Writing Isabelle Rapin Seminar on developmental disabilities December
Writing Isabelle Rapin Seminar on developmental disabilities December 14, 2012 No conflict of interest
Quick Review: Dysphasia and Dyslexia 2
Oral & Written Language § Oral language • develops gradually without specific instruction • provided adequate exposure to its conversational use § Reading written language • grafted on oral language • requires specific instruction § Producing written language • grafted on reading • + requires fine motor skill 3
One-way path in language processing Input (sensory) Decoding Output (motor) Higher order processing Encoding 4
Levels of language encoding 1. Phonology 2. 3. 4. (articulation/intelligibility, prosody) Grammar/syntax Semantics: word/sentence Pragmatics: verbal/nonverbal 5
Language areas in the left hemisphere 6
Required mechanisms for reading § Auditory processing § Phonological awareness (phoneme/letter relation, word segmentation) § Phonological decoding (regular non-words) § Orthographic coding (irregularly spelled words, homonyms) § Single word reading (accuracy, speed) § Spelling ability (real words, non-words, irregular words) Spika et al. , Behav. Genet. , 2011 7
Phonological level § Phoneme = smallest linguistic sound unit in any § § particular language Syllable = co-articulated phonemes processed as units (chunks) Lexicons (i. e. , dictionaries) in our brains • Phonologic n n • • Auditory Visual (letters, ideograms [complex=syllabic]) Word meanings (semantics) Word relations (grammar) 8
Phonologic/reading development § § § § > birth: can make all potential speech-sound discriminations > ~ 1 year: chunk words into whole expressions > ~ 2 years: begin to segment single words 3 -5 years: progressive awareness of phonemes, e. g. , rhymes, initial consonant sounds, syllables, phonetic sequences, cadences kindergarten: starting awareness of letter-sound mapping 1 st grade: read/spell mostly regular words 2 -3 grades: ↑ fluency, learn irregular words, ↑ vocabulary, begin to read for meaning § > ~ 3 rd grade: fluent reading by-passes phonologic decoding, goes directly to lexicon (word dictionary) 9
Progressive reading competence § Word recognition (phonology) • Phonetically consistent (words/nonwords) • Phonetically inconsistent (e. g. , yacht, blood) § Reading fluency (direct access to lexicon) § Comprehension • At the word level (vocabulary) • At the sentence level (+ grammar) • At the idea level (reading now automatic) 10
Cortical activation during reading Shaywitz et al. 2008 11
Brain basis of most prevalent dyslexia § Underactivity of posterior brain regions § Overactivity of interior frontal cortex concerned § with speech articulation Remediation improves but does not “cure” dyslexia • Tend to read slowly • Fluency improves but difficulty reading non-words persists • Poor spelling, etc. very likely 12
WRITING 13
Writing deficits § Writing: hierarchically related to reading § Dysorthographia (poor spelling): the telling sign § of compensated dyslexia Spelling and writing: related to speech articulation • all 3 outputs involve translating inner language into sound-based fine motor commands • Speech requires continuous feedback monitoring of the accuracy of production (phonological loop) 14
Modes of language output § § § 1. gestures 2. speech articulation 3. writing n n § handwriting spelling 4. Sign, other symbolic codes 15
What is writing? § “Transcription is a basic cognitive process … that enables the writer to translate internal language into external written symbols to express ideas in written language. … Transcription ability draws on handwriting and spelling. ” Berninger et al. 2009 16
Language outputs § All are motor § Skilled speakers, readers, & writers program § motor commands to express retrieved chunks of inner language from the lexicon Execute commands ‘on line’ in parallel with • • retrieval of next language chunk to be expressed and programming of the commands for its production § Requires a high degree of over-learning and automation 17
Relation of reading & writing to speech articulation § Children learning to read regularly articulate sotto voce what they are deciphering § They do as well when writing § Fades as reading/writing become automatized § Many compensated dyslexics continue silent articulation when reading and writing 18
VAA: Writing vs. copying 19
Development of speech awareness § 1. At birth: ability to make any auditory discrimination adopted by any language § 2. Discriminate the stream of speech from other environmental sounds § 2. Segment word-chunks from the stream § 3. Segment syllables in phrases & words § 4. Segment individual phonemes 20
Auditory Processing for Reading § Identifying/segmenting individual words § Steps toward identifying individual phonemes/syllables, e. g. , • • • First phonemes/syllables Phonemic games Rhymes § Reciting the alphabet § Learning letter names § Relating letter names to phonemes 21
Prerequisites for reading/writing § § § Syllabication, then individual phonemes Relate letter names/shapes to perceived and produced speech Learn to point to, tap on keyboard, reproduce (write) letters on the basis of letter names 22
Writing § Orthography (letter/syllable spelling) • essential basis for learning to read and write § Whole word knowledge • essential for fluent reading/writing § Speaking/writing • translation of inner language into motor commands for speech articulation n writing letters. keyboarding n 23
Writing Engages Multilevel Processes § integration of vision + audition § phonologic discrimination § several memory processes § attention § acquisition of specific fine motor skills 24
Memory requirements § Short term sequential memory for spoken/read § phonemes, words, phrases Working memory: needed to • • • retrieve needed material from long term storage compare new input with stored material evaluate on-line significance of input prepare commands for motor output Monitor output § Store output 25
Visual perception § Letter shapes • Rounded • Angular § Right/left orientation § Up/down awareness § Sizing § Spacing 26
Auditory/visual integration § In response to letter names: • identifying corresponding printed caps • identifying printed lower case letters • identifying cursive letters • eventually identifying unusual scripts/fonts 27
Letter reversals Examples: p/q, b/d, d/p, b/q, m/w, backward f, s, z, etc. § Most in lower case print § Normal in preschoolers and up to ~ 3 rd grade § Not predictive of either dyslexia or dysgraphia § Not due to defective visual perception § If persistent consider • inefficient working memory • Spatial, R/L confusion (incl. Gerstmann syndrome) 28
Dysgraphia § Classic motor deficit § Deficit in rapid fine motor control (timed) § Deficient procedural memory inadequate learning of motor sequences § Inattention (ADHD) § Lack of motivation 29
Macrographia • Frequent in ASD (e. g. , De. Long, Mostofsky) • Also frequent in ADHD (also inconsistent size and legibility) Micrographia • Frequent in OCD • Sometimes in Asperger-type ASD 30
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