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WIREs Cogn Sci
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Tackling the ‘dyslexia paradox’: reading brain and behavior for early markers of developmental dyslexia

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Developmental dyslexia is an unexplained inability to acquire accurate or fluent reading that affects approximately 5–17% of children. Dyslexia is associated with structural and functional alterations in various brain regions that support reading. Neuroimaging studies in infants and pre‐reading children suggest that these alterations predate reading instruction and reading failure, supporting the hypothesis that variant function in dyslexia susceptibility genes lead to atypical neural migration and/or axonal growth during early, most likely in utero, brain development. Yet, dyslexia is typically not diagnosed until a child has failed to learn to read as expected (usually in second grade or later). There is emerging evidence that neuroimaging measures, when combined with key behavioral measures, can enhance the accuracy of identification of dyslexia risk in pre‐reading children but its sensitivity, specificity, and cost‐efficiency is still unclear. Early identification of dyslexia risk carries important implications for dyslexia remediation and the amelioration of the psychosocial consequences commonly associated with reading failure. WIREs Cogn Sci 2016, 7:156–176. doi: 10.1002/wcs.1383

Brain regions important for reading that are commonly found to be associated with atypical function or structure in dyslexia.
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(a) The first‐sound matching phonological task implemented by Raschle et al. During the task, children heard two consecutively presented common object‐words, spoken in a male or female voice, accompanied by corresponding pictures (‘bat,’ ‘ball’) and had to determine whether two words start with the same sound or different sound. In the control task the children had to determine whether two words were spoken with the same voice or different voice (female or male). (b) Brain regions that demonstrated increased activation in FHD− as compared with FHD+ pre‐readers for phonological greater than voice processing.
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White matter pathways important for reading: arcuate fasciculus (red), superior longitudinal fasciculus (yellow), inferior frontal occipital fasciculus (green), inferior‐longitudinal fasciculus (blue), corpus callosum is not shown.
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