A – 73 Decoding Verbal Fluency in Arabic-Speaking Patients: Challenges, Clinical Frontiers, and Future Pathways

Abstract Objective As of 2020, over 3.5 million individuals in America identified as Middle Eastern/North African, with Arabic as the dominant regional language. The current study examines the current state of verbal fluency (VF) assessment for Arabic-speaking patients. Method Studies of neuropsychological measures published between 2005-2024 assessing semantic and phonemic fluency translated and normed in Arab and/or Arab-American populations were reviewed. Tests with the most extensive use, adaptation, validation, and norming were identified. Results 189 papers were identified and revealed several variations of phonemic fluency tests. "Hah", "meem", "teh" (HMT) were found most compatible with FAS (F = 0.02, A = 0.08, S = 0.06; H = 0.01, M = 0.08, T = 0.07) given frequency of these letters (in the Quran). Another variation, "waaw", "raa", "gaaf" (WRG) was deemed most appropriate as they are not commonly attached to prefixes. While results are mixed, age and educational levels had the most significant effect, congruent with Western literature. Average number of words generated by Arabic-speaking individuals in both fluency tests was lower than those produced by English-speaking adults (FAS). Other research suggested that animals, vegetables, and names are reliable categories of semantic fluency, particularly in non-education-based fluency tests. Conclusion Morphosyntactic differences and declines in nomadic lifestyle can account for differences in phonemic and animal fluency, respectively. Clinicians should utilize timed and untimed measures, compare VF in both languages, and consider age of secondary language acquisition, primary language use frequency, and primary educational language. Future considerations include increasing access to culturally-normed measures and distinguishing between Arabic dialects.