The brain basis of handwriting deficits in Chinese children with developmental dyslexia

The cognitive-linguistic profiles and academic performances of Chinese children with dyslexia across cultures: Beijing, Hong Kong, and Taipei

This study examined the cognitive-linguistic and literacy-related correlates of dyslexia in three Chinese cities and the English word reading and mathematics performances of Chinese children with dyslexia. Chinese children with/without dyslexia were measured with an equivalent test battery of literacy and mathematics in Beijing, Hong Kong, and Taipei. Univariate analysis results suggested that phonological sensitivity distinguished those with and without dyslexia across all three cities in group comparisons. In Taipei and Hong Kong, morphological awareness, delayed copying, and spelling also distinguished the groups. Logistic regression analyses demonstrated that Chinese character reading, as directly compared to Chinese word reading, also distinguished the groups particularly well. In addition, in Beijing and Hong Kong, children with dyslexia performed significantly less well in English word reading than those without dyslexia. In Hong Kong and Taipei, children with dyslexia also had difficulties in mathematics performance. Findings highlight the fundamental importance of some cognitive-linguistic skills for explaining Chinese dyslexia across cultures, the utility of recognizing the individual Chinese character as a foundational unit of analysis in Chinese across cultures, and the generalizability of the comorbidity of both English as a second language (L2) and mathematics with dyslexia in Chinese children in both Beijing and Hong Kong.

Atypical characteristic changes of surface morphology and structural covariance network in developmental dyslexia

BACKGROUND

Developmental dyslexia (DD) is a neurodevelopmental disorder that is characterized by difficulties with all aspects of information acquisition in the written word, including slow and inaccurate word recognition. The neural basis behind DD has not been fully elucidated.

METHOD

The study included 22 typically developing (TD) children, 16 children with isolated spelling disorder (SpD), and 20 children with DD. The cortical thickness, folding index, and mean curvature of Broca's area, including the triangular part of the left inferior frontal gyrus (IFGtriang) and the opercular part of the left inferior frontal gyrus, were assessed to explore the differences of surface morphology among the TD, SpD, and DD groups. Furthermore, the structural covariance network (SCN) of the triangular part of the left inferior frontal gyrus was analyzed to explore the changes of structural connectivity in the SpD and DD groups.

RESULTS

The DD group showed higher curvature and cortical folding of the left IFGtriang than the TD group and SpD group. In addition, compared with the TD group and the SpD group, the structural connectivity between the left IFGtriang and the left middle-frontal gyrus and the right mid-orbital frontal gyrus was increased in the DD group, and the structural connectivity between the left IFGtriang and the right precuneus and anterior cingulate was decreased in the DD group.

CONCLUSION

DD had atypical structural connectivity in brain regions related to visual attention, memory and which might impact the information input and integration needed for reading and spelling.

DysDiTect: Dyslexia Identification Using CNN-Positional-LSTM-Attention Modeling with Chinese Dictation Task

Handwriting difficulty is a defining feature of Chinese developmental dyslexia (DD) due to the complex structure and dense information contained within compound characters. Despite previous attempts to use deep neural network models to extract handwriting features, the temporal property of writing characters in sequential order during dictation tasks has been neglected. By combining transfer learning of convolutional neural network (CNN) and positional encoding with the temporal-sequential encoding of long short-term memory (LSTM) and attention mechanism, we trained and tested the model with handwriting images of 100,000 Chinese characters from 1064 children in Grades 2-6 (DD = 483; Typically Developing [TD] = 581). Using handwriting features only, the best model reached 83.2% accuracy, 79.2% sensitivity, 86.4% specificity, and 91.2% AUC. With grade information, the best model achieved 85.0% classification accuracy, 83.3% sensitivity, 86.4% specificity, and 89.7% AUC. These findings suggest the potential of utilizing machine learning technology to identify children at risk for dyslexia at an early age.

Changes in effective connectivity during the visual-motor integration tasks: a preliminary f-NIRS study

BACKGROUND

Visual-motor integration (VMI) is an essential skill in daily life. The present study aimed to use functional near-infrared spectroscopy (fNIRS) technology to explore the effective connectivity (EC) changes among brain regions during VMI activities of varying difficulty levels.

METHODS

A total of 17 healthy participants were recruited for the study. Continuous Performance Test (CPT), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), and Beery VMI test were used to evaluate attention performance, executive function, and VMI performance. Granger causality analysis was performed for the VMI task data to obtain the EC matrix for all participants. One-way ANOVA analysis was used to identify VMI load-dependent EC values among different task difficulty levels from brain network and channel perspectives, and partial correlation analysis was used to explore the relationship between VMI load-dependent EC values and behavioral performance.

RESULTS

We found that the EC values of dorsal attention network (DAN) → default mode network (DMN), DAN → ventral attention network (VAN), DAN → frontoparietal network (FPN), and DAN → somatomotor network (SMN) in the complex condition were higher than those in the simple and moderate conditions. Further channel analyses indicated that the EC values of the right superior parietal lobule (SPL) → right superior frontal gyrus (SFG), right middle occipital gyrus (MOG) → left SFG, and right MOG → right postcentral gyrus (PCG) in the complex condition were higher than those in the simple and moderate conditions. Subsequent partial correlation analysis revealed that the EC values from DAN to DMN, VAN, and SMN were positively correlated with executive function and VMI performance. Furthermore, the EC values of right MOG → left SFG and right MOG → right PCG were positively correlated with attention performance.

CONCLUSIONS

The DAN is actively involved during the VMI task and thus may play a critical role in VMI processes, in which two key brain regions (right SPL, right MOG) may contribute to the EC changes in response to increasing VMI load. Meanwhile, bilateral SFG and right PCG may also be closely related to the VMI performance.

The comprehension of double negation in Chinese children with reading difficulties

This study investigated the processing of double negation in Chinese children with reading difficulties. The comprehension of Mandarin affirmative, single negative and double negative sentences was tested with Chinese young poor readers and typical readers, using a sentence-picture verification task. Results showed that double negative sentences were most difficult to process for both groups; the poor readers performed significantly worse than the typical readers in comprehending double negative sentences, while no difference between the two groups was observed in comprehending affirmative and single negative sentences. Besides, morphological awareness correlated with the comprehension of double negative and single negative sentences in poor readers, while this correlation did not emerge with typical readers. Overall, our results suggest that children with reading difficulties experienced great processing difficulty in double negation, confirming that reading disorders are also characterised by oral language difficulties, in particular in the comprehension of sentences requiring high processing costs.

Reduction in right lateralized N2 error response to stroke order violations in poor Chinese word spellers: A study on event-related potential markers for Chinese reading and spelling

Stroke order knowledge is critical for Chinese reading and spelling acquisition. Previous studies have demonstrated enhancements of the N2 and P3 event-related potential (ERP) components at the Pz electrode to stroke order violations of Chinese characters in younger adults. However, it remained unclear whether similar ERP responses could be found in children. The current study investigated the ERP responses to stroke order violations of Chinese characters in children and examined the associations of the ERP responses with children's Chinese reading and spelling performance. A total of 26 Grade 2 Hong Kong Chinese children observed stroke-by-stroke displays of Chinese characters and judged whether the Chinese characters were written in the correct order. The ERP results showed larger anterior N2 and posterior P3 at the midline electrodes to the incorrect strokes than to the correct strokes. In addition, a smaller right lateralized temporal N2 response to the incorrect strokes was found in poor spellers as compared with good spellers of Chinese. The effect of the right lateralized temporal N2 response on reading performance was fully mediated through spelling ability. These results demonstrated increases in the anterior N2 and posterior P3 responses to stroke order violation of Chinese characters in second graders and suggest the right lateralized N2 response as a potential neural marker of Chinese literacy development in children.

Functional brain networks underlying the interaction between central and peripheral processes involved in Chinese handwriting in children and adults

The neural mechanisms that support handwriting, an important mode of human communication, are thought to be controlled by a central process (responsible for spelling) and a peripheral process (responsible for motor output). However, the relationship between central and peripheral processes has been debated. Using functional magnetic resonance imaging, this study examined the neural mechanisms underlying this relationship in Chinese handwriting in 36 children (mean age = 10.40 years) and 56 adults (mean age = 22.36 years) by manipulating character frequency (a central variable). Brain network analysis showed that character frequency reconfigured functional brain networks known to underlie motor processes, including the somatomotor and cerebellar network, in both children and adults, indicating that central processing cascades into peripheral processing. Furthermore, the network analysis characterized the interaction profiles between motor networks and linguistic-cognitive networks, fully mapping the neural architecture that supports the interaction of central and peripheral processes involved in handwriting. Taken together, these results reveal the neural interface underlying the interaction between central and peripheral processes involved in handwriting in a logographic writing system, advancing our understanding of the neural basis of handwriting.

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.

Brain Correlates of Chinese Handwriting and Their Relation to Reading Development in Children: An fMRI Study

Handwriting plays an important role in written communication, reading, and academic success. However, little is known about the neural correlates of handwriting in children. Using functional magnetic resonance imaging (fMRI) and a copying task, we investigated regional brain activation and functional lateralization associated with Chinese handwriting in children (N = 36, 9-11 years old), as well as their relations to reading skills. We found significant activation of the bilateral frontal motor cortices, somatosensory cortex, intraparietal sulcus (IPS), fusiform gyrus (FuG), and cerebellum during handwriting, suggesting that an adult-like brain activation pattern emerges by middle childhood. Moreover, children showed left-lateralized and bilateral activation of motor regions and right-lateralized activation of the FuG and cerebellum during handwriting, suggesting that functional lateralization of handwriting is not fully established by this age. Finally, the activation of Exner's area and the lateralization of the IPS and cerebellum during handwriting were correlated with reading skills, possibly representing a neural link between handwriting and reading in children. Collectively, this study reveals the brain correlates of handwriting and their relation to reading development in Chinese children, offering new insight into the development of handwriting and reading skills.

The influence of temporal asynchrony on character-speech integration in Chinese children with and without dyslexia: An ERP study

Dyslexic readers have been reported to show abnormal temporal acuity and multisensory integration deficiency. Here, we investigated the influence of temporal intervals on Chinese character-speech integration in children with and without dyslexia. Visual characters were presented synchronously to the onset of speech sounds (AV0) or before speech sound by 300 ms (AV300). Event-related potentials (ERP) evoked by congruent condition (speech sounds presented with congruent Chinese characters) and by baseline condition (speech sounds presented with Korean characters) were compared. Typically developing (TD) children exhibited congruency effect in AV0 condition, whereas dyslexic children exhibited congruency effect in AV300 condition. Moreover, congruency effect in TD children was due to enhanced neural activation to congruent trials, congruency effect in dyslexic children was contributed by neural suppression for baseline trials. These results suggested that different underlying mechanisms were involved in character-speech integration for typical and dyslexic children.

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.

Influence of assistive technology applications on dyslexic students: The case of Saudi Arabia during the COVID-19 pandemic

In Saudi Arabia, the COVID-19 pandemic forced students with dyslexia to complete their learning through online applications, like their peers without dyslexia. This study explores the influence of assistive technology (AT) on improving the visual perception (VP) and phonological processing (PhP) abilities of students with dyslexia. Three learning applications were used (Google Classroom, Zoom, and Quizlet) as AT platforms. A quantitative approach was adopted based on a quasi-experimental design. Single-subject experimental methods were used to examine the influence of AT on improving students' VP, PhP, and frequency of access (FA). Fourteen students with dyslexia who were selected as participants through purposeful sampling were divided into two experimental groups based on gender. The results showed that AT influenced the VP, PhP, and FA in both experimental groups. Girls scored higher than boys in VP, PhP, and FA, and a positive correlation was found between VP and PhP with AT applications among girls and boys. A simple linear regression analysis showed that a significant and positive relationship exists between FA and the VP and PhP abilities of students with dyslexia through AT applications.

Curved vs. Straight-Line Handwriting Effects on Word Recognition in Typical and Dyslexic Readers Across Chinese and English

Handwriting serves to link auditory and motor routines with visual word processing, which is a hallmark of successful reading. The current study aims to explore the effect of multisensory integration as a pathway to neural specialization for print among typical and dyslexic readers across writing systems. We identified 9-10-year-old dyslexic Chinese children (n = 24) and their typically developing counterparts (n = 24) on whom we conducted both behavioral and electroencephalogram (EEG) experiments. We designed four learning conditions: Handwriting Chinese (HC), Viewing Chinese (VC), Drawing followed by Character Recognition in Chinese (D-C), and Drawing followed by Word Recognition in English (D-E). In both handwriting and drawing conditions, we also designed curved vs. straight-line stimuli. Both behavioral and EEG results showed that handwriting straight line strokes facilitated visual word recognition in Chinese compared to handwriting curved lines. Handwriting conditions resulted in a lateralization of the N170 in typical readers, but not the dyslexic readers. Interestingly, drawing curved lines facilitate word recognition in English among dyslexic readers. Taken together, the results of the study suggest benefits of handwriting on the neural processing and behavioral performance in response to Chinese character recognition and curved-line drawing effects on English word recognition among dyslexic readers. But the lack of handwriting effects in dyslexic readers suggest that students who have deficits in reading may also be missing the link between multisensory integration and word recognition in the visual word form areas. The current study results have implications for maintaining handwriting practices to promote perception and motor integration for visual word form area development for normal readers and suggest that drawing practices might benefit Chinese dyslexic readers in reading English.