Code-switching in multilingual aphasia

• ¹ Lehman College, CUNY, United States
• ² The Graduate Center, CUNY, United States
• ³ State University of New York, New Paltz, United States
• ⁴ University of Oslo, Norway
• ⁵ University of Potsdam, Germany
• ⁶ The Montreal Children's Hospital, Canada

Introduction: This presentation addresses the post-intervention change in frequency and type of code switching (CS) in two of the weaker languages (Spanish and Norwegian) of a multilingual individual with mild aphasia who reported proficiency in 11 languages. CS is typical among multilingual speakers who share the same languages, although for multilingual people with aphasia, CS behavior may reflect word-finding difficulties (Ansaldo et al., 2010) or impairment of language control (Green & Abutalebi, 2013). Method: Our participant, a 64-year-old male who sustained a left CVA and subsequent aphasia 12 months prior to enrollment, was given two courses of intervention approximately six months apart. The first was a modified ORLA (oral reading for language in aphasia) treatment in his native Dutch (Flemish) of 30 hours over 6 weeks. The second “intervention” was a language-learning course in Russian of 40 hours over 4 weeks. The participant was tested three times on separate days for each baseline prior to and following each of the interventions in seven of his languages via Skype over a 5-6 day period. Results of two tasks are reported: an action-description task in which the participant described six individual action pictures with a sentence, and an answering-questions task that required a short response to six “wh” questions. Responses were analyzed for frequency and type of CS from pre to post testing. We differentiated “whole-word” CS (e.g., birthday/cumpleaños) from “within-word” CS (e.g., /livel/ blend of “level” and “nivel”) and compared the pattern of responses following each intervention for a change of over 15%. Results: Spanish: Post-Dutch intervention we noted an increased frequency of CS in both the action-description (25.4%) and answering-questions tasks (20.2%); this was accounted for largely by the relative change in whole-word CS type (action-description: 21.1% vs. 4.4% within and answering-questions: 37.3% vs. -17.1% within). Following Russian intervention, an increase in CS was evident, 50.8% for action description and 40.9% for answering questions, reflective of a within-word CS increase (action-description: 39.7%) and more evenly distributed for the latter task. For CS, the non-target language was primarily Italian. Norwegian: Following Dutch treatment, the proportion of code-switched responses remained the same for action description and answering questions. The type of CS changed with a decrease in whole-word CS (-19.1%) for the answering-questions task. Post-Russian intervention, no production differences were noted in CS frequency for action description, although within-word type increased (16.7%). On the answering-questions task, CS frequency decreased (-33%), particularly whole-word CS (-26%). Across baselines non-target whole- and within-word transfer included English, German, Danish, Swedish and Dutch. Discussion: We suggest the increase in CS in Spanish following treatment in Dutch and post-Russian language introduction likely reflects increased lexical inhibition. In contrast, in Norwegian, the proportion of code-switched responses decreased or remained the same and the proportion of within-word CS increased, suggestive of improved lexical access following both interventions. The contrasting effect (see Figure 1) may be due to relative proficiency (greater in Spanish than in Norwegian) or the differential lexical similarities between the target language and the language of intervention.