Treatment for Alexia With Agraphia Following Left Ventral Occipito-Temporal Damage: Strengthening Orthographic Representations Common to Reading and Spelling Purpose Damage to left ventral occipito-temporal cortex can give rise to written language impairment characterized by pure alexia/letter-by-letter (LBL) reading, as well as surface alexia and agraphia. The purpose of this study was to examine the therapeutic effects of a combined treatment approach to address concurrent LBL reading with surface ... Research Article
Research Article  |   October 01, 2015
Treatment for Alexia With Agraphia Following Left Ventral Occipito-Temporal Damage: Strengthening Orthographic Representations Common to Reading and Spelling
 
Author Affiliations & Notes
  • Esther S. Kim
    University of Arizona, Tucson
  • Kindle Rising
    University of Arizona, Tucson
  • Steven Z. Rapcsak
    University of Arizona, Tucson
    Neurology Section, Southern Arizona VA Health Care System, Tucson
  • Pélagie M. Beeson
    University of Arizona, Tucson
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Esther S. Kim, who is now at the University of Alberta, Edmonton, Canada: esther.kim@ualberta.ca
  • Editor: Rhea Paul
    Editor: Rhea Paul×
  • Associate Editor: Swathi Kiran
    Associate Editor: Swathi Kiran×
Article Information
Language Disorders / Aphasia / Reading & Writing Disorders / Language / Research Articles
Research Article   |   October 01, 2015
Treatment for Alexia With Agraphia Following Left Ventral Occipito-Temporal Damage: Strengthening Orthographic Representations Common to Reading and Spelling
Journal of Speech, Language, and Hearing Research, October 2015, Vol. 58, 1521-1537. doi:10.1044/2015_JSLHR-L-14-0286
History: Received October 10, 2014 , Revised March 30, 2015 , Accepted June 20, 2015
 
Journal of Speech, Language, and Hearing Research, October 2015, Vol. 58, 1521-1537. doi:10.1044/2015_JSLHR-L-14-0286
History: Received October 10, 2014; Revised March 30, 2015; Accepted June 20, 2015

Purpose Damage to left ventral occipito-temporal cortex can give rise to written language impairment characterized by pure alexia/letter-by-letter (LBL) reading, as well as surface alexia and agraphia. The purpose of this study was to examine the therapeutic effects of a combined treatment approach to address concurrent LBL reading with surface alexia/agraphia.

Method Simultaneous treatment to address slow reading and errorful spelling was administered to 3 individuals with reading and spelling impairments after left ventral occipito-temporal damage due to posterior cerebral artery stroke. Single-word reading/spelling accuracy, reading latencies, and text reading were monitored as outcome measures for the combined effects of multiple oral re-reading treatment and interactive spelling treatment.

Results After treatment, participants demonstrated faster and more accurate single-word reading and improved text-reading rates. Spelling accuracy also improved, particularly for untrained irregular words, demonstrating generalization of the trained interactive spelling strategy.

Conclusion This case series characterizes concomitant LBL with surface alexia/agraphia and demonstrates a successful treatment approach to address both the reading and spelling impairment.

Acknowledgments
This work was supported by National Institute on Deafness and Other Communication Disorders Grants DC007647 (awarded to Pélagie M. Beeson) and DC008286 (awarded to Steven Z. Rapcsak). This material is the result of work supported, in part, with resources at the Southern Arizona VA Health Care System (Tucson, AZ). We thank Pauline Lau, Andrew DeMarco, and Mara Lee Goodman for assistance with this article, and all of the participants and their families for their contributions to our research.
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