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  • Level: GCSE
  • Subject: Maths
  • Word count: 9535

Assesment of Reading Difficulties in Patient AM Following the Development of Vascular Dementia.

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Assesment of Reading Difficulties in Patient AM Following the Development of Vascular Dementia. ABSTRACT INTRODUCTION Dementia was defined by Cummings et al. (1980) as 'an acquired, persistent impairment of intellectual function with compromise and at least of the following spheres of activity: language, memory, visuospatial skills, emotion or personality and cognition.' Dementia occurs as a series of subtypes, one of which is known as vascular dementia (Brown, 1993). Vascular dementia is a disease which is most commonly caused by impairment to the circulatory system of the brain following damage caused by a stroke (Alzheimer, Scotland., 2002). Vascular dementia is found to be most prevalent in people aged 60-75 years and is more prevalent amongst the male population in comparison to female. Vascular dementia is seen to result in progressive deterioration of the higher functions of the brain for example memory, recognition, the ability to learn new information and fine motor movements (Alzheimer, Scotland, 2002). These changes commonly occur in a stepwise pattern due to the sudden occurrence of strokes. The features common to vascular dementia which characterise the disease include loss of memory and problems with forgetting recent events. The clarity of speech may alter resulting in difficulties in communicating. Patients may become poor at expressing themselves with problems thinking of the words appropriate to what they want to say as well as understanding the words of others, resulting in slow and effortful speech. Both reading and writing abilities may also be affected in similar ways to speech, all disabilities which can be very frustrating as well as debilitating for the patient. Further cognitive problems may occur in the ability to plan as well as solve problems which patients are often very slow at doing, or else unable to perform such cognitive actions. Problems may also be more physical, with difficulties walking due to weakness of limbs and often occur in loss of awareness on one side of the body. ...read more.


A word by word flanking test was issued which was carried out in the same way and presented in the same way as the letter by letter flanking task discussed previously. The words in the flanking task were 3 and 4 letter words and each word in a trial was unrelated and of the same length to those flanking it. No words in one trial were the same. All words were presented in capital letters in size 12 print, Times New Roman Font and with single spacing between each word. (See appendix B2 for an example of the test given). AM was also given a test in which every word from a short text were taken and presented individually in a list form which maintained the original order in which the words had appeared in the text. AM was later presented the words in individual sentence form as well as in paragraphs. These tests will be presented later. (an example of these tests can be seen in appendix B4). One hundred and ninety words were presented in the first trial and AM was required to read the words aloud. The time taken for him to read all 192 words was measured. A second trial used the same method but using a different text consisting of 158 words. AM was required to read this word list and was timed in the same way as in the first trial but he was only presented the single words after having read both the paragraphs and sentences. Both trials were also given to 6 controls of similar age to AM in order to determine the time it takes for a normal person to read such text in its different forms allowing comparison of AM's performance from that expected on average from a control of similar age who lacks any neurological problems. The final test used to look at AM's single word reading was a computer based test designed to look at the speed with which AM was able read single words which varied in letter length, frequency and image ability. ...read more.


a similar nature in following visuoperceptual stimuli other than written words, including pictures and other types of shapes as well as the capacity to attend to and follow the plot of a detailed television programme or film. These problems of attentional dyslexia are likely to result from damage to AM's left occipital lobe due to damage from the stroke suffered leading to the development of vascular dementia. Damage to this area of the brain has impaired AM's visuoperceptual centre which allows him to read as well as attend to other visuoperceptual stimuli accurately. Damage to the attentional mechanism in this area of the brain has meant that AM has difficulty distributing his attention between items in a visual array, therefore in the case of reading for AM the position of words in a text on a page get mixed up and appear to merge together as AM's damaged attentional mechanism doesn't allow him to track the position of the words on the page thus leading to difficulty in both reading and comprehending what can be read as the attentional window which would allow AM to focus on and understand each consecutive word in a text has been damaged. An abnormally wide attentional window could result in a loss of location information allowing in severe cases of damage letters to drift between words but in the less severe case of AM, words just drift between words with their individual letters remaining in place. The drifting of these words causes the apparent appearance of sentences merging together resulting in AM's reading difficulty. It does however seem from AM's preserved ability to read both sentences and paragraphs accurately albeit slowly that AM's attentional dyslexia is not only mild but he maintains the ability to attend to stimuli short in length, suggesting the greater the interference and number of potential objects to attend to in the visual field the greater AM's difficulty in attending to the target stimuli, resulting in his attentional deficit which characterizes his attentional dyslexia. ...read more.

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