Dyslexia: nature and nurture

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

BACKGROUND

Although dyslexia is the most common learning disorder in children, it has not received adequate attention in Saudi Arabia.

AIMS

This study aimed at determining the prevalence of dyslexia among Saudi students in Grades 3-6, exploring associations between severity of dyslexia, its behavioral indicators, gender and grade, and the moderating role of grade in the relationship between severity and behavioral indicators.

METHODS AND PROCEDURES

The sample consisted of 2848 female students and 2647 male students in Zulfi governorate, Saudi Arabia. A survey-based mixed-methods design was chosen including a structured interview with teachers and three assessments using the Diagnostic Assessment Scale for Dyslexia, the Arabic Reading Test, and the Dyslexia Behavioral Indicators Scale.

OUTCOMES AND RESULTS

Dyslexia was assessed in 5.86 % of the total sample. It was twice as prevalent among male students as among female students (6.54 % and 3.83 %, respectively). The mean score for behavioral indicators of dyslexia was also significantly higher for male than for female students. The correlation between dyslexia severity and behavioral indicators score was high and significant, with grade level as a significant moderator.

CONCLUSIONS AND IMPLICATIONS

We found that, for children with dyslexia in Saudi Arabia, dyslexia was twice as prevalent among male students as among female students. Early dyslexia diagnosis and intervention services are suggested to reduce the risk for reading problems.

Development of an Abbreviated Adult Reading History Questionnaire (ARHQ-Brief) Using a Machine Learning Approach

Several crucial reasons exist to determine whether an adult has had a reading disorder (RD) and to predict a child's likelihood of developing RD. The Adult Reading History Questionnaire (ARHQ) is among the most commonly used self-reported questionnaires. High ARHQ scores indicate an increased likelihood that an adult had RD as a child and that their children may develop RD. This study focused on whether a subset of ARHQ items (ARHQ-Brief) could be equally effective in assessing adults' reading history as the full ARHQ. We used a machine learning approach, lasso (known as L1 regularization), and identified 6 of 23 items that resulted in the ARHQ-Brief. Data from 97 adults and 47 children were included. With the ARHQ-Brief, we report a threshold of 0.323 as suitable to identify past likelihood of RD in adults with a sensitivity of 72.4% and a specificity of 81.5%. Comparison of predictive performances between ARHQ-Brief and the full ARHQ showed that ARHQ-Brief explained an additional 10%-35.2% of the variance in adult and child reading. Furthermore, we validated ARHQ-Brief's superior ability to predict reading ability using an independent sample of 28 children. We close by discussing limitations and future directions.

Diagnostik von Lernstörungen: Zeit zum Umdenken

Zusammenfassung. Lernschwierigkeiten beim Erwerb der Schriftsprache oder des Rechnens gehört für ca. ein Drittel aller Grundschulkinder zum schulischen Alltag. Wenn diese Schwierigkeiten länger andauern, wird von Lernschwächen, Lernstörungen oder Lernbehinderungen gesprochen. Die begriffliche Abgrenzung wird aktuell durch verschiedene Klassifikationskriterien in verschiedenen Klassifikationssystemen (ICD-10/11, DSM-5 oder AWMF Leitlinien) sehr erschwert, was Unsicherheiten in der Diagnostik und auch divergierende pädagogische Konsequenzen zur Folge hat. Eine besondere Rolle spielt dabei das sogenannte doppelte Diskrepanzkriterium für die Diagnose einer Lernstörung: Die Leistung eines Kindes muss unter dem nach dem Alter bzw. der Beschulung und der Intelligenz zu erwartenden Niveau liegen. Die Schulleistung muss also erwartungswidrig ausfallen – das betroffene Kind bleibt hinter den für die Klassenstufe typischen Leistungen und auch hinter den eigenen allgemeinen kognitiven Fähigkeiten zurück. Das Kriterium der Diskrepanz der Schulleistung zur Intelligenz wird seit langem kontrovers diskutiert und ist in den Klassifikationssystemen unterschiedlich verankert. Seine Anwendung hat sowohl für die diagnostische als auch für die pädagogische Praxis weitreichende Konsequenzen. Es führt dazu, dass Kinder mit Diskrepanz zwischen Schulleistung und Intelligenz die Diagnose „Lernstörung“ erhalten, Kinder ohne diese Diskrepanz haben eine „Lernschwäche“, beide Gruppen erfahren unterschiedliche schulische und außerschulische Lernförderung. Der vorliegende Beitrag stellt die Berechtigung dieses Kriteriums der Diskrepanz zwischen Schulleistung und Intelligenz anhand empirischer Evidenz in Frage und beleuchtet Konsequenzen sowohl für die bislang gängige Anwendung des doppelten Diskrepanzkriteriums als auch für den Verzicht darauf. Das Fazit dieser Erörterung rät zum Umdenken.

Sex-related differences in reading achievement

Over the last 40 years, ever-growing interest in sex-related differences in the human brain has led to a vast amount of literature on the subject, a small part of which relates to studies of differences in the ability to read. The data concerning typically developing children mainly come from school-based screening projects (Programme for International Student Assessment, INVALSI) and partially from the standardization of reading tests. These have revealed the existence of a gap in favor of females that primarily appears during adolescence and in situations of sociocultural disadvantage, usually explained on the basis of environmental factors such as socioeconomic status and gender-based education. Dyslexia is a neurodevelopmental disorder that is significantly more prevalent among males, a difference that neuroimaging and genetic studies have attributed to the presence of hormone-related protective factors in females, although it has been hypothesized that a different neurocognitive substrate may also be involved. However, the literature on the subject is still limited, and further studies of the interactions between genetic risk, environmental factors, and brain phenotypes are needed to clarify why females are better at performing reading tasks and less susceptible to dyslexia, regardless of their language or the educational system in the country in which they live. The aim of this mini-review was to describe the studies that have investigated sex-related differences in reading ability in both typically and atypically developing subjects.

The heritability of reading and reading-related neurocognitive components: A multi-level meta-analysis

Reading ability is a complex task requiring the integration of multiple cognitive and perceptual systems supporting language, visual and orthographic processes, working memory, attention, motor movements, and higher-level comprehension and cognition. Estimates of genetic and environmental influences for some of these reading-related neurocognitive components vary across reports. By using a multi-level meta-analysis approach, we synthesized the results of behavioral genetic research on reading-related neurocognitive components (i.e. general reading, letter-word knowledge, phonological decoding, reading comprehension, spelling, phonological awareness, rapid automatized naming, and language) of 49 twin studies spanning 4.1-18.5 years of age, with a total sample size of more than 38,000 individuals. Except for language for which shared environment seems to play a more important role, the causal architecture across most of the reading-related neurocognitive components can be represented by the following equation a² > e² > c². Moderators analysis revealed that sex and spoken language did not affect the heritability of any reading-related skills; school grade levels moderated the heritability of general reading, reading comprehension and phonological awareness.

From BDNF to reading: Neural activation and phonological processing as multiple mediators

The BDNF gene is a prominent promoter of neuronal development, maturation and plasticity. Its Val⁶⁶Met polymorphism affects brain morphology and function within several areas and is associated with several cognitive functions and neurodevelopmental disorder susceptibility. Recently, it has been associated with reading, reading-related traits and altered neural activation in reading-related brain regions. However, it remains unknown if the intermediate phenotypes (IPs, such as brain activation and phonological skills) mediate the pathway from gene to reading or reading disability. By conducting a serial multiple mediation model in a sample of 94 children (age 5-13), our findings revealed no direct effects of genotype on reading. Instead, we found that genotype is associated with brain activation in reading-related and more domain general regions which in turn is associated with phonological processing which is associated with reading. These findings suggest that the BDNF-Val⁶⁶Met polymorphism is related to reading via phonological processing and functional activation. These results support brain imaging data and neurocognitive traits as viable IPs for complex behaviors.

Literacy and Numeracy Underachievement in Boys and Girls With ADHD

Objective: To determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drug Dependence Systems, Western Australian Literacy and Numeracy Assessment database, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: Twenty-three percent of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident in reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.

Literacy and Numeracy Underachievement in Boys and Girls With ADHD

Objective: The aim was to determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drugs of Dependence System and Western Australian Literacy and Numeracy Assessment databases, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: A total of 23% of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident for reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.

Longitudinal Effects of Reading and/or Mathematical Difficulties: The Role of Special Education in Graduation From Upper Secondary Education

This study explores the long-term effects of difficulties in reading and mathematical skills on educational achievement and successful graduation from secondary education as well as the role of special education in successful graduation. Study participants were all 16-year-old ninth graders from one Finnish city (N = 595; 302 females, 293 males) who were followed for 5 years after completing compulsory education. Students' reading and mathematical skills were measured at the end of compulsory education and their achieved grades in literacy and mathematics were received from their upper secondary schools. The overall results show that although part-time special education was available throughout both compulsory and upper secondary education, the negative longitudinal consequences of reading difficulties (RDs) and mathematical difficulties (MDs) on school achievement in literacy, mathematics, and rates of graduation can be seen. The regression path models were estimated separately for female and male students and show that among male students with RDs and MDs, the part-time special education that students received in Grades 7 to 9 was significantly related, but for Grades 10 to 11, this relationship is only significant among students with RDs. Moreover, low levels of school achievement in literacy among female students and in literacy and mathematics among male students significantly increased the likelihood of delayed graduation.

Beyond genes: A systematic review of environmental risk factors in specific reading disorder

BACKGROUND

While an understanding of the genetic contributions to specific reading disorder (RD) is emerging, there is no agreement about which putative hazard factors are clearly involved in the aetiology of this disorder.

AIMS

A literature review looking at the impact of environmental risk variables implicated in RD either per se or when interacting with the genes.

METHODS AND PROCEDURES

We performed a systematic literature review using the following keywords: dyslexia OR reading disability AND environmental risk factors OR environmental hazard factors, in the following electronic databases: PubMed, Scopus and PsycINFO, without any time restrictions.

OUTCOMES AND RESULTS

Gestational weeks and birth weight are among the pre- and peri-natal risk factors shown to reliably predict reading readiness and the odds of having RD. Inconclusive findings have been reported for maternal cigarette smoking, family history of psychiatric and medical diseases, and risk of miscarriage. A broad definition of familial socio-economic status and home literacy environment have been identified as good life-long risk predictors of reading skills.

CONCLUSIONS AND IMPLICATIONS

We highlighted the need to consider environmental hazards, their interactions and interactions with RD-candidate genes in the study of the aetiology of RD in order to provide much-needed insight into how these variables influence reading skills.

Differential Identification of Females and Males with Reading Difficulties: A Meta-Analysis

Males are more likely than females to be identified as having reading difficulties, but it is unclear if this is a result of sample ascertainment or identification bias. The purpose of this meta-analysis was to determine the magnitude of gender differences in reading difficulties using available studies in which researchers investigated this difference and an additional dataset with a representative U.S.

SAMPLE

After conducting a literature search, sixteen studies and a restricted use dataset were included in the present analysis (N = 552,729). A random-effects odds ratio (OR) model indicated that males are 1.83 times more likely than females to have reading difficulties. Moderator analyses revealed that the gender ratio is greater when the identified reading difficulties were more severe. Further, this difference in identification rates across males and females was found without evidence of publication bias. Implications for the identification of students with reading difficulties are discussed.

Visual motion and rapid auditory processing are solid endophenotypes of developmental dyslexia

Although a genetic component is known to have an important role in the etiology of developmental dyslexia (DD), we are far from understanding the molecular etiopathogenetic pathways. Reduced measures of neurobiological functioning related to reading (dis)ability, i.e. endophenotypes (EPs), are promising targets for gene finding and the elucidation of the underlying mechanisms. In a sample of 100 nuclear families with DD (229 offspring) and 83 unrelated typical readers, we tested whether a set of well-established, cognitive phenotypes related to DD [i.e. rapid auditory processing (RAP), rapid automatized naming (RAN), multisensory nonspatial attention and visual motion processing] fulfilled the criteria of the EP construct. Visual motion and RAP satisfied all testable criteria (i.e. they are heritable, associate with the disorder, co-segregate with the disorder within a family and represent reproducible measures) and are therefore solid EPs of DD. Multisensory nonspatial attention satisfied three of four criteria (i.e. it associates with the disorder, co-segregates with the disorder within a family and represents a reproducible measure) and is therefore a potential EP for DD. Rapid automatized naming is heritable but does not meet other criteria of the EP construct. We provide the first evidence of a methodologically and statistically sound approach for identifying EPs for DD to be exploited as a solid alternative basis to clinical phenotypes in neuroscience.

Explaining the sex difference in dyslexia

BACKGROUND

Males are diagnosed with dyslexia more frequently than females, even in epidemiological samples. This may be explained by greater variance in males' reading performance.

METHODS

We expand on previous research by rigorously testing the variance difference theory, and testing for mediation of the sex difference by cognitive correlates. We developed an analytic framework that can be applied to group differences in any psychiatric disorder.

RESULTS

Males' overrepresentation in the low performance tail of the reading distribution was accounted for by mean and variance differences across sex. There was no sex difference at the high performance tail. Processing speed (PS) and inhibitory control partially mediated the sex difference. Verbal reasoning emerged as a strength in males.

CONCLUSIONS

Our results complement a previous finding that PS partially mediates the sex difference in symptoms of attention deficit/hyperactivity disorder (ADHD), and helps explain the sex difference in both dyslexia and ADHD and their comorbidity.

Knowledge and beliefs about developmental dyslexia in pre-service and in-service Spanish-speaking teachers

The present study investigated knowledge, misconceptions, and lack of information about dyslexia among pre-service (PST) and in-service (IST) Spanish-speaking teachers in Spain and Peru. Two hundred and forty-six pre-service teachers and 267 in-service teachers completed the Knowledge and Beliefs about Developmental Dyslexia Scale (KBDDS). In-service teachers scored significantly higher on the total scale, and on the symptoms/diagnosis and general information subscales, than pre-service teachers. The percentages for misconceptions and lack of information ("do not know responses") were higher for PSTs than for ISTs on the general information subscale, the symptoms/diagnosis subscale, and the treatment subscale. Analyses of individual items were conducted to differentiate concepts that teachers did not know from misconceptions. In-service teacher self-efficacy, years of teaching experience, post-graduate training in dyslexia, and prior exposure to a child with dyslexia were positively related to knowledge about dyslexia. Implications for pre-service teacher training and professional development are discussed.

A screening on Specific Learning Disorders in an Italian speaking high genetic homogeneity area

The aim of the present research is to investigate the prevalence of Specific Learning Disorders (SLD) in Ogliastra, an area of the island of Sardinia, Italy. Having experienced centuries of isolation, Ogliastra has become a high genetic homogeneity area, and is considered particularly interesting for studies on different kinds of pathologies. Here we are going to describe the results of a screening carried out throughout 2 consecutive years in 49 second grade classes (24 considered in the first year and 25 in the second year of the study) of the Ogliastra region. A total of 610 pupils (average age 7.54 years; 293 female, 317 male) corresponding to 68.69% of all pupils who were attending second grade in the area, took part in the study. The tool used for the screening was "RSR-DSA. Questionnaire for the detection of learning difficulties and disorders", which allowed the identification of 83 subjects at risk (13.61% of the whole sample involved in the study). These subjects took part in an enhancement training program of about 6 months. After the program, pupils underwent assessment for reading, writing and calculation abilities, as well as cognitive assessment. According to the results of the assessment, the prevalence of SLDs is 6.06%. For what concerns dyslexia, 4.75% of the total sample manifested this disorder either in isolation or in comorbidity with other disorders. According to the first national epidemiological investigation carried out in Italy, the prevalence of dyslexia is 3.1-3.2%, which is lower than the prevalence obtained in the present study. Given the genetic basis of SLDs, this result, together with the presence of several cases of SLD in isolation (17.14%) and with a 3:1 ratio of males to females diagnosed with a SLD, was to be expected in a sample coming from a high genetic homogeneity area.

Gender Differences in Reading Impairment and in the Identification of Impaired Readers: Results From a Large-Scale Study of At-Risk Readers

Reading impairment is more common in males, but the magnitude and origin of this gender difference are debated. In a large-scale study of reading impairment among 491,103 beginning second-graders, gender differences increased with greater severity of reading impairment, peaking at a ratio of 2.4:1 for a broad measure of fluency and a ratio of 1.6:1 for a narrow measure of decoding. Results from three tests indicate that gender differences in reading impairment are attributable primarily to male vulnerability rather than ascertainment bias. Correspondence between identification as an impaired reader by our study criteria and school identification as learning disabled was poor overall and worse for girls: Only 1 out of 4 boys and 1 out of 7 girls identified as reading impaired in our study was school identified as learning disabled.

Gene-environment interaction on neural mechanisms of orthographic processing in Chinese children

The ability to process and identify visual words requires efficient orthographic processing of print, consisting of letters in alphabetic languages or characters in Chinese. The N170 is a robust neural marker for orthographic processes. Both genetic and environmental factors, such as home literacy, have been shown to influence orthographic processing at the behavioral level, but their relative contributions and interactions are not well understood. The present study aimed to reveal possible gene-by-environment interactions on orthographic processing at the behavioral and neural level in a normal children sample. Sixty 12 year old Chinese children from a 10-year longitudinal sample underwent an implicit visual-word color decision task on real words and stroke combinations. The ERP analysis focused on the increase of the occipito-temporal N170 to words compared to stroke combinations. The genetic analysis focused on two SNPs (rs1419228, rs1091047) in the gene DCDC2 based on previous findings linking these 2 SNPs to orthographic coding. Home literacy was measured previously as the number of children's books at home, when the children were at the age of 3. Relative to stroke combinations, real words evoked greater N170 in bilateral posterior brain regions. A significant interaction between rs1091047 and home literacy was observed on the changes of N170 comparing real words to stroke combinations in the left hemisphere. Particularly, children carrying the major allele "G" showed a similar N170 effect irrespective of their environment, while children carrying the minor allele "C" showed a smaller N170 effect in low home-literacy environment than those in good environment.

Postural control is not systematically related to reading skills: implications for the assessment of balance as a risk factor for developmental dyslexia

Impaired postural control has been associated with poor reading skills, as well as with lower performance on measures of attention and motor control variables that frequently co-occur with reading difficulties. Measures of balance and motor control have been incorporated into several screening batteries for developmental dyslexia, but it is unclear whether the relationship between such skills and reading manifests as a behavioural continuum across the range of abilities or is restricted to groups of individuals with specific disorder phenotypes. Here were obtained measures of postural control alongside measures of reading, attention and general cognitive skills in a large sample of young adults (n = 100). Postural control was assessed using centre of pressure (CoP) measurements, obtained over 5 different task conditions. Our results indicate an absence of strong statistical relationships between balance measures with either reading, cognitive or attention measures across the sample as a whole.

Probing the neurocognitive trajectories of children's reading skills

Emerging evidence of the high variability in the cognitive skills and deficits associated with reading achievement and dysfunction promotes both a more dimensional view of the risk factors involved, and the importance of discriminating between trajectories of impairment. Here we examined reading and component orthographic and phonological skills alongside measures of cognitive ability and auditory and visual sensory processing in a large group of primary school children between the ages of 7 and 12 years. We identified clusters of children with pseudoword or exception word reading scores at the 10th percentile or below relative to their age group, and a group with poor skills on both tasks. Compared to age-matched and reading-level controls, groups of children with more impaired exception word reading were best described by a trajectory of developmental delay, whereas readers with more impaired pseudoword reading or combined deficits corresponded more with a pattern of atypical development. Sensory processing deficits clustered within both of the groups with putative atypical development: auditory discrimination deficits with poor phonological awareness skills; impairments of visual motion processing in readers with broader and more severe patterns of reading and cognitive impairments. Sensory deficits have been variably associated with developmental impairments of literacy and language; these results suggest that such deficits are also likely to cluster in children with particular patterns of reading difficulty.

Dyslexia impairs speech recognition but can spare phonological competence

Dyslexia is associated with numerous deficits to speech processing. Accordingly, a large literature asserts that dyslexics manifest a phonological deficit. Few studies, however, have assessed the phonological grammar of dyslexics, and none has distinguished a phonological deficit from a phonetic impairment. Here, we show that these two sources can be dissociated. Three experiments demonstrate that a group of adult dyslexics studied here is impaired in phonetic discrimination (e.g., ba vs. pa), and their deficit compromises even the basic ability to identify acoustic stimuli as human speech. Remarkably, the ability of these individuals to generalize grammatical phonological rules is intact. Like typical readers, these Hebrew-speaking dyslexics identified ill-formed AAB stems (e.g., titug) as less wordlike than well-formed ABB controls (e.g., gitut), and both groups automatically extended this rule to nonspeech stimuli, irrespective of reading ability. The contrast between the phonetic and phonological capacities of these individuals demonstrates that the algebraic engine that generates phonological patterns is distinct from the phonetic interface that implements them. While dyslexia compromises the phonetic system, certain core aspects of the phonological grammar can be spared.

Association of the DYX1C1 dyslexia susceptibility gene with orthography in the Chinese population

Several independent studies have supported the association of DYX1C1 with dyslexia, but its role in general reading development remains unclear. Here, we investigated the contribution of this gene to reading, with a focus on orthographic skills, in a sample of 284 unrelated Chinese children aged 5 to 11 years who were participating in the Chinese Longitudinal Study of Reading Development. We tested this association using a quantitative approach for Chinese character reading, Chinese character dictation, orthographic judgment, and visual skills. Significant or marginally significant associations were observed at the marker rs11629841 with children's orthographic judgments at ages 7 and 8 years (all P values<0.020). Significant associations with Chinese character dictation (all P values<0.013) were also observed for this single-nucleotide polymorphism (SNP) at ages 9, 10, and 11 years. Further analyses revealed that the association with orthographic skills was specific to the processing of specific components of characters (P values<0.046). No association was found at either SNP of rs3743205 or rs57809907. Our findings suggest that DYX1C1 influences reading development in the general Chinese population and supports a universal effect of this gene.

Impairments in speech and nonspeech sound categorization in children with dyslexia are driven by temporal processing difficulties

Auditory processing problems in persons with dyslexia are still subject to debate, and one central issue concerns the specific nature of the deficit. In particular, it is questioned whether the deficit is specific to speech and/or specific to temporal processing. To resolve this issue, a categorical perception identification task was administered in thirteen 11-year old dyslexic readers and 25 matched normal readers using 4 sound continua: (1) a speech contrast exploiting temporal cues (/bA/-/dA/), (2) a speech contrast defined by nontemporal spectral cues (/u/-/y/), (3) a nonspeech temporal contrast (spectrally rotated/bA/-/da/), and (4) a nonspeech nontemporal contrast (spectrally rotated/u/-/y/). Results indicate that children with dyslexia are less consistent in classifying speech and nonspeech sounds on the basis of rapidly changing (i.e., temporal) information whereas they are unimpaired in steady-state speech and nonspeech sounds. The deficit is thus restricted to categorizing sounds on the basis of temporal cues and is independent of the speech status of the stimuli. The finding of a temporal-specific but not speech-specific deficit in children with dyslexia is in line with findings obtained in adults using the same paradigm (Vandermosten et al., 2010, Proceedings of the National Academy of Sciences of the United States of America, 107: 10389-10394). Comparison of the child and adult data indicates that the consistency of categorization considerably improves between late childhood and adulthood, particularly for the continua with temporal cues. Dyslexic and normal readers show a similar developmental progress with the dyslexic readers lagging behind both in late childhood and in adulthood.

Mapping for dyslexia and related cognitive trait loci provides strong evidence for further risk genes on chromosome 6p21

In a genome-wide linkage scan, we aimed at mapping risk loci for dyslexia in the German population. Our sample comprised 1,030 individuals from 246 dyslexia families which were recruited through a single-proband sib pair study design and a detailed assessment of dyslexia and related cognitive traits. We found evidence for a major dyslexia locus on chromosome 6p21. The cognitive trait rapid naming (objects/colors) produced a genome-wide significant LOD score of 5.87 (P = 1.00 × 10⁻⁷) and the implicated 6p-risk region spans around 10 Mb. Although our finding maps close to DYX2, where the dyslexia candidate genes DCDC2 and KIAA0319 have already been identified, our data point to the presence of an additional risk gene in this region and are highlighting the impact of 6p21 in dyslexia and related cognitive traits.

Do more boys than girls have reading problems?

There is controversy within the research literature concerning the relative prevalence of reading problems in boys and girls. The authors report findings from very large and very representative samples of Australian students. Data from the New South Wales Basic Skills Test (BST) for reading, administered annually to third and fifth grade students in New South Wales schools, were analyzed for 1997 to 2006. Poor readers were defined as students who scored in the lowest BST bands, Bands 1 and 2. Average boy/girl ratios for third-grade students were 1.66:1 (Band 1) and 1.44:1 (combined Bands 1 and 2) and for fifth grade students were 2.26:1 (Band 1) and 1.99:1 (combined Bands 1 and 2). The findings of this study confirm earlier research that more boys than girls experience reading problems, but these differences in incidence may be more modest than previous research has suggested.

Cognitive levels of performance account for hemispheric lateralisation effects in dyslexic and normally reading children

Recent theories of developmental dyslexia explain reading deficits in terms of deficient phonological awareness, attention, visual and auditory processing, or automaticity. Since dyslexia has a neurobiological basis, the question arises how the reader's proficiency in these cognitive variables affects the brain regions involved in visual word recognition. This question was addressed in two fMRI experiments with 19 normally reading children (Experiment 1) and 19 children with dyslexia (Experiment 2). First, reading-specific brain activation was assessed by contrasting the BOLD signal for reading aloud words vs. overtly naming pictures of real objects. Next, ANCOVAs with brain activation during reading the individuals' scores for all five cognitive variables assessed outside the scanner as covariates were performed. Whereas the normal readers' brain activation during reading showed co-variation effects predominantly in the right hemisphere, the reverse pattern was observed for the dyslexics. In particular, middle frontal gyrus, inferior parietal cortex, and precuneus showed contralateral effects for controls as compared to dyslexics. In line with earlier findings in the literature, these data hint at a global change in hemispheric asymmetry during cognitive processing in dyslexic readers, which, in turn, might affect reading proficiency.

Association of reading disabilities with regions marked by acetylated H3 histones in KIAA0319

Reading disabilities (RDs) have been associated with chromosome 6p with recent studies pointing to two genes, DCDC2 and KIAA0319. In this study, markers across the 6p region were tested for association with RD. Our strongest findings were for association with markers in KIAA0319, although with the opposite alleles compared with a previous study. We also found association with markers in VMP, but not with DCDC2. Current evidence indicates that differential regulation of KIAA0319 and DCDC2 contributes to RD, thus we used chromatin immunoprecipitation coupled with genomic tiling arrays (ChIP-chip) to map acetylated histones, a molecular marker for regulatory elements, across a 500 kb genomic region covering the RD locus on 6p. This approach identified several regions marked by acetylated histones that mapped near associated markers, including intron 7 of DCDC2 and the 5' region of KIAA0319. The latter is located within the 70 kb region previously associated with differential expression of KIAA0319. Interestingly, five markers associated with RD in independent studies were also located within the 2.7 kb acetylated region, and six additional associated markers, including the most significant one in this study, were located within a 22 kb haplotype block that encompassed this region. Our data indicates that this putative regulatory region is a likely site of genetic variation contributing to RD in our sample, further narrowing the candidate region.

Variation in GRIN2B contributes to weak performance in verbal short-term memory in children with dyslexia

A multi-marker haplotype within GRIN2B, a gene coding for a subunit of the ionotropic glutamate receptor, has recently been found to be associated with variation in human memory performance [de Quervain and Papassotiropoulos, 2006]. The gene locus is located within a region that has been linked to a phonological memory phenotype in a recent genome scan in families with dyslexia [Brkanac et al., 2008]. These findings may indicate the involvement of GRIN2B in memory-related aspects of human cognition. Memory performance is one of the cognitive functions observed to be disordered in dyslexia patients. We therefore investigated whether genetic variation in GRIN2B contributes to specific quantitative measures in a German dyslexia sample by genotyping 66 SNPs in its entire genomic region. We found supportive evidence that markers in intron 3 are associated with short-term memory in dyslexia, and were able to demonstrate that this effect is even stronger when only maternal transmission is considered. These results suggest that variation within GRIN2B may contribute to the genetic background of specific cognitive processes which are correlates of the dyslexia phenotype.

Windows of reflection: conceptualizing dyslexia using the social model of disability

The aim of this study is to develop perceptual knowledge of dyslexia from adults diagnosed with this condition. Historically, the dominant conceptual frameworks used to study dyslexia stem from psychological or educational practice. These disciplines predominantly draw on professional neuro-biological or educational knowledge that can be broadly summarized within a medical or educational model approach. Both the medical and educational models view dyslexia as resulting from a neurological and learning dysfunction. As such, only a small amount of research has attempted to locate dyslexia within a sociological context. This paper analyses the life narratives of adults diagnosed with dyslexia using the social model of disability. The author investigates the impact that disabling barriers have in education and employment for people with dyslexia. The implications of this are discussed, particularly how issues of disabling barriers and social-class structures affect the lives of people with dyslexia. The paper argues that social-class positioning and institutional discrimination (in the form of disabling barriers) shape the experiences of people living with this condition.

Gender ratios for reading difficulties

The prevalence of reading difficulties is typically higher in males than females in both referred and research-identified samples, and the ratio of males to females is greater in more affected samples. To explore possible gender differences in reading performance, we analysed data from 1133 twin pairs in which at least one member of each pair had a school history of reading problems and from 684 twin pairs from a comparison sample with no reading difficulties. Although the difference between the average scores of males and females in these two samples was very small, the variance of reading performance was significantly greater for males in both groups. We suggest that a greater variance of reading performance measures in males may account at least in part for their higher prevalence of reading difficulties as well as for the higher gender ratios that are observed in more severely impaired samples.

The KIAA0319-like (KIAA0319L) gene on chromosome 1p34 as a candidate for reading disabilities

A locus on chromosome 1p34-36 (DYX8) has been linked to developmental dyslexia or reading disabilities (RD) in three independent samples. In the current study, we investigated a candidate gene KIAA0319-Like (KIAA0319L) within DYX8, as it is homologous to KIAA0319, a strong RD candidate gene on chromosome 6p (DYX2). Association was assessed by using five tagging single nucleotide polymorphisms in a sample of 291 nuclear families ascertained through a proband with reading difficulties. Evidence of association was found for a single marker (rs7523017; P=0.042) and a haplotype (P=0.031), with RD defined as a categorical trait in a subset of the sample (n=156 families) with a proband that made our criteria for RD. The same haplotype also showed evidence for association with quantitative measures of word-reading efficiency (i.e., a composite score of word identification and decoding; P=0.032) and rapid naming of objects and colors (P=0.047) when analyzed using the entire sample. Although the results from the current study are modestly significant and would not withstand a correction for multiple testing, KIAA0319L remains an intriguing positional and functional candidate for RD, especially when considered alongside the supporting evidence for its homolog KIAA0319 on chromosome 6p. Additional studies in independent samples are now required to confirm these findings.

Childhood developmental disorders: an academic and clinical convergence point for psychiatry, neurology, psychology and pediatrics

BACKGROUND

Significant advances in understanding brain development and behavior have not been accompanied by revisions of traditional academic structure. Disciplinary isolation and a lack of meaningful interdisciplinary opportunities are persistent barriers in academic medicine. To enhance clinical practice, research, and training for the next generation, academic centers will need to take bold steps that challenge traditional departmental boundaries. Such change is not only desirable but, in fact, necessary to bring about a truly innovative and more effective approach to treating disorders of the developing brain.

METHODS

I focus on developmental disorders as a convergence point for transcending traditional academic boundaries. First, the current taxonomy of developmental disorders is described with emphasis on how current diagnostic systems inadvertently hinder research progress. Second, I describe the clinical features of autism, a phenomenologically defined condition, and Rett and fragile X syndromes, neurogenetic diseases that are risk factors for autism. Finally, I describe how the fields of psychiatry, psychology, neurology, and pediatrics now have an unprecedented opportunity to promote an interdisciplinary approach to training, research, and clinical practice and, thus, advance a deeper understanding of developmental disorders.

RESULTS

Research focused on autism is increasingly demonstrating the heterogeneity of individuals diagnosed by DSM criteria. This heterogeneity hinders the ability of investigators to replicate research results as well as progress towards more effective, etiology-specific interventions. In contrast, fragile X and Rett syndromes are 'real' diseases for which advances in research are rapidly accelerating towards more disease-specific human treatment trials.

CONCLUSIONS

A major paradigm shift is required to improve our ability to diagnose and treat individuals with developmental disorders. This paradigm shift must take place at all levels - training, research and clinical activity. As clinicians and scientists who are currently constrained by disciplinary-specific history and training, we must move towards redefining ourselves as clinical neuroscientists with shared interests and expertise that permit a more cohesive and effective approach to improving the lives of patients.

Genetics of dyslexia: the evolving landscape

Dyslexia is among the most common neurodevelopmental disorders, with a prevalence of 5-12%. At the phenotypic level, various cognitive components that enable reading and spelling and that are disturbed in affected individuals can be distinguished. Depending on the phenotype dimension investigated, inherited factors are estimated to account for up to 80%. Linkage findings in dyslexia are relatively consistent across studies in comparison to findings for other neuropsychiatric disorders. This is particularly true for chromosome regions 1p34-p36, 6p21-p22, 15q21 and 18q11. Four candidate genes have recently been identified through systematic linkage disequilibrium studies in linkage region 6p21-p22, and through cloning approaches at chromosomal breakpoints. Results indicate that a disturbance in neuronal migration is a pathological correlate of dyslexia at the functional level. This review presents a summary of the latest insights into the genetics of dyslexia and an overview of anticipated future developments.

Genes, environment, and dyslexia. The 2005 Norman Geschwind Memorial Lecture

This article presents an overview of some methods and results from our continuing studies of genetic and environmental influences on dyslexia, and on individual differences across the normal range that have been conducted over the past 25 years in the Colorado Learning Disabilities Research Center (CLDRC) and in related projects. CLDRC investigators compare the similarities of identical twin pairs who share all their genes and fraternal twins who share half their segregating genes to assess the balance of genetic, shared family environment, and nonshared environment influences on dyslexia and on individual differences across the normal range. We have learned that among the children we have studied in Colorado, group deficits in reading (dyslexia) and individual differences in reading across the normal range are primarily due to genetic influences, and these genetic influences are often shared with some of the same genetic influences on deficits and individual differences in language and ADHD. We have also learned from our molecular-genetic linkage studies that there are regions on several chromosomes likely to contain genes that influence dyslexia. Several specific genes within these regions have been tentatively identified through molecular-genetic association analyses, but much more research is needed to understand the pathways among specific genes, regions of noncoding DNA that regulate the activity of those genes, the brain, and dyslexia. I conclude with a discussion of our research on individual differences in early reading development, on the role of early learning constraints in dyslexia, and on how genetic influences are expressed through their interaction and correlation with the environment.

Zur Genetik der Lese-Rechtschreibschwäche

Zusammenfassung: Die Lese-Rechtschreibstörung (LRS) ist eine der häufigsten Entwicklungsstörungen. Die Ursachen dieser komplexen Störung sind bisher nur kaum verstanden. Familienuntersuchungen zeigen, dass die LRS familiär gehäuft auftritt und dass das Risiko für ein Geschwisterkind, eine LRS zu entwickeln, ca. 3,5fach erhöht ist. Verschiedene kognitive Fähigkeiten sind mit der LRS korreliert. Hierzu gehören die phonologische Bewusstheit, orthographisches Wissen, phonologisches Dekodieren, auditives Kurzzeitgedächtnis und schnelles Benennen. Eine familiäre Häufung dieser mit der LRS korrelierten Dimensionen und eine hohe Erblichkeit (Heritabilität) wurden wiederholt gefunden. Die Heritabilität für die Lesefähigkeit liegt zwischen 50-60%, für die Rechtschreibstörung zwischen 50 und 70%. Durch genomweite Kopplungsuntersuchungen wurden bisher 9 Kandidatengenregionen (DYX1-9) identifiziert. Vier Kandidatengene, DCDC2, KIAA0319, ROBO1 und DYX1C1 wurden kürzlich beschrieben. Diese beeinflussen die neuronale Migration und sind daher funktionell aussichtsreiche Kandidatengene für die LRS. Allerdings konnte bisher keine funktionell relevante Mutation gefunden werden. Die Komorbidität zwischen LRS und ADHD sowie LRS und Sprachentwicklungsstörungen könnte zum Teil durch gemeinsame genetische Faktoren erklärt werden. In der Zukunft wird es für die Ursachenforschung der LRS entscheidend sein, möglichst alle ursachenrelevanten Dimensionen gemeinsam an ausreichend großen Stichproben zu untersuchen. Neben den relevanten neurobiologischen Faktoren sollten auch Umweltfaktoren und die verschiedenen Interaktionen, wie z.B. Gen-Umwelt und Gen-Gen-Interaktionen untersucht werden. In einem europäischen, kollaborativen Forschungsvorhaben (NeuroDys) wird weltweit die größte Stichprobe von Kindern mit einer LRS gesammelt und untersucht, um durch ein verbessertes Ursachenverständnis unter Einschluss der Identifikation von genetischen Risikofaktoren die Komplexität des Störungsbildes besser zu verstehen und perspektivisch spezifische Therapien zu entwickeln.

Genetic influences on reading difficulties in boys and girls: the Colorado twin study

To test the hypothesis that the genetic etiology for reading disability may differ in males and females, data from identical and fraternal twin pairs were analysed using both concordance and multiple regression methods. The sample included 264 identical (129 male, 135 female) and 214 same-sex fraternal (121 male, 93 female) twin pairs in which at least one member of each pair had reading difficulties. The difference between the identical and fraternal twin pair concordance rates was slightly larger for females than for males, suggesting a possible sex difference in etiology; however, a loglinear analysis of the three-way interaction of sex, zygosity, and concordance was not significant (p> or = 0.17). The estimate of group heritability (h2g), a standardized measure of the extent to which reading difficulties are due to genetic influences, was somewhat greater for females than males (0.65 vs 0.54), but this difference was also not significant (p > or = 0.35). Gender differences in h2g were larger for younger children (less than 11.5 years of age) than for older children. However, the three-way interaction of sex, zygosity, and age was not significant when age was treated either categorically (p > or = 0.86) or continuously (p > or = 0.71). Thus, results of this study provide little or no evidence for a differential genetic etiology of reading difficulties in males and females.

Learning problems, delayed development, and puberty

Language-based learning disorders such as dyslexia affect millions of people, but there is little agreement as to their cause. New evidence from behavioral measures of the ability to hear tones in the presence of background noise indicates that the brains of affected individuals develop more slowly than those of their unaffected counterparts. In addition, it seems that brain changes occurring at approximately 10 years of age, presumably associated with puberty, may prematurely halt this slower-than-normal development when improvements would normally continue into adolescence. The combination of these ideas can account for a wide range of previous results, suggesting that delayed brain development, and its interaction with puberty, may be key factors contributing to learning problems.

Developmental dyslexia

Developmental dyslexia, or specific reading disability, is a disorder in which children with normal intelligence and sensory abilities show learning deficits for reading. Substantial evidence has established its biological origin and the preponderance of phonological disorders even though important phenotypic variability and comorbidity have been recorded. Diverse theories have been proposed to account for the cognitive and neurological aspects of dyslexia. Findings of genetic studies show that different loci affect specific reading disability although a direct relation has not been established between symptoms and a given genomic locus. In both children and adults with dyslexia, results of neuroimaging studies suggest defective activity and abnormal connectivity between regions crucial for language functions--eg, the left fusiform gyrus for reading--and changes in brain activity associated with performance improvement after various remedial interventions.

The development of reading impairment: a cognitive neuroscience model

This review discusses recent cognitive neuroscience investigations into the biological bases of developmental dyslexia, a common disorder impacting approximately 5 to 17 percent of the population. Our aim is to summarize central findings from several lines of evidence that converge on pivotal aspects of the brain bases of developmental dyslexia. We highlight ways in which the approaches and methodologies of developmental cognitive neuroscience that are addressed in this special issue-including neuroimaging, human genetics, refinement of cognitive and biological phenotypes, neural plasticity and computational model-can be employed in uncovering the biological bases of this disorder. Taking a developmental perspective on the biological bases of dyslexia, we propose a simple cascading model for the developmental progression of this disorder, in which individual differences in brain areas associated with phonological processing might influence the specialization of visual areas involved in the rapid processing of written words. We also discuss recent efforts to understand the impact of successful reading interventions in terms of changes within cortical circuits associated with reading ability.