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.

Identifying the risk of dyslexia in bilingual children: The potential of language-dependent and language-independent tasks.

This study investigates the linguistic processing and non-linguistic cognitive abilities of monolingual and bilingual children with and without reading difficulties and examines the relationship between these skills and reading. There were 72 Italian-speaking children: 18 monolingual good readers (MONO-GR, Mage = 10;4), 19 monolingual poor readers (MONO-PR, Mage = 10;3), 21 bilingual good readers (BI-GR, Mage = 10;6), and 16 bilingual poor readers (BI-PR, Mage = 10;6). All bilingual children spoke Italian as their L2. Children completed a battery of standardized Italian reading tests, language-dependent tasks: nonword repetition (NWR), sentence repetition (SR), and phonological awareness (PA), and language-independent tasks: timing anticipation, beat synchronization, inhibition control, auditory reaction time, and rapid automatized naming (RAN). Poor readers scored below good readers on the language-dependent tasks, including NWR, PA, and SR. Beat synchronization was the only language-independent task sensitive to reading ability, with poor readers showing greater variability than good readers in tapping to fast rhythms. SR was the only task influenced by language experience as bilinguals underperformed monolinguals on the task. Moreover, there were weak to moderate correlations between performance on some language-dependent tasks (NWR, PA), language-independent tasks (inhibition control, RAN), and reading measures. Performance on the experimental tasks (except for RAN) was not associated with the length of exposure to Italian. The results highlight the potential of NWR, PA, SR, and beat synchronization tasks in identifying the risk of dyslexia in bilingual populations. Future research is needed to validate these findings and to establish the tasks' diagnostic accuracy.

Telerehabilitation and Wellbeing Experience in Children with Special Needs during the COVID-19 Pandemic.

Social distancing due to the COVID-19 pandemic represented a golden opportunity to implement telerehabilitation for clinical groups of children. The present study aims to show the impact that telerehabilitation had on the experience of well-being of children with special needs being treated at the Foundation IRCCS Neurological Institute 'C. Besta' in Milan (Specific Learning Disorders and Cerebral Palsy diagnosis); it aims to do so by comparing it with experiences of those who did not undertake telerehabilitation despite the diagnosis during the pandemic, and with typically developing children. Results show that the three groups differed in the Support, Respect and Learning dimensions of well-being experience. Post hoc comparisons revealed that children with Specific Learning Disorders and Cerebral Palsy scored higher than normotypical children in Support and in Respect scales. Furthermore, children who experienced telerehabilitation showed the highest scores on the Learning scale in comparison with the other two groups. These results support the importance of reorganizing care and assistance by integrating telemedicine, which seems to have fostered a positive experience of well-being in people with special needs, particularly in the perception of a supportive environment that respects psychological needs.

Dyslexia Telerehabilitation during the COVID-19 Pandemic: Results of a Rhythm-Based Intervention for Reading.

The COVID-19 outbreak necessitated a reorganization of the rehabilitation practices for Learning Disorders (LDs). During the lockdown phase, telerehabilitation offered the possibility to continue training interventions while enabling social distancing. Given such an advantage of telerehabilitation methods for LDs, clinical research is still needed to test the effectiveness of diverse teletraining approaches by comparing their outcomes with those of face-to-face interventions. To compare the effectiveness of telerehabilitation vs. in-presence rehabilitation of dyslexia, a rhythm-based intervention for reading, called Rhythmic Reading Training (RRT), was tested in a small-scale clinical trial during the lockdown phase of the COVID-19 pandemic. Thirty children aged 8-13 with a diagnosis of developmental dyslexia were assigned to either a telerehabilitation or an in-presence rehabilitation setting and received RRT for 10 biweekly sessions of 45 min, supervised by a trained practitioner. The results showed that both telerehabilitation and in-presence rehabilitation were effective in improving reading and rapid automatized naming in children with dyslexia and that the effects were comparable between settings. Therefore, RRT was found to be effective in spite of the administration method (remote or in-presence). These results confirm the potential of telemedicine for the rehabilitation of LDs. Clinical Trial ID: NCT04995471.

Comparison on Well-Being, Engagement and Perceived School Climate in Secondary School Students with Learning Difficulties and Specific Learning Disorders: An Exploratory Study.

Reading and writing skills influence the social status of students, exerting effects not only on learning, but also on wellbeing. This study aimed to assess the impact of diagnosis of specific learning disorder on well-being in secondary-school students, comparing students with a diagnosis of specific learning disorder (SLD-group), students showing learning difficulties without diagnosis (LD-group) and students without learning difficulties (control-group). Students were tested with neuropsychological screening tests in order to identify learning difficulties and were further assessed by means of psychological and school well-being questionnaires. The results show that LD group perceive themselves as having a low sense of mastery and autonomy, less interest and engagement in daily activities and low peer social support than their schoolmates. This result highlights, for the LD group, a low well-being experience, which is not observed in the SLD and control groups. On the contrary, SLD group students do not differ from control group students in any dimensions except for the perceived parents' support and involvement in school life, in which the SLD group show the highest scores. This work underlines the importance of having a diagnosis as it seems to work as a protective factor for both the psychological and school well-being of the student.

Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy.

BACKGROUND: Lombardy was severely hit by the COVID-19 pandemic since February 2020 and the Health System underwent rapid reorganization. Outpatient clinics were stopped for non-urgent patients: it became a priority to manage hundreds of fragile neurological patients who suddenly had less reference points. In Italy, before the pandemic, Televisits were neither recognized nor priced. METHODS: At the Fondazione IRCCS Istituto Neurologico C. Besta, we reorganized outpatient clinics to deliver Neuro-telemedicine services, including Televisits and Teleneurorehabilitation, since March 2020. A dedicated Working Group prepared the procedure, tested the system, and designed satisfaction questionnaires for adults and children. RESULTS: After a pilot phase, we prepared a procedure for Telemedicine outpatient clinics which was approved by hospital directions. It included prescription, booking, consenting, privacy and data protection, secure connection with patients (Teams Microsoft 365), electronic report preparation and delivery, reporting, and accountability of the services. During the March-September 2020 period, we delivered 3167 Telemedicine services, including 1618 Televisits, to 1694 patients (972 adults, 722 children) with a wide range of chronic neurological disorders. We successfully administered different clinical assessment and scales. Satisfaction among patients and caregivers was very high. CONCLUSIONS: During the dramatic emergency, we were able to take care of more than 1600 patients by organizing Neuro-telehealth in a few weeks, lessening the impact of the pandemic on fragile patients with chronic neurological disorders; this strategy is now stably embedded in our care pathways. In Italy, Telehealth is at present recognized and priced and is becoming a stable pillar of the health system.

Evaluation of oro-phonatory development and articulatory diadochokinesis in a sample of Italian children using the protocol of Robbins & Klee.

PURPOSE: The Italian version (Granocchio et al., 2019) of the protocol proposed by Robbins and Klee (1987) allows the assessment of structure of the vocal tract, oromotor and oro-phonatory ability, and articulatory diadochokinesis in children. The aim of this study was to collect the first normative sample of Italian children. METHODS: We measured the total structural score (TSS), total functional score (TFS), oral function score (OFS), phonatory function score (PFS), maximum phonation time (MPT), speed of monosyllable repetition (SMR), and speed of polysyllable repetition (SPR) in 191 typically developing Italian children aged 2.6-6.11 years. RESULTS: Like the finding observed in the original protocol, there were no significant age-related changes in TSS, but the correlation was observed for TFS, OFS, PFS, MPT, SMR and SPR. The Inter-observer agreement was "good" or "excellent" for all scores except for SPR that was "moderate". CONCLUSIONS: The increase in oro-motor, oro-phonatory and diadochokinetic abilities confirmed the progressive maturation of these functions with age. The protocol can therefore be considered a useful instrument to classify speech sound disorders (SSDs) by excluding alterations in anatomical structures and evaluate the motor impairment. This normative sample of Italian children allows to use these measures for diagnostic purposes in young Italian speakers.

Timing anticipation in adults and children with Developmental Dyslexia: evidence of an inefficient mechanism.

Developmental Dyslexia (DD) is a learning disorder characterized by specific difficulties in learning to read accurately and fluently, which has been generally explained in terms of phonological deficits. Recent research has shown that individuals with DD experience timing difficulties in the domains of language, music perception and motor control, probably due to impaired rhythmic perception, suggesting that timing deficit might be a key underlying factor to explain such a variety of difficulties. The present work presents two experiments aimed at assessing the anticipatory ability on a given rhythm of 9-year old Italian children and Italian adults with and without DD. Both adults and children with DD displayed a greater timing error and were more variable than controls in high predictable stimuli. No difference between participants with and without DD was found in the control condition, in which the uncertain timing of the beat did not permit the extraction of regularities. These results suggest that both children and adults with DD are unable to exploit temporal regularities to efficiently anticipate the next sensory event whereas control participants easily are. By showing that the anticipatory timing system of individuals with Developmental Dyslexia appears affected, this study adds another piece of evidence to the multifaceted reality of Developmental Dyslexia.

An Online Tool to Assess Sentence Comprehension in Teenagers at Risk for School Exclusion: Evidence From L2 Italian Students.

This study presents a web-based sentence comprehension test aimed at identifying high school students who are at risk for a language delay. By assessing linguistic skills on a sample of high school students with Italian as an L2 and their monolingual peers, attending a vocational school, we were able to identify a subgroup of L2 students with consistent difficulties in sentence comprehension, though their reading skills were within the average range. The same subgroup revealed to experience a lack of support within the school context, suggesting that poor L2 skills might be a critical variable to consider in order to identify students at risk for school exclusion. Regarding the test, accuracy to the on-line sentence comprehension task was significantly predicted by reading abilities and vocabulary skills, thus indicating that this test might represent a rapid but efficient way to assess linguistic abilities at school. We recommend that establishing a valid and practical procedure for the evaluation of linguistic skills in bilingual students who struggle with their L2 is the first step toward promoting social inclusion in the multilingual classroom, in order to increase their ability to actively participate in school and social activities.

Tell Me a Story: Socio-Emotional Functioning, Well-Being and Problematic Smartphone Use in Adolescents With Specific Learning Disabilities.

Although Specific Learning Disabilities (SLD) are described as specific difficulties in one or more academic areas, often socio-emotional problems are also reported to be related to well-being and school engagement. Moreover, recent evidence shows that emotional problems and reduced social support predict problematic use of new technologies, such as a smartphone, that can, in turn, increase these problems. In this study, we aimed to investigate socio-emotional functioning and its relation to well-being, school engagement, and problematic smartphone use. Social and emotional skills of 19 adolescents with a diagnosis of SLD and 19 control adolescents were assessed through a narrative test; adolescents were requested to narrate complete stories elicited by pictures representing social situations. Information on well-being and problematic smartphone use were collected through questionnaires. The comparison between groups showed differences in cognitive-social skills, although no significant differences in emotional functioning were found. Additionally, the perception of the social environment as supportive and trustworthy was related to general well-being for both groups, whereas the perception of limits and rules set by the adult world appeared to be related to a decreased investment in learning processes only for the SLD students. Finally, correlation analysis showed that smartphone use was associated with reduced perception of social support and to a decreased ability to understand and solve social situations. These results assert the critical role played by social information processing and social support in terms of well-being in adolescence, and contribute to enhancing knowledge of the mechanisms underlying problematic smartphone use in a clinical sample.

ORCA.IT: A New Web-Based Tool for Assessing Online Reading, Search and Comprehension Abilities in Students Reveals Effects of Gender, School Type and Reading Ability.

ORCA.IT, a new online test of online research and comprehension was developed for the Italian population. A group of 183 students attending various types of upper secondary schools in Northern Italy were tested with the new tool and underwent further cognitive and neuropsychological assessment. The different school types involved in the study are representative of the school population in the Italian system, but can also be easily compared with the educational systems of other countries. The new test turned out to have good psychometric properties after accurate item construction and final selection. In particular, Version 1 showed better characteristics than Version 2. Subsequently, comparison with one-way ANOVAs were performed to test whether differences exist between different school types, between groups with and without reading difficulties, and between males and females. Such differences are sometimes reported in the literature, but many remain controversial. Further, Pearson's bivariate correlations were calculated to analyze associations between scores on the ORCA.IT and cognitive/neuropsychological variables. Finally, a stepwise regression analysis was performed on aggregated scores to identify the predictors of performance on each of the two versions. The test, especially in the most complete version (Version 1), appears to accurately and reliably capture students' web searching abilities and online reading comprehension. The tool could highlight differences in online search and comprehension ability between students with and without reading difficulties, not penalizing overall performance but allowing very specific weaknesses to be pointed out. Further, it seems to be able to capture differences due to both educational pathways (different school types) and social attitudes (differences between males and females). Most interestingly, it shows to be clearly resting on specific cognitive and neuropsychological abilities, including language, memory, and attentional skills, which explain a large portion of the total variance. Offline text reading comprehension is a crucial predictor of online reading performance, while decoding ability is not. Prior knowledge also influences the results, as expected. The new tool turns out to be rather independent of previous Internet experience and to measure more cognitively grounded processes related to information gathering, processing, and communicating.

Dyslexic children fail to comply with the rhythmic constraints of handwriting.

In this study, we sought to demonstrate that deficits in a specific motor activity, handwriting, are associated to Developmental Dyslexia. The linguistic and writing performance of children with Developmental Dyslexia, with and without handwriting problems (dysgraphia), were compared to that of children with Typical Development. The quantitative kinematic variables of handwriting were collected by means of a digitizing tablet. The results showed that all children with Developmental Dyslexia wrote more slowly than those with Typical Development. Contrary to typically developing children, they also varied more in the time taken to write the individual letters of a word and failed to comply with the principles of isochrony and homothety. Moreover, a series of correlations was found among reading, language measures and writing measures suggesting that the two abilities may be linked. We propose that the link between handwriting and reading/language deficits is mediated by rhythm, as both reading (which is grounded on language) and handwriting are ruled by principles of rhythmic organization.

Language abilities and gestural communication in a girl with bilateral perisylvian syndrome: a clinical and rehabilitative follow-up.

We present the neuropsychological and linguistic follow-up of a girl with bilateral perisylvian polymicrogyria during 4 years of gestural and verbal speech therapy. Some researchers have suggested that children with bilateral perisylvian polymicrogyria mentally fail to reach the syntactic phase and do not acquire a productive morphology. This patient achieved a mean length of utterance in signs/gestures of 3.4, a syntactic phase of completion of the nuclear sentence and the use of morphological modifications. We discuss the link between gesture and language and formulate hypotheses on the role of gestural input on the reorganization of compensatory synaptic circuits.