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The relationship between specific features of aphasia-friendly written material and comprehension of written material for people with aphasia: An exploratory study

Background : Written material is often inaccessible for people with aphasia. The format of written material needs to be adapted to enable people with aphasia to read with understanding. Aims : This study aimed to further explore some issues raised in Rose, Worrall, and McKenna (2003) concerning the effects of aphasia-friendly formats on the reading comprehension of people with aphasia. It was hypothesised that people with aphasia would comprehend significantly more paragraphs that were formatted in an aphasia-friendly manner than control paragraphs. This study also aimed to investigate if each single aspect of aphasia-friendly formatting (i.e., simplified vocabulary and syntax, large print, increased white space, and pictures) used in isolation would result in increased comprehension compared to control paragraphs. Other aims were to compare the effect of aphasia-friendly formatting with the effect of each single adaptation, and to investigate if the effects of aphasia-friendly formats were related to aphasia severity. Methods & Procedures : Participants with mild to moderately severe aphasia (N = 9) read a battery of 90 paragraphs and selected the best word or phrase from a choice of four to complete each paragraph. A linear mixed model (p < .05) was used to analyse the differences in reading comprehension with each paragraph format across three reading grade levels. Outcomes & Results : People with aphasia comprehended significantly more aphasia-friendly paragraphs than control paragraphs. They also comprehended significantly more paragraphs with each of the following single adaptations: simplified vocabulary and syntax, large print, and increased white space. Although people with aphasia tended to comprehend more paragraphs with pictures added than control paragraphs, this difference was not significant. No significant correlation between aphasia severity and the effect of aphasia-friendly formatting was found. Conclusions : This study supports the idea that aphasia-friendly formats increase the reading comprehension of people with aphasia. It suggests that adding pictures, particularly Clip Art pictures, may not significantly improve the reading comprehension of people with aphasia. These findings have implications for all written communication with people with aphasia, both in the clinical setting and in the wider community. Applying these findings may enable people with aphasia to have equal access to written information and to participation in society.