Effects of Phonomotor Treatment on the Reading Abilities of Individuals with Aphasia and Phonological Alexia

A left hemisphere stroke often results in aphasia characterized by impaired reading (Cherney, 2004; Webb & Love, 1983) and phonological processing abilities (Blumstein, Baker, & Goodglass, 1977; den Ouden & Bastiaanse, 2005). Research has shown that treatment focused at the level of the phoneme improves reading abilities in persons with aphasia (PWA) and phonological alexia (Conway et al., 1998; Kendall et al., 1998; Kendall et al., 2003). These findings are theoretically supported by a connectionist model of phonology (Nadeau, 2001), and a multimodal model of phonological processing and reading (Alexander & Slinger, 2004). Nadeau’s parallel distributed processing (PDP) model of phonology (2001) states that phonologic representations are stored as patterns of connectivity within and between auditory association, articulatory motor, orthographic and semantic/conceptual domains. These connections are strengthened through learning. After stroke, intact phonologic representations and domain connections serve as the foundation for improving reading deficits. Support for this hypothesis comes from language and reading acquisition in children. As children learn to read, they begin to map orthography to established phonologic and semantic knowledge. Welldeveloped phonological knowledge is believed to help children link written and spoken language (Alexander et al., 1991). If the principles of reading development apply to reading rehabilitation after brain injury, then retraining phonemes and phoneme sequences may improve word reading. Alexander and Slinger’s (2004) model of phonological processing and reading uses a multimodal treatment to develop an individual’s explicit awareness of distinct sensorimotor and metalinguistic features of phonemes through association tasks. Alexander (1991) and Torgesen et al. (2001) report multimodal treatment successfully remediates phonological deficits in children with dyslexia. Characteristics of dyslexia (impaired phonological processing and sublexical reading) are seen in PWA and phonological alexia. Therefore, multimodal phonological treatment may be a viable approach to rehabilitate reading deficits associated with this population. Data presented here were retrospectively analyzed from PWA who participated in a phonological treatment study of anomia (Kendall & Nadeau, VA RR&D Merit Review Grant). Nine participants received reading testing before and after treatment, eight of whom were diagnosed with phonologic alexia.The present study investigated the effects of phonomotor treatment on the reading abilities of PWA with phonological alexia, via the following research questions