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Reading Behavior After Brain Injury

Restoring reading requires treating both cognition and behavior.

Source: LubosHouska/Pixabay

After brain injury, neurorehabilitation assesses reading cognition: Can you identify letters? Words? Can you comprehend sentences, paragraphs, stories? They show little interest in pre-injury reading behavior.

In my quest to regain my reading comprehension, I, too, focused on cognition. Until recently, I hadn’t considered that cognition and behavior are two separate aspects of reading needing treatment, even though I’d identified reading as my primary stress-management skill and had brought up again and again that, as a writer, I needed to read novels.

The Lindamood-Bell method of visualizing and verbalizing restored my reading comprehension, but my reading behavior restoration has been ad hoc. Most clinicians didn’t recognize the latter’s effect on me as a writer.

Journalist Phil Rosen noted that “I felt the impact of [not reading fiction novels for six months during studies] on my writing — less thought to eloquence, more tersity and a greater emphasis on delivering news rather than crafting narrative.”

In looking for research on the impact of reading behavior on writing, I found almost nothing on adult writers; none on adults with brain injury. However, research on primary students provides insight. When University of Florida associate professor Yellowlees Douglas and graduate student Samantha Miller discovered strong correlations between the complexity of graduate students’ reading and their writing, Douglas said: "You’d think someone would have studied these effects in adults long ago, but we were astonished to discover no one had.”

Karunaratne and Navaratne in 2021 published a study on reading habits’ effect on writing skills for 15 girls and 15 boys in grade 3 and reoprted: “As per the outputs of the questionnaires the students who maintain a considerable level of reading have ended up with satisfactory levels of [writing skills] assessment by their teachers. And the students who do not have good reading habits had fallen into unsatisfactory level assessment by their class teachers.” They studied time spent reading, reading materials and types, use of the library, and personal attitude toward reading. This last had the greatest influence on reading: Those who showed the greatest interest or most positive attitude towards reading, read more.

Prior to my brain injury, I restricted myself to three mass paperback novels per week, borrowed from the library, carried them everywhere. I read more slowly a literary novel. I read a newspaper daily and a couple on weekends; e-newsletters and magazines daily; a non-fiction book and/or research materials for my writing and business most days. As a primary school student, I read cereal boxes in English and French because the library and family budget couldn’t keep up with the amount of reading I could do. My reading behavior reflected a great interest or positive attitude toward reading. It was my identity.

During brain biofeedback, in which brainwaves, heart rate, respiratory rate, heart rate variability, and skin temperature are measured in real time, I showed a consistent relaxation effect across all parameters while reading.

In the 2021 study, researchers gave the students’ teachers questionnaires to evaluate their writing skill. They noted that creativity and generating ideas had the “highest weightage” on writing skill:

According to the teacher’s evaluation, the students who have a high level of reading can generate more ideas and are more creative in their writing tasks. They have a high level of interest in different types of writing tasks, such as book reviews, essay writing, and story writing. It can be identified that reading different types of books in different genres also helps them to improve creativity and writing and generate new ideas.

This finding dovetails with Rosen’s own self-assessment that his writing became less creative when he eschewed novel reading. He is not the first nor only writer to say that “Good writing requires good reading. The best writers are consummate, dedicated readers.” Horror writer Stephen King is famous for saying his advice to writers is to read, read, read. Children’s book author Madeleine L’Engle peppers her writer's memoir A Circle of Quiet with quotations from a wide variety of authors and books.

My reading habit post-brain injury degenerated to nothing. Because it took my clinicians 18 years to discover Lindamood-Bell’s reading comprehension therapy, I lost my primary stress reliever. Although I read blogs and social media, broadcast news replaced the newspapers, and movies and television replaced books. The latter replaced reading as my go-to stress reliever. I, in essence, became a negative-habit reader.

Practicing my reading comprehension since late 2018, with accountability support from my neurodoc, eventually restored my comfort level with genre fiction reading. However, it hasn’t reverted my primary stress reliever back to novels. That'd require reading behavior treatment.

Douglas and Miller's 2016 study provided insight into reading's impact on mature students’ writing:

“The amount of time spent reading for adult writers may prove less influential than patterns of reading over longer periods of time, as adults have left behind the developmental stages where frequency of practice in reading can exert strong influences on writing, via either the acquisition of syntactic knowledge or of domain-based knowledge.”

After receiving reading comprehension treatment, a person re-enters the development stage in which frequency of reading practice influences writing. But as reading cognition returns to the mature level, switching the focus of reading behavior treatment from daily practice to reading wider and more complex materials becomes critical for the writer:

Students who read academic journals, “literary” fiction, or general non-fiction wrote with greater syntactic sophistication than students who read genre fiction (mysteries, fantasy, or science fiction) or exclusively web-based content aggregators like Reddit, Tumblr, and BuzzFeed.

When restoring reading to writers or voracious readers with brain injury, rehabilitation must not only include treating cognitions like comprehension, concentration, and memory, but also include a behavioral program that starts with daily practice then broadens to a wide variety of harder materials. Delaying treatment turns temporary injury of reading behavior into permanent damage. Delay destroys a person’s identity as a reader.

Copyright ©2024 Shireen Anne Jeejeebhoy


Karunaratne, Sunethra, & Navaratne, Hasanthi. (2023). The Impact of the Reading Habit on the Writing Skills of Primary Students. Studies in Linguistics and Literature. 7. p15. 10.22158/sll.v7n4p15.

Simamora, Devina Wildasari , Mandiri, Bina Insan, & Sulistianingsih Sulistianingsih. Prosiding Seminar Nasional Pendidikan STKIP Kusuma Negara 2022-01-28 ISSN 2716-0157 (Online)

Yellowlees Douglas, & Samantha Miller. (2016) Syntactic Complexity of Reading Content Directly Impacts Complexity of Mature Students’ Writing International Journal of Business Administration Vol. 7, No. 3.

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