A Mixed-Methods Exploration of the Experience of People With Aphasia Using Text-to-Speech Technology to Support Virtual Book Club Participation

Purpose: This mixed-methods research sought to examine the experience of people with aphasia who used text-to-speech (TTS) support to read a novel for virtual book club participation.Method: Six people with chronic aphasia used a TTS system to review portions of a novel about which they conversed during eight virtual book club meetings occurring over 5 weeks. During one-on-one interactions prior to each meeting, participants answered comprehension questions and provided feedback about reading experiences. Then, during group meetings, they reviewed and discussed relevant book content and predicted upcoming content. During a structured individual interview, participants reflected on their supported reading and book club experience.Results: Participants reported a range of reading confidence prior to study participation, mostly influenced by decreased comprehension or reading speed. After book club participation, four participants expressed increased confidence. Some reported searching for key words and skipping difficult words as strategies additional to TTS support. All reviewed at least some book sections more than once either with or without TTS support. Highly motivated participants expressed low frustration and high reading ease and enjoyment. Perceived comprehension was roughly consistent with actual comprehension across participants. Most believed TTS support promoted faster reading than otherwise possible. Participants liked adjustable features affecting speech output rate, word or sentence highlighting, and font size. Psychosocial benefits included decreased isolation and increased friendship.Conclusions: The findings extend previous evidence about perceived and actual benefits associated with TTS support. People with aphasia express positive experiences when given TTS support during book club participation.