Working-memory training improves developmental dyslexia in Chinese 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.

The influence of cognitive ability in Chinese reading comprehension: can working memory updating change Chinese primary school students' reading comprehension performance?

With the development of educational cognitive neuroscience, language instruction is no longer perceived as mechanical teaching and learning. Individual cognitive proficiency has been found to play a crucial role in language acquisition, particularly in the realm of reading comprehension. The primary objective of this study was to investigate two key aspects: firstly, to assess the predictive effects of the central executive (CE) on the Chinese reading comprehension scores of Chinese primary school students, and secondly, to explore the influence of CE training on the Chinese reading comprehension performance of Chinese primary school students. Chinese primary school students were recruited as participants. Experiment 1 used a Chinese N-back task, a Chinese Stroop task, and a number-pinyin conversion task to investigate the predictive effect of the CE components on Chinese reading comprehension. Experiment 2, based on the results of Experiment 1, used the Chinese character N-back training to explore the influence of updating training on Chinese reading comprehension. The findings from Experiment 1 underscored that CE had a predictive effect on Chinese reading comprehension scores. And updating had a prominent role in it. Experiment 2 revealed that the experimental group exhibited an enhancement in their updating performance following N-back training. Although the reading comprehension performance of the two groups after training did not produce significant differences in total scores, the experimental group showed maintained and higher microscopic reading comprehension scores than the control group in the more difficult post-test. In summary, this study yields two primary conclusions: (1) CE was able to predict Chinese reading comprehension scores. Updating has an important role in prediction. (2) Updating training enhances students' updating performance and positively influences students' Chinese microscopic reading comprehension performance.

Working memory capacity and text comprehension performance in children with dyslexia and dyscalculia: a pilot study

Introduction

Different research over the years has shown how the executive processes of Working Memory are a fundamental area that allows the performance of complex cognitive tasks such as language comprehension, reading, mathematical skills, learning or reasoning. Therefore, scientific evidence shows that they are altered in people with dyslexia and dyscalculia. The aim of this research was to study the relationship between semantic updating ability and reading comprehension depending on whether or not the information content had a mathematical character between the two disorders.

Methods

A Pilot Case Study was carried out for this purpose. The sample consisted of 40 participants aged 6 to 11 years, 20 of them with a diagnosis of dyslexia and the remaining 20 with a diagnosis of dyscalculia. The results indicate that people with dyslexia show more difficulties in all those tasks that require reading.

Results

People with dyscalculia obtain worse results in the tasks of stimulus integration and reading comprehension of texts with mathematical content. Furthermore, the correlation between the different areas evaluated shows that people with dyslexia and dyscalculia develop different cognitive processes.

Discussion

Therefore, it is necessary to continue insisting on the importance of explicit work on working memory, since it is a determining and fundamental area in the development of written language comprehension.

Executive functions in Chinese kindergarten children with early reading problems

Learning to read Chinese is a complex task that draws on a range of executive function (EF) skills since early development. However, no studies have examined EF as a potential contributing factor to early reading problems among Chinese children. The present longitudinal study identified 48 poor readers and 48 normal readers among a sample of 190 Chinese children at the end of kindergarten. Measures of EF skills (working memory, inhibition control, and cognitive flexibility) and reading outcomes (word reading, sentence reading fluency, and sentence reading comprehension) were administered to the children. The two groups were retrospectively compared on the EF measures after age and nonverbal IQ were considered. Poor readers were found to perform significantly worse than normal readers in all the examined EF skills. Correlation and regression results revealed a relatively different nature of the relationship between EF and reading in poor readers as compared with normal readers. Inhibition control predicted reading outcomes in poor readers only, while cognitive flexibility predicted reading outcomes in normal readers only. Working memory was significantly correlated to word reading in poor readers and to reading comprehension in normal readers. The results are discussed in terms of the special characteristics of the Chinese language.

Examining Distinctive Working Memory Profiles in Chinese Children With Predominantly Inattentive Subtype of Attention-Deficit/Hyperactivity Disorder and/or Reading Difficulties

Although evidence has shown that both RD and ADHD-I children suffer from working memory problems, inconsistencies in impaired modalities have been reported. This study aimed to (1) compare the three WM domains (i.e., verbal WM, visual-spatial WM, and behavioral WM) among pure ADHD-I, pure RD, comorbid ADHD-I+RD, and typical control groups and (2) examine the impact of comorbidity on the three WM domains. A Chinese sample of participants from Hong Kong included 29 children in the ADHD-I group, 78 children in the RD group, 31 children in the comorbid group (ADHD-I+RD), and 64 children in the TD control group. All participants completed the assessments individually. The findings showed that the children with ADHD-I and/or RD exhibited diverse cognitive profiles. In particular, RD was associated with verbal and visual-spatial working memory deficits, while ADHD-I was associated with behavioral working memory deficits. Interestingly, the comorbid condition demonstrated additive deficits of the two disorders but with greater deficits in behavioral working memory. These findings support the cognitive subtype hypothesis and provide a clearer picture of the distinctive working memory profiles of different groups, allowing for the development of intervention programs in the future.

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia

BACKGROUND

It is important to improve verbal Working Memory (WM) in reading disability, as it is a key factor in learning. There are commercial verbal WM training programs, which have some short-term effects only on the verbal WM capacity, not reading. However, because of some weaknesses in current verbal WM training programs, researchers suggested designing and developing newly structured programs that particularly target educational functions such as reading skills. In the current double-blind randomized clinical trial study, we designed a new Verbal Working Memory-Balance (VWM-B) program which was carried out using a portable robotic device. The short-term effects of the VWM-B program, on verbal WM capacity, reading skills, and postural control were investigated in Iranian children with developmental dyslexia.

RESULTS

The effectiveness of the VWM-B program was compared with the VWM-program as a traditional verbal WM training. In comparison with VWM-program, the participants who received training by the VWM-B program showed superior performance on verbal WM capacity, reading skills, and postural control after a short-term intervention.

CONCLUSIONS

We proposed that the automatized postural control resulting from VWM-B training had a positive impact on improving verbal WM capacity and reading ability. Based on the critical role of the cerebellum in automatizing skills, our findings support the cerebellar deficit theory in dyslexia.

TRIAL REGISTRATION

This trial was (retrospectively) registered on 8 February 2018 with the Iranian Registry of Clinical Trials (IRCT20171219037953N1).

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.

Dyslexia treatment studies: A systematic review and suggestions on testing treatment efficacy with small effects and small samples

Poor response to treatment is a defining characteristic of reading disorder. In the present systematic review and meta-analysis, we found that the overall average effect size for treatment efficacy was modest, with a mean standardized difference of 0.38. Small true effects, combined with the difficulty to recruit large samples, seriously challenge researchers planning to test treatment efficacy in dyslexia and potentially in other learning disorders. Nonetheless, most published studies claim effectiveness, generally based on liberal use of multiple testing. This inflates the risk that most statistically significant results are associated with overestimated effect sizes. To enhance power, we propose the strategic use of repeated measurements with mixed-effects modelling. This novel approach would enable us to estimate both individual parameters and population-level effects more reliably. We suggest assessing a reading outcome not once, but three times, at pre-treatment and three times at post-treatment. Such design would require only modest additional efforts compared to current practices. Based on this, we performed ad hoc a priori design analyses via simulation studies. Results showed that using the novel design may allow one to reach adequate power even with low sample sizes of 30–40 participants (i.e., 15–20 participants per group) for a typical effect size of d = 0.38. Nonetheless, more conservative assumptions are warranted for various reasons, including a high risk of publication bias in the extant literature. Our considerations can be extended to intervention studies of other types of neurodevelopmental disorders.

The Moderation Effect of Processing Efficiency on the Relationship Between Visual Working Memory and Chinese Character Recognition

To investigate the underlying mechanism of the relationship between visual working memory (VWM) and Chinese character recognition, and the moderation effect of processing efficiency on this relationship, 154 first-grade students were administered a battery of tasks for VWM, rapid temporal processing, and Chinese character reading. In the VWM task, the children were asked to remember the jumping routes of a frog and report these routes in reverse sequence. The longest span for which each participant could respond correctly at least four times out of six was the VWM index. In the task of temporal order judgement, the participants were asked to select which of two balls was presented first, with stimulus onset asynchronies varying from 8 to 492 ms according to an adaptive psychophysical procedure. Visual temporal order threshold (VTOT) was utilized as an indicator of processing efficiency. The participants were asked to read 100 characters aloud to measure their word-level reading abilities in Chinese character recognition. After controlling age, non-verbal intelligence, visual short-term memory, morphological awareness, and orthographic awareness, the results of a moderation effect analysis showed that (1) both VWM and visual VTOT predicted Chinese character reading, and (2) the moderation effect of VTOT on the VWM-reading link was significant (p = 0.001). The correlation between VWM and Chinese character reading was positive and significant when VTOTs were above average (i.e., smaller than 87.14 ms); however, the correlation was negative at relatively poor levels of VTOTs (i.e., larger than 231.44 ms).

Evaluating the Effects of Metalinguistic and Working Memory Training on Reading Fluency in Chinese and English: A Randomized Controlled Trial

Children traditionally learn to read Chinese characters by rote, and thus stretching children's memory span could possibly improve their reading in Chinese. Nevertheless, 85% of Chinese characters are semantic-phonetic compounds that contain probabilistic information about meaning and pronunciation. Hence, enhancing children's metalinguistic skills might also facilitate reading in Chinese. In the present study, we tested whether training children's metalinguistic skills or training their working-memory capacity in 8 weeks would produce reading gains, and whether these gains would be similar in Chinese and English. We recruited 35 second graders in Hong Kong and randomly assigned them to a metalinguistic training group (N = 13), a working-memory training group (10), or a waitlist control group (12). In the metalinguistic training, children were taught to analyze novel Chinese characters into phonetic and semantic radicals and novel English words into onsets and rimes. In the working-memory training, children were trained to recall increasingly long strings of Cantonese or English syllables in correct or reverse order. All children were tested on phonological skills, verbal working memory, and word reading fluency in Chinese and in English before and after training. Analyses of the pre- and post-test data revealed that only the metalinguistic training group, but not the other two groups, showed significant improvement on phonological skills in Chinese and English. Working-memory span in Chinese and English increased from the pre- to post-test in the working-memory training group relative to other two groups. Despite these domain-specific training effects, the two training groups improved similarly in word reading fluency in Chinese and English compared to the control group. Our findings suggest that increased metalinguistic skills and a larger working-memory span appear equally beneficial to reading fluency, and that these effects are similar in Chinese and English.

Specific effects of working memory training on the reading skills of Chinese children with developmental dyslexia

Most research on working memory (WM) training for children with developmental dyslexia (DD) has focused on western alphabetical languages. Moreover, most of these studies used a combination of training tasks targeting a variety of WM components, making it difficult to determine whether WM training generates a general improvement in overall reading, or improves specific cognitive skills corresponding to the WM components that are targeted in training. We tested the general and specific effects of WM training on the reading skills of 45 Chinese children with DD, grades 3 to 5. In Experiment 1, the experimental group received a program targeting the verbal WM component; in Experiment 2, the experimental group was trained with a program targeting visuospatial WM. In both experiments the control group played a placebo video game. In Experiment 1, the experimental group outperformed the control group on the visual rhyming task, which is highly correlated with verbal WM. In Experiment 2, the experimental group outperformed the control group on the orthographic awareness test, which is highly correlated with visuospatial WM. Furthermore, in both Experiment 1 and Experiment 2, the experimental groups outperformed the control groups on the fast word naming test, which is highly related to both visuospatial WM and verbal WM. Results indicated that WM training improved specific reading-related cognitive skills that are highly correlated with the specific WM components that were the target of training.

Practice makes imperfect: Working memory training can harm recognition memory performance

There is a great deal of debate concerning the benefits of working memory (WM) training and whether that training can transfer to other tasks. Although a consistent finding is that WM training programs elicit a short-term near-transfer effect (i.e., improvement in WM skills), results are inconsistent when considering persistence of such improvement and far transfer effects. In this study, we compared three groups of participants: a group that received WM training, a group that received training on how to use a mental imagery memory strategy, and a control group that received no training. Although the WM training group improved on the trained task, their posttraining performance on nontrained WM tasks did not differ from that of the other two groups. In addition, although the imagery training group's performance on a recognition memory task increased after training, the WM training group's performance on the task decreased after training. Participants' descriptions of the strategies they used to remember the studied items indicated that WM training may lead people to adopt memory strategies that are less effective for other types of memory tasks. These results indicate that WM training may have unintended consequences for other types of memory performance.