For review, the author has chosen the model study she is imitating for my dissertation. She is working with a struggling writer displaying many characteristics of a dysgraphic; however, my single case study participant suffers from developmental dysgraphia which may subside as the child matures, whereas the adult dysgraphic in the model study experienced acquired dysgraphia after he had contracted encephalitis.
The procedures include description and clinical supervision of a small number of cases (here: a single case) in great detail, with the purpose of identifying basic elements, processes, etc. underlying the target behavior of the case subject. Both the model study and my dissertation are experimental studies to assess a proposed treatment for the diagnosed dysgraphia.
Contents
Introduction
Research Question and Hypothesis
Literature Review
Participant and Methods
Results
Conclusion
Delimitations and Limitations
Summary of Discussion
My Personal Discussion
References
Introduction
For review I have chosen the model study I am imitating for my dissertation. I am working with a struggling writer displaying many characteristics of a dysgraphic; however, my sincle case study participant suffers from developmental dysgraphia which may subside as the child matures, whereas the adult dysgraphic in the model study experienced acquired dysgraphia after he had contracted encephalitis. Despite this obvious divergence, the model study was of great importance to me, and it relates to the material taught in EDUC 591 because it is based on “method 4,” the case study design, which analyzes questions such as, “What are the common elements in...”, or “What characteristics do show?” The procedures include description and clinical supervision of a small number of cases (here: a single case) in great detail, with the purpose of identifying basic elements, processes, etc. underlying the target behavior of the case subject. Both the model study and my dissertation are experimental studies to assess a proposed treatment for the diagnosed dysgraphia.
Research Question and Hypothesis
The research question of the Belgium researchers Marie-Pierre de Partz, Xavier Seron, and Martial Van der Linden (1992) from the Cliniques Universitaires Saint-Luc at Bruxelles, and the Université Catholique de Louvain was whether their proposed visual imagery strategy was affective in re-educating a brain-damaged patient presenting a surface dysgraphia. The authors’ hypothesis was that the case study participant had lost the relevant orthographic representations of some words.
Literature Review
The authors bemoan that there is a marked paucity of literature on therapy for dysgraphia, but praise the effectiveness of single-case studies and well-controlled re-education of such patients through the use of methods and concepts of cognitive neuropsychologists. They quote literature about therapeutic approaches based on hypotheses about selective processing breakdowns of patients after contracting brain lesions (Bachy & de Partz, 1989; Beauvois & Derouesné, 1982; Behrmann, 1987; Byng, 1988; Carlomagno & Parlato, 1989; Cotheart & Byng, 1989; Deloche, Seron, & Ferrand, 1989; de Partz, 1986; Hatfield, 1982; Jones, 1986), and maintain that cognitively oriented re-education approaches demand an understanding of the impaired process as well as the spared one, so that a re-education strategy matched to the problem can be created. De Partz and colleagues found a gap in existing literature; namely that to be useful in the clinical domain, such cognitive models must be sufficiently detailed on the computational level, which is at present only the case for such areas of cognitive processing as reading, writing, naming, number processing, and memory. Therefore, they justify the need of their own paper, which is going to examine the re-education of a selective writing disorder of a surface-dysgraphic patient.
De Partz, Seron, and Van der Linden state that most models of normal writing are based on the standpoint that there are two or three major procedures for producing written language: a) the lexical procedure, entailing the direct retrieval of word spellings stored in the orthographic output lexicon; b) the phonological procedure, dealing with segmental translation from phonology to orthography, allowing the writing of regular and non-words; and c) a third procedure linking the auditory-input lexicon to the orthographic output lexicon via the phonological output lexicon (cf. de Partz, Seron, & Van der Linden, 1992, p. 370).
The authors mention the first study that appeared on the topic of selective impairment of the above-mentioned various components, namely Beauvois and Derouesné’s (1981) report about a case of a patient suffering from severe impairment of the lexical procedure while having maintained a well-preserved phonological procedure. This patient’s output showed that he was able to spell non-words and regular words correctly while giving rise to numerous spelling regularizations when producing ambiguous and irregular words (ibid.). De Partz and colleagues claim that although several cases of surface dysgraphia have been described since this almost twenty-year-old report, few remediation studies have been presented. One of those was Hatfield’s (1982) two-stage retraining program for a surface-dysgraphic patient in which the better-preserved phonological procedure was optimized, and the patiend was trained to use complex conversion rules. Vowels and dipththongs were represented by different graphemes and trained by association with key words; for example, the word SPAIN was associated with RAIN, which the patient was able to write correctly (cf. de Partz, Seron, & Van der Linden, 1992, p. 371).
Another study the authors reviewed was performed by Behrmann (1987) and proposed an item-specific treatment procedure enhancing direct lexical access of 50 incorrectly-written homophones which were taught in pairs (e.g., sail/sale; but/butt, etc.); according to the re-training program, the patient had to associate each homophone of a pair with its pictorial representation (de Partz, Seron, & Van der Linden, 1992, 371). The authors then introduce their own study which also uses a pictorial representation – they developed it on the basis of a cognitive analysis of their patient’s writing and reading deficits.
Participant and Methods
The patient was a 24-year-old male with familial antecedents of left-handedness who had been a nursing student when he contracted encephalitis in 1984, which resulted in a lobectomy of the left temporal point and suction of the lower area of his left frontal lobe. As a consequence, he suffered from a gross alteration of consciousness, and a neurological examination showed a right hemiparesis and mild right hemispatial neglect without hemianopia. The method consisted in re-teaching the patient in two stages: In the first stage, he was re-taught some complex graphemic contextual conversion rules, and in the second stage, the researchers created an original imagery strategy to reteach him the writing of ambiguous and irregular words.
Results
In the first stage, the patient’s relatively spared phonological procedure in writing was reinforced by telling him some spelling rules; a learning which was conventionally didactic and verbal (cf. de Partz, Seron, & Van der Linden, 1992, p. 384). The researchers analyzed 48 spelling errors scored in the 30 erroneously written words out of the Beauvois and Derousné 56-word set, and the 318 spelling errors the patient had made in 250 erroneous words in response to the 1,00 high-frequency written words taken from Juillan et al.’s dictionary (ibid.). The procedure looked like this: 1. each rule was presented and explained to the patient; 2. each rule was trained separately in different writing tasks; 3. all 5 rules were pracized in the same kind of writing tasks; and 4. if there were erros, the rule was explained again to the patient, and the correct word was presented to him to be read and copied (cf. de Partz, Seron, & Van der Linden, 1992, p. 385). After six months, one of the two sets (the 56-words list) was re-administered to the patient. Results showed that a general diminution of errors resulting from misapplication of learnt rules was evident. Another finding was that the score of errors with ambiguous and irregular words was similar in pre-therapy and post-therapy. Statistics used for display were the McNemar’s Test, with P < 0.05. The authors assume that the improvement of the patient was due to the therapy and especially to the five rules (ibid.). They also found that some new errors appeared, due to the inadequate application of learned rules. The authors evaluated the consistency of their patient’s erros, and formulated their main findings thus:
The error consistency would support the hypothesis of a loss of representation and, conversely, the error inconsistency would support a problem of access to spared orthographic representations. So, we compared all the resonses in pre- and post-therapy. ... The results demonstrated consistency of responses for the ambiguous word set and for irregular words Thus, we could interpret LP’s spelling errors as a loss of orthographic representations more than an access deficit to unimpaired orthographic representations. (de Partz, Seron, & Van der Linden, 1992, p. 386)
Thus, the researchers had found that their patient had really lost the representation of words, and was not merely impaired in accessing their stored representations in his memory. This important finding led them to stage two of their treatment, namely the application of an imagery strategy. It functioned as follows: The patient (whose language was French) was shown a pictorial representation of a word; for example, the word “pathologie” was represented by PAT, the H being a long stretcher with a corpse lying on it, and then OLOGIE. The word “hôtel,” which has an accent circonflexe over the “o,” was represented by a capital H with a hotel manager in uniform standing behind it, holding invitingly on his outstretched hand the ^ which looked like a roof, namely the roof of a hotel. Then followed the letters OTEL. The word “flamme” had two M’s represented as flames. The word “ennemi” had the “e” and the two “n’s” depicted as angry faces staring hatefully at each other.
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- Dr. Christina Voss (married Lyons) (Autor:in), 2009, Re-Education of a Surface Dysgraphia with a Visual Imagery Strategy. A Review, München, GRIN Verlag, https://www.grin.com/document/1132806
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