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This study investigated the number of operator errors, task completion time, and workload of subjects at different levels by imposing conditions such as focused text boldness, noise disturbance, and time pressure to simulate a realistic cloud change business process in the laboratory. Results of the study showed that the text bolding of important content reduced the number of errors, whereas noise interference increased the number of errors. Text boldness only reduced the number of corrected errors, and noise interference only increased the number of uncorrected errors. Moreover, bolding was found to have different effects on the number of errors under different noise levels and time pressure levels, with text boldness significantly reducing the number of total errors only in quiet or low time pressure states. Time pressure had no effect on cloud change task error counts, but high time pressure resulted in higher subjective workload. Practitioner Summary: Operator error is one of the main causes of service failure, and reducing operator error in cloud change operations is of practical importance. In this study, we found focused text boldness could reduce operator errors, while noise could increase the number of errors. High time pressure would lead to a high workload. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses readability, suitability, and accountability of online uveitis patient education materials (PEMs). Methods: Two uveitis specialists reviewed the top 10 websites on Google for keyword "uveitis," with a PubMed review control. Readability was assessed using an online calculator, suitability using the Suitability Assessment of Materials (SAM) tool, and accountability using JAMA benchmarks. Results: The mean SAM score was 21.05, indicating that websites were on average adequately suitable to educate patients. WebMD Uveitis website scored the highest at 25.5, while allaboutvision.org scored the lowest at 18.0. The average Flesch Reading Ease (FRE) score was 44.0 (95% CI: 34.2, 53.8). The average reading grade score was 11.0 (95% CI: 9.4, 12.6). WebMD Uveitis page scored highest on readability. The average accountability score among sites was 2.36 out of 4. Conclusions: Uveitis websites are only adequately suitable as PEMs, and all are above the recommended reading level. Uveitis specialists should advise patients on quality of online PEMs. [ABSTRACT FROM AUTHOR]

Following a traumatic brain injury (TBI), people frequently have difficulty understanding nonliteral language, including irony and indirect requests. Despite the handicap that these disorders can represent in daily life, they are rarely treated clinically, and remediation studies are scarce. The present study thus aimed to evaluate the effectiveness of an explicit metapragmatic therapy targeting nonliteral language comprehension and taking into account cognitive processes likely to underlie this comprehension (i.e., contextual processing, theory of mind, and executive functions). This study was registered on the ClinicalTrials.gov system (ID: NCT04708561) before participant recruitment. Two adults with severe TBI took part in the study. An ABA design with multiple baselines was used to assess the evolution of treated and non-treated written literal and nonliteral story comprehension, as well as ecological tasks and tasks assessing the cognitive processes of interest (theory of mind and executive functions). An interview was also conducted at the end of treatment to assess participant satisfaction. Therapy resulted in significant improvement in treated items, with one-month maintenance of gains and generalisation to untreated items in both participants. The generalisation to a working memory task was also observed in one participant. Finally, participant satisfaction with the treatment was high. Our study demonstrated for the first time the potential of a therapy targeting irony and indirect request comprehension in TBI individuals. Clinically, it offers concrete therapeutic avenues and fills a critical gap in the TBI population's evidence for the remediation of nonliteral language comprehension. [ABSTRACT FROM AUTHOR]

The medical information about anemia prevention produced by health-care professionals is difficult to understand because of its complicated terminology. To evaluate quantitatively for the first time the clarity of existing online information about anemia prevention in Japanese. On January 20, 2023, we used the keyword "anemia" to evaluate 200 websites, followed by use of the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) and the Clear Communication Index (CCI) to evaluate understandability and actionability. The PEMAT-P and CCI were both evaluated as excellent in terms of understandability and actionability, with cutoff values of 70% or higher and 90% or higher, respectively. We also evaluated readability using jReadability and quality using the Journal of the American Medical Association (JAMA) Benchmark Criteria and The Global Quality Scale (GQS). The PEMAT-P scores for understandability and actionability exceeded the cutoff value in 59 (29.5%) and 36 cases (18.0%), respectively, while the CCI exceeded the cutoff value in two cases (1.0%). With respect to web pages, nine (4.5%) were considered "readable" and 96 (48.0%) "neutral." These findings suggest that websites on anemia in Japanese have poor "understandability," "actionability," and "readability," and are therefore inaccessible to the general public. Improving existing anemia websites using indicators such as the PEMAT-P could improve behaviors related to anemia prevention. [ABSTRACT FROM AUTHOR]

The effects of psychotherapy for men perpetrating violence toward their female partners have been found to be modest or equivocal; therefore, further research is necessary to determine how therapists can intervene to help clients stop acting violently. To obtain a better understanding of successful therapist strategies in a particular case, we conducted an interpretive phenomenological analysis of interactional patterns and change processes during therapy sessions in four carefully selected cases - two cases in which the use of violence ended after the completion of therapy (violence ended) were compared with two cases in which the client completed therapy but continued to act violently (violence continued). The client's use of violence was addressed repeatedly in all four cases, but the scripting of such events varied between the two case types. I) Violence ended: Joint explorations of the script of "the annoying other" led to therapist strategies that fostered new experiences of the states of mind of the client and partner. This seemed to help clients develop more caring and safer ways of relating to their partner. II) Violence continued: Engagement in the script of "hopeless me" was associated with therapist strategies that relied more on explanations of the client's vulnerability to acting violently. This seemed to hinder deeper comprehension of the clients' use of violence and the needs and intentions of their partners. Contrary to expectations, engagement in the script of "the annoying other" facilitated exploration of emotional states in both the client and his significant other. We present some empirically derived principles for moment-to-moment therapist strategies that facilitated in-session change with men acting violently toward their partner. [ABSTRACT FROM AUTHOR]

This study sought to 1) identify linguistic features important for Chinese text complexity with a theory-based and systematic approach, and 2) address how feature sets and algorithms affect the performance of Chinese text complexity models. Texts from Chinese language arts textbooks from Grades 1 to 6 (N = 1,478) in Mainland China were analyzed. The predictor variables were 265 linguistic features of texts: 154 lexical features and 111 sentence and discourse features. The outcome variable was the complexity level of texts; a one-semester-scale was applied, thus 12 levels in total (two semesters per grade). Features of the categories of character and word frequency, character and word semantic features, lexical diversity, part-of-speech syntactic categories, and referential cohesion were found the most important. With the important features identified, we found that text complexity models with features at all levels outperformed those with features at only one level. Models using the two machine learning algorithms (Random Forest Regression and Support Vector Regression) outperformed those using Linear Regression. This work clarifies important linguistic features for Chinese text complexity, and points to the necessity of considering features across levels and using machine learning algorithms in future text complexity research. [ABSTRACT FROM AUTHOR]

Stroke education materials are crucial for the recovery of stroke patients, but their effectiveness depends on their readability. The American Medical Association (AMA) recommends patient education materials be written at a sixth-grade level. Studies show existing paper and online materials exceed patients' reading levels and undermine their health literacy. Low health literacy among stroke patients is associated with worse health outcomes and decreased efficacy of stroke rehabilitation. We reviewed the readability of paper (i.e brochures, factsheets, posters) and online (i.e American Stroke Association, Google, Yahoo!) stroke patient education materials, reading level of stroke patients, accessibility of online health information, patients' perceptions on gaps in stroke information, and provided recommendations for improving readability. A PRISMA-guided systematic literature review was conducted using PUBMED, Google Scholar, and EbscoHost databases and "stroke", "readability of stroke patient education", and "stroke readability" search terms to discover English-language articles. A total of 12 articles were reviewed. SMOG scores for paper and online material ranged from 11.0 - 12.0 grade level and 7.8 - 13.95 grade level respectively. Reading level of stroke patients ranged from 3rd grade to 9th grade level or above. Accessibility of online stroke information was high. Structured patient interviews illustrated gaps in patient education materials and difficulty with comprehension. Paper and online patient education materials exceed the reading level of stroke patients and the AMA recommended 6th grade level. Due to limitations in readability, stroke patients are not being adequately educated about their condition. [ABSTRACT FROM AUTHOR]

The National Heart, Lung, and Blood Institute (NHLBI) Learn About Chronic Obstructive Pulmonary Disease (COPD) YouTube playlist educates the public on diagnosing, treating, and managing COPD. Despite its potential benefits, it is unknown if users with inadequate health literacy will likely understand and apply the information described in these videos. Assess the Learn About COPD playlist's readability, actionability, and understandability. Central tendency statistics were computed to describe the meta-data of 28 videos available as of April 2023. Assessments included the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV), Accessible Health IT for Limited-Literacy Populations Checklist (LLPC), and the Modified Centers for Disease Control and Prevention (CDC)-Clear Communication Index (CCI) for audiovisual materials. Playlist videos received an average of over 2,000 views (Mdn = 2,220, IQR = 496–8336), with very few "likes" (Mdn = 13, IQR = 1–48 "likes"). PEMAT-understandability (Mdn = 81.81%, IQR = 80–97.72%) and LLPC (Mdn = 87.50%, IQR = 75–93.75%) scores were high (above 80%). However, the modified CDC-CCI median score was 57.14% (IQR = 42.86–75%), and the median PEMAT-actionability score was 50% (IQR = 0–66.67%). The playlist earned passing understandability, acceptability, and usability scores but scored poorly on actionability and communication clarity. Findings could inform enhancements to NHLBI's Learn About COPD YouTube playlist. [ABSTRACT FROM AUTHOR]

This study investigates the visual angle threshold value for the recognition of Chinese characters displayed on the optical head-mounted display. As optical head-mounted displays are becoming increasingly popular in various fields, character legibility has become an important topic for research. In this study, a legibility test was conducted by randomly displaying characters on the optical head-mounted display. The characteristics that were tested included the number of strokes, components and usage frequency rankings. The visual angle threshold value of each character was recorded and analysed. The results indicate that Chinese characters with more strokes, more components and lower usage frequency have a larger visual angle threshold value than characters with fewer strokes, fewer components and higher frequency. The number of strokes and usage frequency rankings were inputted into a regression model to predict the visual angle threshold value for character recognition (R2 = 0.72; Adj-R2 = 0.71). The regression analyses revealed that the foregoing inputs increased the visual angle threshold value. These findings provide a practical reference for the display of Chinese characters on optical head-mounted displays. [ABSTRACT FROM AUTHOR]

Saudi Arabia has the second-highest prevalence of diabetes in the Middle East. Therefore, providing patients with high-quality materials is essential to help them understand their illness. The Patient Education Materials Assessment Tool (PEMAT) contrasts and evaluates materials regarding understandability and actionability. This study aimed to evaluate materials for type 2 diabetes using a printed version of the PEMAT. This observational study was conducted in Riyadh from December 2022 to May 2023. Sixty-nine samples were collected from hospitals affiliated with the Ministry of Health and the government sector. Materials evaluated in this study had an excellent understandability score of 78.9% and a low actionability score of 66.6%, with significant differences between the sources. Some of the materials (42%) achieved high quality regarding understandability and actionability. Less than half of the materials were considered high quality. Approximately 99% of the materials made their purposes completely evident and logically presented the information, and approximately 97% identified at least one action. However, only 17.4% of the materials provided summaries and tangible tools. Health Educators should consider including summaries and tangible tools when developing patient education materials to make them more understandable and actionable. [ABSTRACT FROM AUTHOR]

Abundant research has focused on handovers among nurses and/or doctors in hospitals; far less is known about handovers among care providers in non-clinical contexts, such as care homes for the elderly or the disabled. Focusing on handovers in a residential care home for persons with intellectual disabilities (RCHID), this study argues that handover communication in non-clinical settings is equally important. Ineffective handovers can lead to the deterioration of the residents' health conditions, chaotic situations and even injuries to both care providers and care recipients. Staff in RCHIDs rely heavily on handover communication to obtain information about the residents' needs and to offer appropriate care services. Combining discourse analysis with interactional sociolinguistics, this study analyzes written and spoken discourses involved in handover communication among care providers in a typical RCHID in Hong Kong to investigate what and how communicative functions were achieved through the participants' language use. The data were collected by convenience sampling, including handwritten notes and handover recordings of twelve sessions. Then a group interview of seven care providers was conducted to obtain supplementary data. Findings suggest that handover communication includes informational and interpersonal functions. While information delivery is the main purpose, care providers also establish relationships with one another through small talk about care home residents. The results suggest potential drawbacks of the handovers, including illegible notes, inconsistent information collection, and low interactivity. This study proposes a model that elucidates the correlation between discourse, handover communication and healthcare services, and suggests strategies to enhance such communication. [ABSTRACT FROM AUTHOR]

We investigated prediction skills of adult heritage speakers and the role of written and spoken language experience on predictive processing. Using visual world eye-tracking, we focused on predictive use of case-marking cues in verb-medial and verb-final sentences in Turkish with adult Turkish heritage speakers (N = 25) and Turkish monolingual speakers (N = 24). Heritage speakers predicted in verb-medial sentences (when verb-semantic and case-marking cues were available), but not in verb-final sentences (when only case-marking cues were available) while monolinguals predicted in both. Prediction skills of heritage speakers were modulated by their spoken language experience in Turkish and written language experience in both languages. Overall, these results strongly suggest that verb-semantic information is needed to scaffold the use of morphosyntactic cues for prediction in heritage speakers. The findings also support the notion that both spoken and written language experience play an important role in predictive spoken language processing. [ABSTRACT FROM AUTHOR]

Negated text is a difficult text construction that readers encounter in various forms throughout their lives. Despite a wealth of research on its impact, including potential strategies to improve comprehension, readers maintain poor comprehension when encountering this text construction. Given its large potential impact on reading texts like medical paperwork or insurance documents, it is important to understand not only what makes the construction difficult but also what can help a reader better process the information communicated in this way. The present research explored the impact of rereading on older adults' comprehension and metacomprehension of negated text. Results demonstrated that while rereading was beneficial for older adults' comprehension overall, this benefit was not specific to negated text. Moreover, metacomprehension data demonstrated that both young and older readers are aware of the difficulty they have in understanding negated text, but corresponding comprehension remains low. Results suggest that an additional reading of a passage containing negated text helped to mitigate the comprehension deficits associated with text that has been negated. This demonstrates that the comprehension accuracy can be improved for negated text under these circumstances. Future research should explore what specific factors associated with re-reading helps to improve comprehension accuracy. [ABSTRACT FROM AUTHOR]

The Shiji (史記 or Records of the Grand Historian) is a treasure trove of Chinese language and culture with complex, multifaceted textual images that are truly difficult to completely recreate in translation, requiring translators to make tradeoffs. Burton Watson's 華茲生 translation of the Shiji clearly positions it as a literary text and he regards his main task as conveying the literary charm of the work. He chooses to translate chapters that are highly literary in nature and focuses on molding literary images in the text of the Shiji. Watson's specific translation strategy favors continuity over annotations and avoided covering up the work's literary characteristics with academic characteristics. This effectively promoted the spread of the Shiji among ordinary Western readers. Watson paid meticulous attention to the readability of his English translation and made great achievements in language, literature, and art. Even though the textual images in the translation are only a partial reflection of those found in the original text, they blended images of the self and other and successfully established an undying literary image of the Shiji in the context of the English-speaking world. [ABSTRACT FROM AUTHOR]

Yang Hsien-yi (楊憲益) and Gladys Yang's Selections from Records of the Historian is one of the classic English translations of the Shiji (史記) by Sima Qian (司馬遷). Yang and Yang used distinctive translation strategies in their translation process: faithfulness to the original text, recreation of a classic, flexibility as necessary, and ensuring readability. The translators preserved the structure of the Shiji whenever possible and accentuated the culturally unique thought systems of the Shiji through the strategy of foreignization. However, in places where the narrative form of the original text is likely to cause confusion to English language readers, they were flexible with organization in order to reduce the mental burden to readers. When there are no English equivalents for the Chinese terms used in the Shiji, they also adopted a strategy of domestication. Yang and Yang added explanatory content as appropriate to make their translation accessible in English. [ABSTRACT FROM AUTHOR]

The study aimed to assess the quality and readability of webbased information regarding the gingival recession. An internet search was done using two engines (Google and Bing) with the terms "gingival recession," "gum recession," and "receding gums." Each search engine's top 100 results for each query were filtered out. The websites' reliability and level of quality were evaluated using the JAMA and DISCERN scores, respectively. Readability was analyzed by the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog index (GFI), Simple Measure of Gobbledygook (SMOG) index, the Coleman-Liau score (CL), the Linsear Write (LW) readability formula and the Automated Readability Index (ARI), via an online readability tool. Of the 151 websites, 81.5% were private dental clinics, 9.3% were advertising sites, 4.6% were national health services, and 4.6% were nonprofit organizations. 11.3% of the websites achieved all four JAMA benchmarks, and the JAMA average of all websites was 2.06. The mean FRES was 54.48, and the mean GFI was 12.82. The mean DISCERN scores for all websites were 43.64 and the DISCERN scores of the websites prepared by periodontologists were statistically significantly higher than the others. The online health information regarding gingival recession has fair reliability and difficult readability. It is essential to produce website information free from commercial bias and simple for patients to understand fully. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of the size of pesticide pictograms on comprehensibility and their adherence to principles of familiarity, compatibility, and standardization. Pictograms usually involve complex details, and space limitation demands size reductions, which reduces overall comprehensibility, especially in agriculture and healthcare. Two experiments were conducted. In experiment 1, the effect of different sizes of pictograms on comprehension was tested. In experiment 2, the level of compliance for different ergonomic principles on different sizes of pictograms was investigated. Results of experiment 1 indicated significant variation in comprehension level (p <.05), with maximum comprehension for the size 15 mm × 15 mm (87.6%) and minimum comprehension for the size 7 mm × 7 mm (69.4%). Results of experiment 2 indicated significant variation in compliance of ergonomic principles with different pictogram sizes (p <.05), with maximum compliance for the size 15 mm × 15 mm (7.7, 7.7, 7.6) and minimum compliance for the size 7 mm × 7 mm (6.3, 6.3, 6.3). A significant increase in the comprehensibility of pictograms and their adherence to familiarity, compatibility, and standardization was observed with the increase in the sizes of pictograms. The smallest size of pictograms with a mean comprehension level ≥ 65% and scores for familiarity, compatibility, and standardization ≥ 7 (on a scale of 1 to 10) was 10 mm × 10 mm. The potential application of this research is to identify the most comprehensible size of pictograms that adhere to the principles of familiarity, compatibility, and standardization. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to identify and analyse reading comprehension strategies used by five deaf adults, 22–47 years old, who were close to complete or had already completed their studies at a higher education institution. The method chosen was a partial replication of the one used by Banner and Wang (2011) in their think-aloud study to describe cognitive and metacognitive reading comprehension strategies use among deaf students and adults. The present study included similar interview questions and think-aloud procedures, which were conducted by a deaf teacher, native user of Chilean Sign Language (LSCh). Participants read informational texts and were interrupted three times during the reading task to answer questions about their cognitive and metacognitive processes. Results showed that these deaf adults can use strategies from all the categories identified by Pressley and Afflerbach (1995): constructing meaning, monitoring and improving comprehension, and evaluating comprehension. Some strategies described in the study from Banner and Wang were observed only in individual cases, and some of them were not used at all. The deaf participants of this study also used some strategies that were not included in some previous studies. Since very few deaf adults in Chile have completed higher education, the information provided by this study could be useful in guiding interventions aimed to improve reading comprehension in elementary, high school, and college DHH students. The relevance of early experiences with reading, and motivational factors associated to reading achievement are discussed. [ABSTRACT FROM AUTHOR]

Standard reading passages allow for the study of the integrated functions of speech and voice components in contextual, running speech, with target stimuli in a controlled environment. In both clinical practice and research, these texts provide rapid insight into the characteristics of the patient's speech, with fewer hesitations than in conversational speech and better predictability by the evaluator. Although a plethora of texts exist in different languages, they present various limitations. A specifically created standardised text in each language allowing for an ecological assessment of speech and voice functions, meeting most required criteria for standard speech and voice assessment and adapted to the target language's cultural and linguistic specificities, would therefore be an interesting option. However, no guidelines exist for the creation of such a reading passage. This article describes the international Delphi consensus study carried out to identify a minimal set of criteria to take into account when creating standard reading passages for an overall speech and voice assessment in adolescents and adults. This survey was conducted in three consecutive rounds; forty experts participated in the first round, with a total dropout of 17% from round 1 to round 3. It results in a minimal set of ten criteria which were selected by a majority of the experts and were rated as most important. This set contains five phoneme-level, two word-level, two sentence-level criteria and one global-level criterion. It can be used as a general guideline for the creation of standard reading passages in Indo-European Romance and Germanic languages such as English, French and German. The construction of a new reading passage in French following this guideline is briefly described. [ABSTRACT FROM AUTHOR]

Obtaining accurate prevalence rates of sexual violence is made difficult by discrepancies in self-report questionnaires. Thus, the current study sought to explore participants' perceptions of acceptability (i.e., perceived difficulty and preference) as a potential mechanism of discrepancy between different questionnaires. Participants were 673 college students who completed two frequently used sexual victimization questionnaires, the Sexual Experiences Survey-Short Form Victimization (SES-SFV) and the Post-Refusal Sexual Persistence Scales-Victimization (PRSPS-V). Participants then answered questions about each measure's perceived difficulty and their preference between the two. Participants found the PRSPS-V easier to understand and preferred it 2.5 to 1 over the SES-SFV. Preference was related to reporting; participants who preferred the PRSPS-V reported more instances of sexual victimization on the PRSPS-V by 9.8%. Our results indicate that acceptability impacts reported prevalence rates and is one mechanism of discrepancy between questionnaires. Thus, researchers may wish to consider acceptability when choosing sexual victimization questionnaires. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the readability and reliability of online content related to cerebral palsy (CP) and to classify sites that contain quality and readable information. On April 30, 2022, the term "cerebral palsy" was searched on the Google search engine. The categories, quality, content, readability, Alexa rank values, and backlink numbers of the sites were analyzed. The Journal of American Medical Association score and HONcode seal were used for quality assessment, and the Flesch–Kincaid grade (FKG) and the Simple Measure of Gobbledygook (SMOG) were used for readability assessment. Of the 155 sites, 46 had high-quality content. The quality of health portal and scientific publishing sites appeared to be high. The top 10 sites were determined to be of significantly higher quality (p =.017) than the remaining sites. The average readability values of the sites were not at the recommended level. Despite the abundance of information available on CP-related websites, most of them were not of high quality. Additionally, many websites did not reach the recommended readability levels. Revision of existing online content related to CP and production of new high-quality content in line with readability recommendations is urgently required. [ABSTRACT FROM AUTHOR]

Handwriting is a critical functional skill that impacts academic participation and progress. Occupational therapists address components of grasp in their handwriting intervention as it is commonly assumed that grasp affects legibility, fluency, and endurance, yet research studies examining this relationship are limited. We used scoping review methodology to map existing research on grasp and handwriting performance in school-age children and to identify gaps in the literature. Thirteen articles met search criteria and were categorized by grasp patterns and handwriting performance, and grasp force and handwriting performance. Findings suggest an inefficient grasp can lead to decreased handwriting legibility and fatigue. The current literature is inconclusive and several gaps were identified. Additional studies should address research gaps through inclusion of children with special needs and interventions including lengthier handwriting tasks representative of a typical school day. [ABSTRACT FROM AUTHOR]

Readability is a systematic measure of ease, with which written information can be read and understood. It can affect the reader's ability to access, comprehend, and utilize health information. This study assessed the readability of online COVID-19 information readily available to the public to engage with. At a time when organisations and institutions were rapidly providing advice and reacting to a developing pandemic, it was hypothesised that some of that haste would be associated with a lack of clarity, as measured by readability indices. N = 65 website sources containing information relating to COVID-19 were accessed and assessed for inclusion in the study. Eight readability indices, including Flesch Reading Ease and Flesch-Kincaid Grade Level, were calculated to determine readability scores for each source of information. Readability scores varied greatly between individual sources of COVID-19 information. Despite the recommendation that information be presented to the general public at a sixth-grade reading level, most websites we assessed addressing COVID-19 information and advice presented content at greater than the recommended reading level. Based on these results, a significant amount of information available on the Internet about COVID-19 will not be easily readable for many individuals attempting to use the Internet to help inform their decisions about their health and behavior. [ABSTRACT FROM AUTHOR]

Patient education materials (PEMs) are often used in health education programs to empower patients to self-manage their disease for better health outcomes. Heart failure (HF) patients wanted more information about self-management and educational materials that were easy to understand. Programs with self-efficacy as the core component have proven to be effective in improving patients' self-management. To develop practical, efficacy-enhanced, tailored HF rehabilitation PEMs that satisfy our clients to drive long-lasting behavior change and evaluate the materials' quality (readability, understandability, actionability, and acceptability). Exploratory mixed methods study involving: i) semi-structured interviews; ii) evaluation of the PEMs; iii) revision and reevaluation of the PEMs; iv) publication. An appointed panel of experts evaluates content accuracy, understandability, and actionability. The Patient Education Material Assessment Tool assesses content understandability and actionability. The content readability was assessed using Flesch Kincaid Calculator. Clients' acceptability was assessed using Educational Material Acceptability tool. The newly developed PEMs have good understandability, actionability, readability, and acceptance. Patient-centered PEMs have good acceptance and satisfaction among clients. However, the effectiveness of tailored efficacy-enhanced PEMs for behavior changes needs further evaluation. All stakeholders should be included in developing PEMs. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

The problem in language comprehension in people with right hemisphere damage (RHD) is more equivocal than people with left hemisphere damage. This study explores the reading and listening comprehension of Cantonese-speaking individuals with RHD, left hemisphere damage, and neurotypical healthy controls using the Cantonese Computerized Revised Token Test (CRTT-Cantonese) adapted from the English CRTT. Eighteen native Cantonese-speaking individuals with RHD, 32 individuals with left hemisphere damage and aphasia (PWA), and 42 healthy controls participated in this study. All the participants completed the Cantonese Aphasia Battery, Hong Kong Oxford Cognitive Screen, the listening comprehension version of CRTT-Cantonese (CRTT-L-Cantonese), and the reading comprehension version of CRTT-Cantonese (CRTT-R-WF-Cantonese) across different sessions. Linear mixed-effect analysis revealed significant differences among the groups in CRTT-Cantonese tests. However, there were no significant difference between CRTT-L-Cantonese and CRTT-R-WF-Cantonese within the PWA, RHD and healthy control groups. Tukey post-hoc pairwise comparisons showed that PWA scored significantly lower than RHD and healthy control groups (p < 0.0001) in both CRTT-L-Cantonese and CRTT-R-WF-Cantonese, and the RHD group scored significantly lower than healthy control group only on the CRTT-R-WF-Cantonese. The results demonstrate that the CRTT-L-Cantonese and CRTT-R-WF-Cantonese differentiate language comprehension abilities among PWA, RHD and healthy control groups. Although the current findings did not show any diversion between reading and listening comprehension in RHD group, this group showed poorer performance in reading comprehension when compared to healthy controls. The latter findings may support the view that the right hemisphere contributes to reading comprehension in Chinese. [ABSTRACT FROM AUTHOR]

To assess the suitability of newborn hearing screening brochures by evaluating current state-level brochures and pregnant people's understanding of screening result terminology. In Study 1, state-level brochures were evaluated based on readability, design, picture appropriateness, and use of the word "refer." In Study 2, pregnant people completed a questionnaire that queried their understanding of and expected anxiety about three newborn hearing screening outcomes ("refer," "did not pass," and "pass"). In Study 1, 59 newborn hearing screening brochures were analysed. In Study 2, 43 pregnant people completed surveys during a prenatal appointment. Most of the brochures were found deficient on at least one element. Thirty percent of brochures used the word "refer" to indicate a hearing screening failure; yet, fewer than half of participants understood its meaning. Ratings of expected anxiety were highest in response to the term "did not pass." Based on four study criteria of brochure suitability, 88% of available state-level newborn hearing screening brochures should be modified to make them readily understandable by a broad educational demographic. Discretion in use of the term "refer" should be made when indicating screening results, because the term is not readily understood. [ABSTRACT FROM AUTHOR]

Prediction facilitates word processing in the moment, but the longer-term consequences of prediction remain unclear. We investigated whether prediction error during language encoding enhances memory for words later on. German-speaking participants read sentences in which the gender marking of the pre-nominal article was consistent or inconsistent with the predictable noun. During subsequent word recognition, we probed participants' recognition memory for predictable and unpredictable nouns. Our results indicate that individuals who demonstrated early prediction error during sentence reading, showed enhanced recognition memory for nouns overall. Results from an exploratory step-wise regression showed that prenominal prediction error and general reading speed were the best proxies for recognition memory. Hence, prediction error may facilitate recognition by furnishing memory traces built during initial reading of the sentences. Results are discussed in the light of hypotheses positing that predictable words show a memory disadvantage because they are processed less thoroughly. [ABSTRACT FROM AUTHOR]

Theories about word production differ in whether they assume that lexical selection involves modality-specific representations or modality-neutral ones, called lemmas. The observation that semantic errors in aphasia may be restricted to either speaking or writing has long been taken to challenge lemma models (Hillis et al., 1999; Kemmerer, 2015, 2019). Whereas patients RGB, HW, and RR make semantic errors in speaking but not in writing, patient RCM exhibits the opposite dissociation. Here, using WEAVER++ simulations and a simple mathematical analysis, a model with lemmas is shown to account for the double dissociation observed in patients. In particular, the model captures the patterns of performance of the patients on vocal picture naming, written picture naming, auditory word comprehension, and writing to dictation, explaining 98% of the variance. The challenge is now for modality-specific models to account for the findings that the lemma model was designed to explain in the first place. [ABSTRACT FROM AUTHOR]

On November 14th, 2022, a group of Black community leaders from the Saint Louis, Missouri, area met to discuss their experiences with the serious issues surrounding urban schools in their communities. Although this discussion is specific to a particular time and place, the concerns expressed, and solutions, offered are transferrable to many other communities in the United States. Dr. Adrienne Dixson moderated the discussion. This article is a verbatim transcription of their discussion with minor edits to facilitate ease of readability. The voices of the participants have been preserved. (Adrienne Dixson = AD; Dionne Ferguson = DF; Jacquelyn Lewis-Harris = JLH; Art McCoy = AMC; Cynthia Chapple = CC; Aaron Williams = AW). [ABSTRACT FROM AUTHOR]

A systematic literature review was conducted to determine the effects of reading comprehension instruction beyond vocabulary instruction for students with intellectual disabilities. Database and ancestral searches from 2000 to 2018 were conducted to identify experimental and quasi-experimental studies that were published in peer-reviewed journals. The studies had to consist of implementing reading comprehension instruction beyond just vocabulary instruction to students with intellectual disabilities. The studies also had to include an assessment of reading comprehension performance as an outcome measure. Twenty-two studies published between 2000 and 2018 in peer-reviewed journals were identified. Across the studies, reading comprehension instruction varied and outcome measures were assessed in a multitude of ways across studies. Studies revealed that various types of reading comprehension instruction helped students with intellectual disabilities improve their reading comprehension performance. In particular, instructional delivery practices that involved teaching students with ID to comprehend text through modelling, guided practice opportunities, and corrective feedback appeared to have the greatest impact on improving this population's reading comprehension performance. Discussion about the findings including limitations and directions for future research are presented. [ABSTRACT FROM AUTHOR]

How does linguistic structure affect children's developing cardinal number knowledge? The bootstrapping theory proposes that children might use syntactic information provided by known words such as quantifiers to bootstrap the meanings of unfamiliar words such as number words. Prior studies of numeral and quantifier development have indicated that the bootstrapping mechanism that children can use to discover numeral meanings might work differently in different languages. Nevertheless, support for this conclusion remains preliminary. The present study explored this hypothesis through an investigation of the possible relations between cardinal number knowledge and quantifier comprehension in Mandarin Chinese-speaking children. Notably, in contrast with previous studies, this study also offered a glimpse into children's receptive vocabulary development and its relation with cardinal number knowledge and quantifier comprehension. Results showed that cardinal number knowledge did not seem to be correlated with quantifier comprehension (both "exact" and "non-exact" quantifiers) when controlling for such covariates as children's age, gender, parent education, and family income. Moreover, children's receptive vocabulary size explained a significant amount of variance in their quantifier knowledge over and above children's age, gender, parent education, and family income, but not in their cardinal number development over and above these covariates. These results provide further evidence for the hypothesis that while the bootstrapping mechanism may facilitate number word learning in children speaking languages like English, it might play a lesser role in children speaking classifier languages such as Mandarin Chinese. Implications for the role that general receptive vocabulary plays in the acquisition of number words and quantifiers are also discussed. [ABSTRACT FROM AUTHOR]

One of the unknowns associated with Alain Guiraudie's thriller L'Inconnu du lac/Stranger by the Lake (2013) is what the film is really about. Set at a lake where men have sex with men, the film follows the protagonist Franck, who pursues a relationship with a man despite witnessing that man drown his lover. Whereas some reviews have read the film as a fable about the dangers of casual sex or HIV, this article argues that a key theme is the question of 'knowability': how do we come to know, to read, to make connections? How the film itself connects to a wider viewing audience is a further question this article addresses. To do so, three aspects pertinent to its readability are considered. The first relates to genre: how the film breaks with the generic conventions of the homme fatal thriller. The second pertains to space, with Guiraudie's lakeside being compared to Jean-Didier Urbain's writing on the beach. The third concerns narrative, specifically the self-reflexive element of three 'reader' characters in the film. This article will contend that ultimately Guiraudie's film goes beyond communitarian questions to offer a post-queer vision of connectedness in a world of increasing isolation. [ABSTRACT FROM AUTHOR]

We examined how readers process content and function words in sentence comprehension with ERPs. Participants read simple declarative sentences using a rapid serial visual presentation (RSVP) with flankers paradigm. Sentences contained either an unexpected semantically anomalous content word, an unexpected syntactically anomalous function word or were well-formed with no anomalies. ERPs were examined when target words were in the parafoveal or foveal vision. Unexpected content words elicited a typically distributed N400 when displayed in the parafovea, followed by a longer-lasting, widely distributed positivity starting around 300 ms once foveated. Unexpected function words elicited a left lateralised LAN-like component when presented in the parafovea, followed by a left lateralised, posteriorly distributed P600 when foveated. These results suggested that both semantic and syntactic processing involve two stages – the initial, fast process that can be completed in parafovea, followed by a more in depth attentionally mediated assessment that occurs with direct attention. [ABSTRACT FROM AUTHOR]

Open Educational Resources aim to offer learning to all, yet the language level used in resources could be a barrier to many potential learners. This paper examines the readability of 200 OER courses in English from two major OER course platforms. We compared the means of readability metrics between these OER courses at different educational levels and subject categories that the platforms offer using inferential statistics as well as cluster analyses. Results prove that there is a progression of difficulty between lower and higher educational levels with introductory courses being easier to read. However, the analysis also highlighted that more than 86% of the courses require an advanced level of English language proficiency. On the other hand, subject matter does not appear to be linked with the readability of the courses. This study contributes further to the current discussion of the inclusiveness of OER and the factors that hinder its universal use. The study addresses a gap in the literature as, to our knowledge, no other studies have analysed the linguistic accessibility of OER English learners and consideration of the meaning of the educational levels assigned to OER courses has been limited. [ABSTRACT FROM AUTHOR]

This study was conducted to examine whether online information regarding male infertility on Swedish fertility clinics' websites was readable, suitable, and of appropriate quality. A cross-sectional design was used to evaluate 22 fertility clinics' websites focusing on male infertility by using the Suitability Assessment of Materials (SAM), and the DISCERN instrument. Results showed that information focusing on male infertility was scanty but had an "adequate" readability and was easy to comprehend. The conclusion was that the information on the websites must be reliable, so that men can base their choices concerning their fertility issues on reliable facts. It is important that health care professionals develop high quality sources of information regarding male infertility. [ABSTRACT FROM AUTHOR]

This study aimed to determine the level of readability of online information on gestational diabetes mellitus (GDM). Readability of 100 English-language websites was assessed by five readability measures: Flesch-Kincaid Grade level (FKGL), Gunning Fox Index (GFI), Coleman Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE). A majority (90%+) of the sample was determined to have unacceptable readability levels, with averages at least one standard deviation away from recommended levels. Not more than a tenth of the websites measured readability to be acceptable or not equivalent to grade seven and above. Results suggest an urgent need for health professionals who create online information related to GDM to revisit and revise the text to be simplified and more readable. [ABSTRACT FROM AUTHOR]

Unfolding models are frequently used to develop scales for measuring attitudes. Recently, unfolding models have been applied to examine rater severity and accuracy within the context of rater-mediated assessments. One of the problems in applying unfolding models to rater-mediated assessments is that the substantive interpretations of the latent variable are challenging. The purpose of this study is to evaluate the use of Coh-Metrix indices as an approach for defining the characteristics of essays related to their scoring difficulty. Essays from a rater-mediated writing assessment were selected (N = 100), and rater accuracy was defined using an unfolding model. The scoring difficulty of essays along the unfolding scale (i.e., difficult-to-score below, easy-to-score, and difficult-to-score above) was related to essay feature indices defined with the Coh-Metrix text analyzer. Six areas of essay features were considered: descriptive, text readability, lexical diversity, latent semantic analysis, syntactic complexity, and word information. The results suggest that the substantive interpretation of the underlying unfolding scale can be enhanced by examining essay characteristics with Coh-Metrix indices. This methodology offers a promising approach for understanding the unfolding continuum and gaining information about the characteristics of difficult-to-score essays. Suggestions and implications for evaluating rater-mediated assessment systems using unfolding models are discussed. [ABSTRACT FROM AUTHOR]

In an eye-tracking-while-reading study, we investigated adult monolinguals' (N = 80) processing of two-clause sentences embedded in short narratives. Three principles theorised to guide comprehension of complex sentences were contrasted: one operating at the clause level, namely clause structure (main clause – subordinate clause or vice versa), and two operating at the discourse-level, namely givenness (given-new vs. new-given) and event order (chronological vs. reverse order). The results indicate that clause structure mainly affects early stages of processing, whereas the two principles operating at the discourse level are more important during later stages and for reading times of the entire sentence. Event order was found to operate relatively independently of the other principles. Givenness was found to overrule clause structure, a phenomenon that can be related to the grounding function of preposed subordinate clauses. We propose a new principle to reflect this interaction effect: the grounding principle. [ABSTRACT FROM AUTHOR]

Three patient education texts from the National Cancer Institute (NCI) were subjected to a Coh-Metrix analysis, then further analyzed to obtain Gist Inference Scores (GIS), a new measure of the likelihood that readers will make appropriate inferences about a text's bottom-line meaning. In the GIS formula, the Coh-Metrix psycholinguistic variables referential cohesion, deep cohesion, and latent semantic analysis (LSA) verb overlap increase GIS because cohesive texts that describe related actions are likely to induce gist representations. The Coh-Metrix variables word concreteness, imagability for content words, and hypernymy for nouns and verbs are negatively weighted because they tend to promote verbatim mental representations. NCI texts were modified for a cloze procedure with every tenth word replaced by a blank starting with the second sentence. Participants in two studies received all three cloze-modified texts. Fuzzy-Trace Theory suggests that people are more likely to comprehend high GIS texts "in their own words," and thus fill-the-blanks with multiple words that differ from those omitted by the cloze procedure expressing comparable meaning. In Study One, non-native English speakers appropriately filled blanks with different words at the same rate for all three texts of low-, medium-, and high-GIS. In Study Two, replicating previous findings, for high GIS texts, native English speakers filled blanks appropriately with words other than those removed significantly more often than for medium- or low-GIS texts. High GIS texts apparently afford readers more semantic and lexical flexibility, but non-native English speakers may be ill-equipped to capitalize on this characteristic of high GIS texts. [ABSTRACT FROM AUTHOR]

An introduction is presented to the journal's Short Reports supplemental section.

Research on the use of speed, as an indicator of motor handwriting problems, is controversial and the legibility of the text is the measure mostly examined in children. This case-control study compared handwriting legibility and speed in 25 children with Developmental Coordination Disorder (DCD) and 75 typically developing peers matched by school grade (third and fourth grade). Children with DCD achieved significantly lower scores than their peers in both legibility and speed measures, overall and in the third and in the fourth grade independently. These measures represent a good insight into children's writing abilities and could be both used to screen and monitor. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to evaluate the content, quality, and readability of orthodontic information contained on the websites of general dental practices located in Australia. An online search strategy was adopted to identify practice websites for evaluation. Websites satisfying inclusion/exclusion criteria were checked for the presence of pre-determined orthodontic treatment-related items. Three validated quality of health information and readability tools were applied for website content assessment. A total of 231 websites satisfied inclusion/exclusion criteria. The mean overall [SD] DISCERN score was 29.87 (6.03)/80, [95%CI: 29.09–30.65]. The majority of the websites (88.3%) recorded poor or very poor DISCERN quality of information scores. Most websites described orthodontic clear aligner treatment (91.3%). Information regarding Invisalign® was provided by 69.3% and myofunctional therapy by 22.5%. Only 7 (3%) websites indicated that orthodontic retention was indefinite. The mean [SD] Simple Measure of Gobbledygook (SMOG) score was 10.10 [1.31], (95%CI: 9.95–10.25). The SMOG and Flesch Reading Ease scores were closely correlated (r = −0.9041; 95%CI: −0.93 to −0.88; p < 0.0001) and signified difficult-to-read information. The content authors should consider the use of quality information and readability tools to ensure that readers access high-quality and readable information. [ABSTRACT FROM AUTHOR]

To investigate whether the authoritative COVID-19 consumer health information provided by the Centers for Disease Control and Prevention (CDC) in the United States (U.S.) and the World Health Organization (WHO) is at low readability levels (i.e., at or below a sixth-grade reading level). Major public health organizations, such as these have quickly distributed authoritative COVID-19 health information on the Internet during the pandemic. However, scant research has assessed whether the information disseminated by these two major public health organizations enables access by adults from the general public. This study examines the Flesch-Kincaid grade levels of the COVID-19 health information in English distributed by the CDC and the WHO. The study is guided by communication and information science frameworks. It examines the reading level of the resources to see if they are compatible with the guidelines of the American Medical Association for patient education materials. The methodology used centered on content and document analyses. The samples analyzed were identified through accessing the COVID-19 health information shared on the websites of the public library systems of the twenty largest cities in the U.S. The results show that the documents reviewed in the study are not compatible with the sixth-grade reading level recommended by the American Medical Association for patient education materials. [ABSTRACT FROM AUTHOR]

In less than a decade, the western world has witnessed an unprecedented rise in the numbers of children and adolescents seeking gender transition. Despite the precedent of years of gender-affirmative care, the social, medical and surgical interventions are still based on very low-quality evidence. The many risks of these interventions, including medicalizing a temporary adolescent identity, have come into a clearer focus through an awareness of detransitioners. The risks of gender-affirmative care are ethically managed through a properly conducted informed consent process. Its elements-deliberate sharing of the hoped-for benefits, known risks and long-term outcomes, and alternative treatments-must be delivered in a manner that promotes comprehension. The process is limited by: erroneous professional assumptions; poor quality of the initial evaluations; and inaccurate and incomplete information shared with patients and their parents. We discuss data on suicide and present the limitations of the Dutch studies that have been the basis for interventions. Beliefs about gender-affirmative care need to be separated from the established facts. A proper informed consent process can both prepare parents and patients for the difficult choices that they must make and can ease professionals' ethical tensions. Even when properly accomplished, however, some clinical circumstances exist that remain quite uncertain. [ABSTRACT FROM AUTHOR]

The notorious length of Karl Ove Knausgaard's My Struggle is the result of an ever-increasing preoccupation with speed: as much time went into the first few pages as went into all of the final volume's 1,248 pages. Not surprisingly, critics' appraisals were inversely related to this speed, beginning with nearly unanimous praise and ending with nearly unanimous condemnation. But it is the final volume that reveals the kind of work the novel really is: Against an innate, nearly automatic inclination to produce "what people liked," Knausgaard wanted to write how "he really [thought] things [were]." This desire is one Michael Fried would call "antitheatrical," in that Knausgaard did not want the novel to be for the audience. Yet Knausgaard felt that form and the meaning form produces, which for Fried were the primary means of antitheatricality, might actually have been what people liked about My Struggle. Writing quickly, then, was a way of not giving the audience what they wanted – meaning – by making the text an object – by making it meaningless. My Struggle, despite appearances, is not the epitome of readability; it is a text that wants to mean nothing so that it might truly reject any appeal to the audience. [ABSTRACT FROM AUTHOR]

Normal aging has variable effects on language comprehension, perhaps because comprehension mechanisms vary in their dependence on network structure versus network dynamics. To test claims that processing dynamics are more affected by age than structure, we used EEG to measure and compare the impact of neighborhood size, a core measure of the structure of the lexico-semantic network, and repetition, a simple measure of processing dynamics, on single word processing. Older adults showed robust effects of neighborhood size on the N400, comparable to those elicited by young adults, but reduced effects of repetition. Furthermore, older adults with greater verbal fluency, print exposure, and reading comprehension showed greater repetition effects, suggesting some older adults can maintain processing dynamics that are similar to those of young adults. Thus, the organizational structure of the semantic network seems stable across normal aging, but (some) older adults may struggle to adjust activation states within that network. [ABSTRACT FROM AUTHOR]

Privacy policy is crucial in educating librarians about how vendors handle patron's data and what are their current privacy practices? Fewer have studied the content of library vendors' privacy policies for their readability score and privacy compliance. With this background, the study performed a comprehensive keyword-based, content analysis of 64 privacy policies from three category of library vendors (1) IT vendors (2) E-resource vendors (3) Publisher's cum bookseller's vendors. The study used the Flesch-Kinkaid grade level for readability score and evaluate their privacy compliance with the 11 privacy principles articulated from the India's Personal Data Protection Bill, 2019 (Referred to as "PDPB" in this study). The results indicate low availability of privacy policies (n = 64, 41.29%) out of 155 library vendors. Overall, the average reading grade level on all categories of vendors are similar; they are written for readers above 12 grades and are suitable for college readers. Their privacy compliance is low in all categories, with average compliance of 3∼4 out of the 11 privacy principles. Similarly, the privacy compliance in each vendor's category is the highest for data collection, processing, and sharing principles. In contrast, it is the lowest for accountability, data retention, safeguarding children's data, users' consent and transparency. The article concludes with specific recommendations for vendors to overcome their readability and privacy compliance deficiency, thereby providing librarians with corrective measures when negotiating with vendors to protect patrons' privacy. [ABSTRACT FROM AUTHOR]

This study explores the influence of colour combinations on legibility and aesthetic feelings for the currently popular negative polarity interface design. Legibility was measured in two different ways in two tasks: time threshold (Task I) and a 9-point subjective rating (Task II). In Task I, we combined an adaptive program to measure 37 participants' recognition thresholds and online pseudo-word recognition tasks; in Task II, 44 participants' subjective preferences were measured using a scale. We found that higher brightness contrasts led to better legibility; different background colours with identical brightness and saturation did not cause significant differences; brighter texts produced better subjective preference for aesthetic appearance, legibility, and visual comfort; and different background colours had no significant effect on subjective preference. These findings have implications for digital interface design. Practitioner summary: In display design under negative polarity, experimental results show that higher brightness contrast leads to higher legibility, while background colour has no such significant effect; background brightness and hue have no significant effect on subjective preference, but text brightness and background colour have significant interaction effect on subjective preference. Abbreviations: OLED: organic light-emitting diode; LCD: liquid crystal display; ANOVA: analysis of variance; VDT: visual displsy terminal; CET-4: college english test band 4; ISO: International Organization for Standardization; HSB: hues saturation brightness [ABSTRACT FROM AUTHOR]

Electrophysiological studies suggest that situational event knowledge plays an important role in language processing, but often fail to distinguish whether observed effects are driven by combinatorial expectations, or simple association with the context. In two ERP experiments, participants read short discourses describing ongoing events. We manipulated the situational expectancy of the target word continuing the event as well as the presence of an associated, but inactive event in the context. In both experiments we find an N400 effect for unexpected compared to expected target words, but this effect is significantly attenuated when the unexpected target is nonetheless associated with non-occurring context events. Our findings demonstrate that the N400 is simultaneously influenced by both simple association with – and combinatorial expectations derived from – situational event knowledge. Thus, experimental investigations and comprehension models of the use of event knowledge must accommodate the role of both expectancy and association in electrophysiological measures. [ABSTRACT FROM AUTHOR]

This study examines the link between phonological and morphological awareness and reading comprehension among special-education children who attend self-contained special education classes in regular Arab elementary schools.The three hypotheses were: First, the higher the level of phonological awareness in Arabic among special education learners, the better their reading comprehension level. Similarly, the higher the level of morphological awareness in Arabic among special education learners, the better their reading comprehension level. Third, it is possible to point to a joint effect of a child's phonological awareness and morphological awareness on reading comprehension abilities. This study's findings confirmed all three hypotheses and can subsequently be applied to understanding the processes underlying phonological and morphological awareness. This may be instrumental in discovering methods for promoting literacy and reading comprehension in special education learners. This study may also contribute to development of teacher training programmes that focus on effective methods for raising phonological and morphological awareness, ultimately resulting in improved reading comprehension in special education learners. [ABSTRACT FROM AUTHOR]