Single-word spelling therapy: Revealing the potential to strengthen the graphemic representations of untreated items

Introduction Research into spelling difficulties following a stroke has focused on several different approaches, but one of the most successful and widely reported is that of using a therapy programme that allows a person with aphasia to releam a limited vocabulary of spellings. This study aims to investigate the viability of this type of spelling therapy with a subject whose spelling impairments were more profound than the participants involved in previously reported case studies of a similar nature (Beeson 1999, Beeson et al 2000, 2002). The subject involved in the current study, SK, also had concomitant non linguistic impairments that exacerbated his access to therapy. Method A partial replication of Beeson's (1999) Anagram and Copy Treatment and Copy and Recall Treatment was used to recreate a treatment programme that was tailored to the specific difficulties shown by SK and was also more realistic for therapists within the NHS to duplicate. Results SK was able to releam a very small vocabulary of spellings that suggested an item- specific treatment effect. However, closer analysis of the subject's responses to all tested items implied generalisation on a graphemic level to untreated items - for example an improved ability to correctly write the first letters of untreated words and identify the correct position of letters within an anagram. Discussion The strengthening of graphemic representations, even following a relatively short treatment period, provided positive evidence that spelling therapy can be an effective intervention for even the most severely affected patients. These findings also emphasise the importance of looking in-depth at spelling changes pre-and post-therapy in order to ascertain the true level of improvement, since whole word releaming does not have to be the only marker of success, especially with patients who have profound dysgraphia