Prospective data collection for feeding difficulties and nutrition

INTRODUCTION: The Boston Children’s Hospital Growth and Nutrition Program is a multidisciplinary program focused on assisting babies and children under 6 years of age having problems with feeding and/or weight gain. New patients at the clinic are given questionnaires to complete which provide information on patient demographics, social history, feeding history, etc. The knowledge gained from these questionnaires help identify potential feeding disorders, identify risk factors or causes of malnutrition, and allow for tailored treatment in an individual patient. AIM: To describe the demographic, social, and clinical characteristics of a sample of patients referred to the Boston Children’s Hospital Growth and Nutrition Program while determining whether and how the Growth and Nutrition patient questionnaires should be revised and incorporate validated instruments to track patient feeding, stress, diet and body composition outcomes. METHODS: Examination of 239 patient records from 2015 and 2016 was performed. Data was collected and analyzed from questionnaires completed by guardians or caregivers of the patients, as well as the patients’ electronic medical records. Literature review was performed to assess existing feeding assessments as well as mobile intake tracker applications. A review of the mobile intake tracker applications was also performed. RESULTS: The results of analysis on the patient population at the Boston Children’s Hospital Growth and Nutrition Program showed that a majority of patients were White, Non-Hispanic, with private medical insurance and household income of over $60,000 (>60% of recorded patient population for each item). Similar patterns were observed for the rest of the items, with a few exceptions. The Neonatal Eating Assessment Tool (NeoEAT), Pediatric Eating Assessment Tool (Pedi-EAT), and the Child Oral and Motor Proficiency Scale (ChOMPS) feeding assessments had the most justification for use. The mobile applications Baby Connect and MyFitnessPal had the most desired features for clinical use. CONCLUSION: A few items on more specific portions of the questionnaires were deemed unnecessary for further use in the new patient questionnaires, such as having 4th, 5th, and 6th born choices for birth order of the patient (less than 4% of responses chose one of those answers or ‘Other’). The Neonatal Eating Assessment Tool (NeoEAT), Pediatric Eating Assessment Tool (Pedi-EAT), and the Child Oral and Motor Proficiency Scale (ChOMPS) feeding assessments are recommended for incorporation and use alongside the new patient questionnaires at the BCH GNP. The currently in use “Behavioral Pediatric Feeding Assessment Scale”, or “BPFAS”, is not recommended for continued use over the three assessments mentioned above. The mobile applications Baby Connect and MyFitnessPal are recommended for use in tracking of infant feedings and calories respectively, as the applications possessed the most number of desired features

The effects of different methods of cloze test construction and their relationship with a standardised reading comprehension test

The purpose of this study is to provide guidelines to classroom teachers for the construction of valid and reliable cloze comprehension tests. Review of the related literature suggested there are many diverse and contradictary opinions as to the most appropriate method of constructing cloze tests. The subjects were 49 Year 5 primary school children from two metropolitan schools. Three different comprehension tests were administered. The Gap Reading Comprehension Test and two Cloze Comprehension Tests consisting of 50 and 100 word deletions, in which the deletions began at either the fifth or sixth word of the second sentence. The Cloze Tests were graded with both the exact word and synonymic word scoring methods and then correlated with the Gap Reading Comprehension Test Reliability was established by the split-half method. Concurrent validity and reliablity were found to be greater in the 100 word deletion versions of the Cloze Tests, with increased reliability achieved when the tests were graded with the synonymic word scoring method. The results provide useful guidelines for classroom teachers in the construction of valid and reliable measures of reading comprehension

Studies in readability: An examination of relationships between readibility measures, patterns of difficulty in selected school history texts, and associated responses of twelve to fourteen year olds

A readability survey was carried out on a wide selection of history books, using a computer program, ASTRA 3, developed for the study. The results showed that although the mean readability levels of textbooks provided for 12-14 year olds were appropriate to their readership, there were very large and seemingly random internal fluctuations. This, coupled with an observed lack of scalar correspondence between formulae, has implications for current practices in readability assessment. The responses of readers to readability fluctuations were next investigated, using one subjective measure and three behavioural measures, namely, children's subjective ratings, cloze procedure, reading rate, and stress reaction (Skin Conductance Response). Relatively low cost microcomputer based apparatus was developed for studying the latter two measures. It was found that average 12-14 year old readers were able to perceive variation in difficulty in adjacent passages and these subjective ratings proved to be relatively good predictors of fluctuations in cloze procedure scores. A measure of redundancy based on cloze responses was also shown to be strongly related to children's subjective ratings of contextualised passages. No statistical relationship was found, however, between textual cohesion and either the subjective or the objective indices. These findings raise a number of questions of concern to writers and publishers of school text books. According to the cloze test, all the passages were at frustration level, although this is contrary to what would have been expected from the range of readability indices. Reading rate tended to increase, rather than decrease with difficulty, though in absolute terms the variation was slight. SCR responses tended to be labile and snowed substantial individual. differences. This part of the study opens up a number of questions about the appropriateness of different ways of examining the response of readers to specific 'text features that contribute to readability. In general, the findings in this interrelated series of studies show that a great deal of readability assessment is based on assumptions of dubious validity concerning the distribution of difficulty within texts, the nature of relationships between different readability measures, and the ways in which readers actually respond to hypothesized difficulties

The Benefits of Supplementing the Eighth Grade American History Curriculum with Historical and Realistic Fiction Novels

As the textbook remains the driving force of instructional methodology in the secondary history curriculum, student enthusiasm and achievement in the discipline continue to decline. Textbooks, which fail to tell the complete story of the American experience, are not just shortchanging history, they are ill-suited to the developmental requirements of the adolescent learner. Through personal classroom experience, literature review, and a one-year site-based study, the evidence compiled in this study endorses the integration of social studies trade books, in particular historical and realistic fiction novels, as a prescription for diminishing, if not turning around, the discouraging trend in middle school social studies