Description and Validation of a Test to Evaluate Sustained Silent Reading

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Abstract
Purpose. To construct and validate a test of sustained silent reading. Methods. Standardized 7300 and 7600 word passages were written to evaluate sustained silent reading. Two hundred forty subjects validated whether comprehension questions could discriminate subjects who did and did not read the passage. To evaluate test–retest properties, 49 subjects silently read the standardized passages on separate days. Sixty glaucoma suspect controls and 64 glaucoma subjects had their out loud reading evaluated with the MNRead card and an International Reading Speed Texts (IReST) passage, and their silent reading measured using the 7300 word passage. Sustained silent reading parameters included reading speed and reading speed slope over time. Results. Comprehension questions distinguished individuals who had and had not read passage materials. Bland-Altman analyses of intersession sustained reading speed and reading speed slope demonstrated 95% coefficients of repeatability of 57 words per minute (wpm) and 2.76 wpm/minute. Sustained silent reading speed was less correlated with MNRead (r = 0.59) or IReST passage (r = 0.68) reading speeds than the correlation of these two measures of out loud reading speed with each other (r = 0.72). Sustained silent reading speed was more likely to differ from IReST reading speed by more than 50% in rapid silent readers (odds ratio [OR] = 29, 95% confidence interval [CI] = 10–87), and comparisons of sustained and out loud reading speeds demonstrated proportional error in Bland-Altman analyses. Conclusions. Tests of out loud reading do not accurately reflect silent reading speed in individuals with normal vision or glaucoma. The described test offers a standardized way to evaluate the impact of eye disease and/or visual rehabilitation on sustained silent reading.
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