Comprehensive Test Of Phonological Processing Research Articles

Language and reading in attention-deficit/hyperactivity disorder and comorbid attention-deficit/hyperactivity disorder+developmental language disorder.

The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD+ADHD. The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig etal., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner etal., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen etal., 2012) were examined in 441 children and adolescents between 6 and 16years of age. The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD+DLD than children with DLD only. The combination of comorbid ADHD+DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

The Arabic-Phonological Processing Test (A-PPT): development, validity, and reliability

ABSTRACT This study introduces the Arabic-Phonological Processing Test (A-PPT) and conducts a thorough assessment of its validity and reliability. The A-PPT functions as a tool for evaluating three fundamental phonological processing skills: phonological awareness, phonological memory, and rapid naming. It aligns with the theoretical framework and administration protocols of the Comprehensive Test of Phonological Processing (CTOPP). The A-PPT comprises 10 distinct subtests and features a total of 325 items, all presented in standard Arabic and progressively increase in difficulty. Our research includes 550 Jordanian children aged 4–8, including both kindergarten and primary grades in elementary school. The A-PPT underwent meticulous piloting and comprehensive testing for validation and reliability. Face validity, determined through content expertise, yielded favorable outcomes. Internal consistency reliability, assessed via Cronbach’s alpha, demonstrated acceptable consistency levels for untimed subscales, ranging from .61 to .964, with the lowest alpha value observed in the 7–8-year-old age group, particularly for the Memory of Digits subtest. In contrast, timed subtests exhibited reliability coefficients between 0.817 and 0.916. Exploratory factor analysis revealed three interrelated subscales explaining 76% of the variance. Further evaluations of test-retest and inter-rater reliability demonstrated moderate to excellent correlation coefficients, with intraclass correlation coefficients ranging from .661 to .965 for test-retest reliability and from .748 to .958 for inter-rater reliability. While acknowledging certain limitations, this study's findings reaffirm the A-PPT's acceptable validity and reliability. This highlights its potential as a valuable assessment instrument for evaluating phonological processing skills within the Arabic-speaking population.

Predicting Phonological Awareness: The Roles of Mind-Wandering and Executive Attention

Purpose: This study aimed to investigate the predictive relationships between mind-wandering, executive attention, and phonological awareness. Methodology: A cross-sectional design was utilized, encompassing 300 participants recruited from a large urban university. Participants underwent assessments using the Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2) for phonological awareness, the Mind-Wandering Questionnaire (MWQ) for mind-wandering, and the Attention Network Test (ANT) for executive attention. Data were analyzed through multiple linear regression using SPSS Version 27, assessing the predictive power of mind-wandering and executive attention on phonological awareness. Findings: The regression analysis demonstrated that mind-wandering and executive attention significantly predict phonological awareness, explaining 35% of its variance (R² = 0.35). Mind-wandering was found to have a negative impact on phonological awareness, with a standardized beta coefficient (β) of -0.22 and a p-value of <0.01, indicating that an increase in mind-wandering behaviors is associated with a decline in phonological processing skills. In contrast, executive attention positively influenced phonological awareness, evidenced by a β of 0.28 and a p-value of <0.01. This suggests that individuals with higher executive attention capabilities tend to have better phonological processing abilities. These results highlight the nuanced roles that cognitive processes play in influencing phonological awareness, underscoring the differential impact of mind-wandering and executive attention on language skills development. Conclusion: The study indicates the significant roles that both mind-wandering and executive attention play in phonological awareness. While mind-wandering may serve as a potential hindrance, executive attention appears to facilitate phonological processing skills.

The Comprehensive Test of Phonological Processing, Second Edition: Measurement Invariance for Dual Language Learners

The Comprehensive Test of Phonological Processing, 2nd Edition (CTOPP-2; Wagner et al., 2013) is commonly used in k-12 public schools to assess basic cognitive processing skills foundational for reading achievement. Psychometric support for its use with dual language learners (DLLs), a group representing over 10% of the school-aged population in the United States, is critical. This study tested the metric and scaler invariance of CTOPP-2 scores among school-aged children ( n = 242; 41.3% Spanish-speaking DLL). Results indicate that the CTOPP-2’s three-factor (i.e., Phonological Awareness, Phonological Memory, and Rapid Automatic Naming) measurement structure displays metric and scalar invariance for DLLs. Model fit was improved when the Phonological Awareness and Phonological Memory factors were combined. Implications for future research and the practice of psychoeducational diagnostic assessment with DLLs are discussed.

The P300 event related potential predicts phonological working memory skills in school-aged children.

The P300 event related potential (ERP) has been cited as a marker of phonological working memory (PWM); however, little is known regarding its relationship to behavioral PWM skills in early school-aged children. The current study investigates the P300 ERP recorded in response to native and non-native (English and Spanish) phoneme contrasts as a predictor of PWM skills in monolingual English-speaking first and second grade children. Thirty-three typically developing children, ages 6–9, completed a battery of phonological processing, language, and cognitive assessments. ERPs were recorded within an auditory oddball paradigm in response to both English phoneme contrasts (/ta/, /pa/) and Spanish contrasts (/t̪a/, /d̪a/). The P300 ERP recorded in response to English phoneme contrasts significantly predicted standard scores on the Nonword Repetition subtest of the Comprehensive Test of Phonological Processing, Second Edition. Spanish contrasts did not elicit a P300 response, nor were amplitude or latency values within the P300 timeframe (250–500 ms) recorded in response to Spanish contrasts related to English nonword repetition performance. This study provides further evidence that the P300 ERP in response to native phonemic contrasts indexes PWM skills, specifically nonword repetition performance, in monolingual children. Further work is necessary to determine the extent to which the P300 response to changing phonological stimuli reflects PWM skills in other populations.

Decision Accuracy of Commonly Used Dyslexia Screeners Among Students Who Are Potentially at Risk for Reading Difficulties

Students with dyslexia demonstrate reading difficulty in early literacy skills (e.g., phonemic awareness, word recognition, decoding), and administering screeners is a necessary step to implement effective intervention. There are several commonly used reading screeners, but the decision accuracy and predictive value between them varies. In the current study, scores on two different reading screeners, the Shaywitz DyslexiaScreen (SDS) and Dynamic Indicators of Basic Early Literacy Skills Next (DIBELS Next) were compared for 115 U.S. Grades K–3 students with specific reading deficits using the Phonological Awareness Composite of the Comprehensive Test of Phonological Processing as the criterion. Tests of sensitivity, specificity, and post-test probabilities were used to evaluate the decision accuracy of the data. Results suggested that the decision accuracy for DIBELS Next (78%) was better than SDS (45%), and both sensitivity (DIBELS Next = 90%, SDS = 35%) and positive post-test probability (DIBELS Next = 71%, SDS = 42%) favored DIBELS Next. Thus, the DIBELS Next measures demonstrated acceptable decision accuracy in identifying students with low phonological awareness, but the SDS did not.

Validation of The Reading House and Association With Cortical Thickness.

The American Academy of Pediatrics recommends literacy and school readiness promotion during well visits. The Reading House (TRH) is a children's book-based screener of emergent literacy skills in preschool-aged children. Vocabulary, rhyming, and rapid naming are core emergent skills, and reading abilities are associated with thicker cortex in the left hemisphere. Our objective was to expand validity of TRH relative to these skills and explore association with cortical thickness. Healthy preschool-aged children completed MRI including a T1-weighted anatomic scan. Before MRI, TRH and assessments of rapid naming (Comprehensive Test of Phonological Processing, Second Edition), rhyming (Pre-Reading Inventory of Phonological Awareness), vocabulary (Expressive Vocabulary Test, Second Edition), and emergent literacy (Get Ready to Read!) were administered. Analyses included Spearman-ρ correlations (r ρ) accounting for age, sex, and socioeconomic status (SES). MRI analyses involved whole-brain measures of cortical thickness relative to TRH scores, accounting for covariates. Seventy children completed assessments (36-63 months old; 36 female) and 52 completed MRI (37-63 months; 29 female). TRH scores were positively correlated with Comprehensive Test of Phonological Processing, Second Edition (r ρ = 0.61), Expressive Vocabulary Test, Second Edition (r ρ = 0.54), Get Ready to Read! (r ρ = 0.87), and Pre-Reading Inventory of Phonological Awareness scores (r ρ = 0.64; all P < .001). These correlations remained statistically significant across age, sex, and SES groups. TRH scores were correlated with greater thickness in left-sided language and visual cortex (P-family-wise error <.05), which were similar for higher SES yet more bilateral and frontal for low SES, reflecting a less mature pattern (P-family-wise error <.10). These findings expand validation evidence for TRH as a screening tool for preschool-aged children, including associations with emergent skills and cortical thickness, and suggest important differences related to SES.

Alphabetic Knowledge and Phonological Awareness : A comparison between Malaysian Preschool Children from Public and Private Kindergartens

Alphabetic knowledge and phonological awareness are essential skills in learning to read. This research examined the level of acquisition on alphabetic knowledge and phonological awareness among 60 preschoolers from private and public preschools in Kuching, Sarawak. The mean age of the children was 5.58. The children were administered letter name and sound knowledge, and letter naming fluency tests to examine their alphabetic knowledge; Comprehensive Test of Phonological Processing and Yopp-Singer Phoneme Segmentation Test to examine their phonological awareness. Higher achievement in alphabetic knowledge and phonological awareness was found among preschoolers from private preschools compared to those from public preschools. This study discusses the implications for practice and the ways teachers could explicitly foster alphabetic knowledge and phonological awareness skills in the classroom.&#x0D; Keywords: learning to read, alphabetic knowledge, phonological awareness, preschool children.

Phonological-Orthographic Deficits in Developmental Dyslexia in Three Spanish-English Bilingual Students.

Introduction The purpose of this study is to present three case studies of developmental dyslexia in dual-language learners (DLLs) and our assessment process. We identify how phonological and orthographic deficits influence reading outcomes. We review the literature on theoretical models of bilingualism and reading models of developmental dyslexia to guide the assessment process through a multicomponential approach. We point out differences in the manifestation of dyslexia in more and less transparent writing systems. We suggest that reading instruction in Spanish can afford benefits to English-Spanish DLLs with developmental dyslexia. Method The study included three participants, two in fifth grade (10.3-11.7 years) and one in college (18.7 years). The assessment battery included reading nonwords and sight words (Test of Word Reading Efficiency); reading accuracy, fluency, and comprehension (Gray Oral Reading Tests-Fourth Edition); phonological awareness subtests (Comprehensive Test of Phonological Processing); and rapid automatized naming tests. A language and reading history interview was elicited from the mothers. In addition, we analyzed the participants' phonemic and word errors in reading. Results Our three participants showed core phonological deficits, with decreased performance in decoding nonwords and low accuracy in reading aloud. In spite of their reading and writing deficits, reading comprehension was within average levels for the three participants in this study. Conclusions We show the importance of assessing reading processes in students with a history of reading and writing problems. Our findings are based on three single case studies and are not generalizable. Our aim is to stimulate questions and research on dyslexia and the particular needs of DLLs.

A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities.

Screen-based media use is prevalent in children and is associated with health risks. American Academy of Pediatrics (AAP) recommendations involve access to screens, frequency, content, and co-viewing. The aim of this study was to test the ScreenQ, a composite measure of screen-based media use. ScreenQ is a 15-item parent report measure reflecting AAP recommendations. Range is 0-26, higher scores reflecting greater non-adherence. With no "gold standard" available, four validated measures of skills and parenting practices cited as influenced by overuse were applied as the external criteria, including expressive language, speed of processing, emergent literacy, and cognitive stimulation at home. Psychometric analyses involved Rasch methods and Spearman's ρ correlations. Sixty-nine families were administered ScreenQ. Child age ranged from 36 to 63 months old (52 ± 8; 35 girls). Mean ScreenQ score was 9.6 (±5.0; 1-22). Psychometric properties were strong (rCo-α = 0.74). ScreenQ scores were negatively correlated with CTOPP-2 (Comprehensive Test of Phonological Processing, Second Edition) (rρ = -0.57), EVT-2 (Expressive Vocabulary Test, Second Edition) (rρ = -0.45), GRTR (Get Ready to Read!) (rρ = -0.30) and StimQ-P (rρ = -0.42) scores (all p ≤ 0.01). ScreenQ shows potential as a composite measure of screen-based media use in young children in the context of AAP recommendations. ScreenQ scores were correlated with lower executive, language and literacy skills, and less stimulating home cognitive environment.

Neural and functional correlates of impaired reading ability in schizophrenia

Deficits in early auditory processing (EAP) are a core component of schizophrenia (SZ) and contribute significantly to impaired overall function. Here, we evaluate the potential contributions of EAP-related impairments in reading to functional capacity and outcome, relative to effects of auditory social cognitive and general neurocognitive dysfunction. Participants included 30-SZ and 28-controls of similar age, sex, and educational achievement. EAP was assessed using an auditory working memory (tone-matching) task. Phonological processing and reading Fluency were assessed using the Comprehensive Test of Phonological Processing and Woodcock-Johnson reading batteries, respectively. Auditory-related social cognition was assessed using measures of emotion/sarcasm recognition. Functional capacity and outcome were assessed using the UCSD Performance-based Skills Assessment and Specific Level of Functioning scale, respectively. fMRI resting-state functional-connectivity (rsFC) was used to evaluate potential underlying substrates. As predicted, SZ patients showed significant and interrelated deficits in both phonological processing (d = 0.74, p = 0.009) and reading fluency (d = 1.24, p < 0.00005). By contrast, single word reading (d = 0.35, p = 0.31) was intact. In SZ, deficits in EAP and phonological reading ability significantly predicted reduced functional capacity, but not functional outcome. By contrast, deficits in reading fluency significantly predicted impairments in both functional capacity and functional outcome. Moreover, deficits in reading fluency correlated with rsFC alterations among auditory thalamus, early auditory and auditory association regions. These findings indicate significant contributions of EAP deficits and functional connectivity changes in subcortical and early auditory regions to reductions in reading fluency, and of impaired reading ability to impaired functional outcome in SZ.

Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children

The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. This cross-sectional study of healthy children aged 3 to 5 years (n = 47) was conducted from August 2017 to November 2018. Participants were recruited at a US children's hospital and community primary care clinics. Children completed cognitive testing followed by diffusion tensor imaging (DTI), and their parent completed a ScreenQ survey. ScreenQ is a 15-item measure of screen-based media use reflecting the domains in the AAP recommendations: access to screens, frequency of use, content viewed, and coviewing. Higher scores reflect greater use. ScreenQ scores were applied as the independent variable in 3 multiple linear regression models, with scores in 3 standardized assessments as the dependent variable, controlling for child age and household income: Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2; Rapid Object Naming subtest); Expressive Vocabulary Test, Second Edition (EVT-2; expressive language); and Get Ready to Read! (GRTR; emergent literacy skills). The DTI measures included fractional anisotropy (FA) and radial diffusivity (RD), which estimated microstructural organization and myelination of white matter tracts. ScreenQ was applied as a factor associated with FA and RD in whole-brain regression analyses, which were then narrowed to 3 left-sided tracts supporting language and emergent literacy abilities. Of the 69 children recruited, 47 (among whom 27 [57%] were girls, and the mean [SD] age was 54.3 [7.5] months) completed DTI. Mean (SD; range) ScreenQ score was 8.6 (4.8; 1-19) points. Mean (SD; range) CTOPP-2 score was 9.4 (3.3; 2-15) points, EVT-2 score was 113.1 (16.6; 88-144) points, and GRTR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 (F2,43 = 5.14; R2 = 0.19; P < .01), CTOPP-2 (F2,35 = 6.64; R2 = 0.28; P < .01), and GRTR (F2,44 = 17.08; R2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities (P < .05, familywise error-corrected), controlling for child age and household income. This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children. The findings suggest further study is needed, particularly during the rapid early stages of brain development.

C-57 Prematurity and Perinatal Insult: Examining the relationships between parent and teacher ratings of executive functioning and academic readiness

Abstract Objective Extremely preterm children and those with a history of perinatal insult (e.g., hemorrhage, hypoxic-ischemic injury) show higher rates of cognitive and academic problems, including executive functioning (EF). EF becomes increasingly important in elementary school as curriculum demands increase. The current study examines the relationship between parent- and teacher-reported EF and early academic performance in this population at school-age. Method This study reviewed retrospective neuropsychological evaluations in a sample of 135 patients (ages 3:9-10:5 years, M = 5.8) from an outpatient neurodevelopmental follow-up program for children with perinatal complication. Parent and teacher measures included: Behavior Assessment Scale for Children (BASC-2, 3) and Behavioral Rating Inventory of Executive Functioning (BRIEF, P, 2). Standardized child measures included: Bracken School Readiness (BBCS-III), and subtests from Wechsler Individual Achievement Test (WIAT-III) and Comprehensive Test of Phonological Processing (CTOPP-2). Results BRIEF parent ratings of working memory (p = 0.34) and emotional control (p = .025) were negatively correlated with school readiness. BRIEF teacher inhibition and working memory ratings were negatively correlated with math performance (p = .004 to p = .044), as well as rapid naming (p = .002 to p = .047) and school readiness (p = .048). BRIEF teacher ratings of planning/organization (p = .027), shifting (p = .024), and emotional control (p = .010) were negatively correlated with pre-reading measures. A 95% confidence interval was used. Conclusions Parent and teacher ratings of EF were significantly correlated with measures of academic readiness, early math skill, and pre-reading measures in this sample of children with a history of perinatal complications. Caregiver ratings can be useful in identifying children at-risk for academic problems upon school entry and requiring further neuropsychological evaluation.

C-68 Expanding Pediatric Performance Validity Tests

Abstract Objective Effort testing with children has started to gain traction in the literature. The following case presents data from several number recall tasks similar to the Wechsler Digit Span and may expand the opportunities for embedded performance validity tests (PVTs). Method For the purpose of psychoeducational testing, a comprehensive battery of standardized neuropsychological tests was administered, including visual and auditory attention, language, visual-motor and fine motor skills, visual and auditory processing, executive functioning, and academics. Results The child showed impaired performance on Number Recall from the Kaufman Assessment Battery for Children, 2nd Edition (KABC-II) and Memory for Digits on the Comprehensive Test of Phonological Processing, 2nd Edition (CTOPP-2) that met the Weschler Digit Span cutoff indicative of poor effort. Evidence of Ganser symptoms (e.g., nearly correct or approximate answers) was present on math calculation performance on the Woodcock Johnson Tests of Achievement, 4th Edition (WJTA-IV). Further, apparently deliberate markings of “X” solely on his incorrect responses on a dichotomous (yes/no) reading task also suggested deliberate feigning of low reading skills. Conclusions This case highlights the importance of effort testing in children, especially as poor effort was not apparent to the examiner, nor did there appear to be any obvious gain. Comparing data on tasks similar to already established PVTs may help expand opportunities to test effort systematically and frequently throughout a neuropsychological evaluation, and has implications for other professionals (e.g., School Psychologists, Speech Language Pathologists, etc.) who evaluate children.

Phonological Awareness Assessment and Intervention Practices for Children Who Are D/deaf or Hard of Hearing

There is not general consensus on best practice for assessment and intervention of phonological awareness (PA) for children who are D/deaf or hard of hearing (D/dhh). The current study surveyed the PA practices of teachers of the deaf and speech-language pathologists to explore perceptions of PA importance, familiarity, and helpfulness related to assessment and intervention approaches used when working with children who are D/dhh. Survey responses from speech-language pathologists ( n = 80) and teachers of the deaf ( n = 94) indicated that the majority of respondents perceive PA to be important to literacy instruction with children who are deaf or hard of hearing. Notably there was a significantly higher average PA importance rating for literacy instruction with children with typical hearing than the PA importance rating for children who were D/dhh. There was wide variability in reported PA assessment and intervention practices. Participants reported using some assessments that included explicit items or subtests for PA including the following: Clinical Evaluation of Language Fundamentals, Comprehensive Test of Phonological Processing, and the Dynamic Indicators of Basic Early Literacy Skills. There was not general consensus on a particular instructional method or approach to support literacy development.

The development of phonological awareness among preschoolers

ABSTRACT The phonological awareness (PA) skills represent a major milestone in the development of reading abilities for preschool children. The purpose of this research study was to examine the developmental trajectories of preschoolers’ PA. A related purpose was to explore gender differences in PA. Participants in this study were 767 preschool children (336 males and 431 females) with 249 children in KG1 and 518 children in KG2. These children were randomly selected from a pool of 16 private preschools across the capital of Oman, Muscat. A battery of PA tasks were adapted from the Phonological Awareness Test-Second Edition (PAT-2; [Robertson, C., & Salter, W. (2007). The phonological awareness test 2 (PAT 2). Austin, TX: PRO-ED.]) and the Comprehensive Test of Phonological Processing – Second Edition (CTOPP-2; [Wagner, R., Torgesen, J., Rashotte, C., & Pearson, N. (2012). Comprehensive test of phonological processing (2nd ed.). Austin, TX: Pro-Ed.]). The PA tasks consisted of 19 subtests: rhyming discrimination, rhyming production, syllables segmentation, phoneme segmentation, isolation (firs, medial, and last sound), compound words deletion and phonemes deletion, sound matching (first and last sound), blending words, memory for digits, nonword repetition, and blending nonwords. The results of the study using multi-variate analysis of variance (MANOVA) showed a significant main effect of the grade level, Wilks’ lambda [F(3,763) = 13.44, p < .001, η 2 = .29, gender, F(1,763) = 1.96, p < .001, η 2 = .06], while the interaction (grade level X gender) was not significant.

How Does a Metalinguistic Phonological Intervention Impact the Reading Achievement and Language of African American Boys?

Researchers consistently find a correlation between low literacy levels and high school dropout rates, expulsion, reading achievement, and failing grades for African American males. Low literacy achievement in African American males may result from multiple factors, including dialectic linguistic differences and/or phonological awareness abilities. Phonological deficits are consistently associated with dyslexia. This article documents results from a metacognitive flexibility-based phonological intervention designed to mitigate the effects of dialect differences and phonological awareness among African American boys. Based on their scaled scores on the Comprehensive Test of Phonological Processing–Second Edition Elision subtest, we placed participants in 2 different groups: low phonological awareness (n = 13) and average phonological awareness (n = 17). The 4-week intervention included manipulative phonemic procedures targeting final consonant patterns with an emphasis on a metacognitive understanding of phonological differences between African American English and academic English. We analyzed pre- and posttest data on resulting reading achievement, phonological awareness, and dialect variation using multivariate analysis of variance/multivariate analysis of covariance. We used hierarchical regression to analyze the prediction of reading achievement scores. The findings of this study suggest several recommendations for teachers to increase phonological awareness abilities among students who are at risk for reading difficulties. Teachers can also implement explicit instruction combining phonemic manipulation and verbal scaffolding related to a metacognitive understanding of the phonological differences between African American English and academic English.

Hearing Matters More Than Seeing: A Cross-Modality Study of Statistical Learning and Reading Ability

ABSTRACTThere is growing interest in the link between implicit statistical learning (SL) and reading ability. Although learning to read involves both auditory and visual modalities, it is not known whether reading skills might be more strongly associated with auditory SL or visual SL. Here we assessed SL across both modalities in 36 typically developing children and 36 healthy adults using the classic triplet-learning paradigm. Auditory SL was significantly associated with sentence reading fluency (Woodcock Johnson III Test of Achievement) in the combined sample of children and adults after controlling for age and nonverbal intelligence. In further analysis of the child data, auditory SL was significantly associated with nonword reading accuracy (Woodcock Reading Mastery Test), a relationship which appeared to be mediated by phonological processing abilities (Comprehensive Test of Phonological Processing). These findings suggest that auditory SL might contribute more strongly to certain aspects of reading development compared to visual SL.

Effect of Atomoxetine Treatment on Reading and Phonological Skills in Children with Dyslexia or Attention-Deficit/Hyperactivity Disorder and Comorbid Dyslexia in a Randomized, Placebo-Controlled Trial.

Objectives: Evaluated the effects of atomoxetine on the reading abilities of children with dyslexia only or attention-deficit/hyperactivity disorder (ADHD) and comorbid dyslexia.Methods: Children aged 10–16 years (N = 209) met Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria for dyslexia only (n = 58), ADHD and comorbid dyslexia (n = 124), or ADHD only (n = 27) and were of normal intelligence. Patients were treated with atomoxetine (1.0–1.4 mg/kg/day) or placebo in a 16-week, randomized, placebo-controlled, double-blind trial. The dyslexia-only and ADHD and comorbid dyslexia groups were randomized 1:1; the ADHD-only group received atomoxetine in a blinded manner. Reading abilities were measured with the Woodcock Johnson III (WJIII), Comprehensive Test of Phonological Processing (CTOPP), Gray Oral Reading Tests-4, and Test of Word Reading Efficiency.Results: Atomoxetine-treated dyslexia-only patients compared with placebo patients had significantly greater improvement (p < 0.02) with moderate to approaching high effect sizes (ES) on WJIII Word Attack (ES = 0.72), Basic Reading Skills (ES = 0.48), and Reading Vocabulary (ES = 0.73). In the atomoxetine-treated ADHD and comorbid dyslexia group, improvement on the CTOPP Elision measure (ES = 0.50) was significantly greater compared with placebo (p < 0.02). Total, inattentive, and hyperactive/impulsive ADHD symptom reductions were significant in the atomoxetine-treated ADHD and comorbid dyslexia group compared with placebo, and from baseline in the ADHD-only group (p ≤ 0.02). ADHD symptom improvements in the ADHD and comorbid dyslexia group were not correlated with improvements in reading.Conclusions: Atomoxetine treatment improved reading scores in patients with dyslexia only and ADHD and comorbid dyslexia. Improvements for patients with dyslexia only were in critical components of reading, including decoding and reading vocabulary. For patients with ADHD and comorbid dyslexia, improvements in reading scores were distinct from improvement in ADHD inattention symptoms alone. These data represent the first report of improvements in reading measures following pharmacotherapy treatment in patients with dyslexia only evaluated in a randomized, double-blind trial.

Assessing Auditory Processing Abilities in Typically Developing School-Aged Children.

Large discrepancies exist in the literature regarding definition, diagnostic criteria, and appropriate assessment for auditory processing disorder (APD). Therefore, a battery of tests with normative data is needed. The purpose of this study is to collect normative data on a variety of tests for APD on children aged 7-12 yr, and to examine effects of outside factors on test performance. Children aged 7-12 yr with normal hearing, speech and language abilities, cognition, and attention were recruited for participation in this normative data collection. One hundred and forty-seven children were recruited using flyers and word of mouth. Of the participants recruited, 137 children qualified for the study. Participants attended schools located in areas that varied in terms of socioeconomic status, and resided in six different states. Audiological testing included a hearing screening (15 dB HL from 250 to 8000 Hz), word recognition testing, tympanometry, ipsilateral and contralateral reflexes, and transient-evoked otoacoustic emissions. The language, nonverbal IQ, phonological processing, and attention skills of each participant were screened using the Clinical Evaluation of Language Fundamentals-4 Screener, Test of Nonverbal Intelligence, Comprehensive Test of Phonological Processing, and Integrated Visual and Auditory-Continuous Performance Test, respectively. The behavioral APD battery included the following tests: Dichotic Digits Test, Frequency Pattern Test, Duration Pattern Test, Random Gap Detection Test, Compressed and Reverberated Words Test, Auditory Figure Ground (signal-to-noise ratio of +8 and +0), and Listening in Spatialized Noise-Sentences Test. Mean scores and standard deviations of each test were calculated, and analysis of variance tests were used to determine effects of factors such as gender, handedness, and birth history on each test. Normative data tables for the test battery were created for the following age groups: 7- and 8-yr-olds (n = 49), 9- and 10-yr-olds (n = 40), and 11- and 12-yr-olds (n = 48). No significant effects were seen for gender or handedness on any of the measures. The data collected in this study are appropriate for use in clinical diagnosis of APD. Use of a low-linguistically loaded core battery with the addition of more language-based tests, when language abilities are known, can provide a well-rounded picture of a child's auditory processing abilities. Screening for language, phonological processing, attention, and cognitive level can provide more information regarding a diagnosis of APD, determine appropriateness of the test battery for the individual child, and may assist with making recommendations or referrals. It is important to use a multidisciplinary approach in the diagnosis and treatment of APD due to the high likelihood of comorbidity with other language, learning, or attention deficits. Although children with other diagnoses may be tested for APD, it is important to establish previously made diagnoses before testing to aid in appropriate test selection and recommendations.