Visual and phonological factors in acquired dysgraphia.
The written spelling behaviour of a severely aphasic patient, whose many errors suggested a strong influence of visuo-spatial representations, is described. An experiment was carried out to confirm or refute the importance of visual factors in spelling to dictation. The strongest confirmatory evidence was the patient's propensity for writing the individual letters of a word in nonlinear order, i.e. not left to right, sometimes even beginning in the middle of a word. The influence of whole visual word-contours was also examined. Analysis of the results suggested that, in addition to the visual element, certain phonological factors played a small part in the patient's repertoire of strategies and this was confirmed in a second experiment. The patient's multi-strategy approach to written spelling is discussed on the basis of an information-flow model. This leads on to consideration of the possibility of consolidating the residual phonological system as part of a re-education plan.