Parallel recovery in a trilingual speaker: the use of the Bilingual Aphasia Test as a diagnostic complement to the Comprehensive Aphasia Test

We illustrate the value of the Bilingual Aphasia Test in the diagnostic assessment of a trilingual speaker post-stroke living in England for whom English was a non-native language. The Comprehensive Aphasia Test is routinely used to assess patients in English, but only in combination with the Bilingual Aphasia Test is it possible and practical to provide a full picture of the language impairment. We describe our test selection and the assessment it allows us to make.     

Understanding the relationship between language proficiency,language impairment and rehabilitation: Evidence from a case study

The goal of this study was to address the relationship between language proficiency, language impairment and rehabilitation in bilingual Russian–English individuals with aphasia. As a first step, we examined two Russian–English patients' pre-stroke language proficiency using a detailed and comprehensive language use and history questionnaire and evaluated their impairment using the Bilingual Aphasia Test. We then attempted to replicate and extend Kiran and Roberts' study in 2010, examining results of a primarily semantic treatment for anomia in one Russian–English bilingual patient. The patient's ability to name the trained and untrained items in both the trained (English) and untrained (Russian) languages significantly improved by achieving 100% accuracy. Finally, we examined whether improvements observed in treatment were captured by a broader language test such as the Bilingual Aphasia Test. Results are discussed with respect to factors contributing to the successful treatment and the implications of rehabilitation on assessment of language skills as a function of treatment.     

The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism

Minimally verbal children with autism commonly demonstrate language dysfunction, including immature syntax acquisition. We hypothesised that transcranial direct current stimulation (tDCS) should facilitate language acquisition in a cohort (n?=?10) of children with immature syntax. We modified the English version of the Bilingual Aphasia Test (BAT) to test only basic canonical subject–verb–object sentences. We tested syntactic accuracy after teaching then testing all vocabulary from the subsequent syntax test to ensure validity of syntactic scoring. We used scaffolding sentences for syntax training. All procedures were performed both before and after tDCS. Results demonstrated a large effect size of the difference between pre-/post-tDCS groups (p < 0.0005, d?=?2.78), indicating syntax acquisition. Combining a modified BAT with tDCS constitutes effective modalities for assessment and treatment of immature syntax in children with autism. Future studies should explore the BAT for patients with an inability to use or understand language, in particular bilingual children with autism.     

Understanding the relationship between language proficiency, language impairment and rehabilitation: Evidence from a case study

The goal of this study was to address the relationship between language proficiency, language impairment and rehabilitation in bilingual Russian-English individuals with aphasia. As a first step, we examined two Russian-English patients' pre-stroke language proficiency using a detailed and comprehensive language use and history questionnaire and evaluated their impairment using the Bilingual Aphasia Test. We then attempted to replicate and extend Kiran and Roberts' study in 2010, examining results of a primarily semantic treatment for anomia in one Russian-English bilingual patient. The patient's ability to name the trained and untrained items in both the trained (English) and untrained (Russian) languages significantly improved by achieving 100% accuracy. Finally, we examined whether improvements observed in treatment were captured by a broader language test such as the Bilingual Aphasia Test. Results are discussed with respect to factors contributing to the successful treatment and the implications of rehabilitation on assessment of language skills as a function of treatment.     

The use of the Bilingual Aphasia Test for assessment and transcranial direct current stimulation to modulate language acquisition in minimally verbal children with autism

Minimally verbal children with autism commonly demonstrate language dysfunction, including immature syntax acquisition. We hypothesised that transcranial direct current stimulation (tDCS) should facilitate language acquisition in a cohort (n?=?10) of children with immature syntax. We modified the English version of the Bilingual Aphasia Test (BAT) to test only basic canonical subject-verb-object sentences. We tested syntactic accuracy after teaching then testing all vocabulary from the subsequent syntax test to ensure validity of syntactic scoring. We used scaffolding sentences for syntax training. All procedures were performed both before and after tDCS. Results demonstrated a large effect size of the difference between pre-/post-tDCS groups (p < 0.0005, d?=?2.78), indicating syntax acquisition. Combining a modified BAT with tDCS constitutes effective modalities for assessment and treatment of immature syntax in children with autism. Future studies should explore the BAT for patients with an inability to use or understand language, in particular bilingual children with autism.     

An automated version of the BAT Syntactic Comprehension task for assessing auditory L2 proficiency in healthy adults

Studies of bilingualism sometimes require healthy subjects to be assessed for proficiency at auditory sentence processing in their second language (L2). The Syntactic Comprehension task of the Bilingual Aphasia Test could satisfy this need. For ease and uniformity of application, we automated its English (. The Bilingual Aphasia Test. English version. Hillsdale, NJ: Lawrence Erlbaum Associates) and French (. The Bilingual Aphasia Test, French version. Hillsdale, NJ: Lawrence Erlbaum Associates) versions. Although the Bilingual Aphasia Test is meant to assess neurological disorders affecting language, we hypothesised that ceiling performance in L2 would be rare and L2 errors should be consistent with lack of processing automaticity. Initial data from 13 French–English and 4 English–French bilinguals confirm these expectations. Thus, the automated Syntactic Comprehension task (available online for PC and Mac platforms) is indeed suited to test bilingual English and French proficiency levels in healthy adults.     

Some critical concerns for adapting the Bilingual Aphasia Test to Bahasa Indonesia

One of the most widely spoken languages of the world, Bahasa Indonesia (BI), became standardized as the official language of Indonesia. Based on Malay, it served as lingua franca in various forms throughout the Indonesian archipelago for centuries. Although BI has been habitually learned as a second language, the number of native speakers of BI continues to increase. As a member of the Western Austronesian branch of the Austronesian language family, its grammar and usage bear some resemblance to related languages such as Tagalog. At the same time, certain morphosyntactic and pragmatic characteristics of BI that distinguish it from other languages have been the subject of extensive research and deliberation. For these reasons, the clinical utility of adapting the Bilingual Aphasia Test ( Paradis, M., & Libben, G. (1987) . The assessment of bilingual aphasia. Hillsdale, NJ: Lawrence Erlbaum Associates) is as evident as it is essential.     

Adapting the Bilingual Aphasia Test to Rarotongan (Cook Islands Maori): Linguistic and clinical considerations

This article describes the adaptation of the Bilingual Aphasia Test (BAT) to the Rarotongan dialect of Cook Islands Maori, a Polynesian language spoken in the Cook Islands and expatriate communities. A brief linguistic sketch of Rarotongan is presented. As Rarotongan is characterised by a complex pronominal system, ‘a’ versus ‘o’ possession and optional topicalisation and focus constructions, particular issues arose in obtaining a rigorous adaptation of the BAT. Methods for ensuring effective adaptation across contrastive language pairs and sociocultural aspects of adapting the BAT to Rarotongan are discussed. Obtaining adaptations from several proficient bilingual consultants, comparing versions and group discussion to resolve discrepancies were used for this adaptation and are recommended. It is asserted that every individual has the right to receive accurate, detailed language assessment in each of their languages, irrespective of the languages spoken in the wider community. Further adaptations of the BAT will assist this to be achieved.     

Capacity of the Catalan and Spanish versions of the Bilingual Aphasia Test to distinguish between healthy aging,mild cognitive impairment and Alzheimer's disease

This study analysed the capacity of the Catalan and Spanish versions of the Bilingual Aphasia Test (BAT) to distinguish between normal and pathological aging. Both versions of the test were administered to 45 bilingual subjects: 15 healthy aging subjects, 15 patients with mild cognitive impairment and 15 patients with Alzheimer's disease. To explore which combination of subtests was best suited to differentiate the three study groups, stepwise discriminant analyses were performed using each version of the Bilingual Aphasia Test separately and together. The percentages of properly classified subjects were as follows: 93.3% when the Spanish version was administered, 88.9% when the Catalan version was administered and 95.6% when both versions were used. The subtests that best classified the subjects were of the lexical-semantic type but also related to metalinguistic capacity and language organisation skills. The performance of each group in Catalan and Spanish was more similar than different.     

An automated version of the BAT Syntactic Comprehension task for assessing auditory L2 proficiency in healthy adults

Studies of bilingualism sometimes require healthy subjects to be assessed for proficiency at auditory sentence processing in their second language (L2). The Syntactic Comprehension task of the Bilingual Aphasia Test could satisfy this need. For ease and uniformity of application, we automated its English ( Paradis, M., Libben, G., and Hummel, K. (1987) . The Bilingual Aphasia Test. English version. Hillsdale, NJ: Lawrence Erlbaum Associates) and French ( Paradis, M., & Goldblum, M. C. (1987) . The Bilingual Aphasia Test, French version. Hillsdale, NJ: Lawrence Erlbaum Associates) versions. Although the Bilingual Aphasia Test is meant to assess neurological disorders affecting language, we hypothesised that ceiling performance in L2 would be rare and L2 errors should be consistent with lack of processing automaticity. Initial data from 13 French-English and 4 English-French bilinguals confirm these expectations. Thus, the automated Syntactic Comprehension task (available online for PC and Mac platforms) is indeed suited to test bilingual English and French proficiency levels in healthy adults.     

Profiling performance in L1 and L2 observed in Greek–English bilingual aphasia using the Bilingual Aphasia Test: a case study from Cyprus

The Greek and the English versions of the Bilingual Aphasia Test (BAT) were used to assess the linguistic abilities of a premorbidly highly proficient late bilingual female after a haemorrhagic cerebrovascular accident involving the left temporo-parietal lobe. The BAT was administered in the two languages on separate occasions by the first author, a bilingual English–Greek speech pathologist. The results revealed a non-parallel recovery in the two languages. This information will be used not only to guide clinical intervention for the patient but also to provide the first report on the manifestations of aphasia in Greek. Moreover, the use of the (Standard Modern) Greek version of the BAT to investigate Greek Cypriot aphasics has implications for the use of the BAT on underspecified languages or dialects. Such studies may help with the development of assessment measures and therapy strategies that focus on specific characteristics of one or multiple languages.     

Principles underlying the Bilingual Aphasia Test (BAT) and its uses

The Bilingual Aphasia Test (BAT) is designed to be objective (so it can be administered by a lay native speaker of the language) and equivalent across languages (to allow for a comparison between the languages of a given patient as well as across patients from different institutions). It has been used not only with aphasia but also with any condition that results in language impairment (Alzheimer's, autism, cerebellar lesions, developmental language disorders, mild cognitive impairment, motor neuron disease, multiple sclerosis, Parkinson's, vascular dementia, etc.). It has also been used for research purposes on non-brain-damaged unilingual and bilingual populations. By means of its 32 tasks, it assesses comprehension and production of implicit linguistic competence and metalinguistic knowledge (which provide indications for apposite rehabilitation strategies). Versions of the BAT are available for free download at www.mcgill.ca/linguistics/research/bat/.     

Adapting the Bilingual Aphasia Test to Rarotongan (Cook Islands Maori): Linguistic and clinical considerations

This article describes the adaptation of the Bilingual Aphasia Test (BAT) to the Rarotongan dialect of Cook Islands Maori, a Polynesian language spoken in the Cook Islands and expatriate communities. A brief linguistic sketch of Rarotongan is presented. As Rarotongan is characterised by a complex pronominal system, 'a' versus 'o' possession and optional topicalisation and focus constructions, particular issues arose in obtaining a rigorous adaptation of the BAT. Methods for ensuring effective adaptation across contrastive language pairs and sociocultural aspects of adapting the BAT to Rarotongan are discussed. Obtaining adaptations from several proficient bilingual consultants, comparing versions and group discussion to resolve discrepancies were used for this adaptation and are recommended. It is asserted that every individual has the right to receive accurate, detailed language assessment in each of their languages, irrespective of the languages spoken in the wider community. Further adaptations of the BAT will assist this to be achieved.     

Primary progressive aphasia in a bilingual speaker: a single-case study

We report on the case of an elderly bilingual woman presenting with a diagnosis of primary progressive aphasia. The participant's native language was Friulian (L1), a predominantly oral Romance language, and her second language was Italian (L2), formally learned at primary school in oral and written forms. We investigated her linguistic abilities by means of the Bilingual Aphasia Test ( Paradis, M., & Libben, G. (1987). The assessment of bilingual aphasia. Hillsdale, NJ: Lawrence Erlbaum Associates), which is specifically devised for studying language levels and skills in bilingual/polyglot individuals with aphasia. Specifically, we focused on different tasks extracted from the Bilingual Aphasia Test, targeting phonology, morphology, syntax and lexical semantics. Results show that both languages were affected to a clinically significant degree, but with different profiles in terms of linguistic levels, suggesting the presence of greater phonological, morphological, grammatical and syntactic impairments in L2. Results are discussed in terms of possible dissociations both within the language system of each language and between languages, within the Procedural/Declarative theoretical framework of language acquisition in bilinguals.     

Primary progressive aphasia in a bilingual speaker: a single-case study

We report on the case of an elderly bilingual woman presenting with a diagnosis of primary progressive aphasia. The participant's native language was Friulian (L1), a predominantly oral Romance language, and her second language was Italian (L2), formally learned at primary school in oral and written forms. We investigated her linguistic abilities by means of the Bilingual Aphasia Test ( . The assessment of bilingual aphasia. Hillsdale, NJ: Lawrence Erlbaum Associates), which is specifically devised for studying language levels and skills in bilingual/polyglot individuals with aphasia. Specifically, we focused on different tasks extracted from the Bilingual Aphasia Test, targeting phonology, morphology, syntax and lexical semantics. Results show that both languages were affected to a clinically significant degree, but with different profiles in terms of linguistic levels, suggesting the presence of greater phonological, morphological, grammatical and syntactic impairments in L2. Results are discussed in terms of possible dissociations both within the language system of each language and between languages, within the Procedural/Declarative theoretical framework of language acquisition in bilinguals.     

Principles underlying the Bilingual Aphasia Test (BAT) and its uses

The Bilingual Aphasia Test (BAT) is designed to be objective (so it can be administered by a lay native speaker of the language) and equivalent across languages (to allow for a comparison between the languages of a given patient as well as across patients from different institutions). It has been used not only with aphasia but also with any condition that results in language impairment (Alzheimer's, autism, cerebellar lesions, developmental language disorders, mild cognitive impairment, motor neuron disease, multiple sclerosis, Parkinson's, vascular dementia, etc.). It has also been used for research purposes on non-brain-damaged unilingual and bilingual populations. By means of its 32 tasks, it assesses comprehension and production of implicit linguistic competence and metalinguistic knowledge (which provide indications for apposite rehabilitation strategies). Versions of the BAT are available for free download at www.mcgill.ca/linguistics/research/bat/.     

Profiling performance in L1 and L2 observed in Greek-English bilingual aphasia using the Bilingual Aphasia Test: a case study from Cyprus

The Greek and the English versions of the Bilingual Aphasia Test (BAT) were used to assess the linguistic abilities of a premorbidly highly proficient late bilingual female after a haemorrhagic cerebrovascular accident involving the left temporo-parietal lobe. The BAT was administered in the two languages on separate occasions by the first author, a bilingual English-Greek speech pathologist. The results revealed a non-parallel recovery in the two languages. This information will be used not only to guide clinical intervention for the patient but also to provide the first report on the manifestations of aphasia in Greek. Moreover, the use of the (Standard Modern) Greek version of the BAT to investigate Greek Cypriot aphasics has implications for the use of the BAT on underspecified languages or dialects. Such studies may help with the development of assessment measures and therapy strategies that focus on specific characteristics of one or multiple languages.     

Capacity of the Catalan and Spanish versions of the Bilingual Aphasia Test to distinguish between healthy aging, mild cognitive impairment and Alzheimer's disease

This study analysed the capacity of the Catalan and Spanish versions of the Bilingual Aphasia Test (BAT) to distinguish between normal and pathological aging. Both versions of the test were administered to 45 bilingual subjects: 15 healthy aging subjects, 15 patients with mild cognitive impairment and 15 patients with Alzheimer's disease. To explore which combination of subtests was best suited to differentiate the three study groups, stepwise discriminant analyses were performed using each version of the Bilingual Aphasia Test separately and together. The percentages of properly classified subjects were as follows: 93.3% when the Spanish version was administered, 88.9% when the Catalan version was administered and 95.6% when both versions were used. The subtests that best classified the subjects were of the lexical-semantic type but also related to metalinguistic capacity and language organisation skills. The performance of each group in Catalan and Spanish was more similar than different.     

A comparison of the BAT and BDAE-SF batteries in determining the linguistic ability in Greek-speaking patients with Broca's aphasia

The aim of this study is to test the validity and reliability of the Bilingual Aphasia Test as a measure of language impairment in a Greek-speaking Broca's aphasic population and to investigate relationships with the same aphasic group's performance on the Greek version of the short form of the Boston Diagnostic Aphasia Examination battery, mainly focusing on a series of subtests which are shared by the two batteries, yet occasionally differ in content. Correlation analyses showed that the two instruments yielded highly comparable results with respect to the measurement of reading and listening comprehension, as well as in the performance-based measurement of the automated sequence capacity of the patients. Nevertheless, the Bilingual Aphasia Test, as a more extensive battery, proved to be more sensitive and objective in characterizing the patients' language abilities in a number of individual language functions, including commands, sentence repetition, naming, verbal fluency and syntactic comprehension.     

The effect of literacy on oral language processing: Implications for aphasia tests

Most studies investigating the impact of literacy on oral language processing have shown that literacy provides phonological awareness skills in the processing of oral language. The implications of these results on aphasia tests could be significant and pose questions on the adequacy of such tools for testing non-literate individuals. Aiming at examining the impact of literacy on oral language processing and its implication on aphasia tests, this study tested 12 non-literate and 12 literate individuals with a modified Amharic version of the Bilingual Aphasia Test (Paradis and Amberber, 1991, Bilingual Aphasia Test. Amharic version. Hillsdale, NJ: Lawrence Erlbaum.). The problems of phonological awareness skills in oral language processing in non-literates are substantiated. In addition, compared with literate participants, non-literate individuals demonstrated difficulties in the word/sentence-picture matching tasks. This study has also revealed that the Amharic version of the Bilingual Aphasia Test may be viable for testing Amharic-speaking non-literate individuals with aphasia when modifications are incorporated.