Acquired surface alexia in Spanish: a case report

This paper reports a case study of acquired surface alexia in Spanish and discusses the most suitable tests to detect this syndrome in a writing system that is very regular for reading at the segmental and supra-segmental levels. Patient MM has surface alexia characterized by quantitatively good performance in reading words and pseudowords; accurate but slow and syllabic reading of words, nonwords and sentences; good performance in lexical decision tasks including words and nonwords; errors in lexical decision with pseudohomophones; and homophone confusions. This pattern of reading can be interpreted as a disorder in the lexical reading route and overdependence on the non-lexical route. We discuss nonlexical impairments and the interpretation of alexia and suggest tasks to identify surface alexia in a shallow orthography.     

Age-of-acquisition effects in pure alexia

Pure alexia is an acquired reading disorder in which previously literate adults adopt a letter-by-letter processing strategy. Though these individuals display impaired reading, research shows that they are still able to use certain lexical information in order to facilitate visual word processing. The current experiment investigates the role that a word's age of acquisition (AoA) plays in the reading processes of an individual with pure alexia (G.J.) when other lexical variables have been controlled. Results from a sentence reading task in which eye movement patterns were recorded indicated that G.J. shows a strong effect of AoA, where late-acquired words are more difficult to process than early-acquired words. Furthermore, it was observed that the AoA effect is much greater for G.J. than for age-matched control participants. This indicates that patients with pure alexia rely heavily on intact top-down information, supporting the interactive activation model of reading.     

Age-of-acquisition effects in pure alexia

Pure alexia is an acquired reading disorder in which previously literate adults adopt a letter-by-letter processing strategy. Though these individuals display impaired reading, research shows that they are still able to use certain lexical information in order to facilitate visual word processing. The current experiment investigates the role that a word's age of acquisition (AoA) plays in the reading processes of an individual with pure alexia (G.J.) when other lexical variables have been controlled. Results from a sentence reading task in which eye movement patterns were recorded indicated that G.J. shows a strong effect of AoA, where late-acquired words are more difficult to process than early-acquired words. Furthermore, it was observed that the AoA effect is much greater for G.J. than for age-matched control participants. This indicates that patients with pure alexia rely heavily on intact top-down information, supporting the interactive activation model of reading.     

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.     

Can treatment for pure alexia improve letter-by-letter reading speed without sacrificing accuracy?

An experimental treatment study designed to improve both the accuracy and the speed of reading was administered to a patient with pure alexia and impaired letter naming. The study focused on the use of letter-by-letter reading. A two-stage approach was employed. The first stage implemented a tactile-kinesthetic strategy to improve accuracy. The second stage concentrated on speed. At the end of the treatment, patient DL was reading both trained and untrained words more accurately and with considerably greater speed than prior to treatment. Accuracy and speed of reading at the sentence level improved as well.     

The roles of family history of dyslexia,language, speech production and phonological processing in predicting literacy progress

It is well established that speech, language and phonological skills are closely associated with literacy, and that children with a family risk of dyslexia (FRD) tend to show deficits in each of these areas in the preschool years. This paper examines what the relationships are between FRD and these skills, and whether deficits in speech, language and phonological processing fully account for the increased risk of dyslexia in children with FRD. One hundred and fifty‐three 4–6‐year‐old children, 44 of whom had FRD, completed a battery of speech, language, phonology and literacy tasks. Word reading and spelling were retested 6 months later, and text reading accuracy and reading comprehension were tested 3 years later. The children with FRD were at increased risk of developing difficulties in reading accuracy, but not reading comprehension. Four groups were compared: good and poor readers with and without FRD. In most cases good readers outperformed poor readers regardless of family history, but there was an effect of family history on naming and nonword repetition regardless of literacy outcome, suggesting a role for speech production skills as an endophenotype of dyslexia. Phonological processing predicted spelling, while language predicted text reading accuracy and comprehension. FRD was a significant additional predictor of reading and spelling after controlling for speech production, language and phonological processing, suggesting that children with FRD show additional difficulties in literacy that cannot be fully explained in terms of their language and phonological skills.     

Differential Effects of Two Spelling Procedures on Acquisition,Maintenance and Adaption to Reading

An alternating treatments design was used to assess the effects of a constant time delay (CTD) procedure and a cover-copy-compare (CCC) procedure on three students’ acquisition, subsequent maintenance, and adaptation (i.e., application) of acquired spelling words to reading passages. Students were randomly presented two trials of word lists from their respective curriculum under each condition once daily. Results suggest that both procedures were effective for helping students efficiently acquire spelling words, but the CCC condition resulted in more words learned for all participants, although less pronounced when instructional time was considered. However, the CTD procedure resulted in substantially higher levels of maintenance for Jeremy and Leon, with no significant difference between the two procedures for the Anthony. Adaptation of acquired spelling words to reading was about equal under both conditions for Anthony and Leon, while Jeremy showed higher levels of performance in the CTD procedure. Discussion focuses on discrepant results, matching instructional procedures to specific learning concerns, and directions for future research.     

A longitudinal study of children's text messaging and literacy development

Recent studies have shown evidence of positive concurrent relationships between children's use of text message abbreviations ('textisms') and performance on standardized assessments of reading and spelling. This study aimed to determine the direction of this association. One hundred and nineteen children aged between 8 and 12 years were assessed on measures of general ability, reading, spelling, rapid phonological retrieval, and phonological awareness at the beginning and end of an academic year. The children were also asked to provide a sample of the text messages that they sent over a 2-day period. These messages were analyzed to determine the extent to which textisms were used. It was found that textism use at the beginning of the academic year was able to predict unique variance in spelling performance at the end of the academic year after controlling for age, verbal IQ, phonological awareness, and spelling ability at the beginning of the year. When the analysis was reversed, reading and spelling ability were unable to predict unique variance in textism usage. These data suggest that there is some evidence of a causal contribution of textism usage to spelling performance in children aged 8-12 years. However, when the measure of rapid phonological retrieval (rapid picture naming) was controlled in the analysis, the relationship between textism use and spelling ability just failed to reach statistical significance, suggesting that phonological access skills may mediate some of the relationship between textism use and spelling performance.     

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.     

Units of English spelling‐to‐sound mapping: a rational approach to reading instruction

In this paper a rationale for choosing how many and what types of spelling‐to‐sound units of English to teach children to learn to read is introduced. The rationale is based on an analysis of the frequency with which various units of spelling‐to‐sound mapping occur in monosyllabic words of the English language. Analysis of spelling‐to‐sound mappings at three levels (whole words, onsets and rimes and graphemes) reveals that the distribution of these mappings in English text approximates Zipf's Law. Further analyses reveal that a substantial proportion of text can be read if knowledge of the most frequent mappings at each level is assumed. It is suggested that viewing reading from this perspective can be useful in developing reading instruction so that children are taught information that is most useful in achieving the endpoint of learning to read. Copyright © 2007 John Wiley & Sons, Ltd.     

Selective uppercase dysgraphia with loss of visual imagery of letter forms: a window on the organization of graphomotor patterns

We report a patient who, after a left parieto-occipital lesion, showed alexia and selective dysgraphia for uppercase letters. He showed preserved oral spelling, associated with handwriting impairment in all written production; spontaneous writing, writing to dictation, real words, pseudowords, and single letters were affected. The great majority of errors were well-formed letter substitutions: most of them were located on the first position of each word, which the patient always wrote in uppercase (as he used to do before his illness). The patient also showed a complete inability to access the visual representation of letters. As demonstrated by a stroke segmentation analysis, letter substitutions followed a rule of graphomotor similarity. We propose that the patient's impairment was at the stage where selection of the specific graphomotor pattern for each letter is made and that the apparent selective disruption of capital case was due to a greater stroke similarity among letters belonging to the same case. We conclude that a visual format is necessary neither for spelling nor for handwriting.     

When children write nonwords to dictation

Skill in written spelling of simple, monosyllabic nonwords was investigated in 9- to 11-year-old English children. Two aspects of their spellings were of interest: first, could they spell these nonwords so that they sounded correct (nonword spelling accuracy), and second, did their spellings show evidence of biasing from words heard earlier in the test sequence? Nonword spelling was poorer for children of this age than for tested adults. Nevertheless, significant biasing occurred in these children's spellings, though not to the same extent as in adults' nonword spellings, and significant correlations emerged between reading age, nonword spelling skill, susceptibility to biasing, and real word spelling skill. Children with a reading age greater than 11 years showed biasing from word spellings that was within range of that reported for adults, and, for these more skilled readers, word spelling accuracy correlated significantly with both susceptibility to biasing and with nonword spelling accuracy. These children were not as accurate as tested adults at spelling nonwords. Children with a reading age below 11 years were poorer at nonword spelling and showed no overall biasing, yet they also showed a significant correlation between word spelling skill and nonword biasing. Together with evidence from the same task from adults with specific spelling disorders, these results suggest that word knowledge had a direct (biasing) and an indirect (general word spelling knowledge) effect on the performance of the nonword spelling task. But although skill in word spelling may be a necessary prerequisite for nonword spelling, it need not always be sufficient.     

Effects on spelling of training children to read

Experiment 1 investigated whether training subjects to read words aloud would induce correct written spelling of the words even though spelling had no experimental consequences. Training in reading was followed by a weak increment in correct spelling. Experiment 2 investigated whether overtraining in reading would improve spelling more. Spelling improved as overtraining continued until the subjects spelled all the words correctly. Experiments 3 and 4 investigated the components of overtraining responsible for this improvement in spelling. Initial training in reading followed by repeated opportunities to look at (but not say aloud) the printed words resulted in the same gradual improvement in spelling as seen in Experiment 2. The results were related to Skinner's theory of verbal behavior and to studies of the relationship between speaking and instruction-following in children.     

Spelling in Adults: The Combined Influences of Language Skills and Reading Experience

One hundred and twelve university students completed 7 tests assessing word-reading accuracy, print exposure, phonological sensitivity, phonological coding and knowledge of English morphology as predictors of spelling accuracy. Together the tests accounted for 71% of the variance in spelling, with phonological skills and morphological knowledge emerging as strong predictors of spelling accuracy for words with both regular and irregular sound-spelling correspondences. The pattern of relationships was consistent with a model in which, as a function of the learning opportunities that are provided by reading experience, phonological skills promote the learning of individual word orthographies and structural relationships among words.     

Invented Spelling,Word Stress,and Syllable Awareness in Relation to Reading Difficulties in Children

The study assessed the clinical utility of an invented spelling tool and determined whether invented spelling with linguistic manipulation at segmental and supra-segmental levels can be used to better identify reading difficulties. We conducted linguistic manipulation by using real and nonreal words, incorporating word stress, alternating the order of consonants and vowels, and alternating the number of syllables. We recruited 60 third-grade students, of which half were typical readers and half were poor readers. The invented spelling task consistently differentiated those with reading difficulties from typical readers. It explained unique variance in conventional spelling, but not in word reading. Word stress explained unique variance in both word reading and conventional spelling, highlighting the importance of addressing phonological awareness at the supra-segmental level. Poor readers had poorer performance when spelling both real and nonreal words and demonstrated substantial difficulty in detecting word stress. Poor readers struggled with spelling words with double consonants at the beginning and ending of words, and performed worse on spelling two- and three-syllable words than typical readers. Practical implications for early identification and instruction are discussed.     

Differential Competencies Contributing to Children's Comprehension of Narrative and Expository Texts

The purpose of this study was to examine the connections between the oral reading abilities and the spelling behaviors of third and fifth grade students. Seventy-two third graders and sixty fifth graders from two different schools (one urban and one suburban) were the subjects of the study. Each subject read a selection one level above his/her current grade placement, spelled the words on the appropriate grade level list of the Qualitative Inventory of Word Knowledge and took the appropriate level of the Gates-MacGinitie Reading Tests. Oral readings were scored for accuracy, rate and phrasing. Spellings were scored for accuracy, phonetic quality and stage of spelling development. These scores were then analyzed using correlations, partial correlations and multiple regression techniques. At both grade levels there were high, significant correlations between spelling and reading variables, with spelling variables accounting for from 40% to 60% of the variance in oral reading measures and a smaller, but still significant percentage of the variance when standardized test scores were used as a control. These results confirm a strong relationship between spelling skill and oral reading ability, supporting the argument that a common body of conceptual word knowledge underlies both.     

USING A DICTIONARY: ITS INFLUENCE ON CHILDREN'S READING,SPELLING, AND PHONOLOGY

The developing use of a dictionary has the potential to provide self-teaching opportunities to improve reading, spelling and general phonological skills. Children's dictionary use was examined in two studies to find out patterns of use, skill and frequency of use and the relationships between these and reading, spelling and phonological development. In the first study 39 poor readers were compared with two groups of average readers, one consisting of 39 younger average readers of the same reading age and the other group of 31 average readers matched by age. In the second study 241 children (7–11 years) were divided on the basis of being above or below 9 years in age to examine developmental change. In both studies levels of non-verbal IQ were controlled between groups. Tests of reading vocabulary, spelling, non-word reading and speed and accuracy in looking up words in a dictionary were given. Examining dictionary skills in poor readers showed that they were significantly slower and less accurate in looking up words in a dictionary than their age peers who were average readers. Patterns of dictionary use varied with age with younger readers being three times more likely to give first preference to using a dictionary to look up spellings, whereas older reader expressed a preference that was much more evenly divided between checking spelling and looking up for meaning. Poor readers were much closer to their age peers in pattern of use. Self-rated frequency of dictionary use correlated significantly with spelling skill only in the younger readers. Persuading younger children to use a dictionary more could develop their spelling skills, possibly by encouraging them to be more proactive.     

Surface dyslexia

Two cases of surface dyslexia are described. In this disorder, irregular words such as broad or steak are less likely to be read aloud correctly than regularly-spelled words like breed or steam; and when irregular words are misread the incorrect response is often a regularisation (reading broad as "brode" and steak as "steek, for example). When reading comprehension was tested, homophones were often confused with each other: for example, soar was understood as an instrument for cutting, and route was understood as being part of a tree. Spelling was also impaired, with the majority of spelling errors being phonologically correct: for example, "search" was spelled surch. "Orthographic" errors in reading aloud (omitting, altering, adding or transposing letters) were also noted. These errors were not due to defects at elementary levels of visual processing.

One of our cases was a developmental dyslexic, and the other was an acquired dyslexic. The close similarity of their reading and spelling performance supports the view that surface dyslexia can cccur both as a developmental and as an acquired dyslexia.

A theoretical interpretation of surface dyslexia within the framework of the logogen model (including a grapheme-phoneme correspondence system for reading non-words) was offered: defects within the input logogen system, and in communication from that system to semantics, were postulated as responsible for most of the symptoms of surface dyslexia.     

Recognizing orally spelled words: an analysis of procedures shared with reading and spelling

Some investigators have suggested that recognizing orally spelled words is dependent on the same procedures ordinarily used in spelling, whereas others have viewed it either as dependent on reading procedures or as an independent ability. In the present study, a single subject with dyslexia and dysgraphia was examined on parallel tests of recognizing orally spelled words, reading, and spelling (writing), and a comparison was made of his performance on the three tasks. On both words and nonwords, the patient's errors in recognizing orally spelled words and in reading were alike, whereas his spelling errors were often different. The distinction between recognizing orally spelled words and spelling was further shown by his inability to recognize a set of orally spelled words that he could write correctly to dictation or on the basis of word meaning. These findings suggest that the procedures normally used for reading can accept sequences of letter identities as input when orally spelled words must be recognized.     

The evolution of pure alexia: a longitudinal study of recovery

This case report documents the partial recovery, over a 12-month period, of pure alexia in an adult female following a left occipital infarction. Measures of speed and accuracy were obtained on an oral reading and a lexical decision task immediately postonset and then on 10 subsequent occasions. Explicit letter-by-letter reading was observed only during the first week poststroke but a significant effect of word length was seen in all testing sessions. Reading accuracy was relatively good at all stages and reading latency showed a remarkable decrease over time but did not reach normal reading rates. The inability to use higher-order orthographic knowledge, as manifest in the absence of a word superiority effect, was still noted at one year postonset. We therefore concluded that the change in behavior was attributable to increased proficiency in the use of the adaptive letter-by-letter procedure rather than to the resolution of the underlying deficit. It is suggested that longitudinal neurobehavioral studies add to our understanding of the alexic deficit and provide insight into the recovery process.