Problem-solving approach to agraphia treatment: Interactive use of lexical and sublexical spelling routes

Two patients with acquired spelling impairments due to left hemisphere brain damage participated in a treatment protocol to improve their written spelling. Prior to the initiation of writing treatment, both patients showed some ability to take advantage of sound-to-letter correspondences that resulted in phonologically plausible spelling errors. A homework-based treatment was implemented to improve their ability to resolve spelling errors by increased reliance on phoneme-to-grapheme conversion, self-correction, and use of an electronic speller. Both patients improved their spelling abilities and provided evidence of interactive use of partially spared lexical and sublexical spelling routes to resolve their spelling difficulties.