Aphasia and spelling to dictation: Analysis of spelling errors and editing

Spelling difficulty is a common symptom of aphasia and can entail editing difficulties. Previous research has shown that extensive editing is related to a lower production rate in text writing for persons with aphasia, yet editing difficulty is not commonly examined. It is not known if editing difficulty is related to reading and writing skills or to aspects of the word.

To analyse spelling and editing processes as well as errors in a dictation task performed by Swedish-speaking adults with post-stroke aphasia. Furthermore, the study aimed to identify any relationships between spelling and editing difficulties and characteristics of individual words. Finally, relationships between successful edits and reading and phonological ability were investigated and specific editing strategies or behaviours identified. Correlation analyses were performed between measures of spelling and editing and word frequency and length as well as participants' scores on tests of reading, phonological spelling and phonological decoding.

A total of 16 Swedish speaking participants with post-stroke aphasia wrote a word-dictation task in a keystroke logging program and were tested for phonological spelling, phonological decoding and reading ability. Spelling errors were categorized and analysed.

The most common error type was omission of letter(s) and there was evidence of aphasia-specific writing errors. Both spelling and editing difficulty were related to word frequency and word length. Successful editing was related to participants' scores on the phonological spelling task, but not to phonological decoding or reading ability. Specific editing strategies could be identified, and some strategies were individual, while others were more commonly used.

Word length and word frequency should be taken into consideration in spelling tests for persons with aphasia, and the presence of editing difficulty should be taken into account when assessing spelling difficulties. Treatment for writing difficulties in aphasia should include training in successful editing strategies and individual fitting of digital writing aids. What this paper adds What is already known on the subject Post-stroke aphasia often causes writing and spelling difficulties. Spelling difficulties may entail editing difficulties, in turn causing extensive and/or unsuccessful editing. Extensive editing is known to impede productivity in text writing. Still, editing behaviour, abilities relating to editing or what features of a word that causes editing difficulty has not been investigated for persons with aphasia. What this paper adds to existing knowledge This study adds an in-depth analysis of spelling ability, spelling errors and editing behaviour for persons with aphasia, using keystroke logging and a single-word dictation task. Results showed that both features of the target word (frequency and word length) and the individual abilities of the person with aphasia (score on a phonological spelling task) related to spelling and editing difficulty, editing behaviour and successful editing. Specific editing strategies were analysed and described. What are the potential or actual clinical implications of this work? Word length and word frequency should be taken into consideration when testing single-word spelling for persons with aphasia. When assessing spelling difficulties, both correctness of spelling as well as the presence and nature of any editing difficulties should be taken into account and treatment for writing difficulties in should include training in successful editing strategies. The fitting of digital writing aids for persons with aphasia should be individual, since many of the editing strategies used were individual.