Achievement Gap in Reading Is Present as Early as First Grade and Persists through Adolescence

Prevalence of undiagnosed dyslexia in African-American primary school children

Dyslexia is among the most common neurodevelopmental disorders in children, yet despite its high prevalence all too frequently goes undiagnosed. Consequently dyslexic children all too often fail to receive effective reading interventions. Here we report our findings from a study using a teacher completed evidence-based dyslexia screener to first screen then test predominantly African-American children in grades kindergarten through second grade in two inner city public charter schools in New Orleans. Almost half (49.2%) of the children screened as at risk for dyslexia and of these the majority were found to be dyslexic on more detailed testing. Our results suggest that large numbers of African-American students with dyslexia may be overlooked in schools.

Responding to parental concern about children's reading

Objectives

This study explored if parents are accurate in their reading concerns, with implications for paediatric practice.

Methods

Parents of school-aged children in 34 schools in Ontario, Canada responded to a questionnaire about their children's academic development (27% response), and their children participated in standardized, norm-referenced tests of word reading and an oral sentence recall task. Parental concern status was retrospectively cross-referenced with reading difficulty status (<25th percentile on the word reading tests) for grade 2 children with complete data (n = 294); diagnostic accuracy was evaluated. Demographic and reading-related characteristics of children whose parents' concern did not match their reading difficulty status were explored.

Results

Approximately 22% of parents endorsed concern, while 18.5% of children had word reading difficulty. Parental concern status accurately corresponded with reading difficulty status in 81% of cases (95% CI: 76% to 85%). Specificity was 85% (95% CI: 80% to 90%), while sensitivity was 59% (95% CI: 44% to 73%). Children of unconcerned parents rarely had word reading problems (NPV 91%; 95% CI: 88% to 94%), while children with concerned parents had word reading difficulty in 45% of cases (PPV; 95% CI: 36% to 54%). Apparent inaccuracy (i.e., mismatch between parental concern and reading difficulty status) was related to children's word reading, oral sentence recall skills, and English language learner (ELL) status, but not child age, sex, or parent education.

Conclusions

Many parents of grade 2 children endorse reading concerns. Parental concern is an overall accurate screener for word reading difficulty, although some children will be missed. Evidence-informed recommendations for responding to parental concern are provided.

Early reading at first grade predicts adult reading at age 42 in typical and dyslexic readers

Research indicates that the achievement gap in reading between typical and dyslexic readers is already evident in first grade and persists through adolescence. However, it is not known whether this reading gap persists into adult life. In this report we use an epidemiologic sample of 312 children (typical readers = 246; dyslexic readers = 66), followed longitudinally from age 5 through adulthood and examine two fundamental questions: 1) Is reading level in 1st grade predictive of reading proficiency in adulthood in typical and dyslexic readers? and 2) Are the trajectories of reading development from 1st through 5th grade predictive of reading proficiency in adulthood in typical and dyslexic readers? Our findings indicate that early reading levels in 1st grade as well as the trajectory of reading development through the first five years of school were associated with reading scores in adulthood. This association was stronger for dyslexic than for typical readers, especially the latter factor. These findings indicate that the achievement gap between typical and dyslexic readers persists far beyond adolescence, in fact, into adult life.

A network approach to dyslexia: Mapping the reading network

Research on the etiology of dyslexia typically uses an approach based on a single core deficit, failing to understand how variations in combinations of factors contribute to reading development and how this combination relates to intervention outcome. To fill this gap, this study explored links between 28 cognitive, environmental, and demographic variables related to dyslexia by employing a network analysis using a large clinical database of 1,257 elementary school children. We found two highly connected subparts in the network: one comprising reading fluency and accuracy measures, and one comprising intelligence-related measures. Interestingly, phoneme awareness was functionally related to the controlled and accurate processing of letter-speech sound mappings, whereas rapid automatized naming was more functionally related to the automated convergence of visual and speech information. We found evidence for the contribution of a variety of factors to (a)typical reading development, though associated with different aspects of the reading process. As such, our results contradict prevailing claims that dyslexia is caused by a single core deficit. This study shows how the network approach to psychopathology can be used to study complex interactions within the reading network and discusses future directions for more personalized interventions.

Tracking reading skills and reading-related skills in dyslexia before (age 5) and after (ages 10-17) diagnosis

This study had three goals: to examine the stability of deficits in the phonological and lexical routes in dyslexia (group study), to determine the prevalence of dyslexia profiles (multiple-case study), and to identify the prediction of phonemic segmentation and discrimination skills before reading acquisition on future reading level. Among a group of 373 non-readers seen at age 5, 38 students were subsequently diagnosed as either consistent dyslexic readers (18 DYS) or consistent typical readers (20 TR). Their phonological and lexical reading skills were assessed at ages 10 and 17 and their phonemic segmentation and discrimination skills at age 5. In comparison with TR of the same chronological age (CA-TR), individuals with dyslexia demonstrated an impairment of the two reading routes, especially of the phonological reading route. In the comparison with younger TR (age 10) of the same reading level (RL-TR), only a deficit of the phonological route is observed. In the multiple-case study, the comparisons with CA-TR showed a prevalence of mixed profiles and very few dissociated profiles, whereas the comparison with RL-TR resulted mostly in two profiles depending on the measure: a phonological profile when accuracy was used and a delayed profile when speed was used. In addition, the correlations between early phonemic segmentation and discrimination skills (age 5) and later reading skills (age 17) were significant, and in the group of individuals with dyslexia, early phonemic segmentation skills significantly predicted these later reading skills. Phonological reading deficits are persistent and mainly caused by early phonemic impairments.

Small-Group, Emergent Literacy Intervention Under Two Implementation Models: Intent-to-Treat and Dosage Effects for Preschoolers at Risk for Reading Difficulties

Preschool-age children identified as at risk for later reading difficulties can benefit from supplemental, small-group emergent literacy intervention. As such interventions become commercially available and marketed to preschool programs, it is important to understand their impacts when implemented by intended end users under routine conditions. In this study, we examined the effects of the Nemours BrightStart! (NBS!) intervention on children's emergent literacy skills when implemented by teachers and community aides in authentic preschool classrooms. We randomly assigned 98 classrooms to one of three conditions (NBS! teacher-implemented, NBS! community aide-implemented, or control). Children enrolled in these classrooms who met eligibility criteria and were identified as at risk via an early literacy screener (n = 281) completed pretest and posttest emergent literacy assessments; those assigned to NBS! conditions received intervention from their classroom teacher or a community aide affiliated with a local kindergarten-readiness initiative. Intent-to-treat analyses showed no significant impacts of NBS! on any outcome, and an instrumental variable, as-treated approach showed one significant intervention effect on letter writing. Consequently, we did not replicate results of prior highly controlled efficacy trials. Findings have implications for revising the NBS! theory of change, conducting dosage and as-treated analyses, and moving research-based interventions toward scale-up.

Neural synchronization and intervention in pre-readers who later on develop dyslexia

A growing number of studies has investigated temporal processing deficits in dyslexia. These studies largely focus on neural synchronization to speech. However, the importance of rise times for neural synchronization is often overlooked. Furthermore, targeted interventions, phonics-based and auditory, are being developed, but little is known about their impact. The current study investigated the impact of a 12-week tablet-based intervention. Children at risk for dyslexia received phonics-based training, either with (n = 31) or without (n = 31) auditory training, or engaged in active control training (n = 29). Additionally, neural synchronization and processing of rise times was longitudinally investigated in children with dyslexia (n = 26) and typical readers (n = 52) from pre-reading (5 years) to beginning reading age (7 years). The three time points in the longitudinal study correspond to intervention pre-test, post-test and consolidation, approximately 1 year after completing the intervention. At each time point neural synchronization was measured to sinusoidal stimuli and pulsatile stimuli with shortened rise times at syllable (4 Hz) and phoneme rates (20 Hz). Our results revealed no impact on neural synchronization at syllable and phoneme rate of the phonics-based and auditory training. However, we did reveal atypical hemispheric specialization at both syllable and phoneme rates in children with dyslexia. This was detected even before the onset of reading acquisition, pointing towards a possible causal rather than consequential mechanism in dyslexia. This study contributes to our understanding of the temporal processing deficits underlying the development of dyslexia, but also shows that the development of targeted interventions is still a work in progress.

Identifying the risk of dyslexia in bilingual children: The potential of language-dependent and language-independent tasks

This study investigates the linguistic processing and non-linguistic cognitive abilities of monolingual and bilingual children with and without reading difficulties and examines the relationship between these skills and reading. There were 72 Italian-speaking children: 18 monolingual good readers (MONO-GR, Mage = 10;4), 19 monolingual poor readers (MONO-PR, Mage = 10;3), 21 bilingual good readers (BI-GR, Mage = 10;6), and 16 bilingual poor readers (BI-PR, Mage = 10;6). All bilingual children spoke Italian as their L2. Children completed a battery of standardized Italian reading tests, language-dependent tasks: nonword repetition (NWR), sentence repetition (SR), and phonological awareness (PA), and language-independent tasks: timing anticipation, beat synchronization, inhibition control, auditory reaction time, and rapid automatized naming (RAN). Poor readers scored below good readers on the language-dependent tasks, including NWR, PA, and SR. Beat synchronization was the only language-independent task sensitive to reading ability, with poor readers showing greater variability than good readers in tapping to fast rhythms. SR was the only task influenced by language experience as bilinguals underperformed monolinguals on the task. Moreover, there were weak to moderate correlations between performance on some language-dependent tasks (NWR, PA), language-independent tasks (inhibition control, RAN), and reading measures. Performance on the experimental tasks (except for RAN) was not associated with the length of exposure to Italian. The results highlight the potential of NWR, PA, SR, and beat synchronization tasks in identifying the risk of dyslexia in bilingual populations. Future research is needed to validate these findings and to establish the tasks' diagnostic accuracy.

Reading Strategies for Children with Developmental Language Disorder

Developmental language disorder (DLD) is considered a neurodevelopmental disorder that compromises language comprehension and/or expression and constitutes a risk factor for learning to read. The aim of the present study was to analyse the reading strategies used by students with DLD to read sentences. There is evidence in the literature that, when linguistic resources are insufficient, the keyword strategy (identifying some of the words in the sentence with their own semantic content, with barely no processing of the function words) is used to read sentences. A total of 31 primary and secondary school students diagnosed with DLD were evaluated using the PEALE battery. The results reveal that students with DLD present heterogeneous profiles that are below the established reading level for their age. In addition, children with DLD and better reading skills use the keyword strategy to read sentences. In conclusion, clinical and educational implications for reading intervention in individuals with DLD are discussed.

Longitudinal relations between behavioral engagement and academic achievement: The moderating roles of socio-economic status and early achievement

This study investigated developmental trajectories of observationally coded engagement across the early elementary years and whether these trajectories were associated with children's academic achievement. Furthermore, we evaluated if these relations varied as a function of children's family socio-economic status and early reading and math skills. Data were collected from 301 children who were studied from kindergarten (Mage = 65.74 months; 49% boys) to 2nd grade. Children's behavioral engagement was observed in kindergarten, 1st, and 2nd grade. Reading and math skills were assessed via standardized tests in kindergarten and 2nd grade. Growth mixture models identified two classes of behavioral engagement: most children (87.0%) displayed relatively high behavioral engagement in the fall of kindergarten and decreased significantly across time (referred to below as high-decreasing class), and other children (13.0%) exhibited moderate behavioral engagement in the fall of kindergarten that was stable across time (referred to below as moderate-stable class). After controlling for academic skills in kindergarten and demographic variables (i.e., child age, sex, ethnicity, and family socio-economic status), children in the high-decreasing class displayed higher reading skills, but not math skills, than children in the moderate-stable class. Additional analyses revealed that differences in reading skills between the two classes were present only for children from low socio-economic status families or for children low in kindergarten reading skills. The findings suggest that economically or academically at-risk students might benefit more than their peers from high behavioral engagement.

A meta-analytic review of comprehension deficits in students with dyslexia

Beyond the established difficulties of individuals with dyslexia in word recognition and spelling, it remains unclear how severe their difficulties in comprehension are. To examine this, we performed a meta-analytic review. A random-effects model analysis of data from 76 studies revealed a large deficit in reading comprehension in individuals with dyslexia compared to their chronological-age (CA) controls (g = 1.43) and a smaller one compared to their reading-level (RL) matched controls (g = 0.64). Individuals with dyslexia also differed significantly from their CA controls in listening comprehension (g = 0.43). Results further showed significant heterogeneity in the effect sizes that was partly explained by orthographic consistency (the deficits were larger in languages with low orthographic consistency) and vocabulary matching (the deficits were larger in studies in which the groups were not matched on vocabulary). These findings suggest, first, that individuals with dyslexia experience significant difficulties in both reading and listening comprehension, but the effect sizes are smaller than those reported in the literature for word reading and spelling. Second, our findings suggest that the deficits in reading comprehension are likely a combination of deficits in both decoding and oral language skills.

K-2 principal knowledge (not leadership) matters for dyslexia intervention

Kindergarten through second-grade elementary schools that best serve students with dyslexia have principals who are knowledgeable about dyslexia and understand the best practices for providing intervention for students with dyslexia. In this study, three styles of leadership were examined to understand the implication that leadership has on intervention for dyslexia: transformational, instructional, and integrated leadership. However, many students in elementary schools have difficulty learning to read despite good leadership by the principal, with 5-20% of students being diagnosed with dyslexia. While these students need phonetic, multisensory intervention to build necessary reading skills, this study found that many principals lack knowledge of this specialized instruction. The purpose of this research was to explore variables that determine the school-based level of appropriate intervention for students with dyslexia. A questionnaire assessing leadership skills, knowledge, and beliefs about dyslexia, preparation in reading disorders and/or dyslexia received from degree programs and professional development, and services provided to students with dyslexia was given to K-2 principals serving in schools across the United States. Results indicated that regardless of leadership style, principals who have greater knowledge and more correct beliefs about dyslexia provide more appropriate school-based services for students with dyslexia. Eight detailed K-2 principal/practitioner recommendations are included based upon this key finding.

Family History Is Not Useful in Screening Children for Dyslexia

Accurate and efficient early screening is important for providing effective early intervention for dyslexic readers. While family history is often considered a contributing risk factor for dyslexia, some have suggested that it could serve as a proxy for identification of dyslexia. We examined the classification accuracy of family history as a screening measure for dyslexia using an epidemiologic sample of 398 children followed from age 5 through adulthood. Sensitivity of family history for predicting dyslexia was unacceptably low for all family member groups. Moreover, results from receiver operating characteristic curves indicate that predicting dyslexia using family history does not improve the value of using an evidence-based early screening measure alone. Together, these analyses indicate that family history is inadequate as a screening measure for dyslexia; and thus, the use of positive family history as a proxy for dyslexia is unwarranted.

Dyslexia knowledge, perceived preparedness, and professional development needs of in-service educators

The purpose of this study was to investigate New Jersey educators' dyslexia knowledge and misconceptions, professional development perceptions and needs, and perceived preparedness regarding teaching students with dyslexia. A second purpose was to investigate what factors predicted New Jersey educators' knowledge about dyslexia. A total of 705 in-service educators completed a survey about their dyslexia knowledge, perceived preparedness, and professional development perceptions. Participants had accurate overall knowledge about dyslexia, but some prevailing misconceptions were still present. The greatest predictor of dyslexia knowledge was years of experience in working with students with dyslexia. Reading specialists, educators with greater perceived preparedness and those educators who had training in multi-sensory approaches to instruction had significantly more dyslexia knowledge than other educators. Approximately half of the participants felt prepared to teach students with dyslexia and that working with students with dyslexia prepared them the most. Participants perceived that multi-sensory approaches were the most effective professional development and their undergraduate education was the least effective. Most participants were in support of further professional development on the topic of dyslexia. Implications for in-service educators' professional development and future research directions are discussed.

Brain-behavior dynamics between the left fusiform and reading

The visual word form area (VWFA) plays a significant role in the development of reading skills. However, the developmental course and anatomical properties of the VWFA have only limitedly been investigated. The aim of the current longitudinal MRI study was to investigate dynamic, bidirectional relations between reading, and the structure of the left fusiform gyrus at the early-to-advanced reading stage. More specifically, by means of bivariate correlations and a cross-lagged panel model (CLPM), the interrelations between the size of the left fusiform gyrus and reading skills (an average score of a word and pseudo-word reading task) were studied in a longitudinal cohort of 43 Flemish children (29M, 14F) with variable reading skills in grade 2 (the early stage of reading) and grade 5 (the advanced stage of reading) of primary school. Results revealed that better reading skills at grade 2 lead to a larger size of the left fusiform gyrus at grade 5, whereas there are no directional effects between the size of the left fusiform gyrus at grade 2 and reading skills at grade 5. Hence, according to our results, there is behavior-driven brain plasticity and no brain-driven reading change between the early and advanced stage of reading. Together with pre-reading brain studies showing predictive relations to later reading scores, our results suggest that the direction of brain-behavioral influences changes throughout the course of reading development.

Digital Game-Based Phonics Instruction Promotes Print Knowledge in Pre-Readers at Cognitive Risk for Dyslexia

Dyslexia is targeted most effectively when (1) interventions are provided preventively, before the onset of reading instruction, and (2) remediation programs combine letter-sound training with phoneme blending. Given the growing potential of technology in educational contexts, there has been a considerable increase of letter-sound trainings embedded in digital serious games. One such intervention is GraphoGame. Yet, current evidence on the preventive impact of GraphoGame is limited by the lack of adaptation of the original learning content to the skills of pre-readers, short training duration, and a restricted focus on explicitly trained skills. Therefore, the current study aims at investigating the impact of a preventive, and pre-reading adapted GraphoGame training (i.e., GraphoGame-Flemish, GG-FL) on explicitly trained skills and non-specifically trained phonological and language abilities. Following a large-scale screening (N = 1225), the current study included 88 pre-reading kindergarteners at cognitive risk for dyslexia who were assigned to three groups training either with GG-FL (n = 31), an active control game (n = 29), or no game (n = 28). Before and after the 12-week intervention, a variety of reading-related skills were assessed. Moreover, receptive letter knowledge and phonological awareness were measured every three weeks during the intervention period. Results revealed significantly larger improvements in the GG-FL group on explicitly trained skills, i.e., letter knowledge and word decoding, without finding transfer-effects to untrained phonological and language abilities. Our findings imply a GG-FL-driven head start on early literacy skills in at-risk children. A follow-up study should uncover the long-term impact and the ability of GG-FL to prevent actual reading failure.

Clinical profile of reading ability and reading and writing achievement of children with borderline full-scale intellectual quotient: a prospective study

BACKGROUND

Poor reading ability is one of the common causes of low academic performance. In previous studies, children with dyslexia were found to demonstrate poor academic achievement due to poor reading ability. However, the relationship between academic achievement and reading ability in children with a borderline full-scale intellectual quotient (FSIQ) is unknown. This study aimed to clarify the clinical characteristics of children with borderline FSIQ and poor reading ability, and differentiate these characteristics from those of children with higher FSIQ and poor reading ability.

METHODS

A total of 126 children (aged 6-15 years) identified as having low academic performance were enrolled. The reading ability of children was assessed through their performance on the hiragana (Japanese syllabary) reading task, while their reading and writing achievement was assessed through their reading and writing score on the Kaufman Assessment Battery for Children, Second Edition. Children were categorized into two groups based on their FSIQ score (FSIQ > 85 and 85 ≥ FSIQ ≥ 70). Reading ability in children was evaluated by referring to the linear relationship between FSIQ and the standard deviation value of reading tasks in typically developing children. A one-way analysis of variance (ANOVA) was performed to examine clinical characteristics between higher and lower FSIQ groups. Associations between reading and writing achievement, reading ability, and ages of children were assessed using Pearson's product-moment correlation coefficients for the higher and lower FSIQ groups.

RESULTS

Poorer reading and writing achievement was associated with poorer reading ability in the higher FSIQ group. Conversely, poorer reading and writing achievement and poor reading ability were associated with older age in the lower FSIQ group.

CONCLUSIONS

Poor reading and writing achievement were associated with older age, not with poor reading ability in the lower FSIQ group. Children with lower FSIQ need appropriate educational interventions based on independent assessments to further their academic achievement and reading ability. Moreover, they need more frequent evaluations of their academic achievement than do children with higher FSIQ and poor reading ability since they are more likely to be at a lower academic achievement level at an older age.

Remote learning among students with and without reading difficulties during the initial stages of the COVID-19 pandemic

This article presents the results of a survey on yet under-researched aspects of remote learning and learning difficulties in higher education during the initial stage (March - June 2020) of the COVID-19 pandemic. A total of 2182 students from University of Warsaw in Poland completed a two-part questionnaire regarding academic achievements in the academic year 2019/2020, living conditions and stress related to learning and pandemic, as well as basic demographic information, and Dyslexia Diagnosis Questionnaire (DDQ). The analyses were carried out in three sub-groups of students: who self-reported having a formal diagnosis of dyslexia (CDYS), self-reported reading difficulties, but had no formal diagnosis of dyslexia (SIDYS), and who reported no reading difficulties (CON). The results of the survey revealed that compared with the CON group, more students from CDYS and SIDYS groups did not pass at least one exam in the summer semester. CDYS and SIDYS groups experienced higher stress due to epidemiological restrictions, they had more difficulties than CON with the organisation of learning and obtaining credit during the COVID-19 pandemic. The results indicate a need for special consideration of additional support for students experiencing reading difficulties (whether or not they have a formal diagnosis).

Dyslexia in the 21st century

PURPOSE OF REVIEW

Within the past decade tremendous advances have occurred in our understanding of dyslexia.

RECENT FINDINGS

Reliable data now validate the definition of dyslexia as an unexpected difficulty in reading in an individual who has the ability to be a much better reader. That dyslexia is unexpected is now codified in US federal law (PL 115-391). Replicated studies using functional brain imaging have documented a neural signature for dyslexia. Epidemiologic, longitudinal data now demonstrate that dyslexia is highly prevalent, affecting 20% of the population, affecting boys and girls equally. These data further demonstrate that the achievement gap between dyslexic and typical readers is now evident as early as first grade and persists. Evidence-based, efficient, inexpensive screening tools now offer the possibility of universal screening to identify children at risk for dyslexia as early as first grade. Specialized schools which focus on dyslexic students provide welcoming communities, ensuring that dyslexic children will not only survive but thrive.

SUMMARY

Taken together, these findings indicate that we must act and act now to ensure that this 21st century knowledge of dyslexia is disseminated to educators, policy makers, and most of all to parents of dyslexic children.

From Schools to Scans: A Neuroeducational Approach to Comorbid Math and Reading Disabilities

We bridge two analogous concepts of comorbidity, dyslexia-dyscalculia and reading-mathematical disabilities, in neuroscience and education, respectively. We assessed the cognitive profiles of 360 individuals (mean age 25.79 ± 13.65) with disability in reading alone (RD group), mathematics alone (MD group) and both (comorbidity: MDRD group), with tests widely used in both psychoeducational and neuropsychological batteries. As expected, the MDRD group exhibited reading deficits like those shown by the RD group. The former group also exhibited deficits in quantitative reasoning like those shown by the MD group. However, other deficits related to verbal working memory and semantic memory were exclusive to the MDRD group. These findings were independent of gender, age, or socioeconomic and demographic factors. Through a systematic exhaustive review of clinical neuroimaging literature, we mapped the resulting cognitive profiles to correspondingly plausible neuroanatomical substrates of dyslexia and dyscalculia. In our resulting "probing" model, the complex set of domain-specific and domain-general impairments shown in the comorbidity of reading and mathematical disabilities are hypothesized as being related to atypical development of the left angular gyrus. The present neuroeducational approach bridges a long-standing transdisciplinary divide and contributes a step further toward improved early prediction, teaching and interventions for children and adults with combined reading and math disabilities.

Functional connectivity alterations associated with literacy difficulties in early readers

The link between literacy difficulties and brain alterations has been described in depth. Resting-state fMRI (rs-fMRI) has been successfully applied to the study of intrinsic functional connectivity (iFc) both in dyslexia and typically developing children. Most related studies have focused on the stages from late childhood into adulthood using a seed to voxel approach. Our study analyzes iFc in an early childhood sample using the multivariate pattern analysis. This facilitates a hypothesis-free analysis and the possible identification of abnormal functional connectivity patterns at a whole brain level. Thirty-four children with literacy difficulties (LD) (7.1 ± 0.69 yr.) and 30 typically developing children (TD) (7.43 ± 0.52 yr.) were selected. Functional brain connectivity was measured using an rs-fMRI acquisition. The LD group showed a higher iFc between the right middle frontal gyrus (rMFG) and the default mode network (DMN) regions, and a lower iFc between the rMFG and both the bilateral insular cortex and the supramarginal gyrus. These results are interpreted as a DMN on/off routine malfunction in the LD group, which suggests an alteration of the task control network regulating DMN activity. In the LD group, the posterior cingulate cortex also showed a lower iFc with both the middle temporal poles and the fusiform gyrus. This could be interpreted as a failure in the integration of information between brain regions that facilitate reading. Our results show that children with literacy difficulties have an altered functional connectivity in their reading and attentional networks at the beginning of the literacy acquisition. Future studies should evaluate whether or not these alterations could indicate a risk of developing dyslexia.

The Yale Outcome Study: Outcomes for Graduates with and without Dyslexia

Dyslexia is defined in recent federal legislation as an unexpected difficulty in reading for an individual who has the intelligence to be a much better reader. Despite its high prevalence (20%), there have been few studies of the experience and outcome of dyslexic students at selective 4-year colleges. We examined academic and social experiences in college and outcome in the workplace 5 or more years after graduation in Yale graduates with dyslexia compared with a matched group of Yale graduates who were typical readers. Dyslexic college graduates did not differ from typical graduates in college and the workplace. Parents of dyslexic children often ask about their child’s future. These findings should reassure those professionals (including pediatric neuropsychologists, school psychologists and pediatricians) that dyslexic students can be successful in school and go on to succeed and thrive at selective colleges.

Pre-literacy heterogeneity in Dutch-speaking kindergartners: latent profile analysis

Research demonstrated that a dyslexia diagnosis is mainly given after the most effective time for intervention has passed, referred to as the dyslexia paradox. Although some pre-reading cognitive measures have been found to be strong predictors of early literacy acquisition, i.e., phonological awareness (PA), letter knowledge (LK), and rapid automatized naming (RAN), more insight in the variability of pre-reading profiles might be of great importance for early identification of children who have an elevated risk for developing dyslexia and to provide tailor-made interventions. To address this issue, this study used a latent profile analysis (LPA) to disentangle different pre-reading profiles in a sample of 1091 Dutch-speaking kindergartners. Four profiles emerged: high performers (16.50%), average performers (40.24%), below-average performers with average IQ (25.57%), and below-average performers with below-average IQ (17.69%). These results suggested two at-risk profiles diverging in IQ, which are presumably more likely to develop dyslexia later on. Although below-average profiles differed significantly in rapid naming and IQ, no clear evidence for the double-deficit theory was found in Dutch-speaking kindergartners. Educational level and reading history of the parents appeared to be predictive for children's classification membership. Our results point towards the heterogeneity that is already present in kindergartners and the possibility to identify at-risk profiles prior to reading instruction, which may be the foundation for earlier targeted interventions. However, more extended research is needed to determine the stability of these profiles across time and across different languages.

The relationship between cognitive skills and reading comprehension of narrative and expository texts: A longitudinal study from Grade 1 to Grade 4

Following the increased emphasis on expository text in early grades, this study examined narrative and expository reading comprehension growth in a sample of children who were followed longitudinally from grades 1 to 4, with the goals of explaining potential differences in children's overall performance and growth of narrative and expository text comprehension and identifying the cognitive factors that distinctly contribute to comprehension for each text type. We hypothesized that differences in reading comprehension growth of narrative and expository texts would be explained by various cognitive factors, specifically those related to executive functions (EF; e.g., working memory, planning/organization, shifting, and inhibition). At four annual time points, children (n= 94) read, retold (Recall), and answered questions (CompQ) about expository and narrative passages. Growth curve modeling was used to explore reading comprehension development across the two types of text. On average, results showed that children scored better on reading comprehension of narrative passages than they did on expository passages across all time points. After controlling for socioeconomic status (SES), vocabulary in 1st grade predicted 4th grade comprehension scores (Recall) for both narrative and expository passages, while word reading efficiency (WRE) in 1st grade predicted 4th grade comprehension scores (CompQ) for expository passages only. Additionally, WRE was associated with the growth of expository reading comprehension: children with higher WRE showed a faster growth rate for expository CompQ. The contribution of EF to text comprehension was largely confined to expository text, although planning and organization (measured using a direct cognitive assessment) in 1st grade also predicted 4th grade comprehension scores for narrative text Recall. For expository text comprehens ion, working memory, planning and organization, shifting, and inhibition (measured using a parent rating scale), predicted reading comprehension outcomes. Critically, 1st grade shifting and inhibition not only predicted 4th grade expository text comprehension (CompQ), but also modulated its growth rate: children with stronger shifting and inhibition had faster rates of growth. Together, these findings suggest that expository reading comprehension is (1) more difficult than narrative reading comprehension and (2) is associated with unique cognitive skills.

Text segmentation ability predicts future reading efficiency in Spanish-speaking children

Can the ability to parse unspaced texts (measured by a Text Segmentation Task, TST) index and predict reading efficiency in Spanish-speaking children? A sample of 1112 children (1st to 6th grade) was assessed. Additionally, two subsamples (51 children of 4th-5th grades and 71 children of 1st grade) were followed up. Our results indicate that the TST: a) reflects the acquisition of reading over primary school grades; b) reflects the teacher's judgment about the child's reading development; c) accurately predicts oral reading efficiency one and four years later year, in the former case even after removing the contributions of the IQ and oral reading speed. These results indicate that TST can be used to both index present -and predict future- reading achievements.

Lexical-Level Predictors of Reading Comprehension in Third Grade: Is Spelling a Unique Contributor?

Purpose Considerable research effort has focused on understanding reading comprehension and reading comprehension difficulties. The purpose of this correlational study was to add to the small but growing body of literature on the role that spelling may play in reading comprehension, by investigating the full range of lexical-level literacy skills and whether spelling makes a unique contribution. This study also explored whether these relations vary with the spelling scoring metric. Method Data were collected from 63 children attending Grade 3 in a Midwestern state. In addition to measuring reading comprehension, word recognition, and vocabulary, 4 spelling scoring metrics were examined: the number of words spelled correctly, the number of correct letter sequences (CLS), and Spelling Sensitivity Scores for elements and for words. Results All spelling metrics were significantly correlated with reading comprehension. Results of hierarchical regressions showed that spelling was a significant, unique predictor of reading comprehension when the CLS metric was used. The scoring metrics were differentially related to reading comprehension. Metrics that gave credit based on orthographic precision only (number of words spelled correctly and CLS) were more highly related to reading comprehension than metrics that scored not only on orthographic accuracy but also on phonological and morphological accuracy (Spelling Sensitivity Scores for elements and for words). Conclusion These results indicate that spelling is related to reading comprehension and have theoretical and clinical implications for the use of spelling assessment. Supplemental Material https://doi.org/10.23641/asha.9947216.

Reassessing health literacy best practices to improve medication adherence among patients with dyslexia

BACKGROUND

Dyslexia is characterized as unexpected and persistent difficulty in reading. In addition to language-based deficits, evidence indicates that people with dyslexia may struggle with tasks related to memory and executive function. This discussion paper explores how these non-linguistic deficits could plausibly affect medication adherence among patients with dyslexia.

DISCUSSION

There is a dearth of original research literature exploring the intersection of dyslexia and health behaviors in the United States. The authors examine selected best practices from the field of health literacy with potential to improve medication adherence among patients with dyslexia and suggest areas for further research on the intersection of dyslexia, health literacy and medication adherence.

CONCLUSION

Dyslexia is a high-prevalence condition. Patients with dyslexia may be more likely to experience challenges when learning and implementing complex, multi-step health behaviors, such as the tasks associated with medication adherence. However, there has been no research to assess the specific needs of patients with dyslexia, or design interventions to meet those needs. Foundational research is necessary to develop a health communications framework that meets the needs of these neurodiverse patients.

Reading Disabilities in Adolescents and Adults

Purpose

Reading skills continue to develop into adolescence and adulthood. Difficulties in reading have lifelong repercussions. Many speech-language pathologists who work with older individuals in the school setting face significant issues, including those mandated by recent changes in legislation. Theoretical topics related to reading development and disorders include the variety of orthographic systems across languages and the ways in which adults who are literate in an alphabetic orthographic system experience changes to their spoken and written language processing. In addition, older readers with intellectual or developmental disabilities may benefit from the use of leveled books and the inclusion of illustrations or drawings along with text.

Method

I completed a focused literature review regarding typical reading skills, dyslexia in adolescence and adulthood, recent changes in legislation, orthography, and the use of leveled books for adolescents and adults with intellectual or developmental disabilities.

Conclusions

Further study of reading in older individuals may lead to important theoretical and clinical applications. Speech-language pathologists should keep in mind the various components of reading (such as decoding and comprehension), how these factors relate to oral language, and how they may be addressed in therapy.

Developmental trajectories of white matter structure in children with and without reading impairments

Left temporal-parietal white matter structure is consistently associated with reading abilities in children. A small number of longitudinal studies show that development of this area over time is altered in children with impaired reading. However, it remains unclear how brain developmental patterns relate to specific reading skills such as fluency, which is a critical part of reading comprehension. Here, we examined white matter development trajectories in children with dysfluent reading (20 dysfluent and inaccurate readers, 36 dysfluent and accurate readers) compared to non-impaired readers (n = 14) over 18 months. We found typical age-related increases of fractional anisotropy (FA) in bilateral temporal-parietal areas in non-impaired readers, but a lack of similar changes in dysfluent readers. We also found steeper decreases of mean diffusivity (MD) in the right corona radiata and left uncinate fasciculus in dysfluent inaccurate readers compared to dysfluent accurate readers. Changes in diffusion parameters were correlated with changes in reading scores over time. These results suggest delayed white matter development in dysfluent readers, and show maturational differences between children with different types of reading impairment. Overall, these results highlight the importance of considering developmental trajectories, and demonstrate that the window of plasticity may be different for different children.

Language development and disorders: Possible genes and environment interactions

Language development requires both basic cognitive mechanisms for learning language and a rich social context from which learning takes off. Disruptions in learning mechanisms, processing abilities, and/or social interactions increase the risks associated with social exclusion or developmental delays. Given the complexity of language processes, a multilevel approach is proposed where both cognitive mechanisms, genetic and environmental factors need to be probed together with their possible interactions. Here we review and discuss such interplay between environment and genetic predispositions in understanding language disorders, with a particular focus on a possible endophenotype, the ability for statistical sequential learning.

Identifying atypical change at the individual level from childhood to adolescence

Identifying change at the individual level is an important goal for researchers, educators, and clinicians. We present a set of statistical procedures for identifying individuals who depart from a normative change. Using Latent Change Scores models (LCS), we illustrate how the Individual Likelihood computed from a statistical model for change (IL) and from an alternative unrestricted model (ILsat) can be used to identify atypical trajectories in situations with several measurement occasions. Using LCS and linear regression, we also show how the observed and latent change residuals can be used to identify atypical individual change between 2 measurement occasions. We apply these methods to a measure of general verbal ability (from WISC-R), from a large sample of individuals assessed every 2 years from Grade 1 to 9. We demonstrate the efficiency of these techniques, illustrate their use to identify individual change in longitudinal data, and discuss potential applications in developmental research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Early Identification of Dyslexia: Understanding the Issues

Purpose

The purpose of this tutorial is to provide an overview of the benefits and challenges associated with the early identification of dyslexia.

Method

The literature on the early identification of dyslexia is reviewed. Theoretical arguments and research evidence are summarized. An overview of response to intervention as a method of early identification is provided, and the benefits and challenges associated with it are discussed. Finally, the role of speech-language pathologists in the early identification process is addressed.

Conclusions

Early identification of dyslexia is crucial to ensure that children are able to maximize their educational potential, and speech-language pathologists are well placed to play a role in this process. However, early identification alone is not sufficient—difficulties with reading may persist or become apparent later in schooling. Therefore, continuing progress monitoring and access to suitable intervention programs are essential.

Dyslexia as a Neurodevelopmental Disorder and What Makes It Different from a Chess Disorder

The convenience of referring to dyslexia as a neurodevelopmental disorder has been repeatedly brought into question. In this opinion article, we argue in favor of the current diagnosis of dyslexia based on the criteria of harm and dysfunction. We discuss the favorable clinical and educational outcomes of a neuroscience-informed approach of dyslexia as a disorder. Furthermore, we discuss insights derived from neuroimaging studies and their importance to address problems related to developmental dyslexia.

Predictors for grade 6 reading in children at familial risk of dyslexia

The present study investigates whether grade 6 reading outcomes, reading fluency, and reading comprehension can be predicted by grade 3 reading fluency, familial risk of dyslexia (FR), and grade 3 reading related skills: rapid automatized naming (RAN), phonological awareness (PA), and vocabulary. In a sample of 150 children, of whom 83 had a parent with dyslexia, correlation and regression analyses were performed. FR, measured on a continuous scale, was by itself related to all outcomes. However, FR did not explain any variance on top of grade 3 reading fluency. Grade 3 reading fluency strongly predicted grade 6 reading fluency and was also related to reading comprehension. RAN improved the prediction of grade 6 reading fluency, though the additional explained variance was small. Vocabulary and PA fully explained the variance that grade 3 reading fluency explained in grade 6 reading comprehension. Vocabulary explained a substantial amount of variance in grade 6 reading comprehension making it an interesting clinical target. As we used continuous measures of reading fluency and FR, our findings are not biased by distinct diagnostic criteria.

L1 and L2 reading skills in Dutch adolescents with a familial risk of dyslexia

BACKGROUND

The present study investigated differences in reading and spelling outcomes in Dutch and English as a second language (ESL) in adolescents with a high familial risk of dyslexia, of whom some have developed dyslexia (HRDys) while others have not (HRnonDys), in comparison to a low familial risk control group without dyslexia (LRnonDys). This allowed us to investigate the persistence of dyslexia in the first language (L1) and the effect of dyslexia on the second language (L2), which has, in this case, a lower orthographic transparency. Furthermore, the inclusion of the HRnonDys group allowed us to investigate the continuity of the familial risk of dyslexia, as previous studies observed that the HRnonDys group often scores in between the HRDys and LRnonDys group, and whether these readers without reading deficits in Dutch, have more reading difficulties in ESL.

METHODS

The data of three groups of adolescents were analyzed; 27 LRnonDys, 25 HRdys 25 HRnonDys. The mean age was 14;1 years; months, and 37 were male. All were native speakers of Dutch, attended regular secondary education (grade 7-10), and were non-native speakers of English. Using MANOVA the groups were compared on Dutch and English word reading fluency (WRF), spelling and vocabulary, Dutch pseudoword and loanword reading fluency, phonological awareness (PA), rapid automatized naming (RAN), and verbal short term and working memory. A repeated measures ANOVA was used to compare English and Dutch WRF, spelling and vocabulary directly within the three groups.

RESULTS

The analyses revealed that the HRDys group had a deficit in both reading and spelling in Dutch and ESL. They also performed poorer than the LRnonDys group on all other measures. Effect sizes were especially large for pseudoword reading and the reaction times during the PA task. The HRnonDys group scored generally poorer than the LRnonDys group but this difference was only significant for Dutch pseudoword reading, PA reaction times and verbal short term memory. In general the HRDys and HRnonDys group scored similar in Dutch and English, except for English WRF where the HRDys group scored slightly better than expected based on their Dutch WRF.

DISCUSSION

There was a high persistence of dyslexia. Adolescents with dyslexia had large impairments in reading and spelling, and reading related measures, both in Dutch and ESL. Despite high inter-individual differences, an overall three-step pattern was observed. Adolescents in the HRnonDys group scored in between the HRDys and LRnonDys group, supporting the polygenetic origin of dyslexia and the continuity of the familial risk of dyslexia. The lower orthographic transparency did not have a negative effect on L2 reading, spelling and vocabulary, both in the HRnonDys and HRDys group. The latter group performed slightly better than expected in L2, which may be a result of the massive exposure to English and high motivation to use English by adolescents.

Does the late positive component reflect successful reading acquisition? A longitudinal ERP study

Developmental dyslexia is a reading disorder that is associated with deficits in phonological processing, where the exact neural basis for those processing deficits remains unclear. In particular, disagreement exists whether degraded phonological representations or an impaired access to the phonological representations causes these deficits. To investigate this question and to trace changes in neurophysiology during the process of reading acquisition, we designed a longitudinal study with event related potentials (ERPs) in children between kindergarten and second grade. We used an explicit word processing task to elicit the late positive component (LPC), which has been shown to reflect phonological processing. A brain-wide analysis of the LPC with an electrode-wise application of mixed effects models showed significantly attenuated amplitudes in the left temporo-parietal region in dyslexic children. Since these differences were only present in the word and not in the picture (i.e. control) condition, the attenuated amplitudes might reflect impaired access to the phonological representations of words. This was further confirmed by the longitudinal development, which showed a rapid increase in amplitude at the beginning of reading instruction and a decrease with continuing automatization, possibly pointing to a progression from grapheme-phoneme parsing to whole word reading. Our longitudinal study provides the first evidence that it is possible to detect neurophysiological differences in the LPC between children with dyslexia and control children in both preliterate and very early stages of reading acquisition, providing new insights about the neurophysiological development and a potential marker of later reading problems.

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First longitudinal study of the late positive component (LPC)

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Left temporo-parietal LPC differs between control and dyslexic children.

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LPC increase at reading acquisition and decrease with automatization in typical readers.

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Dyslexic children do not show this neurophysiological course of development.

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Findings might indicate an impaired access to phonological representations.

Neurobiological Bases of Reading Disorder Part II: The Importance of Developmental Considerations in Typical and Atypical Reading

Decoding-based reading disorder (RD; aka developmental dyslexia) is one of the most common neurodevelopmental disorders, affecting approximately 5-10% of school-aged children across languages. Even though neuroimaging studies suggest an impairment of the left reading network in RD, the onset of this deficit and its developmental course, which may include constancy and change, is largely unknown. There is now growing evidence that the recruitment of brain networks underlying perceptual, cognitive and linguistic processes relevant to reading acquisition varies with age. These age-dependent changes may in turn impact the neurocognitive characteristics of RD observed at specific developmental stages. Here we synthesize findings from functional and structural magnetic resonance imaging (MRI) studies to increase our understanding of the developmental time course of the neural bases underlying (a)typical reading. We first provide an overview of the brain bases of typical and atypical (impaired) reading. Next we describe how the understanding of RD can be deepened through scientific attention to age effects, for example, by integrating findings from cross-sectional studies of RD at various ages. Finally, we accent findings from extant longitudinal studies that directly examine developmental reading trajectories beginning in the preliterate stage at both group and individual levels. Although science is at the very early stage of understanding developmental aspects of neural deficits in RD, evidence to date characterizes RD by atypical brain maturation. We know that reading impairment may adversely impact multiple life domains such as academic achievement and social relationships, and unfortunately, that these negative outcomes can persist and compound into adulthood. We contend that exploring the developmental trajectories of RD will contribute to a greater understanding of how neural systems support reading acquisition. Further, we propose and cite evidence that the etiology of RD can be better investigated by distinguishing primary deficits from secondary impairments unfolding along development. These exciting and modern investigatory efforts can also indirectly contribute to a centered practice of early and accurate identification and optimal intervention to support the development of foundational pre-literacy skills and fluent reading. In sum, integrating a developmental understanding into the science and practice of reading acquisition and intervention is both possible and necessary.

Longitudinal stability of pre-reading skill profiles of kindergarten children: implications for early screening and theories of reading

Research suggests that early identification of developmental dyslexia is important for mitigating the negative effects of dyslexia, including reduced educational attainment and increased socioemotional difficulties. The strongest pre-literacy predictors of dyslexia are rapid automatized naming (RAN), phonological awareness (PA), letter knowledge, and verbal short-term memory. The relationship among these constructs has been debated, and several theories have emerged to explain the unique role of each in reading ability/disability. Furthermore, the stability of identification of risk based on these measures varies widely across studies, due in part to the different cut-offs employed to designate risk. We applied a latent profile analysis technique with a diverse sample of 1215 kindergarten and pre-kindergarten students from 20 schools, to investigate whether PA, RAN, letter knowledge, and verbal short-term memory measures differentiated between homogenous profiles of performance on these measures. Six profiles of performance emerged from the data: average performers, below average performers, high performers, PA risk, RAN risk, and double-deficit risk (both PA and RAN). A latent class regression model was employed to investigate the longitudinal stability of these groups in a representative subset of children (n = 95) nearly two years later, at the end of 1st grade. Profile membership in the spring semester of pre-kindergarten or fall semester of kindergarten was significantly predictive of later reading performance, with the specific patterns of performance on the different constructs remaining stable across the years. There was a higher frequency of PA and RAN deficits in children from lower socioeconomic status (SES) backgrounds. There was no evidence for the IQ-achievement discrepancy criterion traditionally used to diagnose dyslexia. Our results support the feasibility of early identification of dyslexia risk and point to the heterogeneity of risk profiles. These findings carry important implications for improving outcomes for children with dyslexia, based on more targeted interventions.

Growth in Reading Comprehension and Verbal Ability From Grades 1 Through 9

We systematically assessed the relationships between growth of four components of verbal ability—Information, Similarities, Vocabulary, and Comprehension subtests of the Wechsler Intelligence Scale–Revised—and longitudinal growth from Grades 1 to 9 of the Woodcock–Johnson Psycho-Educational Battery Passage Comprehension subtest while controlling for Word Identification and Word Attack, using multilevel growth models on a sample of 414 children. Growth was assessed over all grades (1-9), and separately for early grades (1-5) and later grades (5-9). Over all grades, growth in Word Identification had a substantial standardized loading to Passage Comprehension, and all four verbal abilities had smaller, but significant standardized loadings to Passage Comprehension ( p < .05), with Information and Vocabulary having slightly higher loadings than Similarities and Comprehension. For early grades, results were similar to the overall results, with the exception of Vocabulary, which had a nonsignificant loading to Passage Comprehension. For later grades, Word Identification again had the largest, but substantially smaller standardized loading on Passage Comprehension and standardized loadings of all four verbal abilities were statistically significant with Vocabulary and Wechsler Intelligence Scale for Children–Revised (WISC-R) Comprehension having appreciably higher loadings than in the previous analyses. Conversation- and interaction-based intervention and instruction in oral language in general, and vocabulary in particular throughout early childhood and continuing throughout the school years, combined with evidence-based instruction that systematically develops the skills of phonologic awareness, decoding, word reading, fluency, and comprehension in school, may provide a pathway to reducing the achievement gap in reading.

Reading Ability Development from Kindergarten to Junior Secondary: Latent Transition Analyses with Growth Mixture Modeling

The present study examined the reading ability development of children in the large scale Early Childhood Longitudinal Study (Kindergarten Class of 1998-99 data; Tourangeau et al., 2009) under the dynamic systems. To depict children's growth pattern, we extended the measurement part of latent transition analysis to the growth mixture model and found that the new model fitted the data well. Results also revealed that most of the children stayed in the same ability group with few cross-level changes in their classes. After adding the environmental factors as predictors, analyses showed that children receiving higher teachers' ratings, with higher socioeconomic status, and of above average poverty status, would have higher probability to transit into the higher ability group.