Rehabilitation of spelling along the sub-word-level routine

Abstract

Contemporary psycholinguistic models assume at least two routes in writing. These models have been verified on the basis of neuropsychological observations of patients suffering from acquired dysgraphia. Many studies have discussed the architecture of the phonological and graphemic lexicons, their relations to semantic knowledge, and their disruption following neuropsychological damage, but few have dealt with the nature of the sub-word level writing routine and its disruption. This may be due to the fact that, although this routine has importance in languages such as Italian, where orthography is much more regular and predictable, it appears to have a relatively reduced impact on the spelling abilities of educated English-speaking adults. The present paper describes the rehabilitation of dysgraphia along the sub-word-level route in Italian dysgraphic patients. Particular emphasis is given to the treatment of the unit that allows the phonological analysis of the auditory string to be written. The treatment procedure was tested on two patients (RO, and DR suffering from severe dysgraphia. After treatment, the spelling ability of the two subjects was restored to practically normal levels on most subsets of items. Both patients were also able to apply the restored skills to spontaneous writing and to written naming tasks. Results are discussed in relation to the contemporary writing models and the principles of cognitive neurorehabilitation.