How is your B-A-B-Y? Dissociated oral and written production

We report a case study of a patient (HR) with a large left temporal lesion who inserted spelled words, particularly nouns, into his fluent but otherwi se empty spoken production. Although he generated neologisms in picture-nam ing and oral reading tasks, they did not appear in his spontaneous speech. Characteristics of his written production included the following: semantic errors; misspellings; frequency and word-length effects; and better perform ance for concrete nouns than for low-imageability nouns, verbs, function wo rds, adjectives and adverbs. HR's attempts at writing sentences were agramm atic and notably lacking in verbs; he also performed poorly in generating s entences from printed sentence fragments, Although impaired in auditory rhy ming tasks, his performance was superior to the detection of rhymes present ed visually. HR's writing performance and the striking differences between his spoken and written output are similar to those of a number of patients previously reported, We note parallels between these patterns and the chara cteristics of cases where the processing and/or production of written words can be assigned to the right hemisphere.