A systematic review of the impact of childhood vision impairment on reading and literacy in education

Purpose: This systematic review evaluates current literature on the impact vision impairment has on reading and literacy levels within education. Methods: Six databases were searched with inclusion criteria of trials or studies involving children who are blind or vision impaired, and impact on academic or school performance – including reading and literacy. 1262 articles were identified, with 61 papers undergoing full screening. Quality appraisal was performed using Critical Appraisal Skills Program (CASP) and seven articles deemed eligible for inclusion. Results: Included articles achieved a quality score of over 70 % using the CASP checklists. Direct comparison of articles was not possible due to methodological differences in assessing reading and literacy levels. All seven studies investigated aspects of reading speed, with additional measures of reading performance, such as reading reserve, comprehension, and reading accuracy. Discussion: Underlying trends highlighted students with a vision impairment do not perform at same level as their normally sighted peers with respect to reading performance - in terms of speed, but not ability. Additionally, early intervention to enhance literacy skills may help improve educational outcomes. Future direction should be aimed at identifying specific obstacles to learning these students face and providing interventions to improve academic outcomes. (AU)

Action video games and posterior parietal cortex neuromodulation enhance both attention and reading in adults with developmental dyslexia.

The impact of action video games on reading performance has been already demonstrated in individuals with and without neurodevelopmental disorders. The combination of action video games and posterior parietal cortex neuromodulation by a transcranial random noise stimulation could enhance brain plasticity, improving attentional control and reading skills also in adults with developmental dyslexia. In a double blind randomized controlled trial, 20 young adult nonaction video game players with developmental dyslexia were trained for 15 h with action video games. Half of the participants were stimulated with bilateral transcranial random noise stimulation on the posterior parietal cortex during the action video game training, whereas the others were in the placebo (i.e. sham) condition. Word text reading, pseudowords decoding, and temporal attention (attentional blink), as well as electroencephalographic activity during the attentional blink, were measured before and after the training. The action video game + transcranial random noise stimulation group showed temporal attention, word text reading, and pseudoword decoding enhancements and P300 amplitude brain potential changes. The enhancement in temporal attention performance was related with the efficiency in pseudoword decoding improvement. Our results demonstrate that the combination of action video game training with parietal neuromodulation increases the efficiency of visual attention deployment, probably reshaping goal-directed and stimulus-driven fronto-parietal attentional networks interplay in young adults with neurodevelopmental conditions.

Developmental dyslexia susceptibility genes DNAAF4, DCDC2, and NRSN1 are associated with brain function in fluently reading adolescents and young adults.

Reading skills and developmental dyslexia, characterized by difficulties in developing reading skills, have been associated with brain anomalies within the language network. Genetic factors contribute to developmental dyslexia risk, but the mechanisms by which these genes influence reading skills remain unclear. In this preregistered study (https://osf.io/7sehx), we explored if developmental dyslexia susceptibility genes DNAAF4, DCDC2, NRSN1, and KIAA0319 are associated with brain function in fluently reading adolescents and young adults. Functional MRI and task performance data were collected during tasks involving written and spoken sentence processing, and DNA sequence variants of developmental dyslexia susceptibility genes previously associated with brain structure anomalies were genotyped. The results revealed that variation in DNAAF4, DCDC2, and NRSN1 is associated with brain activity in key language regions: the left inferior frontal gyrus, middle temporal gyrus, and intraparietal sulcus. Furthermore, NRSN1 was associated with task performance, but KIAA0319 did not yield any significant associations. Our findings suggest that individuals with a genetic predisposition to developmental dyslexia may partly employ compensatory neural and behavioral mechanisms to maintain typical task performance. Our study highlights the relevance of these developmental dyslexia susceptibility genes in language-related brain function, even in individuals without developmental dyslexia, providing valuable insights into the genetic factors influencing language processing.

Assessing the Efficacy of Large Language Models in Health Literacy: A Comprehensive Cross-Sectional Study.

Enhanced health literacy in children has been empirically linked to better health outcomes over the long term; however, few interventions have been shown to improve health literacy. In this context, we investigate whether large language models (LLMs) can serve as a medium to improve health literacy in children. We tested pediatric conditions using 26 different prompts in ChatGPT-3.5, ChatGPT-4, Microsoft Bing, and Google Bard (now known as Google Gemini). The primary outcome measurement was the reading grade level (RGL) of output as assessed by Gunning Fog, Flesch-Kincaid Grade Level, Automated Readability Index, and Coleman-Liau indices. Word counts were also assessed. Across all models, output for basic prompts such as "Explain" and "What is (are)," were at, or exceeded, the tenth-grade RGL. When prompts were specified to explain conditions from the first- to twelfth-grade level, we found that LLMs had varying abilities to tailor responses based on grade level. ChatGPT-3.5 provided responses that ranged from the seventh-grade to college freshmen RGL while ChatGPT-4 outputted responses from the tenth-grade to the college senior RGL. Microsoft Bing provided responses from the ninth- to eleventh-grade RGL while Google Bard provided responses from the seventh- to tenth-grade RGL. LLMs face challenges in crafting outputs below a sixth-grade RGL. However, their capability to modify outputs above this threshold, provides a potential mechanism for adolescents to explore, understand, and engage with information regarding their health conditions, spanning from simple to complex terms. Future studies are needed to verify the accuracy and efficacy of these tools.

Multimodal Approach in the Diagnosis of Urologic Malignancies: Critical Assessment of ChatGPT-4V's Image-Reading Capabilities.

ChatGPT-4V model with image interpretation tested for distinguishing kidney & prostate tumors from normal tissue.

Using Monte-Carlo simulation to test predictions about the time-course of semantic and lexical access in reading.

One of the main theoretical distinctions between reading models is how and when they predict semantic processing occurs. Some models assume semantic activation occurs after word-form is retrieved. Other models assume there is no-word form, and that what people think of as word-form is actually just semantics. These models thus predict semantic effects should occur early in reading. Results showing words with inconsistent spelling-sound correspondences are faster to read aloud if they are imageable/concrete compared to if they are abstract have been used as evidence supporting this prediction, although null-effects have also been reported. To investigate this, I used Monte-Carlo simulation to create a large set of simulated experiments from RTs taken from different databases. The results showed significant main effects of concreteness and spelling-sound consistency, as well as age-of-acquisition, a variable that can potentially confound the results. Alternatively, simulations showing a significant interaction between spelling-sound consistency and concreteness did not occur above chance, even without controlling for age-of-acquisition. These results support models that use lexical form. In addition, they suggest significant interactions from previous experiments may have occurred due to idiosyncratic items affecting the results and random noise causing the occasional statistical error.

Reading of ingroup politicians' smiles triggers smiling in the corner of one's eyes.

Spontaneous smiles in response to politicians can serve as an implicit barometer for gauging electorate preferences. However, it is unclear whether a subtle Duchenne smile-an authentic expression involving the coactivation of the zygomaticus major (ZM) and orbicularis oculi (OO) muscles-would be elicited while reading about a favored politician smiling, indicating a more positive disposition and political endorsement. From an embodied simulation perspective, we investigated whether written descriptions of a politician's smile would trigger morphologically different smiles in readers depending on shared or opposing political orientation. In a controlled reading task in the laboratory, participants were presented with subject-verb phrases describing left and right-wing politicians smiling or frowning. Concurrently, their facial muscular reactions were measured via electromyography (EMG) recording at three facial muscles: the ZM and OO, coactive during Duchenne smiles, and the corrugator supercilii (CS) involved in frowning. We found that participants responded with a Duchenne smile detected at the ZM and OO facial muscles when exposed to portrayals of smiling politicians of same political orientation and reported more positive emotions towards these latter. In contrast, when reading about outgroup politicians smiling, there was a weaker activation of the ZM muscle and no activation of the OO muscle, suggesting a weak non-Duchenne smile, while emotions reported towards outgroup politicians were significantly more negative. Also, a more enhanced frown response in the CS was found for ingroup compared to outgroup politicians' frown expressions. Present findings suggest that a politician's smile may go a long way to influence electorates through both non-verbal and verbal pathways. They add another layer to our understanding of how language and social information shape embodied effects in a highly nuanced manner. Implications for verbal communication in the political context are discussed.

Literacy overrides effects of animacy: A picture-naming study with pre-literate German children and adult speakers of German and Arabic.

Animacy plays a key role for human cognition, which is also reflected in the way humans process language. However, while experiments on sentence processing show reliable effects of animacy on word order and grammatical function assignment, effects of animacy on conjoined noun phrases (e.g., fish and shoe vs. shoe and fish) have yielded inconsistent results. In the present study, we tested the possibility that effects of animacy are outranked by reading and writing habits. We examined adult speakers of German (left-to-right script) and speakers of Arabic (right-to-left script), as well as German preschool children who do not yet know how to read and write. Participants were tested in a picture naming task that presented an animate and an inanimate entity next to one another. On half of the trials, the animate entity was located on the left and, on the other half, it was located on the right side of the screen. We found that adult German and Arabic speakers differed in their order of naming. Whereas German speakers were much more likely to mention the animate entity first when it was presented on the left than on the right, a reverse tendency was observed for speakers of Arabic. Thus, in literate adults, the ordering of conjoined noun phrases was influenced by reading and writing habits rather than by the animacy status of an entity. By contrast, pre-literate children preferred to start their utterances with the animate entity regardless of position, suggesting that effects of animacy in adults have been overwritten by effects of literacy.

Customizing spatial remapping of letters to aid reading in the presence of a simulated central field loss.

Reading is a primary concern of patients with central field loss (CFL) because it is typically performed with foveal vision. Spatial remapping offers one potential avenue to aid in reading; it entails shifting occluded letters to retinal areas where vision is functional. Here, we introduce a method of creating and testing different remapping strategies-ways to remap text-customized for CFL of different shapes. By simulating CFL in typically-sighted individuals, we tested the customization hypothesis-that the benefits of different remapping strategies will depend on the properties of the CFL. That is, remapping strategies will aid reading differentially in the presence of differently shaped CFL. In Experiment 1, letter recognition in the presence of differently shaped CFL was assessed in and around central vision. Using these letter recognition "maps" different spatial remappings were created and tested in Experiment 2 using a word recognition task. Results showed that the horizontal gap remapping, which did not remap any letters vertically, resulted in the best word recognition. Results were also consistent with the customization hypothesis; the benefits of different remappings on word recognition depended on the different CFL shapes. Although the horizontal gap remapping resulted in very good word recognition, tailoring remapping strategies to the shape of patients' CFL may aid reading with the wide range of sizes and shapes encountered by patients with CFL.

How long is long? Word length effects in reading correspond to minimal graphemic units: An MEG study in Bangla.

This paper presents a magnetoencephalography (MEG) study on reading in Bangla, an east Indo-Aryan language predominantly written in an abugida script. The study aims to uncover how visual stimuli are processed and mapped onto abstract linguistic representations in the brain. Specifically, we investigate the neural responses that correspond to word length in Bangla, a language with a unique orthography that introduces multiple ways to measure word length. Our results show that MEG signals localised in the anterior left fusiform gyrus, at around 130ms, are highly correlated with word length when measured in terms of the number of minimal graphemic units in the word rather than independent graphemic units (aksar) or phonemes. Our findings suggest that minimal graphemic units could serve as a suitable metric for measuring word length in non-alphabetic orthographies such as Bangla.

Contribution of statistical learning in learning to read across languages.

Statistical Learning (SL) refers to human's ability to detect regularities from environment Kirkham, N. Z. (2002) & Saffran, J. R. (1996). There has been a growing interest in understanding how sensitivity to statistical regularities influences learning to read. The current study systematically examined whether and how non-linguistic SL, Chinese SL, and English SL contribute to Chinese and English word reading among native Chinese-speaking 4th, 6th and 8th graders who learn English as a second language (L2). Children showed above-chance learning across all SL tasks and across all grades. In addition, developmental improvements were shown across at least two of the three grade ranges on all SL tasks. In terms of the contribution of SL to reading, non-linguistic auditory SL (ASL), English visual SL (VSL), and Chinese ASL accounted for a significant amount of variance in English L2 word reading. Non-linguistic ASL, Chinese VSL, English VSL, and English ASL accounted for a significant amount of variance in Chinese word reading. Our results provide clear and novel evidence for cross-linguistic contribution from Chinese SL to English reading, and from English SL to Chinese reading, highlighting a bi-directional relationship between SL in one language and reading in another language.

Computerized Executive Functions Training: The efficacy on reading performance of children with dyslexia.

This study aimed to test the efficacy of a newly developed computer-based game naming computerized executive functions (CEF) task on the reading ability of children suffering from dyslexia. Forty dyslexic school students from the fourth and fifth grades were randomized to one of the experimental and control groups. Subjects of the experimental group received 12 sessions of Computerized Executive Functions Training (CEFT), while subjects of the control group played a neutral computer game throughout the 12 sessions. All participants responded to the Reading and Dyslexia Test (NEMA) as the pre- and post-test measure. Results revealed a significant improvement in the reading ability of subjects of the experimental group compared to the control group. Subjects of the experimental group indicated a greater improvement in some components of the NEMA scale including word reading, word chains reading, picture naming, text comprehension, word comprehension and letter fluency relative to the control group. CEFT had no significant effect in modifying the category fluency, phoneme elimination and rhyming components of the NEMA scale. Applying CEFT improves the reading performance of children with dyslexia by enforcing their cognitive abilities like working memory, inhibition control and cognitive flexibility which are necessary for normal reading ability.

The cortical representation of language timescales is shared between reading and listening.

Language comprehension involves integrating low-level sensory inputs into a hierarchy of increasingly high-level features. Prior work studied brain representations of different levels of the language hierarchy, but has not determined whether these brain representations are shared between written and spoken language. To address this issue, we analyze fMRI BOLD data that were recorded while participants read and listened to the same narratives in each modality. Levels of the language hierarchy are operationalized as timescales, where each timescale refers to a set of spectral components of a language stimulus. Voxelwise encoding models are used to determine where different timescales are represented across the cerebral cortex, for each modality separately. These models reveal that between the two modalities timescale representations are organized similarly across the cortical surface. Our results suggest that, after low-level sensory processing, language integration proceeds similarly regardless of stimulus modality.

Oligomerization mediated by the D2 domain of DTX3L is critical for DTX3L-PARP9 reading function of mono-ADP-ribosylated androgen receptor.

Deltex proteins are a family of E3 ubiquitin ligases that encode C-terminal RING and DTC domains that mediate interactions with E2 ubiquitin-conjugating enzymes and recognize ubiquitination substrates. DTX3L is unique among the Deltex proteins based on its N-terminal domain architecture. The N-terminal D1 and D2 domains of DTX3L mediate homo-oligomerization, and the D3 domain interacts with PARP9, a protein that contains tandem macrodomains with ADP-ribose reader function. While DTX3L and PARP9 are known to heterodimerize, and assemble into a high molecular weight oligomeric complex, the nature of the oligomeric structure, including whether this contributes to the ADP-ribose reader function is unknown. Here, we report a crystal structure of the DTX3L N-terminal D2 domain and show that it forms a tetramer with, conveniently, D2 symmetry. We identified two interfaces in the structure: a major, conserved interface with a surface of 973 Å2 and a smaller one of 415 Å2. Using native mass spectrometry, we observed molecular species that correspond to monomers, dimers and tetramers of the D2 domain. Reconstitution of DTX3L knockout cells with a D1-D2 deletion mutant showed the domain is dispensable for DTX3L-PARP9 heterodimer formation, but necessary to assemble an oligomeric complex with efficient reader function for ADP-ribosylated androgen receptor. Our results suggest that homo-oligomerization of DTX3L is important for the DTX3L-PARP9 complex to read mono-ADP-ribosylation on a ligand-regulated transcription factor.

Electrophysiological signatures of spelling sensitivity development from primary school age to adulthood.

Recognizing spelling errors is important for correct writing and reading, and develops over an extended period. The neural bases of the development of orthographic sensitivity remain poorly understood. We investigated event-related potentials (ERPs) associated with spelling error recognition when performing the orthographic decision task with correctly spelled and misspelled words in children aged 8-10 years old, early adolescents aged 11-14 years old, and adults. Spelling processing in adults included an early stage associated with the initial recognition of conflict between orthography and phonology (reflected in the N400 time window) and a later stage (reflected in the P600 time window) related to re-checking the spelling. In children 8-10 years old, there were no differences in ERPs to correct and misspelled words; in addition, their behavioral scores were worse than those of early adolescents, implying that the ability to quickly recognize the correct spelling is just beginning to develop at this age. In early adolescents, spelling recognition was reflected only at the later stage, corresponding to the P600 component. At the behavioral level, they were worse than adults at recognizing misspelled words. Our data suggest that orthographic sensitivity can develop beyond 14 years.

Early life stress, literacy and dyslexia: an evolutionary perspective.

Stress and learning co-evolved in parallel, with their interdependence critical to the survival of the species. Even today, the regulation of moderate levels of stress by the central autonomic network (CAN), especially during pre- and post-natal periods, facilitates biological adaptability and is an essential precursor for the cognitive requisites of learning to read. Reading is a remarkable evolutionary achievement of the human brain, mysteriously unusual, because it is not pre-wired with a genetic address to facilitate its acquisition. There is no gene for reading. The review suggests that reading co-opts a brain circuit centered in the left hemisphere ventral occipital cortex that evolved as a domain-general visual processor. Its adoption by reading depends on the CAN's coordination of the learning and emotional requirements of learning to read at the metabolic, cellular, synaptic, and network levels. By stabilizing a child's self-control and modulating the attention network's inhibitory controls over the reading circuit, the CAN plays a key role in school readiness and learning to read. In addition, the review revealed two beneficial CAN evolutionary adjustments to early-life stress "overloads" that come with incidental costs of school under-performance and dyslexia. A short-term adaptation involving methylation of the FKBP5 and NR3C1 genes is a liability for academic achievement in primary school. The adaptation leading to dyslexia induces alterations in BDNF trafficking, promoting long-term adaptive fitness by protecting against excessive glucocorticoid toxicity but risks reading difficulties by disruptive signaling from the CAN to the attention networks and the reading circuit.

A Systematic Review on Visual-Processing Deficits in Neurofibromatosis Type 1: What Possible Impact on Learning to Read?

This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently experienced by children with Neurofibromatosis type 1 (NF1), as previously shown in dyslexia. Using PRISMA methodological guidelines, we examined 49 studies; most of these reported visual-processing deficits in this population, raising the importance of directly studying the visuo-perceptual and visuo-attentional processes and eye-movement control involved in the learning-to-read process in NF1. The discussion provides a reflection for a better understanding of how visual-processing skills interact with reading deficits in NF1, as well as new avenues for their screening and care.

Conclusiveness, readability and textual characteristics of plain language summaries from medical and non-medical organizations: a cross-sectional study.

This cross-sectional study compared plain language summaries (PLSs) from medical and non-medical organizations regarding conclusiveness, readability and textual characteristics. All Cochrane (medical PLSs, n = 8638) and Campbell Collaboration and International Initiative for Impact Evaluation (non-medical PLSs, n = 163) PLSs of latest versions of systematic reviews published until 10 November 2022 were analysed. PLSs were classified into three conclusiveness categories (conclusive, inconclusive and unclear) using a machine learning tool for medical PLSs and by two experts for non-medical PLSs. A higher proportion of non-medical PLSs were conclusive (17.79% vs 8.40%, P < 0.0001), they had higher readability (median number of years of education needed to read the text with ease 15.23 (interquartile range (IQR) 14.35 to 15.96) vs 15.51 (IQR 14.31 to 16.77), P = 0.010), used more words (median 603 (IQR 539.50 to 658.50) vs 345 (IQR 202 to 476), P < 0.001). Language analysis showed that medical PLSs scored higher for disgust and fear, and non-medical PLSs scored higher for positive emotions. The reason for the observed differences between medical and non-medical fields may be attributed to the differences in publication methodologies or disciplinary differences. This approach to analysing PLSs is crucial for enhancing the overall quality of PLSs and knowledge translation to the general public.

Validation of a computerized version of the MNREAD chart for children.

PURPOSE: We aimed the develop and validate a computerized version of the MNREAD for the assessment of reading speed for children. METHODS: A computerized version of the MNREAD was built in Psykinematix software using the same parameters as the physical chart. We measured the reading velocity of 104 children (n = 44 of the 3rd grade; n = 60 of the 5th grade). Bland-Altaman analysis was used to quantify agreement between two chart measurements. RESULTS: Comparison between the 3rd and 5th-grade children for physical and computerized MNREAD versions showed statistical differences in Maximum Reading Speed (F = 2669.6; p < 0.001), Critical Print Size (F = 17.49; p < 0.001), and Reading Acuity (F = 14.19; p = 0.002) with huge effect size (η2 = 0.930). No differences were found between the versions within grades. Bland-Altman analysis showed 95% of the data points within ± 2 s of the mean difference, suggesting a similarity between versions of the MNREAD parameters. CONCLUSION: Our reading speed values for children in the 5th grade were higher than previous studies, suggesting a better quality of the assessment in the computerized version. Tolerance Limits were calculated as normality references for clinical purposes.