For someone accustomed to reading a novel a week, losing the ability to understand written language could be one of the most disheartening consequences of a stroke or brain injury. Even for less avid readers, difficulty understanding medical instructions and other texts could compromise day-to-day functioning.
This problem, which results from damage to the left side of the brain, is often associated with aphasia. Depending on the specific location of the damage, people with aphasia may also have difficulty understanding spoken language and using language – spoken or written – to express themselves. But it’s the difficulty with reading that’s currently of interest to Kelly Knollman-Porter, assistant professor of speech pathology and audiology at Miami University.
“A person with reading challenges associated with aphasia may have mild or severe difficulty decoding or comprehending written language,” she says. “Unfortunately, these deficits, which are often chronic, can negatively impact an individual’s ability to perform work responsibilities or social activities like reading a menu.”
With the broad availability of affordable text-to-speech software, one might assume that kind of assistive technology would be an obvious solution to aphasia-related reading problems, but Knollman-Porter says there hasn’t been any research to confirm that.
“It hasn’t been studied,” she says. “People with aphasia exhibit varying degrees of reading difficulties. Because of co-occurring speech comprehension challenges, some may find the auditory input of text-to-speech software distracting, negatively influencing comprehension. Others may discover that the technology increases their reading speed and accuracy of understanding.”
Research in this area is of interest to the National Institute on Deafness and Other Communication Disorders (NIDCD), which recently granted Knollman-Porter nearly $500,000 to lead a multi-site study.
Data for the three-year study will be collected at Miami University and Duquesne University, both of which, Knollman-Porter says, have well-established and robust networks of support for those with aphasia. Colleagues from the University of Nebraska – Lincoln, and the University of Arizona will assist with study design and analysis.
At Miami, graduate and undergraduate students will be heavily involved in implementing the study.
“Because this research is clinically relevant, the students will receive not only mentored training in the development and implementation of research protocols but also in techniques they will be able to use clinically as speech language pathologists once they graduate. The students will interact directly with the individuals with aphasia and see first-hand what strategies best facilitate reading comprehension,” Knollman-Porter says.
To evaluate the overall effectiveness of the technology to support readers with aphasia, the research team will collect both quantitative and qualitative data. They will assess how accurately participants de-code and comprehend written text with the help of text-to-speech software, and they will talk to participants about whether – and under what conditions – they like using it. Ultimately, the team hopes to figure out how to adjust key text-to-speech features to help people with aphasia read everyday texts of value to them.
Helping improve the quality of life for real people is Knollman-Porter’s driving force. “I was a speech pathologist working in a hospital for 15 years before I came to Miami,” she says. “My goal is to develop and implement clinical research that will positively promote greater functional independence for people following stroke or brain injury.”
Luckily for people with aphasia, that’s exactly what she’s doing.
Written by Heather Beattey Johnston, Associate Director of Research Communications, Office for the Advancement of Research and Scholarship, Miami University.