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Presentation and reading level of sleep brochures: are they appropriate for sleep disorders patients?

OBJECTIVE: Sleep-disorders patients must be given information and health education they understand. The purpose of this study was twofold: (1) to assess suitability of American Sleep Disorders Association and National Sleep Foundation patient education brochures; and (2) to assess one widely used brochure, using patient input and patient literacy level, as a model for development of future materials. DESIGN: Twelve American Sleep Disorders Association and National Sleep Foundation brochures were assessed for reading level using Grammatik, and for design, presentation, and motivating qualities using the Suitability Assessment of Materials (SAM). Patient literacy level was assessed using the Rapid Estimate Of Adult Literacy in Medicine (REALM). SETTING: The Louisiana State University Medical Center sleep clinic, faculty private sleep clinic, and in the sleep center laboratory. PATIENTS OR PARTICIPANTS: During the months of February-May 1997, 170 sleep disorders patients, 39% African American, 59% white participated in the study. Participants ranged in age from 18-73 years, with a mean age of 46. MEASUREMENTS AND RESULTS: Suitability scores for the 12 brochures indicate that none scored in the superior range, 83% scored adequate, and 17% scored not suitable. Ninety-four percent of the brochures were written on a 12th grade level or higher, yet 37% of the sleep patients tested were reading at less than a 9th grade level. Low-level readers were significantly more likely than their higher-reading-level counterparts to report that a brochure was too long (22% vs 12%; p < .05), and that they would need help reading it (44% vs 3%; p < .001). CONCLUSIONS: Patients need sleep information given to them on a level they understand. When developing and selecting appropriate materials, reading level, length, and suitability of written material should be considered.

Adolescent↗

No implicit memory for stories played during isoflurane/alfentanil/nitrous oxide anesthesia: a reading speed measurement.

UNLABELLED: Implicit memory of intraoperatively presented stories was recently detected by using the reading speed paradigm during propofol-alfentanil-nitrous oxide anesthesia. Our main goal was to evaluate the reading speed test procedure under another anesthetic regimen, i.e., isoflurane combined with nitrous oxide and alfentanil-infusion. In both experiments, patients were premedicated with oral midazolam. In a previous experiment, patients postoperatively read "old" stories that had been presented during anesthesia quicker compared with "new," unpresented stories. The same study design and test material as in the previous experiment were used. One of two audio tapes with two short stories was played randomly to patients during lumbar disk surgery and to awake controls. Approximately 7 h later, a structured interview and the reading speed test were used to determine whether the participants had any explicit or implicit memories of the presented stories. The results of 30 patients and 30 controls were calculated. Whereas the control participants showed an intact explicit and implicit memory of the previously presented material, no such effect was found in the anesthetized patients. The present experiment shows that changing the main anesthetic in otherwise equal study conditions, i. e., propofol to isoflurane (end-expiratory 0.7%), implicit memory is abolished in anesthetized patients. IMPLICATIONS: We showed that implicit memory during general anesthesia can be abolished by changing the hypnotic anesthetic. Increased postoperative reading speed for stories presented during propofol-alfentanil-nitrous oxide anesthesia was shown in a previous experiment, but not in our study using isoflurane for balanced anesthesia.

Adult↗

fMRI during word processing in dyslexic and normal reading children.

The present study addresses phonological processing in children with developmental dyslexia. Following the hypothesis of a core deficit of assembled phonology in dyslexia a set of hierarchically structured tasks was applied that specifically control for different kinds of phonological coding (assembled versus addressed phonological strategies). Seventeen developmental dyslexics and 17 normal reading children were scanned during four different tasks: (1) passive viewing of letter strings (control condition), (2) passive reading of non-words, (3) passive reading of legal words, and (4) a task requiring phonological transformation. Statistical analysis of the data was performed using statistical parametric mapping (SPM96). Comparison of patterns of activation in dyslexic and normal reading children revealed significant differences in Broca's area and the left inferior temporal region for both, non-word reading and the phonological transformation task. The present data provide new evidence for alteration of the phonological system in dyslexic children, and in particular, the system that mediates assembled phonological coding.

Adolescent↗

Magnocellular mediated visual-spatial attention and reading ability.

This study explores the relationship between attentional processing mediated by visual magnocellular (MC) processing and reading ability. Reading ability in a group of primary school children was compared to performance on a visual cued coherent motion detection task. The results showed that a brief spatial cue was more effective in drawing attention either away or towards a visual target in the group of readers ranked in the upper 25% of the sample compared to lower ranked readers. Regression analysis showed a significant relationship between attentional processing and reading when the effects of age and intellectual ability were removed. Results suggested a stronger relationship between visual attentional and non-word reading compared to irregular word reading.

Analysis of Variance↗

IQ and reading progress: a test of the capacity notion of IQ.

Concepts such as developmental reading disorder and dyslexia have been used to refer to children whose actual reading achievement is substantially below that predicted by performance on IQ tests. Such diagnostic concepts assume that IQ sets a limit on either the level of achievement or the rate of progress of which a child is capable. This assumption was investigated in a longitudinal study of an unselected cohort of 741 children whose reading achievement was assessed at ages 7, 9, 11, and 13 years. Findings on rates of progress and levels of achievement clearly indicate that IQ does not set a limit on reading progress, even in extreme low IQ children. Thus, the use of IQ tests to determine achievement potential in reading appears unwarranted.

Achievement↗

The relationship between inattentiveness in the classroom and reading achievement (Part B): an explanatory study.

Findings from an explanatory study of the relationship between inattentiveness in the classroom and reading achievement are reported for a sample of 5,000 students (age, 5-14 years) drawn from a normal school population. Results of structural equation modeling showed that regardless of family socioeconomic status, age, and gender, students' inattentiveness had strong negative effects on their achievement as well as on their attitudes toward reading and reading activity at home. Moreover, the findings indicated strong reciprocal effects, suggesting that whereas inattentive behaviors lead to reduced achievement, reading achievement--mediated by attitudes and reading activity at home--leads to increased attentiveness in the classroom. The strategic implications of the findings are discussed.

Achievement↗

Neurophysiology of fluent and impaired reading: a magnetoencephalographic approach.

This article reviews a series of magnetoencephalographic (MEG) experiments aimed at identifying cortical areas and time windows relevant or even critical for fluent reading. The approach was to compare single-word processing in fluent and dyslexic readers. The activations which differed between the two groups were then studied in more detail to determine their functional roles. In fluent reading, overall visual feature processing occurs about 100 milliseconds (ms) after seeing a word, in the posteromedial extrastriate cortex bilaterally. This activation does not differentiate between letters and symbols. The first reading-specific signal is detected about 150 ms after word onset, when the left inferior occipitotemporal cortex responds preferentially to letter strings. After 200 ms, the left superior temporal cortex, in particular, is engaged in semantic processing of single words and their integration with connected text. While visual feature processing seems to be within normal limits in dyslexic subjects, reading is disrupted during the first 200 ms after seeing a word, at the letter-string specific stage. The subsequent activations are weak and delayed as compared with those in fluent readers. Also presented is a case of deep dyslexia, where the same tools were used to demonstrate that reading comprehension was still subserved by the left hemisphere despite severe damage.

Cerebral Cortex↗

The use of relaxation exercises in the treatment of reading disability.

An adult nonreader, in therapy for serious emotional problems, began to read, at first during the therapy sessions, and then on his own, following treatment that involved a mix of psychodynamic exploration and behavioral interventions. The inability to read was addressed directly, first by having him imagine reading, and then by having him attempt to read, after achieving a state of increased relaxation through the use of muscle and breathing exercises. This result suggests that relaxation exercises should be tried in cases of reading disability at least whenever they are associated with emotional problems. Furthermore, inasmuch as anxiety and stress do not always manifest themselves in ways that are obvious to an observer, the case raises the possibility that relaxation exercises might be helpful even when there are no obvious symptoms of emotional disorder.

Adult↗

Clinical use of the Pepper Visual Skills for Reading Test in low vision rehabilitation.

The Pepper Visual Skills for Reading Test (VSRT) is an assessment instrument designed by Whittaker et al. to evaluate the reading skills of patients with macular degeneration who were able to read to their satisfaction before their vision loss. The VSRT was administered to 10 patients with macular degeneration and central scotomas from the Low Vision Optometry Program at the Hines Veterans Administration Hospital Central Blind Rehabilitation Center and the Visual Impairment Center to Optimize Remaining Sight (VICTORS) at Westside Veterans Administration Medical Center, Chicago. Reading skills were measured before and after a low vision treatment program. Results indicate that this test may be useful in designing low vision training programs, evaluating the progress of individual patients receiving low vision services, and evaluating low vision programs designed to rehabilitate those with reading difficulty.

Aged↗

Comparison of reading speed in normal observers through different forms of equivalent power low vision devices.

Compensation at near for vision loss can be achieved using a variety of equivalent forms of low vision magnifiers. Each has inherent advantages and disadvantages in terms of field, working distance, etc. We compared the reading speed of 60 trained, normal observers with 4 commonly prescribed types of low vision devices of +12 D equivalent power (spectacles, hand magnifier, stand magnifier, and telemicroscope) to their normal reading speed. Although there was individual variance in performance, reading speed with all the devices was generally within 20% of normal reading speed. Implications are that in terms of differences in reading speed for normals, the form of the low vision device is not as significant as acquiring proficiency in the use of the selected device.

Adult↗

The role of context in reading with central field loss.

It has been suggested that readers with central field loss (CFL) may not be able to use context to facilitate reading in the same way that normally sighted readers do because their processing capacity is fully utilized decoding the degraded visual stimulus. If true, this could account for their slow reading, even when text is appropriately magnified. Readers with CFL and normally sighted, age-matched controls read sentences and lists of random words from two dynamic text displays. We used sentence-gain (the ratio of reading rates for sentences to random words) to assess the use of context. Sentence-gain was equivalent across groups. Therefore, reduced reliance on context cannot explain the slower reading rates of people with CFL.

Aged↗

The universality of two routines for reading: evidence from Chinese dyslexia.

A study of 11 Chinese neurological patients with reading disorders indicates that reading aloud a non-alphabetic script, like reading alphabetic scripts, can be accomplished using two distinct routines: one that associates a whole written word with its complete pronunciation, and one that utilizes parts of the written word. Each routine can be selectively impaired by brain damage, resulting in different patterns of reading disability. These data are consistent with the independent neural organization of each routine, and the generality of the two-routine model for reading alphabetic and non-alphabetic scripts.

Adult↗

The pitch of maternal voice: a comparison of mothers suffering from depressed mood and non-depressed mothers reading books to their infants.

BACKGROUND: Research suggests that storybook reading promotes language development and that there is a relationship between maternal affective responses in relation to infant affect and language development. The purpose of this study is to relate maternal paralinguistic and verbal behaviour during storybook reading to maternal mood state. METHOD: Mothers (n = 32) reporting depressed mood (as measured by the Edinburgh Postnatal Depression Scale) were matched on age of baby (mean age = 6 months, mean age = 10 months), sex of baby, educational status of mother and parity with 32 non-depressed mothers. They were video- and audio-taped in their homes while reading a picture-book to their infants. Maternal textual and extra-textual utterances were transcribed and analysed in terms of mean length utterance (MLU), fundamental frequency and pitch modulation. RESULTS: There was an interaction between psychological well being and age group with regard to MLU for text read. Non-depressed mothers had a smaller MLU for younger babies in comparison with older babies, while depressed mothers showed no difference in their MLU. There was a main effect of psychological well being with depressed mothers speaking with a higher mean pitch and more modulations in their pitch, in comparison with non-depressed mothers. Furthermore, there was a significant interaction of the psychological well being of the mother and the mean fundamental frequency used when reading the text and when speaking to their child during the picture-book session. CONCLUSIONS: These differences in maternal speech indicate that mothers who are depressed are less attuned to their infants which might force the infant into self-regulatory patterns that eventually compromise the child's development.

Adult↗

The influence of accommodative insufficiency on reading.

BACKGROUND: It is not known how accommodative insufficiency influences reading performance. METHODS: Reading eye movements were recorded before and after treatment for accommodative insufficiency in 12 school children (eight to 16 years). During the eight-week treatment period all subjects wore a +1.00 D addition when reading. RESULTS: Large variations in reading patterns were found. Despite successful accommodative treatment (p < 0.001), no correlation was found to suggest improved reading velocity. DISCUSSION: Three case reports will be presented and the implications discussed.

Accommodation, Ocular↗

Brain-behavior relationships in reading acquisition are modulated by socioeconomic factors.

Functional neuroimaging may provide insights into the achievement gap in reading skill commonly observed across socioeconomic status (SES). Brain activation during reading tasks is known to be associated with individual differences in children's phonological language skills. By selecting children of equivalent phonological skill, yet diverse socioeconomic backgrounds, we use functional magnetic resonance imaging (fMRI) to demonstrate that a child's experience, as operationalized by SES, can systematically modulate the relationship between phonological language skills and reading-related brain activity in left fusiform and perisylvian regions. Specifically, at lower socioeconomic levels, individual differences in skill result in large differences in brain activation. In contrast, as SES increases, this relationship between phonological language skill and activation is attenuated. Socioeconomic background factors are thus found to modulate brain-behavior relationships in reading, indicating that cognitive, social, and neurobiological influences on reading development are fundamentally intertwined.

Behavior↗

Revisiting the association between reading achievement and antisocial behavior: new evidence of an environmental explanation from a twin study.

Previous studies have reported, but not explained, the reason for a robust association between reading achievement and antisocial behavior. This association was investigated using the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative 1994-1995 birth cohort of 5- and 7-year-olds. Results showed that the association resulted primarily from environmental factors common to both reading and antisocial behavior and was stronger in boys. Environmental factors also explained the relation between reading disability and conduct disorder. Leading candidate environmental risk factors weakly mediated the association. For boys the best explanation was a reciprocal causation model: poor reading led to antisocial behavior, and vice versa. In contrast, the relation between reading achievement and attention deficit hyperactivity disorder was best explained by common genetic influences.

Adolescent↗

Spatial load factor in prediction of reading performance.

Abstract This study investigated whether there is a relationship between reading age and clinical optometric tests that have varying degrees of spatial loading in their design. Spatial loading in this context is the demand on the visual system to process information about the relative position and orientation of stimuli. A total of 112 children aged 8-11 years were assessed using saccadic eye movement and rapid naming tasks with varying spatial loads. All were subtests of Garzia's Developmental Eye Movement test and Liubinas' SeeRite Reading Diagnostic Programme. Variability in load was achieved by comparing rapid naming of numerals vs the spatially loaded letters p, d, b, q; and by comparing the speed of reading numerals presented in increasingly complex arrays. Reading Age was assessed independently and results were analysed by multiple logistic regression. Spatially loaded naming tasks performed at speed exposed a Spatial Loading Factor which clearly differentiates children at risk with reading.

Age Factors↗

Brief report: Multiprogram evaluation of reading habits of primary care internal medicine residents on ambulatory rotations.

OBJECTIVE: To assess the reading habits and educational resources of primary care internal medicine residents for their ambulatory medicine education. DESIGN: Cross-sectional, multiprogram survey of primary care internal medicine residents. PARTICIPANTS/SETTING: Second- and third-year residents on ambulatory care rotations at 9 primary care medicine programs (124 eligible residents; 71% response rate). MEASUREMENTS AND MAIN RESULTS: Participants were asked open-ended and 5-point Likert-scaled questions about reading habits: time spent reading, preferred resources, and motivating and inhibiting factors. Participants reported reading medical topics for a mean of 4.3+/-3.0 SD hours weekly. Online-only sources were the most frequently utilized medical resource (mean Likert response 4.16+/-0.87). Respondents most commonly cited specific patients' cases (4.38+/-0.65) and preparation for talks (4.08+/-0.89) as motivating factors, and family responsibilities (3.99+/-0.65) and lack of motivation (3.93+/-0.81) as inhibiting factors. CONCLUSIONS: To stimulate residents' reading, residency programs should encourage patient- and case-based learning; require teaching assignments; and provide easy access to online curricula.

Ambulatory Care↗