Visual processing speed as a marker of immaturity in lexical but not sublexical dyslexia

Twice-exceptionality unmasked: A systematic narrative review of the literature on identifying dyslexia in the gifted child

In this systematic narrative review, we synthesised the small existing body of research on children who are gifted and dyslexic (G-D) in order to investigate the claim that G-D students have a unique profile, characterised by well-masked word-level reading and spelling difficulties. Our focus was on both the cognitive and academic profiles of this subgroup of twice-exceptional (2e) children and the assessment protocols used to identify them. Findings suggest that despite having processing deficits associated with dyslexia, G-D students' gifted strengths, especially those relating to oral language, may enable them to compensate for their reading difficulties, at least to an extent that they fail to meet standard diagnostic criteria. However, G-D students also perform poorly on word-level reading, reading fluency and spelling tasks when compared with both control groups and their gifted, non-dyslexic peers, providing clear evidence of impaired achievement. Findings from this review highlight the need for (a) a more nuanced approach to the assessment of students presenting with highly discrepant profiles and (b) future research into both the cognitive and academic profiles and the instructional needs of this highly able yet poorly understood group of students, whose potential may be masked and thus underestimated in the school setting.

Cognitive-Motor Training Improves Reading-Related Executive Functions: A Randomized Clinical Trial Study in Dyslexia

Children with developmental dyslexia (DD) often struggle with executive function difficulties which can continue into adulthood if not addressed. This double-blinded randomized clinical trial study evaluated the short-term effects of the Verbal Working Memory-Balance (VWM-B) program on reading-related executive functions, reading skills, and reading comprehension in Persian children with DD. The active control group [12 children with DD with a mean age of 9 years (SD = 0.90)] received training using the single-task VWM program, while the experiment group [15 children with DD with a mean age of 8 years (SD = 0.74)] received training with the dual-task VWM-B program. Both groups received fifteen training sessions, and assessments were conducted before and after the intervention. The groups were homogenized for possible confounders of age, gender, IQ level, and attention level. The study employed separate mixed ANOVA analyses to estimate the impact of training programs on various measured functions. Significant improvements were observed in the outcome measures of backward digit span, text comprehension, verbal fluency, Stroop color-word test and interference, and the reading subtests. Additionally, significant correlations were found between reading skills and backward digit span, text comprehension, verbal fluency, and Stroop variables. In conclusion, the dual-task VWM-B program was found to be more effective than the single-task VWM program in improving selective attention, cognitive inhibition, verbal working memory capacity, information processing speed, naming ability, and lexical access speed. These enhanced executive functions were associated with improved reading skills in children with DD.

Visual attention span deficit in developmental dyslexia: A meta-analysis

BACKGROUND

Visual attention span (VAS) refers to the number of visual elements processed simultaneously in a multielement array. Yet, there are mixed findings regarding VAS deficit in developmental dyslexia (DD) across different tasks, stimuli, languages, control groups, and ages.

AIM

The present meta-analysis aimed to investigate VAS deficit in DD and factors moderating VAS deficit in DD.

METHODS

A meta-analysis based on 32 articles, 54 independent studies, and 4211 subjects was conducted. Effect sizes for each study were calculated and a random-effect model was selected. Task and stimulus types in the VAS task, writing system, orthographic depth, control group type, and age were included as possible moderators.

RESULTS

1) VAS in dyslexic individuals was significantly worse than typically developing individuals; 2) Task-stimulus type (report-verbal/n-back-verbal/n-back-nonverbal), writing system (alphabetic vs. Chinese), and control group type (age matched vs. reading matched) significantly moderated VAS deficit in DD. VAS deficit was more severe in report task with verbal stimuli than in n-back task with verbal and nonverbal stimuli. VAS deficit was more severe in alphabetic language than in Chinese. VAS deficit was more severe when compared with age-matched controls than compared with reading-matched controls.

CONCLUSION

VAS deficit is a possible etiology for DD and moderated by task-stimulus type, writing system, and control group type. These findings have important implications for the understanding of DD.

Intervention targeting different visual attention span components in Chinese children with developmental dyslexia: a study based on Bundesen's theory of visual attention

Within the framework of the theory of visual attention (TVA), the visual attention span (VAS) deficit among individuals with developmental dyslexia has been ascribed to the problems entailed by bottom-up (BotU) and top-down (TopD) attentional processes. The former involves two VAS subcomponents: the visual short-term memory storage and perceptual processing speed; the latter consists of the spatial bias of attentional weight and the inhibitory control. Then, what about the influences of the BotU and TopD components on reading? Are there differences in the roles of the two types of attentional processes in reading? This study addresses these issues by using two types of training tasks separately, corresponding to the BotU and TopD attentional components. Three groups of Chinese children with dyslexia-15 children each in the BotU training, TopD training, and non-trained active control groups were recruited here. Participants completed reading measures and a CombiTVA task which was used to estimate VAS subcomponents, before and after the training procedure. Results showed that BotU training improved both the within-category and between-category VAS subcomponents and sentence reading performance; meanwhile, TopD training enhanced character reading fluency through improving spatial attention capacity. Moreover, benefits on attentional capacities and reading skills in the two training groups were generally maintained three months after the intervention. The present findings revealed diverse patterns in the influences of VAS on reading within the TVA framework, which contributes to enriching the understanding of VAS-reading relation.

Evidence Accumulation Rate Moderates the Relationship between Enriched Environment Exposure and Age-Related Response Speed Declines

Older adults exposed to enriched environments (EEs) maintain relatively higher levels of cognitive function, even in the face of compromised markers of brain health. Response speed (RS) is often used as a simple proxy to measure the preservation of global cognitive function in older adults. However, it is unknown which specific selection, decision, and/or motor processes provide the most specific indices of neurocognitive health. Here, using a simple decision task with electroencephalography (EEG), we found that the efficiency with which an individual accumulates sensory evidence was a critical determinant of the extent to which RS was preserved in older adults (63% female, 37% male). Moreover, the mitigating influence of EE on age-related RS declines was most pronounced when evidence accumulation rates were shallowest. These results suggest that the phenomenon of cognitive reserve, whereby high EE individuals can better tolerate suboptimal brain health to facilitate the preservation of cognitive function, is not just applicable to neuroanatomical indicators of brain aging but can be observed in markers of neurophysiology. Our results suggest that EEG metrics of evidence accumulation may index neurocognitive vulnerability of the aging brain.Significance Statement Response speed in older adults is closely linked with trajectories of cognitive aging. Here, by recording brain activity while individuals perform a simple computer task, we identify a neural metric that is a critical determinant of response speed. Older adults exposed to greater cognitive and social stimulation throughout a lifetime could maintain faster responding, even when this neural metric was impaired. This work suggests EEG is a useful technique for interrogating how a lifetime of stimulation benefits brain health in aging.

Visual attention modulates the transition from fine-grained, serial processing to coarser-grained, more parallel processing: A computational modeling study

During reading acquisition, beginning readers transition from serial to more parallel processing. The acquisition of word specific knowledge through orthographic learning is critical for this transition. However, the processes by which orthographic representations are acquired and fine-tuned as learning progresses are not well understood. Our aim was to explore the role of visual attention in this transition through computational modeling. We used the BRAID-Learn model, a Bayesian model of visual word recognition, to simulate the orthographic learning of 700 4-to 10-letter English known words and novel words, presented 5 times each to the model. The visual attention quantity available for letter identification was manipulated in the simulations to assess its influence on the learning process. We measured the overall processing time and number of attentional fixations simulated by the model across exposures and their impact on two markers of serial processing, the lexicality and length effects, depending on visual attention quantity. Results showed that the two lexicality and length effects were modulated by visual attention quantity. The quantity of visual attention available for processing further modulated novel word orthographic learning and the evolution of the length effect on processing time and number of attentional fixations across repeated exposures to novel words. The simulated patterns are consistent with behavioral data and the developmental trajectories reported during reading acquisition. Overall, the model predicts that the efficacy of orthographic learning depends on visual attention quantity and that visual attention may be critical to explain the transition from serial to more parallel processing.

Visual attention span capacity in developmental dyslexia: A meta-analysis

The visual attention span (VAS) deficit theory of developmental dyslexia (DD) indicates that impaired VAS may cause reading disabilities. However, whether people with dyslexia have VAS deficit is still controversial. The current review evaluates the literature regarding the relationship between VAS and poor reading, as it also examines the possible moderators in measuring the VAS capacity of individuals with dyslexia. A total of 25 papers, with participants of 859 readers with dyslexia and 1048 typically developing readers were included in the meta-analysis. The sample sizes, means and standard deviations (SDs) of the scores in VAS tasks were extracted separately from the two groups, which were used to calculate the effect sizes of group differences in SDs and means by the robust variance estimation model. Results showed higher SDs and lower averages of the VAS test scores for readers with dyslexia than those for typically developing readers, revealing high individual variability and remarkable deficits in VAS of DD. Further subgroup analyses showed that the characteristics of VAS tasks, background languages, and participants modulated the group differences in VAS capacities. Particularly, the partial report task with symbols of relatively high visual complexity and key pressing may be the optimal measurement of VAS skills. A greater VAS deficit in DD was observed in more opaque languages, with a trend of developmental increase in attention deficit, especially at the primary school level. Moreover, this VAS deficit seemed to be independent of the phonological deficit of dyslexia. These findings to some extent supported the VAS deficit theory of DD and (partially) explained the controversial relationship between VAS impairment and reading disabilities.

The visual-attention span deficit in developmental dyslexia: Review of evidence for a visual-attention-based deficit

The visual attention span (VAS) deficit hypothesis in developmental dyslexia posits that a subset of dyslexic individuals shows a multielement parallel processing deficit due to reduced visual attention capacity. However, the attention-based interpretation of poor performance on VAS tasks is hotly debated. The purpose of the present paper is to clarify this issue through a critical review of relevant behavioural and neurobiological findings. We first examine the plausibility of alternative verbal interpretations of VAS performance, evaluating whether performance on VAS tasks might reflect verbal short-term memory, verbal coding or visual-to-verbal mapping skills. We then focus on the visual dimensions of VAS tasks to question whether VAS primarily reflects visuo-attentional rather than more basic visual skills. Scrutiny of the available behavioural and neurobiological findings not only points to a deficit of visual attention in dyslexic individuals with impaired VAS but further suggests a selective endogenous attentional system deficit that relates to atypical functioning of the brain dorsal attentional network. The overview clarifies the debate on what is being measured through VAS tasks and provides insights on how to interpret the VAS deficit in developmental dyslexia.

What Is Going on with Visual Attention in Reading and Dyslexia? A Critical Review of Recent Studies

This critical review examined current issues to do with the role of visual attention in reading. To do this, we searched for and reviewed 18 recent articles, including all that were found after 2019 and used a Latin alphabet. Inspection of these articles showed that the Visual Attention Span task was run a number of times in well-controlled studies and was typically a small but significant predictor of reading ability, even after potential covariation with phonological effects were accounted for. A number of other types of tasks were used to examine different aspects of visual attention, with differences between dyslexic readers and controls typically found. However, most of these studies did not adequately control for phonological effects, and of those that did, only very weak and non-significant results were found. Furthermore, in the smaller studies, separate within-group correlations between the tasks and reading performance were generally not provided, making causal effects of the manipulations difficult to ascertain. Overall, it seems reasonable to suggest that understanding how and why different types of visual tasks affect particular aspects of reading performance is an important area for future research.

Involvement of the dorsal and ventral attention networks in visual attention span

Visual attention span (VAS), which refers to the window size of multielement parallel processing in a short time, plays an important role in higher‐level cognition (e.g., reading) as required by encoding large amounts of information input. However, it is still a matter of debate about the underlying neural mechanism of VAS. In the present study, a modified visual 1‐back task was designed by using nonverbal stimuli and nonverbal responses, in which possible influences of target presence and position were considered to identify more pure VAS processing. A task‐driven functional magnetic resonance imaging (fMRI) experiment was then performed, and 30 healthy adults participated in this study. Results of confirmatory and exploratory analyses consistently revealed that both dorsal attention network (DAN) and ventral attention network (VAN) were significantly activated during this visual simultaneous processing. In particular, more significant activation in the left superior parietal lobule (LSPL), as compared to that in the bilateral inferior frontal gyrus (IFGs), suggested a greater involvement of DAN in VAS‐related processing in contrast to VAN. In addition, it was also found that the activation in temporoparietal junctions (TPJs) were suppressed during multielement processing only in the target‐absent condition. The current results suggested the recruitment of LSPL in covert attentional shifts and top‐down control of VAS resources distribution during the rapid visual simultaneous processing, as well as the involvement of bilateral IFGs (especially RIFG) in both VAS processing and inhibitory control. The present findings might bring some enlightenments for diagnosis of the atypicality of attentional disorders and reading difficulties.

The role of visual-spatial attention in reading development: a meta-analysis

The association between visual attention and reading development has been investigated as a possible core causal deficit in dyslexia, in addition to phonological awareness. This study aims to provide a meta-analytic review of the research on attentional processes and their relation to reading development, to examine the possible influence on it of orthographic depth, age, and attentional tasks (interpreted as serial or parallel processing indices). We included studies with participants up to 18 years of age that have considered the visual spatial attention orienting that sustains the serial visual analysis involved in the phonological pathway of decoding, and the visual attention span that supports the multielement parallel processing that is thought to influence lexical decoding. The results confirm a strong association between visual attention and reading development; we evaluate the evidence and discuss the possibility that visual attention processes play a causal role in determining individual differences in reading acquisition.

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

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

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.

Double Trouble: Visual and Phonological Impairments in English Dyslexic Readers

Developmental dyslexia is a reading disorder characterized by problems in accurate or fluent reading. A deficiency in phonological processing is thought to underpin the reading difficulties of individuals with developmental dyslexia and a variety of explanations have been proposed including deficits in phonological awareness and verbal memory. Recent investigations have begun to suggest that developmental deficits in the acquisition of reading may also co-occur with visual processing deficits, which are particularly salient for visually complex stimuli, yet these deficits have received relatively little attention from researchers. To further explore the nature of phonological and visual processing in developmental dyslexia, we administered a series of non-reading tasks tapping both domains. Unsurprisingly, individuals with developmental dyslexia performed worse than typically developing readers in phonological tasks. More intriguingly, they also struggled with visual tasks, specifically when discriminating between novel visual patterns, and in visuo-spatial working memory, which requires greater attentional control. These findings highlight that individuals with developmental dyslexia present not only with phonological impairments but also difficulties in processing visual materials. This aspect has received limited attention in previous literature and represents an aspect of novelty of this study. The dual phonological and visual impairments suggest that developmental dyslexia is a complex disorder characterized by deficits in different cognitive mechanisms that underpin reading.

Improving sentence reading performance in Chinese children with developmental dyslexia by training based on visual attention span

Deficits in the visual attention span (VAS) are thought to hamper reading performance in dyslexic individuals. However, the causal relationship between VAS deficits and reading disability remains unclear. The present study attempts to address this issue by using a VAS-based intervention to explore the possible influence of VAS on reading processes in Chinese children with dyslexia. Given the influence of the heterogeneity of dyslexia on intervention effects, VAS-impaired dyslexic and VAS-intact dyslexic individuals were separately trained. Therefore, there were five groups of participants in this study, including 10 trained dyslexic individuals with VAS deficits and 10 untrained dyslexic individuals with VAS dysfunction as the baseline reference, 10 trained and 10 untrained dyslexic individuals with an intact VAS, and fourteen age-matched normal readers for reference of normal level. All participants completed reading measures and a visual 1-back task, reflecting VAS capacity with non-verbal stimuli and non-verbal responses, before and after VAS-based training. VAS-based training tasks included a length estimation task regarding the bottom-up attention, visual search and digit cancelling tasks targeting top-down attentional modulation, and visual tracking tasks to train eye-movement control. The results showed that visual training only helped improve VAS skills in VAS-impaired dyslexic individuals receiving training. Meanwhile, their silent sentence reading accuracy improved after training, and there was a significant relationship between training improvements in VAS function and reading performance. The current findings suggest that VAS-based training has a far-transfer effect on linguistic level (i.e., fluent reading). These findings suggest the possibility that VAS-related training may help children with dyslexia improve their reading skills.