Swamy Akshaya, Goswami Sathyapal Puri
Department of Speech and Hearing, Father Muller College, Mangalore, IND.
Deaprtment of Speech Language Pathology, All India Institute of Speech and Hearing, Mysuru, IND.
Cureus. 2024 Jun 29;16(6):e63437. doi: 10.7759/cureus.63437. eCollection 2024 Jun.
Alexia is an acquired condition resulting in impaired abilities to comprehend and/or read aloud written scripts secondary to lesions in the brain involved in reading processes. Just as how linguistic aspects are multi-faceted in persons with aphasia (PWAs), the reading impairments also vary extensively across each PWA depending on the type and nature of the language deficits. Each language has its unique linguistic properties. Whether the impairment is in the spoken form or written form, the dissociations in both aspects across the linguistic distinctions are paramount. Given the diverse orthographic features of Kannada, alongside inquiries into the impairment in oral language skills among individuals with acquired reading difficulties, the study emphasizes distinguishing the concurrent language processes associated with reading impairment.
The study aimed to explore the relationship between spoken language and reading abilities in Kannada-speaking post-stroke survivors with acquired alexia.
The study recruited 15 Kannada-speaking adults with complaints of reading impairment post-ictus through convenient sampling. The enrolled participants included both males and females with a mean age of 42.2 years (SD=15.58; range=20-68) with 16 years of formal education. The study performed three primary investigations; a) linguistic, b) oral reading, and c) reading comprehension. Linguistic tasks entailed semantics, syntax, and phonological tasks. Oral reading entailed real word and non-word reading tasks. Reading comprehension tasks entailed single-word level, sentence-level, and paragraph-level tasks.
Results of overall domain performance across linguistics, oral reading, and reading comprehension revealed superior performance in linguistics (M=71.77, SD=19.18) followed by reading comprehension (M=70.55, SD=24.10) and oral reading (M=41.55, SD=24.66), which was significant (p<0.05). Performance in phonology was weakest (M=58.06, SD=12.44) compared to syntax (M=71.13) and semantics (M=85.33) on comparing PWAs' abilities within the linguistic domain. Reading abilities were compared across oral reading and reading comprehension, which significantly varied (p<0.05), and reading comprehension abilities were superior (M=72.65, SD=24.10). Task-specific variabilities were significant (p<0.05) in both oral reading and reading comprehension, wherein, real word reading (M=58.22) and comprehension at a single level (M=80.22) were better performed. Results of correlation analysis revealed semantics (r=0.494, p<0.05) and phonology (r=0.428, p>0.05) were highly positively correlated to oral reading abilities. Syntax (r=0.412, p>0.05), and semantics (r=0.377, p>0.05) were strongly positively correlated to reading comprehension abilities.
The study has convincingly shown that performance on reading-related tasks reflects the functionality of central semantic, phonological, and syntactic processing elements. The literate adults routinely interact with both spoken and written language and a comprehensive assessment framework of language processing must encompass both modalities (linguistic and reading) for individuals with alexia, specific to Indian languages. Owing to the transparent writing system of the Kannada language, a multimodal phonological and lexical-based reading treatment may prove to be beneficial in remediating reading impairments among adult post-stroke survivors.
失读症是一种后天性病症，由于参与阅读过程的大脑区域受损，导致理解和/或朗读书面文字的能力受损。正如失语症患者的语言方面具有多面性一样，每个失语症患者的阅读障碍也因其语言缺陷的类型和性质而有很大差异。每种语言都有其独特的语言属性。无论障碍是在口语形式还是书面形式中，语言差异在这两个方面的分离都是至关重要的。鉴于卡纳达语多样的拼写特征，除了对后天阅读困难个体的口语技能损伤进行研究外，本研究还强调区分与阅读障碍相关的并发语言过程。
本研究旨在探讨患有后天失读症的卡纳达语中风后幸存者的口语和阅读能力之间的关系。
本研究通过方便抽样招募了15名有阅读障碍主诉的卡纳达语成年患者。入选的参与者包括男性和女性，平均年龄为42.2岁（标准差=15.58；范围=20-68），接受过16年正规教育。本研究进行了三项主要调查：a）语言方面，b）口头阅读，以及c）阅读理解。语言任务包括语义、句法和语音任务。口头阅读包括实词和非实词阅读任务。阅读理解任务包括单词层面、句子层面和段落层面的任务。
语言、口头阅读和阅读理解的总体领域表现结果显示，语言方面表现最佳（M=71.77，标准差=19.18），其次是阅读理解（M=70.55，标准差=24.10）和口头阅读（M=41.55，标准差=24.66），差异具有统计学意义（p<0.05）。在比较失语症患者在语言领域内的能力时，语音方面的表现最弱（M=58.06，标准差=12.44），而句法（M=71.13）和语义（M=85.33）方面表现较好。比较口头阅读和阅读理解的阅读能力，差异具有统计学意义（p<0.05），阅读理解能力更强（M=72.65，标准差=24.10）。口头阅读和阅读理解中任务特定的变异性均具有统计学意义（p<0.05），其中，实词阅读（M=58.22）和单个层面的理解（M=80.22）表现较好。相关分析结果显示，语义（r=0.494，p<0.05）和语音（r=0.428，p>0.05）与口头阅读能力高度正相关。句法（r=0.412，p>0.05）和语义（r=0.377，p>0.05）与阅读理解能力强正相关。
该研究令人信服地表明，与阅读相关任务的表现反映了中枢语义、语音和句法处理元素的功能。有文化的成年人经常与口语和书面语言进行互动，对于患有失读症的个体，特定于印度语言的语言处理综合评估框架必须涵盖这两种模式（语言和阅读）。由于卡纳达语的书写系统具有透明性，基于多模态语音和词汇的阅读治疗可能被证明对改善成年中风后幸存者的阅读障碍有益。
