Individuals with severe traumatic brain injury (TBI) often have reading challenges. They maintain or reestablish basic decoding and word recognition skills following injury, but problems with reading comprehension often persist. Practitioners have the potential to accommodate struggling readers by changing the presentational mode of text in a variety of ways. Text-to-speech (TTS) is one way in which electronic text can be manipulated. Researchers have studied the effect of TTS in conjunction with silent reading for individuals with learning disabilities, specific reading disabilities, attention deficit disorder, and emotional behavioral disorders. However, limited research to date has addressed reading patterns and accommodations for individuals with similar cognitive impairments resulting from TBI. The purpose of this study was to investigate the rate in words per minute (WPM) at which neurotypical readers read as compared to individuals with TBI. Second, I sought to compare comprehension rate and accuracy for factual and inferential information in three contexts: (a) reading only (RO), (b) reading while listening to TTS (RL), and (c) listening only to TTS (LO). I calculated a WPM average for each experimental passage and used a paired samples t-test to determine if a significant difference existed between reading rates of participants with TBI and neurotypical readers. I employed a 3 X 2 repeated measure ANOVA across reading contexts and question type (factual versus inferential). Planned pairwise comparisons allowed determination of significant differences between modalities of listening and reading. The four major findings were: (a) individuals with TBI read significantly slower than neurotypical readers, (b) readers with TBI demonstrated significantly better performance when answering factual comprehension questions than inferential comprehension questions, (c) reading comprehension did not significantly differ across the three contexts of RO, LO, or RL, and (d) analysis of individual performance patterns revealed some participants benefitted from TTS support despite heterogeneity across participants. The clinical implication of this study is that practitioners should evaluate performances across accommodations before applying a blanket approach for reading comprehension. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]