Our understanding of language function has been based on typical cases of right-handed, English-speaking, 60 year-old men with high school education who suffered a single stroke. These research observations built up a 'normal' picture of aphasic people. This approach aided our understanding in how language was organized in the brain.
It is often the case that during clinical assessment it is assumed that an aphasic person only speaks English, or that the knowledge of other languages was not relevant to their language difficulties. Typically, both assessment and treatment take place in English. No notice was taken if a person had grown up speaking another language, or in fact spoke something other than English outside of the hospital setting.
If all a multilingual speakers' languages were processed in the same way, then they would be equally impaired in aphasia. Surprisingly, this is not the case for a substantial minority of aphasic people. There may be different types of aphasic symptoms in the different languages. There may be different levels of severity of aphasic symptoms in the different languages. There may be different rates of recovery of aphasic symptoms in the different languages. It appears that languages in bilinguals may be organized in a distinct way in the brain. It is important that therapists and caregivers be aware of the knowledge of other languages an aphasic might have. It is possible that they have more language function than it appears in English.
Many aspects of aphasia appear to be fairly consistent and predictable, but the patterns of impairment in people who speak more than one language are not. This is unexpected and surprising. It suggests that people who learn to use more than one language do so in many different ways, and that the mental representation of those languages can have a variety of different forms and functions. Researchers today do not have a clear idea on why this is.
Bilingual aphasia has been described since the 19th century but little progress has been made in understanding the difficulties and strengths of these people. My research focuses on using historical approaches to find new ways to understand current research problems. Reading the cases of aphasia from 150 years ago shows a different way of thinking about language learning and memory which may help our current understanding of bilingual aphasia.
Marjorie Perlman Lorch, PhD
Reader in Brain and Language
School of Languages, Linguistics and Culture
University of London
London WC1H 0PD
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