Rehabilitation of a case of pure alexia: Exploiting residual abilities

We present a case study of a 43-year-old woman with chronic and stable pure alexia. Using a multiple baseline design we report the results of two diff erent interventions to improve reading. First, a restitutive treatment appr oach using an implicit semantic access strategy was attempted. This approac h was designed to exploit privileged access to lexical-semantic representat ions and met with little success. Treatment was then switched to a substitu tive treatment strategy, which involved using the patient's finger to prete nd to copy the letters in words and sentences. Reading using this motor cro ss-cuing strategy was 100% accurate and doubled in speed after 4 weeks of i ntervention. We propose that this patient's inability to benefit from the i mplicit semantic access treatment approach may be in part related to her in ability to suppress the segmental letter identification process of word rec ognition.