An increasing number of cognitive neuropsychological treatment studies of acquired dysgraphia have been published in recent years, but to our knowledge there are no corresponding studies of developmental dysgraphia. This paper reports a cognitive neuropsychological treatment programme designed for a child with developmental surface dysgraphia. The treatment aim was to improve functioning of the orthographic output lexicon, and so treatment methods targeted irregular word spelling. Treatment methods were based on previous successful treatments employed in cases of adult acquired surface dysgraphia (Behrmann, 1987; De Partz, Seron, & Van der Linden, 1992; Weekes & Coltheart, 1996). Results showed a significant treatment effect for both spelling and reading of irregular words that was largely stable over time and that generalised partially to spelling of untreated irregular words. Homophone words were not treated but some aspects of homophone reading and spelling also improved, though homophone confusion errors remained. Comparison of treatment effectiveness with and without mnemonics suggested that the mnemonic cue itself was not necessary to achieve treatment success for irregular word spelling. Analyses revealed that untreated irregular words whose spellings became correct as a result of treatment generalisation were those whose original misspellings were closest to being correct prior to treatment. Results also provided preliminary evidence that the mechanism underlying treatment generalisation involved improved access to orthographic representations, resulting in an increased tendency to employ orthography for spelling attempts and reduced reliance on phoneme to grapheme conversion.
In the current report we describe a successful training study aimed at improving recognition of a set of familiar face photographs in K., a 4-year-old girl with congenital prosopagnosia (CP). A detailed assessment of K.'s face-processing skills showed a deficit in structural encoding, most pronounced in the processing of facial features within the face. In addition, eye movement recordings revealed that K.'s scan paths for faces were characterized by a large percentage of fixations directed to areas outside the internal core features (i.e., eyes, nose, and mouth), in particular by poor attendance to the eye region. Following multiple baseline assessments, training focused on teaching K. to reliably recognize a set of familiar face photographs by directing visual attention to specific characteristics of the internal features of each face. The training significantly improved K.'s ability to recognize the target faces, with her performance being flawless immediately after training as well as at a follow-up assessment 1 month later. In addition, eye movement recordings following training showed a significant change in K.'s scan paths, with a significant increase in the percentage of fixations directed to the internal features, particularly the eye region. Encouragingly, not only was the change in scan paths observed for the set of familiar trained faces, but it generalized to a set of faces that was not presented during training. In addition to documenting significant training effects, our study raises the intriguing question of whether abnormal scan paths for faces may be a common factor underlying face recognition impairments in childhood CP, an issue that has not been explored so far.
This paper presents a single case study investigating the mechanisms underlying generalization of treatment benefits to untrained words in spelling. Brunsdon, Coltheart, and Nickels (2005) observed that untreated words that improved tended to be those whose errors were closest to being correct prior to treatment. These words also tended to be high in written frequency. The present study employed the same treatment techniques as those used by Brunsdon et al. with K.M., a developmental surface dysgraphic. During a first treatment the characteristics of words whose spelling improved without specific training were identified. These characteristics were then used in a second treatment to test whether it was possible to predict generalization. The results showed that treatment generalization to untreated irregular words was best predicted by neighbourhood size and frequency. We suggest that the processes underlying treatment generalization are based on the interaction between the orthographic lexicon and the graphemic buffer. Clinical implications are discussed.
This paper reports a treatment case study focused on face perception impairments designed for AL, an 8-year-old child with prosopagnosia. AL's prosopagnosia was characterized by deficits at the level of structural encoding-that is, he was unable to achieve normal basic perception of faces. This impairment then impacted on all subsequent aspects of familiar- and unfamiliar-face processing. Detailed assessment of feature processing revealed impairments in perception of facial features with a dissociation between relatively good perception of the mouth feature and poor perception of eye and nose features. Interestingly, results also suggested at least partial internal representation of facial features despite long-standing deficits in perception of these features. A treatment programme focused on training in perception, and analysis of facial features and familiar-face naming was conducted. Treatment resulted in excellent face naming for familiar faces, a decreased reliance on nonfacial cues and a reduction in AL's tendency to misidentify unfamiliar faces as family members.
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