A Treatment Sequence for Phonological Alexia/Agraphia PurposeDamage to left perisylvian cortex often results in impaired phonological processing abilities with written language profiles consistent with phonological alexia and phonological agraphia. The purpose of this article was to examine a behavioral treatment sequence for such individuals intended to strengthen phonological processing and links between phonology and orthography, as ... Article
Article  |   April 01, 2010
A Treatment Sequence for Phonological Alexia/Agraphia
 
Author Affiliations & Notes
  • Pélagie M. Beeson
    University of Arizona, Tucson
  • Kindle Rising
    University of Arizona, Tucson
  • Esther S. Kim
    University of Arizona, Tucson
  • Steven Z. Rapcsak
    University of Arizona, Tucson, and Southern Arizona VA Health Care System, Tucson
  • Contact author: Pélagie M. Beeson, P.O. Box 210071, Department of Speech, Language, & Hearing Sciences, University of Arizona, Tucson, AZ 85721-0071. E-mail: pelagie@u.arizona.edu.
Article Information
Speech, Voice & Prosodic Disorders / Language Disorders / Aphasia / Reading & Writing Disorders / Speech, Voice & Prosody / Language
Article   |   April 01, 2010
A Treatment Sequence for Phonological Alexia/Agraphia
Journal of Speech, Language, and Hearing Research, April 2010, Vol. 53, 450-468. doi:10.1044/1092-4388(2009/08-0229)
History: Received November 5, 2008 , Accepted July 6, 2009
 
Journal of Speech, Language, and Hearing Research, April 2010, Vol. 53, 450-468. doi:10.1044/1092-4388(2009/08-0229)
History: Received November 5, 2008; Accepted July 6, 2009
Web of Science® Times Cited: 25

PurposeDamage to left perisylvian cortex often results in impaired phonological processing abilities with written language profiles consistent with phonological alexia and phonological agraphia. The purpose of this article was to examine a behavioral treatment sequence for such individuals intended to strengthen phonological processing and links between phonology and orthography, as well as train a means to maximize use of residual orthographic and phonological knowledge for spelling.

MethodTwo women with persistent impairments of written language and phonological processing following damage to left perisylvian cortical regions participated in this study. Both exhibited characteristic features of phonological alexia and agraphia in that reading and spelling performance for real words was better preserved than nonwords (lexicality effect). A 2-stage treatment protocol was administered to strengthen sublexical skills (phonological treatment) and to train interactive use of lexical and sublexical information to maximize spelling performance (interactive treatment).

ResultsBoth participants improved phonological processing abilities and reading/spelling via the sublexical route. They also improved spelling of real words and were able to detect and correct most residual errors using an electronic spelling aid.

ConclusionsBehavioral treatment served to strengthen phonological skills supporting reading and spelling, and provided a functional compensatory strategy to overcome residual weaknesses.

Acknowledgments
This work was supported by Grants DC007646 and DC 008286 from the National Institute on Deafness and Other Communication Disorders. The authors thank Sarah Andersen, Maya Henry, and Erin O’Bryan for their assistance with this article.
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