Dyslexia in Chinese

Increasing inter-word spacing reduces migration errors and improves reading comprehension in students with dyslexia

We report a small study in which we explored the effects of manipulating narrative text on levels of comprehension for students with and without dyslexia. Using two pieces of standardised narrative text deemed to be of similar difficulty and length, we manipulated the texts such that we could present two texts to each participant, one in each condition. The first condition was text using standard inter-word spacing; the second condition used increased inter-word spacing. Scores on standardised comprehension questions were significantly improved for participants with dyslexia. Additionally, given that there is evidence of delayed visual attention disengagement in individuals with specific forms of dyslexia, we hypothesised that the phenomena of migration of letters and words for some readers might be mitigated by increasing inter-word spacing. We did indeed find that incidence of migration was significantly reduced in this condition for all participants.

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

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

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

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

Mental health among children with and without reading difficulties

This study explored the relationship between mental health, i.e., depression and anxiety, and reading difficulties (RD) in Chinese elementary school children. Participants were 1535 grades 3, 4, and 5 students from three elementary schools in Xi'an, China. Children with and without RD were compared to their depression and anxiety. Additionally, children's self-ratings, parents' ratings, and teachers' ratings of depression and anxiety were compared to better understand mental health issues of Chinese children with RD. The findings showed that Chinese children with RD experienced more depression but not anxiety compared to their typically developing peers across all three grade levels. Reports from all three informants consistently reflected that children with RD experienced more depression. However, some inconsistencies were found between self-reported levels of depression and anxiety and the observations made by parents and teachers. Children reported experiencing more depression than their parents and teachers observed but less anxiety than their parents reported. This study emphasizes the importance of understanding the links between RD and mental health and the need for appropriate intervention programs to help children with RD cope with the mental health challenges.

Reading Fluency in Chinese Children With Reading Disabilities and/or ADHD: A Key Role for Morphology

The Triangle Model of Reading proposes that phonology, orthography, and semantics are crucial to understand word reading and reading disability (RD). Morphology has been added as a binding agent to this model. However, it is unclear how these variables relate to word reading in children with attention deficit/hyperactivity disorder (ADHD) or comorbid ADHD and RD (ADHD+RD). This study examined the performance of Chinese children with RD, ADHD, or ADHD+RD in phonology, orthography, semantics, and morphology, and investigated whether morphology made an additional contribution beyond the other skills in explaining word reading fluency. Participants were 151 Grade 1 to 3 Chinese students: RD (n = 31), ADHD (n = 43), ADHD+RD (n = 27), and typically developing controls (TD, n = 50). Results indicated that children with ADHD+RD (a) showed similar performance to RD and ADHD in tone awareness, orthographic legality, and homophone morpheme awareness; (b) had similar performance to RD but worse than ADHD in phonology, semantics, and morpheme production; and (c) had more severe deficits than RD and ADHD in orthographic reversal, morpheme identification, and homograph awareness. Morphology significantly predicted word reading fluency beyond the other skills, and its predictive effect was more salient for ADHD+RD, ADHD, and TD. The findings provide evidence of both shared and additive effects of RD and ADHD. Morphology may be an important diagnostic factor in identifying Chinese reading and behavioral deficit groups and a worthwhile target for intervention.

The multiple-level framework of developmental dyslexia: the long trace from a neurodevelopmental deficit to an impaired cultural technique

Developmental dyslexia is a neurodevelopmental disorder characterized by an unexpected impairment in literacy acquisition leading to specific poor academic achievement and possible secondary symptoms. The multi-level framework of developmental dyslexia considers five levels of a causal pathway on which a given genotype is expressed and hierarchically transmitted from one level to the next under the increasing influence of individual learning-relevant traits and environmental factors moderated by cultural conditions. These levels are the neurobiological, the information processing and the skill level (prerequisites and acquisition of literacy skills), the academic achievement level and the level of secondary effects. Various risk factors are present at each level within the assumed causal pathway and can increase the likelihood of exhibiting developmental dyslexia. Transition from one level to the next is neither unidirectional nor inevitable. This fact has direct implications for prevention and intervention which can mitigate transitions from one level to the next. In this paper, various evidence-based theories and findings regarding deficits at different levels are placed in the proposed framework. In addition, the moderating effect of cultural impact at and between information processing and skill levels are further elaborated based on a review of findings regarding influences of different writing systems and orthographies. These differences impose culture-specific demands for literacy-specific cognitive procedures, influencing both literacy acquisition and the manifestation of developmental dyslexia.

Neurofunctional basis underlying audiovisual integration of print and speech sound in Chinese children

Effortless print-sound integration is essential to reading development, and the superior temporal cortex (STC) is the most critical brain region. However, to date, the conclusion is almost restricted to alphabetic orthographies. To examine the neural basis in non-alphabetic languages and its relationship with reading abilities, we conducted a functional magnetic resonance imaging study in typically developing Chinese children. Two neuroimaging-based indicators of audiovisual processing-additive enhancement (higher activation in the congruent than the average activation of unimodal conditions) and neural integration (different activations between the congruent versus incongruent conditions)-were used to investigate character-sounds (opaque) and pinyin-sounds (transparent) processing. We found additive enhancement in bilateral STCs processing both character and pinyin stimulations. Moreover, the neural integrations in the left STC for the two scripts were strongly correlated. In terms of differentiation, first, areas beyond the STCs showed additive enhancement in processing pinyin-sounds. Second, while the bilateral STCs, left inferior/middle frontal and parietal regions manifested a striking neural integration (incongruent > congruent) for character-sounds, no significant clusters were revealed for pinyin-sounds. Finally, the neural integration in the left middle frontal gyrus for characters was specifically associated with silent reading comprehension proficiency, indicating automatic semantic processing during implicit character-sound integration. In contrast, the neural integration in the left STC for pinyin was specifically associated with oral reading fluency that relies on grapho-phonological mapping. To summarize, this study revealed both script-universal and script-specific neurofunctional substrates of print-sound integration as well as their processing- and region-dependent associations with reading abilities in typical Chinese children.

Anxiety and depression among Chinese children with and without reading disabilities

This study aims to compare anxiety and depression among male and female Chinese children with and without reading disabilities (RDs) and to examine the diverse impacts of anxiety and depression on children's reading comprehension. A total of 132 Chinese children from third to sixth grade living in Taiwan were recruited; half had RD, and the other half were typically developing children. Our results from the first analysis revealed that the anxiety level of female children with RD was significantly higher than that of the other three groups of participants, while the depression level of typically developing children was significantly lower than that of children with RD in general. Additionally, our results regarding the predictive abilities of gender and anxiety for reading comprehension as well as the moderating effect of gender on the ability of anxiety to predict reading comprehension were all statistically significant for the typically developing group but not the RD group. These differences between these two groups were further confirmed by multi-group analysis. Our results enhance the existing knowledge on Chinese children with RD and can increase practitioners' awareness of the possibility of higher levels of anxious and depressive symptoms among these children.

Character and child factors contribute to character recognition development among good and poor Chinese readers from grade 1 to 6

In light of the dramatic growth of Chinese learners worldwide and a need for a cross-linguistic research on Chinese literacy development, this study investigated (a) the effects of character properties (i.e., orthographic consistency and transparency) on character acquisition, and (b) the effects of individual learner differences (i.e., orthographic awareness and phonological awareness) on character recognition. Chinese native-speaking children (over N = 100 for each of grade 1 to 6) completed a lexical decision task. Crossed random effects models suggested (a) character-level orthographic and phonological effects contributed to character recognition development in an asymptotic way from grade 1 to 6, with a moderate effect at earlier ages of acquisition and a stronger facilitation after grade 3; (b) child-level effects of orthographic awareness and character-reading level contributed to all types of characters; (c) the interaction between orthographic consistency and orthographic awareness grew more pronounced among typically developing children progressively from grade 1 to grade 6; and (d) this interaction of character- and child-level factors was not significantly associated with literacy development among children with poor reading skills. We discuss theoretical and practical implications for character development among typically and nontypically developing children.

The Reliability and Validity of an Assessment Tool for Developmental Dyslexia in Chinese Children

Developmental dyslexia (DD) is a common neurobehavioral disorder in children. It refers to the phenomenon in which children with normal intelligence lag significantly behind their peers in reading ability. In China, there is no unified standard for the assessment of dyslexia due to the use of simplified and traditional Chinese characters in different regions. This study was aimed at analyzing the reliability and validity of the self-developed Chinese dyslexia assessment tool named Chinese Reading Ability Test (CRAT), which was suitable for students of grade 3 to 5 in primary school. We randomly selected three primary schools in Shantou city of China, including two in the central district and one in the surrounding district. A total of 1492 students of grades 3 through 5 were recruited. We assessed the reliability of CRAT by test-retest reliability and internal consistency. The validity assessment was realized by discriminant validity, content validity and confirmatory factor analysis (CFA). For reliability, the test-retest correlation coefficient of the total score of the CRAT was 0.671. The difference between the test-retest was not statistically significant. The Cronbach's alpha coefficient of the CRAT was 0.75. For validity, the correlation coefficient between the score of each subscale and the total score of the scale ranged from 0.29 to 0.73. The indexes of the three structural equation models all meet the standard (p > 0.05, χ²/df < 2.00, RMSEA < 0.05, GFI > 0.90, AGFI > 0.90, NFI > 0.90, CFI > 0.90 and IFI > 0.90). The fitting effects of the models were good. The CRAT has sufficient reliability and validity which could be used for the assessment and auxiliary diagnosis of Chinese Dyslexia in primary school students of grade 3 to 5.

Pinyin Is an Effective Proxy for Early Screening for Mandarin-Speaking Children at Risk of Reading Disorders

Reading disorders (RD) are common and complex neuropsychological conditions associated with decoding printed words and/or reading comprehension. Early identification of children at risk of RD is critical to allow timely interventions before mental suffering and reading impairment take place. Chinese is a unique medium for studying RD because of extra efforts required in reading acquisition of characters based on meaning rather than phonology. Pinyin, an alphabetic coding system mapping Mandarin sounds to characters, is important to develop oral language skills and a promising candidate for early screening for RD. In this pilot study, we used a cohort of 100 students (50 each in Grades 1 and 2) to derive novel profiles of applying Pinyin to identify early schoolers at risk of RD. Each student had comprehensive reading related measures in two consecutive years, including Pinyin reading and reading comprehension tested in the first and second year, respectively. We showed that Pinyin reading was mainly determined by phonological awareness, was well developed in Grade 1 and the top predictor of reading comprehension (explaining ∼30% of variance, p < 1.0e-05). Further, students who performed poorly in Pinyin reading [e.g. 1 standard deviation (SD) below the average, counting 14% in Grade 1 and 10% in Grade 2], tended to perform poorly in future reading comprehension tests, including all four individuals in Grade 1 (two out of three in Grade 2) who scored 1.5 SDs below the average. Pinyin is therefore an effective proxy for early screening for Mandarin-speaking children at risk of RD.