Cross-linguistic verbal fluency study in aphasia (Sung et al., 2025)

Purpose: The current study examined the impact of cross-linguistic and cultural differences on an animal fluency task between Korean- and English-speaking persons with aphasia (PWA) and neurologically intact older adults (OAs). Specifically, we investigated the influence of zodiac animals on word retrieval, given their cultural familiarity in East Asia, hypothesizing that Korean speakers have a higher likelihood of producing zodiac animals compared to English speakers.

Method: Sixty-seven PWA (30 English-speaking, 37 Korean-speaking) and 30 OAs (15 per language group) completed an animal fluency task. Analyses focused on three approaches: total correct responses, culturally specific responses (zodiac animals and ratio of zodiac animals), and an item-level comparison of language-general and language-specific items to identify animal items that could differentiate between the language groups.

Results: Korean speakers, both with and without aphasia, produced a greater proportion of zodiac animals compared to English speakers. Conversely, English speakers demonstrated greater semantic diversity in animal responses than Korean speakers.

Conclusions: Both PWA and OA groups demonstrated differential patterns in producing zodiac animals, depending on their language and the culture. These findings shed light on the importance of considering cultural and linguistic diversity during aphasia assessment of word retrieval difficulties.

Supplemental Material S1. Clinical information of English-speaking persons with aphasia.

Supplemental Material S2. Clinical information of Korean-speaking persons with aphasia.

Supplemental Material S3. Summary of the linear mixed-effects models for the total number of correct responses, number and ratio of zodiac animals in within-language comparisons between the persons with aphasia group and the older adult group for English speakers.

Supplemental Material S4. Summary of the linear mixed-effects models for the total number of correct responses, number and ratio of zodiac animals in within-language comparisons between the persons with aphasia group and the older adult group for Korean speakers.

Supplemental Material S5. Summary of the linear mixed-effects models for the total number of correct responses, number and ratio of zodiac animals in between-language comparisons of the persons with aphasia group.

Supplemental Material S6. Summary of the linear mixed-effects models for the total number of correct responses, number and ratio of zodiac animals in between-language comparisons of the older adult group.

Supplemental Material S7. LASSO results comparing English-speaking versus Korean-speaking groups.

Sung, J. E., Shin, J., Scimeca, M., Li, R., & Kiran, S. (2025). Cross-linguistic and multicultural effects on animal fluency performance in persons with aphasia. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2025_AJSLP-24-00398

Publisher Note: This article is part of the Special Issue: Select Papers From the 53rd Clinical Aphasiology Conference.