The role of phonological awareness in treatments of dyslexic primary school children.

The present study investigated whether phonological awareness training is an effective intervention to significantly improve reading in German dyslexic third and fourth graders with a phonological awareness deficit, and whether these children can equally benefit from a phonology-based reading training or a visually-based reading training. German speaking dyslexic elementary school children (n=30; M=9.8 years) were matched by forming triplets based on IQ, reading quotient and phonological awareness and then randomly assigned to one out of three interventions (n=10): a phonological awareness training, a phonology-based reading training (phonics instruction), and a visually-based reading training (repeated reading of sight words). A total of 20 training sessions (30 minutes each) were distributed over four weeks. Typical readers (n=10; M=9.5 years) were assigned to the control group. Phonological awareness training directly improves reading comprehension in German dyslexic children with a phonological awareness deficit. However, these children can equally benefit from a visually-based reading training. In contrast, the phonology-based reading training has a direct selective effect on decoding but not on reading comprehension. Despite divergent short-term patterns, long-term improvement of reading comprehension and decoding is similar across all training groups, irrespective of the training method. Phonological awareness may but does not need to be part of reading remediation in dyslexic children with a phonological deficit when learning to read a consistent orthography. Rather, a visually-based reading strategy might compensate for the phonological deficit in dyslexic children after the initial stage of reading acquisition.

Shared vs. specific brain activation changes in dyslexia after training of phonology, attention, or reading.

Whereas the neurobiological basis of developmental dyslexia has received substantial attention, only little is known about the processes in the brain during remediation. This holds in particular in light of recent findings on cognitive subtypes of dyslexia which suggest interactions between individual profiles, training methods, and also the task in the scanner. Therefore, we trained three groups of German dyslexic primary school children in the domains of phonology, attention, or visual word recognition. We compared neurofunctional changes after 4 weeks of training in these groups to those in untrained normal readers in a reading task and in a task of visual attention. The overall reading improvement in the dyslexic children was comparable over groups. It was accompanied by substantial increase of the activation level in the visual word form area (VWFA) during a reading task inside the scanner. Moreover, there were activation increases that were unique for each training group in the reading task. In contrast, when children performed the visual attention task, shared training effects were found in the left inferior frontal sulcus and gyrus, which varied in amplitude between the groups. Overall, the data reveal that different remediation programmes matched to individual profiles of dyslexia may improve reading ability and commonly affect the VWFA in dyslexia as a shared part of otherwise distinct networks.

Devil in the details? Developmental dyslexia and visual long-term memory for details.

Cognitive theories on causes of developmental dyslexia can be divided into language-specific and general accounts. While the former assume that words are special in that associated processing problems are rooted in language-related cognition (e.g., phonology) deficits, the latter propose that dyslexia is rather rooted in a general impairment of cognitive (e.g., visual and/or auditory) processing streams. In the present study, we examined to what extent dyslexia (typically characterized by poor orthographic representations) may be associated with a general deficit in visual long-term memory (LTM) for details. We compared object- and detail-related visual LTM performance (and phonological skills) between dyslexic primary school children and IQ-, age-, and gender-matched controls. The results revealed that while the overall amount of LTM errors was comparable between groups, dyslexic children exhibited a greater portion of detail-related errors. The results suggest that not only phonological, but also general visual resolution deficits in LTM may play an important role in developmental dyslexia.

Distinct neural signatures of cognitive subtypes of dyslexia: effects of lexicality during phonological processing.

The present study investigates the neurobiological basis of two subtypes of dyslexia with either a double deficit (concerning phonological awareness and rapid naming) or a single rapid naming deficit. We compared such groups of German dyslexic primary school children to each other and with good reading children in a phoneme deletion task performed during fMRI scanning. Children heard German words or pseudowords and repeated the remainder of the stimulus while deleting the initial phoneme (e.g. tear - _ear). In four conditions, the input stimulus (word or pseudoword) could either become another word or pseudoword as output. The word-word condition stuck out against all other conditions involving pseudowords: Dyslexics with a double deficit showed a strong response in left areas 44 and 45 in Boca's region, whereas dyslexics with rapid naming difficulties revealed a contralateral effect in right areas 44 and 45. These findings, which were obtained without presenting written or pictorial stimuli, reveal that a double deficit in dyslexia is not the sum of single deficits, but rather involves the interaction of lexical and phonological processing, making strong demands on the left inferior frontal cortex. In general, the results stress the importance of considering subtypes of dyslexia differentially in order to obtain better insights in the neurocognitive mechanisms of impaired and successful reading.

Distinct neural signatures of cognitive subtypes of dyslexia with and without phonological deficits.

Developmental dyslexia can be distinguished as different cognitive subtypes with and without phonological deficits. However, despite some general agreement on the neurobiological basis of dyslexia, the neurofunctional mechanisms underlying these cognitive subtypes remain to be identified. The present BOLD fMRI study thus aimed at investigating by which distinct and/or shared neural activation patterns dyslexia subtypes are characterized. German dyslexic fourth graders with and without deficits in phonological awareness and age-matched normal readers performed a phonological decision task: does the auditory word contain the phoneme/a/? Both dyslexic subtypes showed increased activation in the right cerebellum (Lobule IV) compared to controls. Subtype-specific increased activation was systematically found for the phonological dyslexics as compared to those without this deficit and controls in the left inferior frontal gyrus (area 44: phonological segmentation), the left SMA (area 6), the left precentral gyrus (area 6) and the right insula. Non-phonological dyslexics revealed subtype-specific increased activation in the left supramarginal gyrus (area PFcm; phonological storage) and angular gyrus (area PGp). The study thus provides the first direct evidence for the neurobiological grounding of dyslexia subtypes. Moreover, the data contribute to a better understanding of the frequently encountered heterogeneous neuroimaging results in the field of dyslexia.

Interaction of phonological awareness and 'magnocellular' processing during normal and dyslexic reading: behavioural and fMRI investigations.

We investigated whether phonological deficits are a consequence of magnocellular processing deficits in dyslexic and control children. In Experiment 1, children were tested for reading ability, phonological awareness, visuo-magnocellular motion perception, and attention shifting (sometimes considered as magnocellular function). A two-step cluster analysis of the behavioural scores revealed four clusters of children. Phonological awareness was correlated with attention (cluster musical sharp1) or motion detection (cluster musical sharp2), whereas attention and motion detection were correlated in cluster musical sharp3. In cluster musical sharp4, all variables were uncorrelated. In Experiment 2, the same variables plus auditory discrimination were tested with fMRI in a sub-sample of Experiment 1. Although dyslexics had reduced activation in visual or auditory cortex during motion detection or auditory discrimination, respectively, they had increased right frontal activation in areas 44 and 45 in all 'magnocellular' (including auditory) tasks. In contrasts, during phonological decisions, there was higher activation for good readers than dyslexics in left areas 44 and 45. Together, the two experiments give insight into the interplay of phonological and magnocellular processing during reading. Distinct left versus right frontal effects reveal partly different underlying neural mechanisms. These data contradict the view that phonological processing deficits in dyslexia necessarily result from impaired magnocellular functioning.