Tag Archives: language

What Language Do You Speak?

There is an interesting phenomenon often observed in brain injury survivors who were fluently bilingual prior to their injuries.  Namely, in survivors who have post-injury language deficits, the first (native) languages tend to return more quickly and fully than their second languages.  This is true even in survivors who were fully fluent in their second language and used the second language in their every day lives.  As TLC is located in Texas, our staff tends to see this most often with Spanish-English bilingual patients.  Many of these patients with language difficulties find it easier to name objects or follow directions when given in Spanish than in English, while prior to their injuries, they were comfortable using both languages.

The return of the first language prior to the second language can have a number of practical consequences.  Many survivors become frustrated at their inability to speak their second language with the same skills as in the past.  Being bilingual is often a point of pride and may have previously allowed the survivor to engage in activities (such as import-export business transactions) that the average person could not.  This may even prevent them from returning to jobs where their second language was the language of their everyday business transactions.  Moreover, if the survivor was previously the primary translator for the family, this may cause difficulties in the ability for the family to access the outside world.  For example, the survivor may have previously been the point person to get information from the school regarding their child’s performance as the survivor could fluently speak to school officials in English while the rest of the family struggled in English.  If the survivor is now unable to converse fluently in English, the family may have significant problems interacting with the school.

There are practical therapy concerns when a survivor struggles with their second language, if the second language is the main language of the community.  In America, English is obviously the dominant language.  As such, most evaluations are conducted in English.  There are a limited number of health care professionals who are comfortable conducting evaluations in another language.  However, if the survivor’s first language is not English and the survivor is significantly stronger in their first language, that first language will need to be the language used in the evaluations so as to get the most accurate measurements of the survivor’s skills.  The same is true in therapy.  If a survivor understands therapy directions significantly better in their first language, then therapy should be conducted in the survivor’s first language.    Additionally, therapists should always inquire as to which language is used in the home.  If the survivor’s first language is different than the language used at home (e.g. someone who spoke Spanish and English married a spouse who only speaks English), then that second language will need extra focus or alternative methods of communication (e.g. pictures) may need to be used.  At TLC, we have a number of staff that are bilingual in Spanish-English and have a contract with a translation service is other help is needed.  Overall, rehabilitation professionals must be aware of survivors’ language skills and adjust their evaluations and therapy accordingly.

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/



Hot Off the Press

Vital to the core mission of the Transitional Learning Center is the conducting of research designed to enhance understanding of and improve treatment strategies for brain injury. The result of this research finds its home in publication in a wide range of top professional journals and chapter after chapter in books relied upon by the traumatic brain injury treatment community. Recently, TLC staff neuropsychologists Drs. Dennis Zgaljardic and Matthew Lambert along with staff occupational therapist Rebekah Miller published a paper on the reliability and validity of a newer test to determine naming deficits. Difficulty with the naming of objects (for example: saying “fork” when you mean “pencil”), known as anomia, is not uncommon with patients who have brain injuries (particularly if the injury is to the left hemisphere of the brain). However since most tests of cognitive abilities are developed using members of the healthy population as a testing sample, it is unclear to what degree these tests might be appropriate when applied to other populations (such as patients with brain injuries). Identifying which tests should or should not be used with a brain injured population is an extremely important component of treatment. Using a test that is not appropriate for an individual with a brain injury can lead to misdiagnosis and based on that misdiagnosis, incorrect treatment.
The paper, titled Naming Test of the Neuropsychological Assessment Battery: Reliability and Validity in a Sample of Patients with Acquired Brain Injury, was published this past December in the Archives of Clinical Neuropsychology.  In the study, the researchers compared the Neuropsychological Assessment Battery (NAB) Naming test with various other neuropsychological tests. The Neuropsychological Assessment Battery is a relatively new group of tests designed to measure a wide range of cognitive skills including memory, attention and of course naming. For the NAB Naming test to be found appropriate for use in a brain injured population, the researchers first looked to see if the test scores correlated with scores on other similar tests that have been shown to be valid with such a population. For instance, a person who scores highly on the NAB Naming test should similarly do well on another naming test. The researchers found this to be true. Next, the researchers looked to see if the NAB Naming test scores were not correlated to unrelated tests. For example, a person’s score on the NAB Naming test should have nothing to do with his or her score on an attention task. This also was found to be true. Thus, the NAB Naming test was found to be an appropriate test to use with individuals who have brain injuries.

Below is a link to the paper abstract:


Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Aphasia Advice

Aphasia, the loss of language skills, is relatively common after a brain injury to the left side of the brain.  The video below was created by a stroke survivor in order to give some tips on how best to communicate with someone who has aphasia.


Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Frankie Muniz

We usually associate having a stroke as a medical condition of older age.  However, it is possible for a younger person to have a stroke.  Frankie Muniz, the 26 year-old actor best known for starring in the sitcom Malcolm in the Middle, suffered a stroke this past Friday.  The fact that his symptoms involved difficulties in language likely indicate that it was  a left-sided stroke, as language is generally controlled by the left side of the brain.  He appears to be doing better from the initial stroke and hopefully will see a full recovery.


Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org