Treatment for Reading and Writing Deficits Following Acquired Brain Injury

Many people with acquired brain injuries have deficits in reading decoding, reading comprehension, and written expression. Alexia is a phenomenon in which a person who previously could read has trouble doing so after having sustained a brain injury; likewise, agraphia is an acquired writing problem affecting one or more aspects of written communication. Alexia and agraphia sometimes co-occur with one another and/or with other language challenges, but they can also occur as isolated phenomena. Methods to treat alexia and agraphia often focus on single intervention techniques that address aspects of reading or writing in isolation-such as matching written and spoken letters or letter sounds, performing choral reading, tracing letters, etc. Existing research suggests that the effectiveness of these techniques is limited. However, when used in combination, such techniques may promote improved reading and written communication skills. As such, the purpose of this research is to determine the extent to which a multicomponent intervention program improves the reading and writing capabilities of people with acquired alexia and/or agraphia.

Study Overview

• Status: Completed
• Conditions: Acquired Brain Injury; Alexia; Agraphia
• Intervention / Treatment: Behavioral: Multicomponent reading and writing treatment

• Study Type: Observational
• Enrollment (Actual): 2

Contacts and Locations

Study Locations

• United States
  • Nebraska
    • Omaha, Nebraska, United States, 68104
      • Quality Living, Inc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 70 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

People enrolled in rehabilitation programs at Quality Living in Omaha, Nebraska, who are between the ages of 14 and 70 years and who experience alexia and/or agraphia secondary to acquired brain injury.

Description

Inclusion Criteria:

• Survivor of acquired brain injury
• Exhibits alexia and/or agraphia
• Past or current client of Quality Living, Inc., Omaha, Nebraska
• Fluent speaker of English

Exclusion Criteria:

• Vision impairment prohibiting reading of 24-point text
• Auditory comprehension problems precluding understanding of consent/assent information

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Acquired brain injury participants; People with acquired alexia and/or agraphia secondary to brain injury who participate in the reading/writing intervention.

Behavioral: Multicomponent reading and writing treatment; Intervention procedures incorporated into the program include drilling on sight words to improve immediate recognition of common words; engaging in Multiple Oral Reading procedures to increase reading fluency; practicing oral spelling of sight words to improve spelling accuracy; generating written sentences to improve accurate spelling and use of written conventions (e.g., punctuation, capitalization); and summarizing and subsequently writing sentences about read material to establish strategies to enhance reading comprehension and promote written expression.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in score on Word Attack subtest of the Woodcock-Johnson III Test of Achievement.	Subtest raw sores range from 0 to 32,with higher scores indicating better performance.	Change from baseline at 8 weeks
Change in score on Passage Comprehension subtest of the Woodcock-Johnson III Test of Achievement.	Subtest raw scores range from 0 to 47, with higher scores indicating better performance.	Change from baseline at 8 weeks
Change in score on Word Reading subtest of the Wide Range Achievement Test 4.	Subtest raw scores range from 0 to 70, with higher scores indicating better performance.	Change from baseline at 8 weeks
Change in score on Spelling subtest of the Wide Range Achievement Test 4.	Subtest raw scores range from 0 to 57, with higher scores indicating better performance.	Change from baseline at 8 weeks
Change in score on Test of Silent Reading Speed and Efficiency.	Raw scores range from 0 to 70, with higher scores indicating better performance.	Change from baseline at 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sight word decoding accuracy	Percent of correct decoding on 315 words included in Dolch pre-primer, primer, kindergarten, first grade, second grade, third grade, and nouns lists. Each word is scored as correct or incorrect, and a percent correct score is computed based on this scoring.	One time per week for 8 weeks
Oral reading rate of passages	Words per minute (wpm) during independent oral reading of passages. The criteria for progression to subsequent passages is a reading rate of 80wpm or better.	As the first of five tasks of each session for 8 weeks (each session is 1 hour).
Decoding errors during oral reading of passages	Percent of uncorrected word decoding errors in a specified passage. The criterion for progression to subsequent passages is fewer than 5% uncorrected words production errors.	As the first of five tasks of each session for 8 weeks (each session is 1 hour).
Oral spelling of words	Number of words spelled correctly on lists containing 15 words each. Introduction of a new word list will occur only after a participant correctly spells all words on the current list.	As the second of five tasks of each session for 8 weeks (each session is 1 hour).

Collaborators and Investigators

• Sponsor: Quality Living, Inc.
• Investigators: Principal Investigator: Karen Hux, Ph.D., Quality Living, Inc., Omaha, Nebraska

Study record dates

Study Major Dates

• Study Start (Actual): August 30, 2018
• Primary Completion (Actual): September 15, 2020
• Study Completion (Actual): September 15, 2020

Study Registration Dates

• First Submitted: September 3, 2018
• First Submitted That Met QC Criteria: September 5, 2018
• First Posted (Actual): September 7, 2018

Study Record Updates

• Last Update Posted (Actual): March 10, 2021
• Last Update Submitted That Met QC Criteria: March 9, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Craniocerebral Trauma; Trauma, Nervous System; Language Disorders; Communication Disorders; Brain Injuries; Wounds and Injuries; Agraphia
• Other Study ID Numbers: Reading/writing treatment

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No