Text-to-speech accommodations for the reading challenges of adults with traumatic brain injury

Objective: This study's purpose was two-fold: (a) to confirm differences in silent reading rates of individuals with and without traumatic brain injury (TBI) and (b) to determine the effect of text-to-speech (TTS) on reading comprehension and efficiency by individuals with TBI. Design and methods: Ten adults with severe TBI answered comprehension questions about written passages presented in three conditions: reading only (RO), listening to ITS presentation only (LO) or reading and listening to TTS simultaneously (RL). The researchers compared reading rate, comprehension accuracy and comprehension rate (efficiency) across conditions. Results: Analysis revealed significantly slower silent reading rates for the participants with TBI than for readers without TBI (n=75). Also, participants with TBI achieved higher comprehension accuracy for factual than inferential questions; however, no significant main effect for comprehension accuracy emerged across reading conditions. In contrast, using comprehension rate as the dependent measure, analysis confirmed a significant main effect for reading condition and question type; post-hoc pairwise comparisons revealed that the RL condition yielded higher comprehension rate scores than the RO condition. Conclusions: As a group, adults with TBI appear to benefit in reading efficiency when simultaneously listening to and reading written passages; however, differences exist that reinforce the importance of individualizing treatment.