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This study explored the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on reading, attention, and psychological well-being among people with developmental dyslexia and/or attention deficits. Various types of dyslexia exist, characterized by different error types. We examined a question that has not been tested so far: which types of errors (and dyslexias) are affected by MBSR training. To do so, we tested, using an extensive battery of reading tests, whether each participant had dyslexia, and which errors types s/he makes, and then compared the rate of each error type before and after the MBSR workshop. We used a similar approach to attention disorders: we evaluated the participants’ sustained, selective, executive, and orienting of attention to assess whether they had attention-disorders, and if so, which functions were impaired. We then evaluated the effect of MBSR on each of the attention functions. Psychological measures including mindfulness, stress, reflection and rumination, lifesatisfaction, depression, anxiety, and sleep-disturbances were also evaluated. Nineteen Hebrew-readers completed a 2-month mindfulness workshop. The results showed that whereas reading errors of letter-migrations within and between words and vowelletter errors did not decrease following the workshop, most participants made fewer reading errors in general following the workshop, with a significant reduction of 19% from their original number of errors. This decrease mainly resulted from a decrease in errors that occur due to reading via the sublexical rather than the lexical route. It seems, therefore, that mindfulness helped reading by keeping the readers on the lexical route. This improvement in reading probably resulted from improved sustained attention: the reduction in sublexical reading was significant for the dyslexic participants who also had attention deficits, and there were significant correlations between reduced reading errors and decreases in impulsivity. Following the meditation workshop, the rate of commission errors decreased, indicating decreased impulsivity, and the variation in RTs in the CPT task decreased, indicating improved sustained attention. Significant improvements were obtained in participants’ mindfulness, perceived-stress, rumination, depression, state-anxiety, and sleep-disturbances. Correlations were also obtained between reading improvement and increased mindfulness following the workshop. Thus, whereas mindfulness training did not affect specific types of errors and did not improve dyslexia, it did affect the reading of adults with developmental dyslexia and ADHD, by helping them to stay on the straight path of the lexical route while reading. Thus, the reading improvement induced by mindfulness sheds light on the intricate relation between attention and reading. Mindfulness reduced impulsivity and improved sustained attention, and this, in turn, improved reading of adults with developmental dyslexia and ADHD, by helping them to read via the straight path of the lexical route.
In this study, we explore the unsolved riddle of the relation between attention and reading through a novel window: that of mindfulness meditation. We examine whether mindfulness meditation, which improves various aspects of attention, can have an effect on reading. We do so by exploring the effect of mindfulness on specific types of developmental dyslexia and on specific types of reading errors. The rationale is that if certain aspects of attention improve following mindfulness practice, and lead to improvement in certain aspects of reading, these aspects of reading may be related to attention. Furthermore, this may help define the conditions in which mindfulness can function as an effective treatment for reading difficulties.
The reading process is a multi-component process, which leads from the first orthographic-visual analysis of a written sequence of letters to sound and meaning. The model for single word reading that we assume here is the dual-route model (
Following this initial stage, the reading process divides into two routes: the lexical route, which allows efficient and rapid reading of words that the reader already knows, and which are stored in the orthographic input lexicon (the written form of the word), and the phonological output lexicon (its phonological form). Reading words that are not stored in these lexica requires the second route – the sublexical route, where reading is done via grapheme-to-phoneme conversion. This route is slower, and is inaccurate when reading words that do not unambiguously obey the grapheme-to-phoneme conversion rules.
Impairments in different stages and components of this process result in various types of dyslexia, each characterized by a different pattern of errors (
A deficit in the sublexical route also gives rise to impaired reading: disordered grapheme-to-phoneme conversion results in a situation whereby the readers can only read words they already know and fail to read new words and non-words. This is called
Recently, another type of dyslexia has been reported, which involves a selective impairment in the sublexical route, which specifically affects the reading of vowel letters,
The question of the relation between reading in general, and specific dyslexias on the one hand, and attention on the other is still an open one.
Epidemiological studies among children (
However, the exact relation and mechanism of causality between ADHD and reading is not clear: text reading, for example, is a task that requires multiple skills, and many of them may be affected by attention. Performance in word and non-word reading tasks may also be affected by multiple factors. Furthermore, these studies have not examined the effect of attention on specific types of dyslexia or on specific types of errors in reading. As we have seen above, various types of dyslexias exist. Some of them may be thought to be associated with specific impairments to attentional processes: LPD, where letter migrations within words could result from inattention to middle letters; attentional dyslexia, where a difficulty in attenuating irrelevant neighboring words may be the cause for letter migrations between them; and neglect dyslexia, where attention allocating to one side of word or text may be the source for the neglect of that side in reading (see discussion in
Additionally, several studies found dissociations between the reading of words and that of numbers or symbols. Individuals with developmental neglect dyslexia who made neglect errors on the left side of words did not make errors on the left side of numbers (
Relatedly,
Finally,
Thus, whereas there are some indications for points of connection and disconnection between attention and reading, the exact relation and mechanism of causality between them are still an open question. By assessing the effect of mindfulness on specific attention functions and specific error types in reading we hope to learn more about the nature of the relation between reading and attention.
A promising direction for the treatment of attention difficulties and possibly also of reading difficulties is the practice of mindfulness meditation. Among mindfulness practices, one of the most studied protocols is Mindfulness-Based Stress Reduction (MBSR). This protocol, developed by
Importantly, mindfulness has a strong conceptual relation with attention, as a fundamental aspect of mindfulness practice is attentional training, and the role of attention is being emphasized in mindfulness instructions (e.g.,
The positive effect of mindfulness on psychological measures can be helpful also in the context of people with dyslexia. During school years, reading deficiencies are often associated with embarrassment, frustration, lack of motivation and low self-esteem (
Combining existing knowledge on the role of attention in reading with the accumulating evidence of enhanced attention following mindfulness practice, we hypothesized that mindfulness can be used to improve reading among people with dyslexia. Moreover, the reported positive effects of mindfulness on other cognitive abilities as well as on practitioners’ wellbeing further suggest that this technique can serve as a highly beneficial intervention for this population. Thus, the aim of the present study was to investigate the effects of MBSR training on reading, attention, and psychological wellbeing among individuals with dyslexia and/or attention deficits. Specifically, we will ask whether reading errors decrease following mindfulness practice, whether specific types of reading errors are differentially affected by mindfulness, and which attention functions are sensitive to mindfulness practice. We will also explore the correlations between the effects of mindfulness on reading errors and on attention functions, to learn about the mechanism that ties reading and attention.
Twenty-four adults started the MBSR workshop. Among them, 17 participants had dyslexia and 14 had ADHD (seven participants had both dyslexia and ADHD). The participants were students in diverse academic fields. They were recruited in various ways: some were approached through the students’ dean’s office, who are in contact with students with learning disabilities, others were recruited via flyers that were posted in Tel Aviv University, inviting individuals with dyslexia and/or ADHD to participate in the study, and some were former participants of the lab’s studies who were invited to participate in this study.
The participants paid a symbolic fee for participating in the MBSR workshop, and committed to attend the meetings and exercise the workshop’s tasks at home. Twenty participants completed the workshop. One participant was excluded from the analyses due to a history of stroke. None of the other participants had a history of brain injuries or neurological problems. The final group of participants included 12 students with dyslexia and 13 with ADHD (six had both). All participants had normal or corrected-to-normal vision. Main demographic characteristics of the participants are presented in
Main demographic characteristics of experimental and control groups.
Age mean (SD) | 30.6 (5) |
Gender | 10 females16 males |
Handedness | 4 left, 22 right |
Mother tongue | 23 Hebrew, 1 Hebrew and English, 1 English, 1 Russian |
Years of education mean (SD) | 15.2 (1.4) |
The study was approved by the Tel Aviv University ethics committee, and written informed consents were obtained from all participants prior to the testing.
In order to determine the reading and attention profiles, we administered to each of the MBSR participants a battery of reading, attention and psychological tests, which we describe below.
For the initial assessment of reading, we used the TILTAN screening test (
The 30 non-words were included for the identification of impairments in the sublexical route, phonological dyslexia, vowel dyslexia, and deep dyslexia, but also contained migratable non-words and non-words that created existing words by substitution, omission, or addition of letters, and were hence also sensitive to various impairments at the orthographic-visual analyzer (visual dyslexia, neglect dyslexia). The list of 30 word pairs was created so that between-word migrations created other existing words, for the identification of attentional dyslexia.
On the basis of this test, we determined, according to a comparison of the error rate of each participant to an age-matched control group of 372 skilled readers, whether she or he had dyslexia. If the participants had dyslexia, we determined which type(s) of dyslexia they had, on the basis of the types of errors they made and the factors that affected their reading – the types of stimuli that were most prone to reading errors and the factors that affected their reading (frequency effect, word length effect, lexicality effect, etc.). This diagnosis of the type of dyslexia guided the additional tests that we administered to each participant, in order to further establish the dyslexia type.
For example, participants who made mainly regularizations errors in irregular words in the screening task were suspected to have surface dyslexia and were therefore administered the continuation tests for surface dyslexia (see
The performance of each of the participants in the screening test and in each of the reading tests was compared with the performance of a control group (372 adults) that was tested throughout the development of the test batteries. Each participant’s performance was compared to the control group using the
The analyses of error rates before and after the workshop were done for each participant out of the tests that s/he did, according to their dyslexia.
Each individual was tested separately, in a quiet room, and the reading tests were administered with no time limit. The resulting diagnoses of the participants are presented in
Diagnoses of reading and attention skills of MBSR participants and indicator of completion of workshop.
Participant | Diagnosis |
Completion of workshop | |
---|---|---|---|
Dyslexia type(s) | Attention deficit(s) | ||
AO | LPD, attentional, surface | – | Yes |
ALE | LPD, surface, attentional, vowel | – | No |
EZ | – | Sustained attention | Yes |
NG | LPD | – | Yes |
ON | – | Sustained attention | Yes |
YH | LPD, surface, attentional | – | No |
SG | LPD, attentional, vowel, surface | Sustained attention | Yes |
RC | Vowel | Sustained attention | Yes |
YS | – | Orienting of attention, executive attention | Yes |
RA | LPD, attentional | – | Yes |
GA | LPD, surface | Sustained attention | Yes |
OR | LPD, vowel, attentional, surface | Sustained attention | Yes |
AF | LPD | – | Yes |
TL | – | Sustained attention, orienting of attention | Yes |
ET | LPD, vowel, surface | – | Yes |
RS | Vowel | – | Yes |
RB | LPD, vowel, attentional, surface | – | No |
GS | Vowel, LPD, surface | Sustained attention | Yes |
YK | LPD, surface | Selective attention | Yes |
JO | – | Orienting of attention | Yes |
ALU | Attentional, LPD | – | No |
SY | – | Sustained attention | Yes |
MS | – | Sustained-, selective-, executive- and orienting of attention | Yes |
OT | Phonological | Sustained attention | No |
We used four attention tasks that were developed to test each of the four functions of attention model, proposed by
For
For
For
For
We analyzed each participant’s baseline performance in each of the attention tasks in order to determine the existence and nature of attention deficits. The resulting diagnoses of the participants are presented in
Because we examine the performance before and after the meditation workshop using the exact same tools, we needed to establish that the tools we used were not sensitive to training effects. We therefore administered the reading and attention tests twice, 3 months apart, to a group of students who did not participate in the MBSR workshop. The students in this group had learning disabilities that were similar to the ones we examined in this study.
In the reading tests of the non-MBSR control group, out of 16 dyslexics (who had types of dyslexia that were similar to the MBSR dyslexia group: LPD, attentional dyslexia, vowel dyslexia, and surface dyslexia), nine made more errors in the second assessment than in the first assessment, while seven made fewer errors. The average error rate in the reading tests did not change [before 16.6% (
Eighteen participants in the control group performed the attention tests twice, without MBSR in the middle, two of them had missing data in the CPT test.
In
For
For
For
Thus, in the attention tests too, the main attention measures (apart from RT) were unaffected by the repetition of the same tests after 3 months, without MBSR training in between.
Eight psychological domains were assessed among the MBSR participants using a battery of seven questionnaires. Participants filled out the questionnaires through an online site
This 26-item questionnaire was developed by
The Perceived Stress Scale (PSS;
The Rumination–Reflection Questionnaire (RRQ;
The Satisfaction with Life Scale (SWLS;
The Center for Epidemiologic Studies – Depression Scale (CES-D scale;
The State-Trait Anxiety Inventory (STAI;
The mini-Sleep Questionnaire was developed in Hebrew at the Technion Sleep Laboratory by
The Mindfulness-Based Stress Reduction (MBSR) is a structured group program developed by
To assess the effects of the workshop on reading, attention skills, and psychological measures among the MBSR participants, all tests were administered twice to each participant, once prior to the workshop and once during the week after the workshop ended. To assess changes in reading ability, we first compared overall change in number of reading errors using a paired
Calculation of individual improvement indices revealed that most dyslexics (10 out of 12, χ2 = 5.33,
When analyzing words and non-words separately, this improvement was significant only for the existing words. Error rate in word reading decreased significantly from 12.1% (
Possibly the most important finding comes from the analysis of improvement separately for each type of error. When we analyze, for the group, the improvement in each type of error out of the relevant words for this error type, we see that surface errors showed a significant decrease following the MBSR training, and that they were the only type of error that showed this significant improvement (see
Comparison of reading errors of the various types before and after the MBSR workshop for the whole group of dyslexic participants: average % (SD) of the various error types, before and after the MBSR workshop and
% Errors before MBSR | % Errors after MBSR | Comparison before and after | |
---|---|---|---|
All errors in words | 12.1% (6.4%) | 9.2% (4.5%) | |
All errors in non-words | 18.0% (15.8) | 14.3% (10.9%) | |
Surface errors | 9.9% (7.9%) | 6.9% (6.3%) | |
Migrations within words | 8.0% (3.1%) | 6.1% (3.4%) | |
Migrations between words | 14.2% (12.3%) | 12.1% (14.3%) | |
Vowel letter errors in non-words | 9.9% (10.4%) | 7.6% (7.4%) |
To examine our assumption that the reduction in reading errors is modulated by the effect of mindfulness on attention, we compared the effect of mindfulness on dyslexic participants who had ADHD (
To examine whether the MBSR training affected specific types of dyslexia, we examined, for each type of dyslexia that our participants had, the effect of MBSR on the relevant error type. The analyses were performed on the percentage of errors out of all possible errors that participants could have performed within the words they read.
Number of reading errors made by dyslexic participants before and after the workshop, separately for each error type; mean overall change per participant across types [(errors after – errors before)/(errors before)]; the number of words each participant read that could detect each error type (migratable words for migration errors, irregular words for surface errors, etc.); and total number of words read in all tests assessed at each timepoint.
Participant | Number of errors |
Mean change of all errors (%) | Total number of words that are sensitive to errors relevant to the dyslexias diagnosed | Total number of words and non-words read | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
LPD |
Vowel |
Attentional |
Surface |
||||||||
Before | After | Before | After | Before | After | Before | After | ||||
AO | 50 | 25 | 44 | 27 | 16 | 7 | –45% | 658 | 698 | ||
NG | 27 | 18 | –8% | 345 | 698 | ||||||
SG | 17 | 29 | 15 | 17 | 12 | 16 | 47 | 33 | 2% | 826 | 936 |
RC | 12 | 2 | –77% | 90 | 464 | ||||||
RA | 16 | 12 | 2 | 4 | –24% | 327 | 458 | ||||
GA | 35 | 22 | 54 | 33 | –25% | 586 | 776 | ||||
OR | 64 | 50 | 22 | 11 | 38 | 16 | 22 | 19 | –35% | 688 | 698 |
AF | 19 | 32 | –26% | 297 | 458 | ||||||
ET | 31 | 19 | 34 | 32 | 15 | 14 | –31% | 558 | 696 | ||
RS | 19 | 10 | –30% | 90 | 618 | ||||||
GS | 17 | 12 | 12 | 11 | 3 | 1 | –6% | 528 | 618 | ||
YK | 21 | 22 | 20 | 24 | 85% | 468 | 536 |
This analysis did not yield any significant specific reduction of errors for any of the dyslexia types. The effect on LPD was assessed by the measure of reduction in letter migrations within words in reading 345 migratable words before and after the workshop for the 10 participants with LPD who participated in the workshop. This analysis yielded no significant reduction: reduction from 9.0% (
The effect on attentional dyslexia was assessed by the measure of reduction in letter migrations between words in reading 150 migratable word pairs before and after the workshop for the four participants with attentional dyslexia who participated in the workshop. This analysis also yielded a reduction from 17.3% migrations between words (
The analysis of the reduction of surface errors in surface dyslexia was made out of the phonologically legal reading of 241 irregular and potentiophonic words. This yielded a reduction from 12.7% surface errors before the workshop (
Finally, the effect on the reading errors of the participants with vowel letter dyslexia was evaluated via the rate of vowel letter errors (substitutions, additions, migrations, and omissions of vowel letters) out of the 60 non-words they read. This yielded a reduction from 29.3% vowel letter errors [
A significant reduction was found in the standard deviations of reaction times (RTs) in the CPT task (before: 117.5 ms [
An additional significantly reduction was found in the measure of commissions: the participants had significantly fewer commissions after the workshop (before: 1.9% [
Two repeated measures ANOVA’s were performed with the within-subjects factors of time (before/after the workshop), target (with/without target) and number of distracters (4, 8, 16, or 32) in the conjunctive search task, one for RTs and one for accuracy. As can be seen in
Two repeated measures ANOVAs were performed with the within-subjects factors of time (before/after the workshop) and target (valid/invalid cue) in the peripheral cueing paradigm, one for RTs and one for accuracy. A significant reduction was found in RTs (before: 757.4 ms [
Two repeated measures ANOVAs were performed with the within-subjects factors of time (before/after the workshop), kind of task (location/direction), and congruency (congruent/incongruent) in the location-direction Stroop-like task. A significant reduction in RTs (overall location and congruity) was obtained (before: 708.1 ms [
The means and standard deviations of the participants’ scores on the various questionnaires are presented in
Scores of psychological measures among MBSR participants, before and after the workshop, and the
Before |
After |
Cohen’s |
||||||
---|---|---|---|---|---|---|---|---|
Mean | Mean | |||||||
Mindfulness | 2.88 | 0.68 | 3.39 | 0.75 | 19 | –4.28 | <0.001 | 0.98 |
Perceived stress | 2.39 | 0.76 | 1.55 | 0.79 | 19 | 4.75 | <0.001 | 1.09 |
Rumination | 3.67 | 0.92 | 3.26 | 0.81 | 18 | 2.49 | 0.02 | 0.59 |
Depression | 2.12 | 0.53 | 1.90 | 0.52 | 18 | 2.46 | 0.02 | 0.58 |
Sleep disturbances | 3.07 | 1.16 | 2.73 | 1.16 | 19 | 2.21 | 0.04 | 0.51 |
Reflection | 3.98 | 0.71 | 3.77 | 0.71 | 18 | 1.91 | 0.07 | 0.45 |
State anxiety | 2.33 | 0.64 | 2.08 | 0.66 | 19 | 1.74 | 0.10 | 0.40 |
Life satisfaction | 3.52 | 1.30 | 3.83 | 1.13 | 18 | –1.39 | 0.18 | 0.33 |
The overall improvement in reading errors was significantly correlated with the improvement in the rate of commissions in the CPT (
Significant correlations were obtained between the improvements in selective attention accuracy and improvement in life satisfaction (
This study aimed at evaluating the effects of mindfulness meditation on reading, attention, and psychological measures in adults with reading and/or attention impairments. The main question regarded the nature of the relationships within the triangle of mindfulness meditation, attention, and specific functions of the reading process. Mindfulness practice was found to improve the reading of the dyslexic participants, as expressed by a general reduction in their reading errors rate. Importantly, this effect stemmed from a specific effect of mindfulness that encouraged reading via the lexical route, leading to a reduction in errors resulting from reading by grapheme-to-phoneme conversion, especially for the participants with ADHD.
In the domain of attention functions, mindfulness practice was found to reduce impulsivity and enhance sustained attention, as well as shorten reaction times to tasks measuring selective, sustained, executive, and orienting of attention functions. Self-reports indicated that the participants also felt improvement in most of the psychological domains that were evaluated, most prominently in mindfulness and perceived stress. Significant correlations indicated that the reading improvement was related to a decrease in impulsivity (fewer commissions in the CPT test). Additional significant correlations were found between psychological and attention changes following the workshop.
Possibly the most important finding of this study, and one that sheds light on the nature of the effect of mindfulness practice on reading, is the specific effect mindfulness had on errors. Reading can proceed via two different routes: a lexical route, which employs knowledge of words, where reading proceeds via identification of the whole word in the orthographic lexicon, which then activates the phonological output lexicon. The other route is a sublexical route, where words are read via grapheme-to-phoneme conversion. The lexical route is the more accurate, efficient and rapid route, whereas reading words via the sublexical route is slow, and often leads to inaccurate reading. For example, reading the word
This result suggests that mindfulness practice keeps reading “on the right track” – in this case, the lexical route. Thus, whereas attention disorders as well as temporary inattention may allow diversion onto the sublexical route, mindfulness assists the reader in keeping reading on the mindful route. This finding is also consistent with the finding that the improvement was significant only for words but not for non-words: if the mindfulness workshop affected reading by leading readers to read words via the lexical, rather than the sublexical route, this would not be expected to affect non-words, which are read exclusively via the sublexical route.
In line with our hypothesis, the MBSR workshop was also found to improve the functioning of sustained-, selective-, orienting-, and executive attention functions, similar to previous findings (e.g.,
The picture that emerges with respect to the relation between attention and reading is quite intricate. Firstly, the results of the current study not only indicate that MBSR helped our dyslexic participants who had sustained attention disorder to stay on the lexical route; they also show that MBSR did not have a specific effect on any type of dyslexia, nor did it have an effect on any specific error type beyond surface errors. These results join previous studies that have shown the independence of dyslexias and attention:
The current study thus adds a piece to the puzzle, by clarifying that whereas attention problems do not underlie dyslexia, they may allow the diversion of reading to the sublexical route, which, in turn, may result in inaccurate reading – surface errors. This aspect of the relation between (sustained)3
It should be noted that reading via the sublexical route not only causes slow and inaccurate reading, but it may also affect reading comprehension: when the word
The increased ability to stay on the lexical track was correlated with self-reported mindfulness. The attentional aspect that most likely led to the increased ability to stay on the lexical track, and which mediated the effect of mindfulness on reading, is the reduction of impulsivity (as measured by the number of commission errors in the CPT task). The overall reduction in reading errors was significantly correlated with the reduction of commissions in the CPT task, and the reduction of reading errors was mainly present in the dyslexic participants who also had a sustained attention deficit. The mediating role of sustained attention in improving reading performance is consistent with
The reduction in surface errors and the improvement in attention measures cannot be ascribed to training effects that result from administering the same tests twice, 3 months apart. We administered the exact same tests twice, 3 months apart, to participants with similar characteristics of dyslexia and attention who did not participate in a meditation workshop, and they showed no improvement in reading error rates or in attention measures.
Consistent with previous reports (e.g.,
The psychological improvements related to MBSR were found to be correlated with attentional measures. The strongest correlation was between the improvement in orienting of attention and the reduction of sleep disturbances. In agreement with
This study is the first to show that mindfulness training can improve reading aloud of single words. This improvement in reading following mindfulness practice is in accordance with the results of
Our study provides support to the idea that mindfulness-based interventions can be used to significantly improve reading as well as the quality of life of individuals with dyslexia and ADHD. The effectiveness of this technique, as well as its simplicity, offer these individuals a new hope for addressing their experienced difficulties, with suggested long-term effects. It also sheds important light on the intricate relation between attention and reading, suggesting that mindfulness assists readers in staying on the lexical track for reading.
NF, ZB, and RT conceived the idea for the study and the research questions. RT was in charge of the meditation practice. NF created the reading tasks, tested the reading of the participants (together with Rakefet Keidar, whom we thank very much) and analyzed the reading data (together with Lilach Khentov-Kraus, and Liora Lopez Morsian, whom we wholeheartedly thank). ZB ran the attention and psychological tests before and after the workshop as part of her MA thesis. Mainly RT, but also ZB and NF, did the statistical analyses. RT and NF wrote together the final manuscript.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
We are grateful to Lilach Khentov-Kraus, Rakefet Keidar, and Liora Lopez Morsian for their help in administering and analyzing the reading tests.
To establish the diagnosis of each type of dyslexia, we further ran tests of reading aloud as well as lexical decision and written word comprehension, with stimuli sensitive to each type of dyslexia. In these additional tests, reading aloud was done without time limit, and the participants were requested to read aloud as accurately and as quickly as possible, and the first responses were counted, even when they were later self-corrected. In the lexical decision and the comprehension tasks, the participants were requested to perform the tasks in silent reading, without sounding out the words they read.
The results of each participant in each of the further reading tasks was compared to those of age-matched controls. In the reading aloud tasks, the number of errors of each type (reading via the sublexical route, vowel omission, substitution, addition, migration, consonant omission, substitution, addition, migration, migrations between words, voicing errors, semantic errors) was compared to the number of these errors in the control group. In the lexical decision and comprehension tasks, the percentage of correct responses was compared to that of the age-matched controls.
To establish the diagnosis of letter position dyslexia, which is characterized by letter migrations within words, we used, beyond the oral reading tasks of migratable words described above, also tasks that tested the participants’ silent reading of words that are most sensitive to this dyslexia– migratable words.
Additional tasks involved
To establish the diagnosis of attentional dyslexia, characterized by migrations of letters between neighboring words (and by omissions of an instance of a letter that appears in two neighboring words in the same position), beyond the two word-pair reading tests, the participants read aloud an additional list of non-word pairs.
The
Each participant with suspected surface dyslexia was tested, in addition to the screening test and the potentiophone reading task, with a lexical discrimination task of pseudo-homophones, and a homophone comprehension task.
The lexical decision task contained 66 word pairs. Each pair included a word spelled correctly and its pseudo-homophone (e.g., knife-nife). For each pair, the participants were requested to circle the word that was spelled correctly.
The reading comprehension task included 40 triads. Each triad consisted of a target word, and two words to choose from: one word that is semantically associated to the target word, and a homophone or a potentiophone of the associated word (e.g., bottle – bear beer). The participants were requested to circle the word that is semantically associated with the target word.
To establish the diagnosis of vowel dyslexia, characterized by substitutions, omissions, additions, and migrations of vowel letters, the participants read in addition to the non-word lists, another word list, and performed two additional tasks of lexical decision and word comprehension.
The word list included 100 words, 3- to 8-letter long (mean = 4.17,
The vowel dyslexia lexical decision task contained 80 items: 45 non-words in which a vowel error creates existing Hebrew words and 35 existing words – 16 of which included a vowel letter and 19 without vowel letters. The items in the task were 2–8 letters (
The reading comprehension task for vowel dyslexia included 52 triads. Each triad consisted of a target word (3–6 letters long,
Additional types of dyslexia exist, but we present here the types that were mostrelevant for the current study. For a fuller exposition of dyslexia types, please see
Most of the participants with attention disorders and dyslexia in our study had asustained attention impairment. The finding that the main effect of keeping thereader on the lexical route happened with these participants, and the significantcorrelations between improved reading and reduced commissions suggest thatlexical reading was modulated by reduced impulsivity and improved performancein the CPT task.