Milena Ruffino

A Causal Link between Visual Spatial Attention and Reading Acquisition

Reading is a unique, cognitive human skill crucial to life in modern societies, but, for about 10% of the children, learning to read is extremely difficult. They are affected by a neurodevelopmental disorder called dyslexia. Although impaired auditory and speech sound processing is widely assumed to characterize dyslexic individuals, emerging evidence suggests that dyslexia could arise from a more basic cross-modal letter-to-speech sound integration deficit. Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration applies. Here we ask whether prereading visual parietal-attention functioning may explain future reading emergence and development. The present 3 year longitudinal study shows that prereading attentional orienting--assessed by serial search performance and spatial cueing facilitation--captures future reading acquisition skills in grades 1 and 2 after controlling for age, nonverbal IQ, speech-sound processing, and nonalphabetic cross-modal mapping. Our findings provide the first evidence that visual spatial attention in preschoolers specifically predicts future reading acquisition, suggesting new approaches for early identification and efficient prevention of dyslexia.

Multisensory spatial attention deficits are predictive of phonological decoding skills in developmental dyslexia

Although the dominant approach posits that developmental dyslexia arises from deficits in systems that are exclusively linguistic in nature (i.e., phonological deficit theory), dyslexics show a variety of lower level deficits in sensory and attentional processing. Although their link to the reading disorder remains contentious, recent empirical and computational studies suggest that spatial attention plays an important role in phonological decoding. The present behavioral study investigated exogenous spatial attention in dyslexic children and matched controls by measuring RTs to visual and auditory stimuli in cued-detection tasks. Dyslexics with poor nonword decoding accuracy showed a slower time course of visual and auditory (multisensory) spatial attention compared with both chronological age and reading level controls as well as compared with dyslexics with slow but accurate nonword decoding. Individual differences in the time course of multisensory spatial attention accounted for 31% of unique variance in the nonword reading performance of the entire dyslexic sample after controlling for age, IQ, and phonological skills. The present study suggests that multisensory “sluggish attention shifting”—related to a temporoparietal dysfunction—selectively impairs the sublexical mechanisms that are critical for reading development. These findings may offer a new approach for early identification and remediation of developmental dyslexia.

Action Video Games Make Dyslexic Children Read Better

Learning to read is extremely difficult for about 10% of children; they are affected by a neurodevelopmental disorder called dyslexia [1, 2]. The neurocognitive causes of dyslexia are still hotly debated [3-12]. Dyslexia remediation is far from being fully achieved [13], and the current treatments demand high levels of resources [1]. Here, we demonstrate that only 12 hr of playing action video games-not involving any direct phonological or orthographic training-drastically improve the reading abilities of children with dyslexia. We tested reading, phonological, and attentional skills in two matched groups of children with dyslexia before and after they played action or nonaction video games for nine sessions of 80 min per day. We found that only playing action video games improved childrens reading speed, without any cost in accuracy, more so than 1 year of spontaneous reading development and more than or equal to highly demanding traditional reading treatments. Attentional skills also improved during action video game training. It has been demonstrated that action video games efficiently improve attention abilities [14, 15]; our results showed that this attention improvement can directly translate into better reading abilities, providing a new, fast, fun remediation of dyslexia that has theoretical relevance in unveiling the causal role of attention in reading acquisition.

Different underlying neurocognitive deficits in developmental dyslexia: A comparative study

The aim of this study was to investigate the role of several specific neurocognitive functions in developmental dyslexia (DD). The performances of 60 dyslexic children and 65 age-matched normally reading children were compared on tests of phonological abilities, visual processing, selective and sustained attention, implicit learning, and executive functions. Results documented deficits in dyslexics on both phonological and non-phonological tasks. More stringently, in dyslexic children individual differences in non-phonological abilities accounted for 23.3% of unique variance in word reading and for 19.3% in non-word reading after controlling for age, IQ and phonological skills. These findings are in accordance with the hypothesis that DD is a multifactorial deficit and suggest that neurocognitive developmental dysfunctions in DD may not be limited to the linguistic brain area, but may involve a more multifocal cortical system.

Attentional engagement deficits in dyslexic children

Reading acquisition requires, in addition to appropriate phonological abilities, accurate and rapid selection of sublexical orthographic units by attentional letter string parsing. Spatio-temporal distribution of attentional engagement onto 3-pseudoletter strings was studied in 28 dyslexic and 55 normally reading children by measuring attentional masking (AM). AM refers to an impaired identification of the first of two sequentially presented masked objects (O1 and O2). In the present study, O1 was always centrally displayed, whereas the location of O2 (central or lateral) and the O1-O2 interval were manipulated. Dyslexic children showed a larger AM at the shortest O1-O2 interval and a sluggish AM recovery at the longest O1-O2 interval, as well as an abnormal lateral AM. More importantly, these spatio-temporal deficits of attentional engagement were selectively present in dyslexics with poor phonological decoding skills. Our results suggest that an inefficient spatio-temporal distribution of attentional engagement - probably linked to a parietal lobule dysfunction - might selectively impair the letter string parsing mechanism during phonological decoding.

Decreased coherent motion discrimination in autism spectrum disorder: the role of attentional zoom-out deficit.

Autism spectrum disorder (ASD) has been associated with decreased coherent dot motion (CDM) performance, a task that measures magnocellular sensitivity as well as fronto-parietal attentional integration processing. In order to clarify the role of spatial attention in CDM tasks, we measured the perception of coherently moving dots displayed in the central or peripheral visual field in ASD and typically developing children. A dorsal-stream deficit in children with ASD should predict a generally poorer performance in both conditions. In our study, however, we show that in children with ASD, CDM perception was selectively impaired in the central condition. In addition, in the ASD group, CDM efficiency was correlated to the ability to zoom out the attentional focus. Importantly, autism symptoms severity was related to both the CDM and attentional zooming-out impairment. These findings suggest that a dysfunction in the attentional network might help to explain decreased CDM discrimination as well as the “core” social cognition deficits of ASD.

Visual spatial attention and speech segmentation are both impaired in preschoolers at familial risk for developmental dyslexia.

Phonological skills are foundational of reading acquisition and impaired phonological processing is widely assumed to characterize dyslexic individuals. However, reading by phonological decoding also requires rapid selection of sublexical orthographic units through serial attentional orienting, and recent studies have shown that visual spatial attention is impaired in dyslexic children. Our study investigated these different neurocognitive dysfunctions, before reading acquisition, in a sample of preschoolers including children with (N=20) and without (N=67) familial risk for developmental dyslexia. Children were tested on phonological skills, rapid automatized naming, and visual spatial attention. At-risk children presented deficits in both visual spatial attention and syllabic segmentation at the group level. Moreover, the combination of visual spatial attention and syllabic segmentation scores was more reliable than either single measure for the identification of at-risk children. These findings suggest that both visuo-attentional and perisylvian-auditory dysfunctions might adversely affect reading acquisition, and may offer a new approach for early identification and remediation of developmental dyslexia.

Zoom-out attentional impairment in children with autism spectrum disorder.

Autism spectrum disorder (ASD) has long been associated with an inability to experience wholes without full attention to the constituent parts. A zoom-out attentional dysfunction might be partially responsible for this perceptual integration deficit in ASD. In the present study, the efficiency of attentional focusing mechanisms was investigated in children affected by ASD. We measured response latencies to a visual target onset displayed at three eccentricities from the fixation. Attentional resources were focused (zoom-in) or distributed (zoom-out) in the visual field presenting a small (containing only the nearest target eccentricity) or large (containing also the farthest target eccentricity) cue, 100 or 800 msec, before the target onset. Typically developing children, at the short cue-target interval, showed a gradient effect (i.e., latencies are slower at the farthest eccentricity) in the small focusing cue, but not in the large focusing cue condition. These results indicate an efficient zoom-in and zoom-out attentional mechanism. In contrast, children with ASD showed a gradient effect also in the large focusing cue condition, suggesting a specific zoom-out attentional impairment. In addition, the ASD group showed an atypical gradient effect at the long cue-target interval only in the small cue condition, suggesting a prolonged zoom-in and sluggish zoom-out attentional mechanism. This abnormal attentional focusing - probably linked to a dysfunctional top-down feedback from fronto-parietal network to the early visual areas - could contribute to the atypical visual perception associated to individuals with ASD which, in turn, could have consequences in their social-communicative development.

The DCDC2 Intron 2 Deletion Impairs Illusory Motion Perception Unveiling the Selective Role of Magnocellular-Dorsal Stream in Reading (Dis)ability

Developmental dyslexia (DD) is a heritable neurodevelopmental reading disorder that could arise from auditory, visual, and cross-modal integration deficits. A deletion in intron 2 of the DCDC2 gene (hereafter DCDC2d) increases the risk for DD and related phenotypes. In this study, first we report that illusory visual motion perception-specifically processed by the magnocellular-dorsal (M-D) stream-is impaired in children with DD compared with age-matched and reading-level controls. Second, we test for the specificity of the DCDC2d effects on the M-D stream. Children with DD and DCDC2d need significantly more contrast to process illusory motion relative to their counterpart without DCDC2d and to age-matched and reading-level controls. Irrespective of the genetic variant, children with DD perform normally in the parvocellular-ventral task. Finally, we find that DCDC2d is associated with the illusory motion perception also in adult normal readers, showing that the M-D deficit is a potential neurobiological risk factor of DD rather than a simple effect of reading disorder. Our findings demonstrate, for the first time, that a specific neurocognitive dysfunction tapping the M-D stream is linked with a well-defined genetic susceptibility.

Spatial and temporal attention in developmental dyslexia.

Although the dominant view posits that developmental dyslexia (DD) arises from a deficit in phonological processing, emerging evidence suggest that DD could result from a more basic cross-modal letter-to-speech sound integration deficit. Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration applies. In the present study the time-course of spatial attention was investigated measuring target detection reaction times (RTs) in a cuing paradigm, while temporal attention was investigated by assessing impaired identification of the first of two sequentially presented masked visual objects. Spatial and temporal attention were slower in dyslexic children with a deficit in pseudoword reading (N = 14) compared to chronological age (N = 43) and to dyslexics without a deficit in pseudoword reading (N = 18), suggesting a direct link between visual attention efficiency and phonological decoding skills. Individual differences in these visual attention mechanisms were specifically related to pseudoword reading accuracy in dyslexics. The role of spatial and temporal attention in the graphemic parsing process might be related to a basic oscillatory “temporal sampling” dysfunction.