Seeing red: Relearning to read in a case of Balint's Syndrome

Balint's Syndrome is a rare condition, often associated with hypoxic brain damage. The major characteristic is an inability to localise objects in space, another is simultanagnosia frequently resulting in reading difficulties. We present RN, a 37 year old woman whose major problem with reading was her inability to recognise individual letters correctly in either lower or upper case. We noted, however, that she was better if the letters were shown in red type. The aims were to determine if RN could relearn letters of the alphabet, investigate whether colour affected her ability to learn, and to explore more specifically whether the red type also helped her to read words.

Using a single case experimental ABA design, we first determined that the optimal font for RN was size 16. In the baseline (A) phase, we assessed her ability to read all lower and upper case letters of the alphabet in black ink. In the intervention (B) phase we used font size 16 in red ink and an errorless learning approach to teaching the letters. Sessions ran 5 times per week (20 minutes per session). The intervention was then applied to picture recognition and word reading with four sets of 10 words and corresponding pictures.

A consistent difference was noted between initial baseline and intervention. Improvement carried over when we returned to baseline.

Using red type and an errorless learning approach enabled RN to re-learn letters of the alphabet and read words she was previously unable to read. This did not however generalise to her everyday life.