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Invited Address: E. Mark Mahone, PhD—Development of Late-Onset Problems With Reading Fluency and Comprehension: Lessons Learned From Neuroimaging, Electrophysiology, and Assessment of Executive and Motor Control Assessment in Children

CE Credit: 1

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Length: 50 minutes

Session offered by Division 40.

In upper-elementary grades and beyond, students are expected to independently read (and learn from) longer, more challenging texts than at younger ages. The goal of this presentation is to demonstrate how processing speed and working memory deficits associated with ADHD impact reading fluency and comprehension. The emphasis is on children grades 4-8 who do not have basic word reading difficulties. This presentation will report findings from neuropsychological and brain mapping techniques in examining brain-behavior relationships underlying ADHD-related processing speed and working memory deficits, and their contribution to reading.

First, children with ADHD have slowed response times on nearly all speeded tasks. Results from investigation of reaction time suggest a delay (slowing) in “response selection/preparation” process among children with ADHD, which is consistent with neuroimaging evidence showing anomalous development of the supplementary motor cortex, thought to be responsible for response control and efficiency of reading. Using neuropsychological assessment, electrophysiology (event-related potentials), and diffusion tensor imaging, we have begun to identify the neurobiological sources of this cognitive slowing among children with ADHD, and have demonstrated how introduction of moderate levels of unpredictability (i.e., “jittering” stimulus cues) may facilitate recruitment of premotor brain circuits (readiness to respond), that may have therapeutic implications for reading fluency.

Second, even children who read accurately may not understand what they read because of executive dysfunction—including working memory limitations, poor inference making, and ineffective comprehension monitoring. Verbal working memory has been linked to reading comprehension (over and above word recognition and language skills). Using event-related functional MRI (fMRI) we examined the relationship between activation associated with mental manipulation of verbal information and reading comprehension. Prefrontal activation associated with verbal working memory predicted reading comprehension, particularly on tests requiring “unsupported” listening. Such formats may place greater demands on working memory, leaving students with ADHD at a disadvantage.

Learning Objective 1
Define processing speed as a component of response preparation (within executive function), and describe how slowed processing speed (associated with ADHD) contributes to inefficient reading efficiency, textual fluency, and (ultimately) reading comprehension, even in the absence of basic word reading deficits.

Learning Objective 2
Comprehend the core elements of working memory and how deficits in working memory (associated w/ADHD) contribute to reading comprehension problems children of late-elementary school age and beyond.

Presenters: E. Mark Mahone, PhD


Supplementary Materials

  • Mahone