Acquired disorders of reading (acquired dyslexia) are common in patients with aphasia subsequent to left hemisphere stroke. Even when language functions recover sufficiently to enable the patient to return to work, an unrecovered dyslexia often interferes significantly with job performance. Patients who cannot return to work may be left with little to occupy their time; the ability to read for pleasure could make a significant difference in their quality of life. The purpose of this project is to test a set of therapy programs for the treatment of acquired dyslexia, based upon a cognitive neuropsychological model of reading. A comprehensive and detailed battery of reading and reading-related tests is used to determine the underlying impairment causing the reading deficit in each patient. This proposal focuses on three specific deficits: 1) impaired access to the visual word form from the visual modality (pure dyslexia); 2) impaired orthographic-phonologic connections (phonologic/deep dyslexia); 3) poor lector/affixed word reading in text (phonological text alexia)). A set of experimental treatment programs has been devised for each of these reading deficits. These therapy programs derive in part from cognitive models of reading, in part from differences in general approach to treatment, and in part from the results of previous treatment studies. A set of general external probe tests are administered to all subjects before and after treatment There are additional external probes for each of the three deficit types, consisting of a list of words targeted for improvement but never trained. Measures include both accuracy and speed of reading. Group studies will examine the efficacy of treatments that have been successful in prior single case studies, and in some instances will compare the efficacy of two treatments with each other. Single case studies will be implemented to explore new treatment protocols or variations on old treatment protocols. Treatment programs are evaluated for efficacy by comparing the accuracy and speed of reading the treatment-specific probe words pre- and post-treatment, and examining performance on the general external probes pre- and post-treatment. The results of this project will increase our understanding of reading and its breakdown, leading to more effective methods of teaching reading to both normal and developmentally dyslexic children, in addition to providing a scientific basis for the choice of effective intervention strategies for the treatment of acquired dyslexia.
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