Heikki Lyytinen Agora Centre & Department of Psychology University of Jyväskylä

1. Early identification and prevention of difficulties in the acquisition of basic scholastic skills – reading and math Heikki Lyytinen Agora Centre & Department of Psychology University of Jyväskylä Niilo Mäki Institute Finland Stockholm, 25. October, 2012

2. Overview of the content of this presentation • Learning to readhighlytransparentorthography • The developmental association betweenspoken and writtenlanguageskills– highlightsfromthe Jyväskylä Longitudinalstudy of Dyslexia (JLD) • Introduction to the JLD: goals and design • Overview of the predictiverelations and theirmodelling • Earlyidentification of children in need of support • Supportingreadingacquisition .. Learning the connectionsbetweenspokenand writtenlanguageusing a learninggame - Graphogame

3. The concept of reading skill Basic readingskill – ability to pronouncewrittenwordsaccurately Literacy – readiness to comprehendfluentlywrittenlanguage; requires sufficientmasteryof the spokenlanguagemeant to belearned to read accurate and fluentbasicdecodingskill a lot of reading to acquirefunctionalreadingskill appropriatevocabularyknowledge, motivation and strategyto comprehend the writtenlanguage

4. Development of nonword reading accuracy during 1st Grade in different orthographies (Scottish data up to 2nd grade) Before school and then in equal time steps to the end of the 2.grade Results from COST A8, Seymour, et al. 2003

5. Readingacquisition and the consistency of the connectionsbetweenspoken and writtenlanguage If the readinginstruction is organizedas itshould… the timechildneeds for the acquisition of the basicreadingskill is the shorter the smaller the number of connectionsonehas to learn(Finnish, Swedish.. < 30 letter-sounds) the moreconsistentare the connections, ie. the fewercomplexities/alternativesneed to belearned and the moreoptimallybuiltphonicsinstructionis available for successfullyengaging the child in training the skill

6. ..when biological factors compromise reading acquisition.. Jyväskylä Longitudinalstudy of Dyslexia (JLD; 1993-)The JLD researchgroupMikko Aro, Timo Ahonen, Kenneth Eklund, Tomi Guttorm, Jarmo Hämäläinen, Ritva Ketonen, Marja-Leena Laakso, Seija Leinonen, Matti Leiwo, Paavo Leppänen, Paula Lyytinen, Kurt Muller, Anna-Maija Poikkeus, Anne Puolakanaho, Ulla Richardson, Paula Salmi, Asko Tolvanen, Minna Torppa, Helena Viholainen

7. The goals of the JLD • to identify (from children at familial risk for dyslexia) • precursors of dyslexia • predictors of compromised acquisition • developmental paths leading to dyslexia • The last step: the development of preventive measures

8. DEFINING FAMILIAL RISK IN THE JYVÄSKYLÄ LONGITUDINAL STUDY OF DYSLEXIA (JLD) • SELECTION CRITERIA FOR THE AT-RISK FAMILIES: parents • At least one parent with diagnosed dyslexia from multiple criteria • Reported dyslexia among at least one of the first degree relatives • IQ at least 85 (Raven matrices) • No reported language problems in childhood or later • No neurological or psychiatric symptoms • No hearing problems For detals, see Leinonen et al. Reading and Writing, 2001

9. AT -RISK GROUP N=108 children CONTROL GROUP N=92 children Number of children who have attended the last originally agreed assessment phase at the 3rd grade Born at the hospitals of Central Finland during 01.04.93-31.07.96 N= 9368 infants I Screening II Screening III Screening Short questionnaire administered at the maternity clinics N=8427 parents Compre-hensive questionnaire N=3146 parents AT -RISK GROUP N=117 infants Assessment of parents’ reading and spelling skills N=410 parents CONTROL GROUP N=105 infants Collection of the data continues VII grade VIII grade IX grade II grade III grade 14 month I grade Neo- natal 6 month 18 month 2 years 2½ years 3½years 4½ years 5 years 5½years 6½years N = 85 N = 101 N = 76 N = 108 N = 108 N = 107 N = 107 N = 107 N = 107 N = 107 N = 107 N = 107 N = 107 N = 112 N = 108 N = 108 N = 107 N = 66 N = 81 N = 73 N = 92 N = 93 N = 96 N = 94 N = 95 N = 93 N = 93 N = 93 N = 92 N = 92 N = 96 N = 94 N = 94 N = 95 N = 1537 N = 1508 N = 1515 N = 2859 CLASSMATES

10. Measures taken at the end of the 2th grade at the averate age of 8 y. 9 months Criteria of dyslexia among children Reading speed Reading 3 and 4 syllabic words and non words – mean response time Reading text – read words / minute Reading non word text – read words / minute Reading word list, standardized test – correctly read words in two minutes Reading and writing accuracy Reading 3 and 4 syllabic words and non words – correct / 40 Reading text – percentage of correctly read words Reading non word text – percentage of correctly read words Spelling words and non words – correct / 18 Criteria • A child was diagnosed as dyslexic, if he / she scored below or at the 10 percentile of the contol group in at least • Three out of four speed measures OR • Three out of four accuracy measures OR • Two speed AND two accuracy measures

11. The reading status of children born at familial risk for dyslexia at school age • Expectation of the geneticinfluences • > 1/2 wouldbeaffected (due to 1 parent’sdyslexia) • The observedresult: 42 /107 • compromisedinitialreadingacquisition 48 / 107 • severe, persistentreadingdisorder42 / 107

12. Children with reading disability 1st gr 2nd gr 3rd gr 8th gr At risk group N = 36 N = 42 N = 38 N = 38 N=108 1st gr 2nd gr 3rd gr 8th gr Control group N = 10 N = 12 N = 9 N = 10 N=92

13. IDENTIFYING & PREDICTING RISK a summary of significant measures P = Predictors D = Differences between groups AgeVariable 7 - yrs Reading accuracy & speed D 5 - yrs Naming speed P & D 4 - 6 yrs Phonological manipulation P & D 5 - 6 yrs Letter knowledge P & D 5 - yrs Verbal memory P & D 3 - 6 yrs Phonological sensitivity P & D 3 - 5 yrs Inflectional skills P & D 2 - 3 yrs Articulation accuracy P 2 yrs Maximum sentence length P & D 6 mth Speech perception P & D Birth ERP to speech sound P & D Lyytinen et al., Annals of Dyslexia, 2004; Dyslexia, 2004; Sage Handbook of Dyslexia, 2008

14. METHODS – ERP recording From: F3, F4, C3, C4, P3, P4 (Ag/AgCl-electrodes), referred to ipsilateral mastoid Bandpass: 0.5-35 Hz, sampling rate 200 Hz

15. Prediction for the very early ERPs Predictors: ERP responses to speech sounds which significantly differentiate children with and without risk Criterion measures: The most important language measures that predict early reading skills and early reading

16. EogL EogR _ 5 µV + F3 F4 500ms C3 C4 P3 P4 Newborn ERPs in the at-risk group Boston Naming Test 5.5 y -.311* Audio-phonemic associations 5.5 y -.451* Rapid Naming: Faults 6.5 y .414* Word identification 6.5 y -.308* Phoneme Deletion 6.5 y -.339* Naming 1st Phoneme 6.5 y -.342* Letter identification 6.5 y -.339* 540-630 ms Word identification 6.5 y -.415** Word identification 6.5 y -.339** /ba/ Writing letters 6.5 y -.336* /da/ Reading 6.5 y -.329* /ga/ Guttorm, et al. (2005) Cortex 41, 291-303.

17. The letter knowledge of 3.5-6.5 year olds (JLD) and reading acquisition Lettter names known Reading acquisition fails during 1. grade 30 25,41 25 Reading acquisition normal during 1. grade 20 16,59 15 14,03 13,57 10,41 10 6,21 5 3,74 3,09 2,68 0,85 0 Lyytinen et al., (2007) Nordic Psychology 3.5 4.5 5 5.5 6.5 Age (years)

18. From the JLD-follow-up from birth to school age of reading-related development Receptive speech, 2.5 y. Pseudoword repetition, 3.5 y. Phonological skills, 3.5 y. Phonological skills, 4.5 y. Phonological skills, 5.5 y. Rapid naming, 5.5 y. Rapid naming, 6.5 y. Letter knowledge, 3.5 y. Letter knowledge, 4.5 y. Letter knowledge, 5 y. Letter knowledge 5.5 y. IQ, 5 y. Lyytinen, et al. Scand. J. of Psychology, 2009. Reading composite, 1. gr. Reading composite 2. gr. -3 -2 -1 0 1 z-score (mean = 0, sd =1) Individual profiles of the prediction measures of the JLD children whose reading acquisition was most severely compromised

19. Precursors/predictors: conclusions • Familialbackgroundincreases the risk of dyslexiasubstantially – relatively the moreso, the moreseverereadingdifficultiesareattended • Speechperception is predictivefrom 6 months and doesso at schoolagestillaftercontrolling for otherknownpredictors • Among at riskchildrenveryearlylanguagedelayscanbeinformative, both in the expressive and receptivelanguagedomainsbutreceptivelanguagemaybemoreimportant • Poorletternamelearningpredictswithoutfalsenegatives (falsepositivesshouldbeaccepted) • Namingfluencypredictsthe mostpersistentdifficulties …alsowhen the phonologicalskillsrevealedbytraditionalassessmenttoolsfail to predict

20. How to supportreadingacquisitionamong at riskchildrenAn enjoyablelearninggame:Graphogame

21. GraphogameThe task: Catch the letterthatmatches the soundyouhear! Competitor’s results Player’s results 9 0 Falling letters A E U Correctly chosen letters Mouse pointer Player’s catcher Competitor’s catcher Programming: Tuomo Hokkanen

24. GraphoMath

25. A learning environment for L1 and L2 spoken and written languages: Graphogame Introduces reading skill of any wanted language Teaches the phonetic basis of language with the help of written language • Tunes the speech perception for the use of a wanted language • Helps in training correct pronunciation of the sounds of a language • Introduces spoken words (vocabulary) via written language

26. How and where Graphogame works Appliesphonics: trains the connectionsbetweenspoken and writtenitems in optimizedorder: fromeasy to differentiateto moresimilarphonemicunits… fromletter-sounds to syllables and words Adaptsautomatically to child’sactualskilllevel Guaranteesexperience of success (80%)

27. Exemplary learning curves of 4-8 year olds (N=726) The cumulative number of learned items Hours of playing Modelling: Janne Kujala

28. 22 Ability to assemblesounds on the basis of letters 20 18 Correctlyassembledsoundst 16 Order of trainingsessions: 14 1.Math game– 2.Letter-sound g. 12 1.Letter-sound g.– 2. Mathgame 10 After 2. training session After 1. training session Beforetraining

29. Remedial reading intervention and computer-assisted instruction (CARRI) (T1-T6) CARRI group (n=25) Follow-up 2 Screening test (N=166) Main- stream group (n=116) Subtest 2 Subtest 3 Subtest 4 Subtest 5 Post test Follow-up 1 IQEstimation RRI group (n=25) Remedial reading intervention (RRI) (T1-T6) T7 May Grade 2 T6 August Grade 2 T8 August Grade 3 T4 March Grade 1 T5 May Grade 1 T3 January Grade 1 Screening August Grade 1 Groupping September Grade 1 T1 October Grade 1 T2 December Grade 1 CARRI group = Computer assisted remedial reading intervention group Mainstream group = Mainstream reading instruction group RRI group = Remedial reading intervention group (=1/4 of the remedial reading support session) Saine et al., ChildDevelopment, 2011

30. Saine et al., ChildDevelopment, 2011

31. Saine et al., ChildDevelopment, 2011

32. Successful preventive practice Effectiveifnotusedtooearly, starting just beforechildentersschool • practiced> 1 times per day in subsequentdays • short < 12 minutes’ sessions • playing in so”active” form as possible (bye.g. repeating the sounds) • the taskof parents: to show thattheyarehappywhenchildplays • playing long enough (2-20 hours) See: www.lukimat.fi(whereFinnishchildren play) or www.graphogame.comfor description and demo in English

33. For explanations, see Lyytinen et al., 2009

34. Illustration of the game developed byJanne Kujala

35. GG training of <5 hours affects brain HL and UR in collaborationwith Swiss colleagues Daniel Brandeis, Sylvia Brehm Pre-Post GG: Children (n=15) before and after playing with Graphogame LG-FG, IFG Words-False fonts No difference Condition differences Condition differences Increased activation in occipito-temporal areas BA18/19 Post-pre interaction between groups playing Graphogame vs Mathgame (same with numbers):p<0.005 Brem et al., PNAS, 2010, 107(17), 7939-7944.

36. Potential assessment use of Graphogame • Dynamicassessment: • Onlinefollow-up of the proceedings of the trainingof the letter-soundconnections • Application of the observedresults to guidingthe nextsteps of the practicetowardscontentsstill in need of furtherpractice i.e. integratingassessment and intervention as made in the response-to-interventionmodel…note, the cycle of refocussingthe intervention canhappen in seconds

37. SupportingFinnishchildren • Allchildrenenteringschoolthisautumnarescreened • forfamilialriskand/orletterknowledge < 7 Motivatingchildrenshowingsuch a risk to play dynamicassessment version of Graphogame > resistance to trainingwithoptimalphonics • Childrenshowingresistance (1-2%) followedindividually for testing the limits of the Graphogame • Note: percentiles 3-15% trainedsuccessfully

38. GRAPHOLEARN model • Ekapeli/Graphogameusedunder the responsibility and funding of the Ministry of Education in Finland • > 200.000 users (2006-) • Centralizedautomatized feedback fromourservers • Couldwork as main model for implementations elsewhere as well

39. The basicprinciples of Graphogamedevelopment for a new writingsystem • Carefulstudy of the writtenlanguageenvironmentwithlocalexperts for developingand implementing an appropriatecontent • Evidence-baseddocumentation of the efficiency of the gameof the contentbeforeanydistribution • Distribution and useunder the responsibility of the localMinistry of Educationafterresearchhasshownitsefficiency in a new orthographic/culturalenvironment

40. For more.., please, • Call: +358 50 552 4892 • Have a look of ourresearch: heikki.lyytinen.info • Ask for reprint(s): heikki.lyytinen@psyka.jyu.fi • The service for Finns: http://www.lukimat.fi/ • ..in English: http://www.graphogame.com • Seealsographolearn.infofor the wholeapproach Thankyou for yourattention!