Multi-step treatment for acquired alexia and agraphia (part II): a dual-route error scoring system

ABSTRACT

Dual-route neuropsychological models posit two distinct but interrelated pathways for reading and writing: the lexical and the sublexical. Individuals with reading/writing deficits often rely on the combined power of the integrated system to perform print-processing tasks. The resultant errors reflect varying degrees of lexical and sublexical accuracy in a single production; however, no system presently exists to analyze errors robustly in both routes. The goal of this project was to develop a system that simultaneously, quantitatively, and qualitatively captures changes in lexical and sublexical errors following treatment. Errors are evaluated hierarchically in both routes according to proximity to a target. This dual-route error scoring (DRES) system was developed using data from a novel treatment study for eight patients with acquired alexia/agraphia; a computerised version of the system was also developed (ADRES). Repeated-measures multivariate analyses of variance and post hoc analyses revealed significant dual-route treatment effects. Qualitative analyses revealed unique patterns of change across participants, reflecting the benefits of error evaluation beyond a binary correct/incorrect judgment. Finally, categorical error shifts were observed via group-level analysis. The results of this study indicate that treatment-induced evolution of reading/writing can be meaningfully and comprehensively represented by this novel scoring system.

KEYWORDS:

• Alexia/dyslexia
• agraphia/dysgraphia
• sublexical
• lexical
• error analysis

Acknowledgements

The authors would first like to thank the individuals who participated in this study. It is because of their commitment, patience, and generosity that this work is both meaningful and possible. We would also like to thank Shreya Ramesh and Marcos Zedan for their hard work generating the automated scoring scripts that will enable free and public access to the hierarchies we developed. Finally, we would like to thank the members of the Aphasia Research Laboratory for their continuous assistance and support..

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Katrina Ross http://orcid.org/0000-0003-2071-6033

Notes

1 Responses are represented with “quotation marks”; the target in all examples is pie, presented in italics (see Table 3).

Additional information

Funding

This work was supported by the Dudley Allen Sargent Research Fund, College of Health & Rehabilitation Sciences: Sargent College, Boston University.