We report the results of a letter naming treatment
designed to facilitate letter-by-letter reading in an aphasic
patient with no reading ability. Patient M.R.'s anomia
for written letters reflected two loci of impairment within
visual naming: impaired letter activation from print (a
deficit commonly seen in pure alexic patients who read
letter by letter) and impaired access to phonology via
semantics (documented in a severe multimodality anomia).
Remarkably, M.R. retained an excellent ability to pronounce
orally spelled words, demonstrating that abstract letter
identities could be activated normally via spoken
letter names, and also that lexical phonological representations
were intact when accessed via spoken letter names.
M.R.'s training in oral naming of written letters
resulted in significant improvement in her oral naming
of trained letters. Importantly, as M.R.'s letter
naming improved, she became able to employ letter-by-letter
reading as a compensatory strategy for oral word reading.
M.R.'s success in letter naming and letter-by-letter
reading suggests that other patients with a similar pattern
of spared and impaired cognitive abilities may benefit
from a similar treatment. Moreover, this study highlights
the value of testing the pronunciation of orally spelled
words in localizing the source of prelexical reading impairment
and in predicting the functional outcome of treatment for
impaired letter activation in reading. (JINS,
1998, 4, 595–607.)
The development of the relation between letter-naming speed and reading ability
