Objective: Controversy has existed for decades as to the parameters of Hyperlexia – a rare ability to perform fluent oral reading disproportionately better than intellect (Cohen, Campbell, & Gerlardo, 1986), while markedly better than comprehension. Proposed definitions have been restricted to predefined subgroups, while other criteria has been so broad (i.e., a difference of only two grade levels) as to render the construct meaningless. Meanwhile, a direct lexical route from orthography to phonology, independent of semantic mediation, has received strong empirical support (Castle et al., 2010). Method: Neuropsychological case study of a 13-year old, non-autistic, 7th grade female with dysmorphic facial characteristics. She showed an early love for the alphabet, as well as a well-documented language-based learning disability. Results: Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) indices were scattered (SS = 68 to 91) with a “borderline” range Full Scale IQ of 72 that favored verbal-auditory over visual-perceptual domains. Remarkable discrepancy was evident on the Gray Oral Reading Tests – Fourth Edition (GORT-4), with “superior” Reading Fluency (95th percentile, >12-7 grade equivalent) juxtaposed with “extremely low” Reading Comprehension (1st percentile, 1-4 grade equivalent). Conclusion: Strictly defined, Hyperlexia would require the presence of autistic spectrum features, precocious reading, intact intellect, strong visual memory – none of which were present in this case. The extreme discrepancy in reading fluency and comprehension presented might be relegated to a “Comprehension Disorder,” which does not capture this profound of a semantic disconnect. If Hyperlexia does not apply to the current case, of what epistemological value is the “symptom”?
A Case of Hyperlexia or Comprehension Disorder: The Crossroads Between Criteria and Epistemology
A Santoro, J Healey, J McGinley; A-70
A Case of Hyperlexia or Comprehension Disorder: The Crossroads Between Criteria and Epistemology. Arch Clin Neuropsychol 2016; 31 (6): 610. doi: 10.1093/arclin/acw043.70
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