Oral reading for language in aphasia: Impact of aphasia severity on cross-modal outcomes in chronic nonfluent aphasia

This study examined the efficacy of a treatment, Oral Reading for Language in Aphasia (ORLA), for individuals with chronic nonfluent aphasia of varying severity levels. With ORLA, the person with aphasia systematically and repeatedly reads sentences aloud, first in unison with the clinician and then independently. Following a period of no treatment, 25 individuals with chronic nonfluent aphasia received 24 sessions of ORLA, 1 to 3 times per week. A small, but significant mean change in the Western Aphasia Battery (WAB) Aphasia Quotient (AQ) was obtained from pre- to post-treatment. When subjects were divided by severity, medium effect sizes were obtained for all severity levels from pre- to post-treatment for the WAB AQ. Medium effect sizes were obtained for the severe aphasia group on the WAB reading subtests only, for the moderate aphasia group on the discourse measures only, and for the mild to moderate aphasia group on both the discourse and WAB writing subtests. Although more intensive therapy is preferred, individuals with chronic nonfluent aphasia may improve their language skills with low-intensity ORLA treatment, and differences in modality-specific outcomes may be anticipated based on the severity of the aphasia.