In defence of dual-route models of reading

Capturing Expert Knowledge for the Personalization of Cognitive Rehabilitation: Study Combining Computational Modeling and a Participatory Design Strategy

Background

Cognitive impairments after stroke are not always given sufficient attention despite the critical limitations they impose on activities of daily living (ADLs). Although there is substantial evidence on cognitive rehabilitation benefits, its implementation is limited because of time and human resource’s demands. Moreover, many cognitive rehabilitation interventions lack a robust theoretical framework in the selection of paper-and-pencil tasks by the clinicians. In this endeavor, it would be useful to have a tool that could generate standardized paper-and-pencil tasks, parameterized according to patients' needs.

Objective

In this study, we aimed to present a framework for the creation of personalized cognitive rehabilitation tasks based on a participatory design strategy.

Methods

We selected 11 paper-and-pencil tasks from standard clinical practice and parameterized them with multiple configurations. A total of 67 tasks were assessed according to their cognitive demands (attention, memory, language, and executive functions) and overall difficulty by 20 rehabilitation professionals.

Results

After assessing the internal consistency of the data—that is, alpha values from .918 to .997—we identified the parameters that significantly affected cognitive functions and proposed specific models for each task. Through computational modeling, we operationalized the tasks into their intrinsic parameters and developed a Web tool that generates personalized paper-and-pencil tasks—the Task Generator (TG).

Conclusions

Our framework proposes an objective and quantitative personalization strategy tailored to each patient in multiple cognitive domains (attention, memory, language, and executive functions) derived from expert knowledge and materialized in the TG app, a cognitive rehabilitation Web tool.

White matter microstructure integrity in relation to reading proficiency☆

Components of reading proficiency such asaccuracy, fluency, and comprehension require the successful coordination of numerous, yet distinct, cortical regions. Underlying white matter tracts allow for communication among these regions. This study utilized unique residualized tract - based spatial statistics methodology to identify the relations of white matter microstructure integrity to three components of reading proficiency in 49 school - aged children with typically developing phonological decoding skills and 27 readers with poor decoders. Results indicated that measures of white matter integrity were differentially associated with components of reading proficiency. In both typical and poor decoders, reading comprehension correlated with measures of integrity of the right uncinate fasciculus; reading comprehension was also related to the left inferior longitudinal fasciculus in poor decoders. Also in poor decoders, word reading fluency was related to the right uncinate and left inferior fronto - occipital fasciculi. Word reading was unrelated to white matter integrity in either group. These findings expand our knowledge of the association between white matter integrity and different elements of reading proficiency.

An Exploratory Study of Phonological Awareness and Working Memory Differences and Literacy Performance of People that Use AAC

Twelve cerebral palsied adolescents and young adults with complex communicative needs who used augmentative and alternative communication were studied. They were classified according to their working memory capacity (high vs. low) into two groups of 6 participants. They were also divided into two groups of 6 participants according to their high vs. low phonological skills. These groups were compared on their performance in reading tests –orthographic knowledge, a word test and a pseudoword reading test- and in the spelling of words, pseudowords and pictures' names. Statistical differences were found between high vs. low phonological skills groups, and between high and low working memory groups. High working memory capacity group scored significantly higher than low working memory group in the orthographic and word reading tests. The high phonological skills group outperformed the low phonological skills group in the word reading test and in the spelling of pseudowords and pictures' names. From a descriptive point of view, phonological skills and working memory, factors known to be highly predictive of literacy skills in people without disabilities, also hold as factors for the participants that used AAC in our study. Implications of the results are discussed.

Testing the direct-access model: GOD does not prime DOG

In three repetition priming experiments that employed identical (e.g., DOG-DOG) and reversed repetitions (e.g., GOD-DOG), it was found that relative to controls (e.g., DOG-DOG), GOD-type words did not prime DOG-type words. Also, neither DUT-type nor TUD-type nonwords primed DUT-type nonwords. In Experiments 1 and 2, these results occurred using both long- and short-term repetition priming conditions, respectively. In Experiment 3, the word results held under conditions of short-term priming coupled with stimulus misorientation. However, the nonword results resembled the word results (i.e., identical but not reversed repetitions primed nonwords). The failure to provide explicit evidence for direct visual access (e.g., GOD does not prime DOG while DOG does) irrespective of other sources of lexical activation supports theories of words recognition that postulate multiple and varied lexical representations that are activated through a matrix of connections.

Is it true that the differences in reading performance between students with and without LD cannot be explained by IQ?

This study was designed to demonstrate whether the differences in reading between students with learning disabilities (LD) and non-learning disabled students (NLD) can be explained by IQ. A sample of 133 Spanish children (85 male, 48 female) ranging in age from 8 to 13 years were classified into four groups according to IQ as measured by the Wechsler Intelligence Scale for Children-Revised (< 80; 81-90; 91-109: 110-140) and into two groups based on reading level (LD and NLD). A lexical decision task was used and we manipulated different word parameters (length, positional syllabic frequency, and familiarity) and pseudoword parameters (length and positional syllabic frequency) to study the routes used by both groups. Our findings indicate that IQ does not explain the differences between children with LD and NLD children in lexical processing. We found that the lexical and sublexical parameters have a greater influence on students with LD than NLD students, independent of IQ. In synthesis, the LD group has more difficulty in lexical processing, which is influenced by poor phonological skills.

Phonological assembly in reading: lexical contribution leads to violation of graphophonological rules

According to current models of reading, the phonological representation of a letter string could be generated by means of two different procedures. The first consists in the looking up or addressing of the phonological representation of the appropriate word in the mental lexicon. The second consists in the assignment of a phonological code to the various orthographic units that occur in the letter string and the assembly of them into a unitary phonological representation. However, the various models of phonological assembly differ in the nature of the knowledge that such assembly requires. On the one hand, dual-route theories assert that the assembly process operates by means of extralexical graphophonological rules and, therefore, without reference to lexical knowledge. On the other hand, in analogy theories and interactive models of phonological assembly, the lexical phonological representations of words orthographically close to the letter string (the orthographic neighborhood) are supposed to contribute to the translation process. The aim of the experiments reported here was to empirically distinguish between these two categories of models. In Experiment 1, subjects were asked to pronounce pseudowords containing the letter g. Results indicate that the phonological representation assigned to the letter g depends on the pronunciation favored by the lexical neighbors. Experiment 2 shows that lexical contribution to phonological assembly also takes place in lexical decision.