Variability in auditory processing performance is associated with reading difficulties rather than with history of otitis media.

The nature and cause of auditory processing deficits in dyslexic individuals have been debated for decades. Auditory processing deficits were argued to be the first step in a causal chain of difficulties, leading to difficulties in speech perception and thereby phonological processing and literacy difficulties. More recently, it has been argued that auditory processing difficulties may not be causally related to language and literacy difficulties. This study compares two groups who have phonological processing impairments for different reasons: dyslexia and a history of otitis media (OM). We compared their discrimination thresholds and response variability to chronological age- and reading age-matched controls, across three auditory processing tasks: frequency discrimination, rise-time discrimination and speech perception. Dyslexic children showed raised frequency discrimination thresholds in comparison with age-matched controls but did not differ from reading age-matched controls or individuals with a history of OM. There were no group differences on speech perception or rise-time tasks. For the dyslexic children, there was an association between phonological awareness and frequency discrimination response variability, but no association with thresholds. These findings are not consistent with a 'causal chain' explanation but could be accounted for within a multiple deficits view of literacy difficulties.

Not all phonological awareness deficits are created equal: evidence from a comparison between children with Otitis Media and poor readers.

Children with reading difficulties and children with a history of repeated ear infections (Otitis Media, OM) are both thought to have phonological impairments, but for quite different reasons. This paper examines the profile of phonological and morphological awareness in poor readers and children with OM. Thirty-three poor readers were compared to individually matched chronological age and reading age controls. Their phonological awareness and morphological awareness skills were consistently at the level of reading age matched controls. Unexpectedly, a significant minority (25%) of the poor readers had some degree of undiagnosed mild or very mild hearing loss. Twenty-nine children with a history of OM and their matched controls completed the same battery of tasks. They showed relatively small delays in their literacy and showed no impairment in morphological awareness but had phonological awareness scores below the level of reading age matched controls. Further analysis suggested that this weakness in phonological awareness was carried by a specific weakness in segmenting and blending phonemes, with relatively good performance on phoneme manipulation tasks. Results suggest that children with OM show a circumscribed deficit in phoneme segmentation and blending, while poor readers show a broader metalinguistic impairment which is more closely associated with reading difficulties.

When does speech sound disorder matter for literacy? The role of disordered speech errors, co-occurring language impairment and family risk of dyslexia.

BACKGROUND: This study considers the role of early speech difficulties in literacy development, in the context of additional risk factors. METHOD: Children were identified with speech sound disorder (SSD) at the age of 3½ years, on the basis of performance on the Diagnostic Evaluation of Articulation and Phonology. Their literacy skills were assessed at the start of formal reading instruction (age 5½), using measures of phoneme awareness, word-level reading and spelling; and 3 years later (age 8), using measures of word-level reading, spelling and reading comprehension. RESULTS: The presence of early SSD conferred a small but significant risk of poor phonemic skills and spelling at the age of 5½ and of poor word reading at the age of 8. Furthermore, within the group with SSD, the persistence of speech difficulties to the point of school entry was associated with poorer emergent literacy skills, and children with 'disordered' speech errors had poorer word reading skills than children whose speech errors indicated 'delay'. In contrast, the initial severity of SSD was not a significant predictor of reading development. Beyond the domain of speech, the presence of a co-occurring language impairment was strongly predictive of literacy skills and having a family risk of dyslexia predicted additional variance in literacy at both time-points. CONCLUSIONS: Early SSD alone has only modest effects on literacy development but when additional risk factors are present, these can have serious negative consequences, consistent with the view that multiple risks accumulate to predict reading disorders.

Predicting dyslexia using prereading skills: the role of sensorimotor and cognitive abilities.

BACKGROUND: It is well established that phonological awareness, print knowledge and rapid naming predict later reading difficulties. However, additional auditory, visual and motor difficulties have also been observed in dyslexic children. It is examined to what extent these difficulties can be used to predict later literacy difficulties. METHOD: An unselected sample of 267 children at school entry completed a wide battery of tasks associated with dyslexia. Their reading was tested 2, 3 and 4 years later and poor readers were identified (n = 42). Logistic regression and multiple case study approaches were used to examine the predictive validity of different tasks. RESULTS: As expected, print knowledge, verbal short-term memory, phonological awareness and rapid naming were good predictors of later poor reading. Deficits in visual search and in auditory processing were also present in a large minority of the poor readers. Almost all poor readers showed deficits in at least one area at school entry, but there was no single deficit that characterised the majority of poor readers. CONCLUSIONS: Results are in line with Pennington's () multiple deficits view of dyslexia. They indicate that the causes of poor reading outcome are multiple, interacting and probabilistic, rather than deterministic.

The roles of family history of dyslexia, language, speech production and phonological processing in predicting literacy progress.

It is well established that speech, language and phonological skills are closely associated with literacy, and that children with a family risk of dyslexia (FRD) tend to show deficits in each of these areas in the preschool years. This paper examines what the relationships are between FRD and these skills, and whether deficits in speech, language and phonological processing fully account for the increased risk of dyslexia in children with FRD. One hundred and fifty-three 4-6-year-old children, 44 of whom had FRD, completed a battery of speech, language, phonology and literacy tasks. Word reading and spelling were retested 6 months later, and text reading accuracy and reading comprehension were tested 3 years later. The children with FRD were at increased risk of developing difficulties in reading accuracy, but not reading comprehension. Four groups were compared: good and poor readers with and without FRD. In most cases good readers outperformed poor readers regardless of family history, but there was an effect of family history on naming and nonword repetition regardless of literacy outcome, suggesting a role for speech production skills as an endophenotype of dyslexia. Phonological processing predicted spelling, while language predicted text reading accuracy and comprehension. FRD was a significant additional predictor of reading and spelling after controlling for speech production, language and phonological processing, suggesting that children with FRD show additional difficulties in literacy that cannot be fully explained in terms of their language and phonological skills.

Separating the influences of prereading skills on early word and nonword reading.

The essential first step for a beginning reader is to learn to match printed forms to phonological representations. For a new word, this is an effortful process where each grapheme must be translated individually (serial decoding). The role of phonological awareness in developing a decoding strategy is well known. We examined whether beginning readers recruit different skills depending on the nature of the words being read (familiar words vs. nonwords). Print knowledge, phoneme and rhyme awareness, rapid automatized naming (RAN), phonological short-term memory (STM), nonverbal reasoning, vocabulary, auditory skills, and visual attention were measured in 392 prereaders 4 and 5 years of age. Word and nonword reading were measured 9 months later. We used structural equation modeling to examine the skills-reading relationship and modeled correlations between our two reading outcomes and among all prereading skills. We found that a broad range of skills were associated with reading outcomes: early print knowledge, phonological STM, phoneme awareness and RAN. Whereas all of these skills were directly predictive of nonword reading, early print knowledge was the only direct predictor of word reading. Our findings suggest that beginning readers draw most heavily on their existing print knowledge to read familiar words.

The causal role of phoneme awareness and letter-sound knowledge in learning to read: combining intervention studies with mediation analyses.

There is good evidence that phoneme awareness and letter-sound knowledge are reliable longitudinal predictors of learning to read, though whether they have a causal effect remains uncertain. In this article, we present the results of a mediation analysis using data from a previous large-scale intervention study. We found that a phonology and reading intervention that taught letter-sound knowledge and phoneme awareness produced significant improvements in these two skills and in later word-level reading and spelling skills. Improvements in letter-sound knowledge and phoneme awareness at the end of the intervention fully mediated the improvements seen in children's word-level literacy skills 5 months after the intervention finished. Our findings support the conclusion that letter-sound knowledge and phoneme awareness are two causal influences on the development of children's early literacy skills.

The development of early literacy in Steiner- and standard-educated children.

BACKGROUND. There is evidence that children who are taught to read later in childhood (age 6-7) make faster progress in early literacy than those who are taught at a younger age (4-5 years), as is current practice in the UK. AIMS. Steiner-educated children begin learning how to read at age 7, and have better reading-related skills at the onset of instruction. Therefore, it is hypothesized that older Steiner-educated children will make faster progress in early literacy than younger standard-educated controls. SAMPLES. A total of 30 Steiner-educated children (age 7-9) were compared to a matched group of 31 standard-educated controls (age 4-6). METHOD. Children were tested for reading, spelling, phonological awareness, and letter knowledge at three time points during their first year of formal reading instruction and again at the end of the second year. RESULTS. There were no significant differences between groups in word reading at the end of the first and second year or reading comprehension at the end of the second year; however, the standard group outperformed the Steiner group on spelling at the end of both years. The Steiner group maintained an overall lead in phonological skills while letter knowledge was similar in both groups. CONCLUSIONS. The younger children showed similar, and in some cases, better progress in literacy than the older children; this was attributed to more consistent and high-quality synthetic phonics instruction as is administered in standard schools. Consequently, concerns that 4- to 5-year-olds are 'too young' to begin formal reading instruction may be unfounded.

Comparison of topical antiaging creams in the management of lateral canthal lines.

OBJECTIVE: This study compared an antiaging treatment with two currently marketed cosmetic antiaging products for the treatment of lateral canthal lines ("crow's feet"). METHODS: Healthy female volunteers (72) aged of 54.6 years (mean) having fine-to-moderate wrinkles in the lateral canthal areas were randomized to one of three treatments applied daily over 28 days: Group A (Purgenesis™ Day Cream, Purgenesis™ Eye Cream, and Purgenesis™ Night Cream); Group B (Prevage® Eye Lotion, Prevage® Day Cream, and Prevage® Night Cream); or Group C (La Mer® Eye Balm, Crème de La Mer® , and La Mer® Night Cream). The effects on anti-wrinkle properties and for sensory attributes and general performance were evaluated on Days 1, 7, and 28. RESULTS: Skin hydration improved significantly at all time points in Groups A and B, and at Day 28 in Group C. Group A patients experienced significant improvements in measured skin elasticity parameters at Day 28; extensibility and maximum amplitude were significantly better at Day 28 in Groups B and C. Benefits were also seen in profilometric parameters with statistical significance only in Group A Volunteer tolerance was good with all three treatments, although moderate and high levels of adverse events were numerically higher in Group B than in Groups A or C, and levels of slight discomfort were significantly more prevalent in Group B. CONCLUSION: The Purgenesis™ antiaging treatment significantly improved skin hydration, elasticity, and profilometry parameters during a 28-day study. This therapy was found to be well tolerated and effective in countering the cutaneous signs of aging.

Improving early language and literacy skills: differential effects of an oral language versus a phonology with reading intervention.

BACKGROUND: This study compares the efficacy of two school-based intervention programmes (Phonology with Reading (P + R) and Oral Language (OL)) for children with poor oral language at school entry. METHODS: Following screening of 960 children, 152 children (mean age 4;09) were selected from 19 schools on the basis of poor vocabulary and verbal reasoning skills and randomly allocated to either the P + R programme or the OL programme. Both groups of children received 20 weeks of daily intervention alternating between small group and individual sessions, delivered by trained teaching assistants. Children in the P + R group received training in letter-sound knowledge, phonological awareness and book level reading skills. Children in the OL group received instruction in vocabulary, comprehension, inference generation and narrative skills. The children's progress was monitored at four time points: pre-, mid- and post-intervention, and after a 5-month delay, using measures of literacy, language and phonological awareness. RESULTS: The data are clustered (children within schools) and robust confidence intervals are reported. At the end of the 20-week intervention programme, children in the P + R group showed an advantage over the OL group on literacy and phonological measures, while children in the OL group showed an advantage over the P + R group on measures of vocabulary and grammatical skills. These gains were maintained over a 5-month period. CONCLUSIONS: Intervention programmes designed to develop oral language skills can be delivered successfully by trained teaching assistants to children at school entry. Training using P + R fostered decoding ability whereas the OL programme improved vocabulary and grammatical skills that are foundations for reading comprehension. However, at the end of the intervention, more than 50% of at-risk children remain in need of literacy support.

Sex and discipline differences in empathising, systemising and autistic symptomatology: evidence from a student population.

Baron-Cohen's [(2002) Trends in Cognitive Sciences, 6, 248-255] 'extreme male brain' theory of autism is investigated by examining the relationships between theory of mind, central coherence, empathising, systemising and autistic-like symptomatology in typical undergraduates. There were sex differences in the expected directions on all tasks. Differences according to discipline were found only in central coherence. There was no evidence of an association between empathising and systemising. In the second study, performance on the Mechanical Reasoning task was compared with Systemising quotient and the Social Skills Inventory was compared with the Empathising Quotient. Moderate, but not high correlations were found. Findings are broadly consistent with the distinction between empathising and systemising but cast some doubt on the tasks used to measure these abilities.

An assessment of anxiety levels in dyslexic students in higher education.

BACKGROUND: It has long been hypothesized that children with learning disabilities, including dyslexia, may be highly vulnerable to emotional consequences such as anxiety. However, research has centred on school-aged children. AIMS: The present study aimed to clarify these findings with dyslexic students in higher education. SAMPLES: Sixteen students with dyslexia were compared with 16 students with no history of learning difficulties. METHODS: Students were asked to complete a written questionnaire concerning trait anxiety levels. They were then told that they would be given a timed reading test and their state anxiety levels were measured using the State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, & Lushene, 1983). Finally, their reading was assessed using the Test of Word Reading Efficiency (TOWRE; Torgesen, Wagner, & Rashotte, 1999). RESULTS: Dyslexic students showed slower reading speeds than controls. They also had higher levels of state anxiety and elevated levels of academic and social, but not appearance, anxiety. CONCLUSIONS: Dyslexic students in higher education show anxiety levels that are well above what is shown by students without learning difficulties. This anxiety is not limited to academic tasks but extends to many social situations. It is proposed that assessment of emotional well-being should form part of the assessment of need for dyslexic students entering higher education.

Reading Self-Efficacy Predicts Word Reading But Not Comprehension in Both Girls and Boys.

The relationship between cognitive skills and reading has been well-established. However, the role of motivational factors such as self-efficacy in reading progress is less clear. In particular, it is not clear how self-efficacy relates to word level reading versus comprehension, and whether this differs in boys and girls. This study examines the relationship between self-efficacy, word reading and reading comprehension across the range of reading abilities after controlling for reading-related cognitive factors. One hundred and seventy nine children (86 males and 93 females) between 8 and 11 years old completed a self-report measure of reading self-efficacy together with measures of reading comprehension and word reading, working memory, auditory short-term memory, phonological awareness, and vocabulary. Boys and girls showed similar levels of attainment and reading self-efficacy. Reading self-efficacy was associated with word reading, but not with reading comprehension in either boys or girls. It is argued that this may reflect important differences between reading self-efficacy and more general measures of reading motivation and engagement. Reading self-efficacy is an element of reading motivation that is closely associated with a child's perceived attainments in reading and is less susceptible to the gender differences seen in broader measures.

The development of phonological awareness in preschool children.

A short-term longitudinal study was carried out on a group of 67 preschool children. At three points in time over a 12-month period, the children were given tests measuring their syllable, rime, and phoneme awareness, speech and language skills, and letter knowledge. In general, children's rime skills developed earlier than their phoneme skills. Structural equation models showed that articulatory skills and syllable and rime awareness predicted later phoneme awareness.

Spelling-stress regularity effects are intact in developmental dyslexia.

The current experiment investigated conflicting predictions regarding the effects of spelling-stress regularity on the lexical decision performance of skilled adult readers and adults with developmental dyslexia. In both reading groups, lexical decision responses were significantly faster and significantly more accurate when the orthographic structure of a word ending was a reliable as opposed to an unreliable predictor of lexical stress assignment. Furthermore, the magnitude of this spelling-stress regularity effect was found to be equivalent across reading groups. These findings are consistent with intact phoneme-level regularity effects also observed in dyslexia. The paper discusses how findings of intact spelling-sound regularity effects at both prosodic and phonemic levels, as well as other similar results, can be reconciled with the obvious difficulties that people with dyslexia experience in other domains of phonological processing.

Spoken word classification in children and adults.

PURPOSE: Preschool children often have difficulties in word classification, despite good speech perception and production. Some researchers suggest that they represent words using phonetic features rather than phonemes. In this study, the authors examined whether there is a progression from feature-based to phoneme-based processing across age groups and whether responses are consistent across tasks and stimuli. METHOD: In Study 1, 120 three- to five-year-old children completed 3 tasks assessing use of phonetic features in classification, with an additional 58 older children completing 1 of the 3 tasks. In Study 2, all of the children, together with an additional adult sample, completed a nonword learning task. RESULTS: In all 4 tasks, children classified words sharing phonemes as similar. In addition, children regarded words as similar if they shared manner of articulation, particularly word finally. Adults also showed this sensitivity to manner, but across the tasks, there was a pattern of increasing use of phonemic information with age. CONCLUSIONS: Children tend to classify words as similar if they share phonemes or if they share manner of articulation word finally. Use of phonemic information becomes more common with age.

Efficacy of small group reading intervention for beginning readers with reading-delay: a randomised controlled trial.

BACKGROUND: This study evaluated the effectiveness of an intervention for reading-delayed children in Year-1 classes. METHODS: A sample (N = 77) of children drawn from 14 schools representing those with the weakest reading skills were randomly allocated to one of two groups. A 20-week intervention group received the intervention for two consecutive 10-week periods, while a 10-week intervention group only received the intervention for the second 10 weeks of the study. The programme was delivered in daily 20-minute sessions that alternated between small group (N = 3) and individual teaching. The programme combined phoneme awareness training, word and text reading, and phonological linkage exercises. RESULTS: The children receiving the intervention during the first 10-week period made significantly more progress on measures of letter knowledge, single word reading, and phoneme awareness than children not receiving the intervention. However, the children who only received the intervention during the second 10-week period made rapid progress and appeared to catch up with the children who had been given the more prolonged intervention. Failure to respond to the intervention was predicted by poor initial literacy skills and being in receipt of free school meals. CONCLUSION: A reading intervention programme delivered on a daily basis by trained teaching assistants is an effective intervention for children who show reading delays at the end of their first year in school. However, around one-quarter of the children did not respond to this intervention and these children would appear to need more intensive or more prolonged help to improve their reading skills.

Literacy difficulties and psychiatric disorders: evidence for comorbidity.

BACKGROUND: Literacy difficulties show high levels of comorbidity with both disruptive and emotional disorders, but questions remain over the nature and specificity of these links. METHOD: Relationships between specific literacy difficulties and psychiatric disorder were investigated in a large-scale national sample of children aged 9 to 15 years. RESULTS: Specific literacy difficulties were more common in children from lower socio-economic backgrounds, and were significantly associated with increased risks of Attention-Deficit Hyperactivity Disorder (especially inattentive symptomatology), Conduct Disorder and anxiety disorders in both girls and boys, and with self-reports of depressed mood in boys. Associations between literacy difficulties and diagnoses of both Attention-Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) were mediated by inattentiveness, as were links with low mood. Links between specific literacy difficulties and anxiety were of a different nature, suggestive of a direct impact of literacy problems on risk for anxiety disorders. CONCLUSIONS: Literacy difficulties are significantly associated with externalizing disorders via inattention, but may constitute a more immediate risk factor for naturally anxious children to develop clinically significant levels of anxiety.

Language and phonological skills in children at high risk of reading difficulties.

BACKGROUND: Dyslexia is now generally acknowledged to involve difficulties in phonological processing. However, the links between reading difficulties and speech difficulties remain unclear. METHOD: In the present study, 17 children with speech difficulties between the ages of four and six were compared to children with a family history of dyslexia and normally developing controls on phonological processing, phonological learning, phonological awareness and literacy tasks. RESULTS: The two groups of children at risk of reading difficulties showed very similar patterns of impairment, with average vocabulary but poor input and output speech processing, phonological learning, phonological awareness and reading development. CONCLUSIONS: It is concluded that the antecedents of reading difficulty are similar in these two groups of children, with both groups showing deficits in the development of phonological representations.