Social communication and restricted, repetitive behavior as assessed with a diagnostic tool for autism (ADOS-2) in women with anorexia nervosa

OBJECTIVE

In anorexia nervosa (AN), the traits of autism spectrum disorder (ASD) are associated with poor outcomes. However, the subtle nature of these characteristics remains poorly understood. We investigated the in-depth patterns of ASD traits using Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) in women with AN.

METHODS

Of 28 women with ICD-10 AN, 16 (age 19-30 years) participated in the ADOS-2, a video-recorded, semistructured diagnostic assessment for social communication and interaction and restricted, repetitive behaviors and interests related to ASD. None of the participants had previously been diagnosed with ASD. Other measurements included the Eating Disorder Examination Questionnaire and the Wechsler Abbreviated Scale of Intelligence-IV.

RESULTS

Five individuals (18% of all, 31% of those assessed) scored above the cutoff for autism in ADOS-2. They had challenges in social communication and interaction, manifesting as sustained difficulties in social relationships and deficits in conversation skills. Few described being frequently misunderstood by others, including in the eating disorder treatment settings. Three individuals showed prominent restricted and repetitive behaviors such as ritual seeking, eating-related routines, sensory sensitivity related to food texture and selective eating, and intense interest in specific topics. The mean duration of AN in women above the cutoff was twice as long compared with those below (12.3 vs. 6.2 years).

DISCUSSION

The ASD-related characteristics and behavior appear to contribute to the manifestation and duration of AN in a subgroup of women. Among these women, the traits of ASD appear to be mixed with eating disorder symptoms, which should be taken into account in the treatment.

Impaired cortical tracking of speech in children with developmental language disorder

In developmental language disorder (DLD), learning to comprehend and express oneself with spoken language is impaired, but the reason for this remains unknown. Using millisecond scale magnetoencephalography (MEG) recordings combined with machine learning models, we investigated whether the possible neural basis of this disruption lies in poor cortical tracking of speech. The stimuli were common spoken words (e.g., 'dog', 'car', 'hammer') and sounds with corresponding meanings (e.g., dog bark, car engine, hammering). In both children with DLD (10 boys and 7 girls) and typically developing (TD) control children (14 boys and 3 girls), aged 10-15 years, the cortical activation to spoken words was best modeled as time-locked to the unfolding speech input at ∼100 ms latency between sound and cortical activation. Amplitude envelope (amplitude changes) and spectrogram (detailed time-varying spectral content) of the spoken words, but not other sounds, were very successfully decoded based on time-locked brain responses in bilateral temporal areas; based on the cortical responses, the models could tell at ∼75-85% accuracy, which of two sounds had been presented to the participant. However, the cortical representation of the amplitude envelope information was poorer in children with DLD compared to TD children at longer latencies (at ∼200-300 ms lag). We interpret this effect as reflecting poorer retention of acoustic-phonetic information in short-term memory. This impaired tracking could potentially affect the processing and learning of words as well as continuous speech. The present results offer an explanation for the problems in language comprehension and acquisition in DLD.Significance statement The neural basis of impaired speech processing in developmental language disorder (DLD) was probed with magnetoencephalography (MEG), natural spoken words and sounds, and state-of-the-art machine learning models. Cortical tracking of speech was normal at initial stages, but impaired at syllable-level latency, reflecting problems in maintaining cortical memory representations of the incoming speech across the word. This offers an explanation for the problems in DLD in identifying words and learning new ones.

Assessment of Developmental Language Disorder in Multilingual Children: Results from an International Survey

INTRODUCTION

The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world.

METHODS

An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD.

RESULTS

The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region.

DISCUSSION

Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

Association of cognitive-linguistic deficits to diffusion tensor imaging parameters in moderate to severe traumatic diffuse axonal injury

Cognitive-linguistic functions are an essential part of adequate communication competence. Cognitive-linguistic deficits are common after traumatic diffuse axonal injury (DAI). We aimed to examine the integrity of perisylvian white matter tracts known to be associated with linguistic functions in individuals with DAI and their eventual association with poor cognitive-linguistic outcomes. Diffusion tensor imaging (DTI) results of 44 adults with moderate-to-severe DAI were compared with those of 67 controls. Fractional anisotropy (FA) values of the superior longitudinal fasciculus (SLF), arcuate fasciculus (AF), SLF with frontal connections to the lower parietal cortex, and AF with temporal connections to the lower parietal cortex were measured using tractography. The associations between white matter integrity FA values and cognitive-linguistic deficits were studied in the DAI group. Cognitive-linguistic deficits were determined based on our earlier study using the novel KAT test. No previous studies have examined the associations between white matter integrity and cognitive-linguistic deficits determined using the KAT test. Patients with DAI showed lower FA values in all left-side tracts than the controls. Unexpectedly, the poor cognitive-linguistic outcome in the language comprehension and production domains was associated with high FA values of several tracts. After excluding five cases with the poorest cognitive-linguistic performance, but with the highest values in the DTI variables, no significant associations with DTI metrics were found. The association between white matter integrity and cognitive-linguistic functioning is complex in patients with DAI of traumatic origin, probably reflecting the heterogeneity of TBI.

Is epileptiform activity related to developmental language disorder? Findings from the HelSLI study

Objective

To study if interictal epileptiform discharges (IEDs) are associated with language performance or pre-/perinatal factors in children with developmental language disorder (DLD).

Methods

We recorded routine EEG in wake and sleep in 205 children aged 2.9-7.1 years with DLD, without neurologic diseases or intellectual disability. We examined the language performance of the children and collected data on pre-/perinatal factors.

Results

Interictal epileptiform discharges were not associated with lower language performance. Children with so-called "rolandic", i.e. centrotemporoparietal, IEDs had better language skills, but age explained this association. Most pre-/perinatal factors evaluated did not increase the risk of rolandic IEDs, except for maternal smoking (OR 4.4, 95% CI 1.4-14). We did not find electrical status epilepticus during slow-wave sleep (ESES)/spike-and-wave activation in sleep (SWAS) in any children.

Conclusions

Interictal epileptiform discharges are not associated with lower language performance, and ESES/SWAS is not common in children with DLD.

Significance

Routine EEGs do not bring additional information about language performance in children with DLD who do not have any neurologic diseases, seizures, intellectual disability, or regression of language development.

Emotion recognition, alexithymia, empathy, and emotion regulation in women with anorexia nervosa

PURPOSE

Anorexia nervosa (AN) is associated with challenges in recognizing, understanding, and interpreting one's own and other's emotional states, feelings, and thoughts. It is unknown whether difficulties in emotion processing occur independently of common comorbid symptoms of AN and predict acute eating disorder characteristics. We aimed to examine emotion recognition, alexithymia, emotion regulation, and empathy in individuals with AN and to assess whether these predict eating disorder symptoms independently from comorbid symptoms.

METHODS

Participants included 42 women with AN and 40 healthy control (HC) women between 18-30 years. Basic and complex emotion recognition was assessed with face photos and video clips. Alexithymia, empathy, emotion regulation, and comorbid symptoms (anxiety, depressive, and obsessive-compulsive symptoms and ASD traits) were assessed with self-assessment questionnaires.

RESULTS

Participants with AN exhibited difficulties in basic and complex emotion recognition, as well as increased alexithymia, decreased empathy, and challenges in emotion regulation when compared to HCs. After controlling for comorbid symptoms, differences remained only in complex emotion recognition. Challenges in emotion recognition were associated with lower body mass index, and increased alexithymia was associated with increased eating disorder symptoms. Increased challenges in emotion regulation were associated with a shorter duration of illness, higher body mass index, and increased eating disorder symptoms.

CONCLUSIONS

Participants with AN displayed widespread deficit in emotion processing, but only challenges in complex emotion recognition occurred independently from comorbid symptoms. Deficits in emotion processing may contribute to the illness severity and thus could be an important treatment target.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Cross-Sectional and Longitudinal Associations Between Quality of Parent-Child Interaction and Language Ability in Preschool-Age Children With Developmental Language Disorder

PURPOSE

This study explores whether the quality of parent-child interaction is associated with language abilities cross-sectionally and longitudinally up to preschool-age among children with developmental language disorder (DLD).

METHOD

Participants were 97 monolingual children with DLD and their parents from the Helsinki Longitudinal SLI study, HelSLI (baseline, age in years;months, M = 4;3, SD = 0;10), of which 71 pairs were followed longitudinally (age in years;months, M = 6;6, SD = 0;5). Video recordings from three play sessions were scored for child, parent, and dyadic behavior using Erickson's sensitivity scale protocol and mutually responsive orientation at baseline. Children's expressive and receptive language and language reasoning ability were assessed at baseline, and expressive and receptive language were assessed at follow-up.

RESULTS

At baseline, engaged child behavior, parent's supportive guidance, and fluent and attuned dyadic behavior were associated with better receptive language ability, and engaged child behavior and dyadic synchrony were positively associated with language reasoning ability in 3- to 6-year-olds. The child's positive engagement and fluent and attuned dyadic behavior at baseline were associated with better expressive and receptive language abilities at follow-up in 6- to 7-year-olds, respectively.

CONCLUSIONS

Fluent and attuned dyadic behavior is associated with better receptive language ability in preschool-age children. Parent behavior alone was not associated with language ability. A connected and mutually attuned parent-child relationship could be a protective factor for language development for children with DLD.

Cognitive Behavioral and Cognitive Remediation Strategies for Managing Co-Occurring Anorexia Nervosa and Elevated Autism Spectrum Traits

Anorexia nervosa (AN) is a potentially severe eating disorder whose core characteristics include energy intake restriction leading to low body weight. Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social interaction and communication as well as repetitive, stereotyped behavior and interests. Both high ASD traits and diagnosed ASD are overrepresented among individuals with AN, and AN and ASD appear to share certain neurocognitive features. These features are associated with the severity of eating disorder symptoms and prolongation of AN. Thus, individuals with AN and high ASD traits or ASD may benefit less from traditional treatment when compared to those with low ASD traits. No previous reviews have summarized what is known about treatment adaptations for individuals with AN and high ASD traits or ASD. The purpose of this narrative review was to investigate the feasibility of cognitive remediation therapy (CRT), cognitive remediation and emotional skill training (CREST), and cognitive behavioral therapy (CBT), and give an overview of treatment modifications for individuals with AN and co-occurring ASD or high ASD traits. We found nine studies that fulfilled our inclusion criteria. The combined results suggest that individuals with AN and high ASD traits or ASD benefit less from CRT, CREST, and CBT than those with AN and low ASD traits. However, CRT and CREST administered in individual format may be associated with improved cognitive flexibility, motivation for change, and decreased alexithymia among adults with AN and high ASD traits or ASD. Individuals with comorbid AN and ASD themselves highlight the importance of treatment adaptations that take the characteristics of ASD into account. In the future, controlled studies of the treatment strategies for individuals with AN and ASD/high ASD traits are needed in order to improve the outcome of individuals with this challenging comorbidity.

Allocation and funding of Speech and Language Therapy for children with Developmental Language Disorders across Europe and beyond

BACKGROUND

Children with Developmental Language Disorder (DLD) have a significant deficit in spoken language ability which affects their communication skills, education, mental health, employment and social inclusion.

AIM

The present study reports findings from a survey by EU network COST ACTION 1406 and aims to explore differences in service delivery and funding of SLT services for children with DLD across Europe and beyond.

METHODS AND PROCEDURES

The survey was completed by 5024 European professionals. COST countries were grouped into Nordic, Anglo-Saxon, Continental, Mediterranean, Central/Eastern and Non-European categories. The use of direct, indirect and mixed interventions, and their relationship to funding available (public, private or mixed) were considered for further analysis.

OUTCOMES AND RESULTS

The results revealed that for direct therapy, there were more cases than expected receiving private funding. For indirect therapy, fewer than expected received private and more than expected public funding. For mixed therapy, fewer cases than expected received private funding.

CONCLUSIONS AND IMPLICATIONS

The results implies that other factors than evidence-based practices, practitioners experience, and patient preferences, drive choices in therapy. More research is needed to gain a better understanding of factors affecting the choice of therapy.

Cognitive-Linguistic outcome in moderate to severe diffuse axonal injury and association with fatigue

PURPOSE

Individuals with traumatic brain injury (TBI) often have persistent cognitive-linguistic deficits that negatively influence their life. Our objective was to examine the cognitive-linguistic outcome in individuals with moderate to severe diffuse axonal injury (DAI) with a novel test battery. As fatigue is a common symptom affecting the lives of individuals with DAI, we also wanted to assess whether the self-reported fatigue was associated with cognitive-linguistic abilities.

METHODS

Selected cognitive-linguistic subtests of the Finnish KAT test and The Mental Fatigue Scale (MFS) were applied to 48 adults with moderate to severe DAI and 27 healthy controls. The majority of the participants with DAI were in the chronic stage. The groups were compared using ANCOVA. Linear regressions were used to analyze the association between MFS and cognitive-linguistic outcomes.

RESULTS

The participants with DAI had significantly poorer scores than the controls in most cognitive-linguistic variables and reported significantly more fatigue. Two of the four cognitive-linguistic composite variables were associated with the degree of self-reported fatigue.

CONCLUSIONS

Cognitive-linguistic deficits are common in individuals with moderate to severe DAI, and The Finnish KAT test is a valuable tool to detect those. Fatigue was associated with linguistic working memory and language production.

Atypical Sensory Processing Is Associated With Lower Body Mass Index and Increased Eating Disturbance in Individuals With Anorexia Nervosa

BACKGROUND

Elevated autism spectrum disorder (ASD) traits are associated with anorexia nervosa (AN). Conversely, eating disturbances, which are core characteristics of AN, are common in ASD. Among individuals with ASD, atypical sensory processing is associated with eating disturbance. Because AN and ASD appear to overlap, it would be crucial to understand whether sensory processing atypicality exist also in AN. Further, it would be essential to find if atypical sensory processing is associated with eating disturbances in individuals with AN, since treatment modifications may be needed. We therefore aimed to examine whether atypical sensory processing is associated with AN and its core characteristics.

METHODS

Participants of the current study included 42 individuals with AN and 40 healthy controls (HCs). All participants were adult women. Sensory processing, other ASD traits, and eating disorder symptoms were assessed with self-report questionnaires.

RESULTS

Individuals with AN reported lower registration, decreased sensation seeking, increased sensory sensitivity, and increased sensation avoiding compared to HCs. When analyzing groups with restrictive AN (AN-R) and binge-purge type AN (AN-BP) separately, only individuals with AN-R exhibited decreased sensation seeking, and only those with AN-BP exhibited lower registration. After controlling for body mass index as a covariate, group differences remained significant only in sensory sensitivity between individuals with AN and HCs. Increased atypical sensory processing predicted lower body mass index and increased disordered eating.

CONCLUSION

Results suggest that sensory processing appears to differ between AN and HC women, and AN subtypes may exhibit distinct sensory processing atypicality. Sensory sensitivity may be stable traits whereas other aspects of atypical sensory processing may be related to acute AN. Atypical sensory processing may contribute to the severity of AN, and thus it is crucial to recognize sensory processing differences when treating individuals with AN.

Anorexia nervosa and comorbid autism spectrum disorders

PURPOSE OF REVIEW

Traits of autism spectrum disorder (ASD) are overrepresented among individuals with anorexia nervosa (AN) and may also moderate the behavioral manifestation of AN. This review aims to provide an overview of AN and comorbid ASD.

RECENT FINDINGS

Elevated ASD traits do not seem to precede AN among some individuals but are rather related to the illness stage. However, studies have suggested that there are ASD-specific mechanisms for developing AN in a subgroup of individuals with AN. Pronounced traits of ASD and diagnosed ASD are associated with illness prolongation and poorer outcomes in AN, and individuals with AN and elevated ASD traits may benefit less from many of the current treatments. Studies do not support a specific genetic relationship between ASD and AN.

SUMMARY

Recent research encourages the improved recognition of elevated ASD traits in individuals with AN and provides grounds for developing tailored treatments for those with this comorbidity.

Language acquisition of early sequentially bilingual children is moderated by short-term memory for order in developmental language disorder: Findings from the HelSLI study

BACKGROUND

The role of domain-general short-term memory (STM) in language development remains controversial. A previous finding from the HelSLI study on children with developmental language disorder (DLD) suggested that not only verbal but also non-verbal STM for temporal order is related to language acquisition in monolingual children with DLD.

AIMS

To investigate if a similar relationship could be replicated in a sample of sequentially bilingual children with DLD. In addition to the effect of age, the effect of cumulative second language (L2) exposure was studied.

METHODS & PROCEDURES

Sixty-one 4-6-year-old bilingual children with DLD and 63 typically developing (TD) bilingual children participated in a cross-sectional study conducted in their L2. Children completed novel game-like tests of visual and auditory non-verbal serial STM, as well as tests of cognitive functioning and language. Interactions of STM for order with age and exposure to L2 (Finnish) were explored as explanatory variables.

OUTCOMES & RESULTS

First, the improvement of non-verbal serial STM with age was faster in sequentially bilingual TD children than in bilingual children with DLD. A similar effect was observed for L2 exposure. However, when both age and exposure were considered simultaneously, only age was related to the differential growth of non-verbal STM for order in the groups. Second, only in children with DLD was better non-verbal serial STM capacity related to an improvement in language scores with age and exposure.

CONCLUSIONS & IMPLICATIONS

The results suggest that, as previously found in Finnish monolingual children, domain-general serial STM processing is also compromised in bilingual children with DLD. Further, similar to the monolingual findings, better non-verbal serial STM was associated with greater language improvement with age and exposure, but only in children with DLD, in the age range studied here. Thus, in clinical settings, assessing non-verbal serial STM of bilingual children could improve the detection of DLD and understanding of its non-linguistic symptoms.

WHAT THIS PAPER ADDS

What is already known on the subject Both phonological and non-verbal STM have been associated with DLD in monolingual and sequentially bilingual children. Monolingual children with DLD have also shown slower non-verbal serial STM development than TD children. What this study adds to existing knowledge Sequentially bilingual TD children's non-verbal serial STM improves more between ages 4 and 7 years than that of their peers with DLD, replicating a finding for monolingual children with DLD. Better non-verbal serial STM was especially associated with early receptive language development in sequentially bilingual children with DLD. L2 exposure showed largely comparable effects with age. These results support the hypothesis that a domain-general serial STM deficit is linked to DLD. What are the potential or actual clinical implications of this work? Non-verbal assessment of STM for serial order in sequentially bilingual children with DLD could benefit the development of better tailored therapeutic interventions.

Structure of Cognitive Functions in Monolingual Preschool Children With Typical Development and Children With Developmental Language Disorder

Purpose Developmental language disorder (DLD) is defined by persistent difficulties with language, but a growing body of evidence suggests that it is also associated with domain-general and nonverbal information-processing deficits. However, the interconnections between cognitive functions, both nonverbal and language related, are still unclear. With the aim of gaining more comprehensive insight into the cognitive deficits related to DLD, we investigated and compared the cognitive structure of children with DLD and typically developing (TD) children. Method As a part of the Helsinki longitudinal SLI study, monolingual Finnish preschoolers (N = 154; TD group: n = 66, DLD group: n = 88) were assessed with 23 tasks measuring nonverbal and verbal reasoning, language processing, memory, visuomotor functions, attention, and social cognition. Exploratory factor analysis and structural equation modeling were performed to examine latent constructs and to test measurement invariance between the TD and DLD groups. Results Measurement invariance was not found across the TD and DLD groups. Best fitting structure for TD children included factors reflecting verbal abilities, processing speed/short-term memory, visuomotor functions, and visuoconstructive abilities/nonverbal reasoning. The DLD group's structure comprised nonverbal abilities, naming/expressive language, verbal comprehension, and verbal/declarative memory. Conclusions The findings suggest that the structure of cognitive functions differs in TD children and children with DLD already at preschool age. Nonverbal functions seem more unified, whereas verbal functions seem more varying in preschoolers with DLD compared to TD children. The results can be used in future research for prognosis of DLD and planning interventions.

Structural white matter connectometry of reading and dyslexia

Current views on the neural network subserving reading and its deficits in dyslexia rely largely on evidence derived from functional neuroimaging studies. However, understanding the structural organization of reading and its aberrations in dyslexia requires a hodological approach, studies of which have not provided consistent findings. Here, we adopted a whole brain hodological approach and investigated relationships between structural white matter connectivity and reading skills and phonological processing in a cross-sectional study of 44 adults using individual local connectome matrix from diffusion MRI data. Moreover, we performed quantitative anisotropy aided differential tractography to uncover structural white matter anomalies in dyslexia (23 dyslexics and 21 matched controls) and their correlation to reading-related skills. The connectometry analyses indicated that reading skills and phonological processing were both associated with corpus callosum (tapetum), forceps major and minor, as well as cerebellum bilaterally. Furthermore, the left dorsal and right thalamic pathways were associated with phonological processing. Differential tractography analyses revealed structural white matter anomalies in dyslexics in the left ventral route and bilaterally in the dorsal route compared to the controls. Connectivity deficits were also observed in the corpus callosum, forceps major, vertical occipital fasciculus and corticostriatal and thalamic pathways. Altered structural connectivity in the observed differential tractography results correlated with poor reading skills and phonological processing. Using a hodological approach, the current study provides novel evidence for the extent of the reading-related connectome and its aberrations in dyslexia. The results conform current functional neuroanatomical models of reading and developmental dyslexia but provide novel network-level and tract-level evidence on structural connectivity anomalies in dyslexia, including the vertical occipital fasciculus.

RETRACTED: Allocation and funding of Speech and Language Therapy for children with Developmental Language Disorders across Europe and beyond

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of Authors and Editor-in-Chief. Whilst conducting further analyses for a companion paper in June 2021 using the survey data reported in this study, it came to the authors' attention that unfortunately there were errors in the data used in the analyses for this paper. The authors believe this to be either human error in data entry or coding or a technical error whilst recoding a variable. They therefore reran their analyses with the correct data for the paper to understand if and how the results differed from those published, and they did indeed change the findings. As soon as this came to the authors' attention (July 2021), they contacted the Editorial office. All authors on the paper are in agreement with this retraction. A new revised article with the correct data, analysis and results is now available: 10.1016/j.ridd.2021.104139.

Voxel and surface based whole brain analysis shows reading skill associated grey matter abnormalities in dyslexia

Developmental dyslexia (DD) is the most prevalent neurodevelopmental disorder with a substantial negative influence on the individual's academic achievement and career. Research on its neuroanatomical origins has continued for half a century, yielding, however, inconsistent results, lowered total brain volume being the most consistent finding. We set out to evaluate the grey matter (GM) volume and cortical abnormalities in adult dyslexic individuals, employing a combination of whole-brain voxel- and surface-based morphometry following current recommendations on analysis approaches, coupled with rigorous neuropsychological testing. Whilst controlling for age, sex, total intracranial volume, and performance IQ, we found both decreased GM volume and cortical thickness in the left insula in participants with DD. Moreover, they had decreased GM volume in left superior temporal gyrus, putamen, globus pallidus, and parahippocampal gyrus. Higher GM volumes and cortical thickness in these areas correlated with better reading and phonological skills, deficits of which are pivotal to DD. Crucially, total brain volume did not influence our results, since it did not differ between the groups. Our findings demonstrating abnormalities in brain areas in individuals with DD, which previously were associated with phonological processing, are compatible with the leading hypotheses on the neurocognitive origins of DD.

Short-Term Memory for Serial Order Moderates Aspects of Language Acquisition in Children With Developmental Language Disorder: Findings From the HelSLI Study

Previous studies of verbal short-term memory (STM) indicate that STM for serial order may be linked to language development and developmental language disorder (DLD). To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence (expressive language, receptive language, and language reasoning). We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing (TD) children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the HelSLI project in this cross-sectional study. The children were 4-6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD.

L2 vocabulary acquisition of early sequentially bilingual children with TD and DLD affected differently by exposure and age of onset

BACKGROUND

Language exposure is known to be a key factor influencing bilingual vocabulary development in typically developing (TD) children. There is, however, a lack of knowledge in terms of exposure effects in children with developmental language disorder (DLD) and, especially, in interaction with age of onset (AoO) of second language acquisition.

AIMS

In the Helsinki longitudinal SLI study (HelSLI), we investigated the receptive and expressive second language (L2) vocabulary performance and cross-sectional vocabulary development of sequentially bilingual children with TD and DLD in order to resolve whether the groups could be differentiated based on their vocabulary performance. More importantly, we examined the effects of AoO and exposure in the vocabulary performance of these two bilingual groups.

METHODS & PROCEDURES

A total of 70 children with DLD from a hospital clinic and 82 with TD from kindergartens were recruited. Children were 3-7 years old with different AoOs for the L2 and varying degrees of language exposure. Multiple regression analysis was used to compare the groups in two receptive and three expressive vocabulary tests while considering the effects of AoO and language exposure.

OUTCOMES & RESULTS

Children with TD outperformed children with DLD in both receptive and expressive vocabulary measures. Exposure predicted vocabulary but AoO did not. The effect of exposure was different in TD and DLD groups in receptive but not in expressive vocabulary. Additionally, the interaction of exposure and AoO was found for receptive vocabulary, but similarly in both groups. With increasing exposure, a difference in performance between the groups became more notable in receptive vocabulary compared with the expressive vocabulary.

CONCLUSIONS & IMPLICATIONS

Bilingual children with TD and DLD can be differentiated by using L2 vocabulary tests when exposure is taken into consideration. Non-significant AoO effects in 3-7 year olds suggest flexibility in terms of when to start L2 immersion. However, exposure is important, and especially children with DLD would need a substantial amount of it relative to their TD peers, so that they would not fall even further behind over time. Differences in benefiting from exposure in receptive mode might offer clinicians and kindergarten personnel an insight for evaluating challenges in bilingual development. Severe challenges in vocabulary development in the DLD group also call for both individually targeted small-group activities for learning words as well as strategies for strengthening vocabulary in various environments and everyday life situations. What this paper adds What is already known on the subject Language exposure is often found to explain more of the variation compared with AoO in early L2 vocabulary. On the other hand, it has been suggested by some researchers, but not all, that AoO effects would be found. Exposure and AoO might also interact differently depending on the task and whether the development is typical or disordered. Contrary to the clinical observation, diagnostic value of receptive vocabulary has often been questioned. What this paper adds to existing knowledge This study indicates that receptive vocabulary might be useful in differentiating bilingual TD and DLD. Language exposure effects differ between TD and DLD groups, but depending on task. Lower performance, but also slower cross-sectional development, is found in receptive vocabulary for children with DLD. Interaction between language exposure and AoO stresses the importance of taking both into consideration when studying bilingual development. What are the potential or actual clinical implications of this work? L2 vocabulary tests can be used in differentiating bilingual children with TD and DLD when exposure is taken into consideration. Difficulties using exposure and, hence, slower development in children with DLD suggest that especially receptive vocabulary might be diagnostic by the accumulating exposure. Investing in ways of supporting vocabulary development through small-group activities and in everyday situations of bilingual children at risk of DLD is highly recommended. This is important to prevent them from incrementally falling further behind their TD peers over time. A limited AoO effect suggests that families have more flexibility in terms of when to place their child in L2 immersion in their early years.

Project DyAdd: Non-linguistic Theories of Dyslexia Predict Intelligence

Two themes have puzzled the research on developmental and learning disorders for decades. First, some of the risk and protective factors behind developmental challenges are suggested to be shared and some are suggested to be specific for a given condition. Second, language-based learning difficulties like dyslexia are suggested to result from or correlate with non-linguistic aspects of information processing as well. In the current study, we investigated how adults with developmental dyslexia or ADHD as well as healthy controls cluster across various dimensions designed to tap the prominent non-linguistic theories of dyslexia. Participants were 18–55-year-old adults with dyslexia (n = 36), ADHD (n = 22), and controls (n = 35). Non-linguistic theories investigated with experimental designs included temporal processing impairment, abnormal cerebellar functioning, procedural learning difficulties, as well as visual processing and attention deficits. Latent profile analysis (LPA) was used to investigate the emerging groups and patterns of results across these experimental designs. LPA suggested three groups: (1) a large group with average performance in the experimental designs, (2) participants predominantly from the clinical groups but with enhanced conditioning learning, and (3) participants predominantly from the dyslexia group with temporal processing as well as visual processing and attention deficits. Despite the presence of these distinct patterns, participants did not cluster very well based on their original status, nor did the LPA groups differ in their dyslexia or ADHD-related neuropsychological profiles. Remarkably, the LPA groups did differ in their intelligence. These results highlight the continuous and overlapping nature of the observed difficulties and support the multiple deficit model of developmental disorders, which suggests shared risk factors for developmental challenges. It also appears that some of the risk factors suggested by the prominent non-linguistic theories of dyslexia relate to the general level of functioning in tests of intelligence.

Neuromagnetic speech discrimination responses are associated with reading-related skills in dyslexic and typical readers

Poor neural speech discrimination has been connected to dyslexia, and may represent phonological processing deficits that are hypothesized to be the main cause for reading impairments. Thus far, neural speech discrimination impairments have rarely been investigated in adult dyslexics, and even less by examining sources of neuromagnetic responses. We compared neuromagnetic speech discrimination in dyslexic and typical readers with mismatch fields (MMF) and determined the associations between MMFs and reading-related skills. We expected weak and atypically lateralized MMFs in dyslexic readers, and positive associations between reading-related skills and MMF strength. MMFs were recorded to a repeating pseudoword /ta-ta/ with occasional changes in vowel identity, duration, or syllable frequency from 43 adults, 21 with confirmed dyslexia. Phonetic (vowel and duration) changes elicited left-lateralized MMFs in the auditory cortices. Contrary to our hypothesis, MMF source strengths or lateralization did not differ between groups. However, better verbal working memory was associated with stronger left-hemispheric MMFs to duration changes across groups, and better reading was associated with stronger right-hemispheric late MMFs across speech-sound changes in dyslexic readers. This suggests a link between neural speech processing and reading-related skills, in line with previous work. Furthermore, our findings suggest a right-hemispheric compensatory mechanism for language processing in dyslexia. The results obtained promote the use of MMFs in investigating reading-related brain processes.

Characteristics of autism spectrum disorders are associated with longer duration of anorexia nervosa: A systematic review and meta-analysis

OBJECTIVE

Anorexia nervosa (AN) is associated with neuropsychological characteristics such as impairments in central coherence, cognitive flexibility, and emotion recognition. The same features also manifest in autism spectrum disorders (ASD) and have been suggested to be associated with illness prolongation in AN. The purpose of this meta-analysis was to examine whether pronounced neuropsychological characteristics related to ASD are associated with illness duration in AN.

METHOD

Four databases (Medline, PsycINFO, Scopus, PubMed) were searched for eligible studies. Search terms were (a) "anorexia nervosa" and (b) "cognitive flexibility" or "set-shifting" or "central coherence" or "emotion recognition" or "theory of mind". The final sample consisted of 53 studies. Duration of AN was divided into three categories in order to investigate differences between the groups with varying illness duration. The meta-analysis was performed with Review Manager using a random-effects model.

RESULTS

Deficits in central coherence, cognitive flexibility, and emotion recognition were pronounced among individuals with prolonged AN compared to those with shorter illness duration.

DISCUSSION

A prolonged course of AN appears to be associated with underlying neuropsychological characteristics that are also distinctive to ASD. Neuropsychological impairments may lead to prolonged AN, and prolonged illness may contribute to the subsequent "neurological scar effect," further strengthening these impairments.

Quick reorganization of memory traces for morphologically complex words in young children

Formation of neural mechanisms for morphosyntactic processing in young children is still poorly understood. Here, we addressed neural processing and rapid online acquisition of familiar and unfamiliar combinations of morphemes. Three different types of morphologically complex words - derived, inflected, and novel (pseudostem + real suffix) - were presented in a passive listening setting to 16 typically developing 3-4-year old children (as part of a longitudinal Helsinki SLI follow-up study). The mismatch negativity (MMN) component of event-related potentials (ERP), an established index of long-term linguistic memory traces in the brain, was analysed separately for the initial and final periods of the exposure to these items. We found MMN response enhancement for the inflected words towards the end of the recording session, whereas no response change was observed for the derived or novel complex forms. This enhancement indicates rapid build-up of a new memory trace for the combination of real morphemes, suggesting a capacity for online formation of whole-form lexicalized representations as one of the morphological mechanisms in the developing brain. Furthermore, this enhancement increased with age, suggesting the development of automatic morphological processing circuits in the age range of 3-4 years.

Understanding developmental language disorder - the Helsinki longitudinal SLI study (HelSLI): a study protocol

BACKGROUND

Developmental language disorder (DLD, also called specific language impairment, SLI) is a common developmental disorder comprising the largest disability group in pre-school-aged children. Approximately 7% of the population is expected to have developmental language difficulties. However, the specific etiological factors leading to DLD are not yet known and even the typical linguistic features appear to vary by language. We present here a project that investigates DLD at multiple levels of analysis and aims to make the reliable prediction and early identification of the difficulties possible. Following the multiple deficit model of developmental disorders, we investigate the DLD phenomenon at the etiological, neural, cognitive, behavioral, and psychosocial levels, in a longitudinal study of preschool children.

METHODS

In January 2013, we launched the Helsinki Longitudinal SLI study (HelSLI) at the Helsinki University Hospital ( http://tiny.cc/HelSLI ). We will study 227 children aged 3-6 years with suspected DLD and their 160 typically developing peers. Five subprojects will determine how the child's psychological characteristics and environment correlate with DLD and how the child's well-being relates to DLD, the characteristics of DLD in monolingual versus bilingual children, nonlinguistic cognitive correlates of DLD, electrophysiological underpinnings of DLD, and the role of genetic risk factors. Methods include saliva samples, EEG, computerized cognitive tasks, neuropsychological and speech and language assessments, video-observations, and questionnaires.

DISCUSSION

The project aims to increase our understanding of the multiple interactive risk and protective factors that affect the developing heterogeneous cognitive and behavioral profile of DLD, including factors affecting literacy development. This accumulated knowledge will form a heuristic basis for the development of new interventions targeting linguistic and non-linguistic aspects of DLD.

Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms

Sluggish cognitive tempo (SCT) was introduced in 1980s in the field of attention deficit hyperactivity disorder (ADHD). Studies indicate that symptoms of SCT are separate from symptoms of ADHD and independently associated with multiple domains of functioning in clinical groups and in typical development. We assessed whether similar pattern would apply to higher functioning autism spectrum disorders (ASD). Children with higher functioning ASD (N = 55; 5-15 years) were divided into the ASD+High SCT (n = 17), the ASD+Medium SCT (n = 18) and the ASD+Low SCT (n = 20) groups based on parent-rated daydreaming and slowness on the Five to Fifteen questionnaire (FTF). The groups were compared on SCT-related impairments found in previous studies: social skills, academic functioning, psychiatric symptoms, and processing speed. Assessment methods were the FTF, the Development and Well-Being Assessment, and the Coding subtest of the WISC-III. The ADHD symptoms were statistically controlled due to the overlap between SCT and ADHD. The ASD+High SCT and ASD+Medium SCT groups were significantly more likely to have the most pronounced social impairments, and the ASD+High SCT group had significantly higher rate of internalizing disorders compared to the ASD+Low SCT group. Our results suggest that children with higher functioning ASD and high or medium levels of SCT symptoms could be at higher risk for psychosocial impairments than children with higher functioning ASD with low levels of SCT symptoms. Co-occurring ADHD symptoms do not explain the finding. Recognizing SCT symptoms in higher functioning ASD would be important to targeting preventive support.

Behavioral and electrophysiological indicators of auditory distractibility in children with ADHD and comorbid ODD

Involuntary switching of attention to distracting sounds was studied by measuring effects of these events on auditory discrimination performance and event-related brain potentials (ERPs) in 6-11-year-old boys with Attention Deficit-Hyperactivity Disorder (ADHD) and comorbid Oppositional Defiant Disorder (ODD) and in age-matched controls. The children were instructed to differentiate between two animal calls by pressing one response button, for example, to a dog bark and another button to a cat mew. These task-relevant sounds were presented from one of two loudspeakers in front of the child, and there were occasional task-irrelevant changes in the sound location, that is, the loudspeaker. In addition, novel sounds (e.g., a sound of hammer, rain, or car horn) unrelated to the task were presented from a loudspeaker behind the child. The percentage of correct responses was lower for target sounds preceded by a novel sound than for targets not preceded by such sound in the ADHD group, but not in the control group. In both groups, a biphasic positive P3a response was observed in ERPs to the novel sounds. The later part of the P3a appeared to continue longer over the frontal scalp areas in the ADHD group than in the controls presumably because a reorienting negativity (RON) ERP response following the P3a was smaller in the ADHD group than in the control group. This suggests that the children with ADHD had problems in reorienting their attention to the current task after a distracting novel sound leading to deterioration of performance in this task. The present study also indicates that children with ADHD and comorbid ODD show same kind of distractibility as found in previous studies for children with ADHD without systematic comorbid ODD.

Attrition in a 30-year follow-up of a perinatal birth risk cohort: factors change with age

Background. Attrition is a major cause of potential bias in longitudinal studies and clinical trials. Attrition rate above 20% raises concern of the reliability of the results. Few studies have looked at the factors behind attrition in follow-ups spanning decades. Methods. We analyzed attrition and associated factors of a 30-year follow-up cohort of subjects who were born with perinatal risks for neurodevelopmental disorders. Attrition rates were calculated at different stages of follow-up and differences between responders and non-responders were tested. To find combinations of variables influencing attrition and investigate their relative importance at birth, 5, 9, 16 and 30 years of follow-up we used the random forest classification. Results. Initial loss of potential participants was 13%. Attrition was 16% at five, 24% at nine, 35% at 16 and 46% at 30 years. The only group difference that emerged between responders and non-responders was in socioeconomic status (SES). The variables identified by random forest classification analysis were classified into Birth related, Development related and SES related. Variables from all these categories contributed to attrition, but SES related variables were less important than birth and development associated variables. Classification accuracy ranged between 0.74 and 0.96 depending on age. Discussion. Lower SES is linked to attrition in many studies. Our results point to the importance of the growth and development related factors in a longitudinal study. Parents' decisions to participate depend on the characteristics of the child. The same association was also seen when the child, now grown up, decided to participate at 30 years. In addition, birth related medical variables are associated with the attrition still at the age of 30. Our results using a data mining approach suggest that attrition in longitudinal studies is influenced by complex interactions of a multitude of variables, which are not necessarily evident using other multivariate techniques.

Project DyAdd: implicit learning in adult dyslexia and ADHD

In this study of the project DyAdd, implicit learning was investigated through two paradigms in adults (18-55 years) with dyslexia (n = 36) or with attention deficit/hyperactivity disorder (ADHD, n = 22) and in controls (n = 35). In the serial reaction time (SRT) task, there were no group differences in learning. However, those with ADHD exhibited faster RTs compared to other groups. In the artificial grammar learning (AGL) task, the groups did not differ from each other in their learning (i.e., grammaticality accuracy or similarity choices). Further, all three groups were sensitive to fragment overlap between learning and test-phase items (i.e., similarity choices were above chance). Grammaticality performance of control participants was above chance, but that of participants with dyslexia and participants with ADHD failed to differ from chance, indicating impaired grammaticality learning in these groups. While the main indices of AGL performance, grammaticality accuracy and similarity choices did not correlate with the neuropsychological variables that reflected dyslexia-related (phonological processing, reading, spelling, arithmetic) or ADHD-related characteristics (executive functions, attention), or intelligence, the explicit knowledge for the AGL grammar (i.e., ability to freely generate grammatical strings) correlated positively with the variables of phonological processing and reading. Further, SRT reaction times correlated positively with full scale intelligence quotient (FIQ). We conclude that, in AGL, learning difficulties of the underlying rule structure (as measured by grammaticality) are associated with dyslexia and ADHD. However, learning in AGL is not related to the defining neuropsychological features of dyslexia or ADHD. Instead, the resulting explicit knowledge relates to characteristics of dyslexia.

Preschoolers' recognition of emotional expressions: relationships with other neurocognitive capacities

We cross-sectionally examined the development of the ability to recognize facial expressions of emotions in preschool-aged children and the relationship between this ability and other neurocognitive capacities, that is, attention/executive functions, language, memory/learning, sensorimotor functions, theory of mind, and visuospatial processing. Children aged 3 to 6 years with no significant developmental deficits (N = 370) were assessed with a nonverbal matching task of emotion recognition ability: The Affect Recognition subtest from the NEPSY-II. The relationship between emotion recognition ability and other neurocognitive capacities was analyzed using correlation, regression, and commonality analyses. The results showed that (a) emotion recognition ability improved with age-this development decelerating mildly between ages 5 and 6-(b) emotion recognition ability correlated with all other neurocognitive capacities, and (c) language, attention/executive functions, and theory of mind were significant predictors of emotion recognition ability in the regression analysis. As revealed by the commonality analysis, and in contrast to most previous studies, language was the most important predictor of nonverbal emotion recognition ability. These results suggest that nonverbal emotion matching is an early maturing skill that develops in relation to other neurocognitive capacities, especially linguistic ability.

[Multilingualism and specific language impairment]

Specific language impairment is one of the most common developmental disturbances in childhood. With the increase of the foreign language population group an increasing number of children assimilating several languages and causing concern in language development attend clinical examinations. Knowledge of factors underlying the specific language impairment and the specific impairment in general, special features of language development of those learning several languages, as well as the assessment and support of the linguistic skills of a multilingual child is essential. The risk of long-term problems and marginalization is high for children having specific language impairment.

Project DyAdd: classical eyeblink conditioning in adults with dyslexia and ADHD

In this study of the project DyAdd (Adult Dyslexia and Attention Deficit Disorder in Finland), classical eyeblink conditioning (EBC) was investigated in both delay and trace paradigms in adults (18-55 years) with dyslexia (n = 37), attention deficit-hyperactivity disorder (ADHD; n = 21), their comorbid combination (n = 8), and healthy controls (n = 35). In addition, the profiles of three participants with a rare autosomal dominant cerebellar disease were assessed (episodic ataxia type 2, EA-2). We found that participants with dyslexia were overall slower learners than controls in eyeblink conditioning. Further, they were the only group that had a reduced number of CRs in mediotemporal-dependent trace paradigm compared to the more cerebellum-dependent delay paradigm. Second, ADHD was found to be related to larger CR amplitude. Third, those with a comorbid condition learned faster and manifested CRs that were not well timed. Fourth, the cerebellar patients showed nearly no conditioning at all. Correlations between EBC and various neuropsychological domains (phonological processing, reading, spelling, arithmetic, executive functions, attention, and fine motor control) over all participants resulted in significant relations only for the delay paradigm: Increased amount of reading errors related with later peak latency and increased amount of self-corrections in fine motor control related with larger response magnitude. Within those who conditioned, relations emerged only for the trace paradigm: better spelling was related to larger response magnitude. These results do not lend support to the cerebellar hypothesis of dyslexia. On the contrary, dyslexia in its pure form seems to be related to a relative dysfunction of a larger hippocampal-cerebellar network. Further, larger responses in the ADHD group are suggested to result from their lowered responding threshold.

The neurophysiological basis of the integration of written and heard syllables in dyslexic adults

OBJECTIVE

Letter-speech sound integration in fluent readers takes place automatically and is dependent on temporal synchrony between letters and sounds. In developmental dyslexia, however, letter-speech sound associations are hard to learn, compromising accurate and fluent reading. We studied the effect of printed text on processing speech sounds in dyslexic and fluent adult readers.

METHODS

Visual stimuli were presented with sequences of spoken syllables including vowel or consonant changes, or changes in syllable intensity, frequency, or vowel duration. As visual material, written syllables or their scrambled images were used. The auditory stimuli were presented either synchronously with the visual stimuli or time delayed. The mismatch negativity (MMN), an index of automatic neural change detection, was recorded.

RESULTS

MMN amplitudes were larger to syllable changes in combination with written syllables than with scrambled images in fluent readers. However, dyslexic readers showed no difference between syllables vs. scrambled image condition. Furthermore, MMNs to consonant and frequency changes peaked later in dyslexic than fluent readers.

CONCLUSIONS

Our results suggest deficient and sluggish audiovisual integration in dyslexic individuals, which is not dependent on the phonological relevance of the deviant type.

SIGNIFICANCE

Unlike previous studies, our study included several different types of syllable changes presented with concurrent print, enabling us to determine in more detail the nature of the audiovisual deficit in dyslexia.

Retrospective assessment of ADHD symptoms in childhood: discriminatory validity of Finnish translation of the Wender Utah Rating Scale

OBJECTIVE

To examine the discriminatory validity of the Wender Utah Rating Scale (WURS) and its five suggested subscales (Conduct Problems, Impulsivity Problems, Mood Difficulties, Inattention/Anxiety, Academic Concerns) in a Finnish sample.

METHOD

WURS was administered to 114 adults, aged 18 to 55 years. Participants with ADHD (n = 37) and dyslexia (n = 36) were compared with healthy controls (n = 41).

RESULTS

The ADHD group scored significantly higher than the control group on all subscales. Compared with the dyslexia group, the ADHD group did not differ in Mood Difficulties or Academic Concerns. Using the total score, the positive predictive value was .53 in this sample and only .21 when the prevalence of ADHD was taken into account.

CONCLUSION

Three out of five domains of WURS are reliable indicators of ADHD. Domains with low discriminatory power, low general prevalence of ADHD, and other developmental disorders within the population decrease the accuracy.

Impaired engagement of the ventral attentional pathway in ADHD

In the cognitive theories of Attention Deficit Hyperactivity Disorder (ADHD) impaired behavioral adjustment has been linked to a deficit in learning to detect regularities or irregularities in the environment. In the neural level, the P3 component of event-related potential (ERP) is modulated by stimulus probability and has been suggested to index activation of the ventral attention network, which constitutes the reorienting system of the human brain. To explore the cortical basis of late positive ERP components and the engagement of the ventral attentional pathway in ADHD, we used ERP recordings complemented by spatiotemporally sensitive magnetoencephalography (MEG) measurements. We followed the activation evoked by frequent Go and infrequent NoGo stimuli in 10 ADHD adults and 13 control subjects. In the ERP recordings, a prominent positive deflection was detected after the infrequent visual stimuli (late positive component, LPC) in both subject groups. In ADHD adults the difference between the responses evoked by infrequent NoGo and frequent Go stimuli was markedly reduced compared to the control group during the LPC. The MEG recordings revealed that the activation detected during the LPC was localized bilaterally in the posterior temporal cortex. Activation of the left and right temporal regions was enhanced after infrequent NoGo stimuli in both subject groups. In ADHD adults, however, the effect of stimulus frequency was less pronounced. We suggest that the activation in the superior temporal cortices during the LPC reflects the action of ventral attention network. The engagement of this stimulus-driven reorienting system is defective in ADHD.

Neural correlates of late positivities associated with infrequent visual events and response errors

The P3 response has been one of the most extensively studied event-related potential (ERP) components. Still, the exact functional role and cortical basis of P3 has remained unsettled. To explore the cortical processes underlying the generation of late positivities, we recorded the activation evoked by frequent Go and infrequent NoGo stimuli and correct versus erroneous responses using combined magnetoencephalography (MEG) and ERP measurements during a visual Go/NoGo task. The stimulus-locked signals in the ERP channels revealed an enhanced negative N2 and a prominent late positive component (LPC) after the complex NoGo stimuli associated with successfully withheld responses. The response-locked ERP signals revealed error-related negativity (ERN) and positivity (Pe) after erroneous responses. The positive LPC and Pe components were coupled with functionally and temporally comparable MEG signals. This MEG activation detected during the positive components was localized bilaterally in the posterior temporal cortex. In the response-locked averages, the temporal activity was enhanced around 200 ms after a commission of an error. In the stimulus-locked averages, the activation was also enhanced after infrequent NoGo stimuli around 500 ms after stimulus onset and delayed about 80 ms for the initially miscategorized NoGo stimuli accompanied by erroneous response. The results suggest that the cortical correlates of Pe are not specifically related to commission of an error, but both the LPC and Pe components, and bilateral temporal cortices, are more generally involved in stimulus-driven attentional processing evoked by unexpected stimuli. The negative ERP components evoked by NoGo stimuli (N2) and erroneous responses (ERN) were found to be associated with partly non-overlapping neural sources.

Project DyAdd: phonological processing, reading, spelling, and arithmetic in adults with dyslexia or ADHD

Difficulties in phonological processing and reading that characterize developmental dyslexia have been suggested also to affect those with attention-deficit/hyperactivity disorder (ADHD). However, it is not known to what extent various intervening factors, such as low intelligence quotient or age, explain the observed difficulties. In this study, the authors investigated the domains of phonological processing, reading, spelling, and arithmetic in 110 adults (ages 18-55 years) in healthy control, dyslexia, and ADHD groups.The aim of the study was specifically to compare domain profiles of participants with ADHD to those in other groups.The results showed that participants with dyslexia had the most generalized difficulties. Participants with ADHD were the least affected, and their difficulties reflected less accurate performance. Furthermore, all the observed differences became nonsignificant when intelligence quotient was controlled for. This suggests that adult ADHD is not related to significant impairments in phonological processing or achievement.

Adult Dyslexia and Attention Deficit Disorder in Finland--Project DyAdd: WAIS-III cognitive profiles

The project Adult Dyslexia and Attention Deficit Disorder in Finland (Project DyAdd) compares adults (n = 119, 18-55 years) with dyslexia, attention-deficit/hyperactivity disorder (ADHD), dyslexia together with ADHD (comorbid), and healthy controls with neuropsychological, psychophysical, and biological methods. The focus of this article is on the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). The clinical groups performed well compared to the norms, and they did not differ from each other. However, compared to the controls, all of them were slightly poorer in their Full IQ, and of the factors, processing speed was relatively difficult for all of them. In addition to the group comparisons, a cluster analysis based on subtest scores was conducted over the clinical groups. It did not suggest a solution that would differentiate between the clinical groups. Instead, four clusters emerged: above average, average, poor perceptual organization, and poor working memory. Thus, differentiating between these clinical groups with the WAIS-III was not possible. However, all of them shared a relative difficulty in processing speed, and group-independent clusters with perceptual or memory difficulties emerged.

Project DyAdd: Fatty acids and cognition in adults with dyslexia, ADHD, or both

Both attention deficit hyperactivity disorder (ADHD) and dyslexia are suggested to co-occur with altered fatty acid (FA) metabolism, but it is unknown how FAs are associated with the cognitive domains that characterize these disorders. In the project DyAdd, we investigated the associations between FAs in serum phospholipids and phonological processing, reading, spelling, arithmetic, executive functions, and attention. Healthy controls (n=36), adults with ADHD (n=26), dyslexia (n=36), or both (n=9) were included in the study. FAs included saturated, monounsaturated, total polyunsaturated, n-3, and n-6 FAs, together with n-6/n-3, AA/EPA, and LA/ALA ratios. When all the study subjects were included in the analyses, especially polyunsaturated FAs (PUFAs) were positively associated with cognition, but reading was least associated with FAs. These associations were modulated by gender, intelligence, n-3 PUFA intake, and group. Accordingly, within the ADHD group, only few associations emerged with PUFAs, n-6 PUFAs, and cognitive domains, whereas in the dyslexia group the more prevalent associations appeared with PUFAs and n-3 PUFAs.

Project DyAdd: Fatty acids in adult dyslexia, ADHD, and their comorbid combination

In project DyAdd, we compared the fatty acid (FA) profiles of serum phospholipids in adults with attention deficit hyperactivity disorder (ADHD) (n=26), dyslexia (n=36), their comorbid combination (n=9), and healthy controls (n=36). FA proportions were analyzed in a 2x2 design with Bonferroni corrected post hoc comparisons. A questionnaire was used to assess dietary fat quality and use of supplements. Results showed that ADHD and dyslexia were not associated with total saturated FAs, monounsaturated FAs, or n-3 polyunsaturated FAs (PUFAs). However, those with ADHD had elevated proportions of total n-6 PUFAs (including gamma-linolenic and adrenic acids) as compared to those without ADHD. Dyslexia was related to a higher proportion of monounsaturated nervonic acid and a higher ratio of n-6/n-3 PUFAs. Among females none of the associations were significant. However in males, all the original associations observed in all subjects remained and ADHD was associated with elevated nervonic acid and n-6/n-3 PUFA ratio like dyslexia. Controlling for poorly diagnosed reading difficulties, education, dietary fat quality, or use of FA supplements did not generally remove the originally observed associations.

Crossmodal Temporal Processing Acuity in Children with Oral Clefts

Objective:

We have previously found that, in children with certain oral clefts, the rate of sequential information processing is significantly impaired in vision and tactile somatosensation but not so clearly in audition. Here, we studied crossmodal functions by investigating temporal processing acuity of cleft children with audiovisual, audiotactile, and visuotactile tasks.

Participants:

Temporal processing acuity was studied in 10-year-old children, 19 with cleft lip with or without cleft palate and 38 with cleft palate or submucous cleft palate.

Design:

Children estimated whether brief stimuli of two concurrent three-stimulus sequences, each in a different modality, were simultaneous or not when the stimulus interval varied adaptively. The 8-millisecond stimuli were flashes in vision, tone bursts in audition, and solenoid touches of a finger in somatosensation.

Results:

The group with cleft lip with or without cleft palate performed better than the group with cleft palate or submucous cleft palate in audiovisual temporal processing acuity, but the group's superiority was not statistically significant in audiotactile or visuotactile temporal processing acuity.

Conclusions:

Audiovisual crossmodal sequential information processing is probably impaired in some cleft children in the group with cleft palate or submucous cleft palate. Our results suggest further studies on the audiovisual capacities of children with cleft.

Evaluation of multi-attribute auditory discrimination in dyslexia with the mismatch negativity

OBJECTIVE

Dyslexia is associated with impairments in the phonological system or with more general auditory dysfunctions. We determined the discrimination of 5 sound contrasts (pitch, duration, intensity, location, and the presence of a gap) in dyslexia with the mismatch negativity (MMN).

METHODS

We compared MMNs of 9 adult dyslexic and 11 control subjects with a new 5-deviant paradigm which enables one to assess the discrimination of each of these features in 15 min. Also, a control oddball condition with pitch and duration deviants was included. In the new paradigm, all deviant stimuli are presented in the same stimulus block so that the standard stimuli, of which there are 50%, alternate with the deviant stimuli.

RESULTS

In the 5-deviant paradigm, a diminished pitch-MMN and an enhanced location-MMN were found in dyslexic individuals. Furthermore, pitch and duration MMNs in this and in the oddball paradigms suggested that smaller MMNs are elicited in the new than oddball paradigm in dyslexic subjects.

CONCLUSIONS

Pitch discrimination is impaired in dyslexia. However, location discrimination, not addressed previously with MMN, is enhanced. Furthermore, dyslexic subjects are more impaired in detecting changes in sound streams with than without variation.

SIGNIFICANCE

In dyslexia research, the new 5-deviant MMN paradigm is feasible and even more sensitive than the traditional oddball paradigm.

Serum lipid fatty acids and temporal processing acuity in children with oral clefts

We investigated the relation between a biological factor (fatty acids, FA) and a cognitive processing speed factor (temporal processing acuity, TPA) that are both suggested to relate to neuronal and cognitive functioning. Blood samples of 49 ten-year-old children with oral clefts were collected for FA analysis in serum triglycerides, cholesteryl esters, and phospholipids on the same day as they performed behavioral TPA tasks (simultaneity/nonsimultaneity judgments) in several perceptual modalities (visual, auditory, tactile, audiotactile, visuotactile, and audiovisual). This population has larger than expected variation in the relevant cognitive measures (TPA, learning ability, and intelligence). Sequential regression analyses (adjusted for age, gender, and cleft type) showed that saturated FAs were not generally associated with TPA. Monounsaturated erucic and nervonic acids were inversely related with TPA. Of the polyunsaturated fatty acids, eicosapentaenoic and docosahexaenoic acids were positively associated with TPA, whereas gamma-linolenic acid was inversely related to TPA. In summary, we found significant relations between a biological (certain FAs) and a cognitive factor (TPA).

Perception of matching and conflicting audiovisual speech in dyslexic and fluent readers: An fMRI study at 3 T

We presented phonetically matching and conflicting audiovisual vowels to 10 dyslexic and 10 fluent-reading young adults during "clustered volume acquisition" functional magnetic resonance imaging (fMRI) at 3 T. We further assessed co-variation between the dyslexic readers' phonological processing abilities, as indexed by neuropsychological test scores, and BOLD signal change within the visual cortex, auditory cortex, and Broca's area. Both dyslexic and fluent readers showed increased activation during observation of phonetically conflicting compared to matching vowels within the classical motor speech regions (Broca's area and the left premotor cortex), this activation difference being more extensive and bilateral in the dyslexic group. The between-group activation difference in conflicting > matching contrast reached significance in the motor speech regions and in the left inferior parietal lobule, with dyslexic readers exhibiting stronger activation than fluent readers. The dyslexic readers' BOLD signal change co-varied with their phonological processing abilities within the visual cortex and Broca's area, and to a lesser extent within the auditory cortex. We suggest these findings as reflecting dyslexic readers' greater use of motor-articulatory and visual strategies during phonetic processing of audiovisual speech, possibly to compensate for their difficulties in auditory speech perception.