Executive functions in adults with developmental dyslexia

The Impact of Metaphors on Academic Text Comprehension: The Case of Students With Dyslexia

Metaphor has long been used by scholars to make concepts more comprehensible. However, this use of figurative language has never been investigated in relation to the way students with dyslexia learn from academic texts. This study aims to assess the impact of metaphors on overall academic text comprehension in university students with and without dyslexia. Excerpts from scientific articles containing metaphors were adapted to be presented in two comparable conditions: metaphorical and literal. Legibility indexes were controlled for to guarantee the same difficulty between conditions. Twenty-eight students with dyslexia and thirty students without dyslexia underwent a multiple-choice comprehension task for two texts, one for each condition, and provided evaluations of text perception. A standardised assessment of general reading comprehension and cognitive abilities, such as reading speed, reading accuracy, and working memory was conducted. Data revealed that, when reading ability was controlled for, students with dyslexia presented significantly lower comprehension scores only in texts containing metaphors, despite comparable perceived complexity and increased interest in metaphorical texts. These findings suggest that metaphors used in educational discourse may not be entirely inclusive, as they seem to impose additional cognitive demands on students with dyslexia.

Goal attainment in individual and group-based neuropsychological interventions for young adults with dyslexia in a randomized controlled trial

In this study, we investigated the outcome of goal attainment in individual and group-based neuropsychological intervention for young adults with dyslexia. Participants (N = 120) were randomly assigned to individual intervention, group intervention, or wait-list control group. Attainment of goals set personally before the intervention was evaluated after the intervention using Goal Attainment Scaling. The participants were asked to report the number of concrete changes made in their study or working habits at five months (after intervention or wait-list control time), at ten months, and 15 months post-interventions. Potential predictive factors for predicting goal attainment were evaluated including background and cognitive variables, self-reported psychological variables (mood, cognitive and behavioral strategies, self-esteem, quality of life), and self-reported behavioral variables (concrete changes made, time used to work on intervention matters). Based on the results, personal goals were, on average, met especially in individual intervention. Nearly 50% of goal attainment was explained by intervention type, behavioral and cognitive strategies, concrete changes made, cognitive capacity, and used time. Concrete changes, e.g., adopting new strategies and methods in study or working habits, were reported in both interventions and more than during the wait-list control period. The changes seemed long-lasting as fifteen months post-intervention, 76.4% reported still using the learned strategies. A structured and relatively short neuropsychological intervention for dyslexia in either individual or group format can lead to attaining pre-set personal goals and positive behavioral changes that can last up to over a year post-intervention.

Low literacy skills in adults can be largely explained by basic linguistic and domain-general predictors

Introduction

Despite having sufficient formal education, a large group of people cannot complete everyday tasks like reading, writing, or making basic calculations. Regarding reading, millions of people are not able to understand more complex texts despite the ability to read simple words or sentences; they have low literacy skills. Even though this problem has been known for decades, the causes and predictors of their poor reading comprehension skills are not fully explored. Socioeconomic, sociodemographic, and reading-related (i.e., linguistic) factors, especially of English-speaking participants and thus users of an opaque orthography, were often assessed. The goal of this study was to examine which linguistic, domain-general, or numerical factors predict substandard complex text reading as the core symptom of low literacy skills in adulthood.

Methods

To this end, we assessed a group of German-speaking participants-users of a transparent orthography-who are at risk for complex text reading deficits.

Results

The results indicated that linguistic variables (reduced word/pseudoword reading, weaker oral semantic and grammatical comprehension), working memory, and age predicted lower performance in text comprehension. This model explained 73% of the total variance, indicating that most of the deficits in complex text reading can be explained by a group of basic underlying linguistic and domain-general factors.

Discussion

We conclude that interventions for adults with low literacy skills and others at risk for complex text reading deficits should address word/pseudoword reading and focus on both written and oral comprehension.

Automatic metaphor processing in developmental dyslexia

INTRODUCTION

Previous research found metaphor impairments with dyslexia; however, it is unclear if difficulties are due to initial activation of the metaphorical meaning or to subsequent discourse integration processes. The study examines the presence of early automatic processing of metaphors in adults with developmental dyslexia, considering the role of executive functions and metaphor familiarity.

METHODS

Using a sentence recall task and a semantic judgment task from the Metaphor Interference Effect (MIE) paradigm, we evaluated two early stages of metaphor comprehension, namely the generation of the figurative meaning and the suppression of the literal meaning. High and low familiar metaphors, and their scrambled counterparts, were aurally presented to participants, who were asked to judge whether sentences were literally true or literally false. Afterwards, they were provided ten minutes to recall the sentences they heard to verify the depth of processing for each type of stimulus. A total of 26 participants with dyslexia were included in the experimental group, and 31 in the control group.

RESULTS

Individuals with dyslexia showed a MIE and an accuracy rate that are similar to participants without dyslexia. Inhibition correlated with the MIE size only for high familiar metaphors, and working memory seemed to play no role in the process. In the recall task, both groups demonstrated a better encoding of the metaphorical sentences compared to scrambled metaphors, but participants with dyslexia recalled less metaphors than did the control group, showing that metaphors are no exception to the limitations in sentence retrieval typically found in dyslexia.

CONCLUSIONS

Our findings suggest that individuals with dyslexia are comparable to participants without dyslexia in their ability to automatically compute metaphorical meanings. Thus, difficulties in metaphor comprehension in people with dyslexia that have been detected in previous studies might depend on meaning construction in context rather than online semantic processing.

Hot and cool executive function and theory of mind in children with and without specific learning disorders

Executive function (EF) in specific learning disorders (SLD) has been investigated using mainly cool EF tasks, whilst less is known about hot EF and theory of mind (ToM) in this population. The aim of this study was to examine group differences in hot and cool EF and ToM in school-aged children with SLD relative to typically developing peers. It also attempted to investigate whether EF measures are significant predictors of ToM in SLD and typical development. Cross-sectional data were collected from 135 school-aged children with and without SLD (8-10 years old), tested on measures of cool & hot EF and ToM. Significant group differences were observed in EFs inhibition (p= .04), working memory (p= .04) and delay of gratification (p < .001), as well as ToM mental state/emotion recognition (p = .019). Inhibition and planning contributed to 22% of the explained variance of ToM mental state/emotion recognition, but not false belief overall. Results suggest that cool EF may be a crucial predictor of ToM in children with and without SLD. Finally, stepwise logistic regression analysis identified specific hot EF and ToM measures contributing to group differentiation, specifically delay of gratification (odds ratio=.995, 95% CI [.993-.998]) and mental state/emotion recognition (odds ratio= .89, 95% CI [.796-.995]). This study contributes to our understanding of cognitive deficits and socio-cognitive impairment in children with SLD, which hold promise for informing interventions aimed at addressing these cognitive challenges.

The ReadFree tool for the identification of poor readers: a validation study based on a machine learning approach in monolingual and minority-language children

In this study, we validated the "ReadFree tool", a computerised battery of 12 visual and auditory tasks developed to identify poor readers also in minority-language children (MLC). We tested the task-specific discriminant power on 142 Italian-monolingual participants (8-13 years old) divided into monolingual poor readers (N = 37) and good readers (N = 105) according to standardised Italian reading tests. The performances at the discriminant tasks of the "ReadFree tool" were entered into a classification and regression tree (CART) model to identify monolingual poor and good readers. The set of classification rules extracted from the CART model were applied to the MLC's performance and the ensuing classification was compared to the one based on standardised Italian reading tests. According to the CART model, auditory go-no/go (regular), RAN and Entrainment100bpm were the most discriminant tasks. When compared with the clinical classification, the CART model accuracy was 86% for the monolinguals and 76% for the MLC. Executive functions and timing skills turned out to have a relevant role in reading. Results of the CART model on MLC support the idea that ad hoc standardised tasks that go beyond reading are needed.

Improving validity of the trail making test with alphabet support

Objective

The Trail Making Test (TMT) is commonly used worldwide to evaluate cognitive decline and car driving ability. However, it has received critique for its dependence on the Latin alphabet and thus, the risk of misclassifying some participants. Alphabet support potentially increases test validity by avoiding misclassification of executive dysfunction in participants with dyslexia and those with insufficient automatization of the Latin alphabet. However, Alphabet support might render the test less sensitive to set-shifting, thus compromising the validity of the test. This study compares two versions of the TMT: with and without alphabet support.

Methods

We compared the TMT-A, TMT-B, and TMT-B:A ratios in two independent normative samples with (n = 220) and without (n = 64) alphabet support using multiple regression analysis adjusted for age and education. The sample comprised Scandinavians aged 70-84 years. Alphabet support was included by adding the Latin alphabet A-L on top of the page on the TMT-B. We hypothesized that alphabet support would not change the TMT-B:A ratio.

Results

After adjusting for age and years of education, there were no significant differences between the two samples in the TMT-A, TMT-B, or the ratio score (TMT-B:A).

Conclusion

Our results suggest that the inclusion of alphabet support does not alter TMT's ability to measure set-shifting in a sample of older Scandinavian adults.

Prenatal organophosphate ester exposure and executive function in Norwegian preschoolers

Organophosphate esters (OPEs) are ubiquitous chemicals, used as flame retardants and plasticizers. OPE usage has increased over time as a substitute for other controlled compounds. This study investigates the impact of prenatal OPE exposure on executive function (EF) in preschoolers.

Methods

We selected 340 preschoolers from the Norwegian Mother, Father, and Child Cohort Study. Diphenyl-phosphate (DPhP), di-n-butyl-phosphate (DnBP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) were measured in maternal urine. EF was measured using the Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P) and the Stanford-Binet fifth edition (SB-5). EF scores were scaled so a higher score indicated worse performance. We estimated exposure-outcome associations and evaluated modification by child sex using linear regression.

Results

Higher DnBP was associated with lower EF scores across multiple rater-based domains. Higher DPhP and BDCIPP were associated with lower SB-5 verbal working memory (β = 0.49, 95% CI = 0.12, 0.87; β = 0.53, 95% CI = 0.08, 1.02), and higher BBOEP was associated with lower teacher-rated inhibition (β = 0.34, 95% CI = 0.01, 0.63). DPhP was associated with lower parent-reported BRIEF-P measures in boys but not girls [inhibition: boys: 0.37 (95% CI = 0.03, 0.93); girls: -0.48 (95% CI = -1.27, 0.19); emotional control: boys: 0.44 (95% CI = -0.13, 1.26); girls: -0.83 (95% CI = -1.73, -0.00); working memory: boys: 0.49 (95% CI = 0.03, 1.08); girls: -0.40 (95% CI = -1.11, 0.36)]. Fewer sex interactions were observed for DnBP, BBOEP, and BDCIPP, with irregular patterns observed across EF domains.

Conclusions

We found some evidence prenatal OPE exposure may impact EF in preschoolers and variation in associations by sex.

Animal models of developmental dyslexia

As some critics have stated, the term "developmental dyslexia" refers to a strictly human disorder, relating to a strictly human capacity - reading - so it cannot be modeled in experimental animals, much less so in lowly rodents. However, two endophenotypes associated with developmental dyslexia are eminently suitable for animal modeling: Cerebral Lateralization, as illustrated by the association between dyslexia and non-righthandedness, and Cerebrocortical Dysfunction, as illustrated by the described abnormal structural anatomy and/or physiology and functional imaging of the dyslexic cerebral cortex. This paper will provide a brief review of these two endophenotypes in human beings with developmental dyslexia and will describe the animal work done in my laboratory and that of others to try to shed light on the etiology of and neural mechanisms underlying developmental dyslexia. Some thought will also be given to future directions of the research.

Self-reported symptoms of developmental dyslexia predict impairments in everyday cognition in adults

BACKGROUND

Research into the impact of dyslexia on everyday cognition in adults with dyslexia is relatively limited and has tended to focus on university students.

AIMS AND METHODS

The present online study aimed to add to this small corpus by investigating the everyday effects of dyslexia on memory and attention in a larger community-based sample. One hundred and seventy-two adult volunteers completed five well-established self-report questionnaires, assessing dyslexia and Attention Deficit Hyperactivity Disorder symptomatology and everyday experiences with memory, attention, and mind-wandering.

RESULTS

After controlling for ADHD symptomatology, hierarchical regression analyses revealed that higher levels of dyslexia-related symptomatology were associated with greater, more frequent everyday memory and attentional problems, but not with a greater propensity to mind-wandering. Increased levels of dyslexia symptomatology were positively associated with the frequency of both everyday attentional lapses (at least when performing a pair of tasks or easy tasks while inhibiting intervening stimuli) and everyday memory failures. No significant associations were found between dyslexia symptomatology and attentional lapses when performing difficult tasks in the presence of concurrent stimuli or between dyslexia symptomatology and the propensity to mind-wandering.

CONCLUSIONS AND IMPLICATIONS

Dyslexia symptomatology was perceived as being associated with more everyday memory and attention problems in adulthood. Adjustments to educational and workplace settings and interventions to compensate for these difficulties are proposed.

Specific learning disorders in young adults: Investigating pragmatic abilities and their relationship with theory of mind, executive functions and quality of life

BACKGROUND

Specific Learning Disorders (SLD) are lifelong conditions often associated with language difficulties, executive dysfunctions, and psychological problems. Previous research has shown that communicative-pragmatic ability may be impaired in SLD. However, the role of other cognitive abilities in explaining pragmatic difficulties has still not been fully investigated. The relationship between pragmatics and quality of life is not yet clear, as well.

AIMS

Firstly, the study assessed pragmatic comprehension abilities in adults with SLD. Secondly, we examined the relationship between pragmatics, theory of mind, executive functions and quality of life.

METHOD AND PROCEDURES

We enrolled 26 adults with SLD and 30 adults without SLD. Standardized tests assessing pragmatic comprehension, theory of mind and executive functions were used. The quality of life was investigated with a self-reported questionnaire.

OUTCOMES AND RESULTS

Pragmatic comprehension abilities were compromised in young adults with SLD. In this clinical population we also found a link between pragmatic comprehension and visual theory of mind. Finally, independently from the presence of SLD, pragmatics abilities were in relationship with quality of life.

CONCLUSIONS AND IMPLICATIONS

Overall, these data highlight the importance of including pragmatic abilities both in the clinical evaluation, as well as in psychological intervention for adults with SLD.

Structural white matter characteristics for working memory and switching/inhibition in children with reading difficulties: The role of the left superior longitudinal fasciculus

Reading difficulties (RDs) are characterized by slow and inaccurate reading as well as additional challenges in cognitive control (i.e., executive functions, especially in working memory, inhibition, and visual attention). Despite evidence demonstrating differences in these readers' language and visual processing abilities, white matter differences associated with executive functions (EFs) difficulties in children with RDs are scarce. Structural correlates for reading and EFs in 8- to 12-year-old children with RDs versus typical readers (TRs) were examined using diffusion tensor imaging (DTI) data. Results suggest that children with RDs showed significantly lower reading and EF abilities versus TRs. Lower fractional anisotropy (FA) in left temporo-parietal tracts was found in children with RDs, who also showed positive correlations between reading and working memory and switching/inhibition scores and FA in the left superior longitudinal fasciculus (SLF). FA in the left SLF predicted working memory performance mediated by reading ability in children with RDs but not TRs. Our findings support alterations in white matter tracts related to working memory, switching/inhibition, and overall EF challenges in children with RDs and the linkage between working memory difficulties and FA alterations in the left SLF in children with RDs via reading.

Cyberbullying and empathy among elementary school students: Do special educational needs make a difference?

The present study investigates involvement in cyberbullying and empathy skills, as well as the relationship between the two among general education sixth grade elementary school students with and without special educational needs (SEN). Specifically, 120 students with SEN (Autistic Spectrum Disorder-ASD, Attention Deficit Hyperactivity Disorder-ADHD, learning disabilities) and 120 students without SEN from 29 randomly selected schools of the second biggest city in Greece completed a self-report questionnaire, which included a short version of the "Cyberbullying Questionnaire" (Smith et al., An investigation into cyber bullying, its forms, awareness and impact, and the relationship between age and gender in cyber bullying. A report to the Anti-Bullying Alliance. Unit for School and Family Studies, 2006) and the "Basic Empathy Scale"-BES (Jolliffe & Farrington, 2006, J Adolesc, 29:589, 2006). The results showed that, regardless of gender, involvement in cyberbullying (as victims/bullies) concerned primarily students with SEN, mainly those with ASD and ADHD. Accordingly, students with SEN and mostly those with ASD expressed lower affective and cognitive empathy compared to the rest of the students. Finally, for all the participating students both affective and cognitive empathy negatively predicted engagement in cyberbullying (as victims/bullies). Implications for preventive actions in elementary education, and especially for children with SEN, are discussed in detail.

The relationship between cognitive control and lexical conflict resolution in developmental dyslexia

Previous studies have revealed that cognitive control functions contribute to the resolution of lexical interference. Both cognitive control (CC) deficits and reduced speed of lexical retrieval in Rapid Automatized Naming (RAN) tasks are characteristics of Developmental Dyslexia (DD), but it is still not fully understood how these deficits relate to each other and to reading problems. To examine this question, we tested adolescents with DD (n = 38), poor readers (PR; n = 25) and typical readers (TR; n = 33) matched on age and IQ, on CC functions with Stroop, Stop Signal, Simon, Backward Digit Span and n-back tasks and on lexical retrieval and lexical conflict resolution with RAN of pictures in semantically homogeneous vs. mixed trials. As expected, in the blocked RAN Task DD individuals showed longer naming times and a greater effect of lexical conflict resolution (indexed by difference scores of naming times in the homogeneous and mixed conditions) than TR participants. We also found significant group differences (TR = PR > DD) in CC measures. Naming time was associated with CC, while the lexical interference effect did not show any association with this set of abilities. These findings suggest that DD individuals show impairments in multiple cognitive functions, such as cognitive control, lexical retrieval and lexical conflict resolution. Our results also suggest that CC functions are involved in lexical retrieval, but we have not found evidence for their involvement in lexical conflict resolution processes.

Automaticity and Executive Abilities in Developmental Dyslexia: A Theoretical Review

Cognitive difficulties are well documented in developmental dyslexia but they present a challenge to dyslexia theory. In this paper, the Model of the Control of Action is proposed as a theoretical explanation of how and why deficits in both automaticity and executive abilities are apparent in the cognitive profiles of dyslexia and how these deficits might relate to literacy difficulties. This theoretical perspective is used to consider evidence from different cognitive domains. The neuroanatomical underpinnings of automaticity and executive abilities are then discussed in relation to the understanding of dyslexia. Links between reading, writing, and executive function are considered. The reviewed evidence suggests that dyslexia theory should consider an interaction between procedural learned behaviour (automaticity) and higher-order (executive) abilities. The capacity to handle environmental interference, develop and engage adaptive strategies accordingly, and plan actions all require interactions between the cerebellum and the prefrontal cortex (PFC). Difficulties in these areas might explain both impairments in the cumulative development of literacy skills in childhood and general task management in everyday life in adulthood. It is suggested that improved measures are required to assess this cerebellar–PFC interaction and to allow early identification of future literacy difficulties, allowing implementation of timely interventions and reasonable adjustments.

Learning and Attention Deficit/Hyperactivity Disorders as Risk Factors for Prolonged Concussion Recovery in Children and Adolescents

OBJECTIVE

Examine pre-existing learning disorders (LD) and attention deficit/hyperactivity disorders (ADHD) as risk factors for prolonged recovery and increased symptomology following pediatric mild traumatic brain injury (mTBI).

METHODS

We conducted a retrospective cohort study of children/adolescents (5-17 years) with mTBI who presented to a Children's Minnesota Concussion Clinic between April 2018 and March 2019. Differences across strata of pre-existing conditions (present vs. absent) in time to recovery measures were estimated via Kaplan-Meier and Cox proportional hazards analyses and differences in symptom trajectories were examined via linear mixed-effects regression models. Regression models were adjusted for age, sex and other confounders.

RESULTS

In our cohort of 680 mTBI patients, those with LD (n = 70) or ADHD (n = 107) experienced significantly longer median durations of symptoms (58 and 68 days, respectively) than those without (43 days). Accordingly, LD was significantly associated with delayed symptom recovery (adjusted hazard ratio (aHR) = 1.63, 95% CI: 1.16-2.29), return to school (1.47, 1.08-2.00), and return to physical activity (1.50, 1.10-2.04). Likewise, ADHD was associated with delayed recovery (1.69, 1.28-2.23), return to school (1.52, 1.17-1.97) and physical activity (1.55, 1.19-2.01). Further, patients with LD or ADHD reported, on average, significantly more concussion symptoms and higher vision symptom scores throughout recovery versus those without. There was no evidence that concussion or vision symptom recovery trajectories varied over time between those with/without LD or ADHD (joint P-interactions > 0.05).

CONCLUSION

Pre-existing LD and ADHD are risk factors for prolonged and more symptomatic mTBI recovery in youth. These results can inform clinical concussion management and recovery expectations.

The role of visual attention in dyslexia: Behavioral and neurobiological evidence

Poor phonological processing has typically been considered the main cause of dyslexia. However, visuo‐attentional processing abnormalities have been described as well. The goal of the present study was to determine the involvement of visual attention during fluent reading in children with dyslexia and typical readers. Here, 75 children (8–12 years old; 36 typical readers, 39 children with dyslexia) completed cognitive and reading assessments. Neuroimaging data were acquired while children performed a fluent reading task with (a) a condition where the text remained on the screen (Still) versus (b) a condition in which the letters were being deleted (Deleted). Cognitive assessment data analysis revealed that visual attention, executive functions, and phonological awareness significantly contributed to reading comprehension in both groups. A seed‐to‐voxel functional connectivity analysis was performed on the fluency functional magnetic resonance imaging task. Typical readers showed greater functional connectivity between the dorsal attention network and the left angular gyrus while performing the Still and Deleted reading tasks versus children with dyslexia. Higher connectivity values were associated with higher reading comprehension. The control group showed increased functional connectivity between the ventral attention network and the fronto‐parietal network during the Deleted text condition (compared with the Still condition). Children with dyslexia did not display this pattern. The results suggest that the synchronized activity of executive, visual attention, and reading‐related networks is a pattern of functional integration which children with dyslexia fail to achieve. The present evidence points toward a critical role of visual attention in dyslexia.

Strategies to Enhance Comprehension in the Healthcare Setting for Patients With Dyslexia

Dyslexia involves extreme difficulty with reading, writing, and spelling in your native language despite at least average intelligence. Health literacy refers to the ability to read, understand, and use health information to make appropriate health decisions. Dyslexia is rarely mentioned as a contributing factor to health literacy. Medical providers should be more aware of the special needs of dyslexic patients and implement interventions to allow them to successfully navigate the healthcare environment.

Neuro-Behavioral Correlates of Executive Dysfunctions in Dyslexia Over Development From Childhood to Adulthood

Dyslexia is a neurobiological learning disability in the reading domain that has symptoms in early childhood and persists throughout life. Individuals with dyslexia experience difficulties in academia and cognitive and emotional challenges that can affect wellbeing. Early intervention is critical to minimize the long-term difficulties of these individuals. However, the behavioral and neural correlates which predict dyslexia are challenging to depict before reading is acquired. One of the precursors for language and reading acquisition is executive functions (EF). The present review aims to highlight the current atypicality found in individuals with dyslexia in the domain of EF using behavioral measures, brain mapping, functional connectivity, and diffusion tensor imaging along development. Individuals with dyslexia show EF abnormalities in both behavioral and neurobiological domains, starting in early childhood that persist into adulthood. EF impairment precedes reading disability, therefore adding an EF assessment to the neuropsychological testing is recommended for early intervention. EF training should also be considered for the most comprehensive outcomes.

Working memory profiles of children with reading difficulties who are learning to read in Greek

This study investigated working memory skills in a small group of 13 nine-year-old Greek children facing reading difficulties and a group of 14 age matched typical Greek readers. The children were assessed on working memory tasks measuring separately the four components of the working memory model of Baddeley and Hitch (1974) as revised by Baddeley (2000): the phonological loop, visuo-spatial sketchpad, episodic buffer and central executive. Both groups completed tests of accuracy of reading, speed of reading and text understanding. The children with reading difficulties performed significantly more poorly than typical readers on all aspects of working memory apart from visual-spatial short-term memory. These results indicate a similar verbal working memory impairment in Greek children with reading difficulties as in their English peers, despite the fact that they are learning to read a language with a transparent rather than an opaque orthography.

Stroop interference in children with developmental dyslexia: An event-related potentials study

Previous studies have identified inhibitory deficits in dyslexic children, but we have little understanding of their neural mechanisms, especially for Chinese children with developmental dyslexia.We used a double-blind controlled trial to study the electroencephalogram responses of dyslexic and non-dyslexic children when performing the Stroop color-word test.Behavioral data showed differences in response time and accuracy between the 2 groups. In the event-related potentials (ERP) results, dyslexic children displayed larger P2 and P3b on congruent trials, while non-dyslexic children displayed larger P2 and P3b on incongruent trials, the 2 groups showed opposite brain activation patterns on the Stroop test.Dyslexic children have poor inhibitory function, and this poor inhibition may be related to their abnormal brain activation patterns.

Statistical Learning and the Effect of Starting Small in Developmental Dyslexia

Purpose Impairments in statistical learning abilities of individuals with developmental dyslexia (DD) have been demonstrated in word segmentation and in visual artificial grammar learning (AGL) tasks, but so far, little attention has been devoted to the AGL abilities of this population in the acoustic verbal domain. This study aimed to test whether adolescents with dyslexia have difficulties in extracting abstract patterns from auditory sequences of nonsense syllables based on a finite state grammar relative to typically developing (TD) peers. We also tested whether incremental presentation of stimuli of different lengths (starting small) has a facilitating effect on learning complex structures in dyslexia (and in TD) as opposed to presenting strings in random order. Method Thirty-one adolescents with DD and 31 age-matched control participants completed an AGL task. Participants passively listened to acoustic sequences of nonsense syllables generated by an artificial grammar in the training phase. In the test phase, they were presented with pairs of novel grammatical and nongrammatical sequences and were required to decide which member of a sequence pair was more similar to the material heard during training. Results Performance levels and the proportion of learners were smaller in participants with DD than in the control group. While the starting small effect was nominally present both in performance levels and in the number of learners in participants with DD, but not in the group with TD, the presentation of strings in incremental order did not statistically improve learning performance in either group. Conclusion Our results suggest that (a) statistical learning of abstract sequences in the acoustic domain is less efficient in people with dyslexia than in TD controls and (b) while incremental presentation of stimuli of different length did not improve learning in our study, the observed pattern of results suggests that the effects of different training designs should be explored further in developmental disorders.

Dyslexia and syllogistic reasoning in adults: Differences in strategy usage

People with dyslexia have been found to prefer spatial over verbal strategies when performing word-based syllogistic reasoning tasks that require self-generated responses. The current research investigated whether this was also the case for pictorially based syllogisms, when responses were required to either concrete or abstract stimuli, and when multiple-choice answers were presented. Adults with and without dyslexia, matched for non-verbal ability, were presented with sets of isomorphic reasoning problems in which the stimuli were either concrete words, abstract words, concrete shapes or abstract pictograms. As expected, there was no group difference in reasoning accuracy. Unlike previous findings, the adults with dyslexia preferred to use a mixed verbal and spatial strategy and performed better with this strategy, while the individuals without dyslexia preferred a verbal strategy and performed more successfully when employing this strategy. The provision of answer options to facilitate strategic change in individuals with dyslexia is discussed.

Is executive dysfunction a potential contributor to the comorbidity between basic reading disability and attention-deficit/hyperactivity disorder?

Our study is one of the few to analyze executive functioning (EF) in a comprehensive, multi-modal fashion as a potential contributor to the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and basic reading disability (RD). We included multiple, traditional, neuropsychological measures of EF, along with the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire, to assess inhibit, shift, working memory (WM), planning, generation fluency, and problem-solving. Participants included 263 children, ages 8-12 years, with RD, ADHD, RD/ADHD, and typically developing controls. When using the traditional measures in a 2 × 2 MANCOVA, we found both RD and ADHD had poor cognitive EF in most areas at the group level, with phonological loop deficits being more specific to RD and behavioral regulation deficits being more specific to ADHD. Children with RD/ADHD performed comparably to those with RD and ADHD alone. Results were similar on the BRIEF. In contrast, only WM predicted both basic reading and inattention when the data were assessed in a continuous fashion. It also explained the correlations between basic reading and inattention, being worthy of longitudinal research to determine if it is a shared contributor to RD/ADHD. When comparing hypotheses as to the nature of RD/ADHD, we found the multiple deficit hypothesis was better supported by our EF data than the phenocopy hypothesis or the cognitive subtype hypothesis.

Holistic processing of Chinese characters in college students with dyslexia

Expert face recognition has long been marked by holistic processing. Hence, due to the many visual properties shared between face perception and Chinese characters, it has been suggested that Chinese character recognition may induce stronger holistic processing in expert readers than in novices. However, there have been different viewpoints presented about Chinese character recognition, one of which suggests that expertise in this skill involved reduced holistic processing which may be modulated by writing experiences/performances. In this study we examined holistic processing in Chinese character recognition in adults with and without dyslexia, using the complete composite paradigm. Our results showed that the adults with dyslexia recognized Chinese characters with a stronger holistic processing effect than the typical controls. It seems that those with dyslexia relied overly on the visual spatial information of characters and showed deficits in attending selectively to their components when processing Chinese characters, which hindered the development of expert reading and writing skills. This effect was in contrast to previous perceptual expertise studies in which reduced holistic processing marked deficits in face/visual object recognition. This study is also the first to show that Chinese adults with dyslexia had persistent below average performances in Chinese literacy.

Relationship Between Eye-Movement Patterns, Cognitive Load, and Reading Ability in Children with Reading Difficulties

Children with reading difficulties (RD) share challenges in executive functions (EF). Neurobiological correlates provide evidence for EF challenges during reading among these readers, but an online cognitive load detection mechanism has yet to be developed. Nevertheless, eye-movement tracking can provide online data of reading patterns (pupil dilation, fixations) and, indeed, atypical eye-movement patterns of children with RD during reading have been documented. To identify eye-movement patterns related to increased cognitive load during reading in children with RD compared to typical readers, eye movements of 8-12-year-old English-speaking children were recorded during their reading of sentences with increasing difficulty (sentences that make sense, then sentences that do not make sense) and comparing incorrect and correct responses. Children with RD demonstrated greater pupil dilation when reading sentences that make sense than when reading sentences that do not make sense and also when reading incorrectly, compared to typical readers. Increased pupil dilation in children with RD when reading sentences correctly was positively correlated with phonological awareness capabilities. Higher phonological awareness and reading abilities were related to increased pupil dilation only in children with RD during correct reading, which is related to a heavier cognitive load. Results suggest that in addition to traditional findings of altered fixation patterns in children with RD, increased pupil dilation during reading may reflect EF challenges among this population. These findings can potentially be used to adapt online written materials for children with RD based on their fixation and pupil dilation patterns.

Frontal volume as a potential source of the comorbidity between attention-deficit/hyperactivity disorder and reading disorders

Prefrontal volume reductions commonly are demonstrated in ADHD, but the literature examining prefrontal volume in reading disorders (RD) is scant despite their also having executive functioning (EF) deficits. Furthermore, only a few anatomical studies have examined the frontal lobes in comorbid RD/ADHD, though they have EF deficits similar to RD and ADHD. Hence, we examined frontal gyri volume in children with RD, ADHD, RD/ADHD and controls, as well as their relationship to EF for gyri found to differ between groups. We found right inferior frontal (RIF) volume was smaller in ADHD, and smaller volume was related to worse behavioral regulation. Left superior frontal (LSF) volume was larger in RD than ADHD, and its size was negatively related to basic reading ability. Left middle frontal (LMF) volume was largest in RD/ADHD overall. Further, its volume was not related to basic reading nor behavioral regulation but was related to worse attentional control, suggesting some specificity in its EF relationship. When examining hypotheses on the etiology of RD/ADHD, RD/ADHD was commensurate with ADHD in RIF volume and both RD and ADHD in LSF volume (being midway between the groups), consistent with the common etiology hypothesis. Nevertheless, they also had an additional gyrus affected: LMF, consistent with the cognitive subtype hypothesis in its specificity to RD/ADHD. The few other frontal aMRI studies on RD/ADHD supported both hypotheses as well. Given this, future research should continue to focus on frontal morphology in its endeavors to find neurobiological contributors to the comorbidity between RD and ADHD.

Both Individual and Group-Based Neuropsychological Interventions of Dyslexia Improve Processing Speed in Young Adults: A Randomized Controlled Study

Effectiveness of individual and group-based neuropsychological interventions on cognitive aspects of dyslexia in young adults was evaluated. Dyslexic adults were randomly assigned into individual intervention (n = 40), group intervention (n = 40), or wait-list control group (n = 40). The interventions focused on cognitive strategy learning, supporting self-esteem, and using psychoeducation. Cognitive performance and symptoms were assessed via psychometric testing and self-report questionnaires at baseline, after the intervention/wait-list control time at 5 months and at 10 months. And, 15 months post intervention long-term status was checked via mailed inquiry. Wait-list control group also received an intervention after the 5-month control period. No significant effects were found in primary self-report outcome measures. Both interventions had a positive effect on a measure of processing speed and attention and the effect remained after the 5-month follow-up period. In self-reported cognitive symptoms, a positive trend was evident in self-reported reading habits. Furthermore, minor self-evaluated benefits reaching up to 15 months post intervention were found. There were no significant differences between the results of individual and group intervention as both interventions improved cognitive performance. The results indicate that a structured neuropsychological intervention could be effective in ameliorating dyslexia-related cognitive symptoms in young adults.

Reassessing health literacy best practices to improve medication adherence among patients with dyslexia

BACKGROUND

Dyslexia is characterized as unexpected and persistent difficulty in reading. In addition to language-based deficits, evidence indicates that people with dyslexia may struggle with tasks related to memory and executive function. This discussion paper explores how these non-linguistic deficits could plausibly affect medication adherence among patients with dyslexia.

DISCUSSION

There is a dearth of original research literature exploring the intersection of dyslexia and health behaviors in the United States. The authors examine selected best practices from the field of health literacy with potential to improve medication adherence among patients with dyslexia and suggest areas for further research on the intersection of dyslexia, health literacy and medication adherence.

CONCLUSION

Dyslexia is a high-prevalence condition. Patients with dyslexia may be more likely to experience challenges when learning and implementing complex, multi-step health behaviors, such as the tasks associated with medication adherence. However, there has been no research to assess the specific needs of patients with dyslexia, or design interventions to meet those needs. Foundational research is necessary to develop a health communications framework that meets the needs of these neurodiverse patients.

E-book reading hinders aspects of long-text comprehension for adults with dyslexia

Developmental dyslexia is a long-lasting reading deficit that persists into adulthood. In spite of many difficulties, some adults with dyslexia reach levels of reading comprehension similar to those of unimpaired readers and successfully study at university. While digital technologies offer many potential tools to facilitate reading, there are differences between printed books and e-books, particularly regarding the interaction between the reader and the text (paratextual cues). This study used long-text reading to investigate (1) different aspects of reading comprehension skills (literal and inferential processes, location of events within a story, and reconstruction of the plot) among university students with dyslexia and (2) the impact of e-book reading on reading comprehension in this population. Thirty adults with dyslexia and 30 matched skilled readers read the same text presented from a printed book and an e-book (Amazon Kindle). Questions were open-ended and both questions and answers used oral format. Results showed that with the printed book, dyslexic adults performed similarly to skilled readers in both literal and inferential reading comprehension tasks. Moreover, they performed at the same level or higher than skilled readers in tasks assessing spatiotemporal aspects of reading (localization of events and plot reconstruction). Conversely, with the e-book reader, the dyslexic adults were outperformed by skilled readers both in literal and spatiotemporal comprehension tasks. These results suggest that reading from an e-book hinders some aspects of reading comprehension for adults with dyslexia. However, when reading a printed book without time pressure, university students with dyslexia performed as well as, or better than, non-impaired readers on some measures of reading comprehension. Therefore, digital reading devices might not always be advantageous to them.

Reading Disabilities in Adolescents and Adults

Purpose

Reading skills continue to develop into adolescence and adulthood. Difficulties in reading have lifelong repercussions. Many speech-language pathologists who work with older individuals in the school setting face significant issues, including those mandated by recent changes in legislation. Theoretical topics related to reading development and disorders include the variety of orthographic systems across languages and the ways in which adults who are literate in an alphabetic orthographic system experience changes to their spoken and written language processing. In addition, older readers with intellectual or developmental disabilities may benefit from the use of leveled books and the inclusion of illustrations or drawings along with text.

Method

I completed a focused literature review regarding typical reading skills, dyslexia in adolescence and adulthood, recent changes in legislation, orthography, and the use of leveled books for adolescents and adults with intellectual or developmental disabilities.

Conclusions

Further study of reading in older individuals may lead to important theoretical and clinical applications. Speech-language pathologists should keep in mind the various components of reading (such as decoding and comprehension), how these factors relate to oral language, and how they may be addressed in therapy.

Beyond Academics: A Model for Simultaneously Advancing Campus-Based Supports for Learning Disabilities, STEM Students' Skills for Self-Regulation, and Mentors' Knowledge for Co-regulating and Guiding

Learning disabilities are highly prevalent on college campuses, yet students with learning disabilities graduate at lower rates than those without disabilities. Academic and psychosocial supports are essential for overcoming challenges and for improving postsecondary educational opportunities for students with learning disabilities. A holistic, multi-level model of campus-based supports was established to facilitate culture and practice changes at the institutional level, while concurrently bolstering mentors' abilities to provide learning disability-knowledgeable support, and simultaneously creating opportunities for students' personal and interpersonal development. Mixed methods were used to investigate implementation of coordinated personal, interpersonal, and institutional level supports for undergraduate science, technology, engineering, and math (STEM) students with learning disabilities. A one-group pre-test post-test strategy was used to examine undergraduate outcomes. Participants included 52 STEM undergraduates with learning disabilities, 57 STEM graduate student mentors, 34 STEM faculty mentors, and 34 university administrators and personnel as members of a university-wide council. Enrolled for 2 years, undergraduates were engaged in group meetings involving psychoeducation and reflective discussions, development of self-advocacy projects, and individual mentorship. Undergraduates reported improved self-efficacy (p = 0.001), campus connection (p < 0.001), professional development (p ≤ 0.002), and self-advocacy (p < 0.001) after two academic years. Graduate student mentors increased their understanding about learning disabilities and used their understanding to support both their mentees and other students they worked with. Council members identified and created opportunities for delivering learning disability-related trainings to faculty, mentors and advisors on campus, and for enhancing coordination of student services related to learning and related disorders. Disability-focused activities became integrated in broader campus activities regarding diversity. This research explicates a role that college campuses can play in fostering the wellbeing and the academic and career development of its students with developmental learning and related disorders. It offers an empirically tested campus-based model that is multilevel, holistic, and strengths-based for supporting positive outcomes of young people with learning disabilities in STEM. Moreover, findings advance the knowledge of supports and skills that are important for self-regulating and navigating complex and multi-faceted disability-related challenges within both the postsecondary educational environment and the young adults' sociocultural context.

Speech Recognition in Noise by Children with and without Dyslexia: How is it Related to Reading?

PURPOSE

Developmental dyslexia is commonly viewed as a phonological deficit that makes it difficult to decode written language. But children with dyslexia typically exhibit other problems, as well, including poor speech recognition in noise. The purpose of this study was to examine whether the speech-in-noise problems of children with dyslexia are related to their reading problems, and if so, if a common underlying factor might explain both. The specific hypothesis examined was that a spectral processing disorder results in these children receiving smeared signals, which could explain both the diminished sensitivity to phonological structure - leading to reading problems - and the speech recognition in noise difficulties. The alternative hypothesis tested in this study was that children with dyslexia simply have broadly based language deficits.

PARTICIPANTS

Ninety-seven children between the ages of 7 years; 10 months and 12 years; 9 months participated: 46 with dyslexia and 51 without dyslexia.

METHODS

Children were tested on two dependent measures: word reading and recognition in noise with two types of sentence materials: as unprocessed (UP) signals, and as spectrally smeared (SM) signals. Data were collected for four predictor variables: phonological awareness, vocabulary, grammatical knowledge, and digit span.

RESULTS

Children with dyslexia showed deficits on both dependent and all predictor variables. Their scores for speech recognition in noise were poorer than those of children without dyslexia for both the UP and SM signals, but by equivalent amounts across signal conditions indicating that they were not disproportionately hindered by spectral distortion. Correlation analyses on scores from children with dyslexia showed that reading ability and speech-in-noise recognition were only mildly correlated, and each skill was related to different underlying abilities.

CONCLUSIONS

No substantial evidence was found to support the suggestion that the reading and speech recognition in noise problems of children with dyslexia arise from a single factor that could be defined as a spectral processing disorder. The reading and speech recognition in noise deficits of these children appeared to be largely independent.

Rapid Automatized Naming, Verbal Working Memory, and Rhythm Discrimination as Predictors of Reading in Italian Undergraduate Students with and without Dyslexia

Whereas the clinical manifestations and the neuropsychological predictors of Developmental Dyslexia (DD) are already well documented in Italian-speaking children, empirical evidence on DD in Italian adults is in contrast rather scarce. The aim of the present study was to investigate the role of a subset of neuropsychological skills, which have been identified by previous literature to be related to reading, in the decoding abilities of a group of Italian undergraduates with and without DD. For this purpose, 39 university students aged between 19 and 27 years, 19 of whom with a diagnosis of DD, underwent an assessment battery including standardized reading tests, rapid automatized naming (RAN), verbal working memory, and rhythmic pattern discrimination tests. Cross-group differences confirmed significantly lower performances of undergraduates with DD in all measures but rhythm discrimination, compared to typical readers, thus showing a non-compensated neuropsychological profile. Regression analyses showed that, while reading speed was strongly and uniquely predicted by RAN speed, reading accuracy was concurrently predicted by RAN and rhythmic abilities. Finally, RAN speed emerged as a strong predictor of reading performance and risk of receiving a diagnosis of DD.

Spoken sentence production in college students with dyslexia: working memory and vocabulary effects

BACKGROUND

Individuals with dyslexia demonstrate syntactic difficulties on tasks of language comprehension, yet little is known about spoken language production in this population.

AIMS

To investigate whether spoken sentence production in college students with dyslexia is less proficient than in typical readers, and to determine whether group differences can be attributable to cognitive differences between groups.

METHODS & PROCEDURES

Fifty-one college students with and without dyslexia were asked to produce sentences from stimuli comprising a verb and two nouns. Verb types varied in argument structure and morphological form and nouns varied in animacy. Outcome measures were precision (measured by fluency, grammaticality and completeness) and efficiency (measured by response times). Vocabulary and working memory tests were also administered and used as predictors of sentence production performance.

OUTCOMES & RESULTS

Relative to non-dyslexic peers, students with dyslexia responded significantly slower and produced sentences that were significantly less precise in terms of fluency, grammaticality and completeness. The primary predictors of precision and efficiency were working memory, which differed between groups, and vocabulary, which did not.

CONCLUSIONS & IMPLICATIONS

College students with dyslexia were significantly less facile and flexible on this spoken sentence-production task than typical readers, which is consistent with previous studies of school-age children with dyslexia. Group differences in performance were traced primarily to limited working memory, and were somewhat mitigated by strong vocabulary.

Verbal and Non-verbal Fluency in Adults with Developmental Dyslexia: Phonological Processing or Executive Control Problems?

The executive function of fluency describes the ability to generate items according to specific rules. Production of words beginning with a certain letter (phonemic fluency) is impaired in dyslexia, while generation of words belonging to a certain semantic category (semantic fluency) is typically unimpaired. However, in dyslexia, verbal fluency has generally been studied only in terms of overall words produced. Furthermore, performance of adults with dyslexia on non-verbal design fluency tasks has not been explored but would indicate whether deficits could be explained by executive control, rather than phonological processing, difficulties. Phonemic, semantic and design fluency tasks were presented to adults with dyslexia and without dyslexia, using fine-grained performance measures and controlling for IQ. Hierarchical regressions indicated that dyslexia predicted lower phonemic fluency, but not semantic or design fluency. At the fine-grained level, dyslexia predicted a smaller number of switches between subcategories on phonemic fluency, while dyslexia did not predict the size of phonemically related clusters of items. Overall, the results suggested that phonological processing problems were at the root of dyslexia-related fluency deficits; however, executive control difficulties could not be completely ruled out as an alternative explanation. Developments in research methodology, equating executive demands across fluency tasks, may resolve this issue. Copyright © 2017 John Wiley & Sons, Ltd.

Comprehension and Generation of Metaphoric Language in Children, Adolescents, and Adults with Dyslexia

Difficulties with figurative language comprehension were documented in adult dyslexia (DYS). In the present research, we investigated the comprehension and generation of metaphors in 37 children, 35 adolescents, and 34 adults with and without DYS. We also tested the contribution of executive function to metaphor processing. A multiple-choice questionnaire with conventional and novel metaphors was used to assess comprehension; a concept-explanation task was used to test conventional and novel metaphor generation (verbal creativity). The findings indicated differences between the dyslexic children and the control group in conventional metaphor comprehension. However, both groups performed similarly in the novel metaphor comprehension test. Furthermore, although children and adolescents with DYS showed similar performance in metaphor generation as their typically developing peers, adults with DYS generated more metaphors than controls. While scores on tests of verbal knowledge and mental flexibility contributed to the prediction of conventional metaphor comprehension, scores on non-verbal tests and mental flexibility contributed to the prediction of novel metaphor generation. Our findings suggest that individuals with DYS are not impaired in novel metaphor comprehension and metaphor generation and that metaphor comprehension and generation utilize different cognitive resources. Copyright © 2016 John Wiley & Sons, Ltd.

A Review about Functional Illiteracy: Definition, Cognitive, Linguistic, and Numerical Aspects

Formally, availability of education for children has increased around the world over the last decades. However, despite having a successful formal education career, adults can become functional illiterates. Functional illiteracy means that a person cannot use reading, writing, and calculation skills for his/her own and the community's development. Functional illiteracy has considerable negative effects not only on personal development, but also in economic and social terms. Although functional illiteracy has been highly publicized in mass media in the recent years, there is limited scientific knowledge about the people termed functional illiterates; definition, assessment, and differential diagnoses with respect to related numerical and linguistic impairments are rarely studied and controversial. The first goal of our review is to give a comprehensive overview of the research on functional illiteracy by describing gaps in knowledge within the field and to outline and address the basic questions concerning who can be considered as functional illiterates: (1) Do they possess basic skills? (2) In which abilities do they have the largest deficits? (3) Are numerical and linguistic deficits related? (4) What is the fundamental reason for their difficulties? (5) Are there main differences between functional illiterates, illiterates, and dyslexics? We will see that despite partial evidence, there is still much research needed to answer these questions. Secondly, we emphasize the timeliness for a new and more precise definition that results in uniform sampling, better diagnosis, conclusion, and intervention. We propose the following working definition as the result of the review: functional illiteracy is the incapability to understand complex texts despite adequate schooling, age, language skills, elementary reading skills, and IQ. These inabilities must also not be fully explained by sensory, domain-general cognitive, neurological or mental disorders. In sum, we suggest that functional illiteracy must be more thoroughly understood and assessed from a theoretical, empirical, and diagnostic perspective.

Do Baseline Executive Functions Mediate Prospective Memory Performance under a Moderate Dose of Alcohol?

Prospective memory (PM) is memory for delayed intentions. While deleterious effects of acute doses of alcohol on PM have been documented previously using between-subjects comparisons, the current study adopted a single blind placebo-controlled within-subjects design to explore whether the extent to which alcohol-related impairments in PM are mediated by executive functions (EFs). To this end, 52 male social drinkers with no history of substance-related treatment were tested using two parallel versions of a clinical measure of PM (the Memory for Intentions Test; Raskin et al., 2010), and a battery of EF measures. Testing took place on two occasions, with the order of administration of the alcohol and placebo conditions being fully counterbalanced. Overall, PM was worse under alcohol and participants showed deficits on five of the six subscales making up the clinical test. Hierarchical multiple regression analyses demonstrated that EFs did not predict PM performance decrements overall but did predict performance when time cues were presented and when verbal responses were required. Phonemic fluency was the strongest of the EF predictors; a greater capacity to gain controlled access to information in long-term memory predicted a smaller difference between placebo- and alcohol-related performance on both the time cue and verbal response scales. PM is crucial to compliance with, and response to, both therapy programs and alcohol harm prevention campaigns. The results indicate that individual differences in cognitive function need to be taken into account when designing such interventions in order to increase their effectiveness.