Limited retention of information in the graphemic buffer

This study examined a patient who mainly made letter deletion errors in spelling. It was hypothesized that his errors were due primarily to limited ability to retain information in the graphemic buffer, a structure that holds sequences of abstract letter identities for output. Consistent with this hypothesis, the patient's spelling accuracy declined on long words, but the number of letters he wrote per response was not related to word length. Moreover, by having him write words forward and backward, it was shown that his accuracy within a word depended on which part of the word he tried to output first. These results also ruled out alternative accounts of the patient's spelling deficit based on neglect or damage to lexical representations.     

Presentation and task effects on migration errors in attentional dyslexia

We report a case study of a patient, FL, who shows symptoms of attentional dyslexia. He performs better at reading aloud single words than pairs of words, where he tends to make letter migration errors. These letter migrations are particularly prevalent from the word presented on the right into FL's response to the word presented on the left. Performance on the word pair reading task is improved if the two words are presented in different cases or the space between them is increased. Further, FL performs better at reading a target word if he is only required to name the initial letter of a distractor word rather than read the whole word. However, single letter distractors then produce more interference than whole words. These findings are consistent with FL having poor letter location coding when attention is diffuse [Cognitive Neuropsychol. 18 (2001) 551; Cognitive Neuropsychol. 13 (1996) 205]. In addition, representations on the left side of his attentional space are particularly weak, and so vulnerable to stimuli on the right when FL adopts a wide spatial window for the task. The data point to a pre-categorical deficit in reading in this case.     

Developmental attentional dyslexia

Attentional dyslexia is a reading deficit in which letters migrate between neighboring words, but are correctly identified and keep their correct relative position within the word. Thus, for example, fig tree can be read as fig free or even tie free. This study reports on 10 Hebrew-speaking individuals with developmental attentional dyslexia and explores in detail the characteristics of their between-word errors. Each participant read 2290 words, presented in word pairs: 845 horizontally presented word pairs, 240 vertically presented word pairs, and 60 nonword pairs. The main results are that almost all migrations preserve the relative position of the migrating letter within the word, indicating that the between-word position can be impaired while the within-word position encoding remains intact. This result is also supported by the finding that the participants did not make many letter position errors within words. Further analyses indicated that more errors occur in longer words, that most migrations occur in final letters (which are the leftmost letters in Hebrew), and that letters migrate both horizontally and vertically, and more frequently from the first to the second word in horizontal presentation. More migrations occurred when the result of migration was an existing word. Similarity between words in a pair did not increase error rates, and more migrations occurred when the words shared fewer letters. The between-word errors included the classic errors of migration of a letter between words, but also omission of one instance of a letter that appeared in the same position in the two words, an error that constituted a considerable percentage of the between-word errors, and intrusion of a letter from one word to the corresponding position in the neighboring word without erasing the original letter in the same position.     

Phonological reading: phenomena and paradoxes

We report a single case study of a patient with an acquired dyslexia. KT had no difficulty in reading regular words and non-words at a normal speed, but he made numerous errors in reading irregular words. These were characterised by "regularisation" of the letter string. We have documented his residual reading abilities and in addition have investigated other aspects of his residual reading skills. We found that his performance on visual lexical processing tasks was very satisfactory, there was no effect of priming from a correctly read irregular word and his reading of polysyllabic words was remarkably good. In particular his assignment of word stress was usually accurate. We consider our findings in relation to current models of phonological reading and conclude that they provide further evidence for a multiple levels computation of the transcoding between print and phonology.     

Rightward bisection errors for letter lines: the role of semantic information

When bisecting words in their middle, people reveal leftward bisection errors. This tendency might emerge from an attentional bias towards the beginning of the word. However, when longer meaningless letter strings are presented, people reveal a rightward bisection bias. To test the role of semantic information on leftward or rightward bisection biases, we tested letter line bisection performance in healthy right-handed students in four independent experiments. A third of the letter lines contained an embedded four-letter word to the left of true centre, another third contained an embedded four-letter word to the right of true centre, while the remaining lines contained no words. Half of these words were emotional words, the other half were neutral words. Results across experiments revealed a stronger rightward bisection bias: (i) for letter lines containing emotional as compared to neutral words, (ii) for letter lines containing words in the left as compared to right half of the lines, and (iii) for those experiments in which the spatial position of letter lines remained within a narrow body-centred space. Findings from this study suggest that letter line bisection performance might be only minimally determined by visuo-spatial attention. Rather, letter line perception might activate the left hemisphere more than the right hemisphere, shifting the subjective midpoint to the right of true centre. Leftward bisection biases for words only, as had been described in the literature, may thus have resulted from automated reading strategies rather than from attentional biases towards the left hemispace.     

The importance of being first: an analysis of tachistoscopic presentations of words

The importance of the first letter of a word as a cue for the rest of the word was explored in a tachistoscopic presentation of four letter English words to the two hemispheres. The positioning of words presented bilaterally and the frequency of the words were manipulated so that the role of the first letter could be examined. The results indicate that the first letter does not play the critical role in word recognition that has been ascribed to it. In the standard bilateral presentation, subjects' recall patterns indicated that first letters were recalled equally well whether the word was presented in the right or left visual field. However, subjects did not recall as many words correctly when they went to the left visual field. The results were interpreted as supporting an information processing view of hemispheric specialization. Such a view proposes several levels of functioning in which the two hemispheres overlap, cooperate, or specialize, depending on the task to be accomplished.     

Reading speed in pure alexia

This study investigated possible causes of differences in reading speed between two alexic patients who read words letter by letter. As both patients appeared to rely on serial left-to-right processing of letters within words, the difference in reading speed did not seem to be related to any differences in the extent to which the patients could recognize letters in words in parallel or ‘ends-in’. Differences in reading speed also seemed to be unrelated to the patients ability to identify individual letters since their letter recognition accuracy was very similar. Furthermore, although patient PD was significantly slower at reading words aloud than patient DC, PD was in fact significantly quicker than DC on a test that has previously been used to assess letter recognition skills in letter-by-letter readers. It is therefore concluded that PD reads words more slowly because of an additional impairment at the level of the word form system. The results therefore reinforce the distinction between Type 1 and Type 2 letter-by-letter readers that was first drawn by Patterson and Kay [Q. J. exp. Psychol.34A, 411–441, 1982].     

Reading without the left ventral occipito-temporal cortex

The left ventral occipito-temporal cortex (LvOT) is thought to be essential for the rapid parallel letter processing that is required for skilled reading. Here we investigate whether rapid written word identification in skilled readers can be supported by neural pathways that do not involve LvOT. Hypotheses were derived from a stroke patient who acquired dyslexia following extensive LvOT damage. The patient followed a reading trajectory typical of that associated with pure alexia, re-gaining the ability to read aloud many words with declining performance as the length of words increased. Using functional MRI and dynamic causal modelling (DCM), we found that, when short (three to five letter) familiar words were read successfully, visual inputs to the patient’s occipital cortex were connected to left motor and premotor regions via activity in a central part of the left superior temporal sulcus (STS). The patient analysis therefore implied a left hemisphere “reading-without-LvOT” pathway that involved STS. We then investigated whether the same reading-without-LvOT pathway could be identified in 29 skilled readers and whether there was inter-subject variability in the degree to which skilled reading engaged LvOT. We found that functional connectivity in the reading-without-LvOT pathway was strongest in individuals who had the weakest functional connectivity in the LvOT pathway. This observation validates the findings of our patient’s case study. Our findings highlight the contribution of a left hemisphere reading pathway that is activated during the rapid identification of short familiar written words, particularly when LvOT is not involved. Preservation and use of this pathway may explain how patients are still able to read short words accurately when LvOT has been damaged.     

Mechanisms of Pure Alexia: Spatially Based Impairment,Letter Identification Deficit,or Both?

We studied reading performance for words and for isolated letters in a pure alexic patient. She performed reasonably well when naming isolated letters but was slower in reading letters than a control subject when reaction times (RTs) were recorded. When the patient read isolated letters, RTs were slower for a subset of letters that cannot be recognized from their left part alone (e.g. “b”, an ambiguous letter, could be read “b” “h” “l” or “k” whereas “a” has no predictable confounders). We observed a significant positive correlation between the RTs for reading a word and the mean RTs for reading each of its composing letters before its uniqueness point (i.e. the point, when reading from the left to the right, where a word cannot be a word other than the one it is). This result suggests that, in our patient, the letter identification deficit can account for the slow, letter-by-letter reading behaviour, insofar as each letter represents a perceptual problem. Our findings can be accounted for by a deficit in the parallel processing of the left and right parts of each letter, compounded with a bias to process first the left part of the letter, and may thus reconcile the hypotheses of spatiallybased deficit (Rapp and Caramazza, 1991) and of a perceptual deficit occurring at the letter identification level (Behrmann and Shallice, 1995; Perri et al., 1996).     

Mechanisms of pure alexia: spatially based impairment,letter identification deficit,or both?

We studied reading performance for words and for isolated letters in a pure alexic patient. She performed reasonably well when naming isolated letters but was slower in reading letters than a control subject when reaction times (RTs) were recorded. When the patient read isolated letters, RTs were slower for a subset of letters that cannot be recognized from their left part alone (e.g. "b", an ambiguous letter, could be read "b" "h" "l" or "k" whereas "a" has no predictable confounders). We observed a significant positive correlation between the RTs for reading a word and the mean RTs for reading each of its composing letters before its uniqueness point (i.e. the point, when reading from the left to the right, where a word cannot be a word other than the one it is). This result suggests that, in our patient, the letter identification deficit can account for the slow, letter-by-letter reading behaviour, insofar as each letter represents a perceptual problem. Our findings can be accounted for by a deficit in the parallel processing of the left and right parts of each letter, compounded with a bias to process first the left part of the letter, and may thus reconcile the hypotheses of spatially-based deficit (Rapp and Caramazza, 1991) and of a perceptual deficit occurring at the letter identification level (Behrmann and Shallice, 1995; Perri et al., 1996).     

Emerging neurophysiological specialization for letter strings

In adult readers, printed words and other letter strings activate specialized visual functions within 200 msec, as evident from neurophysiological recordings of brain activity. These fast, specialized responses to letter strings are thought to develop through plastic changes in the visual system. However, it is unknown whether this specialization emerges only with the onset of word reading, or represents a precursor of literacy. We compared 6-year-old kindergarten children who could not yet read words to adult readers. Both age groups detected immediate repetitions of visually presented words, pseudowords, symbol strings, and pictures during event-related potential (ERP) mapping. Maps from seven corresponding ERP segments in children and adults were analyzed regarding fast (<250 msec) and slow (>300 msec) specialization for letter strings. Adults reliably differentiated words through increased fast (<150 msec) occipito-temporal N1 activity from symbols. Children showed a later, more mid-occipital N1 with marginal word-symbol differences, which were absent in those children with low letter knowledge. Children with high letter knowledge showed some fast sensitivity to letter strings, which was confined to right occipito-temporal sites, unlike the stronger adult N1 specialization. This suggests that a critical degree of early literacy induces some immature, but fast, specialization for letter strings before word reading becomes possible. Children also differentiated words from symbols in later segments through increased right occipito-temporal negativity for words. This slow specialization for letter strings was not modulated by letter knowledge and was absent in adults, possibly reflecting a visual precursor of literacy due to visual familiarity with letter strings.     

Accessing orthographic representations from speech: The role of left ventral occipitotemporal cortex in spelling

The present fMRI study used a spelling task to investigate the hypothesis that the left ventral occipitotemporal cortex (vOT) hosts neuronal representations of whole written words. Such an orthographic word lexicon is posited by cognitive dual‐route theories of reading and spelling. In the scanner, participants performed a spelling task in which they had to indicate if a visually presented letter is present in the written form of an auditorily presented word. The main experimental manipulation distinguished between an orthographic word spelling condition in which correct spelling decisions had to be based on orthographic whole‐word representations, a word spelling condition in which reliance on orthographic whole‐word representations was optional and a phonological pseudoword spelling condition in which no reliance on such representations was possible. To evaluate spelling‐specific activations the spelling conditions were contrasted with control conditions that also presented auditory words and pseudowords, but participants had to indicate if a visually presented letter corresponded to the gender of the speaker. We identified a left vOT cluster activated for the critical orthographic word spelling condition relative to both the control condition and the phonological pseudoword spelling condition. Our results suggest that activation of left vOT during spelling can be attributed to the retrieval of orthographic whole‐word representations and, thus, support the position that the left vOT potentially represents the neuronal equivalent of the cognitive orthographic word lexicon. Hum Brain Mapp, 36:1393–1406, 2015. © 2014 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.     

Letter position dysgraphia

The article describes AE, a Hebrew-speaking individual with acquired dysgraphia, who makes mainly letter position errors in writing. His dysgraphia resulted from impairment in the graphemic buffer, but unlike previously studied patients, most of his errors related to the position of letters rather than to letter identity: 80% of his errors were letter position errors in writing, and only 7% of his errors were letter omissions, substitutions, and additions. Letter position errors were the main error type across tasks (writing to dictation and written naming), across output modalities (writing and typing), and across stimuli, e.g., migratable words (words in which letter migration forms another word), irregular words, and nonwords. Letter position errors occurred mainly in the middle letters of a word. AE's writing showed a significant length effect, and no lexicality, migratability, or frequency effects. His letter position deficit was manifested selectively in writing; he made no letter position errors in reading, demonstrating the dissociability of letter position encoding in reading and writing. These data support the existence of a letter order function in the graphemic buffer that is separate from the function responsible for activating letter identities.     

Neglect dyslexia and the early stages of visual word recognition

Abstract

Neglect dyslexia is an acquired reading disorder in which one side of words or letter strings is misidentified. Caramazza and Hillis (Cognitive Neuropsychology 1990; 7: 391-445) proposed that the disorder reflects an impairment in the early stages of visual word recognition. Three levels of representation are involved, each with corresponding spatial coordinates. These levels reflect a progression away from the physical stimulus toward a more abstract representation of a word. The errors made by a patient with a level one deficit are relative to the location of a word in the visual field. The errors made by a patient with a level two deficit are relative to the spatial position of a letter(s) within the stimulus. The errors made by a patient with a level three deficit are relative to the ordinal position of a letter(s) within a word. We describe how this model may be used to interpret the differing patterns of performance found in neglect dyslexia and evaluate the model according to 19 published single case studies of neglect dyslexia. It is concluded that the model is well supported by these data and may therefore be viewed as a model of the early stages of reading in intact readers.     

Enhancing the spelling performance of learning disabled students. Task variation does not increase the efficacy of directed rehearsal

We investigated whether the efficacy of directed rehearsal could be enhanced by increasing a student's motivation through task variation. The efficacy of three conditions (directed rehearsal, directed rehearsal combined with task variation, and no-training control) on the spelling performance of four students with learning disabilities was compared in an alternating treatments design. Following each spelling error during the directed rehearsal condition, the teacher pronounced the word, the student pronounced the word, the teacher said aloud each letter of the word, and the student said aloud each letter of the word as he wrote the word correctly. This sequence was repeated five times. The same procedure was used during directed rehearsal plus task variation, except that previously learned words were alternately presented with new words. Results showed that although the two training conditions were more effective than no training, there was no difference between the two training procedures in terms of the cumulative number of words learned to criterion. This study showed that the addition of task variation to directed rehearsal does not increase the spelling proficiency of learning disabled students.     

Visual paralexias in a Spanish-speaking patient with acquired dyslexia: a consequence of visual and semantic impairments?

We report the case of a Spanish patient SC who misread 55 per cent of the single words shown to her. SC's reading accuracy was affected by word imageability and frequency. Nonword reading was very poor. The majority of SC's errors to real-word targets bore a close visual similarity to the items that elicited them, but there was no indication of an effect of serial position on the probability that a letter from a target word would be incorporated into the error made to that word. SC made some visual errors in object naming and also showed evidence of a general semantic impairment. We consider the similarity between SC and patient AB reported by Lambon Ralph and Ellis (1997), and suggest that the very high levels of visual errors shown by these two patients may reflect a combination of visual and semantic impairments.     

Letter position coding in attentional dyslexia

We report data from experiments on orthographic and phonological coding in two patients with attentional dyslexia following bilateral parietal damage. Two experiments required the patients to carry out lexical decisions and we varied whether the nonwords were orthographically or phonologically similar to real words. Experiment 1 showed that the patients were sensitive to the orthographic relations between nonwords and words, as they tended to accept as words nonwords whose letters could migrate within the string to form a word. There were no effects of phonological similarity between the nonwords and the words. Experiment 2 demonstrated that the patients were less likely to accept nonwords as words if the word had to be formed by transposing the first two letters in the string. The data suggest that attentional dyslexics are primarily sensitive to orthographic similarity between words and nonwords, and also that the first letters have privileged coding of their locations, despite the patients being poor at coding letter positions. The implications for theories of visual word recognition are discussed.     

"What" and "where" in word reading: ventral coding of written words revealed by parietal atrophy

The visual system of literate adults develops a remarkable perceptual expertise for printed words. To delineate the aspects of this competence intrinsic to the occipitotemporal "what" pathway, we studied a patient with bilateral lesions of the occipitoparietal "where" pathway. Depending on critical geometric features of the display (rotation angle, letter spacing, mirror reversal, etc.), she switched from a good performance, when her intact ventral pathway was sufficient to encode words, to severely impaired reading, when her parietal lesions prevented the use of alternative reading strategies as a result of spatial and attentional impairments. In particular, reading was disrupted (a) by rotating word by more than 50 degrees , providing an approximation of the invariance range for words encoding in the ventral pathway; (b) by separating letters with double spaces, revealing the limits of letter grouping into perceptual wholes; (c) by mirror-reversing words, showing that words escape the default mirror-invariant representation of visual objects in the ventral pathway. Moreover, because of her parietal lesions, she was unable to discriminate mirror images of common objects, although she was excellent with reversible pseudowords, confirming that the breaking of mirror symmetry was intrinsic to the occipitotemporal cortex. Thus, charting the display conditions associated with preserved or impaired performance allowed us to infer properties of word coding in the normal ventral pathway and to delineate the roles of the parietal lobes in single-word recognition.