Treating reading comprehension deficits in sub-acute brain injury rehabilitation: Identifying clinical practice and management

Watter, Kerrin; Copley, Anna; Finch, Emma

doi:10.1016/j.jcomdis.2016.07.006

Cited by 9 publications

(23 citation statements)

References 65 publications

(107 reference statements)

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“…Assessment should consider the characteristics of reading materials such as degree of predictability, analysis and synthesis, amount of organizational structure, amount of inference, speed and stamina over time, and requirements to analyse, synthesize, and summarize materials (16,30). Assessment should also consider the cognitive demands placed on the reader such as to determine the goal or purpose of the reading task; maintain or shift goals fluidly across task requirements; make inferences about task expectations (e.g.…”

Section: Reading Comprehensionmentioning

confidence: 99%

“…Speech-language pathologists have the knowledge and skills to address communication impairment (24,25). Evidence supports SLP interventions to improve attention (26), memory (27,28), social communication (10,29), reading comprehension (30), and executive function and metacognition (31). SLP assessments have been shown to be helpful in detecting subtle but debilitating deficits (2,6,32,33) and in guiding return to school (14,16,34) and return to work (19,20).…”

Section: Introductionmentioning

confidence: 99%

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Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

2017

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Section: Reading Comprehensionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

2017

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“…Although the evidence base for strategy-based interventions is in its infancy, a recent survey of clinicians in Australia found these to be the most widely used reading comprehension treatment for adults with acquired brain injury in clinical practice (Watter, Copley, & Finch, 2016).…”

Section: Introductionmentioning

confidence: 99%

Technology-Enhanced Reading Therapy for People With Aphasia: Findings From a Quasirandomized Waitlist Controlled Study

Caute

Woolf

Wilson

et al. 2019

J Speech Lang Hear Res

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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 quasirandomized waitlist controlled design. Twenty-one people with reading impairments following stroke were randomly assigned to receive 14 hr of therapy immediately or after a 6-week delay. During therapy, participants were trained to use assistive reading technology that 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 as follows: Reading Comprehension Battery for Aphasia–Second Edition, Reading Confidence and Emotions Questionnaire, Communication Activities of Daily Living–Second Edition, Visual Analog Mood Scales, and Assessment of Living With Aphasia. Matched texts were used with the GORT-4 to compare technology-assisted and unassisted reading comprehension. Mixed analyses of variance explored change between T1 and T2, when the immediate group had received therapy but the delayed group had not, thus serving as untreated controls. Pretherapy, posttherapy, 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 nonparametric 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 after therapy that were maintained at follow-up. The Reading Confidence and Emotions Questionnaire 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.

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“…However, studies typically investigate the process and overall outcomes of rehabilitation, not specific interventions provided during rehabilitation [2]. Similarly, a lack of published research has been identified regarding specific interventions and their effectiveness during early, sub-acute ABI rehabilitation [203,232].…”

Section: Ebp and Early Abi Rehabilitationmentioning

confidence: 99%

“…Australian SLPs also identified that sub-acute rehabilitation for CCRC deficits may not be prioritised for all clients given concomitant swallowing or cognitive-communication deficits (e.g. auditory-verbal and social communication skills) [232]. Reduced rehabilitation of CCRC skills in early recovery has also been demonstrated in a recent multi-site study, which reported on "common" SLP interventions in sub-acute rehabilitation for TBI [38].…”

Section: Reading Comprehension After Abi and Early Rehabilitationmentioning

confidence: 99%

Developing a novel, contextual intervention for reading comprehension deficits in early brain injury rehabilitation

Watter¹

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Background and Aims:Changes to cognitive-communication skills, including changes to reading comprehension, are common in adults following acquired or traumatic brain injury. Cognitivecommunication reading comprehension (CCRC) deficits occur at a discourse level, are evident early post-injury and can persist long-term. CCRC deficits have been reported across international populations, and can impact a person's reading ability, participation and independence with tasks involving reading both during rehabilitation and upon return home. If reading comprehension deficits are addressed early in recovery, participation in activities that require discourse-level reading may improve -both early in recovery (e.g., rehabilitation tasks, leisure activities) and longer term (e.g., reading skills for living independently and/or community participation).Speech Language Pathologists (SLPs) provide rehabilitation for CCRC deficits for adults with brain injury, including during early (i.e., sub-acute and post-hospital discharge) rehabilitation. However, there is a lack of published evidence to inform clinical practice regarding the management of reading deficits during early recovery (i.e., <6m post-onset).This evidence-gap impacts SLPs internationally in providing early rehabilitation services to adults with acquired brain injury (ABI) and CCRC deficits.The aim of this thesis was two-fold:(1) To develop a reading comprehension intervention for adults with CCRC deficits that is evidence-based, responsive to contextual and service delivery factors, and able to be delivered by SLPs during sub-acute and early rehabilitation;(2) To evaluate the effectiveness of the intervention with individuals during early rehabilitation, including identifying intervention effectiveness and the experiences of clients and families. Method:This thesis used an emergent multi-phase mixed method design. To address Aim 1, a number of studies were undertaken, including:• Investigating the clinical context and service delivery of sub-acute SLPs working within specialised Australian brain injury rehabilitation centres (reported in Chapter 3); thematic analyses of semi-structured interviews. These were: positive change, supporting independence and self-efficacy, salience, therapeutic alliance and intensity. Conclusion:The evidence base for managing CCRC deficits following ABI has been identified, and an evidence-based contextually-sensitive intervention and service delivery model for the early rehabilitation of CCRC disorders has been developed and successfully piloted. This study has provided preliminary evidence regarding the early intervention for CCRC deficits (at an impairment / skill, activity and participation level) in adults with acquired brain injury, as demonstrated by improvements on formal assessments, SCED results, and as reported by participants / significant others. As such, SLPs should consider addressing reading comprehension early in recovery as a key component of their rehabilitation of cognitivecommunication disorders. Further research is ...

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Treating reading comprehension deficits in sub-acute brain injury rehabilitation: Identifying clinical practice and management

Cited by 9 publications

References 65 publications

Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

Technology-Enhanced Reading Therapy for People With Aphasia: Findings From a Quasirandomized Waitlist Controlled Study

Developing a novel, contextual intervention for reading comprehension deficits in early brain injury rehabilitation

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