Portland State University Portland State University PDXScholar PDXScholar Dissertations and Theses Dissertations and Theses 1990 Reading comprehension of literal, translational, and Reading comprehension of literal, translational, and high inference level questions in aphasic and right high inference level questions in aphasic and right hemisphere damaged adults hemisphere damaged adults Ute Kongsbak Portland State University Follow this and additional works at: https://pdxscholar.library.pdx.edu/open_access_etds Part of the Speech and Hearing Science Commons Let us know how access to this document benefits you. Recommended Citation Recommended Citation Kongsbak, Ute, "Reading comprehension of literal, translational, and high inference level questions in aphasic and right hemisphere damaged adults" (1990). Dissertations and Theses. Paper 4094. https://doi.org/10.15760/etd.5977 This Thesis is brought to you for free and open access. It has been accepted for inclusion in Dissertations and Theses by an authorized administrator of PDXScholar. Please contact us if we can make this document more accessible: [email protected].
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Portland State University Portland State University
PDXScholar PDXScholar
Dissertations and Theses Dissertations and Theses
1990
Reading comprehension of literal, translational, and Reading comprehension of literal, translational, and
high inference level questions in aphasic and right high inference level questions in aphasic and right
Follow this and additional works at: https://pdxscholar.library.pdx.edu/open_access_etds
Part of the Speech and Hearing Science Commons
Let us know how access to this document benefits you.
Recommended Citation Recommended Citation Kongsbak, Ute, "Reading comprehension of literal, translational, and high inference level questions in aphasic and right hemisphere damaged adults" (1990). Dissertations and Theses. Paper 4094. https://doi.org/10.15760/etd.5977
This Thesis is brought to you for free and open access. It has been accepted for inclusion in Dissertations and Theses by an authorized administrator of PDXScholar. Please contact us if we can make this document more accessible: [email protected].
SUMMARY OF THE ANALYSIS OF VARIANCE BY QUESTION TYPE WITHIN AND BETWEEN GROUPS
44
SS DF MS F Probability
LBD TOTAL SCORE between within
RBD TOTAL SCORE between within
258.380 2 3014.233 30
382.853 2 4417.954 30
129.19 1.286 100.474
191.426 1.3 147.265
SS = sum of Squares MS = Mean Squares
DF = Degrees of Freedom (p < .05)
0.291
0.287
'. i iift~· t,1
TABLE IX
SUMMARY OF t-TESTS ON SPICA, SUBTEST VII, AND METAPHORICAL LANGUAGE TEST SCORES
45
TEST overall mean
within group SD*
t-statistic probability
SPICA 13.78 0.691
Subtest VII 14.39 1. 00
Literal Interpre-tat ion 0.375 0.671
Partially Correct 1.594 1.881
Totally Correct 6.188 2.249
* SD = Standard Deviation ** significant (p < .05)
-5.475 0.001**
-3.135 0.004**
-2.108 0.043**
-3.664 0.001**
-5.816 0.001**
Beais
pber
e Aq
e
Hea
isphe
re
1. 00
0 Aq
e 0.1
36
1.00
0 Ti
ae P
ost
0.003
-0
.054
ld
ucat
lon
-0 .1
11
0.145
SP
ICA
aean
0.1
01
0.103
Su
btes
t VI
I 0 .
497
0.105
L
itera
l Sc
ore
0.359
-0
.103
Pa
rtial
Sco
re
0.556
0.0
11
lora
a 1 c
orre
ct
0.128
0 .
011
Meta
Tot
al
0.451
0 .
081
Lite
ral
Infe
r. o. 2
20
-0. 2
13
Tran
s lat
i ona
1
0.451
-0
.121
Hi
gh I
nfer
ence
0.
341
-0.2
50
llST
Tota
l Sc
ore
0.389
-0
.234
TA
BL
E
X
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EL
AT
ION
S W
ITH
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ON
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LL
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AR
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S
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on
SPIC
A Su
btes
t L
itera
l Pa
rtia
l lo
raal
V
II C
orre
ct
Cor
rect
Co
rrect
1.00
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.192
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15
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1 1.0
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31
0.2'
0 0 .
14'
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0 .
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0. 5
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43
0.124
1
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.016
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0 0 .
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55
0.530
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.522
0 .
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60
0.410
0.6
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0.611
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on
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us p
ost
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l O.
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est
VII
0. 3
48
1. 00
0 1.
000
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oo
o.oo
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ul S
core
1.
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000
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00
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ial
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1.00
0 1.
000
1.00
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orre
ct
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004
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eta T
otal
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nfer
ence
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48
....-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~--- 100
' ~, v ' ./,,1 ,,,/ ~
LED RBD
Literal Questions
LED RBD LED RBD LED RBD
Translational Higher Inference NRST Questions Level Questions Total
Figure 1. Mean percentage correct scores for left brain damaged and right brain damaged subjects on test items of the Nelson Reading Skills Test (NRST) by levels of inference.
90
80
70
60
50
40
30
20
10
0
~ ... ; ·~~ ~;·.•
100 100
90 90
80 80
-'
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0 Lt 1 Trans High T otal Lit T rans High T otal
Inf. Inf.
LBD RBD
Figure 2. Mean percentage correct scores on literal, translational and higher inference level test items of the Nelson Reading Skills Test by subject groups.
49
rt
CHAPTER V
SUMMARY AND IMPLICATIONS
SUMMARY
The purpose of this study was to examine and compare
inferential abilities on a reading comprehension task in two
groups of adults who had suffered cerebrovascular accidents
(CVA). Sixteen subjects with a CVA to the right hemisphere
of the brain were compared to an equal number of aphasic
subjects. Subjects were selected after they had
demonstrated an adequate level of functioning on the SPICA
(a test measuring communicative efficiency) to perform the
tasks required in this study. All subjects were
administered the revised version of the Nelson Reading
Skills Test (NRST). On the NRST, test questions are grouped
into three categories representing literal, translational
and high levels of inference. Subjects were presented five
reading paragraphs. They were asked to answer thirty-three
questions pertaining to the reading material by pointing to
the correct answer out of four choices. Subjects were
allowed to refer back to the paragraphs when trying to
answer the questions.
Results revealed total NRST performance to be
significantly better for RBD subjects. RBD subjects also
E I' ~? ~'·
51
performed significantly better than LBD subjects on
translational inference items. The research data did not
reflect the expected error pattern with most errors on
questions requiring high inferential abilities followed by
translational items and fewest errors on literal questions
for either group of subjects.
CLINICAL IMPLICATIONS
Because of its high passage dependency the NRST may be
better suited to test reading comprehension than a number of
tests for aphasia or right hemisphere impairment. The
results of this study do not, however, support previous
research indicating that the NRST is a sensitive measure of
different levels of inferential reading comprehension
(Nicholas & Brookshire, 1987). In fact, the results of this
study confirmed the findings of Graville & Rau (1990)
indicating that the NRST is not suited to detect differences
in performance across levels of inference. Moreover,
performance on the NRST does not illustrate the inference
disorder underlying right hemisphere impairment. Thus,
while the NRST may be a helpful tool for establishing
general reading comprehension abilities in stroke patients
or any adult brain damaged patient population, it does not
appear that it will aid in differentially diagnosing subtle
disorders of inference. Other procedures and materials may
have to be used to determine inferential abilities when
I' J .. \ii
52
examining reading comprehension until a reliable and valid
instrument has been developed. Furthermore, the present
findings indicate the need for research comparing a range of
language functions, including inferencing, in left and right
CVA patients.
IMPLICATIONS FOR FURTHER RESEARCH
This study suggests that the NRST is not a useful
instrument to assess some aspects of reading comprehension
in brain damaged adults. As the NRST did not differentiate
between question types in RBD and LBD subjects, it is
indicated that a different reading instrument be used to
investigate inferential comprehension in brain damaged
populations. It would be erroneous to conclude that
inference failure is not a central deficit of right
hemisphere dysfunction. The literature reviewed for this
study points to the fact that inference may very well be a
core problem in right brain damaged individuals. Since
speech pathologists are becoming more involved in the
diagnosis and treatment of this population, a reading test
which accurately assesses inferential abilities would be
helpful for clinical practice.
t i!
REFERENCES
Burns, M. s. (1985). Language without communication; the pragmatics of right hemisphere damage. In M. S. Burns, A. S. Halper, & s. I. Mogil (Eds.) Clinical management of right hemisphere dysfunction. Rockville, MD: Aspen Systems Corporation, 17-28.
Burns, M.S., Halper, A. S., & Mogil, S. I. (1986). RIC evaluation of communication problems in right hemisphere dysfunction {RICE). Rockville, MD: Aspen Systems Corporation.
Caramazza, A., Gordon, E. B., & DeLuca, D. (1976). Righthemispheric damage and verbal problem solving behavior. Brain & Language, d, 41-46.
Deal, J. L., Deal, L., Wertz, R. T., Kitselman, K., & Dwyer, C. (1979). Right hemisphere Pica percentiles: some speculations about aphasia. In R. H. Brookshire (Ed.) Clinical Aphasiology: Proceedings of the Conference. Minneapolis, MN: BRK Publishers.
DiSimoni, F. G., Keith, R. L., Holt, D. L. (1975). Practicality of shortening the Porch index of communicative ability. Journal of Speech and Hearing Research, 18, 491-497.
DiSimoni, F., Keith, R., & Darley, F. (1980). Prediction of PICA overall score by short versions of the test. Journal of Speech and Hearing Sciences, 2]., 511-516.
Eisenson, J. (1954). Examininq for aphasia. New York: The Psychological Corporation.
Gardner, H; Denes, G.; & Zurif, E. (1975). Critical reading of words and phrases in aphasia. Brain & Language, di 173-190.
Gardner, H. & Zurif, E. (1976). Critical reading at the sentence level in aphasia. Cortex, 11, 62-70.
Goodglass, H., & Kaplan, E. (1983}. Assessment of aphasia and related disorders. Philadelphia, PA: Lea & Febiger.
1
] "l
~"~
' l
f ;,~
Graville, D. J. (1989). Reading comprehension of the Alzheimer's type: factual versus inferential. Master's thesis. Portland State University, Portland, OR.
54
Graville, D. J., & Rau, M. T. (1990). Reading comprehension of directly stated and inferred information in paragraph-length material by nondemented and demented elderly subjects. In T. Prescott (Ed.) Clinical Aphasiology, Vol. 20. Austin, TX: Pro-Ed.
Hanna, G., Schell., & Schreiner, R. (1977). The Nelson reading skills test. Chicago: Riverside Publishing.
Hier, D. B., & Kaplan, J. (1980). Verbal comprehension deficits after right hemisphere damage. Applied Psycholinguistics, i, 279-294.
Holtzapple, P., Pohlman, K., LaPointe, L. & Fletcher Graham, L. (1989). Does SPICA mean PICA? In T. Prescott (Ed.) Clinical Aphasiology, Vol.18. Austin, TX: ProEd.
Kertesz, A. (1982). The Western aphasia battery. New York: The Psychological Corporation.
LaPointe, L. L., & Horner, J. (1979). The Reading comprehension battery for aphasia. Tigard, OR: C. C. Publications.
Myers, P. s. (1986). Right hemisphere communication impairment. In R. Chapey (Ed.) Language Intervention Strategies in Adult Aphasia, (2nd Ed.) Baltimore, MD: Williams & Wilkins.
Myers, P. S. (1990). Inference failure: the underlying impairment in right hemisphere communication disorders. In T. Prescott (Ed.) Clinical Aphasiology, Vol. 20. Austin, TX: Pro-Ed.
Myers, P. & Linebaugh, C. (1985). Extracting implicit meaning: right versus left hemisphere damage. Clinical Aphasiology, 72-82.
Nicholas, L. E., & Brookshire, R.H. (1987). Error analysis and passage dependency of test items from a standardized test of multiple-sentence reading comprehension for aphasic and non-brain-damaged adults. Journal of Speech and Hearing Disorders, 52, 358-366.
.~. Y.;
j • ,;· ~.
I "''
~ .~ :1 \~
1 .:;; ~:.
>· ~·
t! ~~ ~~·
~~ ""
' t ;.•
~ ~
z, ~'
Nicholas, L. E., MacLennan, D. L. and Brookshire, R. H. (1986). Validity of multiple-sentence reading comprehension tests for aphasic adults. Journal of Speech and Hearing Disorders, 51, 82-87 .
55
Pierce, R., & Beekman, L. (1983). Effects of linguistic and extralinguistic context on semantic and syntactic processing in aphasia. In R.H. Brookshire (Ed.), Clinical Aphasiology: Proceedings of the Conference. Minneapolis, MN: BRK Publishers.
Pimental, A. P., & Kingsbury, N. A. (1985). Mini inventorv of right brain injury. Neurotest Associates.
Porch, B. E. (1967). Porch index of communicative ability (Vol. 2). Palo Alto, CA: Consulting Psychologists Press.
Porch, B. E. (1981). Porch index of communicative ability. Administration, scoring, and interpretation. Volume 2, Third edition. Palo Alto, CA: Consulting Psychologists Press.
Schuell, H. (1965). The Minnesota test for differential diagnosis of aphasia. Minneapolis, MN: University of Minnesota Press.
Stachowiak, F., Huber, W., Poeck, K., & Kerschensteiner, M. (1977). Textcomprehension in aphasia. Brain & Language, ~' 177-195.
Stanton, K. M., Yorkston, K. M., Kenyon, V. T., & Beukelman, D.R. (1981). Language utilization in teaching reading to left neglect patients. In R. H. Brookshire (Ed.), Clinical Aphasiology: Proceeding of the Conference, 262-269.
Tompkins, C. A. & Mateer, C. A. (1984). Factors influencing paragraph comprehension by subjects with left or right hemisphere involvement. In R. H. Brookshire (Ed.) Clinical Aphasiology: Proceeding of the Conference, 202-207.
Wilkinson, L. (1986). SYSTAT: The System for Statistics. Evanston, IL: Systat Inc.
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HUMAN SUBJECTS RESEARCH REVIEW COMMIITEE
MEMORANDUM
OFFICE OF GRANTS AND CONTRACTS
DATE: November 21, 1989
TO: '"'Uc:• ICong•bak, ·sp
FROM: Dean Frost, ChairpersoHuman Subjects Research Review Committee (HSRRC) 1989-90
RE: HSRRC Approval
In accordance with your request, the Hu.man Subjects Research Review Committee has reviewed your proposal entitled Reading Comprehension of Literal • Translational. and High Inference Level Items in Aphasic and Right Hemispher~ Daroaged Adults for compliance with DHHS policies and regulations on the protection of human subjects.
The committee is satisfied that your provisions for protecting the rights and welfare cf all subjects participating in the research are adequate and therefore the project is approved. Any conditions relative to this approval are noted below:
DO llOT STAl.T YOUR. llSEAR.CH Pl.OJECT Ulfl'll. -CORJl!Cl'ED COllSEMT POllM IS l.E'l'URMED '1'0 RESEARCH (151). PLEASE RETIJiH THIS FOllM
0 AND CORRECTED CONSENT FOllM wrm!ll 30 MYS nit dit - sr- "- - ._ .t-HSed "1 dla '--* ' A NEW APPROVAL FORM WILL BE ISSUED TO YOU1
L.-llON-n. a.AICl'(Oilid-J
0 ,.... ... d • Ill .. -- .. lllbjecls , ..... ,.,. ... I I.., ii ampkta ... --- _,. b ... Ill iadl • '1114 did-.. ~ ,..lklpetka .... -m.
on..-. lwbdla_,..il~ar.,...la61t
a....-1 _......., (<:k* _,
0 n. ...... - ol obtaW.c Wxmod - 6- .. llllljeic:D , ..... ,.,. •• ••eJil ~}L
Dn...-.o1-......w.x..1~il.,_..1a ...
&.ium91~
Approved oo. condition that a corrected consent fora 1a returned to Jteaearch Service Yi th the follorlna changes:
1. Delete &l.l. reference• to spouse/ward and guardian.a aince thh protocol and coo.sent fora aay only refer to c<>11petent aubjecta. If 1nc011petent subjecta will be used, aubait a separate protocol and consent fo111. 2. Add the standard VA liability at•tement • 3. Change bea11 phere to ~.
L rwxu.eona (Vlll:i< -> O n. Poied or~ O n.,... arPft*ICll(
be ifiW°""' .......... .. ,......, la ..... 0 n. pcopoAI .....
Ute Kongsbak, B.A. Marie T. Rau, Ph.D., CCC-SLP Speech Language Pathology Portland VA Medical Center Portland, OR 97207 (503) 220-8262 x5717
60
Reading Comprehension of Literal. Translational, and High Inference Level Items in Aphasic and
Right Hemisphere Damaged Adults
Consent Form (stroke subjects)
1. The purpose of this study is to gather information on the reading comprehension of subjects who have suffered a stroke to the left or right side of the brain. I understand that I was selected for this study because I have been diagnosed with a stroke.
Ute Kongsbak has explained the details of the study . The procedure involves reading aloud, five passages, and answering the questions following each passage by pointing to the correct answer.
I understand that I will be informed of any changes in the nature of the study or in the procedures, as described above, as they may occur. Ute Kongsbak will answer any and all questions that I have.
2. I understand that there is no physical risk or discomfort involved.
I understand that there is no benefit of this procedure to me, but that the study may help to better understand how reading comprehension is affected in subjects who have suffered a stroke.
3. I consent to the use of the results of this study for publication for scientific purposes, excluding my identity.
4. I understand I may withdraw from the study at any time without prejudice or without prejudice to any VA benefits.
Every reasonable effort to prevent any injury that could result from this study will be taken. In the event of physical injuries resulting from the study, medical care and treatment will be available at this institution. For eligible veterans, compensation damages may be payable under 38 USC 251 or, in some circumstances, under the Federal Tort Claims Act. For non-eligible veterans and non-veterans, compensation would be limited to situations where negligence occurred and would be controlled by the provisions of the Federal Tort Claims Act. For clarification of these laws, contact District Counsel (503) 221-3429.
I
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5. You have not waived any legal rights or released the hospital or its agents from liability for negligence by signing this form.
6. Therefore having given consideration to the above information, I voluntarily consent to participate in this study as described.
Volunteer's Signature Date
Witness's Signature Date
61
1 ~ .. ~ J ;:1
;j l
.,
'
Ute Kongsbak, B.A. Marie T. Rau, Ph.D., CCC-SLP Speech Language Patholo~y Portland VA Medical Center Portland, OR 97207 (503) 220-8262 X5717
Reading Comprehension of Literal.Translational, and High Inference Level Items in Aphasic and
Right Hemisphere Damaged Adults
Consent Form (spouse/guardian)
62
1. The purpose of this study is to gather information on the reading comprehension of subjects who have suffered a stroke to the left or right side of the brain. I understand that my spouse/ward was selected for this study because he/she has been diagnosed with a stroke.
Ute Kongsbak has explained the details of the study. The procedure involves reading aloud, five passages, and answering the questions following each passage by pointing to the correct answer.
I understand that I will be informed of any changes in the nature of the study or in the procedures, as described above, as they may occur. Ute Kongsbak will answer any and all questions that I have.
2. I understand that there is no physical risk or discomfort involved.
I understand that there is no benefit of this procedure to my spouse/ward, but that the study may help to better understand how reading comprehension is affected in subjects who have suffered a stroke.
3. I consent to the use of the results of this study for publication for scientific purposes, excluding my spouse/ward's identity.
4. I understand my spouse/ward may withdraw from the study at any time without prejudice or without prejudice to any VA benefits.
Every reasonable effort to prevent any injury that could result from this study will be taken. In the event of physical injuries resulting from the study, medical care and treatment will be available at this institution. For eligible veterans, compensation damages may be payable under 38 USC 251 or, in some circumstances, under the Federal Tort Claims Act. For non-eligible veterans and non-veterans, compensation would be limited to situations where negligence occurred and would be controlled by the provisions of the
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Federal Tort Claims Act. For clarification of these laws, contact District Counsel (503) 221-3429.
5. You have not waived any legal rights or released the hospital or its agents from liability for negligence by signing this form.
6. Therefore having given consideration to the above information, I voluntarily consent for my spouse/ward to participate in this study as described.
Spouse/Guardian's Signature Date
Witness's Signature Date
63
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:4
APPENDIX C
SHORT PORCH INDEX OF COMMUNICATIVE ABILITY TEST PROTOCOL