A Systemic-Dynamic Lurian Approach to Aphasia in Bilingual Speakers
Kotik-Friedgut, Bella, Communication Disorders Quarterly
This article presents an approach to a variety of syndromes and patterns of language disorders in the different languages of bilingual speakers and polyglots. The approach is based on the systemic-dynamic approach of Vygotsky and Luria in which the concept of extracortical organization of mental functions is especially important. This framework demands that in neuropsychological analysis, all the variables and dynamics of the process of bilingual development (language anamnesis) have to be taken into consideration, along with details of the neurological syndrome. Special attention is paid to the circumstances and manner of second language acquisition.
Case reports of aphasia in bilingual speakers (hereafter referred to as bilinguals) and polyglots have proliferated since the 19th century. One of the interesting features of these cases is the variety of different patterns of disorders that occur with a particular language (Albert & Obler, 1978; Fabbro, 1999; Paradis, 1983). This is also true for the pattern of rehabilitation of aphasia: Each pattern also varies according to the particular language with which it is associated. In fact, Paradis (1977) described no less than six types of rehabilitation dynamics in bilinguals with aphasia.
The catalog of bilingual aphasia phenomenology lists some symptoms typically associated with bilingualism. These problems include switching from one language to another, impaired translation (Paradis, Goldbaum, & Abidi, 1982) or obsessive-compulsive spontaneous translation (Goldstein, 1948/ 1983; Jakobson, 1964; Kauders, 1929/1983), and code mixing (Peresman, 1984). All of these make bilingual aphasia an even more complicated matter.
The central issue in bilingual aphasic research has generally been--and still is--the following: Are the brain mechanisms for speech in bilinguals the same or different for the two languages? The phenomenon of language dissociation (different language disorders and/or rehabilitation of different languages) found in bilinguals with aphasia has usually been considered as evidence that there are different brain mechanisms for each language. On the other hand, similar syndromes and similar rehabilitation patterns have been taken as evidence for a common basis in the brain for different languages. The history of approaches to interpreting special communicative disorders and/or rehabilitation patterns in bilinguals with aphasia starts with several monofactorial hypotheses.
RECENCY OF LANGUAGE ACQUISITION VS. FAMILIARITY OF USE
According to Ribot (1881), the factor of recency of language acquisition is crucial, such as in cases of retrograde amnesia, where the latest experiences are most susceptible to erasure as a result of trauma. Some cases exist to support such an interpretation, but there are many more cases that do not (Albert & Obler, 1978). For example, Pitres (1895/1983) stressed the factors of language familiarity and use with respect to language disorders in bilinguals: The language used most before the onset of aphasia will be the most preserved and will be the first to recover, whereas recovery of the other language will occur later. Analyzing a large number of cases, Albert and Obler came to the conclusion that the number of cases confirming this rule was fairly large, especially in young patients, but there were still many cases that did not fit the explanation. In other instances where it has been impossible to find any explanation, researchers have often referred to affective factors as a possible explanation for various disorders in bilinguals (Bychovsky, 1919/1983; Chlenov, 1948/1983; Krapf, 1957/ 1983).
There are four main theoretical explanations for the selective impairment of different languages:
1. Each language has its own localization in the brain (Scoresby-Jackson, 1867).
2. There is a special "switch" mechanism for shifting between languages (Kauders, 1929/1983; Leischner, 1948/1983; Potzl, 1928/1983). …