,114 individuals with AD and 1,280 cognitively healthy individuals. A meta-analysis showed a significant but small reduction in word output in AD. No consistent decrease in the proportion of unique words was documented, but there was indication that individuals with AD produce more frequent words than do controls. An analysis of errors do...

What can tests of single-word production tell us about word retrieval in connected speech? We examined this question in 20 people with Alzheimer's disease (AD) and in 20 cognitively intact individuals. All participants completed tasks of picture naming and semantic fluency, and provided connected speech through picture descriptions. Picture descriptions were analyzed for total word output, percentages of content words, percentages of nouns, and percentages of pronouns out of all words, type-token ratio of all words and type-token ratio of nouns alone, mean frequency of all words and mean frequency of nouns alone, and mean word length. Individuals with AD performed worse than did cognitively intact individuals on the picture naming and semantic fluency tasks. They also produced a lower proportion of content words overall, a lower proportion of nouns, and a higher proportion of pronouns, as well as more frequent and shorter words on picture descriptions. Group differences in total word output and type-token ratios did not reach significance. Correlations between scores on tasks of single-word retrieval and measures of retrieval in picture descriptions emerged in the AD group but not in the control group. Scores on a picture naming task were associated with difficulties in word retrieval in connected speech in AD, while scores on a task of semantic verbal fluency were less useful in predicting measures of retrieval in context in this population.

This special issue presents papers on the characteristics of speech and language production in Alzheimer’s disease (AD), ranging from the level of the single word to discourse. Although language de...

Mixing languages within a sentence or a conversation is a common practice among many speakers of multiple languages. Language mixing found in multilingual speakers with aphasia has been suggested to reflect deficits associated with the brain lesion. In this paper, we examine language mixing behaviour in multilingual people with aphasia to test the hypothesis that the use of language mixing reflects a communicative strategy. We analysed connected language production elicited from 11 individuals with aphasia. Words produced were coded as mixed or not. Frequencies of mixing were tabulated for each individual in each of her or his languages in each of two elicitation tasks (Picture sequence description, Narrative production). We tested the predictions that there would be more word mixing: for participants with greater aphasia severity; while speaking in a language of lower post-stroke proficiency; during a task that requires more restricted word retrieval; for people with non-fluent aphasia, while attempting to produce function words (compared to content words); and that there would be little use of a language not known to the interlocutors. The results supported three of the five predictions. We interpret our data to suggest that multilingual speakers with aphasia mix words in connected language production primarily to bypass instances of word-retrieval difficulties, and typically avoid pragmatically inappropriate language mixing.

Background: Language mixing in bilingual speakers with aphasia has been reported in a number of research studies, but the reasons for the mixing and whether it reflects typical or atypical behaviour has been a matter of debate. Aims: In this study, we tested the hypothesis that language mixing behaviour in bilingual aphasia reflects lexical retrieval difficulty. Methods & procedures: We recruited a Hebrew-English bilingual participant with mild-moderate non-fluent agrammatic aphasia and assessed his languages at three timepoints. We analysed the participant’s Hebrew and English production for retrieval during single-word naming, sentences, and discourse, and identified all instances of language mixing. Outcomes & Results: We found that there was a greater frequency of language mixing during production of more difficult lexical items, namely the post-morbidly less proficient language (compared to the more proficient language), function words (compared to content words), and single-word naming (compared to retrieval in the context of connected speech tasks), but not for verbs (compared to nouns). Conclusions: In this bilingual participant with non-fluent aphasia, language mixing behaviour closely resembles lexical retrieval difficulty. Thus, we suggest that bilingual speakers with aphasia may mix their languages as a strategy to maximise communication.

The question of interest in this study was whether bilingual individuals show superior executive control compared to monolingual participants. Findings are mixed, with studies showing advantage, disadvantage, or no difference between bilingual and monolingual speakers. In this study, we used different experimental conditions to examine implicit learning, resistance to interference, monitoring, and switching, independently. In addition, we matched our monolingual and bilingual participants on baseline response time. Bilingual participants demonstrated faster implicit learning, greater resistance to interference, more efficient switching compared to monolingual participants. The groups did not differ in monitoring. In conclusion, depending on task complexity and on the target executive control component, there are different patterns of bilingual advantage, beyond the global faster processing speed documented in previous studies. Bilingual young adults showed more efficient adjustments of the cognitive system in response to changes in task demands.

Purpose The effect of repeated naming on both object and action picture naming in individuals with anomic aphasia is explored. We asked whether repeatedly naming the same items leads to improved accuracy and reduced response latency. Method Ten individuals with anomic aphasia and 6 healthy adults, 3 young and 3 old, named a set of 27 object pictures and a set of 27 action pictures presented 1 at a time on a computer screen. We examined accuracy and response times (RTs) across the 2 blocks of 10 repeated trials. Results Results demonstrated higher accuracy and faster RTs for object than for action naming for all participants, with lower accuracy rates and slower RTs for the people with aphasia (PWA) compared with the healthy individuals, and diverging patterns of change across trials. Unlike the healthy participants, whose RTs decreased across trials, PWA continued to demonstrate variability in response latencies across the trials. Conclusions Our preliminary results suggest that measuring RT may be useful in characterizing retrieval difficulty in anomic aphasia and that the retrieval processes in PWA, even in those who experience mild anomia, may be less efficient or different from those processes in neurologically healthy individuals.

Current findings from intervention in bilingual aphasia are inconclusive regarding the extent to which levels of language proficiency and degree of linguistic distance between treated and non-treated languages influence cross-language generalisation and changes in levels of language activation and inhibition following treatment. In this study, we enrolled a 65-year-old multilingual speaker with aphasia and administered treatment in his L1, Dutch. We assessed pre- and post-treatment performance for seven of his languages, five of high proficiency and two of lower proficiency. We asked whether treatment in L1 would generalise to his other languages or increase interference among them. Forty hours of treatment were completed over the course of five weeks. Each language was tested three times at pretreatment and at post-treatment. Testing included measures of narrative production, answering questions, picture description and question generation. Dependent measures examined language efficiency, defined as Correct Information Units (CIUs)/min, as well as language mixing, defined as proportion of code-mixed whole words. We found that our participant’s improved efficiency in Dutch was mirrored by parallel improvement in the four languages of high proficiency: English, German, Italian and French. In contrast, in his languages of lower proficiency, Norwegian and Spanish, improved efficiency was limited. An increase in code-mixing was noted in Spanish, but not in Norwegian. We interpret the increased code-mixing in Spanish as indication of heightened inhibition following improvement in a language of close linguistic proximity, Italian. We conclude that an interaction of language proficiency and linguistic similarity affects cross-language generalisation following intervention in multilingual aphasia.

Background: Language comprehension is incremental and dynamic and a listener extracts meanings of linguistic elements and relationships between them at least as fast as she/he encounters them. Howe...

The contribution that Ton Dijkstra has made to the field of bilingualism, with his colleagues over the years, is beyond measure. He has advanced our field with the thoughtful and thought-provoking models of the bilingual lexicon he has put forward, and with the vast empirical data he and his colleagues have collected from numerous bilinguals, using a variety of experimental methods. This paper by Dijkstra, Wahl, Buytenhuijs, van Halem, Al-jibouri, de Korte, and Rekké (2018) is no exception. It comprises a thoughtful and detailed description of a new model, Multilink, and provides relevant information regarding the context in which the model was developed, its assumptions, its successes and challenges. The model is the first to consider aspects of both word production and word recognition, as well as of word translation, and to explicitly address how translation equivalents that share both form and meaning – cognates – may be processed. Also addressed are word-frequency concerns, including differences in word frequency that are dependent on language proficiency and exposure. The assumptions that are made within the model are clearly laid out, and less-than-ideal decisions that needed to be made are acknowledged. The authors conclude that a model like Multilink could be the basis for a general model of the mental lexicon. In that, they promote the view taken in Libben, Goral, and Libben (2017) that the bilingual – not the monolingual – lexicon should be considered as the default.

Findings from recent psycholinguistic studies of bilingual processing support the hypothesis that both languages of a bilingual are always active and that bilinguals continually engage in processes of language selection. This view aligns with the convergence hypothesis of bilingual language representation (Abutalebi & Green, 2008). Furthermore, it is hypothesized that when bilinguals perform a task in one language they need to inhibit their other, non-target language(s) (e.g., Costa, Miozzo, & Caramazza, 1999) and that stronger inhibition is required when the task is performed in the weaker language than in the stronger one (e.g., Costa & Santesteban, 2004). The study of multilingual individuals who acquire aphasia resulting from a focal brain lesion offers a unique opportunity to test the convergence hypothesis and the inhibition asymmetry. We report on a trilingual person with chronic non-fluent aphasia who at the time of testing demonstrated greater impairment in her first acquired language (Persian) than in her third, later-learned language (English). She received treatment in English followed by treatment in Persian. An examination of her connected language production revealed improvement in her grammatical skills in each language following intervention in that language, but decreased grammatical accuracy in English following treatment in Persian. The increased error rate was evident in structures that are not shared by the two languages (e.g., use of auxiliary verbs). The results support the prediction that greater inhibition is applied to the stronger language than to the weaker language, regardless of their age of acquisition. We interpret the findings as consistent with convergence theories that posit overlapping neuronal representation and simultaneous activation of multiple languages, and with proficiency-dependent asymmetric inhibition in multilinguals.

Individuals with Broca's aphasia show better performance on nouns than on verbs, but distinction between nouns and verbs is not always clear; some verbs are conceptually and/ or phonologically related to nouns, while others are not. Inconsistent results on effects of noun-verb relatedness on verb production have been reported in the literature.We investigated (1) whether verb instrumentality (a conceptual relationship to nouns) or homonymy (a phonological relationship to nouns) would affect verb production in individuals with Broca's aphasia and (2) whether conceptual/ phonological noun-verb relationship would affect responsiveness to aphasia therapy that focused on verb production.Three English speaking individuals with Broca's aphasia produced 96 verbs in sentences in response to picture stimuli. The target verbs included those that use an instrument and those that do not (e.g., to hammer vs. to yawn) and verbs that are phonologically identical to a related noun (e.g., to comb - a comb), morpho-phonologically-related to a noun (e.g., to grind - a grinder), and verbs for which there is no phonologically similar noun (e.g., to lean). The participants' verb retrieval ability was assessed before and after a 4-week period of aphasia therapy.The participants produced more accurate instrumental than non-instrumental verbs both pre- and post-treatment. They also produced more verbs correctly that are homonyms of nouns than verbs that are phonologically related or unrelated to nouns before treatment. However, the effect of homonymy was not observed following treatment.Individuals with Broca's aphasia were more accurate in their production of verbs that were conceptually and phonologically related to nouns than on verb that were not. The performance on verb production improved significantly after therapy. We interpret the results to indicate that whereas prior to treatment the participants relied on phonologically related nouns to retrieve the target verbs, this reliance on knowledge of nouns decreased following therapy that was designed to improve verb production.

This study aimed to examine the so-called bilingual advantage in older adults’ performance in three cognitive domains and to identify whether language use and bilingual type (dominant vs. balanced) predicted performance. The participants were 106 Spanish–English bilinguals ranging in age from 50 years to 84 years. Three cognitive domains were examined (each by a single test): inhibition (the Simon task), alternating attention (the Trail Making test), and working memory (Month Ordering). The data revealed that age was negatively correlated to performance in each domain. Bilingual type – balanced vs. dominant – predicted performance and interacted with age only on the inhibition measure (the Simon task). Balanced bilinguals showed age-related inhibition decline (i.e., greater Simon effect with increasing age); in contrast, dominant bilinguals showed little or no age-related change. The findings suggest that bilingualism may offer cognitive advantage in older age only for a subset of bilinguals.

We review the characteristics of developmental language disorders (primary language impairment, reading disorders, autism, Down syndrome) and acquired language disorders (aphasia, dementia, traumatic brain injury) among multilingual and multicultural individuals. We highlight the unique assessment and treatment considerations pertinent to this population, including, for example, concerns of language choice and availability of measures and of normative data in multiple languages. A summary of relevant, recent research studies is provided for each of the language disorders selected.

We conducted a comprehensive literature review of studies of word retrieval in connected speech in healthy aging, and reviewed relevant aphasia research that could shed light on the aging literature. Four main hypotheses guided the review: (1) Significant retrieval difficulties would lead to reduced output in connected speech. (2) Significant retrieval difficulties would lead to a more limited lexical variety in connected speech. (3) Significant retrieval difficulties would lead to an increase in word substitution errors and in pronoun use, as well as to greater dysfluency and hesitation in connected speech. (4) Retrieval difficulties on tests of single-word production would be associated with measures of word retrieval in connected speech. Studies on aging did not confirm these four hypotheses, unlike studies on aphasia that generally did. The review suggests that future research should investigate how context facilitates word production in old age.

We examined the relative proficiency of four languages (Spanish, German, French, English) of a multilingual speaker with aphasia, JM. JM’s self-rated proficiency was consistent with his naming accuracy for nouns and verbs (The Object and Action Naming Battery, Druks & Masterson, 2000 ) and with his performance on selected subtests of the Bilingual Aphasia Test ( Paradis & Libben, 1987 ). Within and between-language changes were measured following two periods of language treatment, one in a highly proficient language (Spanish) and one in a less-proficient language (English). The various outcome measures differed in their sensitivity to treatment-associated changes. Cross-language treatment effects were linked to the language of the environment at the time of testing and to relative language proficiency.