Letter position dyslexia in Arabic: from form to position

This study reports the reading of 11 Arabic-speaking individuals with letter position dyslexia (LPD), and the effect of letter form on their reading errors. LPD is a peripheral dyslexia caused by a selective deficit to letter position encoding in the orthographic-visual analyzer, which results in migration of letters within words, primarily of middle letters. The Arabic orthography is especially interesting for the study of LPD because Arabic letters have different forms in different positions in the word. As a result, some letter position errors require letter form change. We compared the rate of letter migrations that change letter form with migrations that do not change letter form in 10 Arabic-speaking individuals with developmental LPD, and one bilingual Arabic and Hebrew-speaking individual with acquired LPD. The results indicated that the participants made 40% letter position errors in migratable words when the resulting word included the letters in the same form, whereas migrations that changed letter form almost never occurred. The error rate of the Arabic-Hebrew bilingual reader was smaller in Arabic than in Hebrew. However, when only words in which migrations do not change letter form were counted, the rate was similar in Arabic and Hebrew. Hence, whereas orthographies with multiple letter forms for each letter might seem more difficult in some respects, these orthographies are in fact easier to read in some forms of dyslexia. Thus, the diagnosis of LPD in Arabic should consider the effect of letter forms on migration errors, and use only migratable words that do not require letter-form change. The theoretical implications for the reading model are that letter form (of the position-dependent type found in Arabic) is part of the information encoded in the abstract letter identity, and thus affects further word recognition processes, and that there might be a pre-lexical graphemic buffer in which the checking of orthographic well-formedness takes place.     

Developmental letter position dyslexia

Letter position dyslexia (LPD) is a peripheral dyslexia that causes errors of letter order within words. So far, only cases of acquired LPD have been reported. This study presents selective LPD in its developmental form, via the testing of 11 Hebrew‐speaking individuals with developmental dyslexia. The study explores the types of errors and effects on reading in this dyslexia, using a variety of tests: reading aloud, lexical decision, same‐different decision, definition and letter naming. The findings indicate that individuals with developmental LPD have a deficit in the letter position encoding function of the orthographic visual analyser, which leads to underspecification of letter position within words. Letter position errors occur mainly in adjacent middle letters, when the error creates another existing word. The participants did not show an output deficit or phonemic awareness deficit. The selectivity of the deficit, causing letter position errors but no letter identity errors and no migrations between words, supports the existence of letter position encoding function as separate from letter identification and letter‐to‐word binding.     

Patterns of visual dyslexia

This study reports two Hebrew-speaking individuals with acquired visual dyslexia. They made predominantly visual errors in reading, in all positions of the target words. Although both of them produced visual errors, their reading patterns crucially differed in three respects. KD had almost exclusively letter substitutions, and SF also made letter omissions, additions, letter position errors, and between-word migrations. KD had difficulties accessing abstract letter identity in single-letter tasks, and in letter naming, unlike SF, who named letters well. KD did not show lexical effects such as frequency and orthographic neighbourhood effects and produced nonword responses, whereas SF showed lexical effects, with a strong tendency to produce word responses. We suggest that these two patterns stem from two different deficits - KD has letter identity visual dyslexia, which results from a deficit in abstract letter identification in the orthographic-visual analysis system, yielding erroneous letter identities, whereas SF has visual-output dyslexia, which results from a deficit at a later stage, a stage that combines the outputs of the various functions of the orthographic-visual analyzer.     

Positional dyslexia

Position-specific errors in word reading are usually associated with neglect or visual extinction on the same side as the reading problem. In this study, two patients with left-hemisphere lesions showed visual extinction on the right but reading difficulty on the left side of words and pseudowords. Further study of one patient revealed that he also had problems reading the beginning of words presented tachistoscopically or in vertical orientation. In addition, the positional difficulty was apparent when he named the letters in words. The pattern of results indicates that the positional dyslexia in these patients was not likely attributable to general deficits in visual perception or attention but may have reflected a disorder at a later stage of letter processing.     

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.     

How to make the word-length effect disappear in letter-by-letter dyslexia: implications for an account of the disorder

The diagnosis of letter-by-letter (LBL) dyslexia is based on the observation of a substantial and monotonic increase of word naming latencies as the number of letters in the stimulus increases. This pattern of performance is typically interpreted as indicating that word recognition in LBL dyslexia depends on the sequential identification of individual letters. We show, in 7 LBL patients, that the word-length effect can be eliminated if words of different lengths are matched on the sum of the confusability (visual similarity between a letter and the remainder of the alphabet) of their constituent letters. Additional experiments demonstrate that this result is mediated by parallel letter processing and not by any compensatory serial processing strategy. These findings indicate that parallel processing contributes significantly to explicit word recognition in LBL dyslexia and that a letter-processing impairment is fundamental in causing the disorder.     

No deficiency in left-to-right processing of words in dyslexia but evidence for enhanced visual crowding

Whitney and Cornelissen hypothesized that dyslexia may be the result of problems with the left-to-right processing of words, particularly in the part of the word between the word beginning and the reader's fixation position. To test this hypothesis, we tachistoscopically presented consonant trigrams in the left and the right visual field (LVF, RVF) to 20 undergraduate students with dyslexia and 20 matched controls. The trigrams were presented at different locations (from –2.5° to?+?2.5°) in both visual half fields. Participants were asked to identify the letters, and accuracy rates were compared. In line with the predictions of the SERIOL (sequential encoding regulated by inputs to oscillations within letter units) model of visual word recognition, a typical U-shaped pattern was found at all retinal locations. Accuracy also decreased the further away the stimulus was from the fixation location, with a steeper decrease in the LVF than in the RVF. Contrary to the hypothesis, the students with dyslexia showed the same pattern of results as did the control participants, also in the LVF, apart from a slightly lower accuracy rate, particularly for the central letter. The latter is in line with the possibility of enhanced crowding in dyslexia. In addition, in the dyslexia group but not in the control group the degree of crowding correlated significantly with the students’ word reading scores. These findings suggest that lateral inhibition between letters is associated with word reading performance in students with dyslexia.     

Orthographic effects in the word substitutions of aphasic patients: an epidemic of right neglect dyslexia?

Aphasic patients with reading impairments frequently substitute incorrect real words for target words when reading aloud. Many of these word substitutions have substantial orthographic overlap with their targets and are classified as "visual errors" (i.e., sharing 50% of targets' letters in the same relative position). Fifteen chronic aphasic patients read a battery of words and non-words; non-word reading was poor for all patients, and more than 50% of errors on words involved the substitution of a non-target word. An investigation of the factors conditioning these word substitutions, as well as the production of visual errors, identified a number of similarities to patterns previously reported for patients with right neglect dyslexia, which has been said to occur relatively rarely. These included a strong tendency for errors to overlap targets in initial letter positions, maintenance of target length in errors, and the substitution of words higher in imageability than targets. It is proposed that left hemisphere damage frequently leads to disruption of a level of representation for written words in which letter position is ordinally coded, resulting in exacerbation of a normal processing advantage for early letter positions. A computational model is discussed that incorporates this level of representation and successfully simulates relevant normal and patient data.     

The role of visual spatial attention in adult developmental dyslexia

The present study investigated the nature of visual spatial attention deficits in adults with developmental dyslexia, using a partial report task with five-letter, digit, and symbol strings. Participants responded by a manual key press to one of nine alternatives, which included other characters in the string, allowing an assessment of position errors as well as intrusion errors. The results showed that the dyslexic adults performed significantly worse than age-matched controls with letter and digit strings but not with symbol strings. Both groups produced W-shaped serial position functions with letter and digit strings. The dyslexics' deficits with letter string stimuli were limited to position errors, specifically at the string-interior positions 2 and 4. These errors correlated with letter transposition reading errors (e.g., reading slat as “salt”), but not with the Rapid Automatized Naming (RAN) task. Overall, these results suggest that the dyslexic adults have a visual spatial attention deficit; however, the deficit does not reflect a reduced span in visual–spatial attention, but a deficit in processing a string of letters in parallel, probably due to difficulty in the coding of letter position.     

Lexical processes and eye movements in neglect dyslexia

Neglect dyslexia is a disturbance in the allocation of spatial attention over a letter string following unilateral brain damage. Patients with this condition may fail to read letters on the contralesional side of an orthographic string. In some of these cases, reading is better with words than with non-words. This word superiority effect has received a variety of explanations that differ, among other things, with regard to the spatial distribution of attention across the letter string during reading. The primary goal of the present study was to explore the interaction between attention and lexical processes by recording eye movements in a patient (F.C.) with severe left neglect dyslexia who was required to read isolated word and non-word stimuli of various length. F.C.'s ocular exploration of orthographic stimuli was highly sensitive to the lexical status of the letter string. We found that: (1) the location to which F.C. directed his initial saccade (obtained approximately 230 ms post-stimulus onset) differed between word and non-word stimuli; (2) the patient spent a greater amount of time fixating the contralesional side of word than non-word strings. Moreover, we also found that F.C. failed to identify the left letters of a string despite having fixated them, thus showing a clear dissociation between eye movement responses and conscious access to orthographic stimuli. Our data suggest the existence of multiple interactions between lexical, attentional and eye movement systems that occur from very initial stages of visual word recognition.     

The timing deficit hypothesis of dyslexia and its implications for Hebrew reading

Vast amounts of neuropsychological evidence have been collected in recent years in support of the hypothesis that developmental dyslexia is caused not only by phonological deficits, but also by timing deficits that affect all senses (e.g., Tallal, Miller, & Fitch, 1995; Stein & Walsh, 1997). In parallel, recent developments in the study of Hebrew reading place heavy emphasis on root awareness in the mental lexicon and early root extraction in the process of word identification (e.g., Frost, Forster, & Deutch, 1997). The present study creates a link between the timing hypothesis and the special demands of Hebrew reading. The performance of dyslexics and normally reading children is compared on tasks requiring visual extraction of trigrams that approximates extracting roots out of Hebrew words. Partial findings show that dyslexics take longer and make more errors while performing trigram extractions on all levels examined, and that sequentiality in the task affects dyslexics and skilled readers in different ways.     

An unusual case of dyslexia with dysgraphia

A 63 year old lady suffered dense right homonymous hemianopia, severe dyslexia and dysmorphic and dysphasic dysgraphia for single letters, short words and text. By contrast, she matched these same words from dictation to visually presented word and picture choices, spelled aloud words dictated to her, and named aloud words dictated to her in spelled form.The findings bear on the unsettled issue of lesion site in the syndrome, and prove exception to the ‘bi-directional’ disconnection hypothesis. The use of such tests in other cases may prove these findings common in the syndrome of dyslexia and dysgraphia.     

Neuropsychological evidence for case-specific reading: Multi-letter units in visual word recognition

We describe a patient (GK) who shows symptoms associated with Balint's syndrome and attentional dyslexia. GK was able to read words, but not nonwords. He also made many misidentification and mislocation errors when reporting letters in words, suggesting that his word-naming ability did not depend upon preserved position-coded, letter identification. We show that GK was able to read lower-case words better than upper-case words, but upper-case abbreviations better than lower-case abbreviations. Spacing the letters in abbreviations disrupted identification, as did mixing the case of letters within words. These data cannot be explained in terms of letter-based reading or preserved holistic word recognition. We propose that GK was sensitive to the visual familiarity of adjacent letter forms.     

Lesioning an attractor network: investigations of acquired dyslexia

A recurrent connectionist network was trained to output semantic feature vectors when presented with letter strings. When damaged, the network exhibited characteristics that resembled several of the phenomena found in deep dyslexia and semantic-access dyslexia. Damaged networks sometimes settled to the semantic vectors for semantically similar but visually dissimilar words. With severe damage, a forced-choice decision between categories was possible even when the choice of the particular semantic vector within the category was not possible. The damaged networks typically exhibited many mixed visual and semantic errors in which the output corresponded to a word that was both visually and semantically similar. Surprisingly, damage near the output sometimes caused pure visual errors. Indeed, the characteristic error pattern of deep dyslexia occurred with damage to virtually any part of the network.     

New evidence for morphological errors in deep dyslexia

Morphological errors in reading aloud (e.g., sexist-->sexy) are a central feature of the symptom-complex known as deep dyslexia, and have historically been viewed as evidence that representations at some level of the reading system are morphologically structured. However, it has been proposed (Funnell, 1987) that morphological errors in deep dyslexia are not morphological in nature but are actually a type of visual error that arises when a target word that cannot be read aloud (by virtue of its low imageability and/or frequency) is modified to form a visually similar word that can be read aloud (by virtue of its higher imageability and/or frequency). In the work reported here, the deep dyslexic patient DE read aloud lists of genuinely suffixed words (e.g., killer), pseudosuffixed words (e.g., corner), and words with non-morphological embeddings (e.g., cornea). Results revealed that the morphological status of a word had a significant influence on the production of stem errors (i.e., errors that include the stem or pseudostem of the target): genuinely suffixed words yielded more stem errors than pseudosuffixed words or words with non-morphological embeddings. This effect of morphological status could not be attributed to the relative levels of target and stem imageability and/or frequency. We argue that this pattern of data indicates that apparent morphological errors in deep dyslexic reading are genuinely morphological, and discuss the implications of these errors for theories of deep dyslexia.     

Word associations in deep dyslexia

Deep dyslexia is an acquired reading disorder resulting in the production of semantic errors during oral reading and an inability to read aloud nonwords. Several researchers have postulated that patients with deep dyslexia have both phonological and semantic access impairments but the data supporting these claims are not convincing. In fact, the hallmark feature of deep dyslexia--the semantic errors--strongly implies that these patients can access semantic information from printed words. We test the integrity of the semantic system in two such patients through auditory and visual word association tasks. The data support the notion that semantics remains intact and that the disorder and associated errors arise through a selection impairment related to failure of inhibitory connections in the phonological lexicon.     

Orthographic structure versus morphological structure: principles of lexical organization in a given language

Most models of visual word recognition in alphabetic orthographies assume that words are lexically organized according to orthographic similarity. Support for this is provided by form-priming experiments that demonstrate robust facilitation when primes and targets share similar sequences of letters. The authors examined form-orthographic priming effects in Hebrew, Arabic, and English. Hebrew and Arabic have an alphabetic writing system but a Semitic morphological structure. Hebrew morphemic units are composed of noncontiguous phonemic (and letter) sequences in a given word. Results demonstrate that form-priming effects in Hebrew or Arabic are unreliable, whereas morphological priming effects with minimal letter overlap are robust. Hebrew bilingual subjects, by contrast, showed robust form-priming effects with English material, suggesting that Semitic words are lexically organized by morphological rather than orthographic principles. The authors conclude that morphology can constrain lexical organization even in alphabetic orthographies and that visual processing of words is first determined by morphological characteristics.     

The role of Hebrew letter names in early literacy: the case of multiphonemic acrophonic names

English-speaking children spell letters correctly more often when the letters' names are heard in the word (e.g., B in beach vs. bone). Hebrew letter names have been claimed to be less useful in this regard. In Study 1, kindergartners were asked to report and spell initial and final letters in Hebrew words that included full (CVC), partial (CV), and phonemic (C) cues derived from these letter names (e.g., kaftor, kartis, kibepsilonl, spelled with /kaf/). Correct and biased responses increased with length of congruent and incongruent cues, respectively. In Study 2, preschoolers and kindergartners were asked to report initial letters with monosyllabic or disyllabic names (e.g., /kaf/ or /samepsilonx/, respectively) that included the cues described above. Correct responses increased with cue length; the effect was stronger with monosyllabic letter names than with disyllabic letter names, probably because the cue covered a larger ratio of the letter name. Phonological awareness was linked to use of letter names.     

Cambridge University versus Hebrew University: The impact of letter transposition on reading English and Hebrew

Is reading similarly affected by letter transposition in all alphabetic orthographies? “The Cambridge University effect,” demonstrating that jumbled letters have little effect on reading, was examined using rapid serial visual presentation (RSVP) in English and in Hebrew. Hebrew-English bilinguals were presented sentences in both languages containing words with transposed letters. Sentences were presented rapidly on the screen word by word, and participants had to reproduce the sequence of words perceived. We found a marked difference in the effect of transpositions in the two languages. In English, transpositions had little effect on performance, whereas in Hebrew, performance deteriorated dramatically for words with transposed letters. The differential effects of transposition are accounted for by the difference in lexical organization in Hebrew and in English, suggesting that models of reading in alphabetic orthographies may be language specific.