Frontal volume as a potential source of the comorbidity between attention-deficit/hyperactivity disorder and reading disorders.

Prefrontal volume reductions commonly are demonstrated in ADHD, but the literature examining prefrontal volume in reading disorders (RD) is scant despite their also having executive functioning (EF) deficits. Furthermore, only a few anatomical studies have examined the frontal lobes in comorbid RD/ADHD, though they have EF deficits similar to RD and ADHD. Hence, we examined frontal gyri volume in children with RD, ADHD, RD/ADHD and controls, as well as their relationship to EF for gyri found to differ between groups. We found right inferior frontal (RIF) volume was smaller in ADHD, and smaller volume was related to worse behavioral regulation. Left superior frontal (LSF) volume was larger in RD than ADHD, and its size was negatively related to basic reading ability. Left middle frontal (LMF) volume was largest in RD/ADHD overall. Further, its volume was not related to basic reading nor behavioral regulation but was related to worse attentional control, suggesting some specificity in its EF relationship. When examining hypotheses on the etiology of RD/ADHD, RD/ADHD was commensurate with ADHD in RIF volume and both RD and ADHD in LSF volume (being midway between the groups), consistent with the common etiology hypothesis. Nevertheless, they also had an additional gyrus affected: LMF, consistent with the cognitive subtype hypothesis in its specificity to RD/ADHD. The few other frontal aMRI studies on RD/ADHD supported both hypotheses as well. Given this, future research should continue to focus on frontal morphology in its endeavors to find neurobiological contributors to the comorbidity between RD and ADHD.

Visual processing in reading disorders and attention-deficit/hyperactivity disorder and its contribution to basic reading ability.

Whether visual processing deficits are common in reading disorders (RD), and related to reading ability in general, has been debated for decades. The type of visual processing affected also is debated, although visual discrimination and short-term memory (STM) may be more commonly related to reading ability. Reading disorders are frequently comorbid with ADHD, and children with ADHD often have subclinical reading problems. Hence, children with ADHD were used as a comparison group in this study. ADHD and RD may be dissociated in terms of visual processing. Whereas RD may be associated with deficits in visual discrimination and STM for order, ADHD is associated with deficits in visual-spatial processing. Thus, we hypothesized that children with RD would perform worse than controls and children with ADHD only on a measure of visual discrimination and a measure of visual STM that requires memory for order. We expected all groups would perform comparably on the measure of visual STM that does not require sequential processing. We found children with RD or ADHD were commensurate to controls on measures of visual discrimination and visual STM that do not require sequential processing. In contrast, both RD groups (RD, RD/ADHD) performed worse than controls on the measure of visual STM that requires memory for order, and children with comorbid RD/ADHD performed worse than those with ADHD. In addition, of the three visual measures, only sequential visual STM predicted reading ability. Hence, our findings suggest there is a deficit in visual sequential STM that is specific to RD and is related to basic reading ability. The source of this deficit is worthy of further research, but it may include both reduced memory for order and poorer verbal mediation.

Reading performance is predicted by more than phonological processing.

WE COMPARED THREE PHONOLOGICAL PROCESSING COMPONENTS (PHONOLOGICAL AWARENESS, RAPID AUTOMATIZED NAMING AND PHONOLOGICAL MEMORY), VERBAL WORKING MEMORY, AND ATTENTION CONTROL IN TERMS OF HOW WELL THEY PREDICT THE VARIOUS ASPECTS OF READING: word recognition, pseudoword decoding, fluency and comprehension, in a mixed sample of 182 children ages 8-12 years. Participants displayed a wide range of reading ability and attention control. Multiple regression was used to determine how well the phonological processing components, verbal working memory, and attention control predict reading performance. All equations were highly significant. Phonological memory predicted word identification and decoding. In addition, phonological awareness and rapid automatized naming predicted every aspect of reading assessed, supporting the notion that phonological processing is a core contributor to reading ability. Nonetheless, phonological processing was not the only predictor of reading performance. Verbal working memory predicted fluency, decoding and comprehension, and attention control predicted fluency. Based upon our results, when using Baddeley's model of working memory it appears that the phonological loop contributes to basic reading ability, whereas the central executive contributes to fluency and comprehension, along with decoding. Attention control was of interest as some children with ADHD have poor reading ability even if it is not sufficiently impaired to warrant diagnosis. Our finding that attention control predicts reading fluency is consistent with prior research which showed sustained attention plays a role in fluency. Taken together, our results suggest that reading is a highly complex skill that entails more than phonological processing to perform well.