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Rekindling the love of books - a pilot project exploring whether e-readers help people to read again after a stroke

Caute, A., Cruice, M., Friede, A. , Galliers, J. R., Dickinson, T., Green, R. & Woolf, C. (2016). Rekindling the love of books - a pilot project exploring whether e-readers help people to read again after a stroke. Aphasiology, 30(2-3), pp. 290-319. doi: 10.1080/02687038.2015.1052729


E-readers may facilitate reading in aphasia through “aphasia-friendly” features such as altering text size and formatting (Worrall et al, 2005), and text-to-speech functions. However, no previous research has examined whether e-readers help people with aphasia to read.

This project explored:
• whether people with aphasia can learn to use e-readers following a brief period of training
• whether e-reader training improves reading comprehension
• whether e-readers increase participation in and enjoyment of reading activities

Method and procedures
In phase one, available e-readers were compared using an expert evaluation against a set of criteria, to identify the model with optimum accessibility features and fewest potential barriers. The Kindle Keyboard 3G TM (Amazon) was selected for trialling in phase two.
Four people with self-reported reading difficulties post-stroke participated in phase two. All had mild or mild-moderate aphasia. Four one-hour training sessions aimed to trial accessibility features, identify helpful features, and teach independent operation of these.
A repeated measures design was used. Outcome measures assessed reading comprehension (Gray Oral Reading Tests, Bryant & Wiederholt, 2001) and confidence and emotions associated with reading (Reading Confidence and Emotions Questionnaire, Cocks et al., 2013). Matched texts were used to compare reading comprehension using printed texts and the e-reader. Usability evaluations explored independence in e-reader use and acceptability of the technology. Participation in reading activities and reading enjoyment were explored using qualitative exit interviews.

Outcomes and results
Participants’ reading comprehension on the Kindle, as measured by the GORT-4, did not improve following training and did not exceed comprehension of printed texts. However, reading confidence improved significantly for three of the participants (RCEQ: p<.05, p<.01 and p<.005).
Analysis of exit interviews and usability evaluations indicates that three out of four participants preferred reading on the Kindle to printed texts. These participants read more frequently on the Kindle than they had done before the training, and the technology enabled them to access more challenging texts (e.g. novels). They appreciated different features of the Kindle. Two participants experienced difficulties operating the technology, one of whom would have benefited from a longer training period.

This pilot study suggests that a short block of e-reader training led to improvements in reading confidence, participation and enjoyment. E-readers were not shown to enhance reading comprehension. Larger-scale investigations are warranted to further investigate whether and how e-readers facilitate reading for people with aphasia.

Publication Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Aphasiology, to be made available online:
Publisher Keywords: Aphasia, acquired dyslexia, e-readers, assistive technology, training
Subjects: P Language and Literature > P Philology. Linguistics
Departments: School of Health & Psychological Sciences > Language & Communication Science
Text - Accepted Version
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