M4, T3, remediation of dyslexia and treatment case study of deep dyslexia Flashcards
Remediation/rehabilitation of patients with dyslexia
Goal and success of remediation or rehabilitation depends the individual patient profile of intact and impaired reading processes
Individual patient cases requires detailed assessment of reading, writing, spelling, spoken language, short-term memory and motivation
Remediation/rehab of patients with pure alexia
- Intervention studies have focused on improving the letter-by-letter reading strategy used by pure alexics and found improved reading accuracy and rate for reading of words and individual letters (e.g., Friedman & Lott, 2000)
- Use implicit tasks to increase access of whole words in the orthographic input lexicon (Nickels, Tripolone, & Kohnen, 2010) e.g., repeated visual lexical decision task training
-> Resulted in significant improvements for trained and untrained words
Rem/rehab for patients with pure alexia, Moyer (1979) and Moody (1988)
Moyer (1979) and Moody (1988) used multiple oral reading to remediate pure alexia.
-> Multiple oral reading - repeated reading aloud of texts leads to improvements in accuracy and reading rate for trained and untrained texts
-> Possibly by improving access to the word representations in the orthographic input lexicon or by increasing top-down support
Rem/rehab for patients with attentional dyslexia
Friedmann, Kerbel, and Shvimer (2010) – patient severe developmental difficulties in reading texts and word pairs, could read nearly perfectly when using a word-size window cardboard cutout
Shvimer, Kerbel, and Friedmann (2009) trialed six different strategies to read one word at a time
- Reading with cardboard word–size window cutout led to reduction in reading errors for most of the subjects, followed by finger-tracking underneath the word
-> Not all subjects responded to all strategies in the same way, need to trial different strategies
Rem/rehab for patients with letter-position dyslexia
Study with six different strategies were trialed for 10 Hebrew - speaking developmental letter - position dyslexics (Friedmann & Rahamim,2014)
Strategy successful for most participants was finger-word tracking
Rem/rehab for patients with neglect dyslexia
Techniques rely on shifting attention to the left side using task instruction and also visual cues, unclear if they improve actual processing capacity
- Finger tracking underneath the word
- Colour-coding of the left-most letter
- Flashing LED lights at the left side of a word
- Tapping to the left of words
- Placing a hash sign next to the left-most letter of a word
- Vertical presentation of words can improve performance, but this is not the case for all neglect dyslexics
Rem/rehab for patients with surface dyslexia
Interventions usually focus on reading of irregular words (e.g., sword, friend) and homophones (e.g., caught /court)
Different training types depending on problem with irregular–word reading
Rem/rehab for patients with surface dyslexia, damage at orthographic input lexicon
- Goal to improve the quality of or access to lexical orthographic representations
- Successful intervention presented written irregular words on flashcard along with a mnemonic aid (e.g., picture that matches to word or something that remind of word)
- Ellis et al. (2000) improved patient’s reading through reading a list of words and then listening to recording of correct pronunciation. For incorrect responses needed to repeat the correct word several times and think word meaning
Rem/rehab for patients with surface dyslexia, difficulties with accessing pronunciations for written words
- Goal to improve connection between orthographic lexicon input lexicon and the phonological output lexicon
- Train connections between written words and their pronunciations
- Requires repeated exposure to written word and it’s pronunciation
Rem/rehab for patients with surface dyslexia, difficulty with comprehension of written words
- Goal to improve the connection between the orthographic input lexicon and the word meaning (semantics)
- Sentence Completion Task – select the correct word to complete the sentence
The ladies served cream ____ ( teas [target], tease [homophone foil], teeze [homophonic nonword foil], tens, team, tense [orthographically similar foils]).
Rem/rehab for patients with direct dyslexia
- Does not appear to be any studies/treatment for direct dyslexia
- Due to progressive nature of disorder
- Treatment could focus on the orthographic and semantic link
- Treatment could focus on oral language if comprehension difficulty is not restricted to written words
Rem/rehab for patients with phonological dyslexia or deep dyslexia, grapheme-phoneme conversion pathway
- Training Phonological Dyslexic focus on the nonlexical route to reading aloud (grapheme-phoneme conversion)
- Interventions for Deep Dyslexics may also focus on the nonlexical route because an improved grapheme-phoneme conversion pathway can increase correct word selection and decrease semantic errors
- Focusing on an improved grapheme-phoneme conversion pathway has potential to transfer to untrained words more as it can be used to process words that have a regular pronunciation
- Does not appear to be any studies/treatment using the right hemisphere approach to remediate deep dyslexia
Rem/rehab for patients with phonological or deep dyslexia, letter-sound correspondence
- Improving reading via the nonlexical route, need to train letter–sound correspondences
- DePartz (1986) trained letter–sound correspondences with a deep dyslexic patient
1. Patient learned to associate letters with a word (e.g., m with maman)
2. Patient learned to sound out single letters
3. Non-word reading asking the patient to sound out each letter of a nonword and then blend these sounds together
-> Single letters were taught before multiple-letter graphemes
Rem/rehab of patients with phonological or deep dyslexia, improve oral blending accuracy
- Improving reading via the nonlexical route, and goal is to improve oral blending accuracy
- Deep Dyslexic patient had to sound out each letter, tap the sound when doing so and then drag her finger underneath the letter cards when blending the sounds together to form a word (Yampolsky & Waters, 2002)
Rem/rehab for patients with phonological or deep dyslexia, improve parsing accuracy
- Improving reading via the nonlexical route, and goal is to improve parsing accuracy
- Brunsdon et al. (2002) taught grapheme parsing by presenting two or three grapheme nonwords (e.g., pow , dru ). Patient had to circle the constituent graphemes of the nonwords.
Ska, Garneau-Beaumont, Chesneau & Damien (2003)
- Assessed reading of DD patient according to a cognitive model of reading
- Assessed a priming paradigm rehabilitation program focus on the lexical route to reading aloud
- Patient JH 56 yrs old in 1997
-> Suffered a left ischemic cerebral vascular Sylvain stroke following a triple aorta-coronary by-pass operation
-> Right hemianopsia, right brachio-facial hemiparesis and receptive and expressive aphasia symptoms
Ska, Garneau-Beaumont, Chesneau & Damien (2003), patient JH rehab program
- Appeared to have Deep Dyslexia
- JH right-handed physician, multi-lingual
- One year JH individually followed by speech therapist 4 x week
- Two years in a rehabilitation program
-> 3 individual therapies a week
-> exercises to be done at home and
-> a weekly group therapy session - Dec 2000 JH began rehabilitation for his reading problems
Assessment of JH’s deep dyslexia - peripheral processes
- pass Matching identical words – sill (bill, pill, till, sill)
- pass Letter identification among visually similar letters (c, d, o, p)
- pass Letter identification among auditorily similar letters (b, c, d, e)
- pass Letter denomination – A, d, E, s
- pass Word and nonword repetition (talk, wux)
- pass Unexpected delay repetition of words
Assessment of JH’s deep dyslexia - phonological route (grapheme-phoneme conversion)
pass Letter reading – a, q d, z
fail Phoneme reading – ph, ch,
fail Phoneme identification – ph, ch, sh
Assessment of JH’s deep dyslexia - lexical route
fail Reading words aloud – doll, even, one
fail Reading non-words – wux, lept, phocks
Assessment of JH’s deep dyslexia - assessing linguistic variables and error analysis
Assessing linguistic variables
- Word length effect – work, elephant
- Word frequency – the, aisle read equally
- Orthographic complexity – better irregular than regular words (pint, mint)
- Concrete vs. abstract words (cup, wish)
Error analysis
- semantic, phonological, visual, morphological
Assessing JH’s deep dyslexia, phonological and orthographic input tasks
Phonological input lexicon
pass, Auditory lexical decision task
Orthographic input lexicon
fail, Visual lexical decision (wux, fox)
pass, Irregular words letter switch task (yacth, pnit)
Assessment of JH’s deep dyslexia, semantic system (using pictures)
Semantic system (using pictures)
pass Odd item (choose the image that doesn’t fit)
pass Odd item with subtle relations
pass Written word-picture matching
pass Semantic relation between picture and written word
pass Picture-written word matching (choose the word that matches the pic)
Assessing JH’s deep dyslexia, semantic system (words)
Semantic system (written words)
fail Odd item (written) – fly, frog, spider, tree
fail Odd item with visually similar words (school, schoolgirl, schoolboy, ecology)
fail Semantic matching (carrot, potato, lettuce, pastry)
