Author : James Newton - Monday 17/12/2007
Advance Magazine
For Speech and Language
Pathologists and Audiologists .
Vol. 17 •Issue 51 • Page 18
Some children with dyslexia struggle to read because their brain isn't wired properly to process fast-changing sounds. Sound training via computer exercises literally can rewire the brain, correcting the sound processing problem and improving reading, a new study has found (Restorative Neurology and Neuroscience, October 2007). The finding may help clinicians diagnose dyslexia someday even before reading begins and suggests new methods of treatment.
Children with developmental dyslexia confuse letters and syllables when they read. The idea that they may have an underlying problem processing sound was introduced in the 1970s by Paula Tallal, PhD, founder and co-director of the Center for Molecular and Behavioral Neuroscience at Rutgers University in Newark, NJ. However, the concept had never been tested using brain imaging.
Nadine Gaab, PhD, principle investigator in the Laboratory of Cognitive Neuroscience at Children's Hospital Boston, used functional magnetic resonance imaging (fMRI) to examine how the brains of 9- to 12-year-old children with developmental dyslexia and normal readers responded to sounds before and after using educational software.
Dr. Gaab, first author of the new study, first tested how the children's brains responded to two types of sounds: fast-changing and slow-changing. The sounds were not language but resembled vocal patterns found in speech.
The children listened to the sounds through headphones while she observed using fMRI to observe their brain activity. The fast-changing sounds changed in pitch or other acoustic qualities quickly—over tens of milliseconds—as in normal speech. By contrast, slow-changing sounds changed in hundreds of milliseconds.
Eleven brain areas became more active when typical readers listened to fast-changing sounds, compared to slow-changing ones. Dr. Gaab set this as "normal."
In children with dyslexia, the fast-changing sounds didn't trigger this ramped-up brain activity. Instead, they processed the fast-changing sounds as if they were slow-changing, using the same brain areas at the same lower intensity.
"This is obviously wrong," said Dr. Gaab.
Infants must process fast-changing sounds correctly, like those within the syllable "ba," in order to learn language and later to know what printed letters sound like. Infants use sound processing to grab from speech all the sounds of their native language and then stamp them into their brains, creating a sound map. If they can't analyze fast-changing sounds, their sound map may become confused.
"Children with developmental dyslexia may be living in a world with in-between sounds," explained Dr. Gaab. "It could be that whenever I tell a dyslexic child 'ga,' they hear a mix of 'ga,' 'ka,' 'ba' and 'wa.'"
Reading trouble may develop when these children first see printed letters, cognitive scientists believe, because at this stage their brain wires their internal sound map to letters they see on the page. Linking normal letters to confused sounds may lead to syllable-confused reading.
In the new study changes to the brain occurred in the children with dyslexia after they completed exercises in a computer program called Fast ForWord® Language, from Scientific Learning in Oakland, CA. The program was designed in part by Dr. Tallal, who co-authored the study.
The exercises involved no reading—only listening to sounds that started with simple, changing noises, like chirps that swooped up in pitch. The children then had to respond. For instance, they clicked to indicate whether the pitch went up or down.
The sounds played slowly at first, an easy task for children with dyslexia, but gradually sped up and became more challenging. The exercises then repeated with increasingly complex sounds: syllables, words and, finally, sentences. The repetitive exercises appeared to rewire their brain after eight weeks of daily sessions, about 60 hours total. They responded more like typical readers when processing fast-changing sounds, and their reading improved
It's unclear whether the improvement lasts beyond a few weeks because follow-up tests were not done.
Dr. Gaab has begun recruiting for a new study of preschoolers whose family members have dyslexia. By looking for sound-processing problems via fMRI, she hopes to catch dyslexia at an early stage—before children begin learning to read—and remediate it through sound training. This would spare them from years of frustration and low self-esteem later in life.
In addition, she will investigate what other types of sound training might help children with dyslexia. For example, learning to sing or play an instrument involves gradual, repetitive and intense listening and responding to fast-changing sounds.
"We've done a few studies showing that musicians are much better at processing rapidly changing sounds than people without musical training," said Dr. Gaab. "If musicians are so much better at these abilities and you need these abilities to read, why not try musical training with dyslexic children and see if that improves their reading?"
Elise Temple, PhD, an assistant professor in the Department of Education at Dartmouth College, in Hanover, NH, was the senior author of the study, which was funded by the Haan Foundation and the MIT Class of 1976 Funds for Dyslexia Research.
In addition to Dr. Tallal, Fast ForWord Language was developed by Michael Merzenich, PhD, chair of otolaryngology, Keck Center for Integrative Neurosciences, at the University of California, San Francisco; William Jenkins, PhD, senior vice president at Scientific Learning Corporation; and Steve Miller, PhD, an associate professor at Rutgers University.
James Newton is on staff at Children's Hospital Boston.
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