A Randomized Clinical Trial of Short-Term Effects of Glasses Correction for Low to Moderate Hyperopia in Children: A Pilot Study

Background: To report the short-term effect of glasses correction for low to moderate hyperopia on measures of reading, visual attention and visual function in children using a placebo-controlled, masked, randomized, multi-center clinical trial. Methods: Children ages 6 to <12 years with +1.00 D to < +4.00 D hyperopia and without strabismus or amblyopia were prospectively enrolled. Participants were randomly assigned to Transitions® photochromatic lenses with hyperopic correction or no correction. The primary outcome measures were change in reading (decoding and reading comprehension). Secondary outcome measures were change in attention and changes in visual function. The primary outcome exam was 6 weeks after glasses were dispensed. Results: There were no significant improvements in reading comprehension or decoding after 6 weeks of glasses wear. Participants assigned to the correction group experienced a greater improvement of 9.14 standard score (95% CI: 4.8, 13.5) in CAS Total Attention score while the change was only 3.46 standard score (95% CI: -1.0, 7.9) among those in the placebo group (p = .074). This result appears to have been driven by a significant improvement in Receptive Attention where the change in the correction group was approximately 3.5 times greater than in the placebo group (between-group p = .044). There was a statistically significant between group difference in accommodative response at both the dispensing (immediate change after glasses; p < .001) and 6-week examination (p = .012). Conclusions: Six weeks of glasses correction for low to moderate levels of hyperopia (2.00 D mean) resulted in no change in reading but significant improvements in receptive attention after 6 weeks of treatment in children age 6 to <12 years.

An Exploration of the Heterogeneous Nature of Reading Comprehension Development in First Grade: The Impact of Word and Meaning Skills

This exploratory study builds upon extant reading development studies by identifying discrete groups based on reading comprehension trajectories across first grade. The main goal of this study was to enhance the field’s understanding of early reading comprehension development and its underlying subcomponent skills, with the intent of better understanding the development of comprehension in students who display risk for reading difficulties and disabilities. A sample of first-grade readers ( N = 314) were assessed at three timepoints across the first-grade year. These data were utilized to derive empirical latent classes based on reading comprehension performance across the first-grade year. Reading subcomponent skill assessments (phonological awareness, word reading, decoding, linguistic comprehension, and reading fluency), measured in the fall of first grade, were compared across latent classes to examine how they related to growth across the first-grade year. Results suggest that there were four distinct latent classes with differential reading comprehension development, each of which could also be distinguished by the subskill assessments. These findings are presented within the context of the broader reading research base and implications for practice are discussed.

Effects of a Home Literacy Environment Program on Psychlinguistic Variables in Children from 6 to 8 Years of Age

(1) Background: the objective of this study was to improve certain psycholinguistic and cognitive skills that are fundamental to the development of the reading process, such as phonological awareness, reading decoding, vocabulary and oral narrative comprehension, through the introduction of an Home Literacy Environment Active (HLE(A)) program that involved 54 participants enrolled in the first and second grades of elementary school (from 6 to 8 years old) in the city of Malaga area. (2) Methods: The central task of the intervention program was for the child to read aloud to an adult in the family for between 10 and 15 min, four days per week. In addition, the school students were evaluated on four occasions, at the beginning and end of each academic year, using the Batería de Evaluación de los Procesos Lectores Revisada, Test para la Detección de la Dislexia en niños and Escala Weschsler de Inteligencia instruments. (3) Results: the results demonstrated the efficacy of the HLE(A) program in the improvement of psycholinguistic and cognitive variables measured and, consequently, to an improvement in reading learning and cognitive development. Ultimately, the scientific literature on the subject and the data from the study led us to suggest that it would not only be beneficial for HLE(A) programs to be instituted in early childhood education stage (up to 6 years of age), but that they should be continued after age 6, in elementary education.

Dyslexia: Conceptualization, Assessment, and Intervention

Scholars, teachers, clinicians, and the general public have puzzled over the nature and consequences of severe reading (decoding) problems for more than a century. With the advances of genetics, neuroscience, and psychology, we know much about the underlying nature of reading disability. However, we still have much to learn, and fierce debate continues about whether there is a subgroup of poor readers who can, or should, be called dyslexic. This issue has become highly contentious, as gaining the label can bring significant benefits in terms of resourcing, various forms of test and classroom accommodation, and more positive and understanding responses from others. Many clinicians argue that special cognitive tests are needed to identify and diagnose those with dyslexia. These may take the form of general tests of IQ, or measures of more specific cognitive or executive functioning. Despite their popularity, the evidence for the utility of such measures is low, and many of the processes examined are often problematic for all poor readers, not merely the subgroup deemed to have dyslexia. A further difficulty concerns intervention. There is no strong scientific support for the notion that intervention programs designed to improve underlying cognitive processes (e.g., memory processes) can successfully improve the reading accuracy of those who struggle to acquire literacy. Similarly, interventions geared to improve visual or motor functioning have not proven successful, despite often vociferous support from adherents. The only approach that has strong scientific support takes the form of an educational program that utilizes systematic, structured phonics teaching as part of a broader literacy curriculum. This finding applies equally to those who have been diagnosed as dyslexic and those poor readers who haven’t. For this reason, it is unclear how a dyslexia diagnosis helps to inform the nature of subsequent intervention. In establishing effective forms of intervention that can cater for any child who struggles with their reading, it would appear most efficacious to utilize what is known as a “response to intervention” approach. This requires early identification of, and intervention with, all those who are making limited progress. Intervention should only utilize those approaches that have strong scientific support. The nature and extent of additional educational support should be determined on the basis of the progress that is made when additional help is given. If insufficient progress has resulted, it may well be necessary to increase and intensify the intervention. Such an approach helps to ensure that all struggling children are helped at an early stage, and no one is missed because of an absence of parental advocacy or a lack of family resource that can cover the cost of diagnostic assessment.

Evidence for Cognitive Deficits in X-Linked Charcot-Marie-Tooth Disease

Objective:X-linked Charcot-Marie-Tooth disease (CMTX) is an hereditary neuropathy caused by mutations in GJB1 coding for connexin-32, found in Schwann cells, but also expressed in oligodendrocytes. Reports have identified CNS involvement in CMTX, but no systematic study of cognitive function has been published.Methods:We assessed 24 CMTX patients (13 males; 9GJB1 mutations) with a comprehensive neuropsychological battery, including tests of memory, language, and executive functions.Results:No differences in cognitive performance were observed between males and females. A case-by-case investigation revealed selective deficits in individual patients. One subgroup (29%) demonstrated executive abnormalities; and a non-overlapping subgroup (29%), prominent reading (decoding) abnormalities.Conclusions:The present data provide evidence for cognitive deficits in CMTX. Emerging neuropsychological patterns are also discussed.