Using a translanguaging framework to examine language production in a trilingual person with aphasia

When language abilities in aphasia are assessed in clinical and research settings, the standard practice is to examine each language of a multilingual person separately. But many multilingual individuals, with and without aphasia, mix their languages regularly when they communicate with other speakers who share their languages. We applied a novel approach to scoring language production of a multilingual person with aphasia. Our aim was to discover whether the assessment outcome would differ meaningfully when we count accurate responses in only the target language of the assessment session versus when we apply a translanguaging framework, that is, count all accurate responses, regardless of the language in which they were produced. The participant is a Farsi-German-English speaking woman with chronic moderate aphasia. We examined the participant's performance on two picture-naming tasks, an answering wh-question task, and an elicited narrative task. The results demonstrated that scores in English, the participant's third-learned and least-impaired language did not differ between the two scoring methods. Performance in German, the participant's moderately impaired second language benefited from translanguaging-based scoring across the board. In Farsi, her weakest language post-CVA, the participant's scores were higher under the translanguaging-based scoring approach in some but not all of the tasks. Our findings suggest that whether a translanguaging-based scoring makes a difference in the results obtained depends on relative language abilities and on pragmatic constraints, with additional influence of the linguistic distances between the languages in question.

Trilingual and Multicultural Experiences Mitigating Students' Linguistic Stereotypes: Investigating the Perceptions of Undergraduates of Chinese Heritage Regarding Native/Non-Native English Teachers

Student stereotyping of non-native English-speaking teachers is a common focus of research and there is a paucity of studies targeting trilingual students of multicultural backgrounds. The present study aims to investigate the dimensions of trilingual Chinese heritage undergraduates' perceptions of English teachers from Kachru's stratification of native-English-speaking (Inner-circle), ESL (Outer-circle) and EFL (Expanding-circle) regions. A mixed study design was used to collect data including online questionnaires and an offline semi-structured interview. Quantitative findings indicate the subjects' preference for native speaking teachers, together with a hierarchical ranking in teacher assessments according to race/ethnicity. Qualitative findings demonstrate that students are also less biased on racial grounds, considering all teachers are "qualified and good enough", hence the "Inner > Outer > Expanding = Qualified > Unqualified" result. Multilingual and multicultural factors have been used to account for the mitigated linguistic stereotypes from sociocultural and political perspectives. Findings of this study challenge but nevertheless also confirm to some extent the traditional native/non-native dichotomy that manifests raciolinguistic traits and support Kachru's stratification with statistical evidence. Educational implications are discussed to benefit future practice to further eliminate student prejudice and to better prepare native Chinese teachers of the English language.

Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department

AIMS AND OBJECTIVES

To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department.

BACKGROUND

Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication.

DESIGN

A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview.

METHODS

Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis.

RESULTS

Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consultation.

CONCLUSION

The findings reveal that the quality of communication in this Hong Kong emergency department is compromised by specific factors inherent in the linguistic complexity of Hong Kong emergency departments. These factors include the constant translation of medical information, inadequate documentation of medical information and significant professional and cultural pressures. Each of these issues increases the likelihood that healthcare communication will be difficult, incomplete or incorrect. This research provides empirical evidence for, and justifies the development of, an effective framework to enable clinicians to overcome communication challenges.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study may shed light on the unique conditions faced by clinicians, particularly in relation to communication, in the complex trilingual healthcare context of an emergency department similar to those in Hong Kong, and provide potential policy solutions for barriers to improve communication in such settings.

Cross-language treatment generalisation: A case of trilingual aphasia

BACKGROUND: Recent investigations of language gains following treatment in bilingual individuals with chronic aphasia appear to confirm early reports that not only the treated language but also the non-treated language(s) benefit from treatment. The evidence, however, is still suggestive, and the variables that may mitigate generalisation across languages warrant further investigation. AIMS: We set out to examine cross-language generalisation of language treatment in a trilingual speaker with mild chronic aphasia. METHODS #ENTITYSTARTX00026; PROCEDURES: Language treatment was administered in English, the participant's second language (L2). The first treatment block focused on morphosyntactic skills and the second on language production rate. Measurements were collected in the treated language (English, L2) as well as the two non-treated languages: Hebrew (the participant's first language, L1) and French (the participant's third language, L3). OUTCOMES #ENTITYSTARTX00026; RESULTS: The participant showed improvement in his production of selected morphosyntactic elements, such as pronoun gender agreement, in the treated language (L2) as well as in the non-treated French (L3) following the treatment block that focused on morphosyntactic skills. Speech rate also improved in English (L2) and French (L3) following that treatment block. No changes were observed in Hebrew, the participant's L1. CONCLUSIONS: Selective cross-language generalisation of treatment benefit was found for morphosyntactic abilities from the participant's second language to his third language.