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Dyslexia and Dysgraphia: More Than Written LanguageDifficulties in Common

Abstract

A dual-task paradigm involving concurrent finger tappingand line orientation judgment was used to investigatebrain processing differences in early adolescent goodreaders/poor spellers (dysgraphia), poor readers/poor

spellers (dyslexia) and good readers/good spellers.Whereas all groups were similarly affected during the left-hand tapping condition, in the righ t-hand tappingcondition the good spelling group displayed significantlyless tapping disruption than both poor spelling groups,who did not differ significantly from each other. Fromthese results, it can be inferred that individuals withdyslexia and dysgraphia share a left-hemisphereprocessing limitation that is not confined to writtenlanguage. In light of other relevant research findings, Isuggest that this limitation is due to the absence of adisembedding scanning mechanism for converting spatial

arrays (e.g., spelling patterns ) to temporal form--animpairment putatively caused by attempting to teachwritten language to children who are late in establishingleft-hemisphere motor dominance.

Dual-task time-sharing procedures have been used toinfer cerebral lateralization of verbal and nonverbalactivities (Hellige & Longstreth, 1981; Kinsbourne &Hiscock, 1983). Commonly, these procedures involve

Title: Dyslexia and Dysgraphia: More Than Written Language Difficulties inCommon , By: Mather, David S., Journal of Learning Disabilities, 0022-2194, July1, 2003, Vol. 36, Issue 4Database:Academic Search Elite

Contents

Method

Results

Discussion

TABLE 1 Means andStandard Deviationsfor DemographicVariables by Group

TABLE 2 GroupComparison ofBaseline TappingRate Means andStandard Deviations

TABLE 3 Means andStandard Deviationsfor JLOTPercentage TappingRate Decrement

Participants

Materials

Procedure

Tapping Rate

Line OrientationProcessing Rate

Line OrientationProcessing

Accuracy

NOTES

REFERENCES
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tapping with one hand while performing verbal or spatial tasks, such as readingaloud from unfamiliar text or solving nonverbal block design problems (e.g., Hellige &Longstreth, 1981). Tapping interference is taken as indicating that the hemisphere onthe opposite (contralateral) side of the performing hand is involved in the dualprocessing of both tasks.

Stellern, Collins, Cossairt, and Gutierrez (1986) adopted this paradigm to investigatethe hemispheric specialization of First Nations children. The Judgment of LineOrientation Test (JLOT; Benton, Varney, & Hamsher, 1978) was employed becausestudies of unilateral brain disease had found it to be a strong measure of right-hemisphere integrity (Benton, Hannay, & Varney, 1975; Poizner, Klima, & Bellugi,1987). Stellern et al. (1986) were interested in investigating the possibility that FirstNations students process spatial tasks in the left hemisphere (LH) in view of studiessuggesting unusual right-hemisphere (RH) involvement in language processing inthis culture (e.g., Rogers, Ten Houten, Kaplan, & Gardiner, 1977). Among otherfindings, a post hoc comparison showed that performance on the reading, spelling,and arithmetic subtests of the Wide Range Achievement Test (WRAT; J. Jastak,Bijou, & Jastak, 1978) predicted which hand experienced the greater tappingdisruption during concurrent JLOT performance. Of high WRAT performers, 26 out of27 demonstrated left-hand (i.e., RH) interference, whereas 17 out of 21 low WRATperformers demonstrated right-hand (i.e., LH) disruption. The distinction betweenhigh and low WRAT performance was based on scoring above or below a standardscore of 95 on at least two of the WRAT math, reading, or spelling subtests (seeNote 1).

One possible explanation of the findings by Stellern et al. (1986) comes from thespeculation that hemispheric specialization for nonverbal tasks occurs by default, inconsequence of language development in LH space (LeDoux, Wilson, & Gazzaniga,1977). From this perspective, the left-hand (i.e., RH) tapping interferenceexperienced by the high WRAT performers would signify the typical JLOT RH defaultcondition, whereas the low WRAT performers' right-hand interference would implyincomplete LH language specialization, with consequent LH availability of functionalspace for JLOT processing. Such LH availability is consistent with evidence ofbihemispheric representation of spatial function in developmental dyslexia (Witelson,1977). It is also in keeping with research indicating that poor readers who are poorspellers (i.e., individuals with dyslexia) and good readers who are poor spellers (i.e.,individuals with dysgraphia) both show deficits in orthographic processing (Holmes &Ng, 1993; Maul & Ehri, 1991; Seymour, 1987). That is, an orthographic (spelling)deficit may be accompanied by an LH efficiency for nonverbal tasks requiring similarattention to detail (see Kolinsky, Morais, & Brito-Mendes, 1990; Martino & Winner,1995).

In the present study, this default hypothesis was tested by using the concurrenttapping/line orientation procedure with three groups of White early adolescentsdiffering in spelling ability: good readers/good spellers (GRGS), good readers/poorspellers (GRPS), and poor readers/poor spellers (PRPS). It was predicted thatconcurrent right-hand tapping disruption would be similar for both poor spellinggroups (GRPS and PRPS) and significantly higher than that of the good spellinggroup (GRGS) and, further, that concurrent left-hand tapping would be disrupted only


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in the GRGS group.

Method

Participants

Twelve good readers/poor spellers (GRPS), 12 poor readers/poor spellers (PRPS),and 12 good readers/good spellers (GRGS), ages 11-4 to 14-6, were selected fromsix schools located in Victoria, BC, Canada. All were White; all 12 PRPS groupmembers were boys. There were 5 boys in the GRPS group and 3 in the GRGSgroup. Teacher reports and psychoeducational assessments served to screen outparticipants whose academic deficit may have resulted from neurological, medical,socioeconomic, or emotional factors. Only right-handed participants were used, asidentified by questions adapted from the Edinburgh Inventory (Oldfield, 1971) inaccordance with a dual-task study of handedness and speech lateralizationconducted by Orsini, Satz, Soper, and Light (1985). Passage comprehension and

spelling subtests from the Woodcock-Johnson Psychoeducational Battery(Woodcock & Johnson, 1977) were used to establish reading and spelling levelsconsonant with the following criteria:

PRPS--reading and spelling at least 2 years below grade level;

GRPS--reading at or above grade level while spelling at least 2 years below gradelevel;

GRGS--reading at or above grade level while spelling at least 2 years above eithergrade or reading level.

Table 1 lists the means and standard deviations for age, reading, spelling, and gradelevel for the three groups. The mean reading score of the PRPS group wassignificantly less than that of the GRPS group, (22) = 72.6, p < .0001. The differencebetween the PRPS and GRPS spelling scores was also significant, (22) = 24.4, p < .0005. Thus, although both groups were poor spellers, PRPS participants were moreso--a result consistent with the findings of Frith (1980) and Jorm (1981). Incomparison to the GRGS, the GRPS group did not differ in reading, (22) = .10, p > .50, but scored significantly lower in spelling, (22) = 142.8, p < .0001. This result is inagreement with previous research findings that the spelling deficiencies ofadolescent GRPS participants do not affect reading comprehension (Bruck &Waters, 1988; Frith, 1980; Maul & Ehri, 1991).

Materials

The Judgment of Line Orientation Test (JLOT; Benton et al., 1978) was used toassess lateralization effects of visuospatial processing. This test examines the abilityto estimate angular relationships between line segments by visually matching angledline pairs to 11 numbered radii forming a semicircle (see Figure 1). The test consistsof 30 items, each showing a different pair of angled lines. Its two forms, H and V,
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present the same items, but in a different order.

Tapping was counted using a Gerbrands Model 1271-F recorder consisting of a 3-mm diameter button-switch mounted in a 4 x 2 x 1 inch box.

Procedure

The JLOT is usually administered as an untimed test with accuracy of line orientationas the measure of performance. However, to effectively measure the interference ofthis task with tapping rate, it was important to present the cards as quickly as theycould be processed. Pilot tests demonstrated that this could be accomplished bymounting the alternate forms, H and V, side by side in an 11 x 14-inch four-ringbinder. This procedure permitted a new design to be displayed while the participantwas solving the adjacent one. In this manner, there was no interruption in JLOT taskperformance from delays in the sequencing of card presentation.

Each child was tested individually by the same experimenter. Tapping duration for alltrials was 15 seconds. After 5 seconds of finger tapping practice, baseline single-taskfinger tapping rate was determined for each hand. The recorder was positioned sothat the participant could not see the counter. The first six cards of JLOT Form Hwere then administered as practice trials. The remaining three tasks were thenperformed in counterbalanced blocks of three trials each. Each block consisted of atrial in which the JLOT was performed by itself, a trial in which it was conjoined withleft-hand finger tapping, and a trial in which it was conjoined with right-hand fingertapping. Thus, each participant performed five trials: Trials 1 and 2 consisted oftapping in turn with the left and with the right index fingers; Trials 3, 4, and 5consisted of performing the JLOT without concurrent tapping, with concurrent left-hand tapping, and with concurrent right-hand tapping, respectively. The order in

which the hands were tested was counterbalanced within the three groups.

In the single-task tapping, the participant was instructed to tap with the index fingeras rapidly as possible. In the JLOT task, the participant was told to perform asaccurately as possible. Instructions for the dual-task condition emphasized equallythe tapping and JLOT tasks. In all trials, the participants were required to identifycorrect line choices by number, and the answers were tape-recorded for erroranalysis.

The degree to which tapping rate or JLOT solution rate was disrupted by theconcurrent task was represented by the difference between the right-handpercentage decrement and the left-hand percentage decrement. This was derived

from the following formula for each hand:

[(B-P)/B] x 100,

where B is the baseline performance (number of taps or lines judged), and P is thedual-task score. This measure of decrement has been found to be relativelyindependent of tapping baseline rate (Kinsbourne & Hiscock, 1983).


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Results

Tapping Rate

Baseline tapping performance (i.e., the number of taps with the right and left handswithout concurrent JLOT activity) was analyzed in a 3 (GRGS vs. GRPS vs. PRPS) x2 (hand) analysis of variance, with repeated measures on the second factor. Thisyielded a single main effect for hand, F(1,33) = 62.88, p < .0001. Paired -testanalysis showed that in each case the mean right-hand baseline tapping rate of eachgroup was significantly higher than that of the left hand (see Table 2).

Table 3 lists the means and standard deviations for the JLOT tapping decrementscores. A 3 (GRGS vs. GRPS vs. PRPS) x 2 (hand) analysis of variance, withrepeated measures on the second factor, was used to compare JLOT interferenceeffects between and within groups. The results indicated a significant interactionbetween groups and hand trials, F (2,33) = 4.40, p < .027. Probes of this interaction

showed that the GRGS mean right-hand tapping interference score (M = 3.00) was,as predicted, significantly lower than the GRPS mean, M = 9.83, (11) = 15.27, p < .005, and the PRPS mean, M = 12.08, (11) = 13.50, p < .005. There was nosignificant difference between PRPS and GRPS right-hand tapping interferencemeans, (11) = 0.72, p > .20. These results support the hypothesis that GRGS differsfrom both GRPS and PRPS in LH processing of line orientation judgment, as inferredfrom dual-task interference effects.

Unexpectedly, however, there was no significant difference among the left-handtapping decrement means of any of the three groups. Also, in contrast to the resultsobtained by Stellern et al. (1986), the GRGS participants in this study did notdemonstrate left-greater-than-right interference. Instead, the GRGS group showed

no significant between-hand difference in interference, (11) = .66, p > .20, incontrast to the difference observed with the GRPS group, (11) = 3.67, p < .005, andthe PRPS, (11) = 2.12, p < .05, groups. These findings provide no support for thehypothesis that visuospatial processing is lateralized to the RH by default.

Line Orientation Processing Rate

A 3 (GRGS vs. GRPS vs. PRPS) x 2 (hand) analysis of variance, with repeatedmeasures on the second factor, was used to determine whether one hand interferedmore than the other on the rate of JLOT processing. No significant effects werefound.

Line Orientation Processing Accuracy

Correct response on the JLOT was evaluated by a 3 (GRGS vs. GRPS vs. PRPS) x3 (left-hand vs. right-hand vs. no tapping) analysis of variance, where the repeatedmeasures included line judgment errors without concurrent tapping or with left-orright-hand tapping. This analysis yielded two significant effects. The main effect forgroup, F(2,33) = 3.45, p < .044, was attributable largely to the higher performance ofthe GRGS group under concurrent right-and left-hand tapping conditions. The main
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effect for condition (left-hand tapping vs. right-hand tapping vs. no tapping), F(2,33) =8.14, p < .001, reflects a differential effect of left-hand tapping on JLOT correctresponses across groups. Paired t -test analyses showed significant interferenceeffects only for the left hand in the GRPS, (1,11) = 6.77, p (2-tailed) < .05; thePRPS, (1,11) = 9.48, p (2-tailed) < .05; and the GRGS, (1,11) = 5.04, p (2-tailed)< .05, groups. These data indicate that the contrast in right-hand tappingperformance between good and poor spellers cannot be accounted for by trade-offsin the ability to correctly respond to the line orientation task. That is, there is noevidence that the GRGS group sacrificed the accuracy of their JLOT performance inorder to minimize right-hand tapping interference. The data also suggest that JLOTresponses in the poor spelling groups involved a degree of RH processing notdissimilar to that of the good spelling group.

Discussion

As anticipated, spelling rather than reading impairment predicted right-hand tapping

disruption during a concurrent line orientation judgment task. By implication, thiscould also have been the case with the right-hand interference observed by Stellernet al. (1986) in First Nations students deficient in at least two unspecified subtests ofthe WRAT. Unexpectedly, however, the good readers/good spellers (GRGS) in thepresent study did not demonstrate the same left-hand interference observed byStellern et al. in their high-performing students. Instead, the left-hand tappingdecrement of the GRGS group was not significantly different from either their ownright-hand score or the left-hand score of the poor spelling groups. Similar bilaterallysymmetrical interference was found in a study of White average readers (Grades 2-5) that used a modified version of the JLOT (Hiscock, Antoniuk, Prisciak, & vonHessert, 1985). The reason for this cultural difference is unclear. Perhaps there wasa relative inattentiveness on the part of White participants with this visuospatial task.

For example, McShane and Plas (1984) noted that "the ability of WISC-Rperformance scale subtests to predict achievement gains in such verbally-orientedareas as reading and language, may represent an over-utilization of spatialprocessing strengths on the part of [American] Indian children" (p. 64). If visuospatialprocessing does occur in the RH by default, as LeDoux et al. (1977) speculated, it isnot apparent in the present group of White participants using this dual-taskprocedure. Instead, the GRGS group's bilaterally equal interference observed in thisstudy, and in that by Hiscock et al. (1985), suggests that both the LH and the RHnormally participate in JLOT processing. This eventuality is consistent with severalstudies that have attempted to determine the separate contributions of the twohemispheres in solving this task (Kim, Morrow, Passafiume, & Boller, 1984; Gur etal., 2000; Mehta & Newcombe, 1991; Mehta, Newcombe, & Damasio, 1987; Ng et

al., 2000).

The present experiment controlled for age, ethnic origin, and handedness, but not forgender, as the numbers of boys in each group were highly unequal (12 PRPS, 5GRPS, and 3 GRGS). However, it is unlikely that this difference was a significantsource of variation, because the group contrasts in gender distribution predict thatthe JLOT performance of the GRPS group should be closer to that of the GRGSgroup than that of the PRPS group. That is, the PRPS group consisted entirely ofboys, whereas a majority of girls were present in both of the other groups.
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Furthermore, Hiscock et al. (1985), studying good readers in Grades 2 to 5, foundthat boys performed more accurately than girls in a dual-task line orientation

judgment experiment, and with significantly less disruption in tapping. These effectsare in the opposite direction to those encountered in the present study.

How, then, to explain the right-hand tapping disruption of the poor spelling groupsduring dual-task processing? To begin with, Eden, Stein, Wood, and Wood (1996)found that the incidence of reversed scanning (right to left rather than left to right) ofJLOT stimuli by Grade 5 students with reading disabilities was related to lowperformance on this task. Right-to-left scanning is more typical of RH than of LHoculomotor control (Girotti, Casazza, Musicco, & Avanzini, 1983; Ogden, Mateer, &Wyler, 1984) and, congruently, line orientation processing by individuals withdyslexia disproportionately favors the RH (Rumsey et al., 1987; Shaywitz et al.,1998) and underactivates LH frontal areas (Rumsey et al., 1987). Moreover, LHfrontal lesions impair JLOT processing (Kim et al., 1984), consistent with theimportance of anterior brain regions for visual scanning (Luria, 1966). Thus, althoughthe poor spellers in the present study showed no deficits on the JLOT task, LHprocessing (scanning) may have been more effortful or less automatic (seeWiegersma & Wijnmaalen, 1991), indirectly interfering with right-hand tapping. Thisexplanation is consistent with the observation of Hiscock et al. (1985) that "childrenappear to 'protect' their nonmanual performance at the expense of their performanceon the tapping task" (p. 44).

The idea that atypical scanning may have something to do with faulty spellingreceives added support from a variety of convergent sources. First, in Eden et al.'s(1996) study, reversed (i.e., right-to-left) JLOT scanning by Grade 5 childrencorrelated negatively with reading level (see Note 2). Concordantly, readingdeficiency and academic delay has been shown to be associated, respectively, withless orderly left-to-right scanning of pseudowords (Schwantes, 1979) andunsystematic scanning of nonverbal stimuli (Locher & Worms, 1981). As Morrisonand Manis (1982) concluded in an integrative critique of reading disability research,"deficits appear to be most pronounced in tasks requiring rapid scanning, encoding,and rehearsal of multiple-stimulus arrays, whether the arrays are composed of verbalor nonverbal stimuli" (p. 85).

Second, First Nations elementary school low achievers have been found to benefitfrom training with numeric matrices stimulating the top-to-bottom, left-to-rightscanning patterns required for reading Western languages (Krywaniuk & Das, 1976).Third, in preschoolers, attention to the left-right order of information contributes to theprevention of mirror-image confusion (Casey, 1986). Although such confusion is notuncommon in the early writings of typical readers, individuals with dyslexia areunique in displaying a greater quantity over a longer period of time (Critchley, 1970;Eisenberg, 1966; Sidman & Kirk, 1974; see Note 3).

Fourth, poor spellers/good readers have difficulty remembering the order of letterswithin words (Holmes & Ng, 1993; Romani, Ward, & Olson, 1999) as well as theorder of an array of meaningless shapes (Romani et al., 1999). Analogous difficultiesemerge in individuals with reading disabilities during later (450-2,000 ms) rather thanearlier (0-300 ms) visual processing stages (Morrison, Giordani, & Nagy, 1977) and


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appear to reflect less systematic and orderly scanning strategies (Schwantes, 1979).Indeed, later processing stages may well be more critical for spelling (which requiresrehearsal from memory) than for reading (which does not), explaining why theorthographic strategies of individuals with dysgraphia tend to fail in spelling but not inreading (Frith, 1985; Hodgson & Johnson, 1993). Furthermore, good readers(Baddeley, 1986) but not poor readers (Mitterer, 1982) are able to retainmeaningless sequences of letters in a visual store that is immune to articulatorysuppression. Presumably, this visual store also serves in the retention of nonverbalstimuli (see Morrison et al., 1977), including line orientations. Neuroanatomically, itmay be located in the pars triangularis region (Brodman Area 45) of the frontal lobe(Mather, 2001), consistent with the LH

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