If you have dementia with primary progressive aphasia and speak two languages, prepare matched speaking examples in both languages for the speech assessment. Primary progressive aphasia is a dementia syndrome where language decline appears first and stays most prominent while other thinking skills remain relatively spared. The National Institute on Deafness and Other Communication Disorders explains in its aphasia overview that language brain areas deteriorate over time, so symptoms worsen. Testing both languages gives a fuller picture of total ability than testing one language alone.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Why must both languages be tested?
- What language history should you bring?
- What matched examples should you prepare?
- How will the clinician use the samples?
- How do results shape next steps?
Why must both languages be tested?
A single-language test can understate what a bilingual person can still do. Strength in one language may hide loss in the other. Weakness in the tested language may hide strength in the untested language.
American Speech-Language-Hearing Association guidance recommends in bilingual assessment guidance testing both languages and documenting history, proficiency, dominance, and current use. That record helps the clinician judge whether an error reflects dementia, limited proficiency, or normal cross-language influence. Both languages are often affected in parallel in bilingual aphasia. The language used more recently and more often can remain stronger, even when learned later.
What language history should you bring?
Write a short history for each language before the visit. Include age learned, where learned, years of schooling in each language, and current daily use for listening, speaking, reading, and writing. Note dominance shifts over time. Record which language is used at home, at work, for television, for prayer, and with grandchildren.
Note recent changes in mixing, switching, or avoiding one language. Bring a list of important communication partners for each language. Name the people, situations, and topics that matter most now. This helps the clinician choose relevant words and tasks.
What matched examples should you prepare?
Prepare equivalent, not translated word-for-word, examples in each language. Evidence summarized by Boston University in its bilingual aphasia workshop points to parallel tasks for naming, fluency, repetition, and discourse, scored separately by language.
Bring short lists you can describe, not read aloud during testing: Choose items familiar in each culture and daily life. A kitchen tool common in one household may be rare in another. Tell the clinician which words matter for safety, care, and family contact.
- object naming: cup, key, chair, dog, apple, shirt
- action naming: eating, drinking, walking, cooking, reading
- category fluency topics: animals, foods, clothing
- repetition items: single words, short phrases, longer sentences
- discourse prompts: Cookie Theft picture description, sequential pictures, a familiar story
How will the clinician use the samples?
The clinician will listen for word retrieval, grammar, comprehension, repetition, and motor speech. Logopenic-variant aphasia often brings slow speech with pauses, trouble finding single words, and trouble repeating phrases, with grammar and single-word comprehension preserved. Formal testing may use parallel materials across languages. The Bilingual Aphasia Test by Michel Paradis offers parallel tests and stimulus books for each language plus bilingual sections, as described by McGill University in reporting on the test.
It now covers more than 100 language pairs, but a non-English version needs a native speaker to administer it. Expect separate scores for each language, not one combined score. Expect notes on idioms, culturally specific phrases, and cross-language effects. Ask which tasks were equivalent and which were harder in one language.
How do results shape next steps?
Results guide which language to treat, which contexts to support, and which strategies to teach. Training items in one language can improve those same items in the other, with cognates especially supporting transfer.
Greater idiom loss may appear in the less-used language. Keep samples of everyday talk, messages, and stories in both languages to track change. Bring hearing aids, glasses, dentures, and a current medicine list, because sensory and medical issues affect speech performance.
