Targeting complex orthography in the treatment of a bilingual aphasia with acquired dysgraphia: The case of a Malay/English speaker with conduction aphasia

Background: Disruption of spoken language in people with aphasia tends to interfere with the ability to write, which is referred to as dysgraphia. This study examined the effectiveness of the anagram and copy treatment (ACT), administered in English on a bilingual Malay/English patient with conduction aphasia (GM). ACT is the arrangement of component letters presented in scrambled order (i.e., an anagram) so that the patient could use the letters to form target words, followed by repeated copying of the word. Methods: A single-subject multiple-baseline design was used with sets of English words (both nouns and verbs) sequentially targeted for treatment. Prior to the treatment, a series of single word writing and reading baselines were conducted in two languages: English and Malay. The ACT treatment was done in English, the language reported as more dominant for reading by the patient. Probes assessing generalizations to untrained pictures were presented at 8th, 13th, and 18th sessions. Results: GM showed steady and incremental improvement in the writing of trained nouns and verbs, with generalizations to untrained English nouns and verbs. Conclusions: Single word writing treatment in a non-transparent language may improve dysgraphia among adults with bilingual aphasia through the administration of a structured and systematic treatment