Reading and Writing in Aphasia
What is alexia? What is agraphia?
Agraphia = acquired deficit in writing
Semantic and orthographic processing takes place largely in which area? Extrasylvian or perisylvian?
Extrasylvian!
What is CART? Briefly outline the treatment.
CART (copy and recall treatment) involves repeated copying and delayed recall of targeted words.
What is the lexicality effect?
The concept that real-word performance will be better than non-word performance
What is a primary way to identify pure alexia?
When the individual uses the compensatory strategy of "letter-by-letter" reading
Reading and spelling involve coordination of distributed ________ ________ involved in central linguistic processing and peripheral input/output functions
cortical networks
Name two gyri involved in semantic processing.
Angular gyrus
Middle and inferior temporal gyri
Anterior fusiform gyrus
Anterior-inferior frontal gyrus
T/F: Performance in reading/spelling in global and deep alexia/agraphia is not influenced by stimuli characteristics; it is simply too severe.
False! It is still influenced by stimuli characteristics.
Name one method of treatment for individuals with phonological alexia/agraphia.
"Key word" approach: A set of words is used to help the individual recall what sounds go with which letters
Guided oral reading with feedback in order to increase accuracy
What is a hallmark effect of letter-by-letter processing?
The word-length effect - the longer the word, the more difficult it is for individuals with pure alexia to keep all of the letters in their working memory to decode the word
Disruption in central language-processing skills can affect what three broad areas of written language?
Phonology
Semantics
Orthography
Name two areas involved in phonological processing.
Wernicke's area
Broca's area
Precentral gyrus
Insular cortex
Supramarginal gyrus
Residual reading and spelling abilities may reflect _____ __________ language function.
right hemisphere
In surface alexia/agraphia, what is impaired? What is relatively spared?
Lexical-semantic processing is impaired; phonological processing is relatively spared
What is allographic apraxia? What is apraxic agraphia?
Allographic: An impairment in converting graphemes to letter shapes
Apraxic: Motor programming of handwriting is impaired (not due to muscle weakness, but rather due to damage in the cortices responsible for hand movements)
What affects the variability of acquired alexia and agraphia?
The location of neural injury
The profile of symptoms
T/F: Often, individuals recover better with regards to reading than spelling.
True!
Which type of alexia/agraphia may produce semantically-related but incorrect words when asked to respond to target words? Global or deep?
Deep
With phonological alexia/agraphia, single-word spelling may be relatively preserved, but impairments are noted at the ____-_____.
text-level
How would you assess allographic alexia? What is a compensatory strategy for individuals with this?
Assessment: Ask the person to write the lowercase form of a letter when given the uppercase form (and vice-versa)
Compensatory: Use of letter cards (due to preserved letter recognition)
T/F: The lesion-deficit correlation has been used to study cognitive processes and neural substrates of written language.
True!
What cortex is involved in orthographic processing?
Left occipitotemporal cortex (also called the visual word form area)
What type of stimuli is used in order to assess knowledge of phonology-orthography relations (aka spelling to writing) in individuals with alexia/agraphia?
Reading/spelling nonwords
Extrasylvian damage often results in what types of aphasia? (There are two)
Anomic and transcortical aphasia
How would you assess apraxic alexia? What is a treatment for individuals with this?
Assessment: Ask them to write; handwriting will be poor with stroke additions/deletions, sometimes illegible
Treatment: Practice copying written words with extensive feedback