The intergenerational multiple deficit model and the case of dyslexia

Specificity, Co-Occurrence, and Growth: Math and Reading Skill Development in Children With Learning Disabilities

Learning disabilities are challenging to characterize because they evolve throughout development, frequently co-occur, and have varying domain specificity. Addressing these challenges, we analyzed longitudinal patterns of growth, co-occurrence, and specificity manifesting in the math and reading skills of children with and without learning disabilities. With a sample of 498 Grade 1 children followed for 5 years, we used linear mixed-effects models to explore group-level differences among children with math disability (MD), reading disability (RD), co-occurring disability, and no disability. Findings revealed: Math and reading trajectories of children with learning disabilities parallel those of children without disabilities. Skill growth slows over time, regardless of skill level, suggesting disability-related impairments will not resolve without intervention. Impairment levels and growth trajectories of children with co-occurring disabilities match the within-domain patterns of children with isolated disabilities, supporting a longitudinally maintained additive model of co-occurrence. MD and RD show varying specificity. MD impairments are domain-specific and become more pronounced over time. RD impairments impact both domains early, become more domain-specific over time, but maintain curriculum-contingent math deficits. Findings suggest early math intervention should balance linguistic and conceptual support, as the source of a child's math difficulties may not be clear until well into elementary school.

Beyond the sum of their parts: A multi-dimensional approach to dyscalculia-dyslexia comorbidity integrating studies of the brain, behavior, and genetics

Mathematics learning disorders (MD) and reading learning disorders (RD) are persistent conditions that interfere with success in academic and daily-life tasks, and cannot be attributed to intellectual disabilities, sensory deficits, or environmental factors. Prevalence rates of MD and RD are estimated at 5-10 % of school-age children, and their comorbidity (MDRD) is highly prevalent, with around 40 % of children with MD also experiencing RD. Despite this high comorbidity rate, research on MDRD has received less attention compared to isolated conditions, leaving its neurocognitive mechanisms unclear. In this study, we review behavioral, neuroimaging, and genetic MDRD research and discuss how they support current MDRD models, including the: (1) additive model, which proposes that MDRD results from the addition of neurocognitive deficits unique to MD or RD, (2) domain-general deficits model, which proposes that MDRD stems from executive function deficits, and (3) increased risk model, which proposes that MDRD emerges from phonological deficits characteristic of RD. Further, we recommend updating models of MDRD by integrating the multiple deficit and dimensional models to build a unified framework for research and diagnosis that considers multiple dimensions of mathematics, reading, and domain-general skills. This unified framework highlights the importance of a holistic, functional diagnosis.

Are there distinct subtypes of developmental dyslexia?

Introduction

The aim of this study was to identify if children with dyslexia can be distinguished into discrete categories based on their domain deficits, indicating various neurocognitive subtypes of developmental dyslexia (DD).

Methods

The sample included 101 students in the 3rd, 4th, 5th, and 6th grades of primary school (mean age 11.15 years) with a diagnosis of dyslexia from a public center and Greek as their native language. The students underwent tests assessing a wide range of abilities, specifically phonological, memory, attention, processing speed abilities, motor, visual, and visual-motor skills.

Results

Cluster analysis revealed that children with dyslexia can be divided into three subtypes. The first subtype includes children identified based on their performance in tasks evaluating the phonological abilities, memory, attention, processing speed, along with visual-motor and visual skills. The second subtype comprises children identified based on their performance in memory abilities, motor, and visual-motor skills. The third subtype includes children identified solely based on their performance in the motor skills domain.

Discussion

In conclusion, our findings suggest that school-aged children with DD can be categorized into different subtypes with distinct neurocognitive characteristics. Furthermore, the results indicate that most children with dyslexia experience difficulties in more than one cognitive, sensory or motor domains, supporting contemporary models regarding the existence of multiple neurocognitive deficits in DD.

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

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

Deafness and Specific Learning Disorder: towards a possible comorbidity

BACKGROUND AND AIM

Most children and adolescents with deafness receive one or two cochlear implants (CIs). Despite the CI expanding the potential for auditory rehabilitation in deaf children, the improvements in language and literacy skills of some of these children do not align with the expected outcomes. As the main research question, we wondered if the reading and writing deficits reported in some deaf children with CIs may be characterized as a domain-specific learning disorder, rather than only a consequence of deafness. Thus, we analyzed the academic discrepancies, in both reading and writing, between two groups of deaf children with early CI.

METHOD

Three prelingually deaf children with CI and with unexplained disproportionate learning disorders (Deaf+LD group) were compared to control deaf children with similar clinical history, age at CI implantation and auditory experience (Deaf group). The Deaf+LD group was also matched on chronological age to three hearing children with Specific Learning Disorder (SLD group).

RESULTS

The results showed that the three cases of the Deaf+LD group demonstrated severe reading and writing deficits, with performances significantly below the age level, similarly to children of the SLD group. By contrast, the three children of the Deaf group demonstrated normal reading and writing abilities.

CONCLUSIONS

We suggested considering the possibility of comorbidity between deafness and SLD. This hypothesis was supported by the specific features of the language profile that justify such an association; in fact, deaf children with presumed SLD have profiles much more similar to hearing children with SLD than to other deaf children.

Revisiting the definition of dyslexia

The International Dyslexia Association definition of dyslexia was updated 20 years ago and has been referenced frequently in research and practice. In this paper, researchers from the Florida Center for Reading Research consider the components of the definition and make recommendations for revisions. These include recognizing the persistence of word-reading, decoding, and spelling difficulties, acknowledging the multifactorial causal basis of dyslexia, clarifying exclusionary factors, and denoting comorbidity with other developmental disorders. It is also suggested that the academic and psychosocial consequences of dyslexia be highlighted to reinforce a preventive service delivery model. Lastly, the inclusion of dyslexia within a specific learning disability category is supported.

Intergenerational transmission of the structure of the auditory cortex and reading skills

High-level cognitive skill development relies on genetic and environmental factors, tied to brain structure and function. Inter-individual variability in language and music skills has been repeatedly associated with the structure of the auditory cortex: the shape, size and asymmetry of the transverse temporal gyrus (TTG) or gyri (TTGs). TTG is highly variable in shape and size, some individuals having one single gyrus (also referred to as Heschl's gyrus, HG) while others presenting duplications (with a common stem or fully separated) or higher-order multiplications of TTG. Both genetic and environmental influences on children's cognition, behavior, and brain can to some to degree be traced back to familial and parental factors. In the current study, using a unique MRI dataset of parents and children (135 individuals from 37 families), we ask whether the anatomy of the auditory cortex is related to reading skills, and whether there are intergenerational effects on TTG(s) anatomy. For this, we performed detailed, automatic segmentations of HG and of additional TTG(s), when present, extracting volume, surface area, thickness and shape of the gyri. We tested for relationships between these and reading skill, and assessed their degree of familial similarity and intergenerational transmission effects. We found that volume and area of all identified left TTG(s) combined was positively related to reading scores, both in children and adults. With respect to intergenerational similarities in the structure of the auditory cortex, we identified structural brain similarities for parent-child pairs of the 1st TTG (Heschl's gyrus, HG) (in terms of volume, area and thickness for the right HG, and shape for the left HG) and of the lateralization of all TTG(s) surface area for father-child pairs. Both the HG and TTG-lateralization findings were significantly more likely for parent-child dyads than for unrelated adult-child pairs. Furthermore, we established characteristics of parents' TTG that are related to better reading abilities in children: fathers' small left HG, and a small ratio of HG to planum temporale. Our results suggest intergenerational transmission of specific structural features of the auditory cortex; these may arise from genetics and/or from shared environment.

Caregiver Self-Efficacy in Relation to Caregivers' History of Language and Reading Difficulties and Children's Shared Reading Experiences

PURPOSE

Emerging literature suggests caregiver self-efficacy is an important factor related to caregivers' shared reading practices with their children. Reduced shared reading has been documented among families of caregiver(s) with language-based learning disabilities (LBLD). Yet, it remains unclear whether caregivers' history of language and reading difficulties is associated with caregiver self-efficacy. The purpose of this study was to examine whether self-efficacy in language- and reading-related caregiver activities related to caregiver history of language and reading difficulties and shared reading practices.

METHOD

One hundred seventy-six caregivers of children aged 18-60 months completed a custom self-efficacy in language- and reading-related caregiver activities questionnaire, as well as demographic, history of language and reading difficulties (used both as a continuous measure and to dichotomize caregivers with and without LBLD history), and shared reading measures in a one-time survey.

RESULTS

Caregivers with a history of LBLD reported an overall lower self-efficacy and a reduced amount of time reading with their children per week than caregivers without LBLD history. Examining caregiver history of language and reading difficulties continuously across the whole group, self-efficacy mediated the relationship between caregiver difficulties and shared reading practices, even when caregiver education was incorporated as an additional mediator in models.

CONCLUSIONS

Findings indicate that self-efficacy and caregiver education mediate the relationship between caregiver history of language and reading difficulties and shared reading practices. Consideration of self-efficacy by clinicians and educators is warranted when promoting shared reading practices to caregivers of young children. There is a need for future research to examine relationships between self-efficacy and shared reading among caregivers with LBLD of culturally and linguistically diverse backgrounds.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25901590.

A Model of the Home Literacy Environment and Family Risk of Reading Difficulty in Relation to Children's Preschool Emergent Literacy

This study extends the research on the preschool home literacy environment (HLE) in the context of the family risk (FR) of reading disability (RD) by examining a multiple-deficit model of RD. A total of 1,171 six-year-old Norwegian children were assessed at school entry, the onset of formal reading instruction in Norway. Their parents completed a questionnaire regarding their own RD, education, and the HLE. The final sample after applying the inclusion criteria was 794 children and their parents. The findings suggest, first, that two HLE factors (access to print and reading-related activities) should be distinguished rather than treated as a single factor ("exposure to print") as the majority of previous studies have done. This finding suggests a three-factor HLE model that includes parents' reading interests and habits, reading-related activities, and access to print. Second, family risk of RD is related to some extent to the HLE, even after controlling for parents' education. Third, children's experiences in their home environments and their emergent literacy may not be independent of their family risk of RD. More importantly, this study highlights the potential protective role of the HLE, especially when there is a history of RD within the family. The reason is that the positive association between the HLE and children's code-related emergent literacy remains significant when controlling for family risk of RD (access to print → emergent literacy: 0.39 [0.01, 0.68], p < 0.01; reading-related activities → emergent literacy: 0.37 [0.02, 0.35], p < 0.01; parents' reading interests and habits → emergent literacy: 0.26 [0.001, 0.15], p < 0.01). This finding supports that children's emergent literacy can be improved via a modifiable, dynamic factor such as the HLE.

The Contribution of Perceptual Reasoning Skills to Phonological Awareness for School Age Autistic Children

This study aimed to investigate the phonological awareness (PA) skills of school age autistic children (age range = 6-12) in two parts: (1) comparing their performance on a PA task to non-autistic children with groups matched on chronological age, verbal and non-verbal cognitive skills, and (2) exploring the role of cognitive skills and autism characteristics on PA skills. Results revealed that the groups did not differ in their PA skills (study 1) and that perceptual reasoning skills are associated with the PA skills of autistic participants (study 2). Results highlight the role of non-verbal cognitive skills in literacy development for autistic children and suggest that their perceptual reasoning abilities likely contribute a great deal when learning to read.

Sensory temporal sampling in time: an integrated model of the TSF and neural noise hypothesis as an etiological pathway for dyslexia

Much progress has been made in research on the causal mechanisms of developmental dyslexia. In recent years, the "temporal sampling" account of dyslexia has evolved considerably, with contributions from neurogenetics and novel imaging methods resulting in a much more complex etiological view of the disorder. The original temporal sampling framework implicates disrupted neural entrainment to speech as a causal factor for atypical phonological representations. Yet, empirical findings have not provided clear evidence of a low-level etiology for this endophenotype. In contrast, the neural noise hypothesis presents a theoretical view of the manifestation of dyslexia from the level of genes to behavior. However, its relative novelty (published in 2017) means that empirical research focused on specific predictions is sparse. The current paper reviews dyslexia research using a dual framework from the temporal sampling and neural noise hypotheses and discusses the complementary nature of these two views of dyslexia. We present an argument for an integrated model of sensory temporal sampling as an etiological pathway for dyslexia. Finally, we conclude with a brief discussion of outstanding questions.

Attentional modulation of neural sound tracking in children with and without dyslexia

Auditory selective attention forms an important foundation of children's learning by enabling the prioritisation and encoding of relevant stimuli. It may also influence reading development, which relies on metalinguistic skills including the awareness of the sound structure of spoken language. Reports of attentional impairments and speech perception difficulties in noisy environments in dyslexic readers are also suggestive of the putative contribution of auditory attention to reading development. To date, it is unclear whether non-speech selective attention and its underlying neural mechanisms are impaired in children with dyslexia and to which extent these deficits relate to individual reading and speech perception abilities in suboptimal listening conditions. In this EEG study, we assessed non-speech sustained auditory selective attention in 106 7-to-12-year-old children with and without dyslexia. Children attended to one of two tone streams, detecting occasional sequence repeats in the attended stream, and performed a speech-in-speech perception task. Results show that when children directed their attention to one stream, inter-trial-phase-coherence at the attended rate increased in fronto-central sites; this, in turn, was associated with better target detection. Behavioural and neural indices of attention did not systematically differ as a function of dyslexia diagnosis. However, behavioural indices of attention did explain individual differences in reading fluency and speech-in-speech perception abilities: both these skills were impaired in dyslexic readers. Taken together, our results show that children with dyslexia do not show group-level auditory attention deficits but these deficits may represent a risk for developing reading impairments and problems with speech perception in complex acoustic environments. RESEARCH HIGHLIGHTS: Non-speech sustained auditory selective attention modulates EEG phase coherence in children with/without dyslexia Children with dyslexia show difficulties in speech-in-speech perception Attention relates to dyslexic readers' speech-in-speech perception and reading skills Dyslexia diagnosis is not linked to behavioural/EEG indices of auditory attention.

Dynamics of cognitive predictors during reading acquisition in a sample of children overrepresented for dyslexia risk

Literacy acquisition is a complex process with genetic and environmental factors influencing cognitive and neural processes associated with reading. Previous research identified factors that predict word reading fluency (WRF), including phonological awareness (PA), rapid automatized naming (RAN), and speech-in-noise perception (SPIN). Recent theoretical accounts suggest dynamic interactions between these factors and reading, but direct investigations of such dynamics are lacking. Here, we investigated the dynamic effect of phonological processing and speech perception on WRF. More specifically, we evaluated the dynamic influence of PA, RAN, and SPIN measured in kindergarten (the year prior to formal reading instruction), first grade (the first year of formal reading instruction) and second grade on WRF in second and third grade. We also assessed the effect of an indirect proxy of family risk for reading difficulties using a parental questionnaire (Adult Reading History Questionnaire, ARHQ). We applied path modeling in a longitudinal sample of 162 Dutch-speaking children of whom the majority was selected to have an increased family and/or cognitive risk for dyslexia. We showed that parental ARHQ had a significant effect on WRF, RAN and SPIN, but unexpectedly not on PA. We also found effects of RAN and PA directly on WRF that were limited to first and second grade respectively, in contrast to previous research reporting pre-reading PA effects and prolonged RAN effects throughout reading acquisition. Our study provides important new insights into early prediction of later word reading abilities and into the optimal time window to target a specific reading-related subskill during intervention.

Auditory attention influences trajectories of symbol-speech sound learning in children with and without dyslexia

The acquisition of letter-speech sound correspondences is a fundamental process underlying reading development, one that could be influenced by several linguistic and domain-general cognitive factors. In the current study, we mimicked the first steps of this process by examining behavioral trajectories of audiovisual associative learning in 110 7- to 12-year-old children with and without dyslexia. Children were asked to learn the associations between eight novel symbols and native speech sounds in a brief training and subsequently read words and pseudowords written in the artificial orthography. We then investigated the influence of auditory attention as one of the putative domain-general factors influencing associative learning. To this aim, we assessed children with experimental measures of auditory sustained selective attention and interference control. Our results showed shallower learning trajectories in children with dyslexia, especially during the later phases of the training blocks. Despite this, children with dyslexia performed similarly to typical readers on the post-training reading tests using the artificial orthography. Better auditory sustained selective attention and interference control skills predicted greater response accuracy during training. Sustained selective attention was also associated with the ability to apply these novel correspondences in the reading tests. Although this result has the limitations of a correlational design, it denotes that poor attentional skills may constitute a risk during the early stages of reading acquisition, when children start to learn letter-speech sound associations. Importantly, our findings underscore the importance of examining dynamics of learning in reading acquisition as well as individual differences in more domain-general attentional factors.

Left-dominance for resting-state temporal low-gamma power in children with impaired word-decoding and without comorbid ADHD

One theory of the origins of reading disorders (i.e., dyslexia) is a language network which cannot effectively 'entrain' to speech, with cascading effects on the development of phonological skills. Low-gamma (low-γ, 30-45 Hz) neural activity, particularly in the left hemisphere, is thought to correspond to tracking at phonemic rates in speech. The main goals of the current study were to investigate temporal low-γ band-power during rest in a sample of children and adolescents with and without reading disorder (RD). Using a Bayesian statistical approach to analyze the power spectral density of EEG data, we examined whether (1) resting-state temporal low-γ power was attenuated in the left temporal region in RD; (2) low-γ power covaried with individual reading performance; (3) low-γ temporal lateralization was atypical in RD. Contrary to our expectations, results did not support the hypothesized effects of RD status and poor decoding ability on left hemisphere low-γ power or lateralization: post-hoc tests revealed that the lack of atypicality in the RD group was not due to the inclusion of those with comorbid attentional deficits. However, post-hoc tests also revealed a specific left-dominance for low-γ rhythms in children with reading deficits only, when participants with comorbid attentional deficits were excluded. We also observed an inverse relationship between decoding and left-lateralization in the controls, such that those with better decoding skills were less likely to show left-lateralization. We discuss these unexpected findings in the context of prior theoretical frameworks on temporal sampling. These results may reflect the importance of real-time language processing to evoke gamma rhythms in the phonemic range during childhood and adolescence.

Effects of a developmental dyslexia remediation protocol based on the training of audio-phonological cognitive processes in dyslexic children with high intellectual potential: study protocol for a multiple-baseline single-case experimental design

BACKGROUND

The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children's underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children.

METHODS

A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study.

DISCUSSION

The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.

Virtual reality rehabilitation program on executive functions of children with specific learning disorders: a pilot study

Background

The application of Virtual Reality (VR) in the field of rehabilitation has been widely studied, because it has already proven to be an effective intervention for a variety of physical and cognitive conditions. Nevertheless, its application in pediatric rehabilitation is more recent. This pilot study aims to examine whether a VR-rehabilitation program may have positive effects on the Executive Functions (EFs) of children with Specific Learning Disorders (SLD).

Materials and methods

Twenty-four children with diagnosis of SLD participated to the study (range 7-11 years) and performed the VR-training across 6 weeks in the CARE Lab, that was designed with appropriate structural measures and ad hoc fittings, to hide the sophisticated technology necessary to allow the child to experience a rehabilitative setting with recreational and semi-immersive features. Children were evaluated across three main time-points: T0, assessment of cognitive level and EFs immediately before the start of the intervention; T1, assessment of EFs immediately after the end of VR intervention; T2, follow-up of EFs after 6 months from the end of the VR intervention. The rehabilitation programs were customized according to clinical needs and/or single patient's characteristics, proposing different games with variable complexity levels.

Results

Results showed that scores for visual attention, inhibition, flexibility, and planning abilities were significantly higher than before the intervention, and the most part of these ameliorations were maintained after 6 months.

Conclusion

These findings provide important inputs for the development of new innovative rehabilitation interventions for children with SLD that must be founded in ecological and evidence-based approaches.

Preliteracy Skills Mediate the Relation Between Early Speech Sound Production and Subsequent Reading Outcomes

PURPOSE

Learning to read is a complex, multifaceted process that relies on several speech and language-related subskills. Individual differences in word reading outcomes are indicated among children with inaccurate speech sound productions, with some of these children developing later reading difficulties. There are inconsistent reports as to whether phonological deficits and/or weaknesses in oral language explain these subsequent reading difficulties. Thus, it remains unclear how variability in speech production accuracy in early childhood may impact reading development. Therefore, the present longitudinal study seeks to clarify the relation between speech sound production accuracy in kindergarten and subsequent reading outcomes with a focus on additional potential mediating factors.

METHOD

Speech accuracy, core preliteracy skills (phonological awareness, rapid naming, and letter-name knowledge), and additional potential mediators (phonological memory and oral language abilities) were characterized at the start of formal reading instruction. Word reading, decoding, reading fluency, and comprehension were assessed at the end of second grade. Mediation analyses were conducted to examine factors that mediate the relation between speech accuracy in kindergarten and subsequent reading outcomes.

RESULTS

Initial associations between early speech sound production accuracy and subsequent reading outcomes were indicated; however, mediation effects of preliteracy skills (phonological awareness and letter-name knowledge) were identified for word reading, decoding, and reading fluency outcomes. For reading comprehension, mediation effects of preliteracy and vocabulary skills were observed.

CONCLUSIONS

The relation between speech sound production accuracy and subsequent word reading, decoding, reading fluency, and comprehension was observed to be mediated by preliteracy skills, specifically phonological awareness and letter-name knowledge. For reading comprehension only, vocabulary knowledge were of additional importance.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23671491.

A network approach to dyslexia: Mapping the reading network

Research on the etiology of dyslexia typically uses an approach based on a single core deficit, failing to understand how variations in combinations of factors contribute to reading development and how this combination relates to intervention outcome. To fill this gap, this study explored links between 28 cognitive, environmental, and demographic variables related to dyslexia by employing a network analysis using a large clinical database of 1,257 elementary school children. We found two highly connected subparts in the network: one comprising reading fluency and accuracy measures, and one comprising intelligence-related measures. Interestingly, phoneme awareness was functionally related to the controlled and accurate processing of letter-speech sound mappings, whereas rapid automatized naming was more functionally related to the automated convergence of visual and speech information. We found evidence for the contribution of a variety of factors to (a)typical reading development, though associated with different aspects of the reading process. As such, our results contradict prevailing claims that dyslexia is caused by a single core deficit. This study shows how the network approach to psychopathology can be used to study complex interactions within the reading network and discusses future directions for more personalized interventions.

Goal-directedness enhances letter-speech sound learning and consolidation in an unknown orthography

This study examined how top-down control influenced letter-speech sound (L-SS) learning, the initial phase of learning to read. In 2020, 107 Dutch children (53 boys, M_age  = 106.845 months) learned eight L-SS correspondences, either preceded by goal-directed or implicit instructions. Symbol knowledge and artificial word-reading ability were assessed immediately after learning and on the subsequent day to examine the effect of sleep. Goal-directed children were faster and more efficient in learning a new script and had better learning outcomes compared to children who were not instructed about the goal of the task. This study demonstrates that directing children toward the goal can promote L-SS learning and consolidation, giving insights into how top-down control influences the initial phase of reading acquisition.

The Validity of WISC-V Profiles of Strengths and Weaknesses

The Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V; Wechsler, 2014 ) provides a general intelligence score, representing g, and five index scores, reflecting underlying broad factors. Within person differences between the overall performance across subtests and index scores, denoted as index difference scores, are often used to examine profiles of strengths and weaknesses. In this study, the validity of such profiles was examined for the Dutch WISC-V. In line with previous studies, broad factors explained little variance in index scores. A simulation study showed that variation in index difference scores also reflected little broad factor variance. The simulation study further revealed that, as a consequence, a significant discrepancy between an index score and overall performance was accompanied in only 40%–74% of the cases by a discrepancy on the underlying broad factor. Overall, these results provide little support for the validity and thereby clinical use of WISC-V profiles.

Multimodal intervention in 8- to 13-year-old French dyslexic readers: Study protocol for a randomized multicenter controlled crossover trial

BACKGROUND

Developmental dyslexia, a specific and long-lasting learning disorder that prevents children from becoming efficient and fluent readers, has a severe impact on academic learning and behavior and may compromise professional and social development. Most remediation studies are based on the explicit or implicit assumption that dyslexia results from a single cause related to either impaired phonological or visual-attentional processing or impaired cross-modal integration. Yet, recent studies show that dyslexia is multifactorial and that many dyslexics have underlying deficits in several domains. The originality of the current study is to test a remediation approach that trains skills in all three domains using different training methods that are tailored to an individual's cognitive profile as part of a longitudinal intervention study.

METHODS

This multicenter randomized crossover study will be conducted in three phases and will involve 120 dyslexic children between the ages of 8 and 13 years. The first phase serves as within-subject baseline period that lasts for 2 months. In this phase, all children undergo weekly speech-language therapy sessions without additional training at home (business-as-usual). During the second phase, all dyslexics receive three types of intensive interventions that last 2 month each: Phonological, visual-attentional, and cross-modal. The order of the first two interventions (phonological and visual-attentional) is swapped in two randomly assigned groups of 60 dyslexics each. This allows one to test the efficacy and additivity of each intervention (against baseline) and find out whether the order of delivery matters. During the third phase, the follow-up period, the intensive interventions are stopped, and all dyslexics will be tested after 2 months. Implementation fidelity will be assessed from the user data of the computerized intervention program and an "intention-to-treat" analysis will be performed on the children who quit the trial before the end.

DISCUSSION

The main objective of this study is to assess whether the three types of intensive intervention (phase 2) improve reading skills compared to baseline (i.e., non-intensive intervention, phase 1). The secondary objectives are to evaluate the effectiveness of each intervention and to test the effects of order of delivery on reading intervention outcomes. Reading comprehension, spelling performance and reading disorder impact of dyslexic readers are assessed immediately before and after the multimodal intervention and 2 months post-intervention.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT04028310. Registered on July 18, 2019.

Altered engagement of the speech motor network is associated with reduced phonological working memory in autism

Nonword repetition, a common clinical measure of phonological working memory, involves component processes of speech perception, working memory, and speech production. Autistic children often show behavioral challenges in nonword repetition, as do many individuals with communication disorders. It is unknown which subprocesses of phonological working memory are vulnerable in autistic individuals, and whether the same brain processes underlie the transdiagnostic difficulty with nonword repetition. We used functional magnetic resonance imaging (fMRI) to investigate the brain bases for nonword repetition challenges in autism. We compared activation during nonword repetition in functional brain networks subserving speech perception, working memory, and speech production between neurotypical and autistic children. Autistic children performed worse than neurotypical children on nonword repetition and had reduced activation in response to increasing phonological working memory load in the supplementary motor area. Multivoxel pattern analysis within the speech production network classified shorter vs longer nonword-repetition trials less accurately for autistic than neurotypical children. These speech production motor-specific differences were not observed in a group of children with reading disability who had similarly reduced nonword repetition behavior. These findings suggest that atypical function in speech production brain regions may contribute to nonword repetition difficulties in autism.

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.

Co-Occurrence of Reading and Writing Difficulties: The Application of the Interactive Dynamic Literacy Model

This article presents the application of the interactive dynamic literacy (IDL) model (Kim, 2020b) toward understanding difficulties in learning to read and write. According to the IDL model, reading and writing are part of communicative acts that draw on largely shared processes and skills as well as unique processes and skills. As such, reading and writing are dissociable but interdependent systems that have hierarchical, interactive, and dynamic relations. These key tenets of the IDL model are applied to the disruption of reading and writing development to explain co-occurrence of reading-writing difficulties using a single framework. The following hypotheses are presented: (a) co-occurrence between word reading and spelling and handwriting difficulties; (b) co-occurrence of dyslexia with written composition difficulties; (c) co-occurrence between reading comprehension and written composition difficulties; (d) co-occurrence of language difficulties with reading difficulties and writing difficulties; (e) co-occurrence of reading, writing, and language difficulties with weak domain-general skills or executive functions such as working memory and attentional control (including attention-deficit/ hyperactivity disorder [ADHD]); and (f) multiple pathways for reading and writing difficulties. Implications are discussed.

Home language and literacy environment and its relationship to socioeconomic status and white matter structure in infancy

The home language and literacy environment (HLLE) in infancy has been associated with subsequent pre-literacy skill development and HLLE at preschool-age has been shown to correlate with white matter organization in tracts that subserve pre-reading and reading skills. Furthermore, childhood socioeconomic status (SES) has been linked with both HLLE and white matter organization. It is important to understand whether the relationships between environmental factors such as HLLE and SES and white matter organization can be detected as early as infancy, as this period is characterized by rapid brain development that may make white matter pathways particularly susceptible to these early experiences. Here, we hypothesized that HLLE (1) relates to white matter organization in pre-reading and reading-related tracts in infants, and (2) mediates a link between SES and white matter organization. To test these hypotheses, infants (mean age: 8.6 ± 2.3 months, N = 38) underwent diffusion-weighted imaging MRI during natural sleep. Image processing was performed with an infant-specific pipeline and fractional anisotropy (FA) was estimated from the arcuate fasciculus (AF) and superior longitudinal fasciculus (SLF) bilaterally using the baby automated fiber quantification method. HLLE was measured with the Reading subscale of the StimQ (StimQ-Reading) and SES was measured with years of maternal education. Self-reported maternal reading ability was also quantified and applied to our statistical models as a proxy for confounding genetic effects. StimQ-Reading positively correlated with FA in left AF and to maternal education, but did not mediate the relationship between them. Taken together, these findings underscore the importance of considering HLLE from the start of life and may inform novel prevention and intervention strategies to support developing infants during a period of heightened brain plasticity.

Speech perception deficits and the effect of envelope-enhanced story listening combined with phonics intervention in pre-readers at risk for dyslexia

Developmental dyslexia is considered to be most effectively addressed with preventive phonics-based interventions, including grapheme-phoneme coupling and blending exercises. These intervention types require intact speech perception abilities, given their large focus on exercises with auditorily presented phonemes. Yet some children with (a risk for) dyslexia experience problems in this domain due to a poorer sensitivity to rise times, i.e., rhythmic acoustic cues present in the speech envelope. As a result, the often subtle speech perception problems could potentially constrain an optimal response to phonics-based interventions in at-risk children. The current study therefore aimed (1) to extend existing research by examining the presence of potential speech perception deficits in pre-readers at cognitive risk for dyslexia when compared to typically developing peers and (2) to explore the added value of a preventive auditory intervention for at-risk pre-readers, targeting rise time sensitivity, on speech perception and other reading-related skills. To obtain the first research objective, we longitudinally compared speech-in-noise perception between 28 5-year-old pre-readers with and 30 peers without a cognitive risk for dyslexia during the second half of the third year of kindergarten. The second research objective was addressed by exploring growth in speech perception and other reading-related skills in an independent sample of 62 at-risk 5-year-old pre-readers who all combined a 12-week preventive phonics-based intervention (GraphoGame-Flemish) with an auditory story listening intervention. In half of the sample, story recordings contained artificially enhanced rise times (GG-FL_EE group, n = 31), while in the other half, stories remained unprocessed (GG-FL_NE group, n = 31; Clinical Trial Number S60962-https://www.uzleuven.be/nl/clinical-trial-center). Results revealed a slower speech-in-noise perception growth in the at-risk compared to the non-at-risk group, due to an emerged deficit at the end of kindergarten. Concerning the auditory intervention effects, both intervention groups showed equal growth in speech-in-noise perception and other reading-related skills, suggesting no boost of envelope-enhanced story listening on top of the effect of combining GraphoGame-Flemish with listening to unprocessed stories. These findings thus provide evidence for a link between speech perception problems and dyslexia, yet do not support the potential of the auditory intervention in its current form.

Executive Functions and Rapid Automatized Naming: A New Tele-Rehabilitation Approach in Children with Language and Learning Disorders

Executive function deficits are documented in many neurodevelopmental disorders and may contribute to clinical complexity or rehabilitation resilience. The present research was primarily aimed at presenting and evaluating the feasibility and effectiveness of a telerehabilitation program used during the pandemic period. MemoRAN (Anastasis), a computerised cognitive training to improve executive control during visual-verbal integration tasks was used in a sample of 42 children (5–11 years old) with specific learning or language disorders. The MemoRAN training was based on exercises of inhibition, cognitive flexibility and updating in working memory for three months, with a frequency of approximately three sessions per week. Afterwards, a comparison between a subgroup of children using Memo-RAN and an active control group, using a tele-rehabilitation program directed on reading was conducted. Effect size analysis in pre-post measurements suggests an average effect of MemoRAN in measurements that require control processes, such as accuracy in dictation, reading, inhibition and working memory testing. Comparison with the active control group and the clinical utility implications of these types of treatment will be discussed.

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.

Rapid Automatized Naming as a Universal Marker of Developmental Dyslexia in Italian Monolingual and Minority-Language Children

Rapid Automatized Naming (RAN) is considered a universal marker of developmental dyslexia (DD) and could also be helpful to identify a reading deficit in minority-language children (MLC), in which it may be hard to disentangle whether the reading difficulties are due to a learning disorder or a lower proficiency in the language of instruction. We tested reading and rapid naming skills in monolingual Good Readers (mGR), monolingual Poor Readers (mPR), and MLC, by using our new version of RAN, the RAN-Shapes, in 127 primary school students (from 3rd to 5th grade). In line with previous research, MLC showed, on average, lower reading performances as compared to mGR. However, the two groups performed similarly to the RAN-Shapes task. On the contrary, the mPR group underperformed both in the reading and the RAN tasks. Our findings suggest that reading difficulties and RAN performance can be dissociated in MLC; consequently, the performance at the RAN-Shapes may contribute to the identification of children at risk of a reading disorder without introducing any linguistic bias, when testing MLC.

Altered brain network topology during speech tracking in developmental dyslexia

Developmental dyslexia is often accompanied by altered phonological processing of speech. Underlying neural changes have typically been characterized in terms of stimulus- and/or task-related responses within individual brain regions or their functional connectivity. Less is known about potential changes in the more global functional organization of brain networks. Here we recorded electroencephalography (EEG) in typical and dyslexic readers while they listened to (a) a random sequence of syllables and (b) a series of tri-syllabic real words. The network topology of the phase synchronization of evoked cortical oscillations was investigated in four frequency bands (delta, theta, alpha and beta) using minimum spanning tree graphs. We found that, compared to syllable tracking, word tracking triggered a shift toward a more integrated network topology in the theta band in both groups. Importantly, this change was significantly stronger in the dyslexic readers, who also showed increased reliance on a right frontal cluster of electrodes for word tracking. The current findings point towards an altered effect of word-level processing on the functional brain network organization that may be associated with less efficient phonological and reading skills in dyslexia.

Early Productive Vocabulary Composition as Precursor of Dyslexia

PURPOSE

The aim of this study was to gain more insight into the linguistic characterization of dyslexia by investigating vocabulary acquisition. In a previous study, vocabulary at 17 months of age appeared to be related to familial risk (FR) of dyslexia. The aim of this study was to investigate how the differences in lexical composition further develop up to 3 years (35 months) of age and, more importantly, to what extent these differences can be considered specific precursors of dyslexia later on.

METHOD

In a total number of 262 children from the Dutch Dyslexia Program, 169 with and 93 without FR for dyslexia, productive vocabulary was assessed with the Dutch version of the MacArthur Communicative Development Inventories at ages 17, 23, 29, and 35 months. Reading tests were administered in Grades 2 and 3, resulting in dyslexia diagnosis in 60 FR children (FR-dys), leaving 109 FR children who developed normal reading skills (FR-nondys) and 93 control children. Children's expressive vocabulary was scored according to the total number of words produced and according to the different major linguistic word categories: nouns, predicates, and closed-class words. The analyses comprised a comparison of total productive vocabulary and the number of words per grammatical category at four different ages for the three groups (FR-dys, FR-nondys, and control). Also, correlations were calculated between vocabulary scores and reading scores.

RESULTS

Up to 29 months of age, the total numbers of nouns, predicates, and closed-class words are significantly lower for the FR-dys group as compared with the FR-nondys and control groups; for closed-class words at 23 and 35 months of age, the FR-nondys group's mean values are in between the mean of the FR-dys and control groups. Weak correlations were found between total vocabulary size, number of verbs, number and proportion of predicates at 23 months of age, and word and pseudoword reading fluency in Grades 2 and 3.

CONCLUSIONS

These results indicate that development of vocabulary is a significant though weak predictor of reading fluency and dyslexia; vocabulary size and proportion of verbs at 23 months of age, as well as proportion of closed-class words up to 35 months of age, seem to be the most sensitive indicators of delayed vocabulary development and later reading difficulties. There is no indication that FR for dyslexia by itself is related to vocabulary development.

Tracking Familial History of Reading and Math Difficulties in Children's Academic Outcomes

The current study aimed to investigate the extent to which familial history of reading and math difficulties have an impact on children's academic outcomes within a 3-year longitudinal study, which evaluated their core reading and math skills after first (N = 198; 53% girls) and second grades (N = 166), as well as performance on complex academic tasks after second and third grades (N = 148). At baseline, parents were asked to complete the Adult Reading History Questionnaire (ARHQ) and its adaption, Adult Math History Questionnaire (AMHQ), to index familial history of reading and math difficulties, respectively. Preliminary findings established the psychometric properties of the AMHQ, suggesting that it is a reliable and valid scale. Correlation analyses indicated that the ARHQ was negatively associated with children's reading skills, whereas the AMHQ was negatively related to math outcomes. Path results revealed that the ARHQ predicted children's performance on complex reading tasks indirectly via their core reading skills, and the AMHQ was linked to complex math outcomes indirectly via core math abilities. The ARHQ was also found to be negatively correlated with measures of children's math performance, with path findings suggesting that these relations were indirectly explained by differences in their core reading skills. These results suggest that assessing familial risk for academic difficulties may be crucial to understanding comorbid etiological and developmental associations between reading and math differences.

How Learning to Read Changes the Listening Brain

Reading acquisition reorganizes existing brain networks for speech and visual processing to form novel audio-visual language representations. This requires substantial cortical plasticity that is reflected in changes in brain activation and functional as well as structural connectivity between brain areas. The extent to which a child's brain can accommodate these changes may underlie the high variability in reading outcome in both typical and dyslexic readers. In this review, we focus on reading-induced functional changes of the dorsal speech network in particular and discuss how its reciprocal interactions with the ventral reading network contributes to reading outcome. We discuss how the dynamic and intertwined development of both reading networks may be best captured by approaching reading from a skill learning perspective, using audio-visual learning paradigms and longitudinal designs to follow neuro-behavioral changes while children's reading skills unfold.

Ahead of maturation: Enhanced speech envelope training boosts rise time discrimination in pre-readers at cognitive risk for dyslexia

Dyslexia has frequently been related to atypical auditory temporal processing and speech perception. Results of studies emphasizing speech onset cues and reinforcing the temporal structure of the speech envelope, that is, envelope enhancement (EE), demonstrated reduced speech perception deficits in individuals with dyslexia. The use of this strategy as auditory intervention might thus reduce some of the deficits related to dyslexia. Importantly, reading-skill interventions are most effective when they are provided during kindergarten and first grade. Hence, we provided a tablet-based 12-week auditory and phonics-based intervention to pre-readers at cognitive risk for dyslexia and investigated the effect on auditory temporal processing with a rise time discrimination (RTD) task. Ninety-one pre-readers at cognitive risk for dyslexia (aged 5-6) were assigned to two groups receiving a phonics-based intervention and playing a story listening game either with (n = 31) or without (n = 31) EE or a third group playing control games and listening to non-enhanced stories (n = 29). RTD was measured directly before, directly after and 1 year after the intervention. While the groups listening to non-enhanced stories mainly improved after the intervention during first grade, the group listening to enhanced stories improved during the intervention in kindergarten and subsequently remained stable during first grade. Hence, an EE intervention improves auditory processing skills important for the development of phonological skills. This occurred before the onset of reading instruction, preceding the maturational improvement of these skills, hence potentially giving at risk children a head start when learning to read.

Development of thalamus mediates paternal age effect on offspring reading: A preliminary investigation

The importance of (inherited) genetic impact in reading development is well established. De novo mutation is another important contributor that is recently gathering interest as a major liability of neurodevelopmental disorders, but has been neglected in reading research to date. Paternal age at childbirth (PatAGE) is known as the most prominent risk factor for de novo mutation, which has been repeatedly shown by molecular genetic studies. As one of the first efforts, we performed a preliminary investigation of the relationship between PatAGE, offspring's reading, and brain structure in a longitudinal neuroimaging study following 51 children from kindergarten through third grade. The results showed that greater PatAGE was significantly associated with worse reading, explaining an additional 9.5% of the variance after controlling for a number of confounds-including familial factors and cognitive-linguistic reading precursors. Moreover, this effect was mediated by volumetric maturation of the left posterior thalamus from ages 5 to 8. Complementary analyses indicated the PatAGE-related thalamic region was most likely located in the pulvinar nuclei and related to the dorsal attention network by using brain atlases, public datasets, and offspring's diffusion imaging data. Altogether, these findings provide novel insights into neurocognitive mechanisms underlying the PatAGE effect on reading acquisition during its earliest phase and suggest promising areas of future research.

Overcoming theoretical stagnation through cultural–historical neuropsychology: The case of dyslexia

In this article we argue that cultural–historical neuropsychology manages to escape the theoretical stagnation that characterises the field of dyslexia. To support our argumentation, we first define cultural–historical psychology and neuropsychology and determine their subject matter. Afterwards, we provide an outline of how reading and reading difficulties are perceived through the prism of cultural–historical neuropsychology. We then discuss several mainstream conceptualisations of dyslexia that contribute to the theoretical stagnation in the field. Finally, we explain how cultural–historical neuropsychology avoids each theoretical barrier imposed by mainstream conceptualisations.

Multivariate genome-wide covariance analyses of literacy, language and working memory skills reveal distinct etiologies

Several abilities outside literacy proper are associated with reading and spelling, both phenotypically and genetically, though our knowledge of multivariate genomic covariance structures is incomplete. Here, we introduce structural models describing genetic and residual influences between traits to study multivariate links across measures of literacy, phonological awareness, oral language, and phonological working memory (PWM) in unrelated UK youth (8-13 years, N = 6453). We find that all phenotypes share a large proportion of underlying genetic variation, although especially oral language and PWM reveal substantial differences in their genetic variance composition with substantial trait-specific genetic influences. Multivariate genetic and residual trait covariance showed concordant patterns, except for marked differences between oral language and literacy/phonological awareness, where strong genetic links contrasted near-zero residual overlap. These findings suggest differences in etiological mechanisms, acting beyond a pleiotropic set of genetic variants, and implicate variation in trait modifiability even among phenotypes that have high genetic correlations.

ERP Mismatch Negativity Amplitude and Asymmetry Reflect Phonological and Rapid Automatized Naming Skills in English-Speaking Kindergartners

The mismatch negativity (MMN), an electrophysiological response to an oddball auditory stimulus, is related to reading ability in many studies. There are conflicting findings regarding exactly how the MMN relates to risk or actual diagnosis of dyslexia/reading impairment, perhaps due to the heterogeneity of abilities in children with reading impairment. In this study, 166 English-speaking kindergarten children oversampled for dyslexia risk completed behavioral assessments and a speech-syllable MMN paradigm. We examined how early and late MMN mean amplitude and laterality were related to two established predictors of reading ability: phonological awareness (PA) and rapid automatized naming (RAN). In bootstrapped group analyses, late MMN amplitude was significantly greater in children with typical PA ability than low PA ability. In contrast, laterality of the early and late MMN was significantly different in children with low versus typical RAN ability. Continuous analyses controlling for child age, non-verbal IQ, and letter and word identification abilities showed the same associations between late MMN amplitude with PA and late MMN laterality with RAN. These findings suggest that amplitude of the MMN may relate to phonological representations and ability to manipulate them, whereas MMN laterality may reflect differences in brain processes that support automaticity needed for reading.

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.

Improving cognitive functions in adolescents with learning difficulties: A feasibility study on the potential use of telerehabilitation during Covid-19 pandemic in Italy

Introduction. Learning disabilities are due to genetic and/or neurobiological factors that alter brain functioning by affecting one or more cognitive processes related to learning. This study aimed to assess the efficacy of cognitive telerehabilitation in adolescents with learning disabilities to overcome the treatment problems related to the COVID-19 pandemic lockdown. Methods. Twenty-four patients diagnosed with Unspecified Learning Disability (mean ± SD age: 18.2 ± 2.9 years; 50% male) were enrolled in this study. The patients were assessed by a neuropsychological evaluation at the beginning and at the end of the program. All patients received cognitive treatment via a specific telehealth app to stimulate the cognitive skills related to learning. The treatment lasted four weeks, with a daily training (lasting up to 60 min), for five days a week. Results. Our young patients reported a statistically significant improvement in the main cognitive domains that are usually compromised in learning disabilities, including sustained and selective attention, shifting of attention, control of interference, memory and speed of information processing. Moreover, the patients showed a good usability and motivation during the training. Conclusions. Our study has shown that telerehabilitation could be a valid tool for the rehabilitation of specific cognitive skills in adolescents with learning difficulties.

Unveiling the Mysteries of Dyslexia-Lessons Learned from the Prospective Jyväskylä Longitudinal Study of Dyslexia

This paper reviews the observations of the Jyväskylä Longitudinal Study of Dyslexia (JLD). The JLD is a prospective family risk study in which the development of children with familial risk for dyslexia (N = 108) due to parental dyslexia and controls without dyslexia risk (N = 92) were followed from birth to adulthood. The JLD revealed that the likelihood of at-risk children performing poorly in reading and spelling tasks was fourfold compared to the controls. Auditory insensitivity of newborns observed during the first week of life using brain event-related potentials (ERPs) was shown to be the first precursor of dyslexia. ERPs measured at six months of age related to phoneme length identification differentiated the family risk group from the control group and predicted reading speed until the age of 14 years. Early oral language skills, phonological processing skills, rapid automatized naming, and letter knowledge differentiated the groups from ages 2.5-3.5 years onwards and predicted dyslexia and reading development, including reading comprehension, until adolescence. The home environment, a child's interest in reading, and task avoidance were not different in the risk group but were found to be additional predictors of reading development. Based on the JLD findings, preventive and intervention methods utilizing the association learning approach have been developed.

School-entry language outcomes in late talkers with and without a family risk of dyslexia

Children with familial risk (FR) of dyslexia and children with early language delay are known to be at risk for later language and literacy difficulties. However, research addressing long-term outcomes in children with both risk factors is scarce. This study tracked FR and No-FR children identified as late talkers at 2 years of age and reports development from 4;6 through 6 years. We examined the possible effects of FR-status and late talking (LT) status, respectively, on language skills at school entry, and whether FR-status moderated the associations between 4;6-year and 6-year language scores. Results indicated an effect of LT status on language at both ages, while FR status affected language skills at 6 years only. The interaction between LT and FR statuses was not significant, implying that LT status affected language skills independently of the child's FR status. A proportion of late talkers developed typical language at 6 years of age, while some FR children with typical vocabulary skills in toddlerhood had emerging developmental language disorder by school entry. FR status had a moderating effect on the association between expressive grammar at ages 4;6 and 6 years. Possible explanations for the effect of FR status on language skills are discussed. We highlight limitations in the study size and suggest how these preliminary findings can inform future research.

Multifactorial pathways facilitate resilience among kindergarteners at risk for dyslexia: A longitudinal behavioral and neuroimaging study

Recent efforts have focused on screening methods to identify children at risk for dyslexia as early as preschool/kindergarten. Unfortunately, while low sensitivity leads to under-identification of at-risk children, low specificity can lead to over-identification, resulting in inaccurate allocation of limited educational resources. The present study focused on children identified as at-risk in kindergarten who do not subsequently develop poor reading skills to specify factors associated with better reading outcomes among at-risk children. Early screening was conducted in kindergarten and a subset of children was tracked longitudinally until second grade. Potential protective factors were evaluated at cognitive-linguistic, environmental, and neural levels. Relative to at-risk kindergarteners with subsequent poor reading, those with typical reading outcomes were characterized by significantly higher socioeconomic status (SES), speech production accuracy, and structural organization of the posterior right-hemispheric superior longitudinal fasciculus (SLF). A positive association between structural organization of the right SLF and subsequent decoding skills was found to be specific to at-risk children and not observed among typical controls. Among at-risk children, several kindergarten-age factors were found to significantly contribute to the prediction of subsequent decoding skills: white matter organization in the posterior right SLF, age, gender, SES, and phonological awareness. These findings suggest that putative compensatory mechanisms are already present by the start of kindergarten. The right SLF, in conjunction with the cognitive-linguistic and socioeconomic factors identified, may play an important role in facilitating reading development among at-risk children. This study has important implications for approaches to early screening, and assessment strategies for at-risk children.

Predictors of Children's Early Numeracy: Environmental Variables, Intergenerational Pathways, and Children's Cognitive, Linguistic, and Non-symbolic Number Skills

Early numeracy skills in preschool years have been found to be related to a variety of different factors, including Approximate Number System (ANS) skills, children's cognitive and linguistic skills, and environmental variables such as home numeracy activities. The present study aimed to analyze the differential role of environmental variables, intergenerational patterns, children's cognitive and linguistic skills, and their ANS in supporting early math skills. The sample included 64 children in their last year of kindergarten and one parent of each child. Children were administered a battery of cognitive and linguistic tasks, and a non-symbolic comparison task as a measure of ANS. Parents were administered similar tasks assessing cognitive skills, math skills, and ANS skills (estimation and non-symbolic comparison), together with a questionnaire on home numeracy. Results showed that home numeracy predicted children's early math skills better than a number of parent and child variables. Considering children's skills, their ability in the non-symbolic magnitude comparison task was the strongest predictor of early math skills. Results reinforce the importance of the role of home numeracy activities and children's ANS skills above that of parents' math skills.

Distinct neural substrates of individual differences in components of reading comprehension in adults with or without dyslexia

Reading comprehension is a complex task that depends on multiple cognitive and linguistic processes. According to the updated Simple View of Reading framework, in adults, individual variation in reading comprehension can be largely explained by combined variance in three component abilities: (1) decoding accuracy, (2) fluency, and (3) language comprehension. Here we asked whether the neural correlates of the three components are different in adults with dyslexia as compared to typically-reading adults and whether the relative contribution of these correlates to reading comprehension is similar in the two groups. We employed a novel naturalistic fMRI reading task to identify the neural correlates of individual differences in the three components using whole-brain and literature-driven regions-of-interest approaches. Across all participants, as predicted by the Simple View framework, we found distinct patterns of associations with linguistic and domain-general regions for the three components, and that the left-hemispheric neural correlates of language comprehension in the angular and posterior temporal gyri made the largest contributions to explaining out-of-scanner reading comprehension performance. These patterns differed between the two groups. In typical adult readers, better fluency was associated with greater activation of left occipitotemporal regions, better comprehension with lesser activation in prefrontal and posterior parietal regions, and there were no significant associations with decoding. In adults with dyslexia, better fluency was associated with greater activation of bilateral inferior parietal regions, better comprehension was associated with greater activation in some prefrontal clusters and lower in others, and better decoding skills were associated with lesser activation of bilateral prefrontal and posterior parietal regions. Extending the behavioral findings of skill-level differences in the relative contribution of the three components to reading comprehension, the relative contributions of the neural correlates to reading comprehension differed based on dyslexia status. These findings reveal some of the neural correlates of individual differences in the three components and the underlying mechanisms of reading comprehension deficits in adults with dyslexia.