Right-hemisphere reading in a case of developmental deep dyslexia

The right-hemisphere hypothesis of deep dyslexia has received support from functional imaging studies of acquired deep dyslexia following damage to the left cerebral hemisphere, but no imaging studies of cases of developmental deep dyslexia, in which brain damage is not suspected, have been reported. In this paper, we report the first evidence of right hyperactivation in an adult case of developmental deep dyslexia. Hyperactivation was observed in the right inferior frontal cortex during functional magnetic resonance imaging (fMRI) of the oral reading of imageable content words and nonwords to which imageable lexical responses were frequently made. No evidence of right hyperactivation was observed in the oral reading of function words, nor during the naming of imageable words in response to pictured objects. The results reveal strategic and selective use of right-hemisphere functions for particular types of written stimuli. We propose that children with developmental deep dyslexia compensate for their lack of phonological skills by accessing right-hemisphere imageable associations that provide a mnemonic for linking written forms to spoken names.     

Simultaneous activation of reading mechanisms: evidence from a case of deep dyslexia

We report the performance of LC, a deep dyslexic. We investigated extensively her errors according to serial cognitive neuropsychological models of oral reading. Initial evaluation of her reading suggested impaired access to the phonological output lexicon (POL). Impaired grapheme-to-phoneme conversion (GPC) and semantic errors in reading suggested that LC read via an impoverished semantic route. However, a serial model of oral reading could not explain error differences in reading, picture naming, spontaneous speech, and repetition. Neologisms occurred in oral reading but not in spontaneous speech and repetition. Semantic errors in naming exceeded those in oral reading. To account for these different error patterns we propose that the semantic route, the direct route from the orthographic input lexicon to the POL, and GPC activate simultaneously during reading, converging at the POL to constrain phonological selection. These routes are modular but not functionally encapsulated. For LC, the POL receives ambiguous information due to degradation of all routes, causing reading errors.     

Functional neuroimaging studies of reading and reading disability (developmental dyslexia)

Converging evidence from a number of neuroimaging studies, including our own, suggest that fluent word identification in reading is related to the functional integrity of two consolidated left hemisphere (LH) posterior systems: a dorsal (temporo-parietal) circuit and a ventral (occipito-temporal) circuit. This posterior system is functionally disrupted in developmental dyslexia. Reading disabled readers, relative to nonimpaired readers, demonstrate heightened reliance on both inferior frontal and right hemisphere posterior regions, presumably in compensation for the LH posterior difficulties. We propose a neurobiological account suggesting that for normally developing readers the dorsal circuit predominates at first, and is associated with analytic processing necessary for learning to integrate orthographic features with phonological and lexical-semantic features of printed words. The ventral circuit constitutes a fast, late-developing, word identification system which underlies fluent word recognition in skilled readers.     

Word length effect in early reading and in developmental dyslexia

Vocal reaction times were measured in Italian dyslexics and in proficient readers while they read single words. Three groups of control participants (for a total of 79) were tested. All were in the first, second or third grade of elementary school. Nine third graders with a low level of reading ability when assessed by standard reading procedures were also tested. Results indicated that vocal RTs of control participants were faster and less sensitive to word length as a function of age; also, there was a particularly marked change between first and second graders. Dyslexics' vocal RTs and errors were much worse than those of peer control participants and resembled those of first grade controls. It is suggested that normal readers in an orthographically transparent language (Italian) adopt a lexical strategy quite early in their learning. On the contrary, dyslexics seem unable to learn this mode of processing and continue to use a sub-lexical reading procedure.     

Phonological dyslexia: a test case for reading models

Following brain damage, skilled readers may encounter more severe problems in reading nonwords than familiar words, a type of deficit referred to as phonological dyslexia. We report on 2 individuals with Alzheimer's disease who show phonological dyslexia. Although highly accurate in reading familiar words aloud (even those with irregular spelling, such as sew), they were quite impaired in nonword reading. Both patients performed well in phonological tasks involving the repetition, identification, and manipulation of phonemes of orally presented words and nonwords. These results challenge the idea, proposed in the context of connectionist and evolutionary theories, that phonological dyslexia originates from a phonological deficit. However, the results are consistent with reading models, such as the dual-route model, that attribute phonological dyslexia to a deficit that selectively affects the reading mechanisms responsible for deriving the sounds of nonwords. According to these models, such a deficit is not necessarily accompanied by a more general phonological impairment.     

An analysis of writing in a case of deep dyslexia

In tests of her ability to produce written and spoken language, this deep dyslexic patient produced semantic, visual, and derivational errors, including functor substitutions, and exhibited part-of-speech and abstractness effects in oral reading, oral and written naming, and writing to dictation, but not in repetition of single words and copying from memory. This patient therefore provides confirmation of the hypothesis presented in Nolan and Caramazza (1982) that the defining symptoms of deep dyslexia will be observed in responses to any task which requires lexical mediation. The patient's written responses in all tasks but direct copying were characterized by spelling errors which included transpositions, omissions, substitutions, and additions of letters. A model of writing is proposed which explains these errors in terms of a disruption of a phoneme-grapheme conversion process which normally functions to prevent decay of information from a Graphemic Buffer.     

The nature of the reading deficit in developmental dyslexia: a reply to Ellis

Ellis (1979) credits me with the view that “developmental dyslexia might be regarded as a genetic form of deep dyslexia” and then proceeds to argue that my grounds for this view are ill-founded. He offers an alternative proposal, that developmental dyslexia may be likened to (acquired) surface dyslexia. In this paper I will attempt to answer Ellis' (1979) criticisms and provide a critique of his alternative proposal.     

Acquired dyslexia in Spanish: a review and some observations on a new case of deep dyslexia

Readers and writers of Spanish use an orthography that is highly transparent. It has been proposed that readers of Spanish can rely on grapheme-phoneme correspondences, alone, to access meaning or phonology from print. In recent years, a number of case studies have yielded evidence inconsistent with this idea. We review these studies with particular focus on those that report evidence for reading based on direct lexical mappings between print, orthographic representations, and meaning or phonology. We report a new case of acquired literacy impairment in Spanish, MJ, who presents a pattern of preserved abilities and deficits symptomatic of deep dyslexia. The patient is unable to read nonwords, but can read a substantial number of words. Her reading is characterized by the production of semantic, visual, and derivational errors. We argue that MJ has a deficit in her lexical selection ability, common to both her reading and her naming problems. We propose that MJ, and the other cases we review, demonstrate that lexical reading is adopted by skilled readers even in a transparent language.     

Phonemic deficits in developmental dyslexia

Summary The present study explored a possible relationship between reading difficulties and speech difficulties. Dyslexic and normal readers, matched for Reading Age, were compared first on a reading task and secondly on a speaking task.In the first experiment, the two groups were asked to read nonsense words aloud. Both groups were able to read one-syllable nonwords equally well but the dyslexics had more difficulty than the normal readers when asked to read two-syllable nonwords. Moreover, they found two-syllable nonwords containing consonant clusters particularly difficult. The probability of their making an error increased with the number of consonant clusters.In the second experiment, the subjects were required to repeat real words and nonsense words of two, three, or four syllables. Both groups found nonsense words more difficult to repeat than real words. However, the relative difficulty of nonsense words over real words was greater for the dyslexic group. Their difficulty was especially marked when they had to repeat four-syllable nonsense words.Thus, in both experiments the dyslexic readers were more affected by the phonological complexity of the stimuli than the normal readers were. Hence, it was suggested that the dyslexic readers tested were subject to a general phonemic deficit which affected their ability to process both written and spoken words.     

Reading acquisition, developmental dyslexia, and skilled reading across languages: a psycholinguistic grain size theory

The development of reading depends on phonological awareness across all languages so far studied. Languages vary in the consistency with which phonology is represented in orthography. This results in developmental differences in the grain size of lexical representations and accompanying differences in developmental reading strategies and the manifestation of dyslexia across orthographies. Differences in lexical representations and reading across languages leave developmental "footprints" in the adult lexicon. The lexical organization and processing strategies that are characteristic of skilled reading in different orthographies are affected by different developmental constraints in different writing systems. The authors develop a novel theoretical framework to explain these cross-language data, which they label a psycholinguistic grain size theory of reading and its development.     

Subcortical aphasia with deep dyslexia: A case study of a Japanese patient

The reading performance of a Japanese Broca-type aphasic patient on a single-word reading test was investigated. The result indicated that the subject fits the symptom complex of deep dyslexia in more than one aspect. Unique characteristics of this subject included (1) the isolated subcortical site of the lesion, which apparently produced deep dyslexia, and (2) double dissociations between kanji and kana processing and between oral reading and reading comprehension. The performance of this subject was compared with that of another Japanese deep dyslexic subject in S. Sasanuma (1980, In M. Coltheart, K. Patterson, & J. C. Marshall (Eds.), Deep dyslexia, London: Routledge & Kegan Paul). A theoretical implication was attempted based on a dual coding process scheme by S. Sasanuma and O. Fujimura (1978, Cortex, 7, 1-18).     

Deep dyslexia is right-hemisphere reading

Two views exist concerning the proper interpretation of the form of acquired dyslexia known as deep dyslexia: (a) that it represents reading by a multiply damaged left hemisphere reading system; (b) that it represents reading which relies extensively on right-hemisphere orthographic and semantic processing. Price, Howard, Patterson, Warburton, Friston, and Frackowiak (1998) have recently reported a brain-imaging study whose results, they claim, "preclude an explanation of deep dyslexia in terms of purely right-hemisphere word processing." Their claim conflicts with the conclusions of previous published work, which strongly supports the RH hypothesis, work which they do not mention. Furthermore, I argue that their own results also favor the RH hypothesis (even though they claim otherwise); indeed, their results permit the formulation of a much more detailed version of the RH hypothesis than has hitherto been possible. Hence I conclude that the right-hemisphere interpretation of deep dyslexic reading remains the preferred explanation of deep dyslexia.     

Word associations in deep dyslexia

Deep dyslexia is an acquired reading disorder resulting in the production of semantic errors during oral reading and an inability to read aloud nonwords. Several researchers have postulated that patients with deep dyslexia have both phonological and semantic access impairments but the data supporting these claims are not convincing. In fact, the hallmark feature of deep dyslexia--the semantic errors--strongly implies that these patients can access semantic information from printed words. We test the integrity of the semantic system in two such patients through auditory and visual word association tasks. The data support the notion that semantics remains intact and that the disorder and associated errors arise through a selection impairment related to failure of inhibitory connections in the phonological lexicon.     

Working memory functioning in developmental dyslexia

Working memory impairments in dyslexia are well documented. However, research has mostly been limited to the phonological domain, a modality in which people with dyslexia have a range of problems. In this paper, 22 adult students with dyslexia and 22 age- and IQ-matched controls were presented with both verbal and visuospatial working memory tasks. Performance was compared on measures of simple span, complex span (requiring both storage and processing), and dynamic memory updating in the two domains. The dyslexic group had significantly lower spans than the controls on all the verbal tasks, both simple and complex, and also on the spatial complex span measure. Impairments remained on the complex span measures after controlling statistically for simple span performance, suggesting a central executive impairment in dyslexia. The novelty of task demands on the initial trials of the spatial updating task also proved more problematic for the dyslexic than control participants. The results are interpreted in terms of extant theories of dyslexia. The possibility of a supervisory attentional system deficit in dyslexia is also raised. It seems clear that working memory difficulties in dyslexia extend into adulthood, can affect performance in both the phonological and visuospatial modalities, and implicate central executive dysfunction, in addition to problems with storage.     

发展性阅读障碍儿童阅读中的眼跳定位缺陷：基于新词学习的实验证据

通过与生理年龄匹配儿童比较新词重复学习中眼跳定位模式变化的异同, 探讨发展性阅读障碍儿童在新词学习中的眼跳定位是否存在缺陷。以发展性阅读障碍儿童和生理年龄匹配儿童为被试, 采用重复学习新词范式, 结果发现：(1)与生理年龄匹配组相比, 发展性阅读障碍儿童跳入新词的眼跳距离较短、首次注视落点位置更靠近词首; (2)生理年龄匹配组儿童利用学习次数调节新词眼跳定位模式的能力高于发展性阅读障碍儿童, 即随着新词学习次数的增加, 生理年龄匹配组儿童跳入和跳出新词的眼跳距离随之增长, 首次注视落点位置更靠近词中心; 相比之下, 发展性阅读障碍儿童仅在跳出新词的眼跳距离上有所增长, 但增加幅度也显著小于生理年龄匹配组。结果表明, 发展性阅读障碍儿童在新词学习中的眼跳定位, 及利用学习次数对眼跳定位的调节上均表现出一定缺陷。     

Working memory functioning in developmental dyslexia

Working memory impairments in dyslexia are well documented. However, research has mostly been limited to the phonological domain, a modality in which people with dyslexia have a range of problems. In this paper, 22 adult students with dyslexia and 22 age- and IQ-matched controls were presented with both verbal and visuospatial working memory tasks. Performance was compared on measures of simple span, complex span (requiring both storage and processing), and dynamic memory updating in the two domains. The dyslexic group had significantly lower spans than the controls on all the verbal tasks, both simple and complex, and also on the spatial complex span measure. Impairments remained on the complex span measures after controlling statistically for simple span performance, suggesting a central executive impairment in dyslexia. The novelty of task demands on the initial trials of the spatial updating task also proved more problematic for the dyslexic than control participants. The results are interpreted in terms of extant theories of dyslexia. The possibility of a supervisory attentional system deficit in dyslexia is also raised. It seems clear that working memory difficulties in dyslexia extend into adulthood, can affect performance in both the phonological and visuospatial modalities, and implicate central executive dysfunction, in addition to problems with storage.     

发展性阅读障碍的视觉空间注意加工能力

鉴于阅读起始于基础视觉加工阶段, 越来越多的研究者开始关注阅读障碍者的视觉空间注意加工能力。视觉空间注意是指个体对视觉刺激的空间位置的注意, 可通过线索提示、视觉搜索和视觉注意广度等视觉任务来考察。大量国内外研究发现, 发展性阅读障碍者在视觉空间注意任务下表现出行为和神经活动方面的异常。其中的神经机制问题不仅反映在与视觉空间注意有关的顶叶区域激活异常, 还存在于脑区间功能连接异常(如顶叶区域与字形加工区的功能连接)。未来研究还需利用横断和追踪研究探讨阅读障碍与视觉空间注意能力发展关系的内在机制, 以及探究语言特性对阅读障碍者视觉空间注意缺陷的可能调节作用。