Treatment of a case of phonological alexia with agraphia using the Auditory Discrimination in Depth (ADD) Program

Phonological alexia and agraphia are acquired disorders characterized by an impaired ability to convert graphemes to phonemes (alexia) or phonemes to graphemes (agraphia). These disorders result in phonological errors typifie d by adding, omitting, shifting, or repeating phonemes in words during read ing or graphemes when spelling. In developmental dyslexia, similar phonolog ical errors are believed to result from deficient phonological awareness, a n oral language skill that manifests itself in the ability to notice, think about, or manipulate the individual sounds in words. The Auditory Discrimi nation in Depth (ADD) program has been reported to train phonological aware ness in developmental dyslexia and dysgraphia. We used a multiple-probe des ign to evaluate the ADD program's effectiveness with a patient with a mild phonological alexia and mixed agraphia following a left hemisphere infarcti on. Large gains in phonological awareness, reading and spelling nonwords, a nd reading and spelling real words were demonstrated. A follow-up reassessm ent, 2 months posttreatment, found the patient had maintained treatment gai ns in phonological awareness and reading, and attained additional improveme nt in real word reading.