Reading After Traumatic Brain Injury: Shifts in Engagement, Purpose, and Format Across Everyday Material Types

Reading is central to adult participation in everyday life, yet little is known about how everyday reading habits change following traumatic brain injury (TBI). Prior research has focused primarily on reading speed and comprehension, with less attention to real-world reading behavior. The purpose of this study was to describe and compare everyday reading habits in adults with mild TBI, moderate-severe TBI, and no history of TBI.

Survey data from a sequential mixed-methods study of reading after TBI were analyzed for 170 adults with mild TBI, 55 with moderate-severe TBI, and 370 uninjured controls (UC) with no TBI. Everyday reading behavior was assessed using the Reading Habits Inventory, capturing frequency of reading engagement, estimated daily reading time, reading purpose across material types, and format preference (screen vs. physical). Group differences were examined using chi-square tests, analyses of covariance, and nonparametric tests, with demographic covariates and corrections for multiple comparisons.

TBI groups reported lower weekly engagement with leisure reading than UC, driven by less fiction and magazine reading. Among those who read at least weekly, daily reading time did not differ across groups for most categories; however, participants with mild TBI spent more time reading functional materials than UC (d = -0.34). TBI groups allocated a smaller proportion of reading time to pleasure, and participants with mild TBI allocated a greater proportion to communicating than UC. Screen-based reading was more common in TBI groups for leisure and informational short-form materials. Reading for communication was the dominant reading activity and equivalent across all groups.

Together, these findings suggest that people with TBI allocate their reading time and purpose differently than their uninjured peers, with comparatively lower engagement in leisure reading and more emphasis on functional and communicative purposes, rather than reading being uniformly lower across all material types. Notably, communication was the primary reading activity across all groups. These findings highlight the importance of assessing real-world reading behavior and participation-level outcomes after brain injury, including the pervasiveness of written language as a primary modern communication modality.

https://doi.org/10.23641/asha.34364070.