IOWA CITY, Iowa -- Knowing you have a medical problem or skill deficiency even though tests indicate you are fine can be frustrating, as many individuals recovering from brain injuries can tell you. Most of these patients pass conventional reading assessments, despite complaints of reading difficulties. However, a University of Iowa test could verify the reading difficulty these individuals have.
The Iowa-Chapman Reading Test appears to be more sensitive than other assessments, able to pick up on even subtle reading problems. In a recently published study, 89 percent of 64 patients with lingering complaints of reading difficulties performed below expectations on the Iowa-Chapman test, even though the patients did well on other standard tests.
"Ken Manzel, a senior technician in my lab, and I had been intrigued by the fact that many patients with brain injuries said they had trouble reading even after they passed the other tests," said Daniel Tranel, Ph.D., UI professor of neurology. "We decided one of the problems had to be the tests. Maybe the tests weren't doing the job."
To overcome some of the limitations of existing reading assessments, UI researchers developed their own test based on the Chapman-Cook Speed of Reading Test, originally created in the 1920s to determine silent reading speed and comprehension in grade school children. The researchers were hoping to avoid the ceiling effect found in most reading tests. The other tests were so easy and the test takers had so much time to finish the exercise that almost everyone passed. In contrast, patients must complete the Iowa-Chapman test in two and a half minutes.
"It's pretty hard to do it in two and a half minutes," Tranel said. "You really have to hustle."
The Iowa-Chapman test consists of 25 one- to two-sentence paragraphs, each of which contains one word in the second half of the passage that spoils the meaning. For example, one of the items reads: Tom got badly hurt the other day when fighting with his older brother. As soon as this happened, he ran home to his mother, laughing as hard as he could. Participants must read through the items and cross out the inappropriate word for each passage as quickly as possible. The score is the number of items the patient completes accurately within the time limit.
"It's quick, straight forward to give and very sensitive to reading problems caused by brain injury," Tranel said.
Reading difficulty, or acquired alexia, can occur when the left side of the brain, which houses centers for reading ability, becomes damaged. The damage can occur from stroke, head injury, brain tumor or brain infection. The chief complaint is being unable to read quickly with comprehension.
"Although there is not much we can do as far as rehabilitating the problem, we can at least give people feedback -- let them know that what they are experiencing is real," Tranel said.
Tranel and Manzel's work looking at the effectiveness of the Iowa-Chapman Reading Test appears in a recent issue of Developmental Neuropsychology. The study was supported by a National Institute of Neurological Disorders and Stroke Program Project Grant.
Journal
Developmental Neuropsychology