Developmental dyslexia and vision

Oculomotor Rehabilitation Improves Reading Abilities in Dyslexic Children With Concurrent Eye Movement Abnormalities

The oculomotor abnormalities have been reported in some dyslexic children. The purpose of the study was to evaluate the effects of oculomotor rehabilitation on the reading performance of dyslexic children. Subjects were 50 dyslexic children. Those with oculomotor abnormalities (n = 30) were randomly assigned into 2 groups matched for age. The case group received oculomotor rehabilitation. The rehabilitation program consists of 3 different exercises. The reading and dyslexia tests were performed before and after the intervention. The correct scores of reading tests in the case group posttest increased significantly compared with the control group, and there is a significant difference between the two groups (P = .001). The positive effects of oculomotor rehabilitation on the reading performance of dyslexic children confirmed that the oculomotor program could be a practical tool for improving reading performance in dyslexic children.

Prismatic adaptation coupled with cognitive training as novel treatment for developmental dyslexia: a randomized controlled trial

Despite intense and costly treatments, developmental dyslexia (DD) often persists into adulthood. Several brain skills unrelated to speech sound processing (i.e., phonology), including the spatial distribution of visual attention, are abnormal in DD and may represent possible treatment targets. This study explores the efficacy in DD of rightward prismatic adaptation (rPA), a visuomotor adaptation technique that enables visuo-attentive recalibration through shifts in the visual field induced by prismatic goggles. A digital intervention of rPA plus cognitive training was delivered weekly over 10 weeks to adolescents with DD (aged 13-17) assigned either to treatment (N = 35) or waitlist (N = 35) group. Efficacy was evaluated by repeated measures MANOVA assessing changes in working memory index (WMI), processing speed index (PSI), text reading speed, and words/pseudowords reading accuracy. rPA treatment was significantly more effective than waitlist (p ≤ 0.001; ηp2 = 0.815). WMI, PSI, and reading speed increased in the intervention group only (p ≤ 0.001, ηp2 = 0.67; p ≤ 0.001, ηp2 = 0.58; p ≤ 0.001, ηp2 = 0.29, respectively). Although modest change was detected for words and pseudowords accuracy in the waitlist group only (words: p ≤ 0.001, d = 0.17, pseudowords: p = 0.028; d = 0.27), between-group differences were non-significant. rPA-coupled cognitive training enhances cognitive and reading abilities in adolescents with DD. This innovative approach could have implications for early remedial treatment.

Colour-cued paragraph writing instruction for students with learning disabilities

Expository paragraph writing is difficult to learn and teach. For many students, particularly those with learning disabilities, it is difficult to manage the multiple, simultaneous complex processes required for success. And for their teachers, writing is the content area in which they feel least prepared to teach. This intervention applied the concept of reverse engineering to instructional design to teach expository paragraph writing using a color-cued graphic organizer. The study evaluated the effects of using a systematic color code to highlight the alignment of where ideas originate in a graphic organizer to their development into a sentence within a well-organized expository paragraph. Using a single case research design, with a pre- and post-intervention assessments, students (n = 5) with dyslexia improved their expository paragraph knowledge and skills. Percentage of non-overlapping data and Tau analyses indicate a large to very large effect of the 2-week intervention. Results, suggestions for further research, and implications for practice are discussed.

Insights from a dyslexia simulation font: Can we simulate reading struggles of individuals with dyslexia?

Individuals with dyslexia struggle at explaining what it is like to have dyslexia and how they perceive letters and words differently. This led the designer Daniel Britton to create a font that aims to simulate the perceptual experience of how effortful reading can be for individuals with dyslexia (http://danielbritton.info/dyslexia). This font removes forty percent of each character stroke with the aim of increasing reading effort, and in turn empathy and understanding for individuals with dyslexia. However, its efficacy has not yet been empirically tested. In the present study, we compared participants without dyslexia reading texts in the dyslexia simulation font to a group of individuals with dyslexia reading the same texts in Times New Roman font. Results suggest that the simulation font amplifies the struggle of reading, surpassing that experienced by adults with dyslexia-as reflected in increased reading time and overall number of eye movements in the majority of typical readers reading in the simulation font. Future research could compare the performance of the Daniel Britton simulation font against a sample of beginning readers with dyslexia as well as seek to design and empirically test an adapted simulation font with an increased preserved percentage of letter strokes [Correction added on 10 December 2021, after initial online publication. Abstract has been added].

Individuals with dyslexia use a different visual sampling strategy to read text

Individuals with dyslexia present with reading-related deficits including inaccurate and/or less fluent word recognition and poor decoding abilities. Slow reading speed and worse text comprehension can occur as secondary consequences of these deficits. Reports of visual symptoms such as atypical eye movements during reading gave rise to a search for these deficits' underlying mechanisms. This study sought to replicate established behavioral deficits in reading and cognitive processing speed while investigating their underlying mechanisms in more detail by developing a comprehensive profile of eye movements specific to reading in adult dyslexia. Using a validated standardized reading assessment, our findings confirm a reading speed deficit among adults with dyslexia. We observed different eye movements in readers with dyslexia across numerous eye movement metrics including the duration of a stop (i.e., fixation), the length of jumps (i.e., saccades), and the number of times a reader's eyes expressed a jump atypical for reading. We conclude that individuals with dyslexia visually sample written information in a laborious and more effortful manner that is fundamentally different from those without dyslexia. Our findings suggest a mix of aberrant cognitive linguistic and oculomotor processes being present in adults with dyslexia.

The relation between the severity of reading disorder and visual functions among children with dyslexia

PURPOSE:

The purpose of the study was to investigate the relation between the severity of reading disorder and visual functions among children with dyslexia.

MATERIALS AND METHODS:

The present study included 32 dyslexic children selected from two centers for learning disabilities in Mashhad, Iran. Dyslexics were then classified as mild, moderate, and severe based on an instrument used to determine the severity of their reading disorder. Complete optometric examinations to measure visual acuity, refractive errors, latent and manifest deviations, stereoacuity, and amplitude of accommodation were performed for all participants. The correlation between visual functions among dyslexics and their reading disorder severity was investigated.

RESULTS:

The mean age of the participants in this study was 8.1 ± 0.8 years. Among participants, 40.6%, 31.3%, and 28.1% presented with severe, moderate, and mild levels of reading difficulties, respectively. Only exophoria significantly correlated with the severity of reading disorders. No significant correlation was found between other visual functions and the severity of reading disorders in dyslexic children.

CONCLUSION:

We found that higher exophoria at near has a significant correlation with the severity of dyslexia. A complete and detailed eye examination of patients with dyslexia and correcting their visual impairments might be helpful.

Children with Dyslexia Have Altered Cross-Modal Processing Linked to Binocular Fusion. A Pilot Study

Introduction

The cause of dyslexia, a reading disability characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities, is unknown. A considerable body of evidence shows that dyslexics have phonological disorders. Other studies support a theory of altered cross-modal processing with the existence of a pan-sensory temporal processing deficit associated with dyslexia. Learning to read ultimately relies on the formation of automatic multisensory representations of sounds and their written representation while eyes fix a word or move along a text. We therefore studied the effect of brief sounds on vision with a modification of binocular fusion at the same time (using the Maddox Rod test).

Methods

To check if the effect of sound on vision is specific, we first tested with sounds and then replaced them with proprioceptive stimulation on 8 muscular sites. We tested two groups of children composed respectively of 14 dyslexic children and 10 controls.

Results

The results show transient visual scotoma (VS) produced by sensory stimulations associated with the manipulation of oculomotor balance, the effect being drastically higher in the dyslexic group. The spatial distribution of the VS is stochastic. The effect is not specific for sounds but exists also with proprioceptive stimulations.

Discussion

Although there was a very significant difference between the two groups, we were not able to correlate the (VS) occurrence with the dyslexic’s reading performance. One possibility to confirm the link between VS and reading impairment would be to find a specific treatment reducing the occurrence of the VS and to check its effect on dyslexia.

Dyslexia-related impairments in sequence learning predict linguistic abilities

Dyslexia is often characterized by disordered word recognition and spelling, though dysfunction on various non-linguistic tasks suggests a more pervasive deficit may underlie reading and spelling abilities. The serial-order learning impairment in dyslexia (SOLID) hypothesis proposes that sequence learning impairments fundamentally disrupt cognitive abilities, including linguistic processes, among individuals with dyslexia; yet only some studies report sequence learning deficits in people with dyslexia relative to controls. Evidence may be mixed because traditional sequence learning tasks often require strong motor demands, working memory processes and/or executive functions, wherein people with dyslexia can show impairments. Thus, observed sequence learning deficits in dyslexia may only appear to the extent that comorbid motor-based processes, memory capacity, or executive processes are involved. The present study measured sequence learning in college-aged students with and without dyslexia using a single task that evaluates sequencing and non-sequencing components but without strong motor, executive, or memory demands. During sequencing, each additional link in a sequence of stimuli leading to a reward is trained step-by-step, until a complete sequence is acquired. People with dyslexia made significantly more sequencing errors than controls, despite equivalent performance on non-sequencing components. Mediation analyses further revealed that sequence learning accounted for a large portion of the variance between dyslexia status and linguistic abilities, particularly pseudo-word reading. These findings extend the SOLID hypothesis by showing difficulties in the ability to acquire sequences that may play an underlying role in literacy acquisition.

Oculomotor rehabilitation in children with dyslexia

Background: Dyslexia is the most common learning disorder. Visual and oculomotor deficits in dyslexic children have been reported. The purpose of this study was to measure oculomotor parameters and analyze the effect of oculomotor rehabilitation strategies on dyslexia. Methods: Binocular eye movements were recorded by oculomotor subtype of videonystagmography (VNG) testing on 30 children with dyslexia and 20 typical reader children (aged 8-12) in both genders. Dyslexic children were diagnosed with DSM-V scale by experts in reading disorder centers. We studied those children with developmental dyslexia, who had deficits in eye movements recording. Dyslexic children were divided into 2 groups of case and control. Oculomotor rehabilitation (including fixation, saccade, and tracking training) was performed in case group for 1 hour, twice weekly for 8 weeks. Before the intervention, results of oculomotor tests were compared between 3 groups (healthy, case, and control). Then, to analyze the effect of the intervention, results of oculomotor tests were compared between case and control groups in pre- and post- intervention stage. Data were analyzed by independent and paired samples t tests, ANOVA, and repeated measures tests in SPSS v. 21. Results: There were significant differences in oculomotor characteristics of dyslexic children in comparison with those reported in typical children. Oculomotor rehabilitation intervention had a positive effect on improvement of oculomotor responses and eye movements in dyslexic children. Moreover, there was no statistically significant difference between dyslexic children and non-dyslexic children in oculomotor skills after the training. Conclusion: Our results showed the positive effects of oculomotor rehabilitation on eye movements. Primary oculomotor assessment in dyslexic children and early use of oculomotor rehabilitation combined with other treatments are highly recommended.

The distinctive vertical heterophoria of dyslexics

In this study, we looked for the presence of vertical heterophoria (VH) in 42 dyslexic children (22 males and 20 females) aged 118.5±12.9 months who were compared with a control group of 22 nondyslexic children (eleven males and eleven females) aged 112±9.8 months. Dyslexics presented a low-level (always <1 prism diopter) VH combined with torsion. This oculomotor feature clearly separates the dyslexic group from the normal readers group. It is independent of the type of dyslexia. The essential feature of this VH is a lability that appears during specific stimulation of sensory receptors involved in postural regulation. This lability is demonstrated using a vertical Maddox test conducted under very specific conditions in which postural sensors are successively stimulated in a predetermined order. A quantitative variation in this VH may be seen during the Bielchowsky Head Tilt Test, which reveals hypertonia of the lower or upper oblique muscles. Vertical orthophoria can be achieved by placing low-power prisms asymmetrically within the direction of action of the superior or inferior oblique muscles. The selection of power and axis is not only guided by elements of the eye examination but also from observation of postural muscle tone. All these elements suggest that the VH could be of postural origin and somehow related to the vertical action of the oblique muscles. VH and torsion are not harmful per se. There is no statistical relationship between their level and the various parameters used to assess the reading skills of dyslexic children. VH and torsion could be a clinical marker of global proprioceptive dysfunction responsible for high-level multisensory disturbances secondary to poor spatial localization of visual and auditory information. This dysfunction might also explain the motor disorders concomitant to dyslexia.

On the use of spatial frequency to isolate contributions from the magnocellular and parvocellular systems and the dorsal and ventral cortical streams

Many authors have claimed that suprathreshold achromatic stimuli of low and high spatial frequency can be used to separate responses from different entities in the visual system. Most prominently, it has been proposed that such stimuli can differentiate responses from the magnocellular and parvocellular systems. As is reviewed here, investigators who have examined stimulus specificity of neurons in these systems have found little difference between magno- and parvocellular cells. It has also been proposed that spatial frequency can be used to selectively activate the "magnocellular-dorsal stream". The present review indicates that cells in Area MT of the dorsal stream do prefer very low spatial frequencies. However, the review also shows that cells in Area V4 of the ventral stream respond, not only to relatively high spatial frequencies, but also to low frequency stimuli. Thus, low spatial frequencies cannot be relied upon to selectively activate the dorsal stream.

Evaluation of ocular movements in patients with dyslexia

The aims of this study were to analyze the relationship between dyslexia and eye movements and to assess whether this method can be added to the workup of dyslexic patients. The sample was comprised of 11 children with a diagnosis of dyslexia and 11 normal between 8 and 13 years of age. All subjects underwent orthoptic evaluation, ophthalmological examinations, and eye movement analysis, specifically, stability analysis on fixating a still target, tracking saccades, analysis of fixation pauses, speed reading, saccades, and regressions through the reading of a text. Stability analysis on fixating a still target showed a significant (p < 0.001) difference between the two groups showing an increased amount of loss of fixation among dyslexic subjects (5.36 ± 2.5 s and 0.82 ± 2.1, respectively). Tracking saccades (left and right horizontal axis) did not show a significant difference. When reading parameters were looked into (number of saccades, number of regressions, reading time through the reading of a text), a significant (p < 0.001) difference was found between the groups. This study supports the belief that the alteration of eye movement does not depend on oculo-motor dysfunction but is secondary to a defect in the visual processing of linguistic material. Inclusion of assessment of this defect might prove beneficial in determining the presence of dyslexia in young children at a younger age, and an earlier intervention could be initiated.

Reading performance is not affected by a prism induced increase of horizontal and vertical vergence demand

PURPOSE

Dyslexia is the most common developmental reading disorder that affects language skills. Latent strabismus (heterophoria) has been suspected to be causally involved. Even though phoria correction in dyslexic children is commonly applied, the evidence in support of a benefit is poor. In order to provide experimental evidence on this issue, we simulated phoria in healthy readers by modifying the vergence tone required to maintain binocular alignment.

METHODS

Vergence tone was altered with prisms that were placed in front of one eye in 16 healthy subjects to induce exophoria, esophoria, or vertical phoria. Subjects were to read one paragraph for each condition, from which reading speed was determined. Text comprehension was tested with a forced multiple choice test. Eye movements were recorded during reading and subsequently analyzed for saccadic amplitudes, saccades per 10 letters, percentage of regressive (backward) saccades, average fixation duration, first fixation duration on a word, and gaze duration.

RESULTS

Acute change of horizontal and vertical vergence tone does neither significantly affect reading performance nor reading associated eye movements.

CONCLUSION

Prisms in healthy subjects fail to induce a significant change of reading performance. This finding is not compatible with a role of phoria in dyslexia. Our results contrast the proposal for correcting small angle heterophorias in dyslexic children.

Impaired implicit sequence learning in children with developmental dyslexia

It has been proposed that an impairment of procedural memory underlies a range of linguistic, cognitive and motor impairments observed in developmental dyslexia (DD). However, studies designed to test this hypothesis using the implicit sequence learning paradigm have yielded inconsistent results. A fundamental aspect of procedural learning is that it takes place over an extended time-period that may be divided into distinct stages based on both behavioural characteristics and neural correlates of performance. Yet, no study of implicit sequence learning in children with DD has included learning stages beyond a single practice session. The present study was designed to fill this important gap by extending the investigation to include the effects of overnight consolidation as well as those of further practice on a subsequent day. The results suggest that the most pronounced procedural learning impairment in DD may emerge only after extended practice, in learning stages beyond a single practice session.