Web-based Oral Reading for Language in Aphasia (Web ORLA®): A pilot randomized control trial

Objective:To investigate an intensive asynchronous computer-based treatment delivered remotely with clinician oversight to people with aphasia.Design:Single-blind, randomized placebo-controlled trial.Setting:Free-standing urban rehabilitation hospital.Participants:Adults with aphasia (at least six months post-onset).Interventions:Experimental treatment was Web ORLA® (Oral Reading for Language in Aphasia) which provides repeated choral and independent reading aloud of sentences with a virtual therapist. Placebo was a commercially available computer game. Participants were instructed to practice 90 minutes/day, six days/week for six weeks.Main measures:Change in Language Quotient of the Western Aphasia Battery-Revised from pre-treatment to post-treatment and pre-treatment to six weeks following the end of treatment.Results:32 participants (19 Web ORLA®, 13 Control) completed the intervention and post-treatment assessment; 27 participants (16 Web ORLA®, 11 Control) completed the follow-up assessment six weeks after treatment had ended. Web ORLA® treatment resulted in significant improvements in language performance from pre-treatment to immediately post-treatment (X = 2.96; SD = 4.32; P X = 4.53; SD = 3.16; P ® versus Control groups. However, the Web ORLA® group showed significantly greater gains at the six-week follow-up than the control group (X = 2.70; SD = 1.01; P = 0.013; ES = 1.92).Conclusion:Results provide evidence for improved language outcomes following intensive, web-based delivery of ORLA® to individuals with chronic aphasia. Findings underscore the value of combining clinician oversight with the flexibility of asynchronous practice.