ACQ Vol 12 no 1 2010

than 18 years post brain-damage. Therapy programs are not typically offered to clients who are so many years post injury as the majority of research suggests that the first few months are crucial for improvement (e.g., Cherney & Robey, 2001). The findings thus challenge current models of service delivery. The findings should be interpreted with caution. The current study reports a number of single case studies and included participants with a range of different aetiologies and difficulties. It is therefore difficult to determine whether the findings can be generalised to the wider population. Future research could include larger sample sizes with more homogenous presentations and etiologies. Carrying out further single case studies using a similar approach would also add support to the current findings. There were also a number of limitations regarding methodology. As only one baseline assessment was carried out, one cannot be sure whether the improvement was due to therapy or not. Therapy took place over a very limited time period (5–6 sessions). It is therefore possible that if therapy was extended, more substantial gains could have been made. As no follow-up assessments were carried out, we cannot determine whether the changes in reading accuracy and psychosocial improvements were sustained after the completion of therapy. Future research should therefore include multiple baseline assessments, a longer therapy phase and post therapy follow-up assessment. Some measurements should be interpreted cautiously. The confidence ratings were made subjectively by the participants in the presence of the investigators. It is possible that their presence may have influenced the participants’ response because the participants knew that the investigators wanted them to improve in confidence. Summary This preliminary investigation was a first step in determining whether a personally relevant functional reading therapy program is effective for people with acquired reading difficulties. The results are promising with benefits in accuracy, comprehension, confidence, and social participation and suggest that further research which addresses the limitations above would be worthwhile. Acknowledgements The case studies were undertaken as final year undergraduate students’ honours research projects, and the first and last authors provided supervision throughout the research projects. The authors would like to thank the participants and the staff at the day centre for their support and involvement in this project. Please contact the corresponding author for further information about the reading and feedback questionnaires. References Chapey, R., & Hallowell, B. (2001). Introduction to language intervention strategies in adult aphasia. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 3–17). New York: Lippincott Williams and Wilkins. Cherney, L., & Robey R. (2001). Aphasia treatment: Recovery, prognosis, and clinical effectiveness. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 148–172). New York: Lippincott Williams and Wilkins. Christie, J., Clark, W., & Mortensen, L. (1986). Mount Wilga high level language test . (1st ed.) Sydney: Mt Wilga Rehabilitation Centre. Unpublished manuscript. Coelho, C. (2005). Direct attention training for reading impairment in mild aphasia, Aphasiology , 19 (3–5), 275–283.

Department for Education and Skills (2007). Department for schools and families, workplace. Retrieved 2 July 2009 from http://www.dcsf.gov.uk/readwriteplus/workplace DePartz, M. (1986). Re-education of a deep dyslexic patient: Rationale of the method and results. Cognitive Neuropsychology , 3 (2), 149–177. Fawcus, M., Kerr, J., Whitehead, S., & Williams, R. (1991). Aphasia therapy in practice: Reading . Bicester, UK: Speechmark Publishing. Flesch, R. (1948). A new readability yardstick. Journal of Applied Psychology , 32 , 221–233. Gunning, R. (1952). The technique for clear writing . New York: International Book Co. Hoofien, D., Gilboa, A., Vakil, E., & Donovick, P. J. (2001). Traumatic brain injury (TBI) 10–20 years later: A comprehensive outcome study of psychiatric, symptomatology, cognitive abilities and psychosocial functioning. Brain Injury , 15 (3), 189–209. Kertesz, A. (1982). The Western Aphasia Battery . New York: Grune and Stratton. McLaughlin, G. H. (1969). SMOG grading: A new readability formula. Journal of Reading , 12 (8), 639–646. Parr, S. (1995). Everyday literacy in aphasia: Radical approaches to functional assessment and therapy. Aphasiology , 10 (5), 469–503 Peach, R. (2002). Treatment for phonological dyslexia targeting regularity effects. Aphasiology , 16 (8), 779–789. Ponsford, J., Sloan, S., & Snow, P. (1995). Traumatic brain injury: Rehabilitation for everyday adaptive living . London: Erlbaum Press. Richardson, J. T. E. (2000). Clinical and neuro­ psychological aspects of closed head injury . Hove, UK: Psychology Press. Wallace, S. E., Evans, K., Arnold, T., & Hux, K. (2007). Functional brain injury rehabilitation: Survivor experiences reported by families and professionals. Brain Injury , 21 (13– 14), 1371–1384. Worrall, L., & Fratalli, C. (2000). Neurogenic communication disorders: A functional approach . New York: Thieme. 1 Acquired dyslexia is a condition that commonly co-occurs with aphasia and is characterised by the loss of a previously possessed ability to comprehend the meaning or significance of written words, despite intact vision. There are a range of different types of dyslexia including pure alexia, surface dyslexia, deep dyslexia and phonological dyslexia (Chapey & Hallowell, 2001). 2 A measure of number of years of full-time formal education a person hypothetically requires in order to read the text (Gunning, 1952). Texts with Gunning Fog indices of 12 or less are readable for most literate adults. 3 The Simple Measure of Gobbledygook (SMOG) (McLaughlin, 1969) is a measure of readability. It calculates a grade of reading ability using the following formula: grade = 1.043 30 x number – of – pollysyllables + 3.129 number – of – sentences 4 Measure of readability available on Microsoft Office Word. Dr Cocks and Dr Cruice trained and worked as speech pathologists in Australia before moving to London in 2005 and 2002 respectively, where they now work as senior lecturers and clinical educators at the reading clinic at City University. Information about the reading clinic can be found at http://www.city.ac.uk/lcs/ compass/readingclinic/readingclinic.html. Niina Matthews , Joan Gregoire-Clarke , Lisa Barnett , Ruth Middleton and Emma Phillips graduated from City University in 2008. They now work as speech and language therapists at various locations around the UK.

41

ACQ Volume 12, Number 1 2010

www.speechpathologyaustralia.org.au