Treatment of Single Word Writing for A Malay Patient with Acquired Dysgraphia following Stroke: A Single Case Experimental Study
Introduction: Disruption to the processes that supports spoken language in people with aphasia following stroke also tend to interfere with the ability to write or referred to as dysgraphia. Method: This study examined the effectiveness of a novel treatment for writing by Beeson (1999) administered on a Malay patient (GM) who had significant conduction aphasia affecting both spoken and written language. GM received Anagram and Copy Treatment (ACT) a clinician directed treatment that required the arrangement of component letters presented in scrambled order (i.e. an anagram) for the patient to form a target word, followed by repeated copying of the word. Single subject multiple baseline design was used with sets of words (both nouns and verbs) sequentially targeted for treatment. Prior to the initiation of the writing treatment, a series of single word writing and reading assessments were conducted. Probes assessing generalizations to untrained pictures were presented at 8th, 13th and 18 th sessions. The assessments were repeated after the treatment was completed in order to monitor the progress of the writing treatment. Results: Prior to treatment, GM showed minimal ability to write words, but subsequently demonstrated rapid learning for spelling of the words targeted. He showed steady improvement in the writing of trained nouns and verbs: from 0 10% baseline accuracy to over 90% accuracy at end of treatment for nouns and verbs. Generalizations to untrained nouns and verbs also showed similar results. GM exhibited marked progress: from able to write 22 nouns (44% and 19 verbs (38% in the first probe to 47 nouns (94% and 38 verbs (76% in final probe. Pre and post assessments results revealed that GM performed better in all of the tasks measured. Conclusion: Single word writing treatment may improve dysgraphia among adults with aphasia through the administration of a structured and systematic treatment.