Dissociations between developmental dyslexias and attention deficits

Computerised Attention Functions Training Versus Computerised Executive Functions Training for Children with Attention Deficit/Hyperactivity Disorder: A Randomised Controlled Trial

Background: Attention deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by deficits in attention, hyperactivity, and impulsivity. Current treatments, such as stimulant medication and behavioural therapy, ameliorate symptoms but do not address the core cognitive dysfunctions. This study aimed to investigate the effects of two computerised neurocognitive training programs, attention functions training and executive functions training, in children with ADHD. Methods: Eighty children with ADHD (ages 8-13) were randomly assigned to one of three groups: Attention functions training (AFT), targeting sustained, selective-spatial, orienting, and executive attention; executive functions training (EFT), focusing on working memory, cognitive flexibility, and problem solving; or a passive control group. Training sessions were administered in small groups twice a week for nine weeks. Participants underwent comprehensive assessments of attention (Continuous Performance Test, Conjunctive Visual Search Task), executive functions (Corsi Block-Tapping Tasks), nonverbal reasoning (Raven's Colored Progressive Matrices), parent-rated behavioural symptoms, and arithmetic performance at baseline, post-intervention, and follow-up. Results: The AFT group demonstrated significant improvements in sustained and selective-spatial attention, nonverbal reasoning, inattentive symptoms, and arithmetic performance, and most improvements persisted at follow-up. The EFT group showed gains in nonverbal reasoning and inattentive symptoms, although no improvements were documented in working memory or in parent ratings of executive functions. Conclusions: The AFT program that addressed core attentional functions in children with ADHD produced robust cognitive and behavioural benefits, whereas the EFT program yielded behavioural benefits and a limited improvement in executive functions. Future research should explore different training protocols for broader gains in executive functions. These findings support the potential of theory-driven, structured neurocognitive training targeting basic cognitive functions as an effective small-group intervention for ADHD.

Characterizing different types of developmental dyslexias in French: The Malabi screener

Reading is a complex process involving multiple stages. An impairment in any of these stages may cause distinct types of reading deficits- distinct types of dyslexia. We describe the Malabi, a screener to identify deficits in various orthographic, lexical, and sublexical components of the reading process in French. The Malabi utilizes stimuli that are sensitive to different forms of dyslexia, including "attentional dyslexia", as it is traditionally refered to, characterized by letter-to-word binding impairments leading to letter migrations between words (e.g., "bar cat" misread as "bat car"), and "letter-position dyslexia", resulting in letter transpositions within words (e.g., "destiny" misread as "density"). After collecting reading error norms from 138 French middle-school students, we analyzed error types of 16 students with developmental dyslexia. We identified three selective cases of attentional dyslexia and one case of letter-position dyslexia. Further tests confirmed our diagnosis and demonstrate, for the first time, how these dyslexias are manifested in French. These results underscore the significance of recognizing and discussing the existence of multiple dyslexias, both in research contexts when selecting participants for dyslexia studies, and in practical settings where educators and practitioners work with students to develop personalized support. The test and supporting materials are available on Open Science Framework (https://osf.io/3pgzb/).

Letter Migrations between Words in Reading Aloud Can Result either from an Impairment in Orthographic Input or in Phonological Output

Letter migrations between words in reading aloud (e.g., reading "cane love" as "lane love" or "lane cove") are known to result from a deficit in the visual-orthographic analysis and characterize attentional dyslexia. In spontaneous speech, individuals with impairment in the phonological output buffer may show migrations of phonemes between words. The purpose of this study was to examine whether migrations between words in reading aloud can also result from a deficit in the phonological output buffer, to explore the characteristics of migrations resulting from orthographic input and from phonological output deficits, and to examine methods to distinguish these two sources. Using tasks of reading aloud of lists of 92-182 word pairs, we identified 18 adults and adolescents with developmental dyslexia who made between-word letter migrations in reading aloud, significantly more than age-matched controls (372 adults, 26 7th-graders and 44 4th-5th-graders). To distinguish between the orthographic input and phonological output sources for these migrations, we administered a test assessing orthographic input without spoken output (written semantic decision on 140 migratable word pairs) and a repetition test of 36 auditorily presented migratable word pairs, assessing spoken output without orthographic input (as well as nonword repetition and 3 span tests). These tests indicated that the migrations in reading aloud of 10 of the participants with dyslexia resulted from an orthographic input deficit-they made migrations not only in reading aloud but also in written word pair comprehension, but not in word pair repetition. For the other 8 participants, the migrations resulted from a phonological output deficit: they made migrations in reading aloud and in word pair repetition, but not in comprehension, and had limited spans and made errors in nonword repetition. We identified several differences between the two types of between-word errors: first, the individuals with attentional dyslexia made omissions of a letter that appeared in the same position in the two words, but the phonological output buffer group did not make such omissions. Second, the groups differed in the origin of migration: orthographic input migrations involve letters that are orthographically adjacent, whereas phonological output migrations involve phonologically adjacent phonemes: phonemes that have just been spoken or that are prepared together in the phonological buffer for production. Migrations from the line below and from 2 lines above the target occurred only in the orthographic input group. This study thus indicates that between-word migrations in reading aloud can result not only from attentional dyslexia, but also from a phonological output buffer deficit, and offers ways to distinguish between the two.

Near and Far Transfer Effects of Computerized Progressive Attention Training (CPAT) Versus Mindfulness Based Stress Reduction (MBSR) Practice Among Adults With ADHD

OBJECTIVE

The present study evaluated the near (attention) and far (reading, ADHD symptoms, learning, and quality of life) transfer effects of a Computerized Progressive Attention Training (CPAT) versus Mindfulness Based Stress Reduction (MBSR) practice among adults with ADHD compared to a passive group.

METHOD

Fifty-four adults participated in a non-fully randomized controlled trial. Participants in the intervention groups completed eight 2-hr weekly training sessions. Outcomes were assessed before, immediately after, and 4 months post-intervention, using objective tools: attention tests, eye-tracker, and subjective questionnaires.

RESULTS

Both interventions showed near-transfer to various attention functions. The CPAT produced far-transfer effects to reading, ADHD symptoms, and learning while the MBSR improved the self-perceived quality of life. At follow-up, all improvements except for ADHD symptoms were preserved in the CPAT group. The MBSR group showed mixed preservations.

CONCLUSION

Both interventions have beneficial effects, however only the CPAT group exhibited improvements compared to the passive group.

The cognitive basis of dyslexia in school-aged children: A multiple case study in a transparent orthography

This study focuses on the role of numerous cognitive skills such as phonological awareness (PA), rapid automatized naming (RAN), visual and selective attention, auditory skills, and implicit learning in developmental dyslexia. We examined the (co)existence of cognitive deficits in dyslexia and assessed cognitive skills’ predictive value for reading. First, we compared school‐aged children with severe reading impairment (n = 51) to typical readers (n = 71) to explore the individual patterns of deficits in dyslexia. Children with dyslexia, as a group, presented low PA and RAN scores, as well as limited implicit learning skills. However, we found no differences in the other domains. We found a phonological deficit in 51% and a RAN deficit in 26% of children with dyslexia. These deficits coexisted in 14% of the children. Deficits in other cognitive domains were uncommon and most often coexisted with phonological or RAN deficits. Despite having a severe reading impairment, 26% of children with dyslexia did not present any of the tested deficits. Second, in a group of children presenting a wide range of reading abilities (N = 211), we analysed the relationship between cognitive skills and reading level. PA and RAN were independently related to reading abilities. Other skills did not explain any additional variance. The impact of PA and RAN on reading skills differed. While RAN was a consistent predictor of reading, PA predicted reading abilities particularly well in average and good readers with a smaller impact in poorer readers.

A neural index of inefficient evidence accumulation in dyslexia underlying slow perceptual decision making

Visual processing deficits have been widely reported in developmental dyslexia however the locus of cognitive dysfunction remains unclear. Here, we examined the neural correlates of perceptual decision-making using a dot-motion task and electroencephalography (EEG) and investigated whether presenting deficits were unique to children with dyslexia or if they were also evident in other, typically developing children with equally immature reading systems. Sixty-eight children participated: 32 with dyslexia (DD; 16 females); 21 age-matched controls (AM; 11 females) and 15 reading-matched controls (RM; 9 females). All participants completed a bilaterally presented random-dot-motion task while EEG was recorded. Neural signatures of low level sensory processing (steady state visual evoked potentials; SSVEPs), pre-target attentional bias (posterior α power), attentional orienting (N2), evidence accumulation (centro-parietal positive decision signal; CPP) and execution of a motor response (β) were obtained to dissect the temporal sequence of perceptual decision-making. Reading profile provided a score of relative lexical and sublexical skills for each participant. Although all groups performed comparably in terms of task accuracy and false alarm rate, the DD group were slower and demonstrated an earlier peak latency, reduced slope and lower amplitude of the CPP compared with both AM and RM controls. Reading profile was found to moderate the relationship between word reading ability, reaction time as well as CPP indices showing that lexical dyslexics responded more slowly and had a shallower slope, reduced amplitude and earlier latency of CPP waveforms than sublexical dyslexics. These findings suggest that children with dyslexia, particularly those with relatively poorer lexical abilities, have a reduced rate and peak of evidence accumulation as denoted by CPP markers yet remain slow in their overt response. This is in keeping with hypotheses that children with dyslexia have impairment in effectively sampling and processing evidence about visual motion stimuli.

Visual Attention, Orthographic Word Recognition, and Executive Functioning in Children With ADHD, Dyslexia, or ADHD + Dyslexia

Objective: The current study examined the differences in visual selective attention, orthographic word recognition, and executive functioning. Method: One hundred and forty Ecuadorian children in third and fifth grades of elementary school (8-10 years old) participated in the study-35 with only dyslexia (DD), 35 with the combined type of attention deficit and hyperactivity disorder (ADHD-C), 35 with disorders (DD + ADHD-C), and 35 typical development children (TD). Results: The Ecuadorian children with DD and/or ADHD-C in this age range usually have difficulties in visual selective attention, and also in orthographic word recognition. The executive functioning results showed that such functioning was worse in the ADHD-C groups (with or without DD), but not in the DD group, supporting the dissociation between DD and ADHD-C in executive functioning in this population. Conclusion: The DD + ADHD-C comorbidity produces worse deficits compared to DD, but not compared to ADHD-C, supporting the idea that there are common factors in DD and ADHD-C.

Critical Dynamics in Spontaneous Resting-State Oscillations Are Associated With the Attention-Related P300 ERP in a Go/Nogo Task

Sustained attention is the ability to continually concentrate on task-relevant information, even in the presence of distraction. Understanding the neural mechanisms underlying this ability is critical for comprehending attentional processes as well as neuropsychiatric disorders characterized by attentional deficits, such as attention deficit hyperactivity disorder (ADHD). In this study, we aimed to investigate how trait-like critical oscillations during rest relate to the P300 evoked potential-a biomarker commonly used to assess attentional deficits. We measured long-range temporal correlations (LRTC) in resting-state EEG oscillations as index for criticality of the signal. In addition, the attentional performance of the subjects was assessed as reaction time variability (RTV) in a continuous performance task following an oddball paradigm. P300 amplitude and latencies were obtained from EEG recordings during this task. We found that, after controlling for individual variability in task performance, LRTC were positively associated with P300 amplitudes but not latencies. In line with previous findings, good performance in the sustained attention task was related to higher P300 amplitudes and earlier peak latencies. Unexpectedly, we observed a positive relationship between LRTC in ongoing oscillations during rest and RTV, indicating that greater criticality in brain oscillations during rest relates to worse task performance. In summary, our results show that resting-state neuronal activity, which operates near a critical state, relates to the generation of higher P300 amplitudes. Brain dynamics close to criticality potentially foster a computationally advantageous state which promotes the ability to generate higher event-related potential (ERP) amplitudes.

Reading without words or target detection? A re-analysis and replication fMRI study of the Landolt paradigm

The Landolt paradigm is a visual scanning task intended to evoke reading-like eye-movements in the absence of orthographic or lexical information, thus allowing the dissociation of (sub-) lexical vs. visual processing. To that end, all letters in real word sentences are exchanged for closed Landolt rings, with 0, 1, or 2 open Landolt rings as targets in each Landolt sentence. A preliminary fMRI block-design study (Hillen et al. in Front Hum Neurosci 7:1-14, 2013) demonstrated that the Landolt paradigm has a special neural signature, recruiting the right IPS and SPL as part of the endogenous attention network. However, in that analysis, the brain responses to target detection could not be separated from those involved in processing Landolt stimuli without targets. The present study presents two fMRI experiments testing the question whether targets or the Landolt stimuli per se, led to the right IPS/SPL activation. Experiment 1 was an event-related re-analysis of the Hillen et al. (Front Hum Neurosci 7:1-14, 2013) data. Experiment 2 was a replication study with a new sample and identical procedures. In both experiments, the right IPS/SPL were recruited in the Landolt condition as compared to orthographic stimuli even in the absence of any target in the stimulus, indicating that the properties of the Landolt task itself trigger this right parietal activation. These findings are discussed against the background of behavioural and neuroimaging studies of healthy reading as well as developmental and acquired dyslexia. Consequently, this neuroimaging evidence might encourage the use of the Landolt paradigm also in the context of examining reading disorders, as it taps into the orientation of visual attention during reading-like scanning of stimuli without interfering sub-lexical information.

Situating Human Sexual Conditioning

Conditioning is often thought of as a basic, automatic learning process that has limited applicability to higher-level human behavior. In addition, conditioning is seen as separable from, and even secondary to, "innate" processes. These ideas involve some misconceptions. The aim of this article is to provide a clearer, more refined sense of human sexual conditioning. After providing some background information and reviewing what is known from laboratory conditioning studies, human sexual conditioning is compared to sexual conditioning in nonhumans, to "innate" sexual responding, and to other types of human learning processes. Recommendations for moving forward in human sexual conditioning research are included.

Mindful Reading: Mindfulness Meditation Helps Keep Readers with Dyslexia and ADHD on the Lexical Track

This study explored the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on reading, attention, and psychological well-being among people with developmental dyslexia and/or attention deficits. Various types of dyslexia exist, characterized by different error types. We examined a question that has not been tested so far: which types of errors (and dyslexias) are affected by MBSR training. To do so, we tested, using an extensive battery of reading tests, whether each participant had dyslexia, and which errors types s/he makes, and then compared the rate of each error type before and after the MBSR workshop. We used a similar approach to attention disorders: we evaluated the participants’ sustained, selective, executive, and orienting of attention to assess whether they had attention-disorders, and if so, which functions were impaired. We then evaluated the effect of MBSR on each of the attention functions. Psychological measures including mindfulness, stress, reflection and rumination, lifesatisfaction, depression, anxiety, and sleep-disturbances were also evaluated. Nineteen Hebrew-readers completed a 2-month mindfulness workshop. The results showed that whereas reading errors of letter-migrations within and between words and vowelletter errors did not decrease following the workshop, most participants made fewer reading errors in general following the workshop, with a significant reduction of 19% from their original number of errors. This decrease mainly resulted from a decrease in errors that occur due to reading via the sublexical rather than the lexical route. It seems, therefore, that mindfulness helped reading by keeping the readers on the lexical route. This improvement in reading probably resulted from improved sustained attention: the reduction in sublexical reading was significant for the dyslexic participants who also had attention deficits, and there were significant correlations between reduced reading errors and decreases in impulsivity. Following the meditation workshop, the rate of commission errors decreased, indicating decreased impulsivity, and the variation in RTs in the CPT task decreased, indicating improved sustained attention. Significant improvements were obtained in participants’ mindfulness, perceived-stress, rumination, depression, state-anxiety, and sleep-disturbances. Correlations were also obtained between reading improvement and increased mindfulness following the workshop. Thus, whereas mindfulness training did not affect specific types of errors and did not improve dyslexia, it did affect the reading of adults with developmental dyslexia and ADHD, by helping them to stay on the straight path of the lexical route while reading. Thus, the reading improvement induced by mindfulness sheds light on the intricate relation between attention and reading. Mindfulness reduced impulsivity and improved sustained attention, and this, in turn, improved reading of adults with developmental dyslexia and ADHD, by helping them to read via the straight path of the lexical route.