Dissociation between word reading and word copying in a patient with left visual neglect

A patient with left visual neglect following a right hemisphere infarction is described. When presented with isolated words and nonwords, she made left neglect errors in reading aloud, but not in direct copying. This finding suggests a distinction between two ways of processing orthographic stimuli: depending on the task, the unit of processing can be the letter string or the single letter. In reading, the letter string is treated as a whole while in copying it is processed element-by-element. Left neglect differentially affects the processing of single words: in reading errors involve the left, initial letters, while in copying they involve the single letters, or the left part of the letters, independently of their position within the stimulus.