Association of abnormal cerebellar activation with motor learning difficulties in dyslexic adults

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

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

Proprioceptive intervention improves reading performance in developmental dyslexia: An eye-tracking study

Developmental dyslexia is characterized by difficulties in learning to read, affecting cognition and causing failure at school. Interventions for children with developmental dyslexia have focused on improving linguistic capabilities (phonics, orthographic and morphological instructions), but developmental dyslexia is accompanied by a wide variety of sensorimotor impairments. The goal of this study was to examine the effects of a proprioceptive intervention on reading performance and eye movement in children with developmental dyslexia. Nineteen children diagnosed with developmental dyslexia were randomly assigned to a regular Speech Therapy (ST) or to a Proprioceptive and Speech Intervention (PSI), in which they received both the usual speech therapy and a proprioceptive intervention aimed to correct their sensorimotor impairments (prism glasses, oral neurostimulation, insoles and breathing instructions). Silent reading performance and eye movements were measured pre- and post-intervention (after nine months). In the PSI group, reading performance improved and eye movements were smoother and faster, reaching values similar to those of children with typical reading performance. The recognition of written words also improved, indicating better lexical access. These results show that PSI might constitute a valuable tool for reading improvement children with developmental dyslexia.

Prevalence of malocclusions and parafunctional habits in pediatric patients with developmental dyslexia

Objective

The study aimed to assess the prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits in children with developmental dyslexia (DD).

Methods

Forty pediatric patients (67.5% boys and 32.5% girls, mean age: 11.02 ± 2.53 years, range: 6-15 years) with DD were compared with 40 age- and sex-matched healthy participants for prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits. Dental examinations were performed by an orthodontist.

Results

Pediatric patients with DD exhibited a significantly higher prevalence of Angle Class III malocclusion (22.5% vs. 5.0%, P = 0.024), deep bite (27.5% vs. 7.5%, P = 0.019), midline deviation (55.0% vs. 7.5%, P < 0.0001), midline diastemas (32.5% vs. 7.5%, P = 0.010), wear facets (92.5% vs. 15.0%, P < 0.0001), self-reported nocturnal teeth grinding (82.5% vs. 7.5%, P < 0.0001), nail biting (35.0% vs. 0.0%, P < 0.0001), and atypical swallowing (85.0% vs. 17.5%, P < 0.0001) compared to that in healthy controls.

Conclusions

Pediatric patients with DD showed a higher prevalence of Class III malocclusion, greater orthodontic vertical and transverse discrepancies, and incidence of parafunctional activities. Clinicians and dentists should be aware of the vulnerability of children with dyslexia for exhibiting malocclusion and encourage early assessment and multidisciplinary intervention.

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.

The ReadFree tool for the identification of poor readers: a validation study based on a machine learning approach in monolingual and minority-language children

In this study, we validated the "ReadFree tool", a computerised battery of 12 visual and auditory tasks developed to identify poor readers also in minority-language children (MLC). We tested the task-specific discriminant power on 142 Italian-monolingual participants (8-13 years old) divided into monolingual poor readers (N = 37) and good readers (N = 105) according to standardised Italian reading tests. The performances at the discriminant tasks of the "ReadFree tool" were entered into a classification and regression tree (CART) model to identify monolingual poor and good readers. The set of classification rules extracted from the CART model were applied to the MLC's performance and the ensuing classification was compared to the one based on standardised Italian reading tests. According to the CART model, auditory go-no/go (regular), RAN and Entrainment100bpm were the most discriminant tasks. When compared with the clinical classification, the CART model accuracy was 86% for the monolinguals and 76% for the MLC. Executive functions and timing skills turned out to have a relevant role in reading. Results of the CART model on MLC support the idea that ad hoc standardised tasks that go beyond reading are needed.

Exploratory Investigation of Handwriting Disorders in School-Aged Children from First to Fifth Grade

Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data for a better understanding of the nature and the etiology of HDs. Data from these clinical assessments were analyzed for 27 school-aged children with HD (first to fifth grade). The results underline a high heterogeneity of the children presenting HDs, with many co-occurrences often unknown. However, it was possible to highlight three levels of HDs based on BHK scores: mild HD not detected by the BHK test (26% of children), moderate HD (33%) and dysgraphia (41% of children). The mild nature of the HDs not detected by the BHK test appears to occur at a relatively low frequency of the associated disorders identified during clinical evaluations. On the contrary, dysgraphia appears to be associated with a high frequency of co-occurring disorders identified in the clinical assessment, with a predominance of oculomotor disorders (55% of children), leading to visual-perceptual difficulties and a high level of handwriting deterioration. Finally, children with moderate HD have fewer co-occurrences than children with dysgraphia, but have more difficulties than children with mild HD. This highlights the importance of differentiating between different degrees of HDs that do not respond to the same semiologies. Our findings support the interest in performing a transdisciplinary and standardized clinical examination with developmental standards (neuropsychomotor, neuropsychological and oculomotor) in children with HD. Indeed, HDs can therefore be associated with a multitude of disorders of different natures ranging from poor coordination of the graphomotor gesture to a more general and more complex impairment affecting perceptual-motor, cognitive and/or psycho-affective functions.

Examination of common and unique brain regions for atypical reading and math: a meta-analysis

The purpose of this study is to identify consistencies across functional neuroimaging studies regarding common and unique brain regions/networks for individuals with reading difficulties (RD) and math difficulties (MD) compared to typically developing (TD) individuals. A systematic search of the literature, utilizing multiple databases, yielded 116 functional magnetic resonance imaging and positron emission tomography studies that met the criteria. Coordinates that directly compared TD with either RD or MD were entered into GingerALE (Brainmap.org). An activation likelihood estimate (ALE) meta-analysis was conducted to examine common and unique brain regions for RD and MD. Overall, more studies examined RD (n = 96) than MD (n = 20). Across studies, overactivation for reading and math occurred in the right insula and inferior frontal gyrus for atypically developing (AD) > TD comparisons, albeit in slightly different areas of these regions; however, inherent threshold variability across imaging studies could diminish overlying regions. For TD > AD comparisons, there were no similar or overlapping brain regions. Results indicate there were domain-specific differences for RD and MD; however, there were some similarities in the ancillary recruitment of executive functioning skills. Theoretical and practical implications for researchers and educators are discussed.

An fMRI study of finger movements in children with and without dyslexia

Introduction

Developmental dyslexia is a language-based reading disability, yet some have reported motor impairments, usually attributed to cerebellar dysfunction.

Methods

Using fMRI, we compared children with and without dyslexia during irregularly paced, left or right-hand finger tapping. Next, we examined seed-to-voxel intrinsic functional connectivity (iFC) using six seed regions of the motor system (left and right anterior lobe of the cerebellum, SM1 and SMA).

Results

A whole-brain task-evoked analysis revealed relatively less activation in the group with dyslexia in right anterior cerebellum during right hand tapping. For iFC, we found the group with dyslexia to have greater iFC between the right SM1 seed and a medial aspect of right postcentral gyrus for left hand tapping; and greater iFC between the left SM1 seed and left thalamus, as well as weaker local iFC around the left SM1 seed region for right hand tapping. Lastly, extracted activity and connectivity values that had been identified in these between-group comparisons were not correlated with measures of reading.

Discussion

We conclude that there are some aberrations in motor system function in children with dyslexia, but these are not tied to reading ability.

Working Memory and Manual Dexterity in Dyslexic Children: A Systematic Review and Meta-Analysis

Dyslexic children have impairments in working memory and manual dexterity. Studies have shown that when cognitive development has deficits, motor development is often impaired, indicating a strong interconnection between both domains, and the possibility of interference with each other's proper functioning. Thus, a new literature review is necessary to understand which components of working memory and manual dexterity are affected in dyslexic children and the possible relationship between them. This review aimed to perform a systematic review and meta-analysis to analyze both skills in dyslexic children. The protocol was carried out according to the criteria established by PRISMA being registered at PROSPERO under number CRD 42021238901. Six literature databases were searched to locate studies published between 2001 and 2021: EMBASE, ERIC, ISI Web of Science, PubMed, PsycINFO, and Scopus. 21 studies met the inclusion criteria. The findings suggest that dyslexic children have significantly poorer visuospatial and verbal working memory with more impairments in the phonological loop. No significant differences were found in manual dexterity.

Disruption of Functional Brain Networks Underlies the Handwriting Deficit in Children With Developmental Dyslexia

Developmental dyslexia (DD) is a neurological-based learning disorder that affects 5-17.5% of children. Handwriting difficulty is a prevailing symptom of dyslexia, but its neural mechanisms remain elusive. Using functional magnetic resonance imaging (fMRI), this study examined functional brain networks associated with handwriting in a copying task in Chinese children with DD (n = 17) and age-matched children (n = 36). We found that dyslexics showed reduced network connectivity between the sensory-motor network (SMN) and the visual network (VN), and between the default mode network (DMN) and the ventral attention network (VAN) during handwriting, but not during drawing geometric figures. Moreover, the connectivity strength of the networks showing group differences was correlated with handwriting speed, reading and working memory, suggesting that the handwriting deficit in DD is linked with disruption of a large-scale brain network supporting motoric, linguistic and executive control processes. Taken together, this study demonstrates the alternations of functional brain networks that underly the handwriting deficit in Chinese dyslexia, providing a new clue for the neural basis of DD.

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

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

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

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

Poor visuo-spatial orientation and path memorization in children with dyslexia

PURPOSE

Given the importance of spatial representation and navigation in the natural environment and the presence of sensory motor integration impairment in dyslexic children the aim of this study was to explore the capability in spatial orientation task in dyslexic children.

MATERIALS AND METHODS

We included forty children: 26 dyslexic children (mean age: 10.1 ± 0.3 years old) and 14 typically developing (TD) children (mean age: 10.1 ± 0.4 years old). Children have to walk on an unguided isosceles rectangle triangle of 3 meters that was marked on the ground of a room, during two visual conditions: eyes open and eyes closed. Their paths were recorded using the HTC Vive system (Base + Trackers) with a refresh rate of 90 Hz with accuracy < 0.05 mm.

RESULTS

Results underlined that both groups of children reported poor performance during eyes closed condition. Moreover, dyslexic children, reported poor spatial orientation capabilities in the most difficult conditions, that is during reproduction of hypotenuse and angle of 45 deg.

CONCLUSIONS

We suggested that visual information is important during walking; the poor body orientation observed in dyslexic children could be due to a deficient integration of the sensorial inputs (visual, vestibular and proprioceptive). Further studies testing vestibular/cerebellar rehabilitation could be useful for these kinds of children.HighlightsChildren with dyslexia showed poor spatial orientation capabilities compared to typically developing children, particularly when visual inputs are not available and in the most difficult conditions (like rotation of the body).Poor motor abilities reported by children with dyslexia could be due to cerebrocerebellar pathways impairments.

Automaticity and Executive Abilities in Developmental Dyslexia: A Theoretical Review

Cognitive difficulties are well documented in developmental dyslexia but they present a challenge to dyslexia theory. In this paper, the Model of the Control of Action is proposed as a theoretical explanation of how and why deficits in both automaticity and executive abilities are apparent in the cognitive profiles of dyslexia and how these deficits might relate to literacy difficulties. This theoretical perspective is used to consider evidence from different cognitive domains. The neuroanatomical underpinnings of automaticity and executive abilities are then discussed in relation to the understanding of dyslexia. Links between reading, writing, and executive function are considered. The reviewed evidence suggests that dyslexia theory should consider an interaction between procedural learned behaviour (automaticity) and higher-order (executive) abilities. The capacity to handle environmental interference, develop and engage adaptive strategies accordingly, and plan actions all require interactions between the cerebellum and the prefrontal cortex (PFC). Difficulties in these areas might explain both impairments in the cumulative development of literacy skills in childhood and general task management in everyday life in adulthood. It is suggested that improved measures are required to assess this cerebellar–PFC interaction and to allow early identification of future literacy difficulties, allowing implementation of timely interventions and reasonable adjustments.

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.

Orthographic depth and developmental dyslexia: a meta-analytic study

Cross-cultural studies have suggested that reading deficits in developmental dyslexia (DD) can be moderated by orthographic depth. To further explore this issue and assess the moderating role of orthographic depth in the developmental cognitive trajectories of dyslexic and typical readers, we systematically reviewed 113 studies on DD that were published from 2013 to 2018 and selected 79 in which participants received an official DD diagnosis. Each study was classified according to orthographic depth (deep vs. shallow) and participant age (children vs. adults). We assessed the difference between DD and control groups' performance in reading tasks and in a wide range of cognitive domains associated with reading (phonological awareness (PA), rapid automatized naming (RAN), short-term working memory (WM), and nonverbal reasoning), including age and orthographies as moderators. We found an age-by-orthography interaction effect in word reading accuracy and a significant effect of age in pseudoword reading accuracy, but we found no effect of age and orthographic depth on the fluency parameters. These results suggest that reading speed is a reliable index for discriminating between DD and control groups across European orthographies from childhood to adulthood. A similar pattern of results emerged for PA, RAN, and short-term/WM. Our findings are discussed in relation to their impact on clinical practice while considering the orthographic depth and developmental level.

Decoding the role of the cerebellum in the early stages of reading acquisition

Numerous studies have consistently reported functional activation of the cerebellum during reading tasks, especially in the right cerebellar hemisphere. However, it remains unclear whether this region is also involved in reading during the earliest stages of reading acquisition. Here, we investigated whether and how the cerebellum contributes to reading acquisition. We tested 80 5-6-year-old kindergarteners, who performed a visual word matching task during which functional MRI (fMRI) data were collected. We found that bilateral cerebellar hemispheres were significantly activated during visual word processing. Moreover, activation of left cerebellar lobule VII extending to lobule VIII negatively and significantly correlated with current reading ability, whereas activation of right cerebellar lobule VII extending to lobule VIII significantly and positively correlated with future reading ability. Functional decoding via functional connectivity patterns further revealed that left and right cerebellar lobules connected with different cerebral cortex regions. Our results suggest a division of labor between the left and right cerebellar lobules in beginning readers.

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

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

Reliance on visual feedback from ocular accommodation on motor skills in children with developmental coordination disorder and typically developing controls

Children with developmental coordination disorder (DCD) present with marked impairments in motor skills, including visual-motor integration. Oculomotor anomalies are more prevalent in children with DCD than typically developing children. Children with DCD further demonstrate altered use of visual feedback compared to typically developing controls. We investigated whether the accommodation system, a key component of the oculomotor system, contributes to visual feedback during fine and gross motor skills performance; and whether children with DCD demonstrate differences in reliance on visual feedback from accommodation. Minus dioptre lenses were used to maximally induce accommodation and impede accommodation dynamics. Children with DCD and typically developing controls performed motor skills tests assessing balance, upper limb coordination, visual-motor performance, gross and fine dexterity. Motor skills performance in controls was significantly affected by impeded accommodation in all tasks. Children with DCD demonstrated reliance on accommodation feedback in upper limb and visual-motor tasks only. Children with DCD may be less reliant on visual feedback obtained from accommodation due to adaptive mechanisms to overcome faulty information in the presence of oculomotor anomalies. These results strengthen our previous findings that accommodation anomalies contribute to motor skills impairment, and suggest that performance on these motor tasks is heavily reliant on visual feedback from accommodation.

Adaptive Plasticity Under Adverse Listening Conditions is Disrupted in Developmental Dyslexia

OBJECTIVE

Acoustic distortions to the speech signal impair spoken language recognition, but healthy listeners exhibit adaptive plasticity consistent with rapid adjustments in how the distorted speech input maps to speech representations, perhaps through engagement of supervised error-driven learning. This puts adaptive plasticity in speech perception in an interesting position with regard to developmental dyslexia inasmuch as dyslexia impacts speech processing and may involve dysfunction in neurobiological systems hypothesized to be involved in adaptive plasticity.

METHOD

Here, we examined typical young adult listeners (N = 17), and those with dyslexia (N = 16), as they reported the identity of native-language monosyllabic spoken words to which signal processing had been applied to create a systematic acoustic distortion. During training, all participants experienced incremental signal distortion increases to mildly distorted speech along with orthographic and auditory feedback indicating word identity following response across a brief, 250-trial training block. During pretest and posttest phases, no feedback was provided to participants.

RESULTS

Word recognition across severely distorted speech was poor at pretest and equivalent across groups. Training led to improved word recognition for the most severely distorted speech at posttest, with evidence that adaptive plasticity generalized to support recognition of new tokens not previously experienced under distortion. However, training-related recognition gains for listeners with dyslexia were significantly less robust than for control listeners.

CONCLUSIONS

Less efficient adaptive plasticity to speech distortions may impact the ability of individuals with dyslexia to deal with variability arising from sources like acoustic noise and foreign-accented speech.

Functional parcellation of the right cerebellar lobule VI in children with normal or impaired reading

Neuroimaging studies have reported that the right cerebellar lobule VI is engaged in reading, but its role is unclear. The goal of our study was to identify functionally-dissociable subregions in the right lobule VI and how these subregions contribute to reading in children with normal or impaired reading. In Experiment I, typically developing children performed an orthographic task and a phonological task during functional magnetic resonance imaging (fMRI). We classified the voxels in the right lobule VI into seven zones based on the patterns of functional connectivity with the cerebrum across both tasks. In Experiment II, we compared the brain activation and cerebro-cerebellar connectivities of each subregion between children readers with different reading levels. We did not find significant group differences in cerebellar activation. However, we found that impaired readers had considerably higher functional connectivity between R1 and the right angular gyrus and the right precuneus compared to the control group in the phonological task. These findings show that the right cerebellar lobule VI is functionally parceled and its subregions might be differentially connected with the cerebrum between children with normal reading abilities and those with impaired reading.

Cerebellar Activation During Reading Tasks: Exploring the Dichotomy Between Motor vs. Language Functions in Adults of Varying Reading Proficiency

The nature and extent to which the cerebellum contributes to language processing is not clear. By using fMRI to examine differences in activation intensity in areas associated with motor and language processes, we advance our understanding of how this subcortical structure contributes to language and, more specifically, reading. Functional magnetic resonance imaging data was collected from two groups of adults. One group was classified as typical (proficient) readers, and the other as atypical (less proficient) readers. fMRI was used to measure cerebellar activation during silent reading and silent rapid naming tasks, which differed in degree of language and motor/articulatory processing. Regions of interest associated with motor and language processing were examined in order to compare how cerebellar activation in typical and atypical readers differed as a function of task both within and between groups. Significant differences in activation intensity were noted between individuals of typical and atypical reading proficiency in cerebellar regions associated with motor, but not language processing, during a silent word-reading condition. Additionally, readers who were less proficient showed no differences in activation between tasks in each of the regions of interest within the cerebellum. We provide evidence that, in typical readers, the cerebellum is functionally specialized for reading tasks that vary in language and articulatory processes. In accordance with prior research, we demonstrate that less-proficient adult readers show decreased functional specialization within the cerebellum during reading tasks. We also show that regions of the cerebellum associated with motor/articulatory processing are different between typical and atypically reading adults. Finally, to our knowledge, this is the first brain-imaging study to specifically examine cerebellar activation during rapid naming tasks and we discuss the implications for these findings with regard to current theoretical models that emphasize the link between reading and speech production.

Cerebellar function in children with and without dyslexia during single word processing

The cerebellar deficit hypothesis of dyslexia posits that dysfunction of the cerebellum is the underlying cause for reading difficulties observed in this common learning disability. The present study used functional magnetic resonance imaging (fMRI) and a single word processing task to test for differences in activity and connectivity in children with (n = 23) and without (n = 23) dyslexia. We found cerebellar activity in the control group when word processing was compared to fixation, but not when it was compared to the active baseline task designed to reveal activity specific to reading. In the group with dyslexia there was no cerebellar activity for either contrasts and there were no differences when they were compared to children without dyslexia. Turning to functional connectivity (FC) in the controls, background FC (i.e., not specific to reading) was predominately found between the cerebellum and the occipitaltemporal cortex. In the group with dyslexia, there was background FC between the cerebellum and several cortical regions. When comparing the two groups, they differed in background FC in connections between the seed region right crus I and three left‐hemisphere perisylvian target regions. However, there was no task‐specific FC for word processing in either group and no between‐group differences. Together the results do not support the theory that the cerebellum is affected functionally during reading in children with dyslexia.

Visual statistical learning and orthographic awareness in Chinese children with and without developmental dyslexia

This study examined the role of visual statistical learning in reading and writing and its relationship to orthographic awareness in Hong Kong Chinese children with and without developmental dyslexia. Thirty-five 7- to 8-year-old children with developmental dyslexia and 37 chronologically age-matched controls were tested on visual statistical learning, orthographic awareness, nonverbal cognitive ability, Chinese word reading, and word dictation tasks. Visual statistical learning was assessed using a triplet learning paradigm that required children to detect the temporal order of visual stimuli. Orthographic awareness was measured with a novel character invention task that required children to create pseudocharacters using untaught stroke patterns according to the rules of Chinese character orthography. Children with dyslexia performed significantly worse than their age-matched controls on both the visual statistical learning and orthographic awareness tasks. Furthermore, visual statistical learning was significantly associated with orthographic awareness and word reading. These findings suggest that Chinese children with dyslexia are impaired in visual statistical learning and that such deficits may be related to disrupted orthographic learning abilities, thereby contributing to their reading difficulties.

Development of Dyslexia: The Delayed Neural Commitment Framework

It is now evident that explanations of many developmental disorders need to include a network perspective. In earlier work, we proposed that developmental dyslexia (DD) is well-characterized in terms of impaired procedural learning within the language networks, with the cerebellum being the key structure involved. Here, we deepen the analysis to include the child's developmental process of constructing these networks. The "Delayed Neural Commitment (DNC)" framework proposes that, in addition to slower skill acquisition, dyslexic children take longer to build (and to rebuild) the neural networks that underpin the acquisition of reading. The framework provides an important link backwards in time to the development of executive function networks and the earlier development of networks for language and speech. It is consistent with many theories of dyslexia while providing fruitful suggestions for further research at the genetic, brain, cognitive and behavioral levels of explanation. It also has significant implications for assessment and teaching.

Reading Disabilities in Adolescents and Adults

Purpose

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

Method

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

Conclusions

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

Cerebellar contributions to sequence prediction in verbal working memory

Verbal working memory is one of the most studied non-motor functions with robust cerebellar involvement. While the superior cerebellum (lobule VI) has been associated with articulatory control, the inferior cerebellum (lobule VIIIa) has been linked to phonological storage. The present study was aimed to elucidate the differential roles of these regions by investigating whether the cerebellum might contribute to verbal working memory via predictions based on sequence learning/detection. 19 healthy adult subjects completed an fMRI-based Sternberg task which included repeating and novel letter sequences that were phonologically similar or dissimilar. It was hypothesized that learning a repeating sequence of study letters would reduce phonological storage demand and associated right inferior cerebellar activations and that this effect would be modulated by phonological similarity of the study letters. Specifically, while increased phonological storage demand due to high phonological similarity was expected to be reflected in increased right inferior cerebellar activations for similar relative to dissimilar study letters, the reduction in activation for repeating relative to novel sequences was expected to be more profound for phonologically similar than for dissimilar study letters, especially at higher memory load. Results confirmed the typical effects of cognitive load (5 vs. 2 study letters) and phonological similarity in several cerebellar and neocortical brain regions as well as in behavioral data (accuracy and response time). Importantly, activations in superior and inferior cerebellar regions were differentially modulated as a function of similarity and sequence novelty, indicating that particularly lobule VIIIa may contribute to verbal working memory by generating predictions of letter sequences that reduce the likelihood of phonological loop failure before stored items need to be retrieved. The present study is consistent with other investigations that support prediction, which can be based on sequence learning or detection, as an overarching cerebellar function.

Daily motor characteristics in children with developmental coordination disorder and in children with specific learning disorder

An association between learning disorders and coordination problems has been reported in several studies over the last few decades. In this study, we have investigated daily motor characteristics in children with a diagnosis of specific learning disorder (SLD) and compared them with those of children with developmental coordination disorder (DCD) and those of typically developing controls. Ninety-six children aged 5 to 12 years were included: 29 with a diagnosis of SLD, 33 of DCD, and 34 controls. The Italian version of the Developmental Coordination Disorder Questionnaire 2007 (DCDQ-Italian) was used to measure children's coordination in everyday functional activities. The mean DCDQ-Italian total score was significantly lower in both SLD and DCD groups as compared with controls. Regarding subscores, both clinical groups scored significantly lower than controls on "Fine motor/handwriting" skills and on "General coordination." The DCD group scored also significantly lower than controls on "Control during movement." Moreover, clinical groups differed from each other, with SLD children scoring significantly higher on "Control during movement" and "General coordination" subscores. SLD children diverged from typically developing children in some motor skills during ordinary activities, and although this discrepancy was not as severe as in DCD children, it could have an impact on self-esteem and sport inclusion.

Current perspectives on the cerebellum and reading development

The dominant neural models of typical and atypical reading focus on the cerebral cortex. However, Nicolson et al. (2001) proposed a model, the cerebellar deficit hypothesis, in which the cerebellum plays an important role in reading. To evaluate the evidence in support of this model, we qualitatively review the current literature and employ meta-analytic tools examining patterns of functional connectivity between the cerebellum and the cerebral reading network. We find evidence for a phonological circuit with connectivity between the cerebellum and a dorsal fronto-parietal pathway, and a semantic circuit with cerebellar connectivity to a ventral fronto-temporal pathway. Furthermore, both cerebral pathways have functional connections with the mid-fusiform gyrus, a region implicated in orthographic processing. Consideration of these circuits within the context of the current literature suggests the cerebellum is positioned to influence both phonological and word-based decoding procedures for recognizing unfamiliar printed words. Overall, multiple lines of research provide support for the cerebellar deficit hypothesis, while also highlighting the need for further research to test mechanistic hypotheses.

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

BACKGROUND AND AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

Vertical disconjugacy during reading in dyslexic and non-dyslexic children

PURPOSE

The objective of this study was to explore vertical binocular coordination in dyslexic and non-dyslexic children during saccades and post-saccadic fixation period while reading a text.

METHODS

Binocular eye movements were recorded by an infrared system (Mobile T2^®, SuriCog) in thirty-six dyslexic children from 7.3 to 13.6 years of age (mean age: 10.4 ± 0.3 years) who were asked to silently read a four-line text during binocular viewing. Data were compared to those of thirty-six age-matched non-dyslexic children.

RESULTS

Vertical disconjugacy during post-saccadic fixation was higher in dyslexic children with respect to non-dyslexic children group. Vertical disconjugacy was not age-dependent either for dyslexic children or for non-dyslexic children.

CONCLUSIONS

The poor binocular vertical coordination observed in dyslexic children while reading could suggest a deficiency in the cerebellum and/or extra-ocular muscles involved in vertical eye alignment. Moreover, the fact that this vertical binocular coordination was not age-dependent could be due to an abnormal eye position and/or to a dysfunction of midbrain structures involved in vertical vergences.

Common neural basis of motor sequence learning and word recognition and its relation with individual differences in reading skill

To investigate the neural basis of a common statistical learning mechanism involved in motor sequence learning and decoding, we recorded same participants' brain activation in a serial reaction time (SRT) and word reading task using functional magnetic resonance imaging. In the SRT, a manual response was made depending on the location of a visual cue, and the order of the locations was either fixed or random. In the word reading task, visual words were passively presented. Compared to less skilled readers, more skilled readers showed greater differences in activation in the inferior frontal gyrus pars triangularis (IFGpTr) and the insula between the ordered and random condition in the SRT task and greater activation in those regions in the word reading task. It suggests that extraction of statistically predictable patterns in the IFGpTr and insula contributes to both motor sequence learning and orthographic learning, and therefore predicts individual differences in decoding skill.

How many deficits in the same dyslexic brains? A behavioural and fMRI assessment of comorbidity in adult dyslexics

Dyslexia can have different manifestations: this has motivated different theories on its nature, on its underlying brain bases and enduring controversies on how to best treat it. The relative weight of the different manifestations has never been evaluated using both behavioural and fMRI measures, a challenge taken here to assess the major systems called into play in dyslexia by different theories. We found that adult well-compensated dyslexics were systematically impaired only in reading and in visuo-phonological tasks, while deficits for other systems (e.g., motor/cerebellar, visual magnocellular/motion perception) were only very occasional. In line with these findings, fMRI showed a reliable hypoactivation only for the task of reading, in the left occipito-temporal cortex (l-OTC). The l-OTC, normally a crossroad between the reading system and other systems, did not show the same level of intersection in dyslexics; yet, it was not totally silent because it responded, in segregated parts, during auditory phonological and visual motion perception tasks. This minimal behavioural and functional anatomical comorbidity demonstrates that a specific deficit of reading is the best description for developmental dyslexia, at least for adult well-compensated cases, with clear implications for rehabilitation strategies. The reduced intersection of multiple systems in the l-OTC suggests that dyslexics suffer from a coarser connectivity, leading to disconnection between the multiple domains that normally interact during reading.

Saccade adaptation deficits in developmental dyslexia suggest disruption of cerebellar-dependent learning

BACKGROUND

Estimates of the prevalence of developmental dyslexia in the general population range from 5% to as many as 10%. Symptoms include reading, writing, and language deficits, but the severity and mix of symptoms can vary widely across individuals. In at least some people with dyslexia, the structure and function of the cerebellum may be disordered. Saccadic adaptation requires proper function of the cerebellum and brainstem circuitry and might provide a simple, noninvasive assay for early identification and sub-phenotyping in populations of children who may have dyslexia.

METHODS

Children between the ages of 7 and 15 served as participants in this experiment. Fifteen had been diagnosed with developmental dyslexia and an additional 15 were typically developing children. Five of the participants diagnosed with dyslexia were also diagnosed with an attention deficit hyperactivity disroder and were excluded from further analyses. Participants performed in a saccadic adaptation task in which visual errors were introduced at the end of saccadic eye movements. The amplitudes of primary saccades were measured and plotted as a function of the order in which they occurred. Lines of best fit were calculated. Significant changes in the amplitude of primary saccades were identified.

RESULTS

12/15 typically developing children had significant adaptation of saccade amplitude in this experiment. 1/10 participants with dyslexia appropriately altered saccade amplitudes to reduce the visual error introduced in the saccade adaptation paradigm.

CONCLUSIONS

Proper cerebellar function is required for saccadic adaptation, but in at least some children with dyslexia, cerebellar structure and function may be disordered. Consistent with this hypothesis, the data presented in this report clearly illustrate a difference in the ability of children with dyslexia to adapt saccade amplitudes in response to imposed visual errors. Saccadic adaptation might provide a noninvasive assay for early identification of dyslexia. Future work will determine whether reduced saccadic adaptation is pervasive in dyslexia or whether this identifies a sub-phenotype within the larger population of people identified with reading and language deficits.

The role of feedback in implicit and explicit artificial grammar learning: a comparison between dyslexic and non-dyslexic adults

The importance of feedback for learning has been firmly established over the past few decades. The question of whether feedback plays a significant role in the statistical learning abilities of adults with dyslexia, however, is currently unresolved. Here, we examined the role of feedback in grammaticality judgment, type of structural knowledge, and confidence rating in both typically developed and dyslexic adults. We implemented two artificial grammar learning experiments: implicit and explicit. The second experiment was directly analogous to the first experiment in all respects except training format: the standard memorization instruction was replaced with an explicit rule-search instruction. Each experiment was conducted with and without performance feedback. While both groups showed significantly improved learning in the feedback-based explicit artificial grammar learning task, only the typically developed adults demonstrated higher levels of conscious structural knowledge. The present study demonstrates that the basis for the grammaticality judgment of adults with dyslexia differs from that of typically developed adults, regardless of increase in the level of explicitness.

Possible roles for fronto-striatal circuits in reading disorder

Several studies have reported hyperactivation in frontal and striatal regions in individuals with reading disorder (RD) during reading-related tasks. Hyperactivation in these regions is typically interpreted as a form of neural compensation related to articulatory processing. Fronto-striatal hyperactivation in RD could however, also arise from fundamental impairment in reading related processes, such as phonological processing and implicit sequence learning relevant to early language acquisition. We review current evidence for the compensation hypothesis in RD and apply large-scale reverse inference to investigate anatomical overlap between hyperactivation regions and neural systems for articulation, phonological processing, implicit sequence learning. We found anatomical convergence between hyperactivation regions and regions supporting articulation, consistent with the proposed compensatory role of these regions, and low convergence with phonological and implicit sequence learning regions. Although the application of large-scale reverse inference to decode function in a clinical population should be interpreted cautiously, our findings suggest future lines of research that may clarify the functional significance of hyperactivation in RD.

Comparing Children with and without Dyslexia on the Movement Assessment Battery for Children and the Test of Gross Motor Development

Dyslexia is the most commonly occurring learning disability in the United States, characterized by difficulties with word recognition, spelling, and decoding. A growing body of literature suggests that deficits in motor skill performance exist in the dyslexic population. This study compared the performance of children with and without dyslexia on different subtests of the Test of Gross Motor Development and Movement Assessment Battery for Children and assessed whether there were developmental changes in the scores of the dyslexic group. Participants included 26 dyslexic children (19 boys and 7 girls; 9.5 yr. old, SD = 1.7) and 23 age- and sex-matched typically developing (17 boys and 6 girls; 9.9 yr. old, SD = 1.3) children as a control group. Mann-Whitney U tests indicated that the dyslexic group performed significantly lower than the control group only on the Total Balance subtest of the Movement Assessment Battery for Children. Additionally, the young dyslexic group performed significantly better on the Total Balance subtest, compared to the older dyslexic group. These results suggest that cerebellar dysfunction may account for differences in performance.

Possible roles for fronto-striatal circuits in reading disorder

Several studies have reported hyperactivation in frontal and striatal regions in individuals with reading disorder (RD) during reading-related tasks. Hyperactivation in these regions is typically interpreted as a form of neural compensation related to articulatory processing. Fronto-striatal hyperactivation in RD could however, also arise from fundamental impairment in reading related processes, such as phonological processing and implicit sequence learning relevant to early language acquisition. We review current evidence for the compensation hypothesis in RD and apply large-scale reverse inference to investigate anatomical overlap between hyperactivation regions and neural systems for articulation, phonological processing, implicit sequence learning. We found anatomical convergence between hyperactivation regions and regions supporting articulation, consistent with the proposed compensatory role of these regions, and low convergence with phonological and implicit sequence learning regions. Although the application of large-scale reverse inference to decode function in a clinical population should be interpreted cautiously, our findings suggest future lines of research that may clarify the functional significance of hyperactivation in RD.

WWW support for nursing students with dyslexia and their tutors

The Dyslexia Information Site (DiS) is a live research project currently being tested as a means of using the World Wide Web to provide just-in-time anonymous support to students with dyslexia, and specific information to the tutors who support them. Problems involved in identifying, evaluating and supporting student nurses with dyslexia are outlined and DiS is proposed as a possible solution. Issues concerning the specific problems of dyslexic students are discussed and the corresponding applied Web design is presented. The development of DiS is an example of interdisciplinary partnership.

Implicit learning deficits among adults with developmental dyslexia

The aim of the present study was to investigate implicit learning processes among adults with developmental dyslexia (DD) using a visual linguistic artificial grammar learning (AGL) task. Specifically, it was designed to explore whether the intact learning reported in previous studies would also occur under conditions including minimal training and instructions that do not reveal the grammatical nature of the strings. Twenty-nine (14 DD and 15 typical development (TD)) adults were presented with letter sequences in the training phase and were asked to classify the test strings for their grammaticality. The results of the d' measures in the implicit task indicated that learning had occurred for both groups, as the proportion of hits exceeded the proportion of false alarms. However, a significant difference was found between the groups in their learning measures, as TD readers performed significantly better than individuals with DD, supporting the assumption of a deficit in implicit sequential learning processes among individuals with DD. In order to examine whether the deficit found in the first experiment was indeed due to a deficit in implicit processes, a second experiment was designed in which explicit instructions were given during an AGL task. Results of the explicit task strengthen the assumption that the deficit is indeed specific to implicit sequential processes, as no difference between the groups was found when participants were aware of the existence of the grammar underlying the strings. Theoretical and clinical implications are discussed.

NRSN1 associated grey matter volume of the visual word form area reveals dyslexia before school

Literacy learning depends on the flexibility of the human brain to reconfigure itself in response to environmental influences. At the same time, literacy and disorders of literacy acquisition are heritable and thus to some degree genetically predetermined. Here we used a multivariate non-parametric genetic model to relate literacy-associated genetic variants to grey and white matter volumes derived by voxel-based morphometry in a cohort of 141 children. Subsequently, a sample of 34 children attending grades 4 to 8, and another sample of 20 children, longitudinally followed from kindergarten to first grade, were classified as dyslexics and controls using linear binary support vector machines. The NRSN1-associated grey matter volume of the 'visual word form area' achieved a classification accuracy of ~ 73% in literacy-experienced students and distinguished between later dyslexic individuals and controls with an accuracy of 75% at kindergarten age. These findings suggest that the cortical plasticity of a region vital for literacy might be genetically modulated, thereby potentially preconstraining literacy outcome. Accordingly, these results could pave the way for identifying and treating the most common learning disorder before it manifests itself in school.

Anomalous Cerebellar Anatomy in Chinese Children with Dyslexia

The cerebellar deficit hypothesis for developmental dyslexia claims that cerebellar dysfunction causes the failures in the acquisition of visuomotor skills and automatic reading and writing skills. In people with dyslexia in the alphabetic languages, the abnormal activation and structure of the right or bilateral cerebellar lobes have been identified. Using a typical implicit motor learning task, however, one neuroimaging study demonstrated the left cerebellar dysfunction in Chinese children with dyslexia. In the present study, using voxel-based morphometry, we found decreased gray matter volume in the left cerebellum in Chinese children with dyslexia relative to age-matched controls. The positive correlation between reading performance and regional gray matter volume suggests that the abnormal structure in the left cerebellum is responsible for reading disability in Chinese children with dyslexia.