Between Languages: Clinical Realities and Needs in Multilingual Aphasia Therapy

The rising prevalence of multilingual populations and poststroke aphasia demonstrates the urgency of research on multilingual people with aphasia (MPwA). Understanding the experiences and needs of speech and language therapists (SLTs) working with MPwA is vital for guiding clinical practice and academic research in evaluation and intervention. This study explores the clinical realities, challenges, and educational needs of SLTs in Türkiye.

Twelve SLTs with experience working with MPwA participated, reporting on individuals whose language profiles included Turkish, Kurdish, Arabic, Armenian, English, French, German, and Dutch. A phenomenological qualitative design was employed with purposive, convenience, and snowball sampling. Semistructured interviews were conducted via Zoom. The data were analyzed using thematic analysis and reported in line with Consolidated Criteria for Reporting Qualitative Research guidelines.

Four themes emerged: (1) Language preference (compulsory choice, functional and person-centered bases for language selection, integrating multiple languages), (2) Family involvement (families as therapeutic partners, families as sources of disruption), (3) Systemic challenges in multilingual aphasia therapy (insufficient materials, referral difficulties, training gaps), and (4) Suggested improvements in multilingual aphasia therapy (material development, professional and community networks, training and supporting clinicians and families).

SLT services for MPwA are constrained by a lack of culturally and linguistically appropriate resources, limited multilingual training, and mismatches between SLTs and families. These factors undermine the equity and effectiveness of the intervention. Findings emphasize urgent needs such as developing context-sensitive materials, strengthening networks, expanding specialized training, and promoting systematic employment and training of multilingual SLTs. These implications extend beyond individual therapy, guiding policy, practice, and education for managing multilingual aphasia in diverse sociolinguistic contexts.