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 < 0.01; ES = 0.68) and from pre-treatment to six weeks following the end of treatment (X = 4.53; SD = 3.16; P < 0.001; ES = 1.43). There was no significant difference in the gain from pre-treatment to post-treatment for the Web ORLA^® 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.