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Lay summary: scientific evidence behind ReadClear

Updated 2 months ago
Dr Aida Suárez-GonzálezPrincipal Investigator

ReadClear: An Assistive Reading Tool for People Living with Posterior Cortical Atrophy

 by Aida Suárez-González, Amber John and Roberta McKee-Jackson

Did you know that the back of your brain handles the visual information that comes through the eyes? Yes, it does! This means that you may have poor vision because of eye disease but also because of brain disease. 

Millions of people in the world lose their reading ability because of this disconnect between the brain and the eyes. This is usually due to degenerative conditions or acute brain injury such as stroke.

Posterior cortical atrophy (PCA) is a form of dementia that affects the visual system. In our research, we work together with people with PCA. With their help, we produced a reading aid for brain-related visual impairment. This is the lay summary of that research study (you can read the scientific paper here). 

Lay Summary

Background: Colleagues in my department in the Dementia Research Centre at UCL have been investigating reading for many years. They are particularly interested in people with damage in the back of the brain (the part that controls vision). They found that reading difficulties in these people are improved when paragraphs have fewer words. This is because they experience less “crowding” (lines of text become cluttered). And because words become easier to localize (they do not get lost on the page). They also found that this group of people benefit from smaller font sizes and from visual cues.

With this knowledge in mind, I started working on the development of a software program that could make reading easier for people with this kind of visual impairment. A fantastic team of people living with PCA collaborated in the co-production of the first prototype (read the story of this collaboration in this blog).  We called this piece of software ReadClear.

Aim:  We then decided to test if ReadClear could improve reading in people with PCA compared to a standard e-reader.

Methods: To test if ReadClear worked, we asked 20 people with PCA to take part in a clinical trial to test the reading aid. Half of them used ReadClear for one week and a standard e-reader during the second week. The other half did the reverse. Participants were randomly allocated. This means we as investigators could not predict who would receive exposure to ReadClear first. This is good practice to avoid biased results. We took measures of their reading accuracy and the types of errors they made. We also asked them about their reading experience (whether they liked it or not!).

Results: We found that reading using ReadClear reduced the number of reading errors for participants. They also told us that reading with ReadClear was more pleasant than with a standard e-reader.

Although this reading aid has been tested specifically in people with PCA, it also has the potential to be helpful for people with visual impairment arising from other neurological conditions. In this study, we learned that the use of a compensatory reading aid can improve and support reading in people with brain-related visual impairment. We are now working to transform this aid into a freely-available product for internet browsers and in the Google Play and App store. 


Citation: Suarez-Gonzalez A, Ocal D, Pavisic I, Peacock A, Naessens M, Ahmed S, Butler CR, Leff AP, Yong KXX, Crutch SJ. ReadClear: An Assistive Reading Tool for People Living with Posterior Cortical Atrophy. J Alzheimers Dis. 2019;71(4):1285-1295. doi: 10.3233/JAD-190335.

The people behind. Lots of people have contributed to developing the evidence behind this aid and bringing this project to its current shape. The text manipulation techniques that informed ReadClear are based on the work of Dr Keir Yong, Dr Sebastian Crutch and Dr Alex Leff. Dr Ivanna Pavisic and Dilek Ocal conducted the clinical trial that proved the effectiveness of the app, from recruitment to final data collection. Ashley Peacock wrote the code for the first prototype of ReadClear. Michelle Naessens worked with me processing dozen of files of audio data collected during the trial and marking hundreds of read-aloud words. Dr Samrah Amed and Dr Chris Buttler supported the recruitment of participants and advised on data analysis and write-up. Lots of colleagues at the Dementia Research Centre at UCL helped us to test the app so it could be ready on time for the clinical trial. More than 25 people living with PCA gave their time to make this project possible.