Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
In early childhood, symptoms that correlate with a later diagnosis of dyslexia include delayed onset of speech and a lack of phonological awareness, as well as being easily distracted by background noise. A common myth closely associates dyslexia with mirror writing and reading letters or words backwards. These behaviors are seen in many children as they learn to read and write, and are not considered to be defining characteristics of dyslexia.
School-age children with dyslexia may exhibit signs of difficulty in identifying or generating rhyming words, or counting the number of syllables in words – both of which depend on phonological awareness. They may also show difficulty in segmenting words into individual sounds or may blend sounds when producing words, indicating reduced phonemic awareness. Difficulties with word retrieval or naming things is also associated with dyslexia. People with dyslexia are commonly poor spellers, a feature sometimes called dysorthographia or dysgraphia, which depends on orthographic coding.
Problems persist into adolescence and adulthood and may accompany difficulties with summarizing stories, memorization, reading aloud, or learning foreign languages. Adults with dyslexia can often read with good comprehension, though they tend to read more slowly than others without a learning difficulty and perform worse in spelling tests or when reading nonsense words – a measure of phonological awareness.
Central dyslexias include surface dyslexia, semantic dyslexia, phonological dyslexia, and deep dyslexia. ICD-10 reclassified the previous distinction between dyslexia (315.02 in ICD-9) and alexia (315.01 in ICD-9) into a single classification as R48.0. The terms are applied to developmental dyslexia and inherited dyslexia along with developmental aphasia and inherited alexia, which are considered synonymous.
National Institute of Neurological Disorders and Stroke defines reading disability or dyslexia as follows: "Dyslexia is a brain-based type of learning disability that specifically impairs a person's ability to read. These individuals typically read at levels significantly lower than expected despite having normal intelligence. Although the disorder varies from person to person, common characteristics among people with dyslexia are difficulty with spelling, phonological processing (the manipulation of sounds), and/or rapid visual-verbal responding. In adults, dyslexia usually occurs after a brain injury or in the context of dementia. It can also be inherited in some families, and recent studies have identified a number of genes that may predispose an individual to developing dyslexia."
The NINDS definition is not in keeping with the bulk of scientific studies that conclude that there is no evidence to suggest that dyslexia and intelligence are related. The Rose Review 2009 Definition is more in keeping with modern research and debunked discrepancy model of dyslexia diagnosis:
- Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling.
- Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed.
- Dyslexia occurs across the range of intellectual abilities.
- It is best thought of as a continuum, not a distinct category, and there are no clear cut-off points.
- Co-occurring difficulties may be seen in aspects of language, motor co-ordination, mental calculation, concentration and personal organisation, but these are not, by themselves, markers of dyslexia.
- A good indication of the severity and persistence of dyslexic difficulties can be gained by examining how the individual responds or has responded to well founded intervention.
Dysgraphia is nearly always accompanied by other learning differences such as dyslexia or attention deficit disorder, and this can impact the type of dysgraphia a person might have. There are three principal subtypes of dysgraphia that are recognized. There is little information available about different types of dysgraphia and there are likely more subtypes than the ones listed below. Some children may have a combination of two or more of these, and individual symptoms may vary in presentation from what is described here. Most common presentation is a motor dysgraphia/agraphia resulting from damage to some part of the motor cortex in the parietal lobes.
Dyslexia is a learning disability that manifests itself as a difficulty with word decoding and/or reading fluency. Comprehension may be affected as a result of difficulties with decoding, but is not a primary feature of dyslexia. It is separate and distinct from reading difficulties resulting from other causes, such as a non-neurological deficiency with vision or hearing, or from poor or inadequate reading instruction. It is estimated that dyslexia affects between 5–17% of the population. Dyslexia has been proposed to have three cognitive subtypes (auditory, visual and attentional), although individual cases of dyslexia are better explained by the underlying neuropsychological deficits and co-occurring learning disabilities (e.g. attention-deficit/hyperactivity disorder, math disability, etc.). Although not an intellectual disability, it is considered both a learning disability and a reading disability.
Dyslexia and IQ are not interrelated, since reading and cognition develop independently in individuals who have dyslexia."Nerve problems can cause damage to the control of eye muscles which can also cause diplopia" (WEBMD, 2005)
Surface dyslexia is a type of dyslexia, or reading disorder. According to Marshall & Newcombe's (1973) and McCarthy & Warrington's study (1990), patients with this kind of disorder cannot recognize a word as a whole due to the damage of the left parietal or temporal lobe. Individuals with surface dyslexia are unable to recognize a word as a whole word and retrieve its pronunciation from memory. Rather, individuals with surface dyslexia rely on pronunciation rules. Thus, patients with this particular type of reading disorder read non-words fluently, like "yatchet", but struggle with words that defy pronunciation rules (i.e. exception words). For example, a patient with surface dyslexia can correctly read regular words like "mint", but will err when presented a word that disobeys typical pronunciation rules, like "pint". Often, semantic knowledge is preserved in individuals with surface dyslexia.
There are some common problems not related to dysgraphia but often associated with dysgraphia, the most common of which is stress. Often children (and adults) with dysgraphia will become extremely frustrated with the task of writing (and spelling); younger children may cry, pout, or refuse to complete written assignments. This frustration can cause the child (or adult) a great deal of stress and can lead to stress-related illnesses. This can be a result of any symptom of dysgraphia.
Research on subtypes of dyscalculia has begun without consensus; preliminary research has focused on comorbid learning disorders as subtyping candidates. The most common comorbidity in individuals with dyscalculia is dyslexia. Most studies done with comorbid samples versus dyscalculic-only samples have shown different mechanisms at work and additive effects of comorbidity, indicating that such subtyping may not be helpful in diagnosing dyscalculia. But there is variability in results at present.
Due to high comorbidity with other disabilities such as dyslexia and ADHD, some researchers have suggested the possibility of subtypes of mathematical disabilities with different underlying profiles and causes. Whether a particular subtype is specifically termed "dyscalculia" as opposed to a more general mathematical learning disability is somewhat under debate in the scientific literature.
- Semantic memory: This subtype often coexists with reading disabilities such as dyslexia and is characterized by poor representation and retrieval from long-term memory. These processes share a common neural pathway in the left angular gyrus, which has been shown to be selective in arithmetic fact retrieval strategies and symbolic magnitude judgments. This region also shows low functional connectivity with language-related areas during phonological processing in adults with dyslexia. Thus, disruption to the left angular gyrus can cause both reading impairments and difficulties in calculation. This has been observed in individuals with Gerstmann syndrome, of which dyscalculia is one of constellation of symptoms.
- Procedural concepts: Research by Geary has shown that in addition to increased problems with fact retrieval, children with math disabilities may rely on immature computational strategies. Specifically, children with mathematical disabilities showed poor command of counting strategies unrelated to their ability to retrieve numeric facts. This research notes that it is difficult to discern whether poor conceptual knowledge is indicative of a qualitative deficit in number processing or simply a delay in typical mathematical development.
- Working memory: Studies have found that children with dyscalculia showed impaired performance on working memory tasks compared to neurotypical children. Furthermore, research has shown that children with dyscalculia have weaker activation of the intraparietal sulcus during visuospatial working memory tasks. Brain activity in this region during such tasks has been linked to overall arithmetic performance, indicating that numerical and working memory functions may converge in the intraparietal sulcus. However, working memory problems are confounded with domain-general learning difficulties, thus these deficits may not be specific to dyscalculia but rather may reflect a greater learning deficit. Dysfunction in prefrontal regions may also lead to deficits in working memory and other executive function, accounting for comorbidity with ADHD.
Studies have also shown indications of causes due to congenital or hereditary disorders, but evidence of this is not yet concrete.
Deep dyslexia is usually classified as an "acquired reading disorder", as opposed to a "developmental dyslexia", in previously literate adults as a consequence of a brain injury. However, recently, developmental deep dyslexia has also been reported in children with Williams syndrome.
Deep dyslexia is considered to be a "central dyslexia" as compared to a "peripheral dyslexia". Peripheral dyslexics have difficulty matching the visual characteristics of letters that comprise a word to a stored memory of this word from prior encounters. Central dyslexics are unable to properly match the visual word to the word's meaning. They may also be incapable of speaking, or phonating, the sequence of written letters that they see into the word these letters represent. Deep dyslexia differs from other forms of central dyslexia (phonological dyslexia and surface dyslexia) in that deep dyslexics have many more symptoms and these symptoms are generally more severe. According to the "continuum" hypothesis, deep dyslexia is a more severe form of phonological dyslexia.
Language-based learning disabilities or LBLD are "heterogeneous" neurological differences that can affect skills such as listening, reasoning, speaking, reading, writing, and maths calculations. It is also associated with movement, coordination, and direct attention. LBLD is not usually identified until the child reaches school age. Most people with this disability find it hard to communicate, to express ideas efficiently and what they say may be ambiguous and hard to understand
It is a neurological difference. It is often hereditary, and is frequently associated to specific language problems.
There are two types of learning disabilities: non-verbal, which includes disabilities from psychomotor difficulties to dyscalculia, and verbal, language based.
The word hyperlexia is derived from the Greek terms "hyper" ("over") and "léxis" ("diction", "word").
Developmental language disorder (DLD) is identified when a child has problems with language development that continue into school age and beyond. The language problems have a significant impact on everyday social interactions or educational progress, and occur in the absence of autism spectrum disorder, intellectual disability or a known biomedical condition. The most obvious problems are difficulties in using words and sentences to express meanings, but for many children, understanding of language (receptive language) is also a challenge, although this may not be evident unless the child is given a formal assessment.
Deep dyslexia is mainly characterized by the occurrence of semantic reading errors or semantic paralexias (transposition of letters or words) when reading aloud (e.g. the written word "view" is read aloud as "scene", the word "bird" is read as "canary"). These semantic errors are the major distinguishing feature of deep dyslexia in comparison to other central dyslexias. There are many other symptoms of deep dyslexia, including visual errors (e.g. the written word "thing" is read aloud as "think", the word "skate" is read as "scale") and derivational errors (e.g. the written word "alcohol" is read aloud as "alcoholic", the word "governor" is read as "government"), and poor reading of function words. Additionally, deep dyslexics have more difficulty reading abstract than concrete and highly imaginable words, more difficulty reading adjectives, adverbs, and verbs than nouns, a complete inability to read non-words, and often impairments on tasks of verbal working memory.
While the symptoms of deep dyslexia listed above are different and independent impairments of reading, it is rare to find an individual who only displays some of the characteristics of it; indeed, most patients presenting with semantic paralexias, a hallmark symptom of the disorder, also demonstrate all of the other symptoms. This has resulted in deep dyslexia being considered a symptom-complex and has led to much research into why this variety of symptoms may co-occur in so many patients.
Speech is the act of articulating sounds, and this can be impaired for all kinds of reasons – a structural problem such as cleft lip and cleft palate, a neurological problem affecting motor control of the speech apparatus Dysarthria, or inability to perceive distinctions between sounds because of Hearing loss. Some distortions of speech sounds, such as a Lisp, are commonly seen in young children. These misarticulations should not be confused with language problems, which involve the ability to select and combine linguistic elements to express meanings, and the ability to comprehend meanings.
Although speech disorders can be distinguished from language disorders, they can also co-occur. When a child fails to produce distinctions between speech sounds for no obvious reason, this is typically regarded as a language problem affecting the learning of phonological contrasts. The classification of and terminology for disorders of speech sound production is a subject of considerable debate. In practice, even for those with specialist skills, it is not always easy to distinguish between phonological disorders and other types of speech production problem.
Speech sound disorder (SSD) is a general term for problems with speech production arising from any cause.
Speech Sound Disorders of unknown cause that are not accompanied by other language problems are a relatively common reason for young children to be referred to speech-language therapy (speech-language pathology). These often resolve by around 4-5 years of age with specialist intervention, and so would not meet criteria for DLD. Where such problems continue beyond 5 years of age, they are usually accompanied by problems in broader language domains and have a poorer prognosis, so a diagnosis of DLD with SSD is then appropriate.
Although textbooks draw clear boundaries between different neurodevelopmental disorders, there is much debate about overlaps between them. Many children with SLI meet diagnostic criteria for developmental dyslexia, and others have features of autism.
At its most basic level, dyscalculia is a learning disability affecting the normal development of arithmetic skills.
A consensus has not yet been reached on appropriate diagnostic criteria for dyscalculia. Mathematics is a specific domain that is complex (i.e. includes many different processes, such as arithmetic, algebra, word problems, geometry, etc.) and cumulative (i.e. the processes build on each other such that mastery of an advanced skill requires mastery of many basic skills). Thus dyscalculia can be diagnosed using different criteria, and frequently is; this variety in diagnostic criteria leads to variability in identified samples, and thus variability in research findings regarding dyscalculia.
Other than using achievement tests as diagnostic criteria, researchers often rely on domain-specific tests (i.e. tests of working memory, executive function, inhibition, intelligence, etc.) and teacher evaluations to create a more comprehensive diagnosis. Alternatively, fMRI research has shown that the brains of the neurotypical children can be reliably distinguished from the brains of the dyscalculic children based on the activation in the prefrontal cortex. However, due to the cost and time limitations associated with brain and neural research, these methods will likely not be incorporated into diagnostic criteria despite their effectiveness.
Although hyperlexic children usually learn to read in a non-communicative way, several studies have shown that they can acquire reading comprehension and communicative language after the onset of hyperlexia. They follow a different developmental trajectory relative to neurotypical individuals, with milestones being acquired in a different order. Despite hyperlexic children's precocious reading ability, they may struggle to communicate. Often, hyperlexic children will have a precocious ability to read but will learn to speak only by rote and heavy repetition, and may also have difficulty learning the rules of language from examples or from trial and error, which may result in social problems. Their language may develop using echolalia, often repeating words and sentences. Often, the child has a large vocabulary and can identify many objects and pictures, but cannot put their language skills to good use. Spontaneous language is lacking and their pragmatic speech is delayed. Hyperlexic children often struggle with Who? What? Where? Why? and How? questions. Between the ages of 4 and 5 years old, many children make great strides in communicating.
The social skills of a child with hyperlexia often lag tremendously. Hyperlexic children often have far less interest in playing with other children than do their peers.
Phonological dyslexia is a reading disability that is a form of alexia (acquired dyslexia), resulting from brain injury, stroke, or progressive illness and that affects previously acquired reading abilities. The major distinguishing symptom of acquired phonological dyslexia is that a selective impairment of the ability to read pronounceable non-words occurs although the ability to read familiar words is not affected. It has also been found that the ability to read non-words can be improved if the non-words belong to a family of pseudohomophones.
SLI is defined purely in behavioural terms: there is no biological test for SLI. There are three points that need to be met for a diagnosis of SLI:
- The child has language difficulties that interfere with daily life or academic progress
- Other causes are excluded: the problems cannot be explained in terms of hearing loss, general developmental delay, autism, or physical difficulty in speaking
- Performance on a standardized language test (see Assessment, below) is significantly below age level
There is considerable variation in how this last criterion is implemented. Tombin et al. (1996) proposed the EpiSLI criterion, based on five composite scores representing performance in three domains of language (vocabulary, grammar, and narration) and two modalities (comprehension and production). Children scoring in the lowest 10% on two or more composite scores are identified as having language disorder.
LBLD consists of dyscalculia which comprises the reading of numbers sequentially, learning the time table, and telling time;
dyslexia; and difficulties associated with written language such as trouble learning new vocabulary, letters and alphabets. Auditory processing disorders can cause trouble understanding questions and following directions, understanding and remembering the details of a story's plot or a classroom lecture, learning words to songs and rhymes, telling left from right, and having a hard time with reading and writing .
Difficulties associated with reading and spoken language involve trouble understanding questions and following directions, understanding and retaining the details of a story's plot or a classroom lecture, nonword repetition, learning words to songs and rhymes, and identifying the sounds that correspond to letters, which makes learning to read difficult
Difficulties associated with motor skills include difficulty telling left from right which is part of motor incoordination, visual perceptual problems, and memory problem
Semantic dyslexia is, as the name suggests, a subtype of the group of cognitive disorders known as alexia (acquired dyslexia). Those who suffer from semantic dyslexia are unable to properly attach words to their meanings in reading and/or speech. When confronted with the word "diamond", they may understand it as "sapphire", "shiny" or "diamonds"; when asking for a bus ticket, they may ask for some paper or simply "a thing".
Semantic dementia (SD) is a degenerative disease characterized by atrophy of anterior temporal regions (the primary auditory cortex; process auditory information) and progressive loss of semantic memory. SD patients often present with surface dyslexia, a relatively selective impairment in reading low-frequency words with exceptional or atypical spelling-to-sound correspondences.
Deficits in any area of information processing can manifest in a variety of specific learning disabilities. It is possible for an individual to have more than one of these difficulties. This is referred to as comorbidity or co-occurrence of learning disabilities. In the UK, the term "dual diagnosis" is often used to refer to co-occurrence of learning difficulties.
Developmental verbal dyspraxia (DVD) is a type of ideational dyspraxia, causing speech and language impairments. This is the favoured term in the UK; however, it is also sometimes referred to as articulatory dyspraxia, and in the United States the usual term is childhood apraxia of speech (CAS).
Key problems include:
- Difficulties controlling the speech organs.
- Difficulties making speech sounds
- Difficulty sequencing sounds
- Within a word
- Forming words into sentences
- Difficulty controlling breathing, suppressing salivation and phonation when talking or singing with lyrics.
- Slow language development
Fine-motor problems can cause difficulty with a wide variety of other tasks such as using a knife and fork, fastening buttons and shoelaces, cooking, brushing one's teeth, styling one's hair, shaving, applying cosmetics, opening jars and packets, locking and unlocking doors, and doing housework.
Difficulties with fine motor co-ordination lead to problems with handwriting, which may be due to either ideational or ideo-motor difficulties.
Problems associated with this area may include:
- Learning basic movement patterns.
- Developing a desired writing speed.
- Establishing the correct pencil grip
- The acquisition of graphemes – e.g. the letters of the Latin alphabet, as well as numbers.
According to both the American Association on Intellectual and Developmental Disabilities("Intellectual Disability: Definition, Classification, and Systems of Supports (11th Edition") and the American Psychiatric Association "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV), three criteria must be met for a diagnosis of intellectual disability: significant limitation in general mental abilities (intellectual functioning), significant limitations in one or more areas of adaptive behavior across multiple environments (as measured by an adaptive behavior rating scale, i.e. communication, self-help skills, interpersonal skills, and more), and evidence that the limitations became apparent in childhood or adolescence. In general, people with intellectual disability have an IQ below 70, but clinical discretion may be necessary for individuals who have a somewhat higher IQ but severe impairment in adaptive functioning.
It is formally diagnosed by an assessment of IQ and adaptive behavior. A third condition requiring onset during the developmental period is used to distinguish intellectual disability from other conditions dementia such as Alzheimer's disease or traumatic brain injuries.