Acquired alexia in multilingual aphasia and computer-assisted treatment in both languages: issues of generalisation and transfer.

This single-subject study addresses the issue of investigation and remediation of an acquired reading impairment observed in a Spanish-English bilingual speaker. Detailed bilingual reading testing showed parallel disturbances in the two languages, both from a qualitative and a quantitative point of view, with characteristics of letter-by-letter and aphasic alexia. On the basis of this mixed pattern, common to both languages, a two-step computer-assisted remediation programme was designed for English, then for Spanish, using a crossover AB-AB design. Therapy A consisted of tasks aimed at the inhibition of letter-by-letter reading. This was alternated with therapy B, which was designed to address phonological assembly. Results on therapy reveal transfer of gains when common reading processing are involved and language-specific gains with a greater benefit on the mother tongue when phonological representations are required in therapy and assessment. Consequences for language choice in bilingual aphasia therapy are discussed on the basis of these results.