Clinical Case: A Neuropsychological Intervention Plan for Dyslexia

Psychologist Ángel Martínez Carcelé presents a proposal for neuropsychological assessment and intervention for dyslexia, illustrated by a successful case involving an adolescent. 

Clinical case of a neuropsychological assessment and intervention involving a 12-year-old adolescent with reading and writing difficulties. This article presents the results of a psychometric test battery (DST-J, PROLEC-SE-R, D2, Stroop, and Rey) and outlines a practical three-month cognitive stimulation program. It details the use of the NeuronUP platform to systematically train attention, memory, and language, combining digital and analog tools to support therapeutic success.

The importance of early intervention for dyslexia

Specific Learning Disorder (SLD) with impairment in reading, known as dyslexia accounts for approximately 80% of learning disorder diagnoses, with an estimated prevalence of around 5% of the school-age population (Torres, Barrantes y Tajima, 2016). This neurobiological disorder directly affects accurate and fluent word recognition, as well as decoding. 

The absence of early identification and intervention is significantly associated with declining self-esteem and the development of secondary emotional disorders. When reading and writing difficulties are not addressed in time, they persist and negatively affect the individual into adulthood, prolonging academic and personal limitations. For this reason, it is essential to design programs with an empirical basis in neuropsychology. 

Case presentation: Student with reading and writing difficulties

Background

A 12-year-old adolescent in sixth grade at a public school in the province of Córdoba, Andalusia. The student was initially referred by their teacher to the Educational Guidance Team (EOE) after showing a substantially slower pace of reading and writing development than their peers. The student was subsequently referred to a specialized clinical center for a neuropsychological assessment to identify the affected cognitive processes. 

Dyslexia assessment and diagnostic tests (DST-J, PROLEC-SE, D2, STROOP, and REY)

A standardized psychometric test battery consisting of the following measures was administered: 

• DST-J (Test for the Detection of Dyslexia in Children): The adolescent obtained an overall risk index of 1.50, indicating a high risk. Moderate impairment was found on key subtests, including reading, nonsense-word reading, vocabulary, and phoneme segmentation. No risk was found only for rhyming and copying. 
• PROLEC-SE-R (Battery for the Assessment of Reading Processes): The results confirmed severe difficulties with lexical processes (words and pseudowords) and syntactic processes (punctuation and sentence matching), with performance at the 5th percentile. Reading speed was also critically low (48 words per minute). However, the adolescent showed a notable strength in reading comprehension, scoring at the 75th percentile. 
• D2 Attention Test: Selective attention was assessed using a visual cancellation task. The child achieved a very high score, at the 99th percentile for total effectiveness (TOT), demonstrating consistent productivity and excellent visual stimulus discrimination. 
• Stroop Test: Scores were low on the word-color condition (T=40) and resistance to interference (T=39), suggesting difficulty with inhibitory control in the presence of conflicting stimuli. 
• Rey Complex Figure: Perceptual-motor development and immediate visual memory were assessed. Moderate difficulty was observed on the copy task (20th percentile), along with a severe deficit in recall (1st percentile), confirming impaired short-term visual retention. 

Dyslexia intervention plan with NeuronUP

Program details and clinical goals

To address the adolescent’s needs, an individualized plan was designed using NeuronUP, a web-based neurorehabilitation platform with a theoretical framework validated by experts. The program is grounded in the principle of ecological validity, with the aim of ensuring that digital task training meets the criteria of representativeness (similarity to real-world tasks) and generalization (transfer of cognitive gains to the adolescent’s activities of daily living) (Kvavilashvili & Ellis, 2004). 

The primary clinical goal is to improve reading and writing skills through systematic training of attention, memory, and language. The intervention was scheduled for three sessions per week (Monday, Wednesday, and Friday), each lasting 45 minutes, over a three-month period (a total of 36 sessions delivered remotely from the adolescent’s home). 

Session schedule

The neuropsychological intervention sessions were organized according to the following work plan:

Week	Monday	Wednesday	Friday
Weeks 1–12	Focused work on attention and language.	Focused work on memory and lexical processes.	Integration of executive functions and reading and writing.

NeuronUP activities for working on dyslexia

The platform was used to select dynamic tasks with adjustable difficulty tailored to the adolescent’s profile:

• Attention: Activities such as “Select items from a category” (to stimulate selective attention and semantic memory), “Repeated words” (for selective attention and working memory), and “Animated maze” (to strengthen alternating attention by following changing instructions). 
• Memory: Activities such as “Organize my mess” and “Match the feature to the item,” designed to consolidate and speed up access to the semantic memory store. 
• Language: Activities such as “Word Fishing” (forming words by putting syllables in order), “Name objects using phonological cues” (to address deficits in naming and lexical retrieval), and “Convert numbers into letters” (practicing the lexical-visual reading route). 

To make the intervention more flexible, the digital activities were combined with custom-developed paper-based activities, such as grapheme discrimination grids and tasks combining psychomotor skills with short-term memory, including following a rhythmic sequence by clapping.

Clinical conclusions on the multimodal approach

The use of multimodal platforms such as NeuronUP makes it possible to closely monitor critical neuropsychological variables, such as stimulus exposure time and reaction times. From a clinical perspective, adapting activities by combining digital and hands-on/paper formats is essential to maintain the adolescent’s intrinsic motivation and support treatment adherence. Neuropsychological intervention for learning disorders should not be rigid; accurate assessment of deficits makes it possible to compensate for affected pathways (visual or phonological) by drawing on the adolescent’s preserved strengths, which in this case included excellent reading comprehension and selective attention. 

Personal reflections

My work on developmental dyslexia from an applied neuropsychology perspective has shown me that behind a difficulty in the classroom lies a complex functional and neurobiological disorganization that goes beyond reading alone. Developing personalized materials and combining technological and analog tools not only improves the adolescent’s cognitive performance but also helps prevent school isolation and frustration. As neuropsychology professionals, our goal must go beyond psychometric test scores: we must provide functional strategies that directly support the adolescent’s socioemotional well-being and quality of life. 

References

• American Psychiatric Association (APA) (2013): Manual de Diagnóstico y Estadístico de los Trastornos Mentales, DSM-5. Editorial Médica Panamericana. Madrid – Brickenkamp, R. (2002). Prueba D2 de Atención. Madrid, España: TEA Ediciones – Cuetos, F., Arribas, D., Ramos, J. L (2016) Batería para la Evaluación de los Procesos Lectores en Secundaria y Bachillerato-Revisada. Madrid, España: TEA Ediciones – Dislexia en positivo.Asandis (2010). Guía general sobre la Dislexia. Andalucía – Fawcett, A. J., & Nicolson, R. I. (2004). Test para la Detección de la Dislexia en Niños. Madrid, España: TEA Ediciones 
• Kvavilashvili, L., & Ellis, J. (2004). Ecological validity and twenty years of real-life/laboratory controversy in memory research: A critical (and historical) review. History and Philosophy of Psychology, vol 6, 59-80 
• Rey, A. (1941). REY. Test de Copia de una Figura Compleja. Madrid, España: TEA Ediciones
• Torres, B., Barrantes, M. A ., y Tajima, K, (2016). Psicopatología y Clínica Infantil. APIR

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