E-Readers Better than Paper for Teens With Dyslexia

Fran Lowry

October 03, 2013

Electronic readers (e-readers) are more effective than printed texts for some people with dyslexia, new research suggests.

The results from the study suggest that rather than the device itself, e-readers better facilitate reading in those with dyslexia perhaps because of the short lines used on the e-reader display.

The findings, the investigators write, show that "a small-screen handheld device facilitates reading by improving both speed and comprehension in a subset of high school students with dyslexia.

"This supports and expands on emerging work, demonstrating that relatively simple adjustments to the visual presentation of text, in this case shortening the lines, or in other experiments adding spacing between letters to control crowding, can facilitate reading in those who struggle, or at least in some of them," the investigators, led by Matthew H. Schneps, PhD, from the Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, write.

The study was published September 18 in PLoS One.

Customized Approach to Reading

"E-readers are fast rivaling print as a dominant method for reading," the investigators write. "Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia."

Computers are starting to change the way people interact with the written word, and computer technology has allowed text to be reformatted so that it is customized to the needs and preferences of individuals.

But the authors note that the technology has brought about such changes so rapidly that there has been scant research on how these new approaches to reading affect the ability to decipher the written word.

Prevailing models of dyslexia ascribe reading difficulties to poor phonologic processing, but more recently, dyslexia has been increasingly associated with deficits in visual attention and poor oculomotor control.

As a result, some have suggested that e-readers could be configured to help reduce these deficits, to make reading less of an effort for people with dyslexia, the authors write.

In earlier work, the investigators used gaze-tracking techniques to compare reading on a small-screen e-reader (an iPod Touch) with reading on a larger tablet (an iPad). They found that students with dyslexia who read with the iPod showed better oculomotor performance than when they read using the larger iPad.

In this study, the authors looked at the effects of e-reader formatting on dyslexia.

Specifically, they tested a type of reading method called Span Limited Tactile Reinforcement (SLTR), in which text is displayed on a small-screen handheld device such as a smartphone using large fonts so that only a few words of text are displayed per line.

With this reading method, text is advanced by manually scrolling the text vertically as if it were a long, continuous column of newsprint, the authors explain.

They compared reading comprehension and speed with the traditional method of reading on paper vs that on e-readers using the SLTR method in 103 high school students with dyslexia.

Improved Speed, Comprehension

For reading on paper, the text was printed on normal, letter-size (8.5 x 11 inches) white paper using a 14-point Times font, with 1-inch margins; an average of 13.94 (standard deviation [SD], 1.79) words were printed per line.

For reading on the e-reader, reading material was preloaded on an iPod Touch. The device had a screen resolution of 640 x 960 pixels at 128 pixels/cm. The text was displayed using a Times New Roman font at a setting of 42 points, using short lines that displayed an average of 3.40 (SD = 0.91) words per line.

The researchers found that use of the iPod Touch significantly improved speed and comprehension when compared with traditional presentations on paper for specific subsets of the students.

Those who struggled most with phoneme decoding or efficient sight-word reading read more rapidly using the iPod Touch, and those with limited visual attention span gained in comprehension.

The visual attention span task distinguished those readers who benefitted from iPod formatting from those who did not, "and it is likely that it is deficits in visual attention that are being characterized and tapped by the VA [Visual Attention] Span task to give rise to the interactions we observe," the authors write.

An eye-tracking experiment used to observe reading in 26 high school students with dyslexia, which the researchers had done before the current study, showed that the short lines used in the iPod Touch facilitated their ability to read.

"Notably, readers made fewer fixations overall, and inefficient gaze movements made to re-inspect words were reduced by a factor of two when the iPod was used," the authors write.

The finding that the SLTR reading method on an e-reader helps some students with dyslexia improve their reading speed and comprehension supports the conclusions of prior eye tracking research, they add.

Moreover, it is the short lines, not the e-reader itself, that leads to the benefits.

"We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span," the authors write.

The widespread adoption of e-readers and other digital technologies for reading is causing reading methods to evolve rapidly, and this is "opening the possibility that alternate methods for reading can perhaps reverse historically imposed constraints that have caused so many to struggle, and make reading accessible to many currently excluded," they conclude.

The authors report no relevant financial relationships.

PLoS One. Published online September 18, 2013. Full article

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