Procedural learning difficulties: reuniting the developmental disorders?

Reduced benefit from long-term item frequency contributes to short-term memory deficits in dyslexia

Dyslexia, a specific difficulty in acquiring proficient reading, is also characterized by reduced short-term memory (STM) capacity. Extensive research indicates that individuals with developmental dyslexia (IDDs) benefit less from exposure, and this hampers their long-term knowledge accumulation. It is well established that long-term knowledge has a great effect on performance in STM tasks, and thus IDDs' reduced benefit of exposure could potentially reduce their relative performance in such tasks, especially when frequent items, such as digit-words, are used. In this study we used a standard, widely used, STM assessment: the Digit Span subtest from the Wechsler Adult Intelligence Scale. The task was conducted twice: in native language and in second language. As exposure to native language is greater than exposure to second language, we predicted that IDDs' performance in the task administered in native language will reveal a larger group difference as compared to second language, due to IDDs' reduced benefit of item frequency. The prediction was confirmed, in line with the hypothesis that reduced STM in dyslexia to a large extent reflects reduced benefits from long-term item frequency and not a reduced STM per se.

Procedural auditory category learning is selectively disrupted in developmental language disorder

Speech communication depends on accurate perception and identification of speech sounds, which vary across talkers and word or sentence contexts. The ability to map this variable input onto discrete speech sound representations relies on categorization. Recent research and theoretical models implicate the procedural learning system in the ability to learn novel speech and non-speech categories. This connection is particularly intriguing because several language disorders that demonstrate linguistic impairments are proposed to stem from procedural learning and memory dysfunction. One such disorder, Developmental Language Disorder (DLD), affects 7.5% of children and persists into adulthood. While DLD is associated with general linguistic impairments, it is not yet clear how fundamental perceptual and cognitive processes supporting language are impacted, such as the ability to learn novel auditory categories. We examined auditory category learning in children with DLD and typically developed (TD) children using two well-matched nonspeech auditory category learning challenges to draw upon presumed procedural (information-integration) versus declarative (rule-based) learning systems. We observed impaired information-integration category learning and intact rule-based category learning in the DLD group. Quantitative model-based analyses revealed reduced use of, and slower shifting to, optimal procedural-based strategies in DLD and slower shifting to but similarly efficient use of optimal hypothesis-testing strategies. The dissociation is consistent with the Procedural Deficit Hypothesis of language disorders and supports the theoretical distinction of multiple category learning systems. These findings demonstrate that highly controlled experimental tasks assessing perceptual and cognitive abilities can relate to real-world challenges facing individuals with DLD in forming stable linguistic representations.

Semantic and Syntactic Predictions in Reading Aloud: Are Good Predictors Good Statistical Learners?

Recent research suggests that becoming a fluent reader may partially rely on a domain-general statistical learning (SL) mechanism that allows a person to automatically extract predictable patterns from the sensory input. The goal of the present study was to investigate a potential link between SL and the ability to make linguistic predictions. All previous studies investigated quite general levels of reading ability rather than the dynamic process of making linguistic predictions. We thus used a recently developed predictive reading task, which consisted of having participants read aloud words that were preceded by either semantically or syntactically predictive contexts. To measure the componential nature of SL, we used a visual and an auditory SL task (VSL, ASL) and the classic serial reaction time task (SRT). General reading ability was assessed with a reading speed/comprehension test. The study was conducted online on a sample of 120 participants to make it possible to explore interindividual differences. The results showed only weak and sometimes even negative correlations between the various SL measures. ASL correlated positively and predicted general reading ability but neither semantic nor syntactic prediction effects. Similarly, one of the SRT measures was significantly associated with reading level and reading speed but not with linguistic prediction effects. In sum, there is little evidence that domain-general SL is a good predictor of people's ability to make domain-specific linguistic predictions. In contrast, SL shows a weak but significant association with general reading ability.

The neuroanatomy of developmental language disorder: a systematic review and meta-analysis

Developmental language disorder (DLD) is a common neurodevelopmental disorder with adverse impacts that continue into adulthood. However, its neural bases remain unclear. Here we address this gap by systematically identifying and quantitatively synthesizing neuroanatomical studies of DLD using co-localization likelihood estimation, a recently developed neuroanatomical meta-analytic technique. Analyses of structural brain data (22 peer-reviewed papers, 577 participants) revealed highly consistent anomalies only in the basal ganglia (100% of participant groups in which this structure was examined, weighted by group sample sizes; 99.8% permutation-based likelihood the anomaly clustering was not due to chance). These anomalies were localized specifically to the anterior neostriatum (again 100% weighted proportion and 99.8% likelihood). As expected given the task dependence of activation, functional neuroimaging data (11 peer-reviewed papers, 414 participants) yielded less consistency, though anomalies again occurred primarily in the basal ganglia (79.0% and 95.1%). Multiple sensitivity analyses indicated that the patterns were robust. The meta-analyses elucidate the neuroanatomical signature of DLD, and implicate the basal ganglia in particular. The findings support the procedural circuit deficit hypothesis of DLD, have basic research and translational implications for the disorder, and advance our understanding of the neuroanatomy of language.

Atypical procedural learning in children with developmental coordination disorder: A combined behavioral and neuroimaging study

While procedural learning (PL) has been implicated in delayed motor skill observed in developmental coordination disorder (DCD), few studies have considered the impact of co-occurring attentional problems. Furthermore, the neurostructural basis of PL in children remains unclear. We investigated PL in children with DCD while controlling for inattention symptoms, and examined the role of fronto-basal ganglia-cerebellar morphology in PL. Fifty-nine children (6-14 years; nDCD = 19, ncontrol = 40) completed the serial reaction time (SRT) task to measure PL. The Attention-Deficit Hyperactivity Disorder Rating Scale-IV was administered to measure inattention symptoms. Structural T1 images were acquired for a subset of participants (nDCD = 10, ncontrol = 28), and processed using FreeSurfer. Volume was extracted for the cerebellum, basal ganglia, and frontal regions. After controlling for inattention symptoms, the reaction time profile of controls was consistent with learning on the SRT task. This was not the case for those with DCD. SRT task performance was positively correlated with cerebellar cortical volume, and children with DCD trended towards lower cerebellar volume compared to controls. Children with DCD may not engage in PL during the SRT task in the same manner as controls, with this differential performance being associated with atypical cerebellar morphology.

Motor Adaptation Deficits in Children with Developmental Coordination Disorder and/or Reading Disorder

Procedural learning has been mainly tested through motor sequence learning tasks in children with neurodevelopmental disorders, especially with isolated Developmental Coordination Disorder (DCD) and Reading Disorder (RD). Studies on motor adaptation are scarcer and more controversial. This study aimed to compare the performance of children with isolated and associated DCD and RD in a graphomotor adaptation task. In total, 23 children with RD, 16 children with DCD, 19 children with DCD-RD, and 21 typically developing (TD) children wrote trigrams both in the conventional (from left to right) and opposite (from right to left) writing directions. The results show that movement speed and accuracy were more impacted by the adaptation condition (opposite writing direction) in children with neurodevelopmental disorders than TD children. Our results also reveal that children with RD have less difficulty adapting their movement than children with DCD. Children with DCD-RD had the most difficulty, and analysis of their performance suggests a cumulative effect of the two neurodevelopmental disorders in motor adaptation.

Auditory Category Learning in Children With Dyslexia

PURPOSE

Developmental dyslexia is proposed to involve selective procedural memory deficits with intact declarative memory. Recent research in the domain of category learning has demonstrated that adults with dyslexia have selective deficits in Information-Integration (II) category learning that is proposed to rely on procedural learning mechanisms and unaffected Rule-Based (RB) category learning that is proposed to rely on declarative, hypothesis testing mechanisms. Importantly, learning mechanisms also change across development, with distinct developmental trajectories in both procedural and declarative learning mechanisms. It is unclear how dyslexia in childhood should influence auditory category learning, a critical skill for speech perception and reading development.

METHOD

We examined auditory category learning performance and strategies in 7- to 12-year-old children with dyslexia (n = 25; nine females, 16 males) and typically developing controls (n = 25; 13 females, 12 males). Participants learned nonspeech auditory categories of spectrotemporal ripples that could be optimally learned with either RB selective attention to the temporal modulation dimension or procedural integration of information across spectral and temporal dimensions. We statistically compared performance using mixed-model analyses of variance and identified strategies using decision-bound computational models.

RESULTS

We found that children with dyslexia have an apparent selective RB category learning deficit, rather than a selective II learning deficit observed in prior work in adults with dyslexia.

CONCLUSION

These results suggest that the important skill of auditory category learning is impacted in children with dyslexia and throughout development, individuals with dyslexia may develop compensatory strategies that preserve declarative learning while developing difficulties in procedural learning.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25148519.

Rules generalization in children with dyslexia

BACKGROUND

Rule learning (RL) is the ability to extract and generalize higher-order repetition-based structures. Children with Developmental Dyslexia (DD) often report difficulties in learning complex regularities in sequential stimuli, which might be due to the complexity of the rule to be learned. Learning high-order repetition-based rules represents a building block for the development of language skills.

AIMS

This study investigates the ability to extract and generalize simple, repetition-based visual rules (e.g., ABA) in 8-11-year-old children without (TD) and with a diagnosis of Development Dyslexia (DD) and its relationship with language and reading skills.

METHOD

Using a forced-choice paradigm, children were first exposed to a visual sequence containing a repetition-based rule (e.g., ABA) and were then asked to recognize familiar and novel rules generated by new visual elements. Standardized language and reading tests were also administered to both groups.

RESULTS

The accuracy in recognizing rules was above chance for both groups, even though DD children were less accurate than TD children, suggesting a less efficient RL mechanism in the DD group. Moreover, visual RL was positively correlated with both language and reading skills.

CONCLUSION

These results further confirm the crucial role of RL in the acquisition of linguistic skills and mastering reading abilities.

Attention and motor profiles in children with developmental coordination disorder: A neuropsychological and neuroimaging investigation

AIM

This study aimed to (1) quantify attention and executive functioning in children with developmental coordination disorder (DCD), (2) assess whether some children with DCD are more likely to show attention difficulties, and (3) characterize brain correlates of motor and attention deficits.

METHOD

Fifty-three children (36 with DCD and 17 without) aged 8 to 10 years underwent T1-weighted and diffusion-weighted magnetic resonance imaging, and standardized attention and motor assessments. Parents completed questionnaires of executive functioning and symptoms of inattention and hyperactivity. We assessed regional cortical thickness and surface area, and cerebellar, callosal, and primary motor tract structure.

RESULTS

Analyses of covariance and one-sample t-tests identified impaired attention, non-motor processing speed, and executive functioning in children with DCD, yet partial Spearman's rank correlation coefficients revealed these were unrelated to one another or the type or severity of the motor deficit. Robust regression analyses revealed that cortical morphology in the posterior cingulate was associated with both gross motor skills and inattentive symptoms in children with DCD, while gross motor skills were also associated with left corticospinal tract (CST) morphology.

INTERPRETATION

Children with DCD may benefit from routine attention and hyperactivity assessments. Alterations in the posterior cingulate and CST may be linked to impaired forward modelling during movements in children with DCD. Overall, alterations in these regions may explain the high rate of non-motor impairments in children with DCD.

WHAT THIS PAPER ADDS

Children with developmental coordination disorder have difficulties in attention, processing speed, and executive functioning. Non-motor impairments were not interrelated or correlated with the type or severity of motor deficit. Posterior cingulate morphology was associated with gross motor skills and inattention. Gross motor skills were also associated with left corticospinal tract morphology.

Atypical reliance on monocular visual pathway for face and word recognition in developmental dyslexia

Studies with individuals with developmental dyslexia (DD) have documented impaired perception of words and faces, both of which are domains of visual expertise for human adults. In this study, we examined a possible mechanism that might be associated with the impaired acquisition of visual expertise for words and faces in DD, namely, the atypical engagement of the monocular visual pathway. Participants with DD and typical readers (TR) judged whether a pair of sequentially presented unfamiliar faces or nonwords were the same or different, and the pair of stimuli were displayed in an eye-specific fashion using a stereoscope. Based on evidence of greater reliance on subcortical structures early in development, we predicted differences between the groups in the engagement of lower (monocular) versus higher (binocular) regions of the visual pathways. Whereas the TR group showed a monocular advantage for both stimulus types, the DD participants evinced a monocular advantage for faces and words that was much greater than that measured in the TRs. These findings indicate that the DD individuals have enhanced subcortical engagement and that this might arise from the failure to fine-tune cortical correlates mediating the discrimination of homogeneous exemplars in domains of expertise.

The effect of online visual games on visual perception, oculomotor, and balance skills of children with developmental dyslexia during the COVID-19 pandemic

PURPOSE

To evaluate the effect of online visual games on the balance, visual perception, and oculomotor skills of children with developmental dyslexia during the COVID-19 pandemic.

METHODS

In this single-blind randomized clinical trial, 50 children with developmental dyslexia, aged 7 to 11 years, were recruited from rehabilitation centers in Tehran, Iran, using a convenience sampling strategy. Participants were randomly divided into two groups: intervention (25) and control (25), with close matching based on sex, age, IQ, and type of disease. The interventions consisted of web-based online computer games focusing on visual perception and oculomotor skills. Outcome measures included the Test of Visual Perception Skills-Revised, the Pediatric Balance Scale, and videonystagmography. The Wechsler Intelligence Scale for Children-IV and the Reading and Dyslexia Test were used to evaluate IQ and reading skills, respectively.

RESULTS

The intervention group exhibited significant post-intervention improvements in the Test of Visual Perception Skills-Revised, tracking gain, saccade latency, and saccade velocity scores (all P < 0.001). In contrast, the control group showed no significant differences in these tests in pre- and post-intervention (all P > 0.05). Notably, post-intervention comparisons between the groups revealed significant differences in smooth pursuit eye movements (P < 0.001), saccade latency (P = 0.027), and saccade velocity (P < 0.001). The Pediatric Balance Scale scores remained unchanged in both groups post-intervention (intervention: P = 0.317; control: P = 0.999). Game face validity was affirmed with impact scores above 1.5 for all items, suggesting that the games were straightforward, clear, and relevant.

CONCLUSION

Online visual games enhanced oculomotor and visual perception skills in children with dyslexia but did not influence balance skills.

Language abilities in children and adolescents with DLD and ADHD: A scoping review

PURPOSE

There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences.

METHOD

A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed.

RESULTS

The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary.

CONCLUSION

Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.

Atypical procedural learning skills in children with Developmental Coordination Disorder

We investigated the procedural learning deficit hypothesis in Developmental Coordination Disorder (DCD) while controlling for global performance such as slower reaction times (RTs) and variability. Procedural (sequence) learning was assessed in 31 children with DCD and 31 age-matched typically developing (TD) children through a serial reaction time task (SRTT). Sequential and random trial conditions were intermixed within five training epochs. Two repeated measures ANOVAs were conducted on a Sequence-Specific Learning Index (SSLI) and a Global Performance Index (GPI, speed/accuracy measure) with Epoch (for SSLI and GPI) and Condition (for GPI) as within-subjects factors, and Group as between-subjects factor. Controlling for RTs differences through normalized RTs, revealed a global reduction of SSLI in children with DCD compared with TD peers suggesting reduced sequence learning skills in DCD. Still, a significant Group x Condition interaction observed on GPI indicated that children from both groups were able to discriminate between sequential and random trials. DCD presented reduced procedural learning skills after controlling for global performance. This finding highlights the importance of considering the general functioning of the child while assessing learning skills in patients.

Intact procedural memory and impaired auditory statistical learning in adults with dyslexia

Developmental dyslexia is a reading disorder that is associated with atypical brain function. One neuropsychological theory posits that dyslexia reflects a deficit in the procedural memory system, which supports implicit learning, or the acquisition of knowledge without conscious awareness or intention. This study investigated various forms of procedural learning in adults with dyslexia and typically-reading adults. Adults with dyslexia exhibited typical skill learning on mirror tracing and rotary pursuit tasks that have been well-established as reflecting purely procedural memory and dependent on basal ganglia and cerebellar structures. They also exhibited typical statistical learning for visual material, but impaired statistical learning for auditory material. Auditory statistical learning proficiency correlated positively with single-word reading performance across all participants and within the group with dyslexia, linking a major difficulty in dyslexia with impaired auditory statistical learning. These findings dissociate multiple forms of procedural memory that are intact in dyslexia from a specific impairment in auditory statistical learning that is associated with reading difficulty.

Impaired extraction and consolidation of morphological regularities in developmental dyslexia: A domain general deficit?

The current study examined whether adults with Developmental Dyslexia are impaired in learning linguistic regularities in a novel language, and whether this may be explained by a domain general deficit in the effect of sleep on consolidation. We compared online learning and offline consolidation of morphological regularities in individuals with Developmental Dyslexia (N = 40) and typical readers (N = 38). Participants learned to apply plural inflections to novel words based on morpho-phonological rules embedded in the input and learned to execute a finger motor sequence task. To test the effects of time and sleep on consolidation, participants were assigned into one of two sleep-schedule groups, trained in the evening or in the morning and tested 12 and 24 h later. Unlike typical readers, Dyslexic readers did not extract the morpho-phonological regularities during training and as a group they did not show offline gains in inflecting trained items 24 h after training, suggesting that the deficit in extraction of regularities during training may be related to the deficit in consolidation. The offline gains in dyslexic readers, were correlated with their prior phonological abilities, and were less affected by sleep than those of typical readers. Although no deficit was found in the consolidation of the motor task, dyslexic readers were again less successful in generating an abstract representation of the motor sequence, reflected in a difficulty to generalize the motor sequence knowledge acquired using one hand to the untrained hand. The results suggest that individuals with Developmental Dyslexia have a domain general deficit in extracting statistical regularities from an input. Within the language domain this deficit is reflected in reduced benefits of consolidation, particularly during sleep, perhaps due to reduced prior phonological abilities, which may impede the individual's ability to extract the linguistic regularities during and after training and thus constrain the consolidation process.

Contributions of Lower Structures to Higher Cognition: Towards a Dynamic Network Model

Researchers often attribute higher cognition to the enlargement of cortical regions throughout evolution, reflecting the belief that humans sit at the top of the cognitive pyramid. Implicitly, this approach assumes that the subcortex is of secondary importance for higher-order cognition. While it is now recognized that subcortical regions can be involved in various cognitive domains, it remains unclear how they contribute to computations essential for higher-level cognitive processes such as endogenous attention and numerical cognition. Herein, we identify three models of subcortical-cortical relations in these cognitive processes: (i) subcortical regions are not involved in higher cognition; (ii) subcortical computations support elemental forms of higher cognition mainly in species without a developed cortex; and (iii) higher cognition depends on a whole-brain dynamic network, requiring integrated cortical and subcortical computations. Based on evolutionary theories and recent data, we propose the SEED hypothesis: the Subcortex is Essential for the Early Development of higher cognition. According to the five principles of the SEED hypothesis, subcortical computations are essential for the emergence of cognitive abilities that enable organisms to adapt to an ever-changing environment. We examine the implications of the SEED hypothesis from a multidisciplinary perspective to understand how the subcortex contributes to various forms of higher cognition.

Reading fluency and statistical learning across modalities and domains: Online and offline measures

The vulnerability of statistical learning has been demonstrated in reading difficulties in both the visual and acoustic modalities. We examined segmentation abilities of Hungarian speaking adolescents with different levels of reading fluency in the acoustic verbal and visual nonverbal domains. We applied online target detection tasks, where the extent of learning is reflected in differences between reaction times to predictable versus unpredictable targets. Explicit judgments of well-formedness were also elicited in an offline two-alternative forced choice (2AFC) task. Learning was evident in both the acoustic verbal and visual nonverbal tasks, both in online and offline measures, but learning effects were larger both in online and offline tasks in the verbal acoustic condition. We haven’t found evidence for a significant relationship between statistical learning and reading fluency in adolescents in either modality. Together with earlier findings, these results suggest that the relationship between reading and statistical learning is dependent on the domain, modality and nature of the statistical learning task, on the reading task, on the age of participants, and on the specific language. The online target detection task is a promising tool which can be adapted to a wider set of tasks to further explore the contribution of statistical learning to reading acquisition in participants from different populations.

Developmental dyslexia, developmental coordination disorder and comorbidity discrimination using multimodal structural and functional neuroimaging

Developmental dyslexia (DD) and developmental coordination disorder (DCD) are two common neurodevelopmental disorders with a high co-occurrence rate. This led several authors to postulate that the two disorders share, at least partially, similar neural underpinning. However, even though several studies examined brain differences between typically developing (TD) children and children with either DD or DCD, no previous study directly compared DD, DCD and children with both disorders (COM) using neuroimaging. We acquired structural and resting-state functional MRI images of 136 children (TD = 42, DD = 45, DCD = 20, COM = 29). Difference between TD children and the other groups was assessed using univariate analysis of structural indexes including grey and white matter volumes and functional indexes quantifying activity (fraction of the amplitude of the low frequency fluctuations), local and global connectivity. Regional differences in structural and functional brain indexes were then used to train machine learning models to discriminate among DD, DCD and COM and to find the most discriminant regions. While no imaging index alone discriminated between the three groups, grouping grey and white matter volumes (structural model) or activity, local and global connectivity (functional model) made possible to discriminate among the DD, DCD and COM groups. The most important discrimination was obtained using the functional model, with regions in the cerebellum and the temporal lobe being the most discriminant for DCD and DD children, respectively. Results further showed that children with both DD and DCD have subtle but identifiable brain differences that can only be captured using several imaging indexes pertaining to both brain structure and function.

Individual differences in procedural learning are associated with fiber specific white matter microstructure of the superior cerebellar peduncles in healthy adults

Functional neuroimaging has consistently implicated the fronto-basal ganglia-cerebellar circuit in procedural learning-defined as the incidental acquisition of sequence information through repetition. Limited work has probed the role of white matter fiber pathways that connect the regions in this network, such as the superior cerebellar peduncles (SCP) and the striatal premotor tracts (STPMT), in explaining individual differences in procedural learning. High angular diffusion weighted imaging was acquired from 20 healthy adults aged 18-45 years. Fixel-based analysis was performed to extract specific measures of white matter microstructure (fiber density; FD) and macrostructure (fiber cross-section; FC), from the SCP and STPMT. These fixel metrics were correlated with performance on the serial reaction time (SRT) task, and sensitivity to the sequence was indexed by the difference in reaction time between the final block of sequence trials and the randomized block (namely, the 'rebound effect'). Analyses revealed a significant positive relationship between FD and the rebound effect in segments of both the left and right SCP (p_FWE < .05). That is, increased FD in these tracts was associated with greater sensitivity to the sequence on the SRT task. No significant associations were detected between fixel metrics in the STPMT and the rebound effect. Our results support the likely role of white matter organization in the basal ganglia-cerebellar circuit in explaining individual differences in procedural learning.

The multiple-level framework of developmental dyslexia: the long trace from a neurodevelopmental deficit to an impaired cultural technique

Developmental dyslexia is a neurodevelopmental disorder characterized by an unexpected impairment in literacy acquisition leading to specific poor academic achievement and possible secondary symptoms. The multi-level framework of developmental dyslexia considers five levels of a causal pathway on which a given genotype is expressed and hierarchically transmitted from one level to the next under the increasing influence of individual learning-relevant traits and environmental factors moderated by cultural conditions. These levels are the neurobiological, the information processing and the skill level (prerequisites and acquisition of literacy skills), the academic achievement level and the level of secondary effects. Various risk factors are present at each level within the assumed causal pathway and can increase the likelihood of exhibiting developmental dyslexia. Transition from one level to the next is neither unidirectional nor inevitable. This fact has direct implications for prevention and intervention which can mitigate transitions from one level to the next. In this paper, various evidence-based theories and findings regarding deficits at different levels are placed in the proposed framework. In addition, the moderating effect of cultural impact at and between information processing and skill levels are further elaborated based on a review of findings regarding influences of different writing systems and orthographies. These differences impose culture-specific demands for literacy-specific cognitive procedures, influencing both literacy acquisition and the manifestation of developmental dyslexia.

Gross, Fine and Visual-Motor Skills in Children with Language Disorder, Speech Sound Disorder and Their Combination

Increasing evidence shows that children with Communication Disorders (CDs) may show gross, fine, and visual-motor difficulties compared to children with typical development. Accordingly, the present study aims to characterize gross, fine and visual-motor skills in children with CDs, distinguishing children with CDs into three subgroups, i.e., with Language Disorders (LD), Speech Sound Disorders (SSD), and LD + SSD. In Experiment 1, around 60% of children with CDs (4 to 7 years; 21 with LD, 36 with SSD, and 90 with LD + SSD) showed clinical/borderline scores in balance skills, regardless of the type of communication deficit. However, children with LD, SSD, and LD + SSD did not differ in gross and fine motor skills. In Experiment 2, a higher percentage of children with CDs (4 to 7 years; 34 with LD, 62 with SSD, 148 with LD + SSD) obtained clinical/borderline scores in Visual Perception skills. Moreover, children with LD + SSD performed significantly worsen in Visual Perception and Fine Motor Coordination skills compared to children with SSD only. Our results underlined that CDs are generally associated with gross motor difficulties and that visual-motor difficulties are related to the type of communication deficit. Paying earlier attention to the motor skills of children with CDs could help clinicians design effective interventions.

A failure of sleep-dependent consolidation of visuoperceptual procedural learning in young adults with ADHD

ADHD has been associated with cortico-striatal dysfunction that may lead to procedural memory abnormalities. Sleep plays a critical role in consolidating procedural memories, and sleep problems are an integral part of the psychopathology of ADHD. This raises the possibility that altered sleep processes characterizing those with ADHD could contribute to their skill-learning impairments. On this basis, the present study tested the hypothesis that young adults with ADHD have altered sleep-dependent procedural memory consolidation. Participants with ADHD and neurotypicals were trained on a visual discrimination task that has been shown to benefit from sleep. Half of the participants were tested after a 12-h break that included nocturnal sleep (sleep condition), whereas the other half were tested after a 12-h daytime break that did not include sleep (wakefulness condition) to assess the specific contribution of sleep to improvement in task performance. Despite having a similar degree of initial learning, participants with ADHD did not improve in the visual discrimination task following a sleep interval compared to neurotypicals, while they were on par with neurotypicals during the wakefulness condition. These findings represent the first demonstration of a failure in sleep-dependent consolidation of procedural learning in young adults with ADHD. Such a failure is likely to disrupt automatic control routines that are normally provided by the non-declarative memory system, thereby increasing the load on attentional resources of individuals with ADHD.

Upper Limb Kinematics of Handwriting among Children with and without Developmental Coordination Disorder

Background: Children with developmental coordination disorder (DCD) often experience difficulties with handwriting legibility and speed. This study investigates the relationship between handwriting and upper limb kinematics to characterize movement patterns of children with DCD and typically developing (TD) children. Methods: 30 children with and without DCD matched for age, gender, and parent education were compared across handwriting abilities using a standardized handwriting assessment of both copied and dictated tasks (A-A Handwriting). The 3D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterize movement patterns during handwriting and contrasted with written output. Results: Children with DCD wrote fewer legible letters in both copying and dictation. Children with DCD also showed poor automatization of key writing concepts. Atypical wrist postures were associated with reduced legibility for children with DCD (F (1,27) 4.71, p = 0.04, p-η2 = 0.15); whereas for TD children, better legibility was associated with greater variations in movement speed, particularly of the wrist (rho = −0.578, p < 0.05). Conclusion: Results reflect different movement parameters influencing handwriting in children with DCD. An improved understanding of the movement characteristics during handwriting of these children may assist intervention design.

Understanding Mathematical Learning Disorder in Regard to Executive and Cerebellar Functioning: a Failure of Procedural Consolidation

A burgeoning body of literature in pediatric neuropsychological assessment suggests executive functioning is the foundation of many procedural learning skills as mediated by cerebellar processing. Given the neuropsychological necessity of intact procedural learning ability for efficient academic learning, the accurate identification of what we have termed “procedural consolidation deficit” (PCD) may be an underpinning of mathematical learning disorder (MLD). Thus, one aim of the present study was to perform an exploratory correlational analysis between performance on pediatric neuropsychological tasks of procedural learning and a classification of MLD. The second aim was to utilize regression analysis of measures of procedural learning for predicting a clinically useful classification of MLD. Results revealed a significant correlation between performance on tasks of procedural learning and a classification of MLD. The follow-up regression model yielded the most predictive variables in identifying individuals with MLD, which included: (a) WISC-V Coding; (b) first administration of Trail Making Test Part B; (c) slope across five serial administrations of Trail Making Test Part B. The model was highly significant and had a classification accuracy for MLD of 87.4%. Results suggest performance on procedural learning tasks significantly predict a classification of MLD. Theoretical and clinical implications are discussed.

An Investigation of Developmental Coordination Disorder Characteristics in Children With Childhood Apraxia of Speech

PURPOSE

Children with childhood apraxia of speech (CAS) evidence a high rate of co-occurring fine and gross motor deficits. This clinical focus article reports a preliminary investigation of characteristics of developmental coordination disorder (DCD), a neurodevelopmental disorder categorized by poor motor proficiency and functional limitations, in this population.

METHOD

Children with CAS underwent a comprehensive motor evaluation using the Movement Assessment Battery for Children-Second Edition, the Developmental Coordination Disorder Questionnaire, and a developmental history questionnaire to determine if they met criteria for a DCD diagnosis as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

RESULTS

Six out of seven participants met DCD criteria based on the DSM-5 criteria. Four of these children had a co-occurring diagnosis of developmental language disorder, and all met criteria for DCD.

CONCLUSIONS

Consistent with previous research, the majority of participants demonstrated motor deficits and 85% met criteria for DCD. Despite this high rate of motor deficits, only 57% had previously undergone a physical/occupational therapy evaluation and intervention and only one had a previous diagnosis of DCD. These findings suggest that formal movement assessments are essential for children with a CAS diagnosis.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20540193.

Repeated series learning revisited with a novel prediction on the reduced effect of item frequency in dyslexia

Developmental dyslexia, a difficulty with acquiring fluent reading, has also been characterized by reduced short-term memory (STM) capacity, which is often operationalized with span tasks. The low performance of individuals with dyslexia (IDDs) in such tasks is commonly attributed to poor phonological memory. However, we suggest an alternative explanation based on the observation that many times the items that are used in spans tasks are high-frequency items (e.g., digit words). We suggest that IDDs do not enjoy the benefit of item frequency to the same extent as controls, and thus their performance in span tasks is especially hampered. On the contrary, learning of repeated sequences was shown to be largely independent of item frequency, and therefore this type of learning may be unimpaired in dyslexia. To test both predictions, we used the Hebb-learning paradigm. We found that IDDs’ performance is especially poor compared to controls’ when high-frequency items are used, and that their repeated series learning does not differ from that of controls. Taken together with existing literature, our findings suggest that impaired learning of repeated series is not a core characteristic of dyslexia, and that the reports on reduced STM in dyslexia may to a large extent be explained by reduced benefit of item frequency.

Developmental Dyslexia: Disorder or Specialization in Exploration?

We raise the new possibility that people diagnosed with developmental dyslexia (DD) are specialized in explorative cognitive search, and rather than having a neurocognitive disorder, play an essential role in human adaptation. Most DD research has studied educational difficulties, with theories framing differences in neurocognitive processes as deficits. However, people with DD are also often proposed to have certain strengths - particularly in realms like discovery, invention, and creativity - that deficit-centered theories cannot explain. We investigate whether these strengths reflect an underlying explorative specialization. We re-examine experimental studies in psychology and neuroscience using the framework of cognitive search, whereby many psychological processes involve a trade-off between exploration and exploitation. We report evidence of an explorative bias in DD-associated cognitive strategies. High DD prevalence and an attendant explorative bias across multiple areas of cognition suggest the existence of explorative specialization. An evolutionary perspective explains the combination of findings and challenges the view that individuals with DD have a disorder. In cooperating groups, individual specialization is favored when features that confer fitness benefits are functionally incompatible. Evidence for search specialization suggests that, as with some other social organisms, humans mediate the exploration-exploitation trade-off by specializing in complementary strategies. The existence of a system of collective cognitive search that emerges through collaboration would help to explain our species' exceptional adaptiveness. It also aligns with evidence for substantial variability during our evolutionary history and the notion that humans are adapted not to a particular habitat but to variability itself. Specialization creates interdependence and necessitates balancing complementary strategies. Reframing DD therefore underscores the urgency of changing certain cultural practices to ensure we do not inhibit adaptation. Key improvements would remove cultural barriers to exploration and nurture explorative learning in education, academia, and the workplace, as well as emphasize collaboration over competition. Specialization in complementary search abilities represents a meta-adaptation; through collaboration, this likely enables human groups (as a species and as cultural systems) to successfully adapt. Cultural change to support this system of collaborative search may therefore be essential in confronting the challenges humanity now faces.

Neuroergonomic assessment of developmental coordination disorder

Until recently, neural assessments of gross motor coordination could not reliably handle active tasks, particularly in realistic environments, and offered a narrow understanding of motor-cognition. By applying a comprehensive neuroergonomic approach using optical mobile neuroimaging, we probed the neural correlates of motor functioning in young people with Developmental Coordination Disorder (DCD), a motor-learning deficit affecting 5-6% of children with lifelong complications. Neural recordings using fNIRS were collected during active ambulatory behavioral task execution from 37 Typically Developed and 48 DCD Children who performed cognitive and physical tasks in both single and dual conditions. This is the first of its kind study targeting regions of prefrontal cortical dysfunction for identification of neuropathophysiology for DCD during realistic motor tasks and is one of the largest neuroimaging study (across all modalities) involving DCD. We demonstrated that DCD is a motor-cognitive disability, as gross motor /complex tasks revealed neuro-hemodynamic deficits and dysfunction within the right middle and superior frontal gyri of the prefrontal cortex through functional near infrared spectroscopy. Furthermore, by incorporating behavioral performance, decreased neural efficiency in these regions were revealed in children with DCD, specifically during motor tasks. Lastly, we provide a framework, evaluating disorder impact in ecologically valid contexts to identify when and for whom interventional approaches are most needed and open the door for precision therapies.

Statistical learning in children with a family risk of dyslexia

The assumption that statistical learning is affected in dyslexia has generally been evaluated in children and adults with diagnosed dyslexia, not in pre-literate children with a family risk (FR) of dyslexia. In this study, four-to-five-year-old FR children (n = 25) and No-FR children (n = 33) completed tasks of emerging literacy (phoneme awareness and RAN). They also performed an online non-adjacent dependency learning (NADL) task, based on the Serial Reaction Time (SRT) task paradigm. Children's accuracy (hits), signal sensitivity (d') and reaction times were measured. The FR group performed marginally more poorly on phoneme awareness and significantly more poorly on RAN than the No-FR group. Regarding NADL outcomes, the results were less straightforward: the data suggested successful statistical learning for both groups, as indicated by the hit and reaction time curves found. However, the FR group was less accurate and slower on the task than the No-FR group. Furthermore, unlike the No-FR group, performance in the FR group varied as a function of the specific stimulus presented. Taken together, these findings fail to show a robust difference in statistical learning between children with and without an FR of dyslexia at preschool age, in line with earlier work on older children and adults with dyslexia.

Neural correlates of sequence learning in children with developmental dyslexia

Developmental Dyslexia (DD) is a condition in which reading accuracy and/or fluency falls substantially below what is expected based on the individuals age, general level of cognitive ability, and educational opportunities. The procedural circuit deficit hypothesis (PDH) proposes that DD may be largely explained in terms of alterations of the cortico‐basal ganglia procedural memory system (in particular of the striatum) whereas the (hippocampus‐dependent) declarative memory system is intact, and may serve a compensatory role in the condition. The present study was designed to test this hypothesis. Using Magnetic Resonance Imaging, we examined the functional and structural brain correlates of sequence‐specific procedural learning (SL) on the serial reaction time task, in 17 children with DD and 18 typically developing (TD) children. The study was performed over 2 days with a 24‐h interval between sessions. In line with the PDH, the DD group showed less activation of the striatum during the processing of sequential statistical regularities. These alterations predicted the amount of SL at day 2, which in turn explained variance in children's reading fluency. Additionally, reduced hippocampal activation predicted larger SL gains between day 1 and day 2 in the TD group, but not in the DD group. At the structural level, caudate nucleus volume predicted the amount of acquired SL at day 2 in the TD group, but not in the DD group. The findings encourage further research into factors that promote learning in children with DD, including through compensatory mechanisms.

Subcortical Cognition: The Fruit Below the Rind

Cognitive neuroscience has highlighted the cerebral cortex while often overlooking subcortical structures. This cortical proclivity is found in basic and translational research on many aspects of cognition, especially higher cognitive domains such as language, reading, music, and math. We suggest that, for both anatomical and evolutionary reasons, multiple subcortical structures play substantial roles across higher and lower cognition. We present a comprehensive review of existing evidence, which indeed reveals extensive subcortical contributions in multiple cognitive domains. We argue that the findings are overall both real and important. Next, we advance a theoretical framework to capture the nature of (sub)cortical contributions to cognition. Finally, we propose how new subcortical cognitive roles can be identified by leveraging anatomical and evolutionary principles, and we describe specific methods that can be used to reveal subcortical cognition. Altogether, this review aims to advance cognitive neuroscience by highlighting subcortical cognition and facilitating its future investigation. Expected final online publication date for the Annual Review of Neuroscience, Volume 45 is July 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Atypical connectivity in the cortico-striatal network in NF1 children and its relationship with procedural perceptual-motor learning and motor skills

Introduction

Neurofibromatosis type 1 (NF1) is considered a model of neurodevelopmental disorder because of the high frequency of learning deficits, especially developmental coordination disorder. In neurodevelopmental disorder, Nicolson and Fawcett formulated the hypothesis of an impaired procedural learning system that has its origins in cortico-subcortical circuits. Our aim was to investigate the relationship between cortico-striatal connectivity and procedural perceptual-motor learning performance and motor skills in NF1 children.

Methods

Seventeen NF1 and 18 typically developing children aged between 8 and 12 years old participated in the study. All were right-handed and did not present intellectual or attention deficits. In all children, procedural perceptual-motor learning was assessed using a bimanual visuo-spatial serial reaction time task (SRTT) and motor skills using the Movement Assessment Battery for Children (M-ABC). All participants underwent a resting-state functional MRI session. We used a seed-based approach to explore cortico-striatal connectivity in somatomotor and frontoparietal networks. A comparison between the groups’ striato-cortical connectivity and correlations between connectivity and learning (SRTT) and motor skills (M-ABC) were performed.

Results

At the behavioral level, SRTT scores are not significantly different in NF1 children compared to controls. However, M-ABC scores are significantly impaired within 9 patients (scores below the 15th percentile). At the cerebral level, NF1 children present a higher connectivity in the cortico-striatal regions mapping onto the right angular gyrus compared to controls. We found that the higher the connectivity values between these regions, differentiating NF1 and controls, the lower the M-ABC scores in the whole sample. No correlation was found for the SRTT scores.

Conclusion

NF1 children present atypical hyperconnectivity in cortico-striatal connections. The relationship with motor skills could suggest a sensorimotor dysfunction already found in children with developmental coordination disorder. These abnormalities are not linked to procedural perceptual-motor learning assessed by SRTT.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11689-022-09428-y.

Retrospective Case-Control Study of Communication and Motor Abilities in 143 Children With Suspected Childhood Apraxia of Speech: Effect of Concomitant Diagnosis

Purpose

This study sought to determine if children with childhood apraxia of speech (CAS) plus another major diagnosis (CAS+) are equivalent in communication and motor profiles to those with a primary diagnosis of CAS and no indication or report of any other diagnosis (CAS-Primary).

Method

This retrospective case-control study included a chart review of 143 children who were suspected of having CAS at Children's Hospital-Wisconsin between 1998 and 2004. Participants were between 30 and 127 months old and included 107 males. Participants were assigned to the suspected CAS-Primary group (n = 114) if they had characteristics of CAS but no other major diagnosis (e.g., galactosemia) and to the CAS+ group (n = 29) if a comorbid diagnosis was present. Groups were compared across demographic, communication, and motor characteristics.

Results

Children with CAS+ evidenced more severe motor profiles than those with CAS-Primary, χ² = (1, n = 122) = 4.952, p = .026, and a small-to-medium effect size (Φ = .201). On average, communication profiles also tended to be more severe among those with CAS+ wherein receptive language was poorer and phonemic inventories were smaller than those with CAS-Primary.

Conclusions

These retrospective data suggest that comorbid diagnosis may play an important role in communication and motor development in children with suspected CAS. These exploratory findings should motivate future prospective studies that consider the role of concomitant diagnoses in symptom profile and response to treatment in children with CAS.

A Large-Scale Investigation of White Matter Microstructural Associations with Reading Ability

Reading involves the functioning of a widely distributed brain network, and white matter tracts are responsible for transmitting information between constituent network nodes. Several studies have analyzed fiber bundle microstructural properties to shed insights into the neural basis of reading abilities and disabilities. Findings have been inconsistent, potentially due to small sample sizes and varying methodology. To address this, we analyzed a large data set of 686 children ages 5–18 using state-of-the-art neuroimaging acquisitions and processing techniques. We searched for associations between fractional anisotropy (FA) and single-word and single-nonword reading skills in children with diverse reading abilities across multiple tracts previously thought to contribute to reading. We also looked for group differences in tract FA between typically reading children and children with reading disabilities. FA of the white matter increased with age across all participants. There were no significant correlations between overall reading abilities and tract FAs across all children, and no significant group differences in tract FA between children with and without reading disabilities. There were associations between FA and nonword reading ability in older children (ages 9 and above). Higher FA in the right superior longitudinal fasciculus (SLF) and left inferior cerebellar peduncle (ICP) correlated with better nonword reading skills. These results suggest that letter-sound correspondence skills, as measured by nonword reading, are associated with greater white matter coherence among older children in these two tracts, as indexed by higher FA.

Specific Cues Can Improve Procedural Learning and Retention in Developmental Coordination Disorder and/or Developmental Dyslexia

The present study investigates procedural learning of motor sequences in children with developmental coordination disorder (DCD) and/or developmental dyslexia (DD), typically-developing children (TD) and healthy adults with a special emphasis on (1) the role of the nature of stimuli and (2) the neuropsychological functions associated to final performance of the sequence. Seventy children and ten adults participated in this study and were separated in five experimental groups: TD, DCD, DD, and DCD + DD children and adults. Procedural learning was assessed with a serial reaction time task (SRTT) that required to tap on a specific key as accurately and quickly as possible when stimuli appeared on the screen. Three types of stimuli were proposed as cues: the classical version of the SRTT with 4 squares aligned horizontally on the screen, giving visuospatial cues (VS cues), and two modified versions, with 4 letters aligned horizontally on the screen (VS + L cues) and letters at the center of the screen (L cues). Reaction times (RT) during the repeated and random blocks allowed assessing three phases of learning: global learning, specific learning and retention of the sequence. Learning was considered as completed when RT evolved significantly in the three phases. Neuropsychological assessment involved, among other functions, memory and attentional functions. Our main result was that learning and retention were not influenced by the available cues in adults whereas learning improved with specific cues in children with or without neurodevelopmental disorders. More precisely, learning was not completed with L cues in children with neurodevelopmental disorders. For children with DD, learning was completed with the VS and VS + L cues whereas for children with DCD (with or without DD), learning was completed with combined VS + L cues. Comorbidity between DD and DCD had no more impact on procedural learning than DCD alone. These results suggest that learning depends on the nature of cues available during practice and that cues allowing learning and retention depend on the type of disorder. Moreover, selective attention was correlated with RT during retention, suggesting that this neuropsychological function is important for procedural learning whatever the available cues.

Modeling the influence of motor skills on literacy in third grade: Contributions of executive functions and handwriting

Several nonlanguage factors influence literacy development, and motor skills are among those most studied. Despite the publication of several studies that have supported the existence of this relationship, the type of influence and underlying mechanisms have been little explored. Herein, we propose modeling the relationship between motor skills and literacy through structural equation modeling, testing the contribution of executive functions and handwriting skills as the possible mediators of this relationship. In a study of 278 third-grade children, we used a wide range of measures related to written language (reading, spelling, reading comprehension, and written production), fine motor skills (dominant hand, nondominant hand, and bimanual dexterity), executive functions (verbal and visuospatial working memory, inhibition, and shifting), and handwriting. Structural equation modeling of the relationship between these different variables indicated that in the third grade, the influence of fine motor skills on literacy is fully mediated by both executive functions and handwriting skills. These motor skills effects are observed for both low levels of processing (reading, spelling) and high levels of processing (reading comprehension, written production). The results are discussed in terms of the potential mechanisms underlying different literacy skills and their implications for pedagogical programs.

Regular rhythmic and audio-visual stimulations enhance procedural learning of a perceptual-motor sequence in healthy adults: A pilot study

Procedural learning is essential for the effortless execution of many everyday life activities. However, little is known about the conditions influencing the acquisition of procedural skills. The literature suggests that sensory environment may influence the acquisition of perceptual-motor sequences, as tested by a Serial Reaction Time Task. In the current study, we investigated the effects of auditory stimulations on procedural learning of a visuo-motor sequence. Given that the literature shows that regular rhythmic auditory rhythm and multisensory stimulations improve motor speed, we expected to improve procedural learning (reaction times and errors) with repeated practice with auditory stimulations presented either simultaneously with visual stimulations or with a regular tempo, compared to control conditions (e.g., with irregular tempo). Our results suggest that both congruent audio-visual stimulations and regular rhythmic auditory stimulations promote procedural perceptual-motor learning. On the contrary, auditory stimulations with irregular or very quick tempo alter learning. We discuss how regular rhythmic multisensory stimulations may improve procedural learning with respect of a multisensory rhythmic integration process.

Impaired Perception and Neural Processing of Rules in Developmental Dyslexia

Rules and regularities of language are typically processed in an implicit and effortless way in the human brain. Individuals with developmental dyslexia have problems in implicit learning of regularities in sequential stimuli, but the neural basis of this deficit has not been studied. This study investigated extraction and utilization of a complex auditory rule at neural and perceptual levels in 18 adults with dyslexia and 20 typical readers. Mismatch negativity (MMN) and P3a responses to rule violations in speech stimuli, reflecting change detection and attention switch, respectively, were recorded with electroencephalogram. Both groups reported no or little explicit awareness of the rule, suggesting implicit processing. People with dyslexia showed deficient extraction of the rule evidenced by diminished MMNs estimated to originate particularly from the left perisylvian region. The group difference persisted in the attentive condition after the participants were told about the rule, and behavioral detection of the rule violations was poor in people with dyslexia, possibly suggesting difficulties also in utilizing explicit information of the rule. Based on these results, the speech processing difficulties in dyslexia extend beyond phoneme discrimination and basic auditory feature extraction. Challenges in implicit extraction and effortless adoption of complex auditory rules may be central to language learning difficulties in dyslexia.

Unraveling the Interconnections Between Statistical Learning and Dyslexia: A Review of Recent Empirical Studies

One important aspect of human cognition involves the learning of structured information encountered in our environment, a phenomenon known as statistical learning. A growing body of research suggests that learning to read print is partially guided by learning the statistical contingencies existing between the letters within a word, and also between the letters and sounds to which the letters refer. Research also suggests that impairments to statistical learning ability may at least partially explain the difficulties experienced by individuals diagnosed with dyslexia. However, the findings regarding impaired learning are not consistent, perhaps partly due to the varied use of methodologies across studies - such as differences in the learning paradigms, stimuli used, and the way that learning is assessed - as well as differences in participant samples such as age and extent of the learning disorder. In this review, we attempt to examine the purported link between statistical learning and dyslexia by assessing a set of the most recent and relevant studies in both adults and children. Based on this review, we conclude that although there is some evidence for a statistical learning impairment in adults with dyslexia, the evidence for an impairment in children is much weaker. We discuss several suggestive trends that emerge from our examination of the research, such as issues related to task heterogeneity, possible age effects, the role of publication bias, and other suggestions for future research such as the use of neural measures and a need to better understand how statistical learning changes across typical development. We conclude that no current theoretical framework of dyslexia fully captures the extant research findings on statistical learning.

Mathematics Disability vs. Learning Disability: A 360 Degree Analysis

A fundamental issue for research in mathematics disability (MD) and reading disability (RD) is: If these disabilities are clearly distinct, why is there so high a level of comorbidity, together with the converse; if these disabilities are so similar, why are there clear differences in underlying causes and aetiology? In order to address this puzzle, we introduce the “360 degree analysis” (360DA) framework and apply it to the overlap between RD and MD. The 360DA process starts by analyzing the issue from four perspectives: theoretical, developmental, affective, and pedagogical. Under 360DA, these analyses are then integrated to provide insights for theory, and for individual assessment and support, together with directions for future progress. The analyses confirm extensive similarities between arithmetic and reading development in terms of rote learning, executive function (EF), and affective trauma, but also major differences in terms of the conceptual needs, the motor coordination needs, and the methods of scaffolding. In terms of theory, commonalities are interpreted naturally in terms of initial general developmental delay followed by domain-independent affective trauma following school failure. Dissociations are interpreted in terms of cerebellar vs. hippocampal learning networks, sequential vs. spatial processing, and language vs. spatial scaffolding, with a further dimension of the need for accurate fixation for reading. The framework has significant theoretical and applied implications.

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia

BACKGROUND

It is important to improve verbal Working Memory (WM) in reading disability, as it is a key factor in learning. There are commercial verbal WM training programs, which have some short-term effects only on the verbal WM capacity, not reading. However, because of some weaknesses in current verbal WM training programs, researchers suggested designing and developing newly structured programs that particularly target educational functions such as reading skills. In the current double-blind randomized clinical trial study, we designed a new Verbal Working Memory-Balance (VWM-B) program which was carried out using a portable robotic device. The short-term effects of the VWM-B program, on verbal WM capacity, reading skills, and postural control were investigated in Iranian children with developmental dyslexia.

RESULTS

The effectiveness of the VWM-B program was compared with the VWM-program as a traditional verbal WM training. In comparison with VWM-program, the participants who received training by the VWM-B program showed superior performance on verbal WM capacity, reading skills, and postural control after a short-term intervention.

CONCLUSIONS

We proposed that the automatized postural control resulting from VWM-B training had a positive impact on improving verbal WM capacity and reading ability. Based on the critical role of the cerebellum in automatizing skills, our findings support the cerebellar deficit theory in dyslexia.

TRIAL REGISTRATION

This trial was (retrospectively) registered on 8 February 2018 with the Iranian Registry of Clinical Trials (IRCT20171219037953N1).

Delaying feedback compensates for impaired reinforcement learning in developmental dyslexia

A theoretical framework suggests that developmental dyslexia is characterized by abnormalities in brain structures underlying the procedural learning and memory systems while the declarative learning and memory systems are presumed to remain intact or even enhanced (Procedural Deficit Hypothesis). This notion has been supported by a substantial body of research, which focused on each system independently. However, less attention has been paid to interactions between these memory systems which may provide insights as to learning situations and conditions in which learning in dyslexia can be improved. The current study was undertaken to examine these important but unresolved issues. To this end, probabilistic reinforcement learning and episodic memory tasks were examined in participants with dyslexia and neurotypicals simultaneously within a single task. Feedback timing presentation was manipulated, building on prior research indicating that delaying feedback timing shifts striatal-based probabilistic learning, to become more hippocampal-dependent. It was hypothesized that if the procedural learning and memory systems are impaired in dyslexia, performance will be impaired under conditions that encourage procedural memory engagement (immediate feedback trials) but not under conditions that promote declarative memory processing (long delayed feedback trials). It was also predicted that the ability to incidentally acquire episodic information would be preserved in dyslexia. The results supported these predictions. Participants with dyslexia were impaired in probabilistic learning of cue-outcome associations compared to neurotypicals in an immediate feedback condition, but not when feedback on choices was presented after a long delay. Furthermore, participants with dyslexia demonstrated similar performance to neurotypicals in a task requiring incidental episodic memory formation. These findings attest to a dissociation between procedural-based and declarative-based learning in developmental dyslexia within a single task, a finding that adds discriminative validity to the Procedural Deficit Hypothesis. Just as important, the present findings suggest that training conditions designed to shift the load from midbrain/striatal systems to declarative memory mechanisms have the potential to compensate for impaired learning in developmental dyslexia.

The cognitive basis of dyslexia in school-aged children: A multiple case study in a transparent orthography

This study focuses on the role of numerous cognitive skills such as phonological awareness (PA), rapid automatized naming (RAN), visual and selective attention, auditory skills, and implicit learning in developmental dyslexia. We examined the (co)existence of cognitive deficits in dyslexia and assessed cognitive skills’ predictive value for reading. First, we compared school‐aged children with severe reading impairment (n = 51) to typical readers (n = 71) to explore the individual patterns of deficits in dyslexia. Children with dyslexia, as a group, presented low PA and RAN scores, as well as limited implicit learning skills. However, we found no differences in the other domains. We found a phonological deficit in 51% and a RAN deficit in 26% of children with dyslexia. These deficits coexisted in 14% of the children. Deficits in other cognitive domains were uncommon and most often coexisted with phonological or RAN deficits. Despite having a severe reading impairment, 26% of children with dyslexia did not present any of the tested deficits. Second, in a group of children presenting a wide range of reading abilities (N = 211), we analysed the relationship between cognitive skills and reading level. PA and RAN were independently related to reading abilities. Other skills did not explain any additional variance. The impact of PA and RAN on reading skills differed. While RAN was a consistent predictor of reading, PA predicted reading abilities particularly well in average and good readers with a smaller impact in poorer readers.

The co-occurrence of neurodevelopmental problems in dyslexia

The primary aim of this study was to explore the overlaps between dyslexia and a range of neurodevelopmental disorders and problems (NDPs), specifically symptoms of attention-deficit/hyperactivity disorder, autism spectrum disorder, atypical sensory perception and developmental coordination disorder. Capitalizing on a population-based sample of twins, secondary aims included estimating the heritability of dyslexia and reporting on the measurement characteristics of the scale used to assess dyslexia. A telephone interview regarding symptoms of dyslexia and other NDPs was conducted with parents of 1,688 nine-year-old twins. The prevalence and the heritability of dyslexia were estimated at 8 and 52%, respectively. The boy: girl ratio was 1.5:1. Results revealed that there was more than an eight-fold increase in (diagnostic proxy) NDPs prevalence in the dyslexia group as compared to typical readers. Quantitatively measured symptoms of inattention, oral language problems and atypical sensory perception significantly predicted dyslexia status in a multivariate analysis. By contrast, ASD-related inflexibility was inversely associated with dyslexia in the multivariate model. In sum, dyslexia often overlaps with other NDPs. The current study provides new knowledge supporting the position to move beyond isolated diagnostic categories into behavioural profiles of co-occurring problems when trying to understand the pattern of strengths and needs in individuals with dyslexia.

Resting-state functional brain connectivity is related to subsequent procedural learning skills in school-aged children

This magnetoencephalography (MEG) study investigates how procedural sequence learning performance is related to prior brain resting-state functional connectivity (rsFC), and to what extent sequence learning induces rapid changes in brain rsFC in school-aged children. Procedural learning was assessed in 30 typically developing children (mean age ± SD: 9.99 years ± 1.35) using a serial reaction time task (SRTT). During SRTT, participants touched as quickly and accurately as possible a stimulus sequentially or randomly appearing in one of the quadrants of a touchscreen. Band-limited power envelope correlation (brain rsFC) was applied to MEG data acquired at rest pre- and post-learning. Correlation analyses were performed between brain rsFC and sequence-specific learning or response time indices. Stronger pre-learning interhemispheric rsFC between inferior parietal and primary somatosensory/motor areas correlated with better subsequent sequence learning performance and faster visuomotor response time. Faster response time was associated with post-learning decreased rsFC within the dorsal extra-striate visual stream and increased rsFC between temporo-cerebellar regions. In school-aged children, variations in functional brain architecture at rest within the sensorimotor network account for interindividual differences in sequence learning and visuomotor performance. After learning, rapid adjustments in functional brain architecture are associated with visuomotor performance but not sequence learning skills.

The contribution of individual differences in statistical learning to reading and spelling performance in children with and without dyslexia

Using an individual differences approach in children with and without dyslexia, this study investigated the hypothesized relationship between statistical learning ability and literacy (reading and spelling) skills. We examined the clinical relevance of statistical learning (serial reaction time and visual statistical learning tasks) by controlling for potential confounds at the participant level (e.g., non-verbal reasoning, attention and phonological skills including rapid automatized naming and phonological short-term memory). A 100 Dutch-speaking 8- to 11-year-old children with and without dyslexia participated (50 per group), see also van Witteloostuijn et al. (2019) for a study with the same participants. No evidence of a relationship between statistical learning and literacy skills is found above and beyond participant-level variables. Suggestions from the literature that the link between statistical learning and literacy attainment, and therefore its clinical relevance, might be small and strongly influenced by methodological differences between studies are not contradicted by our findings.

Procedural Learning, Grammar, and Motor Skills in Children With Childhood Apraxia of Speech, Speech Sound Disorder, and Typically Developing Speech

Purpose This case-control study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development would perform differently on a procedural learning assessment and (b) whether grammatical ability would impact group differences. Method Communication, motor, and procedural learning abilities were assessed in 48 children with CAS (n = 13), SSD (n = 20), and typical development (n = 15), between 43 and 97 months of age (M = 66 months, SD = 12 months). Results On average, children with CAS demonstrated grammatical and motor impairments and required an increased number of exposures to the visuospatial sequence to demonstrate procedural learning, compared to peers with SSD or typical development. A subset of children from each group demonstrated an unanticipated procedural learning pattern wherein they evidenced an uptick in reaction time during the second sequenced block. Children with CAS with this pattern still evidenced procedural learning gains by the fifth sequenced block. In contrast, children with SSD and typical development with this pattern showed poor procedural learning outcomes and were characterized by lower scores on language and motor assessments as well. Conclusions This research provides partial support for the procedural learning deficit hypothesis in children with CAS and for a subset of children with SSD as well. Future research should examine the role of a serial reaction time task in identifying children at risk of multisystem communication and motor deficits. Supplemental Material https://doi.org/10.23641/asha.14173532.

The Differential Effects of Auditory and Visual Stimuli on Learning, Retention and Reactivation of a Perceptual-Motor Temporal Sequence in Children With Developmental Coordination Disorder

This study investigates the procedural learning, retention, and reactivation of temporal sensorimotor sequences in children with and without developmental coordination disorder (DCD). Twenty typically-developing (TD) children and 12 children with DCD took part in this study. The children were required to tap on a keyboard, synchronizing with auditory or visual stimuli presented as an isochronous temporal sequence, and practice non-isochronous temporal sequences to memorize them. Immediate and delayed retention of the audio-motor and visuo-motor non-isochronous sequences were tested by removing auditory or visual stimuli immediately after practice and after a delay of 2 h. A reactivation test involved reintroducing the auditory and visual stimuli after the delayed recall. Data were computed via circular analyses to obtain asynchrony, the stability of synchronization and errors (i.e., the number of supplementary taps). Firstly, an overall deficit in synchronization with both auditory and visual isochronous stimuli was observed in DCD children compared to TD children. During practice, further improvements (decrease in asynchrony and increase in stability) were found for the audio-motor non-isochronous sequence compared to the visuo-motor non-isochronous sequence in both TD children and children with DCD. However, a drastic increase in errors occurred in children with DCD during immediate retention as soon as the auditory stimuli were removed. Reintroducing auditory stimuli decreased errors in the audio-motor sequence for children with DCD. Such changes were not seen for the visuo-motor non-isochronous sequence, which was equally learned, retained and reactivated in DCD and TD children. All these results suggest that TD children benefit from both auditory and visual stimuli to memorize the sequence, whereas children with DCD seem to present a deficit in integrating an audio-motor sequence in their memory. The immediate effect of reactivation suggests a specific dependency on auditory information in DCD. Contrary to the audio-motor sequence, the visuo-motor sequence was both learned and retained in children with DCD. This suggests that visual stimuli could be the best information for memorizing a temporal sequence in DCD. All these results are discussed in terms of a specific audio-motor coupling deficit in DCD.