Evaluation of Direct Attention Training and Metacognitive Facilitation to Improve Reading Comprehension in Individuals with Mild Aphasia
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People with aphasia (PWA) frequently present with nonlinguistic deficits, in addition to their compromised language abilities, which may contribute to their problems with reading comprehension. Treatment of attention, working memory and executive control may elicit reading comprehension improvements in PWA, particularly those with mild reading problems. This study evaluated the efficacy of Attention Process Training-3 (APT-3), an intervention combining direct attention training and metacognitive facilitation, for improving reading comprehension in individuals with mild aphasia and concomitant reading comprehension difficulties. A multiple-baseline design across six participants was used to evaluate treatment effects. The primary outcome measure was a maze reading task. Pre- and post-treatment evaluation included cognitive and reading measures. Semi-structured interviews were conducted to evaluate participant-perceived changes in cognition and reading. Visual inspection of graphed maze reading performance data indicated a basic effect between APT-3 and improved maze reading for three of the six participants. Quantitative analyses, using Tau-U, corroborated findings identified through visual analysis. The results suggest that the use of APT-3 has the potential to improve reading in PWA but that it may be more efficacious under certain conditions. Treatment and participant variables, including intensity of treatment and metacognitive strategy usage, are discussed as potential influences on participants' responsiveness to APT-3.