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Contents

1.0 Bilingual Aphasia 1.1 Sign and Symptoms 2.0Methods of Screening Bilingual Aphasia 2.1Control Task 3.0 Management of Bilingual Aphasia 4.0 Future Research 5.0 References

1.0 Bilingual Aphasia The term aphasia refers to impairment of language commonly caused by brain injury due to stroke or trauma. Aphasia is a language disability that affects linguistic competence, understanding, and usage. It affects the speech of an individual in terms of their ability to put words together. While on the other side people who utilise two languages in their daily life schedules are known as bilinguals [1]. People with aphasia who are bilingual may have different levels and characteristics of disability with their two languages. The most distinctive aspect of bilingual people is verbal development. Bilingual people's brains differ from monolingual human minds. Bi- or multilingual individuals have more grey matter than monolingual speakers, according to research. When crucial components of the bilingual mind are injured, healthcare becomes extremely difficult due to these and other differences between the monolingual and bilingual minds [2]. Aphasia has been defined by the National Aphasia Association (NAA) as a linguistic handicap affecting linguistic competence and interpretation and the ability to read and write [3]. A severe head injury causes aphasia, the most common of which is a stroke. Furthermore, other cognitive deficits such as brain trauma, neurological disorders, or diseases can also cause aphasias. The intensity of aphasia can range from moderate and easily treated, such as when the vocabulary returns, to severe and requires the assistance of a speech and language therapist. Furthermore, the prevalence of language use in a person's linguistic environment impacts aphasia symptoms following a brain haemorrhage. Aphasia is characterised by significant damage to the language-dominant part of the head, often the left side. Cognitive-behavioral, language and speech therapy is considered one of the primary treatments for aphasia upon identification of the cause. The patient with aphasia relearns and practices linguistic competence and learning to interact in other methods. Members of the family are frequently involved in every aspect, supporting the individual in speaking [4]. 1.1 Sign and Symptoms Bilingual aphasia can appear in various forms and may indicate the presence of other disorders such as a brain tumour or stroke. The writing symptoms of bilingual aphasia cause agrammatism, misspellings, and incorrect letter formation that does not make sense. As a result, aphasia patients talk in short or partial phrases that make absolutely no sense, such as "book two tables," which means "two books on the table. “Furthermore, due to brain strokes, individuals may replace one phrase for the other and one pronunciation with another, unable to understand others' discussions and create sentences that may not make sense [4]. 2.0 Methods of Screening Bilingual Aphasia	The screening of bilingual aphasia can be done with different techniques such as using a language background questionnaire, Western Aphasia Battery, Picture Description Task, and Aphasia Severity Rating Scale. The method of language background questionnaire for the collection of data along with the self-reported proficiency and the linguistic environment. The questionnaire covers the demographic information with the contexts of acquisition, language use, language preference, and proficiency rating on altered tasks. In addition, it provides information for various factors that include the use of language with the immediate family or extended family members used for different contexts. Thus, the assessment indicates the proficiency of the participant in understanding, speaking, reading, and writing based on a 1-5 rating (5) The other prevalent method of screening Bilingual Aphasia involves the task of picture description which entails a subclass of the language proficiency test. This screening method undertakes a certain procedure as in this test, the participants are asked to explain a picture in detail, focusing on both the overarching theme of the picture and the individual components in that image. [6] Subsequent to that, the overall effect as well as attainment of purpose (if the participant develops the core idea), layout and tactics involving coherence and cohesion, manner of organisation, along with the entire mechanisms; all contributed to the major rubric score by concentrating on the pronunciation, pause in speech and grammar. In the test of the picture description task, the pictures are majorly selected from the Boston Diagnostic Aphasia Examination and the Western Aphasia Battery. [7] Another pertinent method entails the Western Aphasia Battery (WAB) that acts as a tool to evaluate the language functionality in the individuals and discover the existence of Aphasia in the speech along with its type. The Western Aphasia Battery (WAB) test is considered crucial for assessing the linguistic skill along with the non-linguistic skills of the individuals. The linguistic skills of the individuals are gauged in terms of the individuals’ writing, reading, auditory comprehension, fluency and speech. While the non-linguistic skills of the individuals are ascertained in terms of their capabilities of drawing, design and calculation. [8] There have been four predominant factors of Aphasia quotient pertains to the spontaneity in speech, repetition, auditory verbal comprehension as well as naming. In spontaneous speech, the content of the information along with its fluency is assessed. Meanwhile, in the component of auditory verbal comprehension, the comprehension level of the individuals is ascertained through asking them the recognition of auditory words, following the commands concerning sequence and to answer the yes/no questions. Moreover, the repetition in their responses and speech is observed in the third component. In addition to that, the fourth component upholds the naming relating to certain categories involving the naming of objects, fluency of the words, and completion of sentences along with responsive speech. [9] The last screening method involves Aphasia Severity Rating Scale which is majorly employed in scientific studies as well as in clinical practices. The Aphasia Severity Rating Scale upholds the significance due to its simplicity pertaining to its performance which hardly takes 5-15 minutes in its administration. This scale is a 5-point rating scale in which the profile of the individual/patients concerning communication is presented and a severity evaluation is made solely on clinical assessment. [10] In line with that, The ASR entails a scale that measures the degree of aphasia language impairment, where 0 accounts for the higher severity however 4 stands for the barely apparent symptoms. In the severity scale, 0 represents the severity level where the fluency or the speech of the individuals are not comprehendible, while 1 indicates the occasional utterance of meaningful phrases. 2 illustrates the stage of the possibility of the basic conversation leading to the prominent breaks, however, 3 demonstrates the level of minor observable challenges but with no specific limitation. Lastly, 4 elucidates the state of bare apparent issues in speaking and understanding. [11] 2.1Control Task The control tasks such as negative priming demonstrate the prolonged reaction time (RT) that represents the mean of numerous practice trials in cue to minimise the variability of the feedback. The control tasks are used to highlight the errors that occurred during the participant's responses in which the participants are required to trial in pairs following with the prime-probe schema. The control condition is indicated in the prime trial by the two overlapping pictures with differences from the probe trial. The outcome is measured in form of positive or negative priming. Along with this accuracy and reaction time are recorded and measured for each participant involved in the study. On the other hand, the flanker task with the linguistic and non-linguistic stimuli are also used which act as an inhibition task used for the assessment of suppressed responses of the participants existing in the particular context. In both contexts of flanker tasks either linguistic or non-linguistic, stimuli (letters) to observe the response of shorter choice reaction time (12). 3.0Management of Bilingual Aphasia The management of bilingual aphasia can be based on the clinical practices followed under the guidelines and information. The use of bilingualism questionnaires in the personalised treatment of bilinguals with aphasia help to provide insight into the pre-stoke linguistic and communication experiences that further help in the assessment of the pre-stroke language mastery level along with its influence on the post stoke language abilities. The possible invention strategies such as the use of the naming therapy technique can be effective for the treatment of some bilingual people with aphasia having both L1 and L2 concerns. (13) Another strategy for the bilingual intervention includes voluntary language switching can be based on sociocultural background and language used in routines. The use of translation and language switching contributes to maintaining the pre-stoke mode of communication. Also, the evidence-based self-help strategy promotes expressive experiences in either language. Moreover, the cognitive-based treatment also helps to among the non-linguistic skills. Also, it is demonstrated through the study that the use of lexically based treatment can help to improve the naming of cognates as well as non-cognates. Therefore, the use of the therapeutic therapies indicated can help to investigate the skill learning and generalisation within the cognitive-linguistics domains (14). 4.0 Future Research Studies examining investigations on bilingualism using medical procedures (diagnostic, treatment program, evaluation of improvement in healing, etc.) require a comprehensive assessment of all languages spoken by an aphasic patient. Speech-interpreted differences between healthy and aphasia individuals have been explored, and functional magnetic resonance imaging has been used (FMRI). That will allow researchers to comprehend what the mind wanders through to recover from a traumatic brain injury (TBI) and how different brain areas behave afterwards [15]. Neuromuscular Electrical Stimulation is one way that changes activity in the brain in whichever place it stimulates, which has strong determination experts to ask if this shift in cognitive ability could help people re-learn languages. The study of aphasia is still in its early stages. Researchers appear to have a variety of suggestions for how might treat aphasia more effectively in the coming years.

References 1. Kuzmina E, Goral M, Norvik M, Weekes BS, 2019. What influences language impairment in bilingual aphasia? A meta-analytic review. Frontiers in psychology. Apr 4; 10:445. Available at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00445/full 2. Bilinguals of Two Spoken Languages Have More Gray Matter Than Monolinguals. Available at: https://gumc.georgetown.edu/news-release/bilinguals-of-two-spoken-languages-have-more-gray-matter-than-monolinguals/. 3. Aphasia definition. Available at: https://www.aphasia.org/aphasia-definitions/. 4. Aphasia. Available at: https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518. 5. Kohnert K. 2004. Cognitive and cognate-based treatments for bilingual aphasia: A case study. Brain and language. (3):294-302 https://www.sciencedirect.com/science/article/abs/pii/S0093934X04000768 6. Dash T, Kar BR, Kar BR. Characterizing language proficiency in Hindi and English language: implications for bilingual research. International journal of mind brain and cognition. 2012;3(1):73-105. Available at: https://www.researchgate.net/profile/Tanya-Dash-2/publication/267706351_Characterizing_language_proficiency_in_Hindi_and_English_language_Implications_for_bilingual_research/links/57feb5ec08aeaf819a5c337a/Characterizing-language-proficiency-in-Hindi-and-English-language-Implications-for-bilingual-research.pdf 7. Osa García A, Brambati SM, Brisebois A, Désilets-Barnabé M, Houzé B, Bedetti C, Rochon E, Leonard C, Desautels A, Marcotte K. Predicting early post-stroke aphasia outcome from initial aphasia severity. Frontiers in neurology. 2020 Feb 21;11:120. Available at: https://www.frontiersin.org/articles/10.3389/fneur.2020.00120/full 8. Hula W, Donovan NJ, Kendall DL, Gonzalez-Rothi LJ. Item response theory analysis of the Western Aphasia Battery. Aphasiology. 2010 Oct 5;24(11):1326-41. Available at: http://aphasiology.pitt.edu/2001/1/viewpaper.pdf 9. Wikipedia, 2018. Western Aphasia Battery. [Online]. Available at: https://en.wikipedia.org/wiki/Western_Aphasia_Battery [Accessed on 10-Nov-2021]

10. Sapolsky D, Domoto-Reilly K, Dickerson BC. Use of the Progressive Aphasia Severity Scale (PASS) in monitoring speech and language status in PPA. Aphasiology. 2014 Sep 2;28(8-9):993-1003. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235969/ 11. Aphasia.ca, 2018. Aphasia Severity Rating (ASR). [Online] Available at: https://www.aphasia.ca/wp-content/uploads/2019/05/VF-ASR.pdf [Accessed on 10-Nov-2021] 12 Dash T, Kar BR. Bilingual language control and general purpose cognitive control among individuals with bilingual aphasia: Evidence based on negative priming and flanker tasks. Behavioural neurology. 2014 Oct;2014. https://www.hindawi.com/journals/bn/2014/679706/ 13 Centeno JG, Ansaldo AI. Customizing Treatment for Bilingual Speakers With Aphasia: Bilingual clients with aphasia have unique first-versus second-language experiences before their stroke. That’s why clinicians need to incorporate individually tailored bilingualism principles into rehabilitation. The ASHA Leader. 2016 Oct;21(10):52-6. https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR2.21102016.52 14 Fabbro F. The bilingual brain: Bilingual aphasia. Brain and language. 2001 Nov 1;79 (2):201-10. https://www.sciencedirect.com/science/article/abs/pii/S0093934X01924800. 15. What is Aphasia? Available at: https://www.nidcd.nih.gov/health/aphasia.