Computer games improving

reading and brain function in

dyslexia

Teija Kujala

Cognitive Brain Research Unit

Institute of Behavioural Sciences

University of Helsinki

Finland

II World Dyslexia Forum,

Belo Horizonte, Brazil, 2014

Dyslexia

A major deficit causing learning problems

Prevalence estimates range from 5 to 17% (Shaywitz, New Engl. J. Med.)

Modern individuals need extensively reading skills severe consequences from dyslexia

Leading theory on the main cause of dyslexia: an impairment related to phonological processing (e.g., Ramus, Trends Neurosci., 2004)

Support from brain research for weak speech/sound representations in dyslexia

Brain research on dyslexia:

structure and functional areas

Structural abnormalities in

dyslexia: left perisylvian areas,

thalamus, corpus callosum,

cerebellum; A: ectopias in

different dyslexic individuals

(G.D. Rosen)

B: structural differences

between dyslexic and non-

dyslexic individuals in areas

activated during oral language

tasks

B

A

Ramus, Trends Neurosci., 2004

Brain research on dyslexia:

neurophysiology

A neural response for

investigating perisylvian and

frontal areas: the mismatch

negativity (MMN)

Reflects sound discrimination

accuracy at preattentive stage of

processing

Partly distinct sources for speech

and non-speech sounds

B: Pulvermüller & Shtyrov, Progr.

Neurobiol., 2006; C: Molholm et

al., Cer. Cor., 2005

A

B C

Auditory discrimination deficit in

dyslexia

Low-level neural sound discrimination and

attentive sound-change detection in adults with

dyslexia (Baldeweg et al., Annals Neurol., 1999)

Mismatch negativity (MMN) recordings during a

visual task

Attentive discrimination of deviant tones

Frequency and duration changes in sound

sequences

Sound pitch and duration

discrimination in dyslexia

Diminished MMNs for frequency but not for duration changes in dyslexic adults

Also poorer attentive discrimination of frequency but not of duration changes

A correlation between reading errors and MMN + pitch discrimination

Neural speech processing in children

at risk for dyslexia MMN recording for speech sound changes in 6-

year-old children

At-risk participants:

Mother or father + an additional close relative

with dyslexia

Poor performance in reading-related tests

(phonological processing, pseudoword

repetition, reading fluency, reading and writing

syllables and pseudowords, rapid alternating

naming, digit span)

Matched children with typical development

Neural speech processing in

infants at risk for dyslexia

Comparison of neural functions in 6-month-old

infants with vs. without familial risk for dyslexia

(Leppänen et al., Dev. Neuropsychol., 2002)

MMNs were recorded for consonant duration

changes in pseudowords

A fundamental speech learning

dysfunction in dyslexia?

Recent evidence: rapid and automatic neural speech learning (Shtyrov et al., J. Neurosci., 2010)

A prerequisite for efficient language processing and learning?

Speech memory trace formation in normal-reading vs. dyslexic 9-12 year old children (Kimppa et al., in preparation):

Pseudoword stimuli were presented while children watched a movie

Responses for the first 25% and last 25% of the stimuli were compared

Speech memory trace development

Predicting future reading abilities

from low-level neural responses

5-year follow-up study: does MMN predict future

reading skills? (Maurer et al., Biol. Psychiatry, 2009)

MMNs recorded for phoneme and tone changes in

kindergarten from children with or without familial

risk for dyslexia

Reading skills tested at school

Neural activity predicts future

reading abilities

Phoneme-change elicited MMN predicted future

reading skills: stronger left-ward lateralization in

children who became better readers at school

Maurer et al., Biol.

Psychiatry, 2009

Effects of intervention on dyslexia

and brain function

An important area of research:

Optimization of means to alleviate

dyslexia

Helps to understand the

mechanisms underlying dyslexia

Auditory-linguistic training

Reading- and language-skill measures and

fMRI in 8-12 –year old dyslexic and control

children (Temple et al., 2003)

Dyslexic children: exercises designed to

improve auditory and language processing

(Fast ForWord Language); 100 min./day, 5

days/week, 28 days

Before and after intervention:

Reading ability and language tests

fMRI scans during phonological tasks

Results from reading-skill tests

Temple et al., Proc. Natl. Acad. Sci., 2003

Functional imaging results

Temple et al., Proc. Natl. Acad. Sci., 2003

Audiovisual non-linguistic

intervention and MMN

Audio-visual training program (Audilex, Prof. K. Karma) with no linguistic items

Pupils in their first Spring semester with reading impairment two matched groups

We studied:

reading skills

MMN to tone-order reversals

behavioral discrimination of tone-order reversals

Tests: in the beginning and end of Spring semester; the training group played the computer game for 7 weeks (twice a week for 10-15 min.)

Kujala / CBRU

Can we prevent reading problems?

Slow reading-skill acquisition leads to learning and

motivational problems, which further prohibit

achievements at school

Early intervention would be the most effective

prevention of these problems

Training pre-schoolers at risk for

dyslexia Effects of grapheme-speech sound

association training

3 hours of training in brief sessions:

Training group: matching speech

sounds with letters (Graphogame;

Prof. H. Lyytinen)

Control group: mathematical

exercises

Comparison and follow up of:

Pre-reading skills

MMN responses for speech-

sound changes

Competitor’

Player’s

catcher

Falling

letters

Correctl

y chosen

letters

Player’s

results

Competitor’s

results

Mouse

pointer

Intervention effects on pre-

schoolers at risk for dyslexia

Lovio et al., Brain Res., 2012

Do the training effects persist?

A follow-up of 7-year old Finnish school beginners

until the 3rd grade (Saine et al., Child Dev., 2011)

Children at risk for dyslexia:

Remedial Reading Intevention (RRI; 45 min.

sessions)

Computer Assisted Remedial Reading

Intervention (CARRI; (45 min. Sessions of which

GraphoGame training 15 min.)

Children without dyslexia risk: control group

Training period: 1st grade, October-April, 28

weeks

Letter knowledge

Change from August

(baseline assessment) to April

in Grade 1

CARRI group progressed

faster than RRI group

Saine et al., Child Dev., 2011

Spelling

Post-test right after

intervention (Grade 1, May):

CARRI group better than RRI

group; both worse than the

control group

Assessment 16 months after

the end of intervention: RRI

group worse than CARRI and

control groups; no difference

between CARRI and control

groups Saine et al., Child Dev., 2011

Reading accuracy

1st assessment (Grade 1,

January): the training

groups differed from the

control but not from each

others

2nd assessment (Grade 3)

16 months after the end of

intervention: CARRI and

control groups better than

RRI group

Saine et al., Child Dev., 2011

Conclusions

Reading deficits are associated with a wide-

spread pattern of auditory impairments

MMN predicts future reading abilities

Both linguistic and non-linguistic intervention can

alleviate reading impairments

Several brain modules contributing to reading

are affected

Reading-related skills can be improved even

before school age

The training effects can be persistent

Thanks to main collaborators and

colleagues involved

Prof. Mari Tervaniemi, Ms. Lilli Kimppa CBRU, Dept. Psychol. Univ. Helsinki, Finland

Prof. Risto Näätänen Dept. Psychology, Univ. Tarto; CFIN, Univ. Aarhus; CBRU,

Dept. Psychol. Univ. Helsinki, Finland

Dr. Riikka Lovio

Karolinska Institutet, Stockholm, Swerige

Prof. Heikki Lyytinen

Dept. Psychology, Univ. Jyväskylä, Finland

Prof. Paavo Alku

Laboratory of Acoustics and Audio Signal Processing, Aalto Univ., Finland

Prof. Kai Karma

Sibelius Academy, Helsinki, Finland

Greetings from the Neuroplasticity of

Language Group (NeoLanG) from Helsinki,

Finland!