THEaphasia it is a linguistic disorder that manifests itself in the altered production or understanding of oral or written language. It occurs mainly after brain injury or stroke and can also lead to reading comprehension difficulties. As a result, people with aphasia often experience a reduced quality of life.
Reading deficits vary in their manifestations and underlying alterations. They can occur when reading aloud or understanding what is read, both in reference to single words and entire texts. Moreover, the underlying causes of reading deficits are varied: they can concern phonological or lexical processes, as well as be linked to alterations of the cognitive sphere.
Previously, several treatments have been developed to address reading problems. The application of metacognitive strategies was the widely accepted one; this allows the reader to address reading comprehension deficits but has not been shown to explain the behavioral response and to target reading comprehension treatments at the text level for individuals with aphasia.
In XNUMX, Mary Purdy and et al carried out a systematic review published in Journal Aphasiology, to elucidate the reading comprehension treatments by selecting XNUMX articles (all of them having reading comprehension as a primary variable outcome) from Medline, PsychArticles, and PsychInfo databases upto XNUMX . To check the effectiveness of the available treatments and selecting the most rigor approach for reading comprehension difficulties, the authors implemented four treatments in this study:
- Oral reading Treatment: built to improve comprehension by focusing reading aloud in people with aphasia moderate-severe
- Strategy Based Treatment: designed to improve reading comprehension; it varies in terms of quality and composition ratings. It appears as an effective treatment for individuals with mild aphasia or difficulty in reading comprehension.
- Cognitive treatment: focused on the underlying cause i.e attention or memory working problems, which are responsible for reading comprehension difficulties. It shows improvement in people having mild aphasia with some level of text reading ability. caution o working memory, who are held responsible for reading comprehension difficulties. It shows improvements in people with aphasia moderate and some level of residual ability to read the text.
- Hierarchical treatment: it was a computer-based reading treatment given by Kartz and Wertz.Their work illustrated that computer-delivered reading therapy can generalize not only to pen and paper reading but also other non-reading language tasks.
The results of the statistical analysis the quality of the studies analyzed is highly variable. However, the authors of the systematic review report that the treatment of reading aloud it would be the most rigorous of the available approaches and shows itself as potentially capable of improving reading comprehension.
There would also be evidence of the effectiveness of the computerized hierarchical reading treatment, but the degree of efficiency and improvement between groups differs greatly between the various studies conducted with this method.
Purdy and colleagues conclude that reading aloud treatment would appear to lead to the greatest improvement in individuals with aphasia severe, while the other approaches would show more success in those individuals with mild to moderate reading deficits. The remaining treatments, i.e. those based on strategy, cognitive treatments, and hierarchical treatment, have had some success in improving reading comprehension, but the results are inconsistent. Clearly, substantial differences in participants, treatment protocols, and experimental rigor may prevent general conclusions from being drawn about the effectiveness of a particular treatment for each person with aphasia.
In the future, controlled studies of treatments specifically targeting reading comprehension deficits could help improve population understanding aphasia. Taking into account the selection of participants, the intensity of treatment and methodological rigor can also improve the quality and effectiveness of reading comprehension in aphasia.
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