Lott Susan Nitzberg, Carney Aimee Syms, Glezer Laurie S, Friedman Rhonda B
Department of Neurology and Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, Washington, DC USA.
Aphasiology. 2010 Nov;24(11):1424-1442. doi: 10.1080/02687030903580333.
Letter-by-letter readers identify each letter of the word they are reading serially in left to right order before recognizing the word. When their letter naming is also impaired, letter-by-letter reading is inaccurate and can render even single word reading very poor. Tactile and/or kinesthetic strategies have been reported to improve reading in these patients, but only under certain conditions or for a limited set of stimuli. AIMS: The primary aim of the current study was to determine whether a tactile/kinesthetic treatment could significantly improve reading specifically under normal reading conditions, i.e. reading untrained words presented in free vision and read without overt use of the strategy. METHODS #ENTITYSTARTX00026; PROCEDURES: Three chronic letter-by-letter readers participated in a tactile/kinesthetic treatment aimed at first improving letter naming accuracy (phase 1) and then letter-by-letter reading speed (phase 2). In a multiple case series design, accuracy and speed of reading untrained words without overt use of the trained tactile/kinesthetic strategy was assessed before phase 1, after phase 1 and again after phase 2. OUTCOMES #ENTITYSTARTX00026; RESULTS: All three patients significantly improved both their speed and accuracy reading untrained words without overt use of the trained tactile/kinesthetic strategy. All three patients required the additional practice in phase 2 to achieve significant improvement. Treatment did not target sentence level reading, yet two of the three patients became so adept that they could read entire sentences. CONCLUSIONS: This study replicates previous findings on the efficacy of tactile/kinesthetic treatment for letter-by-letter readers with poor letter naming. It further demonstrates that this treatment can alter cognitive processing such that words never specifically trained can be read in free vision without overtly using the trained strategy. The data suggest that an important element in achieving this level of generalization is continuing training beyond the point of initial mastery (i.e. accurate letter naming).
逐字母阅读者在识别单词之前，会按照从左到右的顺序逐个识别他们正在阅读的单词中的字母。当他们的字母命名能力也受损时，逐字母阅读就会不准确，甚至会使单个单词的阅读能力变得很差。据报道，触觉和/或动觉策略可以改善这些患者的阅读能力，但仅在某些条件下或针对有限的一组刺激有效。目的：本研究的主要目的是确定触觉/动觉治疗是否能在正常阅读条件下显著提高阅读能力，即在自由视觉中呈现未经训练的单词且不明显使用该策略的情况下进行阅读。方法#实体开始X00026；程序：三名慢性逐字母阅读者参与了一项触觉/动觉治疗，该治疗首先旨在提高字母命名准确性（第一阶段），然后提高逐字母阅读速度（第二阶段）。在多案例系列设计中，在第一阶段之前、第一阶段之后以及第二阶段之后，评估在不明显使用训练过的触觉/动觉策略的情况下阅读未经训练单词的准确性和速度。结果#实体开始X00026；结果：所有三名患者在不明显使用训练过的触觉/动觉策略的情况下，阅读未经训练单词的速度和准确性均有显著提高。所有三名患者在第二阶段都需要额外的练习才能取得显著改善。治疗并未针对句子层面的阅读，但三名患者中有两名变得非常熟练，以至于他们能够阅读完整的句子。结论：本研究重复了先前关于触觉/动觉治疗对字母命名能力差的逐字母阅读者有效性的研究结果。它进一步证明，这种治疗可以改变认知加工，使得在自由视觉中可以阅读从未专门训练过的单词，而无需明显使用训练过的策略。数据表明，实现这种泛化水平的一个重要因素是在初步掌握（即准确的字母命名）之后继续训练。
