Writing
Isabelle Rapin
Seminar on developmental disabilities
December 14, 2012
No conflict of interest
Quick Review:
Dysphasia and Dyslexia
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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
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One-way path in language
processing
Input
(sensory)
Decoding
Output
(motor)
Higher order
processing
Encoding
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Levels of language encoding
1. Phonology
(articulation/intelligibility, prosody)
2. Grammar/syntax
3. Semantics: word/sentence
4. Pragmatics: verbal/nonverbal
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Language areas in the left
hemisphere
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Required mechanisms for reading
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Auditory processing
Phonological awareness
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Phonological decoding (regular non-words)
Orthographic coding (irregularly spelled words, homonyms)
Single word reading (accuracy, speed)
Spelling ability (real words, non-words, irregular words)
segmentation)
(phoneme/letter relation, word
Spika et al., Behav. Genet., 2011
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Phonological level
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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
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Auditory
Visual (letters, ideograms [complex=syllabic])
• Word meanings (semantics)
• Word relations (grammar)
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Phonologic/reading development
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> 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
1st grade: read/spell mostly regular words
2-3 grades: ↑ fluency, learn irregular words, ↑ vocabulary, begin
to read for meaning
 > ~ 3rd grade: fluent reading by-passes phonologic decoding,
goes directly to lexicon (word dictionary)
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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)
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Cortical activation during reading
Shaywitz et al. 2008
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Brain basis of most prevalent
dyslexia
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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
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WRITING
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Writing deficits
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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)
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Modes of language output
 1. gestures
 2. speech articulation
 3. writing
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handwriting
spelling
 4. Sign, other symbolic codes
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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
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Language outputs
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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
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Relation of reading & writing to
speech articulation
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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
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VAA: Writing vs. copying
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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
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Auditory Processing for Reading
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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
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Prerequisites for reading/writing
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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
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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
 writing letters. keyboarding
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Writing Engages
Multilevel Processes
 integration of vision + audition
 phonologic discrimination
 several memory processes
 attention
 acquisition of specific fine motor skills
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Memory requirements
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Short term sequential memory for spoken/read
phonemes, words, phrases
Working memory: needed to
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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
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Visual perception
 Letter shapes
• Rounded
• Angular
 Right/left orientation
 Up/down awareness
 Sizing
 Spacing
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Auditory/visual integration
 In response to letter names:
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identifying corresponding printed caps
identifying printed lower case letters
identifying cursive letters
eventually identifying unusual scripts/fonts
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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 ~ 3rd 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)
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Dysgraphia
 Classic motor deficit
 Deficit in rapid fine motor control (timed)
 Deficient procedural memory 
inadequate learning of motor sequences
 Inattention (ADHD)
 Lack of motivation
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Macrographia
• Frequent in ASD (e.g., DeLong, Mostofsky)
• Also frequent in ADHD (also inconsistent size
and legibility)
Micrographia
• Frequent in OCD
• Sometimes in Asperger-type ASD
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