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Behavioural Neurology
Volume 26 (2013), Issue 1-2, Pages 55-66

Spelling Intervention in Post-Stroke Aphasia and Primary Progressive Aphasia

Kyrana Tsapkini1 and Argye E. Hillis1,2,3

1Departments of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA
2Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, MD, USA
3Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA

Received 23 April 2012; Accepted 23 April 2012

Copyright © 2013 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Spelling–a core language skill–is commonly affected in neurological diseases such as stroke and Primary Progressive Aphasia (PPA). We present two case studies of the same spelling therapy (learning of phoneme-to-grapheme correspondences with help from key words) in two participants: one who had a stroke and one with PPA (logopenic variant). Our study highlights similarities and differences in the time course of each indivdual's therapy. The study evaluates the effectiveness and generalization of treatment in each case, i.e. whether the treatment affected the trained items and/or untrained items, and whether or not the treatment gains were maintained after the end of therapy. Both participants were able to learn associations between phonemes and graphemes as well as between phonemes and words. Reliable generalization to untrained words was shown only for the participant with post-stroke aphasia, but we were not able to test generalization to untrained words in the individual with PPA. The same spelling therapy followed a different time course in each case. The participant with post-stroke aphasia showed a lasting effect of improved spelling, but we were unable to assess maintenance of improvement in the participant with PPA. We discuss these differences in light of the underlying nature of each disease.