Learning to Read Again After Brain Injury: How to Improve Pure Alexia

Survivors may experience pure alexia after brain injury, which involves difficulty with reading. This usually occurs when a brain injury affects the posterior left hemisphere of the brain.

While learning to read again after brain injury can be challenging, it is possible to improve pure alexia. Speech-Language Pathologists (SLP) are excellent resources for a proper diagnosis and guidance.

This article will discuss some of the most efficient methods and strategies to help survivors regain the ability to read and boost recovery.

How a Brain Injury Can Affect the Ability to Read

The posterior left hemisphere of the brain is responsible for many reading and comprehension skills. When this area sustains an injury, reading difficulties, or pure alexia, can occur.

Pure alexia refers to difficulty with the ability to read, but it does not affect other language skills such as writing. With pure alexia, survivors may still have the ability to process and understand words by listening, speaking, and writing but struggle with reading the words.

Survivors can also struggle with recognizing numbers and objects, which has led some researchers to believe that pure alexia is not simply a language disorder but can sometimes involve a visual processing disorder.

While there continues to be studies on what type of disorder pure alexia is considered, there have been many discoveries showing that language is not completely impaired and can be restored. Therefore, learning to read again after brain injury can be made possible with enough time and effort. 

Working with a Speech-Language Pathologist is also imperative because they can provide a specific rehabilitation plan for you.

Learning to Read Again After Brain Injury: 8 Strategies to Try

Every brain injury is different and its secondary effects vary based on the areas of the brain affected. For this reason, every survivor’s rehabilitation process looks different too.

Here are some of the most effective strategies for survivors learning how to read after brain injury:

1. Help the brain rewire itself

The brain has the ability to rewire itself through neuroplasticity, which allows the brain to create new neural pathways and strengthen existing ones. Thus neuroplasticity is essential for recovery after brain injury; and it is best activated by repetition, or “massed practice.” Engaging in repetitive exercises or therapies can help survivors with pure alexia restore function and the ability to read.

2. Work with a speech-language pathologist

Working with a speech-language pathologist is essential to create a rehabilitation plan best suited for you. Speech-language pathologists, as their name suggests, are experts in helping survivors restore speech and language skills, and other cognitive functions. During a speech therapy session, your SLP will guide you through numerous exercises that target your unique needs, such as the ability to read.

3. Stay engaged with speech therapy apps

Therapy appointments can become limited when insurance stops covering it. Fortunately, there are other forms of therapy you can try right from home. For example, the CT Speech and Cognitive Therapy App was designed by speech-language pathologists to help survivors stay engaged in therapy. 

The app provides access to over 100,000 speech and cognitive exercises. This can help you stay engaged in between therapy sessions. 

4. “Sound out” letters

One example of a speech therapy exercise that your SLP may recommend is sounding out letters. When reading is difficult, survivors can often sound out letters and string the sounds together to form words.

It helps to start with simple words, focusing on the vowels and consonants such as “th” “ch” and “sh” and then stringing the words together. Start slow and work your way up to more complex words.

5. Try reading out loud when you’re ready

Some survivors experience a milder form of pure alexia, meaning they can read but at a much slower pace. When this is the case, speech-language pathologists may recommend verbal reading exercises, such as reading a certain text out loud for 30 minutes every day. 

Once you have “mastered” this text, you can move onto a more challenging piece of text and repeat the same process. In a letter-by-letter reading comprehension study, survivors showed significant improvements in their reading ability both comprehension and speed within two months.

6. Try a tactile or kinesthetic treatment

When survivors struggle sounding out or recognizing a letter, therapists may recommend using a sensory method instead. For instance, tactile or kinesthetic treatments help survivors recognize letters and figure out what sound it makes by tracing them with their hands.

The goal is that over time, survivors will practice naming each letter and then eventually say it out loud. 

Tactile and or kinesthetic treatments can take some time but are proven to be effective. Studies showed that two out of three survivors improved significantly and went from naming a single letter, to reading full sentences.

7. Participate in visual field therapy programs

When a brain injury affects the ability to read, it may not result in pure alexia but rather hemianopic alexia. Survivors with hemianopic alexia lack the ability to plan proper eye movements to fully absorb the text in front of them. They can often read individual words well but struggle with reading along a line of text.

In this situation, your SLP will likely guide you through exercises to help train you to notice what is on the affected side, such as visual scanning training. To do this, draw a line down the side of a page with a highlighter and then scan the page all the way until you reach the highlighter mark. This will help train the brain to make eye movements that span across the entire text.

8. Take advantage of adaptive technology

Lastly, adaptive technology was designed to help individuals with visual impairments express themselves and carry out daily tasks. For example, there are free online programs that convert online text into voice messages, which can help survivors practice reading skills as long as they are following along. 

Additionally, smartphones and tablets have features that help translate text to voice messages, or scan physical books and translate them into speech.

These are some great compensation techniques that you can use to improve your reading skills over the long-term while engaging in speech and language therapy.

Overcoming Pure Alexia & Learning to Read After Brain Injury Again

While an injury to the posterior left hemisphere of the brain can cause reading difficulties, there are many ways to improve language and restore function. Pure alexia can be challenging, but there is hope for survivors learning to read again after brain injury.

Practice is the best way to activate neuroplasticity and rewire the brain, therefore it’s important to find the most effective exercises for you such as visual scanning training or sounding out letters. Speech-language pathologists can help provide a specific rehabilitation plan to boost your recovery and help you overcome pure alexia.