A New Web-Based Word–Picture Matching Test Reveals Psycholinguistic Effects on Word-Level Reading and Auditory Comprehension in Aphasia

Purpose: Word reading comprehension deficits, often measured by word-to-picture matching (WtPM) tasks, are common in aphasia and alexia. To specify the nature of comprehension deficits, WtPM tasks should manipulate psycholinguistic features, have matched written and auditory versions, and provide normed scores measuring speed and accuracy. Here we present a novel web-based WtPM task that meets those needs. We use it to assess word comprehension deficits in left-hemisphere stroke survivors (LHSS). Method: We examined scores for the novel auditory and written WtPM task in a normative sample ( n = 62) and an LHSS sample ( n = 63). Mixed-effects models examined accuracy and response time in both groups, and an analysis of variance compared efficiency between the groups. Correlations compared written WtPM performance and item difficulty to auditory WtPM, written lexical decision, and oral reading. A k -means clustering analysis examined deficit patterns in the LHSS group. Results: WtPM performance was modulated by modality, frequency, and regularity and was impaired in the LHSS group. Written WtPM performance and item difficulty were correlated with auditory WtPM and written lexical decision in both groups and with oral reading in the LHSS group. Over half of the LHSS sample had frank deficits on at least one WtPM task. Comprehension deficits in individual LHSS were often modulated by input modality, word frequency, and regularity. Conclusions: We present a clinically accessible WtPM task that captures individual patterns of word comprehension impairment in both written and auditory modalities. The use of efficiency scores allows for the assessment of mild impairments that are missed by ceiling effects on currently available tasks. Input modality, frequency, and regularity affect word comprehension as measured by WtPM. Individual stroke survivors present with different combinations of these effects, which may help to identify specific deficits and spared abilities that can guide reading comprehension treatment. Supplemental Material: https://doi.org/10.23641/asha.33968839