Barriers to Understanding: Readability of Online Laryngomalacia Resources for Parents

Abstract

Background Laryngomalacia is the most common cause of stridor in infants. Guidelines recommend parent education materials be written at a sixth to eighth-grade reading level, yet compliance of online resources remains unclear. Aim To evaluate the readability of online parental education materials about laryngomalacia across multiple sources and geographic regions. Methods A systematic search identified the top 10 Google results, hospital resources from Australia (n=2), the UK (n=2), and the US (n=5), and outputs from five AI chatbots. Readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and Fry Grade Level. Kruskal-Wallis tests compared readability across source types and regions. Results Of 19 unique resources, only one (5.3%) met recommended reading levels. Mean FKGL was 10.61 (SD=2.24) across all resources, significantly exceeding guidelines. Australian hospitals were most difficult (mean FKGL=13.80); UK hospitals were most accessible (mean FKGL=9.45), though still exceeding recommendations. Significant regional differences existed for FRES (H=6.43, p=0.038) and Fry Grade Level (H=6.19, p=0.045), but not FKGL (H=4.13, p=0.127). Conclusions 94.7% of laryngomalacia parental education materials exceeded recommended readability levels. AI chatbots and Australian hospital websites were particularly inaccessible. Healthcare providers should prioritise simplifying laryngomalacia education materials to support health literacy and parental comprehension.