As regards the discussion on readability levels, yes, familiar words such as "areola", "hospital", "medical" can skew the scoring when checking readability levels, as they are multisyllabic.  Even basic everyday words such as "television" are probably familiar to people with fairly low reading levels, yet as multisyllabic words raise the score for a selected passage.
   Three suggestions: 1) select passages in the text which have fewer of these very familiar multisyllabic words, or 2) try out the text with a pilot group of representative clients, or 3) explain certain words, either in brackets or in a sidebar (box).  Some poorer readers may not cope well wtih bracketed information which interrupts the flow of a sentence.  Some poor readers may not be adept at going between main text and boxes.  (Can you imagine how they cope with instructions on ABM cans, going from a list of instructions to a box!)
    Readability scoring systems, such as SMOG, are useful tools.  They are not perfect, but can help identify text which needs simplifying.  Shorter sentences, and active voice rather than passive, will also help.
      Cheers,
           Virginia
           in sunny Brisbane
    

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