Impaired balance in developmental dyslexia? A meta-analysis of the contending evidence

Background: Developmental dyslexia is typically defined by deficits in phonological skills, but it is also associated with anomalous performance on measures of balance. Although balance assessments are included in several screening batteries for dyslexia, the association between impairments in literacy and deficits in postural stability could be due to the high co-occurrence of dyslexia with other developmental disorders in which impairments of motor behaviour are also prevalent. Methods: We identified 17 published studies that compared balance function between dyslexia and control samples and obtained effect-sizes for each. Contrast and association analyses were used to quantify the influence of hypothesised moderator variables on differences in effects across studies. Results: The mean effect-size of the balance deficit in dyslexia was .64 (95% CI = .44-.78) with heterogeneous findings across the population of studies. Probable co-occurrence of other developmental disorders and variability in intelligence scores in the dyslexia samples were the strongest moderator variables of effect-size. Conclusions: Balance deficits are associated with dyslexia, but these effects are apparently more strongly related to third variables other than to reading ability. Deficits of balance may indicate increased risk of developmental disorder, but are unlikely to be uniquely associated with dyslexia.

Identification of candidate genes for dyslexia susceptibility on chromosome 18

Six independent studies have identified linkage to chromosome 18 for developmental dyslexia or general reading ability. Until now, no candidate genes have been identified to explain this linkage. Here, we set out to identify the gene(s) conferring susceptibility by a two stage strategy of linkage and association analysis. Methodology/Principal Findings: Linkage analysis: 264 UK families and 155 US families each containing at least one child diagnosed with dyslexia were genotyped with a dense set of microsatellite markers on chromosome 18. Association analysis: Using a discovery sample of 187 UK families, nearly 3000 SNPs were genotyped across the chromosome 18 dyslexia susceptibility candidate region. Following association analysis, the top ranking SNPs were then genotyped in the remaining samples. The linkage analysis revealed a broad signal that spans approximately 40 Mb from 18p11.2 to 18q12.2. Following the association analysis and subsequent replication attempts, we observed consistent association with the same SNPs in three genes; melanocortin 5 receptor (MC5R), dymeclin (DYM) and neural precursor cell expressed, developmentally down-regulated 4-like (NEDD4L). Conclusions: Along with already published biological evidence, MC5R, DYM and NEDD4L make attractive candidates for dyslexia susceptibility genes. However, further replication and functional studies are still required.

Visual comparison of multifocal contact lens to monovision

Purpose. To compare visual function with the Bausch & Lomb PureVision multifocal contact lens to monovision with PureVision single vision contact lenses. Methods. Twenty presbyopic subjects were fitted with either the PureVision multifocal contact lens or monovision with PureVision singlevision lenses. Aftera 1-month trial, the following assessments of visual function were made: (a) distance, intermediate, and near visual acuity (VA); (b) reading ability; (c) distance and near contrast sensitivity function (CSF); (d) near range of clear vision; (e) stereoacuity; and (f) subjective evaluation of near vision ability with a standardized questionnaire. Subjects were then refitted with the alternative correction and the procedure was repeated. All measurements were compared between the two corrections, whereas the ``low addition'' multifocal lens was also compared with the ``high addition'' alternative. Results. Distance and near VA were significantly better with monovision than with the multifocal option (p < 0.05). Intermediate VA (p = 0.13) was similar with both corrections, whereas there was also no significant difference in distance and near CSF (p = 0.29 on both occasions). Reading speeds (p = 0.48) and the critical print size (p = 0.90) were not significantly different between the two contact lens corrections, but stereoacuity (p < 0.01) and the near range of clear vision (p < 0.05) were significantly better with the multifocal option than with monovision. Subjective assessment of near ability was similar for both types of contact lens (p = 0.52). The high addition multifocal lens produced significantly poorer distance and near CSF, near VA, and critical print size compared with the low addition alternative. Conclusions. Monovision performed better than a center-near aspheric simultaneous vision multifocal contact lens of the same material for distance and near VA only. The multifocal option provides better stereoacuity and near range of clear vision, with little differences in CSF, so a better balance of real-world visual function may be achieved due to minimal binocular disruption. (Optom Vis Sci 2009;86:98-105)

Early cognitive profiles of emergent readers:a longitudinal study

This longitudinal study examined the contribution of phonological awareness, phonological memory, and visuospatial ability to reading development in 142 English-speaking children from the start of kindergarten to the middle of Grade 2. Partial cross-lagged analyses revealed significant relationships between early performance on block design and matching letter-like forms tasks and later reading ability. Rhyme awareness correlated with later reading ability during the earliest stages, but onset awareness did not emerge as important until after the children had started reading. Digit span correlated significantly with future reading ability at every stage. These findings indicate that although phonological awareness, phonological memory, and visuospatial ability are all necessary for emergent reading, their relative importance varies across the first 2 years of reading development.

Impaired sensitivity to dynamic stimuli in poor readers of a regular orthography

The mappings from grapheme to phoneme are much less consistent in English than they are for most other languages. Therefore, the differences found between English-speaking dyslexics and controls on sensory measures of temporal processing might be related more to the irregularities of English orthography than to a general deficit affecting reading ability in all languages. However, here we show that poor readers of Norwegian, a language with a relatively regular orthography, are less sensitive than controls to dynamic visual and auditory stimuli. Consistent with results from previous studies of English-readers, detection thresholds for visual motion and auditory frequency modulation (FM) were significantly higher in 19 poor readers of Norwegian compared to 22 control readers of the same age. Over two-thirds (68.4%) of the children identified as poor readers were less sensitive than controls to either or both of the visual coherent motion or auditory 2Hz FM stimuli. © 2003 Elsevier Science (USA). All rights reserved.

Separate influences of acoustic AM and FM sensitivity on the phonological decoding skills of impaired and normal readers

Developmental dyslexia is associated with deficits in the processing of basic auditory stimuli. Yet it is unclear how these sensory impairments might contribute to poor reading skills. This study better characterizes the relationship between phonological decoding skills, the lack of which is generally accepted to comprise the core deficit in reading disabilities, and auditory sensitivity to amplitude modulation (AM) and frequency modulation (FM). Thirty-eight adult subjects, 17 of whom had a history of developmental dyslexia, completed a battery, of psychophysical measures of sensitivity to FM and AM at different modulation rates, along with a measure of pseudoword reading accuracy and standardized assessments of literacy and cognitive skills. The subjects with a history of dyslexia were significantly less sensitive than controls to 2-Hz FM and 20-Hz AM only. The absence of a significant group difference for 2-Hz AM shows that the dyslexics do not have a general deficit in detecting all slow modulations. Thresholds for detecting 2-Hz and 240-Hz FM and 20-Hz AM correlated significantly with pseudoword reading accuracy. After accounting for various cognitive skills, however, multiple regression analyses showed that detection thresholds for both 2-Hz FM and 20-Hz AM were significant and independent predictors of pseudoword reading ability in the entire sample. Thresholds for 2-Hz AM and 240-Hz FM did not explain significant additional variance in pseudoword reading skill, it is therefore possible that certain components of auditory processing of modulations are related to phonological decoding skills, whereas others are not.

Evaluation of modern intraocular lenses

Accommodating Intraocular Lenses (IOLs), multifocal IOLs (MIOLs) and toric IOLs are designed to provide a greater level of spectacle independency post cataract surgery. All of these IOLs are reliant on the accurate calculation of intraocular lens power determined through reliable ocular biometry. A standardised defocus area metric and reading performance index metric were devised for the evaluation of the range of focus and the reading ability of subjects implanted with presbyopic correcting IOLs. The range of clear vision after implantation of an MIOL is extended by a second focal point; however, this results in the prevalence of dysphotopsia. A bespoke halometer was designed and validated to assess this photopic phenomenon. There is a lack of standardisation in the methods used for determining IOL orientation and thus rotation. A repeatable, objective method was developed to allow the accurate assessment of IOL rotation, which was used to determine the rotational and positional stability of a closed loop haptic IOL. A new commercially available biometry device was validated for use with subjects prior to cataract surgery. The optical low coherence reflectometry instrument proved to be a valid method for assessing ocular biometry and covered a wider range of ocular parameters in comparison with previous instruments. The advantages of MIOLs were shown to include an extended range of clear vision translating into greater reading ability. However, an increased prevalence of dysphotopsia was shown with a bespoke halometer, which was dependent on the MIOL optic design. Implantation of a single optic accommodating IOL did not improve reading ability but achieved high subjective ratings of near vision. The closed-loop haptic IOL displayed excellent rotational stability in the late period but relatively poor rotational stability in the early period post implantation. The orientation error was compounded by the high frequency of positional misalignment leading to an extensive overall misalignment of the IOL. This thesis demonstrates the functionality of new IOL lens designs and the importance of standardised testing methods, thus providing a greater understanding of the consequences of implanting these IOLs. Consequently, the findings of the thesis will influence future designs of IOLs and testing methods.

Clinical evaluation of a multifocal aspheric diffractive intraocular lens

Aim: To evaluate the performance of an aspheric diffractive multifocal acrylic intraocular lens (IOL), ZMB00 1-Piece Tecnis. Setting: Five sites across Europe. Methods: Fifty-two patients with cataracts (average age 68.5±10.5 years, 35 female) were bilaterally implanted with the aspheric diffractive multifocal IOL after completing a questionnaire regarding their optical visual symptoms, use of visual correction and their visual satisfaction. The questionnaire was completed again 4-6 months after surgery along with measures of uncorrected and best-corrected distance and near visual acuity, under photopic and mesopic lighting, reading ability, defocus curve testing and ocular examination for adverse events. Results: The residual refractive error was 0.01±0.47D with 56% of eyes within ±0.25D and 97% within ±1.0D. Uncorrected visual acuity was 0.02±0.10logMAR at distance and 0.15±0.30 logMAR at near, only reducing to 0.07±0.10logMAR at distance and 0.21±0.25logMAR at near in mesopic conditions.The defocus curve showed a near addition between 2.5-3.0 D allowing a reading acuity of 0.08±0.13 logMAR, with a range of clear vision <0.3 logMAR of ∼4.0 D. The average reading speed was 121.4±30.8 words per minute. Spectacle independence was 100% for distance and 88% for near, with high levels of satisfaction reported. Overall rating of vision without glasses could be explained (r=0.760) by preoperative best-corrected distance acuity, postoperative reading acuity and postoperative uncorrected distance acuity in photopic conditions (p<0.001). Only two minor adverse events occurred. Conclusions: The ZMB00 1-Piece Tecnis multifocal IOL provides a good visual outcome at distance and near with minimal adverse effects.

Oculo-visual changes and clinical considerations affecting older patients with dementia

Purpose: Dementia is associated with various alterations of the eye and visual function. Over 60% of cases are attributable to Alzheimer's disease, a significant proportion of the remainder to vascular dementia or dementia with Lewy bodies, while frontotemporal dementia, and Parkinson's disease dementia are less common. This review describes the oculo-visual problems of these five dementias and the pathological changes which may explain these symptoms. It further discusses clinical considerations to help the clinician care for older patients affected by dementia. Recent findings: Visual problems in dementia include loss of visual acuity, defects in colour vision and visual masking tests, changes in pupillary response to mydriatics, defects in fixation and smooth and saccadic eye movements, changes in contrast sensitivity function and visual evoked potentials, and disturbance of complex visual functions such as in reading ability, visuospatial function, and the naming and identification of objects. Pathological changes have also been reported affecting the crystalline lens, retina, optic nerve, and visual cortex. Clinically, issues such as cataract surgery, correcting the refractive error, quality of life, falls, visual impairment and eye care for dementia have been addressed. Summary: Many visual changes occur across dementias, are controversial, often based on limited patient numbers, and no single feature can be regarded as diagnostic of any specific dementia. Nevertheless, visual hallucinations may be more characteristic of dementia with Lewy bodies and Parkinson's disease dementia than Alzheimer's disease or frontotemporal dementia. Differences in saccadic eye movement dysfunction may also help to distinguish Alzheimer's disease from frontotemporal dementia and Parkinson's disease dementia from dementia with Lewy bodies. Eye care professionals need to keep informed of the growing literature in vision/dementia, be attentive to signs and symptoms suggestive of cognitive impairment, and be able to adapt their practice and clinical interventions to best serve patients with dementia.

Differential outcomes of two -way and transitional programs on English language learners at different entry levels

This study investigated the effects of two types of bilingual education programs (two-way and transitional) on the academic performance, attitudes, and metacognitive awareness of 5th grade students who entered kindergarten or first grade with different levels of English proficiency. The multi-stage sample consisted of students who had participated in each program for a period of at least five years. A mixed model design allowed for the collection of quantitative and qualitative data that were analyzed accordingly and integrated. ^ The findings indicated no significant differences between the two groups on measures of academic achievement in English. Significant differences were found in the number of semesters required for the students to become proficient English speakers. An important conclusion, based on these findings, was that the students enrolled in the two-way bilingual education (TWBE) programs learned English faster. Moreover, they maintained a high level of proficiency in Spanish, scoring significantly higher than the transitional bilingual education group on measures of Spanish reading ability.^ Questionnaire and interview data indicated that the students in the two-way bilingual education programs tended to use more Spanish for recreational purposes and tended to rate themselves as more proficient Spanish speakers than their peers. Conversely, the students enrolled in the transitional bilingual education programs tended to rate themselves as more proficient in English than their peers. ^ The level of English language proficiency upon entering school (five years later) was found to make a difference in academic achievement, as measured by standardized tests. Five years of schooling did not fully eliminate the gap in academic performance between students with different ESOL entry levels at kindergarten. However, entry level did not have an effect on attitudes towards bilingualism. ^ It is concluded that, although there was no significant difference between the two groups on measures of academic achievement in English, TWBE and transitional programs have differential effects. Students in the TWBE programs acquired oral language at a faster rate, developed literacy skills in their native language, and acquired more positive attitudes towards bilingualism. Theoretical, methodological, and policy implications of the findings are discussed. ^

Assessment of iodine intake and related cognitive function impairments in elementary schoolchildren from Terceira Island, Azores (Portugal)

Dissertação de Mestrado, Ciências Biomédicas, 28 de Junho de 2016, Universidade dos Açores.

INVESTIGATING THE USE OF MAZE-CBM FOR HIGH SCHOOL STUDENTS

Recent legislation and initiatives set forth high academic expectations for all high school graduates in the area of reading (National Governors Association Center for Best Practices, 2010; Every Student Succeeds Act, 2015). To determine which students need additional support to meet these reading standards, teachers can conduct universal screening using formative assessments. Maze Curriculum-Based Measurement (Maze-CBM) is a commonly used screening and progress monitoring assessment that the National Center on Intensive Intervention (2013) and the Center on Instruction (Torgesen & Miller, 2009) recommend. Despite the recommendation to use Maze-CBM, little research has been conducted on the reliability and validity of Maze-CBM for measuring reading ability for students at the secondary level (Mitchell & Wexler, 2016). In the papers included in this dissertation, I present an initial investigation into the use of Maze-CBM for secondary students. In the first paper, I investigated prior studies of Maze-CBM for students in Grades 6 through 12. Next, in the second paper, I investigated the alternate-form reliability and validity for screening students in Grades 9 and 10 using signal detection theory methods. In the third paper, I examined the effect of genre on Maze-CBM scores with a sample of students in Grades 9 and 10 using multilevel modeling. When writing these three papers, I discovered several important findings related to Maze-CBM. First, there are few studies that have investigated the technical adequacy of Maze-CBM for screening and progress monitoring students in Grades 6 through 12. Additionally, only two studies (McMaster, Wayman, & Cao, 2006; Pierce, McMaster, & Deno, 2010) examined the technical adequacy of Maze-CBM for high school students. A second finding is that the reliability of Maze-CBM is often below acceptable levels for making screening decisions or progress monitoring decisions (.80 and above and .90 and above, respectively; Salvia, Ysseldyke, & Bolt, 2007) for secondary students. A third finding is that Maze-CBM scores show promise of being a valid screening tool for reading ability of secondary students. Finally, I found that the genre of the text used in the Maze-CBM assessment does impact scores on Maze-CBM for students in Grades 9 and 10.

A leitura no processo ensino aprendizagem em escolas da rede particular, na 4ª série do ensino fundamental em Belém do Pará: Uma busca para além decodificação

O presente estudo está baseado na Metodologia fenomenológica, com pesquisa bibliográfica e de campo. Apresenta como objetivo geral, analisar como se desenvolve o processo de ensino e aprendizagem de leitura, assim como, os estímulos e a prática do ato de ler em alunos de tenra idade em escolas particulares de Belém do Pará, em turmas da 4a Serie, do Ensino Fundamental. Tendo como objetivos específicos averiguar o ponto principal de indagação está centrado na questão se a leitura prática é apenas o desenvolvimento dos códigos linguísticos aprendidos, ou buscar não somente o processo de decodificar, sem considerar os aspectos mais abrangentes como a interpretação do texto, direcionado para o leitor ativo e atuante na compreensão das ideias do autor. Tal questionamento a respeito do processo de aprendizagem da leitura em nível fundamental das escolas particulares de Belém do Pará foi perguntado por meio de pesquisas de campo, a professores, alunos e para a coordenação, utilizando como instrumento de coleta de dados, questionário com perguntas abertas e fechadas de opinião entrevistas e grupos focais. No decorrer deste estudo, nota-se que para formar leitores mirins, serão exigidos alguns requisitos importantes, como a escolha de bons livros e atividades norteadoras de estimulação em classe e até mesmo fora dela. Afim de que principalmente o aluno em fase inicial de aprendizagem, seja e sinta-se preparado e ainda, conscientizado da importância da leitura para o seu questionamento crítico, como cidadão do futuro. Para tanto, fatores que interferem no processo de leitura, tais como: títulos variados, histórias que versem a respeito do imaginário cultural, textos direcionados ao público infantil, que despertem o interesse do alunado, além de apenas lei os códigos linguísticos na aquisição do texto, sem obtenção dos critérios interpretativos, que este possa evocar. A leitura é tida pela sociedade em geral, como um fator que pode levar o individuo a descobertas de novos patamares e horizontes sociais, mas somente indo além do mecanismo na apresentação dos textos cm sala de aula, é que o professor poderá atingir os níveis de compreensão integral do sistema escrito. Ensinando a ler, com elementos fundamentais para a iniciação de leitura interpretativa e proficiente no ensino fundamental. ABSTRACT: The present study is based upon the Phenomenological Methodology, with field and bibliographic research. It presents as a main objective the analysis on how the teaching and learning educational process develop upon the reading skills, as well as the encouragement and practice of reading in students of young ages in private schools in Belém, state of Pará (Brazil), in fourth grade groups, in elementary school. Having set specific goals, the search is centered in the practical reading ability matter, and if such ability is of linguistic code development solely learned or the search of not only the decoding process, without taking in consideration the broadening aspects, such as text comprehension, targeting the active reader especially when it comes to the author's ideas. Such discussion regarding the reading learning process in elementary levels in private schools in Belém, state of Para (Brazil) is questioned by field research, teachers, students and the coordination, using as data collecting instruments, questionnaires with open and closed questions, interviews and focal groups. Along the study, regarding the formation of young readers, it requires some aspects, such as, the choice of good titles and in-class stimulating activities or even outdoor ones, so the students - especially the ones in the initial phase of learning- are and feel prepared and even conscious of the importance of the reading for their critical thinking- as a future citizen. Therefore, the factors that may interfere in the reading process, for instance, varied titles, stories that verse towards the cultural imaginary, texts directed to the young public, that awaken the interest of the student body, beyond the linguistic codes acquired in the texts, not obtaining the interpreting criteria that it might evoke. The reading is, by the society, a fundamental factor that might lead the human being to discovering new standards and social horizons, but only going further the typical mechanisms in presenting the texts in class, is when the teacher may reach the whole levels of comprehension of the written system, teaching how to read, with fundamental elements to the initial reading in elementary school.

The correlation between reading and mathematics ability at age twelve has a substantial genetic component

Dissecting how genetic and environmental influences impact on learning is helpful for maximizing numeracy and literacy. Here we show, using twin and genome-wide analysis, that there is a substantial genetic component to children’s ability in reading and mathematics, and estimate that around one half of the observed correlation in these traits is due to shared genetic effects (so-called Generalist Genes). Thus, our results highlight the potential role of the learning environment in contributing to differences in a child’s cognitive abilities at age twelve.

Gifted students with a reading disability : the impact of lived experience

Gifted students who have a reading disability have learning characteristics that set them apart from their peers. The ability to read impacts upon all areas of the formal curriculum in which print-based texts are common. Therefore, the full intellectual development of gifted students with a reading disability can be repressed because their access to learning opportunities is reduced. When the different learning needs caused by concomitant giftedness and reading disability are not met, it can have serious implications for both academic achievement and the social-emotional wellbeing of these students. In order to develop a deeper understanding of this vulnerable group of students, this study investigated the learning characteristics of gifted students with a reading disability. Furthermore, it investigated how the learning characteristics of these students impact upon their lived experiences. Since achievement and motivation have been shown to be closely linked to self-efficacy, self-efficacy theory underpinned the conceptual framework of the study. The study used a descriptive case study approach to document the lived experiences of gifted students with a reading disability. Nine participants aged between 11 and 18, who were formally identified as gifted with a reading disability, took part in the study. Data sources in the case study database included: cognitive assessments, such as WISC assessments, Stanford Binet 5, or the Raven's Standard Progressive Matrices; the WIAT II reading assessment; the Reader Self-Perception Scale; document reviews; parent and teacher checklists designed to gain information about the students' learning characteristics; and semi-structured interviews with students. The study showed that gifted students with a reading disability display a complex profile of learning strengths and weaknesses. As a result, they face a daily struggle of trying to reconcile the confusion of being able to complete some tasks to a high level, while struggling to read. The study sheds light on the myriad of issues faced by the students at school. It revealed that when the particular learning characteristics and needs of gifted students with a reading disability are recognised and met, these students can experience academic success, and avoid the serious social-emotional complications cited in previous studies. Indeed, rather than suffering from depression, disengagement from learning, and demotivation, these students were described as resilient, independent, determined, goal oriented and motivated to learn and persevere. Notably, the students in the study had developed effective coping strategies for dealing with the daily challenges they faced. These strategies are outlined in the thesis together with the advice students offered for helping other gifted students with a reading disability to succeed. Their advice is significant for all teachers who wish to nurture the potential of those students who face the challenge of being gifted with a reading disability, and for the parents of these students. This research advances knowledge pertaining to the theory of self-efficacy, and self-efficacy in reading specifically, by showing that although gifted students with a reading disability have low self-efficacy, the level is not the same for all aspects of reading. Furthermore, despite low self-efficacy in reading these students remained motivated. The study also enhances existing knowledge in the areas of gifted education and special education because it documents the lived experience of gifted students with a specific learning disability in reading from the students' perspectives. Based on a synthesis of the literature and research findings, an Inclusive Pathway Model is proposed that describes a framework to support gifted students with a reading disability so that they might achieve, and remain socially and emotionally well-adjusted. The study highlights the importance of clear identification protocols (such as the use of a range of assessment sources, discussions with students and parents, and an awareness of the characteristics of gifted students with a reading disability) and support mechanisms for assisting students (for example, differentiated reading instruction and the use of assistive technology).