Reading in people with aphasia: the relationship between assessment of ability and perception

Introduction: Reading comprehension difficulties are a common feature of aphasia, impacting participation in a wide range of social, leisure and work activities and overall quality of life. However, individuals differ in their reading preferences and practices and thus the impact of reading difficulties may also differ. This study explored the relationship between objective assessments of reading comprehension ability and personal perception of reading.

Methods: 74 people with aphasia post-stroke were assessed on the Comprehensive Assessment of Reading in Aphasia, developed for this study. This considered reading of single words, sentences and paragraphs. Participants also completed a supported questionnaire which explored reading ability and difficulties, feelings about reading, reading activity and strategies to support reading.

Results: Significant positive correlations were found between accuracy across the reading comprehension sub-tests. Comprehension accuracy was less strongly associated with rated perception of reading ability and feelings about reading (as rated within the questionnaire). Overall, people with less severe reading comprehension difficulties rated their reading as less problematic but there was more individual variation.

Conclusion: For some individuals, there is a significant difference between their results on reading assessments and the personal perception. This reflects individual differences in the importance of reading and reading preferences. This study clearly demonstrates that, when working with people with aphasia, it is important to consider both comprehension accuracy and the impact of the reading difficulties for the individual person with aphasia, in both assessment and treatment planning.