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

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

Decreased frontal theta frequency during the presence of smartphone among children: an EEG study.

BACKGROUND: Smart devices have become an integral part of our lives. However, research has highlighted the potential implications of smartphone presence on task performance, particularly in young children. This study aimed to determine the effect of a smartphone presence on brainwaves associated with cognitive interruption in children. METHODS: EEG data were collected from 5.3 to 8.5-year-old children performing a simple reaction time task with and without the presence of a smartphone. Theta and alpha bands were calculated, and repeated measure analysis of variance was performed to assess the impact of two conditions on alpha and theta bands: 1) with the presence and; 2) without the presence of a smartphone. EEG waveforms were also correlated with standardized cognitive measures evaluating attention abilities using Pearson correlation. RESULTS: Theta and alpha activity values were higher in the absence vs the presence of a smartphone, with a significant difference between theta bands for the two study conditions. Moreover, the difference between theta bands in the two conditions was significantly correlated with lower scores on an auditory attention test. CONCLUSIONS: The existence of an interactive electronic device during cognitive tasks is associated with alterations in brain activity related to cognitive control. IMPACT: The presence of a smartphone during a simple reaction time task in young children was associated with a significant decrease in frontal theta frequency. A trend of a decreased alpha band in the presence of a smartphone. The differences in theta and alpha frequencies between conditions were significantly correlated with lower scores in auditory and visual attention and inhibition tests.

Greater utilization of executive functions networks when listening to stories with visual stimulation is related to lower reading abilities in children.

Narrative comprehension relies on basic sensory processing abilities, such as visual and auditory processing, with recent evidence for utilizing executive functions (EF), which are also engaged during reading. EF was previously related to the "supporter" of engaging the auditory and visual modalities in different cognitive tasks, with evidence of lower efficiency in this process among those with reading difficulties in the absence of a visual stimulus (i.e. while listening to stories). The current study aims to fill out the gap related to the level of reliance on these neural circuits while visual aids (pictures) are involved during story listening in relation to reading skills. Functional MRI data were collected from 44 Hebrew-speaking children aged 8-12 years while listening to stories with vs without visual stimuli (i.e., pictures). Functional connectivity of networks supporting reading was defined in each condition and compared between the conditions against behavioral reading measures. Lower reading skills were related to greater functional connectivity values between EF networks (default mode and memory networks), and between the auditory and memory networks for the stories with vs without the visual stimulation. A greater difference in functional connectivity between the conditions was related to lower reading scores. We conclude that lower reading skills in children may be related to a need for greater scaffolding, i.e., visual stimulation such as pictures describing the narratives when listening to stories, which may guide future intervention approaches.

A greater modulation of the visual and fronto-parietal networks for children in a post-media versus pre-media exposure group.

AIM: Media use in children has exploded in the past several decades, most recently fuelled by portable electronic devices. This study aims to explore differences in functional brain connectivity in children during a story-listening functional MRI (fMRI) task using data collected before (1998) and after (2013) the widespread adoption of media. METHODS: Cross-sectional data were collected from English-speaking 5- to 7-year-old children at Cincinnati Children's Hospital Medical Center, USA, of a functional MRI narrative comprehension task completed in 1998 (n = 22) or 2013 (n = 25). Imaging data were processed using a graph theory approach, focusing on executive functions, language and visual processing networks supporting reading. RESULTS: Group differences suggest more efficient processing in the fronto-parietal network in the pre-media group while listening to stories. A modulation of the visual and fronto-parietal networks for the post-media exposure group was found. CONCLUSION: Further studies are needed to assess effects over time in the more exposed group to discern a causal effect of portable devices on cognitive networks.

Maternal education as an environmental factor related to reading in children with reading difficulties: A functional magnetic resonance imaging study.

The expanded simple view of reading (SVR) model suggests that word decoding, language comprehension and executive functions are necessary for reading comprehension. Children with reading difficulties (RDs) often have deficits in critical components of reading established in the expanded SVR model and alterations in brain function of reading-related regions. Maternal education could provide children with advantageous educational opportunities or resources that support reading acquisition. The primary goal of this study was to examine the contributions of maternal education to the behavioural and neurobiological correlates of the expanded SVR model. Seventy-two 8- to 12-year-old children with RDs and typical readers (TRs) completed reading, behavioural and an functional magnetic resonance imaging stories-listening task to determine the functional connectivity of the receptive language network to the whole brain in association with maternal education. Higher maternal education was associated with better vocabulary in children with RDs and positive functional connectivity between the receptive language network and regions related to visual processing in children with RDs versus TRs. These data suggest that maternal education supports the ability to comprehend oral language and engagement of neural networks that support imagination/visualization in children with RDs.

Neurobiological perspective on the development of executive functions.

Executive functions are a set of top-down cognitive processes necessary for emotional self-regulation and goal-directed behaviour supporting, among others, academic abilities. Premature infants are at high risk for subsequent cognitive, psychosocial, or behavioural problems even in the absence of medical complications and in spite of normal brain imaging. Given that this is a sensitive period of brain growth and maturation, these factors may place preterm infants at high risk for executive function dysfunction, disrupted long-term development, and lower academic achievements. Therefore, careful attention to interventions at this age is essential for intact executive functions and academic development.

The role of visual attention in dyslexia: Behavioral and neurobiological evidence.

Poor phonological processing has typically been considered the main cause of dyslexia. However, visuo-attentional processing abnormalities have been described as well. The goal of the present study was to determine the involvement of visual attention during fluent reading in children with dyslexia and typical readers. Here, 75 children (8-12 years old; 36 typical readers, 39 children with dyslexia) completed cognitive and reading assessments. Neuroimaging data were acquired while children performed a fluent reading task with (a) a condition where the text remained on the screen (Still) versus (b) a condition in which the letters were being deleted (Deleted). Cognitive assessment data analysis revealed that visual attention, executive functions, and phonological awareness significantly contributed to reading comprehension in both groups. A seed-to-voxel functional connectivity analysis was performed on the fluency functional magnetic resonance imaging task. Typical readers showed greater functional connectivity between the dorsal attention network and the left angular gyrus while performing the Still and Deleted reading tasks versus children with dyslexia. Higher connectivity values were associated with higher reading comprehension. The control group showed increased functional connectivity between the ventral attention network and the fronto-parietal network during the Deleted text condition (compared with the Still condition). Children with dyslexia did not display this pattern. The results suggest that the synchronized activity of executive, visual attention, and reading-related networks is a pattern of functional integration which children with dyslexia fail to achieve. The present evidence points toward a critical role of visual attention in dyslexia.

Chronic pediatric diseases and risk for reading difficulties: a narrative review with recommendations.

Literacy is a major social determinant of health, rooted in skills that develop during early childhood. Children arriving at kindergarten unprepared to learn to read are more likely to have low reading proficiency thereafter. General and health literacy are highly correlated, affecting understanding of health conditions, treatment adherence, and transition to self-care and adult healthcare services. The American Academy of Pediatrics (AAP) recommends literacy and school readiness promotion during well-visits and neurodevelopmental surveillance is emphasized across primary and subspecialty care. While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and chronic medical conditions are less appreciated and under-researched. This review applies an eco-bio-developmental framework to explore literacy across five complex chronic conditions affecting millions of children worldwide: asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease. In each, integration of an efficient reading brain network may be impacted by direct factors, such as ischemia, anesthesia, and/or medications, and also indirect factors, such as altered parent-child routines, hospital stays, and missed school. By integrating literacy into care management plans for affected children, pediatric primary care and specialty providers are poised to identify risks early, target guidance and interventions, and improve academic and health outcomes. IMPACT: While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and/or chronic medical conditions such as asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease are substantial, less appreciated, and under-researched. General and health literacy are highly correlated, with implications for the understanding one's health condition, treatment adherence, and transitioning to self-care, which is especially important for children with complex and/or chronic illness. Pediatric primary care and specialty providers are poised to integrate reading and literacy into care management plans for children with complex and/or chronic illness, including early screening, guidance, support, and interventions.

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

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

Functional MRI research involving healthy children: Ethics, safety and recommended procedures.

AIM: This specific review aims to expose clinicians, researchers and administrators in hospitals to the importance, procedures and safety of fMRI studies to promote the increased utilisation of such studies in different geographical places worldwide. The child's brain is developing rapidly, both structurally and functionally. These functional changes can only be detected using functional scans generated from an MRI machine and referred to as a functional MRI (fMRI). This method may be used clinically in complex medical and surgical conditions (e.g., epilepsy surgery), but these days are often used for research purposes. However, due to ethical and logistical considerations, fMRI in the paediatric population is not widely and equally used in different geographical places. CONCLUSIONS: The benefits of using this method to define the functional changes occurring in the developing brain are discussed in this review, along with desensitisation methods recommended when working with this vulnerable population in research and even in a clinical setting.

Maternal depression is associated with decreased functional connectivity within semantics and phonology networks in preschool children.

INTRODUCTION: Maternal depression is characterized by a lack of emotional responsiveness and engagement with their child, which may lead to the child's decreased cognitive, and language outcomes all related to the child's future reading outcomes. The relations between maternal depression and functional connectivity in neural circuits supporting language in the child was explored. METHODS: Eleven 4-year-old girls completed language abilities assessment and resting-state functional magnetic resonance imaging scan. Their mothers completed the Beck's Depression Inventory (BDI) to examine maternal depression when the child was 12 months old and at the age of 4. Functional connections within the child's resting-state phonology, semantics, language networks were correlated with maternal BDI scores at the age of 4 years. RESULTS: Higher maternal depression was associated with the child's decreased within the semantic and phonological networks connectivity during rest. Higher maternal depression at 4 years moderated the relationship between early depression scores and functional connectivity within the phonological network. CONCLUSIONS: Maternal depression in the first year of life is related to functional connections of phonological processing and enhanced by current maternal depression levels. We conclude that after a mother gives birth, resources should be provided to minimize depressive symptoms and interventions should be applied to support their child's language development for future reading acquisition.

Longer Screen Vs. Reading Time is Related to Greater Functional Connections Between the Salience Network and Executive Functions Regions in Children with Reading Difficulties Vs. Typical Readers.

An adverse relationship between screen exposure time and brain functional/structural connectivity was reported in typically developing children, specifically related to neurobiological correlates of reading ability. As children with reading difficulties (RD) suffer from impairments in reading and executive functions (EF), we sought to determine the association between the ratio of screen time duration to reading time duration and functional connectivity of EF networks to the entire brain in children with RD compared to typical readers (TRs) using resting state data. Screen/reading time ratio was related to reduced reading and EF abilities. A larger screen/reading time ratio was correlated with increased functional connectivity between the salience network and frontal-EF regions in children with RD compared to TRs. We suggest that whereas greater screen/reading time ratio is related to excessive stimulation of the visual processing system in TRs, it may be related to decreased efficiency of the cognitive control system in RDs.

Maternal depression is associated with altered functional connectivity between neural circuits related to visual, auditory, and cognitive processing during stories listening in preschoolers.

BACKGROUND: Maternal depression can influence the early activity of a mother reading stories to a young child, as depressed mothers are less likely to read to their children. Here, maternal depression association to neurobiological circuitry of narrative comprehension, visualization, and executive functions during stories listening was examined in 21 4-year-old girls and their mothers. Maternal depression scores were collected from the mothers, and functional MRI during stories listening was collected from the children. RESULTS: Increased maternal depression was related to decreased functional connectivity between visualization and auditory regions and increased connectivity between the right visual cortex and dorsolateral prefrontal cortex in the children. CONCLUSIONS: This study highlights the need to monitor maternal depression and provide interventions to ensure positive linguistic outcomes in children.

Parent-child joint reading is related to an increased fixation time on print during storytelling among preschool children.

Print exposure in early childhood is related to linguistic skills such as oral language, reading comprehension and spelling during school years. A common way of exposing preschool children to print is during joint storytelling. Research has shown that total fixation time on print during storytelling is between 2% and 6% of the total fixation time on the book and is a function of the child's age. What has yet to be determined, however, are differences, if any, in child fixation time on print during parent vs. experimenter joint storytelling. Here, we examined the effect of parent vs. experimenter storytelling-reading on fixation time on print among 4-6-year-old preschoolers. Specifically, we used an eye-tracking device to compare the fixation time percentage on print while the parent vs. an experimenter were reading a story to the child. Preschoolers fixated more on print when their parent was reading a story to them vs. the experimenter. Positive correlations between fixation time on print and linguistic skills and processing speed were found. Results suggest that joint storytelling with a parent promotes print awareness, an important factor in developing literacy and reading skills, and thus further emphasizes the importance of parent-child joint storytelling.

Maternal reading and fluency abilities are associated with diffusion properties of ventral and dorsal white matter tracts in their preschool-age children.

Early language exposure and shared parent-child reading, as assessed by maternal reading ability and fluency, affect the child's future language and cognitive abilities. The aim of the current study was to explore the association between maternal reading ability and fluency and diffusion properties of language- and cognition-related white matter tracts in their pre-school age children using diffusion tensor imaging (DTI). DTI data were acquired from fifteen girls (mean age: 3.83 ± 0.49 years). Reading ability and fluency were assessed in their mothers. Effects of hemisphere and node on diffusion properties were measured at 100 points along white matter tracts related to language and cognitive abilities. Significant positive correlations were found between maternal reading ability and fractional anisotropy in left and right dorsal and ventral language and executive functions-related tracts, while maternal reading fluency was associated with higher fractional anisotropy in ventral tracts, mainly in the left hemisphere. Fractional Anisotropy was significantly higher in the left compared to the right arcuate, cingulum cingulate, and inferior longitudinal fasciculus and higher in the right compared to the left superior longitudinal fasciculus. Our results signify the importance of maternal reading as a facilitator of the child's future language and cognitive abilities.

Children Use Regions in the Visual Processing and Executive Function Networks during a Subsequent Memory Reading Task.

Memory encoding is a critical process for memory function, which is foundational for cognitive functioning including reading, and has been extensively studied using subsequent memory tasks. Research in adults using such tasks indicates the participation of visual and cognitive-control systems in remembered versus forgotten words. However, given the known developmental trajectories of these systems, the functional neuroanatomy of memory encoding in children may be different than in adults. We examined brain activation for silent word reading and checkerboard viewing during an event-related reading task in 8-12 year-old children. Results indicate greater activation for checkerboard viewing than lexical processing in early visual regions, as well as for lexical processing versus checkerboard viewing in regions in left sensorimotor mouth, cingulo-opercular and dorsal-attention networks. Greater activation for remembered than forgotten words was observed in bilateral visual system and left lateralized regions within the ventral- and dorsal-attention, cingulo-opercular and fronto-parietal networks. These findings suggest a relatively mature reliance on the cognitive-control system, but greater reliance on the visual system in children when viewing words subsequently remembered. The location of regions with greater activity for remembered words reinforces the involvement of the attention and cognitive-control systems in subsequent memory in reading.

Associations between home literacy environment, brain white matter integrity and cognitive abilities in preschool-age children.

AIM: Caregiver-child reading is advocated by health organisations, citing cognitive and neurobiological benefits. The influence of home literacy environment (HLE) on brain structure prior to kindergarten has not previously been studied. METHODS: Preschool-age children completed assessments of language (EVT-2, CTOPP-2 Rapid Object Naming) and emergent literacy skills (Get Ready to Read!, The Reading House) followed by diffusion tensor imaging (DTI). Parents completed a survey of HLE (StimQ-P2 READ), which has four subscales. DTI measures included axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA). RESULTS: Forty-seven children completed DTI (54 ± 7 months, range 36-63; 27 girls). StimQ-P2 READ scores correlated with higher EVT-2, GRTR and TRH scores, controlling for age and gender (P < .01), and also with lower AD, RD and MD in tracts supporting language and literacy skills, controlling for age, gender and income (P < .05, family-wise error corrected). Correlations were strongest for the Bookreading Quantity subscale, including with higher scores on all cognitive measures including CTOPP-2, and also with higher FA in left-lateralised literacy-supporting tracts, controlling for age, gender and income. CONCLUSION: More nurturing home reading environment prior to kindergarten may stimulate brain development supporting language and literacy skills, reinforcing the need for further study.

Reading in children with drug-resistant epilepsy was related to functional connectivity in cognitive control regions.

AIM: This study aimed to define whether individuals with drug-resistant focal epilepsy also used regions related to cognitive control to facilitate reading. METHODS: We focused on patients with drug-resistant focal epilepsy in 2011-2014, who were aged 8-20 years and were being treated at the Cincinnati Children's Hospital, USA. They performed a verb generation functional magnetic resonance imaging task known to involve language and cognitive control, as well as a formal reading assessment. The reading scores were correlated with functional connectivity of the anterior cingulate cortex (ACC) using seed-to-voxel analysis. RESULTS: There were 81 potential patients and 13 (seven females) met the inclusion criteria. Their age at seizure onset was 0-13 years, and they had a mean age of 12.66 ± 3.17 years at the time of the study. Individuals with epilepsy demonstrated average intelligence and word reading ability. Their reading scores were positively correlated with functional connectivity between the ACC and regions related to emotional processing (right amygdala), learning and language processing (left cerebellum) and visual processing. CONCLUSION: Our results support the role that the ACC plays in proficient reading among children with drug-resistant epilepsy, even in those with epileptogenic foci in areas related to language.

Relationship Between Eye-Movement Patterns, Cognitive Load, and Reading Ability in Children with Reading Difficulties.

Children with reading difficulties (RD) share challenges in executive functions (EF). Neurobiological correlates provide evidence for EF challenges during reading among these readers, but an online cognitive load detection mechanism has yet to be developed. Nevertheless, eye-movement tracking can provide online data of reading patterns (pupil dilation, fixations) and, indeed, atypical eye-movement patterns of children with RD during reading have been documented. To identify eye-movement patterns related to increased cognitive load during reading in children with RD compared to typical readers, eye movements of 8-12-year-old English-speaking children were recorded during their reading of sentences with increasing difficulty (sentences that make sense, then sentences that do not make sense) and comparing incorrect and correct responses. Children with RD demonstrated greater pupil dilation when reading sentences that make sense than when reading sentences that do not make sense and also when reading incorrectly, compared to typical readers. Increased pupil dilation in children with RD when reading sentences correctly was positively correlated with phonological awareness capabilities. Higher phonological awareness and reading abilities were related to increased pupil dilation only in children with RD during correct reading, which is related to a heavier cognitive load. Results suggest that in addition to traditional findings of altered fixation patterns in children with RD, increased pupil dilation during reading may reflect EF challenges among this population. These findings can potentially be used to adapt online written materials for children with RD based on their fixation and pupil dilation patterns.

Maternal reading fluency is associated with functional connectivity between the child's future reading network and regions related to executive functions and language processing in preschool-age children.

Reading is an acquired skill that relies on cognitive-control and language abilities. Home reading environment has been positively correlated with activation in parietal-temporal-occipital association cortex supporting mental imagery and narrative comprehension during a story-listening task in preschool-age children. However, the degree to which maternal reading ability influences early brain development, specifically neural circuits involved with language and reading, is not well understood. The current study explored the relationship between maternal reading ability and functional connectivity within the language network, between the language network and networks related to cognitive control and visual processing, as well as between the language network and the entire brain (network-to-voxel analysis) of preschool-age children during a resting state. Thirteen 4-year-old girls and their mothers participated in this study, involving cognitive testing and functional magnetic resonance imaging, including a resting-state scan. Maternal reading ability was negatively correlated with functional connectivity within the child's language network at rest, and also with areas involved in visual processing, cognitive-control, and semantics. These results suggest that children whose mothers exhibit decreased reading ability may demonstrate a greater engagement of the language network and neural circuits related to visual word recognition, cognitive-control, and semantic processing, which later in life support reading.