Abstract Dyslexia is a developmental word reading and spelling disorder affecting from 6% to 17% of school‐age children. Phonological processing deficits—marked by difficulties in representing or accessing the abstract units of spoken language—are widely recognized as a primary cause of reading difficulties in children with dyslexia. These impairments disrupt the ability to establish various levels of spelling‐to‐sound correspondence knowledge, negatively affecting word reading development. The effects of phonological deficits on the development of other components of the “reading system” (i.e., orthography, phonology, semantics, and their interconnections) in children with dyslexia are less well‐studied. In this paper, we examine how difficulties in phonological processing adversely affect the development of the reading system, ultimately resulting in low‐quality lexical representations among children with dyslexia. Finally, we introduce a model of targeted “pressure points” within the reading system to guide instruction aimed at fostering high‐quality word‐level lexical representations in children with dyslexia.

Two-thirds of the world’s languages, including Mandarin and Cantonese, employ pitch variation to convey meaning (lexical tone). Existing diagnostic frameworks for primary progressive aphasia (PPA) have been developed for English speakers, and have not considered the impact of salient language-specific variations, such as tone. This study investigates lexical tone processing in Mandarin- and Cantonese-speaking individuals with PPA and examines their neural signatures using structural neuroimaging.Methods:Seventy-eight native Chinese speakers (54 with PPA; 24 healthy controls) were assessed using the CLAP (Chinese Language Assessment for PPA) battery, a series of neuropsychological and linguistic tasks developed to characterize the linguistic features of Mandarin and Cantonese speakers with PPA. Lexical tone production was examined through repetition and reading of “tone-twister” phrases, as well as repetition of multicharacter phrases varying in articulatory features (place, manner, and tone). Tone perception and comprehension was assessed via identification, discrimination, and tone-word/picture matching tasks. Group differences were analyzed using nonparametric tests and generalized estimating equations, with ROC analyses determining diagnostic accuracy. Structural MRI data were acquired for 55 participants, and voxel-based morphometry (VBM) was used to examine the neural correlates of tone performance.Results:Participants with nonfluent/agrammatic variant PPA (nfvPPA) showed marked impairments in lexical tone production (all p<0.001), with a disproportionately high rate of tonal relative to syllabic errors (p<0.001). In contrast, semantic variant PPA (svPPA) exhibited prominent deficits in three tone perception tasks (all p<0.001). Patients with logopenic variant PPA (lvPPA) showed relatively preserved tone production but a predominance of syllabic errors (p<0.001), suggesting underlying phonological deficits. Lexical tone production tasks demonstrated strong discrimination of nfvPPA (AUC= 0.702–0.907). In contrast, three tone perception tasks exhibited high sensitivity for detecting svPPA (90.9–100%), though specificity was modest (37–63%). Neural correlate analyses revealed that tone production deficits were associated with reduced grey matter volume in the left inferior frontal gyrus, insula, and temporal cortex, whereas tone perception performance correlated with atrophy in the left superior and middle temporal gyri, temporal pole, and orbitofrontal regions.Discussion:Lexical tone processing is differentially impaired across PPA subtypes, with tone production and perception deficits mapping onto distinct neural substrates. These findings underscore the necessity of developing language-specific diagnostic approaches for tonal language speakers and call into question the cross-cultural applicability of current PPA diagnostic strategies, which have been largely shaped by Indo-European language frameworks.

Phonological deficits in the comorbidity of reading difficulty and mathematical difficulty in Chinese adults

Developmental dyslexia (DD) has been related to deficits in multiple cognitive skills. Phonological processing deficits are the most frequently reported in opaque orthographies, but there are few studies of transparent orthographies, such as Spanish. The aim of this study was to comprehensively explore possible deficiencies in cognitive functions in Spanish-speaking Mexican children with DD, to determine whether these deficits can explain problems with decoding fluency and accuracy, and analyze whether they provide support for some of the explanatory hypotheses of DD. An extensive cognitive assessment was performed with Spanish-speaking readers: 40 children (20 girls) with DD (mean age 9.02 years, SD = 1.49) and 40 children (20 girls) who were typical readers (mean age 9.22 years, SD = 1.45). Our results showed that most of the children with DD presented deficits in multiple cognitive skills, although not all of these skills contributed to reading performance. These cognitive deficits were not equally distributed among all children and there was no cognitive skill in which all participants with DD showed poor performance. Our results demonstrated that recognition of letter orientation, phonological awareness, and rapid automatized naming were significant predictors of reading ability. These findings support the idea that reading is a multifactorial process involving many cognitive skills, and its disruption could arise from different causes. The main findings are discussed in relation to the major explanatory hypotheses of DD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

BackgroundImpaired phonological short-term memory is a core feature of the logopenic variant of primary progressive aphasia (lvPPA), but it is not clear whether a core phonological processing deficit is also present.MethodsWe asked three questions: (i) beyond short-term memory impairment, do lvPPA patients have an impairment within phonology itself?; (ii) is their performance in working memory and naming reflective of this phonological impairment?; and (iii) is their repetition performance related to structural and functional differences in key language-dominant regions? We compared non-word and word repetition and short-term memory performance in patients with typical Alzheimer’s disease (tAD), lvPPA per consensus criteria, and others who previously satisfied definitions of lvPPA but had progressed with multi-domain cognitive impairments (lvPPA+).ResultsBayesian analyses revealed no group differences in phonological tasks of word and non-word repetition. We found very strong evidence for an effect of self-reported hearing loss on word and non-word repetition, but not multi-syllabic word/phrase repetition. A comparison of phonological versus working memory and naming tasks produced either no evidence or evidence for no correlation. Beyond the expected grey matter reductions in patients relative to controls, there was anecdotal evidence for an association between non-word repetition and functional connectivity between dorsal premotor and posterior superior temporal gyrus regions in patients.ConclusionsOur results indicated that, in the absence of self-reported hearing loss, patients did not exhibit impairments in tasks tapping “pure” phonological processing. Our results suggest that instead of having a core phonological impairment, lvPPA patients have a working memory/buffering impairment.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13195-025-01856-x.

ABSTRACTIntroductionIn our previous study, we have identified white matter subnetworks linked to phonological processing deficits (e.g., subnetworks centered at the left middle temporal gyrus) in dyslexic children from alphabetic languages using a data‐driven hub‐based white matter network analysis approach. Yet, white matter subnetworks associated with phonological processing skills in individuals from nonalphabetic languages (e.g., Chinese) have never been studied. This study aims to identify hub‐related white matter networks associated with phonological processing skills in Chinese readers.MethodsSixty‐five Chinese‐speaking adults were classified into good readers (n = 37) and poor readers (n = 28) based on the severity of self‐reported reading difficulties and dyslexia symptoms, as assessed by the Chinese adaptation of the Adult Reading History Questionnaire (C‐ARHQ). We explored hub‐related networks corresponding to phonological processing skills among the participants. Mediation analysis was further conducted to examine the relationship between white matter networks, phonological awareness, and character reading ability of these adults.ResultsWe observed structural connectivity of two hub‐related white matter networks accounted for individual differences of phonological awareness in Chinese readers: white matter networks surrounding the left middle temporal gyrus and the left fusiform gyrus. Follow‐up mediation analysis revealed that the two white matter networks further contributed to the character reading ability of Chinese readers through phonological awareness.ConclusionsThe current study provides the first‐hand empirical evidence for the white matter network of phonological processing skills in Chinese readers. The findings offer an important cross‐linguistic insight into the white matter network corresponding to phonological processing in nonalphabetic languages.

Dyslexia remains a struggle even among university students. This study aimed to better describe the profiles of college students with dyslexia using a multi-step screening process. The process included a phone screening interview, a developmental and family history questionnaire, and norm-referenced tests to identify students with phonological processing and word-level reading fluency deficits consistent with extant data on college students and adults with dyslexia. Eighty-two university students responded to our questionnaire, and 71 completed a battery of standardised tests including word-level reading and decoding, phonological processing measures, and cognitive tasks. Over 81% of the participants demonstrated deficits in word-level reading fluency, and 98% showed deficits in rapid automatized naming (RAN). Conversely, phonological awareness and phonological memory deficits were less commonly observed. The overwhelming majority of students reported a history of learning difficulties with reading, spelling, writing, or math. Additionally, the majority had a positive family history of language learning difficulties. This process of identifying college students with dyslexia and the profiles of their strengths and weaknesses supports a multifaceted approach to diagnosing dyslexia. These insights should provide guidelines for clinicians and educators seeking to identify and support college students with dyslexia.

IntroductionThis study compared the phonological, musical, and general cognitive profiles of early-emerging poor, average, and good readers.MethodsWe assessed Cantonese preschool children on Chinese word reading, phonological awareness, lexical tone awareness, musical rhythm perception, musical pitch perception, working memory, and non-verbal intelligence.ResultsEarly-emerging poor readers exhibited poorer phonological awareness than early-emerging average and good readers, whereas the latter two groups did not differ significantly. In the working memory task, early-emerging good readers outperformed both early-emerging average and poor readers, who performed similarly. No significant group differences were found in lexical tone awareness, musical rhythm perception, musical pitch perception, or non-verbal intelligence.DiscussionThe results reflect phonological deficits in early-emerging poor readers. Furthermore, phonological awareness and working memory were useful for identifying early-emerging poor and good readers, respectively. Clinically, these findings imply that early-emerging poor readers may benefit most from initial phonological awareness training, followed by working memory training. Moreover, working memory training may also be beneficial for early-emerging average readers seeking to improve their Chinese word reading.

This study comprehensively analyzes the relationship between reading errors and fluency in children in the second grade of general basic education, considering that this stage represents a critical phase for the acquisition of fundamental reading skills. Through a systematic literature review of research published in the last two decades, we identified the most frequent types of reading errors (omissions, substitutions, inversions and repetitions), their causes and consequences, as well as the factors affecting fluency, including phonological deficit, limited vocabulary, poor reading practice and inadequate pedagogical methods. The results reveal that the persistence of these errors compromises not only the automation of the reading process, but also students' comprehension, motivation and school performance. Likewise, effective strategies such as repeated reading, modeling, paired reading and the multisensory approach are highlighted, which have shown positive results in the development of fluency. The study concludes that reading fluency is a complex skill that requires early and comprehensive educational intervention based on scientific evidence, as well as adequate teacher training to identify, prevent and correct reading errors in a timely manner.

Declarative memory plays a crucial role in learning and may serve as a compensatory mechanism for phonological deficits in individuals with dyslexia. However, research on its variability within this population remains limited. This study aimed to identify distinct declarative memory profiles in children and adolescents with dyslexia and examine their potential compensatory role. A total of 714 participants aged 10-19 years, including 136 individuals with dyslexia and 578 neurotypical controls, completed the Test of Memory and Learning Second Edition (TOMAL-2). A Latent Profile Analysis was used to identify memory subgroups based on six TOMAL-2 indices. Group differences were analyzed using independent samples t-tests, and logistic regression was conducted to assess the predictive utility of memory indices for dyslexia classification. Four distinct declarative memory profiles emerged: Typical Memory Performance (78%), Divergent Memory Abilities (11%), Globally Impaired Memory (8%), and Verbal Delayed Recall Impaired Memory (3%). While most individuals with dyslexia exhibited typical declarative memory performance, they were significantly more likely to belong to the Divergent Memory Abilities or Globally Impaired Memory profiles compared to the controls. The logistic regression analysis revealed that lower sequential and free recall scores, combined with stronger nonverbal memory, were significant predictors of dyslexia. These findings highlight the heterogeneity of declarative memory in dyslexia, demonstrating that while some individuals rely on memory strength to compensate for phonological deficits, others experience broader memory impairments. This variability underscores the need for personalized interventions that leverage declarative memory strength while supporting those with deficits. Future research should explore longitudinal changes and cross-linguistic differences for targeted educational strategies.

Dyslexia, a learning disability affecting reading, has been extensively studied using eye movements. This study aimed to examine in the same design the effects of different psycholinguistic variables, i.e., grammatical category, lexical frequency, word length and orthographic consistency on eye movement patterns during reading in adults. We compared the eye movements of forty university students, twenty with and twenty without dyslexia while they read aloud a meaningful and a meaningless text in order to examine whether semantic context could enhance their reading strategy. Dyslexic participants made more reading errors and had longer reading time particularly with the meaningless text, suggesting an increased reliance on the semantic context to enhance their reading strategy. They also made more progressive and regressive fixations while reading the two texts. Similar results were found when examining grammatical categories. These findings suggest a reduced visuo-attentional span and reliance on a serial decoding approach during reading, likely based on grapheme-to-phoneme conversion. Furthermore, in the whole text analysis, there was no difference in fixation duration between the groups. However, when examining word length, only the control group exhibited a distinction between longer and shorter words. No significant group differences emerged for word frequency. Importantly, multiple regression analyses revealed that orthographic consistency predicted fixation durations only in the control group, suggesting that dyslexic readers were less sensitive to phonological regularities-possibly due to underlying phonological deficits. These findings suggest the involvement of both phonological and visuo-attentional deficits in dyslexia. Combined remediation strategies may enhance dyslexic individuals' performance in phonological and visuo-attentional tasks.

Developmental dyslexia (DD) affects approximately 5-12% of learners, posing persistent challenges in reading and writing. This study presents a novel electroencephalography (EEG)-based methodology for identifying DD using two auditory stimuli modulated at 4.8[Formula: see text]Hz (prosodic) and 40[Formula: see text]Hz (phonemic). EEG signals were processed to estimate one-to-one Granger causality, yielding directed and weighted connectivity matrices. A novel Mutually Informed Correlation Coefficient (MICC) feature selection method was employed to identify the most relevant causal links, which were visualized using connectograms. Under the 4.8[Formula: see text]Hz stimulus, altered theta-band connectivity between frontal and occipital regions indicated compensatory frontal activation for prosodic processing and visual-auditory integration difficulties, while gamma-band anomalies between occipital and temporal regions suggested impaired visual-prosodic integration. Classification analysis under the 4.8[Formula: see text]Hz stimulus yielded area under the ROC curve (AUC) values of 0.92 (theta) and 0.91 (gamma band). Under the 40[Formula: see text]Hz stimulus, theta abnormalities reflected dysfunctions in integrating auditory phoneme signals with executive and motor regions, and gamma alterations indicated difficulties coordinating visual and auditory inputs for phonological decoding, with AUC values of 0.84 (theta) and 0.89 (gamma). These results support both the Temporal Sampling Framework and the Phonological Core Deficit Hypothesis. Future research should extend the range of stimuli frequencies and include more diverse cohorts to further validate these potential biomarkers.

Despite recognition of the underlying phonological impairment observed in the logopenic and nonfluent variants of primary progressive aphasia (PPA), there is relatively little treatment research directed toward strengthening phonological skills. In this study, we focused on remediating phonological deficits in logopenic and nonfluent PPA. Specifically, we hypothesized that behavioral intervention intended to strengthen phonological manipulation skills and sound-letter correspondences-coupled with transcranial direct current stimulation (tDCS)-would improve language abilities, especially in the written modality. Twelve individuals with logopenic or nonfluent variants of PPA and 24 neurotypical adults completed neuropsychological assessment that documented spoken and written language deficits in those with PPA. Phonological skills were consistently impaired in relation to other language processes. Following a double-blind, crossover design, six individuals with PPA were randomized to receive active tDCS with phonological intervention during the first treatment phase, and after a 2-month break, they received a second phase of behavioral intervention paired with sham tDCS. The other six individuals were randomized to receive sham first and active tDCS second. Language skills were evaluated before and after each treatment phase and 2 months after the intervention. Both treatment groups (tDCS-first and sham-first) made significant improvement in phonological transcoding skills in response to behavioral intervention, but those who received active tDCS first showed stronger gains in phonological manipulation ability. This group also showed positive changes in written narratives, which contained more grammatical sentences with increased meaningful content and more accurate spelling. These data provide compelling evidence supporting an approach that targets phonological deficits in logopenic and nonfluent PPA. Specifically, we found that improved phonological skills resulted in better functional communication ability (text-level writing) relevant to everyday life. Positive outcomes were strongest when tDCS was combined with behavioral treatment from the beginning, suggesting that this combination may potentiate positive changes that extend beyond the initial stimulation period. https://doi.org/10.23641/asha.28598195.

Children with dyslexia are characterized by reading difficulties due to phonological and visual failures. Thus, this study aimed to develop visual and phonological parameters to classify students with dyslexia into different visual, phonological and mixed profiles. Eighty-six children diagnosed with dyslexia, from the 3rd to 5th grade of Elementary School, participated in this study. They were assessed in an evaluation of phonological and visual perception skills. Factors were developed to classify their performances into the visual and mixed profiles. Statistical analyses were performed using the stepwise method and predictive analysis of results with the discriminant function. The results indicated that phonological deficit was present in 22% of the students evaluated; visual deficit was present in 26% of the students; and mixed deficit in 18.6% of the students. The results also indicated a fourth group, without phonological and/or visual alterations, in 32.6% of the students evaluated. The results of this study indicated the possibility of classifying profiles based on phonological and visual factors and contributed to the view of multiple deficits in dyslexia, also in the Brazilian context. Discussions on criteria, diagnoses and means of identifying these precocious students should be intensified, since a better characterization of these profiles will allow the indication of more specific remediation programs, in addition to curricular adaptations in Brazilian schools.

Beyond the sum of their parts: A multi-dimensional approach to dyscalculia-dyslexia comorbidity integrating studies of the brain, behavior, and genetics.

Dyslexia is a neurodevelopmental disorder characterized by reading difficulty, which has long been attributed to a phonological processing deficit. However, recent research suggests that general difficulties with learning and memory, but also in memory consolidation, may underlie disordered reading. This review article provides an overview of the relationship between learning and memory, memory consolidation during sleep, and reading and explores the emerging literature on consolidation during sleep in individuals with dyslexia. We consider evidence that sleep appears to be less effective for memory consolidation in children with dyslexia and how this may be related to their deficits in reading. This discussion highlights the need for further research to determine the extent to which atypical sleep patterns may contribute to learning deficits associated with disordered reading.

Listeners implicitly use statistical regularities to segment continuous sound input into meaningful units, eg transitional probabilities between syllables to segment a speech stream into separate words. Implicit learning of such statistical regularities in a novel stimulus stream is reflected in a synchronization of neural responses to the sequential stimulus structure. The present study aimed to test the hypothesis that neural tracking of the statistical stimulus structure is reduced in individuals with dyslexia who have weaker reading and spelling skills, and possibly also weaker statistical learning abilities in general, compared to healthy controls. To this end, adults with and without dyslexia were presented with continuous streams of (non-speech) tones, which were arranged into triplets, such that transitional probabilities between single tones were higher within triplets and lower between triplets. We found that the so-called Triplet Learning Index (ie the ratio of neural phase coherence at the triplet rate relative to the tone rate) was lower in adults with dyslexia compared to the control group. Moreover, a higher Triplet Learning Index was associated with better spelling skills. These results suggest that individuals with dyslexia have a rather broad deficit in processing structure in sound instead of a merely phonological deficit.

DSM-5 classifies dyslexia as a “specific learning disorder with impairment in reading”, emphasizing deficits in phonological processing and letter knowledge. Children with dyslexia commonly exhibit challenges in reading accuracy, fluency, and associated cognitive deficits. Computerized neuropsychological assessments have gained prominence for their precision and control in evaluating cognitive abilities. This manuscript presents the validation outcomes of Askisi-Lexia, a web-based neuropsychological screener developed to assess cognitive and phonological skills in children. The screener effectively differentiated between dyslexic and non-dyslexic participants, with dyslexic children demonstrating significantly lower scores and prolonged response times across all nine tasks (five targeting phonological skills and four evaluating cognitive abilities). Additionally, Askisi-Lexia exhibited high sensitivity and specificity across all subtests. Reliability analysis revealed high internal consistency and test-retest reliability. Notably, moderate correlations were observed between Askisi-Lexia and Test-A, a well-established traditional paper-and-pencil assessment, underscoring the screener’s validity. These findings highlight the efficacy of web-based tools in assessing phonological and cognitive deficits associated with dyslexia. The study underscores the potential of web-based screening applications as practical, engaging, and efficient methods for dyslexia assessment. Such tools facilitate identification and intervention, contributing to significant advancements in educational and clinical practice for children with reading-related challenges.

The left temporo‐parietal cortex (TPC) is critical for phonological decoding during reading and appears hypoactive in dyslexia. Therefore, a promising approach to alleviating phonological deficits in dyslexia is to modulate left TPC functioning. However, it is unclear how neurostimulation alters activity and network interactions in dyslexia. To address this gap, we combined facilitatory transcranial magnetic stimulation (TMS) to the left TPC in adults with dyslexia with an overt word and pseudoword reading task during functional neuroimaging. We found TMS‐induced improvements in pseudoword reading, reduced contributions of right‐hemispheric regions during reading, and substantial changes between the core reading nodes and an extended network involving the right cerebellum. Stronger coupling between temporo‐occipital and frontal cortices was further directly linked to improvements in pseudoword reading. Collectively, we provide evidence for a crucial role of the left TPC for phonological decoding and show that TMS can successfully modulate reading networks to improve reading in dyslexia.

This is the first study examining prevalence and co-occurrence of reading difficulties and attention deficit hyperactivity disorder (ADHD) in a Spanish prison population. A main goal was to explore if prisoners’ reading problems were linked to an underlying phonological deficit or to insufficient schooling. The performance of 117 prisoners on reading, phonological, and rapid automatized naming (RAN) tasks were compared to that of 13-15-year-old secondary students. ADHD was assessed by two self-rating questionnaires. Results showed that prisoners were poorer readers but performed equally on the phonological tasks as the secondary students. These results suggest that lack of reading training and practice could account for prisoners’ low reading performance rather than a phonological deficit. In addition, students’ and prisoners’ prevalence of dyslexia was within the rate of the general population, while prisoners’ prevalence of ADHD was elevated. Finally, 67% of prisoners with poor reading, low phonological skills, or declared dyslexic exhibited comorbid symptoms of ADHD. This is taken as evidence that dyslexia itself may not be directly linked to involvement in antisocial behavior, but in combination with other conditions. Adequate schooling along with regular screening and intervention on learning difficulties could help to prevent the incidence of disturbed behavior or, in the case of conviction, to reduce the likelihood of recidivism.