Effects of Written, Auditory, and Combined Modalities on Comprehension by People With Aphasia

Background People with aphasia experience reading challenges affecting participation in daily activities. Researchers have found combined auditory and written presentation modalities help people with aphasia comprehend contrived sentences and narratives, but less is known about the effects of combined modalities on functional, expository text comprehension. Aims This study's purpose was to examine comprehension accuracy, reviewing time, and modality preference of people with aphasia when presented with edited newspaper articles in written only, auditory only, and combined written and auditory modalities. Method and Procedure Twenty-eight adults with chronic aphasia read and/or listened to 36 passages. Following each passage, participants answered comprehension questions. Then, they ranked the modalities in accordance with preference and provided a rationale for their ranking. Outcomes and Results Comprehension accuracy was significantly better in the combined than auditory-only condition and in the written-only than auditory-only condition; the difference between combined and written-only conditions was not significant. Reviewing time differed significantly among conditions with the written-only condition taking longest and the auditory-only condition taking shortest. Most participants preferred the combined condition. Conclusions Access to combined modalities helps people with aphasia comprehend expository passages such as those found in newspapers better than auditory-only presentation. Furthermore, combined presentation decreases reviewing time from that needed for unsupported reading without compromising comprehension accuracy. Given that most participants preferred combined modality presentation, providing simultaneous auditory and written access to content through text-to-speech technology is a viable strategy when aphasia results in persistent reading challenges.