Action Video Games Enhance Attentional Control and Phonological Decoding in Children with Developmental Dyslexia

Learning and Transfer: A Perspective From Action Video Game Play

A growing body of research documents the positive impact that action video game play has on a range of cognitive skills. Such a result, in which training on one task promotes a broad variety of benefits, is a rarity in the cognitive training domain. Instead, the more typical result is that training on one task promotes benefits on that task alone with only limited transfer to untrained tasks. We have proposed that action video game play promotes broad generalization by first enhancing attentional control abilities. This in turn allows for more information to be accrued as one experiences a new task and thus faster learning of that new task. Possible theoretical and practical considerations of such a view are discussed.

Effects of central vs. peripheral attentional-oculomotor exercise on lexical processing

Past research from our lab has suggested visual demands in video games serve to exercise attentional-oculomotor (A-O) processing in a manner beneficial to reading. However, testing the effect of video games on reading typically requires long timeframes (e.g., multiweek training or years of accumulated video game experience). The current study manipulated within-experiment peripheral and central demands to evaluate the effects of A-O exercise on task performance. Our study included two tasks: an orthographic lexical decision task (OLDT), designed to optimise orthographic lexical processing, and a novel graphic-based health bar decision task (HBDT). In Experiment 1, the stimuli were presented centrally in one block and peripherally in another block to manipulate A-O exercise. We observed greater improvements in the peripheral-first than the central-first group, particularly for the OLDT. In Experiments 2 and 3, we focused on the OLDT, with the HBDT serving as the A-O exercise task, and observed improvements in both centrally and peripherally trained participants. We additionally observed, through analyses of word and bigram frequency, a double dissociation, whereby increased target word frequency was associated with faster target reaction times and improved error rates, whereas increased foil bigram frequency was associated with slower foil reaction times and worse error rates. Taken together, the experiments demonstrate a mechanism beyond simple task learning that drives reading improvements, and A-O exercise, even if movements are small, appears to play a role in the improvements observed. We suggest future research should further develop this paradigm and examine its utility for reading remediation in dyslexia.

Impaired processing of spatiotemporal visual attention engagement deficits in Chinese children with developmental dyslexia

Emerging evidence suggests that visuospatial attention plays an important role in reading among Chinese children with dyslexia. Additionally, numerous studies have shown that Chinese children with dyslexia have deficits in their visuospatial attention orienting; however, the visual attention engagement deficits in Chinese children with dyslexia remain unclear. Therefore, we used a visual attention masking (AM) paradigm to characterize the spatiotemporal distribution of visual attention engagement in Chinese children with dyslexia. AM refers to impaired identification of the first (S1) of two rapidly sequentially presented mask objects. In the present study, S1 was always centrally displayed, whereas the spatial position of S2 (left, middle, or right) and the S1-S2 interval were manipulated. The results revealed a specific temporal deficit of visual attentional masking in Chinese children with dyslexia. The mean accuracy rate for developmental dyslexia (DD) in the middle spatial position was significantly lower than that in the left spatial position at a stimulus onset asynchrony (SOA) of 140 ms, compared with chronological age (CA). Moreover, we further observed spatial deficits of visual attentional masking in the three different spatial positions. Specifically, in the middle spatial position, the AM effect of DD was significantly larger for the 140-ms SOA than for the 250-ms and 600-ms SOA compared with CA. Our results suggest that Chinese children with dyslexia are significantly impaired in visual attentional engagement and that spatiotemporal visual attentional engagement may play a special role in Chinese reading.

The engagement of temporal attention in left spatial neglect

Previous literature showed how left spatial neglect arises from an asymmetrical distribution of spatial attention. However, it was also suggested that left spatial neglect might be partially caused or at least worsened by non-spatial attention disorders of the right-lateralized stimulus-driven attentional fronto-parietal network. Here, we psychophysically tested the efficiency of temporal attentional engagement of foveal perception through meta-contrast (Experiment 1) and "attentional" masking (Experiment 2) tasks in patients with right-hemisphere stroke with left neglect (N+), without left neglect (N-) and matched healthy controls (C). In both experiments, N+ patients showed higher thresholds, not only than Cs, but also than N- patients. Temporal engagement was clinically impaired in all N+ patients and highly correlated with their typical inability to direct spatial attention towards stimuli on the left side. Our findings suggest that a temporal impairment of attentional engagement is a relevant deficit of left spatial neglect.

Effectiveness of the Use of Virtual Reality Rehabilitation in Children with Dyslexia: Follow-Up after One Year

Dyslexia is a common learning disorder that hinders reading fluency and comprehension. Traditional treatments can be tedious for children, limiting their effectiveness. This study investigated the one-year effects of rehabilitation treatment with a virtual reality rehabilitation system (VRRS) on children with dyslexia. Twenty-four children were divided into control (CG) and experimental (EG) groups. The CG underwent conventional neuropsychological treatment (CNT), while the EG underwent VR neurorehabilitation training (VRNT) using the VRRS. Neuropsychological evaluation was conducted before treatment, after six months, and again after one year for both groups. Compared to the control group, children who received VR training showed significant improvement in reading skills, especially in non-word reading and reading speed, even after one year without further VR intervention. VRRS can improve treatment adherence and minimize symptoms by offering engaging activities for children. These findings suggest VRRS may be a valuable tool for dyslexia rehabilitation with long-lasting effects.

A Pilot Study to Improve Cognitive Performance and Pupil Responses in Mild Cognitive Impaired Patients Using Gaze-Controlled Gaming

Mild cognitive impairment (MCI) may progress to severe forms of dementia, so therapy is needed to maintain cognitive abilities. The neural circuitry for oculomotor control is closely linked to that which controls cognitive behavior. In this study, we tested whether training the oculomotor system with gaze-controlled video games could improve cognitive behavior in MCI patients. Patients played a simple game for 2-3 weeks while a control group played the same game using a mouse. Cognitive improvement was assessed using the MoCA screening test and CANTAB. We also measured eye pupil and vergence responses in an oddball paradigm. The results showed an increased score on the MoCA test specifically for the visuospatial domain and on the Rapid Visual Information Processing test of the CANTAB battery. Pupil responses also increased to target stimuli. Patients in the control group did not show significant improvements. This pilot study provides evidence for the potential cognitive benefits of gaze-controlled gaming in MCI patients.

Action video games and posterior parietal cortex neuromodulation enhance both attention and reading in adults with developmental dyslexia

The impact of action video games on reading performance has been already demonstrated in individuals with and without neurodevelopmental disorders. The combination of action video games and posterior parietal cortex neuromodulation by a transcranial random noise stimulation could enhance brain plasticity, improving attentional control and reading skills also in adults with developmental dyslexia. In a double blind randomized controlled trial, 20 young adult nonaction video game players with developmental dyslexia were trained for 15 h with action video games. Half of the participants were stimulated with bilateral transcranial random noise stimulation on the posterior parietal cortex during the action video game training, whereas the others were in the placebo (i.e. sham) condition. Word text reading, pseudowords decoding, and temporal attention (attentional blink), as well as electroencephalographic activity during the attentional blink, were measured before and after the training. The action video game + transcranial random noise stimulation group showed temporal attention, word text reading, and pseudoword decoding enhancements and P300 amplitude brain potential changes. The enhancement in temporal attention performance was related with the efficiency in pseudoword decoding improvement. Our results demonstrate that the combination of action video game training with parietal neuromodulation increases the efficiency of visual attention deployment, probably reshaping goal-directed and stimulus-driven fronto-parietal attentional networks interplay in young adults with neurodevelopmental conditions.

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.

Atypical reliance on monocular visual pathway for face and word recognition in developmental dyslexia

Studies with individuals with developmental dyslexia (DD) have documented impaired perception of words and faces, both of which are domains of visual expertise for human adults. In this study, we examined a possible mechanism that might be associated with the impaired acquisition of visual expertise for words and faces in DD, namely, the atypical engagement of the monocular visual pathway. Participants with DD and typical readers (TR) judged whether a pair of sequentially presented unfamiliar faces or nonwords were the same or different, and the pair of stimuli were displayed in an eye-specific fashion using a stereoscope. Based on evidence of greater reliance on subcortical structures early in development, we predicted differences between the groups in the engagement of lower (monocular) versus higher (binocular) regions of the visual pathways. Whereas the TR group showed a monocular advantage for both stimulus types, the DD participants evinced a monocular advantage for faces and words that was much greater than that measured in the TRs. These findings indicate that the DD individuals have enhanced subcortical engagement and that this might arise from the failure to fine-tune cortical correlates mediating the discrimination of homogeneous exemplars in domains of expertise.

Adults at low reading level are sluggish in disengaging spatial attention

An increasing number of studies show that attentional shifting is a primary contributor during the process of learning to read. However, it remains unclear what is the relationship between attentional shifting and word-reading ability in adult readers whose reading skills have matured. More fundamentally, how attentional shifting affects individuals' reading ability remains poorly understood. To address these issues, we grouped adult readers by the level of Chinese character reading and examined the time course of attentional shifting by setting up multiple stimulus-onset asynchronies (SOAs) in the Posner cue-target paradigm. Based on the phonological mediation hypothesis, we also measured multiple abilities involving phonological processing (i.e., rapid automatic naming and phonological awareness). Results showed that compared with adults at the high reading level, adults at the low reading level showed a selective impairment of attentional disengagement. Rapid automatic naming of Chinese characters played a partially mediating role in the association between attentional shifting and word reading. These results provided evidence for the phonological mediation hypothesis, and suggest that attentional shifting affects word reading by influencing phonological processing in adult Chinese readers.

Do Real-Time Strategy Video Gamers Have Better Attentional Control?

OBJECTIVE

Do real-time strategy (RTS) video gamers have better attentional control? To examine this issue, we tested experienced versus inexperienced RTS video gamers on multi-object tracking tasks (MOT) and dual-MOT tasks with visual or auditory secondary tasks (dMOT). We employed a street-crossing task with a visual working memory task as a secondary task in a virtual reality (VR) environment to examine any generalized attentional advantage.

BACKGROUND

Similar to action video games, RTS video games require players to switch attention between multiple visual objects and views. However, whether the attentional control advantage is limited by sensory modalities or generalizes to real-life tasks remains unclear.

METHOD

In study 1, 25 RTS video game players (SVGP) and 25 non-video game players (NVGP) completed the MOT task and two dMOT tasks. In study 2, a different sample with 25 SVGP and 25 NVGP completed a simulated street-crossing task with the visual dual task in a VR environment.

RESULTS

After controlling the effects of the speed-accuracy trade-off, SVGP showed better performance than NVGP in the MOT task and the visual dMOT task, but SVGP did not perform better in either the auditory dMOT task or the street-crossing task.

CONCLUSION

RTS video gamers had better attentional control in visual computer tasks, but not in the auditory tasks and the VR tasks. Attentional control benefits associated with RTS video game experience may be limited by sensory modalities, and may not translate to performance benefits in real-life tasks.

The Relationship Between Cognitive Resource Consumption During Gameplay and Postgame Aggressive Behaviors: Between-Subjects Experiment

Background

The question of how video games can shape aggressive behaviors has been a focus for many researchers. Previous research has focused on how violent video game content leads to postgame aggressive behaviors. However, video games not only convey violence or prosocial content to players but also require cognitive effort from individuals. Since human cognitive resources are limited, consuming more cognitive resources in a game leads to less cognitive resources to suppress aggressive impulses. Therefore, the depletion of cognitive resources from playing video games may also lead to changes in postgame aggressive behaviors.

Objective

This study aimed to examine the relationship between cognitive resources consumed in video games and postgame aggressive behaviors.

Methods

A total of 60 participants (age: mean 20.22; range 18-24 y) were randomly assigned to either the high-load group or the low-load group. Participants from both groups played a video game centered around college life. In the low-load group, participants followed the gameplay instructions to complete it. In the high-load group, participants were given an extra digital memory task to complete while playing the game. Participants in both groups played the video game for about 25 minutes. A maze selection task was then conducted to measure the participants' helping and hurting behaviors.

Results

The independent samples 2-tailed t tests showed that the high-load group had significantly higher hurting scores (mean 3.13, SD 2.47) than the low-load group (mean 1.90, SD 2.12; t58=-2.07, P=.04; Cohen d=-0.535), whereas helping behaviors were not significantly affected (t58=1.52, P=.13; Cohen d=0.393).

Conclusions

As more cognitive resources are consumed in a video game, more hurting behaviors are exhibited after the game. This finding proposes an alternative route by which video games impact aggressive behaviors, adding to previous theories and raising concerns about the popularity of cognitive training games.

The Role of Visual Factors in Dyslexia

What are the causes of dyslexia? Decades of research reflect a determined search for a single cause where a common assumption is that dyslexia is a consequence of problems with converting phonological information into lexical codes. But reading is a highly complex activity requiring many well-functioning mechanisms, and several different visual problems have been documented in dyslexic readers. We critically review evidence from various sources for the role of visual factors in dyslexia, from magnocellular dysfunction through accounts based on abnormal eye movements and attentional processing, to recent proposals that problems with high-level vision contribute to dyslexia. We believe that the role of visual problems in dyslexia has been underestimated in the literature, to the detriment of the understanding and treatment of the disorder. We propose that rather than focusing on a single core cause, the role of visual factors in dyslexia fits well with risk and resilience models that assume that several variables interact throughout prenatal and postnatal development to either promote or hinder efficient reading.

What's in a game: Video game visual-spatial demand location exhibits a double dissociation with reading speed

This research sought to clarify the nature of the relationship between video game experience, attention, and reading. Previous studies have suggested playing action video games can improve reading ability in children with dyslexia. Other research has linked video game experience with visual-spatial attention, and visual-spatial attention with reading. We hypothesized that the visual-spatial demands of video games may drive relationships with reading through attentional processing. In this experiment we used a hybrid attention/reading task to explore the relationship between video game visual-spatial demands, reading and attention. We also developed novel visual-spatial demand measures using participants' top five played video games for an individual-specific measure of visual demands. Peripheral visual demands in video games were associated with faster reading times, while central visual demands were associated with slower reading times for both phonetic decoding and lexical reading. In addition, video game experience in terms of hours spent playing video games each week interacted with the cueing effect size in the lexical reading condition, with experienced video game players exhibiting a larger cueing effect than participants with less video game experience. These results suggest that exposure to peripheral visual spatial demands in video games may be related to both lexical and sublexical reading processes in hybrid attentional reading tasks such as ours with skilled adult readers, which has implications not only for models of how ventral and dorsal stream reading and visual-spatial attention are integrated, but also for the development of dyslexia diagnostics and remediation.

The effects of bilateral posterior parietal cortex tRNS on reading performance

According to established cognitive neuroscience knowledge based on studies on disabled and typically developing readers, reading is based on a dual-stream model in which a phonological-dorsal stream (left temporo-parietal and inferior frontal areas) processes unfamiliar words and pseudowords, whereas an orthographic-ventral stream (left occipito-temporal and inferior frontal areas) processes known words. However, correlational neuroimaging, causal longitudinal, training, and pharmacological studies have suggested the critical role of visuo-spatial attention in reading development. In a double blind, crossover within-subjects experiment, we manipulated the neuromodulatory effect of a short-term bilateral stimulation of posterior parietal cortex (PPC) by using active and sham tRNS during reading tasks in a large sample of young adults. In contrast to the dual-stream model predicting either no effect or a selective effect on the stimulated phonological-dorsal stream (as well as to a general multisensory effect on both reading streams), we found that only word-reading performance improved after active bilateral PPC tRNS. These findings demonstrate a direct neural connectivity between the PPC, controlling visuo-spatial attention, and the ventral stream for visual word recognition. These results support a neurobiological model of reading where performance of the orthographic-ventral stream is boosted by an efficient deployment of visuo-spatial attention from bilateral PPC stimulation.

Neurocognitive analyses reveal that video game players exhibit enhanced implicit temporal processing

Winning in action video games requires to predict timed events in order to react fast enough. In these games, repeated waiting for enemies may help to develop implicit (incidental) preparation mechanisms. We compared action video game players and non-video game players in a reaction time task involving both implicit time preparations and explicit (conscious) temporal attention cues. Participants were immersed in virtual reality and instructed to respond to a visual target appearing at variable delays after a warning signal. In half of the trials, an explicit cue indicated when the target would occur after the warning signal. Behavioral, oculomotor and EEG data consistently indicate that, compared with non-video game players, video game players better prepare in time using implicit mechanisms. This sheds light on the neglected role of implicit timing and related electrophysiological mechanisms in gaming research. The results further suggest that game-based interventions may help remediate implicit timing disorders found in psychiatric populations.

Visuo-spatial attention deficit in children with reading difficulties

Although developmental reading disorders (developmental dyslexia) have been mainly associated with auditory-phonological deficits, recent longitudinal and training studies have shown a possible causal role of visuo-attentional skills in reading acquisition. Indeed, visuo-attentional mechanisms could be involved in the orthographic processing of the letter string and the graphemic parsing that precede the grapheme-to-phoneme mapping. Here, we used a simple paper-and-pencil task composed of three labyrinths to measure visuo-spatial attention in a large sample of primary school children (n = 398). In comparison to visual search tasks requiring visual working memory, our labyrinth task mainly measures distributed and focused visuo-spatial attention, also controlling for sensorimotor learning. Compared to typical readers (n = 340), children with reading difficulties (n = 58) showed clear visuo-spatial attention impairments that appear not linked to motor coordination and procedural learning skills implicated in this paper and pencil task. Since visual attention is dysfunctional in about 40% of the children with reading difficulties, an efficient reading remediation program should integrate both auditory-phonological and visuo-attentional interventions.

Dyslexia: A Bibliometric and Visualization Analysis

Dyslexia is a disorder characterized by an impaired ability to understand written and printed words or phrases. Epidemiological longitudinal data show that dyslexia is highly prevalent, affecting 10-20% of the population regardless of gender. This study aims to provide a detailed overview of research status and development characteristics of dyslexia from types of articles, years, countries, institutions, journals, authors, author keywords, and highly cited papers. A total of 9,166 publications have been retrieved from the Social Sciences Citation Index (SSCI) and Science Citation Index Expanded (SCI-E) from 2000 to 2021. The United States of America, United Kingdom, and Germany were the top three most productive countries in terms of the number of publications. China, Israel, and Japan led the Asia research on dyslexia. University of Oxford had the most publications and won first place in terms of h-index. Dyslexia was the most productive journal in this field and Psychology was the most used subject category. Keywords analysis indicated that "developmental dyslexia," "phonological awareness," children and fMRI were still the main research topics. "Literacy," "rapid automatized naming (RAN)," "assessment," "intervention," "meta-analysis," "Chinese," "executive function," "morphological awareness," "decoding," "dyscalculia," "EEG," "Eye tracking," "rhythm," "bilingualism," and "functional connectivity" might become the new research hotspots.

Enhanced reading abilities is modulated by faster visual spatial attention

Research has shown improved reading following visual magnocellular training in individuals with dyslexia. Many studies have demonstrated how the magnocellular pathway controls visual spatial attention. Therefore, we have investigated the relationship between magnocellular pathway and visual spatial attention deficits in dyslexia in order to better understand how magnocellular-based interventions may help children to learn to read. Magnocellular function, visual spatial attention, and reading abilities of thirty elementary school students with dyslexia, aged between 8 and 10, were measured. The experimental group received magnocellular-based visual motion training for 12 sessions, while the control group received neutral sessions. All tests were repeated at the end of the training and after 1 month. The magnocellular functioning, visual spatial attention, and reading abilities of the experimental group improved significantly compared to the controls. Additionally, improvement in reaction time of invalid conditions predicted improvements in saccadic eye movements. We conclude that visual magnocellular training improved saccadic eye movement control, visual spatial orientation, and reading ability.

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

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

Remote Neuropsychological Intervention for Developmental Dyslexia with the Tachidino Platform: No Reduction in Effectiveness for Older Nor for More Severely Impaired Children

Tachidino is a web-platform for remote treatment of reading and writing disorders. A total of 91 children with developmental dyslexia and/or dysorthographia participated in the present study and received Tachidino treatment. The purpose of the study was to compare results obtained after four weeks treatment and a six-month follow-up in older versus younger children and in more versus less severely impaired children (separately subdividing them according to reading speed, reading accuracy, and writing accuracy). The results showed no difference in improvement for reading accuracy and speed in the three age groups, but children below 9 years improved more than older children in writing accuracy. Regarding severity groups, children with more severe initial impairments improved more than children with less severe impairments. Additionally, the results were confirmed after controlling for spurious effects due to use of Z-scores and regression to the mean. The findings are discussed in terms of their theoretical and practical implications.

Visual Motion and Decision-Making in Dyslexia: Reduced Accumulation of Sensory Evidence and Related Neural Dynamics

Children with and without dyslexia differ in their behavioral responses to visual information, particularly when required to pool dynamic signals over space and time. Importantly, multiple processes contribute to behavioral responses. Here we investigated which processing stages are affected in children with dyslexia when performing visual motion processing tasks, by combining two methods that are sensitive to the dynamic processes leading to responses. We used a diffusion model which decomposes response time and accuracy into distinct cognitive constructs, and high-density EEG. Fifty children with dyslexia (24 male) and 50 typically developing children (28 male) 6-14 years of age judged the direction of motion as quickly and accurately as possible in two global motion tasks (motion coherence and direction integration), which varied in their requirements for noise exclusion. Following our preregistered analyses, we fitted hierarchical Bayesian diffusion models to the data, blinded to group membership. Unblinding revealed reduced evidence accumulation in children with dyslexia compared with typical children for both tasks. Additionally, we identified a response-locked EEG component which was maximal over centro-parietal electrodes which indicated a neural correlate of reduced drift rate in dyslexia in the motion coherence task, thereby linking brain and behavior. We suggest that children with dyslexia tend to be slower to extract sensory evidence from global motion displays, regardless of whether noise exclusion is required, thus furthering our understanding of atypical perceptual decision-making processes in dyslexia.SIGNIFICANCE STATEMENT Reduced sensitivity to visual information has been reported in dyslexia, with a lively debate about whether these differences causally contribute to reading difficulties. In this large preregistered study with a blind modeling approach, we combine state-of-the art methods in both computational modeling and EEG analysis to pinpoint the stages of processing that are atypical in children with dyslexia in two visual motion tasks that vary in their requirement for noise exclusion. We find reduced evidence accumulation in children with dyslexia across both tasks, and identify a neural marker, allowing us to link brain and behavior. We show that children with dyslexia exhibit general difficulties with extracting sensory evidence from global motion displays, not just in tasks that require noise exclusion.

Towards Consensus on Good Practices for the Use of New Technologies for Intervention and Support in Developmental Dyslexia: A Delphi Study Conducted among Italian Specialized Professionals

The use of new technologies for intervention in developmental dyslexia is steadily growing. In order to better understand the needs, the expectations, and the attitudes of Italian expert health professionals concerning such technologies, a national survey was conducted applying the Delphi methodology. Ad-hoc questionnaires were sent out to a group of eighteen experts over three successive rounds, and anonymously collected responses were aggregated and shared with the group after each round, aiming to reach a consensus on the proposed response. The goal was to define a series of statements that could form the basis for international "good practices" in the use of technologies for intervention to support dyslexia in children and adolescents. In the first round, the experts' general opinions were collected with both multiple choice and open questions, and in the second round consensus was assessed on a series of statements based on the first replies. The cut-off of 75% consensus on each statement was reached after three rounds. Fifteen experts completed all the rounds of the process, and a final version of the statements regarding good practice in the use of technologies for dyslexia could be defined.

Action video game training improves text reading accuracy, rate and comprehension in children with dyslexia: a randomized controlled trial

Dynamic visual attention training using Action Video Games (AVGs) is a promising intervention for dyslexia. This study investigated the efficacy of 5 h (10 × 30 min) of AVG training in dyslexic children (aged 8–13) using ‘Fruit Ninja’, while exploring whether increasing attentional and eye movement demands enhanced AVG effectiveness. Regular (AVG-R; n = 22) and enhanced AVG training (AVG+; n = 23) were compared to a treatment-as-usual comparison group (n = 19) on reading, rapid naming, eye movements and visuo-temporal processing. Playing ‘Fruit Ninja’ for only 5 h significantly improved reading accuracy, rate, comprehension and rapid naming of both AVG groups, compared to the comparison group, though increasing attentional demands did not enhance AVG efficacy. Participants whose low contrast magnocellular-temporal processing improved most following training also showed significantly greater improvement in reading accuracy. The findings demonstrate a clear role for visual attention in reading and highlight the clinical applicability of AVGs as a fun, motivational and engaging intervention for dyslexia.

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

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

Short-Term Touch-Screen Video Game Playing Improves the Inhibition Ability

There is mixed evidence regarding whether video games affect executive function. The inconsistent results in this area may have to do with researchers’ conceptualizations of executive function as a unified construct or as a set of independent skills. In the current study, 120 university students were randomly assigned to play a video game or to watch a screen record of the video game. They then completed a series of behavioral tasks to assess the shifting, updating and inhibiting subcomponents of executive function. Scores on these tasks were also used as indicators of a component-general latent variable. Results based on analysis of covariance showed that, as predicted, the inhibition subcomponent, but not the updating or the shifting subcomponent, was significantly enhanced after gaming. The component-general executive function was not enhanced after gaming once the results were controlled for other subcomponents. The results were unrelated to participants’ self-reported positive and negative affect. The findings add key evidence to the literature on executive function and potentially contribute to the therapeutic use of video games to maintain executive function in the aged population.

Online Videogames Use and Anxiety in Children during the COVID-19 Pandemic

Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. One hundred and sixty-two children (M/F:78/84; age range: 8–10 years; average age 9.4 ± 0.7 years) completed the Videogame Addiction Scale for Children (VASC), the Test of Anxiety and Depression (TAD) and the Children’s Anxiety Meter—State (CAM-S). Demographic variables and data on the access to electronic tools and games preferences were also collected. Overall, 96.3% of the study participants stated to have access to one or more device. They reported a low risk of videogame addiction (VASC score (mean ± SD): 46.7 ± 15.4), a moderate level of trait anxiety (TAD score (mean ± SD): 135 ± 16.8) and a low state anxiety (CAM-S score (mean ± SD): 2.2 ± 2.1). Males reported to spend more time on videogames, to perceive higher self-control and to be more influenced by reinforcement mechanisms; females described higher levels of trait anxiety. In the regression analysis, state anxiety was a predictor of videogame use and addiction (p = 0.01). Further research is needed to confirm these data and to maximize the developmentally positive effects of videogames and preventing the negative consequences.

Beyond Reading Modulation: Temporo-Parietal tDCS Alters Visuo-Spatial Attention and Motion Perception in Dyslexia

Dyslexia is a neurodevelopmental disorder with an atypical activation of posterior left-hemisphere brain reading networks (i.e., temporo-occipital and temporo-parietal regions) and multiple neuropsychological deficits. Transcranial direct current stimulation (tDCS) is a tool for manipulating neural activity and, in turn, neurocognitive processes. While studies have demonstrated the significant effects of tDCS on reading, neurocognitive changes beyond reading modulation have been poorly investigated. The present study aimed at examining whether tDCS on temporo-parietal regions affected not only reading, but also phonological skills, visuo-spatial working memory, visuo-spatial attention, and motion perception in a polarity-dependent way. In a within-subjects design, ten children and adolescents with dyslexia performed reading and neuropsychological tasks after 20 min of exposure to Left Anodal/Right Cathodal (LA/RC) and Right Anodal/Left Cathodal (RA/LC) tDCS. LA/RC tDCS compared to RA/LC tDCS improved text accuracy, word recognition speed, motion perception, and modified attentional focusing in our group of children and adolescents with dyslexia. Changes in text reading accuracy and word recognition speed—after LA/RC tDCS compared to RA/LC—were related to changes in motion perception and in visuo-spatial working memory, respectively. Our findings demonstrated that reading and domain-general neurocognitive functions in a group of children and adolescents with dyslexia change following tDCS and that they are polarity-dependent.