Research-based

Interventions for
Neurobiological Factors
that Contribute to
Academic Skill Deficits
By
Evelyn Egan, M.Ed.
What is dyslexia?
Dyslexia is a specific learning disability that is
neurobiological in origin. It is characterized by difficulties
with accurate and/or fluent word recognition and by poor
spelling and decoding abilities. These difficulties typically
result from a deficit in the phonological component of
language that is often unexpected in relation to other
cognitive abilities and the provision of effective
classroom instruction. Secondary consequences may
include problems in reading comprehension and reduced
reading experience that can impede growth of
vocabulary and background knowledge.
(Lyon et al., 2003b)
Prevalence of dyslexia
Dyslexia is the most common form of learning disability
(LD).
17. 4 % in the school-age population (S. E. Shaywitz, 2004)
More than 35 % of children in grade 4 read below the basis
level of proficiency. (National Center for Educational
Statistics, 2003)
80-90 % of all children served in special education
programs had problems with reading. (Lerner, 1989)
About 80 % of an elementary school sample selected
because of reading problems had difficulties involving the
accuracy of word reading; the remaining 20 % had
difficulties primarily at the level of listening comprehension.

Neurobiological Factor #1: Brain
Structure
1. Anatomical Magnetic Resonance Imaging (MRI)
Studies
- There is some convergence indicating subtle differences
in several brain structures between dyslexic and
nonimpaired readers, especially in left hemisphere
regions supporting language.
- Reduction of the size of the left temporal lobe, area of
the brain posterior to the splenium of the corpus
callosum was larger in both the right and left
hemispheres
o 2. Diffusion Tensor Imaging (DTI)
- Less development of white matter, therefore reduced
myelination of language-mediating areas
Neurobiological Factor #2: Brain
Function
Different types of functional neuroimaging methods are
used to measure brain activation in response to visual,
linguistic, and reading tasks among individuals who read
skillfully and individuals with dyslexia.
Converging evidence from a range of functional imaging
methods used in studies of both groups indicates that a
network of brain areas is involved in the ability to recognize
words accurately, and that adults and children with dyslexia
manifest different patterns of activation in these areas as
compared with skilled readers.
These areas most consistently involve the basal temporal
(for occipitotemporal), temporoparietal, and inferior frontal
regions, somewhat more predominantly in the left
hemisphere. (Eden & Zeffiro, 1998; S. E. Shawwitz & B. A.
Shaywitz, 2005)
Neurobiological Factor #3:
Genetic Factors
Reading problems run in families and occur across family
generations, which is the basis for genetic studies of
reading disability and ability.
The risk in offspring of a parent with a reading disability is
eight times higher than in the general population.
(Pennington & Olson, 2005)
Studies of the heritability of dyslexia and other reading
disabilities show that the familiality is almost entirely
genetic after adolescence, but the variability in reading
disability shows both gentic and nonshared environmental
influences. (Petrill et al., 2006a)
Three areas of research converge in demonstrating that
dyslexia has a heritable component: both twin and family
studies of individuals, along with linkage studies examining
the role of specific genes that congregate within families
that have significant heritability. (Grigorenko, 2001)
Word Recognition Interventions
If there is one cardinal intervention
principle for students with LDs, it is
that training in motor, visual, neural,
or cognitive processes without
academic content does not lead to
better academic outcomes.
Word Recognition Interventions
Classroom Studies, Tutorial Studies, and Intervention Studies
1. Early intervention may reduce the number of students who are at risk for
reading difficulties, those who might be eventually characterized with LDs in
reading, and those who are economically disadvantaged and may be poorly
prepared to read.
2. Intervention studies that address the bottom 10-25 % of the student
population may reduce the number of at-risk students to rates that
approximate 2-6 % (Denton & Mathes, 2003; Torgesen, 2000).
3. Classroom and small-group tutorial programs are effective.
4. The most effective programs were comprehensive, integrated programs
that emphasized instruction in the alphabetic principle, teaching for
meaning, and opportunities for practice.
5. Layering of classroom and tutorial interventions such as in the provision
of classrooms with an intervention emphasizing Peer-Assisted Learning
Strategies (PALS), or where the core reading program was strong, the
number of at-risk students appears to go below 2 % in some studies. These
outcome studies show that these changes are affective through grade 5 and
that domains involving word recognition, fluency, and comprehension are
impacted.
Word Recognition Interventions
Reading Remediation Studies
1. Remedial studies show that foundational skills can be improved in
students with LDs in reading, typically characterized by word
recognition difficulties. The effects are most apparent in word
recognition, but also show transfer to comprehension.
2. A variety of approaches are associated with improvement, including
commercial programs that were incorporated in different studies
(Lindamood-Bell, Phono-Graphix), research-based approaches
(PHAB/DI, RAVE-O, PHAST, PASP), and programs that were not
reviewed (Spell-Read; Rashotte, MacPhee, & Torgesen, 2001).
3. It is clear that the program is less important than how it is
delivered, with the most impressive gains associated with more
intensity and and an explicit and systematic delivery (Torgesen et
al., 2001).
4. There are also associations with the length of instruction.
5. Programs that are explicit, oriented to academic content, teach to
mastery, provide scaffolding and emotional support, and monitor
progress are particularly effective.

What is a reading comprehension
difficulty?
There are four subgroups of poor
readers whose difficulties were in
the following areas: only decoding,
only listening comprehension, both
decoding and listening
comprehension, and orthographic
processing/speed.
Core Cognitive Processes
Language
1. Children with good decoding/poor
comprehending often have more basic
deficits in vocabulary, morphology, and
understanding of syntax that impair
reading comprehension (Nation, Clarke,
Marshall, & Durand, 2004; Stothard &
Hulme, 1992,1996).
2. Ultimately, language development is at
the heart of reading comprehension.

Core Cognitive Processes
Listening Comprehension
1. Listening comprehension includes discourse-level
processes that serve as overarching control
processes that impact reading and listening
comprehension.
2. Children cannot understand written language any
better than they can understand oral language.
3. Any language or cognitive difficulties that hinder
oral language comprehension will also affect
individuals ability to read text or even to
comprehend text read to them.
Core Cognitive Processes
Working Memory
1. Both listening and reading comprehension make
demands on working memory as a storage resource in
which words and sentences are held for more extended
processing and integration with prior knowledge and as
a mental workspace in which previous interpretations of
text can be revised in relation to incoming information
(Barnes, et al., in press).
2. Several studies document relations of verbal working
memory and comprehension and show that working
memory is impaired in poor comprehenders (Stothard &
Hulme, 1992; Nation et al., 1999).
3. Working memory, as assessed by a sentence span test,
contributed unique variance to inference making,
comprehension monitoring, and story structure
knowledge even when decoding ability, verbal IQ, and
vocabulary were controlled.
Core Cognitive Processes
Higher-Order Processes
1. Inferencing A substantial body of research shows that poor
comprehenders understand literal or stipulated meanings
provided by the surface code of the text, but have difficulty
making inferences that require interpretation or integration of
text (see Oakhill, 1993).
2. Prior knowledge and inferencing Poor comprehenders took
longer to master the knowledge base; older, poor
comprehenders performed similarly to younger, skilled
comprehenders; and the sources of their difficulties were similar.
3. Comprehension Monitoring Children who are poor
comprehenders have difficulties with comprehension monitoring
(Nation, 2005).
4. Story Structure Sensitivity Children who struggle with
comprehension are less aware of genre and story structure
variation.
Prevalence
If a child has a significant oral language disorder, it
seems likely that reading comprehension problems will
be identified earlier in development, but many of these
children will also have poor word recognition skills
(Catts, Fey, Tomblin, & Zhang, 2002a).
Children with more subtle difficulties in language
comprehension may be those children who are identifies
later in development, if at all (nation, Clarke, &
Snowling, 2002).
Neurobiological Factor #1: Brain
Structure and Function
Reading and listening are essentially unobservable
processes that require the joint operation of multiple
domains in order to abstract meaning from text or
words.
The processing of discourse therefore appears to be a
distributed network of brain regions (Gernsbacher &
Kaschak, 2003).
Neurobiological Factor #2:
Genetic Factors
Different language skills related to reading
comprehension have been shown to have varying
degrees of heritability across a variety of studies (Plomin
& Kovas, 2005), and oral language disorders certainly
have a significant heritability component (Bishop &
Snowling, 2004).
It cannot be said that LDs that specifically involve poor
reading comprehension are inherited, but it can be said
that the language components of these disorders share
distinct heritable features.
Reading Comprehension
Interventions
In studies, much of the impact on gains in reading
comprehension stems from strategy instruction, often
included as part of a comprehensive approach to
reading instruction in children with word recognition and
fluency difficulties.
Strategic instruction promotes self-regulation and raises
the students level of independence.
Such instruction addresses the executive function
deficiencies commonly observed in students with LDs in
a variety of academic domains.
Strategic Instruction Examples
Teaching of metacognitive strategies
Cooperative learning
Reciprocal teaching
Interactive teaching model
Explicit instruction
Multiple opportunities for instruction
Carefully sequenced lessons
Conclusion
Dyslexia
1. A key for all research efforts is to focus on clearly defined
phenotypes, which for dyslexia we suggest should stem
from the assessment of academic skill deficits.
2. To achieve these goals, it is imperative that the concept of
response to instruction be incorporated into definitions of
dyslexia and other LDs.
Reading Comprehension
Studies involving intervention in reading comprehension can be
improved, even in students with WLRD. In these studies, much
of the impact on gains in reading comprehension stems from
strategy instruction, often included as part of a comprehensive
approach to reading instruction in children with word
recognition and fluency difficulties.

Reference
Fletcher, J. M., Lyon, G. R., Fuchs, L. S., & Barnes, M. A.
(2007). Learning disabilities: From identification to
intervention. New York, NY: The Guilford Press.