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Picture naming and identification in bilingual speakers of Spanish and English with and without aphasia

Background: Equivalent language knowledge is assumed in interpreting assessment results from bilingual speakers with aphasia, regardless of pre‐morbid language experience. Aims: The purpose of this study was to investigate the affect of pre‐morbid language skill, estimated from the performance of 20 neurologically normal bilinguals, on picture identification and naming in four bilingual speakers of Spanish and English with aphasia. Methods & Procedures: Statistical and qualitative analyses of proficiency, language use patterns, literacy, and concentrated language experience were investigated in relation to between‐language differences in picture identification and naming. Outcomes & Results: Three patterns of impairment were identified: higher scores in English consistent with pre‐morbid skill, higher scores in Spanish inconsistent with pre‐morbid skill, and variable performance inconsistent with pre‐morbid skill. Conclusions: Results suggest that interpretation of language impairment in adult bilingual speakers within a given bilingual community must consider expected variability in the proficiency and use of the languages spoken and the differential effects of proficiency on expressive and receptive language performance.