Multiple Oral Re-reading treatment for alexia: The parts may be greater than the whole

Abstract

This study examines the reasons for the success of Multiple Oral Re-reading (MOR; Moyer, 1979), a non-invasive, easily administered alexia treatment that has been reported in the literature and is currently in clinical use. The treatment consists of reading text passages aloud multiple times a day. Findings that MOR improves reading speed on practised as well as novel text have been inconsistent, making MOR's role in the rehabilitation of alexia unclear. We hypothesised that MOR's treatment mechanism works through repetition of high frequency words (i.e., bottom-up processing). We designed and controlled our text passages to test the hypothesis that participants would not improve on all novel text but would improve on text that includes a critical mass of the words contained in the passages they were re-reading. We further hypothesised that the improvement would be at the level of their specific alexic deficit. We tested four participants with phonological alexia and two with pure alexia during 8 weeks of MOR treatment. Contrary to the conclusions of previous studies, our results indicate that improvements in top-down processing cannot explain generalisation in MOR and that much of the improvement in reading is through repetition of the practised words. However, most patients also showed improvement when specific phrases were re-used in novel passages, indicating that practice of difficult words in context may be crucial to reading improvement.

Figures

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Figure 2

Reading speed in syllables per second for phonologic text alexia patients PhTA1 and PhTA2 and pure alexia patients PA1 and PA2. Significant improvements in reading speed were found for the training passages (T) for all patients. Various patterns of improvement were found on the novel generalization passages containing specific words from the T passages (P=Phrase; F=Functor; C=Content words). No significant improvements were found for the control (Ctrl) passages.

Figure 3

Reading accuracy for phonologic text alexia patients PhTA3 and PhTA4. Significant improvements in reading accuracy were found for the training passages (T) as well as the generalization passages that contained trained functors (F) and/or phrases (P). Neither patient showed generalization in the content (C) passages or the Control (Ctrl) passages.