Neuropsychological treatment of dyslexia in the classroom setting.

The purpose of this study was to validate Bakker's (1990, 1992) clinical neuropsychological balance model of dyslexia when implemented in a traditional general education classroom environment. The sample included 45 middle school, right-handed boys and girls (mean age = 12.78) with L-type dyslexia (excessively fast readers who make substantive reading errors), P-type dyslexia (displaying accurate but slow and laborious reading), and M-type dyslexia (readers who commit a combination of L-type and P-type dyslexia errors). The experimental groups (L and P type dyslexia) were presented with hemisphere specific stimulation (HSS) and hemispheric alluding stimuli (HAS). HSS involves the presentation of words into the right visual field (RVF) or the left visual field (LVF) or through tactile exercises with the right or left hand. HAS is achieved by constructing semantically and phonetically challenging letters and words. The children with M-type dyslexia served as a control group and received traditional decoding and comprehension exercises. The readers were exposed to a specific treatment model for 16 weeks, depending on their reading accuracy and comprehension. Statistical analyses indicated that, although there were no significant changes in word recognition for the dyslexia subtypes, the readers with L-type, P-type, and M-type dyslexia exhibited significant improvement in reading accuracy and comprehension as assessed by results from pretest to posttest. These results suggest that Bakker's clinical neuropsychological intervention can be effectively applied to the general education setting as well.

Concurrent verbal and emotion laterality effects exhibited by normally achieving and learning disabled children.

This study assessed both left- and right-hemisphere functions simultaneously when two-syllable words differing only in the initial stop consonant and spoken in different emotional tones were paired dichotically. Seventy-two right-handed normally achieving children, 12 boys and 12 girls at each of grades 1, 3, and 5, were instructed to detect either the presence of a specific word or of a specific emotion. In addition, 30 right-handed learning disabled (LD) children (age-matched to the normal controls) were assessed to determine whether LD children distribute verbal and nonverbal functions to different hemispheres. Results indicated that although both control and LD children demonstrated an overall REA for word stimuli and an LEA for emotional stimuli, and that emotional stimuli were easier to process than word stimuli, LD children were less accurate in processing both types of stimuli than their control counterparts. 'Complementary specialization,' as assessed through distribution of laterality effects, was found to be greater for control children than for LD children. However, the lack of consistency in complementary specialization found among the three developmental grade levels may be indicative that independent brain mechanisms underlying verbal and emotional processing have yet to be fully established in children. Further, in contrast to adult findings, a larger LEA was obtained for the emotion 'happy' than for the emotion 'sad.' It was concluded that whereas independent hemisphere processing for words and emotions is somewhat prevalent for control children, LD children might not be as strongly lateralized for opposite hemisphere processing of these functions.

Lasting auditory attention impairment after persistent middle ear infections: a dichotic listening study.

Dichotic listening performance was studied in children who at an early age had undergone a myringotomy with insertion of ventilating tubes for persistent middle ear infections (otitis media with effusion; OME) and compared with age-equivalent children who had no history of otitis media or hearing problems. The OME group consisted of 19 children with a median age of 9 years; 15 of whom were right-handed, and 14 were boys. The comparison sample comprised 18 children with a median age was 9 years 4 months. Hand preference and sex were matched with the OME group. Both groups were tested with dichotic listening to consonant-vowel syllables and additional forced-attention tasks. The comparison sample showed a weak right-ear advantage, and age-adequate attentional modulations. The children in the OME group showed a strong right-ear advantage, but were not able to modulate the ear advantage during directed-attention tasks. Models for interpreting the result are discussed.

Neuropsychological consequences of traumatic brain injury in children and adolescents.

The study of the relationship between neuroscientific information and cognitive function and dysfunction is clearly a widely expanding field. In particular, there has been a growing body of research on traumatic brain injury (TBI) in children and adolescents. This article conveys recent findings concerning cognitive outcomes, with a particular focus on age differences with TBI, suggests a relationship between specific learning disorders and brain dysfunction, addresses differential hemisphere functioning with TBI, and alludes to recent developments in assessment of TBI.

Taxonomic clustering and frequency associations as features of semantic memory development in children with learning disabilities.

This study investigated taxonomic clustering and use of frequency associations as features in the semantic memory development of children with learning disabilities (LD). Free-recall organization of second- and sixth-grade children with and without LD was analyzed for two types of primary and secondary word lists: (a) items associated with frequency (FA), and (b) items related by category members (CM). In contrast to expected findings, younger, non-disabled children organized words categorically as proficiently as their older nondisabled peers, and the categorization abilities of children with LD were comparable to those of nondisabled subjects, with one exception: Subjects with LD showed less clustering for secondary FA. These results indicate that when individual child-generated word lists (i.e., meaningful and familiar words) are used, children with LD may not be impaired in their ability to recognize and utilize semantic structure to facilitate learning.

The influence of attention on the dichotic REA with normal and learning disabled children.

Recently, Mondor and Bryden (Neuropsychologia, 29, 1179-1190, 1991; Percept. Psychophys. 52, 393-402, 1992) developed a lateralized cueing technique which appears to be a more powerful method than is the forced-attention technique (Bryden, 1978) of controlling the contribution of attentional biases to auditory perceptual asymmetries. This lateralized cueing technique was used to determine the influence of attentional biases on perceptual asymmetries obtained for normal and specific learning disabled (LD) children. Subjects were instructed to attend to, and report from, only the ear in which the cue sounded. The interval between the onset of the cue and the onset of the dichotic trial is varied so as to control the amount of time available to subjects to allocate attention to the cued ear. Results indicated that, for normal children capable of performing the task at a better than chance level, a large REA apparent at 150 msec Stimulus Onset Asynchromy (SOA) was attenuated at longer cueing intervals (450 and 750 msec SOA). For LD children, the magnitude of the initial REA appeared to be attenuated at 450 msec SOA. Thus, these data demonstrate that for normal children as well as for children with specific learning disabilities, attentional factors may contribute to the magnitude of the REA.

Hemisphere and gender differences in mental rotation.

Hemisphere and gender differences in mental rotation for tachistoscopically presented stimuli were assessed in 40 right-handed university students. Twenty male and 20 female subjects each were individually administered (via computer) a mental rotation task which included 10 stimulus presentations at each of eight angular disorientations (0 degrees, 45 degrees, 90 degrees, 135 degrees, 180 degrees, 225 degrees, 270 degrees, and 315 degrees) in each visual half-field (VHF) for a total of 160 trials. Analyses of variance performed on reaction time and accuracy data revealed only a main effect for orientation. A typical mental rotation function for both the left VHF and the right VHF for both genders resulted; however, no gender x visual field interaction was found. Lack of hemisphere and gender differences provide further evidence questioning the interpretation of right-hemisphere male superiority for spatial tasks. Investigation into factors such as task complexity, stimulus familiarity, and task demands may lend further insight into hemisphere and gender differences in mental rotation.

Factorial structure of the Waterloo Handedness Questionnaire for control and learning-disabled adults.

This study examined the factorial structure of the 32-item version of the Waterloo Handedness Questionnaire (Steenhuis & Bryden, 1989) with a sample of control (n = 325) and learning-disabled (LD) (n = 147) subjects. On the basis of Principal Components Analyses, we have replicated the work of Steenhuis and Bryden (1989) who suggested that hand preference factors for control subjects are multifactorial in nature and are related more to "skilled" and "less skilled" activities rather than on distal/proximal musculature. Further, we have found that the factor structure for hand preference in LD adults is somewhat different than of normally achieving adults. The primary difference occurred within Factor 2. Unlike control subjects, whose Factor 2 items were classified as "less skilled" and preference was less lateralized, items loading on this factor for LD subjects were classified as "skilled" and showed strongly lateralized responses for both left and right handers. Presumably, LD adults show a less marked distinction between "skilled" and "less skilled" unimanual motor activities than control subjects suggesting different degrees of manual laterality between the groups.

Verbal and nonverbal auditory processing among left- and right-handed good readers and reading-disabled children.

Cerebral lateralization of left- and right-handed good readers and left- and right-handed reading disabled was examined with a sample of 60 children who ranged in age from 7-13 years via a dichotic selective attention task (free recall, directed left, directed right) using consonant-vowel (CV) and tonal stimuli. Several ANOVAs were conducted to evaluate gender, reader group, handedness, and stimuli effects of left- and right-ear reports across dichotic conditions. Results indicated males outperformed females across stimuli and conditions regardless of handedness and all subjects recalled more tonal stimuli than CV stimuli. More importantly, the expected REA (left hemisphere processing) was found for CV stimuli only by right-handed good readers across all three dichotic conditions. The left-handed good readers and left-handed reading-disabled children were left ear (LE) dominant in free recall and in the directed left condition, but were right ear (RE) dominant in the directed right condition. Conversely, right-handed reading-disabled children produced a REA during free recall and directed right conditions, but were LE dominant in the directed left condition. In contrast, a significant LEA (right hemisphere processing) was found for tonal stimuli across all dichotic conditions for all four groups. These findings lend support to the hypothesis that attentional factors have a greater influence on auditory processing of verbal than nonverbal stimuli for various groups of children and also suggest reversed or bilateralized processing abilities for language in strongly left-handed children with sinistral relatives.

Construct validity of neuropsychological instrumentation with a learning disabled population.

The construct validity of the Reitan-Indiana Neuropsychological Test Battery (R-INB)for Children with a learning disabled population was examined. Forty-two subjects classified as learning disabled also were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Wide Range Achievement Test (WRAT) subtests. Factor analysis of the data revealed four factors: verbal intelligence, psychomotor speed, achievement, and memory. Evidence from this study indicates that the overall construct paradigm as conceptualized by the author of the R-INB does not exist. Implications of these findings are discussed.

Cued dichotic listening with right-handed, left-handed, bilingual and learning-disabled children.

This study used cued dichotic listening to investigate differences in language lateralization among right-handed (control), left-handed, bilingual, and learning-disabled children. A sample of 60 subjects ranging in age from 7-13 yr were administered a CVC dichotic paradigm with three experimental conditions (free recall, directed left, directed right). A three-factor ANOVA design conducted on the data revealed that control, bilingual, and learning-disabled children produced the expected REA suggestive of left hemisphere dominance for language processing whereas left-handed children produced an LEA suggestive of right hemisphere superiority for language processing. The cued attention data derived from groups as well as from individual subjects suggested that in comparison with control children, left-handed children were greatly susceptible to attentional manipulation similar to learning-disabled children only in the opposite hemisphere. Bilingual children were found to have a REA much like control children although recall accuracy was depressed. Further, lambda (lambda) analyses conducted on individual subjects indicated that the magnitude and degree of perceptual asymmetry varied widely among individuals of various anomaly groups. These findings lend support to the hypothesis that attentional factors play a larger role in unilateral processing for some anomalous groups of children (i.e. left-handers and learning-disabled) while not affecting others (i.e. controls and bilinguals).

The effects of hemispatial and asymmetrically focused attention on dichotic listening with normal and learning-disabled children.

The effects of hemispatial and focused attention were examined with 50 normal and learning-disabled children to determine the extent of these two attentional strategies influenced perceptual laterality as reflected by the dichotic listening right-ear advantage (REA). Twenty-five normal children (8 females, 17 males, mean age 9.10 yr) matched with 25 learning-disabled children (8 females, 17 males, mean age 10.1 yr) were administered a dichotic consonant-vowel (CV) and consonant-vowel-consonant (CVC) syllable task. The two types of stimuli were compared across focused attention (free report, focused left, focused right) and hemispatial (central, left hemispace, right hemispace) conditions implemented independently and in systematic combinations. A four-factorial analysis of variance (groups x stimuli x conditions x ears) resulted in a significant REA for normal children across all attentional conditions whereas learning-disabled did not produce a consistent REA across all attentional conditions, and in several instances, produced equivalent left and right hemisphere processing. Right hemispatial orientation increased the magnitude of the REA (i.e., left hemisphere processing) for both groups, whereas left hemispatial orientation increased the magnitude of the left ear report (i.e., right hemisphere processing) only in learning-disabled subjects. Focused attention to the right ear also increased left hemisphere efficiency for both groups of children; however, focused attention to the left ear produced symmetrical functioning by learning-disabled subjects. Congruent combinations of focused attention and hemispatial orientation were not found to enhance the REA beyond its magnitude when each strategy was assessed independently. When focused attention and hemispatial conditions were employed in opposing directions, normal children were more susceptible to the "rightward" direction regardless of the strategy whereas learning-disabled subjects were more susceptible to the "verbal" nature of the strategy. Higher overall processing performance was exhibited for CVC stimuli when compared to CV stimuli. These findings lend support to the hypothesis that hemispatial and asymmetrically focused attention strategies interact with structural mechanisms in producing the observed REA in dichotic listening and do so differentially for normal and learning-disabled children.

Construct validity of the Kaufman Assessment Battery for Children with mildly mentally retarded students.

The construct validity of the Kaufman Assessment Battery for Children (K-ABC) with mildly mentally retarded children was examined. Subjects were given three intelligence tests: the K-ABC, WISC-R, and Stanford Binet, Form L-M. Analysis of variance procedures revealed differences between the K-ABC Mental Processing Composite and the WISC-R Full Scale IQ, whereas the Stanford-Binet IQ was not reliably different from either. Correlational analysis provided supportive evidence that the K-ABC is measuring general intelligence; however, discrepancy between Sequential/Simultaneous scales and intersubtest correlations may not support distinct processing styles for mildly mentally retarded students, although this sample represents a restricted range.

Brain stem evoked response in the assessment of learning disabilities.

Evidence has accumulated rapidly to support the hypothesis that neurological anomalies underlie specific forms of learning disability (LD). This article reviews recent studies directed at the electrophysiological assessment of LD children, with emphasis on the brain stem evoked response(BSER) methodology. Child studies appear to indicate that there are significant differences in BSERs between LD and age-matched normal controls. The methodological and statistical differences among these studies, which have clouded the findings and made replication difficult, are reviewed. Improvements in sampling and empirical procedures are suggested, including the use of discriminant analysis to explore BSER asymmetries in LD children. Future inquiry into the measurement and analysis of BSER activity in LD populations is warranted on the basis of these preliminary findings. New information may bring professionals closer to an understanding of the neurological causes of specific subtypes of LD and permit earlier identification of these "at risk" populations.

The effect of stimulus type and directed attention on dichotic listening with children.

This research investigated the effect of stimulus type and directed attention on dichotic listening performance with children. A sample of 12 (5 male, 7 female; mean age 10.5 years) high academically performing children were administered four types of dichotic stimuli (words, digits, CV syllables, and melodies) in three experimental conditions (free recall, directed left, and directed right) to examine perceptual asymmetry as reflected by the right-ear advantage (REA). While the expected REA for words and CV syllables and the expected LEA for melodies were found under free recall, the directed conditions produced varied results depending on the nature of the stimuli. Directed condition had no effect on recall of CV syllables but had a dramatic effect on recall of digits. Word stimuli and directed condition interacted to produce inconsistent perceptual asymmetry while directed condition reduced overall recall for melodies. The findings lend support to the hypothesis that perceptual asymmetries can be strongly influenced by the type of stimulus material used and the effect of attentional strategy employed.