Rehabilitation in bilingual aphasia: Evidence for within- and between-language generalization

Purpose: The goal of this study was to examine if there was a principled way to understand the nature of rehabilitation in bilingual aphasia such that patterns of acquisition and generalization are predictable and logical. Method: Seventeen Spanish-English bilingual individuals with aphasia participated in the experiment. For each participant, three sets of stimuli were developed for each language: (a) English Set 1, (b) English Set 2 (semantically related to each item in English Set 1), (c) English Set 3 (unrelated control items), (d) Spanish Set 1 (translations of English Set 1), (e) Spanish Set 2 (translations of English Set 2; semantically related to each item in Spanish Set 1), and (f) Spanish Set 3 (translations of English Set 3; unrelated control items). A single-subject experimental multiple baseline design across participants was implemented. Treatment was conducted in 1 language, but generalization to within- and between-language untrained items was examined. Results: Treatment for naming on Set 1 items resulted in significant improvement (i.e., effect size >4.0) on the trained items in 14/17 participants. Of the 14 participants who showed improvement, within-language generalization to semantically related items was observed in 10 participants. Between-language generalization to the translations of trained items was observed in 5 participants, and betweenlanguage generalization to the translations of the untrained semantically related items was observed in 6 participants. Conclusion: The results of this study demonstrated withinand between-language patterns that were variable across participants. These differences are indicative of the interplay between facilitation (generalization) and inhibition.