Socioeconomic Status and Reading Disability: Neuroanatomy and Plasticity in Response to Intervention

Learning to Listen: Changes in Children's Brain Activity Following a Listening Comprehension Intervention

"Are you LISTENING?" may be one of the most frequent questions preschoolers hear from their parents and teachers, but can children be taught to listen carefully-and thus better comprehend language-and if so, what changes occur in their brains? Twenty-seven four- and five-year-old children were taught a language simulation strategy to use while listening to stories: first, they practiced moving graphics on an iPad to correspond to the story actions, and then they practiced imagining the movements. Compared to a control condition, children in the intervention answered comprehension questions more accurately when imagining moving the graphics and on a measure of transfer using a new story without any instruction and with only immovable graphics. Importantly, for children in the intervention, the change in comprehension from the first to the sixth day was strongly correlated with changes in EEG mu and alpha desynchronization, suggesting changes in motor and visual processing following the intervention. Thus, the data are consistent with our hypothesis that a language simulation listening comprehension intervention can improve children's listening comprehension by teaching children to align visual and motor processing with language comprehension.

Cortical Structure in Pre-Readers at Cognitive Risk for Dyslexia: Baseline Differences and Response to Intervention

Early childhood is a critical period for structural brain development as well as an important window for the identification and remediation of reading difficulties. Recent research supports the implementation of interventions in at-risk populations as early as kindergarten or first grade, yet the neurocognitive mechanisms following such interventions remain understudied. To address this, we investigated cortical structure by means of anatomical MRI before and after a 12-week tablet-based intervention in: (1) at-risk children receiving phonics-based training (n = 29; n = 16 complete pre-post datasets), (2) at-risk children engaging with AC training (n = 24; n = 15 complete pre-post datasets) and (3) typically developing children (n = 25; n = 14 complete pre-post datasets) receiving no intervention. At baseline, we found higher surface area of the right supramarginal gyrus in at-risk children compared to typically developing peers, extending previous evidence that early anatomical differences exist in children who may later develop dyslexia. Our longitudinal analysis revealed significant post-intervention thickening of the left supramarginal gyrus, present exclusively in the intervention group but not the active control or typical control groups. Altogether, this study contributes new knowledge to our understanding of the brain morphology associated with cognitive risk for dyslexia and response to early intervention, which in turn raises new questions on how early anatomy and plasticity may shape the trajectories of long-term literacy development.

Differences in educational opportunity predict white matter development

Coarse measures of socioeconomic status, such as parental income or parental education, have been linked to differences in white matter development. However, these measures do not provide insight into specific aspects of an individual's environment and how they relate to brain development. On the other hand, educational intervention studies have shown that changes in an individual's educational context can drive measurable changes in their white matter. These studies, however, rarely consider socioeconomic factors in their results. In the present study, we examined the unique relationship between educational opportunity and white matter development, when controlling other known socioeconomic factors. To explore this question, we leveraged the rich demographic and neuroimaging data available in the ABCD study, as well the unique data-crosswalk between ABCD and the Stanford Education Data Archive (SEDA). We find that educational opportunity is related to accelerated white matter development, even when accounting for other socioeconomic factors, and that this relationship is most pronounced in white matter tracts associated with academic skills. These results suggest that the school a child attends has a measurable relationship with brain development for years to come.

Altered Trajectories: Considering the Long-Term Impact of Educational Disruption during the COVID-19 Pandemic on Neurodevelopment and a Call to Action for Neuropsychology

OBJECTIVE

The COVID-19 pandemic resulted in educational disruption of historic breadth and duration. The impact of school closures and remote learning have been evaluated in recent studies and reflect critical data for neuropsychologists who routinely assess brain development as it relates to diagnosis, recommendations, and informing public policy.

METHOD

Pre-pandemic and contemporaneous literature was summarized, including data on educational disruption and child and adolescent mental health challenges reported during the pandemic, and research on the impact of stress, social isolation, educational achievement, and other factors on brain development during critical developmental windows.

RESULTS

Studies indicate that prolonged educational disruption has resulted in attenuated learning gains, most remarkably for those already at risk for educational disparities. Studies have shown increased mental health challenges for youth during the pandemic, with higher rates of mood and eating disorders, and suicidal ideation. Given that some skills develop optimally within specific time periods, pandemic-related disruption has likely contributed to altered developmental trajectories.

CONCLUSION

Trajectory of neuropsychological development of children and adolescents, especially marginalized students, may be affected by effects on learning and mental health due to prolonged educational disruption and psychological stressors. Evaluation and treatment may be delayed due to backlog and increased demand. Clinical neuropsychological practice recommendations are presented with a call to action for the field in moving forward flexibly to increase access to evaluation services.

Striatal and Behavioral Responses to Reward Vary by Socioeconomic Status in Adolescents

Disparities in socioeconomic status (SES) lead to unequal access to financial and social support. These disparities are believed to influence reward sensitivity, which in turn are hypothesized to shape how individuals respond to and pursue rewarding experiences. However, surprisingly little is known about how SES shapes reward sensitivity in adolescence. Here, we investigated how SES influenced adolescent responses to reward, both in behavior and the striatum-a brain region that is highly sensitive to reward. We examined responses to both immediate reward (tracked by phasic dopamine) and average reward rate fluctuations (tracked by tonic dopamine) as these distinct signals independently shape learning and motivation. Adolescents (n = 114; 12-14 years; 58 female) performed a gambling task during functional magnetic resonance imaging. We manipulated trial-by-trial reward and loss outcomes, leading to fluctuations between periods of reward scarcity and abundance. We found that a higher reward rate hastened behavioral responses, and increased guess switching, consistent with the idea that reward abundance increases response vigor and exploration. Moreover, immediate reward reinforced previously rewarding decisions (win-stay, lose-switch) and slowed responses (postreward pausing), particularly when rewards were scarce. Notably, lower-SES adolescents slowed down less after rare rewards than higher-SES adolescents. In the brain, striatal activations covaried with the average reward rate across time and showed greater activations during rewarding blocks. However, these striatal effects were diminished in lower-SES adolescents. These findings show that the striatum tracks reward rate fluctuations, which shape decisions and motivation. Moreover, lower SES appears to attenuate reward-driven behavioral and brain responses.

White matter microstructural plasticity associated with educational intervention in reading disability

Children's reading progress typically slows during extended breaks in formal education, such as summer vacations. This stagnation can be especially concerning for children with reading difficulties or disabilities, such as dyslexia, because of the potential to exacerbate the skills gap between them and their peers. Reading interventions can prevent skill loss and even lead to appreciable gains in reading ability during the summer. Longitudinal studies relating intervention response to brain changes can reveal educationally relevant insights into rapid learning-driven brain plasticity. The current work focused on reading outcomes and white matter connections, which enable communication among the brain regions required for proficient reading. We collected reading scores and diffusion-weighted images at the beginning and end of summer for 41 children with reading difficulties who had completed either 1st or 2nd grade. Children were randomly assigned to either receive an intensive reading intervention (n = 26; Seeing Stars from Lindamood-Bell which emphasizes orthographic fluency) or be deferred to a wait-list group (n = 15), enabling us to analyze how white matter properties varied across a wide spectrum of skill development and regression trajectories. On average, the intervention group had larger gains in reading compared to the non-intervention group, who declined in reading scores. Improvements on a proximal measure of orthographic processing (but not other more distal reading measures) were associated with decreases in mean diffusivity within core reading brain circuitry (left arcuate fasciculus and left inferior longitudinal fasciculus) and increases in fractional anisotropy in the left corticospinal tract. Our findings suggest that responses to intensive reading instruction are related predominantly to white matter plasticity in tracts most associated with reading.

Impact of Neighborhood Deprivation and Social Vulnerability on Outcomes and Interventions in Patients with Cleft Palate

OBJECTIVE

To examine whether neighborhood disadvantage impacts length of follow-up, interventions, and outcomes for patients with cleft palate.

DESIGN

Retrospective cohort.

SETTING

Cleft Palate Craniofacial Institute Database at St. Louis Children's Hospital.

PATIENTS/PARTICIPANTS

Patients with cleft palate following in St. Louis Children's Hospital Cleft Palate Multidisciplinary Team Clinic.

INTERVENTIONS

Primary palatoplasty between 2012-2017. Patients were divided into quartiles across area deprivation index (ADI) and social vulnerability index (SVI), two validated, composite metrics of neighborhood disadvantage, to examine whether living in neighborhoods from different deprivation quartiles impacts outcomes of interest.

MAIN OUTCOME MEASURE

Follow-up through age 5, surgeries and surgical complications, speech, developmental, and behavioral outcomes.

RESULTS

205 patients were included. 39% of patients belonged to the most deprived ADI quartile, while 15% belonged to the most vulnerable SVI quartile. There were no differences between ADI or SVI quartiles in number of operations received (p ≥ 0.40). Patients in the most deprived ADI quartile were significantly more likely to have speech/language concerns (OR 2.32, 95% CI [1.20-4.89], p = 0.01). Being in a more vulnerable SVI quartile was associated with developmental delay (OR 2.29, 95% CI [1.04-5.15], p = 0.04). ADI and SVI quartile did not impact risk of loss to follow-up in the isolated and combined cleft lip and palate subgroups (p ≥ 0.21).

CONCLUSIONS

Neighborhood disadvantage impacts speech and developmental outcomes in patients with cleft palate despite comparable length of follow-up in multidisciplinary team clinic.

Socioeconomic Disparities in Hypothalamic-Pituitary-Adrenal Axis Regulation and Prefrontal Cortical Structure

Socioeconomic disadvantage during childhood predicts an increased risk for mental health problems across the life span. Socioeconomic disadvantage shapes multiple aspects of children's proximal environments and increases exposure to chronic stressors. Drawing from multiple literatures, we propose that childhood socioeconomic disadvantage may lead to adaptive changes in the regulation of stress response systems including the hypothalamic-pituitary-adrenal (HPA) axis. These changes, in turn, affect the development of prefrontal cortical (PFC) circuitry responsible for top-down control over cognitive and emotional processes. Translational findings indicate that chronic stress reduces dendritic complexity and spine density in the medial PFC and anterior cingulate cortex, in part through altered HPA axis regulation. Socioeconomic disadvantage has frequently been associated with reduced gray matter in the dorsolateral and ventrolateral PFC and anterior cingulate cortex and lower fractional anisotropy in the superior longitudinal fasciculus, cingulum bundle, and uncinate fasciculus during middle childhood and adolescence. Evidence of socioeconomic disparities in hair cortisol concentrations in children has accumulated, although null findings have been reported. Coupled with links between cortisol levels and reduced gray matter in the PFC and anterior cingulate cortex, these results support mechanistic roles for the HPA axis and these PFC circuits. Future longitudinal studies should simultaneously consider multiple dimensions of proximal factors, including cognitive stimulation, while focusing on epigenetic processes and genetic moderators to elucidate how socioeconomic context may influence the HPA axis and PFC circuitry involved in cognitive and emotional control. These findings, which point to modifiable factors, can be harnessed to inform policy and more effective prevention strategies.

Reading and writing difficulties in third- and sixth-grade students: a cross-sectional survey

BACKGROUND

In Southern Italy and, specifically, in the region of Campania, many surveys show that the average of students with reading difficulties is much higher than in northern Italy and abroad. On the other hand, specific learning disorders (SLDs) in Campania are much less certified. Since there are no etiological reasons that can explain this apparent inconsistency, an objective of this cross-sectional study was to evaluate the extent of reading/writing difficulties in students from a province of Campania and then to assess the ability of teachers to identify such difficulties in their students.

METHODS

Of a total of 241 enrolled students, 155 (64.31%), including 73 from primary school and 82 from secondary school, belonging to 5 schools in the province of Salerno (Italy), took part in the survey. Students' reading and writing skills were assessed through standardized tests. The tests results were then compared with teacher judgments and context-related variables.

RESULTS

At the reading test, 28.7% of primary school and 13.4% of lower secondary school students fell below the 5th percentile for age. Results of the writing test were even more significant: almost half of the students of both levels of education performed below the 5th percentile. Teacher judgments showed higher agreement with standardized assessments in primary (88%, K of Cohen=0.68) than in secondary school (78%, K=0.23).

CONCLUSIONS

Reading and writing difficulties were common in our sample. While reading skills tended to improve with age, writing difficulties apparently persisted to some extent in third and sixth-grade classes. The accuracy of teacher judgments on reading skills is relatively high, but teachers seem to hardly report reading difficulties "requiring attention." Although less "severe" than others, such difficulties should be considered, mainly because of their potential developmental trajectories.

Home reading environment, sociometric and demographic factors associated with dyslexia in primary school students in China: A case-control study

Background

Developmental dyslexia (DD) has been generally recognized as a multifactorial psychological disorder in recent decades. However, studies on reading and learning environment, social and demographic factors affecting Chinese developmental dyslexia (DD) are still scarce in China. This study aims to explore multidimensional home influencing factors associated with DD before and after birth.

Methods

A total of 60 dyslexic and 252 normal elementary school students graded 2-5 were recruited in Shantou, China. The Least Absolute Shrinkage and Selection Operator (LASSO) regression model was used for the social and demographic variables screening. Odds ratios (ORs) with 95 % confidence intervals (CIs) for associations between DD and related factors were estimated by multivariate logistic regression models.

Results

Through LASSO regression, we ultimately identified 13 key variables, including maternal education level and family monthly income, among others. The logistic regression analyses showed that the risk of DD was higher in children with lower maternal education levels. Divergent parenting styles may be a risk factor for developing DD as opposed to consistent parenting styles (OR = 4.93, 95%CI: 1.11-21.91). Children whose mothers suffered from malnutrition during pregnancy were more likely to develop DD (OR = 10.31, 95%CI: 1.84-37.86), as well as exposure to second-hand smoking at home every day (OR = 5.33, 95%CI: 1.52-18.66). Interestingly, children's active reading (OR = 0.26, 95%CI: 0.08-0.84; OR = 0.17, 95%CI: 0.04-0.76 for "sometimes" and "often" compared to none, respectively), children having extracurricular reading fairy tale books (OR = 0.37, 95%CI: 0.15-0.90), and children having extracurricular reading composition books (OR = 0.25, 95%CI: 0.09-0.69) were significant protective factors for DD.

Conclusions

Home reading environment, several educational, sociometric and demographic factors may influence the development of dyslexia. We should pay attention to these factors on the development of dyslexia, so as to provide the well social and familial environment to ensure the healthy development of children.

The Role of Environmental Chemicals in the Etiology of Learning Difficulties: A Novel Theoretical Framework

Children from economically disadvantaged communities have a disproportionate risk of exposure to chemicals, social stress, and learning difficulties. Although animal models and epidemiologic studies link exposures and neurodevelopment, little focus has been paid to academic outcomes in environmental health studies. Similarly, in the educational literature, environmental chemical exposures are overlooked as potential etiologic factors in learning difficulties. We propose a theoretical framework for the etiology of learning difficulties that focuses on these understudied exogenous factors. We discuss findings from animal models and longitudinal, prospective birth cohort studies that support this theoretical framework. Studies reviewed point to the effects of prenatal exposure to polycyclic aromatic hydrocarbons on reading comprehension and math skills via effects on inhibitory control processes. Long term, this work will help close the achievement gap in the United States by identifying behavioral and neural pathways from prenatal exposures to learning difficulties in children from economically disadvantaged families.

Childhood socioeconomic status and the pace of structural neurodevelopment: accelerated, delayed, or simply different?

Socioeconomic status (SES) is associated with children's brain and behavioral development. Several theories propose that early experiences of adversity or low SES can alter the pace of neurodevelopment during childhood and adolescence. These theories make contrasting predictions about whether adverse experiences and low SES are associated with accelerated or delayed neurodevelopment. We contextualize these predictions within the context of normative development of cortical and subcortical structure and review existing evidence on SES and structural brain development to adjudicate between competing hypotheses. Although none of these theories are fully consistent with observed SES-related differences in brain development, existing evidence suggests that low SES is associated with brain structure trajectories more consistent with a delayed or simply different developmental pattern than an acceleration in neurodevelopment.

Maternal education as an environmental factor related to reading in children with reading difficulties: A functional magnetic resonance imaging study

The expanded simple view of reading (SVR) model suggests that word decoding, language comprehension and executive functions are necessary for reading comprehension. Children with reading difficulties (RDs) often have deficits in critical components of reading established in the expanded SVR model and alterations in brain function of reading-related regions. Maternal education could provide children with advantageous educational opportunities or resources that support reading acquisition. The primary goal of this study was to examine the contributions of maternal education to the behavioural and neurobiological correlates of the expanded SVR model. Seventy-two 8- to 12-year-old children with RDs and typical readers (TRs) completed reading, behavioural and an functional magnetic resonance imaging stories-listening task to determine the functional connectivity of the receptive language network to the whole brain in association with maternal education. Higher maternal education was associated with better vocabulary in children with RDs and positive functional connectivity between the receptive language network and regions related to visual processing in children with RDs versus TRs. These data suggest that maternal education supports the ability to comprehend oral language and engagement of neural networks that support imagination/visualization in children with RDs.

Brain Engagement During a Cognitive Flexibility Task Relates to Academic Performance in English Learners

English Learners (ELs), students from non-English-speaking backgrounds, are a fast-growing, understudied, group of students in the U.S. with unique learning challenges. Cognitive flexibility-the ability to switch between task demands with ease-may be an important factor in learning for ELs as they have to manage learning in their non-dominant language and access knowledge in multiple languages. We used functional MRI to measure cognitive flexibility brain activity in a group of Hispanic middle school ELs (N = 63) and related it to their academic skills. We found that brain engagement during the cognitive flexibility task was related to both out-of-scanner reading and math measures. These relationships were observed across the brain, including in cognitive control, attention, and default mode networks. This work suggests the real-world importance of cognitive flexibility for adolescent ELs, where individual differences in brain engagement were associated with educational outcomes.

[Formula: see text] Higher access to screens is related to decreased functional connectivity between neural networks associated with basic attention skills and cognitive control in children

Screen-based media has become a prevailing part of children's lives. Different technologies provide limitless access to a wide range of content. This accessibility has immensely increased screen exposure among children, showing that this exposure is associated with decreased cognitive abilities. This study was designed to evaluate how the neurobiological correlates for different sub-components of screen exposure, such as level of access, content, and frequency, are related to different cognitive abilities. Resting-state functional MRI data were collected in 29 native English-speaking children (8-12 years old), in addition to cognitive-behavioral measures. Functional connectivity measures within and between several networks related to cognitive control and attention were calculated [fronto-parietal (FP), cingulo-opercular (CO), dorsal attention (DAN), ventral attention (VAN), salience, default mode (DMN), cerebellar networks]. Sub-components of screen exposure were measured using the Screen-Q questionnaire. Higher access to screens was related to lower functional connectivity between neural networks associated with basic attention skills and cognitive control (i.e., DAN and salience). In addition, higher levels of parent-child interaction during screen exposure were related to increased functional connectivity between networks related to cognitive control and learning (i.e., CO and cerebellar). These findings suggest that screen exposure may reduce the engagement of basic attention and modulation of cognitive control networks and that higher levels of parent-child interaction engage cognitive control networks. An enhanced understanding of these processes can provide an important scientific basis for future educational and medical approaches regarding screen exposure.

ARIA treatment benefits are related to severity of dichotic listening deficits in children

PURPOSE

This study investigated the relationship between dichotic listening (DL) benefits from treatment with Auditory Rehabilitation for Interaural Asymmetry (ARIA) and the severity of DL deficits quantified prior to the onset of treatment. We hypothesized that children with more severe DL deficits would demonstrate greater benefits following ARIA.

METHOD

A scale that quantifies deficit severity was applied to dichotic listening scores obtained before and after training with ARIA at multiple clinical sites (n = 92). Using multiple regression analyses, we evaluated the predictive effects of deficit severity on DL outcomes.

RESULTS

Results demonstrated that deficit severity can predict benefits from ARIA, as measured by improvements in DL scores in both ears.

CONCLUSION

ARIA is an adaptive training paradigm for improving binaural integration abilities in children with DL deficits. The results from this study suggest that children with more severe DL deficits achieve greater benefits from ARIA and that a severity scale may provide important clinical information for recommending intervention.

Exploring Genetic and Neural Risk of Specific Reading Disability within a Nuclear Twin Family Case Study: A Translational Clinical Application

Imaging and genetic studies have characterized biological risk factors contributing to specific reading disability (SRD). The current study aimed to apply this literature to a family of twins discordant for SRD and an older sibling with reading difficulty. Intraclass correlations were used to understand the similarity of imaging phenotypes between pairs. Reading-related genes and brain region phenotypes, including asymmetry indices representing the relative size of left compared to right hemispheric structures, were descriptively examined. SNPs that corresponded between the SRD siblings and not the typically developing (TD) siblings were in genes ZNF385D, LPHN3, CNTNAP2, FGF18, NOP9, CMIP, MYO18B, and RBFOX2. Imaging phenotypes were similar among all sibling pairs for grey matter volume and surface area, but cortical thickness in reading-related regions of interest (ROIs) was more similar among the siblings with SRD, followed by the twins, and then the TD twin and older siblings, suggesting cortical thickness may differentiate risk for this family. The siblings with SRD had more symmetry of cortical thickness in the transverse temporal and superior temporal gyri, while the TD sibling had greater rightward asymmetry. The TD sibling had a greater leftward asymmetry of grey matter volume and cortical surface area in the fusiform, supramarginal, and transverse temporal gyrus. This exploratory study demonstrated that reading-related risk factors appeared to correspond with SRD within this family, suggesting that early examination of biological factors may benefit early identification. Future studies may benefit from the use of polygenic risk scores or machine learning to better understand SRD risk.

The impact of computer–assisted technology on literacy acquisition during COVID-19-related school closures: Group–level effects and predictors of individual–level outcomes

Introduction

The COVID-19 pandemic led to school closure and loss of in-person instruction during the 2019–2020 academic year across the United States, which had a profound impact on the reading development of beginning readers. In this study we tested if a research-informed educational technology (EdTech) program–GraphoLearn–could help alleviate the COVID-19 slide. We also sought to understand the profiles of children who benefitted most from this EdTech program.

Methods

We tested participants’ (N = 172 K-2 children) early literacy skills using a standardized measure (STAR) before and after playing GraphoLearn, and used the pre to post difference as the dependent variable. We first compared children’s STAR actual and expected growth. Then we conducted a multiple regression analysis with data about engagement with GraphoLearn included as predictors. Additional predictors were extracted from GraphoLearn performance at study onset to assess children’s letter-sound knowledge, rime awareness, and word recognition.

Results

The difference between actual average reading growth and expected growth in a regular school year was not statistically significant. This suggests that children in our sample seem to be gaining reading skills as expected in a regular school year. Our multiple linear regression model (which accounted for R2 = 48% of reading growth) showed that older children, with higher baseline GraphoLearn word recognition, who played more units in a fixed number of days, made significantly more early literacy progress.

Discussion

While lacking a control group, our preliminary results suggest that an EdTech program such as GraphoLearn may be a useful reading instructional tool during school shutdowns. In addition, our results suggest that practice with GraphoLearn was more effective and efficient when foundational instruction was already in place.

Growing Brains, Nurturing Minds-Neuroscience as an Educational Tool to Support Students' Development as Life-Long Learners

Compared to other primates, humans are late bloomers, with exceptionally long childhood and adolescence. The extensive developmental period of humans is thought to facilitate the learning processes required for the growth and maturation of the complex human brain. During the first two and a half decades of life, the human brain is a construction site, and learning processes direct its shaping through experience-dependent neuroplasticity. Formal and informal learning, which generates long-term and accessible knowledge, is mediated by neuroplasticity to create adaptive structural and functional changes in brain networks. Since experience-dependent neuroplasticity is at full force during school years, it holds a tremendous educational opportunity. In order to fulfill this developmental and learning potential, educational practices should be human-brain-friendly and "ride" the neuroplasticity wave. Neuroscience can inform educators about the natural learning mechanisms of the brain to support student learning. This review takes a neuroscientific lens to explore central concepts in education (e.g., mindset, motivation, meaning-making, and attention) and suggests two methods of using neuroscience as an educational tool: teaching students about their brain (content level) and considering the neuro-mechanisms of learning in educational design (design level).

Socioeconomic dissociations in the neural and cognitive bases of reading disorders

Childhood socioeconomic status (SES) strongly predicts disparities in reading development, yet it is unknown whether early environments also moderate the cognitive and neurobiological bases of reading disorders (RD) such as dyslexia, the most prevalent learning disability. SES-diverse 6-9-year-old children (n = 155, half with RD) completed behavioral and functional magnetic resonance imaging (fMRI) tasks engaging phonological and orthographic processing, which revealed corresponding double-dissociations in neurocognitive deficits. At the higher end of the SES spectrum, RD was most strongly explained by differences in phonological skill and corresponding activation in left inferior frontal and temporoparietal regions during phonological processing-widely considered the "core deficit" of RD. However, at the lower end of the SES spectrum, RD was most strongly explained by differences in rapid naming skills and corresponding activation in left temporoparietal and fusiform regions during orthographic processing. Findings indicate that children's early environments systematically moderate the neurocognitive systems underlying RD, which has implications for assessment and treatment approaches to reduce SES disparities in RD outcomes. Further, results suggest that reliance on high-SES convenience samples may mask critical heterogeneity in the foundations of both typical and disordered reading development.

Compensatory role of verbal learning and consolidation in reading and spelling of children with dyslexia

The present study investigated the compensatory role of verbal learning and consolidation in reading and spelling of children with (N = 54) and without dyslexia (N = 36) and the role of verbal learning (learning new verbal information) and consolidation (remember the learned information over time) on the response to a phonics through spelling intervention of children with dyslexia. We also took phonological awareness, rapid automatized naming, verbal working memory, and semantics into account. Results showed that children with dyslexia performed better in verbal learning and equal in verbal consolidation compared to typically developing peers. Regression analyses revealed that verbal learning did not predict reading but did predict spelling ability, across both groups; verbal consolidation did not predict reading, nor spelling. Furthermore, neither verbal learning nor verbal consolidation was related to responsiveness to a phonics through spelling intervention in children with dyslexia. Verbal learning may thus be seen as a compensatory mechanism for spelling before the intervention for children with dyslexia but is beneficial for typically developing children as well.

Mechanical Properties of the Developing Brain are Associated with Language Input and Vocabulary Outcome

The quality of language that children hear in their environment is associated with the development of language-related brain regions, in turn promoting vocabulary knowledge. Although informative, it remains unknown how these environmental influences alter the structure of neural tissue and subsequent vocabulary outcomes. The current study uses magnetic resonance elastography (MRE) to examine how children's language environments underlie brain tissue mechanical properties, characterized as brain tissue stiffness and damping ratio, and promote vocabulary knowledge. Twenty-five children, ages 5-7, had their audio and video recorded while engaging in a play session with their parents. Children also completed the Picture Vocabulary Task (from NIH Toolbox) and participated in an MRI, where MRE and anatomical images were acquired. Higher quality input was associated with greater stiffness in the bilateral inferior frontal gyrus and right superior temporal gyrus, whereas greater vocabulary knowledge was associated with lower damping ratio in the right inferior frontal gyrus. These findings suggest changes in neural tissue composition are sensitive to malleable aspects of the environment, whereas tissue organization is more strongly associated with vocabulary outcome. Notably, these associations were independent of maternal education, suggesting more proximal measures of a child's environment may be the source of differences in neural tissue structure underlying variability in vocabulary outcomes.

Assessment of Parent Income and Education, Neighborhood Disadvantage, and Child Brain Structure

IMPORTANCE

Although different aspects of socioeconomic status (SES) may represent distinct risk factors for poor mental health in children, knowledge of their differential and synergistic associations with the brain is limited.

OBJECTIVE

To examine the independent associations between distinct SES factors and child brain structure.

DESIGN, SETTING, AND PARTICIPANTS

We used baseline data from participants aged 9 to 10 years in the Adolescent Brain Cognitive Development (ABCD) study. These data were collected from 21 US sites between September 2017 and August 2018. Study participants were recruited from schools to create a participant sample that closely reflects the US population.

EXPOSURES

Neighborhood disadvantage was measured using the area deprivation index. We also used data on total parent or caregiver educational attainment (in years) and household income-to-needs ratio.

MAIN OUTCOMES AND MEASURES

T1-weighted magnetic resonance imaging was used to assess measures of cortical thickness, surface area, and subcortical volume.

RESULTS

Data from 8862 ABCD participants aged 9 to 10 years were analyzed. The mean (SD) age was 119.1 (7.5) months; there were 4243 girls (47.9%) and 4619 boys (52.1%). Data on race or ethnicity were available for 8857 of 8862 participants: 173 (2.0%) were Asian, 1099 (12.4%) were Black or African American, 1688 (19.1%) were Hispanic, 4967 (56.1%) were White, and 930 (10.5%) reported multiple races or ethnicities. Using 10-fold, within-sample split-half replication, we found that neighborhood disadvantage was associated with lower cortical thickness in the following brain regions (η2 = 0.004-0.009): cuneus (B [SE] = -0.099 [0.013]; P < .001), lateral occipital (B [SE] = -0.088 [0.011]; P < .001), lateral orbitofrontal (B [SE] = -0.072 [0.012]; P < .001), lingual (B [SE] = -0.104 [0.012]; P < .001), paracentral (B [SE] = -0.086 [0.012]; P < .001), pericalcarine (B [SE] = -0.077 [0.012]; P < .001), postcentral (B [SE] = -0.069 [0.012]; P < .001), precentral (B [SE] = -0.059 [0.011]; P < .001), rostral middle frontal (B [SE] = -0.076 [0.011]; P < .001), and superior parietal (B [SE] = -0.060 [0.011]; P < .001). Exploratory analyses showed that the associations of low educational attainment or neighborhood disadvantage and low cortical thickness were attenuated in the presence of a high income-to-needs ratio (η2 = 0.003-0.007).

CONCLUSIONS AND RELEVANCE

The findings of this cross-sectional study suggest that different SES indicators have distinct associations with children's brain structure. A high income-to-needs ratio may play a protective role in the context of neighborhood disadvantage and low parent or caregiver educational attainment. This study highlights the importance of considering the joint associations of different SES indicators in future work.

Educational attainment polygenic scores, socioeconomic factors, and cortical structure in children and adolescents

Genome‐wide polygenic scores for educational attainment (PGS‐EA) and socioeconomic factors, which are correlated with each other, have been consistently associated with academic achievement and general cognitive ability in children and adolescents. Yet, the independent associations of PGS‐EA and socioeconomic factors with specific underlying factors at the neural and neurocognitive levels are not well understood. The main goals of this study were to examine the unique contributions of PGS‐EA and parental education to cortical structure and neurocognitive skills in children and adolescents, and the associations among PGS‐EA, cortical structure, and neurocognitive skills. Participants were typically developing 3‐ to 21‐year‐olds (53% male; N = 391). High‐resolution, T1‐weighted magnetic resonance imaging data were acquired, and cortical thickness (CT) and surface area (SA) were measured. PGS‐EA were computed based on the EA3 genome‐wide association study of educational attainment. Participants completed executive function, vocabulary, and episodic memory tasks. Higher PGS‐EA and parental education were independently and significantly associated with greater total SA and vocabulary. Higher PGS‐EA was significantly associated with greater SA in the left medial orbitofrontal gyrus and inferior frontal gyrus, which was associated with higher executive function. Higher parental education was significantly associated with greater SA in the left parahippocampal gyrus after accounting for PGS‐EA and total brain volume. These findings suggest that education‐linked genetics may influence SA in frontal regions, leading to variability in executive function. Associations of parental education with cortical structure in children and adolescents remained significant after controlling for PGS‐EA, a source of genetic confounding.

Socioeconomic status and reading outcomes: Neurobiological and behavioral correlates

In this chapter, we examine reading outcomes and socioeconomic status (SES) using a developmental cognitive and educational neuroscience perspective. Our focus is on reading achievement and intervention outcomes for students from lower SES backgrounds who struggle with reading. Socioeconomic disadvantage is a specific type of vulnerability students experience, which is often narrowly defined based on parental income, education level, and/or occupational prestige. However, implications of socioeconomic status extend broadly to a suite of areas relevant for reading outcomes including a student's access to resources, experiences, language exposure, academic outcomes, and psychological correlates. Underlying this constellation of factors are brain systems supporting the processing of oral and written language as well as stress-related factors. We review the implications of SES and reading achievement, and their intersectionality, for the science and practice of reading instruction.

The Functional Neuroanatomy of Reading Intervention

The present article reviews the literature on the brain mechanisms underlying reading improvements following behavioral intervention for reading disability. This includes evidence of neuroplasticity concerning functional brain activation, brain structure, and brain connectivity related to reading intervention. Consequently, the functional neuroanatomy of reading intervention is compared to the existing literature on neurocognitive models and brain abnormalities associated with reading disability. A particular focus is on the left hemisphere reading network including left occipito-temporal, temporo-parietal, and inferior frontal language regions. In addition, potential normalization/compensation mechanisms involving right hemisphere cortical regions, as well as bilateral sub-cortical and cerebellar regions are taken into account. The comparison of the brain systems associated with reading intervention and the brain systems associated with reading disability enhances our understanding of the neurobiological basis of typical and atypical reading development. All in all, however, there is a lack of sufficient evidence regarding rehabilitative brain mechanisms in reading disability, which we discuss in this review.

A Cumulative Risk and Resilience Model of Dyslexia

Considerable attention and legislation are currently focused on developmental dyslexia. A major challenge to these efforts is how to define and operationalize dyslexia. In this article, we argue that rather than defining dyslexia on the basis of an underlying condition, dyslexia is best viewed as a label for an unexpected reading disability. This view fits well with a preventive approach in which risk for reading disability is identified and addressed prior to children experiencing reading failure. A risk-resilience model is introduced that proposes that dyslexia is due to the cumulative effects of risk and resilience factors. Evidence for the multifactorial causal basis of dyslexia is reviewed and potential factors that may offset this risk are considered. The implications of a cumulative risk and resilience model for early identification and intervention is discussed.

The Role of Brain Activity in Characterizing Successful Reading Intervention in Children With Dyslexia

Studies of reading intervention in dyslexia have shown changes in performance and in brain function. However, there is little consistency in the location of brain regions associated with successful reading gains in children, most likely due to variability/limitations in methodologies (study design, participant criteria, and neuroimaging procedures). Ultimately for the results to be meaningful, the intervention has to be successful, be assessed against a control, use rigorous statistics, and take biological variables (sex) into consideration. Using a randomized, crossover design, 31 children with dyslexia were assigned to a phonological- and orthographic-based tutoring period as well as a within-subjects control period to examine: (1) intervention-induced changes in behavior (reading performance) and in brain activity (during reading); and (2) behavioral and brain activity pre-intervention data that predicted intervention-induced gains in reading performance. We found gains in reading ability following the intervention, but not following the control period, with no effect of participants' sex. However, there were no changes in brain activity following the intervention (regardless of sex), suggesting that individual brain changes are too variable to be captured at the group level. Reading gains were not predicted by pre-intervention behavioral data, but were predicted by pre-intervention brain activity in bilateral supramarginal/angular gyri. Notably, some of this prediction was only found in females. Our results highlight the limitations of brain imaging in detecting the neural correlates of reading intervention in this age group, while providing further evidence for its utility in assessing eventual success of intervention, especially if sex is taken into consideration.

Reading intervention and neuroplasticity: A systematic review and meta-analysis of brain changes associated with reading intervention

Behavioral research supports the efficacy of intervention for reading disability, but the brain mechanisms underlying improvement in reading are not well understood. Here, we review 39 neuroimaging studies of reading intervention to characterize links between reading improvement and changes in the brain. We report evidence of changes in activation, connectivity, and structure within the reading network, and right hemisphere, frontal and sub-cortical regions. Our meta-analysis of changes in brain activation from pre- to post- reading intervention in eight studies did not yield any significant effects. Methodological heterogeneity among studies may contribute to the lack of significant meta-analytic findings. Based on our qualitative synthesis, we propose that brain changes in response to intervention should be considered in terms of interactions among distributed cognitive, linguistic and sensory systems, rather than via a "normalized" vs. "compensatory" dichotomy. Further empirical research is needed to identify effects of moderating factors such as features of intervention programs, neuroimaging tasks, and individual differences among participants.

Barriers to Building More Effective Treatments: Negative Interactions Amongst Smoking Intervention Components

Meaningfully improved mental and behavioral health treatment is an unrealized dream. Across three factorial experiments, inferential tests in prior studies showed a pattern of negative interactions suggesting that better clinical outcomes are obtained when participants receive fewer rather than more intervention components. Further, relatively few significant main effects were found in these experiments. Modeling suggested that negative interactions amongst components may account for these patterns. This paper evaluates factors that may contribute to such declining benefit: increased attentional or effort burden; components that produce their effects via the same capacity limited mechanisms, making their effects subadditive; and a tipping point phenomenon in which those near a hypothesized "tipping point" for change will benefit markedly from weak intervention while those far from the tipping point will benefit little from even strong intervention. New research should explore factors that cause negative interactions amongst components and constrain the development of more effective treatments.

Second Graders' Grapho-Motor Skill Learning and Verbal Learning: The Effects of Socio-Educational Factors

Introduction: Children from low socioeconomic status (SES) families, and in particular, those with a lower level of maternal education, show lower fine-motor skills and lower vocabulary scores than their SES peers whose mothers have a higher level of education. Furthermore, low SES children frequently have difficulties in reading and spelling. These difficulties are attributed to deficits in the acquisition of skills through practice, such as those required for developing visual-motor routines, alongside deficits in the intentional acquisition of knowledge, such as those required in verbal learning. The aim of the current study was to test the effect of two background factors: low maternal education (ME) and risk of reading and spelling difficulties on practice-dependent learning of a motor task and intentional learning of a verbal task in second graders from low SES families. Methods: In 2016/17, 134 low-SES second graders with higher and lower ME (95 typical learners and 39 with reading and spelling difficulties) were assessed with (a) the Invented Letter Task (ILT; a grapho-motor skill learning task) across five time-points (initial- and end-training Day 1; initial- and end-training Day 2; and 2-weeks post-training), as well as an ILT transfer task; and (b) The Rey Auditory Verbal Learning Test (RAVLT; an intentional word-learning task in which a word list is read to children for five learning trials and is recalled 20 min later). Findings: Lower ME was associated with surplus segments in the performance of the motor task and its transfer to a novel condition as well as with lower recall on the verbal task, but not with the learning of both the motor and the verbal task. Having reading and spelling difficulties affected motor-task accuracy and also the way children learned the task, as evidenced by surplus segments at the beginning of Day 2, which were reduced with further practice. Conclusion: Low ME affected overall performance level. Reading and spelling difficulties resulted in atypical learning of the motor task. Future research on practice-dependent learning in the context of children coming from low SES families should focus on subgroups within this heterogeneous population.

Neighborhood disadvantage and longitudinal brain-predicted-age trajectory during adolescence

Neighborhood disadvantage has consistently been linked to alterations in brain structure; however, positive environmental (e.g., positive parenting) and psychological factors (e.g., temperament) may buffer these effects. We aimed to investigate associations between neighborhood disadvantage and deviations from typical neurodevelopmental trajectories during adolescence, and examine the moderating role of positive parenting and temperamental effortful control (EC). Using a large dataset (n = 1313), a normative model of brain morphology was established, which was then used to predict the age of youth from a longitudinal dataset (n = 166, three time-points at age 12, 16, and 19). Using linear mixed models, we investigated whether trajectories of the difference between brain-predicted-age and chronological age (brainAGE) were associated with neighborhood disadvantage, and whether positive parenting (positive behavior during a problem-solving task) and EC moderated these associations. We found that neighborhood disadvantage was associated with positive brainAGE during early adolescence and a deceleration (decreasing brainAGE) thereafter. EC moderated this association such that in disadvantaged adolescents, low EC was associated with delayed development (negative brainAGE) during late adolescence. Findings provide evidence for complex associations between environmental and psychological factors, and brain maturation. They suggest that neighborhood disadvantage may have long-term effects on neurodevelopment during adolescence, but high EC could buffer these effects.

Socioeconomic status and the developing brain - A systematic review of neuroimaging findings in youth

A growing literature has shown associations between socioeconomic disadvantage and neural properties (such as brain structure and function). In this review, we aimed to synthesize findings on the neural correlates of socioeconomic status (SES) in youth samples across neuroimaging modalities. We also aimed to disentangle the effects of different SES measures (e.g., parent income and education) in our synthesis. We found relatively consistent patterns of positive associations between SES and both volume and cortical surface area of frontal regions, and amygdala, hippocampal, and striatal volume (with most consistent results for composite SES indices). Despite limited longitudinal work, results suggest that SES is associated with developmental trajectories of gray matter structure. Higher SES was also found to be associated with increased fractional anisotropy of some white matter tracts, although there were more null than positive findings. Finally, methodological heterogeneity in brain function and connectivity studies prevented us from making strong inferences. Based on our findings, we make recommendations for future research, discuss the role of mitigating factors, and implications for policy.

Higher maternal education is related to negative functional connectivity between attention system networks and reading-related regions in children with reading difficulties compared to typical readers

Ten to 15% of school-age children have reading difficulties (RD, or dyslexia), defined by deficits in phonological processing, fluency, and executive functions (EFs). Although RD is referred to as a genetic disorder, reading ability may also be affected by environmental factors such as inadequate exposure to literacy and a lack of parental involvement. These environmental components are a part of the socioeconomic status (SES) measure, which is defined by parental occupation, educational attainment, and household income and are positively correlated to reading ability. The goal of the current study was to relate maternal education, a construct of SES to executive functions (EFs) that relate to reading in children with RD compared to typical readers (TRs) using behavioral and neurobiological resting-state fMRI data. The results show that higher maternal education is negatively correlated to inhibitory control for TRs and not for children with RD. Higher maternal education was also associated with negative functional connectivity of the frontal-parietal network to the left central opercular cortex and left occipital gyrus for children with RD compared to TRs. These results suggest that higher maternal education has contrasting roles on the behavioral and neurobiological correlates of EFs for children with RD compared to TRs. We conclude that higher education levels for mothers may provide their children with a structured environment and educational resources that may assist their children with RD and TRs with cognitive development based on their reading profile.

Links between socioeconomic disadvantage, neural function, and working memory in early childhood

Children reared in socioeconomically disadvantaged environments are at risk for academic, cognitive, and behavioral problems. Mounting evidence suggests that childhood adversities, encountered at disproportionate rates in contexts of socioeconomic risk, shape the developing brain in ways that explain disparities. Circuitries that subserve neurocognitive functions related to memory, attention, and cognitive control are especially affected. However, most work showing altered neural function has focused on middle childhood and adolescence. Understanding alterations in brain development during foundational points in early childhood is a key next step. To address this gap, we examined functional near-infrared-spectroscopy-based neural activation during a working memory (WM) task in young children aged 4-7 years (N = 30) who varied in socioeconomic risk exposure. Children who experienced greater disadvantage (lower income to needs ratio and lower Hollingshead index) exhibited lower activation in the lateral prefrontal cortex than children who experienced less to no disadvantage. Variability in prefrontal cortex activation, but not behavioral performance on the WM task, was associated with worse executive functioning in children as reported by parents. These findings add to existing evidence that exposure to early adversity, such as socioeconomic risk, may lead to foundational changes in the developing brain, which increases risk for disparities in functioning across multiple cognitive and social domains.

Gray matter correlates of reading fluency deficits: SES matters, IQ does not

Brain correlates of reading ability have been intensely investigated. Most studies have focused on single-word reading and phonological processing, but the brain basis of reading fluency remains poorly explored to date. Here, in a voxel-based morphometry study with 8-year-old children, we compared fluent readers (n = 18; seven boys) with dysfluent readers with normal IQ (n = 18; six boys) and with low IQ (n = 18; ten boys). Relative to dysfluent readers, fluent readers had larger gray matter volume in the right superior temporal gyrus and the two subgroups of dysfluent readers did not differ from each other, as shown in frequentist and Bayesian analyses. Pairwise comparisons showed that dysfluent readers of normal and low IQ did not differ in core reading regions and that both subgroups had less gray matter volume than fluent readers in occipito-temporal, parieto-temporal and fusiform areas. We also examined gray matter volume in matched subgroups of dysfluent readers differing only in socioeconomic status (SES): lower-SES (n = 14; seven boys) vs. higher-SES (n = 14; seven boys). Higher-SES dysfluent readers had larger gray matter volume in the right angular gyrus than their lower-SES peers, and the volume of this cluster correlated positively with lexico-semantic fluency. Age, sex, IQ, and gray matter volume of the right angular cluster explained 68% of the variance in the reading fluency of higher-SES dysfluent readers. In sum, this study shows that gray matter correlates of dysfluent reading are independent of IQ, and suggests that SES modulates areas sub-serving lexico-semantic processes in dysfluent readers-two findings that may be useful to inform language/reading remediation programs.

Developmental Dyslexia: Environment Matters

Developmental dyslexia (DD) is a multifactorial, specific learning disorder. Susceptibility genes have been identified, but there is growing evidence that environmental factors, and especially stress, may act as triggering factors that determine an individual's risk of developing DD. In DD, as in most complex phenotypes, the presence of a genetic mutation fails to explain the broad phenotypic spectrum observed. Early life stress has been repeatedly associated with the risk of multifactorial disorders, due to its effects on chromatin regulation, gene expression, HPA axis function and its long-term effects on the systemic stress response. Based on recent evidence, we discuss the potential role of stress on DD occurrence, its putative epigenetic effects on the HPA axis of affected individuals, as well as the necessity of early and appropriate intervention, based on the individual stress-associated (endo)phenotype.

Neuroplasticity associated with changes in conversational turn-taking following a family-based intervention

Children's early language environments are associated with linguistic, cognitive, and academic development, as well as concurrent brain structure and function. This study investigated neurodevelopmental mechanisms linking language input to development by measuring neuroplasticity associated with an intervention designed to enhance language environments of families primarily from lower socioeconomic backgrounds. Families of 52 4-to-6 year-old children were randomly assigned to a 9-week, interactive, family-based intervention or no-contact control group. Children completed pre- and post-assessments of verbal and nonverbal cognition (n = 52), structural magnetic resonance imaging (n = 45), and home auditory recordings of language exposure (n = 39). Families who completed the intervention exhibited greater increases in adult-child conversational turns, and changes in turn-taking mediated intervention effects on language and executive functioning measures. Collapsing across groups, turn-taking changes were also positively correlated with cortical thickening in left inferior frontal and supramarginal gyri, the latter of which mediated relationships between changes in turn-taking and children's language development. This is the first study of longitudinal neuroplasticity in response to changes in children's language environments, and findings suggest that conversational turns support language development through cortical growth in language and social processing regions. This has implications for early interventions to enhance children's language environments to support neurocognitive development.

Efficacy of the RtI Model in the Treatment of Reading Learning Disabilities

(1) Background: The response to intervention (RtI) model makes possible the early detection of reading problems and early intervention for students at risk. The purpose of this study is to analyze the effective measures that identify struggling readers and the most effective practices of the RtI model in reading in Primary Education. (2) Method: A systematic review of the literature published between 2010 and 2020 was performed, analyzing in the 31 selected articles, the identification and monitoring methods and the interventions at the different tiers of the RtI model. (3) Results: There are different methods to identify struggling readers, and there is no consensus on the matter. There are also many differences in the implementation of the different tiers of the RtI model; however, its effectiveness is demonstrated. (4) Conclusions: The implementation of the RtI model in a flexible way adapted to the circumstances of each moment, and can be considered as a highly effective resource in the prevention and early detection of reading learning problems.

Rich-club structure contributes to individual variance of reading skills via feeder connections in children with reading disabilities

The present work considers how connectome-wide differences in brain organization might distinguish good and poor readers. The connectome comprises a ‘rich-club’ organization in which a small number of hub regions play a focal role in assisting global communication across the whole brain. Prior work indicates that this rich-club structure is associated with typical and impaired cognitive function although no work so far has examined how this relates to skilled reading or its disorders. Here we investigated the rich-club structure of brain’s white matter connectome and its relationship to reading subskills in 64 children with and without reading disabilities. Among three types of white matter connections, the strength of feeder connections that connect hub and non-hub nodes was significantly correlated with word reading efficiency and phonemic decoding. Phonemic decoding was also positively correlated with connectivity between connectome-wide hubs and nodes within the left-hemisphere reading network, as well as the local efficiency of the reading network. Exploratory analyses also identified sex differences indicating these effects were stronger in girls. This work highlights the independent roles of connectome-wide structure and the more narrowly-defined reading network in understanding the neural bases of skilled and impaired reading in children.

Structural neural correlates of individual differences in categorical perception

Listeners perceive speech sounds categorically. While group-level differences in categorical perception have been observed in children or individuals with reading disorders, recent findings suggest that typical adults vary in how categorically they perceive sounds. The current study investigated neural sources of individual variability in categorical perception of speech. Fifty-seven participants rated phonetic tokens on a visual analogue scale; categoricity and response consistency were measured and related to measures of brain structure from MRI. Increased surface area of the right middle frontal gyrus predicted more categorical perception of a fricative continuum. This finding supports the idea that frontal regions are sensitive to phonetic category-level information and extends it to make behavioral predictions at the individual level. Additionally, more gyrification in bilateral transverse temporal gyri predicted less consistent responses on the task, perhaps reflecting subtle variation in language ability across the population.

Validation of The Reading House and Association With Cortical Thickness

BACKGROUND AND OBJECTIVES

The American Academy of Pediatrics recommends literacy and school readiness promotion during well visits. The Reading House (TRH) is a children's book-based screener of emergent literacy skills in preschool-aged children. Vocabulary, rhyming, and rapid naming are core emergent skills, and reading abilities are associated with thicker cortex in the left hemisphere. Our objective was to expand validity of TRH relative to these skills and explore association with cortical thickness.

METHODS

Healthy preschool-aged children completed MRI including a T1-weighted anatomic scan. Before MRI, TRH and assessments of rapid naming (Comprehensive Test of Phonological Processing, Second Edition), rhyming (Pre-Reading Inventory of Phonological Awareness), vocabulary (Expressive Vocabulary Test, Second Edition), and emergent literacy (Get Ready to Read!) were administered. Analyses included Spearman-ρ correlations (r _ρ) accounting for age, sex, and socioeconomic status (SES). MRI analyses involved whole-brain measures of cortical thickness relative to TRH scores, accounting for covariates.

RESULTS

Seventy children completed assessments (36-63 months old; 36 female) and 52 completed MRI (37-63 months; 29 female). TRH scores were positively correlated with Comprehensive Test of Phonological Processing, Second Edition (r _ρ = 0.61), Expressive Vocabulary Test, Second Edition (r _ρ = 0.54), Get Ready to Read! (r _ρ = 0.87), and Pre-Reading Inventory of Phonological Awareness scores (r _ρ = 0.64; all P < .001). These correlations remained statistically significant across age, sex, and SES groups. TRH scores were correlated with greater thickness in left-sided language and visual cortex (P-family-wise error <.05), which were similar for higher SES yet more bilateral and frontal for low SES, reflecting a less mature pattern (P-family-wise error <.10).

CONCLUSIONS

These findings expand validation evidence for TRH as a screening tool for preschool-aged children, including associations with emergent skills and cortical thickness, and suggest important differences related to SES.

Training-Induced Neural Plasticity in Youth: A Systematic Review of Structural and Functional MRI Studies

Experience-dependent neural plasticity is high in the developing brain, presenting a unique window of opportunity for training. To optimize existing training programs and develop new interventions, it is important to understand what processes take place in the developing brain during training. Here, we systematically review MRI-based evidence of training-induced neural plasticity in children and adolescents. A total of 71 articles were included in the review. Significant changes in brain activation, structure, microstructure, and structural and functional connectivity were reported with different types of trainings in the majority (87%) of the studies. Significant correlation of performance improvement with neural changes was reported in 51% of the studies. Yet, only 48% of the studies had a control condition. Overall, the review supports the hypothesized neural changes with training while at the same time charting empirical and methodological desiderata for future research.

Neuroplasticity in children and adolescents in response to treatment intervention: A systematic review of the literature

The purpose of the present study was to conduct a systematic review of the literature, adhering to PRISMA guidelines, regarding evidence of neuroplasticity in children and adolescents in response to cognitive or sensory-motor interventions. Twenty-eight studies employing seven different types of neuroimaging techniques were included in the review. Findings revealed that significant variability existed across the 28 studies with regard to the clinical populations examined, type of interventions employed, neuroimaging methods, and the type of neuroimaging data included in the studies. Overall, results supported that experience-dependent interventions were associated with neuroplastic changes among children and adolescents in both neurotypical and clinical populations. However, it remains unclear whether these molecular neuroplastic changes, including the degree and direction of those differences, were the direct result of the intervention. Although the findings are encouraging, methodological limitations of the studies limit clinical utility of the results. Future studies are warranted that rigorously define the construct of neuroplasticity, establish consistent protocols across measurement techniques, and have adequate statistical power. Lastly, studies are needed to identify the functional and structural neuroplastic mechanisms that correspond with changes in cognition and behavior in child and adolescent samples.

Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative

This paper provides specific guidelines for the neurodevelopmental evaluation of children aged birth through 5 years with complex congenital heart disease. There is wide recognition that children with congenital heart disease are at high risk for neurodevelopmental impairments that are first apparent in infancy and often persist as children mature. Impairments among children with complex congenital heart disease cross developmental domains and affect multiple functional abilities. The guidelines provided are derived from the substantial body of research generated over the past 30 years describing the characteristic developmental profiles and the long-term trajectories of children surviving with complex congenital heart conditions. The content and the timing of the guidelines are consistent with the 2012 American Heart Association and the American Academy of Pediatrics scientific statement documenting the need for ongoing developmental monitoring and assessment from infancy through adolescence. The specific guidelines offered in this article were developed by a multidisciplinary clinical research team affiliated with the Cardiac Neurodevelopmental Outcome Collaborative, a not-for-profit organisation established to determine and implement best neurodevelopmental practices for children with congenital heart disease. The guidelines are designed for use in clinical and research applications and offer an abbreviated core protocol and an extended version that expands the scope of the evaluation. The guidelines emphasise the value of early risk identification, use of evidence-based assessment instruments, consideration of family and cultural preferences, and the importance of providing multidimensional community-based services to remediate risk.