Dyslexic children suffer from less informative visual cues to control posture

Motor skills and capacities in developmental dyslexia: A systematic review and meta-analysis

In recent decades, the connections between academic skills, such as reading, writing, and calculation, and motor skills/capacities have received increasing attention. Many studies provided evidence for motor difficulties in children and adolescents with dyslexia, prompting the need for a meta-analysis to combine these multiple findings. Therefore, we conducted a meta-analysis using PsycINFO, Pubmed, and SportDiscus as scientific databases. A total of 572 studies were analyzed following several stringent inclusion criteria, resulting in the inclusion of 23 peer-reviewed studies in the final analysis. Our results showed that children and adolescents with dyslexia displayed significant different performances in multiple motor tasks and these differences persisted also when the type of motor task was considered as moderator in the analysis. The present findings are in accordance with the literature that supports a close connection between reading disabilities and difficulties in motor skills/capacities.

Associations between Executive Functions and Sensorimotor Performance in Children at Risk for Learning Disabilities

Executive functions (EF) and sensorimotor skills play a critical role in children's goal-directed behavior and school readiness. The aim of the current study is to provide new insights into the relationship between executive functions and sensorimotor development by considering the risks associated with learning difficulties. Therefore, we investigate the predictive role of EF and sensorimotor skills in the development of learning difficulties during preschool years. Ninety-five preschool children (5-7 years old) were tested, comparing the performance of children that are at risk of learning difficulties (n = 55) to the performance of typically developing children (n = 40). Participants completed a battery for the assessment of sensorimotor skills (i.e., Southern California Sensory Integration Test: postural imitation, body midline crossing, bilateral motor coordination, and standing balance with eyes open) and executive functions (i.e., inhibition, cognitive flexibility, and verbal working memory). Our results show that children at risk for learning difficulties exhibited more impairments on sensorimotor and EF measures (inhibition and verbal working memory) when compared with TD children. We ran three separate binary logistic regression analyses to assess the relative influence of EF and sensorimotor functions on predicting risk for learning difficulties. Our findings demonstrated that verbal working memory as EF function (odd ratio (OR) = 0.91, 95% CI 0.78-0.91, P = 0.05) and standing balance skills as a sensorimotor skill (odd ratio (OR) = 0.86, 95% CI 0.81-0.98, P = 0.01) were the strongest predictors of risk for learning difficulties. The findings point to the importance of supporting children's executive function development and promoting sensorimotor development, as both fundamentally influence school readiness.

Comparison of children with and without dyslexia using functional head impulse test and pediatric balance scale

Purpose

The aim of this study is to compare functionality of vestibulo-ocular reflex (VOR) responses to evaluate the functional properties of the vestibular system and daily balance performance in children with dyslexia and children with normal development.

Method

Fifteen participants diagnosed with dyslexia were included in the study group (SG), and 15 healthy participants were included in the control group (CG). All groups underwent Functional Head Impulse Test (f-HIT) and Pediatric Balance Scale (PBS). f-HIT was performed with at least 15 head impulses at 4000-5000-6000°/s² randomly to the right and left in the plane of the horizontal semicircular canal (SCC). Statistical analysis was performed using descriptive statistics and the Mann-Whitney U test.

Results

SG percentage values were obtained lower than CG percentage values. Comparisons between the two groups showed that there was a significant difference in all parameters (4000-5000-6000°/s² and total) in the right-side stimulation, there was significant difference for 4,000 s² and total correct answers in the left side. In addition, although there was no significant difference between the groups in terms of the PBS score, the SG scores were lower (p = 0.062).

Conclusions

As a novel test, f-HIT, revealed the difference in functionality of vestibular performance in the dyslexia group. In the dyslexia group, f-HIT may be helpful in evaluating and monitoring the vestibular system.

Comparing body posture and postural control in children with intellectual disability and dyslexia to typically developing children using technology‑based assessments

Background/Aims

Children with intellectual disability and dyslexia have poor academic and behavioural skills related to social participation, as well as poor motor skills compared to typically developing children. Most training programmes for these children focus on the academic and behavioural aspects of special education, overlooking musculoskeletal and motor development needs. The aim of this study was to investigate body posture and postural control in children with intellectual disability and dyslexia compared to typically developing children using technology-based assessments.

Methods

A total of 77 children (36 with dyslexia, 21 with intellectual disability and 20 typically developing children) took part in the study. The PostureScreen Mobile app was used to evaluate body posture and the Fizyosoft Balance System was used to assess postural control.

Results

Significant postural differences were observed in children with intellectual disability when compared to typically developing children. Head, shoulder and knee translations in the sagittal plane were significantly higher in children with intellectual disability than typically developing children. Centre of pressure velocities were significantly higher in children with dyslexia. Centre of pressure displacements showed non-significant differences in the children with dyslexia compared to the children with intellectual disability and typically developing children.

Conclusions

The present study found that children with dyslexia had poor postural control and children with intellectual disability had poor quality of posture compared to typically developing children. The authors believe that motor and physical assessments with objective outcome measurements should be conducted for children with dyslexia and intellectual disability to help improve their motor development.

Specific Learning Disorder in Children and Adolescents, a Scoping Review on Motor Impairments and Their Potential Impacts

Mastering motor skills is important for children to achieve functional mobility and participate in daily activities. Some studies have identified that students with specific learning disorders (SLD) could have impaired motor skills; however, this postulate and the potential impacts remain unclear. The purpose of the scoping review was to evaluate if SLD children have motor impairments and examine the possible factors that could interfere with this assumption. The sub-objective was to investigate the state of knowledge on the lifestyle behavior and physical fitness of participants with SLD and to discuss possible links with their motor skills. Our scoping review included preregistration numbers and the redaction conformed with the PRISMA guidelines. A total of 34 studies published between 1990 and 2022 were identified. The results of our scoping review reflected that students with SLD have poorer motor skills than their peers. These motor impairments are exacerbated by the complexity of the motor activities and the presence of comorbidities. These results support our sub-objective and highlight the link between motor impairments and the sedentary lifestyle behavior of SLDs. This could lead to deteriorating health and motor skills due to a lack of motor experience, meaning that this is not necessarily a comorbidity. This evidence emphasizes the importance of systematic clinical motor assessments and physical activity adaptations.

Visual Occlusion Effects On Bipedal Stance Control In Chinese-Speaking Children With Dyslexia

Visual processing of complex character configurations is especially challenging for Chinese-speaking children with dyslexia (CSCD). The purpose of this study was to compare the effects of visual occlusion on postural control between dyslexic and non-dyslexic Chinese-speaking children by examining their visual-perceptual capacity and movement coordination with scale measures. Sixteen dyslexic children (10 males and, 6 females, 9.46 ± 1.26 yrs) and sixteen non-dyslexic children (10 males and 6 females, 9.91 ± 1.18 yrs) were recruited from the campus in Taiwan. Motor and visual perceptual performance were assessed with the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Test of Visual-Perceptual Skills, 4th Edition (TVPS-4). Root mean square (RMS) and sample entropy (SampEn) of center of pressure (COP) were characterized during a bilateral upright stance with eyes open (EO) and eyes closed (EC). The results showed significant group differences in six of the seven TVPS-4 subscales (P < .001-.017) and one category of the MABC-2 (P = .006). In the EO condition, the children with dyslexia showed a greater RMS of COP specifically in the anterior-posterior (AP) direction than did the non-dyslexic children (P = .029). However, SampEn of COP in the two directions were not group dependent (P > .05). In the EC condition, RMS and SampEn of COP did not vary with group (P > .05). RMS of COP in the AP direction was negatively correlated with the sub-score of visual figure-ground in the TVPS-4 (r = - .381, P = .031). In summary, postural control of Chinese-speaking children with dyslexia is more affected with eyes open than with eyes closed, and the effect is related to visual disturbance of the foreground and background.

Parkinson's disease delays predictable visual cue processing without affecting complex and unpredictable visual cue processing in postural control

This study examined the influence of visual information of different complexities and predictability on the body sway of individuals with Parkinson's disease (PD) during upright stance. Twenty-one individuals at initial stages of PD (62.1 ± 7.2 years), under dopaminergic medication, and 21 controls (62.3 ± 7.1 years) stood inside a moving room, performing 10 trials of 60 s. In the first trial, the room remained motionless. Then, the room oscillated in an anterior-posterior direction. There were three blocks of three trials. In the first block, the room oscillated at 0.2 Hz (periodic simple condition); in the second block, periodic frequencies of 0.1, 0.3, and 0.5 Hz were combined (periodic complex condition); in the third block, non-periodic frequencies of 0.1, 0.3, and 0.5 Hz were combined (non-periodic complex condition). Participants were not informed about the room movement. The displacement of the room and trunk were registered using an OPTOTRAK system. Postural sway was examined using mean sway amplitude, and the relationship between visual information and body sway used coherence, gain, and phase. There was no group difference when the room remained motionless. Upon visual manipulation, the PD group displayed larger sway magnitude in the non-periodic complex condition. Individuals with PD also lagged behind the moving room (lower phase values) compared to controls, only in the periodic simple condition. In the remaining measures, there was no group difference. These results suggest that individuals with PD use complex and unpredictable visual information, similar to controls, during upright stance. However, PD might affect the predictable visual cues processing.

Visually guided eye movements reduce postural sway in dyslexic children

Dyslexic children present poorer postural control performance than their peers, perhaps due to different patterns of eye movements. It has been shown that guided eye movements decrease magnitude of body sway in young and older adults, but there is no evidence whether the search for visual information that occurs during eye movements affects postural control in dyslexic children. The aim of this study was to examine the use of guided eye movements and its pattern in the performance of postural control of dyslexic children during upright quiet stance. Twelve children with dyslexia (10.8 ± 1.1 years old) and 12 non-dyslexic children (10.4 ± 1.5 years old) participated in this study. All children were instructed to maintain an upright quiet stance for 60 s either fixating on a target (fixation condition) displayed 1 m ahead in the center of a monitor at eye level, or performing eye movements to follow a target displayed on one side of a monitor, then disappearing and reappearing immediately on the opposite side with a frequency of 0.5 Hz (guided condition). Three trials for each condition were registered. Body sway was measured with an IRED (OPTOTRAK) placed on the children's back. Eye movements were tracked using eye-tracking glasses (ETG 2.0 - SMI). Dyslexic children swayed with larger amplitude under both fixation and guided conditions than non-dyslexic children. Both dyslexic and non-dyslexic children reduced postural sway magnitude under the guided compared to the fixation condition. All children were able to modulate eye movement according to the conditions (fixation and guided) and no difference in eye movements was observed between dyslexic and non-dyslexic children. Eye movements are modulated similarly based upon the visual conditions in dyslexic and non-dyslexic children, and dyslexic children are capable of using available visual information during eye movements to improve postural control, though they do not equal the performance of non-dyslexic children. Eye movement patterns seem not to be related to poor performance of postural control in dyslexic children.

Children with Dyslexia Have Altered Cross-Modal Processing Linked to Binocular Fusion. A Pilot Study

Introduction

The cause of dyslexia, a reading disability characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities, is unknown. A considerable body of evidence shows that dyslexics have phonological disorders. Other studies support a theory of altered cross-modal processing with the existence of a pan-sensory temporal processing deficit associated with dyslexia. Learning to read ultimately relies on the formation of automatic multisensory representations of sounds and their written representation while eyes fix a word or move along a text. We therefore studied the effect of brief sounds on vision with a modification of binocular fusion at the same time (using the Maddox Rod test).

Methods

To check if the effect of sound on vision is specific, we first tested with sounds and then replaced them with proprioceptive stimulation on 8 muscular sites. We tested two groups of children composed respectively of 14 dyslexic children and 10 controls.

Results

The results show transient visual scotoma (VS) produced by sensory stimulations associated with the manipulation of oculomotor balance, the effect being drastically higher in the dyslexic group. The spatial distribution of the VS is stochastic. The effect is not specific for sounds but exists also with proprioceptive stimulations.

Discussion

Although there was a very significant difference between the two groups, we were not able to correlate the (VS) occurrence with the dyslexic’s reading performance. One possibility to confirm the link between VS and reading impairment would be to find a specific treatment reducing the occurrence of the VS and to check its effect on dyslexia.

Dyslexic children need more robust information to resolve conflicting sensory situations

The study involved investigating dyslexic children's postural control responses when visual and somatosensory cues were separately manipulated. Twenty dyslexic and 19 nondyslexic children performed a trial by standing upright inside a moving room and another by lightly touching a moving bar. Both trials lasted 240 s with the following three different stimulus characteristics: low (pretransition), high (transition), and low amplitude (posttransition). Body sway magnitude and the relationship between the movement of the room/bar surface and body sway were examined. When compared to nondyslexic children, dyslexic children oscillated with higher magnitude in the transition and posttransition under visual and somatosensory manipulation; their sway was more influenced by visual manipulation in the transition and posttransition, and they used higher applied force levels in the somatosensory modality in all conditions. The results suggest that dyslexic children could not efficiently reweight visual cues when compared to nondyslexic children. The same was not observed in the somatosensory cues when dyslexic children reduced the influence of the somatosensory stimulus. The proper use of somatosensory information was related to stronger acquired cues and higher applied forces as observed for dyslexic children. Dyslexic children experience difficulties in dynamically reweighting sensory cues although these types of difficulties are overcome when more informative sensory cues are provided.

Eye movement and postural sway in dyslexic children during sitting and standing

In this study, we investigated the eye movement and postural control performance in dyslexic children while reading text and performing Landolt reading when sitting and standing. Fifteen dyslexic and 15 non-dyslexic children were asked to sit in a chair while the eye movements were recorded, and were then asked to stand on an unstable platform while eye movements and postural sway were recorded simultaneously at the time of Landolt reading and text reading. Eye movements were recorded binocularly by Mobile EyeBrain Tracker (MobileT2^®, SuriCog) and center of pressure excursions were recorded by Multitest Equilibre (by Framiral^®). The dependent variables for visual performance in the reading tasks were: total reading time, mean duration of fixation, number of pro- and retro-saccades, and amplitude of pro-saccades. The dependent variable for postural performance was the center of pressure area. The results showed that dyslexic children spent more time reading the text compared to non-dyslexic children (p < 0.02). However, no difference was observed for the Landolt reading task (p > 0.05). Dyslexic children performed longer fixations in the sitting condition as compared to the standing (p < 0.03), namely, higher number of pro- (p < 0.001) and retro- saccades (p < 0.001), and smaller pro-saccades amplitude (p < 0.001). Therefore, when the linguistic and semantic requirements are not involved in the reading task, dyslexic children perform similar to non-dyslexic children even in different task requirements (p > 0.05). Finally, postural performance was poorer in dyslexic children than in non-dyslexic children in both the reading tasks (p < 0.02). However, postural control performance, which was poor in dyslexic children, is not related to lexical and semantic reading requirements.

Eye movements and postural control in dyslexic children performing different visual tasks

The aim of this study was to examine eye movements and postural control performance among dyslexic children while reading a text and performing the Landolt reading task. Fifteen dyslexic and 15 non-dyslexic children were asked to stand upright while performing two experimental visual tasks: text reading and Landolt reading. In the text reading task, children were asked to silently read a text displayed on a monitor, while in the Landolt reading task, the letters in the text were replaced by closed circles and Landolt rings, and children were asked to scan each circle/ring in a reading-like fashion, from left to right, and to count the number of Landolt rings. Eye movements (Mobile T2^®, SuriCog) and center of pressure excursions (Framiral^®, Grasse, France) were recorded. Visual performance variables were total reading time, mean duration of fixation, number of pro- and retro-saccades, and amplitude of pro-saccades. Postural performance variable was the center of pressure area. The results showed that dyslexic children spent more time reading the text and had a longer duration of fixation than non-dyslexic children. However, no difference was observed between dyslexic and non-dyslexic children in the Landolt reading task. Dyslexic children performed a higher number of pro- and retro-saccades than non-dyslexic children in both text reading and Landolt reading tasks. Dyslexic children had smaller pro-saccade amplitude than non-dyslexic children in the text reading task. Finally, postural performance was poorer in dyslexic children than in non-dyslexic children. Reading difficulties in dyslexic children are related to eye movement strategies required to scan and obtain lexical and semantic meaning. However, postural control performance, which was poor in dyslexic children, is not related to lexical and semantic reading requirements and might not also be related to different eye movement behavior.

Feedforward motor control in developmental dyslexia and developmental coordination disorder: Does comorbidity matter?

BACKGROUND AND AIM

Feedforward and online controls are two facets of predictive motor control from internal models, which is suspected to be impaired in learning disorders. We examined whether the feedforward component is affected in children (8-12 years) with developmental dyslexia (DD) and/or with developmental coordination disorder (DCD) compared to typically developing (TD) children.

METHODS

Children underwent a bimanual unloading paradigm during which a load supported to one arm, the postural arm, was either unexpectedly unloaded by a computer or voluntary unloaded by the subject with the other arm.

RESULTS

All children showed a better stabilization (lower flexion) of the postural arm and an earlier inhibition of the arm flexors during voluntary unloading, indicating anticipation of unloading. Between-group comparisons of kinematics and electromyographic activity of the postural arm revealed that the difference during voluntary unloading was between DD-DCD children and the other groups, with the former showing a delayed inhibition of the flexor muscles.

CONCLUSION

Deficit of the feedforward component of motor control may particularly apply to comorbid subtypes, here the DD-DCD subtype. The development of a comprehensive framework for motor performance deficits in children with learning disorders will be achieved only by dissociating key components of motor prediction and focusing on subtypes and comorbidities.

The distinctive vertical heterophoria of dyslexics

In this study, we looked for the presence of vertical heterophoria (VH) in 42 dyslexic children (22 males and 20 females) aged 118.5±12.9 months who were compared with a control group of 22 nondyslexic children (eleven males and eleven females) aged 112±9.8 months. Dyslexics presented a low-level (always <1 prism diopter) VH combined with torsion. This oculomotor feature clearly separates the dyslexic group from the normal readers group. It is independent of the type of dyslexia. The essential feature of this VH is a lability that appears during specific stimulation of sensory receptors involved in postural regulation. This lability is demonstrated using a vertical Maddox test conducted under very specific conditions in which postural sensors are successively stimulated in a predetermined order. A quantitative variation in this VH may be seen during the Bielchowsky Head Tilt Test, which reveals hypertonia of the lower or upper oblique muscles. Vertical orthophoria can be achieved by placing low-power prisms asymmetrically within the direction of action of the superior or inferior oblique muscles. The selection of power and axis is not only guided by elements of the eye examination but also from observation of postural muscle tone. All these elements suggest that the VH could be of postural origin and somehow related to the vertical action of the oblique muscles. VH and torsion are not harmful per se. There is no statistical relationship between their level and the various parameters used to assess the reading skills of dyslexic children. VH and torsion could be a clinical marker of global proprioceptive dysfunction responsible for high-level multisensory disturbances secondary to poor spatial localization of visual and auditory information. This dysfunction might also explain the motor disorders concomitant to dyslexia.