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Friday, January 17, 2014

Confronting word blindness

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Loyola University researchers Jason Cuomo, Murray Flaster and José Biller chronicle the story of a forty year old woman they call M.P. who suffered a sudden onset of ‘word blindness’ following a stroke. This was particularly galling for the kindergarten reading specialist, who’s life mission had been to read to children and to help them learn to read. Thanks to her hard work, M.P. found a way to decipher one word at a time.

Word blindness, or alexia without agraphia is a condition that robs patients of the ability to read. Bizarrely, these people can still write. They can also speak and understand spoken language, they just can’t make out written words. In order to succumb to this syndrome, you’d need to suffer lesions that specifically disrupt visual inputs to the left angular gyrus (the ‘language’ zone), a fortunately rare event. This was most likely the case with M.P., though her biopsies were negative. In any case, M.P. could no longer read or tell time.
M.P. wasn’t about to let things stand as they were and began using all the tools in her arsenal to regain her ability to read. When the normal techniques M.P. was proficient in using to help her young students proved to be totally ineffective, she invented a different tactic. She capitalized on the fact that although she couldn’t recognize letters by sight, she could identify them by their feel. Thus, she traces over each individual letter with her finger until she can piece together the word. 

The authors give the following example of this effective, though arduous technique.
Given a word, M.P. will direct her attention to the first letter, which she is unable to recognize. She will then place her finger on the letter and begin to trace each letter of the alphabet over it in order until she recognizes that she has traced the letter she is looking at. “That is the letter M,” she declares, after tracing the previous 12 letters of the alphabet with her finger while deciphering a word in front of her. Three letters later, she is able to shorten this exercise with a guess: “This word is ‘mother,’” she announces proudly.

Needless to say, this method is far too laborious for pleasure reading, let alone reading to children, which M.P. sorely misses. She’s had to give up her job as a kindergarten teacher and take another job, though she still volunteers her time in her community. It’s been a little over a year since her stroke, and it doesn’t look like her deficit will ever be overcome. Still, thanks to her perseverance, she can at least make out words when she really needs to. 

Jason Cuomo, Murray Flaster, & José Biller (2014). Right Brain: A reading specialist with alexia without agraphia Neurology, 82 (1) : doi: 10.1212/01.wnl.0000438218.39061.93.

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