Pélagie M. Beeson, Ph.D., CCC-SLP Department of Speech, Language, and Hearing Sciences Disclosure
This work is supported by grant R01DC007646 from the the National Institute on Deafness and Other Communication Disorders entitled Developing an Evidence-Based Treatment Continuum for Spoken and Written Language Pélagie Beeson is employed by the University of Arizona, and has no other financial or nonfinancial relationships to disclose.
National Institute on Deafness and Other Communication Disorders Part 1
Pélagie M. Beeson, Ph.D., CCC-SLP Department of Speech, Language, and Hearing Sciences Primary goal of our Aphasia Research Project is to develop and test treatments intended to maximize recovery from spoken and written language impairment ◦ We aim to understand the nature of the impairment (behavioral and neural underpinnings) develop treatment sequences that build upon one another to advance recovery examine behavioral and neural changes in response to treatment Most common cause of aphasia Disrupts vascular support for left perisylvian brain regions Damage results in classic “perisylvian” aphasia types
Broca’s Wernicke’s Conduction Global Left perisylvian region
M S SMG B B = Broca’s area W M = Primary Motor S = Somatosensory SMG = Supramarginal gyrus W = Wernicke’s area Sylvian Fissure
Damage to left perisylvian region due to strokes Broca’s Wernicke’s Conduction Global
Aphasia profiles vary with regard to comprehension and production of language. Semantics
Phonology Orthography
Also in individuals with perisylvian damage who Broca’s Wernicke’s Conduction Global evolve to Anomic Aphasia What does phonological impairment look like?
“No, there’s too many things… too many things different… There’s too many things”
“pa…puh… puh…puh… piles”
“kofale….We have thousands of those in our …. all around it… where we live. They’re all over the place… And they’re good to eat.” phonemic paraphasias What does phonological impairment look like?
Impaired phonological awareness and phonological manipulation skills
/d/-/I/-/g/ [dig] /p/-/A/-/t/ [pat] /b/-/oI/-/l/ [boil] [s] [g]
[t] “Write the [l] letter that [n] [z] goes with the [k] sound.” [th] [r] [w] [b] [ch] [d] 2/20 correct machine + Reading Words Phonological Alexia head + 100 laugh + 90 kept + 80 storm + 70 count + 60 50 glacier + 40 bribe + 30 Reading Nonwords 20 10 dringe “princh” 0 mofer “morph” Reading Spelling Words Nonwords andon “annock” barcle Arizona Battery for Reading and Spelling (ABRS) “bercel” (http://www.aphasia.arizona.edu/) Spelling Words Phonological Agraphia vague + 100 field + 90 bump + 80 debt + 70 pint + 60 trade + 50 gross - 40 30 Spelling Nonwords 20 flig - 10 hoach - marked 0 snite - impairment Reading Spelling Words Nonwords glope - of nonword boak + spelling Arizona Battery for Reading and Spelling (ABRS) (http://www.aphasia.arizona.edu/) cheed - Consider the “apple” apple cognitive processes Acoustic Visual Analysis Analysis Semantics
Phonologic whole words Orthographic Lexical Lexicon Lexicon Lexical sound-letter Sub-lexical Phonemes Graphemes Sub-lexical letter-sound
Speech Motor Graphic Motor Programs Programs
“apple” apple Phonological “apple” apple Impairment Acoustic Visual Analysis Analysis Semantics
Phonologic whole words Orthographic Lexical Lexicon Lexicon Lexical sound-letter Sub-lexical Phonemes Graphemes Sub-lexical letter-sound
Speech Motor Graphic Motor Programs Programs
“apple” apple Testing phonological skills with dusp nonword reading Visual Analysis Semantics
Phonologic whole words Orthographic Can’t use sublexical route Lexicon Lexicon Lexical to assist with reading sound-letter Phonemes Graphemes Sub-lexical letter-sound reg irreg nonwords 100 Can’t sound out words Speech Motor Programs or nonwords 80 Phonological Alexia 60 “dust?” 40 20
0 What is the consequence of phonological impairment on functional reading? 100 3.5 years post 90 LMCA stroke 80 ◦ Conduction 70 Aphasia 60 ◦ WAB AQ: 77.7 50 ◦ BNT: 26/60 40 30 Locks and keys have been 20 “There in the, no, .. in use for thousands of thousand in year. Why? years. Why? Because there 10 Because it … [I don’t have always been thieves. 0 know] Greece … It is the In Greece, long ago Reading Spelling lock and keys.” people had locks and Words Nonwords keys. “dusp” Testing phonological skills with nonword spelling Acoustic Analysis Semantics
Phonologic whole words Orthographic Can’t use sublexical Lexical Lexicon Lexicon sound-letter route to assist with Sub-lexical Phonemes Graphemes letter-sound spelling reg irreg nonwords 100 Graphic Motor Can’t sound out 80 Programs spellings for unfamiliar 60 words or nonwords 40 Phonological Agraphia druffs 20
0 4 months post LMCA stroke ◦ Anomic aphasia ◦ WAB AQ: 82.2 ◦ BNT: 50/60
“This guy flying a kite. Um, he’s walking a dog, or his dog’s walking him, I dunno. Um, this man is fishing….. This man or, man, or m-, is um sailing…This couple is reading a book and pouring a wine. Or listening to the radio. Um… there car in the garage... The frag up the pole… Uh… um it’s a scenery WAB = Western Aphasia Battery behind ‘em… I don’t know.” BNT = Boston Naming Test Phonological impairment has striking effect on sentence-level writing! Well-Formed and Complete Sentences 100
80
60
40 % Correct % 20 “This guy flying a kite. Um, he’s Written picture description 0 walking a dog, or his dog’s walking him, Spoken Written I dunno. Um, this man is fishing….. This Dog is cuming Phonological Text Agraphia man or, man, or m-, is um sailing…This Man is fly kite Beeson, Rising, et al. (2016) couple is reading a book and pouring a sailboat Neuropsychological Rehabilitation wine. Or listening to the radio. Um… lady & guy the picnic and book and there car in the garage... The frag up the pole… Uh… um it’s a scenery with wine behind ‘em… I don’t know.” 2 years post left MCA stroke Broca’s Aphasia with severe apraxia of speech Aphasia Quotient = 40
Written picture description “Bobo … one … Bobo one … bye… bye” Reading Spelling 100 100
80 80
60 60 Regular
Irregular 40 40 Nonwords Percent Correct Percent Percent Correct Percent Global Alexia 20 20 Global Agraphia
0 0
Regular Words Irregular Words Nonwords
stop castle flig pillow type hoach Phonological “pillow” pillow Global Impairment Alexia/Agraphia Acoustic Visual plus lexical-semantic Analysis Analysis and orthographic Semantics impairment (< 30% correct) whole words Phonologic Orthographic 100 Lexical Lexicon Lexicon sound-letter Phonemes Graphemes 80 Sub-lexical letter-sound
60 Regular
Speech Motor Graphic Motor Irregular Programs Programs 40 Nonwords Percent Correct Percent
20 “pill?” pow 0 Two Profiles with Perisylvian Damage showing Phonological Impairment Global Phonological Agraphia Agraphia Lexical-Semantic & Predominantly Phonological Impairment Phonological Impairment (< 30% correct) (lexicality effect)
100 100 Both have impaired 80 80 phonological skills. 60 Regular 60 Irregular 40 Both warrant Percent Correct Percent Nonwords 40 20 phonological treatment. 20 0 0
* Arizona Battery for Reading and Spelling (ABRS) (http://www.aphasia.arizona.edu/) Semantics
Phonology Orthography Aphasia Types • 19 Anomic (many evolved) • 13 Broca’s 1 Global • 9 Conduction 5 Wernicke’s mean range Age (yrs) 59.1 (22.5 – 77.7) TPO (yrs) 2.5 (0.3 – 13.5) WAB AQ 63.4 (16.7 – 96.4) BNT 23.8 (0 – 55) Comprehensive assessment reveals marked underlying phonological impairment
100 Visual-Orthographic Processing
80 Allographic/Graphomotor Skills
60 Semantic Processing
Speech Production 40 Percent Correct Percent Phonology-Orthography 20 Transcoding Phonological Manipulation Lesion overlap 0
n = 47 Assessment of Cognitive and Sensorimotor Processes
n = 47 Comprehensive assessment reveals marked underlying phonological impairment
100 100
80 80
60 60 Words Nonwords 40
40 Correct Percent Percent Correct Percent 20 20
0 n = 47 0 Visual-Orthographic Processing Read Spell Allographic/Graphomotor Skills Phonological impairment easily detected Semantic Processing Speech Production on nonword reading and spelling tasks. Phonology-Orthography Transcoding • Reading and spelling of real words also impaired. Phonological Manipulation • Written spelling more impaired than oral reading. All had phonological impairment, but single word reading and writing was more impaired in some.
100 100 Words Words Nonwords Nonwords 80 80
60 60
40 40 Percent Correct Percent Percent Correct Percent
20 20
0 0 Read Spell Read Spell
Global Agraphia (n = 27) Phonological Agraphia (n=20) (<30% correct spelling of real words) Treatment Sequence for Individuals with Phonological Impairment
Perisylvian Aphasia Perisylvian Aphasia with with Global Agraphia Phonological Agraphia
Lexical-Semantic Tx Phonological Tx Interactive Tx
retrain spelling for specific words retrain sound-letter correspondences and phonological train problem-solving manipulation skills strategies to self-correct spelling errors Lexical Retrieval Cascade Tx
train lexical retrieval strategies including semantic and phonological self-cuing Treatment for Global Agraphia “apple” apple
Acoustic Visual Analysis Analysis retrain spellings
Semantics for specific words
whole words Phonologic Orthographic lexical spelling Lexicon Lexicon sound-letter treatment paired Phonemes Graphemes with repeated letter-sound spoken production of Speech Motor Graphic Motor target words and Programs Programs links to meaning
“apple” apple Purpose ◦ Strengthen written spelling for specific words (and links to meaning) and stimulate spoken production Goal ◦ To retrain single-word written vocabulary for use in communication (and to stimulate spoken production) ◦ To establish written “key words” for use in phonological treatment Approach ◦ Copy and Recall Treatment (CART) Train 24 words (4 groups consonants/2 groups vowels)
leaf net chin cake Copy and Recall Treatment Model Repeat “hammer” “hammer” hammer hammer Copy hammer hammer hammer Recall Beeson, 1999, Aphasiology Beeson, Rewega, Hirsch, 2002, Aphasiology Beeson, Rising, & Volk, 2003, JSLHR “talking” photo album Homework for Copy and Recall Treatment Listen, repeat word, copy word. Key words-Consonants Set 1 rug, top, leaf, safe, net Set 2 cake, fire, moon, pie, dog Set 3 book, goat, zoo, ship, van Set 4 hat, web, chin, judge, three Key words-Vowels Set 1 hat/van, cake/safe, ship/chin fire/pie, net/web, leaf/three Set 2 top/dog, bone/goat, rug/judge moon/zoo, cow/mouth, foot/book
pictures available at http://www.aphasia.arizona.edu/ Daily homework pages for repeated copy practice Review each session for accountability
Homework is fun! 6 5 4 3 Set 1 2 Treatment 2 x per week 1 0 with homework 1 2 3 4 5 6 7 8 9 10 11 12 13 6 5 4 3 2 Set 2 1 Treatment duration 0 1 2 3 4 5 6 7 8 9 10 11 12 13
~ 4-8 weeks 6 5 4 3 2 1 Set 3 0 1 2 3 4 5 6 7 8 9 10 11 12 13
4 sets/6 words trained 6 5 4 to >80% accuracy. 3 2 1 Set 4 0 1 2 3 4 5 6 7 8 9 10 11 12 13 Response to Copy and Recall Treatment
Pre-treatment (1st probe)
After 4 weeks of treatment Improved written and spoken production of targeted words (group performance)
Pre-Tx 100 90 Post-CART 80 70 60 50 40 % Correct % 30 Global Agraphia 20 10 n = 27 0 Written Naming Spoken Naming Speech production limited in some individuals Texting Copy and Recall Treatment (T-CART) Model Repeat “hammer” “hammer” hammer
Retrain spelling and left-handed text messaging
Beeson, Higginson, Rising (2013) JSLHR Fein, Bayley, Rising, Beeson (2019) Aphasiology “apple” apple “apple” apple
Semantics Semantics
Phonologic Orthographic Phonologic Orthographic Lexicon Lexicon Lexicon Lexicon sound-letter Phonemes Graphemes Phonemes Graphemes letter-sound
“apple” apple “apple” apple retrain specific words retrain sound-letter correspondences Treatment Sequence for Individuals with Phonological Impairment Perisylvian Aphasia Perisylvian Aphasia with Phonological Treatment: with Global Agraphia Phonological Agraphia To strengthen sound-letter Lexical-Semantic Tx 20 correspondences and phonological manipulation 27 Phonological Tx skills retrain spelling for /f/ = f m = /m/ specific words retrain sound-letter b – a – t = bat
100 correspondences Use “key words” as needed to 80 and phonological 60 retrieve phonology/orthography 40 manipulation skills 20 0 Written Spoken Naming Naming fire --- /f/ --- f Prerequisite skills ◦ Able to read, write, and name key words for consonants and vowels (we typically use the 24 items from CART) high frequency, concrete, regularly spelled nouns used to retrain sound-letter (and letter-sound) correspondences ◦ Train with lexical items for key words first if necessary (CART) Key words-Consonants Set 1 rug, top, leaf, safe, net Set 2 cake, fire, moon, pie, dog Set 3 book, goat, zoo, ship, van Set 4 hat, web, chin, judge, three
Key words-Vowels Set 1 hat/van, cake/safe, ship/chin fire/pie, net/web, leaf/three Set 2 top/dog, bone/goat, rug/judge moon/zoo, cow/mouth, foot/book
available at http://web.me.com/pelagie1/Aphasia_Research_Project/CART.html “How did you select the key words?”
/d/ - dog /v/ - Vail /r/ - Rick /k/ - Kim
Beeson, P.M., Rewega, M.,Vail, S.M., & Rapcsak, S.Z. (2000). Problem-solving approach to agraphia treatment: Interactive use of lexical and sublexical spelling routes. Aphasiology, 14, 551-565. [interactive treatment] Clinician Patient
Say /p/ /p/
What is your key word for /p/? “pie” (Show picture if necessary).
Write your key word for /p/ pie
Underline /p/ in your word pie DVD or YouTube homework Now say the sound /p/
Beeson, Rising, Kim, & Rapcsak, S. Z. (2010). JSLHR. Sound to letter using key word
/f/ - f [fire]
/d/ - d [dog]
Conduction aphasia with Phonological Agraphia Clinician Patient • Show the letter “s” s • What is your key word for this ? “safe” • Show the picture if necessary • Your key word is “safe”, write “safe” safe
•What’s the 1st sound? “ssss” • Show the letter “s” s “ssss” •What is this sound? What sound goes with this letter? s - /s/
n - /n/
Broca’s aphasia with Phonological Agraphia Letter Sound: Vowels
key word a_e ape
i it
ea ee eat/eel
Conduction aphasia with Phonological Agraphia Homework via DVD or YouTube key word ou out oo cool Blending ◦ What word (or nonword) do these sounds make? e.g., m-ea-n p-o-t n-a-p Segmenting What is the last sound of “hood”? What is the vowel sound in “zone”? What’s the last sound of “maze”? Target /m/ /ae/ /d/
Written Response
m u d
m A d 20 Nonwords ◦ 4 sets of 5 e.g. mog, peth, trib, glipe, zook Probes: written spelling to dictation ◦ Therapy tasks Focus on “sound it out strategy” ◦ Criteria to master a set of 5 80% accuracy across 2 consecutive sessions Write “glope” Not training the items but rather the ability to transcode sounds and letters Homework: Videotape, DVD, or YouTube for stimuli Treatment Sequence for Phonological Impairment Perisylvian Aphasia with Phonological Agraphia
Direct Treatment Gains 100 Post Phonological Tx 90 Pre 80 5 weeks consonants Interactive Tx 70 6 weeks vowels 60 5 weeks blending 50 40 retrain sound-letter 30 correspondences train problem- 20
10 and phonological solving strategies 0 manipulation skills to self-correct L-S S-L L-S Vowels S-L Vowels Nonword Consonants Consonants Blending spelling errors Purpose ◦ Strengthen the interactive use of orthography and phonology Goal ◦ To improve spelling accuracy by increasing self-detection and correction of errors Approach ◦ Use residual or re-trained phonology to sound-out plausible spellings ◦ Identify and correct errors ◦ Use of electronic spell-checker to aid in error correction
anser answer Interactive treatment promotes a problem-solving approach to spelling.
“Write ‘magic’”
He wrote: m a j c [typed into spellchecker] magic
Conduction aphasia with Phonological Agraphia Interactive Spelling Treatment: Problem-solving approach 1. Listen to the word. 2. Repeat it. 3. Sound out the word and try to write it. 4. Look at it. Is it correct? 5. Correct it. Try to get as close as you can. 6. Type in spell checker. 7. Is it correct? 8. If not, do you see the correct word? 9. Copy the correct spelling. 10. Circle the correct spelling. Target Phonologically Franklin Microsoft Word Spell Check Plausible Speller Misspelling circuit serkit circuit serkin, seri, serif subtle suttle subtle settle, scuttle, shuttle, subtle pursuit persoot pursuit per soot, person presort, perrot, persist Treatment Sequence for Phonological Impairment Perisylvian Aphasia Perisylvian Aphasia with with Global Agraphia Phonological Agraphia
Lexical-Semantic Tx Phonological Tx Interactive Tx retrain spelling for specific words retrain sound-letter correspondences train problem- and phonological solving strategies manipulation skills to self-correct spelling errors “Bobo … one … Bobo one … bye… bye”
“House…trees…. car…cars…boy…girls…wine” Using orthography to cue phonology Lexical Phonological Interactive Treatment
“camp” …t ..“tent”
”t” “t” “trombone” Orthography Semantic self cue Orthography Phonology: Phonemic self cue “The writing has really helped because he has started like writing down a few letters and then the word will come right out. And while I’m at work, he’ll call me. And then he starts talking, and I’m like, ‘I don’t know what you’re saying.’ And I’ll say, ‘Start to write it and put it in the spell checker and call me back with it.’ That has amazingly helped….” “It really made a world of difference.” Treatment Sequence for Phonological Impairment Perisylvian Aphasia Perisylvian Aphasia with with Global Agraphia Phonological Agraphia
Lexical-Semantic Tx Phonological Tx 27 Interactive Tx 20
12 High 15 Low
Lexical Retrieval Cascade Tx 100 Gain 100 100 Pre
80 80 80
60 60 60
40 40 40
20 20 20
0 Snd-Let L-S S-L L-S 0 0 S-L L-S S-L L-S S-L L-S S-L L-S Consonants Vowels (n=6) (n=15) Consonants Vowels Consonants Vowels
Global Agraphia (Low) Global Agraphia (High) Phonological Agraphia “Write the letter that goes with the sound.”
[s] [g]
[t] [l] [n] [z] [k] [th] [r] [w] [b] [ch] 20/20 correct [d] 2/20 correct Relearned sound-letter correspondences Phonological Interactive Treatment Pre-Treatment Post-Treatment
/d/-/I/-/g/ [dig] /d/-/I/-/g/ [dig] /p/-/A/-/t/ [pat] /p/-/A/-/t/ [pat] /b/-/oI/-/l/ [boil] /p/-/a/-/t/ [pot] 100 100 100
80 80 80 Speech Production 60 60 60
40 40Transcoding 40 Percent Correct Percent
20 20 20
0 Manipulation 0 0 Pre Tx Post Tx Pre Post Pre Post Global Agraphia (Low) Global Agraphia (High) Phonological Agraphia Response to treatment Anomic aphasia ◦ 1.9 years post onset Phonological Skills ◦ Treatment 100 6 weeks of phonological 8 weeks of interactive treatment 80 ◦ WAB Aphasia Quotient Phonological 60 Manipulation 92.4 95.3 Phonology- ◦ Boston Naming Test 40 Orthography 48/60 52/60 20 ◦ Significant improvement phonological skills 0 Pre Post Response to treatment
Single Word Reading/Spelling 100 90 80 70 60 50 40 30 20 10 0 Reading Reading Spelling Spelling Words Nonwords Words Nonwords
Pre Post With Speller Response to treatment
Phonological Skills Single Word Reading/Spelling Total treatment 100 100 time: 90 90 • 16 weeks 80 80 phonological 70 70 Phonological 60 60 • 6 weeks Manipulation 50 50 interactive Phonology- 40 40 Orthography
30 30 20 20 10 10 0 0 Reading Reading Spelling Spelling Pre Post Words Nonwords Words Nonwords
Pre Post With Speller Phonological Interactive Treatment Before Tx Dog is cuming Man is fly kite sailboat lady & guy the picnic and book with wine
After Tx Well-formed and Complete Sentences The man a reading a book. The lady is pouring 100 wine or soda. A differt man the flyer a 80 kite, the dog help him. A man is fishing of 60 40 a pier. A couple is sailing a boat. 20 0 Pre Post
Beeson, Rising, et al. (2016) Spoken Written Neuropsychological Rehabilitation Patient perspective Positive self-ratings after treatment ◦ overall spelling ability: “somewhat better” ◦ Ability to use strategies (e.g., detect and correct spelling errors): “better” ◦ Overall confidence regarding written and spoken communication: “better” Reported increased confidence writing e-mails to friends and family Was able to return to role as teaching assistant for Sunday school class Lexical Phonological Interactive Treatment
“They’re have a picnic. I don’t know if they’re married, but the man is reading a book. And the woman is… I know Before Tx she’s doing coffee. And I can Picnic see in the house, and she Lunch has her, the car. There’s a Blanket tree…” Shoes After Tx He fly a kite There is a house by the lake. The is a guy He is a the beach. flying a kite with his dog. There was a He is a dog. man and woman relaxing in the yard. A There is a shovel of pail. man was reading a book. The woman There is a sailboat, two was pouring a glass of soda. In the beach people. there is a guy playing in the sand. Treatment Sequence for Phonological Impairment Perisylvian Aphasia Perisylvian Aphasia with with Global Agraphia Phonological Agraphia
Lexical-Semantic Tx Phonological Tx 27 Interactive Tx 20
15 12 Low High
Lexical Retrieval Cascade Tx Current: Alumni: Maya Henry Pelagie Beeson Mira Fein Erin O’Bryan Kindle Rising Christie Shultz Mara Goodman Alyssa Sachs Andrew DeMarco Sharon Antonucci Steven Rapcsak Christine Shipman Dianne Patterson Esther Kim Chelsea Bayley This research is supported by RO1 DC007646 and RO1 357030 from the National Institute on Deafness and other Communication Disorders Beeson, P. M. (1999). Treating acquired writing impairment: Strengthening graphemic representations. Aphasiology, 13(9-11), 767-785. [lexical spelling treatment] Beeson, P.M., Rewega, M.,Vail, S.M., & Rapcsak, S.Z. (2000). Problem-solving approach to agraphia treatment: Interactive use of lexical and sublexical spelling routes. Aphasiology, 14, 551-565. [interactive treatment] Beeson, P. M., Rising, K., & Volk, J. (2003). Writing treatment for severe aphasia. Journal of Speech, Language, Hearing Research, 46, 1038-1060. Beeson, P.M. & Egnor, H. (2006). Combining treatment for written and spoken naming. Journal of the International Neuropsychological Society, 12, 816-827. Beeson, P. M., Rising, K., Kim, E. S., & Rapcsak, S. Z. (2010). A treatment sequence for phonological alexia/agraphia. Journal of Speech, Language, and Hearing Research, 53(2), 450-468. [phonological & interactive treatment] Beeson, P.M., Rising, K., DeMarco, A.T., Foley, T.H., & Rapcsak, S.Z. (2016). The nature and treatment of phonological text agraphia. Neuropsychological Rehabilitation. [phonological & interactive treatment] Henry, M. L., Rising, K., DeMarco, A. T., Miller, B. L., Gorno-Tempini, M. L., & Beeson, P. M. (2013). Examining the value of lexical retrieval treatment in primary progressive aphasia: Two positive cases. Brain and Language, 127 (2), 145-56. Fein, M., Bayley, C., Rising, K., & Beeson, P. M. (2019-online pre-publication). A structured approach to train text messaging in an individual with aphasia. Aphasiology, 1-17. Resources available at http://www.aphasia.arizona.edu/ Arizona Battery for Reading and Spelling
List 1 (regular and irregular words) nonwordsNonwords
• broom circuit slate sure flig (fligg) hard • spring sword vague dusp • eagle branch chant field trad (tradd) • gang learn island bump andon (andin, anden) • mile rough point debt glope (gloap, glowp) • doubt yacht bowl pint hoach (hoche, hoatch) • lose routine grave trade prane (prain, prayne) • grumble group twenty gross snite (snyte, snight) • drive hunch charge friend dringe (drynge, drinj) • honest fact give plastic merber (murber, murbur) Arizona Battery for Reading and Spelling
List 2 (regularRegular and and Irregular irregular Words:words) List 2 nonwordsNonwords • dust blood shampoo reach boke (boak, bok) • sister tone castle wish nace (naise, nayse) • machine chef summer shove wape (waip, wayp) • head answer blame worm cheed (chead, chede) • laugh magnet pine talk grest • kept cough thief compact mofer (mofur, mopher) • storm grill ghost broad smode (smoad, smoed) • count land north round barcle (barkle, barkal) glacier • tomb prove fresh manver (manvir, manvar) • bribe subtle breath choir squate (skwate, skwait)