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Predictive value of a senior comprehensive examination as to performance on a national certification examination.

OBJECTIVE: To determine what value a senior departmental comprehensive examination holds in predicting the future success of a student on the MT(ASCP) certification examination. DESIGN: Part 1: To evaluate the efficacy of the comprehensive examination, scores were obtained in the examination categories of hematology, clinical chemistry, immunohematology, and microbiology for all dinical laboratory science students who have graduated from the University of Mississippi Medical Center since 1993. The data were analyzed to determine if a correlation exists between student performance on the senior comprehensive, and their future performance on the MT(ASCP) national certification examination. Part 2: To determine the extent to which a senior comprehensive examination was required for graduation at other university-based clinical laboratory science programs, a simple survey was e-mailed to members of the clinical laboratory science educators forum. SETTING: 2+2 university-based dinical laboratory science program PARTICIPANTS: Part 1: Previous graduates of the Clinical Laboratory Science Program at the University of Mississippi Medical Center since 1993. Part 2: Program directors who are members of the Clinical Laboratory Sciences Educator's Forum. RESULTS: Part 1: Results indicated a distinct division between participants who scored higher than 74.36% (Group A) on the senior comprehensive examination, and those scoring below 74.36% (Group B). In Group A, 100% of participants passed the MT(ASCP) national certification examination on the first attempt. Results were mixed for Group B. Part 2: The survey indicated that of the 40 respondents, most were similar to the University of Mississippi Medical Center Clinical Laboratory Science Program in that they require a comprehensive to be taken, that the grade received is part of another course grade, and that the examination is prepared using questions submitted by the faculty. CONCLUSIONS: Part 1: The senior departmental comprehensive examination is of value in predicting the future success of a student on the MT(ASCP) national certification examination. Part 2: Unlike the University of Mississippi Medical Center, 16 of the 40 respondents stated that passage of the comprehensive examination was a requirement for graduation. In those programs, the comprehensive was a major part of a course grade.

Allergy and Immunology↗

The effect of graphic organizers on subjective and objective comprehension of a health education text.

This study examined the effect of graphic organizers on the comprehension of a health education brochure text and compared subjective with objective comprehension measures. Graphic organizers are graphical depictions of relations among concepts in a text. Participants read a brochure text about asthma with and without these organizers, and subjective and objective text comprehension was measured. It was found that graphic organizers had effects on four levels of objective comprehension as indicated by open comprehension questions. However, on the subjective comprehension measure using Likert-type scales, the groups with and without graphic organizers did not differ from each other. It is concluded that health education texts could benefit from relatively simple techniques to increase comprehension. Furthermore, in developing health education materials, comprehension should be measured objectively.

Adolescent↗

Reading comprehension and reading related abilities in adolescents with reading disabilities and attention-deficit/hyperactivity disorder.

Reading comprehension is a very complex task that requires different cognitive processes and reading abilities over the life span. There are fewer studies of reading comprehension relative to investigations of word reading abilities. Reading comprehension difficulties, however, have been identified in two common and frequently overlapping childhood disorders: reading disability (RD) and attention-deficit/hyperactivity disorder (ADHD). The nature of reading comprehension difficulties in these groups remains unclear. The performance of four groups of adolescents (RD, ADHD, comorbid ADHD and RD, and normal controls) was compared on reading comprehension tasks as well as on reading rate and accuracy tasks. Adolescents with RD showed difficulties across most reading tasks, although their comprehension scores were average. Adolescents with ADHD exhibited adequate single word reading abilities. Subtle difficulties were observed, however, on measures of text reading rate and accuracy as well as on silent reading comprehension, but scores remained in the average range. The comorbid group demonstrated similar difficulties to the RD group on word reading accuracy and on reading rate but experienced problems on only silent reading comprehension. Implications for reading interventions are outlined, as well as the clinical relevance for diagnosis.

Adolescent↗

Language comprehension in schizophrenia: trait or state indicator?

Language comprehension, measured by the Luria-Nebraska Relational Concepts Factor Scale, was evaluated twice in 15 male DSM-III-R schizophrenic patients during a controlled double-blind haloperidol maintenance (without anticholinergics) and placebo replacement protocol. Fifteen male normal controls were tested once. Patients and controls were matched on age and education. Language comprehension was significantly reduced in patients under both pharmacologic conditions, as compared with controls. Patients' comprehension accuracy did not differ significantly between neuroleptic-treatment and placebo replacement conditions. Patients' comprehension accuracy was independent of positive symptoms, anxiety-depression, measures of clinical course, and CSF and plasma monoamines. Comprehension accuracy was also not associated with patients' educational level or WAIS-R measures of their intellectual and short-term memory functioning. Patients' comprehension performance was significantly associated only with the negative symptom anhedonia-asociality during haloperidol maintenance. Thus, language comprehension in schizophrenic patients was independent of changes in pharmacologic treatment and the positive symptoms of psychosis. Results suggest language comprehension may represent a stable or trait characteristic in schizophrenia.

Adult↗

Comprehension of directly and indirectly stated main ideas and details in discourse by brain-damaged and non-brain-damaged listeners.

Aphasic, right-hemisphere-damaged, and non-brain-damaged subjects heard short narrative paragraphs. Each paragraph contained four main ideas and one or more details related to each main idea. After each paragraph was presented, subjects' comprehension and retention of main ideas and details from the paragraph were tested. Some of the test items directly restated information from paragraphs and others paraphrased information from paragraphs. All groups of subjects remembered main ideas better than they remembered details, and no group of subjects was significantly affected by whether test items directly or indirectly stated information from paragraphs. Disfluent aphasic and right-hemisphere-damaged subjects' overall paragraphs comprehension scores were not significantly poorer than those of non-brain-damaged subjects. Fluent and mixed aphasic subjects' overall paragraph comprehension scores were significantly worse than those of non-brain-damaged and right-hemisphere-damaged subjects. Token Test and Boston Diagnostic Aphasia Examination auditory comprehension scores did not predict aphasic subjects' paragraph comprehension scores. right-hemisphere-damaged subjects' overall paragraph comprehension scores were not significantly those of non-brain-damaged and right-hemisphere-damaged subjects. Token Test and Boston Diagnostic Aphasia Examination auditory comprehension scores did not predict aphasic subjects' paragraph comprehension scores.

Aphasia↗

Reading comprehension and understanding idiomatic expressions: a developmental study.

The aim of the present study was to investigate idiom comprehension in school-age Italian children with different reading comprehension skills. According to our hypothesis, the level of a child's text comprehension skills should predict his/her ability to understand idiomatic meanings. Idiom comprehension in fact requires children to go beyond a simple word-by-word comprehension strategy and to integrate figurative meaning into contextual information. In a preliminary phase, we used a standardized battery of tests (Cornoldi & Colpo, 1998) to assess the ability of second graders and fourth graders to comprehend written texts. Three groups were identified at each age level: good, medium, and poor comprehenders. Children were then presented with familiar idiomatic expressions which also have a literal meaning (e.g., "break the ice"). Idioms were embedded in short stories: in Experiment 1 only the idiomatic interpretation was contextually appropriate, in Experiment 2 a literal reading of the string was also plausible in the context. A multiple-choice task was used in both experiments: children were asked to choose one answer among three corresponding to: (a) the idiomatic meaning; (b) the literal meaning; and (c) an interpretation contextually appropriate but not connected with the idiomatic or literal meaning of the idiom string. The results of both experiments showed that the ability to understand a text indeed predicted children's understanding of idioms in context. To verify whether possible improvements in children's comprehension skills might produce an increase in figurative language understanding, Experiment 3 was carried out. A group of poor comprehenders who participated in Experiments 1 and 2 was tested eight months later. The results of Experiment 3 showed that children whose general comprehension skills improved their performance on an idiom comprehension test.

Child↗

The roles of sequencing and verbal working memory in sentence comprehension deficits in Parkinson's disease.

Studies of sentence comprehension deficits in Parkinson's disease (PD) patients suggest that language processing involves circuits connecting subcortical and cortical regions. Anatomically segregated neural circuits appear to support different cognitive and motor functions. To investigate which functions are implicated in PD comprehension deficits, we tested comprehension, verbal working memory span, and cognitive set-switching in a non-linguistic task in 41 PD patients; we also obtained speech measurements reflecting motor sequencing processes that may be involved in articulatory rehearsal within working memory. Comprehension of sentences with center-embedded or final relative clauses was impaired when they could not be understood from lexical semantic content alone. Overall comprehension error rates correlated strongly with impaired set-switching and significantly with reduced working memory span and speech motor sequencing deficits. Correlations with comprehension of different sentence structures indicate that these impairments do not represent a single deficit; rather, PD comprehension deficits appear to arise from several independent mechanisms. Deficits in cognitive set-switching or underlying inhibitory processes may compromise the ability to process relative clauses. Deficits in verbal working memory appear to impair comprehension of long-distance dependencies. Speech sequencing correlated with neither set-switching nor verbal working memory span, consistent with their being supported by independent, segregated cortico-subcortical circuits.

Aged↗

Comprehension of idioms in adolescents with language-based learning disabilities compared to their typically developing peers.

UNLABELLED: Adolescents with language-based learning disabilities (LBLD) often interpret idioms literally. When idioms are provided in an enriched context, comprehension is compromised further because of the LBLD student's inability to assign multiple meanings to words, assemble and integrate information, and go beyond a local referent to derive a global, coherent meaning. This study tested the effects of context and familiarity on comprehension of 24 idioms in 22 adolescents with LBLD. The students completed the Idiom Comprehension Test (ICT) [Language, Speech, and Hearing Services in Schools 30 (1999) 141; LSHSS 34 (2003) 69] in one of two conditions: in a story or during a verification task. Within each condition were three familiarity levels: high, moderate, and low. The LBLD adolescents' data were then compared to previously collected data from 21 age-, gender-, and reading ability-matched typically developing (TD) peers. The relations between reading and language literacy and idiom comprehension were also examined in the LBLD adolescents. Results showed that: (a) the LBLD adolescents generally performed poorly relative to their TD counterparts; however, the groups performed comparably on the high and moderate familiarity idioms in the verification condition; (b) the LBLD adolescents performed significantly better in the verification condition than in the story condition; and (c) reading ability was associated with comprehension of the low familiarity idioms in the story condition only. Findings are discussed relative to implications for speech-language pathologists (SLPs) and educators working with adolescents with LBLD. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe the importance of metalinguistic maturity for comprehension of idioms and other figures of speech; (2) understand the roles of context and familiarity when assessing idiom comprehension in adolescents with LBLD; and (3) critically evaluate assessments of idiom comprehension and determine their appropriateness for use with adolescents with LBLD.

Adolescent↗

Symmetries and asymmetries in early lexical comprehension and production.

Six children were visited in their homes every two weeks for 18 months from the age of six months in order to observe their developing comprehension and production of words. Controlled testing of the children's developing vocabulary was also carried out to provide a more detailed picture of the precise context in which a word was understood or produced. The results showed both similarities and individual differences among the children in patterns of early comprehension. For all six children there was a very close relationship between early production and comprehension of words: words that were contextually flexible in production tended also to be so in comprehension and words that were context-bound also tended to be so in both modalities although there was some evidence that the two types of word differed in the extent to which comprehension preceded production. All children were also similar in showing evidence of contextually flexible comprehension very early on. However, there were individual differences both in the rate at which comprehension developed and in the lag between comprehension and production. The significance of this pattern of development for accounts of lexical development is explored.

Child Language↗

One frog, two frog, red frog, blue frog: factors affecting children's syntactic choices in production and comprehension.

Two experiments are reported which examine children's ability to use referential context when making syntactic choices in language production and comprehension. In a recent on-line study of auditory comprehension, Trueswell, Sekerina, Hill, and Logrip (1999) examined children's and adults' abilities to resolve temporary syntactic ambiguities involving prepositional phrases (e.g., "Put the frog on the napkin into..."). Although adults and older children used the referential context to guide their initial analysis (pursuing a destination interpretation in a one-frog context and a modifier interpretation in a two-frog context), 4 to 5-year olds' initial and ultimate analysis was one of destination, regardless of context. The present studies examined whether these differences were attributable to the comprehension process itself or to other sources, such as possible differences in how children perceive the scene and referential situation. In both experiments, children were given a language generation task designed to elicit and test children's ability to refer to a member of a set through restrictive modification. This task was immediately followed by the "put" comprehension task. The findings showed that, in response to a question about a member of a set (e.g., "Which frog went to Mrs. Squid's house?"), 4- to 5-year-olds frequently produced a definite NP with a restrictive prepositional modifier (e.g., "The one on the napkin"). These same children, however, continued to misanalyze put instructions, showing a strong avoidance of restrictive modification during comprehension. Experiment 2 showed that an increase in the salience of the platforms that distinguished the two referents increased overall performance, but still showed the strong asymmetry between production and comprehension. Eye movements were also recorded in Experiment 2, revealing on-line parsing patterns similar to Trueswell et al.: an initial preference for a destination analysis and a failure to revise early referential commitments. These experiments indicate that child-adult differences in parsing preferences arise, in part, from developmental changes in the comprehension process itself and not from a general insensitivity to referential properties of the scene. The findings are consistent with a probabilistic model for uncovering the structure of the input during comprehension, in which more reliable linguistic and discourse-related cues are learned first, followed by a gradually developing ability to take into account other more uncertain (or more difficult to learn) cues to structure.

Child↗

Listener comprehension of severely dysarthric speech: effects of linguistic cues and stimulus cohesion.

This study is the second in a two-part series examining the effects of linguistic variables on listener processing of dysarthric speech. The first study (see K. C. Hustad & D. R. Beukelman, 2001) examined the effects of experimentally imposed topic cues, alphabet cues, and combined cues along with a control condition in which no cues were provided on intelligibility of unrelated and related sentences produced by 4 women with severe dysorthria secondary to cerebral palsy. The present study examined the effects of these same variables on listener comprehension of severely dysarthric speech produced by the same speakers. In addition, the relationship between intelligibility and comprehension was examined for each cue and stimulus cohesion condition. Consistent with intelligibility results, the present study found that combined cues resulted in higher comprehension scores than any other cue condition and that no cues resulted in lower comprehension scores than any other cue condition for both related and unrelated sentences. In addition, comprehension scores were higher for alphabet cues than for topic cues in the related-sentences condition. Findings dissimilar from intelligibility results were as follows: (a) comprehension scores associated with alphabet and topic cues did not differ for unrelated sentences, and (b) comprehension scores were higher for related than for unrelated sentences in each cue condition. Finally, significant positive relationships between intelligibility and comprehension data were found only for topic cues in the unrelated-sentences condition and for alphabet cues in the related-sentences condition.

Adult↗

Predicting longitudinal change in language production and comprehension in individuals with Down syndrome: hierarchical linear modeling.

Longitudinal change in syntax comprehension and production skill, measured four times across a 6-year period, was modeled in 31 individuals with Down syndrome who were between the ages of 5 and 20 years at the start of the study. Hierarchical Linear Modeling was used to fit individual linear growth curves to the measures of syntax comprehension (TACL-R) and mean length of spontaneous utterances obtained in 12-min narrative tasks (MLU-S), yielding two parameters for each participant's comprehension and production: performance at study start and growth trajectory. Predictor variables were obtained by fitting linear growth curves to each individual's concurrent measures of nonverbal visual cognition (Pattern Analysis subtest of the Stanford-Binet), visual short-term memory (Bead Memory subtest), and auditory short-term memory (digit span), yielding two individual predictor parameters for each measure: performance at study start and growth trajectory. Chronological age at study start (grand-mean centered), sex, and hearing status were also taken as predictors. The best-fitting HLM model of the comprehension parameters uses age at study start, visual short-term memory, and auditory short-term memory as predictors of initial status and age at study start as a predictor of growth trajectory. The model accounted for 90% of the variance in intercept parameters, 79% of the variance in slope parameters, and 24% of the variance at level 1. The some predictors were significant predictors of initial status in the best model for production, with no measures predicting slope. The model accounted for 81% of the intercept variance and 43% of the level 1 variance. When comprehension parameters are added to the predictor set, the best model, accounting for 94% of the intercept and 22% of the slope variance, uses only comprehension at study start as a predictor of initial status and comprehension slope as a predictor of production slope. These results reflect the fact that expressive language acquisition continues in adolescence and is predicted by syntax comprehension and its growth trajectory.

Adolescent↗

Variability in comprehension strategy use in children with SLI: a dynamical systems account.

The aim was to investigate the stability of comprehension strategy use in children with specific language impairment (SLI). According to principles of Dynamic Systems Theory, behaviour is both unstable and more easily affected by changes in external variables during developmental transitions. The study examined this prediction directly by comparing the comprehension strategy use of children with SLI in two different conditions. The subjects included 16 school-aged children with SLI (ages 6;8-8;5), and eight chronologically age-matched (CA) controls. One group of children with SLI (n = 8) was in a development transition between animacy and word-order comprehension strategy use, demonstrating the emerging use of word-order sentence comprehension strategies (SLI-T). The second group of children with SLI (n = 8) was not in a developmental transition (SLI-N), demonstrating the use of only animacy comprehension strategies characteristic of younger typically developing children. Children were asked to determine the agent in 54 sentences of the forms (NVN, NNV, VNN) with animacy of the noun as a second factor in each of two different conditions designed to vary external processing demands. Analysis of variance and maximum likelihood estimate analysis revealed that comprehension strategies for both groups of children with SLI differed qualitatively from CA controls. In particular, the findings revealed that comprehension strategy use in children with SLI was highly vulnerable to increases in external processing demands as compared with CA controls, suggesting that comprehension strategies in children with SLI are weakly represented regardless of the strategy they use. Findings from the study also illustrate the impact of intrinsic as well as extrinsic contextual factors on the stability and instability of language processing performance in children with SLI.

Case-Control Studies↗

Maternal comprehension of two growth monitoring charts in Sri Lanka.

OBJECTIVE: To investigate the maternal comprehension of two different growth charts and to identify the group of mothers with poor comprehension. DESIGN: An experimental prospective study. SETTING: A child welfare clinic at the De Soysa Hospital for Women, Colombo, Sri Lanka. SUBJECTS: 932 mothers were studied regarding their interpretation of the type of growth chart their infants had been allocated. A total of 413 mothers interpreted the 'road-to-health' chart and 519 mothers interpreted the revised chart. A validated scoring system was used to assess comprehension. The two groups of mothers were comparable. RESULTS: 62.4% (324) mothers who interpreted the revised chart had good comprehension. Only 20.6% (85) mothers had similar comprehension with the road-to-health chart. Education up to or beyond grade 8 in school significantly improved comprehension. CONCLUSION: The design of the growth chart has a powerful effect on maternal comprehension of growth patterns. Length of schooling rather than literacy alone is a marker of a comprehending mother. The policy implications of these findings are that governments and agencies may need to redesign parent held growth charts to achieve better comprehension by mothers.

Anthropometry↗

Profiles of children with specific reading comprehension difficulties.

BACKGROUND: Children with fluent and accurate word reading in the presence of poor text comprehension are impaired on a wide range of reading-related tasks. AIMS: This study investigated the consistency of skill impairment in a sample of poor comprehenders to identify any fundamental skill weakness that (i) might be associated with poor text comprehension, and (ii) might lead to depressed reading development. An additional aim was to determine whether reading comprehension difficulties are associated with more general educational difficulties. SAMPLE: Twenty-three poor comprehenders and 23 good comprehenders with age-appropriate word reading accuracy were assessed when aged 8 years. Concurrent reading and language performance and reading, educational attainment and reasoning skills 3 years later are reported. METHODS: The following skills were assessed when aged 8 years: word reading, text comprehension, vocabulary, syntax, cognitive ability, working memory, comprehension subskills. Listening comprehension, SAT scores and reasoning scores at 11 years are also reported. RESULTS: There was no evidence for any fundamental skill weaknesses in the population of poor comprehenders at Time 1. However, poor vocabulary skills led to impaired growth in word reading ability and poor general cognitive ability led to impaired growth in comprehension. Poor comprehenders obtained lower SAT scores than did the good comprehenders at 11 years. CONCLUSIONS: These findings indicate that a single underlying source of poor comprehension is unlikely. Poor comprehenders are at risk of generally poor educational attainment, although weak verbal or cognitive skills appear to affect the reading development of poor comprehenders in different ways.

Achievement↗

Comparison of comprehensive and limited metabolic evaluations in the treatment of patients with recurrent calcium urolithiasis.

PURPOSE: We compared diagnostic information from limited and comprehensive metabolic evaluations of recurrent calcium stone formers. MATERIALS AND METHODS: A total of 74 men and 45 women with recurrent calcium stones underwent comprehensive metabolic evaluation. The number of specific and total metabolic abnormalities diagnosed on 1 or 2 random 24-hour urinalyses were compared to those obtained on a comprehensive metabolic evaluation. We also examined the ability of the comprehensive evaluation to detect dietary calcium sensitive oxaluria. RESULTS: The comprehensive metabolic evaluation yielded a specific metabolic diagnosis in 90% of the patients compared to 68% for 1 and 75% for 2 urinalyses. Average total number of specific metabolic abnormalities for each patient was approximately 50% higher on a comprehensive metabolic evaluation compared to 1 urinalysis (1.59 +/- 0.08 versus 0.94 +/- 0.07, p <0.05). Hypercalciuria, hyperoxaluria and hypocitruria were diagnosed significantly more often by the comprehensive than by the limited evaluation. Type II absorptive hypercalciuria was the most common pattern of hypercalciuria, and dietary calcium sensitive oxaluria was present in 22% of the patients. CONCLUSIONS: Comprehensive metabolic evaluation yields significantly more useful diagnostic information and allows implementation of a more specific therapeutic plan than limited metabolic evaluation for the recurrent calcium stone former.

Calcium↗

Review of state Comprehensive Cancer Control plans for genomics content.

INTRODUCTION: The goals of this study were to determine U.S. states with Comprehensive Cancer Control plans that include genomics in some capacity and to review successes with and barriers to implementation of genomics-related cancer control initiatives. METHODS: This study was conducted in two phases. Phase one included a content analysis of written state Comprehensive Cancer Control plans (n = 30) for terms related to genomics, or "genomic components" (n = 18). The second phase involved telephone interviews with the Comprehensive Cancer Control plan coordinators in states with plans that contained genomic components (n = 16). The interview was designed to gather more detailed information about the genomics-related initiatives within the state's Comprehensive Cancer Control plan and the successes with and barriers to plan implementation, as defined by each state. RESULTS: Eighteen of the 30 Comprehensive Cancer Control plans analyzed contained genomics components. We noted a large variability among these 18 plans in the types of genomics components included. Nine (56%) of the 16 states interviewed had begun to implement the genomics components in their plan. Most states emphasized educating health care providers and the public about the role of genomics in cancer control. Many states consider awareness of family history to be an important aspect of their Comprehensive Cancer Control plan. Approximately 67% of states with family history components in their plans had begun to implement these goals. Virtually all states reported they would benefit from additional training in cancer genetics and general public health genomics. CONCLUSION: The number of states incorporating genomics into their Comprehensive Cancer Control plans is increasing. Family history is a public health application of genomics that could be implemented more fully into Comprehensive Cancer Control plans.

Genomics↗

Comprehension of skin cancer genetic risk feedback in primary care patients.

Few studies have examined comprehension and miscomprehension of genetic risk feedback for moderate-risk genes in the general population. We examined the prevalence and nature of accurate and inaccurate genetic risk feedback comprehension among those who received genetic testing for melanocortin-1-receptor (MC1R) gene variants that confer moderate melanoma risk. Participants (N&#x2009;=&#x2009;145 Albuquerque, NM) were tested as part of a randomized controlled trial. Two weeks after receiving MC1R genetic risk feedback, participants answered open-ended questions regarding their reactions to the MC1R feedback report. Participants' comprehension of their feedback (average-risk or higher-risk for melanoma) was evaluated through qualitative analysis of open-ended responses. Most participants demonstrated comprehension of their feedback results (i.e., 63% of average-risk participants [ARPs]; 51% of higher-risk participants [HRPs]). Miscomprehension was evident in fewer participants (i.e., 16% of ARPs, 11% of HRPs). A few ARPs misunderstood the purpose of testing, whereas a few HRPs reported confusion about the meaning of their risk feedback. Some participants' responses to the open-ended questions were too ambiguous to ascertain comprehension or miscomprehension (i.e., 21% of ARPs, 38% of HRPs). Taken together, these findings suggest that genetic testing feedback for MC1R risk variants is largely comprehensible to general population participants. This study adds to the work examining comprehension and usage of common, moderate risk genetic information in public health contexts. However, to maximize the utility of genetic risk information in the general population, further research is needed to investigate and address areas where common genetic risk feedback misunderstandings occur.

Genetic testing↗