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/