Brain PowerHealthPersonalTreatment

Reading Re-Evaluation Results After 81 Hours Visualizing and Verbalizing Instruction with Lindamood-Bell

Today was re-evaluation results day! It seems like another lifetime ago yet only yesterday that I received my initial reading assessment results from the Minnesota Lindamood-Bell centre. I’ve completed eighty-one hours of visualizing and verbalizing instruction with Lindamood-Bell’s Double Bay, Australia centre (which because of the time zone difference allowed me to do it two hours per night, five nights per week). I had my re-evaluation this past Sunday, Monday, and Tuesday nights. The time was broken up because of my fatigue — I don’t have a lot of stamina — and because they wanted to use new-to-me stories in addition to the same ones I had been tested on the first time around for the reading comprehension section.

Like before, all the results were normed to my age and gender. And those tests that haven’t been normed in awhile, were used for diagnostic purposes.

Re-Evaluation Results

What I wrote about my June results is in italics; my re-evaluation results underneath each point:

  1. My reading rate is too slow. I’m in the 16th percentile. That means 84 percent of women my age read faster than me.
    1. My reading rate has not increased. I remain in the 16th percentile.
  2. My foundations are solid. These are the ability to hear phonemes, the sound parts that make up words. The ability to recognize and pronounce high-frequency words. The ability to figure out an unknown word within the context of known words.
    1. My foundations remain solid. I can still sound out multi-syllabic words, as they’ve heard and seen during my sessions while reading complex material like philosophy of mind.
    2. Although a couple of my scores dropped in this category, they remained in the above grade 12 level. The word attack — decoding nonsense words, which is about sounding words out — also has only 26 possible points. So going from 26 out of 26 last time to missing 2 of the 26 this time equals a big drop in percentile; if there had been more points, the drop would not have been as large. The symbol to sound one (things like sound out “ou” or “oa”), I like to think dropped because Canadian accent versus Australian accent. Heh. But to be honest, I didn’t put a lot of effort into that one test because in the real world, I can pronounce words okay. It’s my reading comprehension, reading rate, and amount of text I can read that are the issue.
  3. I rely on my vast knowledge bank and familiarity with language to prop up my comprehension. When I cannot see a word but only hear it and I have to pick out an illustration that best represents the word, I cannot rely on my ability to decode a word from its roots to figure out what it means. And so I don’t do so well. Based on results from standard vocabulary tests, I drop about ten percentile points, maybe a bit more, when given the same vocabulary test when heard, not seen, and using pictures instead of words to “define” the word spoken to me.
    1. Well! I’m so chuffed. My Peabody Picture Vocabulary Test result shot up.
    2. There was actually a greater than 10-point discrepancy between a regular vocabulary test and my initial Picture Vocabulary test result.
    3. I went from 82nd percentile to 95th! That’s more like it!
    4. This test measures receptive vocabulary, that is, vocabulary that’s spoken to me. The improvement reflected my improved ability to image words.
  4. My accuracy in reading words is very high.
    1. This remained the same.
  5. Fluency is rate plus accuracy. So my fluency is not at the level that my reading foundations indicate it should be. (Slow reader.)
    1. This has not changed.
    2. My reading rate remains in the 16th percentile.
    3. My accuracy remains very high in the 95th percentile.
    4. Fluency remains in the 63rd percentile. The only way for me to increase it is to read faster.
  6. When I can rely on my knowledge bank and ability to decode words, my comprehension is good. When I read new or lengthy material even text at grade six level, where I can’t rely on my knowledge of content and language, my comprehension drops a lot.
  7. Concept imagery is the ability to conceive a word, sentence, or idea as a whole in a kind of picture. I don’t have it. It’s sort of, uh, depressing . . . more than that . . . grievous and devastating to see one rated as having a mental age of 14.5 or 13.5 years in these tests after eighteen years of rehab, active treatments, and passive home treatments. On the other hand, they confirm I’m not imagining my reading problems. I have real difficulty despite the fact that I’m “articulate” and can read words no problem.

In relation to points 6 and 7: big change! Happy Snoopy dance!!

Concept Imagery

Lindamood-Bell’s visualizing and verbalizing instruction is aimed at improving one’s ability to conceive a word, sentence, or idea as a whole in image form. Being able to conceive a word or sentence or paragraph or idea as an image both improves comprehension and recall. My re-evaluation objectively measured whether I’d learnt how to do this and improved in these two areas. In the words of the Double Bay Associate Director, I “knocked it out of the park.”

Sketch of visualizing and verbalizing instructionAs I’ve detailed in previous posts, Lindamood-Bell Australia began teaching me how to visualize with a single word. We moved on pretty quickly to a single sentence. Once I learnt what is meant by picturing a word then picturing a sentence, I had to learn how to verbalize it. I didn’t really understand “visualizing and verbalizing” until about August even though I was doing it.

It isn’t enough to create a mental image in your mind, that is visualize an entire sentence then a whole paragraph then an entire page; you need to be able to describe that image and also summarize the sentence or paragraph or page in words  clearly — that is, verbalize it to your clinician.

I didn’t get to the chapters/articles level as shown in this diagram by the Minnesota Director. But I did reach the Page level and soon after during the Application stage, the Page by Page level.

So what did that mean?

The Big Result: Reading Comprehension and Recall

In the Gray Oral Reading Test, Form A, which is one of the tests used for diagnostic purposes, I improved hugely. This test measures straight recall. You read a paragraph. They take the text away, and you have to answer four open-ended questions posed to you by the assessor. I had inconsistent and kind of depressing results the first time. This time — 100% all around, well, except for one pesky grade level. But I improved there too! At the grade 6 level, I improved from 75% to 100. Eighth grade I remained at 100%. Tenth grade, I improved from 88% to 100%. Grade 12 I went from 50% to 88%. College level, I went from 75% to 100%. And adult level I remained at 100%.

Gray Oral Reading Test, Form A Pre and Re-evaluation results

I’d noticed my recall had shot up. I was able to not only remember but have confidence in what I was remembering because it felt solid in my memory banks. I remembered what I read — whether pages from the novel The Lions of Al-Rassan or sections in Philosophy of Mind text — because I could see the images in my head. For the first time since my brain injury, I was also able to build up the big picture of what I was reading — this requires recall. If you can’t recall what you read previously, you can’t build up the big picture. But you also need comprehension.

The Gray Oral Reading Tests 4, Forms A/B comprise stories you read out loud then they take the story away and put in front of you five multiple-choice questions. You read along with them as they read out loud the first question and its four possible answers. After you choose A, B, C, or D, they read the next question, and so on. This time I recognized within those questions, concepts such as main idea, higher-order thinking questions, questions about feeling and expression, things I still struggle with but are way, way, WAY, better than back in June. They saw I was stressing over reading stories I recognized from my original assessment, wanting to do better, still not happy at how back in June I’d struggled over answering some of the multiple-choice questions. I was definitely not struggling as much. But was that a practice effect or comprehension? It felt like comprehension to me. They decided to test me again using new-to-me stories without telling me why they were giving me additional stories to read; they scored me on those stories. I was less stressed as I read the new stories, the questions, the multiple choices, and answered the questions. I actually scored better on the new ones than on the ones I knew from the June assessment! That’s what stress does to you!!

As I mentioned earlier, my reading Rate results from this test remained abysmally slow: 16th percentile. Accuracy remained at 95th percentile. Fluency remained at 63rd percentile. But — drum roll –my Comprehension score went from 63rd percentile to 84th! This is actually the top percentile for adults. The best part: I scored 70 out of 70. *Pumping fists*

Gray Oral Reading Tests 4, Forms A/B

They don’t test for volume of language, that is, how much text I can read in a sitting. But we know experientially that I’ve been increasing week after week the volume I’m reading. We began with a sentence. I’m now up to four pages, reading them Page by Page. My next goal is a chapter. I don’t know how I’ll get there, though. I’ll be working on goals next week.

Main Idea

Reading rate is the same. Volume and Comprehension are up. My reading rate hasn’t changed, but I’m understanding much better what I read and I’m reading much more text with comprehension and good recall.

It is possible to restore reading comprehension after brain injury! No strategies needed anymore!! (Well, except for covering off the text . . . for now.)

I haven’t tested my long-term recall in the real world. But every time I summarize what I’ve read so far in the novel, starting from the Prologue, I remember it. The Philosophy of Mind is not as solid with just me reading it, probably because it takes more mental energy and effort. I fatigue quicker with it; fatigue plus huge effort equals not being as disciplined in creating images. I also am not good at creating higher-order thinking questions (HOTs). I’m going to go back to my course modules and use those questions as my HOTs. But I think this day calls for cake!!