The neural signature of orthographic-phonological binding in successful and failing reading development

A behavioural exploration of language aptitude and experience, cognition and more using Graph Analysis

Language aptitude has recently regained interest in cognitive neuroscience. Traditional language aptitude testing included phonemic coding ability, associative memory, grammatical sensitivity and inductive language learning. Moreover, domain-general cognitive abilities are associated with individual differences in language aptitude, together with factors that have yet to be elucidated. Beyond domain-general cognition, it is also likely that aptitude and experience in domain-specific but non-linguistic fields (e.g. music or numerical processing) influence and are influenced by language aptitude. We investigated some of these relationships in a sample of 152 participants, using exploratory graph analysis, across different levels of regularisation, i.e. sensitivity. We carried out a meta cluster analysis in a second step to identify variables that are robustly grouped together. We discuss the data, as well as their meta-network groupings, at a baseline network sensitivity level, and in two analyses, one including and the other excluding dyslexic readers. Our results show a stable association between language and cognition, and the isolation of multilingual language experience, musicality and literacy. We highlight the necessity of a more comprehensive view of language and of cognition as multivariate systems.

Hemispheric dominance in reading system alters contribution to face processing lateralization across development

Face processing dominates the right hemisphere. This lateralization can be affected by co-lateralization within the same system and influence between different systems, such as neural competition from reading acquisition. Yet, how the relationship pattern changes through development remains unknown. This study examined the lateralization of core face processing and word processing in different age groups. By comparing fMRI data from 36 school-aged children and 40 young adults, we investigated whether there are age and regional effects on lateralization, and how relationships between lateralization within and between systems change across development. Our results showed significant right hemispheric lateralization in the core face system and left hemispheric lateralization in reading-related areas for both age groups when viewing faces and texts passively. While all participants showed stronger lateralization in brain regions of higher functional hierarchy when viewing faces, only adults exhibited this lateralization when viewing texts. In both age cohorts, there was intra-system co-lateralization for face processing, whereas an inter-system relationship was only found in adults. Specifically, functional lateralization of Broca's area during reading negatively predicted functional asymmetry in the FFA during face perception. This study initially provides neuroimaging evidence for the reading-induced neural competition theory from a maturational perspective in Chinese cohorts.

Neural bases of reading fluency: A systematic review and meta-analysis

Reading fluency, the ability to read quickly and accurately, is a critical marker of successful reading and is notoriously difficult to improve in reading disabled populations. Despite its importance to functional literacy, fluency is a relatively under-studied aspect of reading, and the neural correlates of reading fluency are not well understood. Here, we review the literature of the neural correlates of reading fluency as well as rapid automatized naming (RAN), a task that is robustly related to reading fluency. In a qualitative review of the neuroimaging literature, we evaluated structural and functional MRI studies of reading fluency in readers from a range of skill levels. This was followed by a quantitative activation likelihood estimate (ALE) meta-analysis of fMRI studies of reading speed and RAN measures. We anticipated that reading speed, relative to untimed reading and reading-related tasks, would harness ventral reading pathways that are thought to enable the fast, visual recognition of words. The qualitative review showed that speeded reading taps the entire canonical reading network. The meta-analysis indicated a stronger role of the ventral reading pathway in rapid reading and rapid naming. Both reviews identified regions outside the canonical reading network that contribute to reading fluency, such as the bilateral insula and superior parietal lobule. We suggest that fluent reading engages both domain-specific reading pathways as well as domain-general regions that support overall task performance and discuss future avenues of research to expand our understanding of the neural bases of fluent reading.

Learning to Read in an Intermediate Depth Orthography: The Longitudinal Role of Grapheme Sounding on Different Types of Reading Fluency

Phonological processing skills, such as phonological awareness, are known predictors of reading acquisition in alphabetic languages with varying degrees of orthographic complexity. However, the role of multi-letter-sound knowledge, an important foundation for early reading development, in supporting reading fluency development remains to be determined. This study examined whether two core foundational skills, phonemic awareness and grapheme sounding, have a predictive role in reading fluency development in an intermediate-depth orthography. The participants were 62 children learning to read in European Portuguese, and they were longitudinally assessed on phonemic awareness, complex grapheme sounding, and reading fluency (decoding, word, and text) from Grade 2 to Grade 3. The results showed that grapheme sounding predicted reading fluency development controlled for nonverbal intelligence and vocabulary, short-term verbal memory, and phonemic awareness. Grapheme sounding plays a prominent role in predicting reading fluency outcomes, whereas phonemic awareness (both accuracy and time per correct item) did not contribute to any of the three types of reading fluency. The fact that grapheme-sounding predicted reading fluency is likely due to complex grapheme-phoneme correspondences being required to achieve proficient reading. These findings provide insights into the cognitive processes underlying reading development in intermediate-depth orthographies and have implications for early literacy instruction.

Variability in auditory processing performance is associated with reading difficulties rather than with history of otitis media

The nature and cause of auditory processing deficits in dyslexic individuals have been debated for decades. Auditory processing deficits were argued to be the first step in a causal chain of difficulties, leading to difficulties in speech perception and thereby phonological processing and literacy difficulties. More recently, it has been argued that auditory processing difficulties may not be causally related to language and literacy difficulties. This study compares two groups who have phonological processing impairments for different reasons: dyslexia and a history of otitis media (OM). We compared their discrimination thresholds and response variability to chronological age- and reading age-matched controls, across three auditory processing tasks: frequency discrimination, rise-time discrimination and speech perception. Dyslexic children showed raised frequency discrimination thresholds in comparison with age-matched controls but did not differ from reading age-matched controls or individuals with a history of OM. There were no group differences on speech perception or rise-time tasks. For the dyslexic children, there was an association between phonological awareness and frequency discrimination response variability, but no association with thresholds. These findings are not consistent with a 'causal chain' explanation but could be accounted for within a multiple deficits view of literacy difficulties.

Dyslexia, the Amsterdam Way

The current aim is to illustrate our research on dyslexia conducted at the Developmental Psychology section of the Department of Psychology, University of Amsterdam, in collaboration with the nationwide IWAL institute for learning disabilities (now RID). The collaborative efforts are institutionalized in the Rudolf Berlin Center. The first series of studies aimed at furthering the understanding of dyslexia using a gamified tool based on an artificial script. Behavioral measures were augmented with diffusion modeling in one study, and indices derived from the electroencephalogram were used in others. Next, we illustrated a series of studies aiming to assess individuals who struggle with reading and spelling using similar research strategies. In one study, we used methodology derived from the machine learning literature. The third series of studies involved intervention targeting the phonics of language. These studies included a network analysis that is now rapidly gaining prominence in the psychopathology literature. Collectively, the studies demonstrate the importance of letter-speech sound mapping and word decoding in the acquisition of reading. It was demonstrated that focusing on these abilities may inform the prediction, classification, and intervention of reading difficulties and their neural underpinnings. A final section examined dyslexia, conceived as a neurobiological disorder. This analysis converged on the conclusion that recent developments in the psychopathology literature inspired by the focus on research domain criteria and network analysis might further the field by staying away from longstanding debates in the dyslexia literature (single vs. a multiple deficit, category vs. dimension, disorder vs. lack of skill).

Attentional modulation of neural sound tracking in children with and without dyslexia

Auditory selective attention forms an important foundation of children's learning by enabling the prioritisation and encoding of relevant stimuli. It may also influence reading development, which relies on metalinguistic skills including the awareness of the sound structure of spoken language. Reports of attentional impairments and speech perception difficulties in noisy environments in dyslexic readers are also suggestive of the putative contribution of auditory attention to reading development. To date, it is unclear whether non-speech selective attention and its underlying neural mechanisms are impaired in children with dyslexia and to which extent these deficits relate to individual reading and speech perception abilities in suboptimal listening conditions. In this EEG study, we assessed non-speech sustained auditory selective attention in 106 7-to-12-year-old children with and without dyslexia. Children attended to one of two tone streams, detecting occasional sequence repeats in the attended stream, and performed a speech-in-speech perception task. Results show that when children directed their attention to one stream, inter-trial-phase-coherence at the attended rate increased in fronto-central sites; this, in turn, was associated with better target detection. Behavioural and neural indices of attention did not systematically differ as a function of dyslexia diagnosis. However, behavioural indices of attention did explain individual differences in reading fluency and speech-in-speech perception abilities: both these skills were impaired in dyslexic readers. Taken together, our results show that children with dyslexia do not show group-level auditory attention deficits but these deficits may represent a risk for developing reading impairments and problems with speech perception in complex acoustic environments. RESEARCH HIGHLIGHTS: Non-speech sustained auditory selective attention modulates EEG phase coherence in children with/without dyslexia Children with dyslexia show difficulties in speech-in-speech perception Attention relates to dyslexic readers' speech-in-speech perception and reading skills Dyslexia diagnosis is not linked to behavioural/EEG indices of auditory attention.

Synesthetic Correspondence: An Overview

Intramodal and cross-modal perceptual grouping based on the spatial proximity and temporal closeness between multiple sensory stimuli, as an operational principle has built a coherent and meaningful representation of the multisensory event/object. To implement and investigate the cross-modal perceptual grouping, researchers have employed excellent paradigms of spatial/temporal ventriloquism and cross-modal dynamic capture and have revealed the conditional constraints as well as the functional facilitations among various correspondence of sensory properties, with featured behavioral evidence, computational framework as well as brain oscillation patterns. Typically, synesthetic correspondence as a special type of cross-modal correspondence can shape the efficiency and effect-size of cross-modal interaction. For example, factors such as pitch/loudness in the auditory dimension with size/brightness in the visual dimension could modulate the strength of the cross-modal temporal capture. The empirical behavioral findings, as well as psychophysical and neurophysiological evidence to address the cross-modal perceptual grouping and synesthetic correspondence, were summarized in this review. Finally, the potential applications (such as artificial synesthesia device) and how synesthetic correspondence interface with semantics (sensory linguistics), as well as the promising research questions in this field have been discussed.

Auditory attention influences trajectories of symbol-speech sound learning in children with and without dyslexia

The acquisition of letter-speech sound correspondences is a fundamental process underlying reading development, one that could be influenced by several linguistic and domain-general cognitive factors. In the current study, we mimicked the first steps of this process by examining behavioral trajectories of audiovisual associative learning in 110 7- to 12-year-old children with and without dyslexia. Children were asked to learn the associations between eight novel symbols and native speech sounds in a brief training and subsequently read words and pseudowords written in the artificial orthography. We then investigated the influence of auditory attention as one of the putative domain-general factors influencing associative learning. To this aim, we assessed children with experimental measures of auditory sustained selective attention and interference control. Our results showed shallower learning trajectories in children with dyslexia, especially during the later phases of the training blocks. Despite this, children with dyslexia performed similarly to typical readers on the post-training reading tests using the artificial orthography. Better auditory sustained selective attention and interference control skills predicted greater response accuracy during training. Sustained selective attention was also associated with the ability to apply these novel correspondences in the reading tests. Although this result has the limitations of a correlational design, it denotes that poor attentional skills may constitute a risk during the early stages of reading acquisition, when children start to learn letter-speech sound associations. Importantly, our findings underscore the importance of examining dynamics of learning in reading acquisition as well as individual differences in more domain-general attentional factors.

Combined multi-session transcranial alternating current stimulation (tACS) and language skills training improves individual gamma band activity and literacy skills in developmental dyslexia

Developmental dyslexia is characterized by the pathologically diminished ability to acquire reading and spelling skills. Accurate processing of acoustic information at the phonemic scale is crucial for successful sound-to-letter-mapping which, in turn, is elemental in reading and spelling. Altered activation patterns in the auditory cortex are thought to provide the neurophysiological basis for the inaccurate phonemic perception. Recently, transcranial electrical stimulation has been shown to be an effective method to ameliorate cortical activation patterns in the auditory cortex. In a sample of children and adolescents with dyslexia, we investigated the effect of multi-session transcranial alternating current stimulation delivered concurrently with a phonological training and in combination with a behavioral literacy skills training. Over a 5-week period the participants received 10 training sessions while gamma-tACS was administered over bilateral auditory cortex. We found that gamma-tACS shifted the peak frequency of auditory gamma oscillations reflecting a more fine-grained processing of time-critical acoustic information. This amelioration was accompanied by increased phonemic processing skills. Moreover, individuals who received gamma-tACS showed significant improvements in their spelling skills four months after the intervention. Our results demonstrate that multi-session gamma-tACS enhances the effects of a behavioral intervention and induces long-term improvement on literacy skills in dyslexia.

Fluent contextual reading is associated with greater synchronization of the visual and auditory networks, fluent reading and better speed of processing in children with dyslexia

The asynchrony theory of dyslexia postulates weaker visual (orthographical processing) and auditory (phonological processing) network synchrony in dyslexic readers. The weaker visual-auditory network synchronization is suggested to contribute to slow processing speed, which supports cognitive control, contributing to single-word reading difficulty and lower reading fluency. The current study aims to determine the neurobiological signature for this theory and to examine if prompting enhanced reading speed through deleted text is associated with a greater synchronization of functional connectivity of the visual and auditory networks in children with dyslexia and typical readers (TRs). We further aimed to determine if the change in visual-auditory connectivity prompted by deleted text is associated with reading fluency and processing speed abilities. Nineteen children with dyslexia and 21 typical readers ages 8-12 years old participated in a fMRI under two types of reading conditions: a still text condition and deleted text condition, in which letters was sequentially deleted from the screen. Effects of diagnostic group and condition on functional connectivity (FC) of visual and auditory networks were examined. Results revealed a significant overall effect of condition with a marginally significant Group × Condition interaction, such that as compared with TRs, children with dyslexia showed a significantly greater increase in visual-auditory FC between the still and deleted text conditions. Additionally, for children with dyslexia, this FC increase was significantly correlated with better reading fluency and verbal/nonverbal processing speed. These results support a relationship between the synchronization of the visual and auditory networks, fluent reading and increased speed of processing abilities in children with dyslexia, which can help guide fluency-based intervention strategies.

A prospective 5-year longitudinal study detects neurocognitive and imaging correlates of seizure remission in self-limiting Rolandic epilepsy

OBJECTIVE

Self-limiting Rolandic epilepsy (RE) is the most common epilepsy in school-age children. Seizures are generally infrequent, but cognitive, language, and motor coordination problems can significantly impact the child's life. To better understand brain structure and function changes in RE, we longitudinally assessed neurocognition, cortical thickness, and subcortical volumes.

METHODS

At baseline, we recruited 30 participants diagnosed with RE and 24-healthy controls and followed up for 4.94 ± 0.8 years when the participants with RE were in seizure remission. Measures included were as follows: T1-weighted magnetic resonance brain imaging (MRI) with FreeSurfer analysis and detailed neuropsychological assessments. MRI and neuropsychological data were compared between baseline and follow-up in seizure remission.

RESULTS

Longitudinal MRI revealed excess cortical thinning in the left-orbitofrontal (p = 0.0001) and pre-central gyrus (p = 0.044). There is a significant association (p = 0.003) between a reduction in cortical thickness in the left-orbitofrontal cluster and improved processing of filtered words. Longitudinal neuropsychology revealed significant improvements in the symptoms of developmental coordination disorder (DCD, p = 0.005) in seizure remission.

CONCLUSIONS

There is evidence for altered development of neocortical regions between active seizure state and seizure remission in RE within two clusters maximal in the left-orbitofrontal and pre-central gyrus. There is significant evidence for improvement in motor coordination between active seizures and seizure remission and suggestive evidence for a decline in fluid intelligence and gains in auditory processing.

Similarities and differences in the neural correlates of letter and speech sound integration in blind and sighted readers

Learning letter and speech sound (LS) associations is a major step in reading acquisition common for all alphabetic scripts, including Braille used by blind readers. The left superior temporal cortex (STC) plays an important role in audiovisual LS integration in sighted people, but it is still unknown what neural mechanisms are responsible for audiotactile LS integration in blind individuals. Here, we investigated the similarities and differences between LS integration in blind Braille (N = 42, age range: 9-60 y.o.) and sighted print (N = 47, age range: 9-60 y.o.) readers who acquired reading using different sensory modalities. In both groups, the STC responded to both isolated letters and isolated speech sounds, showed enhanced activation when they were presented together, and distinguished between congruent and incongruent letter and speech sound pairs. However, the direction of the congruency effect was different between the groups. Sighted subjects showed higher activity for incongruent LS pairs in the bilateral STC, similarly to previously studied typical readers of transparent orthographies. In the blind, congruent pairs resulted in an increased response in the right STC. These differences may be related to more sequential processing of Braille as compared to print reading. At the same time, behavioral efficiency in LS discrimination decisions and the congruency effect were found to be related to age and reading skill only in sighted participants, suggesting potential differences in the developmental trajectories of LS integration between blind and sighted readers.

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.

Dynamic assessment of the effectiveness of digital game-based literacy training in beginning readers: a cluster randomised controlled trial

In this article, we report on a study evaluating the effectiveness of a digital game-based learning (DGBL) tool for beginning readers of Dutch, employing active (math game) and passive (no game) control conditions. This classroom-level randomized controlled trial included 247 first graders from 16 classrooms in the Netherlands and the Dutch-speaking part of Belgium. The intervention consisted of 10 to 15 min of daily playing during school time for a period of up to 7 weeks. Our outcome measures included reading fluency, phonological skills, as well as purpose built in-game proficiency levels to measure written lexical decision and letter speech sound association. After an average of 28 playing sessions, the literacy game improved letter knowledge at a scale generalizable for all children in the classroom compared to the two control conditions. In addition to a small classroom wide benefit in terms of reading fluency, we furthermore discovered that children who scored high on phonological awareness prior to training were more fluent readers after extensive exposure to the reading game. This study is among the first to exploit game generated data for the evaluation of DGBL for literacy interventions.

Neurodevelopmental trajectories of letter and speech sound processing from preschool to the end of elementary school

Learning to read alphabetic languages starts with learning letter-speech-sound associations. How this process changes brain function during development is still largely unknown. We followed 102 children with varying reading skills in a mixed-longitudinal/cross-sectional design from the prereading stage to the end of elementary school over five time points (n = 46 with two and more time points, of which n = 16 fully-longitudinal) to investigate the neural trajectories of letter and speech sound processing using fMRI. Children were presented with letters and speech sounds visually, auditorily, and audiovisually in kindergarten (6.7yo), at the middle (7.3yo) and end of first grade (7.6yo), and in second (8.4yo) and fifth grades (11.5yo). Activation of the ventral occipitotemporal cortex for visual and audiovisual processing followed a complex trajectory, with two peaks in first and fifth grades. The superior temporal gyrus (STG) showed an inverted U-shaped trajectory for audiovisual letter processing, a development that in poor readers was attenuated in middle STG and absent in posterior STG. Finally, the trajectories for letter-speech-sound integration were modulated by reading skills and showed differing directionality in the congruency effect depending on the time point. This unprecedented study captures the development of letter processing across elementary school and its neural trajectories in children with varying reading skills.

Short-term training helps second-language learners read like native readers: An ERP study

This randomized controlled trial study aimed to examine what experience other than immersion may help adult learners read with native-like neural responses. We compared a group of 13 native Chinese English learners completing English letter-sound association training with another group of 12 completing visual symbol-sound association training and included one group of native English readers as the reference. The results showed that after three hours of training, all learners no longer showed attenuated cross-modal mismatch negativity (MMN) to English letter-sound integration as in the pretest. After six hours of training, the learners receiving English letter-sound association training showed enhanced cross-modal MMN and theta oscillations, as native English readers did. The enhanced neural responses were significantly correlated with better phonological awareness. Thus, with training specific to critical second language reading skills of appropriate dosages, adult learners can overcome the constraints of their native language background and learn to read with native-like neural responses.

Disentangling influences of dyslexia, development, and reading experience on effective brain connectivity in children

Altered brain connectivity between regions of the reading network has been associated with reading difficulties. However, it remains unclear whether connectivity differences between children with dyslexia (DYS) and those with typical reading skills (TR) are specific to reading impairments or to reading experience. In this functional MRI study, 132 children (M = 10.06 y, SD = 1.46) performed a phonological lexical decision task. We aimed to disentangle (1) disorder-specific from (2) experience-related differences in effective connectivity and to (3) characterize the development of DYS and TR. We applied dynamic causal modeling to age-matched (n_dys = 25, n_TR = 35) and reading-level-matched (n_dys = 25, n_TR = 22) groups. Developmental effects were assessed in beginning and advanced readers (TR: n_beg = 48, n_adv = 35, DYS: n_beg = 24, n_adv = 25). We show that altered feedback connectivity between the inferior parietal lobule and the visual word form area (VWFA) during print processing can be specifically attributed to reading impairments, because these alterations were found in DYS compared to both the age-matched and reading-level-matched TR. In contrast, feedforward connectivity from the VWFA to parietal and frontal regions characterized experience in TR and increased with age and reading skill. These directed connectivity findings pinpoint disorder-specific and experience-dependent alterations in the brain's reading network.

Goal-directedness enhances letter-speech sound learning and consolidation in an unknown orthography

This study examined how top-down control influenced letter-speech sound (L-SS) learning, the initial phase of learning to read. In 2020, 107 Dutch children (53 boys, M_age  = 106.845 months) learned eight L-SS correspondences, either preceded by goal-directed or implicit instructions. Symbol knowledge and artificial word-reading ability were assessed immediately after learning and on the subsequent day to examine the effect of sleep. Goal-directed children were faster and more efficient in learning a new script and had better learning outcomes compared to children who were not instructed about the goal of the task. This study demonstrates that directing children toward the goal can promote L-SS learning and consolidation, giving insights into how top-down control influences the initial phase of reading acquisition.

Differences in brain functional networks for audiovisual integration during reading between children and adults

Building robust letter-to-sound correspondences is a prerequisite for developing reading capacity. However, the neural mechanisms underlying the development of audiovisual integration for reading are largely unknown. This study used functional magnetic resonance imaging in a lexical decision task to investigate functional brain networks that support audiovisual integration during reading in developing child readers (10-12 years old) and skilled adult readers (20-28 years old). The results revealed enhanced connectivity in a prefrontal-superior temporal network (including the right medial frontal gyrus, right superior frontal gyrus, and left superior temporal gyrus) in adults relative to children, reflecting the development of attentional modulation of audiovisual integration involved in reading processing. Furthermore, the connectivity strength of this brain network was correlated with reading accuracy. Collectively, this study, for the first time, elucidates the differences in brain networks of audiovisual integration for reading between children and adults, promoting the understanding of the neurodevelopment of multisensory integration in high-level human cognition.

Multimodal intervention in 8- to 13-year-old French dyslexic readers: Study protocol for a randomized multicenter controlled crossover trial

BACKGROUND

Developmental dyslexia, a specific and long-lasting learning disorder that prevents children from becoming efficient and fluent readers, has a severe impact on academic learning and behavior and may compromise professional and social development. Most remediation studies are based on the explicit or implicit assumption that dyslexia results from a single cause related to either impaired phonological or visual-attentional processing or impaired cross-modal integration. Yet, recent studies show that dyslexia is multifactorial and that many dyslexics have underlying deficits in several domains. The originality of the current study is to test a remediation approach that trains skills in all three domains using different training methods that are tailored to an individual's cognitive profile as part of a longitudinal intervention study.

METHODS

This multicenter randomized crossover study will be conducted in three phases and will involve 120 dyslexic children between the ages of 8 and 13 years. The first phase serves as within-subject baseline period that lasts for 2 months. In this phase, all children undergo weekly speech-language therapy sessions without additional training at home (business-as-usual). During the second phase, all dyslexics receive three types of intensive interventions that last 2 month each: Phonological, visual-attentional, and cross-modal. The order of the first two interventions (phonological and visual-attentional) is swapped in two randomly assigned groups of 60 dyslexics each. This allows one to test the efficacy and additivity of each intervention (against baseline) and find out whether the order of delivery matters. During the third phase, the follow-up period, the intensive interventions are stopped, and all dyslexics will be tested after 2 months. Implementation fidelity will be assessed from the user data of the computerized intervention program and an "intention-to-treat" analysis will be performed on the children who quit the trial before the end.

DISCUSSION

The main objective of this study is to assess whether the three types of intensive intervention (phase 2) improve reading skills compared to baseline (i.e., non-intensive intervention, phase 1). The secondary objectives are to evaluate the effectiveness of each intervention and to test the effects of order of delivery on reading intervention outcomes. Reading comprehension, spelling performance and reading disorder impact of dyslexic readers are assessed immediately before and after the multimodal intervention and 2 months post-intervention.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT04028310. Registered on July 18, 2019.

The relationship between reading abilities and the left occipitotemporal sulcus: A dual perspective study

Reading activates a region within the left lateral occipitotemporal sulcus (OTS) known as the 'visual word form area' (VWFA). While several studies have investigated the impact of reading on brain structure through neuroplastic mechanisms, it has been recently suggested that individual differences in the pattern of the posterior OTS may predict reading skills in adults. In the present study, we first examined whether the structure and morphology and the anatomical connectivity of the left OTS are associated to reading ability. Second, we explored whether reading skills are predicted by the pattern of the left OTS. We found that reading skills were positively associated with increased connectivity between the left OTS and a network of reading-related regions in the left hemisphere. On the other hand, we did not observe an association between the pattern of the left OTS and reading skills. Finally, we found evidence that the morphology and the connectivity of the left OTS are correlated to its sulcal pattern.

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.

The influence of temporal asynchrony on character-speech integration in Chinese children with and without dyslexia: An ERP study

Dyslexic readers have been reported to show abnormal temporal acuity and multisensory integration deficiency. Here, we investigated the influence of temporal intervals on Chinese character-speech integration in children with and without dyslexia. Visual characters were presented synchronously to the onset of speech sounds (AV0) or before speech sound by 300 ms (AV300). Event-related potentials (ERP) evoked by congruent condition (speech sounds presented with congruent Chinese characters) and by baseline condition (speech sounds presented with Korean characters) were compared. Typically developing (TD) children exhibited congruency effect in AV0 condition, whereas dyslexic children exhibited congruency effect in AV300 condition. Moreover, congruency effect in TD children was due to enhanced neural activation to congruent trials, congruency effect in dyslexic children was contributed by neural suppression for baseline trials. These results suggested that different underlying mechanisms were involved in character-speech integration for typical and dyslexic children.

The different brain areas occupied for integrating information of hierarchical linguistic units: a study based on EEG and TMS

Human language units are hierarchical, and reading acquisition involves integrating multisensory information (typically from auditory and visual modalities) to access meaning. However, it is unclear how the brain processes and integrates language information at different linguistic units (words, phrases, and sentences) provided simultaneously in auditory and visual modalities. To address the issue, we presented participants with sequences of short Chinese sentences through auditory, visual, or combined audio-visual modalities while electroencephalographic responses were recorded. With a frequency tagging approach, we analyzed the neural representations of basic linguistic units (i.e. characters/monosyllabic words) and higher-level linguistic structures (i.e. phrases and sentences) across the 3 modalities separately. We found that audio-visual integration occurs in all linguistic units, and the brain areas involved in the integration varied across different linguistic levels. In particular, the integration of sentences activated the local left prefrontal area. Therefore, we used continuous theta-burst stimulation to verify that the left prefrontal cortex plays a vital role in the audio-visual integration of sentence information. Our findings suggest the advantage of bimodal language comprehension at hierarchical stages in language-related information processing and provide evidence for the causal role of the left prefrontal regions in processing information of audio-visual sentences.

The Functional Neuroanatomy of Reading Intervention

The present article reviews the literature on the brain mechanisms underlying reading improvements following behavioral intervention for reading disability. This includes evidence of neuroplasticity concerning functional brain activation, brain structure, and brain connectivity related to reading intervention. Consequently, the functional neuroanatomy of reading intervention is compared to the existing literature on neurocognitive models and brain abnormalities associated with reading disability. A particular focus is on the left hemisphere reading network including left occipito-temporal, temporo-parietal, and inferior frontal language regions. In addition, potential normalization/compensation mechanisms involving right hemisphere cortical regions, as well as bilateral sub-cortical and cerebellar regions are taken into account. The comparison of the brain systems associated with reading intervention and the brain systems associated with reading disability enhances our understanding of the neurobiological basis of typical and atypical reading development. All in all, however, there is a lack of sufficient evidence regarding rehabilitative brain mechanisms in reading disability, which we discuss in this review.

Altered brain network topology during speech tracking in developmental dyslexia

Developmental dyslexia is often accompanied by altered phonological processing of speech. Underlying neural changes have typically been characterized in terms of stimulus- and/or task-related responses within individual brain regions or their functional connectivity. Less is known about potential changes in the more global functional organization of brain networks. Here we recorded electroencephalography (EEG) in typical and dyslexic readers while they listened to (a) a random sequence of syllables and (b) a series of tri-syllabic real words. The network topology of the phase synchronization of evoked cortical oscillations was investigated in four frequency bands (delta, theta, alpha and beta) using minimum spanning tree graphs. We found that, compared to syllable tracking, word tracking triggered a shift toward a more integrated network topology in the theta band in both groups. Importantly, this change was significantly stronger in the dyslexic readers, who also showed increased reliance on a right frontal cluster of electrodes for word tracking. The current findings point towards an altered effect of word-level processing on the functional brain network organization that may be associated with less efficient phonological and reading skills in dyslexia.

Improving English reading fluency and comprehension for children with reading fluency disabilities

In the English language, students who read words accurately but have impairments in reading fluency are under-studied. The associated difficulties they have with comprehending text make it particularly important to delineate effective interventions for these students. Counter to suggestions that these readers need interventions focused on text reading, we examined the effects of a decoding-focused intervention. The intervention targeted decoding-related skills, including speeded training on sublexical spelling patterns. We examined the efficacy of this program for students with fluency-defined disabilities, and compared gains to those for students with accuracy-defined disabilities. In the initial phase of the program, readers with fluency-defined disabilities made greater gains in fluency, while readers with accuracy-defined disabilities made larger gains in word reading accuracy. The mean fluency score for readers with fluency-defined disabilities came within the average range across the intervention, as did reading comprehension for both groups. Readers' mastery on speeded learning of sublexical spelling patterns predicted unique variance in fluency outcomes, beyond variance accounted for by pre-test fluency and word reading accuracy. The results support intervention approaches focused on decoding-related skills for students who have fluency-defined disabilities and are consistent with theories of reading fluency that identify a role for automaticity with sublexical spelling patterns.

Atypical Relationships Between Neurofunctional Features of Print-Sound Integration and Reading Abilities in Chinese Children With Dyslexia

Conquering print-sound mappings (e.g., grapheme-phoneme correspondence rules) is vital for developing fluent reading skills. In neuroimaging research, this ability can be indexed by activation differences between audiovisual congruent against incongruent conditions in brain areas such as the left superior temporal cortex. In line with it, individuals with dyslexia have difficulty in tasks requiring print-sound processing, accompanied by a reduced neural integration. However, existing evidence is almost restricted to alphabetic languages. Whether and how multisensory processing of print and sound is impaired in Chinese dyslexia remains underexplored. In this study, we applied a passive audiovisual integration paradigm with functional magnetic resonance imaging to investigate the possible dysfunctions in processing character-sound (opaque; semantics can be automatically accessed) and pinyin-sound associations (transparent; no particular meaning can be confirmed) in Chinese dyslexic children. Unexpectedly, the dyslexic group did not show reduced neural integration compared with typically developing readers in either character or pinyin experiment. However, the results revealed atypical correlations between neural integration and different reading abilities in dyslexia. Specifically, while the neural integration in the left inferior frontal cortex in processing character-sound pairs correlated with silent reading comprehension in both children with and without dyslexia, it was associated with morphological awareness (semantic-related) in controls but with rapid naming (phonological-related) in dyslexics. This result indicates Chinese dyslexic children may not use the same grapho-semantic processing strategy as their typical peers do. As for pinyin-sound processing, while a stronger neural integration in the direction of "congruent > incongruent" in the left occipito-temporal cortex and bilateral superior temporal cortices was associated with better oral reading fluency in the control group, an opposite pattern was found in dyslexia. This finding may reflect dyslexia's dysfunctional recruitment of the regions in grapho-phonological processing, which further impedes character learning.

Longitudinal changes in cortical responses to letter-speech sound stimuli in 8-11 year-old children

While children are able to name letters fairly quickly, the automatisation of letter-speech sound mappings continues over the first years of reading development. In the current longitudinal fMRI study, we explored developmental changes in cortical responses to letters and speech sounds across 3 yearly measurements in a sample of 18 8-11 year old children. We employed a text-based recalibration paradigm in which combined exposure to text and ambiguous speech sounds shifts participants' later perception of the ambiguous sounds towards the text. Our results showed that activity of the left superior temporal and lateral inferior precentral gyri followed a non-linear developmental pattern across the measurement sessions. This pattern is reminiscent of previously reported inverted-u-shape developmental trajectories in children's visual cortical responses to text. Our findings suggest that the processing of letters and speech sounds involves non-linear changes in the brain's spoken language network possibly related to progressive automatisation of reading skills.

Neurofunctional basis underlying audiovisual integration of print and speech sound in Chinese children

Effortless print-sound integration is essential to reading development, and the superior temporal cortex (STC) is the most critical brain region. However, to date, the conclusion is almost restricted to alphabetic orthographies. To examine the neural basis in non-alphabetic languages and its relationship with reading abilities, we conducted a functional magnetic resonance imaging study in typically developing Chinese children. Two neuroimaging-based indicators of audiovisual processing-additive enhancement (higher activation in the congruent than the average activation of unimodal conditions) and neural integration (different activations between the congruent versus incongruent conditions)-were used to investigate character-sounds (opaque) and pinyin-sounds (transparent) processing. We found additive enhancement in bilateral STCs processing both character and pinyin stimulations. Moreover, the neural integrations in the left STC for the two scripts were strongly correlated. In terms of differentiation, first, areas beyond the STCs showed additive enhancement in processing pinyin-sounds. Second, while the bilateral STCs, left inferior/middle frontal and parietal regions manifested a striking neural integration (incongruent > congruent) for character-sounds, no significant clusters were revealed for pinyin-sounds. Finally, the neural integration in the left middle frontal gyrus for characters was specifically associated with silent reading comprehension proficiency, indicating automatic semantic processing during implicit character-sound integration. In contrast, the neural integration in the left STC for pinyin was specifically associated with oral reading fluency that relies on grapho-phonological mapping. To summarize, this study revealed both script-universal and script-specific neurofunctional substrates of print-sound integration as well as their processing- and region-dependent associations with reading abilities in typical Chinese children.

How Learning to Read Changes the Listening Brain

Reading acquisition reorganizes existing brain networks for speech and visual processing to form novel audio-visual language representations. This requires substantial cortical plasticity that is reflected in changes in brain activation and functional as well as structural connectivity between brain areas. The extent to which a child's brain can accommodate these changes may underlie the high variability in reading outcome in both typical and dyslexic readers. In this review, we focus on reading-induced functional changes of the dorsal speech network in particular and discuss how its reciprocal interactions with the ventral reading network contributes to reading outcome. We discuss how the dynamic and intertwined development of both reading networks may be best captured by approaching reading from a skill learning perspective, using audio-visual learning paradigms and longitudinal designs to follow neuro-behavioral changes while children's reading skills unfold.

Brain responses during auditory word recognition vary with reading ability in Chinese school-age children

While the close relationship between the brain system for speech processing and reading development is well-documented in alphabetic languages, whether and how such a link exists in children in a language without systematic grapheme-phoneme correspondence has not been directly investigated. In the present study, we measured Chinese children's brain activation during an auditory lexical decision task with functional magnetic resonance imaging. The results showed that brain areas distributed across the temporal and frontal lobes activated during spoken word recognition. In addition, the left occipitotemporal cortex (OTC) was recruited, especially under the real word condition, thus confirming the involvement of this orthographic-related area in spoken language processing in Chinese children. Importantly, activation of the left temporoparietal cortex (TPC) in response to words and pseudowords was positively correlated with children's reading ability, thus supporting the salient role phonological processing plays in Chinese reading in the developing brain. Furthermore, children with higher reading scores also increasingly recruited the left anterior OTC to make decisions on the lexical status of pseudowords, indicating that higher-skill children tend to search abstract lexical representations more deeply than lower-skill children in deciding whether spoken syllables are real. In contrast, the precuneus was more related to trial-by-trial reaction time in lower-skill children, suggesting that effort-related neural systems differ among pupils with varying reading abilities. Taken together, these findings suggest a strong link between the neural correlates of speech processing and reading ability in Chinese children, thus supporting a universal basis underlying reading development across languages.

Graph Analysis of EEG Functional Connectivity Networks During a Letter-Speech Sound Binding Task in Adult Dyslexics

We performed an EEG graph analysis on data from 31 typical readers (22.27 ± 2.53 y/o) and 24 dyslexics (22.99 ± 2.29 y/o), recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), and beta (13–30 Hz) bands. We computed the Phase Lag Index (PLI) to provide an estimate of the functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning Tree (MST), a unique sub-graph connecting all nodes (electrodes) without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking.

Developmental Trajectories of Letter and Speech Sound Integration During Reading Acquisition

Reading acquisition in alphabetic languages starts with learning the associations between speech sounds and letters. This learning process is related to crucial developmental changes of brain regions that serve visual, auditory, multisensory integration, and higher cognitive processes. Here, we studied the development of audiovisual processing and integration of letter-speech sound pairs with an audiovisual target detection functional MRI paradigm. Using a longitudinal approach, we tested children with varying reading outcomes before the start of reading acquisition (T1, 6.5 yo), in first grade (T2, 7.5 yo), and in second grade (T3, 8.5 yo). Early audiovisual integration effects were characterized by higher activation for incongruent than congruent letter-speech sound pairs in the inferior frontal gyrus and ventral occipitotemporal cortex. Audiovisual processing in the left superior temporal gyrus significantly increased from the prereading (T1) to early reading stages (T2, T3). Region of interest analyses revealed that activation in left superior temporal gyrus (STG), inferior frontal gyrus and ventral occipitotemporal cortex increased in children with typical reading fluency skills, while poor readers did not show the same development in these regions. The incongruency effect bilaterally in parts of the STG and insular cortex at T1 was significantly associated with reading fluency skills at T3. These findings provide new insights into the development of the brain circuitry involved in audiovisual processing of letters, the building blocks of words, and reveal early markers of audiovisual integration that may be predictive of reading outcomes.

Predicting Reading From Behavioral and Neural Measures - A Longitudinal Event-Related Potential Study

Fluent reading is characterized by fast and effortless decoding of visual and phonological information. Here we used event-related potentials (ERPs) and neuropsychological testing to probe the neurocognitive basis of reading in a sample of children with a wide range of reading skills. We report data of 51 children who were measured at two time points, i.e., at the end of first grade (mean age 7.6 years) and at the end of fourth grade (mean age 10.5 years). The aim of this study was to clarify whether next to behavioral measures also basic unimodal and bimodal neural measures help explaining the variance in the later reading outcome. Specifically, we addressed the question of whether next to the so far investigated unimodal measures of N1 print tuning and mismatch negativity (MMN), a bimodal measure of audiovisual integration (AV) contributes and possibly enhances prediction of the later reading outcome. We found that the largest variance in reading was explained by the behavioral measures of rapid automatized naming (RAN), block design and vocabulary (46%). Furthermore, we demonstrated that both unimodal measures of N1 print tuning (16%) and filtered MMN (7%) predicted reading, suggesting that N1 print tuning at the early stage of reading acquisition is a particularly good predictor of the later reading outcome. Beyond the behavioral measures, the two unimodal neural measures explained 7.2% additional variance in reading, indicating that basic neural measures can improve prediction of the later reading outcome over behavioral measures alone. In this study, the AV congruency effect did not significantly predict reading. It is therefore possible that audiovisual congruency effects reflect higher levels of multisensory integration that may be less important for reading acquisition in the first year of learning to read, and that they may potentially gain on relevance later on.

Interpreting Developmental Surface Dyslexia within a Comorbidity Perspective

Recent evidence underlines the importance of seeing learning disorders in terms of their partial association (comorbidity). The present concept paper presents a model of reading that aims to account for performance on a naturalistic reading task within a comorbidity perspective. The model capitalizes on the distinction between three independent levels of analysis: competence, performance, and acquisition: Competence denotes the ability to master orthographic–phonological binding skills; performance refers to the ability to read following specific task requirements, such as scanning the text from left to right. Both competence and performance are acquired through practice. Practice is also essential for the consolidation of item-specific memory traces (or instances), a process which favors automatic processing. It is proposed that this perspective might help in understanding surface dyslexia, a reading profile that has provoked a prolonged debate among advocates of traditional models of reading. The proposed reading model proposes that surface dyslexia is due to a defective ability to consolidate specific traces or instances. In this vein, it is a “real” deficit, in the sense that it is not due to an artifact (such as limited exposure to print); however, as it is a cross-domain defect extending to other learning behaviors, such as spelling and math, it does not represent a difficulty specific to reading. Recent evidence providing initial support for this hypothesis is provided. Overall, it is proposed that viewing reading in a comorbidity perspective might help better understand surface dyslexia and might encourage research on the association between surface dyslexia and other learning disorders.

ERP Correlates of Altered Orthographic-Phonological Processing in Dyslexia

Automatic visual word recognition requires not only well-established phonological and orthographic representations but also efficient audio-visual integration of these representations. One possibility is that in developmental dyslexia, inefficient orthographic processing might underlie poor reading. Alternatively, reading deficit could be due to inefficient phonological processing or inefficient integration of orthographic and phonological information. In this event-related potential study, participants with dyslexia (N = 25) and control readers (N = 27) were presented with pairs of words and pseudowords in an implicit same-different task. The reference-target pairs could be identical, or different in the identity or the position of the letters. To test the orthographic-phonological processing, target stimuli were presented in visual-only and audiovisual conditions. Participants with and without dyslexia processed the reference stimuli similarly; however, group differences emerged in the processing of target stimuli, especially in the audiovisual condition where control readers showed greater N1 responses for words than for pseudowords, but readers with dyslexia did not show such difference. Moreover, after 300 ms lexicality effect exhibited a more focused frontal topographic distribution in readers with dyslexia. Our results suggest that in developmental dyslexia, phonological processing and audiovisual processing deficits are more pronounced than orthographic processing deficits.

Audiovisual Learning in Dyslexic and Typical Adults: Modulating Influences of Location and Context Consistency

Learning to read involves efficient binding of visual to auditory information. Aberrant cross-modal binding skill has been observed in both children and adults with developmental dyslexia. Here, we examine the contribution of episodic memory to acquisition of novel cross-modal bindings in typical and dyslexic adult readers. Participants gradually learned arbitrary associations between unfamiliar Mandarin Chinese characters and English-like pseudowords over multiple exposures, simulating the early stages of letter-to-letter sound mapping. The novel cross-modal bindings were presented in consistent or varied locations (i.e., screen positions), and within consistent or varied contexts (i.e., co-occurring distractor items). Our goal was to examine the contribution, if any, of these episodic memory cues (i.e., the contextual and spatial properties of the stimuli) to binding acquisition, and investigate the extent to which readers with and without dyslexia would differ in their reliance on episodic memory during the learning process. Participants were tested on their ability to recognize and recall the bindings both during training and then in post-training tasks. We tracked participants' eye movements remotely with their personal webcams to assess whether they would re-fixate relevant empty screen locations upon hearing an auditory cue-indicative of episodic memory retrieval-and the extent to which the so-called "looking-at-nothing behavior" would modulate recognition of the novel bindings. Readers with dyslexia both recognized and recalled significantly fewer bindings than typical readers, providing further evidence of their persistent difficulties with cross-modal binding. Looking-at-nothing behavior was generally associated with higher recognition error rates for both groups, a pattern that was particularly more evident in later blocks for bindings encoded in the inconsistent location condition. Our findings also show that whilst readers with and without dyslexia are capable of using stimulus consistencies in the input-both location and context-to assist in audiovisual learning, readers with dyslexia appear particularly reliant on consistent contextual information. Taken together, our results suggest that whilst readers with dyslexia fail to efficiently learn audiovisual binding as a function of stimulus frequency, they are able to use stimulus consistency-aided by episodic recall-to assist in the learning process.

Multisensory deficits in dyslexia may result from a locus coeruleus attentional network dysfunction

A fundamental educational requirement of beginning reading is to learn, access, and rapidly process associations between novel visuospatial symbols and their phonological representations in speech. Children with difficulties in such cross-modal integration are often divided into dyslexia subtypes, based on whether their primary problem is with the written or spoken component of decoding. The present review suggests that starting in infancy, perceptions of audiovisual speech are integrated by mutual oscillatory phase-resetting between sensory cortices, and throughout development visual and auditory experiences are coupled into unified perceptions. Entirely separate subtypes are incompatible with this view. Visual or auditory deficits will invariably affect processing to some degree in both domains. It is suggested that poor auditory/visual integration may be diagnostic for both forms of dyslexia, stemming from an encoding weakness in the early cross-sensory binding of audiovisual speech. The review presents a model of dyslexia as a dysfunction of the large-scale ventral and dorsal attention networks controlling such binding. Excessive glutamatergic neuronal excitability of the attention networks by the Locus coeruleus-norepinephrine system may interfere with multisensory integration, with deleterious effects on the acquisition of reading by degrading graphene/phoneme conversion.

Facial speech processing in children with and without dyslexia

What role does the presence of facial speech play for children with dyslexia? Current literature proposes two distinctive claims. One claim states that children with dyslexia make less use of visual information from the mouth during speech processing due to a deficit in recruitment of audiovisual areas. An opposing claim suggests that children with dyslexia are in fact reliant on such information in order to compensate for auditory/phonological impairments. The current paper aims at directly testing these contrasting hypotheses (here referred to as "mouth insensitivity" versus "mouth reliance") in school-age children with and without dyslexia, matched on age and listening comprehension. Using eye tracking, in Study 1, we examined how children look at the mouth across conditions varying in speech processing demands. The results did not indicate significant group differences in looking at the mouth. However, correlation analyses suggest potentially important distinctions within the dyslexia group: those children with dyslexia who are better readers attended more to the mouth while presented with a person's face in a phonologically demanding condition. In Study 2, we examined whether the presence of facial speech cues is functionally beneficial when a child is encoding written words. The results indicated lack of overall group differences on the task, although those with less severe reading problems in the dyslexia group were more accurate when reading words that were presented with articulatory facial speech cues. Collectively, our results suggest that children with dyslexia differ in their "mouth reliance" versus "mouth insensitivity," a profile that seems to be related to the severity of their reading problems.

Gray matter correlates of reading fluency deficits: SES matters, IQ does not

Brain correlates of reading ability have been intensely investigated. Most studies have focused on single-word reading and phonological processing, but the brain basis of reading fluency remains poorly explored to date. Here, in a voxel-based morphometry study with 8-year-old children, we compared fluent readers (n = 18; seven boys) with dysfluent readers with normal IQ (n = 18; six boys) and with low IQ (n = 18; ten boys). Relative to dysfluent readers, fluent readers had larger gray matter volume in the right superior temporal gyrus and the two subgroups of dysfluent readers did not differ from each other, as shown in frequentist and Bayesian analyses. Pairwise comparisons showed that dysfluent readers of normal and low IQ did not differ in core reading regions and that both subgroups had less gray matter volume than fluent readers in occipito-temporal, parieto-temporal and fusiform areas. We also examined gray matter volume in matched subgroups of dysfluent readers differing only in socioeconomic status (SES): lower-SES (n = 14; seven boys) vs. higher-SES (n = 14; seven boys). Higher-SES dysfluent readers had larger gray matter volume in the right angular gyrus than their lower-SES peers, and the volume of this cluster correlated positively with lexico-semantic fluency. Age, sex, IQ, and gray matter volume of the right angular cluster explained 68% of the variance in the reading fluency of higher-SES dysfluent readers. In sum, this study shows that gray matter correlates of dysfluent reading are independent of IQ, and suggests that SES modulates areas sub-serving lexico-semantic processes in dysfluent readers-two findings that may be useful to inform language/reading remediation programs.

Reading-Related Brain Changes in Audiovisual Processing: Cross-Sectional and Longitudinal MEG Evidence

The ability to establish associations between visual objects and speech sounds is essential for human reading. Understanding the neural adjustments required for acquisition of these arbitrary audiovisual associations can shed light on fundamental reading mechanisms and help reveal how literacy builds on pre-existing brain circuits. To address these questions, the present longitudinal and cross-sectional MEG studies characterize the temporal and spatial neural correlates of audiovisual syllable congruency in children (age range, 4-9 years; 22 males and 20 females) learning to read. Both studies showed that during the first years of reading instruction children gradually set up audiovisual correspondences between letters and speech sounds, which can be detected within the first 400 ms of a bimodal presentation and recruit the superior portions of the left temporal cortex. These findings suggest that children progressively change the way they treat audiovisual syllables as a function of their reading experience. This reading-specific brain plasticity implies (partial) recruitment of pre-existing brain circuits for audiovisual analysis.SIGNIFICANCE STATEMENT Linking visual and auditory linguistic representations is the basis for the development of efficient reading, while dysfunctional audiovisual letter processing predicts future reading disorders. Our developmental MEG project included a longitudinal and a cross-sectional study; both studies showed that children's audiovisual brain circuits progressively change as a function of reading experience. They also revealed an exceptional degree of neuroplasticity in audiovisual neural networks, showing that as children develop literacy, the brain progressively adapts so as to better detect new correspondences between letters and speech sounds.

Reading direct speech quotes increases theta phase-locking: Evidence for cortical tracking of inner speech?

Growing evidence shows that theta-band (4-7 Hz) activity in the auditory cortex phase-locks to rhythms of overt speech. Does theta activity also encode the rhythmic dynamics of inner speech? Previous research established that silent reading of direct speech quotes (e.g., Mary said: "This dress is lovely!") elicits more vivid inner speech than indirect speech quotes (e.g., Mary said that the dress was lovely). As we cannot directly track the phase alignment between theta activity and inner speech over time, we used EEG to measure the brain's phase-locked responses to the onset of speech quote reading. We found that direct (vs. indirect) quote reading was associated with increased theta phase synchrony over trials at 250-500 ms post-reading onset, with sources of the evoked activity estimated in the speech processing network. An eye-tracking control experiment confirmed that increased theta phase synchrony in direct quote reading was not driven by eye movement patterns, and more likely reflects synchronous phase resetting at the onset of inner speech. These findings suggest a functional role of theta phase modulation in reading-induced inner speech.

The Neurological Basis of Developmental Dyslexia and Related Disorders: A Reappraisal of the Temporal Hypothesis, Twenty Years on

In a now-classic article published a couple of decades ago (Brain, 2000; 123: 2373-2399), I proposed an "extended temporal processing deficit hypothesis of dyslexia", suggesting that a deficit in temporal processing could explain not only language-related peculiarities usually noticed in dyslexic children, but also a wider range of symptoms related to impaired processing of time in general. In the present review paper, I will revisit this "historical" hypothesis both in the light of a new clinical perspective, including the central yet poorly explained notion of comorbidity, and also taking a new look at the most recent experimental work, mainly focusing on brain imaging data. First, consistent with daily clinical practice, I propose to distinguish three groups of children who fail to learn to read, of fairly equal occurrence, who share the same initial presentation (difficulty in mastering the rules of grapheme-phoneme correspondence) but with differing associated signs and/or comorbid conditions (language disorders in the first group, attentional deficits in the second one, and motor coordination problems in the last one), thus suggesting, at least in part, potentially different triggering mechanisms. It is then suggested, in the light of brain imaging information available to date, that the three main clinical presentations/associations of cognitive impairments that compromise reading skills acquisition correspond to three distinct patterns of miswiring or "disconnectivity" in specific brain networks which have in common their involvement in the process of learning and their heavy reliance on temporal features of information processing. With reference to the classic temporal processing deficit of dyslexia and to recent evidence of an inability of the dyslexic brain to achieve adequate coupling of oscillatory brain activity to the temporal features of external events, a general model is proposed according to which a common mechanism of temporal uncoupling between various disconnected-and/or mis-wired-processors may account for distinct forms of specific learning disorders, with reading impairment being a more or less constant feature. Finally, the potential therapeutic implications of such a view are considered, with special emphasis on methods seeking to enhance cross-modal connectivity between separate brain systems, including those using rhythmic and musical training in dyslexic patients.

Phonology-independent general orthographic knowledge

While reading is among the most important and well-researched topics of developmental psychology, sublexical regularities and how these regularities relate to reading skills have attracted less interest so far. This study tested general orthographic knowledge (GOK) using an indirect reaction time (RT)-based task, in which participants had to detect letters appearing within frequent and infrequent letter clusters. The aim of the method was to minimise the roles of phonological activation and metalinguistic decision. Three different age-groups of German-speaking individuals were tested: first graders (N = 60), third graders (N = 68), and adults (N = 44). Orthographic regularity affected RTs in all three groups, with significantly lower RTs for frequent than for infrequent clusters. The indirect measure of GOK did not show an association with reading measures in first graders and adults, but in the case of third graders it explained variance over and above age and phonological skills. This study provides evidence for phonology-independent GOK, at least in third graders.

The rise and fall of rapid occipito-temporal sensitivity to letters: Transient specialization through elementary school

Letters, foundational units of alphabetic writing systems, are quintessential to human culture. The ability to read, indispensable to perform in today’s society, necessitates a reorganization of visual cortex for fast letter recognition, but the developmental course of this process has not yet been characterized. Here, we show the emergence of visual sensitivity to letters across five electroencephalography measurements from kindergarten and throughout elementary school and relate this development to emerging reading skills. We examined the visual N1, the electrophysiological correlate of ventral occipito-temporal cortex activation in 65 children at varying familial risk for dyslexia. N1 letter sensitivity emerged in first grade, when letter sound knowledge gains were most pronounced and decayed shortly after when letter knowledge is consolidated, showing an inverted U-shaped development. This trajectory can be interpreted within an interactive framework that underscores the influence of top-down predictions. While the N1 amplitudes to letters correlated with letter sound knowledge at the beginning of learning, no association between the early N1 letter response and later reading skills was found. In summary, the current findings provide an important reference point for our neuroscientific understanding of learning trajectories and the process of visual specialization during skill learning.

Automaticity in the reading circuitry

Skilled reading requires years of practice associating visual symbols with speech sounds. Over the course of the learning process, this association becomes effortless and automatic. Here we test whether automatic activation of spoken-language circuits in response to visual words is a hallmark of skilled reading. Magnetoencephalography was used to measure word-selective responses under multiple cognitive tasks (N = 42, 7-12 years of age). Even when attention was drawn away from the words by performing an attention-demanding fixation task, strong word-selective responses were found in a language region (i.e., superior temporal gyrus) starting at ~300 ms after stimulus onset. Critically, this automatic word-selective response was indicative of reading skill: the magnitude of word-selective responses correlated with individual reading skill. Our results suggest that automatic recruitment of spoken-language circuits is a hallmark of skilled reading; with practice, reading becomes effortless as the brain learns to automatically translate letters into sounds and meaning.