Implications of treatment failure for interpreting the cognitive mechanisms underlying acquired alexia

We present a case of alexia with agraphia following damage to left temporo-parieto-occipital cortex. Single-word reading was severely limited and spoken letter naming was also notably impaired. Treatment was implemented using a motor/kinesthetic strategy to improve letter recognition and naming in the context of single-word reading and writing. Although single letter naming improved following treatment, the participant remained unable to successfully decode words using a letter-by-letter strategy. Her limited response to treatment stands in contrast to the few other reported treatment studies employing a motor/kinesthetic approach for severe alexia, and warranted consideration of cognitive and neuroanatomical prognostic factors