Morphological Assessment Features and their Relations to Reading: A Meta-Analytic Structural Equation Modeling Study.

Morphemes are the smallest meaningful unit of language (e.g., affixes, base words) that express grammatical and semantic information. Additionally, morphological knowledge is significantly related to children's word reading and reading comprehension skills. Researchers have broadly assessed morphological knowledge by using a wide range of tasks and stimuli, which has influenced the interpretation of the relations between morphological knowledge and reading outcomes. This review of 103 studies used meta-analytic structural equation modeling (MASEM) to investigate the relations between commonly occurring morphological knowledge assessment features (e.g., written versus oral, spelling versus no spelling) in the literature to reading outcomes, including word reading and reading comprehension. Meta-regression techniques were used to examine moderators of age and reading ability. Morphological assessments that used a written modality (e.g., reading, writing) were more predictive of word reading outcomes than those administered orally. Assessments of morphological spelling were more predictive of both word reading and reading comprehension outcomes than those that did not examine spelling accuracy. Age was a significant moderator of the relation between morphology and word reading, such that the relation was stronger for the younger than the older children. Younger children also demonstrated higher relations between multiple task dimensions and reading comprehension, including oral tasks, tasks without decoding, and tasks that provided context clues. These findings have important implications for future morphological intervention studies aimed to improve children's reading outcomes, in particular the use of orthography and spelling within the context of teaching morphology.

It's about time! Exploring time allocation patterns of adults with lower literacy skills on a digital assessment.

Introduction: Despite the necessity for adults with lower literacy skills to undergo and succeed in high-stakes computer-administered assessments (e.g., GED, HiSET), there remains a gap in understanding their engagement with digital literacy assessments. Methods: This study analyzed process data, specifically time allocation data, from the Program for the International Assessment of Adult Competencies (PIAAC), to investigate adult respondents' patterns of engagement across all proficiency levels on nine digital literacy items. We used cluster analysis to identify distinct groups with similar time allocation patterns among adults scoring lower on the digital literacy assessment. Finally, we employed logistic regression to examine whether the groups varied by demographic factors, in particular individual (e.g., race/ethnicity, age) and contextual factors (e.g., skills-use at home). Results: Adults with lower literacy skills spent significantly less time on many of the items than adults with higher literacy skills. Among adults with lower literacy skills, two groups of time allocation patterns emerged: one group (Cluster 1) exhibited significantly longer engagement times, whereas the other group (Cluster 2) demonstrated comparatively shorter durations. Finally, we found that adults who had a higher probability of Cluster 1 membership (spending more time) exhibited relatively higher literacy scores, higher self-reported engagement in writing skills at home, were older, unemployed, and self-identified as Black. Discussion: These findings emphasize differences in digital literacy engagement among adults with varying proficiency levels. Additionally, this study provides insights for the development of targeted interventions aimed at improving digital literacy assessment outcomes for adults with lower literacy skills.

Outreach for Young Adult African Americans with Risk Factors for Stroke.

BACKGROUND: Research suggests that younger adult African American people (age 18-35 years) have more than double the risk of having a stroke than White people. Stroke risk education is lacking for this cohort; there is a dearth of materials that are targeted and focused for young adult African Americans. There is also little research on developing and testing age and culturally appropriate health literate materials that may help this population better understand personal risk factors for stroke. OBJECTIVE: The aim of this study was to understand factors to guide creating and disseminating plain language health messages about stroke risk awareness among young adult African Americans. METHODS: African American participants age 18 years and older completed an online survey (N = 413). Descriptive statistics, one-way analysis of variance, and two-step cluster analyses were used to evaluate stroke risk awareness, perceived risk of stroke, message creation factors, and online health information seeking behavior. Open-ended survey items described modifiable and non-modifiable reasons for perceived risk of stroke. KEY RESULTS: Participants reported differences on overall stroke risk factor awareness by perceived risk of stroke was significant (F[2, 409] = 4.91, p = .008) with the very low/low group (M = 1.66, p < .01), showing significantly lower overall stroke risk factor awareness compared to the moderate and high/very high groups. Both respondents who thought their stroke risk was very low/low and moderate/high/very high commented about family history (54.1% and 45.9%, respectively) as the reason and 88.2% of very low/low commented that they did not have risk factors for stroke because they were young. Cluster analysis indicated the Mostly Clear Preferences cluster was more likely to select mostly/very on positive, informational, and long-term messages and medical authority sources. The largest of three clusters reported medical sources as the highest rated source for both finding and trusting health information (47.2%, n = 195). CONCLUSION: Young adult African Americans have a scarce understanding of modifiable stroke risk factors; health education materials should focus on positive information messaging that shows a long-term result and is presented by a medical authority. We did not observe any age or sex differences among the data, which suggests different message modalities may not be needed. [HLRP: Health Literacy Research and Practice. 2024;8(1):e38-e46.].

PLAIN LANGUAGE SUMMARY: In this study, we collected data to create a targeted stroke risk awareness health education video for young African American adults (age 18 years and older). The video was based on analysis of data from 413 participants focusing on perception of stroke risk, stroke risk knowledge, as well as preference for message type, source credibility, and modality.

Concordance of informant and self-reported ratings on the Frontal Systems Behavior Scale in adult survivors of pediatric brain tumor.

OBJECTIVE: It has been theorized that pediatric brain tumor survivors may have reduced insight into their executive functioning. Agreement between informants and survivors has been used to probe this theory, but findings have been inconsistent. This study sought to expand on prior work by examining the relationship between participant role and ratings on the Frontal Systems Behavior Scale (FrSBe) among 73 adult survivors and their informants. This study also sought to test whether agreement on scores varied as a function of tumor treatment. METHOD: Dyadic mixed effects models examined the relationship between participant ratings on FrSBe subscales and the role of a participant (survivor or informant). Intraclass correlations (ICC) were used to calculate reliable change indices to evaluate significant divergence in self and informant agreement. RESULTS: Dyadic mixed effects models showed an insignificant relationship between participant role and ratings on the FrSBe apathy and executive dysfunction subscales. Participant role was related to ratings on the disinhibition subscale of the FrSBe. The ICC for apathy was ICC = .583, for disinhibition ICC = .420, and for executive dysfunction ICC = .373. Significant divergence in scores did not vary by history of chemoradiation. CONCLUSIONS: Results demonstrate an effect of role on one FrSBe subscale and weak to moderate agreement between survivor and informant scores, which suggests that agreement between informants and survivors varies by FrSBe domain. The strongest relationship between survivors and informants was seen on apathy, which suggests that apathy is a shared concern for survivors and their families.

Distinct latent symptom profiles in late-onset depressive symptoms in community-dwelling older adults.

OBJECTIVES: To examine the symptom profiles of late-onset depressive symptoms in a sample of older adults. METHOD: The sample included 1,192 participants from the National Alzheimer's Coordinating Center Data Set. Participants were ≥65 years old, community-dwelling, and without cognitive impairment or a prior history of depression. Depressive symptoms were assessed using the Geriatric Depression Scale, 15-item (GDS-15). Latent class analysis (LCA) was used to identify and group participants based on profiles of depressive symptoms. RESULTS: LCA revealed three distinct symptom profiles: (1) an Anhedonia/Amotivation profile with a higher probability of endorsing a combination of low positive emotion and amotivation (6%), (2) an Amotivation/Withdrawal profile with a high probability of endorsing only amotivational depressive symptoms (35%), and (3) an asymptomatic profile with no probability of endorsing any depressive symptoms (59%). Amotivational depressive symptoms were observed across both symptomatic profiles, while depressed mood (e.g. sadness) did not predominantly characterize any profile in this sample. There were also significant differences among symptom profiles in terms of demographic and clinical characteristics. CONCLUSIONS: Findings highlight the importance of understanding depression at the symptom pattern level. A profile-based diagnostic approach may help improve the recognition of depressive symptoms in older adults.

Do Struggling Adult Readers Monitor Their Reading? Understanding the Role of Online and Offline Comprehension Monitoring Processes During Reading.

Comprehension monitoring is a meta-cognitive skill that is defined as the ability to self-evaluate one's comprehension of text. Although it is known that struggling adult readers are poor at monitoring their comprehension, additional research is needed to understand the mechanisms underlying comprehension monitoring and their role in reading comprehension in this population. This study used a comprehension monitoring task with struggling adult readers, which included online eye movements (reread and regression path durations) and an offline verbal protocol (oral explanations of key information). We examined whether eye movements predicted accuracy on the passages' reading comprehension questions, a norm-referenced reading assessment, and an offline verbal protocol after controlling for age and traditional component skills (i.e., decoding, oral language, working memory). Regression path duration uniquely predicted accuracy on the questions; however, decoding and oral vocabulary were the most salient predictors of the norm-referenced reading comprehension measure. Regression path duration also predicted the offline verbal protocol, such that those who exhibited longer regression path duration were also better at explaining key information. These results contribute to the literature regarding struggling adults' reading component skills, eye movement behaviors involved in processing connected text, and future considerations in assessing comprehension monitoring.

Strengthening the Case for Universal Health Literacy: The Dispersion of Health Literacy Experiences Across a Southern U.S. State.

BACKGROUND: How individuals perceive their health literacy may differ based on demographic and individual characteristics. OBJECTIVE: The purpose of this study was to understand the dispersion of health literacy across demographics in the state of Georgia in 2021 and to determine which factors influence health literacy. METHODS: Study participants were age 18 years and older and completed an on-line Health Literacy Questionnaire (N = 520). The participant pool was stratified to mirror state-wide demographics of geography and race. Results were further collapsed into composite scales reflecting basic, communicative, and critical health literacy. Descriptive statistics, bivariate Pearson's correlations, and multiple regression analyses were used. A two-step cluster analysis was performed with the nine health literacy scales. KEY RESULTS: Rural county and no health insurance were negatively related to all three composite scales (rs = .093-.254, ps < .05). Demographic predictors accounted for 6.7% of the variance in basic (F[6, 439] = 5.287, p < .001), 10% in communicative (F[6, 438] = 8.154, p < .001), and 6% for critical (F[6, 439] = 4.675, p < .0010. In all scales, health insurance status was the strongest primary unique predictor (ßs = .236, .295, .181, ps <.05, respectively). In a two-step cluster analysis only health insurance status differentiated the health literacy level clusters (X2(3) = 9.43, 34.51, ps = 024, <.001 respectively). CONCLUSION: Lacking health insurance is the most consistent and largest contributor to low health literacy across the state of Georgia; population demographics are not. Health literacy policies and practices should be developed for universal application and not focus on specific populations. [HLRP: Health Literacy Research and Practice. 2022;6(3):e182-e190.] Plain Language Summary: In this study, demographics that are usually associated with low health literacy like age, sex, race, educational attainment, and type of county (rural or urban) were not associated with; the only significant factor was lack of health insurance. This relationship strengthens the case for universal health literacy precautions that go beyond population demographics.

The Dispersion of Health Information-Seeking Behavior and Health Literacy in a State in the Southern United States: Cross-sectional Study.

BACKGROUND: The transmission of health information from in-person communication to web-based sources has changed over time. Patients can find, understand, and use their health information without meeting a health care provider and are able to participate more in their health care management. In recent years, the internet has emerged as the primary source of health information, although clinical providers remain the most credible source. The ease of access, anonymity, and busy schedules may be motivating factors to seek health information on the web. Social media has surfaced as a popular source of health information, as it can provide news in real time. The increase in the breadth and depth of health information available on the web has also led to a plethora of misinformation, and individuals are often unable to discern facts from fiction. Competencies in health literacy (HL) can help individuals better understand health information and enhance patient decision-making, as adequate HL is a precursor to positive health information-seeking behaviors (HISBs). Several factors such as age, sex, and socioeconomic status are known to moderate the association between HL and HISBs. OBJECTIVE: In this study, we aimed to examine the relationship between HL and HISBs in individuals living in a southern state in the United States by considering different demographic factors. METHODS: Participants aged ≥18 years were recruited using Qualtrics Research Services and stratified to match the statewide demographic characteristics of race and age. Demographics and source and frequency of health information were collected. The Health Literacy Questionnaire was used to collect self-reported HL experiences. SPSS (version 27; IBM Corp) was used for the analysis. RESULTS: A total of 520 participants met the criteria and completed the survey (mean age 36.3, SD 12.79 years). The internet was cited as the most used source of health information (mean 2.41, SD 0.93). Females are more likely to seek health information from physicians than males (r=0.121; P=.006). Older individuals are less likely to seek health information from the internet (r=-0.108; P=.02), social media (r=-0.225; P<.001), and friends (r=-0.090; P=.045) than younger individuals. Cluster analysis demonstrated that individuals with higher levels of HISBs were more likely to seek information from multiple sources than those with lower levels of HISBs (mean range 3.05-4.09, SD range 0.57-0.66; P<.001). CONCLUSIONS: Age and sex are significantly associated with HISB. Older adults may benefit from web-based resources to monitor their health conditions. Higher levels of HL are significantly associated with greater HISB. Targeted strategies to improve HISB among individuals with lower levels of HL may improve their access, understanding, and use of health information.

Unpacking the Simple View of Reading for Struggling Adult Readers.

The Simple View of Reading (SVR), which posits that reading comprehension is the product of decoding and linguistic comprehension, has been studied extensively with school-age readers. However, little is known about the intricacies of the SVR for adults who struggle with reading. This study addresses notable gaps in this literature, including the dimensionality of linguistic comprehension, the interaction between the two SVR components, and the relative contributions of components across different reading proficiency levels. With a sample of 392 struggling adult readers, confirmatory factor analyses indicated that the linguistic comprehension component encompasses the highly related yet separable constructs of oral vocabulary and listening comprehension. Structural equation modeling showed significant main effects of decoding and listening comprehension, but not oral vocabulary, on reading comprehension. In addition, the interaction among the SVR components did not uniquely contribute to variance in reading comprehension. Quantile regression models demonstrated that the unique effects of the SVR components were relatively stable in magnitude across different levels of reading comprehension performance. Implications for instruction and future research are discussed.

Using assessment to individualize early mathematics instruction.

Accumulating evidence suggests that assessment-informed personalized instruction, tailored to students' individual skills and abilities, is more effective than more one-size-fits-all approaches. In this study, we evaluate the efficacy of Individualizing Student Instruction in Mathematics (ISI-Math) compared to Reading (ISI-Reading) where classrooms were randomly assigned to ISI-Math or ISI-Reading. The literature on child characteristics X instruction or skill X treatment interaction effects point to the complexities of tailoring instruction for individual students who present with constellations of skills. Second graders received mathematics instruction in small flexible learning groups based on their assessed learning needs. Results of the study (n=32 teachers, 370 students) revealed significant treatment effects on standardized mathematics assessments. With effect sizes (d) of 0.41-0.60, we show that we can significantly improve 2nd graders' mathematics achievement, including for children living in poverty, by using assessment data to individualize the mathematics instruction they receive. The instructional regime, ISI-Math, was implemented by regular classroom teachers and it led to about a 4-month achievement advantage on standardized mathematics tests when compared to students in control classrooms. These results were realized within one school year. Moreover, treatment effects were the same regardless of school-level poverty and students' gender, initial mathematics or vocabulary scores.

Does Use of Text-to-Speech and Related Read-Aloud Tools Improve Reading Comprehension for Students With Reading Disabilities? A Meta-Analysis.

Text-to-speech and related read-aloud tools are being widely implemented in an attempt to assist students' reading comprehension skills. Read-aloud software, including text-to-speech, is used to translate written text into spoken text, enabling one to listen to written text while reading along. It is not clear how effective text-to-speech is at improving reading comprehension. This study addresses this gap in the research by conducting a meta-analysis on the effects of text-to-speech technology and related read-aloud tools on reading comprehension for students with reading difficulties. Random effects models yielded an average weighted effect size of ([Formula: see text] = .35, with a 95% confidence interval of .14 to .56, p < .01). Moderator effects of study design were found to explain some of the variance. Taken together, this suggests that text-to-speech technologies may assist students with reading comprehension. However, more studies are needed to further explore the moderating variables of text-to-speech and read-aloud tools' effectiveness for improving reading comprehension. Implications and recommendations for future research are discussed.

Acquiring Science and Social Studies Knowledge in Kindergarten Through Fourth Grade: Conceptualization, Design, Implementation, and Efficacy Testing of Content-Area Literacy Instruction (CALI).

With national focus on reading and math achievement, science and social studies have received less instructional time. Yet, accumulating evidence suggests that content knowledge is an important predictor of proficient reading. Starting with a design study, we developed Content Area Literacy Instruction (CALI), as an individualized (or personalized) instructional program for kindergarteners through fourth graders to build science and social studies knowledge. We developed CALI to be implemented in general education classrooms, over multiple iterations (n=230 students), using principles of design-based implementation research. The aims were to develop CALI as a usable and feasible instructional program that would, potentially, improve science and social studies knowledge, and could be implemented during the literacy block without negatively affecting students' reading gains (i.e., no opportunity cost). We then evaluated the efficacy of CALI in a randomized controlled field trial with 418 students in kindergarten through fourth grade. Results reveal that CALI demonstrates promise as a useable and feasible instructional individualized general education program, and is efficacious in improving social studies (d=2.2) and science (d=2.1) knowledge, with some evidence of improving oral and reading comprehension skills (d=.125).

Readers in Adult Basic Education.

The present study explored the reading skills of a sample of 48 adults enrolled in a basic education program in northern Florida, United States. Previous research has reported on reading component skills for students in adult education settings, but little is known about eye movement patterns or their relation to reading skills for this population. In this study, reading component skills including decoding, language comprehension, and reading fluency are reported, as are eye movement variables for connected-text oral reading. Eye movement comparisons between individuals with higher and lower oral reading fluency revealed within- and between-subject effects for word frequency and word length as well as group and word frequency interactions. Bivariate correlations indicated strong relations between component skills of reading, eye movement measures, and both the Test of Adult Basic Education ( Reading subtest) and the Woodcock-Johnson III Diagnostic Reading Battery Passage Comprehension assessments. Regression analyses revealed the utility of decoding, language comprehension, and lexical activation time for predicting achievement on both the Woodcock Johnson III Passage Comprehension and the Test of Adult Basic Education Reading Comprehension.

Investigating morphological awareness and the processing of transparent and opaque words in adults with low literacy skills and in skilled readers.

For adults with low literacy skills, the role of phonology in reading has been fairly well researched, but less is known about the role of morphology in reading. We investigated the contribution of morphological awareness to word reading and reading comprehension and found that for adults with low literacy skills and skilled readers, morphological awareness explained unique variance in word reading and reading comprehension. In addition, we investigated the effects of orthographic and phonological opacity in morphological processing. Results indicated that adults with low literacy skills were more impaired than skilled readers on items containing phonological changes but were spared on items involving orthographic changes. These results are consistent with previous findings of adults with low literacy skills reliance on orthographic codes. Educational implications are discussed.

Using Simulations to Investigate the Longitudinal Stability of Alternative Schemes for Classifying and Identifying Children with Reading Disabilities.

The present study employed data simulation techniques to investigate the one-year stability of alternative classification schemes for identifying children with reading disabilities. Classification schemes investigated include low performance, unexpected low performance, dual-discrepancy, and a rudimentary form of constellation model of reading disabilities that included multiple criteria. Data from Spencer et al. (2014) were used to construct a growth model of reading development. The parameters estimated from this model were then used to construct three simulated datasets wherein the growth parameters were manipulated in one of three ways: A stable-growth pattern, a mastery learning pattern and a fan-spread pattern. Results indicated that overall the constellation model provided the most stable classifications across all conditions of the simulation, and that classification schemes were most stable in the fan-spread condition, and were the least stable under the mastery learning growth pattern. These results also demonstrate the utility of data simulations in reading research.

Modeling the Relations Among Morphological Awareness Dimensions, Vocabulary Knowledge, and Reading Comprehension in Adult Basic Education Students.

This study extended the findings of Tighe and Schatschneider (2015) by investigating the predictive utility of separate dimensions of morphological awareness as well as vocabulary knowledge to reading comprehension in adult basic education (ABE) students. We competed two- and three-factor structural equation models of reading comprehension. A three-factor model of real word morphological awareness, pseudoword morphological awareness, and vocabulary knowledge emerged as the best fit and accounted for 79% of the reading comprehension variance. The results indicated that the constructs contributed jointly to reading comprehension; however, vocabulary knowledge was the only potentially unique predictor (p = 0.052), accounting for an additional 5.6% of the variance. This study demonstrates the feasibility of applying a latent variable modeling approach to examine individual differences in the reading comprehension skills of ABE students. Further, this study replicates the findings of Tighe and Schatschneider (2015) on the importance of differentiating among dimensions of morphological awareness in this population.

Examining the Relationships of Component Reading Skills to Reading Comprehension in Struggling Adult Readers: A Meta-Analysis.

The current study employed a meta-analytic approach to investigate the relative importance of component reading skills to reading comprehension in struggling adult readers. A total of 10 component skills were consistently identified across 16 independent studies and 2,707 participants. Random effects models generated 76 predictor-reading comprehension effect sizes among the 10 constructs. The results indicated that six of the component skills exhibited strong relationships with reading comprehension (average rs ≥ .50): morphological awareness, language comprehension, fluency, oral vocabulary knowledge, real word decoding, and working memory. Three of the component skills yielded moderate relationships with reading comprehension (average rs ≥ .30 and < .50): pseudoword decoding, orthographic knowledge, and phonological awareness. Rapid automatized naming (RAN) was the only component skill that was weakly related to reading comprehension (r = .15). Morphological awareness was a significantly stronger correlate of reading comprehension than phonological awareness and RAN. This study provides the first attempt at a systematic synthesis of the recent research investigating the reading skills of adults with low literacy skills, a historically understudied population. Directions for future research, the relation of our results to the children's literature, and the implications for researchers and adult basic education programs are discussed.

A Quantile Regression Approach to Understanding the Relations Among Morphological Awareness, Vocabulary, and Reading Comprehension in Adult Basic Education Students.

The purpose of this study was to investigate the joint and unique contributions of morphological awareness and vocabulary knowledge at five reading comprehension levels in adult basic education (ABE) students. We introduce the statistical technique of multiple quantile regression, which enabled us to assess the predictive utility of morphological awareness and vocabulary knowledge at multiple points (quantiles) along the continuous distribution of reading comprehension. To demonstrate the efficacy of our multiple quantile regression analysis, we compared and contrasted our results with a traditional multiple regression analytic approach. Our results indicated that morphological awareness and vocabulary knowledge accounted for a large portion of the variance (82%-95%) in reading comprehension skills across all quantiles. Morphological awareness exhibited the greatest unique predictive ability at lower levels of reading comprehension whereas vocabulary knowledge exhibited the greatest unique predictive ability at higher levels of reading comprehension. These results indicate the utility of using multiple quantile regression to assess trajectories of component skills across multiple levels of reading comprehension. The implications of our findings for ABE programs are discussed.

Examining the Underlying Dimensions of Morphological Awareness and Vocabulary Knowledge.

We report results from two studies on the underlying dimensions of morphological awareness and vocabulary knowledge in elementary-aged children. In Study 1, 99 fourth-grade students were given multiple measures of morphological awareness and vocabulary. A single factor accounted for individual differences in all morphology and vocabulary assessments. Study 2 extended these results by giving 90 eighth-grade students expanded measures of vocabulary and morphology that assessed (a) definitional knowledge, (b) usage, (c) relational knowledge, and (d) knowledge of morphological variants, with each potential aspect of knowledge assessed using an identical set of 23 words to control for differential knowledge of specific vocabulary items. Results indicated that a single-factor model that encompassed morphological and vocabulary knowledge provided the best fit to the data. Finally, explanatory item response modeling was used to investigate sources of variance in the vocabulary and morphological awareness tasks we administered. Implications for assessment and instruction are discussed.

An investigation of morphological awareness and processing in adults with low literacy.

Morphological awareness, which is an understanding of how words can be broken down into smaller units of meaning such as roots, prefixes, and suffixes, has emerged as an important contributor to word reading and comprehension skills. The first aim of the current study was to investigate the contribution of morphological awareness independent of phonological awareness and decoding to the reading comprehension abilities of adults with low literacy. Results indicated that morphological awareness was a significant unique predictor of reading comprehension. A second aim of the study was to investigate the processing of morphologically complex words of adults with low literacy in both an oral reading passage and a single-word naming task. Adults' accuracy and response times were measured on different types of morphologically complex words and compared with control words matched on frequency in both the passage and the naming tasks. Results revealed that adults were vulnerable to morphological complexity: they performed more accurately and faster on matched control words versus morphologically complex word types. The educational implications for Adult Basic Education programs are discussed.