Considerations for Multilingual and Culturally Diverse Populations

Abstract

This chapter focuses on discussing the discourse characteristics in the multilingual or culturally-diverse populations. First, the operational definitions of bilingualism and multilingualism in the literature are provided and the implications of this status of using two (or more) languages on clinical evaluation of discourse production are discussed. For example, Pitres’ law and Ribot’s law on bilingual language recovery are compared and contrasted; factors that are related to early stages of language recovery among bilingual or multilingual speakers with aphasia are also described. Next, the components of examining multilingual history and how acculturation affects manifestation of bilingual aphasic symptoms are summarized. This is followed by the discussion of the clinical application of the Bilingual Aphasia Test (BAT) and the Multilingual Aphasia Examination (MAE), as well as differentiation between (pathological) code switching and code mixing in bilingual aphasia. Concerning specific practice guidelines, factors to consider when including interpreters versus laypersons during the time of assessing and managing bilingual or multilingual speakers are discussed. The principles of adopting and modifying existing English-based discourse quantification systems for use in multilingual or multicultural speakers are also described and illustrated with examples. Finally, relevant issues in determining treatment candidacy for discourse therapy and incorporating existing treatment protocols in clinical practice are addressed.