A hierarchical deficit model of reading disability: Evidence from dynamic causal modelling analysis

Deficits have been documented in visuo-orthographic processing as well as phonological retrieval/manipulation during visual word reading in individuals with reading disability (RD); however, the relationship between these deficits remains unclear. Previously, we found that during word reading, visuo-orthographic deficit appears to be a neural signature of RD, but deficits in phonological retrieval/manipulation appears to be a consequence of being RD (Cao et al., 2020). Therefore, in the current study, we directly tested the hypothesis that during visual word reading, deficit in phonological retrieval/manipulation may result from weakened input from visuo-orthographic regions, and that this relationship tends to be universal across languages. We conducted a dynamic causal modelling analysis of fMRI data from Chinese-English bilingual children (9-11 years, N = 78) with or without RD during a visual word rhyming judgment task. We found a weaker connection from the left inferior temporal gyrus (ITG) to the left dorsal inferior frontal gyrus (dIFG) in children with RD and reading controls than the connection found in age controls for both Chinese and English. This finding suggests that the phonological deficit at the dIFG may result from weak input from the visuo-orthographic region and this connection appears to be responsive to reading level rather than RD, because the reading-control children were similar to children with RD. We also found that the left ITG was selectively connected with language-specific regions (i.e., the left inferior parietal lobe (IPL) for Chinese and the left ventral inferior frontal gyrus (vIFG) for English) depending on the language being processed; however, this language selectivity was reduced in children with RD, suggesting that decreased language specialization is associated with RD. Using a double control design, our study suggests that during reading, the visuo-orthographic deficit of RD constrains the development of the connection from orthography to phonology and to other language-specific processing due to distorted quantity and quality of reading.