Examining Shared Reading and White Matter Organization in Kindergarten in Relation to Subsequent Language and Reading Abilities: A Longitudinal Investigation.

Parent-child language interaction in early childhood carries long-term implications for children's language and reading development. Conversational interaction, in particular, has been linked to white matter organization of neural pathways critical for language and reading. However, shared book reading serves an important role for language interaction as it exposes children to sophisticated vocabulary and syntax. Despite this, it remains unclear whether shared reading also relates to white matter characteristics subserving language and reading development. If so, to what extent do these environmentally associated changes in white matter organization relate to subsequent reading outcomes? This longitudinal study examined shared reading and white matter organization in kindergarten in relation to subsequent language and reading outcomes among 77 typically developing children. Findings reveal positive associations between the number of hours children are read to weekly (shared reading time) and the fractional anisotropy of the left arcuate fasciculus, as well as left lateralization of the superior longitudinal fasciculus (SLF). Furthermore, left lateralization of the SLF in these kindergarteners is associated with subsequent reading abilities in second grade. Mediation analyses reveal that left lateralization of the SLF fully mediates the relationship between shared reading time and second-grade reading abilities. Results are significant when controlling for age and socioeconomic status. This is the first evidence demonstrating how white matter structure, in relation to shared reading in kindergarten, is associated with school-age reading outcomes. Results illuminate shared reading as a key proxy for the home language and literacy environment and further our understanding of how language interaction may support neurocognitive development.

Longitudinal changes in brain activation underlying reading fluency.

Reading fluency-the speed and accuracy of reading connected text-is foundational to educational success. The current longitudinal study investigates the neural correlates of fluency development using a connected-text paradigm with an individualized presentation rate. Twenty-six children completed a functional MRI task in 1st/2nd grade (time 1) and again 1-2 years later (time 2). There was a longitudinal increase in activation in the ventral occipito-temporal (vOT) cortex from time 1 to time 2. This increase was also associated with improvements in reading fluency skills and modulated by individual speed demands. These findings highlight the reciprocal relationship of the vOT region with reading proficiency and its importance for supporting the developmental transition to fluent reading. These results have implications for developing effective interventions to target increased automaticity in reading.

Neurobiological predispositions for musicality: White matter in infancy predicts school-age music aptitude.

Musical training has long been viewed as a model for experience-dependent brain plasticity. Reports of musical training-induced brain plasticity are largely based on cross-sectional studies comparing musicians to non-musicians, which cannot address whether musical training itself is sufficient to induce these neurobiological changes or whether pre-existing neuroarchitecture before training predisposes children to succeed in music. Here, in a longitudinal investigation of children from infancy to school age (n = 25), we find brain structure in infancy that predicts subsequent music aptitude skills at school-age. Building on prior evidence implicating white matter organization of the corticospinal tract as a neural predisposition for musical training in adults, here we find that structural organization of the right corticospinal tract in infancy is associated with school-age tonal and rhythmic musical aptitude skills. Moreover, within the corpus callosum, an inter-hemispheric white matter pathway traditionally linked with musical training, we find that structural organization of this pathway in infancy is associated with subsequent tonal music aptitude. Our findings suggest predispositions prior to the onset of musical training from as early as infancy may serve as a scaffold upon which ongoing musical experience can build. RESEARCH HIGHLIGHTS: Structural organization of the right corticospinal tract in infancy is associated with school-age musical aptitude skills. Longitudinal associations between the right corticospinal tract in infancy and school-age rhythmic music aptitude skills remain significant even when controlling for language ability. Findings support the notion of predispositions for success in music, and suggest that musical predispositions likely build upon a neural structural scaffold established in infancy. Findings support the working hypothesis that a dynamic interaction between predisposition and experience established in infancy shape the trajectory of long-term musical development.

Impact of autism genetic risk on brain connectivity: a mechanism for the female protective effect.

The biological mechanisms underlying the greater prevalence of autism spectrum disorder in males than females remain poorly understood. One hypothesis posits that this female protective effect arises from genetic load for autism spectrum disorder differentially impacting male and female brains. To test this hypothesis, we investigated the impact of cumulative genetic risk for autism spectrum disorder on functional brain connectivity in a balanced sample of boys and girls with autism spectrum disorder and typically developing boys and girls (127 youth, ages 8-17). Brain connectivity analyses focused on the salience network, a core intrinsic functional connectivity network which has previously been implicated in autism spectrum disorder. The effects of polygenic risk on salience network functional connectivity were significantly modulated by participant sex, with genetic load for autism spectrum disorder influencing functional connectivity in boys with and without autism spectrum disorder but not girls. These findings support the hypothesis that autism spectrum disorder risk genes interact with sex differential processes, thereby contributing to the male bias in autism prevalence and proposing an underlying neurobiological mechanism for the female protective effect.

A neurogenetic analysis of female autism.

Females versus males are less frequently diagnosed with autism spectrum disorder (ASD), and while understanding sex differences is critical to delineating the systems biology of the condition, female ASD is understudied. We integrated functional MRI and genetic data in a sex-balanced sample of ASD and typically developing youth (8-17 years old) to characterize female-specific pathways of ASD risk. Our primary objectives were to: (i) characterize female ASD (n = 45) brain response to human motion, relative to matched typically developing female youth (n = 45); and (ii) evaluate whether genetic data could provide further insight into the potential relevance of these brain functional differences. For our first objective we found that ASD females showed markedly reduced response versus typically developing females, particularly in sensorimotor, striatal, and frontal regions. This difference between ASD and typically developing females does not resemble differences between ASD (n = 47) and typically developing males (n = 47), even though neural response did not significantly differ between female and male ASD. For our second objective, we found that ASD females (n = 61), versus males (n = 66), showed larger median size of rare copy number variants containing gene(s) expressed in early life (10 postconceptual weeks to 2 years) in regions implicated by the typically developing female > female functional MRI contrast. Post hoc analyses suggested this difference was primarily driven by copy number variants containing gene(s) expressed in striatum. This striatal finding was reproducible among n = 2075 probands (291 female) from an independent cohort. Together, our findings suggest that striatal impacts may contribute to pathways of risk in female ASD and advocate caution in drawing conclusions regarding female ASD based on male-predominant cohorts.

Intergenerational Transmission of Cortical Sulcal Patterns from Mothers to their Children.

Intergenerational effects are described as the genetic, epigenetic, as well as pre- and postnatal environmental influence parents have on their offspring's behavior, cognition, and brain. During fetal brain development, the primary cortical sulci emerge with a distinctive folding pattern that are under strong genetic influence and show little change of this pattern throughout postnatal brain development. We examined intergenerational transmission of cortical sulcal patterns by comparing primary sulcal patterns between children (N = 16, age 5.5 ± 0.81 years, 8 males) and their biological mothers (N = 15, age 39.72 ± 4.68 years) as well as between children and unrelated adult females. Our graph-based sulcal pattern comparison method detected stronger sulcal pattern similarity for child-mother pairs than child-unrelated pairs, where higher similarity between child-mother pairs was observed mostly for the right lobar regions. Our results also show that child-mother versus child-unrelated pairs differ for daughters and sons with a trend toward significance, particularly for the left hemisphere lobar regions. This is the first study to reveal significant intergenerational transmission of cortical sulcal patterns, and our results have important implications for the study of the heritability of complex behaviors, brain-based disorders, the identification of biomarkers, and targets for interventions.

Functional Connectivity in Infancy and Toddlerhood Predicts Long-Term Language and Preliteracy Outcomes.

Functional connectivity (FC) techniques can delineate brain organization as early as infancy, enabling the characterization of early brain characteristics associated with subsequent behavioral outcomes. Previous studies have identified specific functional networks in infant brains that underlie cognitive abilities and pathophysiology subsequently observed in toddlers and preschoolers. However, it is unknown whether and how functional networks emerging within the first 18 months of life contribute to the development of higher order, complex functions of language/literacy at school-age. This 5-year longitudinal imaging project starting in infancy, utilized resting-state functional magnetic resonance imaging and demonstrated prospective associations between FC in infants/toddlers and subsequent language and foundational literacy skills at 6.5 years old. These longitudinal associations were shown independently of key environmental influences and further present in a subsample of infant imaging data (≤12 months), suggesting early emerged functional networks specifically linked to high-order language and preliteracy skills. Moreover, emergent language skills in infancy and toddlerhood contributed to the prospective associations, implicating a role of early linguistic experiences in shaping the FC correlates of long-term oral language skills. The current results highlight the importance of functional organization established in infancy and toddlerhood as a neural scaffold underlying the learning process of complex cognitive functions.

Reading impairment in adolescents with fetal alcohol spectrum disorders.

Purpose: To date, research on effects of prenatal alcohol exposure (PAE) has focused on a broad range of cognitive impairments, but relatively few studies have examined effects of PAE on development of reading skills. Although PAE has been linked to poorer reading comprehension, it remains unclear whether this impairment is attributable to deficits in phonological processing, word reading, oral language skills, and/or executive functioning. Methods: A comprehensive reading battery was administered to 10 adolescents with fetal alcohol syndrome (FAS); 16 with partial FAS; 30 nonsyndromal heavily-exposed; 49 controls. Results: PAE was related to poorer reading comprehension but not to single word reading or phonological processing, suggesting that the mechanics of reading are intact in adolescents with fetal alcohol spectrum disorders at this age. PAE-related impairment in reading comprehension was mediated, in part, by deficits in mastery of oral language skills, including vocabulary, language structure, and verbal fluency. Conclusions: These results are consistent with research showing that reading comprehension in adolescence relies increasingly on linguistic comprehension abilities, especially once word reading becomes automatic and text complexity increases. Our findings suggest that reading-impaired adolescents with PAE will benefit from intervention programs targeting vocabulary knowledge, language structure, verbal fluency, and reading comprehension skills.

Multifactorial pathways facilitate resilience among kindergarteners at risk for dyslexia: A longitudinal behavioral and neuroimaging study.

Recent efforts have focused on screening methods to identify children at risk for dyslexia as early as preschool/kindergarten. Unfortunately, while low sensitivity leads to under-identification of at-risk children, low specificity can lead to over-identification, resulting in inaccurate allocation of limited educational resources. The present study focused on children identified as at-risk in kindergarten who do not subsequently develop poor reading skills to specify factors associated with better reading outcomes among at-risk children. Early screening was conducted in kindergarten and a subset of children was tracked longitudinally until second grade. Potential protective factors were evaluated at cognitive-linguistic, environmental, and neural levels. Relative to at-risk kindergarteners with subsequent poor reading, those with typical reading outcomes were characterized by significantly higher socioeconomic status (SES), speech production accuracy, and structural organization of the posterior right-hemispheric superior longitudinal fasciculus (SLF). A positive association between structural organization of the right SLF and subsequent decoding skills was found to be specific to at-risk children and not observed among typical controls. Among at-risk children, several kindergarten-age factors were found to significantly contribute to the prediction of subsequent decoding skills: white matter organization in the posterior right SLF, age, gender, SES, and phonological awareness. These findings suggest that putative compensatory mechanisms are already present by the start of kindergarten. The right SLF, in conjunction with the cognitive-linguistic and socioeconomic factors identified, may play an important role in facilitating reading development among at-risk children. This study has important implications for approaches to early screening, and assessment strategies for at-risk children.

Sex Differences in Functional Connectivity of the Salience, Default Mode, and Central Executive Networks in Youth with ASD.

Autism spectrum disorder (ASD) is associated with the altered functional connectivity of 3 neurocognitive networks that are hypothesized to be central to the symptomatology of ASD: the salience network (SN), default mode network (DMN), and central executive network (CEN). Due to the considerably higher prevalence of ASD in males, however, previous studies examining these networks in ASD have used primarily male samples. It is thus unknown how these networks may be differentially impacted among females with ASD compared to males with ASD, and how such differences may compare to those observed in neurotypical individuals. Here, we investigated the functional connectivity of the SN, DMN, and CEN in a large, well-matched sample of girls and boys with and without ASD (169 youth, ages 8-17). Girls with ASD displayed greater functional connectivity between the DMN and CEN than boys with ASD, whereas typically developing girls and boys differed in SN functional connectivity only. Together, these results demonstrate that youth with ASD exhibit altered sex differences in these networks relative to what is observed in typical development, and highlight the importance of considering sex-related biological factors and participant sex when characterizing the neural mechanisms underlying ASD.

Relating anthropometric indicators to brain structure in 2-month-old Bangladeshi infants growing up in poverty: A pilot study.

Anthropometric indicators, including stunting, underweight, and wasting, have previously been associated with poor neurocognitive outcomes. This link may exist because malnutrition and infection, which are known to affect height and weight, also impact brain structure according to animal models. However, a relationship between anthropometric indicators and brain structural measures has not been tested yet, perhaps because stunting, underweight, and wasting are uncommon in higher-resource settings. Further, with diminished anthropometric growth prevalent in low-resource settings, where biological and psychosocial hazards are most severe, one might expect additional links between measures of poverty, anthropometry, and brain structure. To begin to examine these relationships, we conducted an MRI study in 2-3-month-old infants growing up in the extremely impoverished urban setting of Dhaka, Bangladesh. The sample size was relatively small because the challenges of investigating infant brain structure in a low-resource setting needed to be realized and resolved before introducing a larger cohort. Initially, fifty-four infants underwent T1 sequences using 3T MRI, and resulting structural images were segmented into gray and white matter maps, which were carefully evaluated for accurate tissue labeling by a pediatric neuroradiologist. Gray and white matter volumes from 29 infants (79 â€‹± â€‹10 days-of-age; F/M â€‹= â€‹12/17), whose segmentations were of relatively high quality, were submitted to semi-partial correlation analyses with stunting, underweight, and wasting, which were measured using height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) scores. Positive semi-partial correlations (after adjusting for chronological age and sex and correcting for multiple comparisons) were observed between white matter volume and HAZ and WAZ; however, WHZ was not correlated with any measure of brain volume. No associations were observed between income-to-needs or maternal education and brain volumetric measures, suggesting that measures of poverty were not associated with total brain tissue volume in this sample. Overall, these results provide the first link between diminished anthropometric growth and white matter volume in infancy. Challenges of conducting a developmental neuroimaging study in a low-resource country are also described.

Putative protective neural mechanisms in prereaders with a family history of dyslexia who subsequently develop typical reading skills.

Developmental dyslexia affects 40-60% of children with a familial risk (FHD+) compared to a general prevalence of 5-10%. Despite the increased risk, about half of FHD+ children develop typical reading abilities (FHD+Typical). Yet the underlying neural characteristics of favorable reading outcomes in at-risk children remain unknown. Utilizing a retrospective, longitudinal approach, this study examined whether putative protective neural mechanisms can be observed in FHD+Typical at the prereading stage. Functional and structural brain characteristics were examined in 47 FHD+ prereaders who subsequently developed typical (n = 35) or impaired (n = 12) reading abilities and 34 controls (FHD-Typical). Searchlight-based multivariate pattern analyses identified distinct activation patterns during phonological processing between FHD+Typical and FHD-Typical in right inferior frontal gyrus (RIFG) and left temporo-parietal cortex (LTPC) regions. Follow-up analyses on group-specific classification patterns demonstrated LTPC hypoactivation in FHD+Typical compared to FHD-Typical, suggesting this neural characteristic as an FHD+ phenotype. In contrast, RIFG showed hyperactivation in FHD+Typical than FHD-Typical, and its activation pattern was positively correlated with subsequent reading abilities in FHD+ but not controls (FHD-Typical). RIFG hyperactivation in FHD+Typical was further associated with increased interhemispheric functional and structural connectivity. These results suggest that some protective neural mechanisms are already established in FHD+Typical prereaders supporting their typical reading development.

Comorbidity of reading disabilities and ADHD: Structural and functional brain characteristics.

Reading disabilities (RD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common developmental disorders. RD and ADHD frequently co-occur, which raises questions about how the disorders interact and to what extent they can be differentiated. To date, the underlying neural mechanisms leading to RD-ADHD comorbidity (COM) are not understood. In this study, structural and functional magnetic resonance imaging (fMRI) were combined with comprehensive behavioral testing in order to characterize the behavior, brain structure, and neural correlates of executive function, phonological processing and reading fluency in 60 children with clinical diagnoses of RD, ADHD, or COM, and controls. Whole-brain analyses of variance were performed on cortical thickness values and on the data of the three fMRI tasks to investigate overall group differences. To validate these findings, a region of interest analysis was performed in regions that have previously been shown to exhibit group differences in children with RD or ADHD using the same paradigms. The neuroimaging results demonstrated structural and functional atypicalities for COM in regions that are frequently associated with deficits in children with isolated ADHD or RD. A combination of shared and distinctive brain alterations between the clinical groups was identified, supporting the multiple deficit model for ADHD, RD, and its comorbidity.

The relationship between socioeconomic status and white matter microstructure in pre-reading children: A longitudinal investigation.

Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white-matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white-matter FA and second-grade reading outcomes were investigated in an SES-diverse sample of 125 children. The three left-hemisphere white-matter tracts most associated with reading, and their right-hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF). There was a significant and positive association between SES and fractional anisotropy (FA) in the bilateral ILF in kindergarten. SES moderated the association between kindergarten ILF and second grade reading performance, such that it was positive in lower-SES children, but not significant in higher-SES children. These results have implications for understanding the role of the environment in the development of the neural pathways that support reading.

The relationship between biological and psychosocial risk factors and resting-state functional connectivity in 2-month-old Bangladeshi infants: A feasibility and pilot study.

Childhood poverty has been associated with structural and functional alterations in the developing brain. However, poverty does not alter brain development directly, but acts through associated biological or psychosocial risk factors (e.g. malnutrition, family conflict). Yet few studies have investigated risk factors in the context of infant neurodevelopment, and none have done so in low-resource settings such as Bangladesh, where children are exposed to multiple, severe biological and psychosocial hazards. In this feasibility and pilot study, usable resting-state fMRI data were acquired in infants from extremely poor (n = 16) and (relatively) more affluent (n = 16) families in Dhaka, Bangladesh. Whole-brain intrinsic functional connectivity (iFC) was estimated using bilateral seeds in the amygdala, where iFC has shown susceptibility to early life stress, and in sensory areas, which have exhibited less susceptibility to early life hazards. Biological and psychosocial risk factors were examined for associations with iFC. Three resting-state networks were identified in within-group brain maps: medial temporal/striatal, visual, and auditory networks. Infants from extremely poor families compared with those from more affluent families exhibited greater (i.e. less negative) iFC in precuneus for amygdala seeds; however, no group differences in iFC were observed for sensory area seeds. Height-for-age, a proxy for malnutrition/infection, was not associated with amygdala/precuneus iFC, whereas prenatal family conflict was positively correlated. Findings suggest that it is feasible to conduct infant fMRI studies in low-resource settings. Challenges and practical steps for successful implementations are discussed.

Emergence of the neural network underlying phonological processing from the prereading to the emergent reading stage: A longitudinal study.

Numerous studies have shown that phonological skills are critical for successful reading acquisition. However, how the brain network supporting phonological processing evolves and how it supports the initial course of learning to read is largely unknown. Here, for the first time, we characterized the emergence of the phonological network in 28 children over three stages (prereading, beginning reading, and emergent reading) longitudinally. Across these three time points, decreases in neural activation in the left inferior parietal cortex (LIPC) were observed during an audiovisual phonological processing task, suggesting a specialization process in response to reading instruction/experience. Furthermore, using the LIPC as the seed, a functional network consisting of the left inferior frontal, left posterior occipitotemporal, and right angular gyri was identified. The connection strength in this network co-developed with the growth of phonological skills. Moreover, children with above-average gains in phonological processing showed a significant developmental increase in connection strength in this network longitudinally, while children with below-average gains in phonological processing exhibited the opposite trajectory. Finally, the connection strength between the LIPC and the left posterior occipitotemporal cortex at the prereading level significantly predicted reading performance at the emergent reading stage. Our findings highlight the importance of the early emerging phonological network for reading development, providing direct evidence for the Interactive Specialization Theory and neurodevelopmental models of reading.

Early development of letter specialization in left fusiform is associated with better word reading and smaller fusiform face area.

A functional region of left fusiform gyrus termed "the visual word form area" (VWFA) develops during reading acquisition to respond more strongly to printed words than to other visual stimuli. Here, we examined responses to letters among 5- and 6-year-old early kindergarten children (N = 48) with little or no school-based reading instruction who varied in their reading ability. We used functional magnetic resonance imaging (fMRI) to measure responses to individual letters, false fonts, and faces in left and right fusiform gyri. We then evaluated whether signal change and size (spatial extent) of letter-sensitive cortex (greater activation for letters versus faces) and letter-specific cortex (greater activation for letters versus false fonts) in these regions related to (a) standardized measures of word-reading ability and (b) signal change and size of face-sensitive cortex (fusiform face area or FFA; greater activation for faces versus letters). Greater letter specificity, but not letter sensitivity, in left fusiform gyrus correlated positively with word reading scores. Across children, in the left fusiform gyrus, greater size of letter-sensitive cortex correlated with lesser size of FFA. These findings are the first to suggest that in beginning readers, development of letter responsivity in left fusiform cortex is associated with both better reading ability and also a reduction of the size of left FFA that may result in right-hemisphere dominance for face perception.

Development of Tract-Specific White Matter Pathways During Early Reading Development in At-Risk Children and Typical Controls.

Developmental dyslexia is a neurodevelopmental disorder with a strong genetic basis. Previous studies observed white matter alterations in the left posterior brain regions in adults and school-age children with dyslexia. However, no study yet has examined the development of tract-specific white matter pathways from the pre-reading to the fluent reading stage in children at familial risk for dyslexia (FHD+) versus controls (FHD-). This study examined white matter integrity at pre-reading, beginning, and fluent reading stages cross-sectionally ( n = 78) and longitudinally (n = 45) using an automated fiber-tract quantification method. Our findings depict white matter alterations and atypical lateralization of the arcuate fasciculus at the pre-reading stage in FHD+ versus FHD- children. Moreover, we demonstrate faster white matter development in subsequent good versus poor readers and a positive association between white matter maturation and reading development using a longitudinal design. Additionally, the combination of white matter maturation, familial risk, and psychometric measures best predicted later reading abilities. Furthermore, within FHD+ children, subsequent good readers exhibited faster white matter development in the right superior longitudinal fasciculus compared with subsequent poor readers, suggesting a compensatory mechanism. Overall, our findings highlight the importance of white matter pathway maturation in the development of typical and atypical reading skills.

Investigating the Influences of Language Delay and/or Familial Risk for Dyslexia on Brain Structure in 5-Year-Olds.

Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced gray matter volume and early language delay in left-hemispheric middle temporal, occipital, and frontal regions. Alterations in middle temporal cortex in children with a retrospective report of early language delay were observed regardless of familial risk for dyslexia. Additionally, while children with isolated familial risk for dyslexia showed gray matter reductions in temporoparietal and occipitotemporal regions, these effects were most profound in children with both risk factors. An interaction effect of early language delay and familial risk was revealed in temporoparietal, occipital, and frontal cortex. Our findings support a cumulative effect of early behavioral and genetic risk factors on brain development and may ultimately inform diagnosis/treatment.

White Matter Alterations in Infants at Risk for Developmental Dyslexia.

Developmental dyslexia (DD) is a heritable condition characterized by persistent difficulties in learning to read. White matter alterations in left-lateralized language areas, particularly in the arcuate fasciculus (AF), have been observed in DD, and diffusion properties within the AF correlate with (pre-)reading skills as early as kindergarten. However, it is unclear how early these alterations can be observed. We investigated white matter structure in 14 infants with (FHD+; ages 6.6-17.6 months) and 18 without (FHD-; ages 5.1-17.6 months) familial risk for DD. Diffusion scans were acquired during natural sleep, and early language skills were assessed. Tractography for bilateral AF was reconstructed using manual and automated methods, allowing for independent validation of results. Fractional anisotropy (FA) was calculated at multiple nodes along the tracts for more precise localization of group differences. The analyses revealed significantly lower FA in the left AF for FHD+ compared with FHD- infants, particularly in the central portion of the tract. Moreover, expressive language positively correlated with FA across groups. Our results demonstrate that atypical brain development associated with DD is already present within the first 18 months of life, suggesting that the deficits associated with DD may result from altered structural connectivity in left-hemispheric regions.