Dyslexia

阅读障碍
  • 文章类型: English Abstract
    患者是一名85岁的男性,有一年的阅读假名困难史。神经心理学评估显示假名(音图)-选择性阅读障碍和汉字(表意文字)-显性书写障碍。MRI显示左枕骨皮质有明显的脑萎缩,导致后皮质萎缩(PCA)的临床诊断。脑脊液淀粉样β1-42水平降低,淀粉样蛋白PET显示在后扣带皮质中积累,precuneus,和额叶.相比之下,tauPET显示在萎缩的大脑区域没有积累。REM睡眠行为障碍的发作和间碘苄基胍(MIBG)心肌闪烁显像的摄取减少提示路易体病理学的参与。具有明显侧向性的PCA很少报道,这是第一个出现假名选择性阅读障碍和汉字显性书写障碍并伴有神经退行性背景的病例。
    The patient was an 85-year-old man with a one-year history of difficulty reading kana. Neuropsychological evaluation revealed kana (phonogram)-selective reading impairment and kanji (ideogram)-dominant writing impairment. MRI revealed significant cerebral atrophy in the left occipital cortex, leading to the clinical diagnosis of posterior cortical atrophy (PCA). Cerebrospinal fluid amyloid β1-42 levels were reduced, and amyloid PET showed accumulation in the posterior cingulate cortex, precuneus, and frontal lobe. In contrast, tau PET showed no accumulation in the atrophied brain areas. Episodes of REM sleep behavior disorder and decreased uptake on meta-iodobenzylguanidine (MIBG) myocardial scintigraphy suggested the involvement of Lewy body pathology. PCA with distinct laterality has been rarely reported, and ‍this is the first case to present Kana-selective reading impairment and Kanji-dominant writing impairment with neurodegenerative background.
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  • 文章类型: Case Reports
    据作者所知,本文是阿尔巴尼亚和邻国首次通过认知行为疗法研究变革性协同干预方法,亲子互动疗法(PCIT),对患有注意力缺陷/多动障碍(ADHD)和并存的对立反抗障碍(ODD)和阅读障碍的儿童进行重金属排毒。阿尔巴尼亚的心理健康意识有限,特别是关于PCIT和类似的治疗,强调了此类干预措施的适用性和适应性的重要性。这项研究表明,多动症合并症的快速管理,比如ODD和阅读障碍,通过联合干预方法和调查生物学方面更好地实现。需要进行大样本量的进一步研究,以评估这种方法的长期可持续性和可扩展性。
    To the best of the authors\' knowledge, this article is the first of its kind in Albania and neighboring countries to investigate the transformative synergistic intervention approach through cognitive behavioral therapy, parent-child interaction therapy (PCIT), and heavy metal detoxification on a child with attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) and dyslexia. The limited mental health awareness in Albania, particularly regarding PCIT and similar treatments, highlights the importance of the applicability and adaptability of such interventions. This study suggests that the rapid management of comorbidities in ADHD, such as ODD and dyslexia, is better achieved by a combined intervention approach and by investigating the biological aspects. Further research with a large sample size is needed to assess the long-term sustainability and scalability of such an approach.
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  • 文章类型: Journal Article
    研究报告说,语音到文本应用程序(STT)可以支持在文本制作中写作困难的学生。然而,现有的研究是稀疏的,显示混合结果,并且缺乏有关STT干预措施及其在学校中适用性的信息。因此,这项研究旨在调查针对STT的系统和密集的辅助技术干预是否可以改善文本生成。使用了修改后的多基线跨主题设计,涉及八名中学生,四个挪威人和四个瑞典人。他们的STT制作的叙述性文本是在干预和生产力期间和之后收集的,准确度,并对文本质量进行了分析。键盘输入是基线对照条件。结果表明,八名学生中有七名提高了文本生产率,单词级准确性的比例得到了保持或提高。标点符号的使用在基线技能较差的参与者中取得了进展。大多数学生的STT产生的文本至少具有与键盘输入相似的意义和文本质量比率。然而,变化的幅度和发展模式各不相同,三个学生表现出最显著的影响。总之,这项研究的干预似乎有利于最初指导STT,和进展监测指导单独调整未来的干预措施,如平衡生产力和正式语言方面。使用STT消除拼写障碍为学生提供了提高其高阶技能的机会,如词汇多样性和整体文本质量。此外,可见的进步,比如产生更长文本的能力,可能会激励继续使用STT。然而,这种发展可能并不总是立竿见影的。
    语音到文本(STT)可能是开发具有严重阅读和写作困难的学生的文本生成的有效工具。例如,增强的文本长度可以为教师提供更多的反馈材料,引导学生改进文本制作。文本到语音可以通过收听产生的句子和文本来促进修订过程,从而进一步提高STT在文本产生中的有用性。通过持续监控学生的STT使用情况和文本制作,教师可以调整内容以进行进一步的干预,以满足个人需求,例如句子构造和文本规划。早期STT干预似乎有益,绕过拼写时,允许更多的时间在文本制作中练习高级技能。
    Studies report that speech-to-text applications (STT) may support students with writing difficulties in text production. However, existing research is sparse, shows mixed results, and lacks information on STT interventions and their applicability in schools. Therefore, this study aimed to investigate whether a systematic and intensive assistive technology intervention focusing on STT can improve text production. A modified multiple-baseline across-subject design was used involving eight middle school students, four Norwegian and four Swedish. Their STT-produced narrative texts were collected during and after the intervention and the productivity, accuracy, and text quality were analysed. Keyboarding was the baseline control condition. The results demonstrated that seven of the eight students increased text productivity and that the proportion of word-level accuracy was maintained or improved. The use of punctuation progressed in participants with poor baseline skills. Most students\' STT-produced texts had at least a similar ratio of meaningfulness and text quality as keyboarding. However, the magnitude of the changes and development patterns varied, with three students showing the most notable impacts. In conclusion, this study\'s intervention seemed beneficial in initially instructing STT, and the progress monitoring guided individually adapted future interventions such as balancing productivity and formal language aspects. Removing the spelling barrier with STT provided an opportunity for students to improve their higher-order skills, such as vocabulary diversity and overall text quality. Furthermore, visible progress, such as the ability to produce longer texts, might motivate continued STT usage. However, such development may not always be immediate.
    Speech-to-text (STT) may be an effective tool for developing text production in students with severe reading and writing difficulties. For example, enhanced text length can provide teachers with more material for feedback, guiding students towards improved text production.Text-to-speech may further enhance the usefulness of STT in text production by facilitating the revision process through listening to produced sentences and texts.By continuously monitoring students’ STT usage and text production, teachers can tailor the content for further interventions to address individual needs such as sentence construction and text planning.Early STT intervention seems beneficial, allowing more time to practise advanced skills in text production when bypassing spelling.
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  • 文章类型: Journal Article
    背景:患有发展性语言障碍(DLD)和阅读困难(RD)的儿童可以根据线人表现出更多的同伴关系问题。
    目标:(1)探索欺凌受害者的分类,通过自我和同行报告进行评估,患有DLD和RD的儿童;(2)评估举报人之间的协议率。
    方法:在83名参与者(9-12岁;10.5±1.1岁)的样本中,使用自我报告(EBIP-Q)和同伴报告社交图(CESC)评估了受害情况。由DLD(n=19)组成,RD(n=32),和对照组(n=32)。
    结果:我们发现在DLD和RD组中,被拒绝的社会测量特征的频率更高,DLD组中同行报告的受害人数较高,DLD和RD组中自我报告的受害情况更严重。除DLD组外,自我报告被归类为受害的可能性更高。对于控制组和RD组,使用最严格的EBIP-Q标准(7分)的线人协议很高,无论使用何种标准,对DLD组都不显著。
    结论:我们发现语言障碍儿童的受害风险更高,尽管根据协议率,自我评估似乎对患有DLD的儿童的检测不足,指出需要将评估和线人结合起来。这篇论文增加了什么?:一些研究表明,患有DLD或RD的儿童在连续数据的几个社交技能量表上获得了较高的受害得分,而得分较低。尽管连续分析在研究中很常见,专业决策通常基于截止标准,而不是与另一组相比分数的高低。这是第一批根据专业人员在DLD和RD儿童的学校环境中使用的自我和同伴评估的截止标准来分析受害情况的作品之一。我们的结果将根据有关受害高风险的证据,提高学校专业人员的认识,尤其是患有DLD的儿童,以及在几种受害措施之间进行选择的含义,在这群孩子中。我们认为我们的结果将有助于更好地发现和预防DLD儿童在学校中的欺凌行为。
    BACKGROUND: Children with Developmental Language Disorder (DLD) and Reading Difficulties (RD) can show more peer relation problems depending on the informant.
    OBJECTIVE: (1) To explore bullying victims\' categorization, evaluated by self- and peer-reports, in children with DLD and RD; and (2) to assess agreement rates between informants.
    METHODS: Victimization was assessed using a self-report (EBIP-Q) and a peer-report sociogram (CESC) in a sample of 83 participants (9-12 years; 10.5 ± 1.1 years), comprising of DLD (n = 19), RD (n = 32), and Control (n = 32) groups.
    RESULTS: We found a higher frequency of the rejected sociometric profile in the DLD and RD groups, a higher peer-reported victimization in the DLD group, and more severe self-reported victimization in the DLD and RD groups. Odds of being classified as victimized were higher for self-report except in the DLD group. Informants\' agreement was high using the most restrictive EBIP-Q criterion (7 points) for both the Control and the RD groups, being non-significant for the DLD group regardless of the criteria used.
    CONCLUSIONS: We found a higher victimization risk in children with language difficulties, although self-assessment seems to under-detect children with DLD according to the agreement rates, pointing out the need to combine assessments and informants. WHAT DOES THIS PAPER ADD?: Several studies have shown that children with DLD or RD obtain higher scores of victimization and score lower on several scales of social skills with continuous data. Although continuous analyses are usual in research, professional decisions are usually based on cut-off criteria more than how high or low a score is in contrast to another group. This is one of the first works that analyses victimization following the cut-off criteria of self and peer assessments that professionals used in the school settings in children with DLD and RD. Our results will raise awareness among school professionals based on the evidence about the high risk of victimization, especially in children with DLD, and the implications of selecting between several measures of victimization, in this group of children. We think that our results would help to better detect and prevent bullying in schools for children with DLD.
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  • 文章类型: Journal Article
    阅读时,诵读困难的读者比普通读者表现出更多和更长的关注。然而,当阅读障碍和控制读者只对一串字母执行视觉任务时,没有显着差异,显示认知过程在阅读中的重要性。阅读中的这种语言和认知处理要求通常会由于阅读困难的读者而被感知到的附加字母和单词镜像图像叠加在主要皮层的主要图像上而受到干扰,诱导内部视觉拥挤。这里,我们表明,对于普通读者来说,无论照明的性质如何,固定的数量和持续时间都保持不变,可以使用Hebbian机制在优化的脉冲宽度照明中擦除额外的图像来控制阅读障碍读者的过量注视和阅读的总持续时间。在这种情况下,然后,固定的数量可以减少约1.8倍,恢复正常的阅读实验。
    When reading, dyslexic readers exhibit more and longer fixations than normal readers. However, there is no significant difference when dyslexic and control readers perform only visual tasks on a string of letters, showing the importance of cognitive processes in reading. This linguistic and cognitive processing requirement in reading is often perturbed for dyslexic readers by perceived additional letters and word mirror images superposed on the primary images on the primary cortex, inducing internal visual crowding. Here, we show that while for a normal reader, the number and the duration of fixations remain invariant whatever the nature of the lighting, the excess of fixations and total duration of reading can be controlled for a dyslexic reader using the Hebbian mechanisms to erase extra images in optimized pulse-width lighting. In this case, the number of fixations can then be reduced by a factor of about 1.8, recovering the normal reading experiment.
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  • 文章类型: Journal Article
    特定学习障碍是特殊教育中的一个教育类别,用于识别阅读等障碍领域,写作,或数学,尽管学生的智力。个性化教育计划团队通过教育干预和住宿来解决学习障碍。为有特定学习障碍的学生提供的一种住宿是辅助技术。职业治疗师需要证据来告知有关辅助技术工具的决策,以满足学习障碍学生的个性化需求。此案例报告描述了以学校为基础的职业治疗师如何评估一名学生的辅助技术需求,以适应她在阅读和写作方面的特定学习障碍。此评估产生了与年龄相关的针对学生和基于证据的建议,需要,和偏好。报告的结果包括通过获取教育材料提高独立性,增加获得适合年龄的阅读材料的机会,增加阅读参与的乐趣。
    Specific Learning Disability is an educational category within special education that identifies an impairment area such as reading, writing, or math despite a student\'s intelligence. Individualized Education Plan teams address learning disabilities with educational interventions and accommodations. One accommodation for students with a specific learning disability is assistive technology. Occupational therapists need evidence to inform decision-making regarding assistive technology tools to meet the individualized needs of students with learning disabilities. This case report describes how a school-based occupational therapist evaluated one student\'s assistive technology needs to accommodate her specific learning disability in reading and writing. This evaluation resulted in student-specific and evidence-based recommendations pertinent to age, need, and preferences. Reported outcomes include increased independence with accessing educational materials, increased access to age-appropriate reading material, and increased pleasure reading participation.
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  • 文章类型: Journal Article
    IRF2BPL(干扰素调节因子2结合蛋白样)基因是普遍存在于人体中的无内含子基因,包括大脑。致病变异导致神经变性,并呈现神经系统疾病的表型特征,包括诵读困难,计算障碍,癫痫,肌张力障碍,神经发育回归,运动技能丧失和小脑共济失调。
    我们介绍了一例9岁男孩因全身强直-阵挛性癫痫发作和轻度张力减退而被送往急诊科的病例。病史包括神经系统消退。经过无关紧要的实验室和成像结果,病人接受了基因检测,揭示了IRF2BPL基因(杂合变体)中的新致病性突变,这是以前文献中从未报道过的。显示了常染色体显性功能丧失突变,在DNA中表示为NM_024496c.911C>T,这导致蛋白质过早终止(p.Glu494)。
    我们的案例强调了早期识别与各种IRF2BPL基因突变相关的神经系统症状的重要性,以便可以提供及时的多学科管理方法。
    UNASSIGNED: IRF2BPL (interferon regulatory factor 2-binding protein-like) gene is an intronless gene present ubiquitously in the human body, including the brain. Pathogenic variants lead to neurodegeneration and present with phenotypic features of a neurological disorder, including dyslexia, dyscalculia, epilepsy, dystonia, neurodevelopmental regression, loss of motor skills and cerebellar ataxia.
    UNASSIGNED: We present a case of a 9-year-old boy who was brought to the emergency department with generalised tonic-clonic seizures and mild hypotonia. A history included neurological regression. After insignificant lab and imaging results, the patient underwent genetic testing, revealing a novel pathogenic mutation in the IRF2BPL gene (heterozygous variant), which had never been reported in the literature before. An autosomal dominant loss of function mutation was demonstrated, denoting in DNA as NM_0 24 496 c.911 C>T, which results in premature protein termination (p.Glu494).
    UNASSIGNED: Our case highlights the importance of early recognition of the neurological symptoms associated with various IRF2BPL gene mutations so that a timely multidisciplinary management approach can be provided.
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  • 文章类型: Clinical Trial Protocol
    背景:在学龄期人群中,具有高智力潜力(HIP)的儿童的患病率很高,并且与学习障碍(如阅读障碍)的合并症的发生率很高,这增加了对言语和语言治疗的需求,并使其变得更加复杂。然而,高智力潜能(HIP-DD)阅读障碍患者的治疗在文献中的引用很少.关于HIP-DD儿童的大部分研究集中在发育性阅读障碍的筛查和诊断上,但只有几个地址补救。发展性阅读障碍是一种严重且持续的疾病,会影响阅读的获得,并暗示几种潜在的认知过程受损。这些包括分类感知的缺陷,快速自动化命名,和语音意识,尤其是音素意识。一些作者声称HIP-DD儿童的潜在缺陷主要涉及快速自动化命名和语音意识。因此,这项研究的目的是提出HIP-DD儿童发展性阅读障碍的补救方案。该协议建议比较针对分类感知的强化干预对阅读技能的影响,快速自动化命名,HIP-DD儿童的语音分析与标准言语治疗方法的比较。
    方法:将对4名法国HIP-DD患者提出多基线单病例实验设计(A1BCA2),为期30周。干预阶段B和C对应于分类感知训练和快速自动化命名训练。在B和C阶段,每个培训课程将与音素分析培训和阅读和写作任务相关联。在纳入时,演讲和语言,心理,并将进行神经心理学评估以定义这四个患者的概况。使用简单的计算机化随机化程序将患者分配到不同的基线长度。阶段的持续时间将被抵消。这项研究将是双盲的。在整个研究期间,将每周进行语音和阅读技能的测量。
    结论:本方案的目的是观察阅读技能随每种干预方式的演变。从这个观察,可以测试有关HIP-DD儿童发展性阅读障碍的补救假设。讨论了该研究的优点和局限性。
    背景:ClinicalTrials.gov,NCT04028310。2019年7月18日注册。版本标识符为no。IDRCB2019-A01453-54,19-HPNCL-02,2019年7月18日。
    The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children\'s underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children.
    A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients\' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study.
    The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed.
    ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.
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  • 文章类型: Journal Article
    阅读习得是通过大脑视觉系统和语言区域的深层变化来实现的,在他们合作的链接中。这些塑料过程的破坏通常导致发展性阅读障碍。然而,阅读机制的非典型发展有时会导致ticker-tape联觉(TTS),弗朗西斯·加尔顿(FrancisGalton)在1883年描述的一种情况,其中个人“在精神上看到打印出来的每个单词(...),就像从一张长长的假想的纸条上一样”。阅读是将字母自下而上地翻译成语音,TTS可以被视为它的反面,将语音自上而下翻译成内部可视化的字母。在一系列的功能性核磁共振实验中,我们研究了MK,有TTS的男人.我们表明,在正常语音感知期间,一组左半球区域在MK中比在对照组中更活跃,包括涉及语音处理的额顶区域,和视觉单词表单区域,对着正字法的枕颞区。这些领域与阅读领域相同,支持将TTS解释为颠倒的阅读。使用动态因果建模,我们进一步表明,平行于阅读,由口语和伪词引起的TTS依赖于沿着不同的词汇和语音路线自上而下的信息流,涉及颞中和上颌回,分别。未来对TTS的研究应该为阅读习得的神经发育机制提供新的思路,他们的变异性和紊乱。
    Reading acquisition is enabled by deep changes in the brain\'s visual system and language areas, and in the links subtending their collaboration. Disruption of those plastic processes commonly results in developmental dyslexia. However, atypical development of reading mechanisms may occasionally result in ticker-tape synesthesia (TTS), a condition described by Francis Galton in 1883 wherein individuals \"see mentally in print every word that is uttered (…) as from a long imaginary strip of paper\". While reading is the bottom-up translation of letters into speech, TTS may be viewed as its opposite, the top-down translation of speech into internally visualized letters. In a series of functional MRI experiments, we studied MK, a man with TTS. We showed that a set of left-hemispheric areas were more active in MK than in controls during the perception of normal than reversed speech, including frontoparietal areas involved in speech processing, and the Visual Word Form Area, an occipitotemporal region subtending orthography. Those areas were identical to those involved in reading, supporting the construal of TTS as upended reading. Using dynamic causal modeling, we further showed that, parallel to reading, TTS induced by spoken words and pseudowords relied on top-down flow of information along distinct lexical and phonological routes, involving the middle temporal and supramarginal gyri, respectively. Future studies of TTS should shed new light on the neurodevelopmental mechanisms of reading acquisition, their variability and their disorders.
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  • 文章类型: Case Reports
    背景:围产期脑损伤可能导致后期神经发育障碍,由于幼儿的神经可塑性,其结果可能会有所不同。最近的神经影像学研究表明,左顶颞区(包括左下顶叶)与语音意识和解码技能有关,这是儿童阅读习得的基本技能。然而,关于围产期脑损伤对儿童语音意识或解码能力发展的影响的文献有限。
    方法:我们报告了一个8岁男孩的案例,该男孩在顶颞叶枕叶的围产期损伤后出现阅读困难。患者足月出生,在新生儿期接受低血糖和癫痫发作治疗。出生后第4天的扩散加权脑磁共振成像显示顶颞枕叶的皮质和皮质下高强度。在8岁的时候,体检并不显著,除了轻微的笨拙。尽管枕叶受伤,病人有足够的视力,正常的眼球运动,没有视野缺陷.韦氏儿童智力量表第四版的全面智商和言语理解指数分别为75和90。进一步评估显示,日本平假名字母得到了充分认可。然而,在平假名阅读测试中,他的阅读速度明显低于对照组儿童。语音意识测试显示,在mora逆转任务中存在重大错误(标准偏差2.7)。
    结论:在顶颞区患有围产期脑损伤的患者需要注意,并且可能会从额外的阅读说明中受益。
    BACKGROUND: Perinatal brain injury may lead to later neurodevelopmental disorders, whose outcomes may vary due to neuroplasticity in young children. Recent neuroimaging studies have shown that the left parietotemporal area (which includes the left inferior parietal lobe) is associated with phonological awareness and decoding skills, which are essential skills for reading acquisition in children. However, the literature on the effect of perinatal cerebral injury on the development of phonological awareness or decoding ability in childhood is limited.
    METHODS: We report the case of an 8-year-old boy who presented with reading difficulty following a perinatal injury in the parieto-temporal-occipital lobes. The patient was born at term and was treated for hypoglycemia and seizures during the neonatal period. Diffusion-weighted brain magnetic resonance imaging on postnatal day 4 revealed cortical and subcortical hyperintensities in the parieto-temporo-occipital lobe. At the age of 8 years, physical examination was unremarkable, aside from mild clumsiness. Despite occipital lobe injury, the patient had adequate visual acuity, normal eye movement, and no visual field defects. Full-scale intelligence quotient and verbal comprehension index on Wechsler Intelligence Scale for Children-Fourth Edition were 75 and 90, respectively. Further assessment revealed adequate recognition of Japanese Hiragana letters. However, he had significantly slower reading speed in the Hiragana reading test than control children. The phonological awareness test revealed significant errors (standard deviation +2.7) in the mora reversal task.
    CONCLUSIONS: Patients with perinatal brain injuries in the parietotemporal area require attention and may benefit from additional reading instructions.
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