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Therapy for Reading Problems in Adults After Brain Injury

This study has been completed.
ClinicalTrials.gov Identifier:
First Posted: July 15, 2003
Last Update Posted: August 15, 2014
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Adults who sustain brain damage due to stroke, head injury, or traumatic surgery may develop difficulty reading. This study examines the effectiveness of behavior-based programs to improve reading ability in these individuals.

Condition Intervention
Dyslexia, Acquired Brain Injuries Cerebrovascular Accident Behavioral: Cognitive Therapy to Improve Reading

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Cognitively-based Treatments of Acquired Dyslexias

Further study details as provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):

Primary Outcome Measures:
  • Improved accuracy and/or speed of reading individual words aloud.

Secondary Outcome Measures:
  • Improved accuracy and/or speed of reading text aloud.

Estimated Enrollment: 58
Study Start Date: August 2002
Study Completion Date: July 2007
Primary Completion Date: July 2007 (Final data collection date for primary outcome measure)
Detailed Description:

Acquired disorders of reading (acquired dyslexia) are common in patients with aphasia subsequent to left hemisphere stroke. Even when language functions recover sufficiently to enable the patient to return to work, continuing dyslexia often interferes significantly with job performance. This study will evaluate cognitive therapies for the treatment of acquired dyslexia.

Each therapy is based upon a cognitive neuropsychological model of reading; the therapies target specific types of reading deficit and stem from the question of re-learning versus re-organization of function. The therapies focus on dyslexic disorders stemming from the following underlying deficits: 1) impaired access to the orthographic word form from the visual modality (pure alexia); 2) impaired orthographic/phonologic connections (phonologic/deep dyslexia); and 3) decreased ability to hold phonologic codes in memory (phonologic text alexia).

Participants in this study will undergo a comprehensive and detailed battery of reading and reading-related tests to determine the underlying impairment causing the reading deficit. Based upon the results of these tests, the patient's dyslexic disorder will be characterized and, if appropriate, the patient will be assigned to one of the treatment programs devised specifically for that type of deficit. Treatment programs are evaluated for efficacy by comparing the accuracy and speed of reading pre- and post-treatment.


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  • Reading deficit subsequent to stroke, traumatic brain injury, brain surgery, or other brain damage
  • Ability to attend 2-3 sessions per week for several months at Georgetown University in Washington, DC

Exclusion Criteria

  • History of developmental dyslexia or learning disabilities
  • Best corrected vision less than 20/40
  • Less than 10 years of formal education
  • Significant memory or comprehension problems
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00064805

United States, District of Columbia
Georgetown University Medical Center
Washington, District of Columbia, United States, 20057
Sponsors and Collaborators
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Principal Investigator: Rhonda B. Friedman, Ph.D. Georgetown University Medical School
  More Information

Additional Information:
Friedman RB, Lott SN. Rapid word identification in pure alexia is lexical but not semantic. Brain Lang. 2000 May;72(3):219-37.
Nitzberg Lott S, Friedman RB. Can treatment for pure alexia improve letter-by-letter reading speed without sacrificing accuracy? Brain Lang. 1999 May;67(3):188-201.
Friedman RB, Sample DM, Lott SN. The role of level of representation in the use of paired associate learning for rehabilitation of alexia. Neuropsychologia. 2002;40(2):223-34.
Marchand Y, Friedman RB. Impaired oral reading in two atypical dyslexics: a comparison with a computational lexical-analogy model. Brain Lang. 2005 Jun;93(3):255-66. Epub 2004 Dec 15.
Lott SN, Sample DM, Oliver RT, Lacey EH, Friedman RB. A patient with phonologic alexia can learn to read "much" from "mud pies". Neuropsychologia. 2008 Aug;46(10):2515-23. doi: 10.1016/j.neuropsychologia.2008.04.004. Epub 2008 Apr 16.
Lott SN, Carney AS, Glezer LS, Friedman RB. Overt use of a tactile-kinesthetic strategy shifts to covert processing in rehabilitation of letter-by-letter reading. Aphasiology. 2010 Nov;24(11):1424-1442.
Lacey EH, Lott SN, Snider SF, Sperling A, Friedman RB. Multiple Oral Re-reading treatment for alexia: The parts may be greater than the whole. Neuropsychol Rehabil. 2010 Aug;20(4):601-23. doi: 10.1080/09602011003710993. Epub 2010 Jul 6. Erratum in: Neuropsychol Rehabil. 2010 Dec;20(6):940.
Kurland J, Cortes CR, Wilke M, Sperling AJ, Lott SN, Tagamets MA, Vanmeter J, Friedman RB. Neural Mechanisms Underlying Learning following Semantic Mediation Treatment in a case of Phonologic Alexia. Brain Imaging Behav. 2008 Sep;2(3):147.

ClinicalTrials.gov Identifier: NCT00064805     History of Changes
Other Study ID Numbers: R01HD036019 ( U.S. NIH Grant/Contract )
First Submitted: July 14, 2003
First Posted: July 15, 2003
Last Update Posted: August 15, 2014
Last Verified: April 2014

Keywords provided by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):
Cognitive therapy
Aphasia therapy
Acquired dyslexia
Phonological deficits
Orthographic deficits
Brain disorders
Brain injury

Additional relevant MeSH terms:
Wounds and Injuries
Brain Injuries
Dyslexia, Acquired
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Cerebrovascular Disorders
Vascular Diseases
Cardiovascular Diseases
Language Disorders
Communication Disorders
Neurobehavioral Manifestations
Neurologic Manifestations
Learning Disorders
Signs and Symptoms
Neurodevelopmental Disorders
Mental Disorders
Neurocognitive Disorders

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