Pathways Into Literacy: The Role of Early Oral Language Abilities and Family Risk for Dyslexia.

The present study investigated the role of early oral language and family risk for dyslexia in the two developmental pathways toward reading comprehension, through word reading and through oral language abilities. The sample contained 237 children (164 at family risk for dyslexia) from the Dutch Dyslexia Program. Longitudinal data were obtained on seven occasions when children were between 4 and 12 years old. The relationship between early oral language ability and reading comprehension at the age of 12 years was mediated by preliteracy skills and word-decoding ability for the first pathway and by later language abilities for the second pathway. Family risk influenced literacy development through its subsequent relations with preliteracy skills, word decoding, and reading comprehension. Although performance on language measures was often lower for the family-risk group than for the no-family-risk group, family risk did not have a specific relation with either early or later oral language abilities.

Dichotic listening as an index of lateralization of speech perception in familial risk children with and without dyslexia.

Atypical language lateralization has been marked as one of the factors that may contribute to the development of dyslexia. Indeed, atypical lateralization of linguistic functions such as speech processing in dyslexia has been demonstrated using neuroimaging studies, but also using the behavioral dichotic listening (DL) method. However, so far, DL results have been mixed. The current study assesses lateralization of speech processing by using DL in a sample of children at familial risk (FR) for dyslexia. In order to determine whether atypical lateralization of speech processing relates to reading ability, or is a correlate of being at familial risk, the current study compares the laterality index of FR children who did and did not become dyslexic, and a control group of readers without dyslexia. DL was tested in 3rd grade and in 5/6th grade. Results indicate that at both time points, all three groups have a right ear advantage, indicative of more pronounced left-hemispheric processing. However, the FR-dyslexic children are less good at reporting from the left ear than controls and FR-nondyslexic children. This impediment relates to reading fluency.

Infant ERPs separate children at risk of dyslexia who become good readers from those who become poor readers.

Dyslexia is heritable and associated with phonological processing deficits that can be reflected in the event-related potentials (ERPs). Here, we recorded ERPs from 2-month-old infants at risk of dyslexia and from a control group to investigate whether their auditory system processes /bAk/ and /dAk/ changes differently. The speech sounds were presented in an oddball paradigm. The children were followed longitudinally and performed a word reading fluency test in second grade. The infant ERPs were subsequently analyzed according to high or low reading fluency in order to find a neurophysiological precursor of poor reading fluency. The results show that the fluent reading children (from both the at-risk and the control group) processed the speech sound changes differentially in infancy as indicated by a mismatch response (MMR). In the control group the MMR was frontally positive and in the fluent at-risk group the MMR was parietally positive. The non-fluent at-risk group did not show an MMR. We conclude that at-risk children who became fluent readers were better at speech processing in infancy than those who became non-fluent readers. This indicates a very early speech processing deficit in the group of later non-fluent readers.

Interventions to improve executive functioning and working memory in school-aged children with AD(H)D: a randomised controlled trial and stepped-care approach.

BACKGROUND: Deficits in executive functioning are of great significance in attention-deficit/hyperactivity disorder (ADHD). One of these executive functions, working memory, plays an important role in academic performance and is often seen as the core deficit of this disorder. There are indications that working memory problems and academic performance can be improved by school-oriented interventions but this has not yet been studied systematically. In this study we will determine the short- and long-term effects of a working memory--and an executive function training applied in a school situation for children with AD(H)D, taking individual characteristics, the level of impairment and costs (stepped-care approach) into account. METHODS/DESIGN: The study consists of two parts: the first part is a randomised controlled trial with school-aged children (8-12 yrs) with AD(H)D. Two groups (each n = 50) will be randomly assigned to a well studied computerized working memory training 'Cogmed', or to the 'Paying attention in class' intervention which is an experimental school-based executive function training. Children will be selected from regular -and special education primary schools in the region of Amsterdam, the Netherlands. The second part of the study will determine which specific characteristics are related to non-response of the 'Paying attention in class' intervention. School-aged children (8-12 yrs) with AD(H)D will follow the experimental school-based executive function training 'Paying attention in class' (n = 175). Academic performance and neurocognitive functioning (primary outcomes) are assessed before, directly after and 6 months after training. Secondary outcome measures are: behaviour in class, behaviour problems and quality of life. DISCUSSION: So far, there is limited but promising evidence that working memory - and other executive function interventions can improve academic performance. Little is know about the applicability and generalization effects of these interventions in a classroom situation. This study will contribute to this lack of information, especially information related to real classroom and academic situations. By taking into account the costs of both interventions, level of impairment and individual characteristics of the child (stepped-care approach) we will be able to address treatment more adequately for each individual in the future. TRIAL REGISTRATION: Nederlands Trial Register NTR3415.

Dyslexia and early intervention: what did we learn from the Dutch Dyslexia Programme?

Part of the Dutch Dyslexia Programme has been dedicated to early intervention. The question of whether the genetically affected learning mechanism of children who are at familial risk (FR) of developing dyslexia could be influenced by training phoneme awareness and letter-sound associations in the prereading phase was investigated. The rationale was that intervention studies reveal insights about the weaknesses of the learning mechanisms of FR children. In addition, the studies aimed to gather practical insights to be used in the development of a system of early diagnosis and prevention. Focused on the last period of kindergarten before formal reading instruction starts in Grade 1, intervention methods with comparable samples and designs but differences in delivery mode (use of computer or manual), tutor (semi-professional or parent), location (at school or at home), and additional practices (serial rapid naming or simple word reading) have been executed to test the hypothesis that the incidence and degree of dyslexia can be reduced. The present position paper summarizes the Dutch Dyslexia Programme findings and relates them to findings of other studies. It is discussed that the Dutch studies provide evidence on why prevention of dyslexia is hard to accomplish. It is argued that effective intervention should not only start early but also be adapted to the individual and often long-lasting educational needs of children at risk of reading failure.

The effectiveness of a 2-year supplementary tutor-assisted computerized intervention on the reading development of beginning readers at risk for reading difficulties: a randomized controlled trial.

Children with low (pre-)literacy skills may benefit from individual tutoring during the early phases of learning to read. Dutch at-risk students from 13 schools received in first and second grade a computerized reading intervention, delivered by non-professional tutors at school. Digital logs indicated that treatment integrity was lower than intended; therefore, the intervention group was subdivided using a completion criterion. Third grade assessments revealed that the subgroup that had finished the program successfully (IF, N = 40) was able to read as fluent as the average reader, outperforming the subgroup that had not completely finished the program (InF, N = 31) as well as the group that had not worked with the program (controls, N = 66) on all reading measures. This study demonstrates that a well-implemented tutoring model can serve as a (cost-)effective complement to the classroom practice for beginning readers.

Precursors of developmental dyslexia: an overview of the longitudinal Dutch Dyslexia Programme study.

Converging evidence suggests that developmental dyslexia is a neurobiological disorder, characterized by deficits in the auditory, visual, and linguistic domains. In the longitudinal project of the Dutch Dyslexia Programme, 180 children with a familial risk of dyslexia (FR) and a comparison group of 120 children without FR (noFR) were followed from the age of 2 months up to 9 years. Children were assessed on (1) auditory, speech, and visual event-related potentials every half year between 2 and 41 months; (2) expressive and receptive language, motor development, behaviour problems, and home-literacy environment by questionnaires at the age of 2 and 3; (3) speech-language and cognitive development from 47 months onwards; and (4) preliteracy and subskills of reading, and reading development during kindergarten and Grades 2 and 3. With regard to precursors of reading disability, first analyses showed specific differences between FR and noFR children in neurophysiological, cognitive, and early language measures. Once reading tests administered from age 7 to 9 years were available, the children were divided into three groups: FR children with and without dyslexia, and controls. Analyses of the differences between reading groups yielded distinct profiles and developmental trajectories. On early speech and visual processing, and several cognitive measures, performance of the non-dyslexic FR group differed from the dyslexic FR group and controls, indicating continuity of the influence of familial risk. Parental reading and rapid naming skills appeared to indicate their offspring's degree of familial risk. Furthermore, on rapid naming and nonverbal IQ, the non-dyslexic FR group performed similarly to the controls, suggesting protective factors. There are indications of differences between the FR and control groups, irrespective of reading outcome. These results contribute to the distinction between the deficits correlated to dyslexia as a manifest reading disorder and deficits correlated to familial risk only.

Child and parental literacy levels within families with a history of dyslexia.

BACKGROUND: The present study concerns literacy and its underlying cognitive skills in Dutch children who differ in familial risk (FR) for dyslexia. Previous studies with FR-children were inconclusive regarding the performance of FR-children without dyslexia as compared to the controls. Moreover, van Bergen et al. (2011) recently showed that FR-children with and without dyslexia differed in parental reading skills, suggesting that those who go on to develop dyslexia have a higher liability. The current study concerned 1) the comparison of three groups of children at the end of second grade and 2) the intergenerational transfer of reading and its underlying cognitive skills from parent to child. METHOD: Three groups of children were studied at the end of second grade: FR-dyslexia (n = 42), FR-no-dyslexia (n = 99), and control children (n = 66). Parents and children were measured on naming, phonology, spelling, and word and pseudoword reading. RESULTS: The FR-dyslexia children were severely impaired across all tasks. The FR-no-dyslexia children performed better than the FR-dyslexia children, but still below the level of the controls on all tasks; the only exception was rapid naming (RAN), on which they were as fast as the controls. Focusing on the FR subsample, parental reading and RAN were related to their offspring's reading status. CONCLUSIONS: We replicated and extended van Bergen et al.'s study in showing that the FR-children who develop dyslexia are likely to have a higher liability. Both the group comparisons and the parent-child relations highlight the importance of good RAN skills for reading acquisition.

Supporting teachers' relationships with disruptive children: the potential of relationship-focused reflection.

A relationship-focused reflection program (RFRP) was developed that targeted teachers' mental representations of relationships with specific children. Relative effectiveness was examined in a randomized comparative trial with repeated measures. Thirty-two teachers were assigned to the RFRP or the comparison intervention directly aimed at teacher behavior. Per teacher, two children (N = 64) were selected with above-median levels of externalizing behavior. Multilevel growth modeling was used to explore intervention effects on teacher-reported Closeness and Conflict, and observed Teacher Sensitivity and Behavior Management Quality. Teaching Efficacy was included as a moderator. The RFRP yielded changes over time in closeness for about half of the teacher-child dyads. In addition, teachers with high efficacy beliefs were more likely to report declines in conflict than low-efficacy teachers. Lastly, significant increases were found in observed sensitivity. These effects were different from those found in the comparison condition and provided preliminary evidence for the potential of in-depth reflection on specific relationships to promote teacher-child relationships.

Early Productive Vocabulary Composition as Precursor of Dyslexia.

PURPOSE: The aim of this study was to gain more insight into the linguistic characterization of dyslexia by investigating vocabulary acquisition. In a previous study, vocabulary at 17 months of age appeared to be related to familial risk (FR) of dyslexia. The aim of this study was to investigate how the differences in lexical composition further develop up to 3 years (35 months) of age and, more importantly, to what extent these differences can be considered specific precursors of dyslexia later on. METHOD: In a total number of 262 children from the Dutch Dyslexia Program, 169 with and 93 without FR for dyslexia, productive vocabulary was assessed with the Dutch version of the MacArthur Communicative Development Inventories at ages 17, 23, 29, and 35 months. Reading tests were administered in Grades 2 and 3, resulting in dyslexia diagnosis in 60 FR children (FR-dys), leaving 109 FR children who developed normal reading skills (FR-nondys) and 93 control children. Children's expressive vocabulary was scored according to the total number of words produced and according to the different major linguistic word categories: nouns, predicates, and closed-class words. The analyses comprised a comparison of total productive vocabulary and the number of words per grammatical category at four different ages for the three groups (FR-dys, FR-nondys, and control). Also, correlations were calculated between vocabulary scores and reading scores. RESULTS: Up to 29 months of age, the total numbers of nouns, predicates, and closed-class words are significantly lower for the FR-dys group as compared with the FR-nondys and control groups; for closed-class words at 23 and 35 months of age, the FR-nondys group's mean values are in between the mean of the FR-dys and control groups. Weak correlations were found between total vocabulary size, number of verbs, number and proportion of predicates at 23 months of age, and word and pseudoword reading fluency in Grades 2 and 3. CONCLUSIONS: These results indicate that development of vocabulary is a significant though weak predictor of reading fluency and dyslexia; vocabulary size and proportion of verbs at 23 months of age, as well as proportion of closed-class words up to 35 months of age, seem to be the most sensitive indicators of delayed vocabulary development and later reading difficulties. There is no indication that FR for dyslexia by itself is related to vocabulary development.

Dutch children at family risk of dyslexia: precursors, reading development, and parental effects.

The study concerns reading development and its precursors in a transparent orthography. Dutch children differing in family risk for dyslexia were followed from kindergarten through fifth grade. In fifth grade, at-risk dyslexic (n = 22), at-risk non-dyslexic (n = 45), and control children (n = 12) were distinguished. In kindergarten, the at-risk non-dyslexics performed better than the at-risk dyslexics, but worse than the controls on letter-knowledge and rapid naming. The groups did not differ on phonological awareness. At-risk dyslexics read less fluently from first grade onwards than the other groups. At-risk non-dyslexics' reading fluency was at an intermediate position between the other groups at the start of reading. By fifth grade they had reached a similar level as the controls on word reading, but still lagged behind on pseudoword reading. Results further showed that the parents of the groups of at-risk children differed in educational level and reading skills. Overall, the groups of at-risk children differed on pre-reading skills as well as on reading development. These differences do not seem to stem from differences in intellectual abilities or literacy environment. Instead, the better reading skills of parents of at-risk non-dyslexics suggest that these children might have a lower genetic liability.

Predictors and Moderators of Treatment Outcome in Cognitive Training for Children With ADHD.

Objective: To explore whether clinical variables and initial cognitive abilities predict or moderate (far) transfer treatment outcomes of cognitive training. Method: A total of 98 children (aged 8-12 years) with ADHD were randomly assigned to Cogmed Working Memory Training or a new cognitive training called "Paying Attention in Class." Outcome measures included neurocognitive assessment, parent and teacher rated questionnaires of executive functioning behavior and academic performance. Predictor/moderator variables included use of medication, comorbidity, subtype of ADHD, and initial verbal and visual working memory skills. Results: Parent and teacher ratings of executive functioning behavior were predicted and moderated by subtype of ADHD. Word reading accuracy was predicted by subtype of ADHD and comorbidity. Use of medication and initial verbal and visual spatial working memory skills only predicted and moderated near transfer measures. Conclusion: Cognitive training can be beneficial for certain subgroups of children with ADHD; individual differences should be taken into account in future trials.

Early home-based intervention in the Netherlands for children at familial risk of dyslexia.

Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10 min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition.

Enhancing the reading fluency and comprehension of children with reading disabilities in an orthographically transparent language.

Breznitz (2006) demonstrated that Hebrew-speaking adults with reading disabilities benefited from a training in which reading rate was experimentally manipulated. In the present study, the authors examine whether silent reading training enhances the sentence reading rate and comprehension of children with reading disabilities and whether results found in Hebrew equally apply to an orthographically transparent language. Training results of 59 Dutch children with reading disabilities and normally achieving children show that children with reading disabilities are able to increase their sentence reading rate with high comprehension levels when pushed to do so with accelerated reading training. Posttest results show that transfer to routine reading is less strong for both accelerated and unaccelerated reading. Only accelerated training allows children with reading disabilities to read at high speed while maintaining high comprehension levels.

Differences in AERP responses and atypical hemispheric specialization in 17-month-old children at risk of dyslexia.

To determine the auditory event-related potential (AERP) correlates of phoneme perception in 17-month-old children at risk of dyslexia and controls, AERPs were elicited by standard (/bAk/) and deviant (/dAk/) word stimuli presented in an oddball paradigm. The at-risk children tended to show delayed P1 and P2 peaks for standard stimuli. Hemispheric group differences were observed for N2 amplitude and P1 latency, suggesting atypical processing of spoken words in at-risk children. Larger P2 and to a lesser extent P1 amplitudes following deviant words occurred in the control but not in the at-risk group, this may signal poorer phoneme discrimination in at-risk children. The present AERP results offer clues to where to look for a marker to identify children at high risk of reading and writing problems at an early age to facilitate early intervention.

Predictors for grade 6 reading in children at familial risk of dyslexia.

The present study investigates whether grade 6 reading outcomes, reading fluency, and reading comprehension can be predicted by grade 3 reading fluency, familial risk of dyslexia (FR), and grade 3 reading related skills: rapid automatized naming (RAN), phonological awareness (PA), and vocabulary. In a sample of 150 children, of whom 83 had a parent with dyslexia, correlation and regression analyses were performed. FR, measured on a continuous scale, was by itself related to all outcomes. However, FR did not explain any variance on top of grade 3 reading fluency. Grade 3 reading fluency strongly predicted grade 6 reading fluency and was also related to reading comprehension. RAN improved the prediction of grade 6 reading fluency, though the additional explained variance was small. Vocabulary and PA fully explained the variance that grade 3 reading fluency explained in grade 6 reading comprehension. Vocabulary explained a substantial amount of variance in grade 6 reading comprehension making it an interesting clinical target. As we used continuous measures of reading fluency and FR, our findings are not biased by distinct diagnostic criteria.

Cortical categorization failure in 2-month-old infants at risk for dyslexia.

Cortical auditory categorization was assessed in 2-month-old infants at genetic risk for dyslexia and controls. Manipulated /bAk/ and /dAk/ speech stimuli were used as frequently presented standards. The neuroelectric brain responses of the control infants were highly sensitive to the phoneme boundary that separated these stimuli, but the infants at risk showed no signs of cortical categorical perception. Cortical sources of the responses were predominantly found in the left hemisphere for the control infants, but mainly in the right hemisphere for the infants at risk. The results demonstrate that impaired categorical perception in dyslexia is already present in infants at risk for the disorder.

Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia.

Purpose: This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally. Method: The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their children's receptive and expressive vocabulary size at ages 17, 23, 29, and 35 months using the Dutch MacArthur Communicative Development Inventories. Dyslexia status at the end of Grade 2 (8 years) rendered 3 groups: FR-dyslexic (n = 51), FR-nondyslexic (n = 92), and typically developing-nondyslexic (TD) children (n = 69). Results: Repeated measures analyses showed that FR-dyslexic children had lower receptive vocabulary scores from 23 months onward and lower expressive scores from 17 months onward than FR-nondyslexic children. Latent growth curve modeling showed lower initial growth rates in FR-dyslexic children, followed by partial recovery, indicating a delayed increase in receptive and expressive vocabulary. FR-nondyslexic and TD children did not differ. Conclusions: Early deficits in receptive and expressive vocabulary are associated with later reading. Early vocabulary growth of FR-dyslexic children is characterized by a delay but not deviance of growth. Vocabulary can be considered an additional risk factor for dyslexia.

L1 and L2 reading skills in Dutch adolescents with a familial risk of dyslexia.

BACKGROUND: The present study investigated differences in reading and spelling outcomes in Dutch and English as a second language (ESL) in adolescents with a high familial risk of dyslexia, of whom some have developed dyslexia (HRDys) while others have not (HRnonDys), in comparison to a low familial risk control group without dyslexia (LRnonDys). This allowed us to investigate the persistence of dyslexia in the first language (L1) and the effect of dyslexia on the second language (L2), which has, in this case, a lower orthographic transparency. Furthermore, the inclusion of the HRnonDys group allowed us to investigate the continuity of the familial risk of dyslexia, as previous studies observed that the HRnonDys group often scores in between the HRDys and LRnonDys group, and whether these readers without reading deficits in Dutch, have more reading difficulties in ESL. METHODS: The data of three groups of adolescents were analyzed; 27 LRnonDys, 25 HRdys 25 HRnonDys. The mean age was 14;1 years; months, and 37 were male. All were native speakers of Dutch, attended regular secondary education (grade 7-10), and were non-native speakers of English. Using MANOVA the groups were compared on Dutch and English word reading fluency (WRF), spelling and vocabulary, Dutch pseudoword and loanword reading fluency, phonological awareness (PA), rapid automatized naming (RAN), and verbal short term and working memory. A repeated measures ANOVA was used to compare English and Dutch WRF, spelling and vocabulary directly within the three groups. RESULTS: The analyses revealed that the HRDys group had a deficit in both reading and spelling in Dutch and ESL. They also performed poorer than the LRnonDys group on all other measures. Effect sizes were especially large for pseudoword reading and the reaction times during the PA task. The HRnonDys group scored generally poorer than the LRnonDys group but this difference was only significant for Dutch pseudoword reading, PA reaction times and verbal short term memory. In general the HRDys and HRnonDys group scored similar in Dutch and English, except for English WRF where the HRDys group scored slightly better than expected based on their Dutch WRF. DISCUSSION: There was a high persistence of dyslexia. Adolescents with dyslexia had large impairments in reading and spelling, and reading related measures, both in Dutch and ESL. Despite high inter-individual differences, an overall three-step pattern was observed. Adolescents in the HRnonDys group scored in between the HRDys and LRnonDys group, supporting the polygenetic origin of dyslexia and the continuity of the familial risk of dyslexia. The lower orthographic transparency did not have a negative effect on L2 reading, spelling and vocabulary, both in the HRnonDys and HRDys group. The latter group performed slightly better than expected in L2, which may be a result of the massive exposure to English and high motivation to use English by adolescents.