Exploring the phonological profiles of children with reading difficulties: A multiple case study

Dyslexia in the twenty-first century: a commentary on the IDA definition of dyslexia

In offering a commentary upon the IDA definition, we address its main components in turn. While each is technically accurate, we argue that, when taken together, the definition, or more accurately, the use to which it is often put, becomes problematic. We outline different current conceptions of dyslexia and conclude that the operationalisation of the definition for diagnostic purposes often results in scientifically questionable diagnoses and inadvertently leads to significant educational inequity. We propose a simpler definition that describes the primary difficulty, avoids reference to causal explanation, unexpectedness, and secondary outcomes, and redirects practitioner and policymaker focus to the importance of addressing and meeting the needs of all struggling readers.

Effects of a developmental dyslexia remediation protocol based on the training of audio-phonological cognitive processes in dyslexic children with high intellectual potential: study protocol for a multiple-baseline single-case experimental design

BACKGROUND

The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children's underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children.

METHODS

A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study.

DISCUSSION

The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.

Phoneme Representation and Articulatory Impairment: Insights from Adults with Comorbid Motor Coordination Disorder and Dyslexia

Phonemic processing skills are impaired both in children and adults with dyslexia. Since phoneme representation development is based on articulatory gestures, it is likely that these gestures influence oral reading-related skills as assessed through phonemic awareness tasks. In our study, fifty-two young dyslexic adults, with and without motor impairment, and fifty-nine skilled readers performed reading, phonemic awareness, and articulatory tasks. The two dyslexic groups exhibited slower articulatory rates than skilled readers and the comorbid dyslexic group presenting with an additional difficulty in respiratory control (reduced speech proportion and increased pause duration). Two versions of the phoneme awareness task (PAT) with pseudoword strings were administered: a classical version under time pressure and a delayed version in which access to phonemic representations and articulatory programs was facilitated. The two groups with dyslexia were outperformed by the control group in both versions. Although the two groups with dyslexia performed equally well on the classical PAT, the comorbid group performed significantly less efficiently on the delayed PAT, suggesting an additional contribution of articulatory impairment in the task for this group. Overall, our results suggest that impaired phoneme representations in dyslexia may be explained, at least partially, by articulatory deficits affecting access to them.

Cognitive Requirements of the Phonological Tests Affect Their Ability to Discriminate Children With and Without Developmental Dyslexia

PURPOSE

The main purpose of this study was to investigate whether the performance on each of seven phonological processing (PP) tests from the Russian Test of Phonological Processing (RuToPP), with their varying levels of linguistic complexity and composite phonological indices, are significant predictors of developmental dyslexia (DD) and can reliably differentiate children with and without reading impairment. Additionally, we examined the general contribution of phonological skills to text reading fluency in children with various levels of reading performance.

METHOD

A total of 173 Russian-speaking 7- to 11-year-old children participated in this study: 124 who were typically developing (TD) and 49 who had been diagnosed with DD. We assessed reading fluency with a standardized reading test and PP with the RuToPP. We investigated the potential of phonological skills to predict the presence or absence of a dyslexia diagnosis using multinomial logistic regression, receiver operating characteristic (ROC) curve analysis, and calculations of the sensitivity and specificity of each test and index. The contribution of phonological skills to reading fluency was also assessed in a mixed group of children.

RESULTS

Six of seven RuToPP tests were significant predictors of dyslexia. However, while the RuToPP correctly identified 93%-99% of TD children, for children with dyslexia, it ranged from 4% to 47% depending on the test. In a mixed group of children with and without dyslexia, performance in the more complex phonological tests was a stronger predictor of reading fluency.

CONCLUSIONS

Our findings are consistent with the literature on predictors of literacy skills and dyslexia while uniquely demonstrating the impact of the complexity level of the phonological tests on the classification outcome. PP is a significant and necessary predictor of reading skills, but it is not sufficient for diagnostic purposes.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20779294.