Intervention for reading and writing Flashcards
Assessment of reading and writing
- Consider pre-morbid literacy skill
- Test silent reading + reading aloud
- Consider keyboard skills
- Can use standardised tests, eg. CAT, WAB, BDAE, PALPA
- Informal assessment of reading and writing in daily activities
- Should be assessed at word, sentence and paragraph level!
CNP model: reading for meaning
- Seen word
- Visual orthographic analysis
- Orthographic input lexicon
- Semantic system
CNP model: reading aloud
- Seen word
- Visual orthographic analysis
- Orthographic input lexicon
- Any path to get you to phonological assembly
- Articulatory programming
-Spoke word
CNP model: writing to dictation
- Heard word
- Auditory phonological analysis
- Phonological input lexicon
- Semantic system
- Orthographic output lexicon
- Graphemic output buffer
- Graphic motor planning
- Written word
CNP model: copying written words
- Seen word
- Visual orthographic analysis
- Graphemic output buffer
- Graphic motor planning
- Written word
3 routes to read words aloud
- Semantic lexical route: involves reading words via access to their meaning
- Required for the disambiguation of heterophonic homographs, eg. tear - Direct lexical route: involves reading aloud via a lexical but not semantic route
- Sublexical route: orthographic-phonological conversion, ‘sounding out’, allows reading of nonword
Acquired dyslexia: peripheral vs central dyslexias
Peripheral dyslexias = secondary dyslexias, secondary to visual /right hemisphere problems
Central dyslexias = primary dyslexias, direct result of a lesion, part of the aphasia process
3 peripheral dyslexias
- Neglect dyslexia
- Attentional dyslexia
- Visual dyslexia
What is neglect dyslexia?
- Spatially determined visual errors
- Eg. left neglect, left side of word/sentence affected
- Log -> dog
What is attentional dyslexia?
- Difficulty with visual specification of word at level of visual orthographic analysis
- Level of visual written word, ‘getting the gist of it’, not looking precisely
- Eg. win fed -> fin fed
What is visual dyslexia?
- Misidentification of one word for a visual similar one
- Similar looking letters
Eg. lend -> land, calm -> claim
3 central dyslexias
- Surface dyslexia
- Deep dyslexia
- Phonological dyslexia
What is surface dyslexia?
- Reading irregular words phonetically
- Over-regularising
- Impairment to lexical routes of reading at different levels
- Orthographic-phonological route preserved
- Regular words read better than irregular words
- Semantic system may/may not be involved, don’t necessarily need to know meaning, just pronunciation
Can occur with deep dyslexia
What is deep dyslexia?
- Unable to read nonwords as the brain is reading the semantics and ‘ignoring’ the written words
- Result of reading via an impaired semantically-mediated lexical route
- Orthographic-phonological conversion also impaired
- Semantic errors in single word reading
- Ape -> monkey
- Unable to read nonwords
- High imageability words read better than low imageability
- Can occur in AD, deep then surface dyslexia appears
Can occur with surface dyslexia
What is phonological dyslexia?
- Reading nonwords as real words
- Results from impaired orthographic-phonological conversation (sub lexical route)
- Poor/nonexistent nonword reading
- Nonwords often read as visually similar real words
- Eg. soof -> soot
Lexical treatment for surface dyslexia
Retraining orthographic knowledge for specific words
Whole word reading
- Targeting specific irregular spelling patterns
- Visual representations on cards can help
- Eg. -ough
Eg. -ow in cow vs row
May work on homographic and homophonic pairs (link to lexical semantics)
- Homographs: eg. what are the different meanings of ‘match’
- Homophones: eg. ‘knight’ vs ‘night’
Treating impaired letter-to-sound conversation for deep and phonological dyslexia
Nonword reading = impairment based not functional based task (doesn’t come up a lot IRL)
- Makes brain rethink and not rely on automatic speech/semantics
- Using it as a barrier to overcome so when reading real words they’re not relying on a system that is present but impaired
Sound-letter correspondence
- Write letter/s that go with a phoneme
- Use cueing hierarchy for support
Oral reading of consonant clusters
- Phoneme segmentation
- Grapheme-phoneme matching
Dysgraphias
Errors in spelling, morphology and syntax
Assessment of writing
Written picture naming
- Could use BNT
- Determine whether it’s a naming impairment or if they’re unable to generate word or if it’s apraxia
- Phonetic (apr) vs phonemic issue
- Consider pre-morbid spelling and grammar ability
- Are they using dominant/non-dom hand?
Formal and informal ax
- Standardised tests: CAT, WAB, BDAE, PALPA
- Informal writing tasks
- Observe functioning in daily activities
Graphemic output buffer impairment
- Errors of grapheme selection
- Impaired across all tasks
- Not affected by regularity/imageability/frequency
- Is affected by word length
- Errors include letter substitutions, deletions, additions, transpositions
Therapy for writing disorders
- Targeting lexical writing route (results generally indicate item-specific improvement)
- Px generating things on their own
- Eg. Writing a shopping list, ‘we’re in the produce section, what’s a fruit that starts with A?’ - Targeting sub-lexical writing route (teaching phoneme-to-grapheme correspondence)
- Focus on modelling for them
- Eg. Copying down a shopping list
Tasks often involve repetitive practice via writing and computer work
Impairment level therapy for writing
- Writing letters to dictation
- Writing words to dictation
- Writing the names of objects
- Completing missing letters
- Sentence completion tasks
Written communication activities and participation
- Consider prompts/supports that may assist the person with dysgraphia
- Notebook/electronic device that records name and address: to assist with copying correct details on forms etc
- Graded crosswords/games, boggle/scrabble, make it clear how it is therapeutic
- Using workbooks for adults
- Make therapy interesting
