Frontal alpha asymmetry during emotion regulation in adults with lifetime major depression.

Emotion regulation (ER) often is impaired in current or remitted major depression (MD), although the extent of the deficits is not fully understood. Recent studies suggest that frontal alpha asymmetry (FAA) could be a promising electrophysiological measure to investigate ER. The purpose of this study was to investigate ER differences between participants with lifetime major depression (lifetime MD) and healthy controls (HC) for the first time in an experimental task by using FAA. We compared lifetime MD (n = 34) and HC (n = 25) participants aged 18-24 years in (a) an active ER condition, in which participants were instructed to reappraise negative images and (b) a condition in which they attended to the images while an EEG was recorded. We also report FAA results from an independent sample of adolescents with current MD (n = 36) and HC adolescents (n = 38). In the main sample, both groups were able to decrease self-reported negative affect in response to negative images through ER, without significant group differences. We found no differences between groups or conditions in FAA, which was replicated within the independent adolescent sample. The lifetime MD group also reported less adaptive ER in daily life and higher difficulty of ER during the task. The lack of differences between in self-reported affect and FAA between lifetime MD and HC groups in the active ER task indicates that lifetime MD participants show no impairments when instructed to apply an adaptive ER strategy. Implications for interventional aspects are discussed.

Emotion regulation training for adolescents with major depression: Results from a randomized controlled trial.

Difficulties in emotion regulation (ER) are thought to contribute to the development and maintenance of major depression (MD) in adolescents. In healthy adults, a task-based training of ER has previously proven effective to reduce stress, but no such studies are available for MD. It is also unclear whether findings can be generalized onto adolescent populations. The final sample consisted of n = 70 adolescents with MD, who were randomized to a task-based ER training (n = 36) or a control training (n = 34). Across four sessions, the ER group was trained to downregulate negative affect to negative images via reappraisal, while the control group was instructed to attend the images. Rumination, stress-, and affect-related measures were assessed as primary outcomes, behavioral and neurophysiological responses (late positive potential, LPP), as secondary outcomes. The trial was preregistered at clinicaltrials.gov (NCT03957850). While there was no significant differential effect of the ER training on primary outcomes, we found small to moderate effects on rumination in the ER group, but not the control group. During reappraisal (compared to attend), the ER group showed an unexpected increase of the LPP during the first, but not during later training sessions. Although replication in large, multicenter trials is needed, our findings on effect sizes suggest that ER training might be promising to decrease rumination in adolescent MD. The LPP increase at the first session may represent cognitive effort, which was successfully reduced over the sessions. Future studies should research whether training effects transfer to daily life and are durable over a longer time period. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion regulation in adolescents with major depression - Evidence from a combined EEG and eye-tracking study.

BACKGROUND: Adolescent major depression (MD) is characterized by deficits in emotion regulation (ER). Little is known about the neurophysiological correlates that are associated with these deficits. Moreover, the additional examination of visual attention during ER would allow a more in-depth understanding of ER deficits but has not yet been applied simultaneously. METHODS: N = 33 adolescents with MD and n = 35 healthy controls (HCs) aged 12-18 years performed an ER task during which they either a) down-regulated their negative affective response to negative images via cognitive reappraisal or b) attended the images without changing their affective response. During the task, the Late Positive Potential (LPP), gaze fixations on emotional image aspects, and self-reported affective responses were collected simultaneously. RESULTS: Compared to HCs, adolescents with MD demonstrated reduced ER success based on self-report but did not differ in LPP amplitudes. Participants in both groups showed increased amplitudes in the middle LPP window when they reappraised negative pictures compared to when they attended them. Only in the HC group, increased LPP amplitudes during reappraisal were paralleled by more positive affective responses. LIMITATION: The applied stimuli were part of picture databases and might therefore have limited self-relevance. CONCLUSIONS: Increased LPP amplitude during ER in both groups might be specific to adolescence and might suggest that ER at this age is challenging and requires a high amount of cognitive resources. These findings provide an important starting point for future interventional studies in youth MD.

Neural processes of reward and punishment processing in childhood and adolescence: An event-related potential study on age differences.

Reward and punishment processing are subject to substantial developmental changes during youth. However, little is known about the neurophysiological correlates that are associated with these developmental changes, particularly with regard to both anticipatory and outcome processing stages. Thus, the aim of this study was to address this research gap in a sample of typically developing children and adolescents. Fifty-four children and adolescents (8-18 years) performed a Monetary Incentive Delay Task comprising a monetary reward and punishment condition. Using event-related brain potential recordings, the cue-P3 and the stimulus-preceding negativity (SPN) were analyzed during the anticipation phase, while the Reward Positivity and the feedback-P3 were analyzed during the outcome phase. When anticipating monetary loss or no gain, SPN amplitude in the right hemisphere decreased with age. Moreover, exploratory analyses revealed a decrease in feedback-P3 amplitudes in response to monetary loss with increasing age. No other group differences were observed. Age-related changes in the SPN and fP3 component suggest that sensitivity to negative outcomes decreases from childhood to late adolescence, supporting the notion that adolescence is associated with reduced harm-avoidance. Longitudinal research including young adults is needed to substantiate our findings and its clinical implications regarding disturbed developmental trajectories in psychiatric populations.

Study protocol for a randomised-controlled study on emotion regulation training for adolescents with major depression: the KONNI study.

INTRODUCTION: Major depression (MD) often has its onset during adolescence and is associated with significant morbidity and mortality. One important factor for the development and maintenance of adolescent MD are disturbances in emotion regulation and the underlying neural processes. Cognitive reappraisal (CR) is a particular adaptive emotion regulation strategy. Previously, it has been shown in healthy adults that a task-based training in CR is efficient to reduce negative affect, and that these effects translate into everyday life.This randomised controlled trial examines for the first time whether a task-based training in CR proves effective in MD adolescents. Specifically, we will investigate whether the CR training improves the ability to downregulate negative affect in MD individuals as assessed by behavioural and neurobiological indices, and whether training effects generalise outside the laboratory. METHODS AND ANALYSIS: Adolescents with MD will be randomly allocated to a group that either receives a task-based training in CR or a control training. Both involve four training sessions over a time period of 2 weeks. In the CR training, participants will be instructed to downregulate negative affective responses to negative pictures via CR, while the control training involves picture viewing. During the training sessions, the Late Positive Potential, gaze fixations on negative picture aspects and affective responses to pictures will be collected. Before and after the training programmes, and at a 2-week follow-up, overall negative and positive affect, rumination and perceived stress will be assessed as primary outcomes. Analyses of variance will be conducted to test the effectiveness of the CR training with regard to both primary outcomes and task-based behavioural and neurobiological parameters. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Medical Faculty of the LMU Munich, Germany. The results will be published in peer-reviewed journals and disseminated through conferences, social media and public events. TRIAL REGISTRATION DETAILS: ClinicalTrials.gov NCT03957850, registered 21st May 2019; URL: https://clinicaltrials.gov/ct2/show/NCT03957850.

Word processing deficits in children with isolated and combined reading and spelling deficits: An ERP-study.

Dissociations between reading and spelling deficits are likely to be associated with distinct deficits in orthographic word processing. To specify differences in automatic visual word recognition, the current ERP-study compared children with isolated reading fluency deficits (iRD), isolated spelling deficits (iSD), and combined reading fluency and spelling deficits (cRSD) as well as typically developing (TD) 10-year-olds while performing a variant of the Reicher-Wheeler paradigm: children had to indicate which of two letters occurred at a given position in a previously presented word, legal pseudoword, illegal pseudoword or nonword. Event-related potentials (N200 and N400) associated with sublexical orthographic and lexical orthographic processing as well as phonological word processing were analyzed. All groups showed a word superiority effect, both on the behavioral and the neurophysiological level. Group differences occurred for phonological word processing. TD and iRD groups showed a higher N400 activation for illegal pseudowords than for nonwords, while the two spelling deficit groups showed no activation differences between these two stimuli conditions. The findings suggest that differences in phonological word processing are associated with spelling problems: children with iSD showed reduced sensitivity for phonological word processing, while these deficits were not evident in children with iRD.

Naming processes in reading and spelling disorders: An electrophysiological investigation.

OBJECTIVE: Reading fluency deficits characteristic for reading disorders (RD; F81.0) have been shown to be strongly associated with slow naming speed (e.g. in rapid automatized naming tasks). In contrast, children with an isolated spelling disorder in the context of unimpaired reading skills (iSD; F81.1) show naming speed task performances that are similar to typically developing (TD) children. However, the exact nature of the naming speed deficit and its relation to RD and the question whether children with iSD are also on the neurophysiological level similar to TD children is still unresolved. METHODS: The time-course and scalp topography of event-related potentials (ERP) activity recorded during a delayed digit-naming task was investigated in ten-year-old children with RD and iSD compared to a TD group. RESULTS: ERP activity differed between the RD and the TD group at around 300 ms after stimulus presentation (left occipito-temporal P2). In contrast, there were no neurophysiological differences between the TD and the iSD group. The P2 component correlated with behavioural performance on the RAN task. CONCLUSIONS: Slow naming speed in RD might result from a slowed-down access and prolonged processing of the word (lexical) form. SIGNIFICANCE: The study establishes a relation between neurophysiological processes of naming tasks and RD.

Resting frontal EEG asymmetry in adolescents with major depression: Impact of disease state and comorbid anxiety disorder.

OBJECTIVE: Greater relative right- than left-frontal cortical activity has been frequently found in adults with major depression (MD). As the few studies in adolescents with MD have been inconclusive, the aim of this study was to assess frontal alpha asymmetry (FAA) in an adolescent sample with MD whilst taking into account possible confounding variables such as disease state and comorbid anxiety disorder. METHODS: An 8-minute resting frontal EEG was assessed in 34 healthy controls (HCs), 16 adolescents with MD in remission without comorbid anxiety disorder (rMDa-), 22 adolescents with acute depression without comorbid anxiety disorder (MDa-), and 23 adolescents with acute depression and comorbid anxiety disorder (MDa+). Alpha power was analyzed over corresponding frontal Regions of Interests. RESULTS: Compared to HCs, MDa+ adolescents demonstrated more left- than right-sided EEG alpha power, indicating greater right-than left-frontal cortical activity. No other group differences emerged. CONCLUSIONS: The results suggest that greater relative right-frontal cortical activity in adolescent MD is not a result of disease state but can be attributed to comorbid anxiety disorder. SIGNIFICANCE: Results suggest that FAA is not linked to adolescent depression per se and highlight the importance of considering comorbid disorders when examining asymmetry patterns in adolescent MD.

State or trait? Auditory event-related potentials in adolescents with current and remitted major depression.

OBJECTIVE: Event-related potential (ERP) studies have revealed abnormal neurophysiological patterns underlying selective attention in patients with Major Depression (MD). Only few included both patients in acute and remitted state to address the question whether these abnormalities are state- or trait- dependent and none focused on adolescent MD. Thus, the aim of our study was to address this question in an adolescent sample. METHODS: 22 adolescents with acute MD, 20 adolescents with remitted MD (rMD) and 32 healthy controls (HC) performed a standard two-tone auditory oddball task while ERPs (N100, P200, N200, P300) were collected. RESULTS: Adolescents with rMD showed a reduced N200 amplitude to target tones across frontal, central and parietal recording sites. Adolescents with MD exhibited a reduced N200 amplitude to targets in the frontal region compared to HC. No differences emerged between rMD and the MD group. CONCLUSIONS: The reduced N200 amplitude in adolescents with rMD and MD presumably reflects difficulties in stimulus classification and response selection. Our results indicate that this neurophysiological characteristic is a trait marker of adolescent depression.

Sex differences in the neural underpinnings of social and monetary incentive processing during adolescence.

The brain's reward system undergoes major changes during adolescence, and an increased reactivity to social and nonsocial incentives has been described as a typical feature during this transitional period. Little is known whether there are sex differences in the brain's responsiveness to social or monetary incentives during adolescence. The aim of this event-related potential (ERP) study was to compare the neurophysiological underpinnings of monetary and social incentive processing in adolescent boys versus girls. During ERP recording, 38 adolescents (21 females, 17 males; 13-18 years) completed an incentive delay task comprising (a) a reward versus punishment condition and (b) social versus monetary incentives. The stimulus-preceding negativity (SPN) was recorded during anticipation of reward and punishment, and the feedback P3 (fP3) along with the feedback-related negativity (FRN) after reward/punishment delivery. During anticipation of social punishment, adolescent boys compared with girls exhibited a reduced SPN. After delivery, male adolescents exhibited higher fP3 amplitudes to monetary compared with social incentives, whereas fP3 amplitudes in girls were comparable across incentive types. Moreover, whereas in boys fP3 responses were higher in rewards than in punishment trials, no such difference was evident in girls. The results indicate that adolescent boys show a reduced neural responsivity in the prospect of social punishment. Moreover, the findings imply that, once the incentive is obtained, adolescent boys attribute a relatively enhanced motivational significance to monetary incentives and show a relative hyposensitivity to punishment. The findings might contribute to our understanding of sex-specific vulnerabilities to problem behaviors related to incentive processing during adolescence.

Resting frontal EEG asymmetry patterns in adolescents with and without major depression.

More right-sided frontal brain resting activity has been postulated to be a correlate of major depression in adults. In children and adolescents, more right-sided activity (as indicated by more left-sided alpha activity) seems to be associated with psychosocial risk factors. However, an association of frontal asymmetry and manifest unipolar depression has not been shown in adolescents so far. We analyzed frontal asymmetry in 20 adolescents (12-17 years) with unipolar depression (12 with first episode, 8 with recurrent depression) and 31 healthy age-matched controls. We found significantly less left-sided alpha power over frontal Regions of Interest in patients, while controls exhibited no asymmetry. In the control group, more left-sided frontal alpha correlated with higher depression scores, which was not observed in the patient group. Our results suggest developmental effects on frontal asymmetry, and prompt further investigations in adolescents to clarify the role of frontal asymmetry in adolescent major depression.

Neurophysiological correlates of word processing deficits in isolated reading and isolated spelling disorders.

OBJECTIVE: In consistent orthographies, isolated reading disorders (iRD) and isolated spelling disorders (iSD) are nearly as common as combined reading-spelling disorders (cRSD). However, the exact nature of the underlying word processing deficits in isolated versus combined literacy deficits are not well understood yet. METHODS: We applied a phonological lexical decision task (including words, pseudohomophones, legal and illegal pseudowords) during ERP recording to investigate the neurophysiological correlates of lexical and sublexical word-processing in children with iRD, iSD and cRSD compared to typically developing (TD) 9-year-olds. RESULTS: TD children showed enhanced early sensitivity (N170) for word material and for the violation of orthographic rules compared to the other groups. Lexical orthographic effects (higher LPC amplitude for words than for pseudohomophones) were the same in the TD and iRD groups, although processing took longer in children with iRD. In the iSD and cRSD groups, lexical orthographic effects were evident and stable over time only for correctly spelled words. CONCLUSIONS: Orthographic representations were intact in iRD children, but word processing took longer compared to TD. Children with spelling disorders had partly missing orthographic representations. SIGNIFICANCE: Our study is the first to specify the underlying neurophysiology of word processing deficits associated with isolated literacy deficits.

Does the late positive component reflect successful reading acquisition? A longitudinal ERP study.

Developmental dyslexia is a reading disorder that is associated with deficits in phonological processing, where the exact neural basis for those processing deficits remains unclear. In particular, disagreement exists whether degraded phonological representations or an impaired access to the phonological representations causes these deficits. To investigate this question and to trace changes in neurophysiology during the process of reading acquisition, we designed a longitudinal study with event related potentials (ERPs) in children between kindergarten and second grade. We used an explicit word processing task to elicit the late positive component (LPC), which has been shown to reflect phonological processing. A brain-wide analysis of the LPC with an electrode-wise application of mixed effects models showed significantly attenuated amplitudes in the left temporo-parietal region in dyslexic children. Since these differences were only present in the word and not in the picture (i.e. control) condition, the attenuated amplitudes might reflect impaired access to the phonological representations of words. This was further confirmed by the longitudinal development, which showed a rapid increase in amplitude at the beginning of reading instruction and a decrease with continuing automatization, possibly pointing to a progression from grapheme-phoneme parsing to whole word reading. Our longitudinal study provides the first evidence that it is possible to detect neurophysiological differences in the LPC between children with dyslexia and control children in both preliterate and very early stages of reading acquisition, providing new insights about the neurophysiological development and a potential marker of later reading problems.

Deficits in Letter-Speech Sound Associations but Intact Visual Conflict Processing in Dyslexia: Results from a Novel ERP-Paradigm.

The reading and spelling deficits characteristic of developmental dyslexia (dyslexia) have been related to problems in phonological processing and in learning associations between letters and speech-sounds. Even when children with dyslexia have learned the letters and their corresponding speech sounds, letter-speech sound associations might still be less automatized compared to children with age-adequate literacy skills. In order to examine automaticity in letter-speech sound associations and to overcome some of the disadvantages associated with the frequently used visual-auditory oddball paradigm, we developed a novel electrophysiological letter-speech sound interference paradigm. This letter-speech sound interference paradigm was applied in a group of 9-year-old children with dyslexia (n = 36) and a group of typically developing (TD) children of similar age (n = 37). Participants had to indicate whether two letters look visually the same. In the incongruent condition (e.g., the letter pair A-a) there was a conflict between the visual information and the automatically activated phonological information; although the visual appearance of the two letters is different, they are both associated with the same speech sound. This conflict resulted in slower response times (RTs) in the incongruent than in the congruent (e.g., the letter pair A-e) condition. Furthermore, in the TD control group, the conflict resulted in fast and strong event-related potential (ERP) effects reflected in less negative N1 amplitudes and more positive conflict slow potentials (cSP) in the incongruent than in the congruent condition. However, the dyslexic group did not show any conflict-related ERP effects, implying that letter-speech sound associations are less automatized in this group. Furthermore, we examined general visual conflict processing in a control visual interference task, using false fonts. The conflict in this experiment was based purely on the visual similarity of the presented objects. Visual conflict resulted in slower RTs, less negative N2 amplitudes and more positive cSP in both groups. Thus, on a general, basic level, visual conflict processing does not seem to be affected in children with dyslexia.

Neurophysiological Mechanisms of Auditory Information Processing in Adolescence: A Study on Sex Differences.

To date, little is known about sex differences in the neurophysiological correlates underlying auditory information processing. In the present study, auditory evoked potentials were evoked in typically developing male (n = 15) and female (n = 14) adolescents (13-18 years) during an auditory oddball task. Girls compared to boys displayed lower N100 and P300 amplitudes to targets. Larger N100 amplitudes in adolescent boys might indicate higher neural sensitivity to changes of incoming auditory information. The P300 findings point toward sex differences in auditory working memory and might suggest that adolescent boys might allocate more attentional resources when processing relevant auditory stimuli than adolescent girls.

Alterations in neural processing of emotional faces in adolescent anorexia nervosa patients - an event-related potential study.

The present study explored the neurophysiological correlates of perception and recognition of emotional facial expressions in adolescent anorexia nervosa (AN) patients using event-related potentials (ERPs). We included 20 adolescent girls with AN and 24 healthy girls and recorded ERPs during a passive viewing task and three active tasks requiring processing of emotional faces in varying processing depths; one of the tasks also assessed emotion recognition abilities behaviourally. Despite the absence of behavioural differences, we found that across all tasks AN patients exhibited a less pronounced early posterior negativity (EPN) in response to all facial expressions compared to controls. The EPN is an ERP component reflecting an automatic, perceptual processing stage which is modulated by the intrinsic salience of a stimulus. Hence, the less pronounced EPN in anorexic girls suggests that they might perceive other people's faces as less intrinsically relevant, i.e. as less "important" than do healthy girls.

Letter-sound processing deficits in children with developmental dyslexia: An ERP study.

OBJECTIVE: The time course during letter-sound processing was investigated in children with developmental dyslexia (DD) and typically developing (TD) children using electroencephalography. METHOD: Thirty-eight children with DD and 25 TD children participated in a visual-auditory oddball paradigm. Event-related potentials (ERPs) elicited by standard and deviant stimuli in an early (100-190 ms) and late (560-750 ms) time window were analysed. RESULTS: In the early time window, ERPs elicited by the deviant stimulus were delayed and less left lateralized over fronto-temporal electrodes for children with DD compared to TD children. In the late time window, children with DD showed higher amplitudes extending more over right frontal electrodes. Longer latencies in the early time window and stronger right hemispheric activation in the late time window were associated with slower reading and naming speed. Additionally, stronger right hemispheric activation in the late time window correlated with poorer phonological awareness skills. CONCLUSIONS: Deficits in early stages of letter-sound processing influence later more explicit cognitive processes during letter-sound processing. SIGNIFICANCE: Identifying the neurophysiological correlates of letter-sound processing and their relation to reading related skills provides insight into the degree of automaticity during letter-sound processing beyond behavioural measures of letter-sound-knowledge.

Right-lateralization of N2-amplitudes in depressive adolescents: an emotional go/no-go study.

BACKGROUND: Recent studies have proposed the process of emotion regulation as a promising target to study the neurophysiological basis of adolescent depression. Emotion regulation has repeatedly been studied with emotional go/no-go paradigms. To date, no study has examined if the left-frontal hypoactivation associated with depression generalizes to active tasks. The aim of this study was therefore to investigate the hemispheric asymmetry of the N2 component in depressed adolescents in an emotion regulation paradigm. METHODS: Twenty-four adolescents diagnosed with major depression (age 11-18) and 30 healthy controls (age 11-18) performed two emotional go/no-go tasks exhibiting negative faces as go trials and positive faces as no-go trials and vice versa. RESULTS: On the behavioral level, no significant group differences emerged. On the neural level, we found a more right-lateralized N2-amplitude in depressed subjects, while it was more left-lateralized in controls. Furthermore, both groups showed a less negative N2-amplitude to positive no-go stimuli. CONCLUSION: This study provides strong support for a general left-frontal hypoactivity in adolescent depression, which also applies to active emotional go/no-go paradigms. Furthermore, the less negative N2 to positive stimuli is consistent with a generally enhanced impulsivity of adolescents toward appetitive stimuli, which is possibly the base of the differential clinical pattern of adolescent in contrast to adult depression.

What does the brain of children with developmental dyslexia tell us about reading improvement? ERP evidence from an intervention study.

Intervention is key to managing developmental dyslexia (DD), but not all children with DD benefit from treatment. Some children improve (improvers, IMP), whereas others do not improve (non-improvers, NIMP). Neurobiological differences between IMP and NIMP have been suggested, but studies comparing IMP and NIMP in childhood are missing. The present study examined whether ERP patterns change with treatment and differ between IMP and NIMP. We investigated the ERPs of 28 children with DD and 25 control children (CON) while performing a phonological lexical decision (PLD) task before and after a 6-month intervention. After intervention children with DD were divided into IMP (n = 11) and NIMP (n = 17). In the PLD-task children were visually presented with words, pseudohomophones, pseudowords, and false fonts and had to decide whether the presented stimulus sounded like an existing German word or not. Prior to intervention IMP showed higher N300 amplitudes over fronto-temporal electrodes compared to NIMP and CON and N400 amplitudes were attenuated in both IMP and NIMP compared to CON. After intervention N300 amplitudes of IMP were comparable to those of CON and NIMP. This suggests that the N300, which has been related to phonological access of orthographic stimuli and integration of orthographic and phonological representations, might index a compensatory mechanism or precursor that facilitates reading improvement. The N400, which is thought to reflect grapheme-phoneme conversion or the access to the orthographic lexicon increased in IMP from pre to post and was comparable to CON after intervention. Correlations between N300 amplitudes pre, growth in reading ability and N400 amplitudes post indicated that higher N300 amplitudes might be important for reading improvement and increase in N400 amplitudes. The results suggest that children with DD, showing the same cognitive profile might differ regarding their neuronal profile which could further influence reading improvement.

The time course of reading processes in children with and without dyslexia: an ERP study.

The main diagnostic criterion for developmental dyslexia (DD) in transparent orthographies is a remarkable reading speed deficit, which is often accompanied by spelling difficulties. These deficits have been traced back to both deficits in orthographic and phonological processing. For a better understanding of the reading speed deficit in DD it is necessary to clarify which processing steps are degraded in children with DD during reading. In order to address this question the present study used EEG to investigate three reading related ERPs: the N170, N400 and LPC. Twenty-nine children without DD and 52 children with DD performed a phonological lexical decision (PLD)-task, which tapped both orthographic and phonological processing. Children were presented with words, pseudohomophones, pseudowords and false fonts and had to decide whether the presented stimulus sounded like an existing German word or not. Compared to control children, children with DD showed deficits in all the investigated ERPs. Firstly, a diminished mean area under the curve for the word material-false font contrasts in the time window of the N170 was observed, indicating a reduced degree of print sensitivity; secondly, N400 amplitudes, as suggested to reflect the access to the orthographic lexicon and grapheme-phoneme conversion, were attenuated; and lastly, phonological access as indexed by the LPC was degraded in children with DD. Processing differences dependent on the linguistic material in children without DD were observed only in the LPC, suggesting that similar reading processes were adopted independent of orthographic familiarity. The results of this study suggest that effective treatment should include both orthographic and phonological training. Furthermore, more longitudinal studies utilizing the same task and stimuli are needed to clarify how these processing steps and their time course change during reading development.