pélagie m. beeson, ph.d., ccc-slp department of speech ......in greece, long ago people had locks...

Pélagie M. Beeson, Ph.D., CCC-SLPDepartment of Speech, Language, and Hearing Sciences

Part 4: MedStar National Rehabilitation Hospital Workshop, March 2019

Reflect damage to specific processes (or combinations of processes) that support reading/spelling

Reliance on residual abilities Characterized by◦ error profile and error types

Associated with brain damage to specific cortical regions

Semantics

Phonology Orthography

phonological impairment

orthographic impairment

middle cerebral artery supplies blood to perisylvian region

posterior cerebral artery supplies blood to ventral cortical regions as well as medial and lateral occipital lobe.

A reminder regarding blood supply to the brain

phonological impairment

orthographic impairment

Semantics Orthog

Phonology

Semantics

Phonology

Semantics


Left perisylvian damage impairs phonological processing

Results in perisylvian aphasias typically accompanied by phonological alexia/agraphia (including deep and global alexia/agraphia)

Semantics


Damage to left posterior inferior temporo-occipital region may result in anomic or transcortical sensory aphasia, and often impairs orthographic knowledge (or access to orthography). Results in surface alexia/agraphia orletter-by-letter reading

glacierbribe “brib”blood “blued”tone +shampoo + castle

L

Trouble with irregularly spelled wordsReliance on phonological strategy

Phonologically Plausible Error (PPE)

PPE

PPE

PPE

PPE

2 weeks post PCA stroke

Surface Agraphia

Trouble with irregularly spelled words

Reliance on phonological strategy

grumbledrivehonestcircuitspringroughyaughtbroadroundfresh quior

Semantics Orthog

Phonology

Semantics

Phonology

Semantics


0

20

40

60

80

100

Perc

ent c

orre

ct Regular

Irregular

Nonwords

Surface Alexia/Agraphia

Regularity effect

Damage to left ventral occipito-temporal cortex associated with posterior cerebral artery stroke typically affects reading and spelling. May also have anomic aphasia.

Chart1

81.751.790

Regular

Irregular

Nonwords

Percent correct

Sheet1

906585

PatientsContorl

82.2999.24

55.8393.79

7594.55

MS spelling

81.751.790

Sheet1

Regular

Irregular

Nonwords

Spelling

Percent Correct

Sheet2

Regular

Irregular

Nonwords

Spelling

Percent Correct

Sheet3

Patients ControlsPatients ControlsPatients Controls

Regular

Irregular

Nonwords

Patients Controls

Percent Correct

Regular

Irregular

Nonwords

Spelling

Percent correct

Semantics Orthog

Phonology

Semantics

Phonology

Semantics


Semantics


0

20

40

60

80

100

Perc

ent c

orre

ct Regular

Irregular

Nonwords

Phonological Alexia/Agraphia Surface Alexia/Agraphia

Lexicality effect Regularity effect

Chart1

81.751.790

Regular

Irregular

Nonwords

Percent correct

Sheet1

906585

PatientsContorl

82.2999.24

55.8393.79

7594.55

MS spelling

81.751.790

Sheet1

Regular

Irregular

Nonwords

Spelling

Percent Correct

Sheet2

Regular

Irregular

Nonwords

Spelling

Percent Correct

Sheet3

Patients ControlsPatients ControlsPatients Controls

Regular

Irregular

Nonwords

Patients Controls

Percent Correct

Regular

Irregular

Nonwords

Spelling

Percent correct

Chart1

Regular

Irregular

Nonwords

Column1

Percent Correct

85

87

25

Sheet1

Column1Series 2Series 3

Regular852.42

Irregular874.42

Nonwords251.83

Category 44.52.85

To resize chart data range, drag lower right corner of range.

Spelling Accuracyreal words

< 30% correct >30%

Reading Spelling

0102030405060708090

100

2 weekspost

3 monthspost

RegIrregNon

0102030405060708090

100

2 weekspost

3 monthspost

RegIrregNon

Surface pattern in reading resolved, but surface pattern in spelling remained.

80 y.o.Anomic aphasiaWAB AQ = 90.4BNT = 30/60

Primary complaints: Reading, spelling, and coming up with the names of things

Reading text PetraThe city of Petra, now an archaeological site in modern day Jordan, was at the height of prosperity in the first century B.C. Petra’s inhabitants accumulated wealth through trade of gold, silver, incense, brass, iron, saffron, sculpture, paintings and purple garments. During its heyday, which lasted for about 500 years, Petra was one of the most lavish cities in history. At its peak, the population was nearly 30,000 people.

At 3 months post-stroke, reading was slow but relatively accurate.

Locks and Keys(2nd grade level)

Petra(12th grade level)

Rate (wpm)

Error rate (per100wd)

Rate (wpm)

Error rate(per100wd)

Pre-Tx 111 0 42 4

Controls ~200 0 ~140 0

Reading text

Writing Sentences to DictationHe was never accused [acquised] of being honest.

She attempted vainly to suppress [suprese] her cough.

Hoping for better luck, he changed [chainged] his pre-game routine.


< 30% correct >30%

“choir”

Phonologic Lexicon

Orthographic Lexicon

choir

Phonemes Graphemes

Semantics

sound-letter

letter-sound

Facilitate interactive use of residual orthography, phonology & semantics

Problem-solving approach to detect and self-correct phonologically plausible errors

“chore choir” quier choir

q-u-i-e-r choirBeeson, et al. (2000) Aphasiology

Purpose◦ Strengthen the interactive use of orthography and phonology

Goal◦ To improve spelling accuracy by increasing self-detection and

correction of errors Approach◦ Use residual phonology to sound-out plausible spellings◦ Identify and correct errors◦ Use of electronic spell-checker to aid in error correction

serkit circuit

1. Listen to the word.2. Repeat it.3. Try to spell it.4. Look at it carefully. Is it as close as you

can get? If not, try again.5. When you get as close as you can, enter it

into the spell checker.6. Look through the list and choose the

correct spelling.7. Remember to press “say” to double check!8. Copy the correct spelling.9. Circle the words that you get by using the

spell checker.

0102030405060708090

100

Reg Irreg Non

Speller

Post

Pre

Spelling Accuracy

*

*

*Corrected with spell checker


< 30% correct >30%

“apple”

Phonological Lexicon

Orthographic Lexicon

apple

Phonemes Graphemes

Semantics

lexical

sublexical

“apple”

Acoustic Analysis

Visual Analysis

apple

Letter naminga-p-p-l-e

Impaired access to orthography

RL

Pure Alexia refers to isolated impairment of reading◦ Disconnection of visual input to cortical regions involved

in orthographic processing◦ Typically results in letter-by-letter reading Characterized by word-length effect Shorter words read more accurately and faster than long words

0

2

4

6

8

10

w ord lengthRe

adin

g Re

actio

n Ti

me

(sec

onds

) 4 letter5 letter

6 letter

7 letter

Posterior cerebral artery stroke: Left inferior temporo-occipital lesion

RL

Chart2

word lengthword lengthword lengthword length

4 letter

5 letter

6 letter

7 letter

Reading Reaction Time(seconds)

5.22

6.88

8.89

9.45

read-write

BB June Performance SummaryReadingWriting

# Correct# CorrectWriting Error Types- Real WordsNumberPercentReading Error Types- Real WordsNumberPercent

HFMFLFHFMFLFPPE32.88PPE125.00

word lengthReg20202060Reg72312MORPH10.96MORPH00.00

4 letter5.2Irreg20181856Irreg3003PIN32.88PIN00.00

5 letter6.88403838116102315NR1110.57NR00.00

6 letter8.89VSW65.76VSW375.00

7 letter9.45% Correct% CorrectSEM21.92SEM00.00

LEX/VSW47.69

PIN/PW2461.53PIN/PW59.61

PIN/LEX820.51NR11.92

NR512.82

nonwordsnonwordsverbsTotal390Total520

# correct7# correct1# correct3

% correct11.66% correct0.05% correct15

verbs

# correct19

% correct95

set of wordspercent of # of correct letters

52.4

41.8

43.8

43.1

22

read-write

4 letter

5 letter

6 letter

% correct

Pre-Treatment

Sheet3

% Correct

: Performance as a Function of Frequency

% correct

: Nouns vs. Functors

PPE

MORPH

PIN

NR

VSW

SEM

SEM/VSW

PW-1

PW-2

PW-3

Misc

URW

Error Types

% Error

BB: Writing Error Types- Real Words

0.9174311927

0

25.6880733945

0.9174311927

11.9266055046

0

0

20.1834862385

14.6788990826

4.5871559633

8.2568807339

12.8440366972

PPE

MORPH

PIN

NR

VSW

SEM

SEM/VSW

URW

Error Types

% Error

BB: Reading Error Types-Real Words

0

11.1111111111

0

0

77.7777777778

0

0

11.1111111111

LEX

PIN

NR

Error Types

% Error

BB: Reading Error Types-Nonwords

77.7777777778

22.2222222222

0

LEX

PIN

NR

Error Types

% Error

BB: Writing Error Types- Nonwords

40

60

0

percent of # of correct letters

percent # of correct written letters

bookbearwoodearthheartblood

c-r-i-s-i-sb-e-l-i-e-f

Slow, laborious reading with evidence of letter-by-letter strategy.

Rapid, correct recognition of orally spelled words.

“I just don’t read, okay. One word at a time, I can pick it out if I work at it.”“… I have to spell things. Sometimes I put my finger and block out a long word so that I take it apart, take the word apart and figure it out that way. I have to do that.”

Locks and keys have been in use for thousands of years. Why? Because there have always been thieves.

Reading rate ~ 10 words per minuteComprehension relatively good

Goal◦ Increase reading rate and accuracy for novel text

Approach◦ Repeated oral reading of same texts ◦ Daily homework

Candidacy◦ Word length effect for single words◦ Slow reading rate for text

Relatively preserved visual perception of orthography◦ relatively good letter identification (letter naming)◦ relatively good single word reading accuracy (despite slowness)

Chart1

RRTRRTRRTRRT

four

five

six

seven

Reaction Time (msec)

Reading Reaction Time

2778

3263

4060

5127

HL list 1

DateSubjTrialOrdersort#item#regfrequency#letterslexicalNameStimRTCorrectStim 1ResponseError TypeError subtype

3/27/0815334.0113reg1 HF4N4.wavnews2844Jnews

3/27/0815367.0126reg1 HF4V7.wavbill2494Jbill

3/27/081531214.01312reg1 HF4Adj14.wavwide2105Jwide

3/27/081531413.011414reg2 MF4N13.wavjury6316Jjury

3/27/081531922.011519reg2 MF4N22.wavyard1248Jyard

3/27/081532225.011622reg2 MF4Adj25.wavthin4499Jthin

3/27/081533236.011732reg2 MF4N36.wavtrip2006Jtrip

3/27/081532430.014124reg1 HF5Adj30.wavlarge4958Jlarge

3/27/081531718.015217reg2 MF5N18.wavshape4919Jshape

3/27/081533135.015431reg2 MF5N35.wavmatch4409Jmatch

3/27/081534040.015540reg2 MF5N40.wavdream4788Jdream

3/27/0815312.01741reg2 MF5V2.wavbroke4101Jbroke

3/27/081531017.018110reg1 HF6N17.wavreport5068Jreport

3/27/081531315.018213reg1 HF6N15.wavletter3432Jletter

3/27/081533624.019236irr1 HF6N24.wavfuture5866Jfuture

3/27/081532741.019527reg2 MF6N41.wavmaster2683Jmaster

3/27/081533034.019630reg2 MF6V34.wavwonder5298Jwonder

3/27/0815345.011064irr2 MF6N5.wavcousin4669Jcousin

3/27/081531516.0110715irr2 MF6N16.wavheaven4090Jheaven

3/27/081533532.0110835irr2 MF6Adj32.wavbright4111Jbright

3/27/081533337.0111633reg3 LF6N37.wavkeeper1746Jkeeper

3/27/081531819.0112118reg1 HF7N19.wavfreedom3751Jfreedom

3/27/081532126.0114621irr2 MF7N26.wavlibrary2743Jlibrary

3/27/08153910.01139reg2 MF4N10.wavfile1398LfilefillVSW

3/27/0815323.01402mod irr3 LF4N3.wavriot4470Lriotfoughtsem

3/27/081531120.014611irr1 HF5N20.wavcolor2673Lcolor"cole-er"PPE

3/27/081533438.014734irr1 HF5N38.wavvalue5187LvaluevelourVSW

3/27/0815378.01517reg2 MF5N8.wavtitle4140Ltitle"t..."PW-1

3/27/081532828.015328reg2 MF5N28.wavverse4370LversevirusVSW

3/27/081536529.018565reg1 HF6N29.wavseason3281Lseason"seasom"PINPPE-a

3/27/081532023.0112620irr1 HF7Adj23.wavspecial7233Lspecial"spee-kel"PPE

3/27/081532933.0113129reg2 MF7N33.wavdisease8958LdiseasedizzierVSWPPE-a

3/27/081532327.0114723irr2 MF7N27.wavbrother4131LbrotherbotherVSW

3/27/081533812.0114838irr2 MF7N12.wavgesture3801Lgesture"guess-ture"PPE

3/27/081533921.0114939irr2 MF7N21.wavpatient4059LpatienttalentURWVSW-a

3/27/081531611.0115416reg3 LF7N11.wavincense2764LincenseincreaseVSW

3/27/0815356.011585irr3 LF7Adj6.wavsincere3383Lsincere"sincar"PINPPE-a

3/27/081532631.0115926irr3 LF7N31.wavlecture13019Llecture"leecher"PINPPE-a

3/27/0815389.01128reg2 MF4N9.wavbaby159rejbaby

3/27/081533739.017537reg3 LF5N39.wavelbow120rejelbow

HL list 2

DateSubjTrialOrdersort#item#regfrequency#letterslexicalNameStimRTCorrectStim 1ResponseError typeError subtype

3/27/08153435.013543irr2 MF4Adj5.wavwarm1815crwarm(false start)

3/27/08153446.01444reg1 HF4N6.wavdate2155Jdate

3/27/081534910.011949reg2 MF4N/V10.wavpass1546Jpass

3/27/081535414.012154reg2 MF4N14.wavlady3861Jlady

3/27/081535923.012259reg2 MF4V23.wavkill1586Jkill

3/27/081537237.012372reg2 MF4N37.wavclay2035Jclay

3/27/081535216.013652irr2 MF4N16.waviron1437Jiron

3/27/081536426.013964mod irr/reg3 LF4N26.wavpity3542Jpity

3/27/081535124.014251reg1 HF5V24.wavspeak2344Jspeak

3/27/081535718.015657reg2 MF5Adj18.wavfresh2055Jfresh

3/27/081538041.015880reg2 MF5N41.wavmotor4121Jmotor

3/27/08153424.017042irr2 MF5N4.wavnovel2894Jnovel

3/27/081536831.017268irr2 MF5N31.wavocean2165Jocean

3/27/081537736.017677reg3 LF5N36.wavlobby2603Jlobby

3/27/081535821.018358reg1 HF6N21.wavdegree5058Jdegree

3/27/081536227.018462reg1 HF6N27.wavcenter3232Jcenter

3/27/081537638.018676reg1 HF6N38.wavreason3771Jreason

3/27/081532528.019125mod irr1 HF6N28.wavhealth3132Jhealth

3/27/08153458.019745reg2 MF6V8.wavtravel3342Jtravel

3/27/081535519.019855reg2 MF6N19.wavburden3660Jburden

3/27/081537030.019970reg2 MF6N30.wavfellow5019Jfellow

3/27/081536732.0110967irr2 MF6Adj32.wavactive5936Jactive

3/27/081537335.0111073irr2 MF6N35.wavgenius11674Jgenius

3/27/08153473.0112247reg1 HF7Adj3.wavmillion2285Jmillion

3/27/081536012.0112360reg1 HF7N12.wavproblem3432Jproblem

3/27/081536629.0113366reg2 MF7N29.wavkingdom13778Jkingdom

3/27/08153697.0113469reg2 MF7V7.wavdestroy5476Jdestroy

3/27/081537840.0115178irr2 MF7N40.wavjournal3791Jjournal

3/27/081537939.0115279irr2 MF7N39.wavcaptain3562Jcaptain

3/27/081535620.0115556reg3 LF7N20.wavnursery3402Jnursery

3/27/08153412.016941irr2 MF5Adj2.wavquiet8111LquietquitVSW

3/27/081534611.011846reg2 MF4N11.wavcamp3263LcampcombVSW

3/27/081535013.012050reg2 MF4N13.wavheat1736LheatheartVSW

3/27/081537517.014875irr1 HF5N17.wavgroup5427LgroupgropeVSW

3/27/081537133.015771reg2 MF5N33.wavanger1956LangerinjureURW

3/27/08153489.017148irr2 MF5N9.wavknife2942LknifenoteURW

3/27/081537434.0111174irr2 MF6N34.wavregion2514LregionregainVSWPPE-a

3/27/081536125.0113261reg2 MF7N25.wavweather4928LweatherwesterVSWPPE-a

3/27/081535315.0114553mod irr2 MF7N15.wavopinion3522Lopinion"optum"PINPPE-a

3/27/081536322.0115063irr2 MF7Adj22.wavancient12242LancientaccentVSW

HL list 3


3/27/08153846.01684reg1 HF4V/N6.wavrace3362crrace(self-correction)

3/27/081539215.01792reg1 HF4V15.wavstop1916Jstop

3/27/081538910.012489reg2 MF4Adj10.wavnine4678Jnine

3/27/081539418.012594reg2 MF4V/N18.wavvote1277Jvote

3/27/081539820.012698reg2 MF4N20.wavcast2174Jcast

3/27/0815310123.0127101reg2 MF4N23.wavjack3172Jjack

3/27/0815311234.0128112reg2 MF4N34.wavfair4450Jfair

3/27/08153868.013286mod irr2 MF4N8.wavhero5089Jhero

3/27/081538326.013783irr2 MF4Adj26.wavzero4410Jzero

3/27/0815310325.0143103reg1 HF5N25.wavparty3431Jparty

3/27/0815311422.0149114irr1 HF5Adj22.wavheavy1946Jheavy

3/27/081538814.016088reg2 MF5N14.wavbirth1567Jbirth

3/27/08153914.016191reg2 MF5Adj4.wavhappy2903Jhappy

3/27/0815311133.0163111reg2 MF5N33.wavgrace4051Jgrace

3/27/0815312041.0168120mod irr2 MF5N41.wavdrama3501Jdrama

3/27/0815310830.0177108reg3 LF5N30.wavnerve5537Jnerve

3/27/0815311738.0178117reg3 LF5N38.wavjelly1337Jjelly

3/27/081539716.018797reg1 HF6N16.wavincome1746Jincome

3/27/081539013.019390irr1 HF6N13.wavvolume7033Jvolume

3/27/0815310628.01101106reg2 MF6Adj28.wavnarrow4409Jnarrow

3/27/081531045.01112104irr2 MF6N5.wavjunior3502Jjunior

3/27/0815311032.01113110irr2 MF6N32.wavvision2064Jvision

3/27/0815311536.01114115irr2 MF6N36.wavdanger3224Jdanger

3/27/0815311335.01119113irr3 LF6N35.wavpigeon3331Jpigeon

3/27/08153879.0112787irr1 HF7Adj9.wavnatural3960Jnatural

3/27/0815310021.01135100reg2 MF7N21.wavvictory2774Jvictory

3/27/0815310224.01136102reg2 MF7N24.wavteacher8539Jteacher

3/27/0815310527.01137105reg2 MF7N27.wavgallery4839Jgallery

3/27/0815310931.01138109reg2 MF7V31.wavexpress2425Jexpress

3/27/0815311839.01139118reg2 MF7N39.wavquarter7252Jquarter

3/27/0815311940.01140119reg2 MF7N/V40.wavbalance3152Jbalance

3/27/0815310729.01156107reg3 LF7N29.wavjanitor11204Jjanitor

3/27/08153823.01582reg1 HF4N3.wavmiss1436LmissmistVSW

3/27/08153812.015981reg2 MF5Adj2.wavrural4270LruralruleURWVSW-a

3/27/081539619.016296reg2 MF5N/V19.wavwatch2136LwatchwitchVSW

3/27/0815311637.0188116reg1 HF6N37.wavground5907LgroundgrandVSW

3/27/08153857.0110085reg2 MF6N7.wavthroat4289LthroatthrowVSW

3/27/081539512.0111795reg3 LF6N12.wavjungle3362LjunglejournalURWVSW-a

3/27/081539311.0112893irr1 HF7N11.wavmachine7841Lmachine"may-chin"PPE

3/27/081539917.0112999irr1 HF7N17.wavthought8051LthoughtthroughVSW

HL list 4


3/27/081531246.018124reg1 HF4N6.wavgame1556Jgame

3/27/0815313717.019137reg1 HF4N17.wavdeal1755Jdeal

3/27/081531223.0110122mod irr/reg1 HF4N3.wavopen3062Jopen

3/27/0815314221.0111142irr1 HF4N21.wavunit3103Junit

3/27/081531298.0129129reg2 MF4N/V8.wavlord3981Jlord

3/27/0815313311.0130133reg2 MF4N11.wavgray3503Jgray

3/27/0815315231.0131152reg2 MF4N31.wavmark2625Jmark

3/27/0815312610.0133126mod irr2 MF4N10.wavevil2444Jevil

3/27/081531212.0144121reg1 HF5Adj2.wavpower3153Jpower

3/27/0815314424.0145144reg1 HF5N24.wavrange2285Jrange

3/27/081531289.0164128reg2 MF5N9.wavframe5547Jframe

3/27/0815313113.0165131reg2 MF5V13.wavdance2435Jdance

3/27/0815315130.0166151reg2 MF5N30.wavwidow9497Jwidow

3/27/0815316041.0167160reg2 MF5N41.wavurban3841Jurban

3/27/0815313632.0173136irr2 MF5Adj32.wavyouth1566Jyouth

3/27/0815315740.0179157reg3 LF5N40.wavcable3143Jcable

3/27/0815314819.0180148irr3 LF5N19.wavjuice2514Jjuice

3/27/0815315637.0190156reg1 HF6N37.wavsingle2534Jsingle

3/27/0815313818.0194138irr1 HF6N18.wavpretty3781Jpretty

3/27/0815314726.01102147reg2 MF6Adj26.wavescape3761Jescape

3/27/081531257.01105125mod irr2 MF6V7.wavoxygen4989Joxygen

3/27/0815314525.01115145irr2 MF6N25.wavweight8161Jweight

3/27/0815313415.01120134irr3 LF6N15.wavshower3162Jshower

3/27/081531274.01124127reg1 HF7Adj4.wavrespect22968Jrespect

3/27/0815315838.01130158irr1 HF7N38.wavtrouble6145Jtrouble

3/27/0815314123.01141141reg2 MF7N23.wavwelcome3681Jwelcome

3/27/0815314928.01143149reg2 MF7V28.wavharmony4709Jharmony

3/27/0815315939.01144159reg2 MF7N39.wavvariety2944Jvariety

3/27/0815313214.01153132irr2 MF7N14.wavfailure7842Jfailure

3/27/0815313516.01157135reg3 LF7N16.wavrejoice6226Jrejoice

3/27/0815313935.0134139mod irr2 MF4V35.wavsoft5068LsoftsortVSW

3/27/0815315434.0150154irr1 HF5N34.wavtrial4011LtrialtrailVSW

3/27/0815313012.0189130reg1 HF6N12.wavnation7263LnationnothingURWVSW-a

3/27/0815315029.01103150reg2 MF6N29.wavminute7451LminutemuteVSW

3/27/0815315536.01104155reg2 MF6N36.wavleader4000LleaderlaborURWVSW-a

3/27/0815315333.01118153reg3 LF6N33.wavkernel2414LkernelcaramelVSW

3/27/0815314020.01125140reg1 HF7N20.wavhusband2804Lhusbandhas beenURWVSW-a

3/27/0815314322.01142143reg2 MF7Adj22.wavcontact5657LcontactconsentVSW

3/27/0815314627.01160146irr3 LF7N27.wavknuckle35687Lknuckle"kangkle"PINPPE-a

3/27/081531235.0138123irr2 MF4Adj5.wavvein269rejvein

RRT compiled































Mean2777.6896551724292895.65488.20

SD1143.77373834691296.33030




























Mean3263.4814814815273486.16868.70

SD1236.63440186441691.3103.5































Mean4060.3333333333304305.98280.70

SD1466.81819227721987.4331.1
























Mean5126.608695652223587015135.80

SD2928.03698963114632.9

Outliers





RRT graph

# lettersRRT# correct

four277829

five326327

six406030

seven512723

RRT graph

four

five

six

seven



Expectation ◦ increased reading rate for new text◦ improved access to orthography, so that reliance on

letter-by-letter reading decreases and whole-word recognition improves

Why treat at text-level rather than single words?◦ Word recognition is assisted by syntactic constraints of sentences semantic content and memory from repeated reading◦ Text reading is the ultimate goal

Reading Materials◦ From any source, but need to control for difficulty Determine grade level using readability statistics in Microsoft Word

◦We have used passages from Scientific Research Associates Reading Laboratory (SRA, 1978) Controlled for length and complexity Reading levels range from grade 1 to grade 6 Most content is interesting and appropriate for adult

readers

Microsoft Word◦ File Options Proofing◦ Check “Show readability statistics”◦ Flesch-Kinkaid grade level will show up when you run spelling/grammar check.

Locks and keys have been in use for thousands of years. Why? Because there have always been thieves.

In Greece, long ago people had locks and keys. But they had a hard time taking their keys with them when they left their homes. That’s because the keys were too big. They were so big that they had to be carried on people’s backs. Some people left their key with a man who sat near their front door. He unlocked the door for the family or their friends. But if thieves came, he used the big key to fight them off.

The city of Petra, now an archaeological site in modern day Jordan, was at the height of prosperity in the first century B.C. Petra’s inhabitants accumulated wealth through trade of gold, silver, incense, brass, iron, saffron, sculpture, paintings and purple garments. During its heyday, which lasted for about 500 years, Petra was one of the most lavish cities in history. At its peak, the population was nearly 30,000 people. The citizens of Petra were unique in the ancient world for their abhorrence of slavery, for the prominent role women played in political life and for their egalitarian approach to governing.

Collect reading rate and accuracy data◦ Baseline: Three sessions prior to starting treatment

Rate (words per minute) = (#words/#seconds) x 60 seconds Accuracy (errors per 100 words) = (#errors/#words) x 100

◦ Probe at beginning of each session for practiced and new text Treatment sessions

Repeated oral reading of targeted text Clinician point out errors and provide assistance with difficult

words or passages. Daily homework!◦ Oral reading of practice text at least 3-5 times per day◦ Homework log for accountability

Beeson, 1998

Locks and keys have been in use for thousands years. Why? Because there have always been thieves.

Beeson, 1998

Improved reading rate while maintaining good accuracy

Resumed work as plumber Resumed pleasure reading

9 months post stroke; 6 months of MOR Tx

PreTx 9 mos. 24 mos

0

10

20

30

40

50

60

70

80

9 10 11 12 13 14 15 16 17 18 19 20 22 23 24 25 26 28 29 30 31 32 33 37 38 39 40 46 47 48 49 47 52 54

Weeks Post Onset

Wor

ds p

er M

inut

e

0%

1%

2%

3%

4%

5%

6%

7%

erro

rs p

er 1

00 w

ords

rateerrors

No Tx Multiple Oral Rereading Tx

rate

errors

Beeson, Magloire, & Robey(2005). Behavioural Neurology.

forcoloq2

4-5 weeks9-10 weeks*24-28 weeks36 weeks52 weeks

4 letter1766614

5 letter38912134

6 letter3914044

7 letter43190130

456910111214

Letter Naming67.388.594.394.2100

Reading - Gram Class7594

Reading - Image/Freq58.791

4-5 weeks (r=.32)*24-28 weeks (r=.42)*36 weeks (r=.04)52 weeks (r=.15)

4 letter7377.93547.043614.252528.8

5 letter11005.74339.77419354843819.6190476193267.5

6 letter14800.84441.13470.9629629632718.8

7 letter14740.38047.9629629634033.59090909093433.1

Mean7377.863636363611005.739130434814800.833333333314740.33333333333547.044339.77419354844441.18047.9629629633614.253819.6190476193470.9629629634033.59090909092528.78571428573267.52718.77777777783433.1363636364

stdev4258.14443486119022.699536660511909.65186826176399.28897464031825.01480541942768.78728820252385.8732938614320.58305788861979.99139728772095.63182539762017.42433813862408.9241554229894.03305553861410.79031602481324.31510116721578.079553051

4-5 weeks (r=.32)*24-28 weeks (r=.42)*36 weeks (r=.04)52 weeks (r=.15)

4 letter7377.93547.043614.252528.8

5 letter11005.74339.77419354843819.6190476193267.5

6 letter14800.84441.13470.9629629632718.8

7 letter14740.38047.9629629634033.59090909093433.1

4258.14443486111825.01480541941979.9913972877894.0330555386

9022.69953666052768.78728820252095.63182539761410.7903160248

11909.65186826172385.8732938612017.42433813861324.3151011672

6399.28897464034320.58305788862408.92415542291578.079553051

45691011121424283652

Letter Naming67.388.594.394.2100

Words-Gram class7594969699

Words-Image/freq58.791959597.5

458910122124283652

Reading Accuracy - Image/freq58.791959597.5

Reading Accuracy - Gram Class7594969699

Reading RT -Image/freq83.22.83

Reading RT -GramClass1843.12.9

4524283652

Reading-Image/freq83.22.83

Reading-GramClass1843.12.9

forcolloq

45691011121445691011121424283652

Letter Naming32.711.55.75.80Letter Naming32.711.55.75.80

Words - Gram Class256Words-Gram class256441

Words - Image/Freq41.39Words-Image/freq41.39552.5

5 weeksB110.044 letter5 letter6 letter7 letter4-5 weeks9-10 weeks*24-28 weeks36 weeks52 weeks

B317.964-5 weeks173839434 letter1766614

B56.479-10 weeks*6914195 letter38912134

24-28 weeks612006 letter3914044

7 weeksA13936 weeks6134137 letter43190130

A315.352 weeks14440

A521.94-5 weeks9-10 weeks*24-28 weeks36 weeks52 weeks

41766614

4 letter5 letter6 letter7 letter4 letter5 letter6 letter7 letter538912134

4-5 weeks836261574-5 weeks1738394363914044

9-10 weeks949186819-10 weeks*681419743190130

24-28 weeks948810010024-28 weeks61200

36 weeks9487968736 weeks613413

52 weeks86969610052 weeks14440

4591012212428365152

Reading - Image/freq58.791959597.5

Writing - Image/freq52.563847166


Writing - Gram Class6677.575

591228365152

4591012212428365152



4524283652

Reading-Image/freq83.22.83

Reading-GramClass1843.12.9

correct

4589101221242728365152





BNT71.778.378.383.3

error

4589101221242728365152





BNT28.321.721.716.7

458910121421242728365152



BNT71.778.378.383.3

Letter Naming67.388.594.394.2100

data

4 letter5 letter6 letter7 letter4-5 weeks (r=.32)*24-28 weeks (r=.42)*36 weeks (r=.04)52 weeks (r=.15)

4-5 weeks836261574 letter7377.93614.32071.62528.8

9-10 weeks949186815 letter11005.73819.62625.93267.5

24-28 weeks94881001006 letter14800.834712952.12718.8

36 weeks948796877 letter14740.34033.63610.73433.1

52 weeks869696100

5/27/9910/07/9912/23/993/21/00

weeks post onset8273651

BNT71.778.378.383.3

Single word reading

Letter Naming4/22/995/27/996/17/997/1/99

Letter Naming32.69230769235.76923076925.769230769203/30/0075%94%96%96%99%

5/7/9906/04/9910/14/9912/23/9917594969699

Grammatical class256443/30/00

4/23/9906/11/9909/16/9912/23/992.50.5870.910.950.950.975

Imageability frequency41.395558.791959597.5

45691011121424283652

Letter Naming32.711.55.75.80

Words-Gram class256441

Words-Image/freq41.39552.5

Imagery/frequency lists

P-31459102124365152

Reading0.5870.910.950.950.975

Writing0.5250.630.840.710.66

Grammatical Class

P-32591228365152

Reading7594969699

Writing6677.575

GORT datawpmerrorserrorsscsaverage errorweeks7.3

B110.0495/6/995/6/99B1917.35/6/992.002.3

5 weeksB317.962B3255/20/994.000.3

B56.4711B511612/15/9935.000.67

05/20/995/20/99A1012.32/3/001

A1394A3423/30/0052.00

7 weeksA315.33A533

A521.9012/15/9912/15/99B2010.3

0B404

37 weeksB279.912/3/002/3/00A2100.67

B4580A401

1A612

A24503/30/003/30/00B1001

44 weeksA449.61B311

A636.92B521

B192.3

52 weeksB363

B547.8

2003fig2bwalternate

4-5 weeks (r=.32)*4-5 weeks (r=.32)*4-5 weeks (r=.32)*4-5 weeks (r=.32)*4258.14443486114258.14443486119022.69953666059022.699536660511909.651868261711909.65186826176399.28897464036399.2889746403


36 weeks (r=.04)36 weeks (r=.04)36 weeks (r=.04)36 weeks (r=.04)1979.99139728771979.99139728772095.63182539762095.63182539762017.42433813862017.42433813862408.92415542292408.9241554229


Pre-Treatment

Treatment

4 letter

5 letter

6 letter

7 letter

Weeks post stroke

Milliseconds

7377.9

11005.7

14800.8

14740.3

3547.04

4339.7741935484

4441.1

8047.962962963

3614.25

3819.619047619

3470.962962963

4033.5909090909

2528.8

3267.5

2718.8

3433.1

2003fig2bw





Pre-Treatment

Treatment

4 letter

5 letter

6 letter

7 letter

Weeks post stroke

Milliseconds

7377.9

11005.7

14800.8

14740.3

3547.04

4339.7741935484

4441.1

8047.962962963

3614.25

3819.619047619

3470.962962963

4033.5909090909

2528.8

3267.5

2718.8

3433.1

2003fig3bw

B15 weeks

B3

B5

A17 weeks

A3

A5

B237 weeks

B4

A244 weeks

A4

A6

B152 weeks

B3

B5

Pre-Treatment

Treatment

Words per minute

10.04

17.96

6.47

39

15.3

21.9

79.9

58

45

49.6

36.9

92.3

63

47.8

2003fig1bw

4-5 weeks4-5 weeks4-5 weeks4-5 weeks



36 weeks36 weeks36 weeks36 weeks


Pre-Treatment

Treatment

4 letter

5 letter

6 letter

7 letter

Percent Correct

83

62

61

57

94

91

86

81

94

88

100

100

94

87

96

87

86

96

96

100

Fig4-PB

11

&A

Page &P

#REF!

#REF!

weeks post onset

words per minute

errors per 100 words

1

Fig4 -PB2

90.0171428571

100.0514285714

110.0171428571

120.0142857143

130.0371428571

140.0171428571

150.0514285714

160.0342857143

170.0314285714

180.0285714286

190.0285714286

200.0314285714

220.06

230.0371428571

240.04

250.0085714286

260.0114285714

280.0114285714

290

300.0057142857

310.0171428571

320.0171428571

330.0114285714

37

380.0257142857

390.0171428571

40

46

470.02

48

490.0057142857

470.0085714286

520.0057142857

540.0057142857

&A

Page &P

rate

errors

Weeks Post Onset

Words per Minute

errors per 100 words

14.77

24.69

25.18

27.8504672897

28.9944134078

39.8757763975

33.687150838

27.3568281938

38.15625

41.2110726644

29.063583815

34.9565217391

38.9

38.1538461538

42.1164021164

41.5122873346

41.5122873346

45.4545454545

41.0097087379

47.7657266811

57.48

64

40

48.9

60

62.71

49.35

67.3

51.73

50.76

DATA PB

weeksrateerrorserrors(n)

20-May914.770.01714285716

27-May1024.690.051428571418

3-Jun1125.20.01714285716

10-Jun1227.90.01428571435

17-Jun1329.00.037142857113

24-Jun1439.90.01714285716

1-Jul1533.70.051428571418

8-Jul1627.40.034285714312

15-Jul1738.20.031428571411

22-Jul1841.20.028571428610last 3wpmerror

29-Jul1929.10.028571428610mean30.4830.030

5-Aug2035.00.031428571411sd7.5200.0126

20-Aug2238.90.0621TX beginsmean39.72341609010.0457142857

27-Aug2338.20.037142857113first 3sd2.10570011690.012453997

2-Sep2442.10.0414

7-Sep2541.50.00857142863

16-Sep2641.50.01142857144

30-Sep2845.50.01142857144

7-Oct2941.000

14-Oct3047.80.00571428572wpmerror

21-Oct3157.480.01714285716all txmean49.3700.017

28-Oct32640.01714285716sd9.3530.015

4-Nov3340.00.01142857144

2-Dec37eye?

penguin9-Dec3848.90.02571428579

kids?15-Dec39600.01714285716

23-Dec40vacation 41-45

3-Feb46

10-Feb4762.710.027

17-Feb48

24-Feb4949.350.00571428572

9-Mar4767.30.00857142863last 3mean56.59666666670.0066666667

21-Mar5251.730.00571428572sd9.28203821010.0016495722

30-Mar5450.760.00571428572

old fig 4

old fig 4

77

88

99

1010

1111

1212

1313

1414

1515

1616

1717

1818

2020

2121

2222

2323

2424

2626

2727

2828

3030

3131

3535

3636

4444

4646

4747

4949

5151

Pre-Treatment

Treatment

Rate

# Errors

Weeks post stroke

Words per Minute

Errors per 100 words

14.77

0.0171428571

24.69

0.0514285714

25.18

0.0171428571

27.8504672897

0.0142857143

28.9944134078

0.0371428571

39.8757763975

0.0171428571

33.687150838

0.0514285714

27.3568281938

0.0342857143

38.15625

0.0314285714

41.2110726644

0.0285714286

29.063583815

0.0285714286

34.9565217391

0.0314285714

38.9

0.06

38.1538461538

0.0371428571

42.1164021164

0.04

41.5122873346

0.0085714286

41.5122873346

0.0114285714

45.4545454545

0.0114285714

41.0097087379

0

47.7657266811

0.0057142857

57.48

0.0171428571

64

0.0171428571

40.03

0.0142857143

48.9

0.0257142857

62.71

0.02

49.35

0.0057142857

67.3

0.0085714286

51.73

0.0057142857

50.76

0.0057142857

2003fig4

77

88

99

1010

1111

1212

1313

1414

1515

1616

1717

1818

2020

2121

2222

2323

2424

2626

2727

2828

3030

3131

3535

3636

4444

4646

4747

4949

5151

&A

Page &P

Pre-Treatment

Treatment

Rate

# Errors

Weeks post stroke

Words per Minute

Errors per 100 words

14.77

0.0171428571

24.69

0.0514285714

25.18

0.0171428571

27.8504672897

0.0142857143

28.9944134078

0.0371428571

39.8757763975

0.0171428571

33.687150838

0.0514285714

27.3568281938

0.0342857143

38.15625

0.0314285714

41.2110726644

0.0285714286

29.063583815

0.0285714286

34.9565217391

0.0314285714

38.9

0.06

38.1538461538

0.0371428571

42.1164021164

0.04

41.5122873346

0.0085714286

41.5122873346

0.0114285714

45.4545454545

0.0114285714

41.0097087379

0

47.7657266811

0.0057142857

57.48

0.0171428571

64

0.0171428571

40.03

0.0142857143

48.9

0.0257142857

62.71

0.02

49.35

0.0057142857

67.3

0.0085714286

51.73

0.0057142857

50.76

0.0057142857

2003fig5

4444

5555

8888

9999

10101010

12121212

14141414

21212121

24242424

27272727

28282828

36363636

51515151

52525252

Pre-Treatment

Treatment

Writing - Image/freq

Writing - Gram Class

BNT

Letter Naming

Weeks post stroke

Percent correct

67.3

52.5

88.5

71.7

94.3

63

66

94.2

100

84

78.3

71

77.5

78.3

66

75

83.3

2003FIG1color






Pre-Treatment

Treatment

4 letter

5 letter

6 letter

7 letter

Percent Correct

Fig. 1. RB’s reading accuracy for single words (of 4, 5, 6, and 7 letters) over the course of one year following stroke

83

62

61

57

94

91

86

81

94

88

100

100

94

87

96

87

86

96

96

100

2003FIG2color





Pre-Treatment

Treatment

4 letter

5 letter

6 letter

7 letter

Weeks post stroke

Milliseconds

Fig 2. RB’s single-word reading reaction time by word length (in letters) over the course of one year following stroke. * statistically significant correlation between word length and reaction time.

7377.9

11005.7

14800.8

14740.3

3547.04

4339.7741935484

4441.1

8047.962962963

3614.25

3819.619047619

3470.962962963

4033.5909090909

2528.8

3267.5

2718.8

3433.1

2003FIG3color

B15 weeks

B3

B5

A17 weeks

A3

A5

B237 weeks

B4

A244 weeks

A4

A6

B152 weeks

B3

B5

Pre-Treatment

Treatment

Words per minute

Fig. 3. RB’s reading rate for text on the Gray Oral Reading Test-3.

10.04

17.96

6.47

39

15.3

21.9

79.9

58

45

49.6

36.9

92.3

63

47.8


< 30% correct >30%

bump

debt

pint


0

1000

2000

3000

4000

5000

6000

RRT

Rea

ctio

n Ti

me

(mse

c)

fourfivesixseven

Word-length effect, but also evidence of surface errors (phonologically plausible)

L R

76 y o male; 14 years educationMild Anomic aphasiaWAB AQ: 91.4; BNT: 50/60

PCA stroke

Chart1

RRTRRTRRTRRT

four

five

six

seven



2778

3263

4060

5127

HL list 1










































HL list 2










































HL list 3










































HL list 4










































RRT compiled































Mean2777.6896551724292895.65488.20

SD1143.77373834691296.33030




























Mean3263.4814814815273486.16868.70

SD1236.63440186441691.3103.5































Mean4060.3333333333304305.98280.70

SD1466.81819227721987.4331.1
























Mean5126.608695652223587015135.80

SD2928.03698963114632.9

Outliers





RRT graph


four277829

five326327

six406030

seven512723

RRT graph

four

five

six

seven




0

1000

2000

3000

4000

5000

6000

RRT

Rea

ctio

n Ti

me

(mse

c)

fourfivesixseven

HARDMILEGRUMBLECIRCUITLEARNROUTINEFACTCHANTBOWLCHARGEVAGUEDEBTGROSS

Phonologically plausible spelling errors

Word length effect for reading time

Spelling

0102030405060708090

100

Word Type

% C

orre

ct RegIrregNon

Surface agraphia profile• Single Word Reading Accuracy: 96%• Overt letter-by-letter reading

Chart1

RRTRRTRRTRRT

four

five

six

seven



2778

3263

4060

5127

HL list 1










































HL list 2










































HL list 3










































HL list 4










































RRT compiled































Mean2777.6896551724292895.65488.20

SD1143.77373834691296.33030




























Mean3263.4814814815273486.16868.70

SD1236.63440186441691.3103.5































Mean4060.3333333333304305.98280.70

SD1466.81819227721987.4331.1
























Mean5126.608695652223587015135.80

SD2928.03698963114632.9

Outliers





RRT graph


four277829

five326327

six406030

seven512723

RRT graph

four

five

six

seven



Chart2

9057.585

Reg

Irreg

Non

Word Type

% Correct

Spelling

Summary

Totalraw% correct

Screening Measures

Direct Copy5555100.00

Case Conversion - upper to lower2626100.00

Case conversion - lower to upper262596.15

Colored Progressive Matrices363288.89HIHFHILFLIHFLILFNW

Visual Lexical Decision604778.33

General Comprehension/Pr

pélagie m. beeson, ph.d., ccc-slp department of speech ......in greece, long ago people had locks...

Documents