Most of the changes are fine. But there are two big losses in translation:

[ A strong tremor in her hand makes it impossible for her to use American Sign Language. ] --> [ Her hand shakes so she does not do sign language. ]

No, she _cannot_ do sign language. The difference between "does not" and "cannot" is big. Rebecca gives no explanation for this corruption of the original meaning.

[ Her parents think she recognizes a couple dozen signs. ] --> [ Her parents think she knows some signs. ]

She cannot make signs with her hands, but she can recognize signs. The word "recognizes" is important because it expresses that she can in fact use sign language, but only one way -- to receive communication, not to send it. Changing this to "knows" eliminates this information and makes this sentence contradict with the preceding one. It is now clear that "do sign language" in the preceding sentence also obscures this information; "do" is vague and hard to understand.

How many is "some"? "Some" could mean 3, or 30, or 300. Again Rebecca's explanation is lacking; this is described as "replacement of numbered items" but in fact it is just straight deletion of all numbers.

So, I would write:

[ Her hand shakes so she cannot speak in sign language. Her parents think she understands about 20 signs. ]

This is clear, easy to read, doesn't needlessly destroy information, and in my opinion is easier to read than Rebecca's simplification.

> "She has trouble seeing" is not as clear as the original "...which has impacted [...] eyesight". True, "impacted" is unwieldy and could be improved, but the causal link between the premature birth and the health difficulties is no longer explicit and must now be inferred, taking more mental effort from the reader.

It's even worse, because "seeing" is often used metaphorically e.g. "She has trouble seeing his point" and "She has trouble seeing how she can find a job." "Eyesight" specifies that the seeing we're talking about has to do with eyes.

I agree - the causal link is very important to note.

In terms of born premature vs born early, I understand that premature is the medical term. As a medical student, I also understand that it can be helpful to use more precise words in describing a situation.

However, I personally think that a lot of our medical jargon is due for simplification. For example, is there really any benefit to saying "epistaxis" rather than "bloody nose", or "rhinorrhea" rather than "runny nose"?

In the case of "born early" - premature and preterm are already interchangeable. I wouldn't mind adding born early to the mix.

From my outside perception, the medical jargon is ripe with greek-latin derived words that are strictly descriptive, adding no causal information whatsoever. My understanding is that the word tachycardia does not give an insight into why the heart beats faster.

As for "born early", I think it misses the actual problem. I think "born too early" is a closer-to-the-spirit simplification.

I can get behind that

The way they rephrased also simply omitted detail, which doesn't seem like a fair comparison. I'd much rather see an example where no detail is lost but would still have wider comprehension. Literally dumbing it down by stripping detail doesn't seem like a clear best practice.

It’s impossible to express the same content using simpler words without making the text much longer, which defeats the purpose of making it easier to read.

The more precise a term is, the more it expresses without added verbiage, but it’s also less likely to be widely understood.

This rather mixes simpler/more difficult and shorter/longer as equivalent - even interchangeable - aspects of writing. But these are not transitive: shorter is not simpler, nor is simpler (i.e., more understandable) necessarily shorter; similarly, a longer piece isn't more difficult simply by its length.

Writing is hard; writing clearly - more understandably - is harder yet. Writing precisely, which would link some concepts of length/wordiness directly with understandability and clarity, is the hardest of all.

"If I Had More Time, I Would Have Written a Shorter Letter" - Blaise Pascal

Premature is a medical term that's a little hard with someone with an intellectual disability to parse unless they're already familiar.

If you don't have that knowledge retained it's a much larger leap to figure out what "premature" means. you have to understand the prefix (pre = before) and know what "mature" means in this context (not old, but rather "not ready").

This complicates the fact that premature birth also requires a lot of prior understanding (why can a baby be born too early? why is that a problem?)

Perhaps the author could have elaborated a little with plain language... "Born too soon" might be clearer.

Agreed. "Too early" or "too soon" is much better.