Language processing impairments across different dimensions result in deficits of informational content, syntactic complexity, and morphological well-formedness of sentences produced by people with aphasia (PWA). Deficits in language processing affect linguistic skills of bi/multilingual PWA in all languages that they have acquired prior to aphasia. However, the impairments of dual or multiple languages in aphasia may not necessarily be parallel. One language may be more preserved than another and be recovered at different paces, including sentence production abilities. This scoping review aims to compare syntactic characteristics and errors demonstrated by bi/multilingual PWAs between their acquired languages and to explore the nature of bilingual impairments in primary progressive aphasia (PPA). We conducted an online search on three databases (MEDLINE, SciVerse Scopus, and Taylor and Francis publications) for original studies on sentence production of bi/multilingual aphasia that were published between 1991 and 2021 using keywords related to “bilingualism”, “aphasia”, and “speech production”. Based on the titles, abstracts, and full-text screenings, 13 studies were found to have met our inclusion criteria. A qualitative synthesis of the accumulated evidence was conducted following the PRISMA guidelines. Collectively, past researchers reported dominance in L1 with higher occurrences of linguistic errors in L2 among participants with sudden onset aphasia. In PPA, language impairments were found to be comparable between L1 and L2, which may indicate parallel deterioration. It is noted that this review is not exhaustive and many of the reviewed studies were based on single case studies. This review also highlighted an urgent need for investigation into multilingual PPA to fully comprehend the nature of sentence production impairment.

Introduction The effects of imageability and familiarity on lexical access have received attention in many languages and in people with aphasia. However, its effect on Malay-speaking individuals with or without aphasia has not been comprehensively addressed. This study aims to investigate comprehension of nouns and verbs in Malay-speaking adults with aphasia and the effect of imagebility and familiarity on comprehension of both word classes. Methods The performance of two groups of participants; control subjects and subject with aphasia were assessed via picture verification task. 14 Malay-speaking adults with aphasia, aged 28-64 years old (mean=50.70) and 20 control subjects with age-, gender- and education-matched, 28-71 years old (mean= 52.29) native speakers of Malay were recruited. 52 nouns and 32 verbs which were controlled for word length, imageability and familiarity were elicited and converted to black and white picture cards. The subjects were asked to judge by saying ‘yes’ or ‘no’ whether the spoken words were the correct name for the picture shown. If the subjects had difficulties speaking, they could point to the yes/no card provided in front of them. Results ANOVA comparing the group of control subjects and people with aphasia (fluent and non-fluent) showed a significant difference between the groups (F(1,32)=14.50, p<0.05), a difference between nouns and verbs (F(1,32 )=24.28, p<0.05), but no significant interaction (F(1,32)=2.82, p=0.10), showing that, as a group, people with aphasia showed poorer performance with verbs than nouns relative to control subjects. When comparing the groups of fluent and non-fluent aphasia, there was a significant main effect of group (F(1,18) = 11.32, p<0.05), reflecting the much better comprehension of both classes of words by people with fluent aphasia. There was a significant main effect of word classes (F(1,18) = 13.54, p<0.05), because the subjects in both groups were less accurate with nouns than verbs. The interaction of group and word class was not significant (F(1,18)=0.27, p=0.61), indicating that the two groups showed a broadly equivalent degree of difficulty with verbs relative to nouns. When simultaneous regression is used, looking for the effects of an independent effect of a variable independent of the effects of the other (potentially-confounded) effects of independent variables, there is no significant independent effect of any variable used in this study on subject’s comprehension performance. A further analysis used logistic regression for each of these variables separately to predict participants’ accuracy in comprehension. Four subjects with aphasia show a significant difference between nouns and verbs but it is noteworthy that all of these subjects also show effects of imageability and only one subject shows familiarity effect, but when the effects of these confounding variables are taken into account, these differences between nouns and verbs are no longer significant. Conclusion This study highlights comprehension of verbs was found to be more difficult than nouns in Malay-speaking adults with aphasia. There was no effect of imageability and familiarity on nouns and verbs comprehension in the group of aphasia subjects when both confounding variables were taken into account.

Introduction Semantic Feature Analysis (SFA) is a treatment for lexical retrieval impairment in which participants are cued by providing semantic information regarding concepts they have difficulty with in naming tasks in an effort to facilitate accurate lexical retrieval (Boyle & Coelho, 1995). People with aphasia are commonly found to have naming deficits and speech-language therapists (SLTs) face difficulties in providing an effective treatment method to treat this deficit. This study aims to examine the use of SFA to address naming deficits for nouns and verbs in a Malay patient (KM) with non-fluent aphasia. Methods The following tests were administered to the subject pre- and post- treatment: 1) Boston Diagnostic Aphasia Examination (BDAE); 2) Malay Object and Action Test (MOAT); and 3) A series of comprehension and production assessments in Malay. Subject was asked to name 101 and 50 pictures from MOAT. The stimuli were coloured photograph pictures. Treatment and probe (untrained) stimuli were selected from pictures that a subject could not name, yielding 40 nouns and 30 verbs. From these, 20 stimuli were randomly chosen as probe items and 20 as treatment stimuli (nouns), 15 treatment and 15 probes (verbs). For the treatment study, single subject A-B-A design was implemented. Three baseline sessions were completed prior to treatment initiation naming for both probe and treatment pictures. Subject attended once-weekly therapy sessions over 8 months. Probes assessing generalizations to untrained pictures were presented at 4th, 8th, and 12th and so on until the end of the programme. Results Results showed that KM’s ability to name trained and untrained picture stimuli improved for both nouns and verbs. KM demonstrated steady improvement in the SFA treatment of trained nouns and verbs: from 5% baseline accuracy to over 90% accuracy at treatment end for nouns and from 0% baseline accuracy to 90% accuracy at treatment end for verbs. Generalizations to untrained nouns and verbs also showed similar results. KM exhibited marked progress - from naming four nouns (20%) and two verbs (13%) in first probe to 17 nouns (85%) and 13 verbs (87%) in final probe. Pre- and post-assessments results revealed that KM performed better in most of the tasks measured. Conclusion Findings from this study replicate outcomes of previous studies using SFA with people with aphasia. SFA is proven to have helped individuals with naming deficits in accessing semantic features of a target word in a structured and systematic way. Training using the same set/number of pictures in the treatment helps a patient’s ability to retrieve untrained words. This procedure could assist practicing SLTs in Malaysia in treating naming deficits among Malay speakers with aphasia, hence increasing their verbal communication.