Word meaning deafness: Spelling words that are not understood

We describe a patient (KW) who shows impaired auditory comprehension of words in the presence of relatively intact written comprehension. His ability to perform auditory discrimination, repetition, and lexical decision tasks for words he cannot understand indicates that he has a word meaning deafness. It has been proposed that this deficit results from an impairment in the mappings between auditory lexical and semantic representations. A pure deficit of this nature would predict intact spelling to dictation for words that cannot be comprehended by way of a direct lexical, nonsemantic route between auditory and orthographic lexicons. In the case of KW, ability to write to dictation is relatively well-preserved for both regular and irregular words, relative to auditory comprehension. The nature of KW's spelling errors was considered. In particular, we reflect on the origin of his spelling errors since these may provide evidence regarding the nature of the lexical nonsemantic route that mediates writing to dictation. KW's performance is discussed in terms of current models of the spelling process.