Impaired activation of the phonological lexicon: effects upon oral reading

The role of the phonological lexicon in oral reading is examined in a patient with a small focal left hemisphere lesion. Impaired access to the patient's phonological lexicon is suggested by a number of findings, including the production of phonemic errors across a variety of tasks; increasing difficulty in word production with increasing word length; and difficulty on tests of homophone and rhyme judgments. Two competing models of reading are tested: the nonlexical ("rules") and the lexical ("no-rules") models. The rules model predicts that a disturbance in the phonological lexicon will result in surface alexia; the no-rules model predicts phonological alexia. Results indicate that the patient's reading is most similar to phonological alexia, providing support for the no-rules model. The applicability of the no-rules model to other forms of acquired alexia is explored.