Can dyslexia be treated? Treatment-specific and generalized treatment effects in dyslexic children's response to remediation

A total of 178 reading disabled children were randomly assigned to one of three treatment conditions providing training in word recognition and decoding skills (DS), oral and written language (OWLS), or classroom survival skills (CSS. an alternative treatment control). Pre- and post-treatment comparisons on an array of standardized and experimental measures indicated that the two experimental treatments (DS, OWLS) resulted in improvement on selected tests significantly greater than that resulting from a third treatment intervention which controlled for treatment time and individual attention (CSS). Effects specific to each experimental treatment were identified, as well as some generalized treatment advantages shared by both experimental groups at post-test. These results indicate that some of the deficits associated with developmental dyslexia are amenable to treatment. Greater generalization of treatment effects was observed following the DS than the OWLS treatment. While DS-instructed children exhibited better word recognition skills, however, their knowledge of grapheme-phoneme correspondence rules was not improved. Several OWLS-specific effects observed on experimental reading and language measures were not replicated on standardized tests which purport to measure the same skills. These results are discussed with respect to (i) possible mechanisms by which disabled readers may acquire word recognition skills, (ii) their failure to acquire and use grapheme-phoneme correspondence rules, and (iii) a possible reduced tendency in the present population to generalize newly acquired specific knowledge to related knowledge domains.     

Written spelling agraphia

When a disorder of single word writing is seen in conjunction with preserved oral spelling and intact written grapheme formation ("written spelling agraphia"), the deficit may be presumed to lie somewhere between letter choice and written motor output. Two potential deficits are considered: (1) visual letter codes are not activated properly and (2) the information contained within properly activated visual letter codes fails to reach intact graphic motor patterns. Two patients with written spelling agraphia were each given a series of tests aimed at distinguishing between the two possibilities. Results suggest that the written spelling agraphia seen in these two patients arises from different underlying deficits. The results are discussed in terms of the patients' CT scan lesion sites, which were markedly different.     

The nature of prolonged word search

Two alternative hypotheses were considered concerning the process of prolonged search for an uncommon word in response to hearing its definition. One alternative is that a conscious retrieval effort brings the target progressively closer to threshold. The second is that the retrieval process is a random neural exploration outside of conscious control. A tachistoscopic probe was devised to compare word recognition thresholds after 10 sec versus 30 sec of presumed search time. Results failed to show a difference between the two delay conditions and were interpreted as inconsistent with the first alternative but consistent with the second.     

Spatial and visual learning deficits in Alzheimer's and Parkinson's disease

Experimental paradigms adopted from animal models were used to compare the neuropsychological mechanisms underlying the dementias of Alzheimer's and Parkinson's diseases. Two tasks were selected because characteristic profiles of impairment in nonhuman primates are seen following selective lesions of frontal cortex, temporal cortex, and fornix. The tasks consisted of a spatial and a visual learning problem, each with two components: (1) original learning and (2) reversal of the original learning. The Alzheimer's patients were significantly impaired on original learning and reversal learning in the visual modality compared with demented Parkinson's patients, even though both groups were equated for severity of dementia. On the spatial tasks, both the Alzheimer's and the demented Parkinson's patients were impaired on reversal learning but not on original learning. The profile of deficits on the visual tasks may serve to differentiate Alzheimer's from Parkinson's dementia and may reflect selective orbitofrontal system lesions in the former.     

Neuropsychological functioning in hemiparkinsonism

A standardized neuropsychological battery including measures of intellectual cognitive, memory, attention-concentration, language, abstraction and mental flexibility, and sensory and motor functions was administered to 21 hemiparkinsonian patients (14 with right side and 7 with left side symptoms) and 17 controls matched for age and education. Patients were impaired in all functions except sensory. For motor functions, impairment was ipsilateral to the side of symptoms. For cognitive functions, right side symptoms were associated with verbal deficits whereas left side symptoms were associated with spatial deficits. Thus, a pattern of neuropsychological deficits consistent with the lateralization of motor symptoms may appear in the early stages of the disease.     

Selective spatial attention and length representation in normal subjects and in patients with unilateral spatial neglect

The aim of this study was to assess whether perceptual representation along the horizontal axis is affected by hemispace position of the stimulus or by orienting attention to one side. Ten control subjects and 10 right brain damaged patients with left unilateral spatial neglect (USN) were asked to bisect lines of five lengths in three space positions (left, center, right) and under three cueing conditions (no cue, left cue, right cue). Normal controls showed significant displacement of bisection opposite to the side of hemispace presentation and toward the side of cueing. USN patients showed a bisection error toward the right end which increased with lines placed in the left hemispace and decreased with lines placed in the right hemispace and when attention was oriented toward the left side. We conclude that (1) In absence of cues normal subjects tend to overestimate the portions of space closer to their body midline; (2) both normal and USN patients tend to overestimate portions of space that they direct their attention to; (3) USN patients' performance without cueing is consistent with an attentional shift toward the right hemispace implying a gradient of overestimation of the right-most portions of space. A common neural substratum for directing attention and space representation can explain these findings.     

Memory for internally generated words in Alzheimer-type dementia: breakdown in encoding and semantic memory

The "generation effect" is a phenomenon in which words that are generated by the subject are remembered better than words which are read. The present experiments examined this effect in patients with mild-to-moderate dementia of the Alzheimer type (DAT), healthy elderly adults, and young adults under a variety of different encoding and retrieval conditions. Experiment 1 employed an intentional learning task with multiple study/test trials using the same list of words. While both the young and elderly adults exhibited higher recall for internally generated words than read words, the DAT patients failed to demonstrate the effect even after repeated exposures to the same stimulus list. Experiment 2 replicated this same pattern of results using an incidental learning paradigm with both recall and recognition tests. Various explanations as to why the DAT patients failed to show the generation effect were discussed with particular emphasis placed on the role of semantic memory and encoding failure.     

Chronic stress, leukocyte subpopulations, and humoral response to latent viruses

Psychological stress has been shown to affect immune system status and function, but most studies of this relationship have focused on acute stress and/or laboratory situations. The present study compared total numbers of leukocytes and lymphocyte subpopulations (determined by flow cytometry) and antibody titers to latent and nonlatent viruses among a group of chronically stressed individuals living near the damaged Three Mile Island (TMI) nuclear power plant with those of a demographically comparable control group. Urinary catecholamine and cortisol levels were also examined. Residents of the TMI area exhibited greater numbers of neutrophils, which were positively correlated with epinephrine levels. The TMI group also exhibited fewer B lymphocytes, T-suppressor/cytotoxic lymphocytes, and natural killer cells. Antibody titers to herpes simplex were significantly different across groups as well, whereas titers to nonlatent rubella virus as well as IgG and IgM levels were comparable.     

Psychic phenomena following near-death experiences: An Australian study

This study examines the incidence of reports of psychic phenomena and associated beliefs both before and after the near-death experience (NDE). The near-death experiencers interviewed reported no more psychic phenomena before the NDE than the general population. There was a statistically significant increase following the NDE in the incidence of 14 of 15 items examined.