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Traumatic Brain Injury
What Makes Reading Enjoyable?
Relearning to read after brain injury using two different methods.
Posted November 4, 2018
I sat opposite my therapist, focusing effortfully on her lesson. She was teaching me how to read post-concussion using strategies: highlighters to highlight words I needed to remember; pens to write notes in the margins and in a notebook to remember the text; two sheets of paper to cover off pages and paragraphs I wasn’t reading; sticky notes to mark key points; a decision list on how to choose material that gave me the best chance of reading. I went home with this clutch of strategies to help me read for five minutes per day, the limit of my ability to read after brain injury.
Reading a familiar book was like studying for university. My therapist monitored my progress weekly or less.
I believed in her. I believed that if she said reading strategies would help, they’d help. I believed that it was just a matter of finding the right strategies that worked for me.
I discovered that an eReader efficiently “covered off” text by enlarging the font. It was a whole heck of a lot less onerous than juggling one sheet of paper to cover off the facing page, a folded sheet to cover off the paragraphs above or below the text I was reading, as well as a book, pen, notebook, highlighter, and sticky notes. Still, I couldn't ditch paperbacks and usually read with the papers and whichever other strategies I could tolerate. Or I'd read sans them and be happy with remembering nothing before or after whatever I was reading. Series became my novels of choice so I'd at least know the main characters. I increased my reading time from five minutes to twenty. I managed over almost two decades to drop my post-reading nap time from two hours to almost none, though I still had to rest on the couch. People reading with me was key to fatigue progress.
Year in. Year out, long after I was discharged, I believed this was reading and I'd progress because I believed in my therapist.
Then one day I stepped onto the subway platform floor and knew: I was not a reader. I hadn’t lost my ability to decode words; strategies only helped me absorb those words. Yet strategies hadn’t helped me comprehend and remember them. Also, readers don’t juggle stationary to read nor need others to read with them. Readers need only the book in their hand to read; the story grabs their minds and pulls them into the plot and the characters’ lives. Dragging oneself back into the real world is the tough part for a reader, not keeping eyes on text and struggling to remember what came before and to predict what will come next. Learning from non-fiction was impossible. I'd been coasting on my accrued knowledge from my voracious pre-brain injury reading, and I'd reached the limit of that.
Strategies hadn’t been hope. They’d been an illusion.
Many years passed before I heard about the Lindamood-Bell process of working on reading comprehension as opposed to decoding words. It was the first time I'd heard an expert talk about what I 'd been seeking: to read the way we read in high school, not in grade school. They called their method “visualizing and verbalizing” because they teach you to create pictures as you read so that you can comprehend, remember, think deeper, predict what will come next, and verbalize all of that to another person or yourself. But would creating imagery give me back the way I’d read before my brain injury? Was this real hope or a more sophisticated illusion?
I plunged in, taking a huge financial risk, which I hadn’t had to do with the therapist. Ontario medicare had covered the therapist; my credit paid for this different kind of reading therapy.
The bedrock of this method is intensively learning to create imagery. Instead of one forty-five-minute session of therapist explaining and going through a printed list of strategies, there were two months of five days per week two-hour sessions of an instructor teaching me how to create imagery then guiding me, pushing me to create imagery for longer and longer bits of text, from sentences to paragraphs, hour in and hour out, to read to them at my sloth pace (expressive language) or to listen to them read to me at a normal pace (receptive language). Grueling. They specifically told me not to do it on my own because my brain needed to rest and recover in between the work. Plus applying the lessons was so tough, I needed their gentle but unrelenting encouragement to keep me on task. There was no head space left to hope or not hope. No need for belief.
Creating imagery was wholly practical.
Every week I increased the amount of text and the grade level I was reading at. I began reading a sentence at grade-five level in July. I ended in the first week of September reading paragraphs of philosophy of mind text. My fatigue went from absolute exhaustion that flattened me on to the couch afterward to resting without feeling my brain was being crushed by the weight of a thousand boulders.
All that effort lead to me really reading — like a university-level reader.
I could picture the story. I remembered the philosophical writings. I could make conclusions and inferences; I could predict what came next (assuming the writer wasn’t being coy or I was overly fatigued). In August, I chose for the last two weeks of instruction application a 500+-page novel I’d been given after my brain injury. I’d used strategies to read it back then and had failed at understanding anything. I’d shelved it when I faced up to the fact I couldn’t follow it. Now its story is alive in my mind. I remain in the sixteenth percentile for reading rate for my gender and age and reading still fatigues, but that doesn’t matter because I’m reading it and am almost a third of the way through it. I continue to progress weekly the number of pages I can read at a time.
Fatiguing effort from creating imagery rewards.
Fatiguing effort from strategies ultimately despairs.
The day came I had to work the Lindamood-Bell visualizing and verbalizing process on my own. I sat down and looked at my coffee table. I was missing something. There was the book. And . . . I blinked. I realized that that was all I needed.
Just the book.
I needed nothing else. No highlighters, no pens, no notebooks, no iPad to look up definitions, no timer.
The burden of strategies was gone.
Reading was no longer like studying for an exam and immediately forgetting most of what I’d studied.
I did have to bring back one sheet to cover off the facing page. It’s the one concession to my brain injury’s effect on my distractability. Still, hope has budded again -- for the pleasure of reading is in following the story, not in decoding words. Next steps: increase my reading rate and meld myself right into the story. I’m finally on my way back to reading like I did before my brain injury.
Copyright ©2018 Shireen Anne Jeejeebhoy. May not be reprinted or reposted without permission.
