Exploring the use of graphics in written health information for people with aphasia

Abstract

Background: One of the documented design features of aphasia-friendly written information is the inclusion of graphics. People with aphasia have identified a preference for the inclusion of photographic illustrations in printed education materials (PEMs); however this preference contrasts with research suggesting that line drawings may be a more effective graphic type. Few studies have explored how graphics affect reading comprehension for people with aphasia. Aims: The aims of this research were (1) to determine if black and white line drawings and colour photographs affect the reading comprehension of people with and without aphasia, and (2) to explore perceptions of graphic helpfulness and preferences for including line drawings and photographic illustrations in PEMs. Methods & Procedures:A total of 22 people with aphasia and 15 of their significant others completed a purposefully developed cloze reading comprehension task, with multiplechoice response options. Response options contained (1) no illustrations, (2) black and white line drawings, or (3) colour photographs. The reading comprehension task was timed. The impact of no illustrations, line drawings, and photographs on (a) reading comprehension (measured in number of paragraphs correctly completed), and (b) response times (measured in seconds) was examined. Participants also completed a face-to-face graphic preference survey. Outcomes & Results: There were no significant differences on the reading comprehension task for participants with aphasia and those without, between (a) the number of paragraphs correctly completed in the set with no graphics, line drawings, and photographs, (b) the time taken to complete paragraphs in each of the three sets, and (c) the mean time taken to correctly complete paragraphs in each of the three sets. In contrast, the majority of participants perceived that pictures help understanding and make reading quicker. Significantly more participants with aphasia, compared to participants without, reported that they needed pictures to understand writing, and all participants with aphasia preferred health information to contain graphics. Several participants did not have a preference for line drawings or photographs in PEMs. Of those who did have a preference, more participants preferred written health information to contain photographs. Conclusions: Both participants with and without aphasia perceived that graphics in PEMs were helpful, however significantly more participants with aphasia reported that graphics

Do particular design features assist people with aphasia to comprehend text? An exploratory study

“…Dietz et al (2009) found that photographs had a significantly positive effect on reading comprehension, measured by asking seven participants with aphasia to read a series of narratives and answer related sets of comprehension questions. In contrast, Rose et al (2011b) reported that in their study of 22 people with aphasia neither line drawings nor photographs had a significant effect on the comprehension of written paragraphs.…”

“…These results align with previous evidence (Rose et al . ), however they require careful consideration in light of the study limitations and further investigation. One possible explanation is that participant's ability to comprehend nouns was already at ceiling, therefore there may not have been scope for the images to have a significant impact on comprehension.…”

“…In contrast, Rose et al . (2011b) reported that in their study of 22 people with aphasia neither line drawings nor photographs had a significant effect on the comprehension of written paragraphs.…”

Refining an Asynchronous Telerehabilitation Platform for Speech-Language Pathology: Engaging End-Users in the Process

“…Participants with aphasia were provided with a user manual containing instructions on the operation of the tablet, mobile broadband device, and eSALT program for reference at home. This user manual was formatted according to aphasia-friendly guidelines outlined by Rose et al (2011). Participants with aphasia were also supplied with the contact details of the lead researcher (AH) and their clinician and were encouraged to make contact if technical issues arose during the trial period.…”

“…Separate information and consent forms were developed for clinician participants and the participants with aphasia. The information sheet for the participants with aphasia was formatted according to the aphasia-friendly guidelines outlined by Rose et al (2011). If required communication support techniques as outlined by Kagan (1998) were employed to facilitate understanding and ensure informed consent was obtained.…”