Intervention studies with developmental samples are difficult to implement, in particular when targeting demographically diverse communities. Online studies have the potential to examine the efficacy of highly scalable interventions aimed at enhancing development, and to address some of the barriers faced by underrepresented communities for participating in developmental research. During the COVID-19 pandemic, we executed a fully remote randomized controlled trial (RCT) language intervention with third and fourth grade students (N = 255; age range 8.19–10.72 years, mean = 9.41, SD = 0.52) from diverse backgrounds across the United States. Using this as a case study, we discuss both challenges and solutions to conducting an intensive online intervention through the various phases of the study, including recruitment, data collection, and fidelity of intervention implementation. We provide comprehensive suggestions and takeaways, and conclude by summarizing some important tradeoffs for researchers interested in carrying out such studies.
Early identification is important for improving reading outcomes for children at risk for reading difficulties, but current methods tend to perform sub-optimally in identifying true risk. One possible reason is that whereas most prediction models assume linear relationships among risk and reading outcome measures, qualitatively different patterns of association may exist among the measures at different skill levels. We implemented dynamic non-linear modeling to test this possibility in two distinct samples of children: 1) 225 pre-kindergarten and kindergarten with concurrent data and 2) 104 children with longitudinal (pre-)kindergarten and second-grade reading scores. Cusp catastrophe modeling was used to evaluate the moderating effects of rapid automatized naming (RAN) and phonological processing, two foundational pre-reading skills, on the concurrent and longitudinal relationship between letter identification and word reading. We further tested whether RAN and phonological processing have independent non-linear effects on the letter-word reading relationship above and beyond that of a single skill. Deficits in RAN and phonological processing beyond a critical level were associated with non-linear changes in the prediction of word reading from letter knowledge, both concurrently and longitudinally, fully supporting the cusp model over the competing models. These findings demonstrate the importance of implementing non-linear models for predicting risk for reading difficulties. There was no evidence for the interactive effects of RAN and phonological processing on reading. Instead, in accordance with the basic tenants of the double-deficit hypothesis, current results suggest that the constructs represent two salient but separable causes of reading impairment, even at the earliest stages of reading ability. These findings suggest that models predicting which at-risk children will develop poor reading must diverge from assumptions of relationships observed in typical reading.
Reading fluency -- the speed and accuracy of reading connected text -- is foundational to educational success. The current longitudinal study investigates the neural correlates of fluency development using a connected-text paradigm with an individualized presentation rate. Twenty-six children completed a functional MRI task in 1st/2nd grade (time 1) and again 1-2 years later (time 2). There was a longitudinal increase in activation in the ventral occipito-temporal (vOT) cortex from time 1 to time 2. This increase was also associated with improvements in reading fluency skills and modulated by individual speed demands. These findings highlight the reciprocal relationship of the vOT region with reading proficiency and its importance for supporting the transition to fluent reading. These results have implications for developing effective interventions to target increased automaticity in reading.
According to several influential theoretical frameworks, phonological deficits in dyslexia result from reduced sensitivity to acoustic cues that are essential for the development of robust phonemic representations. Some accounts suggest that these deficits arise from impairments in rapid auditory adaptation processes that are either speech-specific or domain-general. Here, we examined the specificity of auditory adaptation deficits in dyslexia using a nonlinguistic tone anchoring (adaptation) task and a linguistic selective adaptation task in children and adults with and without dyslexia. Children and adults with dyslexia had elevated tone-frequency discrimination thresholds, but both groups benefited from anchoring to repeated stimuli to the same extent as typical readers. Additionally, although both dyslexia groups had overall reduced accuracy for speech sound identification, only the child group had reduced categorical perception for speech. Across both age groups, individuals with dyslexia had reduced perceptual adaptation to speech. These results highlight broad auditory perceptual deficits across development in individuals with dyslexia for both linguistic and nonlinguistic domains, but speech-specific adaptation deficits. Finally, mediation models in children and adults revealed that the causal pathways from basic perception and adaptation to phonological awareness through speech categorization were not significant. Thus, rather than having causal effects, perceptual deficits may co-occur with the phonological deficits in dyslexia across development.
Robust and efficient speech perception relies on the interpretation of acoustically variable phoneme realizations, yet prior neuroimaging studies are inconclusive regarding the degree to which subphonemic detail is maintained over time as categorical representations arise. It is also unknown whether this depends on the demands of the listening task. We addressed these questions by using neural decoding to quantify the (dis)similarity of brain response patterns evoked during two different tasks. We recorded magnetoencephalography (MEG) as adult participants heard isolated, randomized tokens from a /ba/-/da/ speech continuum. In the passive task, their attention was diverted. In the active task, they categorized each token as ba or da. We found that linear classifiers successfully decoded ba vs. da perception from the MEG data. Data from the left hemisphere were sufficient to decode the percept early in the trial, while the right hemisphere was necessary but not sufficient for decoding at later time points. We also decoded stimulus representations and found that they were maintained longer in the active task than in the passive task; however, these representations did not pattern more like discrete phonemes when an active categorical response was required. Instead, in both tasks, early phonemic patterns gave way to a representation of stimulus ambiguity that coincided in time with reliable percept decoding. Our results suggest that the categorization process does not require the loss of subphonemic detail, and that the neural representation of isolated speech sounds includes concurrent phonemic and subphonemic information.
The mismatch negativity (MMN), an electrophysiological response to an oddball auditory stimulus, is related to reading ability in many studies. There are conflicting findings regarding exactly how the MMN relates to risk or actual diagnosis of dyslexia/reading impairment, perhaps due to the heterogeneity of abilities in children with reading impairment. In this study, 166 English-speaking kindergarten children oversampled for dyslexia risk completed behavioral assessments and a speech-syllable MMN paradigm. We examined how early and late MMN mean amplitude and laterality were related to two established predictors of reading ability: phonological awareness (PA) and rapid automatized naming (RAN). In bootstrapped group analyses, late MMN amplitude was significantly greater in children with typical PA ability than low PA ability. In contrast, laterality of the early and late MMN was significantly different in children with low versus typical with RAN ability. Continuous analyses controlling for child age, nonverbal IQ, and letter and word identification abilities showed the same associations between late MMN amplitude with PA and late MMN laterality with RAN. These findings suggest that amplitude of the MMN may relate to phonological representations and ability to manipulate them, whereas MMN laterality may reflect differences in brain processes that support automaticity needed for reading.
Reading comprehension is a complex task that depends on multiple cognitive and linguistic processes. According to the updated Simple View of Reading framework, in adults, individual variation in reading comprehension can be largely explained by combined variance in three component abilities: (1) decoding accuracy, (2) fluency, and (3) language comprehension. Here we asked whether the neural correlates of the three components are different in adults with dyslexia as compared to typically-reading adults and whether the relative contribution of these correlates to reading comprehension is similar in the two groups. We employed a novel naturalistic fMRI reading task to identify the neural correlates of individual differences in the three components using whole-brain and literature-driven regions-of-interest approaches. Across all participants, as predicted by the Simple View framework, we found distinct patterns of associations with linguistic and domain-general regions for the three components, and that the left-hemispheric neural correlates of language comprehension in the angular and posterior temporal gyri made the largest contributions to explaining out-of-scanner reading comprehension performance. These patterns differed between the two groups. In typical adult readers, better fluency was associated with greater activation of left occipitotemporal regions, better comprehension with lesser activation in prefrontal and posterior parietal regions, and there were no significant associations with decoding. In adults with dyslexia, better fluency was associated with greater activation of bilateral inferior parietal regions, better comprehension was associated with greater activation in some prefrontal clusters and lower in others, and better decoding skills were associated with lesser activation of bilateral prefrontal and posterior parietal regions. Extending the behavioral findings of skill-level differences in the relative contribution of the three components to reading comprehension, the relative contributions of the neural correlates to reading comprehension differed based on dyslexia status. These findings reveal some of the neural correlates of individual differences in the three components and the underlying mechanisms of reading comprehension deficits in adults with dyslexia.
Developmental dyslexia affects 40–60% of children with a familial risk (FHD+) compared to a general prevalence of 5–10%. Despite the increased risk, about half of FHD+ children develop typical reading abilities (FHD+Typical). Yet the underlying neural characteristics of favorable reading outcomes in at-risk children remain unknown. Utilizing a retrospective, longitudinal approach, this study examined whether putative protective neural mechanisms can be observed in FHD+Typical at the prereading stage. Functional and structural brain characteristics were examined in 47 FHD+ prereaders who subsequently developed typical (n = 35) or impaired (n = 12) reading abilities and 34 controls (FHD−Typical). Searchlight-based multivariate pattern analyses identified distinct activation patterns during phonological processing between FHD+Typical and FHD−Typical in right inferior frontal gyrus (RIFG) and left temporo-parietal cortex (LTPC) regions. Follow-up analyses on groupspecific classification patterns demonstrated LTPC hypoactivation in FHD+Typical compared to FHD−Typical, suggesting this neural characteristic as an FHD+ phenotype. In contrast, RIFG showed hyperactivation in FHD+Typical than FHD−Typical, and its activation pattern was positively correlated with subsequent reading abilities in FHD+ but not controls (FHD−Typical). RIFG hyperactivation in FHD+Typical was further associated with increased interhemispheric functional and structural connectivity. These results suggest that some protective neural mechanisms are already established in FHD+Typical prereaders supporting their typical reading development.
Dyslexia is a common neurobiological disorder in which a child fails to acquire typical word reading skills despite adequate opportunity and intelligence. The visual word form area (VWFA) is a region within the left fusiform gyrus that specializes for print over the course of reading acquisition and is often hypoactivated in individuals with dyslexia. It is currently unknown whether atypicalities in this brain region are already present in kindergarten children who will subsequently develop dyslexia. Here, we measured fMRI activation in response to letters and false fonts in bilateral fusiform gyrus in children with and without risk for dyslexia (defined by family history or low scores on assessments of pre-reading skills, such as phonological awareness). We then followed these children longitudinally through the end of second grade to evaluate whether brain activation patterns in kindergarten were related to second-grade reading outcomes. Compared to typical readers who exhibited no risk factors for reading impairment in kindergarten, there was significant hypoactivation to both letters and false-fonts in the left fusiform gyrus in at-risk children who subsequently developed reading impairment, but not in at-risk children who developed typical reading skills. There were no significant differences in letter- or false-font responses in the right fusiform gyrus among the groups. The finding that hypoactivation to print in the VWFA is present in children who subsequently develop reading impairment even prior to the onset of formal reading instruction suggests that atypical responses to print play an early role in the development of reading impairments such as dyslexia.
Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white-matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white-matter FA and second-grade reading outcomes were investigated in an SES-diverse sample of 125 children. The three left-hemisphere white-matter tracts most associated with reading, and their right-hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF). There was a significant and positive association between SES and fractional anisotropy (FA) in the bilateral ILF in kindergarten. SES moderated the association between kindergarten ILF and second grade reading performance, such that it was positive in lower-SES children, but not significant in higher-SES children. These results have implications for understanding the role of the environment in the development of the neural pathways that support reading.
A functional region of left fusiform gyrus termed "the visual word form area" (VWFA) develops during reading acquisition to respond more strongly to printed words than to other visual stimuli. Here, we examined responses to letters among 5- and 6-year-old early kindergarten children (N = 48) with little or no school-based reading instruction who varied in their reading ability. We used functional magnetic resonance imaging (fMRI) to measure responses to individual letters, false fonts, and faces in left and right fusiform gyri. We then evaluated whether signal change and size (spatial extent) of letter-sensitive cortex (greater activation for letters versus faces) and letter-specific cortex (greater activation for letters versus false fonts) in these regions related to (a) standardized measures of word-reading ability and (b) signal change and size of face-sensitive cortex (fusiform face area or FFA; greater activation for faces versus letters). Greater letter specificity, but not letter sensitivity, in left fusiform gyrus correlated positively with word reading scores. Across children, in the left fusiform gyrus, greater size of letter-sensitive cortex correlated with lesser size of FFA. These findings are the first to suggest that in beginning readers, development of letter responsivity in left fusiform cortex is associated with both better reading ability and also a reduction of the size of left FFA that may result in right-hemisphere dominance for face perception.
Numerous studies have shown that phonological skills are critical for successful reading acquisition. However, how the brain network supporting phonological processing evolves and how it supports the initial course of learning to read is largely unknown. Here, for the first time, we characterized the emergence of the phonological network in 28 children over three stages (prereading, beginning reading, and emergent reading) longitudinally. Across these three time points, decreases in neural activation in the left inferior parietal cortex (LIPC) were observed during an audiovisual phonological processing task, suggesting a specialization process in response to reading instruction/experience. Furthermore, using the LIPC as the seed, a functional network consisting of the left inferior frontal, left posterior occipitotemporal, and right angular gyri was identified. The connection strength in this network co-developed with the growth of phonological skills. Moreover, children with above-average gains in phonological processing showed a significant developmental increase in connection strength in this network longitudinally, while children with below-average gains in phonological processing exhibited the opposite trajectory. Finally, the connection strength between the LIPC and the left posterior occipitotemporal cortex at the prereading level significantly predicted reading performance at the emergent reading stage. Our findings highlight the importance of the early emerging phonological network for reading development, providing direct evidence for the Interactive Specialization Theory and neurodevelopmental models of reading.
There is mounting evidence for links between musical rhythm processing and reading-related cognitive skills, such as phonological awareness. This may be because music and speech are rhythmic: both involve processing complex sound sequences with systematic patterns of timing, accent, and grouping. Yet, there is a salient difference between musical and speech rhythm: musical rhythm is often beat-based (based on an underlying grid of equal time intervals), while speech rhythm is not. Thus, the role of beat-based processing in the reading-rhythm relationship is not clear. Is there is a distinct relation between beat-based processing mechanisms and reading-related language skills, or is the rhythm-reading link entirely due to shared mechanisms for processing nonbeat-based aspects of temporal structure? We discuss recent evidence for a distinct link between beat-based processing and early reading abilities in young children, and suggest experimental designs that would allow one to further methodically investigate this relationship. We propose that beat-based processing taps into a listener's ability to use rich contextual regularities to form predictions, a skill important for reading development.
A growing number of studies report links between nonlinguistic rhythmic abilities and certain linguistic abilities, particularly phonological skills. The current study investigated the relationship between nonlinguistic rhythmic processing, phonological abilities, and early literacy abilities in kindergarteners. A distinctive aspect of the current work was the exploration of whether processing of different types of rhythmic patterns is differentially related to kindergarteners' phonological and reading-related abilities. Specifically, we examined the processing of metrical versus nonmetrical rhythmic patterns, that is, patterns capable of being subdivided into equal temporal intervals or not (Povel & Essens, 1985). This is an important comparison because most music involves metrical sequences, in which rhythm often has an underlying temporal grid of isochronous units. In contrast, nonmetrical sequences are arguably more typical to speech rhythm, which is temporally structured but does not involve an underlying grid of equal temporal units. A rhythm discrimination app with metrical and nonmetrical patterns was administered to 74 kindergarteners in conjunction with cognitive and preliteracy measures. Findings support a relationship among rhythm perception, phonological awareness, and letter-sound knowledge (an essential precursor of reading). A mediation analysis revealed that the association between rhythm perception and letter-sound knowledge is mediated through phonological awareness. Furthermore, metrical perception accounted for unique variance in letter-sound knowledge above all other language and cognitive measures. These results point to a unique role for temporal regularity processing in the association between musical rhythm and literacy in young children.
Research suggests that early identification of developmental dyslexia is important for mitigating the negative effects of dyslexia, including reduced educational attainment and increased socioemotional difficulties. The strongest pre-literacy predictors of dyslexia are rapid automatized naming (RAN), phonological awareness (PA), letter knowledge, and verbal short-term memory. The relationship among these constructs has been debated, and several theories have emerged to explain the unique role of each in reading ability/disability. Furthermore, the stability of identification of risk based on these measures varies widely across studies, due in part to the different cut-offs employed to designate risk. We applied a latent profile analysis technique with a diverse sample of 1215 kindergarten and pre-kindergarten students from 20 schools, to investigate whether PA, RAN, letter knowledge, and verbal short-term memory measures differentiated between homogenous profiles of performance on these measures. Six profiles of performance emerged from the data: average performers, below average performers, high performers, PA risk, RAN risk, and double-deficit risk (both PA and RAN). A latent class regression model was employed to investigate the longitudinal stability of these groups in a representative subset of children (n = 95) nearly two years later, at the end of 1st grade. Profile membership in the spring semester of pre-kindergarten or fall semester of kindergarten was significantly predictive of later reading performance, with the specific patterns of performance on the different constructs remaining stable across the years. There was a higher frequency of PA and RAN deficits in children from lower socioeconomic status (SES) backgrounds. There was no evidence for the IQ-achievement discrepancy criterion traditionally used to diagnose dyslexia. Our results support the feasibility of early identification of dyslexia risk and point to the heterogeneity of risk profiles. These findings carry important implications for improving outcomes for children with dyslexia, based on more targeted interventions.
Previous research has suggested a link between musical training and auditory processing skills. Musicians have shown enhanced perception of auditory features critical to both music and speech, suggesting that this link extends beyond basic auditory processing. It remains unclear to what extent musicians who also have dyslexia show these specialized abilities, considering often-observed persistent deficits that coincide with reading impairments. The present study evaluated auditory sequencing and speech discrimination in 52 adults comprised of musicians with dyslexia, nonmusicians with dyslexia, and typical musicians. An auditory sequencing task measuring perceptual acuity for tone sequences of increasing length was administered. Furthermore, subjects were asked to discriminate synthesized syllable continua varying in acoustic components of speech necessary for intraphonemic discrimination, which included spectral (formant frequency) and temporal (voice onset time [VOT] and amplitude envelope) features. Results indicate that musicians with dyslexia did not significantly differ from typical musicians and performed better than nonmusicians with dyslexia for auditory sequencing as well as discrimination of spectral and VOT cues within syllable continua. However, typical musicians demonstrated superior performance relative to both groups with dyslexia for discrimination of syllables varying in amplitude information. These findings suggest a distinct profile of speech processing abilities in musicians with dyslexia, with specific weaknesses in discerning amplitude cues within speech. Because these difficulties seem to remain persistent in adults with dyslexia despite musical training, this study only partly supports the potential for musical training to enhance the auditory processing skills known to be crucial for literacy in individuals with dyslexia. (PsycINFO Database Record
Dyslexia is a heritable reading disorder with an estimated prevalence of 5-17%. A multiple deficit model has been proposed that illustrates dyslexia as an outcome of multiple risks and protective factors interacting at the genetic, neural, cognitive, and environmental levels. Here we review the evidence on each of these levels and discuss possible underlying mechanisms and their reciprocal interactions along a developmental timeline. Current and potential implications of neuroscientific findings for contemporary challenges in the field of dyslexia, as well as for reading development and education in general, are then discussed.
Developmental dyslexia is an unexplained inability to acquire accurate or fluent reading that affects approximately 5-17% of children. Dyslexia is associated with structural and functional alterations in various brain regions that support reading. Neuroimaging studies in infants and pre-reading children suggest that these alterations predate reading instruction and reading failure, supporting the hypothesis that variant function in dyslexia susceptibility genes lead to atypical neural migration and/or axonal growth during early, most likely in utero, brain development. Yet, dyslexia is typically not diagnosed until a child has failed to learn to read as expected (usually in second grade or later). There is emerging evidence that neuroimaging measures, when combined with key behavioral measures, can enhance the accuracy of identification of dyslexia risk in pre-reading children but its sensitivity, specificity, and cost-efficiency is still unclear. Early identification of dyslexia risk carries important implications for dyslexia remediation and the amelioration of the psychosocial consequences commonly associated with reading failure.
Speech processing inherently relies on the perception of specific, rapidly changing spectral and temporal acoustic features. Advanced acoustic perception is also integral to musical expertise, and accordingly several studies have demonstrated a significant relationship between musical training and superior processing of various aspects of speech. Speech and music appear to overlap in spectral and temporal features; however, it remains unclear which of these acoustic features, crucial for speech processing, are most closely associated with musical training. The present study examined the perceptual acuity of musicians to the acoustic components of speech necessary for intra-phonemic discrimination of synthetic syllables. We compared musicians and non-musicians on discrimination thresholds of three synthetic speech syllable continua that varied in their spectral and temporal discrimination demands, specifically voice onset time (VOT) and amplitude envelope cues in the temporal domain. Musicians demonstrated superior discrimination only for syllables that required resolution of temporal cues. Furthermore, performance on the temporal syllable continua positively correlated with the length and intensity of musical training. These findings support one potential mechanism by which musical training may selectively enhance speech perception, namely by reinforcing temporal acuity and/or perception of amplitude rise time, and implications for the translation of musical training to long-term linguistic abilities.
Developmental dyslexia, an unexplained difficulty in learning to read, has been associated with alterations in white matter organization as measured by diffusion-weighted imaging. It is unknown, however, whether these differences in structural connectivity are related to the cause of dyslexia or if they are consequences of reading difficulty (e.g., less reading experience or compensatory brain organization). Here, in 40 kindergartners who had received little or no reading instruction, we examined the relation between behavioral predictors of dyslexia and white matter organization in left arcuate fasciculus, inferior longitudinal fasciculus, and the parietal portion of the superior longitudinal fasciculus using probabilistic tractography. Higher composite phonological awareness scores were significantly and positively correlated with the volume of the arcuate fasciculus, but not with other tracts. Two other behavioral predictors of dyslexia, rapid naming and letter knowledge, did not correlate with volumes or diffusion values in these tracts. The volume and fractional anisotropy of the left arcuate showed a particularly strong positive correlation with a phoneme blending test. Whole-brain regressions of behavioral scores with diffusion measures confirmed the unique relation between phonological awareness and the left arcuate. These findings indicate that the left arcuate fasciculus, which connects anterior and posterior language regions of the human brain and which has been previously associated with reading ability in older individuals, is already smaller and has less integrity in kindergartners who are at risk for dyslexia because of poor phonological awareness. These findings suggest a structural basis of behavioral risk for dyslexia that predates reading instruction.
Ola Ozernov-Palchik, MS, PhD NRSA Postdoctoral Fellow McGovern Institute for Brain Research Massachusetts Institute of Technology