The Role of Letter-Speech Sound Integration in Native and Second Language Reading: A Study in Native Japanese Readers Learning English.

The automatic activation of letter-speech sound (L-SS) associations is a vital step in typical reading acquisition. However, the contribution of L-SS integration during nonalphabetic native and alphabetic second language (L2) reading remains unclear. This study explored whether L-SS integration plays a similar role in a nonalphabetic language as in alphabetic languages and its contribution to L2 reading among native Japanese-speaking adults with varying English proficiency. A priming paradigm in Japanese and English was performed by presenting visual letters or symbols, followed by auditory sounds. We compared behavioral and event-related responses elicited by congruent letter-sound pairs, incongruent pairs, and baseline condition (symbol-sound pairs). The behavioral experiment revealed shorter RTs in the congruent condition for Japanese and English tasks, suggesting a facilitation effect of congruency. The ERP experiment results showed an increased early N1 response to Japanese congruent pairs compared to corresponding incongruent stimuli at the left frontotemporal electrodes. Interestingly, advanced English learners exhibited greater activities in bilateral but predominantly right-lateralized frontotemporal regions for the congruent condition within the N1 time window. Moreover, the enhancement of P2 response to congruent pairs was observed in intermediate English learners. These findings indicate that, despite deviations from native language processing, advanced speakers may successfully integrate letters and sounds during English reading, whereas intermediate learners may encounter difficulty in achieving L-SS integration when reading L2. Furthermore, our results suggest that L2 proficiency may affect the level of automaticity in L-SS integration, with the right P2 congruency effect playing a compensatory role for intermediate learners.

Lexical prosodic representation and access in Japanese children with developmental dyslexia.

Recent research indicates that awareness of the prosodic information present in spoken language could be an important factor for literacy development, and that adults with developmental dyslexia show impaired awareness of lexical prosodic information, while the phonological representations remain intact. We investigated lexical prosodic representation and awareness in Japanese children with and without developmental dyslexia. Lexical prosodic representation was investigated using a cross-modal fragment priming task, and awareness was examined using a fragment identification task. The task was modified for children by selecting words with higher familiarity and fewer trials. As a result, the same pattern of prosodic priming effects was observed between groups; lexical decision time was faster in the prosodic congruent condition than in the incongruent condition. In addition, accuracy and reaction time did not show group differences in the fragment identification task. Relationship between prosody and literacy development may differ between languages but the sample size were small in both groups. Further investigation with larger sample size is required.

Altered brain activity for phonological manipulation in dyslexic Japanese children.

Because of unique linguistic characteristics, the prevalence rate of developmental dyslexia is relatively low in the Japanese language. Paradoxically, Japanese children have serious difficulty analysing phonological processes when they have dyslexia. Neurobiological deficits in Japanese dyslexia remain unclear and need to be identified, and may lead to better understanding of the commonality and diversity in the disorder among different linguistic systems. The present study investigated brain activity that underlies deficits in phonological awareness in Japanese dyslexic children using functional magnetic resonance imaging. We developed and conducted a phonological manipulation task to extract phonological processing skills and to minimize the influence of auditory working memory on healthy adults, typically developing children, and dyslexic children. Current experiments revealed that several brain regions participated in manipulating the phonological information including left inferior and middle frontal gyrus, left superior temporal gyrus, and bilateral basal ganglia. Moreover, dyslexic children showed altered activity in two brain regions. They showed hyperactivity in the basal ganglia compared with the two other groups, which reflects inefficient phonological processing. Hypoactivity in the left superior temporal gyrus was also found, suggesting difficulty in composing and processing phonological information. The altered brain activity shares similarity with those of dyslexic children in countries speaking alphabetical languages, but disparity also occurs between these two populations. These are initial findings concerning the neurobiological impairments in dyslexic Japanese children.

[Early detection of specific reading disorder through response to intervention:a cohort study].

OBJECTIVE: The present study examined the effectiveness of response to intervention (RTI) for the early detection and intervention for specific reading disorder. METHOD: RTIs were applied to seventy-seven first graders (36 boys and 41 girls) for the early detection and intervention of specific reading disorders. The outcomes were examined when the children reached the third grade. RESULTS: Reading difficulties were detected in four children at the beginning of the first grade. Decoding training and vocabulary learning were conducted with these children as interventions for reading difficulties. Three children exhibited improvements in reading difficulties at the end of the first grade. The fourth child responded poorly and was diagnosed with specific reading disorder. The assessment of outcomes at the third grade showed that this child still had reading difficulties, whereas no other child displayed symptoms for being diagnosed with specific reading disorder. CONCLUSION: RTI is effective for the early detection and intervention of specific reading disorder.

[Efficacy of decoding training for children with difficulty reading hiragana].

OBJECTIVE: The present study aimed to clarify the efficacy of decoding training focusing on the correspondence between written symbols and their readings for children with difficulty reading hiragana (Japanese syllabary). METHODS: Thirty-five children with difficulty reading hiragana were selected from among 367 first-grade elementary school students using a reading aloud test and were then divided into intervention (n=15) and control (n=20) groups. The intervention comprised 5 minutes of decoding training each day for a period of 3 weeks using an original program on a personal computer. Reading time and number of reading errors in the reading aloud test were compared between the groups. RESULTS: The intervention group showed a significant shortening of reading time (F(1,33)=5.40, p<0.05, two-way ANOVA) compared to the control group. However, no significant difference in the number of errors was observed between the two groups. Ten children in the control group who wished to participate in the decoding training were included in an additional study;as a result, improvement of the number of reading errors was observed (t= 2.863, p< 0.05, paired t test), but there was no improvement in reading time. CONCLUSIONS: Decoding training was found to be effective for improving both reading time and reading errors in children with difficulty reading hiragana.

[Reading aloud as rehabilitation method for children with dyslexia detected at the first grade in their primary school].

We provided reading aloud instructions to a child who was diagnosed with dyslexia in a regular class of 69 first graders, comprising 33 boys and 36 girls, during a test of reading sentences aloud. The instructions consisted of a 2-step approach, i.e., decoding instruction and vocabulary instruction. First, a decoding instruction, which emphasized an important point in effortless decoding, was presented to the child. Next, a vocabulary instruction, which aimed to facilitate word-form recognition, was provided. We found that, the decoding instruction was effective in decreasing the number of reading errors, and that the vocabulary instruction was effective against reducing the time taken to read aloud.

Development of a reading difficulty questionnaire for adolescents in Japanese.

BACKGROUND: Dyslexia is a neurodevelopmental disorder which occurs in childhood but continues to influence academic and occupational function in adulthood. Recently, a Japanese dyslexia questionnaire and diagnostic procedure was established for primary school children. However, there is currently no procedure for the diagnosis or screening of dyslexia in individuals at or above junior high school age; accordingly, we aimed to develop a questionnaire to screen for reading difficulties in those individuals. METHODS: A questionnaire with various candidate items was developed from two English questionnaires, one Japanese questionnaire, and newly devised items focusing on the Japanese writing system and the most appropriate 28 items were selected. In total, 462 adults and 127 junior high to high school students were enrolled. Of those, 191 participants also took part in reading tests. After the exploratory factor analysis, reliability and validity were evaluated using the above control participants and 12 adolescents with dyslexia. RESULTS: The questionnaire included three factors, i.e., silent reading sub-scale (four items), writing sub-scale (four items), and aloud reading sub-scale (three items). Five were newly devised items focusing on the Japanese writing system. Cronbach's alphas of the three factors were 0.706, 0.638, and 0.568, respectively, and the interclass correlation coefficients (2,1) were 0.743, 0.609, and 0.695, respectively. The silent reading and aloud reading sub-scales were positively correlated with word, non-word, and passage reading time. DISCUSSION: The newly developed questionnaire correlated well with actual reading performance and may be used to screen reading difficulty in Japanese individuals at or above junior high school age.

Incidental findings of brain magnetic resonance imaging study in a pediatric cohort in Japan and recommendation for a model management protocol.

BACKGROUND: The increasing use of magnetic resonance imaging (MRI) in brain researches has led to growing concern over incidental findings (IFs). To establish a practical management protocol for IFs, it is useful to know the actual prevalence and problems of IF management. In the present study, we report the prevalence proportion and some handling problems of IFs in healthy Japanese children, and suggest a management protocol from ethical and practical standpoints. METHODS: Between 2006 and 2008, 120 healthy children aged 5-8 years participated in a structural MRI study conducted in a pediatric cohort in Japan. All MRI images were reviewed by a pediatric neurologist, and detected IFs were classified into 4 categories. RESULTS: IFs of all categories were detected in 40 of the 110 participants (36.4%) for whom T2-weighted or 3D-T1-weighted images were available. Findings of sinusitis and/or otitis media were most frequent (26.4%). Excluding these findings, the prevalence of IFs was still 10.9% (12 findings): 9 findings were categorized as "no referral" (8.2%), 2 as "routine referral" (1.8%), 1 as "urgent referral" (0.9%), and 0 as "immediate referral" (0.0%). In "routine referral" category, only one participant was referred for further examinations. CONCLUSIONS: Although the prevalence of IFs was high, the proportion of those requiring further examination was low. This result revealed a fairly high false-positive rate and suggested that evaluating equivocal findings was the most difficult part of IF management. A management protocol needs to include a process to properly assess the clinical importance of findings.

Strategies behind the establishment of a developmental cohort study in the Tottori City.

BACKGROUND: The Tottori study group, part of the JCS, presides over a community-based cohort study started when subjects-children living in Tottori City-were 5 years old. The social aspects of conducting a cohort study should also be made public, as this information is crucial for conducting community-based cohort studies. METHODS: Documents pertaining to social aspects implemented by the Tottori study group between 2004 and 2008 were arranged chronologically. Information which is crucial for conducting community-based cohort studies were extracted and classified into several categories. RESULTS: Five categories were extracted from the documents: research staff, supporting committee, recruitment, maintenance of motivation and disclosure. Implementation of the social aspects described in maintenance of motivation resulted in fewer subjects dropping out of the study and a re-recruitment rate of approximately 90%. CONCLUSIONS: The following factors are essential for a successful developmental cohort study of children: 1) A birth cohort study should be planned in hospitals with medical staff such as obstetricians and pediatricians; 2) An interdisciplinary group composed of medical or psychological clinicians and researchers with abundant experience in epidemiological study should be included; 3) If possible, an expert or widely known individual in the study's target field should be included as a member of the study staff; 4) For long cohort studies, a researcher with expertise in school education should be included; 5) A support committee should be organized as an external part of the study team.

Relationship between children's intelligence and their emotional/behavioral problems and social competence: gender differences in first graders.

BACKGROUND: The present study examines gender differences in the correlations between intelligence and developmental problems as well as social competence in first graders. METHODS: Ninety parent-child dyads participated in this study. The children comprised 7-year-olds recruited from the first grade of an elementary school. All the children were administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), Parent-child Interaction Rating Scale (IRS), and the parent report version of Strength and Difficulties Questionnaire (SDQ). RESULTS: The findings clarified that the processing speed of boys significantly correlated with their peer relationship. On the other hand, the emotional symptoms exhibited by girls had a more common association with their intellectual abilities. The correlations between parenting and intellectual abilities differed in boys and girls. CONCLUSIONS: Children's gender should be taken into account when assessing the diversity in their intellectual abilities and developmental problems. Moreover, parenting also influences the development of children in various ways.

Differences between children and adults in functional connectivity between the inferior frontal gyrus and extrastriate body area for gestural interaction.

Gestural interaction, where a person initiates interaction (initiator) and another person responds to it (follower), changes during development. The neural network comprising the inferior frontal gyrus (IFG), inferior parietal lobule (IPL), and the lateral occipito-temporal cortex (LOTC) is relevant to gestural interaction. The LOTC includes the extrastriate body area (EBA). Activation of these brain regions depends on the initiating/following role in adults. We conducted functional magnetic resonance imaging study on 18 children and 18 adults, to elucidate developmental changes of the neural mechanism underlying gestural interaction. We manipulated the initiating/following role (initiating/following) and congruency (congruent/incongruent) of executed and observed actions. After analyzing regional brain activity, we assessed psycho-physiological interaction to examine functional connectivity. Activation in the IFG and connectivity between the IFG and EBA in the Initiating rather than Following condition, which might be associated with evaluating social relevance, was stronger in adults than in children. The increase of the incongruency effect in the following condition (relative to the initiating condition) in the bilateral IPL was significantly attenuated in children compared with adults. These results suggest that the fronto-parieto-temporal network, involved in gestural interactions, undergoes developmental changes.

Reading ability and phonological awareness in Japanese children with dyslexia.

UNLABELLED: In alphabetic languages, the deficit of the phonological awareness is considered as the core deficit in developmental dyslexia. However, the role of phonological awareness in the acquisition of reading Japanese kana, the transparent, mora-based phonogram, has not been understood completely. We examine the abilities of Japanese dyslexic children on different types of Japanese phonological tasks, and discussed which tasks significantly account for each aspect of reading ability. METHODS: Fifteen dyslexic children (9.53+/-1.52 years old), and 15 children with normal reading ability (9.17+/-0.90 years old) participated in this study. They performed three types of phonological awareness tasks. The mora counting task and the mora reversal task of words require phonological awareness at the mora level. The letter rhyming task, which resembles the task in English language, requires phonological awareness at the phoneme level. We evaluated the reading ability by the reading speed, the reading errors, and the number of pauses while reading sentences aloud. RESULTS: The task performances of the dyslexic group on all three phonological awareness tasks were significantly lower than those of the control group. Stepwise multiple regression analysis revealed that the mora counting task and the rhyming letter task most significantly explained the reading speed and number of reading pauses. The mora reversal task of words, together with the antegraded digit span, significantly explained the reading errors. CONCLUSIONS: Japanese dyslexics showed deficits of phonological awareness both at the mora and the phoneme levels. Phonological awareness must be crucial for acquiring the ability of decoding phonograms, including Japanese kana.

Delayed neuropsychiatric syndrome in a child following carbon monoxide poisoning.

Here, we report the case of a five-year-old boy with carbonic monoxide (CO) poisoning. The patient initially recovered after the initiation of hyperbaric oxygen (HBO) therapy, but lethargy as well as visual and gait disturbances appeared two days later. Left hemiparesis and mood lability also subsequently appeared. Slow frontal activity was noted on electroencephalography, while fluid-attenuation inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) revealed high signal-intensity lesions in the hippocampus and deeper layers of the occipital and frontal cerebral cortex. The neurological symptoms subsided gradually during the 10-day course of HBO therapy, but the left-hand paresis and quadrantic hemianopsia persisted, in association with impaired attention, slow mental processing, and incontinence. Lesions in the globus pallidum were noted on follow-up MRI at 14 days, and cortical lesions became evident as linear, low signal-intensity areas on T1-weighted imaging 4 months after presentation. Delayed neuropsychiatric syndrome in CO poisoning is rare in childhood, although children should be carefully monitored after CO exposure. The finding of cortical laminar necrosis in this patient is quite atypical in CO poisoning, and suggests a broader and previously nonpredicted pathomechanism in this condition.

Age-dependent atypicalities in body- and face-sensitive activation of the EBA and FFA in individuals with ASD.

Individuals with autism spectrum disorder (ASD) have difficuly in recognizing bodies and faces, which are more pronounced in children than adults. If such difficulties originate from dysfunction of the extrastriate body area (EBA) and the fusiform face area (FFA), activation in these regions might be more atypical in children than in adults. We preformed functional magnetic resonance imaging while children and adults with ASD and age-matched typically developed (TD) individuals observed face, body, car, and scene. To examine various aspects, we performed individual region of interest (ROI) analysis, as well as conventional random effect group analysis. At individual ROI analysis, we examined the ratio of participants showing a category-sensitive response, the size of regions, location and activation patterns among the four object categories. Adults with ASD showed no atypicalities in activation of the EBA and FFA, whereas children with ASD showed atypical activation in these regions. Specifically, a smaller percentage of children with ASD showed face-sensitive activation of the FFA than TD children. Moreover, the size of the EBA was smaller in children with ASD than in TD children. Our results revealed atypicalities in both the FFA and EBA in children with ASD but not in adults with ASD.

Neural substrates of sarcasm: a functional magnetic-resonance imaging study.

The understanding of sarcasm reflects a complex process, which involves recognizing the beliefs of the speaker. There is a clear association between deficits in mentalizing, which is the ability to understand other people's behavior in terms of their mental state, and the understanding of sarcasm in individuals with autistic spectrum disorders. This suggests that mentalizing is important in pragmatic non-literal language comprehension. To highlight the neural substrates of sarcasm, 20 normal adult volunteers underwent functional magnetic-resonance imaging. We used scenario-reading tasks, in which sentences describing a certain situation were presented, followed by the protagonist's comments regarding that situation. Depending on the situation, the semantic content of the comments was classified as sarcastic, non-sarcastic, or contextually unconnected. As the combination of the first and second sentences represented discourse-level information that was not encoded in the individual sentences, sarcasm detection was represented as the differential activation induced by the second sentences. Sarcasm detection activated the left temporal pole, the superior temporal sulcus, the medial prefrontal cortex, and the inferior frontal gyrus (Brodmann's area [BA] 47). The left BA 47 was activated more prominently by sarcasm detection than by the first sentence. These findings indicate that the detection of sarcasm recruits the medial prefrontal cortex, which is part of the mentalizing system, as well as the neural substrates involved in reading sentences. The left BA 47 might therefore be where mentalizing and language processes interact during sarcasm detection.

[Influenza-associated encephalopathy with onset of prolonged convulsion: a case report].

A 1-year-old girl with influenza-associated encephalopathy initially exhibited prolonged febrile convulsions and subsequent drowsiness. She became unconsciousness and experienced a cluster of seizures 4 days later. Diffusion-weighted magnetic resonance imaging (DWI) showed high signal intensity in the bilateral frontal white matter. This signal change migrated to the bifrontal cortical areas and the caudate nuclei within 10 days, when T2 elongation appeared over the gray and white matter of frontal lobes. Choreoathetosis and oculogyric crisis were transiently noted at this period. Frontal lobe signs, including the forded mouth opening response, after diminution of these movement disorders. The DWI signal change subsequently resolved and frontal cortical atrophy appeared thereafter. Levels of inflammatory cytokines in the cerebrospinal fluid were normal during the acute phase of clinical course. The biphasic clinical course with initial prolonged seizure, involvement of the frontal lobes, and the progression of signal change on DWI from white to gray matter, meets the characteristics of "status epilepticus-type acute encephalopathy" suggested by Shiomi et al. Although pentobarbital infusion, steroid pulse therapy and mild hypothermia did not show any apparent effects on the clinical course of this patient, further trial of these therapies may be warranted for the treatment of this type of encephalopathy.

[Polycystic ovary syndrome and hepatocellular adenoma related to long-term use of sodium valproate in a young woman].

Previous studies have reported a high prevalence of polycystic ovary syndrome (PCOS) among women taking sodium valproate (VPA). We report the case of a 28 year-old epileptic female taking VPA, who developed PCOS and later hepatocellular adenoma. She had been taking VPA for intractable epilepsy since the age of 15 months. At the age of 22 years, she suffered spontaneous rupture of a liver tumor that was diagnosed as hepatocellular adenoma. At the age of 24 years, bilateral polycystic ovaries were found by transabdominal ultrasonography, and PCOS was diagnosed. VPA may directly influence steroidogenesis in the ovary and cause hyperandrogenemia with ensuing PCOS. It is known that abnormality in the sex hormones contributes to the onset of hepatocellular adenoma. Therefore, we speculate that hyperandrogenemia due to VPA contributed to the development of hepatocellular adenoma in this case.

Phonemic manipulation in Japanese: an fMRI study.

Phonological awareness is the ability to manipulate abstract phonological representations of language and is crucial to the process of learning to read. The neural substrates underlying this appear to be modality-independent at least in alphabetic languages. Japanese language has different orthographic "kana" system, in which each "kana" character strictly corresponds to a syllable. To investigate the neural substrates underlying phonological manipulation of the Japanese language, functional magnetic resonance imaging (fMRI) was used. Neuroimaging data were obtained from adult healthy volunteers during auditory and visual vowel exchange tasks, identical except for the modality of stimuli presentation: a voice and Japanese "kana" characters. Cerebellar vermis was activated by vowel exchange tasks of both modalities. The posterior parts of the superior temporal sulcus (STS) were active during the auditory tasks, suggesting that phonological representations of auditory stimuli are manipulated in this area. These findings are consistent with the previous studies with alphabetic languages. In contrast, the intraparietal sulci, which has been implicated for visuospatial tasks, was active during the visual tasks. This modality-dependent activation may indicate that the simple orthographic rule of the Japanese allows an alternate visual strategy to conduct the phonological awareness task, bypassing manipulation of phonological representation.

[A case of left thalamic infarction with aphasia and dysgraphia in Kanji].

We reported an 11-year-old girl with left thalamic infarction causing aphasia and dysgraphia. The lesion corresponded to the perfusion area of the tuberothalamic and paramedian arteries. Confrontation naming and word finding were impaired, but phonological cuing was very helpful despite the absence of amnesia. Dysgraphia was observed only in Kanji (morphogram) writing, and was also improved by visual cuings. These findings suggested difficulty in memory retrieval, in which the left thalamus might have some role.