Research Studies on Learning Abilities

Grant Number: 5R01NS049096

Project Title: Neurobiology and Treatment of Reading Disability in NF1

PI: Laurie E. Cutting, PhD

Study Duration: May 2006 - May 2011

Sponsor: NINDS

Abstract: Neurofibromatosis Type 1 (NF1) is a common autosomal dominant neurocutaneous syndrome. NF1 has a range of phenotypic expression, with neurological abnormalities often present, including high signal intensity foci on T2 weighted images and megalencephaly (increased brain volume). However, the most common concern of parents of children with NF1 is learning disabilities (LDs). Approximately half of children with NF1 have LDs, the most debilitating and common of which are reading disabilities. The overall purpose of this research is to gain a deeper understanding of the characteristics and treatment of reading disabilities in NF1.

The first goal is to determine whether children with NF1 who have specific deficits in reading respond the same way, both neurobiologically and neuropsychologically, to specialized treatment known to ameliorate decoding deficits in reading in the general population. An additional goal is to determine which type of intervention is the best for particular types of learner profiles. To accomplish these goals, we will compare children with NF1 who show weaknesses in reading to children with reading disabilities from the general population pre- and post- two different types of intervention, using both behavioral and neurobiological (fMRI) measures. Both interventions focus on teaching sound-symbol relationships, but vary in terms of relative emphasis on verbal versus visual methods of teaching. Determining if children with NF1 with deficits in reading respond to interventions known to be effective for children with reading disabilities in the general population, and, in particular, which type of intervention approach they respond to best, will advance knowledge about the best therapies for LDs in NF1.

Another goal of this research is to determine further the similarities and differences between the cognitive profiles of children with NF1 who have reading disabilities, versus children with reading disabilities in the general population; in particular, this is to determine if interventions developed for other deficits in reading disabilities, besides decoding, will also be useful for children with NF1 who show weaknesses in reading. Finally, we will characterize the neuropsychological and neurobiological differences between children with NF1 who have reading disabilities, versus children with NF1 without a reading disability. The goal of this last aim is to gain an understanding of which factors may serve as "protective" factors in NF1, in terms of developing reading problems. This research utilizes what is known about treatment of LDs in the general population, as well as fMRI methodology, which will further our understanding of how the NF1 gene affects cognition and the brain. Additionally, this research is highly valuable because it will further our knowledge about effective treatments for reading disabilities in general.

For more information, or to become a participant in this study, please consult the corresponding PDFs below.

For additional information, please contact:

Lindsay Goldberg
Phone: (443) 923-9326
Email: readingresearch@kennedykrieger.org

Grant Number: 5R01HD044073

Project Title: Cognitive and Neural Processes in Reading Comprehension

PI: Laurie E. Cutting, PhD

Study Duration: May 2004 - April 2009

Sponsor: NICHD, GCRC

Abstract: Researchers have established the importance of single word reading to reading comprehension. However, deficits in word reading do not fully explain deficits in reading comprehension, especially for older children, indicating that other sources of comprehension failure need to be investigated. This is particularly illustrated by the existence of a significant number of children (approximately three percent), predominantly ten years of age and older, who are poor comprehenders, but nevertheless attain scores within the normal range on conventional measures of single word reading, which typically measure accuracy only. In this proposal, we will use both behavioral and neuroimaging methodologies to examine the source of comprehension failure for these types of poor readers and, more generally, examine other sources of comprehension failure across reader types/ranges of reading ability.

We hypothesize that poor comprehenders who attain normal single word reading accuracy scores have deficits in reading comprehension because of poor fluency of word reading, with poor fluency resulting in a processing "bottleneck" that impedes comprehension. Deficits in other skills beyond the word-level (i.e., accuracy and fluency of word reading) may also contribute to impaired reading comprehension. Other skills that have been found to influence reading comprehension include vocabulary, syntax, visual and verbal working memory, ability to make inferences and planning/organization/monitoring, which could be conceptualized as falling within the overlapping domains of language and executive function.

In this study, we will compare poor comprehenders with normal single word reading accuracy scores to children with traditional reading disabilities (i.e., who have poor single word reading accuracy), as well as to children who are normal readers. We will use functional neuroimaging to examine patterns of activation between these groups during single word reading, sentence comprehension and verbal working memory, in conjunction with behavioral measures of fluency, language and executive function. Understanding the behavioral characteristics critical for and the neurological circuits associated with skilled and impaired reading comprehension, as well as their integration, will advance knowledge about poor comprehenders with normal single word reading accuracy as well as, in general, processes critical for reading comprehension in children.

For more information or to become a participant in this study, please consult the corresponding PDF below.

For additional information, please contact:

Lindsay Goldberg
Phone: (443) 923-9326
Email: readingresearch@kennedykrieger.org

Grant Number: 1 P50 HD052121

Project Title: Center for the Study of Reading Development

Director and PI: Martha Bridge Denckla, MD

Associate Director: Laurie E. Cutting, PhD

Study Duration: September 2006 - July 2011

Sponsor: NICHD

Abstract: Over the past few decades, a tremendous amount of research has been conducted on reading development and disorders, which has yielded significant understanding of the causes and prevention of reading disorders, particularly for young children. This research has shown that the deficits underlying reading disorders in young elementary age children primarily stem from "bottom up" processes -- that is, at the word level. Specifically, it has been shown that the majority of young struggling readers have difficulty decoding words accurately, which adversely impacts reading comprehension. Decoding accuracy difficulties have been shown to primarily stem from deficits in phonological awareness, or understanding the sound structure of the language. These findings have resulted in the emphasis on the teaching of phonological awareness and the alphabetic principle, which has been demonstrated not only to ameliorate reading disorders, but also to substantially lower the risk of reading impairment in beginning readers.

Despite the substantial progress that has been made in understanding early reading disabilities, less is known about other causes of reading difficulty, particularly for older children. Specifically, little is known about the contributions of processes such as fluency, vocabulary, syntax and executive function, to reading comprehension. While there is clearly substantial evidence indicating that reading disorders in children grades K-2 are caused by "bottom-up" processes, the causes of reading disorders in older children (e.g., grades 3-8) are unclear at this time, suggesting that difficulties in reading for older readers are more heterogeneous. Although it is often discussed that word-level issues are no longer the cause of reading disability in adolescents (e.g., Biancarosa & Snow, 2004), there is little empirical evidence to support this assertion. Additionally, there is also little evidence to substantiate the existence of reading difficulties primarily stemming from deficits in more complex (e.g., syntax) and higher level, or "top down," processes.

For each of the projects of this Research Center, the focus is to examine the extent to and manner in which difficulties in component reading skills (both "top down" and "bottom up"), such as decoding accuracy, fluency and reading comprehension, occur among older children. In doing so, we will also examine more carefully the construct of fluency itself by teasing apart the relationships between word reading efficiency and text reading fluency. Examining the potential overlap or separateness between these two, which are typically collectively subsumed under the term fluency, will allow for a greater understanding of diagnostic, classification and treatment implications for children with these types of deficits. To accomplish the overall aims of the center, across the projects, we will use both behavioral (dynamic assessment/short-term learning and static psychometric approaches) and neurobiological (Diffusion Tensor Imaging and functional Magnetic Resonance Imaging) methods to better determine the degree to which "bottom up" and "top down" deficits are present in older readers.

Determining causes of impaired reading in older readers in a fine-grained manner will allow for better classification, identification and treatment. Within this context, we propose four projects that (1) examine the development of word-level efficiency, the relationship between word-level and text-level fluency and comprehension, the influence of different textual demands upon comprehension and specific predictors of each within different subtypes of reading disability; (2) examine the validity of Response-to-Intervention (RTI) as a means of identifying children with reading disabilities beyond second grade, test a set of procedures that may more efficiently identify children who experience late onset reading disabilities and examine the neurobiological signature of children who fail to respond to increasingly intense interventions and (3) determine how the cognitive aspects of ADHD (processing speed, working memory) may influence both "bottom up" and "top down" processes important for reading comprehension. Finally, the Research Center’s work culminates with a project which will build upon the knowledge learned from Projects I, II and III, as well as analyses of extant data sets, in order to determine the prevalence of different types of reading disorders (e.g., decoding accuracy-only, fluency-only, comprehension-only, etc.)

For more information, or to become a participant in this study, please consult the corresponding PDF below.

For additional information, please contact:

Matthew Ryan
Phone: (443) 923-9272
Email: ryanm@kennedykrieger.org

Grant Number: 1-R01-HD-046130

Project Title: Adolescent Reading Programs -- Behavioral and Neural Effects

PIs: Hollis Scarborough, PhD, Haskins Laboratories

Laurie Cutting, PhD, Kennedy Krieger Institute

Study Duration: October 2003 - September 2008

Sponsor: NICHD, GCRC

This five-year project has three major aims. First, this investigation seeks to understand more about the cognitive characteristics and brain activation patterns of adolescents with reading disabilities. Second, this project will provide three kinds of reading intervention, comparing the effectiveness for improving reading with different cognitive and neurobiological profiles. Finally, this project will investigate what kinds of changes in brain organization and cognitive skills accompany improvements in reading and under what conditions these changes occur.

This study is being conducted in the Kennedy Krieger Schools, Prince George's County Public Schools, and the Catholic Schools of the Archdiocese of Baltimore.

For additional information, please contact:

Angela Katenkamp
Phone: (443) 923-9328
Email: arptutoring@kennedykrieger.org

Grant Number: 5R01HD044073-04 Supplement

Project Title: Cognitive and Neural Processes in Reading Comprehension, Adult Supplement

Investigator: Sheryl Rimrodt, MD

Study Duration: May 2005 - April 2008

Sponsor: NICHD

Abstract: Research has established the importance of single word reading to reading comprehension. However, deficits in word reading do not fully explain deficits in reading comprehension, particularly in older children and adolescents. It has been estimated that approximately three percent of children, predominantly ten years of age and older, exhibit poor reading comprehension despite attaining scores within the normal range on conventional measures of single word reading. This suggests that other sources of reading comprehension failure need to be investigated. We hypothesize that poor readers who attain normal scores on tests of single word reading (which are primarily measures of accuracy) may exhibit deficits in fluency of single word reading resulting in a processing "bottleneck" that impedes reading comprehension. Further, we suspect that other factors may also influence reading comprehension including language skills (i.e., vocabulary), visual working memory and executive functioning (i.e., planning, organizing, and self-monitoring). We propose to examine potential sources of poor reading comprehension among children and adolescents by studying subjects with poor single word reading, subjects with poor reading comprehension despite normal scores on tests of single word reading, and controls with typically developing reading skills. We will integrate functional neuroimaging data that examines group differences in activation during single word reading, phonological awareness and sentences reading comprehension, with behavioral measures of naming fluency, language skills, executive function, single word reading, phonological skills and passage reading comprehension. This will further our understanding of children and adolescents with the reading subtype of poor comprehension despite normal word reading accuracy and provide insight into how behavioral characteristics and neuronal activation are interrelated during skilled and impaired reading comprehension.

For more information or to become a participant in this study, please consult the corresponding PDF below.

For additional information, please contact:

Sheryl Rimrodt, MD
Phone: (443) 923-9251

Project Title: Neurobiological Sex Differences in Cognition: Applications to Learning and Education

PI: Laurie E. Cutting, PhD

Study Duration: September 2007 - September 2008

Sponsor: The Foundation for Maryland's Future and the Commonwealth Foundation

It has been well documented in the scientific literature that differences exist between men and women when performing various verbal and visuospatial tasks. In general, men are shown to excel on visuospatial tasks while women outperform men on language-based tasks. Functional neuroimaging studies typically show that the processing of visuospatial information occurs in the right hemisphere and that language processing primarily occurs in the left hemisphere. However, findings from neuroimaging studies looking specifically at the distinctions in processing between the sexes have been less consistent and it is unclear whether or not men and women utilize different parts of their brains to complete the same tasks. A new study in the journal Brain and Language showed that men and women do use different parts of their brains when processing language and visuospatial information.

For the current study we will investigate whether children, when compared with adults, exhibit similar sex differences in basic visuospatial and language processing. Furthermore, we would like to examine whether these differences exist during more complex language and visuospatial processing, as well as whether this extends to and/or impacts learning of novel stimuli. An important area of interest will be to assess whether these differences are already apparent in very young children or whether the differences develop over time and become more distinct with increasing age. To be able to examine this, we have devised a study with a cross-sectional design sampling children across several age groups. Previous studies have shown that language ability is correlated to reading ability and visuospatial skill is predictive of math achievement; thus language and visuospatial skills are fundamental underpinnings for reading and math. Consistently, studies have shown that boys tend to outperform girls in math achievement and visuospatial skills while girls tend to outperform boys in reading achievement and language ability. Therefore, visuospatial and language skills may be differential predictors for reading and math achievement for the two sexes.

Overall, we hypothesize that sex differences in the profile of cognitive strengths may have an impact on which learning strategies will be most effective in different children. The information obtained from this study about individual learning differences may help explain why some students learn better and perform better in academic settings than other students. One possibility is that a given instructional technique may emphasize one cognitive skill over another (e.g., more language-based than visuospatial) -- it may recruit the relative strengths of some individuals, thereby reinforcing the learning process, while hindering the learning process for other students for whom that cognitive skill is a relative weakness. Another benefit of studying individual learning differences is that it may allow us to detect patterns in learning, including sex and age differences. This type of information might allow instruction to be tailored for specific groups of students; for example, one hypothetical result could be that visuospatial approaches to learning are more effective than language-based techniques for male students, but only when they are older.

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