IntroductionAt least 68% of persons with aphasia (PWA) experience reading difficulties. Even though strategy-based interventions are a promising treatment approach for text level reading comprehension deficits in PWA, empirical evidence for their efficacy remains rare. The primary objective of this study is the analysis of the efficacy of a strategy-based intervention on text-level reading comprehension and on reading activities in PWA.Methods and analysisIn a repeated measures trial, 24 PWA will first participate in a waiting period and then in a strategy-based intervention (14 face-to-face-sessions, 60 min each). We will apply two combinations of strategies to treat either the microstructure or the macrostructure, respectively. Participants will be randomly allocated to two parallel groups that will receive these combinations in interchanged sequences. Assessments will be implemented before and after each period as well as 3 and 6 months after the intervention. The primary outcome measure is text-level reading comprehension measured with a German version of the Test de Compréhension de Textes (TCT-D) and represented by the score TCT-D Total . A non-blinded and a blinded rater will evaluate the primary outcome measure. Secondary outcome measures will address specific reading functions, reading activities and cognitive functions. The sample size was determined with an a priori power analysis. For statistical analysis, we will use contrast analyses within repeated measures analysis of variance models. We expect significant improvements in primary and secondary outcome measures during the intervention as compared with changes during the waiting period.Ethics and disseminationThis study was approved by the ethics committee of Deutscher Bundesverband für akademische Sprachtherapie und Logopädie (20–10074-KA-MunmErw+Ko). Results and relevant data will be disseminated in peer-reviewed journals, at conferences and on the Open Science Framework.Trial registration numberDRKS00021411 (see Supplementary Table 1).

Background: Text comprehension entails a complex interaction between cognitive and linguistic factors. In aging, text comprehension depends on text characteristics, particularly semantic load.Persons with residual aphasia may complain of discourse comprehension difficulties without linguistic problems. Three levels of representation are involved in text comprehension (surface level, semantic level constituted by macrostructure and microstructure, and situational level).Attention, verbal working memory, long-term memory, and executive functions combine to allow processing of all levels of representation. Aims:The primary objectives of this multiple case study were (a) to examine microstructure, macrostructure and situational model updating in text comprehension in five participants with left-brain-damage (PWLBD), who continued to complain about problems with discourse comprehension without linguistic problems, and (b) to examine executive function and memory in these participants.Methods and procedure: Five PWLBD were selected for the study. We asked the participants to read and understand three narrative texts. The texts varied according to semantic load (the amount of information). In each text, we assessed macrostructure, microstructure and situational model updating. To evaluate memory and executive functions, we administered specific complementary tasks. Results were compared to normative data obtained from a previous study with a total of 60 neurologically intact control participants, divided into younger (N = 30) and older (N = 30) groups. Outcomes and results:The results for the five PWLBD indicated that text comprehension is influenced by text characteristics, particularly semantic load; the findings demonstrated shortterm memory and cognitive flexibility deficits. Text comprehension in residual aphasia 3Conclusions: These findings have two major implications. Analysing text comprehension using several texts with varying semantic loads is a promising tool for diagnosing residual aphasia and for designing specific cognitive interventions that target reading comprehension abilities in persons with residual aphasia.

Families providing care to relatives with Alzheimer's disease are quickly destabilized by changes that disrupt communication. This pilot mixed-design study aimed to provide a quantitative and qualitative evaluation of a communication-based training program for carers of people with early-stage Alzheimer's disease (AD). Five participants received three training sessions. The use of communication strategies by participants and their effectiveness were evaluated before and after the training, and a focus group was conducted to gather participants' impressions about the impacts of the training on communication with the person they cared for. The AID-COM program appears to have met expectations.

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