Technology‐enhanced reading therapy for people with aphasia: findings from a quasi‐randomized waitlist controlled study

Purpose This study investigated the effects of technology-enhanced reading therapy for people with reading impairments, using mainstream assistive reading technologies alongside reading strategies. Method The study used a quasi-randomised waitlist controlled design. 21 people with reading impairments following stroke were randomly assigned to receive 14 hours of therapy immediately or after a 6-week delay. During therapy, participants were trained to use assistive reading technology which offered a range of features to support reading comprehension. They developed skills in using the technology independently and in applying the technology to their personal reading goals. The primary outcome measure assessed reading comprehension, using Gray Oral Reading Test Fourth Edition (GORT-4). Secondary measures were: Reading Comprehension Battery for Aphasia Second Edition (RCBA-2); Reading Confidence and Emotions Questionnaire (RCEQ); Communication Activities of Daily Living Revised (CADL-2); Visual Analogue Mood Scales (VAMS); and the Assessment of Living with Aphasia (ALA). Matched texts were used with the GORT-4 to compare technology-assisted and unassisted reading comprehension. Mixed ANOVAs explored change between T1 and T2, when the immediate group had received therapy, but the delayed group had not, thus serving as untreated controls. Pre-therapy, post-therapy and follow-up scores on the measures were also examined for all participants. Results GORT-4 results indicated that the immediately treated group improved significantly in technology-assisted reading following therapy, but not in unassisted reading. However, the data were not normally distributed and secondary non-parametric analysis was not significant. The control group was unstable over the baseline, improving significantly in unassisted reading. The whole group analysis showed significant gains in assisted (but not unassisted) reading post therapy that were maintained at follow up. The RCEQ results improved significantly following therapy, with good maintenance of change. Results on all other secondary measures were not significant. Conclusions Technology-assisted reading comprehension improved following the intervention, with treatment compensating for, rather than remediating the reading impairment. Participants’ confidence and emotions associated with reading also improved. Gains were achieved after 14 therapy sessions, using assistive technologies that are widely available and relatively affordable, meaning that this approach could be implemented in clinical practice.