Visual complexity in letter-by-letter reading: "pure" alexia is not pure

Reading problems and their connection with visual search and attention

Attention has been hypothesized to act as a sequential gating mechanism for the orderly processing of letters and words. These same visuoattentional processes are often assumed to partake in some but not all types of visual search. In the current study, 24 dyslexic and 36 typical readers completed an attentionally demanding visual conjunction search. Visual feature search served as an internal control. It has been suggested that reading problems should go hand in hand with specific problems in visual conjunction search-particularly elevated conjunction search slopes (time per search item)-often interpreted as a problem with visual attention. Results showed that reading problems were associated with slower visual search, especially conjunction search. However, reading deficits were not associated with increased conjunction search slopes but instead with increased search intercepts, traditionally not interpreted as reflecting attention. We discuss these results in the context of hypothesized visuoattentional problems in dyslexia. Remaining open to multiple interpretations of the data, the current study demonstrates that difficulties in visual search are associated with reading problems, in accordance with growing literature on visual cognition problems in developmental dyslexia.

General object-based features account for letter perception

After years of experience, humans become experts at perceiving letters. Is this visual capacity attained by learning specialized letter features, or by reusing general visual features previously learned in service of object categorization? To explore this question, we first measured the perceptual similarity of letters in two behavioral tasks, visual search and letter categorization. Then, we trained deep convolutional neural networks on either 26-way letter categorization or 1000-way object categorization, as a way to operationalize possible specialized letter features and general object-based features, respectively. We found that the general object-based features more robustly correlated with the perceptual similarity of letters. We then operationalized additional forms of experience-dependent letter specialization by altering object-trained networks with varied forms of letter training; however, none of these forms of letter specialization improved the match to human behavior. Thus, our findings reveal that it is not necessary to appeal to specialized letter representations to account for perceptual similarity of letters. Instead, we argue that it is more likely that the perception of letters depends on domain-general visual features.

For over a century, scientists have conducted behavioral experiments to investigate how the visual system recognizes letters, but it has proven difficult to propose a model of the feature space underlying this capacity. Here we leveraged recent advances in machine learning to model a wide variety of features ranging from specialized letter features to general object-based features. Across two large-scale behavioral experiments we find that general object-based features account well for letter perception, and that adding letter specialization did not improve the correspondence to human behavior. It is plausible that the ability to recognize letters largely relies on general visual features unaltered by letter learning.

Shallow or deep? The impact of orthographic depth on visual processing impairments in developmental dyslexia

The extent to which impaired visual and phonological mechanisms may contribute to the manifestation of developmental dyslexia across orthographies of varying depth has yet to be fully established. By adopting a cross-linguistic approach, the current study aimed to explore the nature of visual and phonological processing in developmental dyslexic readers of shallow (Italian) and deep (English) orthographies, and specifically the characterisation of visual processing deficits in relation to orthographic depth. To achieve this aim, we administered a battery of non-reading visual and phonological tasks. Developmental dyslexics performed worse than typically developing readers on all visual and phonological tasks. Critically, readers of the shallow orthography were disproportionately impaired on visual processing tasks. Our results suggest that the impaired reading and associated deficits observed in developmental dyslexia are anchored by dual impairments to visual and phonological mechanisms that underpin reading, with the magnitude of the visual deficit varying according to orthographic depth.

Unique, Shared, and Dominant Brain Activation in Visual Word Form Area and Lateral Occipital Complex during Reading and Picture Naming

Identifying printed words and pictures concurrently is ubiquitous in daily tasks, and so it is important to consider the extent to which reading words and naming pictures may share a cognitive-neurophysiological functional architecture. Two functional magnetic resonance imaging (fMRI) experiments examined whether reading along the left ventral occipitotemporal region (vOT; often referred to as a visual word form area, VWFA) has activation that is overlapping with referent pictures (i.e., both conditions significant and shared, or with one significantly more dominant) or unique (i.e., one condition significant, the other not), and whether picture naming along the right lateral occipital complex (LOC) has overlapping or unique activation relative to referent words. Experiment 1 used familiar regular and exception words (to force lexical reading) and their corresponding pictures in separate naming blocks, and showed dominant activation for pictures in the LOC, and shared activation in the VWFA for exception words and their corresponding pictures (regular words did not elicit significant VWFA activation). Experiment 2 controlled for visual complexity by superimposing the words and pictures and instructing participants to either name the word or the picture, and showed primarily shared activation in the VWFA and LOC regions for both word reading and picture naming, with some dominant activation for pictures in the LOC. Overall, these results highlight the importance of including exception words to force lexical reading when comparing to picture naming, and the significant shared activation in VWFA and LOC serves to challenge specialized models of reading or picture naming.

Is Developmental Dyslexia Due to a Visual and Not a Phonological Impairment?

It is a widely held belief that developmental dyslexia (DD) is a phonological disorder in which readers have difficulty associating graphemes with their corresponding phonemes. In contrast, the magnocellular theory of dyslexia assumes that DD is a visual disorder caused by dysfunctional magnocellular neural pathways. The review explores arguments for and against these theories. Recent results have shown that DD is caused by (1) a reduced ability to simultaneously recognize sequences of letters that make up words, (2) longer fixation times required to simultaneously recognize strings of letters, and (3) amplitudes of saccades that do not match the number of simultaneously recognized letters. It was shown that pseudowords that could not be recognized simultaneously were recognized almost without errors when the fixation time was extended. However, there is an individual maximum number of letters that each reader with DD can recognize simultaneously. Findings on the neurobiological basis of temporal summation have shown that a necessary prolongation of fixation times is due to impaired processing mechanisms of the visual system, presumably involving magnocells and parvocells. An area in the mid-fusiform gyrus also appears to play a significant role in the ability to simultaneously recognize words and pseudowords. The results also contradict the assumption that DD is due to a lack of eye movement control. The present research does not support the assumption that DD is caused by a phonological disorder but shows that DD is due to a visual processing dysfunction.

The Clock Counts - Length Effects in English Dyslexic Readers

In reading, length effects (LEs) are defined as an increment in the time taken to read as a function of word length and may indicate whether reading is proceeding in an efficient whole word fashion or by serial letter processing. LEs are generally considered to be a pathognomonic symptom of developmental dyslexia (DD) and predominantly have been investigated in transparent orthographies where reading impairment is characterized as slow and effortful. In the present study a sample of 18 adult participants with DD were compared to a matched sample of typical developing readers to investigate whether the LE is a critical aspect of DD in an opaque orthography, English. We expected that the DD group would present with marked LEs, in both words and non-words, compared to typical developing readers. The presence of LEs in the DD group confirmed our prediction. These effects were particularly strong in low frequency words and in non-words, as observed in reading speed. These preliminary findings may have important theoretical implications for current understanding of DD.

Reading Increases the Compositionality of Visual Word Representations

Reading causes widespread changes in the brain, but its effect on visual word representations is unknown. Learning to read may facilitate visual processing by forming specialized detectors for longer strings or by making word responses more predictable from single letters—that is, by increasing compositionality. We provided evidence for the latter hypothesis using experiments that compared nonoverlapping groups of readers of two Indian languages (Telugu and Malayalam). Readers showed increased single-letter discrimination and decreased letter interactions for bigrams during visual search. Importantly, these interactions predicted subjects’ overall reading fluency. In a separate brain-imaging experiment, we observed increased compositionality in readers, whereby responses to bigrams were more predictable from single letters. This effect was specific to the anterior lateral occipital region, where activations best matched behavior. Thus, learning to read facilitates visual processing by increasing the compositionality of visual word representations.

Pure alexia with intact perception of complex visual stimuli: a case study

After a stroke involving the left occipitotemporal cortex our patient shows a word-length effect and has problems to identify letters or numbers in strings of symbols. But he is normal in identifying isolated letters and in non-verbally categorizing even complex images such as faces or natural scenes. His cortical lesion is stretching from the visual word form area (VWFA) anteriorly causing additional problems to name visual stimuli and to match acoustic stimuli with images. We conclude that our patient suffers from pure alexia without deficits to identify even complex visual stimuli. Our results directly contradict several explanations for letter-by-letter reading.

Are children with developmental dyslexia all the same? A cluster analysis with more than 300 cases

Reading is vital to every aspect of modern life, exacerbated by reliance of the internet, email, and social media on the written medium. Developmental dyslexia (DD) characterizes a disorder in which the core deficit involves reading. Traditionally, DD is thought to be associated with a phonological impairment. However, recent evidence has begun to suggest that the reading impairment in some individuals is provoked by a visual processing deficit. In this paper, we present WISC-IV data from more than 300 Italian children with a diagnosis of DD to investigate the manifestation of phonological and visual subtypes. Our results indicate the existence of two clusters of children with DD. In one cluster, the deficit was more pronounced in the phonological component, while both clusters were impaired in visual processing. These data indicate that DD may be an umbrella term that encompasses different profiles. From a theoretical perspective, our results demonstrate that dyslexia cannot be explained in terms of an isolated phonological deficit alone; visual impairment plays a crucial role. Moreover, general rather than specific accounts of DD are discussed.

Orthographic connectivity in Arabic reading: a case study of an individual with deep dyslexia and letter-by-letter reading

Arabic orthography is complex, partly as a consequence of variations in orthographic connectivity. In this article, we present the case study of CHS, an Arabic individual with deep dyslexia associated with letter-by-letter reading. In the experimental study, we specifically explored the influence of orthographic connectivity on CHS's word recognition and reading abilities. Our results show that CHS's performance was better preserved for words and non-words made up of connected letters than made up of non-connected letters. CHS demonstrated impairment of visuoperceptual mechanisms, which affected the processing of complex orthographic material. These results provide insight into the cognitive processes associated with reading Arabic.

The evolution of cognitive models: From neuropsychology to neuroimaging and back

This paper provides a historical and future perspective on how neuropsychology and neuroimaging can be used to develop cognitive models of human brain functions. Section 1 focuses on the emergence of cognitive modelling from neuropsychology, why lesion location was considered to be unimportant and the challenges faced when mapping symptoms to impaired cognitive processes. Section 2 describes how established cognitive models based on behavioural data alone cannot explain the complex patterns of distributed brain activity that are observed in functional neuroimaging studies. This has led to proposals for new cognitive processes, new cognitive strategies and new functional ontologies for cognition. Section 3 considers how the integration of data from lesion, behavioural and functional neuroimaging studies of large cohorts of brain damaged patients can be used to determine whether inter-patient variability in behaviour is due to differences in the premorbid function of each brain region, lesion site or cognitive strategy. This combination of neuroimaging and neuropsychology is providing a deeper understanding of how cognitive functions can be lost and re-learnt after brain damage - an understanding that will transform our ability to generate and validate cognitive models that are both physiologically plausible and clinically useful.

Functional outcomes following lesions in visual cortex: Implications for plasticity of high-level vision

Understanding the nature and extent of neural plasticity in humans remains a key challenge for neuroscience. Importantly, however, a precise characterization of plasticity and its underlying mechanism has the potential to enable new approaches for enhancing reorganization of cortical function. Investigations of the impairment and subsequent recovery of cognitive and perceptual functions following early-onset cortical lesions in humans provide a unique opportunity to elucidate how the brain changes, adapts, and reorganizes. Specifically, here, we focus on restitution of visual function, and we review the findings on plasticity and re-organization of the ventral occipital temporal cortex (VOTC) in published reports of 46 patients with a lesion to or resection of the visual cortex early in life. Findings reveal that a lesion to the VOTC results in a deficit that affects the visual recognition of more than one category of stimuli (faces, objects and words). In addition, the majority of pediatric patients show limited recovery over time, especially those in whom deficits in low-level vision also persist. Last, given that neither the equipotentiality nor the modularity view on plasticity was clearly supported, we suggest some intermediate possibilities in which some plasticity may be evident but that this might depend on the area that was affected, its maturational trajectory as well as its structural and functional connectivity constraints. Finally, we offer suggestions for future research that can elucidate plasticity further.

Developmental visual perception deficits with no indications of prosopagnosia in a child with abnormal eye movements

Visual categories are associated with eccentricity biases in high-order visual cortex: Faces and reading with foveally-biased regions, while common objects and space with mid- and peripherally-biased regions. As face perception and reading are among the most challenging human visual skills, and are often regarded as the peak achievements of a distributed neural network supporting common objects perception, it is unclear why objects, which also rely on foveal vision to be processed, are associated with mid-peripheral rather than with a foveal bias. Here, we studied BN, a 9 y.o. boy who has normal basic-level vision, abnormal (limited) oculomotor pursuit and saccades, and shows developmental object and contour integration deficits but with no indication of prosopagnosia. Although we cannot infer causation from the data presented here, we suggest that normal pursuit and saccades could be critical for the development of contour integration and object perception. While faces and perhaps reading, when fixated upon, take up a small portion of central visual field and require only small eye movements to be properly processed, common objects typically prevail in mid-peripheral visual field and rely on longer-distance voluntary eye movements as saccades to be brought to fixation. While retinal information feeds into early visual cortex in an eccentricity orderly manner, we hypothesize that propagation of non-foveal information to mid and high-order visual cortex critically relies on circuitry involving eye movements. Limited or atypical eye movements, as in the case of BN, may hinder normal information flow to mid-eccentricity biased high-order visual cortex, adversely affecting its development and consequently inducing visual perceptual deficits predominantly for categories associated with these regions.

A formal analysis of alexia in persistent aura and a comparison to acquired pure alexia

A patient is reported with reversible pure alexia in the context of migraine with aura. Following previous, anecdotal reports, the present study is the first to formally assess word reading, writing, and other linguistic and visual processing and to compare these to a patient with stroke-related pure alexia. The reading impairment, suggestive of letter-by-letter reading, was observed across 7 days but had remitted at a 3-month follow-up. The deficit also affected recognition of letters, suggesting a functional impairment at the level of letter recognition, not just word reading. It went along with reversible abnormalities in diffusion-weighted and fluid-attenuated inversion recovery imaging in areas known to be involved in word reading.

Distinct but Overlapping Patterns of Response to Words and Faces in the Fusiform Gyrus

Converging evidence suggests that the fusiform gyrus is involved in the processing of both faces and words. We used fMRI to investigate the extent to which the representation of words and faces in this region of the brain is based on a common neural representation. In Experiment 1, a univariate analysis revealed regions in the fusiform gyrus that were only selective for faces and other regions that were only selective for words. However, we also found regions that showed both word-selective and face-selective responses, particularly in the left hemisphere. We then used a multivariate analysis to measure the pattern of response to faces and words. Despite the overlap in regional responses, we found distinct patterns of response to both faces and words in the left and right fusiform gyrus. In Experiment 2, fMR adaptation was used to determine whether information about familiar faces and names is integrated in the fusiform gyrus. Distinct regions of the fusiform gyrus showed adaptation to either familiar faces or familiar names. However, there was no adaptation to sequences of faces and names with the same identity. Taken together, these results provide evidence for distinct, but overlapping, neural representations for words and faces in the fusiform gyrus.

Processing deficits for familiar and novel faces in patients with left posterior fusiform lesions

Pure alexia (PA) arises from damage to the left posterior fusiform gyrus (pFG) and the striking reading disorder that defines this condition has meant that such patients are often cited as evidence for the specialisation of this region to processing of written words. There is, however, an alternative view that suggests this region is devoted to processing of high acuity foveal input, which is particularly salient for complex visual stimuli like letter strings. Previous reports have highlighted disrupted processing of non-linguistic visual stimuli after damage to the left pFG, both for familiar and unfamiliar objects and also for novel faces. This study explored the nature of face processing deficits in patients with left pFG damage. Identification of famous faces was found to be compromised in both expressive and receptive tasks. Discrimination of novel faces was also impaired, particularly for those that varied in terms of second-order spacing information, and this deficit was most apparent for the patients with the more severe reading deficits. Interestingly, discrimination of faces that varied in terms of feature identity was considerably better in these patients and it was performance in this condition that was related to the size of the length effects shown in reading. This finding complements functional imaging studies showing left pFG activation for faces varying only in spacing and frontal activation for faces varying only on features. These results suggest that the sequential part-based processing strategy that promotes the length effect in the reading of these patients also allows them to discriminate between faces on the basis of feature identity, but processing of second-order configural information is most compromised due to their left pFG lesion. This study supports a view in which the left pFG is specialised for processing of high acuity foveal visual information that supports processing of both words and faces.

Framing effects reveal discrete lexical-semantic and sublexical procedures in reading: an fMRI study

According to the dual-route model, a printed string of letters can be processed by either a grapheme-to-phoneme conversion (GPC) route or a lexical-semantic route. Although meta-analyses of the imaging literature support the existence of distinct but interacting reading procedures, individual neuroimaging studies that explored neural correlates of reading yielded inconclusive results. We used a list-manipulation paradigm to provide a fresh empirical look at this issue and to isolate specific areas that underlie the two reading procedures. In a lexical condition, we embedded disyllabic Italian words (target stimuli) in lists of either loanwords or trisyllabic Italian words with unpredictable stress position. In a GPC condition, similar target stimuli were included within lists of pseudowords. The procedure was designed to induce participants to emphasize either the lexical-semantic or the GPC reading procedure, while controlling for possible linguistic confounds and keeping the reading task requirements stable across the two conditions. Thirty-three adults participated in the behavioral study, and 20 further adult participants were included in the fMRI study. At the behavioral level, we found sizeable effects of the framing manipulations that included slower voice onset times for stimuli in the pseudoword frames. At the functional anatomical level, the occipital and temporal regions, and the intraparietal sulcus were specifically activated when subjects were reading target words in a lexical frame. The inferior parietal and anterior fusiform cortex were specifically activated in the GPC condition. These patterns of activation represented a valid classifying model of fMRI images associated with target reading in both frames in the multi-voxel pattern analyses. Further activations were shared by the two procedures in the occipital and inferior parietal areas, in the premotor cortex, in the frontal regions and the left supplementary motor area. These regions are most likely involved in either early input or late output processes.

Word and text processing in acquired prosopagnosia

OBJECTIVE

A novel hypothesis of object recognition asserts that multiple regions are engaged in processing an object type, and that cerebral regions participate in processing multiple types of objects. In particular, for high-level expert processing, it proposes shared rather than dedicated resources for word and face perception, and predicts that prosopagnosic subjects would have minor deficits in visual word processing, and alexic subjects would have subtle impairments in face perception. In this study, we evaluated whether prosopagnosic subjects had deficits in processing either the word content or the style of visual text.

METHODS

Eleven prosopagnosic subjects, 6 with unilateral right lesions and 5 with bilateral lesions, participated. In the first study, we evaluated their word length effect in reading single words. In the second study, we assessed their time and accuracy for sorting text by word content independent of style, and for sorting text by handwriting or font style independent of word content.

RESULTS

Only subjects with bilateral lesions showed mildly elevated word length effects. Subjects were not slowed in sorting text by word content, but were nearly uniformly impaired in accuracy for sorting text by style.

INTERPRETATION

Our results show that prosopagnosic subjects are impaired not only in face recognition but also in perceiving stylistic aspects of text. This supports a modified version of the many-to-many hypothesis that incorporates hemispheric specialization for processing different aspects of visual text.

Clinical TVA-based studies: a general review

In combination with whole report and partial report tasks, the theory of visual attention (TVA) can be used to estimate individual differences in five basic attentional parameters: the visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top-down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a) neglect and simultanagnosia, (b) reading disturbances, (c) aging and neurodegenerative diseases, and most recently (d) neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method's most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research.

Ventral aspect of the visual form pathway is not critical for the perception of biological motion

Identifying the movements of those around us is fundamental for many daily activities, such as recognizing actions, detecting predators, and interacting with others socially. A key question concerns the neurobiological substrates underlying biological motion perception. Although the ventral "form" visual cortex is standardly activated by biologically moving stimuli, whether these activations are functionally critical for biological motion perception or are epiphenomenal remains unknown. To address this question, we examined whether focal damage to regions of the ventral visual cortex, resulting in significant deficits in form perception, adversely affects biological motion perception. Six patients with damage to the ventral cortex were tested with sensitive point-light display paradigms. All patients were able to recognize unmasked point-light displays and their perceptual thresholds were not significantly different from those of three different control groups, one of which comprised brain-damaged patients with spared ventral cortex (n > 50). Importantly, these six patients performed significantly better than patients with damage to regions critical for biological motion perception. To assess the necessary contribution of different regions in the ventral pathway to biological motion perception, we complement the behavioral findings with a fine-grained comparison between the lesion location and extent, and the cortical regions standardly implicated in biological motion processing. This analysis revealed that the ventral aspects of the form pathway (e.g., fusiform regions, ventral extrastriate body area) are not critical for biological motion perception. We hypothesize that the role of these ventral regions is to provide enhanced multiview/posture representations of the moving person rather than to represent biological motion perception per se.

Fast word reading in pure alexia: "fast, yet serial"

Pure alexia is a severe impairment of word reading in which individuals process letters serially with a pronounced length effect. Yet, there is considerable variation in the performance of alexic readers with generally very slow, but also occasionally fast responses, an observation addressed rarely in previous reports. It has been suggested that "fast" responses in pure alexia reflect residual parallel letter processing or that they may even be subserved by an independent reading system. Four experiments assessed fast and slow reading in a participant (DN) with pure alexia. Two behavioral experiments investigated frequency, neighborhood, and length effects in forced fast reading. Two further experiments measured eye movements when DN was forced to read quickly, or could respond faster because words were easier to process. Taken together, there was little support for the proposal that "qualitatively different" mechanisms or reading strategies underlie both types of responses in DN. Instead, fast responses are argued to be generated by the same serial-reading strategy.

Preserved mid-fusiform activation for visual words in a patient with a visual word recognition impairment

Previous functional imaging studies have highlighted the role of left ventral temporal cortex in processing written word forms. We explored activation and anatomical connectivity of this region in HE, a professional writer with alexia as a result of stroke affecting primarily white matter in the left inferior temporal lobe. We used a one-back visual recognition task and functional Magnetic Resonance Imaging to elicit automatic activation to various orthographic and non-orthographic stimuli. Surprisingly, HE showed cortical activation in the left mid-fusiform area during the presentation of words and word-like stimuli, suggesting that this region׳s role in processing visual words is intact despite his severely impaired reading. Diffusion Tensor Imaging data further suggest that HE shows an anatomical disconnection between the ventral temporal cortex and posterior middle temporal cortex. Together, these findings suggest that activation of word-specific regions of mid-fusiform gyrus is not sufficient to yield the conscious experience of reading in the absence of activity in downstream regions of the classical reading network.

Alexia With and Without Agraphia: An Assessment of Two Classical Syndromes

Background:

Current cognitive models propose that multiple processes are involved in reading and writing.

Objective:

Our goal was to use linguistic analyses to clarify the cognitive dysfunction behind two classic alexic syndromes.

Methods:

We report four experiments on two patients, one with alexia without agraphia following occipitotemporal lesions, and one with alexia with agraphia from a left angular gyral lesion.

Results:

The patient with occipital lesions had trouble discriminating real letters from foils and his reading varied with word-length but not with linguistic variables such as part of speech, word frequency or imageability. He read pseudo-words and words with regular spelling better, indicating preserved use of grapheme-to-phoneme pronunciation rules. His writing showed errors that reflected reliance on ‘phoneme-to-grapheme’ spelling rules. In contrast, the patient with a left angular gyral lesion showed better recognition of letters, words and their meanings. His reading was better for words with high imageability but displayed semantic errors and an inability to use ‘grapheme-to-phoneme’ rules, features consistent with deep dyslexia. His agraphia showed impaired access to both an internal lexicon and ‘phoneme-to-grapheme’ rules.

Conclusion:

Some cases of pure alexia may be a perceptual word-form agnosia, with loss of internal representations of letters and words, while the angular gyral syndrome of alexia with agraphia is a linguistic deep dyslexia. The presence or absence of agraphia does not always distinguish between the two; rather, writing can mirror the reading deficits, being more obvious and profound in the case of an angular gyral syndrome.

(Con)text-specific effects of visual dysfunction on reading in posterior cortical atrophy

Reading deficits are a common early feature of the degenerative syndrome posterior cortical atrophy (PCA) but are poorly understood even at the single word level. The current study evaluated the reading accuracy and speed of 26 PCA patients, 17 typical Alzheimer's disease (tAD) patients and 14 healthy controls on a corpus of 192 single words in which the following perceptual properties were manipulated systematically: inter-letter spacing, font size, length, font type, case and confusability. PCA reading was significantly less accurate and slower than tAD patients and controls, with performance significantly adversely affected by increased letter spacing, size, length and font (cursive < non-cursive), and characterised by visual errors (69% of all error responses). By contrast, tAD and control accuracy rates were at or near ceiling, letter spacing was the only perceptual factor to influence reading speed in the same direction as controls, and, in contrast to PCA patients, control reading was faster for larger font sizes. The inverse size effect in PCA (less accurate reading of large than small font size print) was associated with lower grey matter volume in the right superior parietal lobule. Reading accuracy was associated with impairments of early visual (especially crowding), visuoperceptual and visuospatial processes. However, these deficits were not causally related to a universal impairment of reading as some patients showed preserved reading for small, unspaced words despite grave visual deficits. Rather, the impact of specific types of visual dysfunction on reading was found to be (con)text specific, being particularly evident for large, spaced, lengthy words. These findings improve the characterisation of dyslexia in PCA, shed light on the causative and associative factors, and provide clear direction for the development of reading aids and strategies to maximise and sustain reading ability in the early stages of disease.

An eye movement study on the role of the visual field defect in pure alexia

Pure alexia is a severe impairment of word reading which is usually accompanied by a right-sided visual field defect. Patients with pure alexia exhibit better preserved writing and a considerable word length effect, claimed to result from a serial letter processing strategy. Two experiments compared the eye movements of four patients with pure alexia to controls with simulated visual field defects (sVFD) when reading single words. Besides differences in response times and differential effects of word length on word reading in both groups, fixation durations and the occurrence of a serial, letter-by-letter fixation strategy were investigated. The analyses revealed quantitative and qualitative differences between pure alexic patients and unimpaired individuals reading with sVFD. The patients with pure alexia read words slower and exhibited more fixations. The serial, letter-by-letter fixation strategy was observed only in the patients but not in the controls with sVFD. It is argued that the VFD does not cause pure alexic reading.

From word superiority to word inferiority: visual processing of letters and words in pure alexia

Visual processing and naming of individual letters and short words were investigated in four patients with pure alexia. To test processing at different levels, the same stimuli were studied across a naming task and a visual perception task. The normal word superiority effect was eliminated in both tasks for all patients, and this pattern was more pronounced in the more severely affected patients. The relationship between performance with single letters and words was, however, not straightforward: One patient performed within the normal range on the letter perception task, while being severely impaired in letter naming and word processing, and performance with letters and words was dissociated in all four patients, with word reading being more severely impaired than letter recognition. This suggests that the word reading deficit in pure alexia may not be reduced to an impairment in single letter perception.

Prelexical representations and processes in reading: evidence from acquired dyslexia

We report a detailed and extensive single-case study of an acquired dyslexic patient, L.H.D., who suffered a left-hemisphere lesion as a result of a ruptured aneurysm. We present evidence that L.H.D.'s reading errors stem from a deficit in visual letter identification, and we use her deficit as a basis for exploring a variety of issues concerning prelexical representations and processes in reading. First, building on the work of other researchers, we present evidence that the prelexical reading system includes an allograph level of representation that represents each distinct visual shape of a letter (e.g., a, A, etc., for the letter A). We extend a theory proposed by Caramazza and Hillis [Caramazza, A., & Hillis, A. (1990a). Spatial representation of words in the brain implied by studies of a unilateral neglect patient. Nature, 346, 267-269] to include an allograph level, and we probe the nature of the allograph representations in some detail. Next, we explore the implications of visual similarity effects and letter perseverations in L.H.D.'s reading performance, arguing that these effects shed light on activation dynamics in the prelexical reading system and on the genesis of L.H.D.'s errors. We also probe the processing of letter case in the visual letter identification process, proposing that separate abstract letter identity and case representations are computed. Finally, we present evidence that the allograph level as well as the abstract letter identity level implement a word-based frame of reference.

What lies beneath: a comparison of reading aloud in pure alexia and semantic dementia

Exaggerated effects of word length upon reading-aloud performance define pure alexia, but have also been observed in semantic dementia. Some researchers have proposed a reading-specific account, whereby performance in these two disorders reflects the same cause: impaired orthographic processing. In contrast, according to the primary systems view of acquired reading disorders, pure alexia results from a basic visual processing deficit, whereas degraded semantic knowledge undermines reading performance in semantic dementia. To explore the source of reading deficits in these two disorders, we compared the reading performance of 10 pure alexic and 10 semantic dementia patients, matched in terms of overall severity of reading deficit. The results revealed comparable frequency effects on reading accuracy, but weaker effects of regularity in pure alexia than in semantic dementia. Analysis of error types revealed a higher rate of letter-based errors and a lower rate of regularization responses in pure alexia than in semantic dementia. Error responses were most often words in pure alexia but most often nonwords in semantic dementia. Although all patients made some letter substitution errors, these were characterized by visual similarity in pure alexia and phonological similarity in semantic dementia. Overall, the data indicate that the reading deficits in pure alexia and semantic dementia arise from impairments of visual processing and knowledge of word meaning, respectively. The locus and mechanisms of these impairments are placed within the context of current connectionist models of reading.

Alexia due to ischemic stroke of the visual word form area

The visual word form area (VWFA) is a region in the posterior left occipitotemporal cortex adjacent to the fusiform gyrus hypothesized to mediate word recognition. Evidence supporting the role of this area in reading comes from neuroimaging studies of normal subjects, case-controlled lesion studies, and studies of patients with surgical resection of the VWFA for tumors or epilepsy. Based on these prior reports, a small discrete lesion to the VWFA would be expected to cause alexia in a literate person without prior brain process, but such a case has not previously been reported to our knowledge. Here, we report the case of a previously-healthy 63-year-old man with the acute onset of alexia without other significant impairments. Magnetic resonance imaging (MRI) of the brain revealed a small ischemic stroke localized to the inferior left occipitotemporal cortex, corresponding to the approximate location of the putative VWFA. Characteristic of pure alexia, testing in the weeks following the stroke revealed a letter-by-letter reading strategy and a word length effect on single word reading. Formal visual field testing was normal. There was no color anomia, or object or face recognition deficits, although a mild agraphia may have been present. This case of acute-onset alexia in a previously normal individual due to a small stroke restricted to the VWFA and sparing occipital cortex and white matter pathways supports the conclusion that the VWFA is crucial for reading.

The VWFA: it's not just for words anymore

Reading is an important but phylogenetically new skill. While neuroimaging studies have identified brain regions used in reading, it is unclear to what extent these regions become specialized for use predominantly in reading vs. other tasks. Over the past several years, our group has published three studies addressing this question, particularly focusing on whether the putative visual word form area (VWFA) is used predominantly in reading, or whether it is used more generally in a number of tasks. Our three studies utilize a range of neuroimaging techniques, including task based fMRI experiments, a seed based resting state functional connectivity (RSFC) experiment, and a network based RSFC experiment. Overall, our studies indicate that the VWFA is not used specifically or even predominantly for reading. Rather the VWFA is a general use region that has processing properties making it particularly useful for reading, though it continues to be used in any task that requires its general processing properties. Our network based RSFC analysis extends this finding to other regions typically thought to be used predominantly for reading. Here, we review these findings and describe how the three studies complement each other. Then, we argue that conceptualizing the VWFA as a brain region with specific processing characteristics rather than a brain region devoted to a specific stimulus class, allows us to better explain the activity seen in this region during a variety of tasks. Having this type of conceptualization not only provides a better understanding of the VWFA but also provides a framework for understanding other brain regions, as it affords an explanation of function that is in keeping with the long history of studying the brain in terms of the type of information processing performed (Posner, 1978).

Not lost in translation: generalization of the primary systems hypothesis to Japanese-specific language processes

The emergentist-connectionist approach assumes that language processing reflects interaction between primary neural systems (Primary Systems Hypothesis). This idea offers an overarching framework that generalizes to various kinds of (English) language and nonverbal cognitive activities. The current study advances this approach with respect to language in two new and important ways. The first is the provision of a neuroanatomically constrained implementation of the theory. The second is a test of its ability to generalize to a language other than English (in this case Japanese) and, in particular, to a feature of that language (pitch accent) for which there is no English equivalent. A corpus analysis revealed the presence and distribution of typical and atypical accent forms in Japanese vocabulary, forming a quasiregular domain. Consequently, according to the Primary Systems Hypothesis, there should be a greater semantic impact on the processing of words with an atypical pitch accent. In turn, when word meaning is intrinsically less rich (e.g., abstract words), speakers should be prone to regularization errors of pitch accent. We explored these semantic-phonological interactions, first, in a neuroanatomically constrained, parallel-distributed processing model of spoken language processing. This model captured the accent typicality effect observed in nonword repetition in Japanese adults and children and exhibited the predicted semantic impact on repetition of words with atypical accent patterns. Second, also as predicted, in word repetition and immediate serial recall of spoken words, human participants exhibited reduced pitch-accent accuracy and/or slower RT for low imageability words with atypical accent patterns, and they generated accent errors reflecting the more typical accent patterns found in Japanese.

Connectionist neuropsychology: uncovering ultimate causes of acquired dyslexia

Acquired dyslexia offers a unique window on to the nature of the cognitive and neural architecture supporting skilled reading. This paper provides an integrative overview of recent empirical and computational work on acquired dyslexia within the context of the primary systems framework as implemented in connectionist neuropsychological models. This view proposes that damage to general visual, phonological or semantic processing abilities are the root causes of different forms of acquired dyslexia. Recent case-series behavioural evidence concerning pure alexia, phonological dyslexia and surface dyslexia that supports this perspective is presented. Lesion simulations of these findings within connectionist models of reading demonstrate the viability of this approach. The commitment of such models to learnt representations allows them to capture key aspects of performance in each type of acquired dyslexia, particularly the associated non-reading deficits, the role of relearning and the influence of individual differences in the premorbid state of the reading system. Identification of these factors not only advances our understanding of acquired dyslexia and the mechanisms of normal reading but they are also relevant to the complex interactions underpinning developmental reading disorders.

The role of human ventral visual cortex in motion perception

Visual motion perception is fundamental to many aspects of visual perception. Visual motion perception has long been associated with the dorsal (parietal) pathway and the involvement of the ventral 'form' (temporal) visual pathway has not been considered critical for normal motion perception. Here, we evaluated this view by examining whether circumscribed damage to ventral visual cortex impaired motion perception. The perception of motion in basic, non-form tasks (motion coherence and motion detection) and complex structure-from-motion, for a wide range of motion speeds, all centrally displayed, was assessed in five patients with a circumscribed lesion to either the right or left ventral visual pathway. Patients with a right, but not with a left, ventral visual lesion displayed widespread impairments in central motion perception even for non-form motion, for both slow and for fast speeds, and this held true independent of the integrity of areas MT/V5, V3A or parietal regions. In contrast with the traditional view in which only the dorsal visual stream is critical for motion perception, these novel findings implicate a more distributed circuit in which the integrity of the right ventral visual pathway is also necessary even for the perception of non-form motion.

Resting-state functional connectivity and reading abilities in first and second languages

An intriguing discovery in recent years is that resting-state functional connectivity (RSFC) is associated with cognitive performance. The current study investigated whether RSFC within the reading network was correlated with Chinese adults' reading abilities in their native language (L1, Chinese) and second language (L2, English). Results showed that RSFC within the reading network was positively correlated to reading abilities in L1 and L2, and RSFC between reading areas and the default network was negatively correlated to reading abilities in L1 and L2. Further conjunction and contrast analyses revealed that L1 and L2 shared similar RSFC correlates including connectivities between the areas for visual analysis (e.g., bilateral posterior fusiform gyrus, lateral occipital cortices, and right superior parietal lobules) and those for phonological processing (e.g., bilateral precentral gyri and postcentral gyrus, Wernicke's area). These results indicate that RSFC is a potential neural marker for reading abilities in both L1 and L2, with important theoretical implications for reading in L1 and L2.

How low can you go: spatial frequency sensitivity in a patient with pure alexia

Pure alexia is a selective deficit in reading, following lesions to the posterior left hemisphere. Writing and other language functions remain intact in these patients. Whether pure alexia is caused by a primary problem in visual perception is highly debated. A recent hypothesis suggests that a low level deficit - reduced sensitivity to particular spatial frequencies - is the underlying cause. We tested this hypothesis in a pure alexic patient (LK), using a sensitive psychophysical paradigm to examine her performance with simple patterns of different spatial frequency. We find that both in a detection and a classification task, LK's contrast sensitivity is comparable to normal controls for all spatial frequencies. Thus, reduced spatial frequency sensitivity does not constitute a general explanation for pure alexia, suggesting that the core deficit in this disorder is at a higher level in the visual processing stream.

Rehabilitation of pure alexia: a review

Acquired reading problems caused by brain injury (alexia) are common, either as a part of an aphasic syndrome, or as an isolated symptom. In pure alexia, reading is impaired while other language functions, including writing, are spared. Being in many ways a simple syndrome, one would think that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions, such as alexia severity and associated deficits. Many patients reported to have pure alexia in the reviewed studies, have associated deficits such as agraphia or aphasia and thus do not strictly conform to the diagnosis. Few studies report clear and generalisable effects of training, none report control data, and in many cases the reported findings are not supported by statistics. We can, however, tentatively conclude that Multiple Oral Re-reading techniques may have some effect in mild pure alexia where diminished reading speed is the main problem, while Tacile-Kinesthetic training may improve letter identification in more severe cases of alexia. There is, however, still a great need for well-designed and controlled studies of rehabilitation of pure alexia.

Distributed circuits, not circumscribed centers, mediate visual recognition

Increasingly, the neural mechanisms that support visual cognition are being conceptualized as a distributed but integrated system, as opposed to a set of individual, specialized regions that each subserve a particular visual behavior. Consequently, there is an emerging emphasis on characterizing the functional, structural,and computational properties of these broad networks [corrected]. We present a novel theoretical perspective, which elucidates the developmental emergence, computational properties, and vulnerabilities of integrated circuits using face and word recognition as model domains. Additionally, we suggest that, rather than being disparate and independent, these neural circuits are overlapping and subject to the same computational constraints. Specifically, we argue that both word and face recognition rely on fine-grained visual representations but, by virtue of pressure to couple visual and language areas and to keep connection length short, the left hemisphere becomes more finely tuned for word recognition and, consequently, the right hemisphere becomes more finely tuned for face recognition. Thus, both hemispheres ultimately participate in both forms of visual recognition, but their respective contributions are asymmetrically weighted.

Intact reading in patients with profound early visual dysfunction

Despite substantial neuroscientific evidence for a region of visual cortex dedicated to the processing of written words, many studies continue to reject explanations of letter-by-letter (LBL) reading in terms of impaired word form representations or parallel letter processing in favour of more general deficits of visual function. In the current paper, we demonstrate that whilst LBL reading is often associated with general visual deficits, these deficits are not necessarily sufficient to cause reading impairment and have led to accounts of LBL reading which are based largely on evidence of association rather than causation. We describe two patients with posterior cortical atrophy (PCA) who exhibit remarkably preserved whole word and letter reading despite profound visual dysfunction. Relative to controls, both patients demonstrated impaired performance on tests of early visual, visuoperceptual and visuospatial processing; visual acuity was the only skill preserved in both individuals. By contrast, both patients were able to read aloud words with perfect to near-perfect accuracy. Reading performance was also rapid with no overall significant difference in response latencies relative to age- and education-matched controls. Furthermore, the patients violated a key prediction of general visual accounts of LBL reading – that pre-lexical impairments should result in prominent word length effects; in the two reported patients, evidence for abnormal word length effects was equivocal or absent, and certainly an order of magnitude different to that reported for LBL readers. We argue that general visual accounts cannot explain the pattern of reading data reported, and attribute the preserved reading performance to preserved direct access to intact word form representations and/or parallel letter processing mechanisms. The current data emphasise the need for much clearer evidence of causality when attempting to draw connections between specific aspects of visual processing and different types of acquired peripheral dyslexia.

Recovery in a letter-by-letter reader: more efficiency at the expense of normal reading strategy

Although changes in reading performance of recovering letter-by-letter readers have been described in some detail, no prior research has provided an in-depth analysis of the underlying adaptive word processing strategies. Our work examined the reading performance of a letter-by-letter reader, FH, over a period of 15 months, using eye movement methodology to delineate the recovery process at two different time points (T1, T2). A central question is whether recovery is characterized either by moving back towards normal word processing or by refinement and possibly automatization of an existing pathological strategy that was developed in response to the impairment. More specifically, we hypothesized that letter-by-letter reading may be executed with at least four different strategies and our work sought to distinguish between these alternatives. During recovery significant improvements in reading performance were achieved. A shift of fixation positions from the far left to the extreme right of target words was combined with many small and very few longer regressive saccades. Apparently, 'letter-by-letter reading' took the form of local clustering, most likely corresponding to the formation of sublexical units of analysis. This pattern was more pronounced at T2, suggesting that improvements in reading efficiency may come at the expense of making it harder to eventually return to normal reading.

Bilateral hemispheric processing of words and faces: evidence from word impairments in prosopagnosia and face impairments in pure alexia

Considerable research has supported the view that faces and words are subserved by independent neural mechanisms located in the ventral visual cortex in opposite hemispheres. On this view, right hemisphere ventral lesions that impair face recognition (prosopagnosia) should leave word recognition unaffected, and left hemisphere ventral lesions that impair word recognition (pure alexia) should leave face recognition unaffected. The current study shows that neither of these predictions was upheld. A series of experiments characterizing speed and accuracy of word and face recognition were conducted in 7 patients (4 pure alexic, 3 prosopagnosic) and matched controls. Prosopagnosic patients revealed mild but reliable word recognition deficits, and pure alexic patients demonstrated mild but reliable face recognition deficits. The apparent comingling of face and word mechanisms is unexpected from a domain-specific perspective, but follows naturally as a consequence of an interactive, learning-based account in which neural processes for both faces and words are the result of an optimization procedure embodying specific computational principles and constraints.

Phonological activation in pure alexia

Pure alexia is a reading impairment in which patients appear to read letter-by-letter. This disorder is typically accounted for in terms of a peripheral deficit that occurs early on in the reading system, prior to the activation of orthographic word representations. The peripheral interpretation of pure alexia has recently been challenged by the phonological deficit hypothesis, which claims that a postlexical disconnection between orthographic and phonological information contributes to or is responsible for the disorder. Because this hypothesis was mainly supported by data from a single patient (IH), who also has surface dyslexia, the present study re-examined this hypothesis with another pure alexic patient (EL). In contrast to patient IH, EL did not show any evidence of a phonological deficit. Her pattern of performance in naming was not qualitatively different from that of normal readers; she appeared to be reading via a mode of processing resulting in strong serial and lexical effects, a pattern often observed in normal individuals reading unfamiliar stimuli. The present results do not obviously support the phonological hypothesis and are more consistent with peripheral interpretations of pure alexia. The peripheral and the phonological accounts of pure alexia are discussed in light of two current models of visual word recognition.

Pure alexia and covert reading: Evidence from Stroop tasks

Patients with pure alexia (also referred to as letter-by-letter readers) show a marked word-length effect when naming visually presented words, evidenced by a monotonic increase in response time (or decrease in accuracy) as a function of the number of letters in the string. Interestingly, despite the difficulty in overtly reporting the identity of some words, many patients exhibit fast and above-chance access to lexical and/or semantic information for the same words. To explore the extent of this covert reading, we examined the degree of interference afforded by the inconsistent (word identity and colour label do not match) versus neutral condition in a Stroop task in a pure alexic patient, EL. EL shows evidence of covert reading on a semantic categorisation task and a lexical decision task. She also demonstrates covert reading by exhibiting Stroop interference of the same magnitude as a matched control subject, when naming the colour of the ink in which a word is printed. When the word shares some but not all letters with the colour name (BLOW instead of BLUE), neither subject shows interference. In contrast with the control subject, EL does not show Stroop interference when various orthographic changes (degraded visual input, cursive font) or phonological or semantic changes are made to the word. These findings indicate that although some implicit processing of words may be possible, this processing is rather rudimentary. Not surprising, this implicit activation may be insufficient to support overt word identification. We explain these findings in the context of a single, integrated account of pure alexia.

Sequential and parallel letter processing in letter-by-letter dyslexia

Four experiments are reported that focus on the issue of sequential vs. parallel letter processing in letter-by-letter (LBL) dyslexia; these were conducted on patient IH. Expt. 1 showed a large linear reduction of word naming times with an increase in the number of orthographic neighbours of the target (i.e., words of the same length differing by just one letter; N size). Given the large negative linear correlation existing between word length and N size, this result raises the possibility that the large word length effect diagnostic of LBL dyslexia may be, in fact, an artefact of uncontrolled N size. Expt. 2 falsified this possibility by showing that the word length effect is unaffected by whether N size is controlled for or not. This result also suggested that the facilitatory effect of increased N size in LBL dyslexia is based on the parallel processing of the constituent letters of the target. Further supporting a contribution of parallel letter processing to overt word recognition performance in the disorder, Expt. 3 showed significant but independent effects of word length and letter confusability (i.e., similarity of the constituent letters of the target word with other letters of the alphabet). The letter confusability effect therefore appears to rest on the parallel analysis of the letters in the target word. Finally, Expt. 4 showed that the facilitatory effect of N size is prevented with high letter-confusability targets. These observations suggest that LBL dyslexia rests on an impairment of letter encoding that results in an excessive level of background noise in the activation of lexical-orthographic representations when letters are processed in parallel. This prevents overt identification of the target and forces sequential letter processing in order to achieve this goal.

Types of case series--the anatomically based approach: commentary on M. F. Schwartz & G. S. Dell: case series investigations in cognitive neuropsychology

The paper addresses a weakness in the Schwartz and Dell paper (2010)-namely, its discussion of the inclusion criteria for case series. The paper distinguishes the different types that exist and how they constrain the theoretical conclusions that one can draw about the organization of the normal cognitive system. Four different types of inclusion criteria are considered. Two are those treated by Schwartz and Dell-namely, theoretically derived clinical criteria, such as the example of semantic dementia, and broad clinical criteria such as the presence of aphasia. In addition, in the present paper two different types of anatomically based criteria are assessed-those using anatomical regions selected a priori and also regions selected as a result of an anatomical group study analysis. Putative functional syndromes are argued to be the empirical building blocks for cognitive neuropsychology. Anatomically based case series can aid in their construction or in their fractionation.

Efficient visual object and word recognition relies on high spatial frequency coding in the left posterior fusiform gyrus: evidence from a case-series of patients with ventral occipito-temporal cortex damage

Recent visual neuroscience investigations suggest that ventral occipito-temporal cortex is retinotopically organized, with high acuity foveal input projecting primarily to the posterior fusiform gyrus (pFG), making this region crucial for coding high spatial frequency information. Because high spatial frequencies are critical for fine-grained visual discrimination, we hypothesized that damage to the left pFG should have an adverse effect not only on efficient reading, as observed in pure alexia, but also on the processing of complex non-orthographic visual stimuli. Consistent with this hypothesis, we obtained evidence that a large case series (n = 20) of patients with lesions centered on left pFG: 1) Exhibited reduced sensitivity to high spatial frequencies; 2) demonstrated prolonged response latencies both in reading (pure alexia) and object naming; and 3) were especially sensitive to visual complexity and similarity when discriminating between novel visual patterns. These results suggest that the patients' dual reading and non-orthographic recognition impairments have a common underlying mechanism and reflect the loss of high spatial frequency visual information normally coded in the left pFG.

Modelling normal and impaired letter recognition: implications for understanding pure alexic reading

Letter recognition is the foundation of the human reading system. Despite this, it tends to receive little attention in computational modelling of single word reading. Here we present a model that can be trained to recognise letters in various spatial transformations. When presented with degraded stimuli the model makes letter confusion errors that correlate with human confusability data. Analyses of the internal representations of the model suggest that a small set of learned visual feature detectors support the recognition of both upper case and lower case letters in various fonts and transformations. We postulated that a damaged version of the model might be expected to act in a similar manner to patients suffering from pure alexia. Summed error score generated from the model was found to be a very good predictor of the reading times of pure alexic patients, outperforming simple word length, and accounting for 47% of the variance. These findings are consistent with a hypothesis suggesting that impaired visual processing is a key to understanding the strong word-length effects found in pure alexic patients.

"Serial" effects in parallel models of reading

There is now considerable evidence showing that the time to read a word out loud is influenced by an interaction between orthographic length and lexicality. Given that length effects are interpreted by advocates of dual-route models as evidence of serial processing this would seem to pose a serious challenge to models of single word reading which postulate a common parallel processing mechanism for reading both words and nonwords (Coltheart, Rastle, Perry, Langdon, & Ziegler, 2001; Rastle, Havelka, Wydell, Coltheart, & Besner, 2009). However, an alternative explanation of these data is that visual processes outside the scope of existing parallel models are responsible for generating the word-length related phenomena (Seidenberg & Plaut, 1998). Here we demonstrate that a parallel model of single word reading can account for the differential word-length effects found in the naming latencies of words and nonwords, provided that it includes a mapping from visual to orthographic representations, and that the nature of those orthographic representations are not preconstrained. The model can also simulate other supposedly "serial" effects. The overall findings were consistent with the view that visual processing contributes substantially to the word-length effects in normal reading and provided evidence to support the single-route theory which assumes words and nonwords are processed in parallel by a common mechanism.