Comorbidities in preschool children at family risk of dyslexia

Childhood Reading Ability and Pain in Childhood Through to Midlife

Dyslexia and pain have recently been shown to correlate on a genetic level, but there has been little exploration of this association on the phenotypic level despite reports of increased pain in Attention Deficit Hyperactivity Disorder, which commonly co-occurs with dyslexia. In this study we test for an association between reading ability, which is the primary feature of dyslexia, and pain both in childhood and adulthood. Logistic regression modeling was used to test associations between reading ability in childhood and pain from childhood to midlife in a large UK birth cohort; the 1958 National Child Development Study. Associations were found between poor childhood reading ability and increased headache and abdominal pain in childhood, and between poor childhood reading ability and headache, eye pain, back pain, and rheumatism in adulthood. Mediation analyses indicated that socioeconomic status (defined by employment) fully mediated the association between poor reading ability in childhood and back pain at age 42. By contrast, the association between reading ability and eye pain acted independently of socioeconomic status. Different mechanisms were thus indicated for the association of reading with different pain types, including manual labor and a potential shared biological pathway. PERSPECTIVE: This study found a relationship between poor reading ability in childhood and pain in childhood and adulthood. Those with reading difficulties should be monitored for pain symptoms. Future research may uncover shared biological mechanisms, increasing our understanding of pain and potential treatments.

A Preliminary Study of Speech Rhythm Differences as Markers of Stuttering Persistence in Preschool-Age Children

PURPOSE

The purpose of this study was twofold: (a) to determine whether there are speech rhythm differences between preschool-age children who stutter that were eventually diagnosed as persisting (CWS-Per) or recovered (CWS-Rec) and children who do not stutter (CWNS), using empirical spectral analysis and empirical mode decomposition of the speech amplitude envelope, and (b) to determine whether speech rhythm characteristics close to onset are predictive of later persistence.

METHOD

Fifty children (3-4 years of age) participated in the study. Approximately 2-2.5 years after the experimental testing took place, children were assigned to the following groups: CWS-Per (nine boys, one girl), CWS-Rec (18 boys, two girls), and CWNS (18 boys, two girls). All children produced a narrative based on a text-free storybook. From the audio recordings of these narratives, fluent utterances were selected for each child from which seven envelope-based measures were extracted. Group-based differences on each measure as well as predictive analyses were conducted to identify measures that discriminate CWS-Per versus CWS-Rec.

RESULTS

CWS-Per were found to have a relatively higher degree of power in suprasyllabic oscillations and greater variability in the timing of syllabic rhythms especially for longer utterances. A logistic regression model using two speech rhythm measures was able to discriminate the eventual outcome of recovery versus persistence, with 80% sensitivity and 75% specificity.

CONCLUSION

Findings suggest that envelope-based speech rhythm measures are a promising approach to assess speech rhythm differences in developmental stuttering, and its potential for identification of children at risk of developing persistent stuttering should be investigated further.

Specific Learning Disabilities and Emotional-Behavioral Difficulties: Phenotypes and Role of the Cognitive Profile

Specific Learning Disabilities (SLD) are often associated with emotional-behavioral problems. Many studies highlighted a greater psychopathological risk in SLD, describing both internalizing and externalizing problems. The aims of this study were to investigate the emotional-behavioral phenotype through the Child Behavior Checklist (CBCL), and evaluate the mediating role of background and cognitive characteristics on the relationship between CBCL profile and learning impairment in children and adolescents with SLD. One hundred and twenty-one SLD subjects (7-18 years) were recruited. Cognitive and academic skills were assessed, and parents completed the questionnaire CBCL 6-18. The results showed that about half of the subjects manifested emotional-behavioral problems with a prevalence of internalizing symptoms, such as anxiety and depression, over externalizing ones. Older children showed greater internalizing problems than younger ones. Males have greater externalizing problems compared to females. A mediation model analysis revealed that learning impairment is directly predicted by age and familiarity for neurodevelopmental disorders and indirectly via the mediation of the WISC-IV/WAIS-IV Working Memory Index (WMI) by the CBCL Rule-Breaking Behavior scale. This study stresses the need to combine the learning and neuropsychological assessment with a psychopathological evaluation of children and adolescents with SLD and provides new interpretative insights on the complex interaction between cognitive, learning, and emotional-behavioral phenotypes.

Working memory training in children with developmental language disorder: Effects on complex syntax in narratives

This study assesses the impact of a working memory training program on the syntactic complexity of the spontaneous speech of French-speaking children with Developmental Language Disorder (DLD). Thirty-nine 6- to 12-year-old children with DLD were allocated to a WM training (DLD^MM, N = 20) or an active control group (DLD^SQULA, N = 19). The computerized training sessions took place three times a week, yielding 12 training hours per participant. Syntactic complexity was assessed in storytelling, measuring mean length of utterances, use of embedded clauses and rate of errors in complex utterances. The performance of participants with DLD was first compared to previous spontaneous data of 40 typically-developing (TD) children of the same age. Then, intragroup (pre- vs. post-test) and intergroup (DLD^MM vs. DLD^SQULA) comparisons were made to assess the impact of the working memory training on the language measures. Global results confirmed syntactic impairment in children with DLD, as opposed to TD children, with large differences for the use of embedded clauses. Findings also suggested gains in the mastery of embedded clauses in children who participated in the WM training, whereas no gains were observed in the DLD control group. These findings confirm deficits in complex syntax in children with DLD, in particular in embedded clauses, and may encourage the clinical use of language sample analysis, which provides an ecological account of children's language performance. While our results should be replicated on a larger scale, they also suggest positive transfer effects of working memory training on the capacity of participants with DLD to produce embedded clauses, in line with previous studies showing a positive effect of WM training on tasks of expressive syntax. It thus seems that working memory training can yield benefits for language, which leaves open the door to new therapeutic approaches for children with DLD.

Visual and social differences in dyslexia: deep phenotyping of four cases with spared phonology

Diagnostic criteria for dyslexia describe specific reading difficulties, and single-deficit models, including the phonological deficit theory, have prevailed. Children seeking diagnosis, however, do not always show phonological deficits, and may present with strengths and challenges beyond reading. Through extensive neurological, neuropsychological, and academic evaluation, we describe four children with visuospatial, socio-emotional, and attention impairments and spared phonology, alongside long-standing reading difficulties. Diffusion tensor imaging revealed white matter alterations in inferior longitudinal, uncinate, and superior longitudinal fasciculi versus neurotypical children. Findings emphasize that difficulties may extend beyond reading in dyslexia and underscore the value of deep phenotyping in learning disabilities.

Self-reported symptoms of developmental dyslexia predict impairments in everyday cognition in adults

BACKGROUND

Research into the impact of dyslexia on everyday cognition in adults with dyslexia is relatively limited and has tended to focus on university students.

AIMS AND METHODS

The present online study aimed to add to this small corpus by investigating the everyday effects of dyslexia on memory and attention in a larger community-based sample. One hundred and seventy-two adult volunteers completed five well-established self-report questionnaires, assessing dyslexia and Attention Deficit Hyperactivity Disorder symptomatology and everyday experiences with memory, attention, and mind-wandering.

RESULTS

After controlling for ADHD symptomatology, hierarchical regression analyses revealed that higher levels of dyslexia-related symptomatology were associated with greater, more frequent everyday memory and attentional problems, but not with a greater propensity to mind-wandering. Increased levels of dyslexia symptomatology were positively associated with the frequency of both everyday attentional lapses (at least when performing a pair of tasks or easy tasks while inhibiting intervening stimuli) and everyday memory failures. No significant associations were found between dyslexia symptomatology and attentional lapses when performing difficult tasks in the presence of concurrent stimuli or between dyslexia symptomatology and the propensity to mind-wandering.

CONCLUSIONS AND IMPLICATIONS

Dyslexia symptomatology was perceived as being associated with more everyday memory and attention problems in adulthood. Adjustments to educational and workplace settings and interventions to compensate for these difficulties are proposed.

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

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

The relationship between entrainment dynamics and reading fluency assessed by sensorimotor perturbation

A consistent relationship has been found between rhythmic processing and reading skills. Impairment of the ability to entrain movements to an auditory rhythm in clinical populations with language-related deficits, such as children with developmental dyslexia, has been found in both behavioral and neural studies. In this study, we explored the relationship between rhythmic entrainment, behavioral synchronization, reading fluency, and reading comprehension in neurotypical English- and Mandarin-speaking adults. First, we examined entrainment stability by asking participants to coordinate taps with an auditory metronome in which unpredictable perturbations were introduced to disrupt entrainment. Next, we assessed behavioral synchronization by asking participants to coordinate taps with the syllables they produced while reading sentences as naturally as possible (tap to syllable task). Finally, we measured reading fluency and reading comprehension for native English and native Mandarin speakers. Stability of entrainment correlated strongly with tap to syllable task performance and with reading fluency, and both findings generalized across English and Mandarin speakers.

Modeling the influence of motor skills on literacy in third grade: Contributions of executive functions and handwriting

Several nonlanguage factors influence literacy development, and motor skills are among those most studied. Despite the publication of several studies that have supported the existence of this relationship, the type of influence and underlying mechanisms have been little explored. Herein, we propose modeling the relationship between motor skills and literacy through structural equation modeling, testing the contribution of executive functions and handwriting skills as the possible mediators of this relationship. In a study of 278 third-grade children, we used a wide range of measures related to written language (reading, spelling, reading comprehension, and written production), fine motor skills (dominant hand, nondominant hand, and bimanual dexterity), executive functions (verbal and visuospatial working memory, inhibition, and shifting), and handwriting. Structural equation modeling of the relationship between these different variables indicated that in the third grade, the influence of fine motor skills on literacy is fully mediated by both executive functions and handwriting skills. These motor skills effects are observed for both low levels of processing (reading, spelling) and high levels of processing (reading comprehension, written production). The results are discussed in terms of the potential mechanisms underlying different literacy skills and their implications for pedagogical programs.

Mathematics Disability vs. Learning Disability: A 360 Degree Analysis

A fundamental issue for research in mathematics disability (MD) and reading disability (RD) is: If these disabilities are clearly distinct, why is there so high a level of comorbidity, together with the converse; if these disabilities are so similar, why are there clear differences in underlying causes and aetiology? In order to address this puzzle, we introduce the “360 degree analysis” (360DA) framework and apply it to the overlap between RD and MD. The 360DA process starts by analyzing the issue from four perspectives: theoretical, developmental, affective, and pedagogical. Under 360DA, these analyses are then integrated to provide insights for theory, and for individual assessment and support, together with directions for future progress. The analyses confirm extensive similarities between arithmetic and reading development in terms of rote learning, executive function (EF), and affective trauma, but also major differences in terms of the conceptual needs, the motor coordination needs, and the methods of scaffolding. In terms of theory, commonalities are interpreted naturally in terms of initial general developmental delay followed by domain-independent affective trauma following school failure. Dissociations are interpreted in terms of cerebellar vs. hippocampal learning networks, sequential vs. spatial processing, and language vs. spatial scaffolding, with a further dimension of the need for accurate fixation for reading. The framework has significant theoretical and applied implications.

Neuro-Behavioral Correlates of Executive Dysfunctions in Dyslexia Over Development From Childhood to Adulthood

Dyslexia is a neurobiological learning disability in the reading domain that has symptoms in early childhood and persists throughout life. Individuals with dyslexia experience difficulties in academia and cognitive and emotional challenges that can affect wellbeing. Early intervention is critical to minimize the long-term difficulties of these individuals. However, the behavioral and neural correlates which predict dyslexia are challenging to depict before reading is acquired. One of the precursors for language and reading acquisition is executive functions (EF). The present review aims to highlight the current atypicality found in individuals with dyslexia in the domain of EF using behavioral measures, brain mapping, functional connectivity, and diffusion tensor imaging along development. Individuals with dyslexia show EF abnormalities in both behavioral and neurobiological domains, starting in early childhood that persist into adulthood. EF impairment precedes reading disability, therefore adding an EF assessment to the neuropsychological testing is recommended for early intervention. EF training should also be considered for the most comprehensive outcomes.

Home activities and cognitive skills in relation to early literacy and numeracy: testing a multifactorial model in preschoolers

The aim of the present study was to test environmental and cognitive variables as possible cross-domain predictors of early literacy and numeracy skills. One hundred forty-eight preschool children (mean age = 64.36 months ± 3.33) were enrolled in the study. The battery included a home literacy and home numeracy questionnaire, measures and phonological and visuo-spatial working memory, tasks tapping response inhibition, and predictors of literacy (vocabulary, phonological awareness, letter knowledge) and numeracy (magnitude comparison, number knowledge) skills. The structural equation model indicated that verbal working memory and, to a lesser extent, inhibition represented cross-domain predictors, whereas home numeracy activities and visuo-spatial working memory explained additional variance only for early numeracy skills. Implications for parents and educators are discussed.

Annual Research Review: Reading disorders revisited - the critical importance of oral language

This paper discusses research on reading disorders during the period since their classification within the overarching category of neurodevelopmental disorders (Journal of Child Psychology and Psychiatry, 53, 2012, 593). Following a review of the predictors of learning to read across languages, and the role of language skills as critical foundations for literacy, profiles of reading disorders are discussed and putative causal risk factors at the cognitive, biological, and environmental levels of explanation considered. Reading disorders are highly heritable and highly comorbid with disorders of language, attention, and other learning disorders, notably mathematics disorders. The home literacy environment, reflecting gene-environment correlation, is one of several factors that promote reading development and highlight an important target for intervention. The multiple deficit view of dyslexia (Cognition, 101, 2006, 385) suggests that risks accumulate to a diagnostic threshold although categorical diagnoses tend to be unstable. Implications for assessment and intervention are discussed.

Defining and understanding dyslexia: past, present and future

Dyslexia is a difficulty in learning to decode (read aloud) and to spell. DSM5 classifies dyslexia as one form of neurodevelopmental disorder. Neurodevelopmental disorders are heritable, life-long conditions with early onset. For many years, research on dyslexia proceeded on the basis that it was a specific learning difficulty - specific meaning that the difficulty could not be explained in terms of obvious causes such as sensory problems or general learning difficulties (low IQ). However, the failure to find qualitative differences in reading, and phonological skills, between children with dyslexia and children with more general learning problems led this kind of 'discrepancy' definition to fall from favour. The Rose Review stated that dyslexia can occur across the IQ range and that poor decoding skills require the same kinds of intervention irrespective of IQ. In this paper, we argue that loosening the criteria for dyslexia has influenced common understanding of the condition and led to diagnostic confusion. In the longer term, the use of the term may need to change. Implications for research and practice are discussed.

Rhythm in the blood: The influence of rhythm skills on literacy development in third graders

Several studies have shown the influence of rhythm skills on the processing of written language, especially at the beginning of literacy development. The first objective of this study was to determine the persistence of this link at an advanced grade level. The second objective was to better understand the factors underlying this relationship and, more specifically, to examine the hypothesis of mediation by phonological and/or motor skills. In total, 278 third graders performed literacy tasks (word/pseudoword decoding and spelling), a rhythm production task, two phonological tasks (phonological awareness and rapid automatized naming), and motor tasks. Significant correlations were observed between literacy and each of rhythm skills, phonological skills, and motor skills. However, structural equation models showed that the influence of rhythm skills on literacy was mediated neither by phonological skills nor by motor abilities. These results suggest that rhythm skills continue to play a role in the acquisition of written language in third graders and that this contribution seems to be independent of phonological and motor skills.

Reintroducing Dyslexia: Early Identification and Implications for Pediatric Practice

Dyslexia is a common learning disorder that renders children susceptible to poor health outcomes and many elements of socioeconomic difficulty. It is commonly undiagnosed until a child has repeatedly failed to learn to read in elementary school; this late diagnosis not only places the child at an academic disadvantage but also can be a precursor to psychiatric comorbidities such as anxiety and depression. Genetic and neuroimaging research have revealed that dyslexia is heritable and that it is undergirded by brain differences that are present even before reading instruction begins. Cognitive-behavioral research has revealed that there are early literacy skill deficits that represent red flags for dyslexia risk and can be measured at a preschool age. Altogether, this evidence points to dyslexia as a disorder that can be flagged by a pediatrician before school entry, during a period of heightened brain plasticity when interventions are more likely to be effective. In this review, we discuss the clinical implications of the most recent advances in dyslexia research, which converge to indicate that early identification and screening are crucial to the prevention or mitigation of adverse secondary consequences of dyslexia. We further highlight evidence-based and practical strategies for the implementation of early risk identification in pediatric practice so that physicians can be empowered in their ability to treat, educate, and advocate for their patients and families with dyslexia.

Is atypical rhythm a risk factor for developmental speech and language disorders?

Although a growing literature points to substantial variation in speech/language abilities related to individual differences in musical abilities, mainstream models of communication sciences and disorders have not yet incorporated these individual differences into childhood speech/language development. This article reviews three sources of evidence in a comprehensive body of research aligning with three main themes: (a) associations between musical rhythm and speech/language processing, (b) musical rhythm in children with developmental speech/language disorders and common comorbid attentional and motor disorders, and (c) individual differences in mechanisms underlying rhythm processing in infants and their relationship with later speech/language development. In light of converging evidence on associations between musical rhythm and speech/language processing, we propose the Atypical Rhythm Risk Hypothesis, which posits that individuals with atypical rhythm are at higher risk for developmental speech/language disorders. The hypothesis is framed within the larger epidemiological literature in which recent methodological advances allow for large-scale testing of shared underlying biology across clinically distinct disorders. A series of predictions for future work testing the Atypical Rhythm Risk Hypothesis are outlined. We suggest that if a significant body of evidence is found to support this hypothesis, we can envision new risk factor models that incorporate atypical rhythm to predict the risk of developing speech/language disorders. Given the high prevalence of speech/language disorders in the population and the negative long-term social and economic consequences of gaps in identifying children at-risk, these new lines of research could potentially positively impact access to early identification and treatment. This article is categorized under: Linguistics > Language in Mind and Brain Neuroscience > Development Linguistics > Language Acquisition.

Genome-wide association study of word reading: Overlap with risk genes for neurodevelopmental disorders

Reading disabilities (RD) are the most common neurocognitive disorder, affecting 5% to 17% of children in North America. These children often have comorbid neurodevelopmental/psychiatric disorders, such as attention deficit/hyperactivity disorder (ADHD). The genetics of RD and their overlap with other disorders is incompletely understood. To contribute to this, we performed a genome-wide association study (GWAS) for word reading. Then, using summary statistics from neurodevelopmental/psychiatric disorders, we computed polygenic risk scores (PRS) and used them to predict reading ability in our samples. This enabled us to test the shared aetiology between RD and other disorders. The GWAS consisted of 5.3 million single nucleotide polymorphisms (SNPs) and two samples; a family-based sample recruited for reading difficulties in Toronto (n = 624) and a population-based sample recruited in Philadelphia [Philadelphia Neurodevelopmental Cohort (PNC)] (n = 4430). The Toronto sample SNP-based analysis identified suggestive SNPs (P ~ 5 × 10^-7 ) in the ARHGAP23 gene, which is implicated in neuronal migration/axon pathfinding. The PNC gene-based analysis identified significant associations (P < 2.72 × 10^-6 ) for LINC00935 and CCNT1, located in the region of the KANSL2/CCNT1/LINC00935/SNORA2B/SNORA34/MIR4701/ADCY6 genes on chromosome 12q, with near significant SNP-based analysis. PRS identified significant overlap between word reading and intelligence (R²  = 0.18, P = 7.25  × 10^-181 ), word reading and educational attainment (R²  = 0.07, P = 4.91 × 10^-48 ) and word reading and ADHD (R²  = 0.02, P = 8.70 × 10^-6 ; threshold for significance = 7.14 × 10^-3 ). Overlap was also found between RD and autism spectrum disorder (ASD) as top-ranked genes were previously implicated in autism by rare and copy number variant analyses. These findings support shared risk between word reading, cognitive measures, educational outcomes and neurodevelopmental disorders, including ASD.

Reconsidering the Evidence That Systematic Phonics Is More Effective Than Alternative Methods of Reading Instruction

There is a widespread consensus in the research community that reading instruction in English should first focus on teaching letter (grapheme) to sound (phoneme) correspondences rather than adopt meaning-based reading approaches such as whole language instruction. That is, initial reading instruction should emphasize systematic phonics. In this systematic review, I show that this conclusion is not justified based on (a) an exhaustive review of 12 meta-analyses that have assessed the efficacy of systematic phonics and (b) summarizing the outcomes of teaching systematic phonics in all state schools in England since 2007. The failure to obtain evidence in support of systematic phonics should not be taken as an argument in support of whole language and related methods, but rather, it highlights the need to explore alternative approaches to reading instruction.

Funcionamiento ejecutivo y desempeño lector en niños con y sin dificultades de lectura: Un estudio de seguimiento ocular

Introducción: Las funciones ejecutivas incluyen habilidades como la memoria de trabajo, el control inhibitorio, la planeación y la flexibilidad cognitiva. Estas habilidades, resultan fundamentales para el desarrollo de procesos cognitivos complejos como el aprendizaje de la lectoescritura, encontrando que aquellos niños con dificultades de lectura tienden a presentar un nivel menor en el rendimiento en tareas de funciones ejecutivas. Objetivo: Caracterizar el rendimiento en funciones ejecutivas y su relación con el nivel de lenguaje y lectura en niños de 8 a 12 años con dificultades de lectura y sus controles por edad y género en relación a los patrones de seguimiento visual. Método: Participantes: 9 niños con dificultades de lectura y 9 controles. Procedimiento: Se evaluó el nivel de lenguaje, funciones ejecutivas y lectura haciendo uso del Eye Tracker Tobii Tx300.  Se analizaron los mapas de calor, glaze plot y las áreas de interés. Resultados y Conclusiones: Los niños con dificultades de lectura presentan un nivel de desempeño menor en tareas de funciones ejecutivas especialmente en el control inhibitorio y la planeación, estando estas asociadas directamente con el nivel de lenguaje y el rendimiento lector. De igual forma, las métricas visuales a partir del uso del Eye Tracker permite corroborar estas fallas en el procesamiento en tiempo real frente a tareas que implican demandas cognitivas de alto nivel.  

Deficient Explicit Access to Phonological Representations Explains Phonological Fluency Difficulties in Greek Children With Dyslexia and/or Developmental Language Disorder

It is well-established that children with dyslexia and/or Developmental Language Disorder (hereafter children with DDLD) perform poorly on phonological tasks compared to typically developing (TD) children. However, there has been some debate as to whether their phonological deficit arises directly from an impairment in phonological representations, or instead from deficient access to (intact) phonological representations. This study tested the Degraded Phonological Representations Hypothesis and the Deficient Phonological Access Hypothesis using a task that is not often used with children with DDLD, namely phonological fluency. Both hypotheses predict that children with DDLD will retrieve fewer items than their TD peers in the phonological fluency task. However, while the Degraded Phonological Representations Hypothesis predicts smaller clusters of phonologically related items in children with DDLD, the Deficient Phonological Access Hypothesis predicts that the two groups will not differ in cluster size. How phonological fluency performance related to children's language, literacy, and phonological skills was investigated. Further, the specificity of a phonological fluency deficit in children with DDLD was tested using a nonverbal (design) fluency task. Sixty-six children with DDLD aged 7-12 years and 83 TD children aged 6-12 years, all monolingual Greek speakers, were tested on three phonological fluency categories, on nonverbal IQ, language, literacy, and phonological tasks, and on a design fluency task. The DDLD group produced significantly fewer correct responses and fewer switches compared to the TD group, but the two groups showed similar clustering and average cluster size. After controlling for age, children's language, literacy, and phonological skills significantly predicted the number of correct responses produced. The two groups did not differ significantly on the number of unique designs generated in the design fluency task. Furthermore, children with DDLD showed poorer phonological fluency performance relative to their TD peers even after design fluency performance was controlled, demonstrating the specificity of their phonological fluency deficit. This study adds to the theoretical debate on the locus of the phonological deficit in dyslexia and DLD. The findings support the hypothesis that the phonological deficit in dyslexia and DLD lies in deficient explicit access to intact phonological representations.

Developmental Outcomes for Children at High Risk of Dyslexia and Children With Developmental Language Disorder

We followed children at family risk of dyslexia and children with preschool language difficulties from age 3½, comparing them with controls (N = 234). At age 8, children were classified as having dyslexia or Developmental Language Disorder (DLD) and compared at earlier time points with controls. Children with dyslexia have specific difficulties with phonology and emergent reading skills in the preschool period, whereas children with DLD, with or without dyslexia, show a wider range of impairments including significant problems with executive and motor tasks. For children with both dyslexia and DLD, difficulties with phonology are generally more severe than those observed in children with dyslexia or DLD alone. Findings confirm that poor phonology is the major cognitive risk factor for dyslexia.

Longitudinal relationships between speech perception, phonological skills and reading in children at high-risk of dyslexia

Speech perception deficits are commonly reported in dyslexia but longitudinal evidence that poor speech perception compromises learning to read is scant. We assessed the hypothesis that phonological skills, specifically phoneme awareness and RAN, mediate the relationship between speech perception and reading. We assessed longitudinal predictive relationships between categorical speech perception, phoneme awareness, RAN, language, attention and reading at ages 5½ and 6½ years in 237 children many of whom were at high risk of reading difficulties. Speech perception at 5½ years correlated with language, attention, phoneme awareness and RAN concurrently and was a predictor of reading at 6½ years. There was no significant indirect effect of speech perception on reading via phoneme awareness, suggesting that its effects are separable from those of phoneme awareness. Children classified with dyslexia at 8 years had poorer speech perception than age-controls at 5½ years and children with language disorders (with or without dyslexia) had more severe difficulties with both speech perception and attention control. Categorical speech perception tasks tap factors extraneous to perception, including decision-making skills. Further longitudinal studies are needed to unravel the complex relationships between categorical speech perception tasks and measures of reading and language and attention.

Executive function and childhood stuttering: Parent ratings and evidence from a behavioral task

PURPOSE

The purpose of this study was to examine the executive function (EF) abilities of preschool children who do (CWS) and do not stutter (CWNS) using a parent-report questionnaire and a behavioral task.

METHOD

Participants were 75 CWS and 75 CWNS between the ages of 3;0 and 5;11 (years; months). Parents rated their children's EF abilities using the Behavioral Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, Espy, & Isquith, 2003). Children's ability to integrate cognitive flexibility, inhibitory control, and working memory was measured using a behavioral task, the Head-Toes-Knees-Shoulders (HTKS; Cameron Ponitz, McClelland, Matthews, & Morrison, 2009).

RESULTS

The CWS were judged by their parents as being less proficient in working memory, shift/flexibility, and overall EF than the parents of the CWNS. Children in the CWS group were also 2½ to 7 times more likely than children in the CWNS group to exhibit clinically significant difficulties with EF. Behavioral task findings revealed that 3-year old CWS performed more poorly than their peers on the HTKS. Parental ratings of executive function and working memory were significantly and moderately correlated with receptive and expressive vocabulary skills only for the CWNS group.

CONCLUSION

CWS have more difficulty with EF in everyday life and may experience early delays in their ability to integrate aspects of attention and EF compared to CWNS.

Language Skills, but Not Frequency Discrimination, Predict Reading Skills in Children at Risk of Dyslexia

This study evaluated the claim that auditory processing deficits are a cause of reading and language difficulties. We report a longitudinal study of 245 children at family risk of dyslexia, children with preschool language impairments, and control children. Children with language impairments had poorer frequency-discrimination thresholds than controls at 5.5 years, but children at family risk of dyslexia did not. A model assessing longitudinal relationships among frequency discrimination, reading, language, and executive function skills showed that frequency discrimination was predicted by executive skills but was not a longitudinal predictor of reading or language skills. Our findings contradict the hypothesis that frequency discrimination is causally related to dyslexia or language impairment and suggest that individuals at risk for dyslexia or who have language impairments may perform poorly on auditory processing tasks because of comorbid attentional difficulties.

Verbal Working Memory as a Longitudinal Mechanism of Vocabulary Problems in Preschoolers with ADHD

Elucidation of early potential risk factors of Attention-Deficit/Hyperactivity Disorder (ADHD) is important to allow for early identification of ADHD and targeted early intervention for children with ADHD. Delayed language skills, particularly poor vocabulary, is an early-developing potential risk factor that is thought to be involved in developmental pathways to ADHD; however, mechanisms explaining the relationship between poor vocabulary skills and ADHD symptoms are unclear and warrant investigation. The present study examines the relationship between poor vocabulary skills and ADHD symptoms by testing cognitive mechanisms, namely verbal working memory (WM), that might account for this link. Participants were 109 young children between the ages of three and six and their primary caregivers. Diagnostic information on ADHD symptoms was available from parents and teachers/daycare providers via standardized rating forms. Vocabulary skills and WM were measured through child performance on laboratory tasks. Mediation analyses found poor verbal working memory significantly partially explained the vocabulary-ADHD association for both parent and teacher-rated ADHD symptoms. Further, effects of verbal WM on the association between poor vocabulary and increased ADHD symptoms largely held at one-year follow-up. Development of early interventions targeting verbal WM may be a promising new direction for early ADHD intervention work.

Articulation Speaks to Executive Function: An Investigation in 4- to 6-Year-Olds

Executive function (EF) and language learning play a prominent role in early childhood development. Empirical research continues to point to a concurrent relation between these two faculties. What has been given little attention, however, is the association between EF and speech articulation abilities in children. This study investigated this relation in children aged 4-6 years. Significant correlations indicated that children with better EF [via parental report of the Behavior Rating Inventory of Executive Function (BRIEF) inventory] exhibited stronger speech sound production abilities in the articulation of the "s" and "sh" sounds. Furthermore, regression analyses revealed that the Global Executive Composite (GEC) of EF as measured by the BRIEF, served as a predictor for speech sound proficiency and that speech sound proficiency served as a predictor for the GEC. Together, these results demonstrate the imbricated nature of EF and speech sound production while bearing theoretical and practical implications. From a theoretical standpoint, the close link between EF and speech articulation may indicate a common ontogenetic pathway. From a practical perspective, the results suggest that children with speech difficulties could be at higher risk for EF deficits.

Executive Function in Preschoolers with Primary Language Impairment

PURPOSE

The purpose of this study was to evaluate whether preschoolers with primary language impairment (PLI) show deficits in executive function (EF) compared with their peers with typical development (TD) when inhibition, updating, and mental-set shifting are examined using both linguistically based and visually based tasks.

METHOD

Twenty-two 4- and 5-year-old preschoolers with PLI and 30 preschoolers with TD completed 2 sets of computerized EF tasks: 3 that were linguistically based and 3 that were visually based. This permitted us to test the hypothesis that poor performance on EF tasks in preschoolers with PLI results from impaired language rather than impaired EF.

RESULTS

The PLI group scored significantly lower than the TD group on linguistically and visually based updating tasks and mental-set shifting tasks. The PLI and TD groups did not differ significantly for accuracy or response time on linguistically and visually based inhibition tasks.

CONCLUSION

Results suggest that preschool-age children with PLI have domain-general EF deficits in updating and mental-set shifting but not inhibition deficits, as measured by our tasks.

Reading disorders and dyslexia

PURPOSE OF REVIEW

We review current knowledge about the nature of reading development and disorders, distinguishing between the processes involved in learning to decode print, and the processes involved in reading comprehension.

RECENT FINDINGS

Children with decoding difficulties/dyslexia experience deficits in phoneme awareness, letter-sound knowledge and rapid automatized naming in the preschool years and beyond. These phonological/language difficulties appear to be proximal causes of the problems in learning to decode print in dyslexia. We review data from a prospective study of children at high risk of dyslexia to show that being at family risk of dyslexia is a primary risk factor for poor reading and children with persistent language difficulties at school entry are more likely to develop reading problems. Early oral language difficulties are strong predictors of later difficulties in reading comprehension.

SUMMARY

There are two distinct forms of reading disorder in children: dyslexia (a difficulty in learning to translate print into speech) and reading comprehension impairment. Both forms of reading problem appear to be predominantly caused by deficits in underlying oral language skills. Implications for screening and for the delivery of robust interventions for language and reading are discussed.

Socio-Emotional and Cognitive Resilience in Children with Reading Disabilities

In recent times, research on resilience in children facing adversities has proliferated. In this review, the authors characterize resilience in children with reading disorders (RD). To organize our discussion and categorize the specific outcomes such children demonstrate, we adopt the terms cognitive resilience and socio-emotional resilience. By paralleling other resilience research, we seek to uncover protective factors in the hopes that they can be targeted in education and interventions to improve cognitive functioning, socio-emotional wellbeing, and academic success of children with RD. We conclude by considering current limitations and addressing the need for future resilience research in this specific population of children.

The development of executive function and language skills in the early school years

BACKGROUND

The developmental relationships between executive functions (EF) and early language skills are unclear. This study explores the longitudinal relationships between children's early EF and language skills in a sample of children with a wide range of language abilities including children at risk of dyslexia. In addition, we investigated whether these skills independently predict children's attention/behaviour skills.

METHOD

Data are presented from 243 children at four time points. Children were selected for being at risk of reading difficulties either because of a family history of dyslexia (FR; N = 90) or because of concerns regarding their language development (LI; N = 79) or as typically developing controls (TD; N = 74). The children completed tasks to assess their executive function and language skills at ages 4, 5 and 6 years. At 6 (T4) and 7 years (T5) parents and teachers rated the children's attention/behaviour skills.

RESULTS

There was a strong concurrent relationship between language and EF at each assessment. Longitudinal analyses indicated a considerable degree of stability in children's language and EF skills: the influence of language on later EF skills (and vice versa) was weak and not significant in the current sample. Children's EF, but not language, skills at T3 predicted attention/behaviour ratings at T4/T5.

CONCLUSIONS

There is a strong concurrent association between language and EF skills during the preschool and early school years, when children with language impairment show persistent EF deficits. Latent variables measuring language and EF show high longitudinal stability with little evidence of significant or strong reciprocal influences between these constructs. EF, but not language, skills predict later ratings of children's attention and behaviour.

Imaging the "At-Risk" Brain: Future Directions

OBJECTIVES

Clinical neuroscience is increasingly turning to imaging the human brain for answers to a range of questions and challenges. To date, the majority of studies have focused on the neural basis of current psychiatric symptoms, which can facilitate the identification of neurobiological markers for diagnosis. However, the increasing availability and feasibility of using imaging modalities, such as diffusion imaging and resting-state fMRI, enable longitudinal mapping of brain development. This shift in the field is opening the possibility of identifying predictive markers of risk or prognosis, and also represents a critical missing element for efforts to promote personalized or individualized medicine in psychiatry (i.e., stratified psychiatry).

METHODS

The present work provides a selective review of potentially high-yield populations for longitudinal examination with MRI, based upon our understanding of risk from epidemiologic studies and initial MRI findings.

RESULTS

Our discussion is organized into three topic areas: (1) practical considerations for establishing temporal precedence in psychiatric research; (2) readiness of the field for conducting longitudinal MRI, particularly for neurodevelopmental questions; and (3) illustrations of high-yield populations and time windows for examination that can be used to rapidly generate meaningful and useful data. Particular emphasis is placed on the implementation of time-appropriate, developmentally informed longitudinal designs, capable of facilitating the identification of biomarkers predictive of risk and prognosis.

CONCLUSIONS

Strategic longitudinal examination of the brain at-risk has the potential to bring the concepts of early intervention and prevention to psychiatry.

Oral language deficits in familial dyslexia: A meta-analysis and review

This article reviews 95 publications (based on 21 independent samples) that have examined children at family risk of reading disorders. We report that children at family risk of dyslexia experience delayed language development as infants and toddlers. In the preschool period, they have significant difficulties in phonological processes as well as with broader language skills and in acquiring the foundations of decoding skill (letter knowledge, phonological awareness and rapid automatized naming [RAN]). Findings are mixed with regard to auditory and visual perception: they do not appear subject to slow motor development, but lack of control for comorbidities confounds interpretation. Longitudinal studies of outcomes show that children at family risk who go on to fulfil criteria for dyslexia have more severe impairments in preschool language than those who are defined as normal readers, but the latter group do less well than controls. Similarly at school age, family risk of dyslexia is associated with significantly poor phonological awareness and literacy skills. Although there is no strong evidence that children at family risk are brought up in an environment that differs significantly from that of controls, their parents tend to have lower educational levels and read less frequently to themselves. Together, the findings suggest that a phonological processing deficit can be conceptualized as an endophenotype of dyslexia that increases the continuous risk of reading difficulties; in turn its impact may be moderated by protective factors. (PsycINFO Database Record

Phonological memory and word learning deficits in children with specific language impairment: A role for perceptual context?

BACKGROUND

Sensitivity to perceptual context (anchoring) has been suggested to contribute to the development of both oral- and written-language skills, but studies of this idea in children have been rare.

AIMS

To determine whether deficient anchoring contributes to the phonological memory and word learning deficits of children with specific language impairment (SLI).

METHODS AND PROCEDURES

84 preschool children with and without SLI participated in the study. Anchoring to repeated items was evaluated in two tasks - a phonological memory task and a pseudo-word learning task.

OUTCOMES AND RESULTS

Compared to children with typical development, children with SLI had poorer phonological memory spans and learned fewer words during the word learning task. In both tasks the poorer performance of children with SLI reflected a smaller effect of anchoring that was manifested in a smaller effect of item repetition on performance. Furthermore, across the entire sample anchoring was significantly correlated with performance in vocabulary and grammar tasks.

CONCLUSIONS AND IMPLICATIONS

These findings are consistent with the hypothesis that anchoring contributes to language skills and that children with SLI have impaired anchoring, although further studies are required to determine the role of anchoring in language development.

Developmental dyslexia: predicting individual risk

BACKGROUND

Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known.

METHODS

The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6 months (T1) at approximately annual intervals on tasks tapping cognitive, language, and executive-motor skills. The children were recruited to three groups: children at family risk of dyslexia, children with concerns regarding speech, and language development at 3;06 years and controls considered to be typically developing. At 8 years, children were classified as 'dyslexic' or not. Logistic regression models were used to predict the individual risk of dyslexia and to investigate how risk factors accumulate to predict poor literacy outcomes.

RESULTS

Family-risk status was a stronger predictor of dyslexia at 8 years than low language in preschool. Additional predictors in the preschool years include letter knowledge, phonological awareness, rapid automatized naming, and executive skills. At the time of school entry, language skills become significant predictors, and motor skills add a small but significant increase to the prediction probability. We present classification accuracy using different probability cutoffs for logistic regression models and ROC curves to highlight the accumulation of risk factors at the individual level.

CONCLUSIONS

Dyslexia is the outcome of multiple risk factors and children with language difficulties at school entry are at high risk. Family history of dyslexia is a predictor of literacy outcome from the preschool years. However, screening does not reach an acceptable clinical level until close to school entry when letter knowledge, phonological awareness, and RAN, rather than family risk, together provide good sensitivity and specificity as a screening battery.

Early language and executive skills predict variations in number and arithmetic skills in children at family-risk of dyslexia and typically developing controls

Two important foundations for learning are language and executive skills. Data from a longitudinal study tracking the development of 93 children at family-risk of dyslexia and 76 controls was used to investigate the influence of these skills on the development of arithmetic. A two-group longitudinal path model assessed the relationships between language and executive skills at 3-4 years, verbal number skills (counting and number knowledge) and phonological processing skills at 4-5 years, and written arithmetic in primary school. The same cognitive processes accounted for variability in arithmetic skills in both groups. Early language and executive skills predicted variations in preschool verbal number skills, which in turn, predicted arithmetic skills in school. In contrast, phonological awareness was not a predictor of later arithmetic skills. These results suggest that verbal and executive processes provide the foundation for verbal number skills, which in turn influence the development of formal arithmetic skills. Problems in early language development may explain the comorbidity between reading and mathematics disorder.

Reading and language disorders: the importance of both quantity and quality

Reading and language disorders are common childhood conditions that often co-occur with each other and with other neurodevelopmental impairments. There is strong evidence that disorders, such as dyslexia and Specific Language Impairment (SLI), have a genetic basis, but we expect the contributing genetic factors to be complex in nature. To date, only a few genes have been implicated in these traits. Their functional characterization has provided novel insight into the biology of neurodevelopmental disorders. However, the lack of biological markers and clear diagnostic criteria have prevented the collection of the large sample sizes required for well-powered genome-wide screens. One of the main challenges of the field will be to combine careful clinical assessment with high throughput genetic technologies within multidisciplinary collaborations.