Fractionating the multi-character processing deficit in developmental dyslexia: Evidence from two case studies

Developmental Dyslexia: Insights from EEG-Based Findings and Molecular Signatures-A Pilot Study

Developmental dyslexia (DD) is a learning disorder. Although risk genes have been identified, environmental factors, and particularly stress arising from constant difficulties, have been associated with the occurrence of DD by affecting brain plasticity and function, especially during critical neurodevelopmental stages. In this work, electroencephalogram (EEG) findings were coupled with the genetic and epigenetic molecular signatures of individuals with DD and matched controls. Specifically, we investigated the genetic and epigenetic correlates of key stress-associated genes (NR3C1, NR3C2, FKBP5, GILZ, SLC6A4) with psychological characteristics (depression, anxiety, and stress) often included in DD diagnostic criteria, as well as with brain EEG findings. We paired the observed brain rhythms with the expression levels of stress-related genes, investigated the epigenetic profile of the stress regulator glucocorticoid receptor (GR) and correlated such indices with demographic findings. This study presents a new interdisciplinary approach and findings that support the idea that stress, attributed to the demands of the school environment, may act as a contributing factor in the occurrence of the DD phenotype.

Visual attention modulates the transition from fine-grained, serial processing to coarser-grained, more parallel processing: A computational modeling study

During reading acquisition, beginning readers transition from serial to more parallel processing. The acquisition of word specific knowledge through orthographic learning is critical for this transition. However, the processes by which orthographic representations are acquired and fine-tuned as learning progresses are not well understood. Our aim was to explore the role of visual attention in this transition through computational modeling. We used the BRAID-Learn model, a Bayesian model of visual word recognition, to simulate the orthographic learning of 700 4-to 10-letter English known words and novel words, presented 5 times each to the model. The visual attention quantity available for letter identification was manipulated in the simulations to assess its influence on the learning process. We measured the overall processing time and number of attentional fixations simulated by the model across exposures and their impact on two markers of serial processing, the lexicality and length effects, depending on visual attention quantity. Results showed that the two lexicality and length effects were modulated by visual attention quantity. The quantity of visual attention available for processing further modulated novel word orthographic learning and the evolution of the length effect on processing time and number of attentional fixations across repeated exposures to novel words. The simulated patterns are consistent with behavioral data and the developmental trajectories reported during reading acquisition. Overall, the model predicts that the efficacy of orthographic learning depends on visual attention quantity and that visual attention may be critical to explain the transition from serial to more parallel processing.

The visual-attention span deficit in developmental dyslexia: Review of evidence for a visual-attention-based deficit

The visual attention span (VAS) deficit hypothesis in developmental dyslexia posits that a subset of dyslexic individuals shows a multielement parallel processing deficit due to reduced visual attention capacity. However, the attention-based interpretation of poor performance on VAS tasks is hotly debated. The purpose of the present paper is to clarify this issue through a critical review of relevant behavioural and neurobiological findings. We first examine the plausibility of alternative verbal interpretations of VAS performance, evaluating whether performance on VAS tasks might reflect verbal short-term memory, verbal coding or visual-to-verbal mapping skills. We then focus on the visual dimensions of VAS tasks to question whether VAS primarily reflects visuo-attentional rather than more basic visual skills. Scrutiny of the available behavioural and neurobiological findings not only points to a deficit of visual attention in dyslexic individuals with impaired VAS but further suggests a selective endogenous attentional system deficit that relates to atypical functioning of the brain dorsal attentional network. The overview clarifies the debate on what is being measured through VAS tasks and provides insights on how to interpret the VAS deficit in developmental dyslexia.

Probabilistic modeling of orthographic learning based on visuo-attentional dynamics

How is orthographic knowledge acquired? In line with the self-teaching hypothesis, most computational models assume that phonological recoding has a pivotal role in orthographic learning. However, these models make simplifying assumptions on the mechanisms involved in visuo-orthographic processing. Against evidence from eye movement data during orthographic learning, they assume that orthographic information on novel words is immediately available and accurately encoded after a single exposure. In this paper, we describe BRAID-Learn, a new computational model of orthographic learning. BRAID-Learn is a probabilistic and hierarchical model that incorporates the mechanisms of visual acuity, lateral interference, and visual attention involved in word recognition. Orthographic learning in the model rests on three main mechanisms: first, visual attention moves over the input string to optimize the gain of information on letter identity at each fixation; second, top-down lexical influence is modulated as a function of stimulus familiarity; third, after exploration, perceived information is used to create a new orthographic representation or stabilize a better-specified representation of the input word. BRAID-Learn was challenged on its capacity to simulate the eye movement patterns reported in humans during incidental orthographic learning. In line with the behavioral data, the model predicts a larger decline with exposures in number of fixations and processing time for novel words than for known words. For novel words, most changes occur between the first and second exposure, that is to say, after creation in memory of a new orthographic representation. Beyond phonological recoding, our results suggest that visuo-attentional exploration is an intrinsic portion of orthographic learning seldom taken into consideration by models or theoretical accounts.

Involvement of the dorsal and ventral attention networks in visual attention span

Visual attention span (VAS), which refers to the window size of multielement parallel processing in a short time, plays an important role in higher‐level cognition (e.g., reading) as required by encoding large amounts of information input. However, it is still a matter of debate about the underlying neural mechanism of VAS. In the present study, a modified visual 1‐back task was designed by using nonverbal stimuli and nonverbal responses, in which possible influences of target presence and position were considered to identify more pure VAS processing. A task‐driven functional magnetic resonance imaging (fMRI) experiment was then performed, and 30 healthy adults participated in this study. Results of confirmatory and exploratory analyses consistently revealed that both dorsal attention network (DAN) and ventral attention network (VAN) were significantly activated during this visual simultaneous processing. In particular, more significant activation in the left superior parietal lobule (LSPL), as compared to that in the bilateral inferior frontal gyrus (IFGs), suggested a greater involvement of DAN in VAS‐related processing in contrast to VAN. In addition, it was also found that the activation in temporoparietal junctions (TPJs) were suppressed during multielement processing only in the target‐absent condition. The current results suggested the recruitment of LSPL in covert attentional shifts and top‐down control of VAS resources distribution during the rapid visual simultaneous processing, as well as the involvement of bilateral IFGs (especially RIFG) in both VAS processing and inhibitory control. The present findings might bring some enlightenments for diagnosis of the atypicality of attentional disorders and reading difficulties.

Atypical viewing position effect in developmental dyslexia: A behavioural and modelling investigation

The probability of recognizing a word depends on the position of fixation during processing. In typical readers, the resulting word-recognition curves are asymmetrical, showing a left-of-centre optimal viewing position (OVP). First, we report behavioural results from dyslexic participants who show atypical word-recognition curves characterized by the OVP being right of centre with recognition probability being higher on the rightmost than on the leftmost letters. Second, we used BRAID, a Bayesian model of word recognition that implements gaze position, an acuity gradient, lateral interference and a visual attention component, to examine how variations in the deployment of visual attention would affect the OVP curves. We show that the atypical dyslexic curves are well simulated assuming a narrow distribution of visual attention and a shifting of visual attention towards the left visual field. These behavioural and modelling findings are discussed in light of current theories of visual attention deficits in developmental dyslexia.

The role of visual-spatial attention in reading development: a meta-analysis

The association between visual attention and reading development has been investigated as a possible core causal deficit in dyslexia, in addition to phonological awareness. This study aims to provide a meta-analytic review of the research on attentional processes and their relation to reading development, to examine the possible influence on it of orthographic depth, age, and attentional tasks (interpreted as serial or parallel processing indices). We included studies with participants up to 18 years of age that have considered the visual spatial attention orienting that sustains the serial visual analysis involved in the phonological pathway of decoding, and the visual attention span that supports the multielement parallel processing that is thought to influence lexical decoding. The results confirm a strong association between visual attention and reading development; we evaluate the evidence and discuss the possibility that visual attention processes play a causal role in determining individual differences in reading acquisition.

A neural index of inefficient evidence accumulation in dyslexia underlying slow perceptual decision making

Visual processing deficits have been widely reported in developmental dyslexia however the locus of cognitive dysfunction remains unclear. Here, we examined the neural correlates of perceptual decision-making using a dot-motion task and electroencephalography (EEG) and investigated whether presenting deficits were unique to children with dyslexia or if they were also evident in other, typically developing children with equally immature reading systems. Sixty-eight children participated: 32 with dyslexia (DD; 16 females); 21 age-matched controls (AM; 11 females) and 15 reading-matched controls (RM; 9 females). All participants completed a bilaterally presented random-dot-motion task while EEG was recorded. Neural signatures of low level sensory processing (steady state visual evoked potentials; SSVEPs), pre-target attentional bias (posterior α power), attentional orienting (N2), evidence accumulation (centro-parietal positive decision signal; CPP) and execution of a motor response (β) were obtained to dissect the temporal sequence of perceptual decision-making. Reading profile provided a score of relative lexical and sublexical skills for each participant. Although all groups performed comparably in terms of task accuracy and false alarm rate, the DD group were slower and demonstrated an earlier peak latency, reduced slope and lower amplitude of the CPP compared with both AM and RM controls. Reading profile was found to moderate the relationship between word reading ability, reaction time as well as CPP indices showing that lexical dyslexics responded more slowly and had a shallower slope, reduced amplitude and earlier latency of CPP waveforms than sublexical dyslexics. These findings suggest that children with dyslexia, particularly those with relatively poorer lexical abilities, have a reduced rate and peak of evidence accumulation as denoted by CPP markers yet remain slow in their overt response. This is in keeping with hypotheses that children with dyslexia have impairment in effectively sampling and processing evidence about visual motion stimuli.

Speech-Brain Frequency Entrainment of Dyslexia with and without Phonological Deficits

Developmental dyslexia is a cognitive disorder characterized by difficulties in linguistic processing. Our purpose is to distinguish subtypes of developmental dyslexia by the level of speech–EEG frequency entrainment (δ: 1–4; β: 12.5–22.5; γ1: 25–35; and γ2: 35–80 Hz) in word/pseudoword auditory discrimination. Depending on the type of disabilities, dyslexics can divide into two subtypes—with less pronounced phonological deficits (NoPhoDys—visual dyslexia) and with more pronounced ones (PhoDys—phonological dyslexia). For correctly recognized stimuli, the δ-entrainment is significantly worse in dyslexic children compared to controls at a level of speech prosody and syllabic analysis. Controls and NoPhoDys show a stronger δ-entrainment in the left-hemispheric auditory cortex (AC), anterior temporal lobe (ATL), frontal, and motor cortices than PhoDys. Dyslexic subgroups concerning normolexics have a deficit of δ-entrainment in the left ATL, inferior frontal gyrus (IFG), and the right AC. PhoDys has higher δ-entrainment in the posterior part of adjacent STS regions than NoPhoDys. Insufficient low-frequency β changes over the IFG, the inferior parietal lobe of PhoDys compared to NoPhoDys correspond to their worse phonological short-term memory. Left-dominant 30 Hz-entrainment for normolexics to phonemic frequencies characterizes the right AC, adjacent regions to superior temporal sulcus of dyslexics. The pronounced 40 Hz-entrainment in PhoDys than the other groups suggest a hearing “reassembly” and a poor phonological working memory. Shifting up to higher-frequency γ-entrainment in the AC of NoPhoDys can lead to verbal memory deficits. Different patterns of cortical reorganization based on the left or right hemisphere lead to differential dyslexic profiles.

Visual attention in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: The Danish high risk and resilience study VIA 7

BACKGROUND

Attention deficits are found in children at familial high risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP) using assessment methods relying on motor-based response latency. This study compares visual attention functions in children at FHR-SZ or FHR-BP with controls using an unspeeded task unconfounded by motor components.

METHODS

Visual attention was assessed in 133 7-year-old children at FHR-SZ (N = 56) or FHR-BP (N = 32), and controls (N = 45) using the unspeeded paradigm, TVA-based whole report. We compared four parameters of visual attention: visual processing speed, visual short-term memory, threshold for visual perception, and error rate. Further, we investigated their potential relationships with severity of psychopathology, adequacy of the home environment, and neurocognitive measures.

RESULTS

Children at FHR-SZ displayed significant deficits in perceptual processing speed of visual attention compared with controls (p < .001; d = 0.75) as did children at FHR-BP (p < .05; d = 0.54). Visual processing speed was significantly associated with spatial working memory (β = -0.23; t(68) = -3.34, p = .01) and psychomotor processing speed (β = 0.14, t(67) = 2.11, p < .05).

LIMITATIONS

Larger group sizes would have permitted inclusion of more predictors in the search for neurocognitive and other factors associated with the parameters of TVA-based whole report.

CONCLUSIONS

Young children at FHR-SZ and FHR-BP display significant deficits in processing speed of visual attention, which may reflect the effect of shared vulnerability risk genes. Early identification of children at FHR-SZ and FHR-BP with perceptual processing speed impairments may represent a low-cost basis for low-risk interventions.

Remediation of Allophonic Perception and Visual Attention Span in Developmental Dyslexia: A Joint Assay

Categorical perception of phonemes and visual attention span are cognitive processes that contribute independently to poor reading skills in developmental dyslexia. We here explored whether training programs specifically targeting one or the other process do improve reading performance in dyslexic children. The dyslexic participants were trained using either the RapDys© program designed to improve phonemic perception or the MAEVA© program targeting visual attention span. Each participant was provided the two programs successively for intensive training. Results show specific effects of RapDys© on phonemic discrimination and pseudo-word reading. MAEVA© specifically improved visual attention span and irregular word reading. Phonemic awareness and regular word reading improved after application of both training programs, suggesting similar positive effects of both methods although effects of concomitant phonic training cannot be ruled out (as there was no control group). The overall findings suggest that both categorical perception and visual attention span remediation contribute to reading.

Developing a Visual Attention Assessment for Children at School Entry

Whereas young children’s visual attention has been explored in a number of previous studies, so far it has not been investigated by an assessment based on Bundesen’s Theory of Visual Attention (TVA). TVA is a prominent visual attention model that has been widely used as foundation in studies targeting older children, adolescents or adults. In this paper we explore the utility of adopting TVA to explore the visual attention of 4- to 5- year olds and present the development of a simplified adapted version of a TVA-based assessment designed for this age group. Key assessment alterations included the substitution of letter stimuli with black and white symbols and the reduction of assessment duration. The suitability of the assessment for the target age group was subsequently tested in two consecutive studies (Study I: N = 43; Study II: N = 24). Study results show that measuring visual attention based on a simplified TVA-based assessment appears feasible in such a young age group, provided that the study design takes into account the capabilities of these young children. The authors argue that by adopting this kind of visual attention assessment the relationship between visual attention development and early learning could be better understood.

What bilateral damage of the superior parietal lobes tells us about visual attention disorders in developmental dyslexia

Neuroimaging studies have identified the superior parietal lobules bilaterally as the neural substrates of reduced visual attention (VA) span in developmental dyslexia. It remains however unclear whether the VA span deficit and the deficits in temporal and spatial attention shifting also reported in dyslexic children reflect a unitary spatio-temporal deficit of attention - probably linked to general posterior parietal dysfunction- or the dysfunction of distinct attentional systems that relate to different neural substrates. We explored this issue by testing an adult patient, IG, with a specific damage of the bilateral superior parietal lobules after stroke, on tasks assessing the VA span as well as temporal and spatial attention shifting. IG demonstrated a very severe VA span deficit, but preserved temporal attention shifting. Exogenous spatial orientation shifting was spared but her performance was impaired in endogenous attention. The overall findings show that distinct sub-systems of visual attention can be dissociated within the parietal lobe, suggesting that different attentional systems associated with specific neural networks can be selectively impaired in developmental dyslexia.

Visual attention span performance in German-speaking children with differential reading and spelling profiles: No evidence of group differences

An impairment in the visual attention span (VAS) has been suggested to hamper reading performance of individuals with dyslexia. It is not clear, however, if the very nature of the deficit is visual or verbal and, importantly, if it affects spelling skills as well. The current study investigated VAS by means of forced choice tasks with letters and symbols in a sample of third and fourth graders with age-adequate reading and spelling skills (n = 43), a typical dyslexia profile with combined reading and spelling deficits (n = 26) and isolated spelling deficits (n = 32). The task was devised to contain low phonological short-term memory load and to overcome the limitations of oral reports. Notably, eye-movements were monitored to control that children fixated the center of the display when stimuli were presented. Results yielded no main effect of group as well as no group-related interactions, thus showing that children with dyslexia and isolated spelling deficits did not manifest a VAS deficit for letters or symbols once certain methodological aspects were controlled for. The present results could not replicate previous evidence for the involvement of VAS in reading and dyslexia.

Enhancing reading performance through action video games: the role of visual attention span

Recent studies reported that Action Video Game-AVG training improves not only certain attentional components, but also reading fluency in children with dyslexia. We aimed to investigate the shared attentional components of AVG playing and reading, by studying whether the Visual Attention (VA) span, a component of visual attention that has previously been linked to both reading development and dyslexia, is improved in frequent players of AVGs. Thirty-six French fluent adult readers, matched on chronological age and text reading proficiency, composed two groups: frequent AVG players and non-players. Participants performed behavioural tasks measuring the VA span, and a challenging reading task (reading of briefly presented pseudo-words). AVG players performed better on both tasks and performance on these tasks was correlated. These results further support the transfer of the attentional benefits of playing AVGs to reading, and indicate that the VA span could be a core component mediating this transfer. The correlation between VA span and pseudo-word reading also supports the involvement of VA span even in adult reading. Future studies could combine VA span training with defining features of AVGs, in order to build a new generation of remediation software.

Do dyslexic individuals present a reduced visual attention span? Evidence from visual recognition tasks of non-verbal multi-character arrays

A controversy has recently developed regarding the hypothesis that developmental dyslexia may be caused, in some cases, by a reduced visual attention span (VAS). To examine this hypothesis, independent of phonological abilities, researchers tested the ability of dyslexic participants to recognize arrays of unfamiliar visual characters. Employing this test, findings were rather equivocal: dyslexic participants exhibited poor performance in some studies but normal performance in others. The present study explored four methodological differences revealed between the two sets of studies that might underlie their conflicting results. Specifically, in two experiments we examined whether a VAS deficit is (a) specific to recognition of multi-character arrays as wholes rather than of individual characters within arrays, (b) specific to characters' position within arrays rather than to characters' identity, or revealed only under a higher attention load due to (c) low-discriminable characters, and/or (d) characters' short exposure. Furthermore, in this study we examined whether pure dyslexic participants who do not have attention disorder exhibit a reduced VAS. Although comorbidity of dyslexia and attention disorder is common and the ability to sustain attention for a long time plays a major rule in the visual recognition task, the presence of attention disorder was neither evaluated nor ruled out in previous studies. Findings did not reveal any differences between the performance of dyslexic and control participants on eight versions of the visual recognition task. These findings suggest that pure dyslexic individuals do not present a reduced visual attention span.

Relationships between Categorical Perception of Phonemes, Phoneme Awareness, and Visual Attention Span in Developmental Dyslexia

We tested the hypothesis that the categorical perception deficit of speech sounds in developmental dyslexia is related to phoneme awareness skills, whereas a visual attention (VA) span deficit constitutes an independent deficit. Phoneme awareness tasks, VA span tasks and categorical perception tasks of phoneme identification and discrimination using a d/t voicing continuum were administered to 63 dyslexic children and 63 control children matched on chronological age. Results showed significant differences in categorical perception between the dyslexic and control children. Significant correlations were found between categorical perception skills, phoneme awareness and reading. Although VA span correlated with reading, no significant correlations were found between either categorical perception or phoneme awareness and VA span. Mediation analyses performed on the whole dyslexic sample suggested that the effect of categorical perception on reading might be mediated by phoneme awareness. This relationship was independent of the participants’ VA span abilities. Two groups of dyslexic children with a single phoneme awareness or a single VA span deficit were then identified. The phonologically impaired group showed lower categorical perception skills than the control group but categorical perception was similar in the VA span impaired dyslexic and control children. The overall findings suggest that the link between categorical perception, phoneme awareness and reading is independent from VA span skills. These findings provide new insights on the heterogeneity of developmental dyslexia. They suggest that phonological processes and VA span independently affect reading acquisition.

Orthographic processing deficits in developmental dyslexia: Beyond the ventral visual stream

Fast effortless reading has been associated with the Visual Word Form Area (VWFA), a region in the ventral visual stream that specializes in the recognition of letter strings. Several neuroimaging studies of dyslexia revealed an underactivation of this region. However, most of these studies used reading tasks and/or were carried out on adults. Given that fluent reading is severely impaired in dyslexics, any underactivation might simply reflect a well-established reading deficit in impaired readers and could be the consequence rather than the cause of dyslexia. Here, we designed a task that does not rely on reading per se but that tapped early visual orthographic processing that forms the basis of reading. Dyslexic children aged 8-12years and age-matched controls were asked to search for letters, digits, and symbols in 5-element strings (Experiment 1). This novel task was complemented by a classic task known to activate the VWFA, namely the passive viewing of pseudowords and falsefonts (Experiment 2). We found that in addition to significant group differences in the VWFA, dyslexic children showed a significant underactivation of the middle occipital gyrus (MOG) relative to the control group. Several areas in the MOG are known for their engagement in visuospatial processing, and it has been proposed that the MOG is necessary for ordering the symbols in unfamiliar strings. Our results suggest that the VWFA deficit might be secondary to an impairment of visuospatial processing in the MOG. We argue that efficient processing in MOG in the course of reading acquisition is critical for the development of effortless fast visual word recognition in the VWFA.

A Componential Analysis of Visual Attention in Children With ADHD

OBJECTIVE

Inattentive behaviour is a defining characteristic of ADHD. Researchers have wondered about the nature of the attentional deficit underlying these symptoms. The primary purpose of the current study was to examine this attentional deficit using a novel paradigm based upon the Theory of Visual Attention (TVA).

METHOD

The TVA paradigm enabled a componential analysis of visual attention through the use of a mathematical model to estimate parameters relating to attentional selectivity and capacity. Children's ability to sustain attention was also assessed using the Sustained Attention to Response Task. The sample included a comparison between 25 children with ADHD and 25 control children aged 9-13.

RESULTS

Children with ADHD had significantly impaired sustained attention and visual processing speed but intact attentional selectivity, perceptual threshold and visual short-term memory capacity.

CONCLUSION

The results of this study lend support to the notion of differential impairment of attentional functions in children with ADHD.

An Analysis of Reading Skill Development using E-Z Reader

Previously reported simulations using the E-Z Reader model of eye-movement control suggest that the patterns of eye movements observed with children versus adult readers reflect differences in lexical processing proficiency (Reichle et al., 2013). However, these simulations fail to specify precisely what aspect(s) of lexical processing (e.g., orthographic processing) account for the concurrent changes in eye movements and reading skill. To examine this issue, the E-Z Reader model was first used to simulate the aggregate eye-movement data from 15 adults and 75 children to replicate the finding that gross differences in reading skill can be accounted for by differences in lexical processing proficiency. The model was then used to simulate the eye-movement data of individual children so that the best-fitting lexical-processing parameters could be correlated to measures of orthographic knowledge, phonological-processing skill, sentence comprehension, and general intelligence. These analyses suggest that orthographic knowledge accounts for variance in the eye-movement measures that is observed with between-individual differences in reading skill. The theoretical implications of this conclusion will be discussed in relation to computational models of reading and our understanding of reading skill development.

Clinical TVA-based studies: a general review

In combination with whole report and partial report tasks, the theory of visual attention (TVA) can be used to estimate individual differences in five basic attentional parameters: the visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top-down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a) neglect and simultanagnosia, (b) reading disturbances, (c) aging and neurodegenerative diseases, and most recently (d) neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method's most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research.

TVA-based assessment of visual attentional functions in developmental dyslexia

There is an ongoing debate whether an impairment of visual attentional functions constitutes an additional or even an isolated deficit of developmental dyslexia (DD). Especially performance in tasks that require the processing of multiple visual elements in parallel has been reported to be impaired in DD. We review studies that used parameter-based assessment for identifying and quantifying impaired aspect(s) of visual attention that underlie this multi-element processing deficit in DD. These studies used the mathematical framework provided by the "theory of visual attention" (Bundesen, 1990) to derive quantitative measures of general attentional resources and attentional weighting aspects on the basis of behavioral performance in whole- and partial-report tasks. Based on parameter estimates in children and adults with DD, the reviewed studies support a slowed perceptual processing speed as an underlying primary deficit in DD. Moreover, a reduction in visual short term memory storage capacity seems to present a modulating component, contributing to difficulties in written language processing. Furthermore, comparing the spatial distributions of attentional weights in children and adults suggests that having limited reading and writing skills might impair the development of a slight leftward bias, that is typical for unimpaired adult readers.

The phonological and visual basis of developmental dyslexia in Brazilian Portuguese reading children

Evidence from opaque languages suggests that visual attention processing abilities in addition to phonological skills may act as cognitive underpinnings of developmental dyslexia. We explored the role of these two cognitive abilities on reading fluency in Brazilian Portuguese, a more transparent orthography than French or English. Sixty-six children with developmental dyslexia and normal Brazilian Portuguese children participated. They were administered three tasks of phonological skills (phoneme identification, phoneme, and syllable blending) and three visual tasks (a letter global report task and two non-verbal tasks of visual closure and visual constancy). Results show that Brazilian Portuguese children with developmental dyslexia are impaired not only in phonological processing but further in visual processing. The phonological and visual processing abilities significantly and independently contribute to reading fluency in the whole population. Last, different cognitively homogeneous subtypes can be identified in the Brazilian Portuguese population of children with developmental dyslexia. Two subsets of children with developmental dyslexia were identified as having a single cognitive disorder, phonological or visual; another group exhibited a double deficit and a few children showed no visual or phonological disorder. Thus the current findings extend previous data from more opaque orthographies as French and English, in showing the importance of investigating visual processing skills in addition to phonological skills in children with developmental dyslexia whatever their language orthography transparency.

Visual processing of multiple elements in the dyslexic brain: evidence for a superior parietal dysfunction

The visual attention (VA) span deficit hypothesis of developmental dyslexia posits that impaired multiple element processing can be responsible for poor reading outcomes. In VA span impaired dyslexic children, poor performance on letter report tasks is associated with reduced parietal activations for multiple letter processing. While this hints towards a non-specific, attention-based dysfunction, it is still unclear whether reduced parietal activity generalizes to other types of stimuli. Furthermore, putative links between reduced parietal activity and reduced ventral occipito-temporal (vOT) in dyslexia have yet to be explored. Using functional magnetic resonance imaging, we measured brain activity in 12 VA span impaired dyslexic adults and 12 adult skilled readers while they carried out a categorization task on single or multiple alphanumeric or non-alphanumeric characters. While healthy readers activated parietal areas more strongly for multiple than single element processing (right-sided for alphanumeric and bilateral for non-alphanumeric), similar stronger multiple element right parietal activations were absent for dyslexic participants. Contrasts between skilled and dyslexic readers revealed significantly reduced right superior parietal lobule (SPL) activity for dyslexic readers regardless of stimuli type. Using a priori anatomically defined regions of interest, we showed that neural activity was reduced for dyslexic participants in both SPL and vOT bilaterally. Finally, we used multiple regressions to test whether SPL activity was related to vOT activity in each group. In the left hemisphere, SPL activity covaried with vOT activity for both normal and dyslexic readers. In contrast, in the right hemisphere, SPL activity covaried with vOT activity only for dyslexic readers. These results bring critical support to the VA interpretation of the VA Span deficit. In addition, they offer a new insight on how deficits in automatic vOT based word recognition could arise in developmental dyslexia.

New insights on developmental dyslexia subtypes: heterogeneity of mixed reading profiles

We examined whether classifications based on reading performance are relevant to identify cognitively homogeneous subgroups of dyslexic children. Each of the 71 dyslexic participants was selected to have a mixed reading profile, i.e. poor irregular word and pseudo-word reading performance (accuracy and speed). Despite their homogeneous reading profile, the participants were found to split into four distinct cognitive subgroups, characterized by a single phonological disorder, a single visual attention span disorder, a double deficit or none of these disorders. The two subgroups characterized by single and contrasted cognitive disorders were found to exhibit a very similar reading pattern but more contrasted spelling performance (quantitative analysis). A qualitative analysis of the error types produced in reading and spelling provided some cues about the participants' underlying cognitive deficit. The overall findings disqualify subtyping based on reading profiles as a classification method to identify cognitively homogeneous subgroups of dyslexic children. They rather show an opaque relationship between the cognitive underpinnings of developmental dyslexia and their behavioral manifestations in reading and spelling. Future neuroimaging and genetic studies should take this issue into account since synthesizing over cognitively heterogeneous children would entail potential pitfalls.

Evidence for deficits in the temporal attention span of poor readers

Background

While poor reading is often associated with phonological deficits, many studies suggest that visual processing might also be impaired. In particular, recent research has indicated that poor readers show impaired spatial visual attention spans in partial and whole report tasks. Given the similarities between competition-based accounts for reduced visual attention span and similar explanations for impairments in sequential object processing, the present work examined whether poor readers show deficits in their “temporal attention span” – that is, their ability to rapidly and accurately process sequences of consecutive target items.

Methodology/Principal Findings

Poor and normal readers monitored a sequential stream of visual items for two (TT condition) or three (TTT condition) consecutive target digits. Target identification was examined using both unconditional and conditional measures of accuracy in order to gauge the overall likelihood of identifying a target and the likelihood of identifying a target given successful identification of previous items. Compared to normal readers, poor readers showed small but consistent deficits in identification across targets whether unconditional or conditional accuracy was used. Additionally, in the TTT condition, final-target conditional accuracy was poorer than unconditional accuracy, particularly for poor readers, suggesting a substantial cost arising from processing the previous two targets that was not present in normal readers.

Conclusions/Significance

Mirroring the differences found between poor and normal readers in spatial visual attention span, the present findings suggest two principal differences between the temporal attention spans of poor and normal readers. First, the consistent pattern of reduced performance across targets suggests increased competition amongst items within the same span for poor readers. Second, the steeper decline in final target performance amongst poor readers in the TTT condition suggests a reduction in the extent of their temporal attention span.

Intervention for a multi-character processing deficit in a Greek-speaking child with surface dyslexia

A case study with a 12-year-old boy, R.F., who was a monolingual speaker of Greek is reported. R.F. showed slow word reading and a difficulty in spelling irregular words but not nonwords. Assessments revealed that R.F. did not appear to have a phonological deficit, but indicated impaired multicharacter processing ability for visually presented letter arrays. On the basis of previous research linking multicharacter processing and reading we developed an intervention aimed at improving R.F.'s ability to report letter arrays of increasing length. Following a 9-week programme, improvement was observed, and investigation of R.F.'s reading revealed gains in single word reading speed and accuracy. The findings support the significance of intervention studies for testing hypotheses regarding causal relationships among cognitive processes and the notion of specific profiles of developmental dyslexia/dysgraphia in both opaque and transparent orthographies.

Developmental dyslexia: exploring how much phonological and visual attention span disorders are linked to simultaneous auditory processing deficits

The simultaneous auditory processing skills of 17 dyslexic children and 17 skilled readers were measured using a dichotic listening task. Results showed that the dyslexic children exhibited difficulties reporting syllabic material when presented simultaneously. As a measure of simultaneous visual processing, visual attention span skills were assessed in the dyslexic children. We presented the dyslexic children with a phonological short-term memory task and a phonemic awareness task to quantify their phonological skills. Visual attention spans correlated positively with individual scores obtained on the dichotic listening task while phonological skills did not correlate with either dichotic scores or visual attention span measures. Moreover, all the dyslexic children with a dichotic listening deficit showed a simultaneous visual processing deficit, and a substantial number of dyslexic children exhibited phonological processing deficits whether or not they exhibited low dichotic listening scores. These findings suggest that processing simultaneous auditory stimuli may be impaired in dyslexic children regardless of phonological processing difficulties and be linked to similar problems in the visual modality.

The role of visual processing speed in reading speed development

A steady increase in reading speed is the hallmark of normal reading acquisition. However, little is known of the influence of visual attention capacity on children's reading speed. The number of distinct visual elements that can be simultaneously processed at a glance (dubbed the visual attention span), predicts single-word reading speed in both normal reading and dyslexic children. However, the exact processes that account for the relationship between the visual attention span and reading speed remain to be specified. We used the Theory of Visual Attention to estimate visual processing speed and visual short-term memory capacity from a multiple letter report task in eight and nine year old children. The visual attention span and text reading speed were also assessed. Results showed that visual processing speed and visual short term memory capacity predicted the visual attention span. Furthermore, visual processing speed predicted reading speed, but visual short term memory capacity did not. Finally, the visual attention span mediated the effect of visual processing speed on reading speed. These results suggest that visual attention capacity could constrain reading speed in elementary school children.

Distinct neural signatures of cognitive subtypes of dyslexia with and without phonological deficits

Developmental dyslexia can be distinguished as different cognitive subtypes with and without phonological deficits. However, despite some general agreement on the neurobiological basis of dyslexia, the neurofunctional mechanisms underlying these cognitive subtypes remain to be identified. The present BOLD fMRI study thus aimed at investigating by which distinct and/or shared neural activation patterns dyslexia subtypes are characterized. German dyslexic fourth graders with and without deficits in phonological awareness and age-matched normal readers performed a phonological decision task: does the auditory word contain the phoneme/a/? Both dyslexic subtypes showed increased activation in the right cerebellum (Lobule IV) compared to controls. Subtype-specific increased activation was systematically found for the phonological dyslexics as compared to those without this deficit and controls in the left inferior frontal gyrus (area 44: phonological segmentation), the left SMA (area 6), the left precentral gyrus (area 6) and the right insula. Non-phonological dyslexics revealed subtype-specific increased activation in the left supramarginal gyrus (area PFcm; phonological storage) and angular gyrus (area PGp). The study thus provides the first direct evidence for the neurobiological grounding of dyslexia subtypes. Moreover, the data contribute to a better understanding of the frequently encountered heterogeneous neuroimaging results in the field of dyslexia.

Effect of orthographic processes on letter identity and letter-position encoding in dyslexic children

The ability to identify letters and encode their position is a crucial step of the word recognition process. However and despite their word identification problem, the ability of dyslexic children to encode letter identity and letter-position within strings was not systematically investigated. This study aimed at filling this gap and further explored how letter identity and letter-position encoding is modulated by letter context in developmental dyslexia. For this purpose, a letter-string comparison task was administered to French dyslexic children and two chronological age (CA) and reading age (RA)-matched control groups. Children had to judge whether two successively and briefly presented four-letter strings were identical or different. Letter-position and letter identity were manipulated through the transposition (e.g., RTGM vs. RMGT) or substitution of two letters (e.g., TSHF vs. TGHD). Non-words, pseudo-words, and words were used as stimuli to investigate sub-lexical and lexical effects on letter encoding. Dyslexic children showed both substitution and transposition detection problems relative to CA-controls. A substitution advantage over transpositions was only found for words in dyslexic children whereas it extended to pseudo-words in RA-controls and to all type of items in CA-controls. Letters were better identified in the dyslexic group when belonging to orthographically familiar strings. Letter-position encoding was very impaired in dyslexic children who did not show any word context effect in contrast to CA-controls. Overall, the current findings point to a strong letter identity and letter-position encoding disorder in developmental dyslexia.

Impaired letter-string processing in developmental dyslexia: what visual-to-phonology code mapping disorder?

Poor parallel letter-string processing in developmental dyslexia was taken as evidence of poor visual attention (VA) span, that is, a limitation of visual attentional resources that affects multi-character processing. However, the use of letter stimuli in oral report tasks was challenged on its capacity to highlight a VA span disorder. In particular, report of poor letter/digit-string processing but preserved symbol-string processing was viewed as evidence of poor visual-to-phonology code mapping, in line with the phonological theory of developmental dyslexia. We assessed here the visual-to-phonological-code mapping disorder hypothesis. In Experiment 1, letter-string, digit-string and colour-string processing was assessed to disentangle a phonological versus visual familiarity account of the letter/digit versus symbol dissociation. Against a visual-to-phonological-code mapping disorder but in support of a familiarity account, results showed poor letter/digit-string processing but preserved colour-string processing in dyslexic children. In Experiment 2, two tasks of letter-string report were used, one of which was performed simultaneously to a high-taxing phonological task. Results show that dyslexic children are similarly impaired in letter-string report whether a concurrent phonological task is simultaneously performed or not. Taken together, these results provide strong evidence against a phonological account of poor letter-string processing in developmental dyslexia.

Neural dissociation of phonological and visual attention span disorders in developmental dyslexia: FMRI evidence from two case reports

A dissociation between phonological and visual attention (VA) span disorders has been reported in dyslexic children. This study investigates whether this cognitively-based dissociation has a neurobiological counterpart through the investigation of two cases of developmental dyslexia. LL showed a phonological disorder but preserved VA span whereas FG exhibited the reverse pattern. During a phonological rhyme judgement task, LL showed decreased activation of the left inferior frontal gyrus whereas this region was activated at the level of the controls in FG. Conversely, during a visual categorization task, FG demonstrated decreased activation of the parietal lobules whereas these regions were activated in LL as in the controls. These contrasted patterns of brain activation thus mirror the cognitive disorders' dissociation. These findings provide the first evidence for an association between distinct brain mechanisms and distinct cognitive deficits in developmental dyslexia, emphasizing the importance of taking into account the heterogeneity of the reading disorder.