Treatment of a case of phonological alexia with agraphia using the Auditory Discrimination in Depth (ADD) Program

Abstract

Phonological alexia and agraphia are acquired disorders characterized by an impaired ability to convert graphemes to phonemes (alexia) or phonemes to graphemes (agraphia). These disorders result in phonological errors typified by adding, omitting, shifting, or repeating phonemes in words during reading or graphemes when spelling. In developmental dyslexia, similar phonological errors are believed to result from deficient phonological awareness, an oral language skill that manifests itself in the ability to notice, think about, or manipulate the individual sounds in words. The Auditory Discrimination in Depth (ADD) program has been reported to train phonological awareness in developmental dyslexia and dysgraphia. We used a multiple-probe design to evaluate the ADD program's effectiveness with a patient with a mild phonological alexia and mixed agraphia following a left hemisphere infarction. Large gains in phonological awareness, reading and spelling nonwords, and reading and spelling real words were demonstrated. A follow-up reassessment, 2 months posttreatment, found the patient had maintained treatment gains in phonological awareness and reading, and attained additional improvement in real word reading. (JINS, 1998, 4, 608–620.)

Effects of Intensive Phonomotor Treatment on Reading in Eight Individuals With Aphasia and Phonological Alexia

“…The lack of improvement with comprehension is inconsistent with prior work using similar treatments (Conway et al, 1998;Kendall et al, 2003). However, this difference can, in part, be accounted for by differences in variables, such as treatment intensity and frequency, outcome measures, and alexia severity.…”

Treatability of different components of aphasia--Insights from a case study

“…The LiPS program is arranged hierarchically and divided into three stages: (1) oral awareness training, (2) simple nonword training (e.g., single syllables), and (3) complex nonword training (2-3 syllables) [13]; [6] Word Attack 0 38 -Word Identification 10 10 -Lindamood Auditory Conceptualization [7] Total Converted Score 27 58 § 100 however, the subject was only able to complete the first two stages in the 74 hours. The patient was unable to progress to complex nonword training because of a significant speech-motor programming impairment.…”

“…However, the benefits of prior knowledge decline as either the extent of network damage increases, or when, as in the present case of a right-handed person with a very large left-hemisphere lesion, little prior knowledge exists in the unaffected networks of the right hemisphere. In contrast, in a previously reported successful use of a form of phonological therapy involving a subject with acquired phonological alexia [13], the subject was left-handed and the dominant Broca's area was substantially preserved; functional imaging studies demonstrated that following treatment, greater engagement of both the right perisylvian regions and the left Broca's area was exhibited [35].…”

“…Motivated by results of developmental phonological dyslexia treatment in children [1][2][3][4], the success of acquired phonological alexia treatment in adults [5][6][7][8][9][10], and our own prior success with alexia treatment in an adult patient with stroke using a modified version of the Lindamood Phoneme Sequencing (LiPS) program [11][12][13], we provided the subject with 74 hours of phonological treatment. Most of the sessions were conducted in the subject's home.…”

Facilitating international efforts for dyslexia: a review of ‘Dyslexia in Context: Research, Policy and Practice’ edited by Gavin Reid & Angela Fawcett, London: Whurr Publishers, 2004, 349 pages + Xii, ISBN 1 86156426 0, £25.00

“…While many may not agree with Van der Leij's perspective, the chapter is well presented and thought provoking. The author's unique application of common terms provides the reader with a refreshing opportunity to reflect on how Van der Leij's constructs of inflexible and flexible abilities fit with the reader's own views of dyslexia and the burgeoning evidence of neural plasticity being present across the life span when effective treatment paradigms or principles are utilized (Adair et al, 2000;Conway et al, 1998;Kendall, Conway, Rosenback, & Gonzalez-Rothi, 2003;Torgesen, Wagner, Rashotte, Alexander, & Conway, 1998). Chapter 4, John Stein, includes a succinct review of genetics and the roles such research may play in future diagnosis.…”