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. 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 ( = 2.96; SD = 4.32;  < 0.01; ES = 0.68) and from pre-treatment to six weeks following the end of treatment ( = 4.53; SD = 3.16;  < 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 ( = 2.70; SD = 1.01;  = 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.