Differences between monolinguals and bilinguals have been documented in neuropsychological test performance. Various explanations have been provided to explain why differences exist among these language groups. Hispanic-Americans are individuals born and reside in the United States and have a family background extending to one of the Spanish-speaking countries in Latin America or Spain. Furthermore, Hispanic-American children from Hispanic homes where Spanish is their first language find themselves academically at a disadvantage because their English vocabulary may be lower than English monolinguals. Time perspective (TP) refers to an individual’s orientation towards the past, present, or future. One’s ability to change their TP in order to adapt to changes in cultural context can result in optimal psychological well-being. In one study, researchers reported no relationship existed between ethnicity and TP on cognition. To our knowledge, no study has examined the relationship between language and TP in Hispanic-Americans’ speed attention performance. Therefore, it was predicted that monolinguals would outperform bilinguals on speed attention tasks. Next, it was predicted that monolinguals would report higher scores on future time orientation compared to bilinguals, and bilinguals would report higher scores on past and present time orientation compared to monolinguals. Finally, differences in TP would correlate with speed attention tasks between language groups.

The sample consisted of 119 Hispanic-Americans with a mean age of 19.45 (SD = 1.43). Participants were broken into three groups: English first language monolingual (EFLM), English first language bilingual (EFLB), and English second language bilingual (ESLB). The Comalli Stroop part A and B, Trail Making Test part A, and Symbol Digit Modalities Test written and oral parts were used to evaluate speed attention and the Zimbardo Time Perspective Inventory was used to evaluate time orientation in our sample.

ANOVAs revealed the EFLM group outperformed the ESLB group on the Comalli Stroop part B, p = .020, np2 = .07. Next, we also found on the Symbol Digit Modalities Test written part the EFLB group outperformed both bilingual groups, p = .025, np2 = .06. Regarding TP, the EFLB group reported higher past negative orientation compared to the EFLM group, p = .033, np2 = .06. Additionally, we found the bilingual groups reported higher present-fatalistic compared to the EFLM group, p = .023, np2 = .06. Pearson’s correlation revealed no significant correlations between TP and speed attention tasks on any of our language groups.

As expected, the EFLM group outperformed the ESLB group on several speed attention tasks, but the EFLM group only outperformed the EFLB group on the Symbol Digit Modalities Test written part. Additionally, we found that our EFLB sample reported higher orientation of the past and present compared to monolinguals. Our sample level of acculturation could have been a factor influencing the relationship between TP and speed attention. Future studies using larger representative samples should include measures of acculturation and examine if TP influences other cognitive domains (e.g., executive function) in Hispanic-American monolingual and bilingual speakers.

The aim of the present study was to analyse the effects of the transcranial random noise stimulation (tRNS) technique when placed on the left dorsolateral prefrontal cortex (L-DPFC) and left inferior frontal gyrus (L-IFG), for the improvement of verbal fluency performance and creativity skills in a group of multilingual healthy adults.

Fifty healthy adults, aged 18-47 years, participated in the study. All of them were native Spanish speakers of which three were bilingual (Spanish and English) and 47 were multilingual (Spanish, Basque and English). The study had a randomized, counterbalanced, double-blind, sham-controlled design. The participants were randomly allocated to either a tRNS active group or a placebo-control group. All participants were tested individually in one session divided into three parts: (1) baseline, (2) online, and (3) offline assessment. In the active condition, a 1.5mA current (100-500 Hz) was delivered for 20 minutes (online phase). Participants’ verbal fluency was assessed through semantic and phonemic verbal fluency tasks in three different languages (Spanish, Basque and English), while creativity was assessed in their native language with the Remote Associations Test (RAT, pre and post forms) for convergent thinking, and with the Unusual Uses subtest (UU, pre and post forms) for divergent thinking. In addition, the linguistic profile of the participants was evaluated with the Language Experience and Proficiency Questionnaire (LEAP-Q), and their processing speed and cognitive flexibility were assessed with the Stroop Color and Word Test (SCWT).

The results showed significant differences in phonemic fluency between the groups during the online assessment in Spanish (F= 5.31, p = 0.026), and in the offline assessments in Spanish (F=6.44, p = 0.015) and English (F=10.80, p = 0.002), with participants in the active condition performing better. While no differences were observed in the performance of the groups in verbal fluency in Basque, neither in the online (F=1.06, p = 0.31), nor in the offline assessment (F=2.62, p = 0.11). Furthermore, no significant differences were observed between groups in semantic verbal fluency tasks in any of the languages, neither during stimulation nor offline. However, there were no differences between conditions in the online (Spanish, F=0.86, p = 0.35; English, F=2.95, p = 0.09; and Basque, F=0.01 p = 0.94) and offline (Spanish, F=2.53, p = 0.11; English, F=0.74, p = 0.39; and Basque, F=1.39, p = 0.24) semantic tasks. In creativity, significant differences were observed between groups on the RAT (F=9.58, p = 0.003), while no differences were observed in the performance of any of the three dimensions of the UU (Originality, F=0.44, p = 0.51; Flexibility, F=0.42, p = 0.51; Fluency, F=0.69, p = 0.41). In the SCWT, statistically significant differences were only observed in the colour-word part (F=7.60, p = 0.008) during the online assessment, showing a better performance of the participants under the tRNS condition compare to the sham condition.

The results obtained in this study suggest that the excitatory effects of tRNS over the L-DLPFC L-IFG could contribute to the improvement of phonemic verbal fluency and verbal convergent thinking, in healthy individuals.

The current study aimed to evaluate the psychometric properties and diagnostic accuracy of the 32-item version of the Multilingual Naming Test (MINT) in a sample of English and Spanish monolinguals and bilingual older adults from two ethnic groups (EA; European Americans and HA; Hispanic American) with typical and atypical aging. An IRT model was used to identify 24 MINT Items assessed across ethnicity and language testing groups (Spanish and English). We analyzed the discriminant and predictive validity of the 32-item and 24-item scales across diagnostic groups (cognitively normal [CN], mild cognitive impairment [MCI], and dementia [AD]). Diagnostic accuracy was then assessed with both versions applying ROC (Receiver Operating Characteristics) curve reporting using AUC (Area Under the Curve). We expected the MINT to distinguish between the CN and AD groups but not between CN and MCI and the MCI and AD. We conducted IRT analyses to evaluate the cross-language validity of the items from the 32-item MINT in English and Spanish through Rasch Analysis across our two ethnic groups. Finally, we tested the association between MINT scores and MRI volumetric measures of language-related areas in both cerebral hemispheres’ temporal and frontal lobes.

The sample comprised 281 participants (178 females) enrolled in the 1Florida Alzheimer’s Disease Research Center (ADRC), with 175 participants self-identified as HA (51 tested in English and 124 in Spanish) and 106 EA, all of them monolingual English speakers. The participants were classified into three diagnostic groups: 1. CN (n = 94); 2. MCI (n = 148); and 3. AD (n = 39). Participants are evaluated yearly through a comprehensive neuropsychological battery, including the MINT is a standard CN task that requires patients to retrieve words upon presentation of a line drawing.

We obtained a ceiling effect in four items (Butterfly, Glove, Watch, and Candle). Four items were easier in English (Blind, Gauge, Porthole, and Pestle) and four in Spanish (Dustpan, Funnel, Anvil, and Mortar). In the 32-item version of the MINT, EA scored significantly higher than HA, but when removing those eight items, the ethnic difference was attenuated and no longer statistically significant (controlling for education). The ROC curves showed that both versions of the MINT had poor accuracy when identifying CN participants and were acceptable in identifying dementia participants but unacceptable for classifying MCI participants. The 32-item MINT in English and Spanish and the 24-item MINT in Spanish were significantly correlated with the bilateral MTG. However, the 24-item MINT in English was only correlated with this area’s volume in the right hemisphere. The left FG correlated with MINT scores regardless of language and MINT version. We also found some differential correlations depending on the language of administration. The bilateral hippocampi, STG, MTG and FG, and right ITG were significantly correlated only with MINT Spanish scores, while the left ITG was significant only when either version of the MINT was administered in English.

Our results highlight the importance of analyzing cross-cultural samples when implementing neuropsychological tests.

Although the majority of Japanese speakers live in Japan, there are also large populations of Japanese speakers in the United States of America and Brazil, with more than a million Japanese speakers across the two countries. Only 53% of foreign-born Japanese individuals in the United States report proficiency in English. Although there has been increasing attention to the neuropsychological assessment of linguistically diverse patients broadly in recent years, there are specific considerations unique to Japanese that clinicians and researchers should be aware of when working with Japanese speakers outside of Japan. The aim of the present study is to present considerations and appropriately normed assessments of verbal abilities for Japanese patients.

A systematic review of cognitive screeners and assessments of verbal fluency, verbal memory, and verbal academic skills that have been translated and normed for use with Japanese speaking populations was conducted. Studies published in both English and Japanese were reviewed. Test content modifications, administration modifications, and relevant cultural and linguistic considerations were synthesized and summarized.

One consideration in translation is the use of words that are linguistically and culturally comparable across the two languages. Multiple cognitive screeners and verbal learning/memory tasks have been translated with cultural equivalency considerations (e.g., for the Montreal Cognitive Assessment, velvet, church, and daisy were changed to silk, shrine, and lily). In Japanese, there is a one-to-one correspondence between sound (syllable) and graphemes (kana script), compared to one-to-many associations in alphabet-based languages like English. This impacts normative expectations on letter fluency tasks. The hiragana letters, A, Ka, and Shi (fc, fr, L) are recommended because there are relatively large number of words that start with these letters and the number of words generated with these letters showed close to normal distributions in previous research. Unlike letter fluency, semantic fluency is believed to be relatively culture-free and independent of language systems. The Japanese writing system utilizes both phonographic systems where written symbols map onto sounds, and logographic systems, where written symbols map onto concepts. This is in contrast to English, which has a solely phonographic written system. These two separate writing systems complicate the assessment of reading among Japanese-speaking individuals, as there may be a dissociation between abilities in reading in the phonographic versus logographic systems. Acculturation has been shown to impact performance on certain verbal task performances, along with demographic variables such as immigration generation status and bilingualism.

Neuropsychologists should be familiar with linguistic differences between English and Japanese such as the one-to-one correspondence between sound and grapheme in Japanese and the use of both phonographic and logographic systems in written Japanese. Neuropsychologists should also be careful to use tests that are translated for cultural equivalence rather than direct translations, and that have been normed for use with Japanese speakers. Finally, general cross-cultural considerations in assessment such as the evaluation of bilingualism, familiarity with the testing environment, and other factors remain essential.

The research examining the influence of bilingualism on cognition continues to grow. Past research shows that monolingual speakers outperformed bilingual speakers on language, memory, and attention and processing speed tasks. However, the opposite has been found favoring bilingual speakers, when comparing executive functioning abilities. Furthermore, researchers have reported that no differences in executive functioning abilities exist between young adult monolingual speakers compared to young adult bilingual speakers. Moreover, limited research exists examining cognition abilities between monolinguals, bilinguals that learn a language (e.g., English) first, and bilinguals that learn the same language (e.g., English) second. We examined young adult monolinguals cognition abilities (e.g., memory) compared to young adult bilinguals that learned English as a first or second language. It was expected that the monolingual group would outperform both bilingual groups on memory, language, and attention and processing tasks, but no differences would be found on executive functioning tasks.

The sample consisted of 149 right-handed undergraduate students with a mean age of 19.58 (SD = 1.90). Participants were neurologically and psychologically healthy and divided into three language groups: English first language (EFL) monolingual speakers, EFL bilingual speakers, and English second language (ESL) bilingual speakers. All the participants completed a background questionnaire and comprehensive neuropsychological battery that included memory, language, executive functioning, and attention and processing speed tasks in English. A series of ANOVA’s were used to evaluate cognitive tasks (e.g., Boston Naming Test, Trail Making Test) between the language groups. Participants demonstrated adequate effort on one performance validity test.

Language groups were well demographically matched. We found the EFL monolingual group outperformed the ESL bilingual group on the Wide Range Achievement Test, fourth edition task and the Controlled Oral Word Association Test (COWAT) phonemic task, p’s < .05, np’s2 = .04-.05. Additionally, results revealed both monolingual groups outperformed the ESL bilingual group on the Wechsler Adult Intelligence Scale, Third edition vocabulary task and the Boston Naming Test, p’s < .05, np’s2 = .06-.15. No significant differences were found on any of the cognitive tasks between the EFL monolingual group and the EFL bilingual group.

As expected, the ESL bilingual group performed worse on language tasks compared to both monolingual groups, specifically the EFL monolingual group. However, in the opposite direction, we found the EFL monolingual demonstrated better phonemic verbal fluency abilities on the COWAT compared to the ESL bilingual group. The current data suggest that bilingualism influences cognitive abilities (e.g., language, executive functioning) more ESL bilingual speakers compared to EFL monolingual speakers. A possible explanation may be due to the type of interaction that ESL bilingual speakers may prefer to have (i.e., mix language conversations) compared to EFL speaking groups. Future studies with a larger bilingual speaking sample should investigate if the Adaptive Control Hypothesis which suggest that different types of conversations may be placing different demands of language control influences cognitive abilities.

A systematic approach is vital for adapting neuropsychological tests developed and validated in western monocultural, educated and English-speaking populations. However, rigorous and uniform methods are often not implemented during adaptation of neuropsychological tests and cognitive screening tools across different languages and cultures. This has serious clinical implications. Our group has adapted the Addenbrooke’s Cognitive Examination (ACE) III for the Bengali speaking population in India. We have taken a 'culture-specific’ approach to adaptation and illustrate this by describing the process of adapting the ACE III naming sub-test, with a focus on the process of selecting culturally appropriate and psychometrically reliable items

Two studies were conducted in seven phases for adapting the ACE III naming test. Twenty-three items from the naming test in the English and the different Indian ACE-R versions were administered to healthy Bengali speaking literate adults to determine image agreement, naming and familiarity of the items. Eleven items were identified as outliers. We then included 16 culturally appropriate items that were semantically similar to the items in the selected ACE-R versions of which 3 were identified as outliers. The final corpus consisting of 24 items was administered to 30 patients with mild cognitive Impairment, Alzheimer’s disease and vascular dementia, and 60 healthy controls matched for age and education to determine which items in the corpus best discriminated patients and the controls, and to examine their difficulty levels.

The ACE III Bengali naming test with an internal consistency of .76 included 12 psychometrically reliable, culturally relevant high naming-high familiarity and high naming-low familiarity living and non-living items. Item difficulty ranged from .47 to .88 and had discrimination indices >.44.

A key question for test development/adaptation is whether to aim for culture-broad or culture-specific tests. Either way, a systematic approach to test adaption will increase the likelihood that a test is appropriate for the linguistic/cultural context in which it is intended to be used. Adaptation of neuropsychological tests based on a familiarity driven approach helps to reduce cultural bias at the content level. This coupled with appropriate item selection statistics helps to improve the validity of the adapted tests and ensure cross-cultural comparability of test scores both across and within nations.

The world’s 8 billion people speak about 7000 languages; 3.2 billion of those people natively speak the top 10 languages. Currently neuropsychology is moderately well-developed in 6 of the top 10 languages, serving roughly 2.5 billion. Developing robust neuropsychology in all 7000 languages to serve everyone equitably in their native language seems impractical within the next few decades. However, 1-2 billion people speak a major language as their second language so a pragmatic strategy may be to develop an alternative approach of second-language neuropsychology (SLN) to serve clients who speak rare languages natively but widely-diffused languages as their second language. This strategy involves adapting all levels of neuropsychological services to the second language user.

Intended participants are those who speak a language of limited (e.g., <1 million speakers) diffusion as their first language and a language of wider diffusion (historically-colonial languages such as English, Russian, Mandarin, or Arabic; regional trade languages such as Swahili or Lingala; or nationalized languages such as Indonesian or Tagalog) as their second or more language. Intended participants are those with Basic Interpersonal Communication Skills (BICS) in their second language, but not necessarily Cognitive and Academic Language Proficiency (CALP). SLN will adapt current neuropsychology techniques in the following domains:

1. 1. Oral language: interview, feedback, treatment, and communication among professionals;

2. 2. Detailed language use evaluation;

3. 3. testing and norms;

4. 4. written materials: reports, client education materials, treatment materials, professional education materials, etc.

The language style for such communication will use standard versions of such traditional or national languages, as commonly taught as a second language. It will use basic vocabulary, simple grammatical structures, and broadly-understood cultural referents. It will minimize grammatical complexity, slang, regionalisms, figures of speech, and metaphor. Materials will be available in the specified language both for those who are literate and for those with inadequate literacy. The development of such language style will require both written materials and training of neuropsychologists and allies. Once core SLN materials are developed, these may be further localized for specific communities to contribute to acceptance and effectiveness. These general strategies will need modification to the specifics of each major language, writing system, and population. This will be particularly true for testing language functioning itself, a particular challenge for the SLN strategy. The SLN strategy will require empirical verification of its viability in each major language and population. Some may perceive SLN as neo-colonialist and culturally insensitive; this may be mitigated in part through diversifying the neuropsychology workforce, community-based research, piloting, focus groups, and localization of materials.

Because this is a proposal and not yet a research project, prototype neuropsychological screening protocols for English-as-a-Second-Language and Spanish-as-a-Second-Language will be presented as examples.

Cultural and linguistic diversity present major challenges to providing equitable neuropsychological services to the world’s population. Current neuropsychology resources are least accessible to major populations that may be most in need. The SLN strategy is not perfect or universal but may reach the next 1-2 billion underserved population

South Africa has a multi-lingual population where fewer than 10% of the population speak English as a first language. This poses a challenge regarding language usage for a verbal fluency task. This study investigated the difference in number of words produced by independent groups of non-English examinees required to produce words in English, or in their first language, on a category verbal fluency task.

A study on South African non-English first language participants was conducted using the Category Verbal Fluency test (animals) for a sample of nonclinical adults (N = 264) aged 18-60 years with 8-12 years of disadvantaged (poorly resourced) quality of education. Participants either had an African indigenous first language, or Afrikaans (a Dutch derivative) as a first language. The data were derived from one group of either African indigenous or Afrikaans first language participants who were required to use English for word production (Group A English) (n = 159; African indigenous n = 135; Afrikaans n = 24) and another group of participants who were required to use their first language (Group B First Language) (n = 105; African indigenous n = 83; Afrikaans n = 22). The comparative data were stratified for age ranges 18-20, 21-30, 31-40, 41-50 and 51-60 years. Level of education was broadly equivalent across the comparative groups. T-test analyses compared the number of words produced between the English versus indigenous African groups, and English versus Afrikaans first language groups for each age category.

The comparison for the indigenous African first language participants, revealed no significant differences in word production for words produced in English or first language regardless of age. In the comparison for the Afrikaans first language participants there was a highly consistent tendency for better word production in Afrikaans than in English. These results indicate that socio-cultural factors may be influential for English language proficiency on a verbal fluency task, rather than the effect of first language usage “per se”.

Since the dismantling of the Apartheid system in South Africa thirty years ago, English has become the main language used in government and business and is the preferred language of tuition in schools for those speaking English or an African indigenous language, whereas during the Apartheid era, two official languages were used for government, business, and schooling (Afrikaans and English). Currently, many Afrikaans speaking individuals continue to have Afrikaans as the preferred primary language of tuition in the schools and it persists as the preferred language for use in many Afrikaans dominated business arenas. This study attests to a high level of English fluency amongst those South Africans with an indigenous African first language, who clearly are as fluent in word production using English as they are when using their first language, in contrast to the indications for Afrikaans speaking individuals. Practitioners need to be alert to sociocultural factors that can impact on the optimal use of language in test situations, which may not necessarily be the first language.

The Boston Naming Test (BNT) is a 60-item confrontation naming task requiring participants to name a series of pictures. Prior research has shown that bilingual children have smaller vocabularies than monolinguals and that this effect continues into adulthood. Numerous studies have confirmed that bilingual adults name fewer pictures correctly than monolinguals on the BNT. Research also shows that self-reported workload correlates with neuropsychological test performance and that estimates of workload provide additional information regarding cognitive outcomes. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX; Hart & Staveland 1988) with healthy adults on a neuropsychological test (i.e., the Tower of Hanoi). Research also shows that bilinguals report higher perceived workloads on cognitive tasks compared to monolinguals. Although this work has recently extended to other tests, to our knowledge, the workload profile of the BNT remains relatively unexplored. We evaluated BNT performance and perceived workload via the NASA-TLX in monolinguals and bilinguals. We predicted that monolinguals would outperform bilinguals on the BNT, but that bilinguals would report higher workloads.

The study sample consisted of 84 healthy participants (36 monolinguals, 48 bilinguals) with a mean age of 28.94 (SD = 10.76). Participants completed the standard 60-item BNT in English. The NASA-TLX scale was utilized to evaluate perceived workload across six subscales. The NASA-TLX was also completed in English after the completion of the BNT. ANOVAs were used to test BNT performance and perceived workload ratings between our language groups.

We found that monolinguals performed better on the BNT compared to bilinguals, p =.001, np2 = 24. However, bilinguals reported exerting more effort when completing the BNT compared to monolinguals, p =.002, np2 = .11. Additionally. bilinguals also experienced more frustration when completing the BNT compared to monolinguals, p =.034, np2 = .05.

As expected, results revealed that monolinguals outperformed bilingual participants on the BNT. However, bilinguals exerted more effort on the BNT and reported the BNT to be more frustrating. A possible reason for bilinguals underperforming and reporting higher perceived workloads on the BNT may be because correct responses were only accepted in English. This may have caused bilingual speakers to exert increased effort to complete the task in a non-native language. In turn, this increased effort likely increased cognitive load and led to higher frustration levels. Further research is needed to confirm our findings and support the idea that bilingualism leads to perceiving greater effort and frustration, and to determine whether there are subgroup differences in BNT performances among bilingual individuals (e.g., English learned as a first language compared to English learned as a second language).