Intervention for reading and writing

Question 1

Assessment of reading and writing

Answer 1

• 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!

Question 2

CNP model: reading for meaning

Answer 2

• Seen word
• Visual orthographic analysis
• Orthographic input lexicon
• Semantic system

Question 3

CNP model: reading aloud

Answer 3

• Seen word
• Visual orthographic analysis
• Orthographic input lexicon
• Any path to get you to phonological assembly
• Articulatory programming
  -Spoke word

Question 4

CNP model: writing to dictation

Answer 4

• Heard word
• Auditory phonological analysis
• Phonological input lexicon
• Semantic system
• Orthographic output lexicon
• Graphemic output buffer
• Graphic motor planning
• Written word

Question 5

CNP model: copying written words

Answer 5

• Seen word
• Visual orthographic analysis
• Graphemic output buffer
• Graphic motor planning
• Written word

Question 6

3 routes to read words aloud

Answer 6

1. Semantic lexical route: involves reading words via access to their meaning
   - Required for the disambiguation of heterophonic homographs, eg. tear
2. Direct lexical route: involves reading aloud via a lexical but not semantic route
3. Sublexical route: orthographic-phonological conversion, ‘sounding out’, allows reading of nonword

Question 7

Acquired dyslexia: peripheral vs central dyslexias

Answer 7

Peripheral dyslexias = secondary dyslexias, secondary to visual /right hemisphere problems
Central dyslexias = primary dyslexias, direct result of a lesion, part of the aphasia process

Question 8

3 peripheral dyslexias

Answer 8

1. Neglect dyslexia
2. Attentional dyslexia
3. Visual dyslexia

Question 9

What is neglect dyslexia?

Answer 9

• Spatially determined visual errors
• Eg. left neglect, left side of word/sentence affected
• Log -> dog

Question 10

What is attentional dyslexia?

Answer 10

• 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

Question 11

What is visual dyslexia?

Answer 11

• Misidentification of one word for a visual similar one
• Similar looking letters
  Eg. lend -> land, calm -> claim

Question 12

3 central dyslexias

Answer 12

1. Surface dyslexia
2. Deep dyslexia
3. Phonological dyslexia

Question 13

What is surface dyslexia?

Answer 13

• 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

Question 14

What is deep dyslexia?

Answer 14

• 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

Question 15

What is phonological dyslexia?

Answer 15

• 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

Question 16

Lexical treatment for surface dyslexia

Answer 16

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’

Question 17

Treating impaired letter-to-sound conversation for deep and phonological dyslexia

Answer 17

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

Question 18

Dysgraphias

Answer 18

Errors in spelling, morphology and syntax

Question 19

Assessment of writing

Answer 19

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

Question 20

Graphemic output buffer impairment

Answer 20

• 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

Question 21

Therapy for writing disorders

Answer 21

1. 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?’
2. 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

Question 22

Impairment level therapy for writing

Answer 22

• Writing letters to dictation
• Writing words to dictation
• Writing the names of objects
• Completing missing letters
• Sentence completion tasks

Question 23

Written communication activities and participation

Answer 23

• 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