Dyslexia studies
Today, I’m looking at two studies pertaining to dyslexia, each available in full text. First, McDonough (2023) “Research on dyslexia is identifying the many factors — neural to societal — that are linked to the condition” in Harvard Gazette. Here are some excerpts.
As a child, Roberto Olivardia didn’t enjoy reading. Processing the words on a page fatigued him. But Olivardia — now a psychologist at McLean Hospital and a lecturer at Harvard Medical School — never considered that he might have dyslexia. Decades later, Olivardia witnessed his six-year-old son experiencing a similar fatigue. Only the six-year-old’s was worse. Only after his son’s diagnosis of dyslexia did Olivardia become aware of the condition’s complexities: how misunderstood it is among parents, teachers, and doctors; how it manifests in myriad ways; and how a diagnosis can change everything.
Yet getting that diagnosis is not always easy because physicians and scientists are still putting together the many puzzle pieces of dyslexia, a language-based learning disability that affects an estimated 7 to 10 percent of the population. The condition is marked by a person’s difficulty to accurately and fluently read words and to accurately decode and spell words.
Although the causes for dyslexia are complex, a main factor is a person’s difficulty with phonological and phonemic awareness; that is, their ability to recognize and manipulate the spoken parts of words, which sets the stage for decoding, blending, and, ultimately, reading words. Imagine, for example, being presented a word from a language other than your native language, written using symbols or an alphabet associated with that language. It may be possible to get a sense of the sounds in the word — but remembering all of them and blending them together could be hard. Each letter would need to be deciphered, and their sounds stitched together to form a word. It’s a process that can take time.
Unlike with spoken language, humans haven’t evolved a natural capacity for learning to read through exposure. Instead, learning to read requires that different areas of the brain that evolved for other purposes — including vision and sound perception — be retrained to work together to recognize and interpret written words. If scientists wanted to pinpoint the basis of dyslexia, they would need to explore the many brain regions involved in reading, as well as the neural pathways connecting them.
In one of the first studies exploring anatomical brain differences in people with dyslexia, published in Annals of Neurology in 1979, Galaburda and a colleague highlighted some interesting patterns that he would later also find in brains of other dyslexic people, including unusual symmetry between the two hemispheres and anomalies in the development of the cortex.
At that point, “we knew a lot about how the brain of a person with dyslexia differed in activation patterns and different tasks,” Galaburda says. But an important question remained: Did dyslexia cause these differences, or did these differences cause dyslexia?
Gaab focused on answering this question. An MIT research group she was a part of focused its study on one white matter tract called the arcuate fasciculus, or the “the arc,” which connects key brain areas involved in reading: those related to vision and sound processing at the back of the brain and the inferior frontal gyrus, an area responsible for comprehension and meaning. In a subsequent longitudinal study in which the brains of kindergartners were scanned, Gaab and colleagues demonstrated that children who had lower phonological processing skills, a risk factor for dyslexia, also had smaller arcs.
They compared brain scans from children with a familial risk for dyslexia with those from children without the familial risk and found that children at risk for the condition showed differences in the arc even before beginning formal schooling. Moreover, the rate of the structure’s development was slower among those who later developed poor reading skills regardless of familial risk. To the researchers, this suggested that some children began kindergarten with brains that were less well equipped for learning to read.
Their initial study, published in Cerebral Cortex in 2017, found that infants of parents who had struggled with reading showed alterations in the arc compared to infants of parents who hadn’t struggled to read. In subsequent studies, they observed a link between these alterations and phonological processing and oral language skills in kindergarten. They also found that the microstructure of the arc can be shaped by lifestyle factors, such as how early and often a child is read to.
In addition to linking risk factors for dyslexia to specific parts of the brain, her work shows that some of these risks can be inherited. And the findings indicate that while genetics matter, environment can matter, too. Perhaps more important, they suggest that risk factors for dyslexia exist early — very early.
Despite so many children already at risk before starting school, U.S. school systems tend to identify children with dyslexia only after it’s clear that something is wrong — at around nine or ten years old. Gaab, who describes herself as a “translational neuroscientist,” has become a tireless proponent of early intervention. She advocated for a new Massachusetts law that was signed by the governor in 2018, requiring screening for dyslexia for children in kindergarten. And she’s been developing a tablet-based tool that can be used to screen children for reading problems as early as age four. This latter tool is especially useful because fMRI data, while good for exploring overall patterns of brain differences between groups, is impractical in educational contexts and does not have the sensitivity and specificity necessary to identify at-risk children.
Proper early identification is key, adds Gaab, because studies indicate that 50 to 90 percent of at-risk readers can reach average levels of performance with targeted instruction, and that interventions are more effective in kindergarten and first grade than later on.
According to Olivardia, children who are never identified, or who live in communities without access to these interventions, might get lumped into generic remedial reading classes. But if their instruction isn’t tailored to dyslexia, “it’s as if you don’t understand the language someone is speaking, so they just speak louder,” he says. “You’re like, that doesn’t help me at all.”
Early intervention does more than help get reading levels on track. Children with dyslexia are more likely to experience depression, anxiety, and other mental health issues. But that’s not due to differences in their brains; it’s because in our society, literacy is key to academic and workplace success.
Olivardia understands the importance of reframing dyslexia for his patients. He talks to them about the many successful people who are thought to have had dyslexia — from Einstein to Picasso to British business magnate Richard Branson — and stresses his own observations that people with dyslexia exhibit above-average creativity and entrepreneurial skills. Research backs this up: A 2009 study in Dyslexia found a prevalence of dyslexia three times higher among entrepreneurs than people in the general population, while a higher prevalence of dyslexia has also been identified among students who pursue art or engineering. Other research points to a superior ability to connect unusual combinations of ideas among people with dyslexia.
I found this article accessible and helpful in articulating the differences in the brains of people with and without dyslexia. I also like its emphasis on early identification and the role dyslexia may play in entrepreneurial and creative endeavors. The next study moves to early adulthood. McDowall, Rimfield & Krishnan (2024) published “Cognitive Reappraisal Reduces Academic Anxiety in University Students with Dyslexia” in Mind, Brain & Education.
University students with dyslexia have greater anxiety than their peers without dyslexia, especially related to their academic studies. Most universities focus on mitigating the learning needs of these students, for example, providing more time during exams. Relatively little attention is paid to the psychological impact of having dyslexia. In this preregistered study, we investigated whether cognitive reappraisal reduced academic anxiety in university students with dyslexia. We codesigned negative and neutral scenarios about academic life with university students with dyslexia. We presented university students (54 students with dyslexia and 51 neurotypical students) with these scenarios about academic life and asked them to rate their anxiety. As hypothesized, we observed that students with dyslexia had higher academic anxiety than those without dyslexia (d = 0.43). When instructed to use cognitive reappraisal, all students, irrespective of having dyslexia or not, benefitted from an anxiety reduction (d = 0.87). Our experimental research indicates cognitive reappraisal may be a valuable tool to support students. Furthermore, it may help those with dyslexia to manage the heightened emotional demands of academia. Intervention trials that assess the real-world implementation of cognitive reappraisal are now warranted.
To be included in the dyslexia group, participants had to report they had a diagnosis of dyslexia and also had to score above the cut-off on the Abbreviated Adult Reading History Questionnaire (ARHQ-Brief). We excluded participants with diagnoses of autism, epilepsy, or a known genetic disorder such as Down syndrome. However, we did not exclude participants with other learning difficulties or attention deficit hyperactivity disorder (ADHD), as these commonly co-occur and excluding these participants would limit the generalizability of our findings.
At the start of the experiment, participants were given instructions in video format. Participants were told how to use cognitive reappraisal as an emotional regulation strategy, such as changing their interpretation of a situation to a more positive one. They were also given examples of cognitive reappraisal and shown the prompt for when to use it.
Students with dyslexia showed significantly higher emotional reactivity scores than those without dyslexia. Students with dyslexia found the negative conditions evoked much more anxiety than the neutral condition. This difference was slightly attenuated in the students without dyslexia. Participants had higher anxiety when they did not use reappraisal relative to when they did.
We compared general and academic specific anxiety in the same individuals to evaluate whether group differences were generalized or mainly reflected academic anxiety. Participants with dyslexia did not show significantly higher generalized anxiety scores than participants without dyslexia. In contrast, when examining academic anxiety as assessed by AAS, participants with dyslexia did show higher anxiety than students without dyslexia.
We compared the use of cognitive reappraisal strategies in participants daily lives to measure if there was a difference between the groups. Students with dyslexia did not report differential use of cognitive reappraisal in daily life relative to students without dyslexia.
An original feature of our cognitive reappraisal paradigm was having realistic academic scenarios codesigned by people with lived experience. The use of cognitive reappraisal alleviated anxiety in these real-world scenarios.
We also assessed whether students with dyslexia benefited more from cognitive reappraisal than their peers. Given that academic anxiety is higher in students with dyslexia, and those with greater anxiety in academic domains are less likely to use positive reinterpretation strategies, we predicted that teaching students' cognitive reappraisal would have a greater effect on those with dyslexia. However, we did not find evidence to support this; instead, we saw that both groups of students benefitted similarly from using cognitive reappraisal. One interpretation could be that cognitive reappraisal is no more effective the more anxious a person is and only brings a certain degree of emotional relief. Another possibility is that individuals with dyslexia who pursue higher education may have stronger protective strategies. In this vein, they may already employ cognitive reappraisal strategies in their regular life and, therefore, derive less benefit from being asked to use them. However, both groups of students reported using cognitive reappraisal to the same extent in their everyday lives.
As academic challenges are an inevitable part of university, this increased anxiety could considerably impact their overall university experience. Furthermore, these students may find themselves at a greater risk of poor academic performance as a consequence of academic anxiety.
In line with what we observed experimentally, students with dyslexia reported higher academic anxiety than students without dyslexia. Our findings are consistent with the idea that students with dyslexia have greater academic anxiety—but not necessarily general anxiety—than students without dyslexia. This is particularly critical as university services may be focused on the assessment and support of diagnosed anxiety disorders such as generalized anxiety.
There is some debate on how subtypes of dyslexia relate to emotional reactivity, but empirical data are limited. Given we had both phonological decoding and sight word efficiency scores, we explored whether these subskills of reading differentially correlated with emotional reactivity. We found that phonemic decoding emerged as the only significant unique contributor in explaining academic anxiety over and above variance accounted for by age and sight word. At face value, this supports the theory that there are subtypes of dyslexia that could influence the association between mental health difficulties and dyslexia. Phonological processing is considered the core deficit in dyslexia, and difficulties in this domain may be the key driver of difficulties in reading speed. However, it may simply be that phonemic decoding was the hardest task for all participants and, therefore, was related to academic anxiety.
In summary, this study examined the efficacy of cognitive reappraisal—an emotional regulation strategy—for reducing academic anxiety in university students with dyslexia. As expected, students with dyslexia were found to have higher levels of academic anxiety compared to their peers. Cognitive reappraisal was found to reduce academic anxiety in both students with and without dyslexia. Both groups benefited from the strategy. The results are promising, suggesting that cognitive reappraisal can be a valuable tool for alleviating academic anxiety for students with dyslexia. Future research is needed to incorporate cognitive reappraisal in interventions designed to support students with dyslexia. By supporting students with dyslexia in managing their academic anxiety, we not only enhance their educational experience but also equip them with essential tools to tackle challenging academic situations throughout their lives.
This time, I thought the research was helpful in identifying both the co-occurrence of dyslexia and academic anxiety and the value of cognitive reappraisal in reducing that anxiety. Taken together these articles illustrate the importance of early identification and intervention as well as ongoing support for people with dyslexia.