Reading recovery: a case study using a multicomponent treatment for acquired alexia

Background: Individuals with acquired alexia have reading deficits that typically impede successful completion of daily activities, thus resulting in impaired functional independence. Research-based treatment approaches for acquired alexia often address single aspects underlying reading. To date, no research has explored the simultaneous presentation of several treatments or treatment including functional daily reading activities. Aims: The purpose of this study was to determine the effectiveness of a multicomponent reading intervention to increase letter recognition, grapheme-to-phoneme conversion, and single-word decoding by an individual with acquired alexia. Methods &Procedures: The study participant, JB, was an 86-year-old female 5 months postonset of a left cerebrovascular accident. JB attended 40 1-hr treatment sessions over a 5-month period. She completed five activities during each session: (a) decoding consonant-vowel-consonant (CVC) words; (b) performing grapheme-to-phoneme activities requiring letter recognition, naming, and associated phoneme production; (c) engaging in repeated and choral reading tasks; (d) performing modified Anagram and Copy Treatment and Copy and Recall tasks; and (e) engaging in reading of functional materials. Outcomes &Results: Intervention was effective in enhancing JB’s letter identification, grapheme-to-phoneme conversion, and single-word decoding skills. Decoding of CVC words, phonological awareness, and functional reading skills improved steadily over the treatment period. Conclusions: The participant progressed from meeting criteria for global alexia to displaying behaviours more consistent with pure alexia. By the conclusion of treatment, she accurately identified most graphemes and produced corresponding phonemes for letter-by-letter and phonological single-word decoding; in the home setting, she attempted to read and write independently, requested assistance with reading when necessary, and independently attended to pictorial cues presented with reading materials.