Simplifying informed consent as a universal precaution.

One barrier to participating in clinical research is that patients with low literacy skills (1 in 5 US adults) may struggle to understand the informed consent document (ICD). Writing consents using health literacy and plain language guidelines including simplified syntax and semantics can increase understandability and facilitate inclusivity of research populations with literacy challenges. Our study aim was to evaluate a simplified ICD for understandability while considering factors known to relate to comprehension (reading skills and working memory). We performed an on-line survey of 192 adults ages 18-77 in Georgia. Participants performed significantly better on the simplified ICD test. We built an additional model with all version x measure interactions (i.e., age, sex, race, urbanicity, GMVT, WM). This model did not significantly improve model fit, F < 1.00, suggesting that individual differences did not moderate the effect of simplification. Our findings suggest that using plain language and simplified syntax and semantics in ICD as a universal precaution may reduce cognitive reading burden for adults regardless of differences in reading skill or working memory. Increasing understandability in ICD may help improve targets for clinical trial enrollment.

Embedding Assessment Literacy Can Enhance Graduate Attribute Development in a Biomedical Sciences Curriculum.

This paper describes the successful implementation of an assessment literacy strategy within a Biomedical Sciences degree. Teaching was aligned with an assessment literacy framework and aimed to prepare undergraduates for a literature comprehension assessment. Students were introduced to the assessment purpose and an adapted Miller's pyramid model illustrated how the assessment contributed to competency development during their degree. Students read primary research papers and answered questions relating to the publications. They were then introduced to the processes of assessment and collaboratively graded answers of different standards. Finally, student and faculty grades were compared, differences considered, and key characteristics of answers discussed. Most students reported that they understood more about assessment standards than prior to the intervention [139/159 (87.4%)] and felt it had helped prepare them for their exam [138/159 (86.8%)]. The majority also reported they had increased confidence in evaluating data [118/159 (74%)], communicating their reasoning [113/159 (71%)] and considering what a reader needs to know [127/159 (79.9%)]. Students were asked to state the most important thing they had learned from the assessment literacy teaching. Notably, no responses referred to domain-specific knowledge. 129 free text responses were mapped to the University of Edinburgh graduate attribute framework. 93 (72%) statements mapped to the graduate attribute category "Research and Enquiry," 66 (51.16%) mapped to "Communication" and 21 (16.27%) mapped to "Personal and Intellectual Autonomy." To explore any longer-term impact of the assessment literacy teaching, a focus group was held with students from the same cohort, 2 years after the original intervention. Themes from this part of the study included that teaching had provided insights into standards and expectations for the assessment and the benefits of domain specific knowledge. A variety of aspects related to graduate attributes were also identified. Here, assessment literacy as a vehicle for graduate attribute development was an unexpected outcome. We propose that by explicitly engaging students with purpose, process, standards, and expectations, assessment literacy strategies may be used to successfully raise awareness of developmental progression, and enhance skills, aptitudes, and dispositions beneficial to Biomedical Sciences academic achievement and life after university.

Quality and Readability of Online Health Information on Common Urologic Cancers: Assessing Barriers to Health Literacy in Urologic Oncology.

INTRODUCTION: A growing number of Americans search online for health information related to urologic oncologic care each year. The American Medical Association recommends that medical information be written at a maximum sixth-grade level in order to be comprehensible by the majority of patients. As such, it is important to assess the quality and readability of online patient education material that patients are being exposed to. METHODS: A Google search was performed using the terms "testicular cancer," "prostate cancer," "kidney cancer," and "bladder cancer," and the top 30 results for each were reviewed. Websites were categorized based on their source. Readability was assessed using the Flesch-Kincaid Grade Level, the Gunning Frequency of Gobbledygook, and the Simple Measure of Gobbledygook indices. Quality was assessed using the DISCERN Quality Index (1-5 scale). RESULTS: A total of 91 websites were included in our analysis. On average, online health information pertaining to urologic cancers is written at a 10th- to 11th-grade reading level, which is significantly higher than that of an average American adult and that recommended by the American Medical Association (P < .01). The overall quality of websites was 3.4 ± 0.7, representing moderate to high quality. There was no significant difference in readability based on cancer type or information source. CONCLUSIONS: Despite being of moderate to high quality, online patient education materials related to common urologic cancers are often written at a grade level that exceeds the reading level of an average American adult. This presents as a barrier to online health literacy and calls into question the utility of these resources.

Dynamically predicting comprehension difficulties through physiological data and intelligent wearables.

Comprehending digital content written in natural language online is vital for many aspects of life, including learning, professional tasks, and decision-making. However, facing comprehension difficulties can have negative consequences for learning outcomes, critical thinking skills, decision-making, error rate, and productivity. This paper introduces an innovative approach to predict comprehension difficulties at the local content level (e.g., paragraphs). Using affordable wearable devices, we acquire physiological responses non-intrusively from the autonomous nervous system, specifically pulse rate variability, and electrodermal activity. Additionally, we integrate data from a cost-effective eye-tracker. Our machine learning algorithms identify 'hotspots' within the content and regions corresponding to a high cognitive load. These hotspots represent real-time predictors of comprehension difficulties. By integrating physiological data with contextual information (such as the levels of experience of individuals), our approach achieves an accuracy of 72.11% ± 2.21, a precision of 0.77, a recall of 0.70, and an f1 score of 0.73. This study opens possibilities for developing intelligent, cognitive-aware interfaces. Such interfaces can provide immediate contextual support, mitigating comprehension challenges within content. Whether through translation, content generation, or content summarization using available Large Language Models, this approach has the potential to enhance language comprehension.

Dyslexia Articles Unboxed: Analyzing Their Readability Level.

OBJECTIVE: Dyslexia is characterized by difficulties with fluent word recognition, decoding, or spelling, and it has been linked to family history. Given the impact of dyslexia on broad academic activities and well-being, ensuring that information about dyslexia is accessible to affected children and their families is vital. This study aims to assess the readability levels of dyslexia-related websites, with the hypothesis that such websites should be written at an appropriate readability level to accommodate those who may also have reading challenges. METHODS: This study analyzes the readability of 50 web articles on dyslexia using 6 readability formulas: Flesch-Kincaid Reading Ease, Flesch-Kincaid Grade Level, Gunning Fog Score, Simple Measure of Gobbledygook (SMOG) Index, Coleman Liau Index, and Automated Readability Index. The search term "What is dyslexia" was used on Google. Each article was analyzed using the online calculation website WebFX. The readability goal for these websites was set at fifth grade, a level recommended for patients with reading challenges. RESULTS: The study found that among the 50 websites, the lowest median readability score was 11.8 (corresponding to a 12th-grade level) on the SMOG Index, while the highest scores were 15.5 on both the Gunning Fog Score and the Coleman Liau Index (indicative of college-level readability). Almost none of the websites had scores below a fifth-grade level. CONCLUSION: Most websites related to dyslexia are too complex. Tools such as readability metrics and sentence restructuring by AI can help make the information more accessible and understandable to the stakeholders.

The impact of flipping class intervention on reading comprehension: Different approaches and proficiency levels.

Flipped classes can improve English language teaching and learning, especially reading outcomes, by enhancing student engagement and motivation through interactive and captivating educational materials. The goal of this study is to examine the effects of different schema activations in different English flipped class formats in pre-reading activities on the reading comprehension of students with different reading proficiency levels. A quasi-experimental research design was employed involving 30 first-year students from the first university and 28 first-year students from the second university in Surabaya, Indonesia, who were studying English as a general course at an intermediate level. The study used informed consent and two different formats, A and B, where pre-reading tasks were completed in class or asynchronously online, respectively. The study found that using video-based pre-reading activities in flipped class can improve comprehension and schema acquisition. Flipped classes can provide personalized learning experiences, but its effectiveness varies depending on the strategies and delivery methods used. While most students benefit from flipped classes, those who struggle with self-discipline and time management may find it challenging to adapt to the online component and may experience lower performance as a result.

Trial participants' self-reported understanding of randomisation phrases in participation information leaflets can be high, but acceptability of some descriptions is low, especially those linked to gambling and luck.

BACKGROUND: Evidence indicates that trial participants often struggle to understand participant information leaflets (PILs) for clinical trials, including the concept of randomisation. We analysed the language used to describe randomisation in PILs and determine the most understandable and acceptable description through public and participant feedback. METHODS: We collected 280 PILs/informed consent forms and one video animation from clinical research facilities/clinical trial units in Ireland and the UK. We extracted text on how randomisation was described, plus trial characteristics. We conducted content analysis to group the randomisation phrases inductively. We then excluded phrases that appeared more than once or were very similar to others. The final list of randomisation phrases was then presented to an online panel of participants and the public. Panel members were asked to rate each phrase on a 5-point Likert scale in terms of their understanding of the phrase, confidence in their understanding and acceptability of the phrase. RESULTS: Two hundred and eighty PILs and the transcribed text from one video animation represented 229 ongoing or concluded trials. The pragmatic content analysis generated five inductive categories: (1) explanation of why randomisation is required in trials; (2) synonyms for randomisation; (3) comparative randomisation phrases; (4) elaborative phrases for randomisation (5) and phrases that describe the process of randomisation. We had 48 unique phrases, which were shared with 73 participants and members of the public. Phrases that were well understood were not necessarily acceptable. Participants understood, but disliked, comparative phrases that referenced gambling, e.g. toss of a coin, like a lottery, roll of a die. They also disliked phrases that attributed decision-making to computers or automated systems. Participants liked plain language descriptions of what randomisation is and those that did not use comparative phrases. CONCLUSIONS: Potential trial participants are clear on their likes and dislikes when it comes to describing randomisation in PILs. We make five recommendations for practice.

'Getting it write' in a new era of patient online access to primary care health records.

AIM: To explore how to help make online consultation notes easier for patient audiences to understand. BACKGROUND: Most patients in England will soon be able to access all new prospective entries (including free-text) within their online primary care health record via the NHS App or other online services. METHOD: We conducted interviews and focus group discussions with 26 patients from underserved communities. Participants responded to vignettes about fictional patient consultation scenarios and assessed the clarity of corresponding simulated records. Participants were then asked to identify potential comprehension issues, offensive content, or anxiety triggers. RESULTS: Most participants struggled to understand a large proportion of simulated notes, particularly medical acronyms, clinician shorthand, and non-clinical abbreviations. Participants also identified issues that may cause unintended offence or additional anxiety. Participants considered that most patients will struggle to fully understand the content of their consultation notes in their current format. They made a number of suggestions about how this service may be improved to meet the needs of patient audiences and maintain positive patient-clinician relationships. CONCLUSION: Opening up online record access to include patient audiences necessitates a significant cultural shift in the way that consultation notes are written and used. To maximise NHS investment in this policy and avoid worsening health inequalities, it is essential to ensure that all patients can understand and access the benefits of online access to their notes. To do this, clinicians need to be supported to manage the challenges of writing for patient audiences, while continuing to maintain effective clinical care.

The Embodied Effect in the Comprehension of Chinese Action-Verb Metaphors.

Embodied cognition holds that one's body, actions, perceptions, and situations are integrated into the cognitive process and emphasizes the fact that sensorimotor systems play a role in language comprehension. Previous studies verified the embodied effect in literal language processing but few of them paid attention to metaphors in embodied cognition. The present study aims to explore the embodied effect in the comprehension of Chinese action-verb metaphor. Participants watched a video containing icons and corresponding actions to learn the relationship between them and how to perform these actions in the learning phase and in the test phase, a series of action-describing metaphor phrases were presented to participants with either the icons as primes or no prime at all. The results confirmed the embodied effect as the reaction times (RTs) were significantly shorter when action prime matched the action-verb in the following action-verb metaphor than that of no-prime condition, which are consistent with the facilitation observed in previous relevant studies in embodied cognition. In conclusion, this study verified the embodied effect in the comprehension of Chinese action-verb metaphor, offering further support to embodied cognition and providing a new interpretation for the metaphoric meaning construction of Chinese action-verbs.

An experimental study of the process of felt understanding in intergroup relations: Japanese and Chinese relations in Japan.

"Felt understanding" is a crucial determinant of positive interpersonal and intergroup relationships. However, the question of why felt understanding shapes intergroup relations has been neglected. In a pre-registered test of the process in intergroup relations with a sample from East Asia, we manipulated felt understanding (understood versus misunderstood by an outgroup) in an experimental study (N = 476). The results supported the expectation that felt understanding would lead to a more positive intergroup orientation and action intention. The results of parallel mediation analyses showed that felt understanding indirectly predicted intergroup outcomes through felt positive regard, intergroup overlap, and outgroup stereotypes. Furthermore, the results of post-hoc sequential mediation analyses indicated that felt understanding indirectly predicted intergroup outcomes sequentially through felt positive regard and intergroup overlap, followed by outgroup stereotypes.

The effects of a tier 2 reading comprehension intervention aligned to tier 1 instruction for fourth graders with inattention and reading difficulties.

This study reports a secondary analysis from a quasi-experimental design study (N = 13 schools) to examine the effects of aligned Tier 1 (T1) and Tier 2 (T2) instruction for a subsample of fourth graders with inattention and reading difficulties. Of this sample (N = 63 students), 100% received free- or reduced-price lunch, 92% identified as Hispanic, and 22% received special education services. T1 instruction focused on implementing practices to support reading comprehension and content learning during social studies instruction. The aligned T2 intervention focused on remediating reading comprehension difficulties using the same evidence-based practices implemented in T1, thus supporting students with connecting learning and applying skills across settings. Schools were assigned to one of three conditions: (a) aligned T1-T2 instruction; (b) nonaligned T1-T2 instruction, in which T1 and T2 practices were not intentionally aligned; or (c) business-as-usual (BaU) T1 and T2 practices. No significant differences were detected between the nonaligned T1-T2 and BaU conditions on student outcomes. However, large, statistically significant effects were detected in favor of the aligned T1-T2 condition compared to BaU on measures of content knowledge (Unit 1 ES = 0.85; Unit 2 ES = 1.46; Unit 3 ES = 0.79), vocabulary (Unit 1 ES = 0.88; Unit 2 ES = 0.85), and content reading comprehension (ES = 0.79). The aligned T1-T2 condition also outperformed the nonaligned T1-T2 condition on content knowledge (Unit 2 ES = 1.35; Unit 3 ES = 0.56), vocabulary (Unit 1 ES = 0.82), and the content reading comprehension assessment (ES = 0.69). Various effect sizes were not different from zero after correcting for clustered data. Although the magnitude of the effect sizes suggested promise, additional research is needed to fully understand the effects of aligned instruction on the reading outcomes of students with inattention and reading difficulty.

The effectiveness of visual-based interventions on health literacy in health care: a systematic review and meta-analysis.

BACKGROUND: Limited Health Literacy (HL) is an obstacle to accessing and receiving optimal health care and negatively impacts patients' quality of life, thus making it an urgent issue in the health care system. Visual-based interventions are a promising strategy to improve HL through the use of visual aids and pictorial materials to explain health-related concepts. However, a comprehensive summary of the literature on the topic is still scarce. METHODS: To fill this gap, we carried out a systematic review and meta-analysis with the aim to determine the effectiveness of visual-based interventions in improving comprehension of health related material in the clinical population. Independent studies evaluating the effectiveness of visual-based interventions on adults (> 18 years) and whose primary outcome was either health literacy (HL) or comprehension were eligible for the review. After a systematic literature search was carried out in five databases, 28 studies met the inclusion criteria and thus were included. Most of the studies were randomized controlled trials and they focused on HL and health knowledge as outcomes. RESULTS: The review and meta-analysis showed that visual-based interventions were most effective in enhancing the comprehension of health-related material compared to traditional methods. According to meta-analytic results, videos are more effective than traditional methods (Z = 5.45, 95% CI [0.35, 0.75], p < 0.00001) and than the employment of written material (Z = 7.59, 95% CI [0.48, 0.82], p < 0.00001). Despite this, no significant difference was found between video and oral discussion (Z = 1.70, 95% CI [-0.46, 0.53], p = 0.09). CONCLUSIONS: We conclude that visual-based interventions, particularly the ones using videos, are effective for improving HL and the comprehension of health-related material.

The role of embodied cognition in action language comprehension in L1 and L2.

In this study we carried out a behavioral experiment comparing action language comprehension in L1 (Italian) and L2 (English). Participants were Italian native speakers who had acquired the second language late (after the age of 10). They performed semantic judgments on L1 and L2 literal, idiomatic and metaphorical action sentences after viewing a video of a hand performing an action that was related or unrelated to the verb used in the sentence. Results showed that responses to literal and metaphorical L1 sentences were faster when the action depicted was related to the verb used rather than when the action depicted was unrelated to the verb used. No differences were found for the idiomatic condition. In L2 we found that all responses to the three conditions were facilitated when the action depicted was related to the verb used. Moreover, we found that the difference between the unrelated and the related modalities was greater in L2 than in L1 for the literal and the idiomatic condition but not for the metaphorical condition. These findings are consistent with the embodied cognition hypothesis of language comprehension.

Evaluating the accuracy and readability of ChatGPT in providing parental guidance for adenoidectomy, tonsillectomy, and ventilation tube insertion surgery.

OBJECTIVES: This study examined the potential of ChatGPT as an accurate and readable source of information for parents seeking guidance on adenoidectomy, tonsillectomy, and ventilation tube insertion surgeries (ATVtis). METHODS: ChatGPT was tasked with identifying the top 15 most frequently asked questions by parents on internet search engines for each of the three specific surgical procedures. We removed repeated questions from the initial set of 45. Subsequently, we asked ChatGPT to generate answers to the remaining 33 questions. Seven highly experienced otolaryngologists individually assessed the accuracy of the responses using a four-level grading scale, from completely incorrect to comprehensive. The readability of responses was determined using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. The questions were categorized into four groups: Diagnosis and Preparation Process, Surgical Information, Risks and Complications, and Postoperative Process. Responses were then compared based on accuracy grade, FRE, and FKGL scores. RESULTS: Seven evaluators each assessed 33 AI-generated responses, providing a total of 231 evaluations. Among the evaluated responses, 167 (72.3 %) were classified as 'comprehensive.' Sixty-two responses (26.8 %) were categorized as 'correct but inadequate,' and two responses (0.9 %) were assessed as 'some correct, some incorrect.' None of the responses were adjudged 'completely incorrect' by any assessors. The average FRE and FGKL scores were 57.15(±10.73) and 9.95(±1.91), respectively. Upon analyzing the responses from ChatGPT, 3 (9.1 %) were at or below the sixth-grade reading level recommended by the American Medical Association (AMA). No significant differences were found between the groups regarding readability and accuracy scores (p > 0.05). CONCLUSIONS: ChatGPT can provide accurate answers to questions on various topics related to ATVtis. However, ChatGPT's answers may be too complex for some readers, as they are generally written at a high school level. This is above the sixth-grade reading level recommended for patient information by the AMA. According to our study, more than three-quarters of the AI-generated responses were at or above the 10th-grade reading level, raising concerns about the ChatGPT text's readability.

New measures of number line estimation performance reveal children's ordinal understanding of numbers.

Children's performance on the number line estimation task, often measured by the percentage of absolute error, predicts their later mathematics achievement. This task may also reveal (a) children's ordinal understanding of the target numbers in relation to each other and the benchmarks (e.g., endpoints, midpoint) and (b) the ordinal skills that are a necessary precursor to children's ability to understand the interval nature of a number line as measured by percentage of absolute error. Using data from 104 U.S. kindergartners, we measured whether children's estimates were correctly sequenced across trials and correctly positioned relative to given benchmarks within trials at two time points. For both time points, we found that each ordinal error measure revealed a distinct pattern of data distribution, providing opportunities to tap into different aspects of children's ordinal understanding. Furthermore, children who made fewer ordinal errors scored higher on the Test of Early Mathematics Ability and showed greater improvement on their interval understanding of numbers as reflected by a larger reduction of percentage of absolute error from Time 1 to Time 2. The findings suggest that our number line measures reveal individual differences in children's ordinal understanding of numbers, and that such understanding may be a precursor to their interval understanding and later mathematics performance.

The Relation between Consumer Perception and Objective Understanding of Front-of-Package Nutrition Labels (FOPNLs); Results from an Online Representative Survey.

BACKGROUND: This study investigates the efficacy of Front-of-Pack Nutrition Labels (FOPNLs) as a cost-effective tool for improving dietary choices among Greek consumers. The purpose of the study was to investigate Greek customers' preferences and comprehension of commonly used European FOPNL schemes. METHODS: The Hellenic Food Authority and the Agricultural University of Athens performed a representative online survey in March 2022, titled "The Role of Nutritional Labelling in Public Perception and Food Procurement." Consumers responded to a questionnaire separated into two parts. Part one included (i) personal, sociodemographic information, and (ii) subjective opinions on the FOPNL schemes, and part two comprised (iii) an objective understanding of NutriScore and NutrInform Battery, using 15 different foods. Participants were randomly allocated to these groups, and general mixed models were used for analysis. RESULTS: A total of 1389 adults completed the first part of the survey, and 74.8% completed the second part. The Multiple Traffic Lights scheme was the preferred FOPNL, chosen by 48.4% of respondents, compared to 19.7% for NutrInform Battery and 12.3% for NutriScore. However, the mean objective assessment score was highest for NutriScore (5.8 ± 2.3) compared to NutrInform Battery (5.4 ± 1.9). CONCLUSION: The results highlight the necessity for comprehensive nutrition education programs by showing a considerable gap between subjective preferences and an objective understanding of nutrition labels.

[The OMAGE comprehension interview: a method for building patient-centered care plans]. / Entretien de compréhension Omage : une méthode pour élaborer des plans de soins centrés sur le patient.

OMAGE comprehension interviews (CIs) use a card game as a vehicle for active listening. CIs performed by training professionals revealed new information for 92% of patients. CIs seem to be an effective method for building patient-centered management plans, can be used by a wide range of health professionals and as prerequisites for medication reconciliation and patient education.

The effects of question previewing on response accuracy and text processing: An eye-movement study.

The present study investigated the impact of manipulating reading strategies (i.e., reading the questions first [QF] or reading the passage first [PF]) during a reading comprehension test where we explored how reading strategy was related to student characteristics (i.e., reading achievement and working memory capacity). Participants' eye movements were monitored as they read 12 passages and answered multiple-choice questions. We examined differences in (a) response accuracy, (b) average total time on words in the text, (c) total task reading time, and (d) time reading text relevant to questions as a function of PF and QF strategies. Analyses were conducted to examine whether findings varied as a function of student characteristics (i.e., reading achievement and working memory capacity) and grade level (Grades 3, 5, and 8). Several interesting findings emerged from our study, including a limited effect of reading strategy use on response accuracy, with only eighth graders demonstrating better accuracy in the QF condition, and several demonstrations of PF leading to more efficient test-taking processes, including (a) longer average total reading times on words in the passage in the PF condition that could be associated with creating a better mental model of the text, (b) often being associated with less total-task time, and (c) being associated with more successful search strategies. Implications for providing teachers and students with strategies are discussed.

Assessing parental comprehension of online resources on childhood pain.

We aimed to examine the patient education materials (PEMs) on the internet about "Child Pain" in terms of readability, reliability, quality and content. For our observational study, a search was made on February 28, 2024, using the keywords "Child Pain," "Pediatric Pain," and "Children Pain" in the Google search engine. The readability of PEMs was assessed using computer-based readability formulas (Flesch Reading Ease Score [FRES], Flesch-Kincaid Grade Level [FKGL], Automated readability index (ARI), Gunning Fog [GFOG], Coleman-Liau score [CL], Linsear Write [LW], Simple Measure of Gobbledygook [SMOG]). The reliability and quality of websites were determined using the Journal of American Medical Association (JAMA) score, Global Quality Score (GQS), and DISCERN score. 96 PEM websites included in our study. We determined that the FRES was 64 (32-84), the FKGL was 8.24 (4.01-15.19), ARI was 8.95 (4.67-17.38), GFOG was 11 (7.1-19.2), CL was 10.1 (6.95-15.64), LW was 8.08 (3.94-19.0) and SMOG was 8.1 (4.98-13.93). The scores of readability formulas showed that, the readability level of PEMs was statistically higher than sixth-grade level with all formulas (P = .011 for FRES, P < .001 for GFOG, P < .001 for ARI, P < .001 for FKGL, P < .001 for CL and P < .001 for SMOG), except LW formula (P = .112). The websites had moderate-to-low reliability and quality. Health-related websites had the highest quality with JAMA score. We found a weak negative correlation between Blexb score and JAMA score (P = .013). Compared to the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability grade level of child pain-related internet-based PEMs is quite high. On the other hand, the reliability and quality of PEMs were determined as moderate-to-low. The low readability and quality of PEMs could cause an anxious parent and unnecessary hospital admissions. PEMs on issues threatening public health should be prepared with attention to the recommendations on readability.

Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss.

This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.