Preliminary Evidence for the Effects of Bilingual ECoLoGiC Treatment for People With Aphasia

Purpose: The focus of this preliminary study is to report the effects of bilingual Expanding Communication and Language Opportunities Generated in Conversation Treatment (ECoLoGiC-Tx) on formal measures of language, functional communication, and patient/family-reported outcomes (P/FROMs) in bilingual people with aphasia (PWA). Method: Two bilingual participants, P1 (70 years old, Hebrew–English, moderate Broca's aphasia) and P2 (73 years old, Yiddish–English, mild anomic aphasia), participated in this quasi-experimental, pretest/posttest case series, with a follow-up session 6 weeks after the bilingual intervention. The use of the ECoLoGiC-Tx model for bilingual PWA incorporated dual-language use, including code-switching, translanguaging, and translation, as natural communicative choices. Therapy was personalized and context sensitive, taking into account each participant's sociocultural and linguistic history, language preferences, and real-life communication contexts, with an emphasis on person-centered goals and participant-driven meaningful conversation. Results: Results indicated that both PWA demonstrated the generalization of language improvements across formal test measures, functional communication, and P/FROMs. These gains were largely maintained at a 6-week follow-up. Importantly, improvements were observed across languages and modalities and were generalized to tasks that were not directly targeted in therapy. Self-report outcomes also reflected positive change, although some variability across measures and individuals was observed, consistent with the multidimensional nature of patient- and family-reported communication outcomes. Conclusions: This empirically grounded bilingual ECoLoGiC-Tx provides preliminary evidence that addressed the complex and multifaceted challenges inherent in bilingual aphasia therapy, offering a promising foundation for future research and clinical applications in bilingual conversation therapy. Future directions include expanding the evidence base through larger, more diverse participant samples with varied bilingual profiles and directly investigating conversation-level outcomes to better capture communication changes beyond standardized measures. Supplemental Material: https://doi.org/10.23641/asha.33378070