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Old 02-22-2015, 11:15 AM #1
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Default skipping letters/misreading words

Has anyone had any difficulty with reading? In particular, occasionally skipping small words like "a" or "the" and misreading words like "change" as "charge". If so, what types of exercises did you do to correct it and what specific visual dysfunction were you diagnosed with.

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Old 02-22-2015, 11:44 AM #2
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I had reading and comprehension problems the first couple of months after my injury.

My speech therapist had me do exercises with short sentences. For example I'd have to read short instruction on say, how to do laundry (sort clothes, put in washer, put in detergent, turn on, etc.).

I also read short articles rather than longer readings such as books. After a while it came back and my reading comprehension tested as normal on my NPA.

Is your vision normal otherwise? If you have vision deficits a referral to a neuro ophthalmologist may be indicated.

When was your injury?
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What Happened: On November 29, 2010, I was walking across the street and was hit by a light rail commuter train. Result was a severe traumatic brain injury and multiple fractures (skull, pelvis, ribs). Total hospital stay was two months, one in ICU followed by an additional month in neuro-rehab. Upon hospital discharge, neurological testing revealed deficits in short term memory, executive functioning, and spatial recognition.

Today: Neuropsychological examination five months post-accident indicated a return to normal cognitive functioning, and I returned to work approximately 6 months after the accident. I am grateful to be alive and am looking forward to enjoying the rest of my life.
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Old 02-22-2015, 12:29 PM #3
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I've unfortunately had several injuries in 2014 with the latest being at the end of November. The word skipping seems to be strictly a visual thing as it doesn't seem to happen if I read things using spritz (http://www.spritzinc.com/). I saw a neuro-opthamologist who then referred me to vision therapy. I'm not sure they are finding what is actually up with my eyes so I was hoping I could see if other people had the same problem and what their diagnosis was.
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Old 02-22-2015, 01:54 PM #4
Mark in Idaho Mark in Idaho is offline
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The problem does not need to necessarily be an eye issue. It can be a processing issue. When we read, we rarely read the entire word. Our brain does not need to see and define every letter to understand what the word is in normal situations. It tries to take short cuts as we read. For some of us, those short cuts fail. As the brain see 'cha' or even 'cha ge' it attempts to fill in the rest based on words indexed in memory and the context of the word. Occasionally, especially for those of us with mTBI, it messes up.

Stress tends to make this problem worse. Fatigue does too.

I have this problem. Have for over a decade.

Google 'jumbled words' and you will find a lot about how the brain takes short cuts in this way.

In my experience, this symptom parallels word finding struggles. It happens at times when I am also having word finding troubles. It could be that the brain, as it reads the word, is struggling to recognize and index the correct word and instead, substitutes the wrong word.

I just had to learn to live with it.
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Old 02-22-2015, 02:32 PM #5
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Mark, thanks for the response: the reason I believe it is an eye issue is because I don't see this happening with spritz which displays words in a stationary position avoiding the eye movement.

What did you do to attempt to correct your situation? I know you are living with it but I'm sure you attempted something to try and get the most functionality back.
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Old 02-22-2015, 04:07 PM #6
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I corrected much of my problem by learning to be more relaxed and unstressed.

I don't see the Spritz vs RSVP vs normal reading as having much to do with this. Your eye sees the word as a whole, not as something moving past the eye. Unfortunately, the video is entire inadequate at demonstrating Spritz so, I have to try to understand it from reading the descriptions.

Reading is not a 'look at each letter' action. The brain looks at the whole word. It appears the Spritz method just changes how you eye moves between words. It does not change how your eye sees each word.

The brain uses indexing to process visual images. In your brain is an index of each word you know. It also has an index of all of the things you see during your day. When you see those images again, it does not need to decipher the image to understand it. It just indexes the stored image as it was previously deciphered and uses that previously deciphered information. Those images that have not been indexed are usually ignored until further understanding of that image is needed.

I do not know this to be true but in my experience, I sometimes seem to grasp letters from the previous word or a following word into the image of the word I need to process. This may be why the word sometimes gets erroneously defined. This may have to do with the fact that I have a minor horizontal gaze (nystagmus) disorder. It is a common symptom of brain injury.

I was assessed at a rehab hospital about 6 years ago and my dysfunctions did not reach a 'needing treatment' threshold. Keep in mind that many with similar dysfunction but more serious in the early stages consider reaching our level of function as a remarkable recovery. Perfect recovery is a myth.

I would caution you about doing too much reading on smart phones and such. The eye is put under more load when trying to read those small and often fast moving screens. Spritz is designed to increase reading speed on those devices, not directly improve reading accuracy.

btw, I tried the Spritz test. I could read the words fast but lost all comprehension. The Spritz method demands good memory functions. With line by line reading, I can capture the concept of the line without having to memorize the words and compile them into a sentence. For me, the longer the image is in front of my eyes, the more i remember it. The flashed images fade from memory too fast.
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Old 02-22-2015, 04:59 PM #7
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Quote:
Originally Posted by Mark in Idaho View Post
I corrected much of my problem by learning to be more relaxed and unstressed.

I don't see the Spritz vs RSVP vs normal reading as having much to do with this. Your eye sees the word as a whole, not as something moving past the eye. Unfortunately, the video is entire inadequate at demonstrating Spritz so, I have to try to understand it from reading the descriptions.

Reading is not a 'look at each letter' action. The brain looks at the whole word. It appears the Spritz method just changes how you eye moves between words. It does not change how your eye sees each word.

The brain uses indexing to process visual images. In your brain is an index of each word you know. It also has an index of all of the things you see during your day. When you see those images again, it does not need to decipher the image to understand it. It just indexes the stored image as it was previously deciphered and uses that previously deciphered information. Those images that have not been indexed are usually ignored until further understanding of that image is needed.

I do not know this to be true but in my experience, I sometimes seem to grasp letters from the previous word or a following word into the image of the word I need to process. This may be why the word sometimes gets erroneously defined. This may have to do with the fact that I have a minor horizontal gaze (nystagmus) disorder. It is a common symptom of brain injury.

I was assessed at a rehab hospital about 6 years ago and my dysfunctions did not reach a 'needing treatment' threshold. Keep in mind that many with similar dysfunction but more serious in the early stages consider reaching our level of function as a remarkable recovery. Perfect recovery is a myth.

I would caution you about doing too much reading on smart phones and such. The eye is put under more load when trying to read those small and often fast moving screens. Spritz is designed to increase reading speed on those devices, not directly improve reading accuracy.

btw, I tried the Spritz test. I could read the words fast but lost all comprehension. The Spritz method demands good memory functions. With line by line reading, I can capture the concept of the line without having to memorize the words and compile them into a sentence. For me, the longer the image is in front of my eyes, the more i remember it. The flashed images fade from memory too fast.
The reason I brought up Spritz is because it isolates your brain processing from your ocular motility: if you can process the words on Spritz at a fast rate but have trouble reading, I would reason that it must be ocular motility. I also can barely comprehend what I'm reading when I'm doing it on Spritz (though that was always the case even before any concussions).

Interestingly enough, I find it much easier to read on my smartphone than I do on my computer with a much larger type. Again I attribute this to having to move your eyes less when reading small print.

I suppose I need to re-teach myself how to read by reading very slowly at first and increasing my rate as a small child would.
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Old 02-22-2015, 05:45 PM #8
Mark in Idaho Mark in Idaho is offline
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The smart phone could be easier because you have less visual clutter to sort through or the line lengths are shorter. The Spritz also only shows one word at a time so there is no visual clutter at all. Your problem could just be the visual clutter. It creates a heavier processing load.

Keep in mind that Spritz changes more than one parameter. It displays only one word so there is no visual distraction caused by the previous or following word or words above or below. It puts that word at the prime spot in your vision so the letters are not viewed outside that position. It displays the word without context so the brain can only consider the spelling. And, yes, it creates a situation where the eye does not need to scan but that also reduces the processing load on the brain freeing up that processing bandwidth for deciphering the word.

So, your reason based on ocular motility is short sighted. Any of the other differences could contribute to the improved accuracy.
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Old 02-22-2015, 06:03 PM #9
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It's definitely not the clutter issue (there is just as much text on my phone as on a pdf on my computer) but it could be the shorter line lengths! Interesting idea.. so you believe that it's more difficult for the brain to process longer lines of text? In that case I suppose I should attempt to shrink line lengths on my computer and see what happens.

Have you attempted to retrain your brain to read? I know you said you said you cope with stress but have you attempted to create any sort of exercise routine for yourself to improve the processing/reading?
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Old 02-22-2015, 06:46 PM #10
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Studies show that line lengths near or longer than 80 characters are more difficult for the eye to follow. The Spritz app sets a boundary around the words to be read so that adds to readability. The total number of pixels (rods and cones in your eye) compared to the number used to read the text field is likely much higher on your computer than on your phone. For example, if the pdf uses 5 to 15% of your visual field but your phone only uses 1 or 2% of you visual field, that is a big difference in processing load. The Spritz app uses even less of your visual field.

I deal with this processing load when I need to fill out a paper form by covering the text above and below with paper. Otherwise, the visual processing load can be overwhelming.

This forum works good because this Reply to Thread form has minimal text clutter. The worst clutter is the emoticons.

I used to be able to create reams of documents in MSWord. (Word 2003 or earlier) When the new MSWord with ribbons came out, the new visual clutter made it so I struggle to create documents. I am highly aware of visual processing load.
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