Comorbidity and cognitive overlap between developmental dyslexia and congenital amusia in children

Do early musical impairments predict later reading difficulties? A longitudinal study of pre-readers with and without familial risk for dyslexia

The present longitudinal study investigated the hypothesis that early musical skills (as measured by melodic and rhythmic perception and memory) predict later literacy development via a mediating effect of phonology. We examined 130 French-speaking children, 31 of whom with a familial risk for developmental dyslexia (DD). Their abilities in the three domains were assessed longitudinally with a comprehensive battery of behavioral tests in kindergarten, first grade, and second grade. Using a structural equation modeling approach, we examined potential longitudinal effects from music to literacy via phonology. We then investigated how familial risk for DD may influence these relationships by testing whether atypical music processing is a risk factor for DD. Results showed that children with a familial risk for DD consistently underperformed children without familial risk in music, phonology, and literacy. A small effect of musical ability on literacy via phonology was observed, but may have been induced by differences in stability across domains over time. Furthermore, early musical skills did not add significant predictive power to later literacy difficulties beyond phonological skills and family risk status. These findings are consistent with the idea that certain key auditory skills are shared between music and speech processing, and between DD and congenital amusia. However, they do not support the notion that music perception and memory skills can serve as a reliable early marker of DD, nor as a valuable target for reading remediation. RESEARCH HIGHLIGHTS: Music, phonology, and literacy skills of 130 children, 31 of whom with a familial risk for dyslexia, were examined longitudinally. Children with a familial risk for dyslexia consistently underperformed children without familial risk in musical, phonological, and literacy skills. Structural equation models showed a small effect of musical ability in kindergarten on literacy in second grade, via phonology in first grade. However, early musical skills did not add significant predictive power to later literacy difficulties beyond phonological skills and family risk status.

Do developmental dyslexia and congenital amusia share underlying impairments?

Developmental dyslexia and congenital amusia have common characteristics. Yet, their possible association in some individuals has been addressed only scarcely. Recently, two converging studies reported a sizable comorbidity rate between these two neurodevelopmental disorders (Couvignou et al., Cognitive Neuropsychology 2019; Couvignou & Kolinsky, Neuropsychologia 2021). However, the reason for their association remains unclear. Here, we investigate the hypothesis of shared underlying impairments between dyslexia and amusia. Fifteen dyslexic children with amusia (DYS+A), 15 dyslexic children without amusia (DYS-A), and two groups of 25 typically developing children matched on either chronological age (CA) or reading level (RL) were assessed with a behavioral battery aiming to investigate phonological and pitch processing capacities at auditory memory, perceptual awareness, and attentional levels. Overall, our results suggest that poor auditory serial-order memory increases susceptibility to comorbidity between dyslexia and amusia and may play a role in the development of the comorbid phenotype. In contrast, the impairments observed in the DYS+A children for auditory item memory, perceptual awareness, and attention might be a consequence of their reduced reading experience combined with weaker musical skills. Comparing DYS+A and DYS-A children suggests that the latter are more resourceful and/or have more effective compensatory strategies, or that their phenotype results from a different developmental trajectory. We will discuss the relevance of these findings for delving into the etiology of these two developmental disorders and address their implications for future research and practice.

Auditory cortex and beyond: Deficits in congenital amusia

Congenital amusia is a neuro-developmental disorder of music perception and production, with the observed deficits contrasting with the sophisticated music processing reported for the general population. Musical deficits within amusia have been hypothesized to arise from altered pitch processing, with impairments in pitch discrimination and, notably, short-term memory. We here review research investigating its behavioral and neural correlates, in particular the impairments at encoding, retention, and recollection of pitch information, as well as how these impairments extend to the processing of pitch cues in speech and emotion. The impairments have been related to altered brain responses in a distributed fronto-temporal network, which can be observed also at rest. Neuroimaging studies revealed changes in connectivity patterns within this network and beyond, shedding light on the brain dynamics underlying auditory cognition. Interestingly, some studies revealed spared implicit pitch processing in congenital amusia, showing the power of implicit cognition in the music domain. Building on these findings, together with audiovisual integration and other beneficial mechanisms, we outline perspectives for training and rehabilitation and the future directions of this research domain.

Explicit processing of melodic structure in congenital amusia can be improved by redescription-associate learning

Congenital amusia is a neurodevelopmental disorder of musical processing. Previous research demonstrates that although explicit musical processing is impaired in congenital amusia, implicit musical processing can be intact. However, little is known about whether implicit knowledge could improve explicit musical processing in individuals with congenital amusia. To this end, we developed a training method utilizing redescription-associate learning, aiming at transferring implicit representations of perceptual states into explicit forms through verbal description and then establishing the associations between the perceptual states reported and responses via feedback, to investigate whether the explicit processing of melodic structure could be improved in individuals with congenital amusia. Sixteen amusics and 11 controls rated the degree of expectedness of melodies during EEG recording before and after training. In the interim, half of the amusics received nine training sessions on melodic structure, while the other half received no training. Results, based on effect size estimation, showed that at pretest, amusics but not controls failed to explicitly distinguish the regular from the irregular melodies and to exhibit an ERAN in response to the irregular endings. At posttest, trained but not untrained amusics performed as well as controls at both the behavioral and neural levels. At the 3-month follow-up, the training effects still maintained. These findings present novel electrophysiological evidence of neural plasticity in the amusic brain, suggesting that redescription-associate learning may be an effective method to remediate impaired explicit processes for individuals with other neurodevelopmental disorders who have intact implicit knowledge.

The Perception of Lexical Tone and Intonation in Whispered Speech by Mandarin-Speaking Congenital Amusics

PURPOSE

A fundamental feature of human speech is variation, including the manner of phonation, as exemplified in the case of whispered speech. In this study, we employed whispered speech to examine an unresolved issue about congenital amusia, a neurodevelopmental disorder of musical pitch processing, which also affects speech pitch processing such as lexical tone and intonation perception. The controversy concerns whether amusia is a pitch-processing disorder or can affect speech processing beyond pitch.

METHOD

We examined lexical tone and intonation recognition in 19 Mandarin-speaking amusics and 19 matched controls in phonated and whispered speech, where fundamental frequency (f _o) information is either present or absent.

RESULTS

The results revealed that the performance of congenital amusics was inferior to that of controls in lexical tone identification in both phonated and whispered speech. These impairments were also detected in identifying intonation (statements/questions) in phonated and whispered modes. Across the experiments, regression models revealed that f _o and non-f _o (duration, intensity, and formant frequency) acoustic cues predicted tone and intonation recognition in phonated speech, whereas non-f _o cues predicted tone and intonation recognition in whispered speech. There were significant differences between amusics and controls in the use of both f _o and non-f _o cues.

CONCLUSION

The results provided the first evidence that the impairments of amusics in lexical tone and intonation identification prevail into whispered speech and support the hypothesis that the deficits of amusia extend beyond pitch processing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19302275.

The relationship between acoustic and musical pitch processing in adolescents

Amusia is defined as a difficulty processing the tonal pitch structure of music such that an individual cannot tell the difference between notes that are in-key and out-of-key. A fine-grained pitch discrimination deficit is often observed in people with amusia. It is possible that an intervention, early in development, could mitigate amusia; however, one challenge identifying amusia early in development is that identifying in- and out-of-key notes is a meta-cognitive task. Given the common co-occurrence of difficulties with pitch discrimination, it would be easier to identify amusia in developing children by using a pitch change detection task. The goal of this study was to explore the behavioural and neurophysiological profiles of adolescents with poor pitch processing (Poor PP) abilities compared to those with normal pitch processing (Normal PP) abilities. Neurophysiologically, the Poor PPs exhibited a similar event-related potential (ERP) profile to adult amusics during both acoustic and musical pitch discrimination tasks. That is, early ERPs (ERAN, MMN) were similar in Poor PPs compared to Normal PPs, while late positivities (P300, P600) were absent in Poor PPs, but present in Normal PPs. At the same time behavioural data revealed a double dissociation between the abilities to detect a pitch deviant in acoustic and musical context, suggesting that about a third of the children would be missed by selecting a fine-grained acoustic pitch discrimination task to identify the presence of amusia in early childhood.

Development of auditory cognition in 5- to 10-year-old children: Focus on musical and verbal short-term memory

Developmental aspects of auditory cognition were investigated in 5-to-10-year-old children (n = 100). Musical and verbal short-term memory (STM) were assessed by means of delayed matching-to-sample tasks (DMST) (comparison of two four-item sequences separated by a silent retention delay), with two levels of difficulty. For musical and verbal materials, children's performance increased from 5 years to about 7 years of age, then remained stable up to 10 years of age, with performance remaining inferior to performance of young adults. Children and adults performed better with verbal material than with musical material. To investigate auditory cognition beyond STM, we assessed speech-in-noise perception with a four-alternative forced-choice task with two conditions of phonological difficulty and two levels of cocktail-party noise intensity. Partial correlations, factoring out the effect of age, showed a significant link between musical STM and speech-in-noise perception in the condition with increased noise intensity. Our findings reveal that auditory STM improves over development with a critical phase around 6-7 years of age, yet these abilities appear to be still immature at 10 years. Musical and verbal STM might in particular share procedural and serial order processes. Furthermore, musical STM and the ability to perceive relevant speech signals in cocktail-party noise might rely on shared cognitive resources, possibly related to pitch encoding. To the best of our knowledge, this is the first time that auditory STM is assessed with the same paradigm for musical and verbal material during childhood, providing perspectives regarding diagnosis and remediation in developmental learning disorders.

Congenital amusia-pathology of musical disorder

Amusia also known as tone deafness affects roughly 1.5% population. Congenital amusia appears from birth and lasts over life span. Usually, it is not associated with other diseases. Its link to hearing impairment has been definitively excluded. Neurobiological studies point to asymmetrical processing of musical signals in auditory cortex of left and right brain hemispheres. The finding was supported by discovering microlesions in the right-side gray matter. Because of its connection with asymmetry, amusia has been classified to disconnection syndromes. Alternatively to the neurobiological explanation of amusia background, an attention was turned to the significance of genetic factors. The studies done on relatives and twins indicated familial aggregation of amusia. Molecular genetic investigations linked amusia with deletion of 22q11.2 chromosome region. Until now no specific genes responsible for development of amusia were found.