The level of audiovisual print-speech integration deficits in dyslexia

Letter-speech sound integration in typical reading development during the first years of formal education

This study investigated the neural basis of letter and speech sound (LS) integration in 53 typical readers (35 girls, all White) during the first 2 years of reading education (ages 7-9). Changes in both sensory (multisensory vs unisensory) and linguistic (congruent vs incongruent) aspects of LS integration were examined. The left superior temporal cortex and bilateral inferior frontal cortex showed increasing activation for multisensory over unisensory LS over time, driven by reduced activation to speech sounds. No changes were noted in the congruency effect. However, at age nine, heightened activation to incongruent over congruent LS pairs were observed, correlating with individual differences in reading development. This suggests that the incongruency effect evolves at varying rates depending on reading skills.

The N400 in readers with dyslexia: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to assess whether (i) significant differences exist in the N400 response to lexico-semantic tasks between typically developing (TD) readers and readers with dyslexia, and (ii) whether these differences are moderated by the modality of task presentation (visual vs. auditory), the type of task, age, or opaque orthography (shallow and transparent alphabets vs Chinese morpho-syllabary). Twenty studies were included in the meta-analysis, and the analysis did not demonstrate strong evidence of publication bias. An overall effect size of Hedge's g = 0.66, p < .001, was found between typically developing readers and readers with dyslexia. All moderators were found to be significant; larger effects were associated with visual modality (g = 0.692, p < .001), semantically incongruent sentence tasks (g = 0.948, p < .001), pseudowords/characters tasks (g = 0.971, p < .001), and orthography [Chinese (g = 1.015, p < .001) vs. alphabets (g = 0.539, p < .001)]. Analysis of reaction time showed Hedge's g = 1.613, p < .001. Results suggest that the N400 reliably differentiated between typically developing readers and readers with dyslexia. Implications for future research and practice are discussed.

Sex Differences in Low-Level Multisensory Integration in Developmental Dyslexia

Reading acquisition involves the integration of auditory and visual stimuli. Thus, low-level audiovisual multisensory integration might contribute to disrupted reading in developmental dyslexia. Although dyslexia is more frequently diagnosed in males and emerging evidence indicates that the neural basis of dyslexia might differ between sexes, previous studies examining multisensory integration did not evaluate potential sex differences nor tested its neural correlates. In the current study on 88 adolescents and young adults, we found that only males with dyslexia showed a deficit in multisensory integration of simple nonlinguistic stimuli. At the neural level, both females and males with dyslexia presented smaller differences in response to multisensory compared to those in response to unisensory conditions in the N1 and N2 components (early components of event-related potentials associated with sensory processing) than the control group. Additionally, in a subsample of 80 participants matched for nonverbal IQ, only males with dyslexia exhibited smaller differences in the left hemisphere in response to multisensory compared to those in response to unisensory conditions in the N1 component. Our study indicates that deficits of multisensory integration seem to be more severe in males than females with dyslexia. This provides important insights into sex-modulated cognitive processes that might confer vulnerability to reading difficulties.

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

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

Similarities and differences in the neural correlates of letter and speech sound integration in blind and sighted readers

Learning letter and speech sound (LS) associations is a major step in reading acquisition common for all alphabetic scripts, including Braille used by blind readers. The left superior temporal cortex (STC) plays an important role in audiovisual LS integration in sighted people, but it is still unknown what neural mechanisms are responsible for audiotactile LS integration in blind individuals. Here, we investigated the similarities and differences between LS integration in blind Braille (N = 42, age range: 9-60 y.o.) and sighted print (N = 47, age range: 9-60 y.o.) readers who acquired reading using different sensory modalities. In both groups, the STC responded to both isolated letters and isolated speech sounds, showed enhanced activation when they were presented together, and distinguished between congruent and incongruent letter and speech sound pairs. However, the direction of the congruency effect was different between the groups. Sighted subjects showed higher activity for incongruent LS pairs in the bilateral STC, similarly to previously studied typical readers of transparent orthographies. In the blind, congruent pairs resulted in an increased response in the right STC. These differences may be related to more sequential processing of Braille as compared to print reading. At the same time, behavioral efficiency in LS discrimination decisions and the congruency effect were found to be related to age and reading skill only in sighted participants, suggesting potential differences in the developmental trajectories of LS integration between blind and sighted readers.

Neural pathways of attitudes toward foreign languages predict academic performance

Learning attitude is thought to impact students' academic achievement and success, but the underlying neurocognitive mechanisms of learning attitudes remain unclear. The purpose of the present study was to investigate the neural markers linked to attitudes toward foreign languages and how they contribute to foreign-language performance. Forty-one Chinese speakers who hold differentiated foreign language (English) attitudes were asked to complete an English semantic judgment task during a functional magnetic resonance imaging (fMRI) experiment. Multimethod brain imaging analyses showed that, compared with the positive attitude group (PAG), the negative attitude group (NAG) showed increased brain activation in the left STG and functional connectivity between the left STG and the right precentral gyrus (PCG), as well as changed functional segregation and integration of brain networks under the English reading task, after controlling for English reading scores. Mediation analysis further revealed that left STG activity and STG-PCG connectivity mediated the relationships between English attitudes and English reading performance. Taken together, these findings suggest that objective neural markers related to subjective foreign language attitudes (FLAs) exist and that attitude-related neural pathways play important roles in determining students' academic performance. Our findings provide new insights into the neurobiological mechanisms by which attitudes regulate academic performance.

Audiovisual multisensory integration in individuals with reading and language impairments: A systematic review and meta-analysis

Differences in sensory function have been documented for a number of neurodevelopmental conditions, including reading and language impairments. Prior studies have measured audiovisual multisensory integration (i.e., the ability to combine inputs from the auditory and visual modalities) in these populations. The present study sought to systematically review and quantitatively synthesize the extant literature on audiovisual multisensory integration in individuals with reading and language impairments. A comprehensive search strategy yielded 56 reports, of which 38 were used to extract 109 group difference and 68 correlational effect sizes. There was an overall difference between individuals with reading and language impairments and comparisons on audiovisual integration. There was a nonsignificant trend towards moderation according to sample type (i.e., reading versus language) and publication/small study bias for this model. Overall, there was a small but non-significant correlation between metrics of audiovisual integration and reading or language ability; this model was not moderated by sample or study characteristics, nor was there evidence of publication/small study bias. Limitations and future directions for primary and meta-analytic research are discussed.

Examination of common and unique brain regions for atypical reading and math: a meta-analysis

The purpose of this study is to identify consistencies across functional neuroimaging studies regarding common and unique brain regions/networks for individuals with reading difficulties (RD) and math difficulties (MD) compared to typically developing (TD) individuals. A systematic search of the literature, utilizing multiple databases, yielded 116 functional magnetic resonance imaging and positron emission tomography studies that met the criteria. Coordinates that directly compared TD with either RD or MD were entered into GingerALE (Brainmap.org). An activation likelihood estimate (ALE) meta-analysis was conducted to examine common and unique brain regions for RD and MD. Overall, more studies examined RD (n = 96) than MD (n = 20). Across studies, overactivation for reading and math occurred in the right insula and inferior frontal gyrus for atypically developing (AD) > TD comparisons, albeit in slightly different areas of these regions; however, inherent threshold variability across imaging studies could diminish overlying regions. For TD > AD comparisons, there were no similar or overlapping brain regions. Results indicate there were domain-specific differences for RD and MD; however, there were some similarities in the ancillary recruitment of executive functioning skills. Theoretical and practical implications for researchers and educators are discussed.

Neurodevelopmental trajectories of letter and speech sound processing from preschool to the end of elementary school

Learning to read alphabetic languages starts with learning letter-speech-sound associations. How this process changes brain function during development is still largely unknown. We followed 102 children with varying reading skills in a mixed-longitudinal/cross-sectional design from the prereading stage to the end of elementary school over five time points (n = 46 with two and more time points, of which n = 16 fully-longitudinal) to investigate the neural trajectories of letter and speech sound processing using fMRI. Children were presented with letters and speech sounds visually, auditorily, and audiovisually in kindergarten (6.7yo), at the middle (7.3yo) and end of first grade (7.6yo), and in second (8.4yo) and fifth grades (11.5yo). Activation of the ventral occipitotemporal cortex for visual and audiovisual processing followed a complex trajectory, with two peaks in first and fifth grades. The superior temporal gyrus (STG) showed an inverted U-shaped trajectory for audiovisual letter processing, a development that in poor readers was attenuated in middle STG and absent in posterior STG. Finally, the trajectories for letter-speech-sound integration were modulated by reading skills and showed differing directionality in the congruency effect depending on the time point. This unprecedented study captures the development of letter processing across elementary school and its neural trajectories in children with varying reading skills.

Disentangling influences of dyslexia, development, and reading experience on effective brain connectivity in children

Altered brain connectivity between regions of the reading network has been associated with reading difficulties. However, it remains unclear whether connectivity differences between children with dyslexia (DYS) and those with typical reading skills (TR) are specific to reading impairments or to reading experience. In this functional MRI study, 132 children (M = 10.06 y, SD = 1.46) performed a phonological lexical decision task. We aimed to disentangle (1) disorder-specific from (2) experience-related differences in effective connectivity and to (3) characterize the development of DYS and TR. We applied dynamic causal modeling to age-matched (n_dys = 25, n_TR = 35) and reading-level-matched (n_dys = 25, n_TR = 22) groups. Developmental effects were assessed in beginning and advanced readers (TR: n_beg = 48, n_adv = 35, DYS: n_beg = 24, n_adv = 25). We show that altered feedback connectivity between the inferior parietal lobule and the visual word form area (VWFA) during print processing can be specifically attributed to reading impairments, because these alterations were found in DYS compared to both the age-matched and reading-level-matched TR. In contrast, feedforward connectivity from the VWFA to parietal and frontal regions characterized experience in TR and increased with age and reading skill. These directed connectivity findings pinpoint disorder-specific and experience-dependent alterations in the brain's reading network.

Neural correlates of multisensory integration in the human brain: an ALE meta-analysis

Previous fMRI research identified superior temporal sulcus as central integration area for audiovisual stimuli. However, less is known about a general multisensory integration network across senses. Therefore, we conducted activation likelihood estimation meta-analysis with multiple sensory modalities to identify a common brain network. We included 49 studies covering all Aristotelian senses i.e., auditory, visual, tactile, gustatory, and olfactory stimuli. Analysis revealed significant activation in bilateral superior temporal gyrus, middle temporal gyrus, thalamus, right insula, and left inferior frontal gyrus. We assume these regions to be part of a general multisensory integration network comprising different functional roles. Here, thalamus operate as first subcortical relay projecting sensory information to higher cortical integration centers in superior temporal gyrus/sulcus while conflict-processing brain regions as insula and inferior frontal gyrus facilitate integration of incongruent information. We additionally performed meta-analytic connectivity modelling and found each brain region showed co-activations within the identified multisensory integration network. Therefore, by including multiple sensory modalities in our meta-analysis the results may provide evidence for a common brain network that supports different functional roles for multisensory integration.

Differences in brain functional networks for audiovisual integration during reading between children and adults

Building robust letter-to-sound correspondences is a prerequisite for developing reading capacity. However, the neural mechanisms underlying the development of audiovisual integration for reading are largely unknown. This study used functional magnetic resonance imaging in a lexical decision task to investigate functional brain networks that support audiovisual integration during reading in developing child readers (10-12 years old) and skilled adult readers (20-28 years old). The results revealed enhanced connectivity in a prefrontal-superior temporal network (including the right medial frontal gyrus, right superior frontal gyrus, and left superior temporal gyrus) in adults relative to children, reflecting the development of attentional modulation of audiovisual integration involved in reading processing. Furthermore, the connectivity strength of this brain network was correlated with reading accuracy. Collectively, this study, for the first time, elucidates the differences in brain networks of audiovisual integration for reading between children and adults, promoting the understanding of the neurodevelopment of multisensory integration in high-level human cognition.

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

BACKGROUND

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

METHODS

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

DISCUSSION

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

TRIAL REGISTRATION

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

The influence of temporal asynchrony on character-speech integration in Chinese children with and without dyslexia: An ERP study

Dyslexic readers have been reported to show abnormal temporal acuity and multisensory integration deficiency. Here, we investigated the influence of temporal intervals on Chinese character-speech integration in children with and without dyslexia. Visual characters were presented synchronously to the onset of speech sounds (AV0) or before speech sound by 300 ms (AV300). Event-related potentials (ERP) evoked by congruent condition (speech sounds presented with congruent Chinese characters) and by baseline condition (speech sounds presented with Korean characters) were compared. Typically developing (TD) children exhibited congruency effect in AV0 condition, whereas dyslexic children exhibited congruency effect in AV300 condition. Moreover, congruency effect in TD children was due to enhanced neural activation to congruent trials, congruency effect in dyslexic children was contributed by neural suppression for baseline trials. These results suggested that different underlying mechanisms were involved in character-speech integration for typical and dyslexic children.

Brain Source Correlates of Speech Perception and Reading Processes in Children With and Without Reading Difficulties

Neural correlates in reading and speech processing have been addressed extensively in the literature. While reading skills and speech perception have been shown to be associated with each other, their relationship remains debatable. In this study, we investigated reading skills, speech perception, reading, and their correlates with brain source activity in auditory and visual modalities. We used high-density event-related potentials (ERPs), fixation-related potentials (FRPs), and the source reconstruction method. The analysis was conducted on 12–13-year-old schoolchildren who had different reading levels. Brain ERP source indices were computed from frequently repeated Finnish speech stimuli presented in an auditory oddball paradigm. Brain FRP source indices were also computed for words within sentences presented in a reading task. The results showed significant correlations between speech ERP sources and reading scores at the P100 (P1) time range in the left hemisphere and the N250 time range in both hemispheres, and a weaker correlation for visual word processing N170 FRP source(s) in the posterior occipital areas, in the vicinity of the visual word form areas (VWFA). Furthermore, significant brain-to-brain correlations were found between the two modalities, where the speech brain sources of the P1 and N250 responses correlated with the reading N170 response. The results suggest that speech processes are linked to reading fluency and that brain activations to speech are linked to visual brain processes of reading. These results indicate that a relationship between language and reading systems is present even after several years of exposure to print.

Atypical Relationships Between Neurofunctional Features of Print-Sound Integration and Reading Abilities in Chinese Children With Dyslexia

Conquering print-sound mappings (e.g., grapheme-phoneme correspondence rules) is vital for developing fluent reading skills. In neuroimaging research, this ability can be indexed by activation differences between audiovisual congruent against incongruent conditions in brain areas such as the left superior temporal cortex. In line with it, individuals with dyslexia have difficulty in tasks requiring print-sound processing, accompanied by a reduced neural integration. However, existing evidence is almost restricted to alphabetic languages. Whether and how multisensory processing of print and sound is impaired in Chinese dyslexia remains underexplored. In this study, we applied a passive audiovisual integration paradigm with functional magnetic resonance imaging to investigate the possible dysfunctions in processing character-sound (opaque; semantics can be automatically accessed) and pinyin-sound associations (transparent; no particular meaning can be confirmed) in Chinese dyslexic children. Unexpectedly, the dyslexic group did not show reduced neural integration compared with typically developing readers in either character or pinyin experiment. However, the results revealed atypical correlations between neural integration and different reading abilities in dyslexia. Specifically, while the neural integration in the left inferior frontal cortex in processing character-sound pairs correlated with silent reading comprehension in both children with and without dyslexia, it was associated with morphological awareness (semantic-related) in controls but with rapid naming (phonological-related) in dyslexics. This result indicates Chinese dyslexic children may not use the same grapho-semantic processing strategy as their typical peers do. As for pinyin-sound processing, while a stronger neural integration in the direction of “congruent > incongruent” in the left occipito-temporal cortex and bilateral superior temporal cortices was associated with better oral reading fluency in the control group, an opposite pattern was found in dyslexia. This finding may reflect dyslexia's dysfunctional recruitment of the regions in grapho-phonological processing, which further impedes character learning.

Longitudinal changes in cortical responses to letter-speech sound stimuli in 8-11 year-old children

While children are able to name letters fairly quickly, the automatisation of letter-speech sound mappings continues over the first years of reading development. In the current longitudinal fMRI study, we explored developmental changes in cortical responses to letters and speech sounds across 3 yearly measurements in a sample of 18 8-11 year old children. We employed a text-based recalibration paradigm in which combined exposure to text and ambiguous speech sounds shifts participants' later perception of the ambiguous sounds towards the text. Our results showed that activity of the left superior temporal and lateral inferior precentral gyri followed a non-linear developmental pattern across the measurement sessions. This pattern is reminiscent of previously reported inverted-u-shape developmental trajectories in children's visual cortical responses to text. Our findings suggest that the processing of letters and speech sounds involves non-linear changes in the brain's spoken language network possibly related to progressive automatisation of reading skills.

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.

How Learning to Read Changes the Listening Brain

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

Graph Analysis of EEG Functional Connectivity Networks During a Letter-Speech Sound Binding Task in Adult Dyslexics

We performed an EEG graph analysis on data from 31 typical readers (22.27 ± 2.53 y/o) and 24 dyslexics (22.99 ± 2.29 y/o), recorded while they were engaged in an audiovisual task and during resting-state. The task simulates reading acquisition as participants learned new letter-sound mappings via feedback. EEG data was filtered for the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), and beta (13–30 Hz) bands. We computed the Phase Lag Index (PLI) to provide an estimate of the functional connectivity between all pairs of electrodes per band. Then, networks were constructed using a Minimum Spanning Tree (MST), a unique sub-graph connecting all nodes (electrodes) without loops, aimed at minimizing bias in between groups and conditions comparisons. Both groups showed a comparable accuracy increase during task blocks, indicating that they correctly learned the new associations. The EEG results revealed lower task-specific theta connectivity, and lower theta degree correlation over both rest and task recordings, indicating less network integration in dyslexics compared to typical readers. This pattern suggests a role of theta oscillations in dyslexia and may reflect differences in task engagement between the groups, although robust correlations between MST metrics and performance indices were lacking.

Developmental Trajectories of Letter and Speech Sound Integration During Reading Acquisition

Reading acquisition in alphabetic languages starts with learning the associations between speech sounds and letters. This learning process is related to crucial developmental changes of brain regions that serve visual, auditory, multisensory integration, and higher cognitive processes. Here, we studied the development of audiovisual processing and integration of letter-speech sound pairs with an audiovisual target detection functional MRI paradigm. Using a longitudinal approach, we tested children with varying reading outcomes before the start of reading acquisition (T1, 6.5 yo), in first grade (T2, 7.5 yo), and in second grade (T3, 8.5 yo). Early audiovisual integration effects were characterized by higher activation for incongruent than congruent letter-speech sound pairs in the inferior frontal gyrus and ventral occipitotemporal cortex. Audiovisual processing in the left superior temporal gyrus significantly increased from the prereading (T1) to early reading stages (T2, T3). Region of interest analyses revealed that activation in left superior temporal gyrus (STG), inferior frontal gyrus and ventral occipitotemporal cortex increased in children with typical reading fluency skills, while poor readers did not show the same development in these regions. The incongruency effect bilaterally in parts of the STG and insular cortex at T1 was significantly associated with reading fluency skills at T3. These findings provide new insights into the development of the brain circuitry involved in audiovisual processing of letters, the building blocks of words, and reveal early markers of audiovisual integration that may be predictive of reading outcomes.

ERP Correlates of Altered Orthographic-Phonological Processing in Dyslexia

Automatic visual word recognition requires not only well-established phonological and orthographic representations but also efficient audio-visual integration of these representations. One possibility is that in developmental dyslexia, inefficient orthographic processing might underlie poor reading. Alternatively, reading deficit could be due to inefficient phonological processing or inefficient integration of orthographic and phonological information. In this event-related potential study, participants with dyslexia (N = 25) and control readers (N = 27) were presented with pairs of words and pseudowords in an implicit same-different task. The reference-target pairs could be identical, or different in the identity or the position of the letters. To test the orthographic-phonological processing, target stimuli were presented in visual-only and audiovisual conditions. Participants with and without dyslexia processed the reference stimuli similarly; however, group differences emerged in the processing of target stimuli, especially in the audiovisual condition where control readers showed greater N1 responses for words than for pseudowords, but readers with dyslexia did not show such difference. Moreover, after 300 ms lexicality effect exhibited a more focused frontal topographic distribution in readers with dyslexia. Our results suggest that in developmental dyslexia, phonological processing and audiovisual processing deficits are more pronounced than orthographic processing deficits.

Convergent and divergent brain structural and functional abnormalities associated with developmental dyslexia

Brain abnormalities in the reading network have been repeatedly reported in individuals with developmental dyslexia (DD); however, it is still not totally understood where the structural and functional abnormalities are consistent/inconsistent across languages. In the current multimodal meta-analysis, we found convergent structural and functional alterations in the left superior temporal gyrus across languages, suggesting a neural signature of DD. We found greater reduction in grey matter volume and brain activation in the left inferior frontal gyrus in morpho-syllabic languages (e.g. Chinese) than in alphabetic languages, and greater reduction in brain activation in the left middle temporal gyrus and fusiform gyrus in alphabetic languages than in morpho-syllabic languages. These language differences are explained as consequences of being DD while learning a specific language. In addition, we also found brain regions that showed increased grey matter volume and brain activation, presumably suggesting compensations and brain regions that showed inconsistent alterations in brain structure and function. Our study provides important insights about the etiology of DD from a cross-linguistic perspective with considerations of consistency/inconsistency between structural and functional alterations.

Poor reading is characterized by a more connected network with wrong hubs

Using graph theory, we examined topological organization of the language network in Chinese children with poor reading during an auditory rhyming task and a visual spelling task, compared to reading-matched controls and age-matched controls. First, poor readers (PR) showed reduced clustering coefficient in the left inferior frontal gyrus (IFG) and higher nodal efficiency in the bilateral superior temporal gyri (STG) during the visual task, indicating a less functionally specialized cluster around the left IFG and stronger functional links between bilateral STGs and other regions. Furthermore, PR adopted additional right-hemispheric hubs in both tasks, which may explain increased global efficiency across both tasks and lower normalized characteristic shortest path length in the visual task for the PR. These results underscore deficits in the left IFG during visual word processing and conform previous findings about compensation in the right hemisphere in children with poor reading.

Gray matter correlates of reading fluency deficits: SES matters, IQ does not

Brain correlates of reading ability have been intensely investigated. Most studies have focused on single-word reading and phonological processing, but the brain basis of reading fluency remains poorly explored to date. Here, in a voxel-based morphometry study with 8-year-old children, we compared fluent readers (n = 18; seven boys) with dysfluent readers with normal IQ (n = 18; six boys) and with low IQ (n = 18; ten boys). Relative to dysfluent readers, fluent readers had larger gray matter volume in the right superior temporal gyrus and the two subgroups of dysfluent readers did not differ from each other, as shown in frequentist and Bayesian analyses. Pairwise comparisons showed that dysfluent readers of normal and low IQ did not differ in core reading regions and that both subgroups had less gray matter volume than fluent readers in occipito-temporal, parieto-temporal and fusiform areas. We also examined gray matter volume in matched subgroups of dysfluent readers differing only in socioeconomic status (SES): lower-SES (n = 14; seven boys) vs. higher-SES (n = 14; seven boys). Higher-SES dysfluent readers had larger gray matter volume in the right angular gyrus than their lower-SES peers, and the volume of this cluster correlated positively with lexico-semantic fluency. Age, sex, IQ, and gray matter volume of the right angular cluster explained 68% of the variance in the reading fluency of higher-SES dysfluent readers. In sum, this study shows that gray matter correlates of dysfluent reading are independent of IQ, and suggests that SES modulates areas sub-serving lexico-semantic processes in dysfluent readers-two findings that may be useful to inform language/reading remediation programs.

Audiovisual processing and selective attention in adult dyslexic readers: An event-related potential study

Developmental dyslexia is a specific reading disability characterized by decoding and spelling deficits that continue into adulthood. Because reading involves both attentional functions and audiovisual (AV) processing, the aim of this study was to explore the associations between the two factors in adult dyslexic readers. Adult non-impaired and dyslexic readers undertook alphabetic and non-alphabetic tasks, each composed of three experimental blocks. Two experimental blocks contained left and right spatial selective attention manipulations, and another block included central presentations of the stimuli. Event-related potential (ERP) and behavioural parameters were collected and analysed, particularly with respect to the N1-P2 ERP complex. The dyslexic readers showed deviant patterns of amplitudes when it came to alphabetic stimuli processing. However, there was no difference between the two groups with regard to the non-alphabetic stimuli. These results imply that adult dyslexic readers allocate altered attentional resources when it comes to the processing of AV alphabetic stimuli.

Cortical responses to letters and ambiguous speech vary with reading skills in dyslexic and typically reading children

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Text recalibrates ambiguous speech perception in children with and without dyslexia.

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Dyslexia and poorer reading skills are linked to reduced left fusiform activation.

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Poorer letter-speech sound matching is linked to higher superior temporal activation.

One of the proposed issues underlying reading difficulties in dyslexia is insufficiently automatized letter-speech sound associations. In the current fMRI experiment, we employ text-based recalibration to investigate letter-speech sound mappings in 8–10 year-old children with and without dyslexia. Here an ambiguous speech sound /a?a/ midway between /aba/ and /ada/ is combined with disambiguating “aba” or “ada” text causing a perceptual shift of the ambiguous /a?a/ sound towards the text (recalibration). This perceptual shift has been found to be reduced in adults but not in children with dyslexia compared to typical readers. Our fMRI results show significantly reduced activation in the left fusiform in dyslexic compared to typical readers, despite comparable behavioural performance. Furthermore, enhanced audio-visual activation within this region was linked to better reading and phonological skills. In contrast, higher activation in bilateral superior temporal cortex was associated with lower letter-speech sound identification fluency. These findings reflect individual differences during the early stages of reading development with reduced recruitment of the left fusiform in dyslexic readers together with an increased involvement of the superior temporal cortex in children with less automatized letter-speech sound associations.

Time course of the unmasked attentional blink

The Attentional Blink (AB) usually refers to the impaired report of a second target (T2) if it appears within 200-500 ms after a first target within a rapid sequence of distractors. The present study focused on a less studied AB variant known as the unmasked AB, where T2 is the last item of the sequence and T2 report is unaffected. This aspect of the unmasked AB holds promise for an experimental paradigm in which measures of on-going event-related processing are unconfounded by differences in late-stage processing. To fully characterize the unmasked AB paradigm, we used a randomization statistics approach to comprehensively examine the electroencephalographic signature of the unmasked AB. We examined the unmasked AB with auditory and visual T2s-participants attended to either the auditory or visual information within a sequence of paired auditory-visual stimuli, and reported targets within the attended modality stream while ignoring the other. As predicted, T2 report was unaffected by the unmasked AB. The visual AB was associated with delayed but intact N2 and P3 components, and a suppressed N1. We suggest that this N1 is linked to auditory processing of the distractor stream, and reflects the cognitive system prioritizing the processing of visual targets over auditory distractors in response to AB-related processing load. The auditory AB only indicated a delayed but intact P3. Collectively, these findings support the view that the AB limits the entry of information into consciousness via a late-stage modal bottleneck, and suggest an ongoing compensatory response at early latencies.

Development of Print-Speech Integration in the Brain of Beginning Readers With Varying Reading Skills

Learning print-speech sound correspondences is a crucial step at the beginning of reading acquisition and often impaired in children with developmental dyslexia. Despite increasing insight into audiovisual language processing, it remains largely unclear how integration of print and speech develops at the neural level during initial learning in the first years of schooling. To investigate this development, 32 healthy, German-speaking children at varying risk for developmental dyslexia (17 typical readers and 15 poor readers) participated in a longitudinal study including behavioral and fMRI measurements in first (T1) and second (T2) grade. We used an implicit audiovisual (AV) non-word target detection task aimed at characterizing differential activation to congruent (AVc) and incongruent (AVi) audiovisual non-word pairs. While children’s brain activation did not differ between AVc and AVi pairs in first grade, an incongruency effect (AVi > AVc) emerged in bilateral inferior temporal and superior frontal gyri in second grade. Of note, pseudoword reading performance improvements with time were associated with the development of the congruency effect (AVc > AVi) in the left posterior superior temporal gyrus (STG) from first to second grade. Finally, functional connectivity analyses indicated divergent development and reading expertise dependent coupling from the left occipito-temporal and superior temporal cortex to regions of the default mode (precuneus) and fronto-temporal language networks. Our results suggest that audiovisual integration areas as well as their functional coupling to other language areas and areas of the default mode network show a different development in poor vs. typical readers at varying familial risk for dyslexia.

Temporal representation impairment in developmental dyslexia for unisensory and multisensory stimuli

Dyslexia has been associated with a problem in visual-audio integration mechanisms. Here, we investigate for the first time the contribution of unisensory cues on multisensory audio and visual integration in 32 dyslexic children by modelling results using the Bayesian approach. Non-linguistic stimuli were used. Children performed a temporal task: they had to report whether the middle of three stimuli was closer in time to the first one or to the last one presented. Children with dyslexia, compared with typical children, exhibited poorer unimodal thresholds, requiring greater temporal distance between items for correct judgements, while multisensory thresholds were well predicted by the Bayesian model. This result suggests that the multisensory deficit in dyslexia is due to impaired audio and visual inputs rather than impaired multisensory processing per se. We also observed that poorer temporal skills correlated with lower reading skills in dyslexic children, suggesting that this temporal capability can be linked to reading abilities.

Children With Reading Difficulty Rely on Unimodal Neural Processing for Phonemic Awareness

Phonological awareness skills in children with reading difficulty (RD) may reflect impaired automatic integration of orthographic and phonological representations. However, little is known about the underlying neural mechanisms involved in phonological awareness for children with RD. Eighteen children with RD, ages 9–13, participated in a functional magnetic resonance imaging (fMRI) study designed to assess the relationship of two constructs of phonological awareness, phoneme synthesis, and phoneme analysis, with crossmodal rhyme judgment. Participants completed a rhyme judgment task presented in two modality conditions; unimodal auditory only and crossmodal audiovisual. Measures of phonological awareness were correlated with unimodal, but not crossmodal, lexical processing. Moreover, these relationships were found only in unisensory brain regions, and not in multisensory brain areas. The results of this study suggest that children with RD rely on unimodal representations and unisensory brain areas, and provide insight into the role of phonemic awareness in mapping between auditory and visual modalities during literacy acquisition.

Word inversion sensitivity as a marker of visual word form area lateralization: An application of a novel multivariate measure of laterality

An area within the ventral occipitotemporal cortex (vOTC), the "visual word form area" (VWFA), typically exhibits a strongly left-lateralized response to orthographic stimuli in skilled readers. While individual variation in VWFA lateralization has been observed, the behavioral significance of laterality differences remains unclear. Here, we test the hypothesis that differences in VWFA lateralization reflect differing preferences for holistic orthographic analysis. To examine this hypothesis, we implemented a new multivariate method that uses machine learning to assess functional lateralization, along with a traditional univariate lateralization method. We related these neural metrics to behavioral indices of holistic orthographic analysis (inversion sensitivity). The multivariate measure successfully detected the lateralization of orthographic processing in the VWFA, and as hypothesized, predicted behavioral differences in holistic orthographic analysis. An exploratory whole brain analysis identified further regions with a relationship between inversion sensitivity and lateralization: one near the junction of the inferior frontal and precentral sulci, and another along the superior temporal gyrus. We conclude that proficient native readers of English exhibit differences in cortical lateralization of the VWFA that have significant implications for reading behavior.

Reading-Induced Shifts in Speech Perception in Dyslexic and Typically Reading Children

One of the proposed mechanisms underlying reading difficulties observed in developmental dyslexia is impaired mapping of visual to auditory speech representations. We investigate these mappings in 20 typically reading and 20 children with dyslexia aged 8–10 years using text-based recalibration. In this paradigm, the pairing of visual text and ambiguous speech sounds shifts (recalibrates) the participant’s perception of the ambiguous speech in subsequent auditory-only post-test trials. Recent research in adults demonstrated this text-induced perceptual shift in typical, but not in dyslexic readers. Our current results instead show significant text-induced recalibration in both typically reading children and children with dyslexia. The strength of this effect was significantly linked to the strength of perceptual adaptation effects in children with dyslexia but not typically reading children. Furthermore, additional analyses in a sample of typically reading children of various reading levels revealed a significant link between recalibration and phoneme categorization. Taken together, our study highlights the importance of considering dynamic developmental changes in reading, letter-speech sound coupling and speech perception when investigating group differences between typical and dyslexic readers.

The Functional Neuroanatomy of Letter-Speech Sound Integration and Its Relation to Brain Abnormalities in Developmental Dyslexia

This mini-review provides a comparison of the brain systems associated with developmental dyslexia and the brain systems associated with letter-speech sound (LSS) integration. First, the findings on the functional neuroanatomy of LSS integration are summarized in order to obtain a comprehensive overview of the brain regions involved in this process. To this end, neurocognitive studies investigating LSS integration in both normal and abnormal reading development are taken into account. The neurobiological basis underlying LSS integration is consequently compared with existing neurocognitive models of functional and structural brain abnormalities in developmental dyslexia-focusing on superior temporal and occipito-temporal (OT) key regions. Ultimately, the commonalities and differences between the brain systems engaged by LSS integration and the brain systems identified with abnormalities in developmental dyslexia are investigated. This comparison will add to our understanding of the relation between LSS integration and normal and abnormal reading development.

Dyslexia on a continuum: A complex network approach

We investigated the efficacy of graph-theoretic metrics of task-related functional brain connectivity in predicting reading difficulty and explored the hypothesis that task conditions emphasizing audiovisual integration would be especially diagnostic of reading difficulty. An fMRI study was conducted in which 24 children (8 to 14 years old) who were previously diagnosed with dyslexia completed a rhyming judgment task under three presentation modality conditions. Regression analyses found that characteristic connectivity metrics of the reading network showed a presentation modality dependent relationship with reading difficulty: Children with more segregated reading networks and those that used fewer of the available connections were those with the least severe reading difficulty. These results are consistent with the hypothesis that a lack of coordinated processing between the neural regions involved in phonological and orthographic processing contributes towards reading difficulty.

Letter and Speech Sound Association in Emerging Readers With Familial Risk of Dyslexia

In alphabetic scripts, learning letter-sound (LS) association (i.e., letter knowledge) is a strong predictor of later reading skills. LS integration is related to left superior temporal cortex (STC) activity and its disruption was previously observed in dyslexia (DYS). Whether disruption in LS association is a cause of reading impairment or a consequence of decreased exposure to print remains unclear. Using fMRI, we compared activation for letters, speech sounds and LS association in emerging readers with (FHD+, N = 50) and without (FHD-, N = 35) familial history of DYS, out of whom 17 developed DYS 2 years later. Despite having similar reading skills, FHD+ and FHD- groups showed opposite pattern of activation in left STC: In FHD- children activation was higher for incongruent compared to congruent, whereas in FHD+ it was higher for congruent LS pairs. Higher activation to congruent LS pairs was also characteristic of future DYS. The magnitude of incongruency effect in left STC was positively related to early reading skills, but only in FHD- children and (retrospectively) in typical readers. We show that alterations in brain activity during LS association can be detected at very early stages of reading acquisition, suggesting their causal involvement in later reading impairments. Increased response of left STC to incongruent LS pairs in FHD- group might reflect an early stage of automatizing LS associations, where the brain responds actively to conflicting pairs. The absence of such response in FHD+ children could lead to failures in suppressing incongruent information during reading acquisition, which could result in future reading problems.

EEG Resting State Functional Connectivity in Adult Dyslexics Using Phase Lag Index and Graph Analysis

Developmental dyslexia may involve deficits in functional connectivity across widespread brain networks that enable fluent reading. We investigated the large-scale organization of electroencephalography (EEG) functional networks at rest in 28 dyslexics and 36 typically reading adults. For each frequency band (delta, theta alpha and beta), we assessed functional connectivity strength with the phase lag index (PLI). Network topology was examined using minimum spanning tree (MST) graphs derived from the functional connectivity matrices. We found significant group differences in the alpha band (8-13 Hz). The graph analysis indicated more interconnected nodes, in dyslexics compared to typical readers. The graph metrics were significantly correlated with age in dyslexics but not in typical readers, which may indicate more heterogeneity in maturation of brain networks in dyslexics. The present findings support the involvement of alpha oscillations in higher cognition and the sensitivity of graph metrics to characterize functional networks in adult dyslexia. Finally, the current results extend our previous findings on children.

A Selective Deficit in Phonetic Recalibration by Text in Developmental Dyslexia

Upon hearing an ambiguous speech sound, listeners may adjust their perceptual interpretation of the speech input in accordance with contextual information, like accompanying text or lipread speech (i.e., phonetic recalibration; Bertelson et al., 2003). As developmental dyslexia (DD) has been associated with reduced integration of text and speech sounds, we investigated whether this deficit becomes manifest when text is used to induce this type of audiovisual learning. Adults with DD and normal readers were exposed to ambiguous consonants halfway between /aba/ and /ada/ together with text or lipread speech. After this audiovisual exposure phase, they categorized auditory-only ambiguous test sounds. Results showed that individuals with DD, unlike normal readers, did not use text to recalibrate their phoneme categories, whereas their recalibration by lipread speech was spared. Individuals with DD demonstrated similar deficits when ambiguous vowels (halfway between /wIt/ and /wet/) were recalibrated by text. These findings indicate that DD is related to a specific letter-speech sound association deficit that extends over phoneme classes (vowels and consonants), but – as lipreading was spared – does not extend to a more general audio–visual integration deficit. In particular, these results highlight diminished reading-related audiovisual learning in addition to the commonly reported phonological problems in developmental dyslexia.

Simulating reading acquisition: The link between reading outcome and multimodal brain signatures of letter-speech sound learning in prereaders

During reading acquisition, neural reorganization of the human brain facilitates the integration of letters and speech sounds, which enables successful reading. Neuroimaging and behavioural studies have established that impaired audiovisual integration of letters and speech sounds is a core deficit in individuals with developmental dyslexia. This longitudinal study aimed to identify neural and behavioural markers of audiovisual integration that are related to future reading fluency. We simulated the first step of reading acquisition by performing artificial-letter training with prereading children at risk for dyslexia. Multiple logistic regressions revealed that our training provides new precursors of reading fluency at the beginning of reading acquisition. In addition, an event-related potential around 400 ms and functional magnetic resonance imaging activation patterns in the left planum temporale to audiovisual correspondences improved cross-validated prediction of future poor readers. Finally, an exploratory analysis combining simultaneously acquired electroencephalography and hemodynamic data suggested that modulation of temporoparietal brain regions depended on future reading skills. The multimodal approach demonstrates neural adaptations to audiovisual integration in the developing brain that are related to reading outcome. Despite potential limitations arising from the restricted sample size, our results may have promising implications both for identifying poor-reading children and for monitoring early interventions.

Neural Noise Hypothesis of Developmental Dyslexia

Developmental dyslexia (decoding-based reading disorder; RD) is a complex trait with multifactorial origins at the genetic, neural, and cognitive levels. There is evidence that low-level sensory-processing deficits precede and underlie phonological problems, which are one of the best-documented aspects of RD. RD is also associated with impairments in integrating visual symbols with their corresponding speech sounds. Although causal relationships between sensory processing, print-speech integration, and fluent reading, and their neural bases are debated, these processes all require precise timing mechanisms across distributed brain networks. Neural excitability and neural noise are fundamental to these timing mechanisms. Here, we propose that neural noise stemming from increased neural excitability in cortical networks implicated in reading is one key distal contributor to RD.

A General Audiovisual Temporal Processing Deficit in Adult Readers With Dyslexia

PURPOSE

Because reading is an audiovisual process, reading impairment may reflect an audiovisual processing deficit. The aim of the present study was to test the existence and scope of such a deficit in adult readers with dyslexia.

METHOD

We tested 39 typical readers and 51 adult readers with dyslexia on their sensitivity to the simultaneity of audiovisual speech and nonspeech stimuli, their time window of audiovisual integration for speech (using incongruent /aCa/ syllables), and their audiovisual perception of phonetic categories.

RESULTS

Adult readers with dyslexia showed less sensitivity to audiovisual simultaneity than typical readers for both speech and nonspeech events. We found no differences between readers with dyslexia and typical readers in the temporal window of integration for audiovisual speech or in the audiovisual perception of phonetic categories.

CONCLUSIONS

The results suggest an audiovisual temporal deficit in dyslexia that is not specific to speech-related events. But the differences found for audiovisual temporal sensitivity did not translate into a deficit in audiovisual speech perception. Hence, there seems to be a hiatus between simultaneity judgment and perception, suggesting a multisensory system that uses different mechanisms across tasks. Alternatively, it is possible that the audiovisual deficit in dyslexia is only observable when explicit judgments about audiovisual simultaneity are required.

Neurogenetics of developmental dyslexia: from genes to behavior through brain neuroimaging and cognitive and sensorial mechanisms

Developmental dyslexia (DD) is a complex neurodevelopmental deficit characterized by impaired reading acquisition, in spite of adequate neurological and sensorial conditions, educational opportunities and normal intelligence. Despite the successful characterization of DD-susceptibility genes, we are far from understanding the molecular etiological pathways underlying the development of reading (dis)ability. By focusing mainly on clinical phenotypes, the molecular genetics approach has yielded mixed results. More optimally reduced measures of functioning, that is, intermediate phenotypes (IPs), represent a target for researching disease-associated genetic variants and for elucidating the underlying mechanisms. Imaging data provide a viable IP for complex neurobehavioral disorders and have been extensively used to investigate both morphological, structural and functional brain abnormalities in DD. Performing joint genetic and neuroimaging studies in humans is an emerging strategy to link DD-candidate genes to the brain structure and function. A limited number of studies has already pursued the imaging-genetics integration in DD. However, the results are still not sufficient to unravel the complexity of the reading circuit due to heterogeneous study design and data processing. Here, we propose an interdisciplinary, multilevel, imaging-genetic approach to disentangle the pathways from genes to behavior. As the presence of putative functional genetic variants has been provided and as genetic associations with specific cognitive/sensorial mechanisms have been reported, new hypothesis-driven imaging-genetic studies must gain momentum. This approach would lead to the optimization of diagnostic criteria and to the early identification of 'biologically at-risk' children, supporting the definition of adequate and well-timed prevention strategies and the implementation of novel, specific remediation approach.

Phonetic recalibration of speech by text

Listeners adjust their phonetic categories to cope with variations in the speech signal (phonetic recalibration). Previous studies have shown that lipread speech (and word knowledge) can adjust the perception of ambiguous speech and can induce phonetic adjustments (Bertelson, Vroomen, & de Gelder in Psychological Science, 14(6), 592–597, 2003; Norris, McQueen, & Cutler in Cognitive Psychology, 47(2), 204–238, 2003). We examined whether orthographic information (text) also can induce phonetic recalibration. Experiment 1 showed that after exposure to ambiguous speech sounds halfway between /b/ and /d/ that were combined with text (b or d) participants were more likely to categorize auditory-only test sounds in accordance with the exposed letters. Experiment 2 replicated this effect with a very short exposure phase. These results show that listeners adjust their phonetic boundaries in accordance with disambiguating orthographic information and that these adjustments show a rapid build-up.

Neural initialization of audiovisual integration in prereaders at varying risk for developmental dyslexia

Learning letter-speech sound correspondences is a major step in reading acquisition and is severely impaired in children with dyslexia. Up to now, it remains largely unknown how quickly neural networks adopt specific functions during audiovisual integration of linguistic information when prereading children learn letter-speech sound correspondences. Here, we simulated the process of learning letter-speech sound correspondences in 20 prereading children (6.13-7.17 years) at varying risk for dyslexia by training artificial letter-speech sound correspondences within a single experimental session. Subsequently, we acquired simultaneously event-related potentials (ERP) and functional magnetic resonance imaging (fMRI) scans during implicit audiovisual presentation of trained and untrained pairs. Audiovisual integration of trained pairs correlated with individual learning rates in right superior temporal, left inferior temporal, and bilateral parietal areas and with phonological awareness in left temporal areas. In correspondence, a differential left-lateralized parietooccipitotemporal ERP at 400 ms for trained pairs correlated with learning achievement and familial risk. Finally, a late (650 ms) posterior negativity indicating audiovisual congruency of trained pairs was associated with increased fMRI activation in the left occipital cortex. Taken together, a short (<30 min) letter-speech sound training initializes audiovisual integration in neural systems that are responsible for processing linguistic information in proficient readers. To conclude, the ability to learn grapheme-phoneme correspondences, the familial history of reading disability, and phonological awareness of prereading children account for the degree of audiovisual integration in a distributed brain network. Such findings on emerging linguistic audiovisual integration could allow for distinguishing between children with typical and atypical reading development. Hum Brain Mapp 38:1038-1055, 2017. © 2016 Wiley Periodicals, Inc.

Are the literacy difficulties that characterize developmental dyslexia associated with a failure to integrate letters and speech sounds?

The ‘automatic letter‐sound integration hypothesis’ (Blomert, 2011) proposes that dyslexia results from a failure to fully integrate letters and speech sounds into automated audio‐visual objects. We tested this hypothesis in a sample of English‐speaking children with dyslexic difficulties (N = 13) and samples of chronological‐age‐matched (CA; N = 17) and reading‐age‐matched controls (RA; N = 17) aged 7–13 years. Each child took part in two priming experiments in which speech sounds were preceded by congruent visual letters (congruent condition) or Greek letters (baseline). In a behavioural experiment, responses to speech sounds in the two conditions were compared using reaction times. These data revealed faster reaction times in the congruent condition in all three groups. In a second electrophysiological experiment, responses to speech sounds in the two conditions were compared using event‐related potentials (ERPs). These data revealed a significant effect of congruency on (1) the P1 ERP over left frontal electrodes in the CA group and over fronto‐central electrodes in the dyslexic group and (2) the P2 ERP in the dyslexic and RA control groups. These findings suggest that our sample of English‐speaking children with dyslexic difficulties demonstrate a degree of letter‐sound integration that is appropriate for their reading level, which challenges the letter‐sound integration hypothesis.

A Randomized Controlled Trial on The Beneficial Effects of Training Letter-Speech Sound Integration on Reading Fluency in Children with Dyslexia

A recent account of dyslexia assumes that a failure to develop automated letter-speech sound integration might be responsible for the observed lack of reading fluency. This study uses a pre-test-training-post-test design to evaluate the effects of a training program based on letter-speech sound associations with a special focus on gains in reading fluency. A sample of 44 children with dyslexia and 23 typical readers, aged 8 to 9, was recruited. Children with dyslexia were randomly allocated to either the training program group (n = 23) or a waiting-list control group (n = 21). The training intensively focused on letter-speech sound mapping and consisted of 34 individual sessions of 45 minutes over a five month period. The children with dyslexia showed substantial reading gains for the main word reading and spelling measures after training, improving at a faster rate than typical readers and waiting-list controls. The results are interpreted within the conceptual framework assuming a multisensory integration deficit as the most proximal cause of dysfluent reading in dyslexia.

TRIAL REGISTRATION

ISRCTN register ISRCTN12783279.