Narrative comprehension by people with aphasia given single versus combined modality presentation

Background: People with aphasia experience comprehension impairments that hinder participation in daily activities. Presenting information through more than one modality may reduce demands on cognitive resources and promote improved comprehension by people with aphasia. Previous researchers have documented improved comprehension of sentence-length material given simultaneous auditory and written presentation. However, less is known about the potential benefits people with aphasia derive from combined auditory and written presentations when processing paragraph-length narratives.Aims: This study's purpose was to examine comprehension accuracy and reviewing time for people with aphasia when processing short and long paragraph-length narratives in auditory only, written only, and combined auditory and written conditions. Additionally, we documented participants' preferred presentation modality.Methods and Procedures: Twenty adults with chronic aphasia listened to, read, or listened to and read (combined) six short and six long narratives. After each narrative, participants answered 10 multiple-choice questions presented via the Written Choice Strategy. After reviewing all narratives, participants indicated their most and least preferred presentation modalities.Outcomes and Results: No significant comprehension differences emerged across presentation conditions. However, when considering only long narratives, participants performed with significantly greater accuracy given the combined auditory and written condition compared to either the written only or the auditory only condition. Reviewing time was shortest given auditory only presentation of short narratives; however, interpretation of this result warrants caution given that the auditory condition had a fixed rate of presentation but the other two conditions did not. Greatest efficiency occurred in the auditory only condition, followed by the combined condition, and then the written only condition. Most participants preferred the combined auditory and written condition, and the majority least preferred the auditory only condition.Conclusions: Results suggest that presenting multi-sentence narratives through more than one modality may support comprehension for some people with aphasia; however, the effect is not universal and differs depending on the length of material presented. Researchers need to investigate further response differences from people with varying aphasia severities and profiles.