Targeted treatment to improve reading in aphasia (Boukrina et al., 2024)

Purpose: Acquired reading deficits, or alexia, affect a significant proportion of individuals with aphasia. We sought to improve treatment for alexia by targeting specific cognitive information-processing components critical to reading (i.e., phonology or semantics).

Method: To target either phonological or semantic processing, we administered two anomia treatments, phonomotor treatment (PMT) and semantic feature analysis, modified to include a focus on reading throughout the therapy. Chronic left-hemisphere stroke survivors (N = 5) completed one or two 60-hr treatment rounds. Based on predictions from a computational reading model, three participants received the treatment recommended for their specific reading challenges (e.g., PMT for phonological deficits), while two participants had the nonrecommended treatment first, followed by the recommended model-matched treatment. Changes in reading aloud accuracy and response times (RTs) from before to after treatment were examined as a function of matching treatment to the deficit profile, type of treatment, therapy round, and word characteristics.

Results: Participants’ reading aloud accuracy improved after treatment relative to baseline with higher accuracy for high-frequency words and shorter words. After the first treatment round, participants’ accuracy and RT improved, irrespective of whether treatment was matched to the deficit profile. Furthermore, participants who completed the second treatment round continued achieving accuracy gains. Following treatment, participants demonstrated enhanced reading efficiency and generalized improvements on the selected sections of the Woodcock Reading Mastery Test.

Conclusions: While larger studies are needed to test for the effects of matching treatment type to the deficit profile, we conclude that treatments targeting specific information-processing components can effectively improve reading. Doubling the treatment dose offers small but significant gains.

Supplemental Material S1. Mixed linear effects analyses of accuracy data including the random slopes of participants on assessment time to address Research Aim 1: the effectiveness of tailoring treatments to specific deficit profiles.

Supplemental Material S2. Mixed linear effects analyses of response time data to address Research Aim 1: the effectiveness of tailoring treatments to specific deficit profiles (using a gamma distribution with a log link function).

Supplemental Material S3. Mixed linear effects analyses of response time data to address Research Aim 2: continued improvements with doubling of reading therapy duration (using a gamma distribution with a log link function).

Supplemental Material S4. Mixed linear effects analyses of response time data to address Research Aim 3: changes in reading efficiency after treatment (using a gamma distribution with a log link function).

Supplemental Material S5. Mean performance on all administered Woodcock Reading Mastery subtests (raw scores).

Boukrina, O., Madden, E. B., Giordano, N., Karim, D., Staples, R., & Graves, W. W. (2024). Targeting phonology or semantics to improve reading aloud response times and accuracy: A case series investigation of stroke survivors with aphasia. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2024_AJSLP-23-00364

Publisher Note: This article is part of the Special Issue: Select Papers From the 52nd Clinical Aphasiology Conference.