Iconic reading in a case of alexia without agraphia caused by a brain tumor: a tachistoscopic study

The lack of nonverbal reading comprehension in the clinical disconnection syndrome, alexia without agraphia, has been contradictory to the relative reading comprehension of the right hemisphere in split brains. We report a 39-year-old patient with verbal alexia without agraphia caused by brain tumor. On rapid tachistoscopic presentation of object names, he denied seeing anything but showed nonverbal reading comprehension by pointing to the corresponding objects. He lost this ability when he recovered ability to name individual letters of the object names. Our results suggest that even partial verbal reading such as the naming of single letters makes demonstration of iconic reading impossible and that total functional disconnection from verbalization, as initially noted in this case or in split brain studies, is necessary to show nonverbal reading comprehension.     

Contrasting Effects of Letter-spacing in Alexia: Further Evidence that Different Strategies Generate Word Length Effects in Reading

The reading behaviour of two alexic patients (SA and WH) is reported. Both patients are severely impaired at reading single words, and both show abnormally strong effects of word length when reading. These two symptoms are characteristic of letter-by-letter reading. Experiment 1 examined the pattern of errors when the patients read large and small words. Further experiments examined the effects of inter-letter spacing on word naming (Experiments 2a and 2b) and the identification of letters in letter strings (Experiment 3). For both patients, letter identification was better for widely spaced letters in letter strings, and this effect was most pronounced for the central letters in the strings. This is consistent with abnormally strong flanker interference in letter identification. However, inter-letter spacing affected word reading behaviour in the two patients in different ways. SA's word reading improved with widely spaced letters; WH's word reading was disrupted. This suggests that these patients adopted different strategies when reading words. We conclude that several reading behaviours can elicit word length effects, and that these different behaviours can reflect strategic adaptation to a common functional deficit in patients. We discuss the implications both for understanding alexia and for models of normal word identification.     

Auditory repetition priming is impaired in pure alexic patients

Alexia without agraphia, or "pure" alexia, is an acquired impairment in reading that leaves writing skills intact. Repetition priming for visually presented words is diminished in pure alexia. However, it is not possible to verify whether this priming deficit is modality-specific or modality independent because reading abilities are compromised. Hence, auditory repetition priming was assessed with lexical decision and word stem completion tasks in pure alexic patients with lesions in left inferior temporal-occipital cortex and the splenium. Perceptually based, modality-specific priming models predict intact auditory priming, since auditory association cortex is spared in the patients. Alternatively, modality-independent models, which suggest that priming reflects the temporary modification of an amodal system, might predict impairments. Baseline performance was matched in the patients and controls, although lexical decision priming measures showed an interaction between group and repetition lag. The patients showed intact immediate priming but significantly less priming than controls at longer delays. Furthermore, word stem completion priming was abolished in the patients. One explanation for the deficit is that left inferior temporal-occipital cortex supports amodal aspects of priming, as suggested by recent neuroimaging results. Another possibility is that long-term auditory priming relies on covert orthographic representations which were unavailable in the patients. The results provide support for interactive models of word identification.     

Is nevtral NEUTRAL? Visual similarity effects in the early phases of written-word recognition

For simplicity, contemporary models of written-word recognition and reading have unspecified feature/letter levels—they predict that the visually similar substituted-letter nonword PEQPLE is as effective at activating the word PEOPLE as the visually dissimilar substituted-letter nonword PEYPLE. Previous empirical evidence on the effects of visual similarly across letters during written-word recognition is scarce and nonconclusive. To examine whether visual similarity across letters plays a role early in word processing, we conducted two masked priming lexical decision experiments (stimulus-onset asynchrony = 50 ms). The substituted-letter primes were visually very similar to the target letters (u/v in Experiment 1 and i/j in Experiment 2; e.g., nevtral–NEUTRAL). For comparison purposes, we included an identity prime condition (neutral–NEUTRAL) and a dissimilar-letter prime condition (neztral-NEUTRAL). Results showed that the similar-letter prime condition produced faster word identification times than the dissimilar-letter prime condition. We discuss how models of written-word recognition should be amended to capture visual similarity effects across letters.     

Varieties of alexia from fusiform, posterior inferior temporal and posterior occipital gyrus lesions

Reading impairments of three alexia patients, two pure alexia and one alexia with agraphia, due to different lesions were examined quantitatively, using Kanji (Japanese morphogram) words, Kana (Japanese phonetic writing) words and Kana nonwords. Kana nonword reading was impaired in all three patients, suggesting that widespread areas in the affected occipital and occipitotemporal cortices were recruited in reading Kana characters (corresponding to European syllables). In addition, the findings in patient 1 (pure alexia for Kanji and Kana from a fusiform and lateral occipital gyri lesion) and patient 2 (pure alexia for Kana from a posterior occipital gyri lesion) suggested that pure alexia could be divided into two types, i.e. ventromedial type in which whole-word reading, together with letter identification, is primarily impaired because of a disconnection of word-form images from early visual analysis, and posterior type in which letter identification is cardinally impaired. Another type of alexia, alexia with agraphia for Kanji from a posterior inferior temporal cortex lesion (patient 3), results from deficient whole-word images of words per se, and thus should be designated "orthographic alexia with agraphia". To account for these impairments, a weighted dual-route hypothesis for reading is suggested.     

The effect of age of acquisition in visual word processing: further evidence for the semantic hypothesis

The authors investigated whether the meaning of visually presented words is activated faster for early-acquired words than for late-acquired words. They addressed the issue using the semantic Simon paradigm. In this paradigm, participants are instructed to decide whether a stimulus word is printed in uppercase or lowercase letters. However, they have to respond with a verbal label ("living" or "nonliving") that is either congruent with the meaning of the word (e.g., saying "living" to the stimulus DOG) or incongruent (e.g., saying "nonliving" to the stimulus dog). Results showed a significant congruency effect that was stronger for early-acquired words than for late-acquired words. The authors conclude that the age of acquisition is an important variable in the activation of the meaning of visually presented words.     

Parafoveal and foveal processing of abbreviations during eye fixations in reading: making a case for case

The processing of abbreviations in reading was examined with an eye movement experiment. Abbreviations were of 2 distinct types: acronyms (abbreviations that can be read with the normal grapheme-phoneme correspondence [GPC] rules, such as NASA) and initialisms (abbreviations in which the GPCs are letter names, such as NCAA). Parafoveal and foveal processing of these abbreviations was assessed with the use of the boundary change paradigm (K. Rayner, 1975). Using this paradigm, previews of the abbreviations were either identical to the abbreviation (NASA or NCAA), orthographically legal (NUSO or NOBA), or illegal (NRSB or NRBA). The abbreviations were presented as capital letter strings within normal, predominantly lowercase sentences and also sentences in all capital letters such that the abbreviations would not be visually distinct. The results indicate that acronyms and initialisms undergo different processing during reading and that readers can modulate their processing based on low-level visual cues (distinct capitalization) in parafoveal vision. In particular, readers may be biased to process capitalized letter strings as initialisms in parafoveal vision when the rest of the sentence is normal, lowercase letters.     

Selective alexia and agraphia sparing numbers-a case study

We report a patient (MT) with a highly specific alexia affecting the identification of letters and words but not numbers. He shows a corresponding deficit in writing: his letter writing is impaired while number writing and written calculation is spared. He has no aphasia, no visuo-perceptual or -constructional difficulties, or other cognitive deficits. A similar pattern of performance has to our knowledge only been reported once before [Anderson, S. W., Damasio, A. R., & Damasio, H. (1990). Troubled letters but not numbers. Domain specific cognitive impairments following focal damage in frontal cortex. Brain, 113, 749-766]. This study shows that letter and number reading are dependent on dissociable processes. More interestingly, it points to a common mechanism subserving the perception and production of letters. We suggest that a deficit in a visuo-motor network containing knowledge of the physical shape of letters might explain the pattern of performance displayed by MT.     

Improving perception of letters and visual structure of language.

Information about letters and the physical structure of language printed in Roman characters was given to children beginning to read. Experimental investigations coupled three alternative graphic modes of printing upper- and lower-case letters with an instructional intervention termed "Alpha-Beta" which provides practice in letter sorting, matching of letters, associative matching, and memory matching. In respect to graphics, Mode A letters were in standard alphabet form. Mode B provided standard letters with each backed by a unique half-tone (Visually Stippled Alphabet); Mode C provided standard letters with each backed by a unique visual texture (Visually Patterned Alphabet). Pre-posttest change in reading readiness was measured using the Metropolitan Readiness Test. In the first study 224 English-speaking 5- to 6-yr.-old children were tested. In the second there were 158 Spanish-speaking girls and boys 6 to 7 years old. It was predicted that Alpha-Beta intervention involving visually patterned alphabet would lead to the greatest increases in readiness scores. This is confirmed in both studies for children low in reading readiness preexperiment. Children high in reading readiness are less affected. The second experiment involved Spanish-speaking children and investigated intervention by Alpha-Beta against a no-intervention control. This confirms the value of Alpha-Beta per se. Possible explanations for the improvements are identified.     

Rapid word identification in pure alexia is lexical but not semantic

Following the notion that patients with pure alexia have access to two distinct reading strategies-letter-by-letter reading and semantic reading-a training program was devised to facilitate reading via semantics in a patient with pure alexia. Training utilized brief stimulus presentations and required category judgments rather than explicit word identification. The training was successful for trained words, but generalized poorly to untrained words. Additional studies involving oral reading of nouns and of functors also resulted in improved reading of trained words. Pseudowords could not be trained to criterion. The results suggest that improved reading can be achieved in pure alexia by pairing rapidly presented words with feedback. Focusing on semantic processing is not essential to this process. It is proposed that the training strengthens connections between the output of visual processing and preexisting orthographic representations.     

Visual similarity effects in immediate verbal serial recall

The role of visual working memory in temporary serial retention of verbal information was examined in four experiments on immediate serial recall of words that varied in visual similarity and letters that varied in the visual consistency between upper and lower case. Experiments 1 and 2 involved words that were either visually similar (e.g. fly, cry, dry; hew, new, few ) or were visually distinct (e.g. guy, sigh, lie; who, blue, ewe ). Experiments 3 and 4 involved serial recall of both letter and case from sequences of letters chosen such that the upper- and lower-case versions were visually similar, for example Kk, Cc, Zz, Ww , or were visually dissimilar, for example Dd, Hh, Rr, Qq . Hence in the latter set, case informationwas encoded interms of both the shape and the size of the letters. With both words and letters, the visually similar items resulted in poorer recall both with and without concurrent articulatory suppression. This visual similarity effect was robust and was replicated across the four experiments. The effect was not restricted to any particular serial position and was particularly salient in the recall of letter case. These data suggest the presence of a visual code for retention of visually presented verbal sequences in addition to a phonological code, and they are consistent with the use of a visual temporary memory, or visual "cache", in verbal serial recall tasks.     

Phonological alexia with optic and tactile anomia: a neuropsychological and anatomical study

We describe a patient with phonological alexia caused by a small hemorrhage in the posterior-inferior portion of the left temporal lobe. The lesion induced a highly selective impairment of phonological reading without concomitant oral language deficits other than anomia for objects presented in the visual and tactile modalities. We propose that an intact dorsal pathway from inferior visual association areas to Wernicke's area via the angular gyrus could mediate reading by the lexical route, while damage to a ventral pathway disrupted the patient's ability to read nonwords. We suggest further that although visually and tactually presented objects could be recognized and both verbally and nonverbally identified, they could not be named because of a disconnection from the area of word representations.     

Vocalization-at-presentation and immediate recall, with varying presentation-rates

An experiment is reported in which the subject read visually presented lists with four different degrees of vocalization; immediately after reading each list he was required to reproduce it either aloud or in writing. Each list consisted of eight consonants and presentation rates were varied between I and 4 letters per sec. For any given series of lists, the subject was asked either to read the letters silently, or to mouth them silently, or to whisper them, or to say them aloud while reading.

At the fastest presentation-rate immediate recall improved monotonically with the degree of vocalization during reading of the lists; at slower rates this generalization held less well, especially for the lower degrees of vocalization. Vocalization was most helpful at the highest presentation-rate.

The overall amount correctly recalled was better for more slowly presented lists and for written as opposed to spoken recall. Analysis of the errors suggested that acoustic confusions were affected by the conditions of presentation; and that serial order intrusions were independent of presentation-or recall-conditions. An apparent variation of transpositions with voicing-and-recall-method failed to reach statistical significance. Theoretical implications of the experiment are discussed, including reference to Broadbent's theory of short-term memory (1958).     

Errors resembling semantic paralexias in Spanish-speaking aphasics.

Forty-one Spanish-speaking left-hemisphere-damaged patients were selected and divided into seven groups (transcortical, Broca's aphasia, conduction aphasia, Wernicke's aphasia, anomic aphasia, alexia without agraphia, and global aphasia). A reading battery composed of eight different subtests was given to each patient (reading of letters, reading of syllables, reading of pseudowords, reading of words, reading of sentences, understanding commands, reading and comprehension of texts, and logographic reading). Different types of reading errors were analyzed. Only in the logographic reading subtest were some word-recognition errors found, resembling semantic paralexias. It is proposed that semantic paralexias in English (and other languages) depend upon the partial logographic nature of the reading system. The importance of cross-linguistic analysis of reading errors, taking into account reading system idiosyncracies, is emphasized.     

Preserved Semantic Priming Effect in Alexia

BH, a left-handed patient with alexia and nonfluent aphasia, was presented with a lexical-decision task in which words and pronounceable pseudowords were preceded by semantically related or unrelated picture primes (Experiment 1). In Experiment 2, BH was given an explicit reading task using the word lists from Experiment 1. Performance on Experiment 2 disclosed severe reading deficits in both oral reading and semantic matching of the words to pictures. However, in Experiment 1, BH demonstrated a significant semantic priming effect, responding more accurately and more quickly to words preceded by related primes than by unrelated primes. The present results suggest that even in a patient with severe alexia, implicit access to semantic information can be preserved in the absence of explicit identification. The possibility of categorical gradient in implicit activation (living vs. nonliving) in BH was also discussed, which, however, needs to be clarified in the further investigation.     

Visual constraints in reading: evidence from non-ocular behaviour

On-line evidence of visual constraints in reading is reported for measures other than eye behaviour. Text was read from a CRT using a moving window between 6 and 19 characters wide, with letters outside the window replaced by blanks, dashes, or visually similar letters. Reading speed was self-adjusted; subjects performed a subsidiary task while reading aloud. Window width and the visual context beyond the window affected dual task performance, and together with fount size, also reading accuracy. The form of text background further affected two measures of eye-voice span. These findings complement ones for ocular behaviour obtained using a CRT window coordinated with a reader's eye fixations.     

Time,space, and memory for order

Information about the order of items in a sequence can be conveyed either spatially or temporally. In the present investigation, we examined whether these different modes of presentation map onto compatible mental representations of serial order. We examined this issue in three immediate serial-recall experiments, in which participants recalled lists of letters in the temporal order in which they had appeared. Each letter in a to-be-remembered sequence was presented in a unique spatial position, with the order of these spatial positions progressing from either left to right or right to left. In this way, the visually presented lists contained both temporal and spatial order information. Recall of the temporal order information was more accurate with congruent spatial order information—that is, when the letters progressed from left to right, following the typical reading direction of English—than when the spatial order information was incongruent. These results suggest compatible representations of serial order when sequences are conveyed spatially and temporally.     

Effects of parafoveal word length and orthographic features on initial fixation landing positions in reading

Previous research has demonstrated that readers use word length and word boundary information in targeting saccades into upcoming words while reading. Previous studies have also revealed that the initial landing positions for fixations on words are affected by parafoveal processing. In the present study, we examined the effects of word length and orthographic legality on targeting saccades into parafoveal words. Long (8?C9 letters) and short (4?C5 letters) target words, which were matched on lexical frequency and initial letter trigram, were paired and embedded into identical sentence frames. The gaze-contingent boundary paradigm (Rayner, 1975) was used to manipulate the parafoveal information available to the reader before direct fixation on the target word. The parafoveal preview was either identical to the target word or was a visually similar nonword. The nonword previews contained orthographically legal or orthographically illegal initial letters. The results showed that orthographic preprocessing of the word to the right of fixation affected eye movement targeting, regardless of word length. Additionally, the lexical status of an upcoming saccade target in the parafovea generally did not influence preprocessing.