Neural dissociation of visual attention span and phonological deficits in developmental dyslexia: A hub-based white matter network analysis

Development and Validity of the Adult Reading History Questionnaire (ARHQ) for Chinese

The Adult Reading History Questionnaire (ARHQ) is a popular instrument for screening dyslexia in adults. Yet, there is no evidence suggesting its applicability in Chinese. The present study aims to develop a Chinese Adult Reading History Questionnaire (Chinese-ARHQ) and to assess its validity among Chinese adults. A total of 2439 Chinese adults completed the questionnaire of Chinese-ARHQ with 2234 questionnaires valid for further analysis (Nmales = 825, Mage = 26.29 years, SDage = 9.12). Among these participants, 184 completed the questionnaire twice and 221 completed reading-related tests. Results showed that the Chinese-ARHQ had good internal consistency reliability (Cronbach's α = 0.88), and the test-retest reliability was 0.81. Three factors (current reading, dyslexia symptoms and memory) were extracted through exploratory factor analysis. The scores of Chinese-ARHQ and its factors were both related to reading and phonological skills, revealing the good criterion validity of the questionnaire. Receiver operating characteristic (ROC) analysis revealed that the optimal threshold for the Chinese-ARHQ was 0.36 with a sensitivity of 83.3% and a specificity of 75.9%. Additionally, adults screened by the Chinese-ARHQ (> 0.36) performed worse in reading and phonological awareness, further validating the Chinese-ARHQ as a reliable screening tool for Chinese dyslexia in adults.

Visual attention matters during word recognition: A Bayesian modeling approach

It is striking that visual attention, the process by which attentional resources are allocated in the visual field so as to locally enhance visual perception, is a pervasive component of models of eye movements in reading, but is seldom considered in models of isolated word recognition. We describe BRAID, a new Bayesian word-Recognition model with Attention, Interference and Dynamics. As most of its predecessors, BRAID incorporates three sensory, perceptual, and orthographic knowledge layers together with a lexical membership submodel. Its originality resides in also including three mechanisms that modulate letter identification within strings: an acuity gradient, lateral interference, and visual attention. We calibrated the model such that its temporal scale was consistent with behavioral data, and then explored the model's capacity to generalize to other, independent effects. We evaluated the model's capacity to account for the word length effect in lexical decision, for the optimal viewing position effect, and for the interaction of crowding and frequency effects in word recognition. We further examined how these effects were modulated by variations in the visual attention distribution. We show that visual attention modulates all three effects and that a narrow distribution of visual attention results in performance patterns that mimic those reported in impaired readers. Overall, the BRAID model could be conceived as a core building block, towards the development of integrated models of reading aloud and eye movement control, or of visual recognition of impaired readers, or any context in which visual attention does matter.

Validation of a screening test based on symbols visual search to detect visuo-attentionnal reading difficulties

OBJECTIVE

Visuo-attentional dyslexia has been associated with impaired simultaneous visual processing of multiple items made of separable features (i.e. symbols). We designed a visual search screening test, consisting to find the (unique) black circle among circles of various colours versus among circles combined with a bar of various length and location. We evaluated its reliability and its validity to detect visuo-attentional deficit prone to affect reading. RESULTS OF STUDY 1: Assessment of 2015 children between 3 and 11 years old established that the screening test was feasible from kindergarten, and that our index contrasting visual search performance for symbols relative to colours (the Temporal Gap) decreased with age. Satisfactory test-retest reliability of the standardised index (independent from age) was found on a sample of 69 individuals. RESULTS OF STUDY 2: Reading speed and inaccuracy assessed for 769 4th and 5th grades children were significantly correlated to the Temporal Gap. A Temporal Gap above 75th centile predicted reading efficiency deficit above 95th percentile with 63 % sensitivity and 71 % specificity.

PERSPECTIVES

Our screening test can be used in clinic to detect whether a child with developmental dyslexia presents visuo-attentional fragility prone to contribute to the reading difficulties. Its validity as early predictor of a risk to develop visuo-attentional dyslexia needs further investigation.

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

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

Investigating Dyslexia through Diffusion Tensor Imaging across Ages: A Systematic Review

Dyslexia is a neurodevelopmental disorder that presents a deficit in accuracy and/or fluency while reading or spelling that is not expected given the level of cognitive functioning. Research indicates brain structural changes mainly in the left hemisphere, comprising arcuate fasciculus (AF) and corona radiata (CR). The purpose of this systematic review is to better understand the possible methods for analyzing Diffusion Tensor Imaging (DTI) data while accounting for the characteristics of dyslexia in the last decade of the literature. Among 124 articles screened from PubMed and Scopus, 49 met inclusion criteria, focusing on dyslexia without neurological or psychiatric comorbidities. Article selection involved paired evaluation, with a third reviewer resolving discrepancies. The selected articles were analyzed using two topics: (1) a demographic and cognitive assessment of the sample and (2) DTI acquisition and analysis. Predominantly, studies centered on English-speaking children with reading difficulties, with preserved non-verbal intelligence, attention, and memory, and deficits in reading tests, rapid automatic naming, and phonological awareness. Structural differences were found mainly in the left AF in all ages and in the bilateral superior longitudinal fasciculus for readers-children and adults. A better understanding of structural brain changes of dyslexia and neuroadaptations can be a guide for future interventions.

Neurocognitive mechanisms of co-occurring math difficulties in dyslexia: Differences in executive function and visuospatial processing

Children with dyslexia frequently also struggle with math. However, studies of reading disability (RD) rarely assess math skill, and the neurocognitive mechanisms underlying co-occurring reading and math disability (RD+MD) are not clear. The current study aimed to identify behavioral and neurocognitive factors associated with co-occurring MD among 86 children with RD. Within this sample, 43% had co-occurring RD+MD and 22% demonstrated a possible vulnerability in math, while 35% had no math difficulties (RD-Only). We investigated whether RD-Only and RD+MD students differed behaviorally in their phonological awareness, reading skills, or executive functions, as well as in the brain mechanisms underlying word reading and visuospatial working memory using functional magnetic resonance imaging (fMRI). The RD+MD group did not differ from RD-Only on behavioral or brain measures of phonological awareness related to speech or print. However, the RD+MD group demonstrated significantly worse working memory and processing speed performance than the RD-Only group. The RD+MD group also exhibited reduced brain activations for visuospatial working memory relative to RD-Only. Exploratory brain-behavior correlations along a broad spectrum of math ability revealed that stronger math skills were associated with greater activation in bilateral visual cortex. These converging neuro-behavioral findings suggest that poor executive functions in general, including differences in visuospatial working memory, are specifically associated with co-occurring MD in the context of RD. RESEARCH HIGHLIGHTS: Children with reading disabilities (RD) frequently have a co-occurring math disability (MD), but the mechanisms behind this high comorbidity are not well understood. We examined differences in phonological awareness, reading skills, and executive function between children with RD only versus co-occurring RD+MD using behavioral and fMRI measures. Children with RD only versus RD+MD did not differ in their phonological processing, either behaviorally or in the brain. RD+MD was associated with additional behavioral difficulties in working memory, and reduced visual cortex activation during a visuospatial working memory task.

Visual attention span deficit in developmental dyslexia: A meta-analysis

BACKGROUND

Visual attention span (VAS) refers to the number of visual elements processed simultaneously in a multielement array. Yet, there are mixed findings regarding VAS deficit in developmental dyslexia (DD) across different tasks, stimuli, languages, control groups, and ages.

AIM

The present meta-analysis aimed to investigate VAS deficit in DD and factors moderating VAS deficit in DD.

METHODS

A meta-analysis based on 32 articles, 54 independent studies, and 4211 subjects was conducted. Effect sizes for each study were calculated and a random-effect model was selected. Task and stimulus types in the VAS task, writing system, orthographic depth, control group type, and age were included as possible moderators.

RESULTS

1) VAS in dyslexic individuals was significantly worse than typically developing individuals; 2) Task-stimulus type (report-verbal/n-back-verbal/n-back-nonverbal), writing system (alphabetic vs. Chinese), and control group type (age matched vs. reading matched) significantly moderated VAS deficit in DD. VAS deficit was more severe in report task with verbal stimuli than in n-back task with verbal and nonverbal stimuli. VAS deficit was more severe in alphabetic language than in Chinese. VAS deficit was more severe when compared with age-matched controls than compared with reading-matched controls.

CONCLUSION

VAS deficit is a possible etiology for DD and moderated by task-stimulus type, writing system, and control group type. These findings have important implications for the understanding of DD.

Adaptive compensation of arcuate fasciculus lateralization in developmental dyslexia

Previous studies have reported anomalies in the arcuate fasciculus (AF) lateralization in developmental dyslexia (DD). Still, the relationship between AF lateralization and literacy skills in DD remains largely unknown. The purpose of our study is to investigate the relationship between lateralization of three segments of AF (AF anterior segment (AFAS), AF long segment (AFLS), and AF posterior segment (AFPS)) and literacy skills in DD. A total of 26 children with dyslexia and 31 age-matched control children were included in this study. High angular diffusion imaging, combined with spherical deconvolution tractography, was used to reconstruct the AF. Connectivity measures of hindrance-modulated orientational anisotropy (HMOA) were computed for each of the three segments of the AF. The lateralization index (LI) of each AF segment was calculated by (right HMOA - left HMOA)/(right HMOA + left HMOA). Results showed that the LIs of AFAS and AFLS were positively correlated with reading accuracy in children with dyslexia. Specifically, the LI of AFAS was positively correlated with nonword and meaningless text reading accuracy, while the LI of AFLS accounted for word reading accuracy. The results suggest adaptive compensation of arcuate fasciculus lateralization in developmental dyslexia and functional dissociation of the anterior segment and long segment in the compensation.

Toward the characterization of a visual form of developmental dyslexia: Reduced visuo-attentional capacity for processing multiple stimuli made of separable features

Some dyslexics cannot process multiple letters simultaneously. It has been argued that this reduced visuo-attentional (VA) letter span could result from poor reading ability and experience. Here, moving away from reading context, we showed that dyslexic group exhibited slower visual search than normal readers group for "symbols", defined as graphic stimuli made up of separable visual features, but not for filled objects. Slowness in symbol visual search was explained by reduced VA field and atypical ocular behaviour when processing those letter-like stimuli and was associated with reduced VA letter span and impaired elementary visuo-spatial perception. Such a basic visual search deficit can hardly be attributed to poor reading ability and experience. Moreover, because it is specific to letter-like stimuli (i.e., "symbols"), it can specifically hinder reading acquisition. Symbol visual search can easily be tested in the pre-reading phase, opening up prospects for early risk detection and prevention of VA dyslexia.

Enhancing reading accuracy through visual search training using symbols

Children with reading disorders present with inaccurate and/or delayed printed word identification. Regarding visual-attentional processing, printed words are letter strings, and each letter is a symbol made of separable features. Simultaneous processing of separable features has been evidenced to be specifically impaired in visual search tasks using symbols in poor readers as well as in a patient with superior parietal lobules (SPL) lesion. Additionally, activation in the SPL has been shown to be abnormally low in dyslexic readers displaying a reduced span of letter strings processing. This deficit has been assumed to impair visual-attentional sampling of printed words. An experiment conducted with 21 dyslexic children tested the hypothesis that a training program based on visual symbol search may stimulate the SPL, leading to a potential benefit transferred to reading performance. We designed the VisioCogLetters serious game and introduced it at random for one month (10 min every day) between four monthly reading sessions. No training was provided between the other (control) reading sessions. Reading accuracy increased without any speed-accuracy trade-off specifically in the session after training. Moreover, the percentage of improvement correlated with the individual time spent at home on training. These results show that improved visual search skills on symbols can translate into enhanced reading performance, and pave a new avenue for future rehabilitation tools.

Dyslexia: Causes and Concomitant Impairments

In recent decades, theories have been presented to explain the nature of dyslexia, but the causes of dyslexia remained unclear. Although the investigation of the causes of dyslexia presupposes a clear understanding of the concept of cause, such an understanding is missing. The present paper proposes the absence of at least one necessary condition or the absence of all sufficient conditions as causes for impaired reading. The causes of impaired reading include: an incorrect fixation location, too short a fixation time, the attempt to recognize too many letters simultaneously, too large saccade amplitudes, and too short verbal reaction times. It is assumed that a longer required fixation time in dyslexic readers results from a functional impairment of areas V1, V2, and V3 that require more time to complete temporal summation. These areas and areas that receive input from them, such as the fusiform gyrus, are assumed to be impaired in their ability to simultaneously process a string of letters. When these impairments are compensated by a new reading strategy, reading ability improves immediately.

The determinants of saccade targeting strategy in neurodevelopmental disorders: The influence of suboptimal reading experience

Whether eye-movements deficits are causal in reading disorders (RD) or rather a consequence of linguistic processing difficulty experienced by disabled readers has been extensively debated.Since RD are frequently comorbid with the Neurofibromatosis type1 (NF1), children with NF1 were used as a comparison group for children with dyslexia in this study.Eye movements were recorded while 21 dyslexic, 20 NF1, and 20 typically developing children performed an oculomotor lateralized bisection task. In this experiment, we manipulated the type of stimulus - discrete (words and strings of hashes) versus continuous (solid lines) - and the visual field where the stimulus was displayed (left vs right). The results showed that (1) only proficient readers (TD and NF1 without RD) showed fully developed oculomotor mechanisms for efficient reading, with a clear preferred viewing location located to the left of the word's centre in both visual fields, and fine-tuned saccade targeting guided by the between-character space information and (2) NF1 poor readers mirrored the dyslexic eye movement behaviour, with less accuracy and more variability in saccadic programming, no sensitivity to the discreteness of the stimuli, particularly in the left visual field. We concluded that disruption to oculomotor behaviour reflectsthe fact that many of the processes involved in reading are not yet automatized for children with RD, independently of NF1. This suggests that the differences in saccade targeting strategy between children with and without RD would be secondary consequences of their reduced reading experience.

Visual attention span as a predictor of reading fluency and reading comprehension in Arabic

Introduction

Visual attention span is a measure of multielement parallel processing. Individuals with higher visual attention span are expected to allocate more attention to letters within strings, which boosts letter identification and translates into more efficient reading. Given the high visual complexity of the Arabic writing system, we expected visual attention span to be an important predictor of reading in the Arabic language.

Methods

Native Arabic readers from Grade 4 and Grade 5 were recruited in Iraqi schools. We assessed the contribution of visual attention span to their reading fluency performance in tasks of fully vowelized word and pseudo-word reading, non-vowelized text reading, and written text comprehension. Their phonological awareness, IQ, and single letter processing speed were further evaluated.

Results

Results showed that visual attention span was a significant unique predictor of all the reading measures. Visual attention span and phonological awareness accounted for a similar amount of variance in word and pseudo-word reading fluency. Visual attention span was a far higher predictor than phonological awareness for text reading fluency and the sole predictor of text comprehension.

Discussion

The role of visual attention span to reading is discussed by reference to current word recognition models. Higher involvement of visual attention is expected in vowelized script to compensate for increased crowding in the presence of diacritics. Visual attention would thus contribute to sub-lexical orthographic parsing and favor orthography-to-phonology mapping, in particular for the pseudo-words that do not benefit from efficient lexical feedback. In non-vowelized script, higher visual attention would enhance the accurate and fast identification of root letters within words, thus resulting in faster word recognition.

Altered spontaneous brain activity in Down syndrome and its relation with cognitive outcome

Although Down syndrome (DS) is the most common genetic cause of neurodevelopmental delay, few neuroimaging studies have explored this population. This investigation aimed to study whole-brain resting-state spontaneous brain activity using fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) strategies to find differences in spontaneous brain activity among young people with DS and controls and to correlate these results with cognitive outcomes. The sample comprised 18 persons with DS (age mean = 28.67, standard deviation = 4.18) and 18 controls (age mean = 28.56, standard deviation = 4.26). fALFF and ReHo analyses were performed, and the results were correlated with other cognitive variables also collected (KBIT-2 and verbal fluency test). Increased activity was found in DS using fALFF in areas involving the frontal and temporal lobes and left cerebellum anterior lobe. Decreased activity in DS was found in the left parietal and occipital lobe, the left limbic lobe and the left cerebellum posterior lobe. ReHo analysis showed increased activity in certain DS areas of the left frontal lobe and left rectus, as well as the inferior temporal lobe. The areas with decreased activity in the DS participants were regions of the frontal lobe and the right limbic lobe. Altered fALFF and ReHo were found in the DS population, and this alteration could predict the cognitive abilities of the participants. To our knowledge, this is the first study to explore regional spontaneous brain activity in a population with DS. Moreover, this study suggests the possibility of using fALFF and ReHo as biomarkers of cognitive function, which is highly important given the difficulties in cognitively evaluating this population to assess dementia. More research is needed, however, to demonstrate its utility.