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PubMed2004

Early development of children at familial risk for dyslexia--follow-up from birth to school age.

We review the main findings of the Jyväskylä Longitudinal study of Dyslexia (JLD) which follows the development of children at familial risk for dyslexia (N = 107) and their controls (N = 93). We will illustrate the development of these two groups of children at ages from birth to school entry in the skill domains that have been connected to reading and reading disability in the prior literature. At school entry, the highest score on the decoding task among the poorer half (median) of the at risk children--i.e. of those presumably being most likely genetically affected--is 1 SD below the mean of the control group. Thus, the familial risk for dyslexia shows expected consequences. Among the earliest measures in which group differences as well as significant predictive associations with the first steps in reading have emerged, are indices of speech processing in infancy. Likewise, various measures of early language including pronunciation accuracy, phonological, and morphological skills (but not performance IQ) show both group differences and predictive correlations, the majority of which become stronger as the reliability of the measures increases by age. Predictive relationships tend to be strong in general but higher in the at risk group because of its larger variance in both the predictor variables and in the dependent measures, such as early acquisition of reading. The results are thus promising in increasing our understanding needed for early identification and prevention of dyslexia.

Child↗
PubMed2000

A connectionist approach to making the predictability of English orthography explicit to at-risk beginning readers: evidence for alternative, effective strategies.

A case is made (and illustrated with empirical data with children) for connectionist models that are not only computationally explicit but also instructionally explicit. First-graders (N = 128) at the bottom of their classes in reading (average 11.5 percentile on nationally normed tests) participated in a 3-layer intervention. In the first layer, kept constant for all treatment groups, the alphabet principle was taught, making functional spelling units and alternations explicit. In the second layer, which varied systematically across treatment groups, children received different kinds of tutor modeling in learning a set of words of varying spelling-sound predictability, using different connections between printed and spoken words, singly or in combination. In the third layer, also kept constant, children read and discussed illustrated books. Over the 4-month, 24-lesson intervention, all 7 treatment groups in the second layer improved more in word-specific learning than a contact control group that received phonological and orthographic awareness training without explicit instruction on orthographic-phonological connections. Of these 7, only 3 kinds of explicit modeling (whole word, letter-phoneme, and combined whole word and letter-phoneme) resulted in greater transfer to untrained words than the contact control or the other 4 kinds of explicit modeling. Results are discussed in reference to the controversy over whether dual route or connectionist models best account for the acquisition of reading.

Child↗
PubMed2004

Auditory processing skills and phonological representation in dyslexic children.

It is now well-established that there is a causal connection between children's phonological skills and their acquisition of reading and spelling. Here we study low-level auditory processes that may underpin the development of phonological representations in children. Dyslexic and control children were given a battery of phonological tasks, reading and spelling tasks and auditory processing tasks. Potential relations between deficits in dyslexic performance in the auditory processing tasks and phonological awareness were explored. It was found that individual differences in auditory tasks requiring amplitude envelope rise time processing explained significant variance in phonological processing. It is argued that developmentally, amplitude envelope cues may be primary in establishing well-specified phonological representations, as these cues should yield important rhythmic and syllable-level information about speech.

Anomia↗
PubMed2002

Deaf poor readers' pattern reversal visual evoked potentials suggest magnocellular system deficits: implications for diagnostic neuroimaging of dyslexia in deaf individuals.

Deafness and developmental dyslexia in the same individual may jointly limit the acquisition of reading skills for different underlying reasons. A diagnostic marker for dyslexia in deaf individuals must therefore detect the presence of a neurobiologically based dyslexia but be insensitive to the ordinary developmental influences of deafness on reading skill development. We propose that the functional status of the magnocellular visual system in deaf individuals is potentially such a marker. We present visual evoked potential (VEP) evidence that adult deaf poor readers as a group display magnocellular system deficits not observed in deaf good readers. We recorded pattern-reversal VEPs to high- and low-contrast checkerboard stimuli, which primarily activate the parvocellular and magnocellular pathways, respectively. Principal components analysis of these VEPs produced a time-ordered sequence of three early components that displayed interactions between reading skill and stimulus contrast across multiple scalp recording sites. Deaf poor readers displayed an abnormal absence of contrast-sensitive VEP responses at occipital sites during early visual processing (75 ms poststimulus), whereas deaf good readers showed the expected early contrast-sensitive occipital VEP responses. Over the subsequent 225 ms, the occipital VEP behavior of deaf poor readers closely approximated that of deaf good readers. The VEPs of deaf poor readers were apparently characterized by delayed responses to low-contrast stimuli compared with deaf good readers. Our results provide the first neurobiological evidence that developmental dyslexia exists within the deaf population and is associated with the same underlying magnocellular system deficit that has been observed in hearing dyslexics. Direct neural imaging of the status of the magnocellular visual system in deaf individuals may eventually provide differential diagnosis of developmental dyslexia in the deaf population.

Adult↗
PubMed1991

Familial thyroid disease and delayed language development in first admission patients with schizophrenia.

One hundred consecutive first admission patients with a DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder were compared with 100 randomly selected community controls. Childhood histories of physical, medical, and perinatal trauma, as well as physical and cognitive development, were examined by structured interviews with all available mothers of patients and controls. The prevalence of specific psychiatric disorders and several medical illnesses among first degree and more distant relatives was determined by family history questionnaires. The patient group did not have an excess of childhood head injuries, serious infections, or perinatal/birth complications compared with controls. With social class level taken into account, it was found that the acquisition of reading skills occurred significantly later in patients than controls. Family histories of schizophrenia and thyroid disorders were significantly more frequent among patients than controls. These data fail to indicate any childhood physical or medical environmental trauma that could lead to an increased risk for schizophrenia, although patients were substance abusers to a greater extent than controls. This study also confirms the already known contribution of familial factors and suggests an association of the inheritance of thyroid disorders with schizophrenia. Delayed development of reading skills suggests that precursers of illness may appear early in life before psychosis is evident.

Adult↗
PubMed1996

Analysis of interinstitutional observer agreement in interpretation of dobutamine stress echocardiograms.

OBJECTIVES: This study sought to determine the degree of interinstitutional agreement in the interpretation of dobutamine stress echocardiograms. BACKGROUND: Dobutamine stress echocardiography involves subjective interpretation. Consistent methods for acquisition and interpretation are of critical importance for obtaining high interobserver agreement and for facilitating communication of test results. METHODS: Five experienced centers were each asked to submit 30 dobutamine stress echocardiograms (dobutamine up to 40 micrograms/kg body weight per min and atropine up to 1 mg) obtained in patients undergoing coronary angiography. Thus, a total of 150 dobutamine stress echocardiograms were interpreted by each center without knowledge of any other patient data. Left ventricular wall motion was assessed using a 16-segment model but was otherwise not standardized. No patient was excluded because of poor image quality or inadequate stress level. Echocardiographic image quality was assessed using a five-point scale. RESULTS: Angiographically significant coronary artery disease (> or = 50% diameter stenosis) was present in 95 patients (63%). By a majority decision (three or more centers), the sensitivity, specificity and accuracy of dobutamine echocardiography were 76%, 87% and 80%, respectively. Abnormal or normal results of stress echocardiography were agreed on by four or all five of the centers in 73% of patients (mean kappa value 0.37, fair agreement only). Agreement on the left anterior descending artery territory (78%) was similar to that for the combined right coronary artery/left circumflex artery territory (74%), and for specific segments the agreement ranged from 84% to 97% and was highest for the basal anterior segment and lowest for the basal inferior segment. Agreement was higher in patients with no (82%) or three-vessel coronary artery disease (100%) and lower in patients with one- or two-vessel disease (61% and 68%, respectively). Agreement on positivity or negativity of stress test results was 100% for patients with the highest image quality but only 43% for those with the lowest image quality (p = 0.003). CONCLUSIONS: The current heterogeneity in data acquisition and assessment criteria among different centers results in low interinstitutional agreement in interpretation of stress echocardiograms. Agreement is higher in patients with no or advanced coronary artery disease and substantially lower in those with limited echocardiographic image quality. To increase interinstitutional agreement, better standardization of image acquisition and reading criteria of stress echocardiography is recommended.

Cardiotonic Agents↗
PubMed2002

Paediatric cochlear implantation: prosthetic hearing and language development.

CONTEXT: Cochlear implantation offers hearing and vocational benefits to children and adults who lose their hearing after acquiring speech and language. But such implantations in prelingually deaf children are controversial, with concerns about diagnosis in very young children, safety, and durability. Implantation of children under age 2 years is potentially associated with higher surgical and anaesthesia risks, and with more challenging preoperative and postoperative management. STARTING POINT: Although only a small number of children implanted before age 2 have sufficient maturity and implant experience to undergo adult-type speech recognition tests, surgical series show that these children may be implanted safely and that their subsequent speech perception is at least as good as children implanted at an older age. The Nottingham, UK, group recently reported on a consecutive sample of 12 children aged under 2 years at implantation (Arch Otolaryngol Head Neck Surg 2002; 128: 11-14). S S Hehar and colleagues show satisfactory perioperative and postoperative surgical outcomes. 2 years after the implantation, mean scores on the Listening Progress Profile had increased from 1 to 42. Median scores of Categories of Auditory Performance increased from 0 to 5. There were no significant differences compared with a historical control group of deaf children implanted at ages 3-5. WHERE NEXT? Early results from parental observation of auditory behaviours show that children who receive a cochlear implant at an early age perform at least as well as those implanted later. These data, combined with more rigorous speech recognition results in older children, merit a gradual reduction in the age of implantation, although the uncertainties inherent in audiometric assessment and measurement of hearing-aid benefit in infants must be borne in mind. Cochlear implants in prelingually deafened children permit improved development of speech reception, language acquisition, and reading comprehension.

Child↗
PubMed1979

Orthography and familiarity effects in word processing.

Both orthographic regularity and visual familiarity have been implicated as contributors to the efficiency of processing visually presented words. Our studies sought to determine which of the internal codes representing words in the nervous system are facilitated by these two variables. To do this, sets of letter strings in which orthography and familiarity were factorially combined were used as the basis for physical, phonetic, semantic, and lexical judgments. The data indicated consistent effects of orthography on the activation of all codes. These effects were seen in same-different matching and in judgments of stimulus orientation, which are based on visual codes; in judgments of pronounceability based on phonetic codes; in judgments of meaningfulness based on semantic codes; and in lexical decisions, which are based on phonetic and semantic codes together. Familiarity, on the other hand, had a clear influence on the activation of semantic codes and to a lesser extent affected phonetic codes. Despite previous positive results found in matching letter strings, however, no influence of familiarity occurred in judgments based on visual codes once evidence for criterion shifting was eliminated. Our negative results included direct tests of facilitation in matching acronyms (e.g., FBI) and in matching both regular and irregular strings familiarized by specific training. It now appears that earlier findings of visual familiarity effects may be attributed to response biases resulting from the activation of higher level codes sensitive to familiarity, and to the use of small sets of training stimuli that allowed subjects to induce orthographic-like rules. The results obtained so far with our methods seem to reconcile an inconsistent literature by showing that speeded decisions based on visual codes are most strongly influenced by rule-governed processing mechanisms sensitive to orthographic structure, whereas decisions based on phonetic and semantic codes are affected about equally by rule-governed mechanisms and by stimulus-specific mechanisms sensitive to familiarity. This conclusion may lead to changes in notions of how effective various kinds of visual training are likely to be at different stages in the acquisition of reading skill.

Discrimination Learning↗
PubMed1996

Intellectual impairment in children exposed to polychlorinated biphenyls in utero.

BACKGROUND: In utero exposure to polychlorinated biphenyls, a ubiquitous environmental contaminant, has been linked to adverse effects on neurologic and intellectual function in infants and young children. We assessed whether these effects persist through school age and examined their importance in the acquisition of reading and arithmetic skills. METHODS: We tested 212 children, recruited as newborns to overrepresent infants born to women who had eaten Lake Michigan fish contaminated with polychlorinated biphenyls. A battery of IQ and achievement tests was administered when the children were 11 years of age. Concentrations of polychlorinated biphenyls in maternal serum and milk at delivery were slightly higher than in the general population. A composite measure of prenatal exposure was derived from concentrations in umbilical-cord serum and maternal serum and milk. RESULTS: Prenatal exposure to polychlorinated biphenyls was associated with lower full-scale and verbal IQ scores after control for potential confounding variables such as socioeconomic status (P = 0.02). The strongest effects related to memory and attention. The most highly exposed children were three times as likely to have low average IQ scores (P <0.001) and twice as likely to be at least two years behind in reading comprehension (P = 0.03). Although larger quantities of polychlorinated biphenyls are transferred by breast-feeding than in utero, there were deficits only in associated with transplacental exposure, suggesting that the developing fetal brain is particularly sensitive to these compounds. CONCLUSIONS: In utero exposure to polychlorinated biphenyls in concentrations slightly higher than those in the general population can have a long-term impact on intellectual function.

Child↗
PubMed2003

Neuropsychological deficits in a child with a left penetrating brain injury.

This case study reports neuropsychological and structural magnetic resonance (MRI) studies of a 10-year-old girl with a left hemisphere lesion, caused by an underwater fishing harpoon penetrating her head when she was 6 years old. The patient showed a marked deficit in the acquisition of reading, writing and arithmetic, as well as an attentional deficit. Magnetic resonance images revealed left cortical lesions in the orbital region and the gyrus angularis, as well as in the caudate and putamen nuclei and longitudinal inferior fascicle. Neuropsychological assessment showed frontal and parietal lobe dysfunctions consistent with the lesional data. The structural data explain the neuropsychological impairment and suggest that, although the left lesion was early and relatively small, plasticity was incomplete.

Child↗
PubMed1997

A computer-interfaced vertometer system for contact lenses.

BACKGROUND: The conventional vertometer (lensometer) is difficult to use for accurate measurement of contact lenses whose back vertex power (BVP) varies across the optic zone. BVPs of multifocal rigid and soft contact lenses have previously been measured using a conventional vertometer incorporating the Scheiner principle, which makes use of two light paths equidistant from the center of the lens. METHODS: We have developed a computer-based vertometer system based on the Scheiner principle which can be used to produce a profile of BVPs across rigid and soft contact lenses. A computer interface to the vertometer allows rapid acquisition of readings and software-based ray tracing derives in-air dioptric power readings across the optic zone at specific ray heights. RESULTS: Results are presented for soft and rigid, and spherical and aspheric surface contact lenses. CONCLUSIONS: The system improves the measurement resolution of a standard vertometer and shows an acceptable level of precision and accuracy for most applications.

Contact Lenses↗
PubMed1997

Phonological processing skills in speech and language impaired children.

Phonological processing has been shown by many researchers to be strongly related to the acquisition of reading and spelling skills. Children with speech and language impairment appear to be at increased risk for phonological processing problems and hence literary difficulties. However, not all children with speech and language impairment experience difficulties: the literature is not clear as to which groups of speech and language impaired children are most severely affected nor which aspects of phonological processing are most likely to be impaired. Rigorous subject selection was employed to compare the performance of four groups of 20 children, aged approximately 6 years: speech-impaired (Speech); language-impaired (Language); speech and language impaired (Mixed); and children with normally developing language (Normal), by use of a battery of phonological processing tasks. The results supported the research that has shown speech and language impaired children to have weaker phonological processing skills than the general population. All the subjects in this sample appeared to be at risk: the Mixed children demonstrated the most difficulty, followed by the Language group, with the Normal group performing the best. Whilst the Speech group as a whole performed significantly more poorly than the Normal group, it consisted of two levels of performance which, on post hoc analysis were shown to relate to the pattern of speech impairment exhibited by the child.

Child↗
PubMedDate not supplied

Language-based learning disabilities.

The purpose of this paper is to highlight the complexity of the relationship between oral language development and the acquisition of reading skills. As background information, a hierarchy of language development including factors related to both oral and written language is discussed. Case studies of two learning-disabled males are presented to illustrate the differences in reading skills between two children with similar language comprehension abilities. Discussion of the underlying processing deficits responsible for these differences is also included.

Adolescent↗
PubMed2004

Current status of treatments for dyslexia: critical review.

The acquisition of reading is a complex neurobiologic process. Identifying the most effective instruction and remedial intervention methods for children at risk of developing reading problems and for those who are already struggling is equally complex. This article aims to provide the clinician with a review of more current findings on the prevention and remediation of reading problems in children, along with an approach to considering the diagnosis and treatment of a child with dyslexia. The first part of the review describes interventions targeted at preventing reading difficulties in the at-risk younger child. The second part of the review discusses the efficacy of approaches to treat the older, reading-disabled child ("intervention studies"). Factors that impact the response to treatment are also discussed, as are neuroimaging studies that offer insight into how the brain responds to treatment interventions. With appropriate instruction, at-risk readers can become both accurate and fluent readers. In contrast, although intensive, evidence-based remedial interventions can markedly improve reading accuracy in older, reading-disabled children, they have been significantly less effective in closing the fluency gap. Owing to the dynamic course of language development and the changes in language demands over time, even after a child has demonstrated a substantial response to treatment interventions, his or her subsequent progress should be carefully tracked to ensure optimal progress toward the development of functional reading and written language skills.

Child↗
PubMed1972

The effects of fading on the acquisition and retention of oral reading.

Comparisons were made between reading programs that involved superimposition of correlated pictoral and printed stimuli, fading of the pictoral stimuli, and overt observing (touching) responses. Nursey school children aged 4 to 5.8 yr learned and retained oral reading behavior better when fading was used; observing responses had no effect.

Journal Article↗
PubMed2001

Drawing performance in prediction of special learning difficulties of kindergarten children.

Recent experimental studies indicate the importance of drawing process in determining the final shape of the drawn product. Emphasis has been given on short-term and working memory, visual perception, visuospatial encoding, planning, sequencing, and depiction of the third dimension. The above prerequisites are also necessary for the acquisition of reading and spelling. The aim of the present study was to investigate the prereading and drawing abilities of kindergarten children. 20 boys and girls were selected from 1,237 kindergarten children, based on their performance on a set of drawing tasks. The drawings were used as tools to indicate the conditions under which deficiencies in the cognitive system become apparent. Those 20 children and 20 matched controls were again tested during their first three years in primary school. The reassessment on the first and third year included tasks on drawing as well as on reading and spelling (speed and accuracy) based on the curriculum. The results showed an effect of the same cognitive factors in both areas of knowledge. The cognitive deficiencies observed across tasks focused on the children's information processing and were apparent in both symbolic systems.

Child↗