Reading Rehab for Brain Injury: Adding Out Loud Summarizing

Published Categorised as Personal, Health, Brain Power, Brain Biofeedback

It is never that easy, is it? Never as easy as: go for assessment, start treatment. Sigh.

I was thinking: this week we begin the new brain biofeedback training for reading.

But nope.

Once the ADD Centre get full cap parameters — the EEG readings from 19 points on your head — they like to pinpoint precisely the numbers they need from the exact locations they want to train.

Apparently, I produce too much theta at C3 and FP1-F3.

And so this week my trainer put an electrode over FP1-F3 and assessed my brainwaves there for three minutes; then did the same at C3.

For the rest of the session, she kept the electrode at C3 while we did HRV training, reading, and SMIRB (stop my irritating ruminations book writing). This week, like last, she had me deep breathe to the HRV screen first with eyes closed then with eyes open to relax me, for my heart was pounding away (it would not be a normal week for me sans some new stressor). My heart may go fast, but it rarely pounds so that I can feel it. I was not a happy camper!

Ramryge angels at Gloucester Cathedral, England

Brain injury grief is

extraordinary grief

research proves

needs healing.

Next, she started up the assessment screen again while I read out loud the first paragraph from a timed reading book of readings. At the end of the paragraph, she had me summarize it out loud to her. We repeated for the second paragraph. A total of 4 minutes of actual reading, longer if you include summarizing time.

I learnt a thing. Maybe two.

I learnt a new reason to do a reading strategy I’d been told to do before and I had balked at because it had felt a lot like studying for university exams, the bane of my life, and it hadn’t worked back then anyway. I still forgot everything I’d read.

My trainer said: summarize, out loud, to the wall if you don’t have someone to summarize to, what you just read — after every paragraph.

Summarizing out loud — not silently — that was the difference from rehab teachings — tells your brain again what you read and tells your brain: remember this! Your brain is then more likely to stuff it into your long-term memory. I don’t think it worked for me for the first decade after my brain injury because those networks were not working well. No amount of stuffing was going to get the info through fucked-up neurons.

Hopefully, you won’t have to do this forever, she added. At some point, children taught this technique incorporate it as an automatic skill. At some point, they do this automatically, silently, without even realizing they’re summarizing in their head as they go along.

Hopefully, this is true for folks with brain injury too, I added silently to myself.

Also — and this is important for people with brain injury — reading in the presence of and to another is easier!

I don’t get headaches when I read out loud to my trainer or my neurodoc. It’s like having a coach. There is something about the in-person human social bond (we are biologically social animals) that assists us to read.

And, as well, the presence of the other person exists as an external motivation.

People with brain injury lack motivation.

And often have initiation deficit.

Getting going is hard. You need all sorts of workarounds — calendar apps in smartphones, routines, humans — to begin a task.

On top of which, reading on our own requires a shit-load of energy just to start.

But there’s no need to consume that energy when you’re with another, for they start us.

Then there’s accountability.

Accountability works for anyone working on anything difficult. You’re more likely to do it when you’re facing someone expecting you to. And when you’re more likely to do it and do it regularly, eventually you will slowly, slowly begin to improve. Even injured, untreated brains can reconnect neurons to regain lost skills, albeit at frozen molasses speed and probably imperfectly and not the same.

Having another coaching us, keeping us accountable, helps us keep at it over the years and years it takes.


Picking up on the summarizing theme, this week, I have begun reading Danté’s Inferno out loud to my neurodoc. For ten minutes tops, I read one stanza; then I try to summarize it. If I fail or if I didn’t understand the story when reading the entire stanza all at once, I read one line at a time. Lastly, we discuss what each line means before I read the next stanza. I wonder how much I’ll remember next week . . .

(I taught my neurodoc something new: poetry is how stories used to be written. Prose is relatively new. So the Inferno is in poetic form because that’s how they used to write. And, oh yeah, writers chose their own punctuation back then too. He pointed out that I had retained my ability to understand old English, imperfectly maybe, but I hadn’t lost my linguistic skills from reading Chaucer, King James Bible — magnificent writing — before my injury.)

Anyway, I read two or three stanzas for a total of eight minutes. Phew. Really interesting but tiring. Eight minutes seems so minute, and the feeling of escape, of positivity only lasted eight minutes too. How much better for my mental health if it had been one hour.

My neurodoc said: think of it as seven-and-a-half eight minutes. Then you’ll have achieved your hour. Since I will only read this once a week, it will take two months to achieve that hour.

Well, brain injury life is slow.


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My Duck logo walking on my books in pink and blue shading.



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