B – 35 Linguistic Diversity and Bilingualism in Post-TBI Cognitive Recovery: Is There a Cognitive Reserve Effect?

Abstract Objective Cognitive reserve (CR) has gained attention as a factor influencing recovery following mild to severe traumatic brain injury (TBI), with bilingualism emerging as a key variable. This review synthesizes current evidence on the impact of linguistic diversity and bilingualism on cognitive recovery after TBI, aiming to determine whether bilingualism provides a CR effect. Specifically, it explores how bilingualism influences cognitive outcomes such as attention, executive function, and verbal abilities across acute and chronic recovery phases. Method Articles were selected based on the following criteria: publication within the past ten years in peer-reviewed journals, focus on cognitive reserve, cultural and linguistic factors impacting TBI, measurable cognitive outcomes, and inclusion of CR indicators such as education, occupation, and multilingual experience. Pediatric and adult populations were included to capture the impact of TBI across the lifespan. Results Evidence suggests bilingual individuals often show better cognitive recovery than monolinguals, particularly in the chronic phase. Enhanced performance on visuomotor tasks involving processing speed supports the hypothesis that bilingualism enhances neural efficiency and flexibility. However, bilinguals may perform worse in acute recovery, showing variability by stage. Cultural and linguistic factors—such as limited access to culturally competent care, language barriers, and stigma—can hinder rehabilitation for culturally and linguistically diverse individuals, leading to poorer psychosocial and functional outcomes. Conclusion Despite inconsistencies, findings indicate bilingualism and linguistic diversity are important in understanding TBI recovery. Bilingualism may act as a CR factor supporting long-term cognitive outcomes. Future research should explore how CR, linguistic experience, and sociocultural background interact to improve recovery models.