Understanding the relation between reading and anxiety among upper elementary students with reading difficulties.

This study examined the relations between reading anxiety, general anxiety, and test anxiety in a sample of students with reading difficulties (n = 536). It also tested if dimensions of anxiety were differentially related to word reading accuracy and fluency, text reading fluency, or reading comprehension. The results indicated that the three anxiety measures were significantly related (r = 0.51 to 0.56, p < .001). Additionally, higher reading anxiety was related to poorer word reading fluency, text reading fluency, and comprehension outcomes. Further analyses indicated that these relations existed in students who fell in the middle and upper quantiles for reading, but not the lowest quantile. This pattern of findings suggests that the relation is complex and varies depending on severity of reading difficulty. Results may help to inform future efforts to support students with reading difficulties, including students with dyslexia.

Executive functions underlie word reading and reading fluency in Chinese children with attention deficit/hyperactivity disorder, reading disabilities, and comorbid attention deficit/hyperactivity disorder and reading disabilities.

The current study examined the executive function (EF) deficits and their roles in reading in one hundred and four Cantonese-speaking children with typical development, reading disabilities (RD), ADHD, and comorbid ADHD and RD (ADHD + RD). Children's EF and reading skills were measured. Analysis of variance results showed that all children with disorders manifested deficits in verbal and visuospatial short-term and working memory and behavioral inhibition. Moreover, children with ADHD and ADHD + RD also exhibited deficits in inhibition (IC and BI) and cognitive flexibility. These findings demonstrated that the EF deficits in Chinese children with RD, ADHD, and ADHD + RD are similar to those in their counterparts using alphabetic languages. However, children with ADHD + RD displayed more severe deficits in visuospatial working memory compared to children with RD and ADHD, which was inconsistent with that observed in children using alphabetic languages. Regression analysis results showed that verbal short-term memory was a significant predictor for both word reading and reading fluency in children with RD and ADHD + RD. Moreover, behavioral inhibition significantly predicted reading fluency in children with ADHD. These findings also agreed with previous studies. Collectively, the results of the current study showed that the EF deficits and their roles in reading found in Chinese children with RD, ADHD, and ADHD + RD are mainly consistent with children using alphabetic languages. However, more studies are still needed to confirm these findings, especially comparing the severity of working memory among these three disorders.

Are General Anxiety, Reading Anxiety, and Reading Self-Concept Linked to Reading Skills Among Chinese Adolescents With and Without Dyslexia?

This study investigated the cross-sectional relationships between reading-related affective and cognitive factors and reading skills among adolescents with and without dyslexia. Participants were 120 Chinese-speaking eighth graders, including 60 adolescents with dyslexia and 60 typically developing adolescents from Hong Kong, China. Adolescents completed questionnaires on general anxiety, reading anxiety, and reading self-concept. They were also assessed on measures of rapid digit naming, verbal working memory, word reading, reading fluency, and reading comprehension. The results showed that readers with dyslexia reported higher levels of general anxiety and reading anxiety and lower levels of reading self-concept than typical readers. They also showed difficulties in rapid digit naming and verbal working memory. Importantly, controlling for rapid digit naming and verbal working memory, reading self-concept was uniquely associated with word reading and reading fluency for readers with and without dyslexia. Furthermore, reading anxiety and reading self-concept were uniquely associated with reading comprehension for the two groups of readers. The findings point to the importance of considering affective factors when examining the reading skills of Chinese readers and the utility of targeting these factors when supporting the learning of adolescents with and without dyslexia.

What Factors Contribute to Reading in ADHD: Examining Reading-Related Skills in Children With ADHD Only/Comorbid Developmental Dyslexia.

BACKGROUND: ADHD and developmental dyslexia (DD) frequently co-occur. However, it is unclear why some children with ADHD acquire DD while others do not. METHODS: A total of 830 children (including typically developing controls, ADHD only, DD only, and ADHD + DD groups) of two ages (younger: first-third grade; older: fourth-sixth grade) were assessed on measures of reading ability and reading-related skills. RESULTS: The clinical groups had different degrees of impairment in each reading-related skill. Regression results found that the four groups had different skills in predicting reading ability in younger and older grades. Especially, rapid automatized naming (RAN) was the only predictor of reading ability in children with ADHD only. CONCLUSIONS: The study highlights that RAN plays an important role in the reading development of children with ADHD only, reflecting the possible protective role of RAN in reading development.

A Register Study Suggesting Homotypic and Heterotypic Comorbidity Among Individuals With Learning Disabilities.

The present study examined whether learning disabilities (LD) in reading and/or math (i.e., reading disability [RD], math disability [MD], and RD+MD) co-occur with other diagnoses. The data comprised a clinical sample (n = 430) with LD identified in childhood and a sample of matched controls (n = 2,140). Their medical diagnoses (according to the International Classification of Diseases nosology) until adulthood (20-39 years) were analyzed. The co-occurrence of LD with neurodevelopmental disorders was considered a homotypic comorbidity, and co-occurrence with disorders or diseases from the other diagnostic categories (i.e., mental and behavioral disorders, diseases of the nervous system, injuries, other medical or physical diagnoses) was considered a heterotypic comorbidity. Both homotypic and heterotypic comorbidity were more common in the LD group. Co-occurring neurodevelopmental disorders were the most prominent comorbid disorders, but mental and behavioral disorders, diseases of the nervous system, and injuries were also pronounced in the LD group. Accumulation of diagnoses across the diagnostic categories was more common in the LD group. No differences were found among the RD, MD, and RD+MD subgroups. The findings are relevant from the theoretical perspective, as well as for clinical and educational practice, as they provide understanding regarding individual distress and guiding for the planning of support.

Internalizing problems in individuals with reading, mathematics and unspecified learning difficulties: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to examine if individuals with reading difficulties (RD), mathematics difficulties (MD), or unspecified learning difficulties (ULD) experience internalizing problems (i.e., anxiety, depression, somatic complaints, and social withdrawal) to the same extent, and if the effect sizes are influenced by moderators (age, internalizing problems type, anxiety type, rater type, selection criteria, and attention control). We reviewed 2,806 studies published in English between January 2000 and April 2023. Our final sample consisted of 96 studies that reported effect sizes or data to calculate them (a total of 120 unique samples, 83,260 participants, age range = 7.3 - 34.8 years). Risk of bias and sensitivity were assessed. A random-effects model analysis revealed a significant and moderate overall effect size (Hedge's g = -.54), indicating that individuals with RD, MD or ULD experience more internalizing problems than their chronological-age (CA) controls. Follow-up analyses showed that neither learning difficulties type nor age of participants were significant moderators, but selection criteria (diagnosis versus screening) and internalizing problems type were. These findings suggest that individuals with RD do not differ from those with MD or ULD in internalizing problems, and all fare poorly compared to CA controls.

Mental health among children with and without reading difficulties.

This study explored the relationship between mental health, i.e., depression and anxiety, and reading difficulties (RD) in Chinese elementary school children. Participants were 1535 grades 3, 4, and 5 students from three elementary schools in Xi'an, China. Children with and without RD were compared to their depression and anxiety. Additionally, children's self-ratings, parents' ratings, and teachers' ratings of depression and anxiety were compared to better understand mental health issues of Chinese children with RD. The findings showed that Chinese children with RD experienced more depression but not anxiety compared to their typically developing peers across all three grade levels. Reports from all three informants consistently reflected that children with RD experienced more depression. However, some inconsistencies were found between self-reported levels of depression and anxiety and the observations made by parents and teachers. Children reported experiencing more depression than their parents and teachers observed but less anxiety than their parents reported. This study emphasizes the importance of understanding the links between RD and mental health and the need for appropriate intervention programs to help children with RD cope with the mental health challenges.

Associative gene networks reveal novel candidates important for ADHD and dyslexia comorbidity.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is commonly associated with developmental dyslexia (DD), which are both prevalent and complicated pediatric neurodevelopmental disorders that have a significant influence on children's learning and development. Clinically, the comorbidity incidence of DD and ADHD is between 25 and 48%. Children with DD and ADHD may have more severe cognitive deficiencies, a poorer level of schooling, and a higher risk of social and emotional management disorders. Furthermore, patients with this comorbidity are frequently treated for a single condition in clinical settings, and the therapeutic outcome is poor. The development of effective treatment approaches against these diseases is complicated by their comorbidity features. This is often a major problem in diagnosis and treatment. In this study, we developed bioinformatical methodology for the analysis of the comorbidity of these two diseases. As such, the search for candidate genes related to the comorbid conditions of ADHD and DD can help in elucidating the molecular mechanisms underlying the comorbid condition, and can also be useful for genotyping and identifying new drug targets. RESULTS: Using the ANDSystem tool, the reconstruction and analysis of gene networks associated with ADHD and dyslexia was carried out. The gene network of ADHD included 599 genes/proteins and 148,978 interactions, while that of dyslexia included 167 genes/proteins and 27,083 interactions. When the ANDSystem and GeneCards data were combined, a total of 213 genes/proteins for ADHD and dyslexia were found. An approach for ranking genes implicated in the comorbid condition of the two diseases was proposed. The approach is based on ten criteria for ranking genes by their importance, including relevance scores of association between disease and genes, standard methods of gene prioritization, as well as original criteria that take into account the characteristics of an associative gene network and the presence of known polymorphisms in the analyzed genes. Among the top 20 genes with the highest priority DRD2, DRD4, CNTNAP2 and GRIN2B are mentioned in the literature as directly linked with the comorbidity of ADHD and dyslexia. According to the proposed approach, the genes OPRM1, CHRNA4 and SNCA had the highest priority in the development of comorbidity of these two diseases. Additionally, it was revealed that the most relevant genes are involved in biological processes related to signal transduction, positive regulation of transcription from RNA polymerase II promoters, chemical synaptic transmission, response to drugs, ion transmembrane transport, nervous system development, cell adhesion, and neuron migration. CONCLUSIONS: The application of methods of reconstruction and analysis of gene networks is a powerful tool for studying the molecular mechanisms of comorbid conditions. The method put forth to rank genes by their importance for the comorbid condition of ADHD and dyslexia was employed to predict genes that play key roles in the development of the comorbid condition. The results can be utilized to plan experiments for the identification of novel candidate genes and search for novel pharmacological targets.

Association between urinary 2-hydroxyethyl mercapturic acid and dyslexia among school-aged children.

Ethylene oxide is commonly used in industrial synthesis and medical disinfection. It is a known human carcinogen and has neurotoxicity. However, the association between ethylene oxide exposure and neurodevelopmental disorders remains unclear. This study aimed to evaluate the association between urinary concentrations of 2-hydroxyethyl mercapturic acid (HEMA; metabolite of ethylene oxide) and dyslexia among school-aged children. A total of 355 dyslexic children and 390 controls from three cities in China were enrolled in this case-control study from November 2017 to December 2020. Urinary HEMA was detected in 100% of the urine samples, suggesting widespread exposure to ethylene oxide in the children. Notably, the children with dyslexia had higher concentrations of urinary HEMA compared to the controls (geometric mean: 2.92 vs. 2.47 ng/mL) (P = 0.004). In the multivariable-adjusted model, urinary concentrations of HEMA were significantly associated with dyslexia risk. The individuals within the highest HEMA concentration demonstrated a 1.97-fold increased odds of dyslexia compared to those within the lowest quartile (95% confidence interval: 1.20-3.23). Thus, these findings suggested the possible link between HEMA levels and the risk of dyslexia. Further studies are warranted to validate this finding and illustrate the underlying mechanism.

Heterogeneity of short-term memory deficits in children with dyslexia.

Many studies have highlighted short-term memory (STM) impairment in dyslexic individuals. Several studies showed deficits for both item and serial order aspects of verbal STM in dyslexic individuals. These group-based studies, however, do not inform us about the prevalence of these deficits and, importantly, their potential heterogeneity at the individual level. The present study examined both group-level and individual STM profiles in dyslexic and age-matched non-dyslexic children. While confirming previous group-based results of both item and serial order STM deficits, individual analyses indicated two distinct profiles: one profile was associated with verbal item STM and phonological impairment while another profile showed selective serial STM deficits in both verbal and visual domains. Our results highlight the need for practitioners to consider the heterogeneous nature of STM impairment in dyslexia and to adapt STM and reading treatment strategies accordingly.

Does reading anxiety impact on academic achievement in higher education students?

Poor readers have lower academic achievement and increased anxiety, including reading anxiety, which may perpetuate lower academic achievement. We explored reading anxiety in university students, investigating whether the association between reading ability and academic achievement is mediated by reading anxiety (independent of general anxiety). Participants were students (n = 169, 69% female, age = 20.70) at an Australian university who completed an online reading assessment (decoding skills, phonological awareness, orthographical knowledge and comprehension), and a survey examining reading anxiety, trait anxiety and self-reported reading history. Academic achievement was based on university grades. Two reading anxiety factors (social and non-social) were identified; both factors were distinct from trait anxiety. Reading ability was negatively correlated with reading anxiety and positively correlated with academic achievement. Reading anxiety was not correlated with academic achievement and it did not mediate the relationship between reading ability and academic achievement as expected. As this was the first study to explore reading anxiety in adults, further research is required to determine the impact reading anxiety may have on university students beyond academic achievement.

Associations between dyslexia and children's mental health: Findings from a follow-up study in China.

Dyslexia is a common learning difficulty that can lead to adverse health outcomes and socioeconomic difficulties. Evidence from longitudinal studies on the association between dyslexia and psychological symptoms in children is limited. Moreover, the psychological trends of children with dyslexia are unclear. In this study, we enrolled 2,056 students in Grades 2 to 5, including 61 dyslexic children, who participated in three mental health surveys and dyslexia screening. All the children were surveyed for symptoms of stress, anxiety and depression. We used generalized estimating equation models to estimate changes in psychological symptoms of children with dyslexia over time and the association between dyslexia and psychological symptoms. The results showed that dyslexia was associated with stress and depressive symptoms in children in both crude (ß = 3.27, 95% confidence interval [CI] [1.89∼4.65], ß=1.20, 95%CI: [0.45∼1.94], respectively) and adjusted models (ß = 3.32, 95%CI: [1.87∼4.77], ß=1.31, 95%CI: [0.52∼2.10], respectively). In addition, we found no significant differences in the emotional status of dyslexic children in either survey. Dyslexic children are at risk for mental health issues, and persistent emotional symptoms. Therefore, interventions regarding not only reading ability but also psychological conditions should be pursued.

Bioenvironmental Predictors of Childhood Reading and Speech Difficulties.

PURPOSE: Reading and speech difficulties are common in childhood, yet it is not fully understood how much of their etiology is shared. This partly derives from methodological issues related to overlooking the potential co-occurrence between the two sets of difficulties. This study investigated the effects of five bioenvironmental predictors in a sample assessed for such co-occurrence. METHOD: A combination of exploratory and confirmatory analyses was performed on longitudinal data from the National Child Development Study. Exploratory latent class analysis was performed on children's reading, speech, and language outcomes at ages 7 and 11 years. Membership in the obtained classes was modeled using a regression with sex and four early-life predictors: gestation period, socioeconomic status, maternal education, and the home reading environment. RESULTS: The model yielded four latent classes that broadly reflected (1) average reading and speech, (2) excellent reading, (3) reading difficulties, and (4) speech difficulties. Early-life factors significantly predicted class membership. Male sex and preterm birth emerged as risk factors for both reading and speech difficulties. Protective effects against reading difficulties were identified for maternal education, and lower (but not higher) levels of socioeconomic status and the home reading environment. CONCLUSIONS: Co-occurrence of reading and speech difficulties in the sample was low, and differential patterns of effect of the social environment were supported. Reading outcomes were under stronger malleable influence than speech outcomes.

Impact of Dyslexia and Health Literacy on Racial and Gender Disparity in the Incarcerated Population.

Dyslexia is the most common learning disability and involves difficulty in reading, writing, and spelling in your native language despite at least average intelligence. A disproportionate share of incarcerated individuals have both dyslexia and are African American. Behavior manifestations associated with dyslexia often lead to life choices resulting in incarceration. Dyslexia is rarely considered as playing a role in unemployment, drug misuse, and incarceration. Dyslexia screening upon prison admission permits identification of individuals with dyslexia and allows for specialized reading classes to boost self-esteem and develop a skill set that is desirable in the workforce upon release. Dyslexia should be recognized as a social determinant of health whose early recognition and intervention may engender self-confidence in those affected and encourage them to be positively engaged in society.

Diagnostic survey of dyslexia and accompanying behavioral indicators in primary school students in Saudi Arabia.

BACKGROUND: Although dyslexia is the most common learning disorder in children, it has not received adequate attention in Saudi Arabia. AIMS: This study aimed at determining the prevalence of dyslexia among Saudi students in Grades 3-6, exploring associations between severity of dyslexia, its behavioral indicators, gender and grade, and the moderating role of grade in the relationship between severity and behavioral indicators. METHODS AND PROCEDURES: The sample consisted of 2848 female students and 2647 male students in Zulfi governorate, Saudi Arabia. A survey-based mixed-methods design was chosen including a structured interview with teachers and three assessments using the Diagnostic Assessment Scale for Dyslexia, the Arabic Reading Test, and the Dyslexia Behavioral Indicators Scale. OUTCOMES AND RESULTS: Dyslexia was assessed in 5.86 % of the total sample. It was twice as prevalent among male students as among female students (6.54 % and 3.83 %, respectively). The mean score for behavioral indicators of dyslexia was also significantly higher for male than for female students. The correlation between dyslexia severity and behavioral indicators score was high and significant, with grade level as a significant moderator. CONCLUSIONS AND IMPLICATIONS: We found that, for children with dyslexia in Saudi Arabia, dyslexia was twice as prevalent among male students as among female students. Early dyslexia diagnosis and intervention services are suggested to reduce the risk for reading problems.

Exploring reading profiles of rural school students.

This study investigates the reading profiles of rural Grade 5 and 6 students (N = 262), a sample with a high proportion of English language learners. We administered a battery of reading and cognitive assessments to classify students' reading profiles and evaluate if performance on cognitive measures predicted membership in particular profiles. Data were analyzed using latent profile analysis. Latent profile analysis showed four distinct reading profiles in our sample: students with severe reading disabilities (< 2%), students at high risk of reading disability (14%), students at some-risk of reading disability (46%), and students who are typical readers (38%). Lower performance on cognitive measures was associated with group membership in the severe reading profile group compared to the group of students at some-risk of reading failure. In contrast, higher performance on cognitive measures was associated with group membership in the typical reader group compared to students at some-risk of reading failure. In keeping with the findings from past studies documenting reader profiles, we found heterogeneity in the reading profiles of rural upper-elementary grade students. We discuss the need for multicomponent interventions that target all areas of reading with some flexibility in the dosage of each reading component dependent on the reader profiles established prior to intervention.

Tracking reading skills and reading-related skills in dyslexia before (age 5) and after (ages 10-17) diagnosis.

This study had three goals: to examine the stability of deficits in the phonological and lexical routes in dyslexia (group study), to determine the prevalence of dyslexia profiles (multiple-case study), and to identify the prediction of phonemic segmentation and discrimination skills before reading acquisition on future reading level. Among a group of 373 non-readers seen at age 5, 38 students were subsequently diagnosed as either consistent dyslexic readers (18 DYS) or consistent typical readers (20 TR). Their phonological and lexical reading skills were assessed at ages 10 and 17 and their phonemic segmentation and discrimination skills at age 5. In comparison with TR of the same chronological age (CA-TR), individuals with dyslexia demonstrated an impairment of the two reading routes, especially of the phonological reading route. In the comparison with younger TR (age 10) of the same reading level (RL-TR), only a deficit of the phonological route is observed. In the multiple-case study, the comparisons with CA-TR showed a prevalence of mixed profiles and very few dissociated profiles, whereas the comparison with RL-TR resulted mostly in two profiles depending on the measure: a phonological profile when accuracy was used and a delayed profile when speed was used. In addition, the correlations between early phonemic segmentation and discrimination skills (age 5) and later reading skills (age 17) were significant, and in the group of individuals with dyslexia, early phonemic segmentation skills significantly predicted these later reading skills. Phonological reading deficits are persistent and mainly caused by early phonemic impairments.

Reading Fluency in Chinese Children With Reading Disabilities and/or ADHD: A Key Role for Morphology.

The Triangle Model of Reading proposes that phonology, orthography, and semantics are crucial to understand word reading and reading disability (RD). Morphology has been added as a binding agent to this model. However, it is unclear how these variables relate to word reading in children with attention deficit/hyperactivity disorder (ADHD) or comorbid ADHD and RD (ADHD+RD). This study examined the performance of Chinese children with RD, ADHD, or ADHD+RD in phonology, orthography, semantics, and morphology, and investigated whether morphology made an additional contribution beyond the other skills in explaining word reading fluency. Participants were 151 Grade 1 to 3 Chinese students: RD (n = 31), ADHD (n = 43), ADHD+RD (n = 27), and typically developing controls (TD, n = 50). Results indicated that children with ADHD+RD (a) showed similar performance to RD and ADHD in tone awareness, orthographic legality, and homophone morpheme awareness; (b) had similar performance to RD but worse than ADHD in phonology, semantics, and morpheme production; and (c) had more severe deficits than RD and ADHD in orthographic reversal, morpheme identification, and homograph awareness. Morphology significantly predicted word reading fluency beyond the other skills, and its predictive effect was more salient for ADHD+RD, ADHD, and TD. The findings provide evidence of both shared and additive effects of RD and ADHD. Morphology may be an important diagnostic factor in identifying Chinese reading and behavioral deficit groups and a worthwhile target for intervention.

Pathogenesis of Comorbid ADHD and Chinese Developmental Dyslexia: Evidence From Eye-Movement Tracking and Rapid Automatized Naming.

BACKGROUND: ADHD and Chinese developmental dyslexia (DD) have a very high comorbidity rate; however, which cognitive deficits characterize the comorbidity and when they occur during cognitive processing are still under debate. METHODS: Rapid automatic naming (RAN) tasks with eye-movement tracking were conducted with 75 children who were typically developing, had comorbid ADHD and DD, had only ADHD, and had only DD. RESULTS: The clinical groups had longer first fixation durations than the control for RAN digits. Temporal eye-movement measures, such as gaze duration and total reading time, were found to vary between the comorbidity and ADHD groups. Spatial eye-movement measures, such as regression probability and incoming saccade amplitude, differed between the comorbidity and DD groups. CONCLUSIONS: These results indicate that investigation with eye-movement measures combined with RAN tasks can strengthen the understanding of the pathogenesis of comorbid ADHD and DD.