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Does anyone have any experience working with bilinguals with aphasia? Any suggestions for how to structure therapy if one of the client's languages is completely foreign to you?

Hope

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Dear Hope,
It is indeed challenging to provide support for the "other" language in bilinguals with aphasia, but so important to do so. Possibilities will depend greatly on what the two languages are, along with your client's level of impairment, & setting. Ideally you will be able to partner with individuals who have expertise in the client's other languages and do some indirect facilitation- spouse, children, grandchildren, community members, friends etc could all be great partners. In some cases "foreign language" programs on CDs available through a local library, bookstore or on-line can be valuable sources of stimuli and be the basis for a home-program implemented with a family member. There are also websites available in many different languages that provide some stimuli that can be adapted for tx and home programs (or clinician-mentored family practice in rehab facility etc). I (Kohnert, 2004 and 2005) reported on an intervention study in bilingual aphasia using two different treatments designed to support both languages (on cognitive- focusing on attention, perception, categorization etc of NONverbal information) and the other a cognate treatment (elefante/elephant). References for these articles are below. There is a 1997 book editted by GloraJean Wallace with lots of case studies and practical information on cultural and linguistic diversity in various acquired disorders in adults. I also have a chapter in press specifically on bilingual aphasia intervention and bridging client-clinician mismatch.References for all these are below. If you want to share more specific information about your clients perhaps I as well as others could help brainstorm a bit more.
Best wishes,
-k
REFERENCES
Wallace, G. L. (1997). Assessment of individuals from diverse backgrounds. Wallace, G. (Ed.), Multicultural neurogenics: A resource for speech-language pathologists. San Antonio, TX: Communication Skill Builders.


Kohnert, K. (2004). Cognitive and cognate treatments for bilingual aphasia: A case
study. Brain and Language, 91, 294–302.
Kohnert, K. (2005). Cognitive-linguistic interactions in bilingual aphasia: Implications for
intervention. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders [Publication of Special Interest Division 2 of the American Speech-Language-Hearing Association], 15(2), 9–14.

Kohnert, K. (in press). Language disorders in bilingual children and adults. San Diego: Plural.

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