Aphasia in two languages? Important facts you need to know!

Welcome sign in multiple languages

If you or a loved one has aphasia, then you know that aphasia, most often caused by stroke, results in difficulty producing and/or comprehending language. But what if a person spoke two languages before acquiring aphasia?

In this situation, both languages can be affected. This condition is known as bilingual aphasia. Here are a few additional facts about bilingual aphasia that might help you understand it better.

  • You did not have to be equally proficient in both languages before acquiring aphasia to have bilingual aphasia.
  • You may be able to produce words more easily in one language than the other.
  • Your comprehension may be better in one language than the other.
  • You may be able to comprehend in both languages but only be able to produce words in one language.
  • The language that is more preserved is not necessarily the first language you learned or the language you spoke more fluently before getting aphasia.
  • You may mix both languages together when you speak when you do not intend to. This can be frustrating, but it is not uncommon.
  • As you regain some of your language function, one language may improve more than the other. Also, some days you may do better with one language than the other.

If you have bilingual aphasia, sharing information about your language needs with your speech-language pathologist (speech therapist) is crucial. Of course, if you have aphasia, you may have difficulty expressing your thoughts, so a family member or friend may have to help.

One of the most important things to tell your therapist is how and with whom you use both languages. It may be relevant to include how your language has changed since you acquired aphasia. Here are some example scenarios:

  • Before aphasia you primarily spoke Spanish at home and English at work. Now you are home most of the time but are only getting therapy in English. (This is pretty important information for your therapist!)
  • You speak Mandarin with your parents, who live with you, and English with your grown children, who live nearby. Socially (e.g., at church, in community groups) you speak English and Mandarin. So, both languages are important for you!
  • The majority of people around you are bilingual, so you can use either language, so your goals are to communicate better overall, regardless of language.

Most therapists will ask if you are bilingual, but they might not ask you such detailed questions. Once your speech therapist understands your goals, she can better help you in therapy herself or help you to find a therapist who speaks both of your languages.

Please note! If your English proficiency is limited, and your therapist cannot provide the services you need, then your therapist is ethically obligated to find an interpreter or refer you to a bilingual therapist. As a patient or family member, do not be afraid to ask for an interpreter, especially if you are in the hospital, as most hospitals have access to professional interpreters!

If you are looking for a bilingual speech-language pathologist, you can search the American Speech-Language-Hearing Association website using the link below.


If you are interested in materials about aphasia in multiple languages (in Hebrew, Spanish, Creole and more), then visit National Aphasia Association website at this link:


For information about stroke in Spanish, see http://esamericanheart.convertlanguage.com/presenter.jhtml?identifier=3053186

If you are a speech-language pathologist looking for help in working with someone with bilingual aphasia, see the following link:


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