alexia

What Books Do Your Clients Want to Read?

๐Ÿ“š What books do your clients want to read? ๐Ÿ“š โฃ
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Iโ€™ve been working with a client who belongs to an online book club, and the most recent discussion focused on passages from Kate Andersen Browerโ€™s โ€œ๐—™๐—ถ๐—ฟ๐˜€๐˜ ๐—ช๐—ผ๐—บ๐—ฒ๐—ป: ๐—ง๐—ต๐—ฒ ๐—š๐—ฟ๐—ฎ๐—ฐ๐—ฒ ๐—ฎ๐—ป๐—ฑ ๐—ฃ๐—ผ๐˜„๐—ฒ๐—ฟ ๐—ผ๐—ณ ๐—”๐—บ๐—ฒ๐—ฟ๐—ถ๐—ฐ๐—ฎโ€™๐˜€ ๐—™๐—ถ๐—ฟ๐˜€๐˜ ๐—Ÿ๐—ฎ๐—ฑ๐—ถ๐—ฒ๐˜€โ€ ๐Ÿ‡บ๐Ÿ‡ธโฃ
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Weโ€™ve been using ๐—”๐˜๐˜๐—ฒ๐—ป๐˜๐—ถ๐˜ƒ๐—ฒ ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ถ๐—ป๐—ด ๐—ฎ๐—ป๐—ฑ ๐—–๐—ผ๐—ป๐˜€๐˜๐—ฟ๐—ฎ๐—ถ๐—ป๐—ฒ๐—ฑ ๐—ฆ๐˜‚๐—บ๐—บ๐—ฎ๐—ฟ๐—ถ๐˜‡๐—ฎ๐˜๐—ถ๐—ผ๐—ป (๐—”๐—ฅ๐—–๐—ฆ) and the ๐—ฃ๐—ค๐—ฅ๐—ฆ๐—ง ๐—บ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ to dive into the passages for the book club, allowing my client to better understand what she is reading and come up with discussion points for the group ๐Ÿ—ฃโฃ

Alexia and Aphasia Textbooks

๐Ÿ“š Textbook Time! ๐Ÿ“š โฃ
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A good textbook is invaluable when trying to dive into the specifics of a certain disorder or condition. When I find a text that is well-written and full of resources, I find that I come back to it time and time again.โฃ
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For alexia, here are the texts that I have found to be helpful as clinical resources:โฃ

Alexia Treatment: Life Participation Approach

In order for therapy to make the biggest impact, therapy tasks need to be centered around meaningful activities ๐Ÿ—ฃโฃ
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The ๐—Ÿ๐—ถ๐—ณ๐—ฒ ๐—ฃ๐—ฎ๐—ฟ๐˜๐—ถ๐—ฐ๐—ถ๐—ฝ๐—ฎ๐˜๐—ถ๐—ผ๐—ป ๐—”๐—ฝ๐—ฝ๐—ฟ๐—ผ๐—ฎ๐—ฐ๐—ต ๐˜๐—ผ ๐—”๐—ฝ๐—ต๐—ฎ๐˜€๐—ถ๐—ฎ utilizes a model known as the ๐—”-๐—™๐—ฅ๐—ข๐—  (Living with Aphasia: Framework for Outcome Measurement). The A-FROM has 4 distinct domains that all contribute to living with aphasia.

Alexia Classifications

When diagnosing an alexia, there are 2 major types of classifications: ๐—ฃ๐—ฒ๐—ฟ๐—ถ๐—ฝ๐—ต๐—ฒ๐—ฟ๐—ฎ๐—น ๐—”๐—น๐—ฒ๐˜…๐—ถ๐—ฎ๐˜€ and ๐—–๐—ฒ๐—ป๐˜๐—ฟ๐—ฎ๐—น ๐—”๐—น๐—ฒ๐˜…๐—ถ๐—ฎ๐˜€ โฃ
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๐˜—๐˜ฆ๐˜ณ๐˜ช๐˜ฑ๐˜ฉ๐˜ฆ๐˜ณ๐˜ข๐˜ญ ๐˜ˆ๐˜ญ๐˜ฆ๐˜น๐˜ช๐˜ข๐˜ด affect the early stages of the reading process and involve difficulty perceiving the written word. In a Peripheral Alexia, individual letters may be misidentified and lead to errors such as reading โ€œbookโ€ for BOOT.โฃ
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๐˜Š๐˜ฆ๐˜ฏ๐˜ต๐˜ณ๐˜ข๐˜ญ ๐˜ˆ๐˜ญ๐˜ฆ๐˜น๐˜ช๐˜ข๐˜ด affect the later stages of the reading process and involve impairments of lexical processing and sublexical processing. In a Central Alexia, the semantic system may be impaired which results in the word COW being misread as โ€œhorseโ€ (thereby making a semantic substitution).โฃ

Assistive Technology: Text-to-Speech Software

Text-to-Speech is a type of assistive technology that reads digital text aloud. While there are quite a few Text-to-Speech (TTS) softwares and apps to choose from, several popular ones include the following:โฃ ๐—ก๐—ฎ๐˜๐˜‚๐—ฟ๐—ฎ๐—น ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ฒ๐—ฟ, ๐—ง๐—ง๐—ฆ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ฒ๐—ฟ, ๐—ง๐—ฎ๐—น๐—ธ ๐—•๐˜‚๐˜๐˜๐—ผ๐—ป, and ๐—•๐—ฟ๐—ผ๐˜„๐˜€๐—ฒ๐—ฎ๐—น๐—ผ๐˜‚๐—ฑ.

Alexia Treatment: Discourse/Paragraph-Level Treatments

Treatment for alexia at the paragraph/discourse-level tends to emphasize metacognitive strategy use and environmental supports. โฃ Approaches you may consider using include:โฃ ๐—”๐˜๐˜๐—ฒ๐—ป๐˜๐—ถ๐˜ƒ๐—ฒ ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ถ๐—ป๐—ด ๐—ฎ๐—ป๐—ฑ ๐—–๐—ผ๐—ป๐˜€๐˜๐—ฟ๐—ฎ๐—ถ๐—ป๐—ฒ๐—ฑ ๐—ฆ๐˜‚๐—บ๐—บ๐—ฎ๐—ฟ๐—ถ๐˜‡๐—ฎ๐˜๐—ถ๐—ผ๐—ป (๐—”๐—–๐—ฅ๐—ฆ), PQRST, and Supported Reading Comprehension Strategies.

The Neuroscience of Reading

Reading is not something that we are inherently hard-wired to do, like talking or listening. Instead, we need to be taught this skill through direct instruction. โฃ
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In order to accomplish this, we rely on the brainโ€™s ability to change itself (also called ๐—ป๐—ฒ๐˜‚๐—ฟ๐—ผ๐—ฝ๐—น๐—ฎ๐˜€๐˜๐—ถ๐—ฐ๐—ถ๐˜๐˜†). Through neuroplasticity, neurological pathways are developed throughout the brain that allow for the skill of reading to develop and solidify.โฃ

Alexia Assessment: Paragraph/Discourse-Level Assessments

When assessing reading skills at the paragraph/discourse-level, emphasis is typically placed on comprehension of stated and implied main ideas โฃ
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By utilizing a paragraph/discourse-level assessment, youโ€™ll get better insight into your clientโ€™s inferencing skills, the effect of text length on comprehension, and better insight into how reading difficulties may impact functional reading tasks in everyday life (such as reading a menu or reading an online news article) โฃ
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Oral Reading for Language in Aphasia

Looking for a general sentence/discourse-level treatment for alexia? Consider checking out ๐—ข๐—ฟ๐—ฎ๐—น ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ถ๐—ป๐—ด ๐—ณ๐—ผ๐—ฟ ๐—Ÿ๐—ฎ๐—ป๐—ด๐˜‚๐—ฎ๐—ด๐—ฒ ๐—ถ๐—ป ๐—”๐—ฝ๐—ต๐—ฎ๐˜€๐—ถ๐—ฎ (ORLA)!โฃ
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ORLA is based on a stimulation approach, where repetitive practice through multiple modalities leads to over-learning of skills (and therefore better maintenance of therapy gains)โฃ

Assistive Technology: iPhone Speak Screen

Many people are familiar with text-to-speech apps that are downloaded onto a computer or phone, but did you know that many smartphones have their own built-in text-to-speech programs? ๐Ÿ“ฑ โฃ
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๐—ถ๐—ฃ๐—ต๐—ผ๐—ป๐—ฒ ๐—ฆ๐—ฝ๐—ฒ๐—ฎ๐—ธ ๐—ฆ๐—ฐ๐—ฟ๐—ฒ๐—ฒ๐—ป is an accessibility option that will enable the iPhone to read aloud all the text on the phone screen. Whether you are browsing through the IG app, checking the weather on your phone, or reading online news articles on Safari, iPhone Speak Screen can read aloud almost any text displayed! ๐Ÿ“š โฃ
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Alexia Treatment: Sentence-Level Treatments

When treating alexia at the sentence-level, syntax and morphology are areas that might be contributing to reading difficulties. ๐Ÿ“š โฃ Thankfully, there are a variety of intervention techniques and approaches that can be used to treat these domains.

Alexia Assessment: Sentence-Level Assessments

While some people with alexia will be relatively successful reading single words, they may encounter difficulty reading at the sentence-level. ๐Ÿ“– โฃ When assessing reading at the sentence-level, it will be helpful to look at factors beyond just decoding/reading single words in order to determine where the breakdown in reading lies. ๐Ÿ” โฃ

Assistive Technology--CPen Reader

Many assistive technologies exist to help people with communication disorders better navigate the world. When it comes to reading, however, one of the most powerful is the ๐—–-๐—ฃ๐—ฒ๐—ป ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ฒ๐—ฟ!โฃ The C-Pen Reader is a portable, pocket-sized pen that is able to scan printed words and read them aloud. The pen has a built-in dictionary that allows it to provide a definition for any word scanned, and even allows scanned text to be uploaded to a PC or Mac!โฃ

Alexia Treatment--Combined Lexical and Sublexical Approach

For many people with alexia, there is no one single cause for their reading difficulties. Rather, there are a variety of language processing components that are compromised and result in difficulty reading single words.โฃ ๐—–๐—ผ๐—บ๐—ฏ๐—ถ๐—ป๐—ฒ๐—ฑ ๐—Ÿ๐—ฒ๐˜…๐—ถ๐—ฐ๐—ฎ๐—น ๐—ฎ๐—ป๐—ฑ ๐—ฆ๐˜‚๐—ฏ๐—น๐—ฒ๐˜…๐—ถ๐—ฐ๐—ฎ๐—น ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ (Johnson, Ross, & Kiran, 2017) is designed to target ๐˜ผ๐™‡๐™‡ aspects of written word processing. โฃ

Alexia Assessment--The Arizona Battery for Reading and Spelling

Alexia assessment is no simple taskโ€”there are LOTS of variables to consider that can influence reading performance, and it can be difficult to tease apart where a personโ€™s breakdown in reading lies.โฃ When assessing alexia at the single-word level, one of the most powerful assessments out there is the ๐—”๐—ฟ๐—ถ๐˜‡๐—ผ๐—ป๐—ฎ ๐—•๐—ฎ๐˜๐˜๐—ฒ๐—ฟ๐˜† ๐—ณ๐—ผ๐—ฟ ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ถ๐—ป๐—ด ๐—ฎ๐—ป๐—ฑ ๐—ฆ๐—ฝ๐—ฒ๐—น๐—น๐—ถ๐—ป๐—ด (ABRS). โฃ