Influence of reader characteristics in aphasia (Webster et al., 2023)

Purpose: The study improves our understanding of the reading comprehension difficulties seen in people with aphasia. It investigates the influence of reader characteristics, including personal demographic variables, and linguistic and wider cognitive skills, on text comprehension.Method: Seventy-five people with aphasia and 87 neurologically typical readers completed a test of paragraph comprehension. People with aphasia also completed background tests of language, attention, recognition memory, and executive functions. The influence of demographic variables (age, gender, and level of education) was analyzed separately in the group of people with aphasia and the typical readers using analyses of variance. In the people with aphasia, the relationship between paragraph comprehension and the language and cognitive tests was explored using correlational analyses.Results: In the typical readers, there was a significant effect of gender and level of education and a significant three-way interaction. For the people with aphasia, there were no significant effects of demographic variables. Significant positive correlations were found between performance on paragraph comprehension and each of the language tests and with tests of auditory attention, executive functions, and recognition memory for words.Conclusions: In people with aphasia, the effects of demographic variables were overshadowed by the effect of their language difficulties. The association seen across language measures reflects the shared semantic representations across single-word, sentence, and text levels, across modalities. The study emphasizes the importance of attention, executive functions, and short-term memory in the comprehension of and memory for what we read. The contribution of both language difficulties and wider cognitive skills needs to be considered when planning intervention.Supplemental Material S1. Example paragraph and the associated comprehension questions.Webster, J., Morris, J., Salis, C., & Howard, D. (2023). Reading for meaning: The influence of reader characteristics on paragraph understanding in aphasia. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00153