Rate- and accuracy-disabled subtype profiles among adults with dyslexia in the Hebrew orthography

This study examined a subtyping scheme rooted in the dissociation between reading rate and accuracy in an exceptionally large sample of adult readers with dyslexia using a wide variety of behavioral and event-related potential (ERP) measures. Stage 1 was a behavioral study, in which basic reading skill, reading comprehension, linguistic and cognitive tasks were administered to 661 learning-disabled university students (n = 382) and their non-learning-disabled peers (n = 279). Based on a word reading measure, accuracy-disabled and rate-disabled subgroups were identified, as was a subgroup with deficits in both rate and accuracy. The results support the persistence of a rate versus accuracy dissociation into adulthood. Accuracy disability was related to a broad range of deficits affecting phonological, orthographic, and morphological processing, verbal memory, attention, and reading comprehension. Rate disability appeared to be associated with slower processing of printed material, alongside largely intact functioning resembling those of skilled readers. In stage 2, electroencephalogram (EEG)-ERP measurements were obtained from 140 participants recruited from the larger sample. Activation in visual association cortex, indicated by the N170 amplitude, was found to be lower for accuracy-disabled than skilled readers, and comparable between rate-disabled and skilled readers. The lowest amplitude was found in the double-deficit subgroup. The findings support the existence of distinctive reading disability profiles, based on selective deficits in reading rate versus accuracy and associated with different basic reading, linguistic, and cognitive skills as well as electrophysiological responses.