Can reading-specific training stimuli improve the effect of perceptual learning on peripheral reading speed?

Perceptual Learning of Visual Span Improves Chinese Reading Speed

Purpose

Evidence has indicated that the size of the visual span (the number of identifiable letters without movement of the eyes) and reading speed can be boosted through perceptual learning in alphabetic scripts. In this study, we investigated whether benefits of perceptual learning could be extended to visual-span size and sentence reading (all characters are presented at the same time) for Chinese characters and explored changes in sensory factors contributing to changes in visual-span size following training.

Methods

We randomly assigned 26 normally sighted subjects to either a control group (n = 13) or a training group (n = 13). Pre- and posttests were administered to evaluate visual-span profiles (VSPs) and reading speed. Training consisted of trigram (sequences of three characters) character-recognition trials over 4 consecutive days. VSPs are plots of recognition accuracy as a function of character position. Visual-span size was quantified as the area under VSPs in bits of information transmitted. A decomposition analysis of VSPs was used to quantify the effects of sensory factors (crowding and mislocation). We compared the size and sensory factors of visual span and reading speed following training.

Results

Following training, the visual-span size significantly increased by 11.7 bits, and reading speed increased by 50.8%. The decomposition analysis showed a significant reduction for crowding (-13.1 bits) but a minor increase in the magnitude of mislocation errors (1.46 bits) following training.

Conclusions

These results suggest that perceptual learning expands the visual-span size and further improves Chinese text sentence-reading speed, indicating that visual span may be a common sensory limitation on reading that can be overcome with practice.

Common constraints limit Korean and English character recognition in peripheral vision

The visual span refers to the number of adjacent characters that can be recognized in a single glance. It is viewed as a sensory bottleneck in reading for both normal and clinical populations. In peripheral vision, the visual span for English characters can be enlarged after training with a letter-recognition task. Here, we examined the transfer of training from Korean to English characters for a group of bilingual Korean native speakers. In the pre- and posttests, we measured visual spans for Korean characters and English letters. Training (1.5 hours × 4 days) consisted of repetitive visual-span measurements for Korean trigrams (strings of three characters). Our training enlarged the visual spans for Korean single characters and trigrams, and the benefit transferred to untrained English symbols. The improvement was largely due to a reduction of within-character and between-character crowding in Korean recognition, as well as between-letter crowding in English recognition. We also found a negative correlation between the size of the visual span and the average pattern complexity of the symbol set. Together, our results showed that the visual span is limited by common sensory (crowding) and physical (pattern complexity) factors regardless of the language script, providing evidence that the visual span reflects a universal bottleneck for text recognition.

Perceptual learning leads to long lasting visual improvement in patients with central vision loss

BACKGROUND

Macular Degeneration (MD), a visual disease that produces central vision loss, is one of the main causes of visual disability in western countries. Patients with MD are forced to use a peripheral retinal locus (PRL) as a substitute of the fovea. However, the poor sensitivity of this region renders basic everyday tasks very hard for MD patients.

OBJECTIVE

We investigated whether perceptual learning (PL) with lateral masking in the PRL of MD patients, improved their residual visual functions.

METHOD

Observers were trained with two distinct contrast detection tasks: (i) a Yes/No task with no feedback (MD: N = 3; controls: N = 3), and (ii) a temporal two-alternative forced choice task with feedback on incorrect trials (i.e., temporal-2AFC; MD: N = 4; controls: N = 3). Observers had to detect a Gabor patch (target) flanked above and below by two high contrast patches (i.e., lateral masking). Stimulus presentation was monocular with durations varying between 133 and 250 ms. Participants underwent 24- 27 training sessions in total.

RESULTS

Both PL procedures produced significant improvements in the trained task and learning transferred to visual acuity. Besides, the amount of transfer was greater for the temporal-2AFC task that induced a significant improvement of the contrast sensitivity for untrained spatial frequencies. Most importantly, follow-up tests on MD patients trained with the temporal-2AFC task showed that PL effects were retained between four and six months, suggesting long-term neural plasticity changes in the visual cortex.

CONCLUSION

The results show for the first time that PL with a lateral masking configuration has strong, non-invasive and long lasting rehabilitative potential to improve residual vision in the PRL of patients with central vision loss.

Evaluation of a gaze-controlled vision enhancement system for reading in visually impaired people

People with low vision, especially those with Central Field Loss (CFL), need magnification to read. The flexibility of Electronic Vision Enhancement Systems (EVES) offers several ways of magnifying text. Due to the restricted field of view of EVES, the need for magnification is conflicting with the need to navigate through text (panning). We have developed and implemented a real-time gaze-controlled system whose goal is to optimize the possibility of magnifying a portion of text while maintaining global viewing of the other portions of the text (condition 1). Two other conditions were implemented that mimicked commercially available advanced systems known as CCTV (closed-circuit television systems)—conditions 2 and 3. In these two conditions, magnification was uniformly applied to the whole text without any possibility to specifically select a region of interest. The three conditions were implemented on the same computer to remove differences that might have been induced by dissimilar equipment. A gaze-contingent artificial 10° scotoma (a mask continuously displayed in real time on the screen at the gaze location) was used in the three conditions in order to simulate macular degeneration. Ten healthy subjects with a gaze-contingent scotoma read aloud sentences from a French newspaper in nine experimental one-hour sessions. Reading speed was measured and constituted the main dependent variable to compare the three conditions. All subjects were able to use condition 1 and they found it slightly more comfortable to use than condition 2 (and similar to condition 3). Importantly, reading speed results did not show any significant difference between the three systems. In addition, learning curves were similar in the three conditions. This proof of concept study suggests that the principles underlying the gaze-controlled enhanced system might be further developed and fruitfully incorporated in different kinds of EVES for low vision reading.

Learning to recognize letters in the periphery: Effects of repeated exposure, letter frequency, and letter complexity

Patients with central vision loss must rely on their peripheral vision for reading. Unfortunately, limitations of peripheral vision, such as crowding, pose significant challenges to letter recognition. As a result, there is a need for developing effective training methods for improving crowded letter recognition in the periphery. Several studies have shown that extensive practice with letter stimuli is beneficial to peripheral letter recognition. Here, we explore stimulus-related factors that might influence the effectiveness of peripheral letter recognition training. Specifically, we examined letter exposure (number of letter occurrences), frequency of letter use in English print, and letter complexity and evaluated their contributions to the amount of improvement observed in crowded letter recognition following training. We analyzed data collected across a range of training protocols. Using linear regression, we identified the best-fitting model and observed that all three stimulus-related factors contributed to improvement in peripheral letter recognition with letter exposure being the most important factor. As an important explanatory variable, pretest accuracy was included in the model as well to avoid estimate biases and was shown to have influence on the relationship between training improvement and letter exposure. When developing training protocols for peripheral letter recognition, it may be beneficial to not only consider the overall length of training, but also to tailor the number of stimulus occurrences for each letter according to its initial performance level, frequency, and complexity.

Rehabilitation Approaches in Macular Degeneration Patients

Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient's quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in order to develop simple and efficient methods that improve the patient's visual performances in many different contexts. One very promising approach to face this challenge is based on perceptual learning (PL). Through intensive practice, PL can induce neural plasticity in sensory cortices and result in long-lasting enhancements for various perceptual tasks in both normal and visually impaired populations. A growing number of studies showed how appropriate PL protocols improve visual functions in visual disorders, namely amblyopia, presbyopia or myopia. In order to successfully apply these approaches to more severe conditions such as AMD, numerous challenges have to be overcome. Indeed, the overall elderly age of patients and the reduced cortical surface that is devoted to peripheral vision potentially limit neural plasticity in this population. In addition, ocular fixation becomes much less stable because patients have to rely on peripheral fixation spots outside the scotoma whose size keeps on evolving. The aim of this review article is to discuss the recent literature on this topic and to offer a unified approach for developing new rehabilitation programs of AMD using PL. We argue that with an appropriate experimental and training protocol that is adapted to each patient needs, PL can offer fascinating opportunities for the development of simple, non-expensive rehabilitation approaches a large spectrum of visual functions in AMD patients.

Gains following perceptual learning are closely linked to the initial visual acuity

The goal of the present study was to evaluate the dependence of perceptual learning gains on initial visual acuity (VA), in a large sample of subjects with a wide range of VAs. A large sample of normally sighted and presbyopic subjects (N = 119; aged 40 to 63) with a wide range of uncorrected near visual acuities (VA, −0.12 to 0.8 LogMAR), underwent perceptual learning. Training consisted of detecting briefly presented Gabor stimuli under spatial and temporal masking conditions. Consistent with previous findings, perceptual learning induced a significant improvement in near VA and reading speed under conditions of limited exposure duration. Our results show that the improvements in VA and reading speed observed following perceptual learning are closely linked to the initial VA, with only a minor fraction of the observed improvement that may be attributed to the additional sessions performed by those with the worse VA.

A New Font, Specifically Designed for Peripheral Vision, Improves Peripheral Letter and Word Recognition, but Not Eye-Mediated Reading Performance

Reading speed is dramatically reduced when readers cannot use their central vision. This is because low visual acuity and crowding negatively impact letter recognition in the periphery. In this study, we designed a new font (referred to as the Eido font) in order to reduce inter-letter similarity and consequently to increase peripheral letter recognition performance. We tested this font by running five experiments that compared the Eido font with the standard Courier font. Letter spacing and x-height were identical for the two monospaced fonts. Six normally-sighted subjects used exclusively their peripheral vision to run two aloud reading tasks (with eye movements), a letter recognition task (without eye movements), a word recognition task (without eye movements) and a lexical decision task. Results show that reading speed was not significantly different between the Eido and the Courier font when subjects had to read single sentences with a round simulated gaze-contingent central scotoma (10° diameter). In contrast, Eido significantly decreased perceptual errors in peripheral crowded letter recognition (-30% errors on average for letters briefly presented at 6° eccentricity) and in peripheral word recognition (-32% errors on average for words briefly presented at 6° eccentricity).

The effect of normal aging and age-related macular degeneration on perceptual learning

We investigated whether perceptual learning could be used to improve peripheral word identification speed. The relationship between the magnitude of learning and age was established in normal participants to determine whether perceptual learning effects are age invariant. We then investigated whether training could lead to improvements in patients with age-related macular degeneration (AMD). Twenty-eight participants with normal vision and five participants with AMD trained on a word identification task. They were required to identify three-letter words, presented 10° from fixation. To standardize crowding across each of the letters that made up the word, words were flanked laterally by randomly chosen letters. Word identification performance was measured psychophysically using a staircase procedure. Significant improvements in peripheral word identification speed were demonstrated following training (71% ± 18%). Initial task performance was correlated with age, with older participants having poorer performance. However, older adults learned more rapidly such that, following training, they reached the same level of performance as their younger counterparts. As a function of number of trials completed, patients with AMD learned at an equivalent rate as age-matched participants with normal vision. Improvements in word identification speed were maintained at least 6 months after training. We have demonstrated that temporal aspects of word recognition can be improved in peripheral vision with training across a range of ages and these learned improvements are relatively enduring. However, training targeted at other bottlenecks to peripheral reading ability, such as visual crowding, may need to be incorporated to optimize this approach.

Reading performance is enhanced by visual texture discrimination training in Chinese-speaking children with developmental dyslexia

BACKGROUND

High order cognitive processing and learning, such as reading, interact with lower-level sensory processing and learning. Previous studies have reported that visual perceptual training enlarges visual span and, consequently, improves reading speed in young and old people with amblyopia. Recently, a visual perceptual training study in Chinese-speaking children with dyslexia found that the visual texture discrimination thresholds of these children in visual perceptual training significantly correlated with their performance in Chinese character recognition, suggesting that deficits in visual perceptual processing/learning might partly underpin the difficulty in reading Chinese.

METHODOLOGY/PRINCIPAL FINDINGS

To further clarify whether visual perceptual training improves the measures of reading performance, eighteen children with dyslexia and eighteen typically developed readers that were age- and IQ-matched completed a series of reading measures before and after visual texture discrimination task (TDT) training. Prior to the TDT training, each group of children was split into two equivalent training and non-training groups in terms of all reading measures, IQ, and TDT. The results revealed that the discrimination threshold SOAs of TDT were significantly higher for the children with dyslexia than for the control children before training. Interestingly, training significantly decreased the discrimination threshold SOAs of TDT for both the typically developed readers and the children with dyslexia. More importantly, the training group with dyslexia exhibited significant enhancement in reading fluency, while the non-training group with dyslexia did not show this improvement. Additional follow-up tests showed that the improvement in reading fluency is a long-lasting effect and could be maintained for up to two months in the training group with dyslexia.

CONCLUSION/SIGNIFICANCE

These results suggest that basic visual perceptual processing/learning and reading ability in Chinese might at least partially rely on overlapping mechanisms.