Replicating the Expected and the Unexpected: Neuropsychological and Symptom Profiles in a Neurotypical Romanian-English Bilingual Sample.

This study examines the impact of limited English proficiency (LEP) on cognitive test performance in Romanian-English bilinguals, replicating prior research on cross-cultural neuropsychological assessment. Results indicate that tests with high verbal mediation, such as verbal fluency and auditory verbal learning, are significantly affected by LEP, with participants performing better when tested in their native Romanian language, while tests with low verbal mediation (e.g., Coding, Stroop Word Reading, and recognition trials of the Hopkins Verbal Learning Test–Revised) remain robust to LEP. The Boston Naming Test—Short Form (BNT-15) effectively differentiates degrees of LEP and predicts performance variability, supporting the conceptualization of LEP as a dimensional construct. Symptom-report measures were generally unaffected by LEP, underscoring their relative robustness. The findings emphasize the necessity of developing population-specific normative data and administering cognitive tests in the native language to improve diagnostic accuracy in individuals with LEP.