An executive-functions-based reading training enhances sensory-motor systems integration during reading fluency in children with dyslexia.

The Simple View of Reading model suggests that intact language processing and word decoding lead to proficient reading comprehension, with recent studies pointing at executive functions as an important component contributing to reading proficiency. Here, we aimed to determine the underlying mechanism(s) for these changes. Participants include 120 8- to 12-year-old children (n = 55 with dyslexia, n = 65 typical readers) trained on an executive functions-based reading program, including pre/postfunctional MRI and behavioral data collection. Across groups, improved word reading was related to stronger functional connections within executive functions and sensory networks. In children with dyslexia, faster and more accurate word reading was related to stronger functional connections within and between sensory networks. These results suggest greater synchronization of brain systems after the intervention, consistent with the "neural noise" hypothesis in children with dyslexia and support the consideration of including executive functions as part of the Simple View of Reading model.

Children with developmental dyslexia have equivalent audiovisual speech perception performance but their perceptual weights differ.

As reading is inherently a multisensory, audiovisual (AV) process where visual symbols (i.e., letters) are connected to speech sounds, the question has been raised whether individuals with reading difficulties, like children with developmental dyslexia (DD), have broader impairments in multisensory processing. This question has been posed before, yet it remains unanswered due to (a) the complexity and contentious etiology of DD along with (b) lack of consensus on developmentally appropriate AV processing tasks. We created an ecologically valid task for measuring multisensory AV processing by leveraging the natural phenomenon that speech perception improves when listeners are provided visual information from mouth movements (particularly when the auditory signal is degraded). We designed this AV processing task with low cognitive and linguistic demands such that children with and without DD would have equal unimodal (auditory and visual) performance. We then collected data in a group of 135 children (age 6.5-15) with an AV speech perception task to answer the following questions: (1) How do AV speech perception benefits manifest in children, with and without DD? (2) Do children all use the same perceptual weights to create AV speech perception benefits, and (3) what is the role of phonological processing in AV speech perception? We show that children with and without DD have equal AV speech perception benefits on this task, but that children with DD rely less on auditory processing in more difficult listening situations to create these benefits and weigh both incoming information streams differently. Lastly, any reported differences in speech perception in children with DD might be better explained by differences in phonological processing than differences in reading skills. RESEARCH HIGHLIGHTS: Children with versus without developmental dyslexia have equal audiovisual speech perception benefits, regardless of their phonological awareness or reading skills. Children with developmental dyslexia rely less on auditory performance to create audiovisual speech perception benefits. Individual differences in speech perception in children might be better explained by differences in phonological processing than differences in reading skills.

From spelling to reading: An intervention program with children at risk of reading failure.

This study aimed to assess the impact of an interactive spelling program on reading acquisition of children at risk of developing reading difficulties as well as to assess its effect on spelling and phonemic awareness. From an initial pool of 144 first-grade children attending four Portuguese primary schools, 53 children with low performances in letter knowledge and phonemic awareness tasks, and considered by their teachers to be at risk of developing reading difficulties, were selected. These children were randomly assigned to three groups: an experimental group that underwent an interactive spelling program, a comparison group that underwent a phonological awareness program, and a control group that underwent a copying program. The programs, conducted in pairs, comprised 12 sessions lasting 20 to 30 min twice a week. The pretest and posttest included word reading, word spelling, and phonemic awareness assessments. Data analysis showed that the spelling group significantly outperformed the other groups across all measures except in the phonemic awareness task, where there were no differences with the phonological group. The word copying group consistently yielded the lowest results. Unlike the other two groups, the posttest results of the experimental group also reached the class average in word reading. For ethical reasons, after the final assessments the control group underwent a version of the interactive spelling program. This study suggests that spelling activities can contribute significantly to reading acquisition and can serve as a valuable pedagogical tool to proactively address challenges in learning to read.

The challenge of remote treatment in neuropsychological intervention for reading and spelling in dyslexia: A prospective observational cohort study.

Telemedicine approaches have proved to be valuable solutions for the delivery of treatment for many health-related issues, and crucial during the pandemics. Nonetheless, the efficacy of such Web-based practices in developmental dyslexia needs to be thoroughly evaluated. To this aim, the effects of a multi-componential program for neuropsychological intervention in dyslexia delivered as an outpatient program were compared with those obtained with a remotely delivered, Web-based treatment, based on the same methodological principles and delivered with the same duration and intensity. The treatment-related changes obtained with a combination of visual hemisphere-specific stimulation and training of visual-spatial attention through action video games, were compared to those obtained through remote treatment via the Tachidino Web-based platform. Both treatments had a duration of 4 weeks. The same battery of reading and phonemic awareness tests was delivered in presence, before and after treatment, as well as at 6-months follow-up. User satisfaction was assessed through parents and user questionnaires. Both treatments were significantly and similarly effective in improving reading speed, reading accuracy, and writing accuracy. No reduction in the effects was observed after treatment discontinuation. The Web-based treatment may thus offer a valid alternative to in-person intervention, optimizing the flexibility, capillary diffusion and cost-effectiveness of intervention.

Twice-exceptionality unmasked: A systematic narrative review of the literature on identifying dyslexia in the gifted child.

In this systematic narrative review, we synthesised the small existing body of research on children who are gifted and dyslexic (G-D) in order to investigate the claim that G-D students have a unique profile, characterised by well-masked word-level reading and spelling difficulties. Our focus was on both the cognitive and academic profiles of this subgroup of twice-exceptional (2e) children and the assessment protocols used to identify them. Findings suggest that despite having processing deficits associated with dyslexia, G-D students' gifted strengths, especially those relating to oral language, may enable them to compensate for their reading difficulties, at least to an extent that they fail to meet standard diagnostic criteria. However, G-D students also perform poorly on word-level reading, reading fluency and spelling tasks when compared with both control groups and their gifted, non-dyslexic peers, providing clear evidence of impaired achievement. Findings from this review highlight the need for (a) a more nuanced approach to the assessment of students presenting with highly discrepant profiles and (b) future research into both the cognitive and academic profiles and the instructional needs of this highly able yet poorly understood group of students, whose potential may be masked and thus underestimated in the school setting.

Sex-related differences in reading achievement.

Over the last 40 years, ever-growing interest in sex-related differences in the human brain has led to a vast amount of literature on the subject, a small part of which relates to studies of differences in the ability to read. The data concerning typically developing children mainly come from school-based screening projects (Programme for International Student Assessment, INVALSI) and partially from the standardization of reading tests. These have revealed the existence of a gap in favor of females that primarily appears during adolescence and in situations of sociocultural disadvantage, usually explained on the basis of environmental factors such as socioeconomic status and gender-based education. Dyslexia is a neurodevelopmental disorder that is significantly more prevalent among males, a difference that neuroimaging and genetic studies have attributed to the presence of hormone-related protective factors in females, although it has been hypothesized that a different neurocognitive substrate may also be involved. However, the literature on the subject is still limited, and further studies of the interactions between genetic risk, environmental factors, and brain phenotypes are needed to clarify why females are better at performing reading tasks and less susceptible to dyslexia, regardless of their language or the educational system in the country in which they live. The aim of this mini-review was to describe the studies that have investigated sex-related differences in reading ability in both typically and atypically developing subjects.

A network approach to dyslexia: Mapping the reading network.

Research on the etiology of dyslexia typically uses an approach based on a single core deficit, failing to understand how variations in combinations of factors contribute to reading development and how this combination relates to intervention outcome. To fill this gap, this study explored links between 28 cognitive, environmental, and demographic variables related to dyslexia by employing a network analysis using a large clinical database of 1,257 elementary school children. We found two highly connected subparts in the network: one comprising reading fluency and accuracy measures, and one comprising intelligence-related measures. Interestingly, phoneme awareness was functionally related to the controlled and accurate processing of letter-speech sound mappings, whereas rapid automatized naming was more functionally related to the automated convergence of visual and speech information. We found evidence for the contribution of a variety of factors to (a)typical reading development, though associated with different aspects of the reading process. As such, our results contradict prevailing claims that dyslexia is caused by a single core deficit. This study shows how the network approach to psychopathology can be used to study complex interactions within the reading network and discusses future directions for more personalized interventions.

Understanding variation in prospective poor decoders: A person-centred approach from kindergarten to Grade 2.

In the present study, we aimed to clarify variation in prospective poor decoders by studying the development of their word decoding skills during the first 1½ years of formal reading education and their unique pre-reading profiles before the onset of formal reading education. Using structural equation modelling and a factorial mixed model analysis of variance (ANOVA), we found autoregression and growth in the word decoding efficiency of prospective poor decoders (n = 90) and matched prospective adequate decoders (n = 90) in first and second grade. However, the gap between the two groups widened over time. Next, we zoomed in on the group of poor decoders by retrospectively studying their individual variation regarding cognitive and linguistic pre-reading skills. Using latent profile analysis, we found three distinct pre-reading profiles: (1) Poor PA, Letter Knowledge, RAN, and Verbal STM; (2) Poor PA and Letter Knowledge; and (3) Poor RAN. Together, these findings suggest that reading difficulties emerge at the intersection of multiple risk factors which can be detected in kindergarten, and that these reading problems persist throughout early reading education.

Insights from a Web-based survey into the psychosocial experiences of adults with dyslexia: Findings from a final comment question.

Not seemingly measuring up to Western societies' educational and occupational expectations for success, adults with dyslexia are at risk for discrimination, humiliation, low self-esteem, low self-efficacy, depression, and anxiety. We analysed 113 responses to the final comment question that was incorporated at the end of a quantitative survey on the socioemotional experiences of adults with dyslexia. The final comment question was not intended for conveying personal experiences, yet the final comment responses were personal, in-depth, and substantive - indicators of quality recommended in survey research. Thematic analysis was used to analyse the data and develop themes. One overarching theme was yearnings for understanding and acceptance. Its associated subthemes included (1) "This stuff is torture", (2) "Thank God I'm not normal, (3) educational experience, (4) coping strategies, (5) family support, and (6) generational dyslexia. This study contributes to the small but growing body of literature on the socioemotional experiences of adults with dyslexia. Among the implications for practice, policy and research, a larger challenge at the broader society level that embraces diversity, equity, and inclusion for individuals with dyslexia is forefront.

Disentangling dyslexia from typical L2-learning in emergent literacy.

The present paper assessed how dyslexia can be identified in school children with another language than their first language. Participants were school children with Norwegian as their second language (L2), and two groups of children with Norwegian as their first language (L1): a control group (L1-Con), and a dyslexia group (L1-Dys). All were 2nd and 3rd graders who had attended Norwegian schools from 1st grade on. None of the individuals in L1-Con or the L2 group were identified with any learning disability. However, slow literacy progress was seen in some L2-children. The children were tested individually within the symptomatic and cognitive levels. Results were analysed in two steps: (1) group comparisons; (2) L2 individual profiles and tentative L2 subgrouping. An unexpected L2 profile showed language scores below norm, coupled with some scores within and some scores above norm within the cognitive domain. Case assessment of the L2 group resulted in three subgroups: one comparable to L1-Con, one comparable to L1-Dys, and one with a result in between these two groups. Low linguistic scores cannot be considered valid markers of dyslexia in L2. Within the cognitive domain, a variety of low scores can indicate dyslexia, while high scores can be compensatory.

Growing up with dyslexia: Child and parent perspectives on school struggles, self-esteem, and mental health.

Children with dyslexia, compared with typically reading peers, are at increased risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown. Our aim was to explore the socio-emotional experience of growing up with dyslexia from both child and parent perspectives. In so doing, we aimed to gain a better understanding of self-esteem and mental health in the context of dyslexia. One-to-one semi-structured interviews with 17 children with reading difficulties (aged 9-14 years; 16 with a diagnosis of dyslexia) and their mothers (interviewed separately) were analysed using Braun and Clarke's reflexive thematic analysis approach with a neurodiversity lens. We developed three themes to address the research aim: (1) Different in a good/bad way; (2) Exhausted and overwhelmed; and (3) It takes a community: Family school connections. Children discussed having "worries" and experiencing school-related stress and embarrassment. Mothers perceived children's internalising and externalising behaviour (meltdowns), school refusal, and homework resistance as emotional responses to children's school struggles due to poor "person-environment fit." Our analysis highlights the particular importance of parent support, friendship, and school-connectedness for the wellbeing of children with dyslexia.

The revision process during handwritten text production: The case of French higher education students with dyslexia.

The goal of this paper is to observe revision during handwritten text production of French students with and without dyslexia. Subjects with typical language development automate spelling during childhood and adolescence, progressively with experience, this enables them-according to capacity theory applied to written text production (McCutchen, Educational Psychology Review, 8, 1996, 299)-to allocate more cognitive resources to higher-level processes (Bereiter & Scardamalia, The psychology of written composition. Hillsdale: Lawrence Erlbaum, 1987). A lack of automation in spelling could result in poor compositional performance (Fayol & Miret, Psychologie Française, 50, 2005, 391). Moreover, Morken and Helland (Dyslexia, 19, 2013, 131) have shown that young children with dyslexia, engaged in a sentence dictation task, revise their text as much as control children, however their revisions are of lower quality. If students with dyslexia have not totally automated spelling (Mazur-Palandre, Développements (Revue Interdisciplinaire du développement Cognitif Normal et Pathologique), 18, 2016, 177), what is the impact on higher-level processes, such as revision? Our goal is to examine if students with dyslexia and control students proofread their texts in the same way. Results show that they display some similarity but students with dyslexia seem to have a deficit in the error detection mechanism (Horowitz & Breznitz, International Journal of Disability, Development and Education, 58, 2011, 33) and revisions are less efficient. We discuss these results by considering previous studies we conducted on spelling, speech and neuropsychological assessments of our dyslexic participants.

The cumulative effect of socioeconomic status and dyslexia on linguistic, cognitive and reading skills among Arabic-speaking children.

Research has shown that children with dyslexia and children with a low socioeconomic status (SES) fall behind in terms of literacy acquisition, but a question remains regarding the cumulative effect of dyslexia and SES on linguistic, cognitive and reading skills. To examine the impact of cognition and environment on literacy development, we returned to the data set of 1,441 elementary school children (223 dyslexic readers and 1,241 typical readers) from low and medium-high SES backgrounds within Palestinian society in Israel who had participated in the development study of a comprehensive battery of tests in oral and written Arabic. The findings of this retrospective study reveal that, across grade levels, dyslexic readers from a low SES background showed similar performance to those from a medium-high SES background on most linguistic, cognitive and reading measures. As for typical readers, SES contributed to individual differences in all linguistic, cognitive and reading indices, with the exception of RAN. Finally, a cumulative effect of dyslexia and SES was found in relation to morphology, vocabulary, listening comprehension and text-reading accuracy.

Modelling the eye movements of dyslexic children during reading as a continuous time random walk.

The study of eye movements during reading is considered a valuable tool for understanding the underlying cognitive processes and for its ability to detect alterations that could be associated with neurocognitive deficiencies or visual conditions. During reading, the gaze moves from one position to the next on the text performing a saccade-fixation sequence. This dynamics resembles processes usually described as continuous time random walk, where the jumps are the saccadic movements and waiting times are the duration of fixations. The time between jumps (intersaccadic time) consists of stochastic waiting time and flight time, which is a function of the jump length (the amplitude of the saccade). This motivates the present proposal of a model of eye movements during reading in the framework of the intermittent random walk but considering the time between jumps as a combined stochastic-deterministic process. The parameters used in this model were obtained from records of eye movements of children with dyslexia and typically developed for children performing a reading task. The jump lengths arise from the characteristics of the selected text. The time required for the flights was obtained based on a previously proposed model. Synthetic signals were generated and compared with actual eye movement signals in a complexity-entropy plane.

Ordinal pattern transition networks in eye tracking reading signals.

Eye tracking is an emerging technology with a wide spectrum of applications, including non-invasive neurocognitive diagnosis. An advantage of the use of eye trackers is in the improved assessment of indirect latent information about several aspects of the subjects' neurophysiology. The path to uncover and take advantage of the meaning and implications of this information, however, is still in its very early stages. In this work, we apply ordinal patterns transition networks as a means to identify subjects with dyslexia in simple text reading experiments. We registered the tracking signal of the eye movements of several subjects (either normal or with diagnosed dyslexia). The evolution of the left-to-right movement over time was analyzed using ordinal patterns, and the transitions between patterns were analyzed and characterized. The relative frequencies of these transitions were used as feature descriptors, with which a classifier was trained. The classifier is able to distinguish typically developed vs dyslexic subjects with almost 100% accuracy only analyzing the relative frequency of the eye movement transition from one particular permutation pattern (plain left to right) to four other patterns including itself. This characterization helps understand differences in the underlying cognitive behavior of these two groups of subjects and also paves the way to several other potentially fruitful analyses applied to other neurocognitive conditions and tests.

The cognitive basis of dyslexia in school-aged children: A multiple case study in a transparent orthography.

This study focuses on the role of numerous cognitive skills such as phonological awareness (PA), rapid automatized naming (RAN), visual and selective attention, auditory skills, and implicit learning in developmental dyslexia. We examined the (co)existence of cognitive deficits in dyslexia and assessed cognitive skills' predictive value for reading. First, we compared school-aged children with severe reading impairment (n = 51) to typical readers (n = 71) to explore the individual patterns of deficits in dyslexia. Children with dyslexia, as a group, presented low PA and RAN scores, as well as limited implicit learning skills. However, we found no differences in the other domains. We found a phonological deficit in 51% and a RAN deficit in 26% of children with dyslexia. These deficits coexisted in 14% of the children. Deficits in other cognitive domains were uncommon and most often coexisted with phonological or RAN deficits. Despite having a severe reading impairment, 26% of children with dyslexia did not present any of the tested deficits. Second, in a group of children presenting a wide range of reading abilities (N = 211), we analysed the relationship between cognitive skills and reading level. PA and RAN were independently related to reading abilities. Other skills did not explain any additional variance. The impact of PA and RAN on reading skills differed. While RAN was a consistent predictor of reading, PA predicted reading abilities particularly well in average and good readers with a smaller impact in poorer readers.

Ahead of maturation: Enhanced speech envelope training boosts rise time discrimination in pre-readers at cognitive risk for dyslexia.

Dyslexia has frequently been related to atypical auditory temporal processing and speech perception. Results of studies emphasizing speech onset cues and reinforcing the temporal structure of the speech envelope, that is, envelope enhancement (EE), demonstrated reduced speech perception deficits in individuals with dyslexia. The use of this strategy as auditory intervention might thus reduce some of the deficits related to dyslexia. Importantly, reading-skill interventions are most effective when they are provided during kindergarten and first grade. Hence, we provided a tablet-based 12-week auditory and phonics-based intervention to pre-readers at cognitive risk for dyslexia and investigated the effect on auditory temporal processing with a rise time discrimination (RTD) task. Ninety-one pre-readers at cognitive risk for dyslexia (aged 5-6) were assigned to two groups receiving a phonics-based intervention and playing a story listening game either with (n = 31) or without (n = 31) EE or a third group playing control games and listening to non-enhanced stories (n = 29). RTD was measured directly before, directly after and 1 year after the intervention. While the groups listening to non-enhanced stories mainly improved after the intervention during first grade, the group listening to enhanced stories improved during the intervention in kindergarten and subsequently remained stable during first grade. Hence, an EE intervention improves auditory processing skills important for the development of phonological skills. This occurred before the onset of reading instruction, preceding the maturational improvement of these skills, hence potentially giving at risk children a head start when learning to read. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=e0BfT4dGXNA.

Visual and social differences in dyslexia: deep phenotyping of four cases with spared phonology.

Diagnostic criteria for dyslexia describe specific reading difficulties, and single-deficit models, including the phonological deficit theory, have prevailed. Children seeking diagnosis, however, do not always show phonological deficits, and may present with strengths and challenges beyond reading. Through extensive neurological, neuropsychological, and academic evaluation, we describe four children with visuospatial, socio-emotional, and attention impairments and spared phonology, alongside long-standing reading difficulties. Diffusion tensor imaging revealed white matter alterations in inferior longitudinal, uncinate, and superior longitudinal fasciculi versus neurotypical children. Findings emphasize that difficulties may extend beyond reading in dyslexia and underscore the value of deep phenotyping in learning disabilities.

Multimodal intervention in 8- to 13-year-old French dyslexic readers: Study protocol for a randomized multicenter controlled crossover trial.

BACKGROUND: Developmental dyslexia, a specific and long-lasting learning disorder that prevents children from becoming efficient and fluent readers, has a severe impact on academic learning and behavior and may compromise professional and social development. Most remediation studies are based on the explicit or implicit assumption that dyslexia results from a single cause related to either impaired phonological or visual-attentional processing or impaired cross-modal integration. Yet, recent studies show that dyslexia is multifactorial and that many dyslexics have underlying deficits in several domains. The originality of the current study is to test a remediation approach that trains skills in all three domains using different training methods that are tailored to an individual's cognitive profile as part of a longitudinal intervention study. METHODS: This multicenter randomized crossover study will be conducted in three phases and will involve 120 dyslexic children between the ages of 8 and 13 years. The first phase serves as within-subject baseline period that lasts for 2 months. In this phase, all children undergo weekly speech-language therapy sessions without additional training at home (business-as-usual). During the second phase, all dyslexics receive three types of intensive interventions that last 2 month each: Phonological, visual-attentional, and cross-modal. The order of the first two interventions (phonological and visual-attentional) is swapped in two randomly assigned groups of 60 dyslexics each. This allows one to test the efficacy and additivity of each intervention (against baseline) and find out whether the order of delivery matters. During the third phase, the follow-up period, the intensive interventions are stopped, and all dyslexics will be tested after 2 months. Implementation fidelity will be assessed from the user data of the computerized intervention program and an "intention-to-treat" analysis will be performed on the children who quit the trial before the end. DISCUSSION: The main objective of this study is to assess whether the three types of intensive intervention (phase 2) improve reading skills compared to baseline (i.e., non-intensive intervention, phase 1). The secondary objectives are to evaluate the effectiveness of each intervention and to test the effects of order of delivery on reading intervention outcomes. Reading comprehension, spelling performance and reading disorder impact of dyslexic readers are assessed immediately before and after the multimodal intervention and 2 months post-intervention. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04028310. Registered on July 18, 2019.

Stroop performance is related to reading profiles in Hebrew-speaking individuals with dyslexia and typical readers.

There is a debate in the literature regarding the level of contribution of executive functions (EF) to reading comprehension (RC), in the context of the simple view of reading (SVR) model. The current study aims to create sub-profiles of reading and cognitive abilities based on a measure traditionally used for evaluating EF, that is, the Stroop task, and specifically, Stroop time. Ninety-seven adults with and without reading difficulties performed reading and cognitive tasks, including the Stroop tests. Four groups were created based on Stroop performance time and a reading profile was created for each group. A mediation analysis was conducted to determine if reading accuracy and linguistic abilities predict RC mediated by Stroop time. Participants with a shorter Stroop time demonstrated better reading abilities, whereas those with longer Stroop time showed decreased reading performance. Stroop time was also negatively associated with better performance in additional cognitive abilities. A mediation analysis suggested that decoding ability and linguistic ability predict RC through EF. Our findings support the SVR model and the involvement of EF in reading proficiency and might be used for designing EF-based interventions for reading and RC difficulties.