Attentive Reading and Constrained Summarization (ARCS) is designed for people who have problems with word-finding, topic maintenance, or other cognitive-linguistic skills at the level of discourse. “Discourse” refers to verbal or written communication beyond the sentence level.
Free DIRECT download: ARCS tutorial (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- What is Attentive Reading and Constrained Summarization (ARCS)?
- Two ways to do ARCS from the literature.
- How ARCS was adapted for writing.
- Who is a candidate for ARCS?
- How to find and print readable passages.
- How I’m trying ARCS in my practice.
- Try ARCS or ARCS-W and share your tips!
- Related Eat, Speak, & Think posts.
- References.
What is Attentive Reading and Constrained Summarization (ARCS)?
Attentive Reading and Constrained Summarization (ARCS) is a discourse-level treatment that taps into both cognitive and linguistic skills. In order to be successful, our patient has to:
- Pay attention as they read or listen to an passage.
- Remember the main ideas and key words.
- Verbally summarize the material while using specific words and staying on topic.
I learned about ARCS from Lisa Edmonds’ presentation “Word Retrieval Training with Nouns and Verbs: Treatment for Facilitating Generalization”, which is part of ASHA’s eWorkshop “Aphasia Treatment: Maximizing Functional Outcomes” (WEB18016).
They’ve also adapted ARCS to include written discourse, and it’s known as Attentive Reading with Constrained Summarization – Writing or ARCS-W.
Check out the reference section to find two studies on ARCS and two on ARCS-W. I’ve summarized the therapy procedures for each paper below.
Two ways to do ARCS from the literature
ARCS procedure from Rogalski and Edmonds (2008)
Treatment sessions were an hour, once a week for 17 weeks. They used brief news articles from The Week Magazine. In this protocol, we’d ask our patient to:
- Read aloud 2-3 sentences with the intent to summarize the information. Clinician corrects reading errors.
- Re-read silently for comprehension, if necessary.
- Summarize the information while following the constraints (see below). Clinician prompts patient as needed.
We’d repeat these steps until we’ve worked our way through the passage or article.
Constraints:
- Summarize only what is written.
- No non-informational or general words, like “thing” or “stuff.”
- No pronouns.
Enhanced ARCS procedure from Rogalski et al. (2013)
Participants received 18 session, approximately 2 per week for 10 weeks, each 50 minutes long. They used LiteracyNet.org‘s collection of abridged news articles. The articles had a mean word count of 213.25 words and were written at a mean grade level of 5.81.
In this protocol, our patient would:
- Read the entire passage aloud. Clinician corrects reading errors.
- Re-read the first sentence aloud with intent to summarize. Clinician corrects reading errors.
- Silently re-read the sentence for comprehension, if necessary.
- Summarize the information aloud, following the constraints (see below). Clinician prompts patient as needed.
- Re-read the sentence aloud. Repeat 1 – 5 for the entire passage.
- Summarize the entire passage aloud from memory.
Constraints:
- No pronouns.
- Don’t use non-specific words (thing, stuff).
- No opinions or unrelated words.
How ARCS was adapted for writing
Obermeyer and Edmonds (2018)
Treatment sessions were 1.5 hours long, twice a week for 12 weeks. They used news articles from Newsela.com written at 6th grade level. Articles were an average of 200 words for two participants, and 100 words for the third participant.
Under this protocol, our patient would:
- Listen as clinician reads the entire article aloud.
- Read 1 – 3 sentences silently, twice for comprehension.
- Write down key words.
- Compare key words to clinician’s list of key words and create a final list.
- Verbally summarize the content using the key word list and following the constraints (see below).
- Produce written summary, read it aloud, and check for errors.
Repeat these steps through the entire article.
Then our patient would:
- Reread or listen to the entire article.
- Produce a summary of the entire article verbally, without using key word list.
- Write a summary of the article, without using key word list.
- Rate the completeness of their written summary on a scale from 1 to 5.
Constraints:
- Use specific words (no pronouns or other nonspecific words).
- Stay on topic.
- Optional personalized constraint, as needed to limit behavior that’s distracting from the task.
Modified ARCS-W from Obermeyer et al. (2019)
Treatment sessions were 1.5 hours long for 24 sessions at the frequency of 2-3 per week. They used articles from Newsela.com written at the 6th grade reading level.
Following this protocol, our patient would:
- Silently read the text as the clinician reads the entire article aloud.
- Read 1 – 3 sentences twice for comprehension.
- Write down key words.
- Compare list with the clinician’s list and create a final list.
- Use the key word list to plan a verbal summary.
- Verbally summarize the section from memory, following the constraints (see below). Clinician provides feedback regarding constraints and content.
- Use the key word list to plan a written summary.
- Write a summary of the section from memory.
- Read the summary aloud and check for accuracy. Clinician provides feedback regarding constraints and including key word content.
We would repeat these steps until we’ve worked our way through the article. Then our patient would:
- Read the entire article.
- Summarize the article verbally and in writing from memory. Clinician provides feedback.
Constraints:
- Don’t use nonspecific words (pronouns, “thing”, “stuff”, etc).
- Stay on topic.
- Use complete sentences.
Who is a candidate for ARCS or ARCS-W?
We can consider ARCS or ARCS-W for someone who can talk beyond the sentence level and can read at least basic paragraphs, but who has difficulty with any of the following:
- Attention.
- Word-finding.
- Uninformative or empty speech (pronouns, non-specific words, paraphasias).
- Maintaining the topic of conversation.
- Reading comprehension and retention.
- Auditory comprehension and retention
- Writing.
How to find and print readable passages
Two useful online tools
The Readability Test Tool is a free online tool that allows you to calculate readability scores and and other statistics about the text. Simply enter the URL and you’ll receive a variety of readability indices including the Flesh Kincaid Grade Level and the Flesch Kincaid Reading Ease. You’ll also see stats such as:
- # of words and sentences
- Average words per sentence
- Average syllables per word.
PrintFriendly is a free online tool that allows you to easily turn just about any page into readable text, which you can then print or save as a PDF.
8 places to find reading material online
Using a patient’s own reading material for therapy is ideal, but I often find that the material is too far above their ability or doesn’t work for a variety of reasons (especially at the beginning). I like to have at least a couple of articles on hand, in case I need it.
I generally look for interesting, non-controversial passages or short articles that are written between a Grade 4 to Grade 7 level.
CommonLit offers a wide variety of fiction and non-fiction texts, from Grade 3 – 12. The site also offers many texts in Spanish. Although geared for schools, SLPs who work with adults can sign up for free accounts. Without an account, you can access the reading material and parent guides online and also download PDFs. With an account, you also have access to narration, comprehension questions, media, and teacher guides.
LiteracyNet.org offers news stories, abridged versions, and story outlines. Most stories also include video and audio versions as well as online comprehension activities. The site is a partnership between the CNN San Francisco bureau and Literacyworks. While it’s no longer being updated, there’s a long list of general interest stories available.
Newsela.com is an excellent source of reading passages. Each article is published at five reading levels. SLPs who are not school-based can sign up for a free account, which allows access news articles. Sign up as a “teacher” and use your work email and organization details to add your “school” to their database. (Per email communication with a customer service rep at Newsela on 7/9/2020.)
PBS NewsHour Extra offers articles and videos geared for grades 6 through 12.
Science News for Students offers news stories (350 – 800 words) and features (1,500 – 2,400 words) on a variety of science topics.
TalkPath News by Lingraphica offers short news articles with narration via their free iOS or Android app or via their website. You or your patient would have to create a free account in order to access the text.
The Week Magazine offers short and longer news articles. This is where Rogalski & Edmonds (2008) obtained their reading material.
TweenTribune is a Smithsonian site offering interesting passages from Grade K – 12, and each article is offered at four different reading levels. The site also has articles written in Spanish.
How I’m trying ARCS in my practice
I was excited to listen to Dr. Edmond’s talk as it gave me a concrete way to expand my existing treatment method. I’ve used a similar method for years, for reading or listening at the paragraph level, and it’s been helpful for my patients. But I immediately saw how changing my method would likely improve outcomes for at least some of my patients.
I started using ARCS with three of my patients two weeks ago with some changes to my old practice, including:
- Writing out the “rules” for summarizing.
- Asking my patient to identify the key words and discussing them.
- Using short articles instead of single paragraphs.
- Asking my patients to practice summarizing for a home exercise program.
Try ARCS or ARCS-W and share your tips!
I’m really liking using ARCS with my patients, but I find that I’m making adjustments to how I do it to suit my patients’ particular challenges. I’d love to hear about how you use ARCS or ARCS-W. Please leave a comment below.
Related Eat, Speak, & Think posts
- My patient improved conversation with ARCS.
- Free multimedia resources for the SLP.
- Collaborative goal setting to identify meaning cognitive goals.
- Improve aphasia outcomes by creating intensive home exercise programs.
References
- Obermeyer, J. A., & Edmonds, L. A. (2018). Attentive Reading with Constrained Summarization adapted to address written discourse in people with mild aphasia. American Journal of Speech-Language Pathology (27), 392-405. https://doi.org/10.1044/2017_AJSLP-16-0200
- Obermeyer, J. A., Rogalski, Y., & Edmonds, L. A. (2019). Attentive Reading with Constrained Summarization – Written, a multi-modality discourse-level treatment for mild aphasia. Aphasiology. https://doi.org/10.1080/02687038.2019.1686743
- Rogalski, Y., & Edmonds, L. A. (2008). Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study. Aphasiology, 22(7), 763-775. https://doi.org/10.1080/02687030701803796
- Rogalski, Y., Edmonds, L. A., Daly, V. R., & Gardner, M. J. (2013). Attentive Reading and Constrained Summarisation (ARCS) discourse treatment for chronic Wernicke’s aphasia. Aphasiology. https://www.tandfonline.com/doi/abs/10.1080/02687038.2013.810327
Free DIRECT download: ARCS tutorial (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
I found this article very helpful, thank you! I enjoy using this with clients who require more of a challenge. Can you suggest ways to approach goal writing when you know you will be utilizing this technique? I have found it difficult in the past to accurately reflect/quantify what is being targeted.
That’s a great question! I use ARCS to target different skills, for example: reading comprehension and retention, auditory short term memory (they only listen to the material), word finding, and pragmatics (staying on topic and being concise).
I try to write my goals based on the real-world outcome we’re trying to achieve. For example:
(1) Patient will demonstrate ability to recall at least 5 specific details from information he has recently heard with 80% accuracy independently across three sessions to improve auditory short term memory for daily interactions by 5/7/2022.
(2) Patient will demonstrate the ability to use word finding strategies independently to convey intended meaning in 80% of opportunities while retelling a story to improve verbal expression and decrease frustration by 5/7/2022.
I hope that’s helpful!
Lisa