The nature and treatment of phonological text agraphia

Pélagie M. Beeson, Kindle Rising, Andrew T. DeMarco, Taylor Howard Foley, Steven Z. Rapcsak

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Phonological alexia and agraphia are written language disorders characterised by disproportionate difficulty reading and spelling nonwords in comparison to real words. In phonological alexia, it has been shown that, despite relatively accurate reading of words in isolation, text-level reading deficits are often marked and persistent. Specifically, some individuals demonstrate difficulty reading functors and affixes in sentences, a profile referred to as phonological text alexia. In this paper, we demonstrate an analogous manifestation of the phonological impairment on text-level writing and suggest the term “phonological text agraphia”. We examined four individuals with phonological alexia/agraphia who also showed disproportionate difficulty writing well-formed sentences in comparison to their grammatical competence in spoken utterances. Implementation of a phonological treatment protocol resulted in significantly improved sublexical phonology skills as well as improvements in grammatical accuracy of written narratives. These findings support the notion of a common phonological impairment underlying nonword reading/spelling deficits and sentence-level difficulties.

Original languageEnglish (US)
Pages (from-to)568-588
Number of pages21
JournalNeuropsychological Rehabilitation
Issue number4
StatePublished - May 19 2018


  • Agraphia
  • alexia
  • aphasia
  • phonological text alexia
  • spelling
  • writing

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Rehabilitation
  • Arts and Humanities (miscellaneous)
  • Applied Psychology


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